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Treatments
Other treatments available for pulmonary tuberculosis were also based on the principle of resting and isolating the affected area to prevent further spread and to give it time to heal. This philosophy underpinned the majority of treatments employed for all types of TB and in the case of the lungs necessitated the forced collapse of all or part of the lung.
The surgical procedures described here sound very drastic from a modern perspective but were a common approach in the pre-antibiotic era. With no effective drug treatments surgical approaches were at the forefront of tuberculosis treatment and it is clear that many of the patients from Stannington recovered, or at least showed significant improvements, and went on to live normal lives.
Phrenic Crush or Phrenectomy
The phrenic nerves can be located in the neck, one on the left and one on the right side, and pass down either side of the body between the lung and the heart to the diaphragm. By crushing or severing either the left or the right phrenic nerve the left or the right of the diaphragm would be permanently disabled forcing the muscle to relax and lift up, all done with the aim of putting pressure on the base of the lung and causing some degree of collapse. Breathing would be impaired by this procedure but would continue as long as the other diaphragm continued to function normally.
Pneumoperitoneum
Phrenic crush was usually used in conjunction with pneumoperitoneum. Although ordinarily the presence of pneumoperitoneum is an indication of serious illness in its own right it was also purposefully induced as a means of treating pulmonary tuberculosis. It was carried out by inserting air into the abdominal peritoneal cavity, which would force the diaphragm to rise and so immobilise part of the lung and limit the respiratory function.
Thoracoplasty
With the same intentions as other pulmonary treatments, thoracoplasty was designed as a collapse therapy utilised to collapse cavities in the apex of the lungs caused by tuberculosis. During this procedure multiple ribs would be removed, usually 6-8 ribs and the chest pushed towards the thoracic cavity causing the upper lobe of the lung to collapse. The results of this treatment were permanent and disfiguring but meant no further procedure would be necessary.
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