The case histories of two patients in whom tuberculin sensitivity was low and from whose secretions tubercle bacilli were cultured are described and discussed.
The case histories of two patients in whom tuberculin sensitivity was low and from whose secretions tubercle bacilli were cultured are described and discussed.
A series of 28 cases of spontaneous pneumothorax occurring over the last five years has been described and discussed. A method of treatment, which has been comfortable for the patient, has saved hospital time and given satisfactory results, is described.
Over and above the acute respiratory conditions produced in industry by irritant and sensitising substances it is probable that long-term changes which give rise to the symptom complex of chronic bronchitis can be caused or aggravated by the working environment. There is evidence that prolonged exposure to dust can cause harm to the respiratory tract and that certain dusts are more capable of producing damage than others. In most cases there are non-occupational factors which contribute to the final condition, with the result that it is impossible to be sure of the part occupation has played in any particular patient, and in consequence the disease does not qualify for prescription under the Industrial Injuries Act. There is need for further field investigations aimed at identifying with precision the occupational hazards likely to lead to chronic bronchitis. This would not only enable “compensation” to be granted in appropriate cases but, what is more important, it would make it possible to institute preventive measures.
An enquiry into the efficacy of long-term bed rest and chemotherapy in a Sanatorium is described. The results are tabulated according to admission-lesion, and it is noted that good results were obtained even in fairly advanced cases.
The relationship to surgery of prolonged chemotherapy is assessed and its particular usefulness is seen again in the chronic cases. The relevant literature is also briefly reviewed.
In summary, inspiratory positive pressure breathing (IPPB) by itself and independently has therapeutic value, particularly in asthma, bronchitis and emphysema. It probably accomplishes this result by helping to clear the bronchial airways of obstructing secretions and exudations, although other effects as yet unknown may be important. The therapeutic results are erratic and the use of IPPB is justified only by the otherwise inexorable progress to an asphyxial death of crippling chronic pulmonary disease.
The technique may also be used as a means of temporarily diminishing venous return in acute pulmonary œdema, and of expanding collapsed segments of lung in respiratory paralysis and post-operative immobilisation of the lung. The hazards of this form of treatment are slight.
Fungous diseases of the lung occurring in Britain are reviewed. The incidence and significance of C. albicans in sputum is considered. Broncho-pulmonary aspergillosis, cryptococcosis (torulosis) and histoplasmosis are discussed as being mycotic diseases of interest in Britain.
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