The History of Tuberculosis

A pair of lungs Tuberculosis has been known under a variety of names during the course of history. It has often been a difficult disease to diagnose and has been confused with many other diseases. The actual name "Tuberculosis" was introduced during the first half of the nineteenth century and it refers to the diseased condition caused by infectious agents known as tuberculosis bacteria or tubercle bacilli. The disease has been also known under other names, such as phthisis, Scrofula, tabes, bronchitis, and inflammation of the lungs, hectic fever, gastric fever, and lupus. It was also known as the great white plague or "consumption". The word consumption is employed in the Bible to translate Schachepheth, which is also the Modern Hebrew word tuberculosis. Although tuberculosis can attack the whole body it is frequently known more for its damage to the lungs.

Many early attempts at treatment can be found throughout world history. Greeks believed cutting off cool air eventuated in a burning-up of the tissues of the body. The Romans put great importance on the diet. The Hebrews appear to have been exposed to TB for many years, and made a number of attempts to control the disease from diet to the destruction of clothing. Early reported "cures" from physicians included warm sea air, milk from pregnant women, seaweed placed under the pillow, cold baths and deep breathing. Most of these proved to be fruitless, and it would be many years before any real cures could be found. Many people believed that the disease was a form of punishment and this can be found in a number of ancient literatures, including the Bible. By 1650 consumption was the leading cause of mortality and it became a reference in some of Shakespeare's plays, one of the consumptive lovers, in "Much A Do About Nothing", as well as scrofula in Macbeth.

The first real breakthrough in understanding tuberculosis came when a German bacteriologist named Robert Koch isolated the infectious agent known as tuberculosis bacteria or tubercle bacilli in 1882. He was later awarded the Nobel Prize for physiology or medicine in 1905.

A botanical student from Silesia in Germany opened the first sanatorium in 1854. Hermann Brehmer was himself a sufferer from the disease and was advised by his doctors to go to the Himalayan Mountains. He went on to have a house built in the middle of a pine forest in Gorbersdorf, where he combined botanical research with a search for a cure. Sick patients were given much wholesome food and plenty of fresh air. This became the most modern way to fight the disease. This idea was soon followed by sanatoriums being developed in USA where as in the UK in the second half of the nineteenth century, many consumption patients were nursed (and died) in the poor law institutions. With other Countries showing us the way forward pressure was now on to open sanatoriums in England and Wales. The sanatoriums provided medical care for almost 100 years. It became one of the most remarkable and unique periods of medical care in history.

By 1889 in the USA the National Tuberculosis Association fully realised that TB was distinctly preventable and that it was not directly inherited. The Association set out to educate the community at large and France and Germany in 1892 and the Dutch in 1897 followed this idea. A committee was formed called The National Association to the Prevention of Tuberculosis or NAPT for short. NAPT books were provided to members of the community, educating people about bad food, bad air and unhealthy drinking water. People were advised against overcrowding in the home, overworking and overstraining themselves. The NAPT could only advise and they had no real powers to improve city dwellers and tackle poverty. The UK soon followed the example set by the NAPT. The International Union against Tuberculosis was founded in 1902 with its offices based in Berlin. This office closed during the First World War but re-opened in Geneva in 1920. The International Union monitored the progress of the Institutions and encouraged a system of TB control throughout Europe.

Although the sanatoriums’ first idea of medical care was rest and fresh air, progress and improvement was slow. A number of seemingly reliable treatments were tried to master what seemed an unstoppable disease. No real progress was made until new antibiotics were first used between 1945-1960. From the sanatoriums opening until the 1940s some of these treatments included the use of iron salts, sodium chloride, calcium chloride, chlorine gas, hydreraganic acid and iodine. For a long time copper and gold salts were used in the treatment of TB although they proved to have little or no value in the treatment and they also caused injuries to other parts of the body and the skin. Gold salt and sunlight became more widely used after Koch’s findings that these two agents inhibited the growth of tubercle bacilli. In light of these findings, light therapy and ultraviolet rays were also used, but they also caused sunburn. It was believed that patients who developed the most pigmentation of the skin from heliotherapy recovered more satisfactorily from extrapulmonary forms of tuberculosis. As time went on and little or no progress was Creating an artificial pneumothorax made in finding a cure other treatments were sought after Artificial pneumothorax became a wide spread form of treatment. Under medical supervision a lung would be artificially collapsed then refilled. It was hoped that it would some how rest the infected lung. On some occasions ribs were removed and this allowed pressure to be taken off the infected lung.

As the public became better educated in the workings of the disease, and the government had taken steps to improve housing and poverty the number of cases were slowly dropping. It had taken almost three thousand years to understand the full nature of tuberculosis, and only when the antibiotics became more sophisticated was a real cure on the way. Between 1945 to 1960 a remarkable development was made and more patients were cured using the new antibiotics. Now with the disease under control less and less beds were needed. During the 1960s many sanatoriums started to close. By the middle of the 1960's there were only a few beds available for patients suffering from TB.