THE LUETIN REACTION 317 



pared with the cutaneous reaction of v. Pirquet, it appears from an 

 analysis of 2974 examinations collected by Petit that 94.3 per cent, 

 of clinically tubercular cases showed the reaction, while among non- 

 tubercular individuals only 18.4 per cent, reacted. The eye reaction 

 would thus seem to be more useful from the diagnostic standpoint, 

 and it is to be hoped that it may yet be improved to such a degree 

 that dangerous reactions may with certainty be avoided. 



As in the case of the v. Pirquet reaction, systemic and focal 

 symptoms do no occur. 



The Tuberculin Test According to Moro (Dermo-reaction). Moro 

 has shown that a skin reaction may be obtained in tubercular individ- 

 uals after inunction with a salve composed of equal parts of the 

 old tuberculin of Koch and of lanolin. To this end a small amount 

 of the salve (about the size of a pea) is for a minute rubbed into an 

 area of the skin measuring not more than 5 cm. in diameter. The 

 best district for this purpose is the skin just below the sternum or 

 in the vicinity of the nipple. After drying for about ten minutes 

 the patient may dress, no special covering being required. After 

 twenty-four to forty-eight hours a dermatitis then develops which 

 is characterized by the appearance of miliary nodules of variable 

 size and number, which occur either singly or confluent. At the 

 same time there is a more or less extensive general redness of the 

 affected area, accompanied by a certain amount of itching (see 

 Plate IX). 



Regarding the clinical value of the method our knowledge is as 

 yet too meager to warrant its general recommendation, v. Pirquet 

 states that he has been able to obtain positive results only in highly 

 susceptible individuals, but suggests that it may be tried, if for 

 any reason the cutaneous or the eye reaction cannot be employed. 



THE LUETIN REACTION 



While a number of different investigators had previously attempted 

 a skin reaction diagnosis in connection with syphilis, satisfactory 

 results could hardly be expected so long as the successful cultivation 

 of the corresponding spirochete in pure culture had not been accom- 

 plished. The solution of the latter problem we owe to the painstaking 

 work of Noguchi, and to the same investigator belongs the credit 



