The Tuberculin Test — a Tool in Case Finding

¹ Medical Director and Associate in Social Research, Wisconsin Anti-Tuberculosis Association.

1. It would appear that we cannot build a good case for school tuberculin testing programs on the basis alone of active clinical cases among the school populations studied. The "yield" is low compared with case-finding programs in certain other groups in the population—and appears to be declining rapidly.

2. Cases found through such studies, however, are early. They are also found more economically than through general x-raying of school populations.

3. Follow-up of family associates of child reactors, while an excellent idea in theory, is as yet spotty in practice.

4. Just as 25 years ago, we must "repeat and repeat and repeat" if tuberculin testing programs are to go forward in quantity and quality. Without such eternal emphasis and re-emphasis, they are likely to stagnate.

5. The educational impact of the tuberculin skin test, and of cases found through it, may in the end be the greatest value of the test. The skin test, like the chest x-ray film and other screening tests, must be valued by the part it plays in the total tuberculosis control program—not by the dollar sign. In the words of a famous victim of tuberculosis, Robert Louis Stevenson, writing in one of his delightful books of travel, "The most beautiful adventures are not always those we go to seek."