The diseases of infants and children . f the cutaneousreaction makes it easily the choice of methods. It is made by washing theskin of the upper arm with ether or alcohol, applying a drop of undilutedold-tuberculin, and then scarifying slightly through this with a sterilizedneedle or the special drill-shaped scarificator made for the purpose. Acontrol scarification should be made a couple of inches distant for thepurpose of comparison. A positive reaction develops within 24 hours,sometimes longer, and consists of a red, slightly indurated maculo-papule5 mm. ( inch) or more in diameter (Fig.
The diseases of infants and children . f the cutaneousreaction makes it easily the choice of methods. It is made by washing theskin of the upper arm with ether or alcohol, applying a drop of undilutedold-tuberculin, and then scarifying slightly through this with a sterilizedneedle or the special drill-shaped scarificator made for the purpose. Acontrol scarification should be made a couple of inches distant for thepurpose of comparison. A positive reaction develops within 24 hours,sometimes longer, and consists of a red, slightly indurated maculo-papule5 mm. ( inch) or more in diameter (Fig. 182). It reaches its heightusually upon the 2d day and fades slowly, often leaving slight papule of smaller size than 5 mm. is not to be considered certainlypositive (von Pirquet).^ If the reaction obtained is doubtful or negative, 1 Wien. mod. Woch., 1907, LVII, 1370. 2 Wien. klin. Woch., 1907, XX, 933. 3 Berl. klin. Woch., 1907, XLIV, 7. ^ Comp. rend. acad. sci., 1907, CXLIV, Peers Lehrb. der Kinderh., 1914, Fkj 1H2.—Thk Vom Pirqi et TirBEHctLiN Reaction. Child with incipient puhnonjiry tulxTc-ulosis; a + reaction. Tiic control scarification isbarely to be seen, and is inidwaj- between the tnberculin reactions. (Kolmvr, A Practical Tijct-htiiik of Iiif( clion, Imiiniiillii (iiid S/irriJic Tin rdpi/, 1!(17.) TUBERCULOSIS 561 a second trial may be made in a few days or, still better, the intracutan-eous test may be used. Value of the Tuberculin Reaction.—Under ordinary circumstances it isfair to assume that a negative tuberculin reaction, especially if it is stillso on the second trial, excludes the presence of tuberculous infection inthe patient. In patients gravely ill in an advanced stage of the disease,the organism may be so unable to produce antibodies that no reaction takesplace. Cases of general miliary tuberculosis and of tuberculous meningitismay also fail to respond to the test. There is often, too, observed aninhibitory action
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