koch's tuberculin treatment 151 



to bring it to the required strength. The dose commences 

 with -g^ milligramme. If reaction occurs, this must be 

 further diminished. Injections are made every other day 

 with slightly increasing doses, so that there is never a rise 

 of temperature of over 1° F. Koch has by this treatment 

 found great improvement to take place in cases of lupus^ 

 and satisfactory results have also followed the employment- 

 of the remedy in tuberculosis of the lungs. But we must- 

 beware of expecting, at present, an absolute cure for con- 

 sumption. In early cases of phthisis the treatment prO' 

 mises to be useful and is worthy of careful trial, but, of 

 course, much further work must be done before we can 

 judge of the measure of success of this new treatment. 



Practical Disinfection. — The sputa should be received into 

 5 per cent. carboUc or mercuric chloride, and never per- 

 mitted to dry on handkerchiefs. Phthisical patients should 

 not expectorate in the streets, but should carry a proper 

 receiver with them to receive the sputum. Where a vessel 

 into which to expectorate is not at hand, it may be received 

 into rags, which should be burned without being allowed to 

 dry. Handkerchiefs of paper are now made at a trifling 

 cost, specially intended for the use of phthisical patients. 



Rooms and wards occupied by phthisical patients should! 

 be disinfected either as previously described or by rubbing 

 them with half-baked bread, and precautions should be 

 taken to prevent the accumulation of dust and its dis- 

 semination throughout the atmosphere ; that is to say, 

 when sweeping or dusting is to be carried out, the floor 

 should be liberally sprinkled with wet tea-leaves. There 

 should be no unnecessary ledges or hangings on which dust 

 can accumulate. 



Some medical otEcers in this country are now making it 

 a practice to disinfect after cases of phthisis, and this pro- 

 cedure is greatly to be recommended. 



