Ambulatory Pneumoperitoneum on Chinese

Abstract

Ambulatory pneumoperitoneum was given from one month to eight years in 1031 cases of pulmonary tuberculosis among Chinese. Some of them (5 per cent) received air one to four times only and stopped treatment because of initial discomfort and pain experienced, and/or due to the influence of others, laymen and medical. It was only during the past two decades, more particularly after World War II, that the Chinese gradually became aware of and acquainted with the universal orthodox methods of treating tuberculosis. Pneumoperitoneum, though simple in experienced hands, first made its appearance in Hong Kong and Canton in 1941. It was not fully appreciated as a safe orthodox method of treatment for pulmonary tuberculosis by the medical profession here until after World War II. The energetic efforts of the local Anti-Tuberculosis Association in tuberculosis education through the radio, newspapers, schools, printed pamphlets, mass x-ray film inspection of employees and students; the establishment of a conveniently situated tuberculosis center, free hospitals and clinics; the the constant drive for much needed funds to carry on the work and finally, the ease of accessibility to foreign modern equipment, literature, and the available well trained personnel in the past few years (five to be more exact), have contributed much in opening the eyes of the local populace toward the beneficial effects of modern methods of treatment. Here, today, pneumopenitoneum has become one of the established conventional methods of collapse therapy. Indeed, it has gradually displaced pneumothorax in our clinic. Our experience has convinced us of the various well known complications (pleural effusions, empyema, broncho-pleural fistulas, thickened pleuras, mediastinal shifts, unexpanded lung, etc.) of pneumothorax, and the lack of serious complications (few and rare) of pneumoperitoneum, to the extent that lately we have used the latter exclusively to initiate collapse therapy when this treatment was indicated. Up to 1948 pneumothorax had been attempted on all suitable cases for collapse therapy on one or both sides, and it was only on failing to establish a good collapse after one month or more or following failures after two or more trials that pneumoperitoneum was resorted to. In the past five years there has been an increasing number of cases in our clinic receiving pneumopenitoneum without having had pneumothorax tried. The encouraging good results with so few complications were so convincing that since December 1952, all cases suitable for collapse therapy received pneumoperitoneum as initial treatment exclusively. The value and importance of isolation with a reasonable period of sanitonium treatment is indisputably the best treatment for the tuberculosis * Presented in part at the Third International Congress on Diseases of the Chest,