The White Death—A History of Tuberculosis

Abstract

‘Between 1864 and 1889 the mean life expectancy of Prussian nuns, declared healthy on entry into the noviciate, was three years as a result of tuberculosis.’‘Between 1803 and 1810 Britain imported some 4000 Mozambique army volunteers to Ceylon (Sri Lanka) to form new regiments. By 1820, 3640 (91%) of these unfortunates were dead from tuberculosis.’These are just two of the fascinating facts that Dr Thomas Dormandy has collected in this brilliant history of the effect, investigation, false dawns and ultimately successful treatment of tuberculosis from Roman to modern times. The list of luminaries who died or suffered from tuberculosis is impressive: Keats, Shelley, Chekhov, all of the six Bronte children, Chopin, Paganini, Tsarevitch Nicholas, Robert Louis Stevenson, Kafka, D. H. Lawrence and finally George Orwell—probably England's finest author of the 20th Century. Even as late as 1967, tuberculosis killed Vivien Leigh, the star of ‘Gone with the Wind’. However, whilst this disease accounted for many of the great and the good, it was, and still is, above all else a disease of the poor. It was a mass killer in England during the first quarter of the 19th Century as the industrial revolution arrived. It is interesting to note that then, as in modern Russia and the USA, prisons, on account of their overcrowding, were an unending source of the disease. Before 1910 no American ‘lifer’ lasted more than 12 years, and between 1890 and 1895 tuberculosis was the assigned cause of death in 75% of the prison population in the state of Massachusetts. The book includes an interesting chapter on the spread of bovine tuberculosis via milk and the different steps taken to counter this threat by authorities in the USA (active) and the UK (inactive). Once again, the interest of the British farmer appeared to outweigh the interests of the health of the British nation. As late as 1938 the government-sponsored Milk Industry Bill, a relatively modest assortment of preventative measures which would have enabled (but not compelled) local authorities to impose pasteurization of milk, was defeated in the House of Commons at its first reading. In 1946, 7–10% of ‘pasteurized’ milk sold in London contained live tubercle bacilli.