Nurses' Papers on Tuberculosis :: read before the Nurses' Study Circle of the Dispensary Department, Chicago Municipal Tuberculosis SanitariumChicago (Ill.). Municipal Tuberculosis Sanitarium. Dispensary Department
Science
Nurses' Papers on Tuberculosis :: read before the Nurses' Study Circle of the Dispensary Department, Chicago Municipal Tuberculosis Sanitarium
Chicago (Ill.). Municipal Tuberculosis Sanitarium. Dispensary Department
Tuberculosis
_a_ ROBERT KOCH ascribes the tuberculin reaction to the increased
necrotic process around the tubercle, the histological changes
consisting of hyperaemia, exudation and softening.
_b_ EHRLICH considers the formation of antibodies an essential feature in
the mechanism of reaction. Formation of antibodies takes place in
the middle of the three layers encircling the tubercle, the layer
damaged by toxins, but not yet rendered incapable of reaction.
_c_ WASSERMANN maintains that the antituberculin found in the tuberculous
process draws the injected tuberculin out of the circulation to the
tuberculous focus. The interaction that takes place between
antituberculin and tuberculin results in formation of ferments which
digest albumin, resulting in the softening of tissue. Absorption of
softened tissue causes fever.
_d_ CARL SPENGLER--Toxins in the blood of the tuberculous are kept in
check by antibodies. Injected tuberculin unites with antibodies,
thus setting the toxins free. Result--autointoxication.
_e_ WOLFF-EISNER--Bacteriolysin is present in the organism of the
tuberculous, as result of previous infection; bacteriolysin sets
free the potent substances of the injected tuberculin; this acts on
the body and the tuberculous focus, producing a reaction.[10]
TUBERCULIN TESTS
I. SUBCUTANEOUS (hypodermic); introduced by Robert Koch in 1890.
II. CUTANEOUS; introduced by Von Pirquet in 1907.
III. CONJUNCTIVAL (ophthalmic); introduced about the same time by
Wolff-Eisner and Calmette in 1907.
IV. PERCUTANEOUS (inunction or salve); introduced by Moro in 1908.
V. INTRACUTANEOUS (needle track reaction); introduced as a test by Mantoux
in 1909. Described previously by Escherich.
I. SUBCUTANEOUS TUBERCULIN TEST
1. APPARATUS AND SOLUTIONS NECESSARY:
Glass cylinder graduated to cc.
1 cc pipette graduated to 1/10 cc.[11]
10 cc pipette graduated to 1/10 cc.[12]
Hypodermic needle suited to the syringe.
Two or more 1/2 oz. bottles.
1/2% carbolic acid solution.
Normal salt solution.
1 cc. Old Tuberculin.
2. PREPARATION OF APPARATUS:
Glass apparatus, syringe and needles boiled before use.
Some keep needles and syringe in 95% alcohol.
3. MAKING SOLUTIONS:
Tuberculin No. I: Tuberculin No. II:
Label one bottle Another
_.1 cc. = 1 mg. T_ _.1 cc. = .1 mg. T_
No. I { Put 0.1 cc. T in bottle No. I
{ Add 9.9 cc. of 1/2% carbolic acid solution
{ Put 1 cc. of Tuberculin solution from
No. II { No. I into bottle No. II
{ Add 9 cc. of 1/2% carbolic solution
In making dilutions you may use your syringe instead of pipette.
Dilutions can be kept _one week_ in a dark, cool place.
Discard turbid solutions.
4. PREPARATION OF THE PATIENT FOR THE TEST:
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