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The Body Is Constantly in Motion |
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The development of x-rays was perhaps the most significant breakthrough in the detection and diagnosis of tuberculosis. Unfortunately, the body itself is constantly in motion and varies by individual, so the ideal measurement is always a projection from a moving picture onto a timeless chart: |
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The perfect chest roentgenogram, repeatedly obtained, is the aim of those who practice roentgenology. The very nature of the problem prevents the realization of this aim. The chest is a moving, dynamic part of the body and cannot be completely still. It varies from person to person. In some it is thin and easy to penetrate. In others it is thick and heavy from fat or muscle and hard to penetrate. Some lungs are stiff and hard to inflate. Others are made full and voluminous without great effort. To register lungs satisfactorily with these variables is at all times difficult. (Diagnostic Standards 1955, 71) |
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Further, each body subjected to tuberculosis is going through its own biographical and physiological, historical development, and as it develops tuberculosis changes. Thus, "the clinical picture of serious necrotic lesions of primary tuberculosis and widespread dissemination from them is observed more often in infancy than in later life and more frequently in nonwhite than in white persons." (Diagnostic Standards 1955, 17). Thomas Mann describes one of the tuberculosis sanatorium patients in The Magic Mountain responding to another's new diagnosis of a moist spot. "You can't tell," Joachim said. "That is just what you never can tell. They said you had already had places, of which nobody took any notice and they healed of themselves, and left nothing but a few trifling dullnesses. It might have been the same way with the moist spot you are supposed to have now, if you hadn't come up here at all. One can never know" (Mann 1929, 192). There are several intertwined puzzles involved here. |
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Not only the disease and the body, but also the patient's experience has been constantly in motion. Thus Bates points out that institutionalization in a sanatorium may well have worked cures for reasons not usually recorded in the medical archive. Successful recovery may be due to good relationships with nurses, doctors, and other patients, together with removal from bad home conditions. She summarizes: "Psychological factors have long been thought to alter the course of |
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