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February 9, 1946


JAMA. 1946;130(6):348. doi:10.1001/jama.1946.02870060034009

Although pulmonary calcification has been generally interpreted as evidence of healed tuberculosis, we recognize now that this disease is not the only important cause of such lesions. Recent epidemiologic studies have shown that a large proportion of persons with pulmonary calcification have negative tuberculin reactions. Lumsden and his associates1 concluded, after a careful epidemiologic study of Coffee County in southwestern Alabama and Giles County in south central Tennessee, that skin testing with any of the tuberculosis preparations available, as a sole means of establishing an epidemiologic index or rate of incidence of tuberculous infection in a community or in a region, is of doubtful value or definitely futile. Smith2 suggested that the area of high prevalence of pulmonary calcification and tuberculin negative reactors corresponds with the endemic area of histoplasmosis. Palmer3 found in a study in which 3,000 nurses in Detroit, Kansas City, Minneapolis and Philadelphia were

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