Early Tuberculosis

¹ McConnelsville, Ohio

1. By carefully taking the clinical history and classifying the symptoms according to their etiology, and assigning to those present their combined value, one can make a probable diagnosis in nearly all frank cases of early clinical tuberculosis.

2. The sputum should always be examined, no matter where the patient thinks it comes from. A twenty-four or forty-eight hour specimen should be examined in all cases where the amount raised in small. Examining by one of the methods which concentrate the bacilli will show their presence in many instances where they are not found by the smear method.

3. Areas of atrophy of the soft tissues over the thorax should be looked for because they tell of previous inflammation in the underlying lung and pleura.

4. Diminished motion of the chest wall on one side is present in all cases of unilateral active clinical tuberculosis.

5. The x-ray is a great aid to diagnosis. Many plates on which an opinion is given are so poor that they are not only value less but harmful. A moderately soft plate, carefully developed, is most dependable. A negative film does not imply the absence of disease.

6. Rales may indicate the presence of active disease in the underlying lung or pleura, or of a chronic or obsolete process. They must be interpreted in conjunction with other symptoms. Those who examine chests for early tuberculosis in frequently should disregard all rales except those which are of a definitely moist nature.

7. All cases in which there is a suspicion of tuberculosis which cannot be proved otherwise should have a tuberculin test made.