Dr. Margaret H. D. Smith: We have been using adrenal steroids in the treatment of tuberculosis in children. We have a relatively small number of cases, not enough to set up a controlled, randomized, case study. We decided a couple of years ago, when we embarked on this study, to treat consecutive cases for certain indications, and see where we got, hoping to find out in the first place whether steroids seemed to do good or whether they seemed to do harm; in the second place, if they did seem to do good, to try and find out what sort of treatment dosage, what treatment schedule, and so forth, might be indicated. We thought then that, if we actually ended up with some sort of positive experience and data, that perhaps we might, under other circumstances, be able to do a properly controlled study. Our observations on the use of steroids in the treatment of tuberculosis have really been patterned on the experience of various European investigators, who started us on our way.
I am not going to say very much about the use of steroids in tuberculous meningitis because that is an indication for the use of steroids which is fairly generally accepted. I think that the data which have been gathered in Italy, in South Africa, and in many other parts of the world, as well as in the few cases that we have had occasion to treat here, make one realize that steroids are a very valuable adjunct in the treatment of tuberculous meningitis.
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