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The next meeting \\4ill be held in New London. The fol-
lowing officers were elected; President, Dr. S. B. St. John,
Hartford, Conn.; secretary. Dr. W. M. Sweet, Philadelphia.
jrf Cuntnt ^ittratrtrt.
July 2$, 1098.
1. The Diagnostic and Therapeutical Use of Tuberculin,
By Lawr.vson Brown.
2. Permanent Stenosis of the Ductus Communis from In-
flammatory Infiltration or Cicatricial Contraction of
a Duodenal Ulcer. By Hor.\ce Packard.
3. Report of a Case of Melanosarcoma of the Orbit,
By Guthrie McConnell and Rudolph Burman.
I. The Diagnostic and Therapeutical Use of
Tuberculin. — Brown remarks that until recently
it was thought unwise to give tuberculin to any
patient who was not constantly under a doctor's im-
mediate supervision, in other words, who was not
in a sanatorium or hospital. Recent practical re-
sults, however, have Buy Cheap Prograf shown that this is not neces-
sary, and furthermore, they have shown that am-
bulant patients and patients at work may be givien
tuberculin in carefully graded doses, so that not only
no harm may accrue, but that the patient may de-
rive great benefit. This means that the former rule
that the patient should remain in bed or at rest in
a reclining position the day of and the day follow-
ing injection does not need to be enforced. Brown-
thinks, however, that where possible, patients should
take less exercise the day after the Buy Prograf Online injection of
tuberlin. Rise of temperature to 100° F. for more
than two hours necessitates rest in bed during that
day and the greater part of Buy Prograf the next, or until the
temperature becomes and stays normal, though prac-
tically when accompanied by very slight symptoms
the temperature is almost invariably normal the sec-
ond day even if the patient does not remain in bed.
Many medicinal substances have been' administered
in conjunction with tuberculin, but seein of little
value. \'"arious toxines or secondary organisms
have been suggested for use in connection with
tuberculin but have yet to be thoroughly tested.
The effects of repeated Cheap Prograf doses of tuberculin upon the
aniiTial economy have not been thoroughly worked
out. The weight seems to be little affected.
Changes in the blood have been noted by a number
of observers, but the results are still conflicting.
The untoward results are very interesting, particu-
larly in regard to the mobilization of the tubercle
bacillus. Baldwin was tmable to find any evidence
that tuberculin, even in large doses, produces this
effect. The work of Liebmann, who found many
tubercle bacilli in the blood followin.g tuberculin
injections, has never been verified, and Brown
thinks, can be discredited on account of faulty tech-
nique. The sputum and the urine are affected
somewhat, but usually only following reactions. An
antipyretic effect is uni|uestionably present in many
patients. The results obtained from tuberculin are
exceedingly diflictilt to determine. It must not be
forgotten that tuberculin is a powerful toxine, tliat
if administered carelessly it may prodtice great and
irreparable harm. The vast majority of men who
have used tuberctilin seem to be convinced that it
has some beneficial eft'ect. Our author is convinced
of this although, he states, he has some diflictilty
in proving from the results which he lias oiitaiiied
that a markedly lieneficial effect is present, lie
thinks the present status of tuberculin may be ex-
pressed in a few words: Tuberculin when properly
given does no harm, may produce no apparent im-
niediate results, but may markedly benefit an in-
dividual patient who can follow at the same time
the hygienic dietetic treatment while in a health re-
sort or at home or at rest. It may even prove of
benefit to those who must continue at work. Small
doses and careful increases are most important, and
bv following these very closely some patients, even
in advanced stages, reap great benefit. The imme-

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