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The White Plague in the City of Angels

Caroline Luce, Author
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Tuberculosis and Its History

Tuberculosis is an infectious disease caused by a mycobacterium called tubercle bacilli. In over ninety-percent of the cases, the disease infects the lungs first, where it attacks and kills cells, forming pus-filled clusters called tubercles.  If untreated, the tubercles grow into ulcerous cavities and the infection can spread into the nervous system (causing tuberculosis meningitis), lymphatic system (causing scrofula of the neck), the skin (causing lupus), and bones and joints (causing Pott’s disease of the spine, in some cases resulting in a deformity referred to as a “hunchback”). In its most serious form (“miliary tuberculosis”), it can kill within days, but in most cases it follows a “chronic, protracted course,” meaning that the victims often live with the disease for decades.

Tuberculosis likely has been present in humans since the dawn of humankind. Signs of the disease have been found in human remains from the Neolithic era and in Egyptian mummies from 3000 BC. References to a disease called “yakshma,” the Hindu word for consumption, appear in writings from ancient India and Emporer Shennong of China refers to the disease in a medical text written in 2700 BC. The Greek physician Hippocrates described a disease he called phthisis as the most common and deadly illness of his time. Twice in the Bible, God threatens to smite the Israelites with a disease called shachepheth (in Hebrew shakh-eh’-feth means “a wasting disease” or “consumption”), which is described as a “terror, consumption and the burning ague…” (Leviticus 26:16), and a “fever, inflammation, and heat” that “pursues you until you perish” (Deuteronomy 28:22). Tuberculosis was the principle cause of death in 17th century Europe, infecting those at every level of the socioeconomic hierarchy including kings Louis XIII of France and Edward VI of England, earning it the name "The White Plague."

Although doctors in these societies varied in their diagnoses of the disease, the symptoms associated classically with phthisis included high fevers, sweats, breathlessness, severe cough and bloody sputum, and rapid weight loss. Because the disease appeared to eat away, or “consume,” the flesh of its victims, Western European doctors most commonly referred to it as consumption. Rene Laennec, a French scientist, who suffered himself from tuberculosis and eventually died from the disease, was one of the first doctors to develop a precise method for diagnosing the pulmonary lesions cause by phthisis by listening to his patients breathe using his invention, the stethoscope. Laennec’s French colleagues, Pierre Charles Alexandre Louis and Gaspard Laurent Bayle, used his findings to evaluate the progression of the disease in the body and identify six types of the disease. In 1839, German scientist Johann Lukas Schöenlein first described phthisis as “tuberculosis.”

It is impossible to know exactly how many people were infected by the white plague because “consumption” was used to describe any number of chronic lung disorders and many non-pulmonary forms of the disease were largely misdiagnosed. But by the estimate of some medical historians, as many half of the population in early 19th century England died from tuberculosis. These included some of Britain’s most famous literary icons: Lord Byron, Percy Shelly, John Keats, and Brönte sisters Maria, Elizabeth and Emily. The disease claimed the lives of Frederic Chopin and Anton Chekov, and became the subject of Giacomo Puccini’s opera La Bohème. Nineteenth century American writers suffered from tuberculosis as well, including Nathaniel Hawthorne and Henry David Thoreau and the family of Ralph Waldo Emerson. With so many writers and artists of the nineteenth century making the disease - and their personal struggles to overcome it - the subject of their work, tuberculosis became a ubiquitous part of both European and American culture.

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