US 2304817 A
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Description (OCR text may contain errors)
Dec. 15, 1942. M. 5mm4 2,304,817
i PATCH TEST f Filed July 19, '1941 F/a. i
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MA URlcE GRoZ/H BY WWA@ l Patented Dec. .15, 1942 UNITED STATE s PATENT ori-lee PATCH 'rlllsr Maurice Grozln, New York, N. Y.
Application July 19,
- This invention relates to patch tests.
The patch test to be discussed herein will be considered in particular relation to its use in determining infection oi a suspect with tuberculosis.' However, the application of the test for other purposes-will, from the description of structures and method oi use, become obvious.
Such patch test has been found to have specic adaptability for carrying on testing in which tuberculin, or a similar medium, in varying concentrations, is brought into contact with the skin of a suspect. The patch test of this invention provides, among other things, for facility in the observation of the reaction which then takes place, both during the time the reactionis going forward, and after the reaction has been completed.
Many different methods of testing have been Y followed ln, the past, including a technique in -which not only was the skin of the'suspect penetrated by an instrument such as a hypoderznic needle, but, in fact, the techniquerequired that a substantial breach should be made in the skin of the suspect so that thev test ingredient might properly react. Such technique, of course, gave great pain to the suspect; if the suspect .were
` a child,these tests have appreciable value ln mass testing in schools and in similar relations where large numbers of children assemble,-the
antagonismof the child became an important obstacle to be overcome. 'I'he fear of the child, in many cases, has been a problem of major' A proportions in connection with these tests.
Tests, wherein an ingredient has been applied to the skin, have been used. However, the technique in such cases, and the apparatus availed 941, serial No. 403,092 -2 claims; (el. 12s-'ci ,either in substance or in quantity, has been indicated as desirable or required. In such cases, the entire test procedure has been required to be commenced anew from the very beginning.
It is an object of the invention to provide a patch test wherein the progress of the reaction may be observed at any time that the patch test is in position upon the skin of the suspect, Y
and such observation may be effected without dislocation of the locale 'of the reaction, and without in any way reducing the eectivenessV of the test reaction.
It is an object of the invention to provide a' patch test, wherein, during the progress of the reaction, the reaction state may be observed, and the conditions of the reactions may, at the time of such observation, be revised under the control of the techinician and in accordance with the indications derived from such observations.
Such change may, for instance, be eiected by a change of ingredient or its concentration.
It is an object of the invention to provide a patch test wherein, throughout the test, the locale of the reaction remains xed, but the reaction conditions may be varied at the option of the technician, so that a number of reactions under different conditions may be observed in come apparent, s o that the use of such a test of, have resulted incomplete concealment of the reaction area at al1 times throughout the entire period of reaction. To observe the reaction, the technician was required roughly to estimate the time necessary for the reactionto go to comconnection with a single xed reaction area.
It is an object of the invention to provide a patch test by the use of which the technician is enabled to make his diagnosis of a condition for which the test is being carried on earlierv with relation to the time when the 'indications bemakes it possible to avoid danger of unnecessary inalnmation which arises `in some cases from contact of the skin of the suspect with the' test medium over too long a period.
pletion, and then allow himself a margin of error. He did not remove the reaction-concealing means until well beyond the time the re'action should have been completed. Then, andthen only, was he able to determine the stage, if any, to which the reaction nrlight have progressed.
In some cases, the reaction time thus allowed by the technician might have been insuiilcient.
This required renewal of the test procedurai In other cases, the reaction might have gone for too long a. time. In such oase, deleterious effects might have: been produced, and the' technician would have been none the wiser until he had' completely destroyedthe test means 'as located upon the skin of the suspect. It has not been found; feasible, in the past, to replace the test means properly in association with the test area,
especially where a change of the ingredient,
It object of the invention to prcvide'a.l patch test wherein, because oi limitation of the area -of reaction exposed to view, by definition of the space within `which the reaction takes place, determination of the state of the reaction,
at any of its stages, is made simpler. .l
Other objects of this invention will" be set forth hereinafter. .0r will be apparent from the description and the drawing; in which aref illustrated embodiments exemplifying the invention. The invention, however, is not intended to be restricted to any particular construction, or any particular arrangement of parts, or any particular application oi' any such construction or arrangement of parts, or any speciiic method of operation, or any of various details thereof, herein shown and described, as the same may be l modified in various particulars, or be applied in many varied relations,- Without departing from appear:
Fig. 1 is an elevational View of an arm having a patch test applied thereon;
Fig. 2 is a plan view,"to enlarged scale, of the patch test shown in Fig. 1;
Fig. 3 is a longitudinal cross-sectional viewA showing the manner in which the patch test is applied to the'arm of Fig. 1, and illustrating the method of manipulation thereof to ascertain the intermediate states of reaction;
Fig.'4 is a plan view of a patch test of modi# fied construction; and
Fig. 5 is a transverse cross-sectional view substantially on the'llne 5--5 of Fig. 4.
.0n the drawing, a patch test P is `shown as it would'appear, applied to the skin of the arm I0 of Aa suspect. Patch test P may be applied by means such as a strip I2; strip I2 may be a piece oi' material cut or formed as shown in the shape of an oblong, although such shape, or theA specithe naps are seated within their respective openings, are in contact with the skin of the suspe, may have means appliedthereto to iix the relationship ofthe fi'aps with relationship to the skin,A and, therefore, with relation to the walls of the openings, or to assist in so locating the ap. Such means, in o ne instance, may take the form of an adhesive coatingon each of faces 34. 'I'he coating may, if desired, be the same type of adhesive coating generally used for adhesive tapes used in medical dressings.
'I'he test medium or media, as, for instance, tuberculin or similar substance, which is to be brought into juxtaposition to the skin of the arm I0 so as to, study its reaction therewith, may be -made an integeral part of the patch test so that a particular patch test with a particularftest medium, or with different test media. oi' various compositions or concentrations, may be capable iied typeof material used for strip l2, may not 1 be of specific importance.. In one case, strip I2 has been made from material such as used in the manufacture of the well-known adhesive tapes used in connection. with medical` dressings, that is, a closely woven strip capable of having an adhesive face formed on one side by the application of an adhesive coating.
In the case of strip I2, shown in Fig. 2, a num ber of openings I4, I6 and I8 have been formed `in .the strip. The number of openings may be determined'by the nature of the test or tests to be carried on, whether simultaneous tests with the same test medium are desired, or whether it is desired to carry on simultaneously a plurality of tests with'a plurality of test media.` Openings such as openings I4, I6 ,and I8 may be de ned in strip I2 by cutting or otherwise severing the material of strip I2. In the instance shown, the materialof strip I2 has been severed just sufiiciently so asto define flaps 20, 22 and 24.l Suflilcient of the material at` each flap is left un` severed so that, while the flaps 'are free to move out of openings I4, I6 and I8 to uncover the skin areas defined by the openings, and to be moved into and tofill the openings, still the iiaps remain secured to the main body 26 of the material of strip I2, merely hinging'upon the respective sections 28, 30 and 32, respectively; connectingtheiiapstomainbodyl.
The material from which strip I2 is formed is of sufiicient thickness to givebody to the flaps,
and also to assure that, when the ilaps are hinged to move into position'within openings I4, I6 and" Il, the aps will beretained securely in position by engagement of the edge walls of flaps] 2022 and 24 with the walls of openings I4, I6 and I8, respectively.
Faces 34 of flaps 20, 22 and 24 which, when "of the reaction.
of being supplied. In such case, the particular medium or media, in the properconcentration,
is applied in any desired manner' to face 34 of the respective flaps 20, 22 and 24. The method of, incorporation of the test medium with Aface dium, and then the impregnated material may' have been cut up into small sections. If face 34 of the flaps has had a coating of adhesive material applied thereto, one of these sections 36 may be adhered to face 34. In such case, section 36 desirably will be lessin extent than the eiective area of the flap to permit the flap to present to the skin of the suspect at least substantial perimetric portions of adhesive-coated`4 surface to engage the skin for holding the flap Also the test of a solution of the active ingredient, and have been dropped upon the coating of face 34, and
then permittedto dry into the coating.
After strip I2 has been located on thejskin ofthe suspect, the reaction may be observed at,
any time the technician desires merely by lifting the iiap out of its respective opening. The skin at such location is thus exposed and is capable of thoroughl inspection to determine the state After the `technician has completed his observation, he merely bendsand pushes the ilap back into po ition, sealing the opening, and bringing the a and the testcmedium again into contact with the skin so that the reaction may then continue.
In order to afford 'a control withl which the reactions at the diierent areas may be checked. the test medium may be omitted from onel of the skin areas covered by .Ja flap, or an ingredient which is wholly without reactive eiect upon the skinof a suspect may be applied to the ap or mayotherwise be brought into conjunction with `the skin of one area. Thus, by lifting the ilap atan area at which al positive .test medium, is present and the ap at an area where the neutral ingredient is effective, the true and relative condition of the reaction upon the skin of the test medium may be studiedldirectly.
In order to assure that strip I2 adhere to the "skin as a. whole, portions of the strip, at
face 38, which are not included' in a flap, may have a coating of an adhesive substance applied thereto. This adhesive substance may be the same as -or similar to the adhesive used upon face 34. y f
On Fig. 4, patchv test`40 of modified construction is shown. Patch test 40 may comprisev a strip 42 of material through which a plurality of openings 44, 46 and 48 extend. Strip 42 may be applied to and be retained in position upon the skin of the arm substantially in the same way as indicated for strip l2. No flaps are provided.
at openings 44, 46, and 48.
Patches 50, 52 and 54 are provided, and are ingredient which will be whollywithout effect upon the skin of a suspect, in the same manner as one of the flaps, say iiap 22, was so provided.
Patches 50, 52 and 54'may have an adhesive vcoating upon their faces 56 which are, at least in part and at openings 44, 46 and 48', brought into contact with the skin. This adhesive conl 1 tact serves, in addition to the adhesive action of strip 42 itself, to anchor strip 42 in-position, and thus fixedly to locate the reaction areas vdefined by openings 44, 46 and-48. 1
Patches su, s2 and 54 are shown 'as positioned' on strip 42 to extend transversely of vthe width of strip 42. Patches 50, 52 and 54 may be slightly longer than the width of strip 42'so that portions of these strips-will bend over the edges of strip 42, and adhesively attach themselves to the skin of the suspect. Simply byl lifting any one of patches 50, 52 and. 54 to disengage it from its engagement with the skin of the suspect, and then to free it from its covering relation over -the respective opening, is all thatis necessary to permit inspection of the reaction area at the selected opening. Strip 42' is in n`o way affected nor'is the reaction area in any way changed. After the inspection, the particular patch is pushed back into position, so that the reactionmay continue as before, without change or disturbance ,of the reaction area. v
Thus, in either of these cases, theprogress of the reaction may bev determined atany time. Immediately that such observation discloses the presence of. the condition for which the testis being made, the patch test may be removed from .the arm. If, however, no such positive reaction has appeared, the technician, if he so desires, may change the test medium at that particular reaction'area. For instance, in the case of test for tuberculin may be added to the reaction area through the opening, and then the 4opening -may be closed by means of a flap ora patch, according to which patch. test is used.' For instance', such 'change may be 'either a change of concentration, or a' change of ingredient. In either case, without changing `the location o f the patch test, the change can be effected .by depositing a drop of the test medium upon skin, flap or patch, and then returning flap or patch into its reaction position.
- similar test ingredient applied thereto, a iiap" progress of the reactionfis thus possible,`and the reaction may be terminated as soon as any positive indication appears.
Information regarding the particular ingredient upon a particular fiap or upon a particular test patch may be imprinted, in'theform of indicia 51, upon face 58 of the flap or upon face 60 of the patch. For instance, the lpatches may be supplied separately from strip 42, in which case such identification would be of material importance.
Many other changes could be effected in the particular apparatus designed, and in methods of operation and use set forth, and in specific details thereof, without substantially departing from the invention intended to be defined in the claims, the specific 'description being merely of exemplifying embodiments in accordance with the statutes.
What is claimed as new and useful is:
1. A patch test for use in determining the pathological reaction of a human body to tuberculin and similar substances, the test includingi a strip of substantially flexible material, the strip having means on one face for adhesively retaining the-strip in position upon and in a fixed relation to a portion of the skin of the body, the strip having a plurality of openings therethrough at spaced apart positions, sections of the strip being partially severed from the strip to define the openings and to form flap sections including the adhesive means, each `flap section being capable of movement relative to the strip into contact with the skin of the body to close its opening and to be retained in engagement with the skin at the opening or away from the skin of the body to permit inspection of the skin through its opening,
the flap sections remaining engaged with'the strip so as not to'become separated therefrom, one or more of' the nap sections having tuberculin or section having the ingredient applied thereto being movable relatively to the strip without disturbance of the relation of association of the strip to the respective openingpg. v g, e
2. A patch test '.fo use in determining the pathological reaction of a human body to tuberculin and similar substances, the test including a strip of substantially flexible. material, the strip having means on one face for adhesively retaining the strip in a fixed relation to a portion of the skin of .the..body, the strip having an opening tuberculosis, a drop or similar quantity of' therethrough, a section of thestrip being partially severed from the strip to dene the openingr and to form a fiapsection including the adhesive means, the flap section being' capable of movement relative to the strip into contact with ,the
Y skin of the body to `close the opening and to be It'should be understood that, under certain conl 'in plac' g the patch test in action at the very beginning'of such a reaction. Observation ofthe retained in engagement with ythe skin at the opening or away from the body to allow inspection' of the bodythrough the opening, the flap section remaining engaged with the material'of the'strip so as not to become separated therefrom, the flapl section having tuberculin' or similar test ingredient applied thereto, the flap4 section, when not moved away'from the strip, lbeing in position to hmaintain the ingredient in contact with the skin at the openingftheap -sectionbeing movable relatively to the strip to permit inspection oi' the' skin at the opening without disturbance of the lassociated relationship-'of the strip and the skin at the opening. l
' Y v MAURICE GROZIN.