ABSTRACT
The continued decline in tuberculosis mortality, which began in the middle of the last century, has probably been due to a conglomerate of reasons, not least of which was the advent of streptomycin treatment in 1941. This must, however, be seen in its correct context since one of the major reasons for the decline in tuberculosis is that of improved living conditions and a greater social awareness. Cawthorne and Ranger reviewed 22 patients between 1951 and 1956 who had received less than 20 g total dose of streptomycin but in whom there were signs of both balance disorders and a hearing loss. They noted that the symptoms of intoxication were unlikely to appear on a daily regime of 0.5 g streptomycin or less, although it was appreciated that in certain tuberculosis infections treatment may necessitate at least 1 g/day. The recognition of streptomycin-induced ototoxicity resulted in the introduction in the early 1950s of dihydrostreptomycin.
