"I Must Die"
Tuberculosis, it seems, has always been with us. Evidence of tubercular decay has been found in the spines of Egyptian mummies thousands of years old, and the disease was common both in ancient Greece and Imperial Rome. While it may have lessened its grip on mankind during some periods of history, TB never completely let go.
The Poet John Keats
Credit: Unknown
Attempts at cures were varied, but uniformly ineffective. Roman physicians recommended bathing in human urine, eating wolf livers, and drinking elephant blood. Fresh milk—human, goat, or camel—figured in many treatment regimens. Depending upon the time and country in which they lived, patients were exhorted to rest or to exercise, to eat or to abstain from food, to travel to the mountains or to live underground.
And yet, TB continued to claim victims by the millions. When, in 1820, the poet John Keats (who had schooling in medicine) coughed a spot of bright red blood, he told a friend, "It is arterial blood. I cannot be deceived. That drop of blood is my death warrant. I must die." Within a year, at just 25, he did.
Consumed by Love
Poster advertising Puccini's opera
Credit: Unknown
Other artists and writers who succumbed to TB in the 19th century included Frederick Chopin, Anton Chekov, Robert Louis Stevenson, and Emily Brontë, while 20th century victims included Franz Kafka, George Orwell, and D.H. Lawrence. Consumption became romanticized in the popular imagination as a disease of the young, pure, and passionate. The heroines of Alexandre Dumas's 1852 novel, Camille, and Giacomo Puccini's 1896 opera, La Bohème, were among the fictional characters whose deaths from TB were imagined to result from thwarted love affairs.
A Doctor's View
The variable course of TB only served to make it more baffling and terrifying. Physicians could not easily predict whether a consumptive patient would succumb within months, linger for years, or somehow manage to overcome the disease altogether. According to the 19th century American physician William Sweetser, the first stage of consumption was marked by a dry, persistent cough, pains in the chest, and some difficulty breathing, any of which could be symptoms of less dire illnesses.
The second stage brought a cough described by Dr. Sweetser as "severe, frequent, and harassing" as well as a twice-daily "hectic fever," an accelerated pulse, and a deceptively healthy ruddiness in the complexion.
In the final, fatal stage, wrote the doctor, "the emaciation is frightful and the most mournful change is witnessed...the cheeks are hollow…rendering the expression harsh and painful. The eyes are commonly sunken in their sockets...and often look morbidly bright and staring." At this point, throat ulcers made eating difficult and speech was limited to a hoarse whisper. Once the distinctive "graveyard cough" began, diagnosis was certain and death inevitable. Rarely, wrote Dr. Sweetser, "life, wasted to the most feeble spark, goes out almost insensibly." More typically, severe stomach cramps, excessive sweating, a choking sensation, and vomiting of blood preceded the victim's demise.
A New Theory
As long as the cause of TB remained unknown, efforts to cure it were based more on trial and error than on any scientific reasoning. In general, consumption was not thought of as a contagious disease. Rather, most believed it to be hereditary, and a result, at least in part, of an person's mental and moral weaknesses. The English physician Benjamin Marten was among the first to propose an alternative in his 1720 publication, A New Theory of Consumption. Marten believed that "wonderfully minute living creatures," which could be spread by prolonged close contact between infected and healthy people, caused TB.
His conjecture would remain just that for another century and a half. Then, on an extraordinary evening in March 1882, an obscure German country doctor astounded the European medical establishment and became an overnight sensation with his proof that the dread disease that had felled so many was caused by a microscopic organism. The doctor was Robert Koch, and the announcement opened the way to an age of optimism in the battle against TB.
Related Links
History of TB in Sweden
back to top