hypersensitiveness 515 



Dependable Methods of Tuberculin Production and Stand- 

 ardization. — It would appear from the research so far reported in 

 this chapter that there are at present four methods available for 

 the production of fairly pure tuberculin. The products of these 

 methods have been designated as MA-100, TPA, TFT, and SOTT 

 or PPD, respectively. A new method of producing PPU has been 

 suggested by Seibert and Glenn (1941). It is discussed briefly 

 later in this chapter. Because all of these tuberculins except 

 the purified protein derivative are more or less antigenic and 

 lead to the development of skin hypersensitiveness in some 

 individuals wlien injected repeatedly, Long (1934) recommends 

 that the latter (PPD) be used in determining the presence of 

 tuberculin allergy in man. 



There have been developed also two methods of standardiza- 

 tion tliat give wluit appear to be consistent and dependable re- 

 sults. These may be designated as the standardized intracutane- 

 ous method of Aroiison (recommended by Seibert) and the 

 spermatocyte reaction of Long. 



Diagnostic Tuberculin Tests. — In diagnostic Avoi-k both local 

 and systemic reactions have been used to determine tuberculin 

 hypersensitiveness. Among the tests based upon local allergic 

 phenomena may be mentioned the cutaneous tuberculin test of von 

 Pirquet, the percutaneous tuberculin reaction of Moro, the intra- 

 cutaneous test of Mantoux and the ophtlialmo-tuberculin reaction 

 of Calmette or a similar one called the conjunctival-tuberculin 

 reaction of Wolff-Eisner. Koch first employed a subcutaneous 

 tuberculin test in which a positive reaction is indicated by both a 

 local and a systemic reaction. Tlie technique and allergic phe- 

 nomena involved in each of the various tests may be summarized as 

 follows : 



The von Pirqukt Test. — Tlie technique of the von Pirquet test 

 consists in first washing the inner surface of the forearm with 

 ether and applying two drops of Koch's OT to the surface of the 

 skin about 10 em. apart. Then with a sharp instrument one 

 scarifies by pressure and rotation a small area about midway 

 between the two drops of tuberculin. This serves as a control. 

 Similar scarifications are then made through each drop of tuber- 

 culin after which the latter is allowed to dry. While dressing is 



