Tuberculosis: new treatments in evolution

Published on April 2, 2014   38 min

A selection of talks on Clinical Practice

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Tuberculosis-- New Treatments in Evolution by Stephen Gillespie, Professor of Medicine at the University of St. Andrews. In this presentation, I will outline a little of the history of anti-tuberculosis chemotherapy and tell you something of the exciting new studies that are currently underway.
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Tuberculosis is an ancient disease. It was described by Hippocrates, who recognized that this disease was untreatable. Avicenna recognized that tuberculosis was contagious. And he advised that patients should be put into quarantine. This concept was developed further by Herman Brehmer in the 19th century, who developed what is known as the Sanatorium Movement. This approach was widely adopted across Europe with most cities opening sanatoria for TB treatment. Most of them were not closed until the 1970s. In the 1880s, there were campaigns in the United States and the United Kingdom to raise awareness of tuberculosis. Public health notification was established. And public information campaigns advising against coughing and spitting were placed in public transport.
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In the early antibiotic era, research showed that tuberculosis was not susceptible to the newly available drugs. Many thought that this was due to the complexity of the organism and that tuberculosis might prove too difficult to treat. At this time, there were many other potential cures including pelargonium roots, a Zulu treatment for respiratory infection. Cod liver oil was thought to be useful in preventing the disease. Gold was applied by some physicians with a degree of success. But many patients experienced toxicity. It was the discovery by Selman Waksman and Albert Schatz of streptomycin that revolutionized tuberculosis chemotherapy. In the United States, this drug was introduced into practice without clinical trials.

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