“Tutocain” as a Shock Preventative in Tuberculous Guinea Pigs Injected with Tuberculin.

Abstract

The symptoms following the rapid absorption of tuberculin in the tuberculous guinea pig, in which the subcutaneous inoculation of small amounts of tuberculin invariably prove fatal, are well known.

Fischel 1 has suggested that the severe tuberculin reaction can be mitigated by introducing tuberculin into the skin with a view to retarding absorption and slowly removing the toxic factors elaborated upon the contact of tuberculin with tuberculous tissues. It had occurred to us that if conditions could be set up subcutaneously which would retard absorption of this toxic factor, and at the same time permit the use of larger amounts of tuberculin, some therapeutic results might be developed, without the danger of fatal issue.

To produce these conditions, a local anesthetic, hydrochloride of p-amino-benzoyl-di-methyl-amino-methyl-butanol or by its trade name, the “Tutocain” brand of Butamin, which induces an edema and at the same time renders it painless, was selected. As a rule 4 cc. of a 1% solution was injected subcutaneously. The guinea pigs had been rendered tuberculous by the subcutaneous inoculation of 1 cc. of a suspension of tubercle bacilli (virulent strain No. 427) into the inguinal region 4 weeks previous to the tests. Animals were subjected to an intracutaneous tuberculin test before they were employed in the experiments, only animals showing a strongly positive reaction being used.

One half hour after the application of the drug 0.4 cc. of old tuberculin was injected subcutaneously into the infiltrated area. Previous tests had shown that 0.2 cc. of the same tuberculin was sufficient to cause death of tuberculous guinea pigs within 24 hours.

Guinea pigs, from numbers 1 to 10, were autopsied one week after the test inoculation and the extent of the infection noted. All guinea pigs showed extensive and typical tuberculous lesions in the liver, spleen, lymph nodes, and lungs. The remainder of the guinea pigs were kept under observation for subsequent tests.