The history of tuberculosis

¶ … History of Tuberculosis

Tuberculosis (TB) is an infectious disease caused by bacteria whose scientific name is Mycobacterium tuberculosis. TB is a disease with deep historical roots; there are several reports of ancient Egyptian mummies having signs of tubercular decay in their skull and vertebrae. (Canadian Lung Association) Due to these signs, some scientists contend that TB has been affecting humans for at least 4000 years. There is also evidence that the ancient Greeks were exposed to, and aware of, the disease that would eventually be diagnosed as TB. More than 2400 years ago, Hippocrates wrote that pthisis was the most common disease of humans, and he further noted that it was nearly always fatal. (Canadian Lung Association) The Greek word pthisis actually means "a dwindling or wasting away," which provides an accurate account of the effects of the disease. (MedTerms Medical Dictionary) It was thought that Columbus brought TB to the new world in 1492, but evidence was found to the contrary in 1994, when scientists reported that they had identified TB bacterium DNA in the mummified remains of a woman who died in the Americas 500 years before Columbus set sail for the New World. (Nebraska Dept. Of Health and Human Services)

In Europe during the late Renaissance and Early Modern Era, roughly the 17th and 18th centuries, the continent was overtaken by the "Great White Plague," which was later diagnosed as TB. (Nebraska Dept. Of Health and Human Services - NDHHS) This outbreak did provide physicians with the opportunity to make significant advances in the diagnosis of the disease. In his Opera Medica of 1679, Sylvius was the first to identify actual tubercles as a consistent and characteristic change in the lungs and other areas of consumptive patients, and he also described the progression to abscesses and cavities. (New Jersey Dept. Of Health and Senior Services - NJDHSS) Twenty years after Sylvius' publication, the Republic of Lucca in Italy issued the following decree that indicated an understanding of the disease as communicable and infectious: "henceforth, human health should no longer be endangered by objects remaining after the death of a consumptive. The names of the deceased should be reported to the authorities, and measures undertaken for disinfection." (Canadian Lung Association) This was an important step for doctors and civic leaders who trying to contain the spread of the disease. In 1720, the English doctor Benjamin Marten was the first to surmise that germs, or in his words, "wonderfully minute creatures" could be the cause of the symptoms. (NDHHS) He argued that eating, drinking, sleeping, or being in close proximity to a consumptive patient for long periods of time could cause a healthy person to catch the disease.

An incredible breakthrough in identifying and fighting tuberculosis occurred in 1882 when the German physician Robert Koch discovered the organism that caused the disease. It was called a tubercle bacillus because small rounded bodies (tubercles) occurred in the diseased tissue and where characteristic of the disease. Through his many experiments with the organism, Dr. Koch worked on developing a cure for TB, even isolating a protein from the tubercle bacillus that he tried as an immunizing agent and later as a treatment for TB. (NDHHS) Although he failed in finding a cure, Koch's discovery was to be later used as the screening tool (tuberculin skin tests) for identifying people and animals infected with tubercle bacilli. A further significant advance came in 1895 when Wilhelm Konrad von Rontgen discovered the radiation that bears his name. Now the progress and severity of a patient's disease could be accurately followed and reviewed. (NJDHSS)

An important development in the treatment of TB started in 1886 in the United States. The physician Edward Trudeau led the sanatorium movement, based on the European model of strict supervision in providing fresh air and sunshine, bed rest, and nutritious foods. (NDHHS) This movement took place in conjunction with growing infection control measures in large urban centers of the country, and TB patients who could not be treated in local dispensaries were removed from the general population and place into sanatoriums. By 1938 there were more than 700 sanatoriums throughout the U.S., yet the number of patients outnumbered the beds available. (NDHHS) Thankfully after centuries, even millennia, of humans succumbing to TB, during World War II doctors were finally able to create a medicine to treat patients with this disease.

In 1943, Selman A. Waksman, who had been working for decades to find an antibiotic that was effective against Mycobacterium tuberculosis, was finally successful. Streptomycin purified from Streptomyces griseus was first administered to a human on November 20, 1944 with impressive results. The disease immediately stopped its progression, the bacteria disappeared from the patient's sputum, and there was a full recovery. (eMedtv.com) This development helped to significantly decrease the rate of TB infection in the United States in the following decades, and despite a slight uptick in the 1970s and 1980s due to lax public health efforts, TB cases have seen a steady decline since the 1990s. (Centers for Disease Control)