Abstract
Tubercular cavity is one of the most serious sources of infection. Its types of healing process are: 1. Closed, 2. Open and 3. Cicatrized. For a long time, direct injection of various anti-tuberculosis drugs through chest's skin into cavity had been tried by many researchers. The authors checked clinical results, degree of resistance of TB bacilli by direct injection of Isoniazid into pulmonary tubercular cavity.
1) 5ml of 20mg/ml solution of Isoniazid was injected into larger pulmonary cavities of 25 TB cases. 16 to 51% of the cases were improved. Reduction of both coughing and sputum was reported in approximately 37 to 45% of the cases. Therefore, it may be stated that the method is very effective therapy in cases that have cavities and complain of cough or sputum excretion.
2) It was found that excretion of TB bacilli decreased in 45% of the cases and that dimension of cavities reduced in 50% of the cases, by means of the methcd. However, bacilli negative result was not obtained in bacteriological cultures of sputum.
3) Remarkable congestion, fibrination and purification were found in lining of cavities by histological examinations.
4) Degree of resistance of tuberculosis bacilli varied. Number of days of development of resistance did not vary regardless of means of administration of Isoniazid. In about 20% of the cases, any resistance of TB bacilli did not appeare for 16 weeks.
5) Blood concentration of Isoniazid was examined according to the method of Kelly et al. i. e., by means of spectrophotometer (with wavelength of 266mμ). If 20mg/ml of Isoniazid was injected into tubercular pulmonary cavity, blood concentration of Isoniazid became 1.6γ/ml by one hour. In case of oral administration of 200mg of Isoniazid, blood concentration of Isoniazid by 2 hours was 2.4γ/ml. In case of hypodermic injection of 50mg of Isoniazid, blood concentration by 30 minutes was 11.1γ/ml.
6) Direct injection of Isoniazid into pulmonary tubercular cavity is expected to improve symptoms, reduce tuberculosis bacilli and dimension of cavities. The authors' method may be recommended as a proper method which shall be conducted before collapse therapy.
