Observations on active domiciliary treatment of cases of pulmonary tuberculosis

Abstract

Summaryo(a)The reasons why domiciliary active therapy is required are mentioned with a brief description of a scheme which takes a patient through the stages of phrenic nerve crush, pneumoperitoneum, artificial pneumothorax induction and adhesion section with an average of eleven nights in hospital. It is felt that the safety of the scheme hinges on the type of case that is picke for artificial pneumothorax therapy and for that reason the case records of 7,206 patients over a nineteen-year period are reviewed and the complications of 703 artificial pneumothoraces noted. Especial emphasis is placed on the type of artificial pneumothorax which causes complications and which, in my opinion, it is dangerous to keep resting at home.(b)Reasons are given why we consider it better to start D.A.T. with a spell of pneumoperitoneum therapy combined with phrenic nerve crush.(c)Some observations are made arising from our experience with D.A.T.(d)It is considered that the scheme has a definite place in our armamentarium as things stand today and that some form of collapse therapy is better than none in the minimal, sputum-positive case. The reasons why domiciliary active therapy is required are mentioned with a brief description of a scheme which takes a patient through the stages of phrenic nerve crush, pneumoperitoneum, artificial pneumothorax induction and adhesion section with an average of eleven nights in hospital. It is felt that the safety of the scheme hinges on the type of case that is picke for artificial pneumothorax therapy and for that reason the case records of 7,206 patients over a nineteen-year period are reviewed and the complications of 703 artificial pneumothoraces noted. Especial emphasis is placed on the type of artificial pneumothorax which causes complications and which, in my opinion, it is dangerous to keep resting at home. Reasons are given why we consider it better to start D.A.T. with a spell of pneumoperitoneum therapy combined with phrenic nerve crush. Some observations are made arising from our experience with D.A.T. It is considered that the scheme has a definite place in our armamentarium as things stand today and that some form of collapse therapy is better than none in the minimal, sputum-positive case.