204 APPLIED IMMUNOLOGY 



through a course of treatment and has reached large 

 doses, these must not be continued indefinitely, lest 

 the patient become over-stimulated and thrust into the 

 '' negative phase," hence no longer capable of the pro- 

 duction of specific antibodies. It were better to cease 

 inoculations for several months, when, if indications 

 arise, a new course of treatment may be instituted. 



As a general rule, tuberculin therapy is contra- 

 indicated in acute, diffuse and chronic affections with 

 acute exacerbations. It is far more applicable to so- 

 called surgical or localized tuberculosis than to the 

 pulmonary form of the disease. In short, it may be 

 stated that tuberculin should not be employed in phthi- 

 sis pulmonalis except in the afebrile or mildly febrile 

 cases. It is definitely contra-indicated when a remedia- 

 ble surgical condition, as caries, sequestrum, tubercu- 

 lous kidney, etc., exists, until after operative interven- 

 tion. The usual acute or advanced case of pulmonary 

 involvement should be invariably treated by rest in con- 

 junction with the well-known climatic, dietetic, and 

 hygienic antituberculosis measures. Subsequently, if 

 there be no contra-indication and the patient is not 

 progressing satisfactorily, tuberculin should supple- 

 ment the treatment. Tuberculin therapy is decidedly 

 contra-indicated in debilitated or wasted individuals 

 or patients exhibiting very active lesions or extensive 

 complications, characterized by considerable and in- 



