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Chapter 13

Chapter 13 - Tuberculosis


Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat
Chapter
13

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Chapter 13 The Peoples Plague: Tuberculosis
Used to be called consumption; characterized by nostalgia, depression, and excessive
sexual indulgence; stimulates artistic talent and mental activity lawl
TB was still is thought to produce spells of euphoria, increased appetite, exacerbated
sexual desireHaving TB was imagined to be an aphrodisiac, and to confer extraordinary
powers of seduction. Susan Sontag, Illness as a Metaphor
1800s, epidemic peak in Europe; persons afflicted considered beautiful and exotic; extreme
thinness, long neck/hands, shining eyes, pale skin, red cheeks; painful death by drowning in
ones own blood; chronic infectious disease
Romanticized in operas, movies, and literature
La Traviata, La Boheme, The Woman of the Camellias, Camille
Believed to be due to hereditary predisposition or living habits (debauched bohemian
lifestyle, pverty, sexual promiscuity
History
Found in bony remains that predate human writing
Potts disease described in Egyptian mummies dating from 3700-1000 BC
oMummy of priest from 100 BC discovered near Thebes; destruction of spinal
bones
oNo evidence of PTB in mommies of this period
oHigh priest of Ramses II; small child found with PTB in lungs (1000-400 BC)
Incan mummy of boy with Potts disease (700 AD); M. bovis in 17 thousand years old
bison in Wyoming; presence of TB in prehistoric America
PTB is a more recent form of TB than the one that infects the bones
Hypothesis: M. tuberculosis evolved from M. bovis after the domestication of cattle
(between 8000-4000 BC)
oEpidemic form of TB didnt occur before this time
Spread to Middle East, Greece, and India via nomadic tribes (Indo-Europeans) who
were mild-drinking herdsmen; migrated from forests of central/eastern Europe
~1500 BC
Clay tablet in Assyrian King Ashurbanipal (668-626 BC)s library described the
disease; coughs frequently, sputum is thick and sometimes contains blood, breathing
is like a flute, skin is cold
Hippocrates; called disease phthisis meaning to waste; individual was emaciated
and debilitated with red cheeks, great suffering leading to death; disease due to evil
air; not contagious
Aristotles; contagious due to bad and heavy breath.
Galen; theory of contagion of phthisis came to be accepted in the Roman Empire;
contagious agent not found
Middle ages
oFeudal system
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oRoyalty claimed talents of divine origins; ability to heal disease, specifically
scrofula simply by touching
Clovis of France, Edward the Confessor of England, Edward I, Philip
VI of Valois, Charles II, Louis XVI
oHealing ritual ceremonies; king/queen touches the sufferer, makes the sign of
the cross, and provided the afflicted with a gold coin; known as Kings Evil or
the Royal Touching in England; persisted until early 18th century
oShakespeares Macbeth (act IV, scene iii)
Tis called the evil:
A most miraculous work in this good king;
Which often, since my here-remain in England,
I have seen him do. How he solicits heaven,
Himself best knows: but strangely visited people,
All swoln, and ulcerous, pitiful to the eye,
The mere despair of surgery, he cures
hanging a golden stamp about their necks,
Put on with holy prayers; and this spoken,
To the succeeding royalty he leaves
The healing benediction. With this strange virtue,
He hath a heavenly gift of prophecy,
And sundry blessings hang about his throne,
That speak him full of grace
Tuberculosis; recent vintage, refers to tubercles (characteristic small
knots/nodules) in the lungs
oFirst described by Franciscus Sylvius, 1679; described their evolution into
lung ulcers
oPathologists of his time believed the disease was due to tumors or abnormal
glands rather than infection
Benjamin Marten (1772); first credible speculation; caused by animalcule or their
seed transmitted by the Breath [a consumptive] emits from his Lungs that may be
caught by a sound Person. (random capitalization much?)
16th century epidemic wave began in England, peaking in 1780
o20% of deaths in England due to TB
oSpread to rest of Western Europe, reaching peak in the 1800s (La Traviata
and La Boheme were written during this time)
oPeaks between 1875-1880 in Eastern Europe
oReached North America by 1900
Prevalent in cities along Atlantic coast
¼ of deaths in New York due to TB in 1804; Similar death rate in
Boston 1812-1821
Doesnt affect all segments of US population equally; higher African
American fatalities in Baltimore and NYC in 1804; Baltimore: twice
mortality rate for females above 15 than males; NYC: twice mortality
rate for males above 15 than females
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