252 APPLIED IMMUNOLOGY 



The physical and clinical state of the patient, 

 apart from the variability in the virulence of bacteria, 

 ofttimes presents a difficult problem as to the correct 

 dosage of bacterin. In this connection, the age, sex, 

 and stature of the patient, the gravity of his illness, 

 the acuity or chronicity of the affection, a non-febrile 

 or febrile condition and his debilitated or toxic state 

 demand the keenest discrimination. The golden rule 

 is the sicker the patient the smaller the dose, but both 

 the clinical symptomatology and the opsonic index may 

 suffice to determine that he is too sick for any dose, 

 however infinitesimal. 



Subsequent inoculations both as to size of doses and 

 intervals may be governed in most diseases by close 

 and accurate observation of the clinical symptoms or 

 by the revelations of opsonic indices or by the utiliza- 

 tion of both of these controls, an advisable procedure 

 for the best results in no small number of cases. 

 Generally speaking, the clinical symptomatology is 

 of primary importance and the opsonic index takes 

 second place ; at times, however, these become reversed. 

 It is an easy matter to control properly the process 

 of immunization by study of the clinical symptoms, 

 and success will obtain only by an experienced and 

 careful observation of such trivial phenomena as 

 malaise, indisposition to work or play, bodily aches, 

 grippe-like attacks, headache, anorexia, slight fever. 



