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Spitting Blood: The History of Tuberculosis

Carsten Timmermann recommends a global history of tuberculosis

Published: June 7, 2013 at 8:53 am
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Reviewed by: Carsten Timmermann
Author: Helen Bynum
Publisher: OUP
Price (RRP): £16.99


Traces of DNA in ancient bones discovered in various places around the planet suggest that Mycobacterium tuberculosis has been in evidence for as long as Homo sapiens. In the 1880s the slow-growing rod-shaped micro-organism was identified by German physician Robert Koch as the main cause of the illness suffered by consumptives. As long as humans have lived together in crowded places, this bacterium, it appears, has lived with us, producing the tuberculous lesions in lungs, bones and other organs which gave sufferers the feeling that they were being consumed from within.

The discovery in Koch’s laboratory, as Helen Bynum argues in this well-researched and immensely readable history, provided the basis for turning an omnipresent chronic wasting illness, assumed at the time to be the consequence of lives lived out of balance, into the specific condition known as tuberculosis.

While much consumption may have been caused by Mycobacterium tuberculosis, the two were not identical, and Bynum makes this clear by focusing on the people suffering from the different illnesses that in the age of bacteriology would be described as forms of the same disease. This spans from the scrofulous, thought to be curable by the king’s touch in the Middle Ages through to the 19th century, which saw “consumption’s fashionistas” succumbing: the poet John Keats, the Brontës or the consumptive mistresses of writers and composers immortalised in novels such as Dumas’s La Dame aux Camélias or operas such as Puccini’s La Bohème.

The story of the long, slow death of George Orwell, in particular, provides focus to the book’s prologue. Bynum also discusses the great sanatoria, eugenic concerns, and, of course, the expectations raised by modern biomedicine, which has given us vaccines and antibiotics and the hope that this scourge may be consigned to the past.

Under the impression of HIV-Aids and in the age of multi resistance, we have to assume that tuberculosis will stay with us: a quintessential social disease and a mirror of wider historical developments.

Spitting Blood is, therefore, more than just the history of “an ever-present smouldering cause of sickness and death”. Bynum uses the wasting illness that we associate with Mycobacterium tuberculosis as a lens on the history of the human condition, from the Stone Age to the present day.


Carsten Timmermann is a lecturer at the Centre for the History of Science, Technology and Medicine at the University of Manchester


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