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Tuberculosis, also known as: phthsis, TB, consumption, 'white plague' or 'wasting disease'
(abbreviated TB for tubercle bacillus, named consumption because it appeared to consume the patient from within, white plague as it imparted a deathly white pallor to the skin, wasting disease because of fatigue, lack of appetite and steady weight loss )


T.B. can attack different parts of the body and so produce a series of different symptoms but always creating the distinctive tubercle (tuberculous nodule). The different symptoms meant that tuberculosis was not identified as a unified disease until the 1820s and was not named tuberculosis until 1839 by J.L. Schoenlein.

Infection is usually from one of three sources - infected milk, cough or breath droplet infection from an infected person or from breathing infected dust.

If the infection is in the bones (especially the spine) then it is Pott's Disease. (? also called 'White Swelling' ?)
An infection in the lymphatic system around the neck is Scrofula. (Scrofula also known as King's Evil as it was believed that a King's touch could cure it.)
Miliary tuberculosis (the lesions formed resemble millet seeds) was the result of the disease invading the circulatory system.
The condition Lupus vulgaris results in painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around nose and ears. The lesions may ultimately develop into disfiguring skin ulcers if left untreated. The term "lupus" to describe an ulcerative skin disease dates to the late thirteenth century, though it was not until the mid-nineteenth that two specific skin diseases were classified, one being Lupus vulgaris. The term "lupus", from the Latin for wolf, may derive from the rapacity and virulence of the disease; a 1590 work described it as "a malignant ulcer quickly consuming the neather parts; ... very hungry like unto a woolfe"
Tuberculous meningitis is also possible and until the development of antibiotics it was invariably fatal.

The 'classic' form of T.B. is the form most common in adults where the lungs or pleura are infected - pulmonary tuberculosis. The disease begins gradually with coughing and later traces of blood in the sputum (haemotysis), untreated it leads to fever and death.

The discovery of the bacillus causing tuberculosis was announced by Robert Koch on 24 March 1882 as mycobacterium tuberculosis. But the disease itself was probably known to the Ancient Greeks, if not before, as the origins of the disease are in the first domestication of cattle (which also gave humanity viral poxes).

Koch mis-used his fame as discoverer to squash the idea that bovine and human tuberculosis were similiar. This held back the recognition of infected milk as a source of infection which could then be remedied by pastuerization.

The first genuine success in immunizing against tuberculosis was developed from attenuated bovine strain tuberculosis by A. Calmette and J. M. Guerin in 1906 - BCG (Bacilli-Calmette-Guerin). It was first used on humans in 1924 in France, although national arrogance prevented its widespread use in either the US, Britain or Germany until after WW II.

Tuberculosis has caused the most widespread public concern in the 19th and early 20th centuries as the endemic disease of the urban poor. In 1815 England one in four deaths were of consumption, by 1918 one in six deaths in France were still caused by T.B. After the establishment that the disease was contagious in the 1880s T.B. was made a notifiable disease in Britain; there were campaigns to stop spitting in public places and the infected poor were 'encouraged' to enter sanatoria that rather resembled prisons. Whatever the purported benefits of the fresh air and labour in the sanatoria, 75 per cent of those who entered were dead within five years (1908).

Across Europe in 1850 it killed 500 out of 100,000 people but by 1950 the number had fallen to 50 out of 100,000. Improvements in public health were reducing tuberculosis even before the arrival of antibiotics. Although the disease's significance was stilll such that when the Medical Research Council was formed in Britain in 1911 it's first project was tuberculosis.

It was not until 1946 with the development of the antibiotic streptomycin that treatment rather than prevention became a possibility.

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