TUBERCULIN THERAPY 205 



creasing fever, although shght dyspnoea, increased 

 respirations, accelerated pulse-rate and even hsemop- 

 tysic tendencies, with or without evidences of dry pleu- 

 ritis, are not necessarily contra-indications. Extreme 

 caution must be exercised in practicing tuberculin in- 

 oculations on ambulatory patients, and particularly 

 is this so if they are febrile, even though slightly and 

 only occasionally. Menstruation and the supervention 

 of an acute infection as a " cold," tonsillitis, bronchitis, 

 etc., are definite indications for the temporary suspen- 

 sion of bacterial inoculations. 



A matter of some importance in tuberculin therapy 

 is the prevalence of mioced infection in tuberculous 

 processes, either pulmonary or surgical. The advent 

 of the secondary invading bacterium is characterized 

 by an increased and typical irregularity of tempera- 

 ture. Under such circumstances culture and reculture 

 of the suppuration from time to time and the prepara- 

 tion and administration of autogenous bacterins, pre- 

 ceding or alternating with tuberculin, will produce 

 results not obtainable with tuberculin alone. 



Indications and Results of Tuberculin Therapy 

 in Tuhercidosis, — Tuberculin is a powerful therapeu- 

 tic agent in all localized, subacute and chronic forms 

 of tuberculosis, not excluding the pulmonary type, 

 provided the patient is not markedly asthenic or feb- 

 rile. The immediate clinical effects of tuberculin 



