26 An Introduction to Medical Mycology 



The authors did not consider it proved that specific acquired sensitization 

 to fungi was due to the test injections of trichophytin, although such a possi- 

 bility was suggested. 



We found that in children with no obvious fungous infection a negative 

 reaction to trichophytin was the invariable rule. When a fungous infection 

 was present, the reactivity of the skin to trichophytin varied according to 

 the species of infecting organism. Eight children whose scalps were infected 

 with A. schoenleini or T. violaceum showed negative reactions to the 

 intracutaneous test with trichophytin. In seven of 27 children whose scalps 

 were infected with M. audouini there was a reaction to trichophytin, but 

 in only one instance was a 4 plus reaction noted. In the remaining 20 

 children the response was negative. When M. lanosum was the infecting 

 organism, the result of the intracutaneous test was usually positive. The 

 test was considered helpful in determining the prognosis and the type 

 of therapy to be employed. If the reaction to trichophytin was negative, 

 the time for cure was usually prolonged, whereas a vigorous reaction was 

 frequently followed by a rapid clinical response to treatment. 



(b) Specificity of the trichophytin test.— The work of the older 

 investigators repeatedly showed that after deep infections with fungi, the 

 cutaneous test with trichophytin invariably invoked a cutaneous response, 

 which could be elicited for many years thereafter. Marcussen pointed 

 out that (1) trichophytin did not possess a primary toxic effect, (2) reac- 

 tions were not caused by hypersensitivity to the culture medium or its 

 components and (3) the commercial extract and a monovalent vaccine 

 made from T. gypseum (fluffy) caused the same or similar reactions. 

 All these points favor the belief that the reaction to trichophytin is spe- 

 cific. Sulzberger and Kerr and later Sulzberger, Lewis and Wise showed 

 that patients did not react in a uniform manner to both oidiomycin and 

 trichophytin and that sensitization to one extract did not necessarily bring 

 about sensitization to the other. In further support of the opinion that the 

 reaction to trichophytin is specific are the figures in Tables 1, 2 and 3. 

 We have recorded reactions in 70 patients. The patients listed in Table 1 

 were considered to have trichophytid, and all revealed a strong reaction to 

 trichophytin. The patients represented in Table 2 were selected because 

 they reacted strongly to oidiomycin and cultural examinations showed M. 

 albicans. The patients listed in Table 3 reacted strongly to catarrhal vaccine. 

 The dissimilarity in both the number and the strength of the reactions to 

 these three extracts in all three groups is at once apparent. 



( C ) IS THE SPECIFICITY OF THE TRICHOPHYTIN TEST DETERMINED BY SPECIES 



or genus?— The work of W. Jadassohn, Schaaf and Wohler showed that 

 the antigen in trichophytin which elicits the reaction is not a single sub- 



