Chapter V: Intracutaneous Tuberculin Test

1. SYNONYMS--Mantoux Test

2. APPLICATION OF TEST:

Injection into skin (needle parallel to skin) of 1/100 mg. of Old
Tuberculin (according to Mantoux).

3. REACTION:

Onset in a few hours, well developed in 24 hours, acme in 48 hours.
Reaction consists of a central nodule surrounded by a halo of
redness.

This is the intracutaneous test as originally suggested by Mantoux.

CONCLUSIONS

Comparing the various tuberculin tests we find that:

1 _The Subcutaneous Tuberculin Test_ has the advantage of focal reaction, disclosing in a certain percentage of cases the seat of the disease.

The subcutaneous test should, however, never be employed unless _as a last resort_, and then only after all other methods of diagnosis are exhausted and an absolute diagnosis is very essential.

In the vast majority of suspected cases of tuberculosis, thorough study of the history of the case, combined with thorough physical examination, furnishes all the necessary data for diagnosis and an efficient plan of treatment.

2 _The Cutaneous Tuberculin Test_ is a very efficient diagnostic measure in children under two years of age in whom a positive cutaneous tuberculin reaction indicates active disease.

Positive cutaneous tuberculin reaction in adults indicates existence of a tuberculous process, somewhere in the body; it does not indicate that the process is active.

Negative cutaneous tuberculin reaction is one of the corroborative evidences of absence of tuberculosis, unless reaction is prevented by very advanced disease or tolerance to tuberculin established by tuberculin treatment.

3 Thorough study of the history and thorough physical examination of each individual case are more important and should precede the application of any test.

FOOTNOTES:

[1] For illustration, see Knopf, "Tuberculosis," Chap. IV, page 67.

[2] See Carrington, "Fresh Air and How to Use It," Chap. II, page 29.

[3] For illustration, see Carrington, "Fresh Air and How to Use It," Chap. II, page 37.

[4] For illustration, see Carrington, "Fresh Air and How to Use It," Chap. VIII, page 128.

[5] For illustration, see Knopf, "Tuberculosis," Chap. IV, page 58.

[6] For illustration, see Carrington, "Fresh Air and How to Use It," Chap. VII, page 108.

[7] See previous footnote.

[8] For illustration, see Journal of Outdoor Life, January 1914.

[9] For illustration, see Carrington, "Fresh Air and How to Use It," Chap. IV, page 55.

[10] For a diagrammatic presentation of Wolff-Eisner's theory, see "Tuberculin Treatment" by Riviere and Moreland, page 6.

[11] Not absolutely necessary: may get along with graduated cylinder and syringe.

[12] See previous footnote.

(END)

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Transcriber's Amendments

Transcriber's Note: Blank pages have been deleted. Paragraph formatting has been made consistent. The publisher's inadvertent omissions of important punctuation have been corrected.

Other changes are listed below. The listed source publication page number also applies in this reproduction except possibly for footnotes since they have been moved.

Page Change

7 the acute inflamatory[inflammatory] at the beginning,
9 systematic treatment was underaken[undertaken].
9 Bodingon of Sutton, Coldfield[Sutton Coldfield], England,
10 The fundimental[fundamental] principle
19 fit to make to a printed questionaire[questionnaire].
23 who visits the physican[physician]
28 Tuberculosis Sanitarium is extending sanatorum[sanatorium] care
35 [Split first footnote into two.]
36 in the shelter of a strong windbrake[windbreak].
43 makes a family, ordinnarily[ordinarily]
58 [Split first footnote into two.]
58 Hyperdermic[hypodermic] needle suited to the syringe
62 absence of conclusive symptons[symptoms] or signs,
62 (thourough[thorough][et seq.] study of the case,
63 all other methods of diagnosis were thouroughly[thoroughly]
63 from a diameter of 10 millimeters in [the] average case
66 [Added (END).]

On page 50 of the original publication, the following portion of a paragraph has two extraneous lines here marked in brackets:

All of the cooking was done by the teacher. Careful attention to
[is given. Children are weighed once in two weeks. Instruction]
[is chiefly practical. Instruction in gardening is given twice a week]
general cleanliness and hygiene of the teeth was insisted upon.
Individual drinking cups and tooth brushes were provided. The
children took turns in washing dishes, setting the table and helping....

The extraneous lines are duplicates of lines further up the page and have been deleted.

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End of Project Gutenberg's Nurses' Papers on Tuberculosis :, by Various