TUBERCULIN THERAPY 203 



time must be extended to a year or more.^ Any at- 

 tempt to " push the treatment," by shortening the 

 intervals or carelessly increasing the size of the doses, 

 will result in failure. 



Limitations and Contra-indications of Tuberculin 

 Therapy. — Two facts must be emphatically and in- 

 delibly impressed in the mind of the tuberculin thera- 

 peutist. They are: First, that tuberculin acts simply 

 as an accessory to nature, and, second, that tolerance, 

 even to large doses of tuberculin, does not necessarily 

 confer immunity against tuberculosis. If these points 

 are fully realized, tuberculin, in capable hands, will 

 measure up to expectations and be accorded its right- 

 ful place in modern therapeutics. 



Success in tuberculin therapy is directly propor- 

 tionate to the degree of dosage attainable without pro- 

 ducing deleterious reactions or intolerance. In the 

 average case this is a procedure of months' or perhaps 

 years' duration, in the event of the necessity of inter- 

 mittent administration. Obviously, little can be ex- 

 pected from a short course of tuberculin inoculations 

 with a maximum tolerant dose of only a fraction of a 

 milligramme. 



After the patient has been successfully carried 



^ Tuberculinum Purum, " T. P.," is an exception to this doctrine, since 

 the patient may receive the entire series of inoculations in the course of 

 three or four months, due to the lesser toxicity of this preparation, making 

 it possible to ascend the scale of doses rapidly. 



