October 1956

Why Drugs Are not Enough in the Treatment of Tuberculosis

Author Affiliations

Selah, Wash.

Medical Director and Superintendent, Central Washington Tuberculosis Hospital.

AMA Arch Intern Med. 1956;98(4):463-466. doi:10.1001/archinte.1956.00250280065008

With the advent of long-term chemotherapy 6 and the resultant conversion of a large percentage of patients' sputums and gastric cultures, there were many optimistic opinions that the present antituberculous drugs would cure tuberculosis. D'Esopo and co-workers 7 reported that when these patients whose cultures had converted on streptomycin and PAS were resected, it was difficult to grow tubercle bacilli from the resected specimens. However, acid-fast rods were present in a large number of these specimens, so the question arose: Are these tubercle bacilli dead or merely dormant?11 By six months after chemotherapy was stopped a significant percentage of the negative nonresected patients with open cavities had reactivated.12 On June 1, 1952, we began our present treatment regimen, consisting of streptomycin, aminosalicylic acid, and isoniazid used concurrently and continuously from admission to discharge, with early resectional surgery when indicated.1 When digested portions of our first 22 resected

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