A PRELIMINARY REPORT UPON TEN CASES OF CHRONIC JOINT DISEASE, TREATED BY TUBERCULINE INJECTIONS BY WRIGHT'S METHOD

A low tuberculo-opsonic index with local joint symptoms, may be accepted as evidence of joint tuberculosis. But a practically normal tuberculo-opsonic index, together with local joint symptoms, neither proves nor disproves joint tuberculosis.

When the diagnosis of joint tuberculosis has been made a high tuberculo-opsonic index should be maintained, if possible.

With a high tuberculo-opsonic index an operation for the removal of all or part of the local disease may be undertaken; not so with a low index.

If use of the diseased joint lowers the opsonic index, the joint must be protected; if it does not lower the index, it may be permitted; if it raises the index it should be insisted upon.

General elevation of the temperature following a tubercle injection, indicates too large a dose. A persistent lowering of the index during treatment by tubercle injection, indicates that the injection has been given at the wrong time, during what Wright calls the negative phase, instead of during the positive phase.

While the time has been too short and the patients too few to predict ultimate results, the fact that the results thus far have been by no means brilliant, should be taken as encouraging rather than discouraging. I believe the tubercle injection treatment guided by the tuberculo-opsonic index to be a most promising step in advance in the treatment of tubercular joint disease.

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