Monthly Medicine: The History of Tuberculosis

Hi all!

Welcome, once more, to another post in our series entitled Monthly Medicine, in which we take a disease each month to focus our research, and present a few gruesome, grizzly, or ghastly little articles on the history or epidemiology of the disease. This month, we’ve chosen the history of tuberculosis, arguably one of the History of Medicine’s most infamous diseases. In this post, I shall conduct a brief overview of the history of tuberculosis, including some of the key aspects of the disease, but the history of the disease is so broad and far-reaching that it shall by no means be totally exhaustive. And so, without further ado, we shall begin.

Mycobacterium_tuberculosis
Fig. 1

Tuberculosis, caused by the bacterium Mycobacterium Tuberculosis, is an infectious disease that generally affects the lungs but can also affect other areas of the body. Its symptoms (depending on the type of TB and the location of the infection) can include coughing up blood, lack of appetite, night sweats, fever, amongst a number of other symptoms.[1] One of the biggest killers in the modern day, MSF estimated that every year 1.4 million people are killed by the disease, with another 9 million suffering from it.[2] Treatment often requires the use of multiple antibiotics over a long period of time, although recent resurgences and the rise of antibiotic resistant strains has meant that Tuberculosis has reared its ugly head once more in the contemporary world.

Historically, Tuberculosis has been referred to under a plethora of different pseudonyms and guises. Among the list are ‘consumption’, ‘the white plague’, ‘scrofula’, ‘Pott’s Disease’, and ‘pthisis (or pthisis pumoniasis)’, all of which were used to denote the disease throughout history. The disease itself has plagued mankind throughout antiquity and into the modern day, and remains one of the largest infectious disease killers of all of history. The organism causing tuberculosis has been found to have existed as long as 15,000 to 20,000 years ago and has been found in relics from India, China, and ancient Egypt.[3] Throughout the Medieval era, evidence of Tuberculosis has been found in lymph nodes from the neck or cervix of sufferers. Put simply, Tuberculosis is an ancient disease, and can be found throughout the history of epidemiology as a hugely prominent infectious killer.

Cristobal_Rojas_37a
Fig. 2

In the seventeenth  and eighteenth century, there was a surge of medical interest in the treatment of the disease. Franciscus Sylvius, a Dutch physician, began differentiating between the different forms of the disease;  Benjamin Marten publish his work on the disease entitled A New Theory of Consumptions more Especially of Phthisis or Consumption of the Lungs, in which he posited that the cause of tuberculosis was a microscopic organism that he called an animacula; and in 1779, Percivall Pott, an English surgeon, first discovered the legions which were to be named after him. The disease reached an epidemic level in Europe, believed to have started at some point in the seventeenth century, and lasted for upwards of two hundred years.[4] Dubbed ‘The White Plague’, for its effect upon the pallor and constitution of its sufferers, the ‘White Plague’ permeated across many corners of the European continent. It was in the wake of this epidemic that the emergence of a new, somewhat unusual sociological entity occurred in the nineteenth century.

Joseph_Severn_-_Posthumous_Portrait_of_Shelley_Writing_Prometheus_Unbound_1845
Fig. 3

Strangely enough, in the nineteenth century, the disease became something of an iconic fashion trend within the romantic movement – the tortured genius suffering from consumption became a desirable image to many. Famous sufferers included poets John Keats and Percy Shelley, Edgar Allan Poe, Robert Louis Stevenson, and Emily Bronte. Suffering from Tuberculosis was believed to bestow a form of intense sensitivity to the sufferer, to aid artists in their suffering for their craft. Thus, the image of the ‘consumptive artist’ or the ‘romantic disease’ that permeated nineteenth-century culture produced a curious epidemiological entity that brought together romanticism, artistic expression, and suffering in an usual way.

The causative organism for Tuberculosis was eventually discovered by Robert Koch in 1882. Following this discovery, the need to keep patients of Tuberculosis isolated in sanatoriums and hospitals was brought to the forefront of medical practitioner’s concerns. Eventually, following a number of scientific discoveries, the “BCG” vaccine was introduced in 1921 and treatments are constantly being re-examined and redeveloped into the contemporary era.

Footnotes:

  1. Further listing of the symptoms of Tuberculosis can be found at http://www.nhs.uk/Conditions/Tuberculosis/Pages/Symptoms.aspx
  2. Statistics referred from the MSF website at http://www.msf.org.uk/tuberculosis
  3. http://www.news-medical.net/health/History-of-Tuberculosis.aspx
  4. http://www.news-medical.net/health/History-of-Tuberculosis.aspx

Image Attribution:

Fig. 1- Photo Credit: Janice Carr Content Providers(s): CDC/ Dr. Ray Butler; Janice Carr This media comes from the Centers for Disease Control and Prevention‘s Public Health Image Library (PHIL), with identification number #8438.

Fig. 2 – Cristobal RojasObra de arte, Pintura de Cristóbal Rojas (1857–1890) Galería de Arte Nacional, Caracas- Venezuela. – 150 Pinturas Antológicas. Juan Calzadilla. Fundación Museos Nacionales, Galería de Arte Nacional, Caracas, 2012

Fig. 3 – Joseph Severn –  Title, year, and collection of painting from Morris, Lawrence, ed (2009). Daily Life through World History in Primary Documents. Greenwood Press. Volume 3, p. 132., Posthumous Portrait of Shelley Writing Prometheus Unbound, oil on canvas. Keats-Shelley Memorial House, Rome, Italy.

oseph SevernImage from Internet search: [1]. Title, year, and collection of painting from Morris, Lawrence, ed (2009). Daily Life through World History in Primary Documents. Greenwood Press. Volume 3, p. 132.

Posthumous Portrait of Shelley Writing Prometheus Unbound, oil on canvas. Keats-Shelley Memorial House, Rome, Italy.

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