Clinical results and physiological effects of immobilizing lung chamber therapy in chronic pulmonary tuberculosis.

The mechanism by which a normal pulmonary ventilation was produced in patients with pulmonary tuberculosis without voluntary breathing and without movement of the chest wall was described in 1940.' An adequate gas exchange between the lungs and the atmosphere could not be maintained in animals with experimental respiratory paralysis by the alternating pressure method of Thunberga until the bronchial tree was kept open by equalizing the pressures on both sides of the chest wall; by accurately counterbalancing the resistance in the respiratory passageway from the nose to the alveoli, an equal pressure was maintained on the outer and inner surfaces of the thoracic cage and the upper and lower surfaces of the diaphragm.1.3-Pressure respiration with constant lung volume was then achieved by varying the density of atmospheric air, with complete arrest of chest movement in patients in whom excessive narrowing of the bronchial tree was not present. In subsequent clinical reports by the authors and others, this form of lung rest was shown to be responsible for closure of cavity and arrest of disease in cases of pulmonary tuber~ulosis .~-~ The intention of this paper is (1) to describe some of the unique physiological effects of ventilating the lungs without apparent lung movement, and (2) to present the follow-up results of 19 of 29 cases in which arrest of disease took place as a consequence of immobilizing lung chamber therapy.