PROGNOSTIC VALUE OF OPHTHALMO REACTION 59 



A severe reaction after a very small dose is less favorable, denoting a very 

 much increased hypersusceptibility. 



(b) With very marked clinical manifestations } a reaction obtained only 

 after large doses of tuberculin would speak for an unfavorable prognosis 

 because the reactive power of the organism is weak. A severe reaction 

 after a very small dose is more favorable, denoting a stronger reactive 

 power of the individual. 



Wolf-Eisner and Teichmann formulated the following three hypotheses 

 in regards to the conjunctival test. 



1. A positive conjunctival reaction is indicative of an active tubercu- 

 losis; associated with manifest clinical symptoms a strongly positive test 

 would speak for a more favorable prognosis than if the reaction were weak 

 or negative. The same interpretation can be applied to the cutaneous 

 reaction. 



2. A negative reaction (conjunctival or cutaneous) with manifest 

 tuberculosis would point toward an unfavorable prognosis. The outlook 

 is also unfavorable if the ophthalmo reaction is positive but the cutaneous 

 test negative. 



3. With the cutaneous test, the local reaction sometimes continues 

 longer than four days. This is known as a " prolonged or continued reac- 

 tion" and is found among normal subjects, among individuals in whom the 

 lesions are undergoing a healing process and those in whom the tuber- 

 culosis has existed for over ten years. The prognosis therefore is favorable. 



