ocal reaction
resulted from an injection of the same dose of the remedy (.01 ccm.)[2].

The general reaction consists of an attack of fever, which, beginning
mostly with chills, raises the temperature to over 39 deg., often up to
40 deg. and even 41 deg. Other noticeable symptoms are pains in the
joints, a tendency to cough, great languor, and often nausea and
vomiting. Several times we observed a faint icteric coloring and in some
cases the appearance on neck and breast of an exanthema resembling
measles. As a rule the attack begins 4-5 hours after the injection and
lasts 12-15 hours. In exceptional cases it may begin much later, but
then it is not nearly so intense. The patients experience remarkably
little weakness from the attack and feel relatively well as soon as it
is over, generally better than they did before it came on.

The local reaction can best be observed on those patients whose
tuberculose affection is plainly visible, for instance those afflicted
with lupus. In them changes take place that prove the specific
antitubercular action of the remedy in a most surprising way. The
diseased portions of the skin in the face, etc. begin to swell and turn
red even before the attack of chills set in, although the injection is
made under the skin of the back, a point decidedly remote from the
affected parts. The swelling and reddening increases during the fever
and can attain a very marked degree so that the lupus-tissue turns
reddish brown and necrotic. In the case of more sharply defined lupus
centres the more swollen and dark red parts were edged by a white seam
nearly a centimeter wide and this again was surrounded by a wide bright
red border. The swelling of the diseased parts gradually decreases after
the cession of fever and may have entirely disappeared after 2 or 3
days. A serum exudes from these lupus-centres and, drying, forms a crust
on them which changes into scabs that fall off in 2-3 weeks and
sometimes leave a smooth red scar after a single injection. Generally
several injections are necessary to effect a complete removal of the
lupose tissue, but of this I will speak further on. It is very important
to note that the changes during this process are exclusively limited to
the portions of the skin affected by lupus; even the faintest and
smallest bits of diseased tissue go through the entire process and
become visible on account of their swelling and reddening, while the
actual scab-tissue in which the