The forgotten plague: TB
“By the dawn of the 19th Century, the disease had killed 1 in 7 of all people that had ever lived, more than any other illness.”
Anyone who’s a Bronte or Keats or Chopin fan hasn’t forgotten. But it’s true that most of us don’t really appreciate what a widespread scourge tuberculosis was.
I recommend the first half of Jessamyn West’s The Woman Said Yes, about her own bout with TB as a young woman, and her years in a sanatorium as well as her recovery.
The above clip is only part of a longer documentary. More about tuberculosis here.
You might be interested in “The Forgotten Plague” by Frank Ryan that tells the story of how doctors and scientists discovered the cause and found a cure for TB. Its interest lies in the fact that TB is one of the first diseases to be cured by antibiotics with one of the first antibiotics ever created. These days it’s old hat, but was a miracle at the time.
https://www.amazon.com/Forgotten-Plague-Battle-Against-Tuberculosis/dp/0316763810
I had no idea it was so prevalent. Doc Halliday of the “Gunfight at the OK Corral” fame died of it as well. Reportedly, he caught it from his mother while caring for her when she was contagious.
Geoffrey Britain: For me the definitive Doc Holliday will always be Val Kilmer in “Tombstone”:
“I’m Your Huckleberry — Tombstone”
https://www.youtube.com/watch?v=R8OWNspU_yE
Kilmer is a complete nut but when he nailed it, he nailed it.
Betty MacDonald’s book “The Plague and I” (1948) is well worth reading. It is a vivid account of her struggle with TB in the 1930s. The title is a riff on that of her first and most famous book “The Egg and I”.
Thomas Mann’s “The Magic Mountain” (Der Zauberberg) is largely set in an Alpen TB sanatorium, dealing with the disease and treatment in the early 20th C. along the way of examining the modern crisis of liberalism.
PS. When Dana Loesch challenged Eric Swalwell to a debate on the NRA by saying “I’m your Huckleberry,” I about fell out of my chair and became a fan for life.
https://www.bizpacreview.com/2019/04/19/im-your-huckleberry-dana-loesch-steps-in-to-accept-eric-swalwells-challenge-for-the-nra-and-ups-the-ante-746870
I second the Betty Macdonald book, all of them actually!
Years ago I was exposed to TB— no doubt another perk of being raised in a poor inner city neighborhood. It was discovered by those tine tests they routinely gave kids.
An NYC welfare type agency sent me for X-rays and treatment every month for a year. Might have been poisonous, but too late.
Supposedly the result is now I’m functionally immune to TB, though it’s possible the original infection can still manifest at any time.
One of the worst experiences in my life was when my 8 year old daughter was diagnosed with tubercular meningitis.
The doctor who made it had just lost another young child to the same disease, and one of my daughter’s symptoms was a stiff neck.
Fortunately it turned out to be wrong, she had a bad reaction to a VERY strong antibiotic.
But, lord, I wouldn’t wish that on my worst enemy.
I’m still mulling over “By the dawn of the 19th Century, the disease had killed 1 in 7 of all people that had ever lived, more than any other illness.”
I mean, I know tuberculosis has been a terrible killer and still is, but 1 in 7 is a tough number to digest. According to wiki, the news is better but still not good:
As of 2018 one-quarter of the world’s population is thought to be infected with TB. New infections occur in about 1% of the population each year. In 2017, there were more than 10 million cases of active TB which resulted in 1.6 million deaths. This makes it the number one cause of death from an infectious disease.
Consumption. Said by many New England Protestants to mean you must be immoral, even if evidence of said immorality was hard to demonstrate. Susan Sontag goes into some of this in her book “Illness As Metaphor.”
If everything MEANS something, then it must MEAN something if you’re consumptive, or when you’re diagnosed with something else really bad.
I certainly noticed how some people reacted to me once it was known I had MS at age 34. You can then be reclassified as a loser, as defective in some way. As Anton Chigurh says in the film No Country for Old Men, “If this is where the rule you followed has brought you, of what use was the rule?”
“The Mosquito: A Human History of our Deadliest Predator” by Timothy Winegard (2019) is an overview of world history as determined by mosquito born disease. So much you never knew nor thought about, from ancient history to settlement of the new world, from swamps as tools of war to malaria resistance as a force in America’s present makeup. The recitation of death rates by disease is difficult to fathom.
A serious problem is the emergence of a TB strain resistant to all, yes all, known antibiotics.
However, I doubt the significance of the report that TB has killed “1 in 7 of all people that had ever lived, more than any other illness.” That reflects the explosion of the human population in the last millenium, more than anything else.
And take comfort: most TB infections are asymptomatic, and yield a small area of scarring in the apex of one lung, within which some TB bugs remain walled off.
The remark that one quarter of the world’s population is “infected” must be seen in this context, since TB caused only an estimated 1.6 million deaths in 2018. There were after all 7.8 billion humans on the planet in 2018.
But with the bug’s resistance, and the possibility of nucleic acid transfer to other bacterial species, we have a basis for serious concern. The prospect is that antibiotic resistance can become very widespread, among many bugs.
Cicero: Good points.
Still 1.6 mil is a lot of deaths. Malaria scores ~400,000. Not to be sneezed at either.
Both may not kill you, but still make you miserable. I knew a missionary who acquired malaria doing God’s work, but was dogged by it the rest of his life.
Bjorn Lomborg, the “Skeptical Environmentalist,” won my heart in his critique of climate change vs disease. Lomborg is a “lukewarmist.” He accepts the claim that humanity is causing some global warming and it’s worth paying attention to. However, he insists on ranking the risks of climate change with the ongoing real costs of diseases like TB and malaria.
After making the consequent cost/benefit/risk calculations, Lomborg concludes that our money is better spent on TB/malaria initiatives than things like Paris Accords, which at best will reduce global warming by a few tenths of a degree.
Tangent: I’ve been following the Johns Hopkins statistics page on the Wuhan virus, which is based mostly on official numbers from China. It’s been stuck at confirmed cases in the high 30,000s the past few days.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Unless the virus has suddenly, inexplicably become much less transmissible, the Chinese government must be lying — again.
An interesting new theory is that the virus is transmissible via respiratory and oral-fecal routes and that the respiratory (lung-to-lung, so to speak) is much more lethal, and the oral-fecal route is relatively mild.
https://wattsupwiththat.com/2020/02/08/the-corona-epidemic-a-dangerous-and-a-less-danerous-form/
Cancers killed an estimated 9.6 million worldwide in 2018. Makes TB death rate pale in comparison.
My uncle and his two youngest sons died of TB in the early 30’s. It was devastating to the family.
Cicero: So we don’t care about TB deaths?
I failed to add that cancer incidence increases markedly with age. So mankind has wonderfully increased its life span these past 250 years or so. While TB was still there!
Cicero: Not getting your point.
“…must be lying…”
But they were always lying….
And as the Democrats have been showing us—up close and personal—it’s a very hard habit to break.
As for THE disease, one does not, of course, wish to seem hysterical; but it is far past the time to be profoundly terrified…and not JUST about China:
https://www.theamericanconservative.com/dreher/the-plague-pushes-china-to-breaking-point-coronavirus/
Even if one were inclined to pooh-pooh the already terrifying dimensions, and speed, of fatalities—and even vaster potential numbers of victims—the economic ramifications, for China and therefore the world, will be catastrophic.
(To be sure, Meghan and Harry are acting up, and a celebrity English TV personality has come out of the closet,.)
My grandmother’s mother died of TB when my grandmother was only 4. Her father remarried and had no more children. His new wife was jealous of my grandmother and kept her locked in her room much of the time. Yes, there really were wicked stepmothers.
My brother had a friend who lived up in a canyon and was sick, so sick that I told my brother that, you know, people could actually get sick and die. So we brought the friend down and he stayed with us for a while before going to the Boston area to stay with his mother and step father. He didn’t believe in doctors, thought he just needed to eat right — shades of Steve Jobs — think happy thoughts, and that anyway the docs would never figure out what the problem was. Finally, his step dad dragged him off to the doctor and, voila, instant diagnosis: tuberculosis. Yes, he recovered.
Yeah, it’s not a 3rd world disease, I know of a woman who came down with it as a young woman in Illinois. She got better, but she watches the news about it and is scared of the antibiotic strains getting wider spread.
But [the Chinese officials] were always lying….
Barry Meislin: True. But I think they are lying more now. I think it’s a difference which makes some difference.
My guess is they can’t admit the case numbers exceed 40-50k. My guess is well over 100k.
But they built a hospital for 1000 patients in 11 days so I guess it evens out…
I had an acquaintance in San Francisco who developed TB. He figured he caught it riding mass transit. The antibiotics were working for him, but he had to be careful to keep taking them.
I was amazed at how much healthier I became after I stopped riding buses and subways.
“By the dawn of the 19th Century, the disease had killed 1 in 7 of all people that had ever lived, more than any other illness.”
This statement sounded dubious to me, but pulling out actual data that might bear on it took a lot of net-fu.
Eventually I got a cite for the annual global death rate of tuberculosis in 1800 as 1000 per 100,000 (John F. Murray, A Century of Tuberculosis, American Journal of Respiratory and Critical Care Medicine, https://doi.org/10.1164/rccm.200402-140OE). This is pretty much the peak historical death rate. The peak occurred due to increased urban concentration and the absence up to that time of any effective treatment.
To put this in perspective I had to dig up the annual global death rate of all causes in 1800. I could not find any data on this but eventually I got a cite for the average global life expectancy in 1800 as 29 years (https://ourworldindata.org/life-expectancy). From this one can calculate the annual global death rate in 1800 as about 3400 per 100,000.
One always has to wonder if given mortality data includes or ignores infant mortality. Infant mortality is often ignored because doing so makes all the other mortality figures look substantially better. But there is no way to tell from the data I have, so I’ll just have to assume that infant mortality is included.
This data indicates that tuberculosis accounted for more than one quarter of all deaths in 1800. Things likely weren’t much more than a factor of two better in the several preceding centuries and, due to the explosion of the human population, those centuries are going to dominate the historical record. So 1 out of 7 deaths up to 1800 sounds like it could reasonably be the case.
TomR: Great work! I shared your sense of the dubious, but was lazy and let it go that “a lot” of people died of TB.
I hope to see more comments from you.
TomR add this to your calculations (and dont forget to look up its older names, before it was called tuberculosis, and consumption)
The discovery of the earliest known cases of human tuberculosis (TB) in bones found submerged off the coast of Israel shows that the disease is 3000 years older than previously thought. Direct examination of this ancient DNA confirms the latest theory that bovine TB evolved later than human TB.
[snip]
The bones, thought to be of a mother and baby, were excavated from Alit-Yam, a 9000 year-old Pre-Pottery Neolithic village, which has been submerged off the coast of Haifa, Israel for thousands of years. Professor Israel Hershkovitz, from Tel-Aviv University’s Department of Anatomy, noticed the characteristic bone lesions that are signs of TB in skeletons from the settlement, one of the earliest with evidence of domesticated cattle.
[snip]
Dr Donoghue said: “What is fascinating is that the infecting organism is definitely the human strain of tuberculosis, in contrast to the original theory that human TB evolved from bovine TB after animal domestication. This gives us the best evidence yet that in a community with domesticated animals but before dairying, the infecting strain was actually the human pathogen. The presence of large numbers of animal bones shows that animals were an important food source, and this probably led to an increase in the human population that helped the TB to be maintained and spread.
TomR add this to your calculations (and dont forget to look up its older names, before it was called tuberculosis, and consumption)
Artfldgr: I’m fond of “phthisis” as an earlier name for TB. It has a lovely Lovecraftian ring.
“…I guess it evens out…”
We will have to really work hard on our gallows humor…. (We have our work cut out for us…)
https://spectator.us/china-hiding-bad-coronavirus/
https://www.zerohedge.com/geopolitical/were-totally-dark-japan-not-doing-enough-contain-outbreak-diamond-princess-passengers
https://www.zerohedge.com/health/death-rate-5-harrowing-admission-wuhan-doctor
Of course, the Chinese are denying that it’s a weaponized virus—indeed, blame the bats! Blame the snakes! Blame the turtles!…and then compare it to SARS…or the flu!!
https://www.cbsnews.com/news/coronavirus-news-chinese-ambassador-cui-tiankai-dismisses-coronavirus-theories-as-absolutely-crazy/
(Skeptics worth their salt might wish point out that that such a denial can only mean one thing.)
And China was working so hard—and investing so much—on being the world’s supreme super power. (Talking up a storm, too!)
Ah, irony….
Ah, delusions of grandeur….
(Not sure, though, why they felt they had to be so supreme, though. Weren’t/Aren’t they big enough? Though I suppose one could ask the same about any of ’em. Turkey, Russia…. Maybe it’s a Communist thang, or a despotic thang. Or a respect thang? Heh…. Or maybe they’re just angry because “we” appropriated their best recipes. Well, something for the Bernie Bros to sink their teeth into….)
And while we’re at it, here’s that legendary column (one of so, so many—maybe it should be reproduced every once in a while…lest one forget!) from a card-carrying member of the “best and brightest” club:
https://www.nytimes.com/2009/09/09/opinion/09friedman.html
Phthisis is close to Phthiotis/Phthia, Achilleus’ home (northern Greece today, so’west Thessaly back when) with his men, the autochthonous Myrmidons (ants, sprung in place from the soil). If I remember right, Phthia is also sourced by Herodotus as the originating region of the pre-Achaian migration south into Attica and the Peloponnese. Some sense of the notion of “destroyer” tags along with Phthia, I guess.
My grandpa (Mom’s Dad) died of TB in the state sanitarium in southern Arkansas in 1961. Horrific to visit him there with Mom and my younger brother on a vacation we took that summer. Skin & Bone.
Heartbreaking.
My family’s story . . . my father started and escaped from the Bataan Death March (early 1942), made his way to Corrigedor where he fought, but was captured upon the surrender to the Japanese. He spent almost 3 years at Camp Cabanatuan until the camp was liberated by Colonel Mucci’s Rangers in 1945. He was barely alive. In camp, among several other diseases, he contracted TB. The camp doctor severed the phrenic nerve to the affected lung as the only available treatment. Luckily the other lung remained healthy. He spent a year at Fitzsimmons Hospital in Denver immediately after the war. By then rifampin and I think streptomycin were in use. He died young for his family at age 54.
An interesting sidelight. Recently, my wife was out of town and so I took my young daughter (I’m an older father) to see her doctor. I guessed – by looking and by her name – that the Dr. was Filipina. And so I casually asked her where in the Philippines her family was from. You can imagine my surprise when she answered Cabanatuan City. It turns her family were some of those who met the rescued prisoners and carried them to safety. My father was too weak to walk and was carried in a caribou cart. When her mother comes from the Philippines we are going to all meet. Her mother was a little girl at the time, but knows the family history first hand.
I grew up in NM and many people came to the dry dessert climate of NM because of their TB.
https://www.desertusa.com/desert-new-mexico/ruins-dripping-springs.html
TB can have a high “R”, replication rate (each case on average infects so many new cases), but it can also have a very long incubation period, such that patients who are infected can shed the bacterium for months or years before they have symptoms themselves. Both of these together are unusual. This makes TB a real hassle to hospitals. They have to do PPD skin tests on everyone who had contact with the patient (or chest xrays if that person had a previous PPD positivity). And they have to treat the convertors–the hospital staff that developed a positive skin test or xray change–and this takes forever and they have to warn their spouses and family; and the hospital has to clean up the room where the patient was, together with medical equipment and respirators, etc, that the patient used. Whew! Also they may not be able to release the patient until they have negative sputum, depending in local public health regulations. Needless to say these patients cost the hospitals a lot and they shudder when they have an active case of TB in-house. Sometimes these patients are in the hospital for many weeks, mostly awaiting a negative sputum. Plus the bug is hard to kill in the environment and can survive many months in dust.