Health and Medicine
97 Tuberculosis in America
Meghan Gamble; Kennedy Key; and Alexis Vaka
introduction
Tuberculosis, a highly variable communicable disease of humans that affects the lungs, shook 20th century America to the core. “In 1900, 194 of every 100,000 U.S. residents died from TB; most were residents of urban areas, and later in 1940, TB remained a leading cause of death” (Achievements in Public Health, 1999). As society continued without a cure throughout the 20th century, the death toll was compounding. Until the breakthrough discovery in the science of vaccinations and antibiotics, extensive and invasive treatments were utilized, often with low success rates. But when Robert Koch discovered the cause of tuberculosis and Selman Waksman developed antibiotics to combat it, the course of the disease changed forever. Innovation within science and technology to combat tuberculosis spurred the field of medicine to improve the course of public health into the future.
Background
Prior to the discovery of antibiotics for the treatment of Tuberculosis, multiple treatments, some extreme, were considered the best options for combating the disease. The formation of tuberculosis sanitariums, the artificial pneumothorax, and thoracoplasty were all commonly utilized treatments prior to the discovery of antibiotic therapies (Hurt, 2004, section 1945). Among home therapy, sanitarium quarantine was one of the most commonly prescribed treat-
ments. It was believed that the rest and environment of an isolated area within sanitariums would slow the effects of the disease and prevent it from further spreading to society (Hurt, 2004, section 1945). Ambulant patients, those who were close to being cured, were housed in open-air cottages, with the remainder of patients in the sanitarium under full or partial bed rest treatment until they were strong enough to be moved to the cottages (University of Virginia Historical Collections at the Claude Moore Health Sciences Library, 2007). While bed and cottage treatment had little measurable influence on the progression of tuberculosis, and was deemed “the alternative in a desperate search for the cure” (Ibid, pg 1) the primary use of fresh air and complete or partial immobility as a cure for disease shows the progression of tuberculosis therapy over time. Until scientifically proven treatments for Tuberculosis were formulated, such as Waksman’s streptomycin, society was confined to remedies of hope and rest as they waited for a cure to this deadly illness.
Within sanitariums, doctors performed surgeries, some extreme, for the health and welfare of patients. Two of the most commonly utilized surgeries for lung rest were the thoracoplasty and the artificial pneumothorax. The thoracoplasty involves removing ribs in a patient to reduce the volume of the lung. The compression of the lung causes cavities in lung tissue, formed by the disease, to retract and have the potential to close (Sellors, 1947). This practice, which i