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April 6, 1901


JAMA. 1901;XXXVI(14):969-970. doi:10.1001/jama.1901.02470140039004

At the last meeting of the German Pathological Society an interesting discussion was precipitated by Baumgarten's1 remarks concerning the differential histologic diagnosis of tuberculous and gummous orchitis. The differentiation of tuberculosis and syphilis is a problem that has a much wider interest than merely that of an examination question in medical schools. Baumgarten points out that quite commonly the macroscopic and microscopic appearances are so typical that the diagnosis is easy, but cases are sure to occur in which difficulties arise. The demonstration of B. tuberculosis is a sure criterion of tuberculosis, but in old, chronic cases of this disease, no matter whether in the testicle or elsewhere, bacilli may not be found in spite of prolonged search, and negative results do not exclude tuberculosis. Syphilis and tuberculosis may occur together, and consequently the finding of tubercle bacilli does not certainly always exclude syphilis. For these reasons the differential