In order to study the detergent process of pulmonary cavity-walls in tuberculosis, the author examined 236 cavities obtained from 60 autopsy cases and 10 resection cases. Results were as follows:
1) Healing process of cavity-walls were found only in chemotherapeutically treated cases, i. e., in 12 of 15 cases treated with more than 1 year, in 7 of 16 cases with more than 6 months and in 2 of 23 cases. with less than 6 months of continued chemotherapy.
2) Fifty nine healed or healing cavities were found by the macroscopical and histological observations. Twenty four of these cavities showed complete or incomplete disappearance of necrotic layer. In the necrotic layer of 35 cavities, there were elimination, marked thinning or penetration of capillaries, mesenchymal cells and polymorphonuclear leucocytes with intense phagocytosis. The resorption of casious substances were demonstrated in the remaining or thinning necrotic layers. There were no tubercle bacilli in these areas.
3) Although it is believed that the opening of drainage bronchi is important for the healing mechanism of cavity, they were not seen in 7 of the 59 cavities.
4) Detergent of cavity-walls depended mainly upon elimination of necrotic layer, and resorption and organization of caseous substances.
5) In detergent process of cavity-walls, unspecific young granulation tissue played a very important role, thereby specific granulation tissue showed atrophy, and sometimes disappearance.
6) In most cases, the elimination of necrotic layer was found in the inner parts of the unspecific granulation tissue, which showed sparseness, bleeding, edema or epithelial regeneration.
7) It seems that the penetrating of capillaries, mesenchymal cells and polymorphonuclear leucocytes has definite significance for the resorption of caseous substances.
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