WEBVTT Kind: captions; Language: en 00:00:07.001 --> 00:00:12.000 Every year in America there are more than 100,000 new cases of tuberculosis. 00:00:13.000 --> 00:00:16.001 Of all infectious diseases, tuberculosis is still the greatest killer. 00:00:17.000 --> 00:00:20.000 This film on tuberculosis presents aspects of its 00:00:20.000 --> 00:00:22.001 diagnosis, treatment and control. 00:00:43.001 --> 00:00:48.001 Music In spite of the progress of preventive medicine, in spite of public health 00:00:48.001 --> 00:00:53.001 programs on community, state and national level, tuberculosis still attacks 00:00:53.001 --> 00:00:57.000 almost as many Americans today as 10 years ago. 00:00:58.000 --> 00:01:02.000 Although the number of deaths from tuberculosis has been gradually falling 00:01:02.000 --> 00:01:03.001 off. Why? 00:01:04.001 --> 00:01:08.000 For one thing, industrialization has spread faster 00:01:08.000 --> 00:01:09.001 than industrial health programs. 00:01:11.000 --> 00:01:14.001 In some occupations there remains the hazard of infection. 00:01:16.000 --> 00:01:20.001 Poverty and ignorance, whether in back country or in city slums, 00:01:21.000 --> 00:01:22.001 contribute to the spread of tuberculosis. 00:01:25.000 --> 00:01:30.001 Ignorance or negligence, as in this case or in this case. 00:01:33.001 --> 00:01:37.000 And then there are wars, the greatest spreaders of tuberculosis. 00:01:38.001 --> 00:01:42.001 The work of scientists alone cannot eliminate the deadly 00:01:42.001 --> 00:01:44.001 bacteria that cause tuberculosis. 00:01:46.000 --> 00:01:47.001 It takes community action. 00:01:50.001 --> 00:01:55.000 In the city where Mary Smith attends high school, tuberculin 00:01:55.000 --> 00:01:57.000 tests are given to all pupils. 00:02:10.001 --> 00:02:13.001 Two days later, the results are checked. 00:02:15.000 --> 00:02:19.001 The tuberculin test shows that this apparently healthy boy is infected. 00:02:24.001 --> 00:02:26.001 Mary's arm shows no reaction, however. 00:02:28.000 --> 00:02:31.001 Her test indicates that she has not been infected with tuberculosis. 00:02:34.000 --> 00:02:38.000 Soon afterwards, Mary's aunt comes to live with her. She seems 00:02:38.000 --> 00:02:39.001 run down and needs a rest. 00:02:40.001 --> 00:02:43.001 Actually, she has a well-advanced case of tuberculosis. 00:02:45.000 --> 00:02:49.001 Through sneezing, coughing and direct touch, Mary may have been infected. 00:02:51.000 --> 00:02:54.000 Often, bacilli of tuberculosis are breathed in by their victim. 00:02:54.001 --> 00:02:59.001 They pass through nose and mouth into the trachea and on through the smaller 00:02:59.001 --> 00:03:02.000 passages, deeper and deeper into the lung. 00:03:03.000 --> 00:03:08.000 At their ends, in the deepest recesses of the lungs, the bronchi eye branch out 00:03:08.000 --> 00:03:13.000 into very small bronchioles, which contain air sacs whose walls are 00:03:13.000 --> 00:03:14.001 principally tiny blood vessels. 00:03:15.001 --> 00:03:20.000 The tuberculin bacilli at once attract disease-fighting cells, which begin to 00:03:20.000 --> 00:03:22.000 surround and envelop the germs. 00:03:22.001 --> 00:03:25.000 Many of the cells, however, are killed by the bacilli. 00:03:25.001 --> 00:03:30.001 Then larger body defense cells come to the rescue by swallowing up smaller cells 00:03:30.001 --> 00:03:32.001 and the bacilli they contain. 00:03:44.000 --> 00:03:51.000 Within a few hours, some air sacs have been filled with masses 00:03:51.000 --> 00:03:54.000 of these cells, which hold in most of the bacilli 00:03:54.000 --> 00:03:56.000 and prevent their further spread. 00:03:58.000 --> 00:04:01.001 At the end of a few weeks, the bacilli, although they may have multiplied for a 00:04:01.001 --> 00:04:03.001 time, are walled off temporarily. 00:04:05.001 --> 00:04:11.001 Or, as rather commonly happens, they may have been carried through lymph vessels 00:04:11.001 --> 00:04:13.000 to bronchial lymph nodes. 00:04:13.001 --> 00:04:15.001 There, they may have been similarly walled off. 00:04:17.000 --> 00:04:21.000 This may have been the case of Mary Smith, who by now has finished high school. 00:04:21.001 --> 00:04:26.000 She has a job and is working, working hard, playing hard, making 00:04:26.000 --> 00:04:27.001 every effort to keep slender. 00:04:30.001 --> 00:04:33.000 She's having too little to eat. She's getting too little 00:04:33.000 --> 00:04:34.001 rest and too much excitement. 00:04:36.001 --> 00:04:40.001 Her vitality and body resistance have become lowered, and tuberculosis 00:04:40.001 --> 00:04:42.000 reinfection has commenced. 00:04:47.001 --> 00:04:51.000 Reinfection may come from outside, from tubercle bacilli 00:04:51.000 --> 00:04:53.000 carried from the air into the lungs. 00:04:56.000 --> 00:04:59.000 Or it may come from spreading of a primary infection. 00:05:01.001 --> 00:05:07.001 Either by the breakdown of the primary pulmonary focus or of the lymph node 00:05:07.001 --> 00:05:13.000 focus, either directly into the lung or in a roundabout way through the 00:05:13.000 --> 00:05:18.001 bloodstream, or finally into the bronchial tubes, with discharge of germs into 00:05:18.001 --> 00:05:22.000 other parts of the lung and formation of a new diseased area. 00:05:27.000 --> 00:05:33.001 Although at any time healing may again take place, 00:05:33.001 --> 00:05:38.000 the diseased part may grow and spread, forming a larger and larger cavity. 00:05:42.000 --> 00:05:46.001 The first of this series of x-rays shows a small, dark appearing cavity. 00:05:48.000 --> 00:05:51.001 In the second, the dark shaped area has grown noticeably larger. 00:05:54.000 --> 00:05:59.000 And here it has reached the advanced stage of chronic 00:05:59.000 --> 00:06:01.000 ulcerative pulmonary tuberculosis. 00:06:05.001 --> 00:06:10.000 For several months, Mary has tired easily, and she's been losing weight steadily, 00:06:10.000 --> 00:06:12.000 and she coughs very often. 00:06:16.001 --> 00:06:22.001 All this begins to worry her, and she finally decides to 00:06:22.001 --> 00:06:24.000 make an appointment with her physician. 00:06:29.000 --> 00:06:32.001 Mary's doctor soon detects signs that indicate tuberculosis. 00:06:33.001 --> 00:06:37.001 He suggests that she go to a tuberculosis clinic for further examination. 00:06:39.001 --> 00:06:41.001 She takes a sample of sputum to the clinic. 00:06:43.001 --> 00:06:45.001 Then she is given another tuberculin test. 00:06:50.000 --> 00:06:54.000 Among other checkups, an x-ray picture of her lungs is made. 00:06:55.000 --> 00:06:59.000 X-rays are one of our best means of getting evidence when infection is present. 00:07:03.000 --> 00:07:07.001 The report of the clinic goes back to Mary's physician. 00:07:08.000 --> 00:07:10.001 He explains to Mary the findings of the clinic. 00:07:11.000 --> 00:07:16.000 Then he points out that x-rays show tuberculosis in her upper right lung. 00:07:18.001 --> 00:07:21.000 The doctor tries not to alarm Mary. 00:07:21.001 --> 00:07:27.001 However, he makes it clear that she will have to submit to a long treatment, a 00:07:27.001 --> 00:07:32.000 treatment that will take her away from home to a tuberculosis hospital where she 00:07:32.000 --> 00:07:36.001 will get proper medicine, proper food, rest, and possible surgery. 00:07:39.000 --> 00:07:44.000 Under the care of nurses and doctors, Mary is undergoing the standard treatment. 00:07:47.000 --> 00:07:54.000 She is being trained in sanitary procedures, like using coverings when 00:07:54.000 --> 00:07:58.000 she coughs and disposing of them into a receptacle which will be burned. 00:08:04.000 --> 00:08:07.000 Fortunately, Mary is able to take an adequate amount of nourishment. 00:08:08.001 --> 00:08:12.001 Milk, citrus fruit juices, meat, potatoes, and vegetables. 00:08:13.001 --> 00:08:17.001 Proper food not only gives her the necessary body fuel, but materials which 00:08:17.001 --> 00:08:19.000 will heal the injured parts. 00:08:22.001 --> 00:08:28.000 Repair is a slow process, but proper medicine, good food, and rest will work 00:08:28.000 --> 00:08:33.001 wonders, even in the advanced stage of tuberculosis, as in the case of the ant. 00:08:34.001 --> 00:08:38.001 A number of different surgical procedures can be used, either to help the lung 00:08:38.001 --> 00:08:41.001 rest or to remove the damaged portion of the lung. 00:08:42.001 --> 00:08:46.001 New drugs are constantly being developed to aid in the recovery of the patient. 00:08:55.000 --> 00:09:00.000 But even after the rest and building up of strength in the hospital, Mary passes 00:09:00.000 --> 00:09:03.000 through a long stage of convalescence at home. 00:09:04.001 --> 00:09:10.000 In an organized effort to help patients like Mary, public and private hospitals 00:09:10.000 --> 00:09:11.001 have been built all over the country. 00:09:14.000 --> 00:09:19.001 Mobile units like this one for schools, for communities, or for large factories. 00:09:22.001 --> 00:09:27.000 Regular checkups by a physician help discover infection before it spreads. 00:09:29.000 --> 00:09:34.000 We have mobilized against tuberculosis, all the resources of modern science. 00:09:34.001 --> 00:09:37.001 We are constantly building better and more efficient tools. 00:09:38.000 --> 00:09:42.000 But only by checking an ever increasing number of citizens. 00:09:42.000 --> 00:09:45.001 By going after tuberculosis before the disease spreads, 00:09:46.000 --> 00:09:47.001 can tuberculosis be conquered? 00:09:48.000 --> 00:09:52.001 Only if we fight it on a nationwide front can we achieve a lasting 00:09:52.001 --> 00:09:54.001 control over tuberculosis.