Recently Soper and Amberson1 called attention to a striking change in the concept of pulmonary tuberculosis in adults. The older German phthisiatrists and pathologists, basing their belief largely on necropsy evidence, declared that every man at the end of his life has some tuberculosis in the apex of his lung. The researches of Behring gave much support to the prevailing idea that almost all human beings were infected with tubercle bacilli in infancy or early childhood, that this primary infection in the great majority of cases became localized, encapsulated, inactivated or cured, and that a reinfection or a superinfection took place in a certain number of people under the influence of endogenous or exogenous factors. The introduction and employment of tuberculin testing by the Pirquet method further confirmed the belief in early universal infection with tubercle bacilli. In fact, the test came to be considered clinically unimportant above the
PRIMARY TUBERCULOSIS IN ADULTS. JAMA. 1939;113(2):146–147. doi:10.1001/jama.1939.02800270046010
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