Romance and Sickness: The Tuberculosis Fascination in 18th-Century Europe
In the late 18th century, Romanticism arose, and strong feelings and touching beauty became the highest pursuit of Europeans at that time. The nobles once considered a healthy and strong body to be a sign of barbarism, while a weak body was seen as a symbol of elegance and nobility.
To make their cheeks look paler, they applied lead powder and even arsenic. In order to obtain a slim waist, they tightened their tights so tightly that they deformed their ribs.
In this environment, people invariably found that tuberculosis patients with the development of the disease, will have "rosy cheeks", "visible collarbones" and "fair skin", which made the literary and artistic youth at that time enthusiastically pursue this disease, hoping to obtain a melancholy and romantic temperament in the long illness.
This deadly disease was given the name "consumption" by people at the time, which means "consumption" and "consumption", and the lives of tuberculosis patients seemed to be slowly being worn.
At that time, people were obsessed with sentimental literary and artistic feelings, as if the more troubled the youth, the easier it was to be embraced by this "romantic" disease. This particular morbid concept not only breeds strange emotions, but also weaves life and death, weakness and grace into an intricate picture.
At that time, this morbid aesthetic permeated the field of literature and art, and many literary giants such as Byron, Shelley, and Keats were fascinated by this disease.
Byron once said, "If I were to die, I wished I could die of this romantic disease," and he even hoped that when he was dying of a serious illness, he would hear the ladies marvel at his dying face.
Shelley was deeply obsessed with Keats, who died prematurely from tuberculosis, and the eulogy was like a song: "Ah, even in death he is beautiful, and in death he is beautiful, like a man who has fallen asleep." ”
Margaret in "La Traviata" Image source network
This morbid fascination has also left a deep mark in the literary classics. In Alexandre Dumas's "La Traviata" and Puccini's "The Bohemian", the heroine is also fated by tuberculosis, and finally dances with the disease to the land of the Yellow Spring.
And in that era of glamour and sadness, tuberculosis caused immeasurable suffering. Coughing, phlegm, coughing up blood, chest pain, mercilessly wrapped around each patient, giving them a melancholy temperament while also sending them into the arms of death.
Tuberculosis was like a poignant song of tragedy, raging and spreading across the European land of that era. It gives people a "sensitive" appearance, but it also reveals the "romantic" illusion of death.
At that time, about a quarter of the population died of tuberculosis, which is the most painful memory of this period. In this history, we have witnessed people's mysterious fascination with disease and a special aesthetic of fragile life, which makes us deeply reflect on the subtle relationship between beauty and death, fascination and reality.
Superstition to Science: Exploring the Evolution and Breakthrough of TB
As science advances, people's understanding of TB has gradually changed. However, in ancient Europe, due to the limitation of medical level, various hypotheses about the cause of tuberculosis emerged, and some unscientific treatments were also tried, such as bloodletting and vomiting.
Some doctors even believe that tuberculosis is caused by annoying God, and as long as you pray sincerely on time and get God's forgiveness, the condition will improve.
Until 1839, German doctor Johann Lukas Schonlein discovered that there was a gray-white nodule in patients who died of tuberculosis, so he named the disease tuberculosis, which laid the foundation for future research on tuberculosis.
However, at the time, when examining these gray nodules using traditional staining techniques, it was difficult to observe the presence of specific bacteria under the microscope. Coupled with some observations, if parents had tuberculosis, their children were also likely to develop it, so some scholars at the time thought that tuberculosis may be the result of inheritance.
During this period, the famous German medical scientist and public health scientist Fiersau (who first discovered leukemia and proposed the formation mechanism of embolism) also held a similar view, which to a certain extent influenced the scientific research direction of tuberculosis.
However, in addition to the mainstream voice, there are also some scholars who have their own opinions, pathologist Kornheim once vaccinated tuberculosis patients with lesions into rabbits, and soon the rabbits showed the typical symptoms of tuberculosis.
However, the mainstream school believes that it is the toxins contained in the lesions that induce the genetic diseases of rabbits.
And the protagonist of our story, Koch, on the basis of the medical research of Hanler, Davan and others, has successfully isolated and cultured Bacillus anthracis by pure culture of solid media. At this time, he developed a strong interest in tuberculosis.
Koch often dissected tuberculosis-dead bodies in hospitals, removing the patient's nodules, grinding them and looking them under a microscope, but found no special findings. He thinks this could be due to the bacteria being too small or the immature dyeing technique.
After that, by continuously refining the staining method, Koch finally clearly observed a bacterium that had never been seen before. Through a large number of sample observations, he found that the bacteria were only present in diseased individuals, but not in healthy individuals. However, Koch believes that to rigorously prove that TB is related to the observed bacteria, four conditions must be met:
01
Pathogenic microorganisms must be present in sick animals, not in healthy animals.
02
This pathogenic microorganism can be isolated from diseased animals in pure cultures.
03
When isolated pure cultures are artificially inoculated with sensitive animals, symptoms specific to the disease must be present.
04
From artificially inoculated animals, pure cultures with the same traits as the original pathogenic microorganism can be isolated again.
(Robert Koch, source network)
Through these conditions, Koch established the famous "Koch's Law". To test his idea, Koch decided to continue experimenting to obtain pure cultured observations.
After several changes in medium formulations, he finally observed tiny colonies on serum medium. Subsequently, he injected guinea pigs with this bacterium, and soon after, the guinea pigs showed symptoms of tuberculosis and died after 4-6 weeks.
In the dead guinea pigs, Koch rediscovered the bacteria he had originally discovered. Thus, Koch confirmed that tuberculosis was caused by bacteria and declared Mycobacterium tuberculosis as the causative agent of tuberculosis at the Physiological Society of Berlin, Germany, on March 24, 1882.
This conclusion was shared by all scholars, including Fairshaw. Koch was also awarded the 1905 Nobel Prize in Physiology or Medicine for his significant contributions to tuberculosis research.
Subsequently, French scientists Carmet and Jielang obtained a strain of Mycobacterium tuberculosis with very low toxicity after 13 years of hard work. Injecting it into the human body as a vaccine not only does not cause tuberculosis, but also effectively protects people from tuberculosis. This attenuated Mycobacterium tuberculosis was later named BCG, and the small scar on our arm is exactly the trace of BCG vaccination as children.
Challenges and Hopes: Reality and Vision for Ending TB
Today, advances in science and technology have given us more and more means to fight TB, but TB has not been completely eliminated.
According to the World Health Organization, it remains the 13th deadliest disease worldwide, after COVID-19, making it the second most contagious killer.
As of 2021, about 10.6 million people worldwide were infected with TB. In addition, some TB bigentrative bacillus have developed drug resistance due to improper prescriptions by some health providers, poor quality of medicines, or premature interruption of treatment by patients, which seriously affects the effectiveness of TB treatment.
At the same time, in order to treat MDR-TB, patients need to take more expensive and toxic drugs, which further increases the difficulty and burden of treatment.
As an infectious disease that seriously endangers human public health security, the prevention and control of tuberculosis has attracted the close attention of all governments. The WHO aims to completely eliminate tuberculosis by 2035, hoping that this initiative will help the development of new vaccines and therapeutics.
(Source: WHO official website)
Resources:
[1].https://www.who.int/zh
[2].https://www.who.int/zh/news-room/fact-sheets/detail/tuberculosis
[3].https://bestpractice.bmj.com/topics/zh-cn/165
[4].https://zhuanlan.zhihu.com/p/257879521
[5].https://www.bilibili.com/video/BV14m4y167nq/?spm_id_from=333.337.search-card.all.click&vd_source=c6a2ce63ea14b877a7fc08cdbdb2fed8
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Authors/Lei Jiaxuan, Cao Yuyang
Audit/Mo XII
Editor/Mai Xuanfeng
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