What kid doesn’t like to be sung to sleep? My mom knew loads of songs that were popular in the mid-1900s. One was the Scottish folk tune “My Bonnie lies over the ocean” which has a lively melody. She used to tell me about the Great White Plague of consumption, a disease that sounded just awful, especially when sung to the same tune:
My Bonnie has tuberculosis.
My Bonnie has only one lung.
My Bonnie spits blood in her pocket
And dries it and chews it for gum.
Mom explained that tuberculosis (TB) was a raging infection with horrific symptoms such as a persistent cough, feeling tired all the time, unintentional loss of appetite and weight, fever, night sweats – and coughing up blood.
A germ called Mycobacterium tuberculosis causes TB and typically infects the lungs, although it can attack other parts of the body. Robert Koch first identified and described the bacillus in 1882, winning him the Nobel Prize in physiology or medicine in 1905.
The TB infection progresses to active TB disease when the bacteria overcome the immune system’s natural defenses and begin to multiply. This happens soon after the initial infection in primary TB disease (1–5 percent of cases).
In the remaining majority of cases, a latent infection occurs with no obvious symptoms from the dormant bacilli. Active TB arises in 5–10 percent of the latent cases, often many years after the initial infection.
The bacteria are spread through the air when people who have active TB in their lungs cough, spit, speak or sneeze mucus, phlegm or sputum.
TB was identified as a single disease in the 1820s. In 1839, German naturalist and professor of medicine J. L. Schönlein coined the name “tuberculosis.”
René Laennec, who invented the stethoscope in 1816, died from TB at the young age of 45 ten years later in 1826. The French physician and musician contracted the potentially lethal disease while studying contagious patients and infected bodies.
Dr. John Croghan, the owner of Mammoth Cave in Kentucky from 1839 onwards, brought a number of people with tuberculosis into the cave between 1838 and 1845, speculating that the constant temperature and purity of the cave air would help stop the disease – but each patient died within one year after arriving.
A medical movement for treating tuberculosis in clean hospital-like facilities called sanatoriums had become popular in the previous century, especially in North America and across the Big Pond in Europe. Hermann Brehmer is credited with opening the first TB sanatorium in 1859 in Görbersdorf (now Sokołowsko) in Silesia (modern Poland with some Czech Republic and Germany).
By 1900, TB was the #1 cause of death in the U.S. People who could afford it would move to places with pure, clean air. Mountain air was especially prized for its alleged curative properties.
Large multi-room boarding houses sprang up in the Colorado Rockies where patients could rest and recuperate – or perish. The stone-cold truth was that every other person treated with sunshine and fresh air in TB sanitoriums died within five years.
At the turn of the 20th century, tuberculosis was one of the most critical health problems in the United Kingdom. The Royal Commission Appointed to Inquire into the Relations of Human and Animal Tuberculosis was established in 1901. Its job was two-fold: 1) find out if tuberculosis in animals and humans was the same disease, and 2) to determine if animals and humans could infect each other.
By 1919, the Royal Commission had evolved into the UK’s Medical Research Council (MRC), part of United Kingdom Research and Innovation (UKRI) which coordinates and funds medical research in the United Kingdom.
In 1904, young Dr. Edward Livingston Trudeau founded the National Association for the Study and Prevention of Tuberculosis, known now as the American Lung Association (ALA). A firm believer that everyday people could wage war on TB, Trudeau’s ALA “was the first to combine the energies of physicians and laypersons in the fight against death and disease.”
Denmark began promoting Christmas Seals during 1904 as a way to raise money for tuberculosis programs. Three years later, in 1907, Christmas Seals spread to the U.S. when Emily Bissell led a group of volunteer citizens to organize and launch the first American “direct mail” fundraiser campaign to cleanse the scourge of TB.
In 1906, Albert Calmette and Camille Guérin developed the first successful vaccine to immunize against tuberculosis from attenuated bovine-strain tuberculosis.
In 1943, Selman Waksman discovered a compound called streptomycin that acted against M. tuberculosis:
“The compound was first given to a human patient in November 1949 and the patient was cured.”
Today, according to the U.S. Centers for Disease Control and Prevention (CDC), the U.S. is close to wiping out tuberculosis:
“In 2018 the CDC noted a total of 9,029 new TB cases in the United States, representing a 0.7% decrease from 2017. The incidence in 2018 was 2.8 per 100,000 persons, which is the lowest number recorded since the CDC began tracking TB in 1953.”
But an estimated 25 percent of the world’s population has been infected with M. tuberculosis. New infections occur in about 1 percent of the world’s population each year. An estimated 8.6 million chronic cases were active in 2012.
The international fight against consumption is far from over. Working together, communities can reduce the spread of infection and reduce the number of tuberculosis deaths.