British medical journal . hological observation, as the earliest sites of origin ofpulmonary tuberculosis. This distribution of dull areas is quite different fromthe irregttlarly distributed of pulmonary collapse oratelectasis, and also from the usual localization of apneumococcal or influenzal bronchopneumonia, and alsofrom the usual position of pulraonarj- infarcts. It hasbeen present in every case of early pulmonary tuberculosiswhich I have examined during the last few jears. Almostinvariably the whole series of tyiiical spots can bs detectedin both lungs, though they are usually lar
British medical journal . hological observation, as the earliest sites of origin ofpulmonary tuberculosis. This distribution of dull areas is quite different fromthe irregttlarly distributed of pulmonary collapse oratelectasis, and also from the usual localization of apneumococcal or influenzal bronchopneumonia, and alsofrom the usual position of pulraonarj- infarcts. It hasbeen present in every case of early pulmonary tuberculosiswhich I have examined during the last few jears. Almostinvariably the whole series of tyiiical spots can bs detectedin both lungs, though they are usually larger on one sidethan on the other. Only ver5 Iarely, and in the veryearliest stage of an infection, they may be present in theapex or apices of one lung only. All the dull areas shown in this diagram are pulmonaryareas. Occasionally, even in adults, and especially inthose who have suffered from spasmodic dyspnoeadescribed as asthma, it is possible to detect on theposterior aspect of the chest an area of ditllness, which is. caused by enlargement of the bronchial glands, especiallyof those situated at the root of the right lung. This areais found close to the spine at the third dorsal level—aposition which is definitely below the dull areas- of theupper apices and internal to the dull areas of thelower apices. If this glandular area is small it may existon the right side only; if larger, it may usually be detected(Ijut much smaller) on the lei;t side also. The real existence of these dull pulmonary and glandularareas is readily confirmed b} an .r-ray examination. Inevery one of six cases of incipient intlmonary tuberculosisin which I had detected their presence, my colleague. Orton, without knowing my results beforehand,confirmed them by examination by screen and last of the six was speciallj interesting, because verdict, based on the screen examination, appearedto contradict my previous result by percussion, but when hetook the photograph h
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Keywords: ., bookcentury1800, bookdecade1850, booksubjectmedicine, bookyear185
