J.Jpn. Surg. Soc.. 54(9): 763-771, 1953

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Original article

EXPERIMENTAL STUDIES ON THE HEMORRHAGIC PHENOMENON OF MANTOUX REACTION

In the light of the previously described clinical fact that some Mantoux reactions performed prior to surgery become hemorrhagic following opertation, an experiment was attempted. Because muscle tissue is always crushed in operation, influence of crushing of muscle was studied, as one of various factors in operative stress, and directly in the place of the former, muscle extract was also used.
1) When muscle of the femur was crushed or muscle extract was injected intravenously, tuberculin reaction of tuberculous guinea pigs became hemorrhagic.
2) An amount of muscle extract, with which by the intravenous route tuberculin reaction of guinea pigs became hemorrhagic was only 1 : 2 or 1 : 4 diluted 1.0 cc., so it is almost equivalent, as compared with human body weight, to an amount of the muscle expected to be crushed in operation.
3) In the observation of muscle extract directly upon tuberculin reaction locally or by route of vessels, no hemorrhage occurred.
4) Neverthless, the result was also obtained that muscle extract in itself had a certain direct injurying effect on the capillary wall by intravenous injection.
5) By crushing of muscle of the femur and intravenous injection of muscle extract, hemorrhage was present in the lungs of tuberculous guinea pigs.
6) From the results of these experiments, crushing and absorption of muscle in operation may relate, in some degree, to the postoperative hemorrhage of Mantoux reaction in clinical cases. The author has some hesitates in saying that the latter relates to the intrapulmonary tuberculous change or to postoperative phlegmasia with blood.
7) Some of these experiments are connected with Shwartzman phenomenon.
8) Influence of crushing of muscle in operation was also discussed, concerning this study. (author's abstract)

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