200 APPLIED IMMUNOLOGY 



method in the control of tuberculin therapy, not only 

 because of the tedious technic of the opsonic index, 

 but also on account of the inferior results of the latter 

 method, at least in the pulmonary form of the disease. 

 The practitioner should not be led to believe that 

 tuberculin treatment, properly guided by the clinical 

 symptoms, is an easy matter requiring no special in- 

 struction or knowledge. Far better that he realize 

 that tuberculin is a double-edged sword, cutting suc- 

 cess on the one hand and strewing disaster on the 

 other. Due consideration and correct interpretation 

 of trivial symptoms, as malaise, headache, slight fever, 

 weakness, grippy sensations, vague pains, insomnia, 

 anorexia, nausea, loss of weight ; slight focal reactions, 

 as increased cough, expectoration, rales, pleuritic and 

 laryngeal pains, vesical irritability, suppurative and 

 other inflammatory signs; marked tenderness, pain, 

 redness and swelling at the site of injection, are most 

 important in therapeutic inoculations, and indicate 

 that, for the time at least, the patient's tolerance to 

 tuberculin has been reached; a further inoculation at 

 this time may spell disaster. High fever, prostration, 

 marked focal inflammatory signs and prolongation of 

 systemic reactive phenomena mean that the patient 

 has received an overdose of tuberculin and that treat- 

 ment must be indefinitely suspended. Dogmatic in- 

 structions to increase progressively the dose every 



