Chapter 7 : Tuberculosis: the People's Plague

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Tuberculosis (TB) is an ancient disease that has plagued humans throughout recorded history and even earlier. TB of the lungs is the most familiar form of the disease, giving rise to the slang word “lunger.” When localized to the lungs, TB can run an acute course, causing extensive destruction of lung tissue in a few months—so-called galloping consumption. TB can affect organs other than the lungs, including the intestine and larynx; sometimes the lymph nodes in the neck are affected, producing a swelling called scrofula. The word “tuberculosis” refers to the fact that the disease causes characteristic small knots or nodules called “tubercles” in the lungs. Franciscus Sylvius first described these in 1650; he also described their evolution into what he called lung ulcers. To the Victorians, the blood in the sputum blended metaphorically with menstrual blood, and so in a strange way sickness and death were blended with eroticism and procreation. Mycobacterium tuberculosis and M. avium are human pathogens that cause lung disease. M. avium causes opportunistic infections in immunocompromised people (e.g., those with AIDS); its symptoms can include weight loss, fevers, chills, night sweats, abdominal pains, diarrhea, and overall weakness. Coughing, pallor, spitting of blood, night sweats, and painful breathing signify that the disease is active. The lesion becomes infiltrated with lymphocytes and macrophages, and a delayed hypersensitivity reaction, similar to that experienced with a bee sting, occurs. Today it is recognized that tuberculosis is an infectious and a societal disease.

Citation: Sherman I. 2007. Tuberculosis: the People's Plague, p 104-129. In Twelve Diseases That Changed Our World. ASM Press, Washington, DC. doi: 10.1128/9781555816346.ch7
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