Monday February 19, 2018

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
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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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Scars: Types and Treatment

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It is important to treat scars as per their types.
  • Scars are of many types
  • Scars’ treatment varies from type to type
  • It is important to treat scars as per their types

“Scars are tattoos with better stories”. The stories might be very interesting to hear, but the truth is that most of these stories are nevertheless based on some painful moments.

The most superficial injuries like superficial burns and abrasions will heal by epithelialization (formation of tissue over the wound), without any scar formation. But scars are inevitable in deeper injuries.  For many, scars aren’t too bad if they are found in a place easy to cover or are too small to be of any measurable significance.

To save your skin from the scars, make sure to treat them  as per their types.
To save your skin from the scars, make sure to treat them as per their types. Same Condition
Scar tissue

The scar formation rate depends on certain factors like the age of the individual, the site of the wound, the wound healing time, and also the skin tension.  Scars of the wounds on the trunk of younger patients, which may heal slowly probably due to infection, take longer to mature. Also, scars that have a lot of tension across them will take a longer time to mature than scars in older people and in thin-skinned areas, which heal rapidly. These scars have minimal tension across them. Surgical incisions that are made along the tension lines leave minimal and usually acceptable scars. These skin tension lines are where the maximum tension is found when the skin is in a relaxed position. The incisions made across these lines lead to the big, bad, and ugly scars.

There are many types of scars and the treatment mode for each of them is dependent on the factors mentioned above along with their types.

Some of the types and their treatment approaches are listed below.

Scar Treatment

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Pigmentation altered:

Scars are mostly hyperpigmented and when they are present in the areas likely to be noticed, it is advisable to cover them up with cosmetic camouflage or tattoos!!(if possible).

Tattooed scars:

During the process of healing, the implantation of any foreign object like dirt or soot can result in the formation of a tattooed scar, wherein the foreign object would be seen through the pigmentation of the scar. This type of scar can be prevented by taking adequate treatment steps in the beginning, with proper wound management by brushing off the foreign material from the abrasions. The treatment of these scars in the later stage is very difficult.

Hypertrophic Scars:

In some instances, some scars go through the process of formation or remodelling to be exact, longer than usual. Such scars become hypertrophic scars. These scars are red, raised, itchy and painful and finally become pale and mature. These scars most commonly occur in children and in wounds where the healing is delayed probably due to infection.

The occurrence of such a scar can be controlled by a quiet primary healing. But, even if the scar does occur, massage of the scar with moisturizing cream or the application of pressure to the scar can speed up the process of maturation. Scar revision surgery is usually done if the scars cross the skin tension lines or in the event of any wound healing complication. Otherwise, the revision is avoided as there are chances of the scars occurring again.

Also Read: Novel stroke treatment repairs damaged brain tissue

Keloid scars:

The major differentiating characteristic between a hypertrophic and a keloid scar is the lack of spontaneous resolution of the latter into a pale scar. There is an extreme growth of tissue beyond the boundaries of the original wound and it most commonly occurs in the Afro-Caribbean and oriental racial groups. It is surprising to note that they often occur in wounds that healed without any complication. The common locations of occurrence of this type of scar are the central chest, the back, shoulders, and the ear-lobes. It is difficult to treat this type of scar. Treatment options include the application of external pressure, injection with steroids (triamcinolone), surgical resection etc. Yet, the most successful and documented method so far has been a combination of surgery and radiotherapy or cryotherapy.

Acne Scar Treatment:

This is one of the most common issues faced by teens and adults alike. The best approach towards avoidance is to prevent the formation of acne in the first place and follow the recommended diet and hygiene practices. But if the situation is already out of control, consult your dermatologist who might recommend a microdermabrasion, commonly known as the chemical peel. You can also ask him about other options like Fractional laser therapy and laser resurfacing.

Scars' type and treatments is very important to know in order to save your skin. Same Condition
Scars’ type and treatments is very important to know in order to save your skin. Same Condition
Some more treatment modalities:

The options available are of course plentiful but no single method is considered safe or effective. Read on to find out some innovative inventions. But always consult your dermatologist to see if it’s a viable option for you.

  1. Compression by silicone gel sheeting: The anti- keloidal effect of silicone is believed to work by increasing the temperature, hydration and probably the oxygen tension of scar. No formal reports are available for this theory. But, this method has been in use since the early 1980s to treat hypertrophic burn scars with successful therapeutics effects to its advantage.
  2. Cordran tape: A surgical tape containing steroid (flurandrenolide), that has been known to soften the hypertrophic and keloid scars.
  3. Interferon therapy: The interferons by their antifibrotic action prevent the hypertrophic scar formation.
  4. Onion extracts: There are some products available, with this composition, over the counter without any prescription. Even though it was initially considered a placebo, some studies have shown a real correlation between the healing and these products. Safer to use on smaller scars!
  5. Topical vitamin E formulation: Vitamin E has also shown significant benefits in the treatment of scars and there are products available, over the counter, containing hydrocortisone, silicone and Vitamin E.

Always consult your dermatologist, even before buying the “over the counter” products. Your skin is safe as long as you keep it safe. Same Condition

Scars: Types and Treatment