TUBERCULIN THERAPY 201 



three, five, or seven days, without due regard to the 

 physiological effects, are criminal. No man should ever 

 employ tuberculin who is ignorant of its physiologi- 

 cal action. This action may escape notice, except by 

 the skilled observer. The phenomena which do occur 

 often demand keen discrimination as to the size and in- 

 terval of subsequent dosage. The patient should have 

 his temperature, pulse and respirations recorded at 

 three-hour intervals for two or three days before and 

 throughout the course of treatment. His weight should 

 also be noted weekly. If febrile he must remain 

 quietly in bed. In general the initial dose should be 

 quite small in accordance with the directions given 

 above for the particular tuberculin concerned. If no 

 reaction whatever be produced, the dose may be 

 doubled in three or four days. If there be slight evi- 

 dence, general or focal, but nothing definite, the same 

 sized dose should be repeated. If, however, a slight 

 reaction occur, the next inoculation must not be given 

 until all traces of the reaction have disappeared for 

 three or four days, and then not more than half of 

 the previous dose should be given. If, after any in- 

 oculation, a severe reaction be precipitated, no further 

 inoculation shall be given for two or three weeks after 

 the patient's condition has returned to normal, and the 

 dose then must be not more than a fourth or a half of 



