Differential Diagnosis 2

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On the 19th she was given subcutaneous injection of tuber- 326 DIFFERENTIAL DIAGNOSIS culin, 0.005 gram, and showed the temperature reaction indicated in Fig. 115. At entrance the urine showed an intense reaction for diacetic acid, but was otherwise negative, as was the blood. Stool showed no guaiac reaction.
Discussion. — This is the history of what we would ordinarily call simple acute dyspepsia. It comes out of a clear sky, as it were, without previous illness, without known cause. Yet, on p
...hysical examination, there is enough in the lungs to hint strongly at pul- monary tuberculosis. The low blood-pressure and the a"-ray ex- amination afford confirmatory evidence. It is noteworthy that in the a:-ray picture the left lung appears more extensively in- volved than the right. The tuberculin reaction does not seem to me of much importance.
Almost any one of her age and living in a large city will have a positive tuberculin reaction, al- though the size of the dose which produced this reaction gives it, perhaps, some signifi- cance.


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