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14
present results go, it would appear that in a definitely tubercular case the blood
sedimentation rate is just as important, if not more so, than the extent of disease
seen radiologically in determining the likelihood of a positive gastric lavage result.
This point is illustrated by the accompanying figs., 1 to 4. In each case the most
significant feature in the skiagram is an abnormally large hilar shadow on the
right side. In the cases depicted in figs. 1, 2 and 3 the blood sedimentation rate was
raised and the gastric lavage finding positive. In the last case, however, although
the skiagram, fig. 4, is no less suggestive of tuberculosis than the other three, the
blood sedimentation rate was within normal limits. In this case the gastric lavage
finding was negative ; later, however, the child's condition relapsed, and a rise in
the blood sedimentation rate coincided with the finding of tubercle bacilli in the
sputum. The blood sedimentation rates were determined by the Westergren method.
The figures represent the length of clear plasma in millimetres in a column of blood
200 mm. long at the end of one hour. A figure of 10 or under is considered within
normal limits.
FIG. 1.-SKIAGRAM OF CHEST. BLOOD
MENTATION RATE 90 (WESTERGREN METHOD).
GASTRIC LAVAGE POSITIVE.
FIG. 2.-SKIAGRAM OF CHEST. BLOOD SEDI-
MENTATION RATE 70. GATERIC LAVAGE POSITIVE.
FIG. 3.-SKIAGRAM OF CHEST. BLOOD
MENTATION RATE 49. GASTRIC LAVAGE POSITIVE.
FIG. 4.-SKIAGRAM OF CHEST. BLOOD
MENTATION RATE7. GASTRIC LAVAGE NEGATIVE.
IN THIS CASE THE SEDIMENTATION RATE ROSE
TO 40 LATER AND TUBERCLE BACILLI WERE
FOUND IN THE SPUTUM.
Summary and
conclusions.
An account has been given of the method of demonstrating tubercle bacilli in
children by gastric lavage. Following a brief summary of previous investigations
the work ou the subject in progress at High Wood hospital is described. The results
obtained so far suggest that the method is of definite value.
I wish to thank Dr. A. G. L. Reade, medical superintendent of High Wood hospital,
for allowing me to carry on this investigation and for the encouragement he has given