Treatment of chronic pulmonary tuberculosis complicating silicosis; intermittent positive pressure breathing and streptomycin.

Abstract

Gaining ascendancy from the writings of Detweiler 1 (1878), rest in bed has become the traditional and essential treatment of pulmonary tuberculosis. However, since the advent of special drugs and procedures, there gradually has developed a regimen with definite indications and limitations for rest, both physical and physiological. It is recognized generally that the supplementary use of streptomycin is required for the acute exudative forms of tuberculosis with toxemia; but, in the chronic types with cavitation and persistent tubercle bacilli in the sputum, artificial pneumothorax, pneumoperitoneum, thoracoplasty or pulmonary resection may be indicated. There is increasing evidence that sustained rest in cases with emphysema is ineffectual, if not actually disturbing. Similarly, the employment of collapse therapy for atelectasis is harmful, owing to impaired drainage and aeration. Thus, closely associated in treatment are the aspects of a disease for which dynamic therapy as well as rest should be considered. In an