THE VALUE OF THE EXAMINATION OF GASTRIC CONTENTS FOR TUBERCLE BACILLI

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Abstract
The finding of tubercle bacilli in the sputum definitely establishes the diagnosis of pulmonary tuberculosis. The authors are convinced of the importance of gastric lavage for the detection of tubercle bacilli in patients who are unable to raise any sputum and in those cases in which a positive sputum cannot be obtained by the ordinary method. In a series of 639 cases in whom tubercle bacilli could not be obtained either in prepns. stained directly or by concentration methods, 187 patients, or 29.2%, were found to have a positive sputum by means of gastric lavage. The authors agree with other workers on this subject that guinea-pig inoculation of the gastric contents is a much more delicate test and yields a larger % of positive results than does direct microscopy. 32 non-tuberculous cases sent mistakenly to the sanatorium were used as controls; none of these cases yielded a positive result. Gastric lavage, apart from its diagnostic value, is of therapeutic importance when it must be decided to institute collapse therapy. This test is also helpful as a prognostic sign to evaluate the effect of collapse therapy especially pneumothorax. Gastric lavage should be done before any case of pneumothorax is discontinued. The test is of value in deciding upon other forms of collapse therapy. It helps to expose simulators, either those who deliberately deny that they have sputum, or those who hand in false sputa for examination. Tuberculous lesions of the lung should not be considered healed until tubercle bacilli are repeatedly absent on gastric lavage. This would certainly result in fewer breakdowns and re-admissions to sanatoria.
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