Excerpt from Pulmonary Tuberculosis
It is the purpose of this book to supply the general practitioner with information concerning the etiology, diagnosis, prognosis and treatment of pulmonary tuberculosis, its clinical forms and common complications. An experience of over twenty years with the tuberculosis problems in New York City has convinced the author that: (1) The physician can, and should, do more than recognize phthisis in its earliest, or pretuberculous stage and at once consign the patient to a sanatorium. (2) That "incipient" does not always mean curable tuberculosis, and conversely, that "advanced" disease does not necessarily indicate a hopeless outlook. (3) That institutional treatment is not the only effective method of handling the phthisical patient. (4) If all tuberculous persons in this country would consent to hospitalization, the available institutions would hardly accommodate ten percent, of eligible patients. (5) Even those treated in sanatoriums must be cared for by their family physicians before admission and after discharge. (6) Careful home treatment is productive of practically the same immediate and ultimate results as institutional treatment, and is less costly to the patient and to the community.
Recent investigations of tuberculous infection have radically changed our views on the transmissibility of tuberculosis. On the one hand, it was found that patients who indiscriminately expectorate tubercle bacilli are a greater menace than has hitherto been suspected. Infants may be infected by mere contact with phthisical persons. On the other hand, there is hardly a person living in a large city who has escaped infection with tubercle bacilli. In other words, despite the vigorous and costly efforts which have been made during the past thirty years, the majority of the population in civilized countries harbor tubercle bacilli in their bodies. But, what is of more importance, not every one infected with tubercle bacilli is destined to become sick. For this reason, a sharp distinction is made in the following chapters between infection and disease, or tuberculosis and phthisis.
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