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A COMPARISON OF PHYSICAL SIGNS AND X-RAY PICTURES OF THE CHEST IN EARLY STAGES OF TUBERCULOSIS

HENRY SEWALL, M.D.; S. B. CHILDS, M.D.
Arch Intern Med (Chic). 1912;X(1):45-67. doi:10.1001/archinte.1912.00060190052006.
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GENERAL CONSIDERATION OF THORACIC ACOUSTICS  Within the past year it has occurred to one of us to become acutely impressed with the necessity of making an absolute diagnosis in a series of cases presenting rational evidences of pulmonary tuberculosis. Physical examination of these persons disclosed none of the signs usually depended on for the apprehension of incipient lung disease, but the clinical history of lessened energy, susceptibility to fatigue, digestive disturbance, ocasional afternoon temperatures and various other accompaniments of failing health plainly indicated a serious constitutional disturbance which, if tuberculous, implied an active undermining of powers which it was of vital importance to check at once. Fortunately, at this time there was under observation a patient whose chest was negative to even expert examination — pursued along catholic lines — although tubercle bacilli had for a while appeared in his sputum a few months previously and his clinical condition

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