All surgical methods pass through three stages: first, the pioneer stage, during which the surgeon is happy if the operation has been successful, that is to say, if the patient has survived it; then the second stage, in which, the rate of mortality having diminished, the surgeon endeavors to render the operation more efficacious, and finally the third stage, in which he tries to perform an efficacious operation with as little mutilation as possible.
Surgical treatment of pulmonary tuberculosis has already passed the first two stages. It no longer endangers life, and it is efficacious. This is the result of thirty years of continued effort on the part of surgeons all over the world. At present the problem consists in performing the operation without mutilating the patient.
Examination of a patient on whom a routine thoracoplasty has been performed reveals that the deformity he presents is due to three causes: