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106
Special Diagnostic Tests.
As in previous years, Mantoux Tuberculin tests have been carried out. As explained before,
except in certain rare circumstances, a negative reaction to all tests precludes the fact of tuberculous
infection having been previously acquired ; and the test therefore is a useful aid in excluding tuberculosis
in doubtful cases in children.
It may be mentioned that skin tests have been done in different ways for many years, the
"Von Pirquet" reaction being obtained by injection under the skin, and the "Moro" reaction by
rubbing 10 per cent. tuberculin in lanoline into the skin.
During the past year, Miss Robinson and I have used a modification of Moro's reaction—known
as the Vollmer Tuberculin Patch test. In this test, two pieces of prepared filter paper, impregnated
with tuberculin, are held in contact with specially cleaned skin (usually forearm) by a piece of ordinary
adhesive strapping—a control being placed between them. The tuberculin contained in the filter papers
is quite dry and in concentrated form. The natural moistness of the skin causes the tuberculin to
activate and after 48 hours the strapping is removed. If a positive reaction has been obtained, a
small reddened patch appears in the sites covered by the filter papers and can be contrasted with the
control.
This is a very simple test, and appears (as far as can be judged by our experience) a sufficiently
reliable one for general use—especially in those cases where children are nervous and wriggle about,
making the "intra-dermal" Mantoux Test difficult to accomplish. Also it has the advantage that
no needle has to be used and so relieves a certain amount of apprehension in the minds of parents
and guardians. No deleterious effects have ever been noticed as a result of doing either test in this
Dispensary.
I append the statistics regarding these tests and again have much pleasure in placing upon
record the great help afforded by Miss Robinson in carrying them out and keeping the records of
same during the past year.
MANTOUX AND VOLLMER TESTS, 1938.
No. of
Injections.
Positive Reactions.
Number.
Percentage.
1-10,000 dilution
217
27
12.4
1—1 000 dilution
178
10
5.6
1-100 dilution
146
8
5.4
Vollmer Patch Test
49
6
12.2
Totals
590
51
8.6
Number of Children who
received the Test.
Number.
Reaction.
Positive.
Negative.
For the first time
197
47
150
For the second time
22
-
22
For the third time
13
1
12
For the fourth time
13
1
12
For the fifth time
12
2
10
For the sixth time
2
-
2
Totals
259
51
208