1908 Journal of the American Medical Association  
should be investigated in the suspected tuberculosis patients. He added that his purpose was not necessarily to have action taken by this Section, but to emphasize that such an ocular basis for tuberculosis existed and that whenever it did, it was necessary, to investigate the matter and consider closely the relation of the eye to the general condition, that this relation might not be overlooked. Dr. H. C. Parker, Indianapolis, said that he had not made over ten tests within the past two
more » ... the past two months, and in only one of these had he obtained a positive reaction. This reaction had been obtained in a nurse used as a control in whom there was not the slightest evidence of a tuberculous condition either present or past, and whose family history was excellent. In this case the reaction was violent with marked subjective symptoms, accompanied with purulent discharge, the lid showing edema and chemosis. A smear taken from the conjunctival sac showed numerous lance-shaped diplocoeci resembling closely and called pneumococci. Several of Dr. Parker's later negative tests were made in undoubted eases of clinical tuberculosis. Dr. Parker said that several recent writers had become enthusiastic over the results obtained by the Calmette reaction, while others had put forth a warning note either against its reliability or its too promiscuous use. by physicians possessing no intimate knowledge of ocular lesions, past or present. Arnold Knapp's case (reported in the Archives of Ophthalmology, March, 1908) of interstitial keratitis following the instillation of Calmette solution in an eye previously healthy showed that the test was not without danger. Weber, in the British Medical Journal, Feb. 15, 1908, re-ported the cases of five healthy doctors who tried the test on themselves, each obtaining a positive reaction, three of which were violent. Dr. Parker said that it was without doubt true that much more information was necessary on this subject; also that the test should be made only in eyes showing no ocular lesion or scar on the surface of the eyeball; and that, even in such instances, the test was not free from some danger.
doi:10.1001/jama.1908.25310520012001c fatcat:2qabwcjzczbs5osyarrbavnode