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

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Xovemher, 1927 The Health Bulletin 15
secure a single antero-posterioi- and
an oblique film, the necessary equipment
for stereoscopic films not being
available except in Greensboro, where
we were exceedingly fortunate to get
both stereoscopic and oblique films
made by Dr. Joseph Shohan. Since Dr.
Shohan is to present his findings in
the next paper to this section I will
not discuss this phase of the subject
further.
It is by the careful weighing of the
evidences obtained by all the various
aids that an accurate diagnosis of
tracheo-brouchial tuberculosis can be
lows in
the wake of the tracheo- bronchial
form), when not properly treated,
offers a very poor prognosis in children.
The first and probably the most important
step in the treatment of childhood
tuberculosis is to prevent fiirther
infection of the child by locating
the source of the infection, usually
some member of the family or servant
in the home, and to make sure that
the child will not continue to get massive
doses of tubercle bacilli. If this
is done and if, in addition to the usual
rest, hygienic and dietetic treatment of
Figure 5.
School Hour for Children Taking Treatment at the North Carolina Sanatorium
made. The general practitioner who
does not have access to an X-ray is
certainly justified in making a strongly
probable or tentative diagnosis of tuberculosis
in a child who has a positive
tuberculin test and suspicious symptoms,
without any other discoverable
condition to explain such symptoms. If
he also obtains a history of close exposure
and the tuberculin test is
strongly positive, the evidence is practically
conclusive.
Fortunately the prognosis in the
tracheo-bronchial form of childhood
tuberculosis is good under proper treatment.
The pulmonary form of the disease,
however (which frequently foladults.
heliotherapy or the quartz light
treatment is empkiyed, childhood tuberculosis
can usually be cured. At the
North Carolina Sanatorium we now
have a modern building for children
where special attention is given their
treatment.
The value of the school tuberculosis
clinic consists not alone in the discovery
of the cases of clinical tubei'culosis
in the school at a stage in which
they can be cured and before they become
infectious. Many adult subjects
of tuberculosis who are throwing off
bacilli in the homes from which the
IX)sitive tuberculin test cases come are
discovered ; the positive tuberculin test