Object of the Month: August 2021 Pneumothorax After Küss, Waldek and Wagner, Prague, around 1925
The BCG (bacillus Calmette-Guérin) tuberculosis vaccine was introduced to medical practice in the 1920s. Only in the 1940s were antibiotics employed to cure the disease: beginning with a combination of streptomycin, para-aminosalicylic acid and isoniazid. In previous decades, physicians treated tuberculosis with rest, sun and fresh air. Invasive methods included artificial pneumothorax, collapse therapy by introducing oxygen or nitrogen into the pleural cavity. The infected lung collapses, closing cavities left by necrotized tissue and limiting the spread of bacilli and toxins in the body by both blood and lymphatic paths. Carlo Forlanini (1847-1918) constructed the first device for artificial pneumothorax in the 1880s. In 1913, Georges Küss (1887-1966) improved the apparatus, introducing a mechanism that regulated, using communicating vessels, the volume of insufflated gas and the resulting pleural pressure. This ensured effective lung collapse with minimum side effects. In Czechoslovakia, the Pleš sanatorium begun to employ Küss’s device in the early 1920s. In 1923, Jaroslav Jedlička (1891-1974) published an article on the experience with pleural pressure control. The instrument maker Waldek and Wagner started producing the instrument at about the same time.