I. There is a definite need for a reliable test
to guide the clinician in dealing with the
problem of pulmonary tuberculosis.
II. The sedimentation of the erythrocytes in blood
plasma is increased in conditions in which
there is an increase of the fibrinogen and
serum -globulin contents of the blood. This
occurs in diseases associated with toxaemia
and tissue destruction.
III. The sedimentation rate is an index of the
amount of toxaemia present, and this in pulmonary
tuberculosis infers the degree of
activity and powers of resistance.
IV. The "one hour" reading of the sedimentation
test in millimetres percent conveys most information
to the clinician and is compatible
with clinical experience.
V. The sedimentation test lacks specificity and
hence is of limited value in the diagnosis of
pulmonary tuberculosis; an abnormal rate does
however indicate that a lesion is active and
the extent.
VI. A series of tests, performed at intervals over
a period of several months, affords valuable
data upon which a prognosis may be based.
Further it gives information concerning the
powers of resistance present, and enables the
clinician to judge the amount and rate of
progress.
VII. The sedimentation test is not only more sensitive than clinical findings in indicating the
amount of toxaemia but also in prophesying ensuing
complications, save in haemoptysis due
to rupture of the Rasmussen type of aneurysm.
VIII. The test excels as a means of regulating routine
sanatorium treatment. It also evidences
the need of instituting additional forms of
treatment and depicts further progress.
IX. When a maintained normal sedimentation test,
in a patient that has been definitely active
at some time, conflicts with the continued
presence of tubercle bacilli in the sputum or
some other single sign of activity, the whole
clinical picture and rate must be viewed in
relation to each other and the case kept under
observation for many months before quiescence
and inactivity are definitely considered.
X. In a certain number of patients a rising sedimentation
rate does not coincide with the
definite clinical progress present; further
observation will reveal some outside influence
