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Chapter 13 : The People's Plague: Tuberculosis

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The People's Plague: Tuberculosis, Page 1 of 2

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Abstract:

Tuberculosis is an ancient disease that has plagued humans throughout recorded history and even before. Tuberculosis of the lungs (called pulmonary TB) is the form of the disease we are most familiar with, giving rise to the slang word “lunger". Three mycobacteria, Mycobacterium tuberculosis, M. leprae, and M. avium, are human pathogens that respectively cause TB, leprosy, and a pulmonary disease with swollen glands in the neck. Genetically, M. bovis and M. tuberculosis have been shown to be >99.5% identical, so differences in their pathogenic nature are still to be explained. The increased density of people provided ideal conditions for the aerial transmission of M. tuberculosis and pulmonary TB. Tubercle bacilli are rather robust and can survive in moist sputum for 6 to 8 months. Infection may result if as few as 5 bacteria reach the grape-like clusters of the thin-walled air sacs (alveoli) of the lung. Primary tuberculosis is a self-limiting infection that often goes unnoticed: it appears to be a cold, and usually there is little impairment of lung function. If there is a protective immune response, which occurs in 85 to 90% of cases, the disease may progress no further, calcification of the tubercles may take place, and the tuberculin test remains positive. Chest X rays show tubercles and fluid in the lung, and sounds of gurgling and slush can be heard through a stethoscope placed on the chest.

Citation: Sherman I. 2006. The People's Plague: Tuberculosis, p 274-301. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch13
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Figures

Image of Figure 13.1
Figure 13.1

Movie poster for the 1936 tragic romance Camille. Courtesy Popcorn Posters.

Citation: Sherman I. 2006. The People's Plague: Tuberculosis, p 274-301. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch13
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Image of Figure 13.2
Figure 13.2

Scrofula in a young man. The enlarged lymph glands in the neck resemble a piglet (“scrofus” is “pig” in Latin).

Citation: Sherman I. 2006. The People's Plague: Tuberculosis, p 274-301. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch13
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Image of Figure 13.3
Figure 13.3

Tuberculosis of the spine (Potts' disease) in a reconstruction of an Egyptian mummy.

Citation: Sherman I. 2006. The People's Plague: Tuberculosis, p 274-301. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch13
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Image of Figure 13.4
Figure 13.4

The royal touching to cure scrofula. Queen Anne is touching young Samuel Johnson to cure him of the “king's evil.” (Courtesy of Bridgeman Art Library.)

Citation: Sherman I. 2006. The People's Plague: Tuberculosis, p 274-301. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch13
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Image of Figure 13.5
Figure 13.5

The acid-fast rod-shaped bacillus that causes tuberculosis, Mycobacterium tuberculosis, as seen with the scanning electron microscope. (Courtesy of Dennis Kunkel Microscopy, Inc.)

Citation: Sherman I. 2006. The People's Plague: Tuberculosis, p 274-301. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch13
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Image of Figure 13.6
Figure 13.6

The death rate from tuberculosis in England and Wales. (From T. McKeowan, The Role of Medicine, Princeton University Press, 1976, p. 9.)

Citation: Sherman I. 2006. The People's Plague: Tuberculosis, p 274-301. In The Power of Plagues. ASM Press, Washington, DC. doi: 10.1128/9781555816483.ch13
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