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December 22, 1928


JAMA. 1928;91(25):1952-1960. doi:10.1001/jama.1928.02700250016004

Physicians supervising a large group of patients with pulmonary tuberculosis uniformly dread the appearance of dyspeptic symptoms. Their concern is deepest when the abdominal ailment exhibits itself as bowel malfunction. Clinical experience and operative and necropsy studies have demonstrated that the dyspepsia of those thoracically tuberculous quite commonly indicates abdominal, usually enteric, disease of like cause.

When this extension of tuberculosis occurs, the therapeutic problem presents aspects differing widely from those in which one deals only with a comparatively well localized lesion in the lungs. There are added to the needs for management of the pulmonary disturbance the control and treatment of lesions seriously affecting the patient from the standpoints of adequate feeding, relief of pain, nausea, vomiting, dehydrating and exhausting diarrhea, loss of sleep and rest, a peculiar systemic "intoxication" and the possibility of sudden accidents, as hemorrhage or perforation, and the complications incident to ascites, abscess or bowel

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