This isn’t really an IMHO medical thread, just some musing about the subject because of a book I read.
I just read Betty MacDonald’s The Plague And I. She’s the same author who wrote 1945’s The Egg And I. After she had left the egg farm she described in that first book, she lived and worked as a single mom in Seattle. In the late 30’s, she came down with tuberculosis and had to go to a sanatorium.
The treatment she described was pretty hard. Not hard because it was painful or rigorous, but because it was nothing. That’s what the patient did: nothing. They laid in bed, moving as little as possible, for a month. Talking, laughing, singing, reading, and writing were forbidden. Using a bedpan and being propped up a bit for meals was all the activity a patient was permitted.
Only gradually was a patient permitted a little more activity. A hospital stay could take a year or years.
The theory was that your lungs would “wall off” the infected place with membrane, and the membrane was fragile when it was just forming. Keeping the lungs as still as possible would permit the membrane to form and complete a successful walling-off. Was this woo? It seems to me that once a bacteria is in your body, a membrane wouldn’t keep it in one place.
But it sounded like survival rates for the hospitalized were much better than for the un-hospitalized, so maybe they were on to something.
TB treatment was pretty much benign to harmful before the development of streptomycin in the 1940s. Rest cure may have been boring, and it didn’t particularly help (other than, possibly, removing people from the environment of other diseases and improving their nutrition [if middle or upper class]). Unlike gold injections, collapsing the lungs, sawing at people’s rib cages, and other barbarisms, at least it didn’t actively hurt the patient.
Back when the White Death was popular, Stacy Aumonier, a now forgotten British writer of exquisite short stories lay dying…
*In the last few years of his life, he would spend long spells in various sanatoria, some better than others. In a letter to his friend, Rebecca West, written shortly before his death, he described the extraordinarily uncomfortable conditions in a sanatorium in Norfolk in the winter of 1927, where the dampness was so severe that a newspaper left beside the bed would feel “sodden to the touch in the morning.”
*
*Shortly before his death, he sought treatment in Switzerland, but died of the disease in Clinique La Prairie at Clarens beside Lake Geneva on 21 December 1928.
* Stacy Aumonier
The most popular TB treatment was to head West. Colorado, Arizona, etc. each had untold thousands of TB patients come for the dry mountain air. It was also the most effective treatment available.
Here’s a PDF of a medical article on the subject from 1907.
Para-amino salicylic acid (PAS) was the first effective anti-tubercular, and was on the market prior to streptomycin. PAS, which is still used occasionally, can have terrible GI side effects (it is, after all, an aspirin derivative) and streptomycin will make you deaf and in a permanent state of vertigo if you take it long enough. Dihydrostreptomycin, which is used now, is a little better but not all that much.
Collapsing lungs, etc. did nothing for people whose tuberculosis struck in other organs.