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Title: The use of the sedimentation test to the clinician in the prognosis and treatment of pulmonary tuberculosis
Author: Shaffer, H.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1933
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I. There is a definite need for a reliable test to guide the clinician in dealing with the problem of pulmonary tuberculosis. II. The sedimentation of the erythrocytes in blood plasma is increased in conditions in which there is an increase of the fibrinogen and serum -globulin contents of the blood. This occurs in diseases associated with toxaemia and tissue destruction. III. The sedimentation rate is an index of the amount of toxaemia present, and this in pulmonary tuberculosis infers the degree of activity and powers of resistance. IV. The "one hour" reading of the sedimentation test in millimetres percent conveys most information to the clinician and is compatible with clinical experience. V. The sedimentation test lacks specificity and hence is of limited value in the diagnosis of pulmonary tuberculosis; an abnormal rate does however indicate that a lesion is active and the extent. VI. A series of tests, performed at intervals over a period of several months, affords valuable data upon which a prognosis may be based. Further it gives information concerning the powers of resistance present, and enables the clinician to judge the amount and rate of progress. VII. The sedimentation test is not only more sensitive than clinical findings in indicating the amount of toxaemia but also in prophesying ensuing complications, save in haemoptysis due to rupture of the Rasmussen type of aneurysm. VIII. The test excels as a means of regulating routine sanatorium treatment. It also evidences the need of instituting additional forms of treatment and depicts further progress. IX. When a maintained normal sedimentation test, in a patient that has been definitely active at some time, conflicts with the continued presence of tubercle bacilli in the sputum or some other single sign of activity, the whole clinical picture and rate must be viewed in relation to each other and the case kept under observation for many months before quiescence and inactivity are definitely considered. X. In a certain number of patients a rising sedimentation rate does not coincide with the definite clinical progress present; further observation will reveal some outside influence.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available