Abstract
Hemolytic and non-hemolytic streptococci obtained from the interior of tonsils immediately after tonsillectomy have been used for the preparation of filtrates and extracts of intact organisms. A large number of patients with a variety of conditions has been tested by the intracutaneous method with these preparations.
The present report deals chiefly with certain reactions obtained with filtrates of young broth cultures. The intracutaneous injection of 0.01-0.04 cc. has produced in nearly all adults positive reactions which develop after a latent period of 8 to 12 hours. The intensity of the reaction has shown wide variation. The weaker reactions consist of a central, red, slightly tender elevation surrounded by slight swelling and erythema 1.5 to 2.5 cm. in diameter. Stronger reactions consist of a central pustule which upon culture has without exception proved to be sterile. Surrounding the pustule there is a red, hot, indurated zone, and outside of this a halo of erythema. The most intense reactions have measured 10 or 12 cm. in diameter and have been extremely tender. The full intensity of the reaction is attained after 24 to 48 hours. The reaction fades out in the course of two to ten days showing in the later stages a pigmented spot upon which, in some cases, a fine desquamation occurs. In a few instances there has been conspicuous lymphangitis extending up the arm from the site of the reaction with tender epitrochlear and axillary lymph nodes. The phenomena of a local infection with cellulitis, lymphangitis, lymphadenitis, have in the most intense reactions, been reproduced in a striking way. That these reactions are due to an acquired hypersensitiveness is shown by the fact that of 12 children under six months of age none has shown even a weakly positive reaction.
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