Volume 1

A manual of surgical treatment / by W. Watson Cheyne and F.F. Burghard.

Date:
1912-1913
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: A manual of surgical treatment / by W. Watson Cheyne and F.F. Burghard. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    I c.c, which is the usual maximum dose in cases that do weh under the treatment. The maximum dose of T.K. may be taken as 20 mgrs. (or 2 c.c. of tlie original fluid : this costs 17s., which renders it an expensive remedy). The maximum dose of bacillary emulsion is said to be 10 mgrs., and of P.T.O. I c.c, after which a more potent preparation is used. But no hard and fast line as to the sec^uence of the doses can be laid down, and in each case a careful study of the patient's temperature and other symptoms is necessary. If there is any noticeable reaction it is advisable not to increase the dose, but to administer the same after the fever has subsided : this may be necessary more than once, and the amount must not be increased until this dose causes no reaction. A reaction obtained after a moderate increase is in general an indication that the patient is highly susceptible and is an indication to increase the doses slowly. Bandelier and Ropke's list is mainly applical)le to phthisis, and in surgical tubercle in which the lungs are unaffected the increases may often be somewhat more rapid, and an occasional reaction need not cause alarm. The injections should be made into the subcutaneous tissues of the arm, back or flank, and the degree of local reaction, if any, round the site of injection carefully noticed. Occasionally this is somewhat severe and may be an obstacle to further progress, necessitating very slow advances in the dosage. If much redness and swelling are produced hot fomentations may be applied. Tuberculin has been given by the mouth and does not appear to be entirely^ devoid of action when administered thus. But the amount absorbed is uncertain, and the advantages of the method are not apparent, whilst its disadvantages are obvious : in any case, no attempt to administer large doses in this way must be made.
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