THE PROBLEM OF IMMUNITY IN TUBERCULOSIS

EDWARD R. BALDWIN
1909 American Journal of the Medical Sciences  
It is my purpose to take a brief retrospect of past achievements in attempts artificially to protect against tuberculosis, and then to indicate what seems to me the special problems for the future. It must be confessed that much discouragement has resulted from the numerous experiments on animals in this direction during the past two decades. This problem has engaged the thought and labor of the foremost workers in immunity research, and it will continue to do so with the enthusiastic hope
more » ... red by every new discovery, however little it may contribute to the ultimate object. A review of the achievements already attained, with due credit to the authors for priority, is peculiarly difficult, and also impossible in the limits of this address. The difficulties are real because of the simultaneous experimentation in different laboratories and countries, which have independently followed similar lines impelled by the same ideas. The most important example of this common motif is the principle of immunization with bacteria of attenuated virulence, formulated by the immortal Pasteur and applied to tuberculosis as soon as the illustrious Koch made it possible by the discovery of the bacillus. It is noteworthy that this principle holds at present the leading place in the hope for success in the future, and it is natural that these experiments should have begun in France (Daremberg, Grancher and Ledoux-Lebard, Martin, Hericourt and Richet, and Courmont and Dor). The immediate results were discouraging; too little was known of the mechanism of immunity to make use of the crude methods then employed as a basis for thorough experimenta¬ tion; and the discovery of tuberculin and antitoxins for other diseases directed attention to these fields of greater promise. As it is not generally known that Americans engaged in the earlier experimentation with a considerable degree of success, it is appropriate that they should receive mention here. As early as 1S89 Dixon made some preliminary experiments with attenuated bacilli, and Trudeau, working under exceptionally difficult con¬ ditions, produced a relatively strong immunity with cultures of avian tubercle bacilli (IS92), and later with attenuated human cultures. The late Emil de Schweinitz, in 1894, had more marked success on guinea-pigs immunized with the same attenuated cul¬ tures employed in Trudeau's experiments. This period was also one of diligent but unsuccessful search for antitoxic immunity by means of divers extracts and products of the tubercle bacillus. The soluble extracts of tubercle bacilli having failed to immunize
doi:10.1097/00000441-190901000-00012 fatcat:nb3sxqltdrejbihtr64qa4y6ay