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At that time he gave a history of pleuritic type chest pain, cough, and blood-streaked sputum. Physical examination revealed bilateral crepitations in the lungs, and his chest radiograph showed dense fibrotic infiltration over the entire right lung field with evidence of cavitation in the right upper lobe. On the left there were scattered, less dense infiltrations in the lower two-thfirds. Sputum smears for acid-fast bacilli initially were reported as Gaffky VI. Subsequent sputa were negative. No cultures were made. A diagnosis of far advanced, pulmonary tuberculosis was made, and treatment consisted of repeated artificial pneumothoraces on the right. After one year he was discharged as improved.The patient remained well for two years, but was readmitted in 1941 because of shortness of breath, cough, and one episode of haemoptysis: at that time he received several additional artificial pneumothorax treatments. Sputum smears were negative for acid-fast bacilli.His third admission was in 1948 for 10 days, and once more he was given a pneumothorax on the right.The patient then felt well enough to do light work as a carpenter and as a farmer. He was admitted for the fourth time in November 1965 because of bloodstreaking in the sputum. His chest radiograph showed dense infiltration in the upper two-thirds of the right lung with cavity formation, while the left lung was 722 on 10 May 2018 by guest. Protected by copyright.

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