Cresson TB Sanatorium Remembered

Early Treatment:  The most common early treatments of tuberculosis were rest, fresh air, sunshine, good food, and competent medical supervision.

Lung Collapse Therapy
A successful collapse of the lung facilitated healing by resting the affected area.  Collapse therapy was likened to putting a splint on a broken leg to immobilize it. 
Shot Bags -  An early form of non-invasive lung rest treatment for patients who had infections of both lungs was the "shot bag" method. A bag containing one pound of shot was placed on either collarbone of the patient and the amount of shot increased 4 or 5 ounces each week until the patient was carrying 5 pounds of weight on the upper part of each lung. This restricted the excursions of the lungs, made them quiescent, taught correct breathing and produced partial rest for the lungs.
Artificial Pneumothorax - compression of the affected lung by the introduction of air into the pleural cavity, between the chest wall and the lung.  The air would be absorbed and refills were usually given once a week.  Pneumo was designed to be continued anywhere from two to four years or more.
Bilateral Pneumothorax - compression of both lungs by pneumothorax.  In this procedure, a portion of both lungs were collapsed and patients, though short of breath, could lead moderately active lives.  
Interpleural Pneumolysis - cauterizing of adhesions between the chest wall and lung.  The adhesions prevented the lungs from collapsing satisfactorily.
Thoracoplasty - removal of the ribs on one side of the thorax to accomplish a permanent collapse of the diseased part of the lung.  This surgery was necessary when pleural adhesions prevented the use of pneumothorax.
Phrenicotomy - Cutting or crushing of the phrentic nerve on one side causing elevation of the corresponding diaphragm, thus compressing the lower part of the lung on that side.
Plombage - Inserting porcelain balls into the thoracic cavity to collapse he lung beneath.  It was a one-time procedure unlike pneomothorax which had to be repeated.
Lung Surgery:  Surgical resection of infected lungs was not possible in the 1940s and 1950s, because the science of anesthesia at the time was not sufficiently advanced to permit surgery on the lungs of an anesthetized patient.  After solving this problem, the following surgeries were performed:
Pneumonectomy:  Removal of the entire affected lung.
Lobectomy:  Removal of the affected lobe of a lung.
Drugs:  Effective drugs were not introduced until the 1950's.  The various drugs developed and the combination in which they were used meant that by the 1980's the cure rate was 98%.  Streptomycin, developed in 1944, was the first drug used against TB.  It was successful at first, but the TB bacillus soon developed resistance to the drug.  Fortunately, European scientists in the late 1940's developed a drug named para-aminosalycilic acid (PAS).  By using the two drugs in combination they prevented drug resistance from occurring and they proved an effective cure. 
But there were drawbacks.  Streptomycin was given by injection and often was painful while PAS was given in large quantities and could be nauseating.  In 1952 a new drug named Isoniazid was developed.  By combining all three drugs, treatment length could be reduced to 18 months.  By the mid 1960's the effectiveness of these drugs and newer drugs spelled the end of the sanatorium system, with all of them being closed or converted to other uses.  (See History 1 Page write-up of Sir John Crofton who was responsible for breakthrough research that led to the first effective combined treatment regimen for TB.)