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In this episode of AnthroPawlogy Unearthed we will cover a brief history of tuberculosis, as well as how it has impacted and continues to impact our modern world.
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What is AnthroPawlogy Unearthed?
Stories from the past and their impact on the present day. This podcast aims to illustrate how the past has a very real impact on the present. "AnthroPawlogy Unearthed" is a podcast from WKNC 88.1 FM HD-1/HD-2.
00:00
Lachlan Vester
The bacterial infection known today as tuberculosis has gone by many names throughout history. For a large chunk of time in Western Europe, it was called consumption, a name that stemmed from the fact that the disease slowly wasted the afflicted person away. This is AnthroPawlogy Unearthed, and I'm Lachlan Vester. Now you may be wondering, Lachlan, why would you want to research and produce a podcast about tuberculosis? And to that I say, one, you need to mind your own business. And two, I read a really good book recently, that book being Everything is Tuberculosis by John Green. I would gladly recommend it to any and everyone, even if you have no particular affection for infectious disease literature, which quite frankly is a niche that I now live in. Or was I? Oh yeah, tuberculosis TB has a laundry list of symptoms.
01:11
Lachlan Vester
Some of its greatest hits include fever, chills, loss of appetite, and weight loss. That last one is like a direct result of the aforementioned appetite loss. Remember, it's called consumption. So it consumes you. Your body is so starved of nutrients that it begins to eat itself to survive. Somehow this grotesque process was weirdly romanticized in the 18th and 19th centuries, especially in women. The thin, paled, glassy eyed look of a TB patient was considered attractive. Like, seriously, being gaunt was like in fashion. TB was also seen as the disease of the creatives. Like it traded your physical form for poetic genius or artistic creativity. People genuinely thought that TB could make you better at writing a sonnet. Now you're probably thinking, this is really disturbing and fascinating, but why is this like a Western Europe thing?
02:07
Lachlan Vester
And to that I offer the all purpose answer to an upsetting number of historical questions. Racism. Back then, it was widely believed by many, if not all white people that TB was the disease of the whites. For the whites, yes, really. While this is so obviously false, try explaining reason to a 19th century European aristocrat or you know, a Facebook or Twitter comment section. So TB spreads pretty freely in cramped and unsanitary conditions. Think urban tenements, prisons, or ironically, sanatoriums. That makes it all the more important for staff in those facilities to have access to proper ppe. Spoiler alert. They didn't. Historically, especially not in privileged areas. And in many cases, they still don't. Now all of us are pretty familiar with respiratory infection prevention thanks to the pandemic of 2020. Masks, hand washing, air circulation, the whole shebang.
03:06
Lachlan Vester
But back in TB heyday, germ theory hadn't even been invented yet, so people were out here guessing pretty badly. One of the most popular theories was the miasma theory, or the belief that noxious air caused disease. And while obviously this is incorrect, although half points for the air part, I guess it was somehow better than the humorous theory of the middle ages which blamed the illness on an imbalance of black bile, yellow bile, blood and phlegm. Phlegm does show up later though, so stay tuned. Miasma theory reigned supreme for centuries, but eventually lost its crown to science. In the 19th century, Robert Koch publishes postulates that advanced germ theory to the point that people finally said, hey, wait a minute, tiny organisms might be doing this. Which, you know, shocking.
03:56
Lachlan Vester
TB is a bacterial infection, it's aerobic, which means it thrives in a oxygen rich environment like your lungs. The bacteria that causes it is Mycobacterium tuberculosis, which. Right. Oh fuck, you mean I had such a good. TB is a bacterial infection, it's aerobic, which means it thrives in an oxygen rich environment like your lungs. The bacteria that causes it, Mycobacterium tuberculosis, reproduces really slowly. We're talking once every 16 to 20 hours can. Compared to other bacteria, that's practically glacial. This makes TB difficult to detect early and very hard to treat. TB also has a lipid rich cell envelope. Think of it like armor, which makes it highly drug resistant. This is one of the biggest challenges healthcare workers face when treating tb, especially in resource poor settings. Now let's talk testing. Diagnosing TB is complicated and it is very expensive.
04:59
Lachlan Vester
If you want early accurate results, you're gonna be spending a lot of money. I'll walk you through the three most common testing methods ranked from meh to Please let me see a real doctor. First up, we're gonna start with the Please let me see a real doctor. Which is the chest radiograph. Also known as basically just a chest X ray. This is the TV equivalent saying good enough for government work. It looks for lung scarring and the infamous tubercles which are only present in an active late stage case of tb. This means that chest X rays are almost useless for early detection. But guess what? They're cheap, so governments love them. Especially in those low income areas where expensive treatment is too much of a load for the government to bear. The next test is the menteau test. This one's a little less archaic.
05:57
Lachlan Vester
It involves injecting a small amount of tuberculin into the forearm and waiting 48 to 72 hours. If your body reacts, congratulations, you've met TB before. But even this test has its problems. People with HIV can get false negatives, people with heavy TB can get false negatives. And honestly, it's almost impressive how frequently and miserably this test can fail. A little personal aside here, my parents actually had this test done when they applied to college. Neither of them had TB nor had come in contact with tb. It just was interesting to me that this was the test that the colleges decided would best. And I think that's mostly because it's quick compared to the next test, which is a full microbiological study, which microbiological studies are the gold standard.
06:47
Lachlan Vester
You take a sample of sputum, which is basically your mucousy spit, and grow a culture from it. This process takes several weeks due to the slow reproductive rate of tb, but is the most definitive way to detect TB and of course the most expensive. Now you may be asking Lachlan, how do we keep TB from spreading through our communities? Great question. The answer of course being public health. Contact tracing, education, isolation protocols, vaccines, all of these are key. But here's the outrageous part. There is only one TB vaccine and it's not even that great. Why? Because TB is most common in impoverished areas and pharmaceutical companies see little profit in improving a vaccine for people who can't afford it. Which not to get too Ghost hunter about this feels like a one way ticket to hell to me.
07:52
Lachlan Vester
Now we've had a bit of a heavy time talking about testing and public health. Let's do something a little more fun. Let's use our imaginations. Imagine it's 1912. You're a patient in a mountain sanatorium. This place is much less of a hospital and more like a prison, but with better views. The treatment? Not so much medical as it is. Don't move and hope you stop dying. Doctors believe rest, rich food, and just staying alive is the cure to TB at this time. So you lie still on a balcony in the freezing cold while a nurse insists the fresh air will save you. You drink gallons of milk. You journal. You write poems. You draw. Because TB is the disease of creatives. Days turn to weeks into months. For some people, those months turn to years.
08:47
Lachlan Vester
You start to wonder if you'll ever leave this place, or if you'll be another fading photograph and a forgotten patient record. This was the reality for so many people trapped in the global sanatoriums system. While it might seem like a distant old timey tragedy for people in the global south or marginalized communities in the global north, this is still happening. But hey, let's not end on a note of righteous despair. Because there is hope in the fight against TB if you know where to look. TB is treatable TB is preventable when healthcare systems are functional, which is sometimes. Public health programs like vaccination, contact tracing, and education are working slowly. The progress is glacial, but glacial is still moving forward. And there are researchers and there are advocates working tirelessly to develop better solutions. Let's zoom out.
09:45
Lachlan Vester
The story of TB isn't about a disease, and it's about poverty, inequality, and human behavior. It's about how we respond to invisible threats, sometimes with fear, sometimes with brilliance, and sometimes spectacularly bad ideas. So why make a whole podcast episode about tb? Because understanding diseases like TB isn't just memorizing symptoms or ranking tests by price tag. It's about seeing the whole system history, culture, economics, and yes, racism. It's about paying attention to what we choose to ignore. Because if we don't talk about it, TB won't remain a ghost of the past. It'll keep haunting our future. AnthroPawlogy Unearthed is A podcast from WKNC 88.1 FM HD1HD2, Raleigh, NC. The theme music is produced by Samuel White. I'm Lachlan Vester, your host, and I'll see you next time.