We humans have successfully reproduced until we have covered this Planet with our 7 billion plus persons, and despite many threats we still persist. However the dinosaurs lived millions of years and only died because of an extinction event; whereas we have lived for only tens of thousands years in comparison.
As we emerged from Africa and began to migrate across the world over these thousands of years, one of the diseases which predates any link to animal disease (such as bovine) is Tuberculosis (TB). Mycobacterium tuberculosis complex (MTBC) has been defined by the recent work of molecular genetics researchers. We have blamed animals for our diseases and, until recently in the UK, hundreds of innocent badgers were blamed for causing bovine TB and they were slaughtered. The fear was that the cattle could pass TB to us through their milk.
Hippocrates in Book 1, Of the Epidemics (410-400 BCE) described a disease of “weakness of the lung” with fever and cough which he referred to as phthisis. Phthisis was described as the commonest disease of the period and usually as being fatal. This term was often seen on death certificates of British citizens in the 18th and 19th centuries when such records were beginning to be recorded.
Many diseases have travelled with us and continue to kill us despite great advances in understanding the diseases and developing treatments and vaccines where possible.
By the mid seventeenth century it was recorded in the London Bills of Mortality that one in five of the deaths in the city was due to consumption (another word for TB). From the seventeenth to the nineteenth century in England, like the other great towns and cities of Europe and America, it swept on in a continuing epidemic of such monstrous proportion, the disease was called the White Plague of Europe. But the history of TB is that in the later part of the 17th century Tuberculosis mortality slowly decreased.
In 1650 doubts had been expressed as to the contagiousness of phthisis, by the faculty of Paris. Soon TB spread over Northern Europe. Northern physicians seem to have been led to believe that the disease was due to a constitutional hereditary defect rather than due to contagion by the fact that it was particularly common and severe in certain families.
In 1679 Sylvius de la Boe, an Amsterdam physician, in his work Opera Medica, was probably the first to use the term tubercles in phthisis of the lung which he called tubercula glandulosa. In addition Sylvius described the association between phthisis and a disease of the lymph glands of the neck called scrofula.
TB in the 18th Century
Tuberculosis mortality probably peaked in England in 1780, at a death rate of one thousand, one hundred and twenty for each one hundred thousand living people each year. This means that one and a quarter percent of the entire population died of the disease each year.11 It is not known how many people got TB but survived it in the 18th century. By the end of the 18th century one in every four deaths in England was attributable to the disease. Then a major reversal occurred and death rates began to fall.
At this time knowledge of disease was derived almost exclusively from its symptoms. But dissatisfied with vague explanations of the disease physicians started to search for more concrete knowledge by dissecting the bodies of dead patients. In 1700 John Manget was carrying out such an autopsy when he observed tubercles so small as to resemble “millet seed” present in all parts of the body. This type of disseminated disease is now called “miliary” tuberculosis.
History of TB in the 19th Century
Around the turn of the 19th century, the death rate worldwide was estimated at 7 million people a year, with 50 million people openly infected. London and New York were two of the worst affected cities. Consumption was probably the most common killer of American colonial adults. It accounted for more than 25% of deaths in New York city between 1810 and 1815.13
In 1891,my Great Granddad Thomas, a tailor, died of TB. He and his wife and her family lived in Halifax, Yorkshire, England after they were married. They later moved nearer York, to be nearer his family. York was a hell hole in Victorian times.
Nearly 3,000 families lived in what Rowntree classed as sub-standard housing, many in slums. These were cramped, cold and dirty without proper water supplies and with overflowing privies shared by many households.
Thomas’ father, Robert, had died when he was 54 years old, near York. Thomas’ brother Alfred (a waiter) died when he was 52. Another brother, Robert, (a Publican) died when he was 42. A sister, Louisa, died when she was 20. I have no more information on Thomas’s other siblings and their cause of death, but no doubt his 8 siblings lived and worked in cramped conditions due to the oppressive existence during this toxic industrial era.
The main employers in Yorkshire when Thomas died were mill owners. Yorkshire was full of mills creating cloths to meet demand around the world. My Great Granddad would have been sewing locally made cloths into outfits for the wealthy mill owners and their families, no doubt.
The mill workplaces were like prisons, and the homes the workers went back to were even more grim. Yorkshire is a place of undulating landscape where streams and rivers proliferate. It was ideal to locate water hungry industry there, especially for processing cloth. By the time Thomas died, the mills would have steam driven machinery. The machinery was so loud, older workers became deaf. The minute fibre fragments in the air also caused lung diseases. Before 1844 people could die in the machinery until it was fenced off under regulation. It was mostly women who toiled in these factories. Before 1833 there was no restriction on hours people were forced to work.
Thomas died nearly into the 20th century, and he was only 30. He was a father to two boys and two girls, the last born just two years before he died. My Great, Great Grandmother, Thomas’ mother, Sarah, died in 1905. She outlived many of her children, but was living in Scarborough on the East coast by then. One of her daughters, Clara was living there with her husband and four children in 1901. They had escaped the confines of the mill town existence. But many who suffered from tuberculosis believed the sea air would heal them. See details of the famous novelist, Ann Bronte who went there but died of TB nevertheless.
A description of a workers revolt is found here:
Many of us will have similar sad stories about losing members of our family to tuberculosis. It is the case that many people die from tuberculosis because they are made vulnerable to it if they suffer similar risk factors to my ancestors. Usually they are in a poverty trap surrounded by wealthy industrialists.
In the 1900s, the unfairness made them sufficiently angry they would revolt, as in Todmorden. Life was very hard for the weavers and they were oppressed with little dignity left. But the mills also suffered from peak output then slump, and there was no safety net when workers were left without income. By the 1914 War the mills were past their peak, goods being made more competitively priced abroad. Men enlisted and we know we never saw many of them return. One of the causes of death whilst at war was TB, contracted whilst in some foreign trench fighting a hopeless and dismal battle against equally miserable enemies.
Those days of the industrial British Empire taught people bitter lessons about class structure . They learned that to be powerful one had to be a ruthless master. Controlling one’s workers required the tactic of making strong people powerless and unable to fight back meaningfully, using the law to entrap them if they tried to rise up. This process made workers feel hopeless. Their diet was poor because they had little nutritious food available now the generations before them had been forced to leave the farmland and made to work in the mills.
This technique would then be adopted by those who enlisted and were sent abroad to fulfil some order to ‘tame savages’ in Africa and such-like. It has been a template ever since, to perpetuate a sense of hopelessness amongst those who have become a target for the colonisers. The colonisers arrived like a disease to infect their innocent victims and, in the 21st century, we see that we have not redeemed ourselves.
In 1993 the World Health Organisation (WHO) declared Tuberculosis to be a public health emergency. In 1994 WHO announced a new strategy called DOTS, for the global control of TB. The WHO TB report for 2019 showed that the world is not on track to reach the 2020 targets of the END TB Strategy.
People already in the at risk groups will also be susceptible to other diseases, such as Covid 19. All diseases spread when people are in a powerless situation, such as becoming homeless but without a social care safety net. Or they might be fleeing their homes from war, persecution, climate change driven economic stress and unable to find shelter except in crowded refugee camps. They might live in poverty shacks such as Favelas, crowded in on each other. HIV could be rampant in the area where they live, reducing their immune system’s ability to fight TB. 98% of TB cases are in Africa. The very place from which our original human ancestors first became bipedal. But we have neglected our birth place and placed untold industrial theft on this once magnificent continent. The population has been brutalised through slavery, led by colonial corruption into a mire of greed and an abuse of power.
There are 22 countries which share the highest burden of TB.
Top 20 by estimated absolute number (in alphabetical order)
Angola, Bangladesh, Brazil, China, DPR Korea, DR Congo, Ethiopia, India, Indonesia, Kenya, Mozambique, Myanmar, Nigeria, Pakistan, Philippines, Russian Federation, South Africa, Thailand, UR Tanzania, Viet Nam
Additional 10 by estimated incidence rate (in alphabetical order)
Cambodia, Central African Republic, Congo, Lesotho, Liberia, Namibia, Papua New Guinea, Sierra Leone, Zambia, Zimbabwe