Tuberculosis
“The beautiful Lady Mary! How could she die? – And of consumption – But it is a path I have prayed to follow. I would wish all I love to perish of that gentle disease. How glorious! To depart in the hey-day of the young blood — the heart all passion — the imagination all fire — amid the remembrances of happier days — in the fall of the year — and so be buried up forever in the gorgeous autumnal leaves! Thus died the Lady Mary”. (Poe, 1902) In the early 20th century many famous poets and authors spoke of a disease, such as the one that affected Lady Mary. Unfortunately these descriptions of consumption are highly romanticized, and the actual effects of the disease have proven to be significantly less adoring.
Consumption is the early name for what is now known as tuberculosis. Tuberculosis is an infection caused by bacteria called Mycobacterium tuberculosis. Tuberculosis comes in multiple types that can affect the lungs, kidneys, bones, lymph nodes, and brain. There are two primary categories of tuberculosis, pulmonary tuberculosis and extrapulmonary tuberculosis. Pulmonary tuberculosis is a form of the disease that occurs in the lungs, while extrapulmonary tuberculosis is a form of the disease that occurs in places other then the lungs.
Tuberculosis is not something that is new to the history books. Modern strains of the tuberculosis bacteria appear to have originated from a common ancestor approximately 20,000-15,000 years ago. For example, tuberculosis was found in Egyptian mummies dating back more then 5000 years ago. While looking at the skeletons of these mummies, scientist noticed deformities in the spine that correspond with a form of tuberculosis caused by the bacteria Mycobacterium bovis. This form of tuberculosis is known as Pott’s disease; Tuberculosis that results from a blood infection that spreads to the spine. The form most commonly known today however, pulmonary tuberculosis, did not occur until much later.
The first case of pulmonary tuberculosis dates back to approximately 400 B.C. Historians have used this to suggest that the bacterium that causes pulmonary tuberculosis, Mycobacterium tuberculosis, evolved from Mycobacterium bovis after cattle were domesticated between 8000 and 4000 B.C. It is thought that the disease spread to the Middle East, Greece, and India through nomadic Indo-European tribes who were milk-drinking herds men that migrated around 1500 B.C. From here the disease appears to have continued to spread. (Sherman, 2017)
Tuberculosis reached epidemic proportions in Europe during the 16th century. It is likely that the cause of this rise is due to the shift from rural to urban living. Town dairies were also created at this time, which also may have been the cause for this rise in tuberculosis. As urban development continued, trade as well as population began to increase. Soon these urban towns became cities, and conditions became more crowded and unsanitary. England also began taxing houses based off of he amount of windows located in the house. This lead to people rebreathing the exhaled air of those surrounding them in crowded airless rooms. Also, as cities grew so did poverty and malnutrition, which leads to a weakened immune system. (Sherman, 2017)
As tuberculosis became more prevalent, authors of books poems, and other forms of art began to romanticize about the disease. An example of this is in the famous opera Camille, where the main character was a beautiful that had tuberculosis. Many believed that the victims of the disease where attractive due to their thin physic, pail face, rosy cheeks, and supposedly sparkling eyes. This was even the basis for much of the fashion during the Victorian era. Unfortunately today the stigma for tuberculosis is a lot less romantic.
Today it is known that tuberculosis is spread through the air from person to person, which leads to many people avoiding contact with anyone they know how has tuberculosis. For the beginning stages of tuberculosis, victims are required to stay isolated from other people for months at a time. This has a huge impact on the family’s as well as the victims of those who have tuberculosis. Also, as medications have proven successful for the treatment of tuberculosis, certain strains of tuberculosis have become drug resistant, making it significantly harder, and more painful, to fight off the disease. The two drug resistant types of tuberculosis are called multidrug-resistant tuberculosis (MDR TB), and extensively drug-resistant tuberculosis (XDR TB). MDR TB is a form of tuberculosis where the bacterium is resistant to two of the most important drugs when treating tuberculosis. XDR TB is a form of tuberculosis where the bacterium is resistant to nearly all medicines used to treat tuberculosis. (“Centers for Disease Control”, 2017) drug resistant tuberculosis developed when people who had the normal strain of tuberculosis, but did not properly finish their treatment. Now MDR TB as well as XDR TB can be spread through the air from person to person as well.
In Irwin Sherman’s book The Power of Plagues Sherman states, “…tuberculosis is not only an infectious disease but a societal one as well…in order for ‘the people’s plague’ to be eradicated, the subtle interplay between disease and society must be fully appreciated. Until that time, TB remains a disease that could re-emerge to threaten us once again.” (Sherman, 2017) This is a significant statement, because it shows how much control society actually has on the spread of the disease. The disease has shown to be more prominent in areas where poor hygiene, over crowding, and compromised immune systems exists. Rather then continuing to add to the list of drugs used to treat tuberculosis, societies affected by the disease need to look at their own living conditions, and start putting forth public health measures in order to minimize the breading ground for the disease. Public health measures also need to be put in place to educate those with the disease about the effects of not properly taking their medication, and drug resistant strains of the disease.
References
Robert A. Stewart (ed. J. A. Harrison), “Notes to Metzengerstein,” The Complete Works of Edgar Allan Poe — Vol. II: Tales – part 01 (1902), pp. 370-373
“Tuberculosis (TB).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 9 Nov. 2017, www.cdc.gov/tb/topic/drtb/default.htm.
Sherman, Irwin W. The power of plagues. ASM Press, 20