206 APPLIED IMMUNOLOGY 



inoculations are ofttimes distinctive and impressive. 

 Briefly summarized they are: (1) local, manifested by 

 improvement in healing tendencies at a former opera- 

 tive site, disappearance of inflammatory signs, of 

 cough, expectoration and tubercle bacilli from the spu- 

 tum, although the last is very persistent and may never 

 take place; (2) general, comprising improvement in 

 appetite, digestion, strength, weight, disappearance of 

 fever, etc., and (3) mental, that is, general morale. 



The various forms of tuberculosis in which tuber- 

 culin has proved useful, if not curative, comprise 

 pulmonar}', genito-urinary, bones and joints, intes- 

 tinal, peritoneal, laryngeal, ocular, mastoidal and 

 lymph-nodal. 



In most sanitaria, tuberculin is routinely employed 

 in selected cases, namely, afebrile or mildly febrile pa- 

 tients, when an incipient infection may be aborted or 

 the course of a chronic loulmonary process favorably 

 influenced. In 1907, Trudeau stated that during the 

 past 15 years the post-discharge mortality of patients 

 from the Saranac Sanitarium was 18 to 25 per cent, 

 less with tuberculin-treated than non-treated cases. 

 Indeed this deduction is reasonable in view of the fact 

 that tuberculin cautiously and competently adminis- 

 tered is the best expectorant obtainable. Recently, 

 tuberculinum purum, " T. P.," has been extolled in 

 the treatment of this form of the disease (Fig. 18). 



