Consumption, part one



We now know that "consumption" covered a large range of illnesses, since it described any kind of illness that included coughing and wasting away.  Over the years of the 18th and 19th centuries, the diagnosis of consumption became more and more specific until Robert Koch discovered it was caused by the micro-organism mycobacterium tuberculosis in 1882.  It is still dreaded today, since it is second only to AIDS as the most lethal illness caused by a single infectious agent and 1.4 million people died from it in 2011 (World Health Organization, "Tuberculosis," http://www.who.int/mediacentre/factsheets/fs104/en/index.html, accessed 14 December 2012).  It is the only disease that is so virulent and infectious that all US health care workers must be tested yearly for it.  You may have had a TB test yourself.

Queen Mary I (1516-1558)
touching neck to heal boy
of TB
(Wellcome Library)

"A Collection of Remarkable Cures of the KING's EVIL,
Perfected by the Royal Touch,
Collected f[r]om the Writings
of many eminent Physicians and Surgeons,
and learned Men," 1748
(Wellcome Library)

 

We have discussed "The King's Evil," which was a form of tuberculosis (TB) that settled in the neck, and was thought to be cured by the touch of a king or queen (see November 13 post).  This practice ended in the early 18th century (although the apothecary who wrote the above book hadn't seemed to have gotten the message).

"Nocturnal sweats, and great thirst, as well as purulent expectoration, are symptoms that discover a confirmed consumption ... in this confirmed state of the distemper there is generally a great dejection of appetite, and a nauseous loathing of foods, with dead sickness of stomach, frequent vomitings, which are sometimes caused by excess of green choler, like verigrease, or juice of leeks, that is often ejected, to free the stomach of its burden; and sometimes excited by a long and vehement fit of coughing, that nature employs to pump and ease the lungs." (Blackmore, Richard.  A Treatise of Consumptions and Other Distempers Belonging to the Breast and Lungs (London: 1724), 135 and 28; quoted in Madden, Deborah.  "Pastor and Physician: John Wesley's Cures for Consumption" in Madden, 'Inward and Outward Health,'  95.)

John wrote in his journal on 8 May 1777:  "I went to Yarn.  There I found a lovely young woman in the last stage of a consumption; but such a one as I never read of, nor heard any physician speak of, but Dr. Wilson.  The seat of the ulcers is not the lungs, but the windpipe.  I never knew it cured ... this young woman died in a few weeks." (Wesley, John.  The Journal of the Rev. John Wesley, A.M. (4 vols, London: J. Kershaw, 1827) 8 May 1777, vol 4, 94 in Madden, "Pastor," 95.)  In 1767, he wrote that he also had been in the last stage of consumption (Wesley, Letter to Mary Bosanquet, 16 August 1767 in Letters (Telford), vol,. 5, 61, quoted in Madden, "Pastor," 96), so he had personal experience with the illness, almost dying of it in 1753 (Madden, "Pastor," 102).  As consumption could describe varying illnesses, we do not know if he had TB.

Pewter spittoon
Receptacle for spit,
which went out of fashion in the 1880s
when it was realized spitting contributed to
the spread of diseases like TB
(Wellcome Library)

China spittoon
(Wellcome
Library)

What we label TB today is spread through the air by coughing, sneezing or spitting.  Only a few of the tiny germs need to be inhaled for the recipient to become infected.  WHO reports that 1/3 of the people in the world have been infected with TB but are not yet ill.  TB can stay latent and non-transmissible for years, but once the TB becomes active an ill person can infect up to 10-15 people per year (WHO, "Tuberculosis).