Bed Rest, Collapse, and Streptomycin in the Treatment of Pulmonary Tuberculosis

I. Clinical and Roentgenologic Observations (A Preliminary Report)

¹ The Nassau County Tuberculosis Hospital, Farmingdale, New York.
² The Tuberculosis Service, U.S. Naval Hospital, St. Albans, N. Y.

1) Seventy-six cases of pulmonary tuberculosis who received streptomycin therapy have been reviewed.

2) Most of them received one gram daily for six weeks following an observation period of six weeks or more during which time the disease progressed, failed to improve, or improved less than was desired or expected.

3) The results obtained were subjected to analysis by a group of specialists who found that 71 per cent of the cases showed roentgenologic improvement following streptomycin therapy, 83 per cent showed definite over-all clinical improvement, and 59 per cent showed roentgenologic and over-all clinical improvement greater than could be expected without streptomycin.

4) The results for the group are as follows:

Apparently arrested....................... 2 (2.6 per cent)

Quiescent................................. 13 (17 per cent)

Still active.............................. 57 (74 per cent)

Prepared for definite collapse therapy.... 40 (52 per cent)

Dead...................................... 4 (5 per cent)

One of the deaths followed pneumonectomy, one followed tuberculous meningitis, and two resulted from steadily progressive pulmonary tuberculosis.

5) The rationale behind our indications for streptomycin therapy has been discussed.

6) An attempt has been made to correlate the findings observed on roentgenograms of the chest with the observations of the pathologist at autopsy following the use of streptomycin therapy, and an attempt has been made to interpret these changes in anatomic terms.

7) The results have been achieved, we believe, by an integrated program of streptomycin and collapse therapy superimposed upon bed rest.