No. 11

For a long time those who have dealt constantly with the problems of tuberculosis involving as they do, not only the responsibility of diagnosis, but also the far more difficult question of treatment, have been impressed with the similarity of symptoms which occur in so-called early tuberculosis and in patients suffering from undoubted hyperthyroidism.

The symptoms of toxemia caused by tuberculosis poisoning and those caused by thyroid poisoning may be placed side by side and for a long distance in the column there will be no divergence between them.

Fatigue, loss of weight, slight afternoon rise of temperature, tachycardia, nervousness more or less marked, where have we so far in the picture anything that does not point with startling earnestness to what we have learned to know and dread as the first signs of pulmonary tuberculosis?

If, as we believe, many of these patients can be shown to be suffering with thyrotoxicosis rather than with tuberculosis, it is evident that our study of the physical condition of these

border-line patients will have to be carried to the point of excluding this condition as carefully as we now differentiate from lues, cardiovascular conditions, malignant disease and nontuberculous lung infections.

It has also long been evident that hyperthyroid conditions are often found as a complication in lung tuberculosis, that patients who have been under the most careful sanitarium treatment for a long time do not get well. In spite of the fact that their cough has gone and all physical signs have disappeared from their chests, they continue to run a slight temperature; they refuse to gain weight and remain as weak as when they began their treat

ment.

Shall we persist in calling these patients psycho-neurotics, hysterical or unreasonable individuals, or shall we try to find a physical cause for their trouble when we know that thyroid disfunction is usually followed by exactly this syndrome?

It would be wise, I think, to spend a little time in going over some of the recent experimental work that has

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For a long time those w
constantly with the probl
culosis involving as they
the responsibility of diag
the far more difficult que
ment, have been impres
similarity of symptoms v
so-called early tuberculos
tients suffering from und
thyroidism.

The symptoms of toxe
tuberculosis poisoning an
by thyroid poisoning
side by side and for a
in the column there wil
ence between them.

Fatigue, loss of weig
noon rise of temperatu
nervousness more or less
have we so far in the
that does not point wit
estness to what we h
know and dread as th
pulmonary tuberculosis
If, as we believe, m
tients can be shown
with thyrotoxicosis
tuberculosis, it is
study of the physical c

ra

e

Read before the Sou

No. 11

ng time those who have dealt with the problems of tubervolving as they do, not only sibility of diagnosis, but also Dre difficult question of treatve been impressed with the of symptoms which occur in early tuberculosis and in paFering from undoubted hyper

1.

mptoms of toxemia caused by sis poisoning and those caused id poisoning may be placed side and for a long distance lumn there will be no divergveen them.

e, loss of weight, slight aftere of temperature, tachycardia, ess more or less marked, where so far in the picture anything not point with startling earnto what we have learned to d dread as the first signs of ry tuberculosis?

we believe, many of these paan be shown to be suffering yrotoxicosis rather than with osis, it is evident that our the physical condition of these

border-line patients will have to be carried to the point of excluding this condition as carefully efully as we now differentiate from lues, cardiovascular conditions, malignant disease and nontuberculous lung infections.

It has also long been evident that hyperthyroid conditions are often found as a complication in lung tuberculosis, that patients who have been under the most careful sanitarium treatment for a long time do not get well. In spite of the fact that their cough has gone and all physical signs have disappeared from their chests, they continue to run a slight temperature; they refuse to gain weight and remain as weak as when they began their treat

ment.

Shall we persist in calling these patients psycho-neurotics, hysterical or unreasonable individuals, or shall we try to find a physical cause for their trouble when we know that thyroid disfunction is usually followed by exactly this syndrome?

It would be wise, I think, to spend a little time in going over some of the recent experimental work that has

No. 11

ng time those who have dealt with the problems of tubervolving as they do, not only sibility of diagnosis, but also ore difficult question of treatre been impressed with the of symptoms which occur in early tuberculosis and in paFering from undoubted hyper

ב.

mptoms of toxemia caused by sis poisoning and those caused id poisoning may be placed side and for a long distance lumn there will be no divergween them.

e, loss of weight, slight after= of temperature, tachycardia, ess more or less marked, where so far in the picture anything not point with startling earnto what we have learned to d dread as the first signs of -y tuberculosis?

we believe, many of these paIn be shown to be suffering rotoxicosis rather than with Osis, it is evident that our the physical condition of these

border-line patients will have to be carried to the point of excluding this condition as carefully as we now differentiate from lues, cardiovascular conditions, malignant disease and nontuberculous lung infections.

It has also long been evident that hyperthyroid conditions are often found as a complication in lung tuberculosis, that patients who have been under the most careful sanitarium treatment for a long time do not get well. In spite of the fact that their cough has gone and all physical signs have disappeared from their chests, they continue to run a slight temperature; they refuse to gain weight and remain as weak as when they began their treatment.

Shall we persist in calling these patients psycho-neurotics, hysterical or unreasonable individuals, or shall we try to find a physical cause for their trouble when we know that thyroid disfunction is usually followed by exactly this syndrome?

It would be wise, I think, to spend a little time in going over some of the recent experimental work that has