Barnes, Eric Gordon

2018-01-31T11:17:10Z

2018-01-31T11:17:10Z

1949

Cavitation in the lung continues to present a difficult problem in the clinical treatment of tuberculosis. The greater part of the clinical treatment of pulmonary tuberculosis is directed towards endeavouring to close cavities. This is partly due to the fact that no specific remedy has been found until recently to combat the tubercle bacillus and that in the majority of cases cavitation is present by the time the disease is diagnosed. Collapse measures in such cases may be instituted with a view to arresting the disease and also closing the cavity but only too often general rest aided by the collapse treatment results in arrest of the disease but fails to close the cavity. The cavity persists as a potential source of haemoptysis and of bronchogenic spread of the disease at an early or later date, whilst being at the same time a source of danger to the patient's family and society.

In approaching the subject of persistent cavities as a study for this thesis, it has been felt that a true conception of the mechanism governing the behaviour of cavities can only be reached when an exhaustive survey has been made of all the possible factors which come into play. Only when these factors are regarded in a balanced proportion can a truer conclusion be reached regarding the root causes underlying the occasions when surgical means fail to close cavities. There are no prospects that with the advent of streptomycin, or other more effective antibiotics, cavitation will cease to be a problem in pulmonary tuberculosis.

The type of persistent cavity which has been studied has been the one frequently to be found in the chronic or arrested case. The active cavity with progressive necrosis within its walls has not been included for the purpose of this study.

The course of pulmonary tuberculosis is long and hard in most cases at the best of times. To this may be added the ordeal of a series of operations, each one resulting in discomfort and disappointment to the patient, months being added to months, leading into years, whilst the cavity persists as an ever -present source of danger to himself and a barrier from his family and society. All the knowledge and experience which can be brought to bear, in order that the quickest and most effective means can be employed early in the treatment of cavities, will result in that much less unnecessary suffering being imposed upon the patient. And what is the purpose of all the treatment of the physician if it is not to alleviate suffering?

http://hdl.handle.net/1842/26240

The University of Edinburgh

Annexe Thesis Digitisation Project 2017 Block 15

Persistent cavities in pulmonary tuberculosis: a critical inquiry into the principles underlying causation and means of treatment; with a study of four cases

Thesis or Dissertation

Doctoral

MD Doctor of Medicine