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disrepute great discrimination is necessary in selecting the
cases for injection, and even then its administration should
only rest in the hands of experienced practitioners. By
repeated and increasing injections of tuberculin, the body
tissues are stimulated, anti-toxins including immunising substances
being produced. These anti-toxins combine with the
toxin produced by the growth of the tubercle bacillus in the body,
and neutralize any potent toxicity. Further, these anti-toxins
either directly or indirectly overcome the bacilli themselves
and prevent their growth. By producing as indicated, a
high degree of immunity, the tubercular focus is gradually
encapsuled and shut off from the rest of the body by an
impenetrable (to bacilli) matrix of fibrous tissue which indeed
may in time become calcified and stone-like.
Instead of producing anti-bodies by injections of tuberculin,
a similar process, although not so lasting, may be brought about
by the patient himself, and is called auto-inoculation. By
graduated daily exercise, going on to graduated labour, patients,
under proper supervision, themselves manufacture a certain
amount of toxin at the focus of the disease, and this toxin
passing into the circulation causes the production of anti-bodies
which have the same effect as described above.
The intensive method of tuberculin administration is the
one employed in most cases attending the Deptford Dispensary,
and the kinds of tuberculin we favour are a sequence of F.T.O.,
P.T., and O.T., or as a preliminary to the injection of O.T.,
we use in some cases either B.E., T.R. or T.A.F.
the dispensary.
A dispensary may either be newly built, or a house or other
building may be adapted for the purpose. We have found the
latter procedure sufficient for our needs. An up-to-date establishment
includes the following:—doctor's, nurse's (or dressing)
and waiting rooms, dispensary, laboratory, caretaker's rooms
and the usual offices.