A new and rapid method for the control of urinary tuberculosis; preliminary report.

From the School of Medicine, University of Buffalo; Departments of Urology, Millard Fillmore Hospital and E. J. Meyer Memorial Hospital, Buffalo ; Department of Biology, University of Bu ffalo, and Department of Pathology, Millard Fillmore Hospital. This study was undertaken to determine whether there existed a more rapid and permanent control of inoperable or bilateral renal tuberculosis than the present therapeutic methods offered. It was not the purpose to supplant the existing treatment of unilateral upper tract tuberculosis with its secondary bladder symptoms nor lower tract involvement which is still a surgical procedure but rather to hasten the contro,l of those cases which were treated by expectant hygienic measures in the preoperative stages of this disease (Fig. 1). With the advent of streptomycin such a control seemed to be available. Hinshaw, Feldman and Pfeutze, and Poole and Cook, from whom I quote liberally, in their study of one hundred various types, arrived at the following conclusions: "That the Mycobacterium of tuberculosis is susceptible to streptomycin and that the course of the disease can be changed if an adequate dose is administered. However, the drug is bacteriostatic rather than bactericidal and has only a suppressive effect and that its lasting benefit would then depend upon the material resources of the body to promote recovery. The tubercle bacilli have a strong tendency to develop resistance against streptomycin and this usually occurs 1 month after the treatment is instituted and nearly always after the second month, and for these reasons the antibiotic should be used in rather early cases and in large daily doses to 3 gm." It must be also borne in mind that streptomycin is