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A Study of the Precipitin and Complement Fixation Reactions with Tuberculous Exudates with Special Reference to Tuberculous Pleuritis

From the Dermatological Research Institute of Philadelphia and the Pathological Laboratories of the Graduate School of Medicine of the University of Pennsylvania

Abstract

This investigation was undertaken for the purpose of determining whether the immunological reactions of precipitation and complement fixation occur with pleural exudates of tuberculous origin, as additional means and aids for the differential diagnosis of pleural effusions. The necessity for diagnostic aids of this character has been impressed upon the writer since 1913, when he found large numbers of Japanese soldiers and many civilians in Mukden, South Manchuria, with mild pleuritis and exudates of unknown origin. At least 52 per cent of a group of forty-two of these individuals yielded negative v. Pirquet tubeculin skin reactions; cultures of the fluids from twenty-one were negative and tubercle bacilli were not found by smear methods. It is commonly believed that these "light pleurisies" (1) are of tuberculous origin but this has not been proven and the exact etiology is unknown.