204 Dr. A. E. Wright and Staff-Surgeon S. T. Eeid. [Oct. 21, 



tissues are extensively invaded by the staphylococcus is inoculated with the 

 corresponding vaccine in such a manner as to develop a pronounced 

 negative phase. 



The association of a negative phase with a reaction similar to that 

 conveniently spoken of as the tuberculin reaction, suggested to us the 

 propriety of enquiring whether the true tuberculin reaction, as seen after 

 the injection of Koch's old tuberculin into a tubercular patient, was also 

 associated with a negative phase. 



The opportunities for investigating the question which have presented 

 themselves have not yet been sufficiently numerous to allow of our formulat- 

 ing a final answer to this question. The observations which are set forth 

 below seem to us to suggest that the development of a negative phase, with a 

 dose of tuberculin smaller than that which would produce this result in a 

 healthy patient, may prove to be an index of tubercular infection. Such a 

 conclusion would be in harmony with our experience in connection with the 

 therapeutic inoculation of tubercle vaccine (new tuberculin). We find in this 

 connection that the negative phase supervenes upon very much smaller doses 

 and persists much longer in the case where the patient is the subject of 

 extensive infection than in the contrary case. 



Observation 1. — Case diagnosed, Tubercular choroiditis. 



Date. 



Tuberculo-opsonic index. 



Clinical data. 



26.4.05 



5 milligrammes 



29.4.05 



28.4.05 



0-9 



old tuberculin inoculated. 



0-29 

 0-95 



Some constitutional re- 

 action, t. 100° F. 



Observation 2. — Case diagnosed, Lupus erythematosus. 



Date. 



Tuberculo-opsonic index. 



Clinical data. 



12.1.05 



Inoculation of 1 



13.1.05 



17.1.05 



26.1.05 



0-73 



milligramme old tuberculin. 



0- 85 



1- 6 

 0-5 



No rise of temperature 

 or constitutional or 

 local reaction. 



