TUBERCULIN IN ORTHOPEDIC DIAGNOSIS

1. The tuberculin reactions are specific in the sense that only those who have a tuberculous infection react.

2. The reactions are quantitative in character and latent cases react to large doses or to repeated doses and to the v. Pirquet test.

3. Only small doses should be employed: the v. Pirquet reaction is useful only in young children and as an additional test in adults.

4. The combination of two local reactions made at one sitting checked up if necessary by the subcutaneous test has yielded extremely satisfactory results in orthopedic cases.

5. The reactions are not infallible, but are at least as accurate as the other biologic tests in common use.

6. The reactions reveal only the nature of the infection and do not of themselves show the location of the focus (focal reaction excepted).

7. The local diagnosis must be made in the light of all the clinical findings.

There are many practical points purposely omitted from this paper, a very important one being the question as to who is to perform the tests and especially to interpret the results. I believe many mistakes to have arisen because the reactions have been entrusted to house physicians, assistants, and others and I would counsel each investigator to do his own work or at least to determine for himself whether the reactions are positive or negative before drawing any deductions from them. I have learned not to rely upon the findings of others.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?