Tuberculinum Denys

The Filtered tuberculous bouillon of Denys

is one of the tuberculins most often employed by homoegpaths. Humeau and Ravet, of Havre, have published lately the results of their practice (Art medical, January, 1912, and Archives medico-chirurgicales de Normandie, March, 1912).

These physicians are using the tuberculin of Denys, in true homeopathic doses, either hypodermically or by mouth.

Humeau and Ravet never commence lower than the ninth decimal, and often much higher.

Once the initial dose is fixed, 9th, 12th, or sometimes the lith decimal (20th in one case), the treatment is continued by three injections a week, until the 3x dilution is reached. If there is no reaction, these doses are of 1/10, 2/10, 3/10, etc., of each solution.

After 9/10 of one dilution, they pass to the next lower decimal dilution, so as to have a regular and constant. progression. When a reaction is produced, it is an invariable rule to suspend all further injections, until the disappearance of all reactionary phenomena.

The custom of Humeau and Ravet is, even at the beginning, to avoid aggravations, they never begin at once with tuberculin. In treating a case of pulmonary tuberculosis the patient is first given hygienic treatment, more or less severe, sometimes rest in bed, the individual requirements governing each case.

The patient's temperature is taken, he is given, according to the indications, an internal remedy, and meanwhile, before the injection of tuberculin, is given close study. This minute knowledge of the patient is necessary for fixing the initial dose, and the character of the further specific treatment.

The dose, that is, the intensity of the excitation, must be such that the affection will take on a more acute form during which, temporarily, the patient will be weakened. Its action, to be effectual, however must not pass beyond the successful reactionary struggle of which the organism of the patient is capable.

Humeau and Ravet have seen the great majority of their curable patients obtain from the treatment, amelioration and even complete cure; but besides these results they have had, also, cases where the same remedy in widely different dosage, did not appear to act. They were unable to judge in advance the favourable or unfavourable reaction. In another series of tuberculous cases these physicians have adhered to one and the same dilution satisfactorily, without increasing the dose.

P. Jousset gives the filtered tuberculous bouillon of Denys successfully in the 6th, 10th, and 12th decimal. As soon as a reaction appears, he prefers to suspend the injections entirely rather than continue with weaker doses. In another article, collaborated with C.

Proust (Art medical, Nov., 1907), Jousset's opinion, from an experience with more than forty phthisical patients, was that the bouillon of Denys, with a careful technique, is entirely inoffensive, and that its beneficial influence is shown by the constitutional condition, the febrile movement, and even by the condition of the pulmonary lesion. Jousset remarks that, in this treatment, the cure is assured when the injections of pure filtered bouillon do not pro-duce an increase in temperature.

In such case, and then only, we must discontinue the treatment. Tuinzing uses the 7th and 8th decimals. Rankin, in a sanatorium, employed doses from 1/1000 of a milligram to 10 milligrams.

I have personally given, by mouth, the tuberculin of Denys in the form of globules saturated with the high dilutions, the 100th, the 200th and the 500th centesimal. As extreme as these dilutions appear, it is yet• with them that I have in advanced cases most frequently and most easily arrested the progress of the disease: I refer to cavities. Again, as extraordinary as may seem what I am about to say, these tuberculous cavities are not protected from medicinal aggravations, not even against these imperceptible closes that old school physicians have termed quackery.

To deal with the theory of attenuations in this cursory manner is vain, when we have examined from every angle, and confirmed the facts. I have often arrested, temporarily, with these high dilutions, the development of a progressive tuberculosis characterised by a persistence of the fever (but, not the fever having great fluctuations, from streptococci or acute pneumococcal infection), an incessant cough, abundant expectoration, pulmonary perituberculous congestion, and anorexia. I give one single dose of ten globules of the 100th, 200th, or 500th ; in the beginning I repeat the dose every three to eight days, till an improvement takes place (requiring sometimes only two or three doses).

As long as the improvement continues we must not renew the dose. I have thus been able to lengthen the intervals between the closes, from eight to twenty-one days, and from fifteen days to a month. The tuberculous quiescenoe may last many months. In a patient who appeared unusually improved and who had only a slight expectoration in the morning, I had this expectoration examined : it still contained a number of the bacilli of Koch, and some pneumococci.

Here, then, was a case of temporary cessation of perituberculous congestion all about the tuberculous foci, without a cure of the tuberculosis. I have at present among my patients a young girl with a cavity in which the tuberculous process progressed rapidly, and who during her paroxysms of coughing vomited almost, incessantly. For the past year and a half this patient, taking Denys' 500th, has kept fairly well. The cough having almost left her, the poor girl announces to me that she is cured.

No class of persons exceeds the tuberculous in optimism !

Temporary as the ameliorations are, they constitute nevertheless, a real progress in tuberculinotherapy, and the above method of treatment far excels the sedative syrups, which latter have a depressing effect, excels equally Creosote, which ruins the stomach, and superalimentation, which occasions enteritis. There may, of course, be some advantage in employing, during the interval of the doses, any accessory measure which may assist in bringing about a favourable result. But the two cases that I have cited, and also others, have been treated solely by these attenuated doses of Denys', without the employment of any adjuvants.

Many of the patients were too poor to undergo expense. The tuberculin of Denys' in high dilution is also used by Nebel, Vannier, Chiron, and others.