Thursday December 12, 2019

Was the First Tuberculosis Hospital in Kentucky built inside a Cave?

Tuberculosis or the “white plague” remained incurable until the discovery of streptomycin in 1943

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Mammoth Cave, Kentucky. Image source: Wikimedia Commons

In 1842, Bowling Green, Kentucky, the Mammoth Cave held a bizarre scene. Thin figures wearing dressing gowns moved weakly in and out of the huts. There were frequent noises of coughing and hollowing. The cave held consumptive or tuberculosis patients who were volunteers of a medical experiment. The experiment lasted for a short period of 5 months. Five people lost their life inside the cave and the others died soon after getting back to the surface.

ROUTINE OF THE PATIENTS

  • There were 10 wooden cottages located at a distance of about a mile and half from the entrance of the cave where the patients lived. These cottages measured 12×18 feet which had canvas roofs and furrowed floors. There were two stone cottages, one served as the dining room and the other was a residence.
  • Cool air was considered healthy for the patients so they were told to keep the temperature of their cottage as low as possible. The patients controlled the temperature through a stove and thermometer which was present in every cottage.

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Mammoth Cave National Park preserves the cave system and a part of the Green River valley and hilly country of south central Kentucky. This is the world's longest cave system, with more than 365 miles explored. Image: Wikimedia Commons
Mammoth Cave National Park preserves the cave system and a part of the Green River valley and hilly country of south central Kentucky. This is the world’s longest cave system, with more than 365 miles explored.
Image: Wikimedia Commons
  • The residents synced their schedule to that of the outside world. The cave was dark which was lit by fat lamps during the day and with taper candles at night. The residents did not bother about the darkness as they got used to it. The patients spent their time talking to each other, exploring the cave and reading books.
  • The residents attended episcopal services held each Sunday and read sermons. Their meals were brought by outside slaves that usually included venison.

TREATMENT STRATERGY

  • In the 19th century, medical science didn’t have much to offer. Fresh air, healthy food and gentle exercise were the basic tools of treatment. Although cave air was known to improve health according to physicians belonging to the era.
  • The air inside the Mammoth cave is believed to be exceptionally potent. It maintained a temperature of 60 Fahrenheit and was a bit moist. It was proved to be beneficial for the lungs and imparted energy.
  • The promoters of the cave noted that the workers inside the cave’s saltpeter mine never fell ill. Some of the oldest newspapers belonging to that era noted that human and animal remains found inside the Mammoth cave were still undecayed and intact.

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  • Owing to the curative properties of the cave air, Dr. John Croghan purchased the Mammoth cave for $10,000 in 1839 and built a large health resort. In the year 1842, he welcomed 11 patients who began Croghan’s medical experiment.

THE HARDSHIPS

  • The patients believed that their deteriorating condition justified participating in this unusual action.
  • One patient claimed that he felt stronger, took the exercise and preserved a good diet.
  • However, one can’t deny the difficulties of cave life. The patients wished to go return home to their families as they were feeling isolated. There was lack of lightening and a lot of smoke from cooking fires.
  • Reportedly, only one person named Oliver H.P Anderson returned home after the end of medical experiment. A slave and cave guide said that the patients looked like a company of skeletons.
  • After 5 patients died, their bodies were laid put on the Corpse Rock. After the beginning of the deaths, Croghan ended the medical experiment as made the patients return. These patients died not long after they returned home.

AFTER THE EXPERIMENT

  • Croghan never said or published anything about the disastrous result of the experiment. He did not display any feelings about the people who lost their lives. Croghan was hesitant to accept failure.
  • However, physicians believe that fresh air is a good remedy for tuberculosis even after the Cave experiment failed. Croghan gave up on the idea to turn the cave into a health resort. He glorified the cave by turning it into a tourist destination which still persists.
  • No other physician ever repeated this medical experiment and no their patient took residence in this cave. The wooden huts were dismantled whereas the stone cottages remain standing.
  • Just like his patients, Dr. Croghan also died of tuberculosis in 1849.

MODERN BELIEFS

  • Horace C. Hovey, in his 1882 guide book, says, “The air is slightly exhilarating and sustains one in a ramble of five or ten hours, so that at its end he is hardly sensible of fatigue”
  • Stories of the cave came to be popular among the cave’s visitors and literature.
  • The cave’s visitors reported hearing coughing sounds from around the huts in the cave.
A national park ranger guiding tourists through Mammoth Cave Image: Wikimedia Commons
A national park ranger guiding tourists through Mammoth Cave
Image: Wikimedia Commons
  • Croghan’s experiment is still appreciated by many physicians. The cool climate is believed to cure consumptives.
  • Physicians of the mid-19th century noted that the absence of light made the disease worse and led to increase in deposition of tubercles in the lungs.
  • Tuberculosis or the “white plague” remained incurable until the discovery of streptomycin in 1943.
  • Visitors today enjoy exploring this dark, gloomy and bizarre place. The site is being operated by National Park Service since 1941. It offers tours of the cave and its surroundings.
  • The visitors have to go for the Violet City Lantern Tour or Historic Tour of the Cave to view the stoned tuberculosis huts.
  • The NPS does not allow people with serious health conditions to take the tour even though people claim that cave air improves their health.

-by Shubhi Mangla, an intern at Newsgram. Twitter @shubhi_mangla

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Machine Learning Can Help Doctors to Improve End-Of-Life Conversation with Patients

A deeper understanding of these conversations, which are often freighted with emotion and uncertainty, will also help reveal what aspects or behaviors associated with these conversations are more valuable for patients and families

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Machine Learning
A Research used Machine Learning algorithms to analyze 354 transcripts of palliative care conversations collected by the Palliative Care Communication Research Initiative, involving 231 patients. Pixabay

Researchers at University of Vermont have used Machine Learning and natural language processing (NLP) to better understand conversations about death, which could eventually help doctors improve their end-of-life communication.

Some of the most important, and difficult, conversations in healthcare are the ones that happen amid serious and life-threatening illnesses.

Discussions of the treatment options and prognoses in these settings are a delicate balance for doctors and nurses who are dealing with people at their most vulnerable point and may not fully understand what the future holds.

“We want to understand this complex thing called a conversation. Our major goal is to scale up the measurement of conversations so we can re-engineer the healthcare system to communicate better,” said Robert Gramling, director of the Vermont Conversation Lab in the study published in the journal Patient Education and Counselling.

Gramling and his colleagues used machine learning algorithms to analyze 354 transcripts of palliative care conversations collected by the Palliative Care Communication Research Initiative, involving 231 patients.

They broke each conversation into 10 parts with an equal number of words in each, and examined how the frequency and distribution of words referring to time, illness terminology, sentiment and words indicating possibility and desirability changed between each decile.

“We picked up some strong signals,” said Gramling.

Conversations tended to progress from talking about the past to talking about the future, and from sadder to happier sentiments. “There was quite a range, they went from pretty sad to pretty happy,” Gramling added.

Machine Learning
Researchers at University of Vermont have used Machine Learning and natural language processing (NLP) to better understand conversations about death, which could eventually help doctors improve their end-of-life communication. Pixabay

The consistent results across multiple conversations show just how much people make meaning out of stories in healthcare.

“What we found supports the importance of narrative in medicine,” he said.

That knowledge could eventually help healthcare practitioners understand what makes a “good” conversation about palliative care, and how different kinds of conversations might require different responses.
That could help create interventions that are matched to what the conversation indicates the patient needs the most.

ALSO READ: Light Alcohol Consumption Might Also Increase Cancer Risk: Study

A deeper understanding of these conversations, which are often freighted with emotion and uncertainty, will also help reveal what aspects or behaviors associated with these conversations are more valuable for patients and families. (IANS)