. Medical diagnosis for the student and practitioner. subsides, be-comes chronic and may even become arrested. Early positive diagnosis is usually impossible. The Broncho-pneumonic Form.—The broncho-pneu-monic form is characterized pathologically by broncho-pneumonic tuberculous lesions and shows a tendency tofusion, caseation and cavity formation. It presents the symptoms of an acute broncho-pneumoniaof the common type followed by the signs of septic absorp-tion, pulmonary infiltration and cavity formation. Tubercle bacilli may be and usually are present early,but their appearance may be dela
. Medical diagnosis for the student and practitioner. subsides, be-comes chronic and may even become arrested. Early positive diagnosis is usually impossible. The Broncho-pneumonic Form.—The broncho-pneu-monic form is characterized pathologically by broncho-pneumonic tuberculous lesions and shows a tendency tofusion, caseation and cavity formation. It presents the symptoms of an acute broncho-pneumoniaof the common type followed by the signs of septic absorp-tion, pulmonary infiltration and cavity formation. Tubercle bacilli may be and usually are present early,but their appearance may be delayed. Hemoptysis may occur and is some-times the first event. Comment.—In both the lobar and broncho-pneumonic forms of acutetuberculosis a delayed diagnosis is almost always necessary. The most carefulquestioning as to previous health and family history may yield no informa-tion, and the appearance of tubercle bacilli and the signs of destructive in-filtration associated with hectic fever mav be the onlv means of diagnosis. Pseudo-crisisor Fig. -Tuber- cle bacilli. (Exag-gerated. See plateunder Sputum forbetter exposition.) Early diagnosisdifficult. Is evidentlater. Bacillioften present early. Previous healthimportant. CHRONIC ULCERATIVE TUBERCULOSIS Definition.—.4 tuberculous disease of the lung characterized by chronicity,variability in severity and frequent intermissions. Aside from individualresistance, its termination in recovery or death depends upon the promptnesswith which a diagnosis is made and rational measures instituted. Pathologic Anatomy.—The lesions are ordinarily those of a slowly pro-gressive chronic tuberculous broncho-pneumonia; the terminal bronchiolesand the alveoli being the seat of a sluggish inflammation forming areas ofperibronchial pneumonia which may advance rapidly, remain almost un-changed over long periods or undergo complete arrest. The tendency in badcases is toward fusion of areas, ulceration and cavity formation. Favorable cases
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
