TUBERCULOSIS TUBERCULIN THERAPY 727 



similar to the foregoing by diluting the original product 1 : 10 (AX; 

 1 c.c. of this is in turn diluted to 1 : 10 (B); of this, 1 : 10 (C); and of 

 this, 1 : 10 (D); 1 c.c. of A contains 0.5 milligram; 1 c.c. of B, 0.05; 

 1 c.c. of C, 0.005, and 1 c.c. of D, 0.0005 milligram. 



Beraneck's tuberculin is marketed, ready diluted, in a series of syringes, 

 A/128, A/64, A/32, to A/4, A/2, A, B, C, to H. H is the pure tuber- 

 culin. Each solution is one-half the strength of the next stronger one. 

 The increase of dosage is usually by 0.1 c.c. until 0.5 c.c. is given. Then 

 0.1 c.c. of the next stronger dilution is given, and so on. 



Dixon's tuberculin is supplied in syringes in the series of dilutions 

 given in the following table, so that the doses may be increased as is 

 found desirable : 



TABLE 27. ADMINISTRATION OF DIXON'S TUBERCULIN 



AMOUNT (IN GRAMS) OP AMOUNT (IN GRAMS) OF 



DILUTION EXTRACT OF TUBERCLE DILUTION EXTRACT OF TUBERCLE 



No. BACILLI CONTAINED IN No. BACILLI CONTAINED IN 



1 0.001 11 0.1 



2 0.01 12 0.11 



3 0.02 13 0.12 



4 0.03 14 0.13 



5 0.04 15 0.14 



6 0.05 16 0.15 



7 0.06 17 0.16 



8 0.07 18 0.17 



9 0.08 19 0.18 



10 0.09 20 0.19 



It is suggested that in ordinary cases the injection of each dilution be 

 repeated at least five times before changing to the next number or next 

 stronger dilution. 



As a general rule, the succeeding doses of a tuberculin may be in- 

 creased by 0.1 c.c., due care being exercised when the dilutions are 

 changed. If the patient is quite sensitive, it may be well to repeat the 

 first dose of each stronger solution once or more often as it is reached, 

 and, instead of proceeding to 0.2 c.c., give only 0.15 c.c., thus tiding over 

 the gap. If the patient is not so sensitive, a few leaps may be taken 

 with the weaker dilution, so as to test the patient's tolerance, and, if it 

 is good, the next higher dilution is given at once. 



Site of Injection. Injections are probably best given in the back, 

 at the lower angle of the scapula. Local reactions are more reliable 

 here than when the injections are given in the arm. All injections 

 should be given under aseptic precautions and with a sterilized syr- 

 inge, in exactly the same manner as any bacterial vaccine is given. 

 All injections should be subcutaneous; intramuscular injections are 



