"The duration of pulmonary consumption in children varies; but it is generally more rapid with them than with adults, as in a large proportion of cases the tubercular disease commences in young subjects in the bronchial glands, and remains often for a considerable time unnoticed especially when unattended by a cough. The length of time during which tuberculization may have been proceeding before it is discovered is generally very uncertain. The suppuration or softening of tubercles in the bronchial glands very rarely occurs without corresponding diseases afterwards appearing in some parts of the lungs, which affords all the characteristic symptoms of pulmonary phthisis. The disease has, however, proved fatal, having been accompanied with decided hectic fever, when the bronchial glands alone have been found to be the seat of the malady." So wrote Coley1 in 1846.
Nevertheless it was not until within comparatively recent years that it was deemed
STOLL HF. THE DIAGNOSTIC SIGNIFICANCE OF D'ESPINE'S SIGN. Am J Dis Child. 1915;X(3):183-193. doi:10.1001/archpedi.1915.04110030032003