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The Pathology of Early Pulmonary Tuberculosis as Revealed by X Rays

Asst. Radiologist to Westminster Hospital, Radiologist to the Royal Chest Hospital

This excerpt was created in the absence of an abstract.

Pulmonary tuberculosis is the commonest disease of mankind and has been the subject of scientific investigation since time immemorial. Many of the symptoms of consumption were known and described even before the Christian era, and the literature of the Middle Ages contains numerous astute observations on the mode of onset and mode of death in this disease. It was not until 1882 that the bacillus was discovered, and this date marks the beginning of scientific knowledge of pulmonary tuberculosis. A host of papers, many of them clinical and pathological classics, have appeared since that date, but despite all the intellect and energy devoted to the problems involved, most of them are still unsolved. The mode of entry of the bacillus, the anatomical nature of the primary lesion and its site are still subjects of contention. The spread of the disease through the lungs and the stages and types of the tubercle formations, are intimately associated with the problem of immunity; but to-night I intend to discuss only the earliest focus, its anatomy, its situation, and the mode of entry of the bacillus.

The improvements in X-ray technique of the last ten years have added considerably to our ability to diagnose the disease in its early stages; and, without question, to-day the competent chest radiologist can detect an early pulmonary focus at least some weeks before physical signs manifest themselves.