Clinicians have frequently observed that patients with a passive congestion in the lung due either to a heart condition, or resulting from a pulmonary condition, rarely develop clinical evidences of tuberculosis. A recent exposition of this view was put forward by Sewall,1 who described patients with labile vasomotor systems as well as with symptoms of neurasthenia. On physical and roentgen-ray examination, these patients reveal slight sclerosis of the hilum lymph nodes and upper bronchial radiations. These findings, Sewall asserts, are due to a "subtle intoxication" by the tubercle bacillus; they are nonprogressive, and most of the subjects of this toxemia never develop clinical tuberculosis.
Passive congestion in the lungs may result from a variety of clinical conditions. Very commonly, pulmonary irritation may occur in the form of bronchitis due to a degeneration in some part of the circulatory system. The lung vessels become engorged and the surface epithelial cells
LEVINSON SA, PETERSEN WF. THE EFFECT OF PASSIVE HYPEREMIA OF THE LIVER ON TUBERCLE FORMATION. JAMA. 1923;81(9):723–728. doi:10.1001/jama.1923.02650090021006
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