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Further Comments on Insect Sting Allergy

Ralph Bookman, MD
Arch Intern Med. 1985;145(2):368. doi:10.1001/archinte.1985.00360020212043.
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To the Editor.  —Clinical allergy's most distressing problem is its inability to validate solid clinical observations with any degree of scientific validity. This relates to the editorial by Schwartz1 in the August Archives.Dr Schwartz refers to skin tests as "validating" clinical observations. Skin tests are never quantitative and experience indicates that they are only corroborative. When the skin test result disagrees with clinical facts it should be disregarded. A patient who is clearly clinically sensitive whether to hymenoptera, to an animal pet, to pollen, or any other allergens may have a negative skin test just as a positive skin test may be seen in the absence of clinical evidence. It would be impossible to practice effectively without accepting such a dictum. Believe the patient, not the skin test, should be axiomatic unless the test is corroborative.I would not question the effectiveness of venom in testing and


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