520 STATE BOARD OF AGRICULTURE. 



Of one hundred thirteen which showed no reaction after the injection 

 of tuberculin and were killed, eighty-nine and thirty-eight one-hundredths 

 per cent, were free from tuberculosis. This demonstrates, throwing aside 

 all possibility of error in determining the disease as must be done in 

 every case, that there were fourteen and eighteen one-hundredths per cent, 

 of failures in the cases condemned by the reaction and ten and sixty-two 

 one-hundredths per cent, of failures where there vas no reaction. The 

 importance of this summary cannot be overestimated. 



In reviewing the reports and opinions of tuberculin as a diagnostic 

 agent the Lancet of March 21, 1891, has the following to say: "The im- 

 portance of a new aid to the diagnosis of tubercular disease within 

 the body is obvious, not only as enabling one to differentiate it from 

 allied conditions, but as a guide to the early adoption of therapeutical 

 measures. In Koch's tuberculin it was hoped that we should possess 

 a divining-rod which would reveal the hidden foci of an insidious malady, 

 and there were many who declared that therein would lie its chief value. 

 Experience, however, as embodied in these reports, compels but a guarded 

 acceptance of this opinion. A few observers such as Professors Lichtheim 

 and Schreiber of Konigsberg, and Dr. P. Guttman of Berlin regard it 

 as an efficient test, but Prof. Leyden (Berlin) thinks it cannot be solely 

 relied upon, and Prof. Gerhardt says that no reaction was observed in 

 some cases when bacilli were present. Prof. Ebstein (Gottingen), who 

 appears to have been the least impressed of all with the value of the 

 remedy, does not think there is any absolute certainty in its use for 

 diagnostic purposes. Prof. Biermer (Breslau) is also very cautious; he 

 had two cases of undoubted tuberculosis with bacillary expectoration, 

 which gave no reaction, cither local or general; while in another case, of 

 alcohol tabes, with no suspicion of tubercle, there was a marked general 

 reaction. Prof. Quincke (Kiel) thought it gave more certain indications 

 in cases of slight lung disease, but could not admit there was latent tuber- 

 cle in every case in which a general reaction followed the injection. The 

 Greifswald professors — Mosler, Strubing, and Peiper, — speak with some- 

 what more confidence, whilst Professor Schultze of Bonn thinks it a test 

 within limits and Professor Weber of Halle that it is far less certain 

 diagnostically in internal than in external tubercle. Professor Finkler of 

 Bonn met with but few exceptions to the rule of reaction among cases 

 of commencing phthisis, and did not regard the absence of reaction in 

 chronic phthisis as diminishing its value in diagnosis. Lastly, Professor 

 Rumff (Marburg) believed it was a test which should always lead to 

 greater care in physical exploration of the chest and in search for bacilli." 



In July, 1892, Bang reviewed the work of some experimenters. Schutz 

 and Rosval tested sixty-six animals, forty-four of which responded to the 

 tuberculin. In ten of these which showed a reaction, traces of tuberculosis 

 could not be found upon autopsy. In Nocard's cases, twenty cows reacted 

 and eighteen were found to be tuberculous. The other two had liver dis> 

 ease and enlarged lymphatic glands. Thirty-seven cases did not react. 

 Of these thirty-five were healthy and two affected with a mild form of 

 tubercle. 



Clement reports that out of 500 animals tested he had only a single 

 error, 100 of these 500 reacted and were slaughtered. The error was in a 

 case of advanced tuberculosis which failed to respond to a small dose of 

 tuberculin. 



