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.

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    however, that these dilutions become less active in course of time. The date of preparation should therefore be placed on the tube. The subcutaneous injection of tuberculin prescribed by Koch has the advantage of the most exact dosage, which is necessary for tuberculin—the most potent drug in the whole Pharmacopoeia for diagnosis. .. .. . . In addition to the subcutaneous method, Method of ,r , ., , , Mendel s intravenous method comes into Administration. questjon> Tn the action of tuberculin given by these two methods there is only a difference of time and degree; the reaction occurs much sooner and is far more marked by the intravenous method. But this is no advantage; on the contrary, the subcutaneous test is easier to perform and applicable to every case, e.g., children and women with arm-veins difficult to make prominent. So what Koch [86] stated in his first pub- lication, still holds to-day.: To obtain a reliable result, it (tuberculin) must be given subcutaneously. The injection is made under the skin, which Technique of should be rubbed with ether. The rapid Administration. insertion of the sharp needle is then almost painless. _ The best site for injection is the back, Site below the level of shoulder-blades on a level with the last ribs and alternately on the two sides. In spite of aseptic precautions, it sometimes happens, especially if the re- action be severe, that there is a painful infiltration of the needle track, the so-called needle track reaction, which will be described later. The arm is still often chosen as the site for injection. This may be more convenient, because the patient does not need to undress. Yet injec- tions in the upper or lower arm are not to be recommended. They often result in very severe needle-track reactions, not infrequently in extensive infiltration, which hampers the free movements of the arm in a disagree- able manner. This may occur when no error in technique has been made or aseptic precautions overlooked. According to Schiitz and Videky the local inflammatory irritability of the skin and of the subcutaneous connec- tive tissue is greatest in the arm. The best time for the injection is the early hours of the forenoon. It is not advisable to inject in the evening, because reactions mav set in after six hours, pass unnoticed during sleep and have completely passed away by the following morning, with the result that the reaction escapes the notice of the physician also and the next dose is un-