Many cases present themselves at hospital
showing signs of early pulmonary tuberculosis,
which upon investigation appear to be the result of
pressure on the lungs by enlarged bronchial glands.
Some years ago, Percy Kidd drew attention to
this occurrence but did not suggest any specific
treatment.
In view of the fact that hospitals for tuberculosis
refuse so far as possible - all cases so
far advanced that there is little hope of permanent
arrest, it is most important to discriminate between
early and advanced stages of the disease.
It is the object of this thesis to discuss
certain cases which at first sight appear far more
advanced than is really the case, but in which the
symptoms are misleading and apparently inconsistent,
and to submit the theory that certain patients who
appear to show signs of established pulmonary tuberculosis
and who would be classed as fairly advanced
cases, may in reality be suffering from enlarged
bronchial glands, yielding very satisfactorily to
treatment.
This is based on a number of cases in the
Brompton Hospital for Consumption and Diseases of
the Chest and at a Tuberculosis Dispensary, of which
six hospital cases have been appended in illustration.
It will be noted that the patients are all
children or young persons and this point is
important -
(1) because tuberculosis in children has a much
greater tendency to become widespread than in
adults;
(2) because there is far greater hope of complete
arrest while the trouble is still confined to
the lymphatic system;
(3) because if there be any truth in Dr. Batty Shawls
contention that development of tuberculosis in
later life is more often due to auto-infection
than to re-infection from outside sources, it is
the more important to arrest the disease in its
earliest manifestations
