[The National Tuberculosis Association and its affiliated associations present Behind the Shadows, a Windsor Production]
[Direction...Leo Lipp, Photography...William Miller, Animation... Marchus Slonim, K. K. Bosse]
[Narrator:] Yes, the story of tuberculosis is a dramatic one. Tuberculosis is older than history. It's never given civilized men peace.
No one, artist or statesman, rich or poor, young or old, is immune. Once it was a hopeless case, but now thanks to our knowledge it can be brought under control.
Now let me tell you about it. Tuberculosis is caused by a germ so small, thousands could pass through a pinhole without crowding. We know exactly what it looks like.
The tubercle bacillus is a living plant. It grows and reproduces. It dies quickly in boiling water or sunshine, but thrives in the human body.
How does the germ get into the body? Well, careless people who have the disease may spit on the floor or sidewalk. Mixed with the dust, the germs may be blown about and breathed by others.
This child, for example, may carry the germs on the lollipop to her mouth or germs may be left on any article that touches the lips.
The next person who puts one of these articles into his mouth gives the germs the chance to get into his body, but far more important is the danger of direct contact especially lip contact of one who has the disease with one who hasn't.
How can our little friend, John, for example, escape getting into his lungs some of the tuberculosis germs of his Aunt Alice, who has been visiting.
She loves him dearly, but doesn't seem to realize that what she calls her chronic bronchitis is really tuberculosis.
Now let us suppose that some of the germs of Aunt Alice's lungs have actually made their way into John's lungs. They've gained a foothold here in the lung substance. What happens then?
We have focused a powerful microscope on the spot and here we see the germs attached to the lung substance. John is now infected. Soon the germs increase in number and begin to spread.
But see? The cells of the body seem to be waking up. They are [?] in a tight little capsule called a tubercle. It's a battle royal now, but this time the body wins. Lucky John.
Of course, these are just diagrams, but that is about what happens. There you see the first tubercle. Eventually a gritty substance called calcium takes the place of the destroyed lung substance, and the little shell becomes hard and stony.
In fact, it is this gritty material that casts its shadow on the x-ray film. Here is an x-ray picture of such a first tubercle. The disease in this case gets no further than that first tubercle, except that some germs may escape to the nearby lymph glands or nodes.
Lymph glands serve as filters, stopping germs from spreading over the body. Here they are stopped. The lymph glands may suffer some damage but this is repaired just as in the lung substance. These two show on the x-ray film.
No two cases of tuberculosis are exactly alike, but what we have seen probably happens very commonly. Many, many persons are affected as children, but never know it and are none the worse for it, but on with the story.
John has grown. He's a senior in high school now and he's been infected again, though he doesn't know it. Perhaps his aunt has come to live with the family.
Because John had already been infected, the cells of his body have been stimulated or sensitized to the further attacks of these tuberculosis germs.
Now, in their eagerness to surround the germs and protect the body from them, the cells often destroy themselves, thus giving the germs a chance to spread and once they get started the germs soon destroy tissue and do real damage until they are checked.
Besides John was a bit careless. He used up too much of his energy. Hard work at school, strenuous athletics, out late at night.
Let's look again at John's lungs. Yes, the original tubercle is still there firm and hard, and the healed lymph nodes, but look, there's a bit of trouble here.
Nothing to get excited about, you say. Yet that is the real beginning of serious tuberculosis. John has no symptoms, he probably feels perfectly well.
He wouldn't think of going to a doctor. A dark tragedy is staring John in the face but lucky John, the enemy was discovered. How?
In the up-to-date high school he attended, the tubercle test was offered to all students. This test is simple and harmless. Well, here is John at the head of the line. With a few drops of a liquid called tuberculum is injected into the skin.
Hurt? Well, yes, about like a mosquito bite and a lot less harmful than many a mosquito bite. Two days later the test is read. If the spot is raised and reddened, it is called positive.
What does that mean? Only that at some time, tuberculosis germs have entered the body.
In this school, 30 percent of the children were positive. So these were x-rayed to see if the germs were doing any damage. John was one of them. No need to x-ray the others because without infection there can be no tuberculosis.
When John's family doctor looked at the developed film, this is what he saw. The old shadow scarcely visible and here in the upper part of the right lung some suspicious shadows. Not very serious.
John spent a short time in bed and then he went back to school, but what bothered the doctor was where did John get his infection and his re-infection. He knew that every case comes from another, so naturally he sent for John's parents.
[Doctor:] I just wanted to make sure, Mrs. Brown, that John did not get his infection at home. Your lungs are absolutely all right and so are Mr. Brown's and Jean shows only a positive tuberculum test.
[Mrs. Brown:] Doctor, my sister, Alice, has come to live with us again. She coughs a lot.
[Doctor:] By all means ask her to come see me.
[Narrator:] To make a long story short the doctor found that Aunt Alice had an old chronic tuberculosis. There were tubercle bacilli in her sputum.
See this cavity in the lungs? From it comes a steady stream of germs. Yet, she didn't feel sick enough to complain. There are many such people. For John's sake she consented to go to the sanatorium.
Now suppose we pick up the story where we left it with John. Just a little inflammation here. With rest in bed the little tubercles which cast these shadows harden and quickly start the spread of the disease.
Suppose this had not been discovered. What then? Well, it probably would have spread. Watch this spot. It is being hollowed out. Now, it is a cavity.
Inside, the germs are growing fast and many of them escape into the air passages and are coughed up. A veritable factory of germs is such a cavity; serious for the patient and dangerous to all those with whom he comes in close contact.
It takes years of rest in bed to heal it and sometimes never heals but goes on to death, but I'm happy to say that even this serious condition is not hopeless today, when there's a way of collapsing a diseased lung. Let me show you how that is done.
It requires a simple operation called pneumothorax, which means putting air into the chest. Since the lung is soft it is easily collapsed as one would squeeze a sponge.
The cavity is closed and that stops the manufacture of germs. It rests the lung and gives it a chance to heal. The cough stops, the fever goes down and best of all no more germs are spit up. That is exactly the way John's Aunt Alice was treated.
Of course, the air gradually leaks out but it's an easy matter to put in more air every two weeks or so until the lung has healed completely. Then gradually the lung is allowed to re-expand. Pneumothorax is a lifesaver for thousands.
I'm sure that you now appreciate that the earlier tuberculosis is discovered the more certain is the cure. Delay is not only dangerous, it is costly.
[Woman:] But, doctor, what is the answer to this problem? Surely once they get tuberculosis the money is well spent on the cure?
[Narrator:] Yes, but money well spent in prevention will make cure unnecessary. We must beat our silent enemy to it and strike him down before he strikes us.
Every young person from 15 to 25 years ought to have the benefit of the tuberculin test and the x-ray and someday I hope that we shall make a routine practice of testing every child from babyhood with tuberculin.
You spot the enemy at his first shadow. I am confident you young people will see the victorious end of this struggle.
[The End]