Read Online Outbreak! Plagues That Changed History by Bryn Barnard - Free Book Online
Authors: Bryn Barnard
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that passed from person to person suspended in microscopic droplets of saliva from a person’s sneeze or cough. It could be avoided but not cured.
The bacterium
Mycobacterium tuberculosis
Confronted with this new knowledge, the middle class became obsessed with cleanliness, sure that TB microbes were lurking everywhere. Bodily fluids became scary, human smells repulsive (the search for effective underarm deodorants and antiperspirants starts here). Spitting, kissing, and even talking were now seen as bacteriological menaces. One story told of the tubercular worker who licked his fingers while he turned the pages of documents, spreading consumption far and wide. One British sign from that era reads, “Don’t Spit! It’s Disgusting and It Spreads Germs!”
In the United States, control of tuberculosis was first systematized in New York City. By 1900, Dr. Herman Biggs of the Metropolitan Board of Health had developed the basic procedures still used for the control of TB around the world. These included free sputum exams, mandatory reporting of cases, mandatory isolation and treatment of those infected, education of the public about the disease, and monitoring of living conditions. The methods were despotic by today’s standards, and the system concentrated on the poor, by now stigmatized and stereotyped as society’s primary TB carriers. Biggs proceeded from the notion that still animates all public health systems: the well-being of society is more important than private liberty. Since he was focusing on people with little political or economic clout, few objected. By contrast, the middle class and wealthy enjoyed private medicine, where the well-being of the individual comes first. The two systems, public and private, developed separately, in tandem.
Restrictions on the individual reached their apex with the creation of the sanitarium, an institution that totally cut off consumptives from society, sometimes voluntarily, sometimes mandatorily, sometimes for years, sometimes for life. If one was rich, a sanitarium might be a fancy seaside spa or a mountain resort. If one was poor, a sanitarium was little better than a prison. By 1950, over a hundred thousand sanitarium beds existed in the United States alone. Sanitarium doctors experimented with an amazing variety of therapies to try to treat TB. These included bed rest, fresh air, lung collapse, rib removal, exposure to heat, exposure to cold, exposure to sun, gold therapy, calcium therapy, iodine therapy, horse riding, the milk cure, the grape cure, the wine cure, and cod-liver oil. Dietarytherapies ranged from strict limits on what a patient could eat to stuffing them with nutritious food. For society, the main benefit was the removal of infectious individuals.
Before an antibiotic cure for tuberculosis was discovered, daily doses of fresh air were considered vital to preventing and treating the disease, even in the coldest weather.
Meanwhile, a new social reform movement, moral environmentalism, lobbied for better housing for the poor, public parks, public schools, hospitals, efficient waste disposal, sewers, water systems, street cleaning, and the regulation of markets, slaughterhouses, and restaurants. The idea was simple and owes much to Edwin Chadwick: improve the environment and you improve the person. The combination of control, isolation, diet, and improved living conditions worked. In 1828, TB deaths in England were about four thousand per million. By 1948, TB deaths in the United States had dropped to about four hundred per mil-lion. With the advent of antibiotics—drugs that could actually kill the tuberculosis bacterium—the American TB death rate dropped to its lowest ever: ninety per million. The tuberculosis decline among American minorities was not so steep. Indeed, in many developing nations, rates had not declined at all. Nevertheless, the mood was so optimistic that in 1980, a panel of experts convened by the U.S. Congress was
The bacterium
Mycobacterium tuberculosis
Confronted with this new knowledge, the middle class became obsessed with cleanliness, sure that TB microbes were lurking everywhere. Bodily fluids became scary, human smells repulsive (the search for effective underarm deodorants and antiperspirants starts here). Spitting, kissing, and even talking were now seen as bacteriological menaces. One story told of the tubercular worker who licked his fingers while he turned the pages of documents, spreading consumption far and wide. One British sign from that era reads, “Don’t Spit! It’s Disgusting and It Spreads Germs!”
In the United States, control of tuberculosis was first systematized in New York City. By 1900, Dr. Herman Biggs of the Metropolitan Board of Health had developed the basic procedures still used for the control of TB around the world. These included free sputum exams, mandatory reporting of cases, mandatory isolation and treatment of those infected, education of the public about the disease, and monitoring of living conditions. The methods were despotic by today’s standards, and the system concentrated on the poor, by now stigmatized and stereotyped as society’s primary TB carriers. Biggs proceeded from the notion that still animates all public health systems: the well-being of society is more important than private liberty. Since he was focusing on people with little political or economic clout, few objected. By contrast, the middle class and wealthy enjoyed private medicine, where the well-being of the individual comes first. The two systems, public and private, developed separately, in tandem.
Restrictions on the individual reached their apex with the creation of the sanitarium, an institution that totally cut off consumptives from society, sometimes voluntarily, sometimes mandatorily, sometimes for years, sometimes for life. If one was rich, a sanitarium might be a fancy seaside spa or a mountain resort. If one was poor, a sanitarium was little better than a prison. By 1950, over a hundred thousand sanitarium beds existed in the United States alone. Sanitarium doctors experimented with an amazing variety of therapies to try to treat TB. These included bed rest, fresh air, lung collapse, rib removal, exposure to heat, exposure to cold, exposure to sun, gold therapy, calcium therapy, iodine therapy, horse riding, the milk cure, the grape cure, the wine cure, and cod-liver oil. Dietarytherapies ranged from strict limits on what a patient could eat to stuffing them with nutritious food. For society, the main benefit was the removal of infectious individuals.
Before an antibiotic cure for tuberculosis was discovered, daily doses of fresh air were considered vital to preventing and treating the disease, even in the coldest weather.
Meanwhile, a new social reform movement, moral environmentalism, lobbied for better housing for the poor, public parks, public schools, hospitals, efficient waste disposal, sewers, water systems, street cleaning, and the regulation of markets, slaughterhouses, and restaurants. The idea was simple and owes much to Edwin Chadwick: improve the environment and you improve the person. The combination of control, isolation, diet, and improved living conditions worked. In 1828, TB deaths in England were about four thousand per million. By 1948, TB deaths in the United States had dropped to about four hundred per mil-lion. With the advent of antibiotics—drugs that could actually kill the tuberculosis bacterium—the American TB death rate dropped to its lowest ever: ninety per million. The tuberculosis decline among American minorities was not so steep. Indeed, in many developing nations, rates had not declined at all. Nevertheless, the mood was so optimistic that in 1980, a panel of experts convened by the U.S. Congress was
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