Excerpt from The Practical Medicine Series, Vol. 9: Comprising Ten Volumes on the Year's Progress in Medicine and Surgery
Pirquet's Cutaneous Tuberculin Reaction has been much discussed. The procedure consists in scarifying as for vaccination. This scarified area is treated by Pirquet with a 4 per cent, solution of "old" tuberculin. Others use from 1 to 4 per cent, solutions. If the patient be tuberculous, then according to Pirquet, there appears within 48 hours a papule surrounded by a hyperemic zone 1 inch to 1? inches in diameter. The disappearance of this papule is often followed by a brownish pigmentation of the skin which may persist for some time. The reaction has various degrees of severity, from a very small papule to a large and intensely inflamed area. However, the severity of the reaction is not a measure of the extent of the tuberculous process. The reaction is not attended by general symptoms such as fever and malaise.
F. L. Christian makes his tests by scarifying 3 small areas about 2 inches apart and applying the ointment to 2 of these areas, using the third, the center one, as a control. The reaction begins in from 4 to 8 hours. In most instances the reaction was still quite evident at from 2 to 4 days after the inunction. No inconvenience was experienced, no rise of temperature or malaise; the usual manifestation was a red areola about the scarifications, some slight swelling, itching and in some the formation of small nodules, all of which disappeared in a week or less. In 7 cases out of 18 reported by Christian there was no reaction, although tubercle bacilli were present and marked constitutional tuberculosis.
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