Monday December 18, 2017

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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Kidney disease may increase the risk of Diabetes: says a study

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Kidney disease may increase the risk of diabetes.
Kidney disease may increase the risk of diabetes. IANS

New York, Dec 12: If you are suffering from kidney dysfunction, you may be at high risk of developing diabetes, finds a study.

The risk may be attributed to the rising level of urea — the nitrogen-containing waste product in blood, which comes from the breakdown of protein in foods.

Kidneys normally remove urea from the blood, but it can build up when kidney function slows down, resulting in greater insulin resistance as well as secretion in the body.

“We have known for a long time that diabetes is a major risk factor for kidney disease, but now we have a better understanding that kidney disease, through elevated levels of urea, also raises the risk of diabetes,” said the Ziyad Al-Aly, Assistant Professor at the Washington University in St. Louis.

“When urea builds up in the blood because of kidney dysfunction, it often results in increased insulin resistance and impaired insulin secretion,” Ziyad added.

The findings, published in the journal Kidney International, are significant because urea levels can be lowered through medication, diet — for example, by eating less protein — and other means, thereby allowing for improved treatment and possible prevention of diabetes, the researchers said.

For the study, the team evaluated the records of 1.3 million adults without diabetes over a five-year period, beginning in 2003.

Out of these, 117,000 of those without diabetes — or 9 per cent — had elevated urea levels, signalling poor kidney function and were at 23 per cent higher risk of developing diabetes. (IANS)

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WHO launches a new global effort to end TB by 2030

The announcement was made in the Global Ministerial Conference in Moscow.

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WHO will start working towards ending Tuberculosis
Dr. Simon Angelo (L) examines Iman Steven suffering from tuberculosis, held by her mother (R) at the hospital of Doctors Without Borders (MSF), June 15, 2016, at the Protection of Civilians (PoC) site in Malakal, South Sudan. VOA

Delegates from 114 countries have agreed to take urgent action to end tuberculosis (TB) by 2030, the WHO said.

The announcement on Friday came as the delegates gathered in Moscow for the first WHO global ministerial conference on ending tuberculosis, Xinhua news agency reported.

The delegates promised to achieve strengthen health systems and improve access to the people regarding TB prevention and care so that no one is left behind.

They also agreed to mobilize sufficient and sustainable financing through increased domestic and international investments to close gaps in implementation and research.

Resources are expected to advance research and development of new tools to diagnose, treat and prevent TB, and to build accountability through a framework to track and review progress on ending TB.

“Today marks a critical landmark in the fight to end TB,” said World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus.

“It signals a long overdue global commitment to stop the death and suffering caused by this ancient killer.”

Though global efforts to combat TB have saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37 per cent, progress in many countries has stalled, global targets are off-track and persistent gaps remain in TB care and prevention, according to the WHO.

As a result, TB still kills more people than any other infectious disease. Due to its antimicrobial resistance, TB is also the leading killer of people with HIV.

Representatives at the meeting, which was attended by over 1,000 participants, also promised to minimize the risk and spread of drug resistance and do more to engage people and communities affected by or at risk of TB. (IANS)

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Now Rats may help in Detecting Tuberculosis

The rats learn to recognize the presence of TB in samples of mucus that is coughed up from the patient's lower airways.

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Rats and treatment of Tuberculosis
FILE - An African Giant Pouch rat is seen before a training session where the rats will learn to detect tuberculosis (TB) at a laboratory in Sokoine University for Agriculture in Morogoro, Tanzania, Jan. 31, 2006. VOA

London, November 16,2017:

Giant rats are probably not the first thing that come to mind to tackle tuberculosis but scientists hope their sniffing skills will speed up efforts to detect the deadly disease in major cities across the world.

Tuberculosis, which is curable and preventable, is one of the world’s deadliest infectious diseases, according to the World Health Organization (WHO), killing 1.7 million people in 2016 and infecting 10.4 million others.

African Giant Pouched Rats, trained by Belgian charity APOPO, are known for sniffing out landmines in countries from Angola to Cambodia and for detecting TB cases in East Africa.

Over the next few years, APOPO plans to fight tuberculosis at the source by launching TB-detection rat facilities in major cities of 30 high-risk countries including Vietnam, India and Nigeria.

Rats can play a role in containing Tuberculosis
Dr. Simon Angelo (L) examines Iman Steven suffering from tuberculosis, held by her mother (R) at the hospital of Doctors Without Borders (MSF), June 15, 2016, at the Protection of Civilians (PoC) site in Malakal, South Sudan. VOA

“One of the best ways to fight TB at source is in major cities that draw a lot of people from the rural areas,” James Pursey, APOPO spokesman, told the Thomson Reuters Foundation.

“It is a vicious circle. You can be reinfected. To fight TB, you have to hit it hard,” he said by phone from Zimbabwe.

Many people get infected in big, densely populated cities and spread the disease to rural areas, according to Pursey.

The rats learn to recognize the presence of TB in samples of mucus that is coughed up from the patient’s lower airways.

In Tanzania, people in communities where TB is most common, including in prisons, often fail to show up for screening because of a lack of money or awareness, placing a huge burden on health authorities, health experts said.

“TB is a disease of poverty,” said Pursey. “If nothing changes it can only get worse.”

The APOPO has seen the TB detection rate increase by 40 percent in clinics it has worked with in Tanzania and Mozambique, according to Pursey, who said that using rats to screen did not negate the need for proper diagnostic testing.

While a technician may take four days to detect a case of TB, a trained rat can screen 100 samples in 20 minutes, and a rat screening costs as little as 20 US cents, APOPO said.