The Roentgen Ray Treatment of Tuberculosis of the Mediastinal Lymph Nodes

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Although roentgen irradiation has come to be recognized as the most satisfactory method of treating tuberculosis of the superficial lymph glands, little attention has been directed to the treatment of the same affection when it involves deeply situated glands, especially those which lie in and about the mediastinum. No doubt this is true because the latter pathological process is more obscure. However, not infrequently the pressure exerted by the inflammatory enlargement of the tracheo-bronchial and bronchial lymph nodes causes symptoms in many cases of tuberculosis at some stage of the disease. We have found that this difficulty may be relieved in selected cases and sometimes—particularly in children—the progress of the disease may apparently be arrested.

It seems that the role of the lymphatic glandular system in tuberculosis is not always fully appreciated by some clinicians, especially roentgenologists, because often the earliest signs of tuberculosis which are sought for and recognized by physical examinations or roentgeno-graphic studies are the manifestations of the pathological processes which develop in the parenchyma of the lungs. However, it is often possible to determine with some degree of certainty, the presence of the infection in even earlier stages and possibly before pulmonary lesions have developed, if known facts about the pathogenesis and clinical course of tuberculosis are taken into consideration, and if clinicians are on the alert to intepret correctly the insidious early manifestations of tuberculosis.

It is generally recognized that tuberculosis is frequently contracted by inhalation, sometimes by ingestion, occasionally by inocculation and. . .



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