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May 13, 1905


JAMA. 1905;XLIV(19):1539. doi:10.1001/jama.1905.02500460047014

The great necessity in pulmonary tuberculosis is a means of early diagnosis. Perhaps we overlook the fact, in our hunt for specific diagnostic and curative means, that the clinician who makes the early diagnoses is the one who puts together the minor symptoms and signs, rather than the one who waits for striking and characteristic phenomena. It is well that we should note in this disease, as in others difficult of early diagnosis, those slight deviations from the physiologic which often occur and which are often overlooked. It has long been known that in women with outspoken pulmonary tuberculosis there is often a febrile crisis which can announce and accompany the menses. It is perhaps less well known that in very early cases fever may occur only at the menstrual period. The natural history of such cases has lately been