Serum Skin Test in Tuberculosis. 



91 



where, the main point of interest being that the subcutaneous 

 injection oLa- mixture of. the fresh blood of tuberculous guinea-pigs 

 with exudate resulting from the intraperitoneal lysis of tubercle 

 bacilli into a normal guinea-pig caused the appearance of a definite 

 local reaction. Upon the analysis of the phenomenon, it was 

 found that the peritoneal exudate could be replaced by a crude 

 tuberculin, and the serum of tuberculous guinea-pigs could also 

 be replaced by human tuberculous serum, and in this form it 

 proved to furnish a very good method for early diagnosis of 

 tuberculosis, the technique of which is as follows: Subcutaneous 

 injection into a normal guinea-pig of 0.05 c.c. of a mixture of 

 fresh tuberculous blood serum of human or animal origin (1 c.c.) 

 with tuberculin (crude diluted — I to 10 — 0.1 c.c.) left at room 

 temperature for 2-3 hours, causes in 24 hours a local reaction 

 similar in its aspect to a tuberculin reaction. The controls in- 

 jected in similar way with the mixture of normal serum and tuber- 

 culin show no reaction. The property on which this serum skin 

 test depends, appears in the blood of tuberculous guinea-pigs 

 sometimes as early as the end of the first week after injection. 

 When used as a diagnostic method with human sera, this test can 

 be applied in all the stages of tuberculosis as long as the circulating 

 antibodies exist free in the blood. I proved experimentally that 

 tuberculous guinea-pigs within the last week or two of life fail to 

 give this reaction, which finding seems to be true also for very 

 advanced human cases. As compared with other skin tests used 

 for diagnosis in tuberculosis, namely, one suggested by Schur- 

 mann, 1 who injects suspected material under the skin of guinea- 

 pigs and subsequently tests them by regular tuberculin test, or 

 the test suggested by Baureisen, 2 who injects suspected material 

 under the skin of guinea-pigs made tuberculous two or three weeks 

 previously, it seems that the method described by me covers 

 better the different kinds of conditions in which the diagnosis 

 may be called for. For the skin test described by Schurmann, 

 it is necessary to have material containing virulent tubercle 

 bacilli, which is not on hand in all cases of tuberculosis coming 

 for diagnosis. The technique adopted by Baureisen has the dis- 



1 Schurmann, cited from Z. f. Baki., Vol. 59, p. 653. 



2 Baureisen, Centr. f. Gyn., 1913, No. 23, p. 848. 



