The Tuberculosis Nurse: Her Function and Her Qualifications: A Handbook for Practical Workers in the Tuberculosis CampaignLa Motte, Ellen N. (Ellen Newbold)
History
The Tuberculosis Nurse: Her Function and Her Qualifications: A Handbook for Practical Workers in the Tuberculosis Campaign
La Motte, Ellen N. (Ellen Newbold)
Tuberculosis -- Nursing; Tuberculosis -- Nursing -- United States -- History
=Tuberculin Tests.= There are two tuberculin tests commonly used, which
enable the specialist to diagnose doubtful cases. These are the eye and
the skin test. Strictly speaking, the public health nurse has nothing to
do with these tests, since they are entirely within the realm of the
physician, but she should at least understand their significance. The
Von Pirquet, or Skin Test, consists of inoculating the forearm with a
drop of tuberculin of a certain strength. A positive reaction is
manifest by a slight redness appearing within twenty-four hours and this
may persist for a day or two, after which it disappears. This test has
no value in the case of adults, since all adults are supposed to possess
some slight tuberculous focus, and therefore a reaction has no
significance. In the case of children, however, a positive skin test has
some value. Children are not as a matter of course supposed to possess
tubercular foci, and a positive reaction would therefore indicate that
they have become infected. A reaction, however, gives no indication as
to the location of the focus—it only proves its existence.
The Calmette, or Eye Test, has more importance. A drop of tuberculin is
placed inside the lower eyelid of one eye, and if a reaction occurs, it
does so within twenty-four hours. The conjunctiva becomes slightly red
and inflamed, which condition persists for a day or two and then
disappears. In adults as well as children, this is a positive indication
of tuberculosis—not necessarily of a mere latent focus, but of a
possible lesion which must be watched and guarded against. It gives no
indication, however, of the location of the lesion.
These tests are useful to specialists in helping them to highly refined
diagnoses. Dr. Hamman, however, questions the validity of these
extremely early diagnoses, unless they are confirmed by sputum findings.
If the bacilli are not found the diagnosis rests entirely with the
examiner, and is therefore dependent upon the personal equation.
=Registration of Cases.= Most States have laws which require the
notification of infectious diseases, including tuberculosis. This means
that all physicians are required to report their cases of tuberculosis
to the Health Department, filling in a card, more or less complex, in
which is set forth the patient’s name, age, address, occupation, and the
duration and stage of the disease. In Baltimore, the nurses also are
allowed to register their tuberculous patients in this way, with the
city as well as the State Health Department. The card used is the same
as that used by the physicians, but with this difference—since a nurse
is unable to make a diagnosis herself, she is required to place in the
corner of the card the name and address of the physician or dispensary
responsible for the diagnosis. In this way the authorities are enabled
to know how many patients are under the nurses’ supervision, and the
sources of the diagnosis.
Public-domain text, read in full here on John Shaqi.
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