In recent times emphasis has been laid on the need to treat sick people, not only to
attempt to remedy organic disorders. Tuberculosis patients have many complaints which
vary with each individual, so it is difficult to treat a case only from x-Ray and
laboratory findings without studying the patient himself. The other day f was consulted
by a patient who brought his latest chest x-Ray with him. He complained of increasing
symptoms and was worried about getting worse. A comparison of his X-Ray with
previous films showed no great change, but gave me the impression of some localised
improvement. When I explained X-Ray findings to tile patient he did not seem
convinced. He obviously thought that his pulmonary lesions had become worse because
of his increased symptoms, and that I was not telling him the truth, This worried me
and I realised again how difficult it is to treat a case without studying the individual.
In our daily clinic we meet many patients who complain of various symptom and we
try to investigate them by means of physical examinations and laboratory.
investigations. If we cannot find any organic changes in these examinations, we do not
usually investigate further, considering that we have achieve our purpose. Even where
no pathological changes are found, unless the patient is free from symptoms, it is
difficult to say that treatment has finished. The complaints of tuberculosis patients
are various in origin. Apart from typical symptoms caused by tuberculosis, they also
complain of symptoms of neurotic origin and of symptoms due to toxicity from
anti-tuberculous drugs. It is very difficult to differentiate clinically between these
symptoms. According to recent reports from Japan, (Nihon Medical School, Tokyo) about
50% of patients suspected of toxic phenomena due to anti-tuberculous drugs were
neurotic. I present here the case of a Tuberculosis patient whose vertigo developed
during chemotherapy and was controlled without any change in his regiment This
patient-29year old, male, suffered from sudden severe vertigo on 2nd.March 1956,after
his father´s death. At that time he couldn´t walk without a stick and his doctor,
suspecting toxic phenomena, ordered Streptomycin to be discontinued, A summarized
history of the patient is as follows:
Admission : 27th September, 1954.
Family history : father, 2 brothers, 1 sister died from Tuberculosis. Mother and 1
brother are suffering from Tuberculosis.
History : June ´51 Bloodstaind sputum. X-Ray taken. Nov. ´51-March ´52 Bed rest
and P.A.S. Resumed normal life until sudden Haemoptysis. June ´52-Dce. ´52 Bed rest.
Streptomycin and P.A.S.
X-Ray Findings : Infiltration in Right middle lung field.
MA.T.B.
Laboratory Examinations :
Sputum : 22nd April 55 Conc. 3+
5th. March 55 Conc. -
27th. March 56 Conc. -
Sed. Rate. 20th Sept. 55 lst. Hr. 2㎜.
2nd. Hr. 3㎜.
18th. Jan. 156 lst. hr. 1㎜.
2nd. hr. 2㎜.
Hb. 18th. Jan. 156. 99%
5th mauh 56. 98%
Treatment Streptomycin 60Gms.)
P.A.S. 1125Gms.)
Prior to admission.
I.N.AH. 16Gms.)
These three drugs have been continued since admission. Now, 3 months after
vertigo developed, the patient has quite recovered from his symotoms following
psychotherapy.
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