Clinical tuberculosis . ration at hilus of upper lobe. Case 2851. Female, age 26 years, occupation—ofSee work. Clinical History.—One brother ill of tuberculosis at the present was delicate until fifteen years of age, since which time she hasbeen in fair health, but has had an unusual number of colds from whichshe always recovered slowly. She has had the ordinary diseases of child-hood and several attacks of supposed malaria. For the past two or threeyears in the fall she has found it necessary to take a vacation in orderto be able to continue her work. During the past year she has
Clinical tuberculosis . ration at hilus of upper lobe. Case 2851. Female, age 26 years, occupation—ofSee work. Clinical History.—One brother ill of tuberculosis at the present was delicate until fifteen years of age, since which time she hasbeen in fair health, but has had an unusual number of colds from whichshe always recovered slowly. She has had the ordinary diseases of child-hood and several attacks of supposed malaria. For the past two or threeyears in the fall she has found it necessary to take a vacation in orderto be able to continue her work. During the past year she has not feltas well as usual. She has now, or has recently shown, the following symptoms: I. Toxic Group. II. Reflex Group. III. Tuberculous Processper se. Malaise Lack of enduranceLoss of strengthNervous instabilitySlight digestive disturb- Slight hoarsenessTickling in larynxDry hacking cough Protracted colds ance Loss of a few pounds inweight Feeling o f increasedwarmth, although tem-perature not increased,when taken. Fig. 99.—Peribronchial thickening in a child six and a half years of age. COMPARATIVE PHYSICAL AND X-RAY EX.\MINATIONS 529 Physical Examination.—Inspection and palpation reveal the following:Chest considerably flattened over the apices. The soft tissues show amoderate degree of degeneration over both apices, most markedly on theright. This degeneration includes the skin, .subcutaneous tissue, sterno-cleidomastoidci, sealeni and pectorales anteriorly and the trapezii andlevator anguli scapula) posteriorly. Aside from the degeneration which is noted, the pectoralis, trapezius,and levator anguli scapulse on the right show slightly increased tone (spasm).The sternocleidomastoideus, sealeni, pectoralis and trapezius on the leftalso show slight increased tone (spasm). The right side of the chest seems to lag a little more than the left. This degeneration of the muscles and subcutaneous tissue indicates aulironie inflammation, affecting both lungs, which is more m
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