r scarlet fever rarely is again attacked by the same, as a rule
he is permanently proof against them.

In the same way as vaccination protects from small pox, an injection of
Koch's remedy acts against pulmonary consumption. Koch makes a cautious
statement:

"On the other hand it is possible, from analogy with other
infectious diseases that those who are once cured become
permanently exempt."

Koch reaches this result, that beginning phthisis can with certainty be
cured with his remedy. On the other hand, advanced consumptives, in
whose lungs large cavities already exist, may possibly be improved but
can not be cured. However he provokes the idea, that perhaps his method
of treatment together with a surgical operation, that removes all
gangrenous matter from the lungs, may yet have beneficial results in the
end. The idea is not entirely new to treat lung diseases with the aid of
surgery; unfortunately the operations have heretofore been thought too
risky. Perhaps we will now have a new branch in operative technic,
surgery of the lungs. Koch advises to conduct this lung surgery after
the manner of operating empyema. This is an operation performed in the
case of suppurative pleurisy to remove the pus from the pleural cavity.
This operation has been successfully carried out for a long time.

Koch makes it of especial importance, that while treating consumption
with the new remedy, the general attendance and nursing is not to be
neglected. Koch also calls attention to what has been said before, that
the general hygienic factors, good hospital treatment, mountain climate,
etc., will never be dispensed with, on the contrary will be
indispensible to the furtherance of cure.

In conclusion Koch again remarks that brilliant results are only
promised in the early stages of pulmonary consumption (phthisis).
Physician and patient must move all levers as to the existence or
non-existence of tuberculous diseases.

Then those daily pictures of extreme wretchedness from consumption will
be a thing of the past. Then the danger of contagion will be lessened
resulting from the decrease of the number of tuberculous persons and of
the tubercle-bacilli, and perhaps it will soon be possible to name the
day on which with the last tubercle-bacillus the ravaging pest,
tuberculosis, will be extirpated.

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| Transcriber's Note: