Tuberculin in diagnosis and treatment : a text-book of the specific diagnosis and therapy of tuberculosis for practitioners and students / By Dr. Bandelier ... and Dr. Roepke.

  • Bandelier, B. (Bruno), 1871-1924.
Date:
1913
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculin in diagnosis and treatment : a text-book of the specific diagnosis and therapy of tuberculosis for practitioners and students / By Dr. Bandelier ... and Dr. Roepke. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    89/350 (page 69)
    By this modification the conjunctival test is not freed from the odium resting upon it—in essentials it remains the same. Besides, it is unintelligible that Wolff-Eisner should, on the one hand, reject a dilution of tuberculin kept for eight days as too old and dangerous, and, on the other hand, declare that a tuber- culin ointment has exceptional keeping powers, and is effective. In our opinion a \ per cent, watery solution of carbolic acid is a much more reliable vehicle for tuberculin than vaseline. After the failure of the tuberculin instillation it is not likely that a practitioner would be enticed into rubbing tuberculin oint- ment into the eyes of his patients. Nevertheless, we feel it our duty most expressly to warn all doctors against such a diagnostic manipulation. That tuberculin vaseline is more dangerous and unsuitable for the human eye than.the instillation of tuber- culin is evident, the method is more troublesome, the dosage—a quantity the size of a pea—quite inexact and control as to whether the ointment is good or not quite impossible. The conjunctival test modified for practice by means of tuberculin vaseline should be decisively rejected. |v. I Lafite-Dupont and Molinier have recommended the Nasal Reaction (Rhino-reaction) as a substitute for Reaction. t]ie ophthalmo reaction, as it is free from risk and not visible externally. A swab of cotton-wool the size of a small lentil is dipped into a 1 per cent, dilution of Calmette's tuberculin and applied for ten minutes to the lower turbinal or the septum. After twelve to eighteen hours the reaction occurs, consisting of congestion and exudation of the part dabbed, and leads to the formation of a slightly bleeding scab, which lasts from four to eight days, and after peeling off leaves behind a slightly inflamed spot. There seems to be as little need for the Nasal Test as for the urethral, rectal, and vaginal tuberculin tests. The last-named is possibly of value in veterinary medicine; Richter recommends it for cattle. 3.—THE SUBCUTANEOUS TUBERCULIN TEST. The technique of the subcutaneous reaction Selection of is of the greatest importance if its full value Tuberculin to be is to be obtained and its disadvantages Employed. excluded. It will therefore be described in detail. As a rule, only Koch's tuberculin (old tuberculin) is em- ployed. For two years we have preferred Koch's albumose-free tuberculin, which, owing to the removal of the simultaneous toxic effect of the albumose, usually renders the general reactions much milder.