. Radiography and radio-therapeutics . , and states thatnearly all the cases he examined showed a condition of this kind. Whenthese bronchial shadows are accompanied by mottling the condition issaid to be active. He also contends that in the majority of cases thedisease started at the hilus by an infection of the bronchial glands, andan extension from these glands takes place towards and involving theapex. Bythell records the results of an examination of several hundreds ofchildren. He found in a large percentage of these cases signs of tubercu-lous infection in the glands at the roots of the
. Radiography and radio-therapeutics . , and states thatnearly all the cases he examined showed a condition of this kind. Whenthese bronchial shadows are accompanied by mottling the condition issaid to be active. He also contends that in the majority of cases thedisease started at the hilus by an infection of the bronchial glands, andan extension from these glands takes place towards and involving theapex. Bythell records the results of an examination of several hundreds ofchildren. He found in a large percentage of these cases signs of tubercu-lous infection in the glands at the roots of the lungs. While admitting that in the examination of a large number of cheststhese shadows are to be seen, the writer cannot agree that a diagnosis oftuberculosis can be made in every case. It is quite probable that otherconditions than tuberculosis will give rise to peribronchial chronic bronchitis, asthma, and any disease which leads to chronicirritation of these parts, may cause an increased formation of fibrous tissue. Fig. 251.—A case of long-standing lung patient was about 50 years of age, with a history of a severepulmonary attack 30 years before. TUBERCULOSIS OF THE LUNGS 295 around the bronchi; the repeated inhalation of dust and smoke, which is aconcomitant of dwelling in towns, might quite easily cause a peribronchialthickening. These peribronchial shadows are frequently present in thechests of patients who are suffering from cancer, but it would be absurd toargue that in every case these increased shadows indicated the presence ofa peribronchial invasion by cancer cells. Nor would it be reasonable toassume that the victims of cancer were also afflicted with tuberculosis. The appearance of the chest shadows in many patients known to havecancer is strongly suggestive of peribronchial phthisis. It must be borne inmind that both diseases may be present in the same patient. It is quitepossible that some ofthe patients may havehad phthisis in ea
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