Of Poets, Paupers and Planes: Tuberculosis in the City

Abstract

Tuberculosis has afflicted human populations for thousands of years, but it was not until the nineteenth century that it came to be perceived as an epidemic that posed a serious public health problem. The dramatic rise in the incidence and the salience of tuberculosis, or “consumption,” coincided with the Industrial Revolution and the massive migration of populations to urban areas in Europe and the United States. In bringing unprecedented numbers of people together, industrial cities physically facilitated the spread of infectious diseases like tuberculosis. The transitions to city life and a capitalist industrial economy had great impact on culture and society, and these changes provided new ways of perceiving the intersections of health, illness, and class. Anxieties about the urban industrial lifestyle and the fate of the ever-changing city played out in perceptions of tuberculosis and its causes and possible treatments. Concerns about status and the growing underclass of laborers affected perceptions of consumptive patients and one’s own vulnerabilities to tuberculosis. Within the nineteenth century in Europe and the United States, tuberculosis evolved from being a romanticized disease of bohemian artists and musicians to being a social disease of the poor living in urban slums. In the beginning of the twentieth century, racial tensions in the United States fueled theories about tuberculosis and deviance in the African-American and immigrant populations. By the mid-twentieth century, tuberculosis began to fade from the people’s consciousness, and it was eventually deemed to be “eradicated” in the Western world thanks to advances in antibiotic therapy. In the past twenty years, however, tuberculosis has “returned,” in virulent, multi-drug resistant forms. The HIV/AIDS epidemic has played a role in this comeback, as weakened immune systems are unable to ward off tubercle bacillae. Perceptions of tuberculosis are very different in the current global era and reflect the anxieties about globalization today