180 APPLIED IMMUNOLOGY 



The contra-indications to the use of the subcutane- 

 ous tuberculin test may be stated to be general miliary 

 tuberculosis, acute phthisis, advanced pulmonary 

 tuberculosis, tuberculous meningitis, markedly as- 

 thenic individuals and convalescents from an acute ill- 

 ness, conditions in which any tuberculin application 

 may fail to produce reaction; in patients running a 

 marked irregular temperature, and possibly also in 

 children, the scarification or von Pirquet test takes 

 precedence over the method of subcutaneous injection. 



Intradermic Injection, — Mantoux has strongly 

 recommended this method for the administration of 

 tuberculin, diagnostically, and to determine, by the 

 severity of the reaction, the sensitiveness of the pa- 

 tient prior to therapeutic inoculations. He claims 

 that it is more sensitive than other tuberculin tests. 

 Indeed it would appear too delicate, as almost all adults 

 show a reaction, although tuberculosis, clinically, is 

 absent. The test may be serviceable in very young 

 children, but is not destined to become popular. Man- 

 toux employs 0.01 milligranmie injected into the skin 

 of the thigh. The reaction is not unlike the local in- 

 flammatory process observed in the subcutaneous 

 method. 



Scarification or von Pirquet Cutaneous Reaction, 

 —This test, like the subcutaneous method, depends 

 upon the antituberculin in the body fluids of the in- 



