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Tuberculins
280
THE
BRITISH
JOURNAL
OF
TUBERCULOSIS,
PREPARATIONS A N D APPLIANCES. TUBERCULINS. TUBERCULIN is i n c r e a s i n g in favour b o t h as a d i a g n o s t i c a n d t h e r a p e u t i c agent. K n o w l e d g e r e g a r d i n g t h e n a t u r e a n d influence of t u b e r c u l i n has a d v a n c e d . M e t h o d s of p r e c i s i o n are nov,- e m p l o y e d in t h e p r e p a r a t i o n of t h e various tuberculins, a n d t u b e r c u l i n s are a v a i l a b l e in c o n v e n i e n t f o r m s for clinical use. T h e excessive doses of f o r m e r days a r e b e i n g r e p l a c e d b y a carefully g r a d u a t e d system. U n d e r t h e n e w r e g i m e n t h e usefulness of t u b e r c u l i n is b e i n g widely e x t e n d e d . Busy p r a c t i t i o n e r s desirous of o b t a i n i n g a concise s u m m a r y of our p r e s e n t k n o w l e d g e should consult the u p - t o - d a t e article in the n e w edition of " T h e E x t r a P h a r m a c o p c e i a . ''1 M u c h of t h e g r o w i n g p o p u l a r i t y of t u b e r c u l i n is d u e to the e n t e r p r i s e of l e a d i n g firms in p r o v i d i n g r e l i a b l e p r e p a r a t i o n s in c o n v e n i e n t a n d r e a d i l y a v a i l a b l e forms. W e have r e c e n t l y h a d o p p o r t u n i t i e s of e m p l o y i n g a n u m b e r of these, a n d believe the f o l l o w i n g notes will be of service in g u i d i n g m e d i c a l p r a c t i t i o n e r s in the selections of t r u s t w o r t h y b r a n d s . Messrs. Allen a n d H a n b u r y have issued a useful b o o k l e t 2 giving a w e l l - a r r a n g e d s u m m a r y of ~he c h a r a c t e r i s t i c s a n d m e t h o d s of e m p l o y m e n t of the various tuberculins, a n d p r o v i d i n g a s e r v i c e a b l e table of g r a d u a t e d doses for the g u i d a n c e of p r a c t i t i o n e r s using tuberculinj in t h e i r practice. T h i s firm s u p p l i e s t u b e r c u l i n in v a r i o u s doses, put u p
A S E P T I C A L L - G L A S S S Y R I N G E FOR T U B E R C U L I N
INJECTIONS.
in s e a l e d Jena-glass sterile capsules, w h i c h t h e y t e r m " A z o u l e s , " so. p r o v i d i n g a n easily e m p l o y e d m e a n s for a d m i n i s t e r i n g t u b e r c u l i n to a n y case w i t h the m i n i m u m of trouble. T h e a s e p t i c all-glass h y p o d e r m i c syringe s u p p l i e d b y M e s s r s . Allen arid H a n b u r y , a n d h e r e illustrated, 8 is a d m i r a b l y a d a p t e d for t h e a d m i n i s t r a t i o n of t u b e r c u l i n . 1 ,, The Extra Pharmacopceia of Martindale and Westcott." Revised by -~. Harrison Martindale, Ph.D., F.C.S., and W. Wynn Westcott, M.B., D.P.B. Fourteenth edition. London : H. K. Lewis. z9Io. Price ~2s. net. 2 ,, The Tubercnlins and their Uses as Diagnostic and Curative Agents." London : Alien and Hanbury, Ltd., 7, Vere Street, W. z9io. Supplied to medica~ practitioners on application. [Telephone : 628 Paddington. ] [~_~-I ;~ The Aseptic All-Glass Hypodermic Syringe is supplied by Messrs. Allen and Hanbury, Ltd., 7, Vere_Street, W., at from 6s. to ~s. each, complete in metal case.
PREPARATIONS
AND APPLIANCES
28i
"We have used it with the greatest satisfaction. T h e barrel and piston a r e made entirely of glass, the piston being ground to fit the barrel without the intervention of any washer. T h e parts are readily .detached, and can be easily" sterilized. It is worth noting that the :syringe is of such a length that the working piston is not exposed to contamination b y touch when filling the syringe. Messrs. Allen and Hanbury have also favoured Us with their tuberculin for the conduct -of Von Pirquet's Cutaneous Diagnostic Reaction. T h e tuberculin, human or bovine, is supplied in tubes, with ejector ready for use. In employing this diagnostic means, the specially designed "vaccinating p e r f o r a t o r " should always be employed. T h e perforating raspatory of Von Pirquet has a metal handle and a platinum-iridium blade, with an obtuse-angled end, can be readily sterilized, and its employment causes no pain, and greatly facilitates the carrying out of the test. 1 Messrs. Burroughs, Wellcome and Co. also provide a thoroughly reliable and standardized series of tuberculins. These are prepared at the Wellcome Physiological Research Laboratories, Brockwell Hall, Herne Hill, London. ~ The tuberculin is supplied in d o s e d phials, each containing sufficient to enable the practitioner to draw up into his hypodermic syringe!the dose required. Tuberculins are also provided both for diagnostic and therapeutic purposes, as well as for ~aboratory tests. T h e phials for use in employing the Von Pirquet reaction are excellent. Recently this enterprising firm has arranged for the supply of tuberculin in a convenient " t a b l o i d " form, consisting of dried bacillary substance. This can be administered hypodermically, or, if thought fit, may be given by the mouth. Messrs. Duncan, Flockhart and Co. have issued a booklet which will be helpful to practitioners. 3 It gives directions regarding the technique of inoculation, and particulars regarding the employment of tuberculin. T h e preparations supplied by this firm we have found to be most satisfactory. T h e y include a sterilized dilution of glycerineh'ee old tuberculin in glass capsules for Calmette's test, and a speciat sterile dilution of Koch's original tuberculin for the Von Pirquet cuti-reaction. For Moro's test, or the so-called percutaneous reaction, a sterilized ointment containing 50 per cent. of Koch's old tnberculin is sent out in a flexible gelatine capsule, with ejector nozzle and glass spatula for spreading the ointment. \V. Martindale also makes a feature of tuberculin preparations. 4 This firm provides tuberculin in most convenient "Sterules," freshly p r e p a r e d and ready for use. Tuberculins for diagnostic purposes are also available in suitable form to meet the convenience of practitioners requiring reliable and easily applied preparations. i The Vaccinating Perforator for Von Pirquet's surface vaccination is supplied loy Messrs. Allen and Hanbury at 7 s. 6d. each. The tuberculin (human or bovine) is supplied ready for use at IS. per tube. 2 Full particulars regarding the "Wencome" Brand Tuberculins may be obtained on application to Messrs. Burroughs, Wellcome and Co., Snow Hill Buildings, London, E.C. [Telephone : 133oo CentraL] ~ " Notes on Vaccine Therapy and Tuberculin Treatment and Diagnosis." This will be supplied to medical practitioners on application to Messrs. Duncan, Flockhart and Co., lO4-1o8, South Canongate, Edinburgh. 4 Particulars may be obtained on application to W. Martindale, io, New Cavendish Street, London, W. [Telephone: 4688 Gerrard.] Reference should also be made to "The Extra Pharmacopoeia of Martindale and Westcott."
THE
BRITISH
JOURNAL
OF
TUBERCULOSIS,
PREPARATIONS A N D APPLIANCES. TUBERCULINS. TUBERCULIN is i n c r e a s i n g in favour b o t h as a d i a g n o s t i c a n d t h e r a p e u t i c agent. K n o w l e d g e r e g a r d i n g t h e n a t u r e a n d influence of t u b e r c u l i n has a d v a n c e d . M e t h o d s of p r e c i s i o n are nov,- e m p l o y e d in t h e p r e p a r a t i o n of t h e various tuberculins, a n d t u b e r c u l i n s are a v a i l a b l e in c o n v e n i e n t f o r m s for clinical use. T h e excessive doses of f o r m e r days a r e b e i n g r e p l a c e d b y a carefully g r a d u a t e d system. U n d e r t h e n e w r e g i m e n t h e usefulness of t u b e r c u l i n is b e i n g widely e x t e n d e d . Busy p r a c t i t i o n e r s desirous of o b t a i n i n g a concise s u m m a r y of our p r e s e n t k n o w l e d g e should consult the u p - t o - d a t e article in the n e w edition of " T h e E x t r a P h a r m a c o p c e i a . ''1 M u c h of t h e g r o w i n g p o p u l a r i t y of t u b e r c u l i n is d u e to the e n t e r p r i s e of l e a d i n g firms in p r o v i d i n g r e l i a b l e p r e p a r a t i o n s in c o n v e n i e n t a n d r e a d i l y a v a i l a b l e forms. W e have r e c e n t l y h a d o p p o r t u n i t i e s of e m p l o y i n g a n u m b e r of these, a n d believe the f o l l o w i n g notes will be of service in g u i d i n g m e d i c a l p r a c t i t i o n e r s in the selections of t r u s t w o r t h y b r a n d s . Messrs. Allen a n d H a n b u r y have issued a useful b o o k l e t 2 giving a w e l l - a r r a n g e d s u m m a r y of ~he c h a r a c t e r i s t i c s a n d m e t h o d s of e m p l o y m e n t of the various tuberculins, a n d p r o v i d i n g a s e r v i c e a b l e table of g r a d u a t e d doses for the g u i d a n c e of p r a c t i t i o n e r s using tuberculinj in t h e i r practice. T h i s firm s u p p l i e s t u b e r c u l i n in v a r i o u s doses, put u p
A S E P T I C A L L - G L A S S S Y R I N G E FOR T U B E R C U L I N
INJECTIONS.
in s e a l e d Jena-glass sterile capsules, w h i c h t h e y t e r m " A z o u l e s , " so. p r o v i d i n g a n easily e m p l o y e d m e a n s for a d m i n i s t e r i n g t u b e r c u l i n to a n y case w i t h the m i n i m u m of trouble. T h e a s e p t i c all-glass h y p o d e r m i c syringe s u p p l i e d b y M e s s r s . Allen arid H a n b u r y , a n d h e r e illustrated, 8 is a d m i r a b l y a d a p t e d for t h e a d m i n i s t r a t i o n of t u b e r c u l i n . 1 ,, The Extra Pharmacopceia of Martindale and Westcott." Revised by -~. Harrison Martindale, Ph.D., F.C.S., and W. Wynn Westcott, M.B., D.P.B. Fourteenth edition. London : H. K. Lewis. z9Io. Price ~2s. net. 2 ,, The Tubercnlins and their Uses as Diagnostic and Curative Agents." London : Alien and Hanbury, Ltd., 7, Vere Street, W. z9io. Supplied to medica~ practitioners on application. [Telephone : 628 Paddington. ] [~_~-I ;~ The Aseptic All-Glass Hypodermic Syringe is supplied by Messrs. Allen and Hanbury, Ltd., 7, Vere_Street, W., at from 6s. to ~s. each, complete in metal case.
PREPARATIONS
AND APPLIANCES
28i
"We have used it with the greatest satisfaction. T h e barrel and piston a r e made entirely of glass, the piston being ground to fit the barrel without the intervention of any washer. T h e parts are readily .detached, and can be easily" sterilized. It is worth noting that the :syringe is of such a length that the working piston is not exposed to contamination b y touch when filling the syringe. Messrs. Allen and Hanbury have also favoured Us with their tuberculin for the conduct -of Von Pirquet's Cutaneous Diagnostic Reaction. T h e tuberculin, human or bovine, is supplied in tubes, with ejector ready for use. In employing this diagnostic means, the specially designed "vaccinating p e r f o r a t o r " should always be employed. T h e perforating raspatory of Von Pirquet has a metal handle and a platinum-iridium blade, with an obtuse-angled end, can be readily sterilized, and its employment causes no pain, and greatly facilitates the carrying out of the test. 1 Messrs. Burroughs, Wellcome and Co. also provide a thoroughly reliable and standardized series of tuberculins. These are prepared at the Wellcome Physiological Research Laboratories, Brockwell Hall, Herne Hill, London. ~ The tuberculin is supplied in d o s e d phials, each containing sufficient to enable the practitioner to draw up into his hypodermic syringe!the dose required. Tuberculins are also provided both for diagnostic and therapeutic purposes, as well as for ~aboratory tests. T h e phials for use in employing the Von Pirquet reaction are excellent. Recently this enterprising firm has arranged for the supply of tuberculin in a convenient " t a b l o i d " form, consisting of dried bacillary substance. This can be administered hypodermically, or, if thought fit, may be given by the mouth. Messrs. Duncan, Flockhart and Co. have issued a booklet which will be helpful to practitioners. 3 It gives directions regarding the technique of inoculation, and particulars regarding the employment of tuberculin. T h e preparations supplied by this firm we have found to be most satisfactory. T h e y include a sterilized dilution of glycerineh'ee old tuberculin in glass capsules for Calmette's test, and a speciat sterile dilution of Koch's original tuberculin for the Von Pirquet cuti-reaction. For Moro's test, or the so-called percutaneous reaction, a sterilized ointment containing 50 per cent. of Koch's old tnberculin is sent out in a flexible gelatine capsule, with ejector nozzle and glass spatula for spreading the ointment. \V. Martindale also makes a feature of tuberculin preparations. 4 This firm provides tuberculin in most convenient "Sterules," freshly p r e p a r e d and ready for use. Tuberculins for diagnostic purposes are also available in suitable form to meet the convenience of practitioners requiring reliable and easily applied preparations. i The Vaccinating Perforator for Von Pirquet's surface vaccination is supplied loy Messrs. Allen and Hanbury at 7 s. 6d. each. The tuberculin (human or bovine) is supplied ready for use at IS. per tube. 2 Full particulars regarding the "Wencome" Brand Tuberculins may be obtained on application to Messrs. Burroughs, Wellcome and Co., Snow Hill Buildings, London, E.C. [Telephone : 133oo CentraL] ~ " Notes on Vaccine Therapy and Tuberculin Treatment and Diagnosis." This will be supplied to medical practitioners on application to Messrs. Duncan, Flockhart and Co., lO4-1o8, South Canongate, Edinburgh. 4 Particulars may be obtained on application to W. Martindale, io, New Cavendish Street, London, W. [Telephone: 4688 Gerrard.] Reference should also be made to "The Extra Pharmacopoeia of Martindale and Westcott."