THE VALUE OF THE INTRACUTANEOUS TUBERCULIN TEST IN EXTENSIVE TUBERCULOSIS

The belief is quite general that the skin hypersensitiveness to tuberculin is frequently lost in the presence of an overwhelming tuberculous infection, such as general miliary tuberculosis and tuberculous meningitis. This belief is based on repeated statements to that effect in textbooks and articles dealing with the tuberculin skin test. Since we accept the fact that skin hypersensitiveness to tuberculin means that there is a focus of tuberculous infection somewhere in the body, if the reaction is frequently lost in one of the forms of tuberculosis in children in which diagnosis is most difficult, i. e., miliary tuberculosis, then the test loses much of its importance.

The statistics on the tuberculin test, especially in children, are based mainly on the results obtained with the Pirquet skin test. Hess¹ tested twelve cases of tuberculous meningitis and found 17 per cent, positive. Dunn and Cohen² tested 120 cases of miliary