The Achilles Heel of Tuberculosis Control

The Achilles Heel of Tuberculous Disease, its vulnerable spot is its curability in its early stages, its strong point is its capacity for multiplication by virtue of its contagiousness in its advanced stages. One person with active disease infects others and each of these infects others and so on ad infinitum. The old term for it would be "geometrical progression," the modern term, "chain reaction." The person with advanced disease spits more tubercle bacilli and is a more potent spreader of disease than the person with minimal disease who spits few or no tubercle bacilli.

To control tuberculosis, therefore, we must discover and treat the early case, and prevent it from becoming the advanced case, the chief spreader of disease! The combined use of the tuberculin test, the x-ray film of the chest and chemotherapy will enormously reduce the spread of the disease. The tuberculin test wisely repeated will tell not only that infection has occurred but will tell when it occurred and frequently where it occurred and even the source of that infection. Likewise, the x-ray film of the chest must be repeated at appropriate intervals, especially at certain ages and with highly exposed groups of persons, on all positive reactors whether recent converters or not!

Conviction is settled that minimal active pulmonary tuberculosis should be treated with chemotherapy. Just how minimal does tuberculosis have to be before one would not treat it with chemotherapy? The next few years will answer this. question. At present, it seems wise to treat with chemotherapy recent converters in highly exposed groups and recent converters at the most vulnerable ages.