Forty Years' Experience with Artificial Pneumothorax

¹ professor, Diseases of the Chest, School of Medicine, Temple University, Philadelphia, Pennsylvania.

An attempt has been made to report briefly my personal experience with artificial pneumothorax covering a period of 40 years. My first 16 years may be called the dark era. It was an era of exploration, a period of trial and error. The last 25 years have been illuminating and rewarding. It was the success of artificial pneumothorax that led to the other surgical developments that now crown the achievements of the thoracic surgeon and it was the importance that surgery has assumed in the treatment of tuberculosis that has changed the entire aspect of sanatorium treatment. It has brought the sanatorium down from isolation on the mountain top to the large cities where the patients come from and the medical talent resides. It has transformed the wooden cottage and the primitive shack into a modern hospital where a team of experts is assembled—a phthisiologist, a thoracic surgeon, a roentgenologist and bronchoscopist who devote their combined talents in the interest of the patient. It has helped to clip the annual death rate from 200 per 100,000 in 1908 to 30 per 100,000 in 1949. And finally, it is my considered judgment that artificial pneumothorax is still the best single procedure in the treatment of pulmonary tuberculosis in carefully selected cases, properly administered and in combination with all tried and effective remedies, new and old.