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Tuberculosis Then and Now

Tuberculosis Then and Now: Perspectives on the History of an Infectious Disease

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  • Book Info
    Tuberculosis Then and Now
    Book Description:

    In Tuberculosis Then and Now leading scholars and new researchers in the field reflect on the changing medical, social, and cultural understanding of the disease and engage in a wider debate about the role of narrative in the social history of medicine and how it informs current debates and issues surrounding the treatment of tuberculosis and other infectious diseases. Through a case study of the history of tuberculosis and its treatment, this collection examines medicine and health care from the perspectives of class, race, and gender, providing a challenging and refreshing addition to the field of bacteria-centred accounts of the history of medicine.

    eISBN: 978-0-7735-7704-6
    Subjects: Anthropology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-2)
  3. 1 Tuberculosis and Its Histories: Then and Now
    (pp. 3-23)

    There have been major changes in how historians have approached the writing of the history of tuberculosis over the past thirty years and multiple ways in which the topic is currently addressed. This volume reflects many of these developments but also takes the subject into new territory by explicitly exploring continuities and discontinuities between tuberculosis now and then. The authors in this volume exemplify a growing feature of medical history, namely, how historians can engage in debates on current responses to specific disease problems. In this introduction we reflect on the past and present history of the disease and explore...

  4. 2 Lay Disease Narratives, Tuberculosis, and Health Education Films
    (pp. 24-48)

    This essay makes a speculative proposal: by using an approach to tuberculosis that focuses on the storied nature of lay understandings of disease, it may be possible to gain a broad grasp of its place in the culture of the past. It is a contribution to the strand within medical history that seeks to move beyond the social historical towards the cultural historical in an attempt to make an account of the past that places the experience of disease and medicine proportionally as an aspect of life and not its whole. Because the prevalence and threat of tuberculosis have declined...

  5. 3 Targeting Patient Zero
    (pp. 49-71)

    On 16 October 1990 , New Yorkers found Patient Zero’s haggard, gaunt face looking out at them from their morning paper, his empty gaze staring wearily into the distance. As part of a series on the resurgence of tuberculosis in the city, theNew York Postfeatured on its front page a homeless man who, the paper claimed, had been spreading the disease up and down Manhattan for eight months:

    Leo Maker, homeless and a junkie, roamed the city for eight months spreading tuberculosis. Coughing and highly contagious, he left a trail of tuberculosis germs from the Bronx to the...

  6. 4 Beyond the Total Institution: Towards a Reinterpretation of the Tuberculosis Sanatorium
    (pp. 72-99)

    When Erving Goffman published his seminal studyAsylumsin 1961 , few would have anticipated its far-reaching impact on social theory and, somewhat later, the historiography of medical institutions.¹ Such institutions had previously been regarded as loci of care. But with Michel Foucault and Thomas Szasz, Goffman popularised the view that they ought to be studied as social institutions that shaped medical knowledge. Szasz coined the terminstitutional pathologyto begin to understand what he called a misguided definition of (mental) illness. For him, institutions combined a general inability to usefully treat a mental illness with an explicit aim to...

  7. 5 The Great White Plague Turns Alien: Tuberculosis and Immigration in Australia, 1901–2001
    (pp. 100-122)

    The historiography of modern nationalism has recently taken a distinct turn. A number of studies have shown how the public health management of populations through medico-legal border control has actively constituted national identities. And many of these studies have persuasively demonstrated the close connections between communicable-disease prevention, race-based exclusions and restrictions, and the formation of racialised nations.¹ Australian history is exemplary in this respect, in large part because of the stridency and efficacy of the white Australia policy. Initially implemented in each of the Australasian colonies in the late nineteenth century, the national Immigration Restriction Act (1901) was one version...

  8. 6 Importation, Deprivation, and Susceptibility: Tuberculosis Narratives in Postwar Britain
    (pp. 123-147)

    Tuberculosis is now acknowledged as a global health catastrophe. A third of the world’s population are infected with the bacillus, eight million people develop active tuberculosis every year, and some two million die. With co-infection with HIV and the emergence of drug-resistant strains that have led in turn to the adoption of the who Directly Observed Therapy, Shortcourse (dots) strategy, tuberculosis has “apparently made a resurgence almost everywhere in the world.”¹ This includes in sub-Saharan Africa, in the former Soviet Union and Eastern Europe, in South America, and in New York and London. In their study, Matthew Gandy and Alimuddin...

  9. 7 Before McKeown: Explaining the Decline of Tuberculosis in Britain, 1880-1930
    (pp. 148-170)

    Since the 1950s, the views of Thomas McKeown on the causes of the decline of mortality from pulmonary tuberculosis (TB)¹ in Britain have become well known and vigorously debated.² McKeown’s claim that improved nutrition and standards of living were the principal factor in the halving of mortality from the 1830s to the 1900s continues to exercise medical historians, as well as historical demographers and epidemiologists. One reason for this is the corollary of his argument, namely, that the three other factors he identified – medical intervention, public health measures, and changes in the disease – were relatively minor causes in the overall...

  10. 8 “The right not to suffer consumption”: Health, Welfare Charity, and the Working Class in Spain during the Restoration Period
    (pp. 171-188)

    One of the features most frequently mentioned to highlight the social impact of tuberculosis is that it was the main cause of mortality in every industrialised country in the nineteenth century. In Spain, tuberculosis contributed to around 7 percent of the general mortality rate between 1901 and 1930, which resulted in about thirty thousand deaths each year. Some contemporaries claimed that deficiencies in the data collection and analysis meant the actual figure was as high as seventy thousand; indeed, some estimates multiplied the official number of deaths from tuberculosis by ten. However, high mortality was not the only feature that...

  11. 9 Lobbying and Resistance with regard to Policy on Bovine Tuberculosis in Britain, 1900–1939: An Inside/Outside Model
    (pp. 189-212)

    One of the most interesting and challenging problems related to bovine tuberculosis in Britain in the first half of the twentieth century is explaining the nature of policy-making, its implementation through legislation and regulation, and the outcomes in terms of disease in both animals and humans. Above all, we must account for why it was known and widely accepted in the 1920s and early 1930s that 40 percent of the milking herd was infected, yet why it was not until the 1950s that the radical measures of a major, nationwide slaughter campaign were put in place.

    This chapter seeks to...

  12. 10 At Home in the Colonies: The WHO-MRC Trials at the Madras Chemotherapy Centre in the 1950s and 1960s
    (pp. 213-234)

    Attitudes towards and treatment of communicable diseases changed considerably during the 1950s. New anti-malarials, the unprecedentedly powerful antibiotic penicillin, and the new anti-tuberculosis drugs were finally demonstrating the staggering – but as yet unfulfilled – potential of chemotherapy to challenge some of the world’s most intransigent disease problems.¹ With the introduction of effective combined chemotherapy treatments, for instance using streptomycin, para-amino-salicylic acid (PAS), and isoniazid, came dreams of the total eradication of tuberculosis (a disease that though already in steep decline across the developed world was on the increase in many poorer countries). Chemotherapies promised treatments and cures for a range of...

  13. Contributors
    (pp. 235-236)
  14. Index
    (pp. 237-243)