The Health bulletin [serial] - University of North Carolina at Chapel Hill

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14 The Health Bulletin November, 1927
cal signs to be found in the cliest in
childhood tuberculosis.
Such physical signs as anemic
mucous membranes, pale skin, poorly
developed and flabby muscles are more
fretiuently found in the tuberculous
child, though the appearance of ruddy
health does not exclude tuberculosis.
The physical examination and laboratory
examinations in the study of
childhood tuberculosis are of more
real value in the discovery of other
abnormal conditions which might explain
the symptoms than in demonstrating
the presence of a tuberculous
The X-ray is of greater iniiK)rtance in
making an accurate diagnosis of childhood
tuberculosis than in the usual pulmonary
type of the disease. The characteristic
densities of tracheo-bronchial
tuberculosis are a small focus situated
at the periphery I'arely larger and
often smaller than a pea, and nodules
due to the involvement of the regional
pulmonary and tracheo-bronchial glands
which drain the area of this primary
focus. The X-ray also has its definite
limitations. Many of the lesions are
not sufficiently dense to cast a shadow
on the film and this is especially true
Figure 4.
Children's Building, North Carolina Sanatorium.
Terrace.
Boys Taking Sunbath on the
Heliotherapy or Sunrays is Important in the Treatment of Childhood Tuberculosis as
Indeed it is in the Proper Nutrition of the Child.
lesion. The discovery of diseased tonsils
and otitis media, heart disease, or
the discovery of pus in the urine, intestinal
parasites or their ova in the
stool, or of malarial parasites in the
blood through laboratory examinations
should indicate the need of caution before
diagnosing tuberculosis. If there
are no such defects or if the suspicious
symptoms persist after such defects
are corrected, it is much more likely
that the case is one of tracheo-bronchial
tuberculosis.
of the early lesion. Within the hilum
region also the lesions are surrounded
by so many other structures which cast
heavy shadows, the spine, sternum,
heart and large blood vessels, that they
are frequently obscured. This is especially
true when only a single anteroposterior
film is taken. This difficulty
is overcome in large part if oblique as
well as antero-posterio films are made.
Stereoscopic antero-posterior films are
really essential for a satisfactory X-ray
study of childhood tuberculosis. In the
school clinic we were only able to