A treatise on the diseases of infancy and childhood . ds are still small,is necessarily uncertain, on account of the absence of symptoms. Whenthey have increased in size and are so located as to press on the pneu-mogastric or recurrent laryngeal nerve, producing the spasmodic coughalready described, the differential diagnosis between that disease andpertussis may be made by attention to the following facts : Bronchialphthisis occurs singly, and is non-contagious, while pertussis occurs asan epidemic, and with evidences of contagion. There are no successivestages, to wit, those of catarrh, paro
A treatise on the diseases of infancy and childhood . ds are still small,is necessarily uncertain, on account of the absence of symptoms. Whenthey have increased in size and are so located as to press on the pneu-mogastric or recurrent laryngeal nerve, producing the spasmodic coughalready described, the differential diagnosis between that disease andpertussis may be made by attention to the following facts : Bronchialphthisis occurs singly, and is non-contagious, while pertussis occurs asan epidemic, and with evidences of contagion. There are no successivestages, to wit, those of catarrh, paroxysmal cough, and decline, as inthat disease, and the cough, though paroxysmal, is short, and withoutwhoop or vomiting. In feeble children, with inherited tubercular diathesis, emaciation,sweats, and a chronic cough, with the absence of pulmonary symptoms,should excite suspicions that the bronchial glands are involved. Theevidence is almost conclusive if the cough become paroxysmal, andthere be a loud, persistent tracheal or bronchial rale. Fig. Bacillus tuberculosis. (Sternberg ) In certain patients affected with this form of tuberculosis, we haveseen that the prominent symptoms are due to compression of one ormore of the large vessels in the chest. Compression of these vessels,and consequent retarded circulation, may be confidently referred to en-larged bronchial glands, since aneurism, carcinomatous or other tumors,which would produce a similar result, are very rare before the diagnosis is rendered certain by the physical signsobserved by auscultation, and percussion over the sternum and theinterscapular space. The condition of the external glands should alsobe observed, as those of the axilla, neck, and groin. 174 TUBERCULOSIS. The diagnosis of pulmonary, though more readily made than that ofintracranial and bronchial tuberculosis, is often difficult and is, in part, explained by the fact that the tubercles are so fre-quently disseminat
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