The Natural History of Tuberculosis In the Human Body1,2

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Abstract
This report consists of a follow-up study on 611 children who reacted to tuberculin from birth to five years of age. No evidence of clinical tuberculosis has appeared in 556 subjects (90.98%); 33 (5.40%) developed clinical lesions from which they recovered; and 22 (3.60%) died from tuberculosis. Observation revealed that tuberculous primary pulmonary infiltrates slowly resolved without causing significant illness regardless of how much or how little treatment by way of hospitalization was administered. Therefore, beginning with adolescence, the procedure adopted for all young tuberculin reactors was periodic examinations of the organs that clinical disease frequents, especially the bones, joints, lymph nodes, kidneys, and the lungs. Among 33 children who recovered from clinical disease, the lesions were restricted to the chest in 11 (to the lungs in 9), to the extrathoracic organs in 17, and to the organs of two systems in 5. Of the 22 who died, 18 had acute fatal forms of tuberculosis for which there was no effective treatment at the time. The remaining 4 had chronic disease with complications or with such late diagnosis as to nullify any form of treatment.

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