This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1913 Excerpt: ...the field of diagnosis. It is only by expert X-ray examination and by careful consideration of constitutional signs and symptoms that this can be ruled out. Sometimes it is impossible to do this. (c) Bronchial breathing and bronchial whispered voice heard on auscultation over the vertebra? below the seventh cervical ...
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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1913 Excerpt: ...the field of diagnosis. It is only by expert X-ray examination and by careful consideration of constitutional signs and symptoms that this can be ruled out. Sometimes it is impossible to do this. (c) Bronchial breathing and bronchial whispered voice heard on auscultation over the vertebra? below the seventh cervical spine. This is known as D'Espine's sign. It is present only when the mass of glands is fairly large. As these glands are usually confined to the anterior mediastinum they do not cause the dullness and changes in quality of the voice or breath sounds posteriorly unless of considerable size. (d) Signs of intrathoracic pressure such as enlarged superficial veins on the chest, unequal pupils, hoarseness, paroxysmal " brassy " cough, dyspnoea, sibilant inspiration or inspiratory stridor heard over both lungs due to pressure on the trachea, defective air entry in one lobe due to pressure on a bronchus. (e) In addition to the above, the presence of enlarged tuberculous glands in the neck, axillae or elsewhere would suggest the possibility of similar infection of the glands at the root of the lung. It is in children that the tuberculin tests find their greatest field of usefulness. The cutaneous Tuberculin test is by far the best to employ. The dein Diagnosis, 0f the technique have been described in an earlier chapter. In children five years or under a positive cutaneous test is definite evidence of a tuberculous focus somewhere in the body. A positive test along with constitutional signs and symptoms as enumerated above, with or without signs in the lungs, justifies a definite diagnosis of tuberculosis which requires prompt and aggressive treatment. The X-ray, like the tuberculin test, is of far more value in diagnosing tuberculosis in childr...
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