SPECIFIC BACTERL\L REACTIONS 185 



Method of Mucous Membrane Instillation, — 

 Wolff -Eisner first reported on the use of ten per cent. 

 " Alttuberculin " as a valuable diagnostic test when 

 instilled into the conjunctiva. Almost synchronously, 

 Calmette pointed out the irritation due solely to the 

 contained glycerin in ordinary tuberculins, especially 

 '* O. T.," and recommended its application as an oph- 

 thalmic test only after precipitation and purification 

 with alcohol. Even as such the conjunctival test has 

 not been received in all quarters with much favor, 

 owing to a number of serious ophthalmic complications, 

 which have arisen incident to the use of tuberculin in 

 the eye. Therefore, it is strongly contra-indicated in 

 conjunctivitis, ulcers, blepharitis, iritis, keratitis, tra- 

 choma and all diseases of the internal structures of 

 the eye. Scrofulous persons are predisposed to the 

 formation of phl^^ctenules as a result of the reaction. 

 Tuberculin for this test is obtainable, commercially, 

 in either solution or tablet form. Baldwin advises an 

 initial instillation into the conjunctival cul-de-sac of 

 one minim of a one-half per cent, solution; in the 

 absence of a reaction in forty-eight hours, the same 

 quantity of a one per cent, solution is instilled into the 

 other eye. The reaction usually develops in three to 

 twelve hours, but may be delayed a day or two, and 

 often endures for a week. It is characterized by itch- 

 ing, burning, serofibrinous exudate, congestion and 



