A CONTRIBUTION TO THE CHEMOTHERAPY OF TUBERCULOSIS : FIRST CLINICAL REPORT.
A general review of the cases will, I think, indicate that the preparation greatly improves or apparently cures pulmonary and surgical tuberculosis in the first and second stages, and that it seems also to produce beneficial effects upon the disease in the third stage. The duration of these beneficial effects is still to be established by more numerous trials and many years of observation. The preparation must be given intravenously, and the doses must be increased or decreased according to the age and constitution of each patient (page 156). Moreover, it should be borne in mind that the pathological phenomena and the constitution of each patient have much to do with the determination of the dose. The manner of action of the preparation is not yet entirely clear. But if it acts primarily upon the tissues which bear the tubercular lesions and then indirectly against the germ, as I assume at present, the activity which the tissues exert will have much to do with the efficacy of the preparation. If this hypothesis is correct, the minimum doses (10 to 12 mg.) will be best suited to a patient who is greatly emaciated, and should be gradually increased as the reactions, pathological processes, nutrition, etc., indicate. In any case, the dose of the preparation must be determined by the condition and constitution of the patient. In animal experiments I have been fortunate enough to obtain results which no other preparation has given. The clinical application and the establishment of its full efficacy in human cases must be left to the physician.
Kitasato Institute for Infectious Diseases, Tokyo, Japan.
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Koga