What is Plombage?

Plombage is a treatment which was used for tuberculosis in the 1930s through the 1950s. With the advent of antibiotic drugs to treat patients with tuberculosis, plombage was abandoned as a method of treatment. Since it could cause considerable complications for the patient, this was probably for the best, although doctors noted some positive outcomes as a result of this treatment. Medical journals contain a number of accounts of patients 50 years or more post-plombage who developed cancers, infections, and other problems as a direct result of the treatment.

This treatment approach was part of a technique known as collapse therapy. Physicians theorized that the lesions caused by tuberculosis never got a chance to heal because the lung was constantly working. They thought that collapsing the upper lobe of the lung would give it a chance to rest, thus allowing the lesions to heal. Initially collapse therapy was done by forcing air into the pleural space surrounding the lung to force the lobe to collapse, but this required periodic reinjections of air.

In plombage, the lobe was collapsed and then a material such as wax, lucite balls, or plastic balls was placed to hold the lobe in a collapsed state. Sometimes referred to as “ping pong ball plombage,” the technique sometimes resulted in complications such as fistula, infection, and hemorrhage. These complications paled when compared with the long term complications of plombage. In the 1990s and 2000s, patients who had received plombage therapy presented with cancers and severe infections which were linked to the materials still inside their chests.

Medical journals from the heyday of plombage document the various techniques used and their outcomes. Doctors reported positive results from collapse therapy, which encouraged other doctors to pick up this surgical treatment for tuberculosis for their own patients. However, once antituberculosis drugs were introduced, doctors had a much less invasive method for treating this disease, and plombage quickly fell out of favor.

After the therapy fell into disuse, radiologists were most likely to encounter it, in the form of ghostly shapes on radiology films caused by the objects used to keep the lung collapsed, and in fact such films were sometimes used as medical or diagnostic puzzles for medical students to provide them with examples of the types of things they might encounter in the practice of medicine. Tuberculosis continues to be a threat and several drug resistant forms have arisen around the world, complicating the drug therapies which once showed such promise. Researchers in drug development and tuberculosis treatment rarely stay ahead of this disease for long.