dread of the outer air, particularly at night, could be abolished in ordinary life, more would be done for public health than by the most costly devices for eluding microbes. Not only consumption, but the other respiratory diseases, which are equally destructive, are chiefly fomented by the universal practice of breathing vitiated air in stuffy and overheated rooms. The cases most suitable for the treatment are those in an early stage. Other special institutions for dealing with consumption are hospitals, in which England is far in advance of other countries, and dispensaries; the latter find much favour in France and Belgium.
In Great Britain the pioneer work as regards the establishment of tuberculosis dispensaries was the establishment of the Victoria Dispensary for Consumption in Edinburgh in 1887, where the procedure is similar to that in Dr Calmette’s dispensaries in France. In connexion with the dispensary home visits are made, patients suitable to sanatoria selected, advanced cases drafted to hospitals, bacteriological examinations made, cases notified under the voluntary system, and the families of patients instructed. There is an urgent need for the multiplication of such dispensaries throughout the United Kingdom. The recent act providing for the medical inspection of schools has done much to sort out cases of tuberculosis occurring in children, and to provide them with suitable treatment and prevent them from becoming foci for the dissemination of the disease. In Germany special open-air schools, termed forest-schools, are provided for children suffering from the disease, and an effort is being made in England to provide similar schools.
Of specific remedies it must suffice to say that a great many substances have been tried, chiefly by injection and inhalation, and good results have been claimed for some of them. The most noteworthy is the treatment by tuberculin, first introduced by Koch in 1890, which, having sunk into use as a diagnostic reagent for cattle, received a new lease of life owing to the valuable work done by Sir Almroth Wright on opsonins. The tuberculins most in use are Koch’s “old” tuberculin T.O., consisting of a glycerin broth culture of the tubercle bacilli, and Koch’s T.R. tuberculin, consisting of a saline solution of the triturated dead tubercle bacilli which has been centrifuged. This latter is much in use, the dosage being carefully checked by the estimation of the tuberculo-opsonic index. The injections are usually unsuitable to very advanced cases. Marmorek’s serum, the serum of horses into which the filtered young cultures of tubercle bacilli have been injected, and in which a tuberculo-toxin has been set free, has proved very successful. Behring’s Tulase is a tuberculin preparation formed by a process of treating tubercle bacilli with chloral, and Béreneck’s tuberculin consists of a filtered bouillon culture treated with orthophosphoric acid. The variety of cases to which these treatments are suitable can only be estimated from a careful consideration of each on its own merits.
In the treatment of tuberculous lesions, the surgeon also plays his part. Tuberculosis is specially prone to attack the spongy bone-tissue, joints, skin (lupus) and lymphatic glands—especially those of the neck. Recognizing the infective nature of the disease, and knowing that from one focus the germs may be taken by the blood-stream to other parts of the body, and so cause a general tuberculosis, the surgeon is anxious, by removing the primary lesion, to cut short the disease and promote immediate and permanent convalescence. Thus, in the early stage of tuberculous disease of the glands of the neck, for instance, these measures may render excellent service, but when the disease has got a firm hold, nothing short of removal of the glands by surgical operation is likely to be of any avail. The results of this modern treatment of tuberculous disease of the skin and of the lymphatic glands has been highly gratifying, for not only has the infected tissue been completely removed, but the resulting scars have been far less noticeable than they would have been had less radical measures been employed. One rarely sees now a network of scars down the neck of a child, showing how a chain of tuberculous glands had been allowed to work out their own cure. A few years ago, however, such conditions were by no means unusual.
Bibliography.—“Tuberculosis,” in Allbutt and Rolleston’s System of Medicine (1909); A. Ransome, Milroy Lectures; “Tuberculosis,” in Osler’s Modern Medicine (1907); Second Interim Report of the Royal Commission on Tuberculosis (1907); Report, by C. Theodore Williams and H. Timbrell Bulstrode, of the International Congress on Tuberculosis held at Paris in 1905; Alexander Foulerton, Milroy Lectures (1910); Sir Thomas Oliver, Diseases of Occupation; Arthur Newsholme, The Prevention of Tuberculosis (1908); Douglas Powell, “Lecture on the Prevention of Consumption,” Journ. San. Inst. (Aug. 1904); Calmette and Guérin, “Origine intestinale de la tuberculose pulmonaire,” Annales de l’institut Pasteur, vol. xix. No.10; D. Muller, “Milk as a source of infection in Tuberculosis,” Journ. Compar. Path. and Therapeutics, vol. xix. (H. L. H.)
TUBEROSE. The cultivated tuberose (Polianthes tuberosa) is a plant allied to the Mexican agaves, and is a native of the same country. The tuberous root-stock sends up a stem 3 ft. in height, with numerous lanceolate leaves and terminal racemes of waxy white funnel-shaped very fragrant flowers. Each flower is about 112 in. long, with a long tube and a six-parted limb. The stamens are six in number, emerging from the upper part of the tube, and bear linear anthers. The ovary is three-celled, and the ovoid fruit is crowned by the persistent flower. The plant is largely grown in the United States and at the Cape of Good Hope for export to England, as it is found that imported bulbs succeed better than those grown in the United Kingdom. The double-flowered form is that principally grown.
Cultivated plants require a rich soil, considerable heat, and, at first, abundance of water.
TÜBINGEN, a town of Germany, in the kingdom of Württemberg, picturesquely situated on the hilly and well-wooded banks of the Neckar, at its junction with the Ammer and Steinlach, 22 m. south of Stuttgart by road and 43 m. by rail. Pop. (1905), 16,809. The older town is irregularly built and unattractive, but the newer suburbs are handsome. The most conspicuous building is the old ducal castle of Hohentübingen, built in 1507–1535 on a hill overlooking the town, and now containing the university library of 460,000 volumes, the observatory, the chemical laboratory, &c. Among the other chief buildings are the quaint old Stiftskirche (1469–1483), a Gothic building containing the tombs of the rulers of Württemberg, the new aula and numerous institutes of the university, all of which are modern, and the town-hall dating from 1435 and restored in 1872. The university possesses a very important library. A monument was erected in 1873 to the poet Johann Ludwig Uhland (1787–1862), who was born and is buried here, and another, in 1881, to the poet Johann Christian Friedrich Hölderlin (1770–1843). Tübingen’s chief claim to attention lies in its famous university, founded in 1477 by Duke Eberhard of Württemberg. Melanchthon was a lecturer here (1512–1518). The university adopted the reformed faith in 1534, and in 1537 a Protestant theological seminary, a residential college—the so-called Stift—was incorporated with it. In 1817 a Roman Catholic theological faculty was added, with a seminary called the Konvikt, and there are now also faculties of law, medicine, philosophy, political economy and natural science. The leading faculty has long been that of theology, and an advanced school of theological criticism, the founder and chief light of which was F. C. Baur, is known as the Tübingen school. The university was attended in 1908 by 1891 students and had a teaching staff of over 100. The commercial and manufacturing industries of the town are slight. Printing, book-selling, the manufacture of surgical and scientific instruments, chemicals, gloves and vinegar, and the cultivation of hops, fruit and vines are among the leading occupations of the inhabitants. The country in the neighbourhood of Tübingen is very attractive; one of the most interesting points is the former Cistercian monastery of Bebenhausen, founded in 1185, and now a royal hunting-château.
Tübingen is mentioned as a strong fortress in 1078, and was ruled from 1148 by counts palatine. In 1342 it was purchased by the count of Württemberg, whose descendants afterwards acquired the title of duke. The treaty of Tübingen is the name
