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August 4, 1956


JAMA. 1956;161(14):1386-1388. doi:10.1001/jama.1956.02970140042011

Nothing has deceived those seeking to treat and prevent tuberculosis more than its pathogenesis. Early pathological observations established the prevalence of primary tuberculous complexes with pulmonary and regional lymph node components. These were frequently seen in the bodies of persons who had no evidence of clinical tuberculosis in life and in whom none was found at autopsy. Such apparently well controlled primary complexes were also seen in bodies with coexisting destructive and progressive tuberculous lesions. Ghon1 dissected 184 bodies of children who had reacted to tuberculin and in all but seven found the pulmonary and/or regional lymph node components of primary tuberculous complexes (five located extrathoracically). Since then the pulmonary component has been known as the Ghon tubercle.

When periodic tuberculin testing of children was introduced, it was observed that, in most of those whose skin reaction had recently become positive, roentgenograms of the chests were clear, but in