Tuberculosis Tb Quotes

Love hasn't got anything to do with the heart, the heart's a disgusting organ, a sort of pump full of blood. Love is primarily concerned with the lungs. People shouldn't say "she's broken my heart" but "she's stifled my lungs." Lungs are the most romantic organs: lovers and artists always contract tuberculosis. It's not a coincidence that Chekhov, Kafka, D.H. Lawrence, Chopin, George Orwell and St Thérèse of Lisieux all died of it; as for Camus, Moravia, Boudard and Katherine Mansfield, would they have written the same books if it werent for TB?

We cannot address TB only with vaccines and medications. We cannot address it only with comprehensive STP programs. We must also address the root cause of tuberculosis, which is injustice. In a world where everyone can eat, and access healthcare, and be treated humanely, tuberculosis has no chance. Ultimately, we are the cause. We must also be the cure.

TB in the twenty-first century is not really caused by a bacteria that we know how to kill. TB in the twenty-first century is really caused by those social determinants of health, which at their core are about human-built systems for extracting and allocating resources. The real cause of contemporary tuberculosis, is for lack of a better term, us.

I’m a novelist, not a historian of medicine. TB is rare where I live. It doesn’t affect me. And that’s all true. But I hear Shreya, and Henry, and so many others calling to me: Marco. Marco. Marco.

Twentieth century women's fashions (with their cult of thinness) are the last stronghold of the metaphors associated with the romanticizing of TB in the late eighteenth and early nineteenth centuries.

Far more potently than any miracle medicine, relatively uncelebrated shifts in civic arrangements--better nutrition, housing, and sanitation, improved sewage systems and ventilation--had driven TB mortality down in Europe and America. Polio and smallpox had also dwindles as a result of vaccinations. Cains wrote, "The death rates from malaria, cholera, typhus, tuberculosis, scurvy, pellagra, and other scourges of the past have dwindled in the US because humankind has learned how to prevent these diseases.... To put most of the effort into treatment is to deny all precedent.

This year, thousands of doctors will attend to millions of TB patients, and just as my great-grandfather could not save his son, these physicians will be unable to save their patients, because the cure is where the disease is not, and the disease is where the cure is not.

At this time, there was a superstition among upper class women that the blood of young children helped keep the bloom of youth and that young fat helped conserve a young skin. There was also TB raging through the city; at that time, it was a disease that was one hundred percent fatal, as in those years there was no penicillin, but there was a popular belief that ingested human blood soothed and healed tuberculosis. Enriqueta now began kidnapping children of all ages, some for prostitution and some to be killed to create her healing tonics and “facial crèmes.” Everything that she possibly could she used from these children: the blood, bones (that she pounded into powder), and the fat.

She had been maimed by an illness that was so far out of fashion it might have been a wartime recipe for pink blancmange made from cornflour when everyone these days ate real chocolate mouse and tiramisu. TB was Spam fritters and two-bar electric fires and mangles and string bags and French knitting and a Bakelite phone in a freezing hall and loose tea and margarine and the black of the newspaper coming off on your fingers and milk in glass bottles and books from Boots Lending library with a hole in the spine where they put the ticker, and doilies and antimacassars and the wireless tuned to the Light Programme. It was outside lavatories and condensation and slum dwellings and no supermarkets. It was tuberculosis, which had died with the end of people drinking nerve tonics and Horlicks.

Theobald Smith, yet another of those forgotten heroes of medical history. Smith, born in 1859, was the son of German immigrants (the family name was Schmitt) in upstate New York and grew up speaking German, so was able to follow and appreciate the experiments of Robert Koch more quickly than most of his American contemporaries. He taught himself Koch’s methods for culturing bacteria and was thus able to isolate salmonella in 1885, long before any other American could do so. Daniel Salmon was head of the Bureau of Animal Husbandry at the U.S. Department of Agriculture and was primarily an administrator, but the convention of the day was to list the bureau head as lead author on the department’s papers, and that was the name that got attached to the microbe. Smith was also robbed of credit for the discovery of the infectious protozoa Babesia, which is wrongly named for a Romanian bacteriologist, Victor Babeş. In a long and distinguished career, Smith also did important work on yellow fever, diphtheria, African sleeping sickness, and fecal contamination of drinking water, and showed that tuberculosis in humans and in livestock was caused by different microorganisms, proving Koch wrong on two vital points. Koch also believed that TB could not jump from animals to humans, and Smith showed that that was wrong, too. It was thanks to this discovery that pasteurization of milk became a standard practice. Smith was, in short, the most important American bacteriologist during what was the golden age of bacteriology and yet is almost completely forgotten now.

I should acknowledge, I guess, that one reason I'm interested in TB is that I have obsessive-compulsive disorder, and my particular obsessive worries tend to circle around microbes and illness. Before the germ theory of disease, we did not know that around half the cells in my body do not, in fact, belong to my body - they are bacteria and other microscopic organisms colonizing me. And to one degree or another, these microorganisms can also control the body - shaping the body's contours by making it gain or lose weight, sickening the body, killing the body. There's even emerging evidence that one's microbiome may have a relationship with thought itself through the gut-brain information axis, meaning that at least some of my thoughts may belong not to me, but to the microorganisms in my digestive tract. Research indicates that certain gut microbiomes are associated with major depression and anxiety disorders; in fact, it's possible that my particular microbiome is at least partly responsible for my OCD, meaning that the microbes are the reason I am so deeply afraid of microbes.

The infection of kusang (the company of bad people) is worse than tuberculosis. TB will kill a person for just one life whereas this infection will ruin endless lives.

Edna never took decisions lightly. She was a woman of few words, a listener, a reader of silences, of the pauses that came between thoughts and ideas. Living in the South, she had learned to decipher absence, fill in the gaps, read smiles and smirks and hand gestures, and then wait for clarity. She would do that now. Take her time, weigh the pros and cons of staying in Savannah and enduring its codes or following the thousands of other migrants and becoming a nurse in a TB hospital. (pg. 26)

Tuberculosis is an airborne disease. Carried out of the lungs with each cough are thousands of fluid droplets, plumes of minuscule crusaders. Some of them will contain the tiny rod-shaped TB bacteria, each only three-thousandths of a millimetre long. The fluid droplets themselves start off fairly big, perhaps a few tenths of a millimetre. These droplets are being pulled downwards by gravity and once they hit the floor, at least they’re not going anywhere else. But it doesn’t happen quickly, because it’s not just liquids that are viscous. Air is too – it has to be pushed out of the way as things move through it. As the droplets drift downwards, they are bumped and jostled by air molecules that slow their descent. Just as the cream rises slowly through viscous milk to the top of the bottle, these droplets are on course to slide through the viscous air to reach the floor. Except they don’t. Most of that droplet is water, and in the first few seconds in the outside air, that water evaporates. What was a droplet big enough for gravity to pull it through the viscous air now becomes a mere speck, a shadow of its former self. If it was originally a droplet of spit with a tuberculosis bacterium floating about in it, it’s now a tuberculosis bacterium neatly packaged up in some leftover organic crud. The gravitational pull on this new parcel is no match for the buffeting of the air. Wherever the air goes, the bacterium goes. Like the miniaturized fat droplets in today’s homogenized milk, it’s just a passenger. And if it lands in a person with a weak immune system, it might start a new colony, growing slowly until new bacteria are ready to be coughed out all over again.

Today nearly two billion people on earth may host the tuberculosis bacterium. Over the next decade, ninety million will develop active TB. Eventually thirty million will die. Tuberculosis, once the most Romantic of illnesses, is now the deadliest disease on earth. Controlling the bacterium is the twenty-first century’s greatest public health challenge.

At the other end of the train car, the middle-aged man opens his coat to reveal a red supervillain outfit underneath. His chest has the letters TB on it, plus a picture of jacks. Not the kind you use on a car, but the kind kids play with. And the TB doesn’t stand for tuberculosis, either. This is Jack the Toy Boy. Erg. His name makes him sound more like a porn star than a supervillain.

penicillin, which was discovered in 1928 by Alexander Fleming and put to therapeutic medical uses from 1941. Penicillin had no relevance to TB specifically, but it opened the way to the development of a series of additional “magic bullets” and to the belief that TB could be eradicated globally by a spectacular technological fix. The first of these “wonder drugs” applicable to tuberculosis was the antibiotic streptomycin, which was discovered at Rutgers University by Selman Waksman in 1943.

On the level of the individual patient, tuberculosis is now understood to be an infectious disease, but one that spreads unhurriedly from person to person, usually after a prolonged period of contact, and that characteristically attacks the body in a protracted siege. Similarly, in society as a whole, TB can be understood as an epidemic in slow motion, lasting even for centuries in a single place and then retreating gradually and mysteriously over the course of generations.

In miliary tuberculosis, Koch’s invading bacilli can metastasize throughout the body from an initial lesion in the lungs. But since Mycobacteria can sometimes enter the body via the different pathways of ingestion, inoculation, or vertical transmission, they can establish the original infection in a locus other than the lungs. This multiplicity of possible sites of infection makes tuberculosis one of the most polymorphous of all diseases, capable of attacking any tissue or organ—skin, heart, central nervous system, meninges of the brain, intestines, bone marrow, joints, larynx, spleen, kidney, liver, thyroid, and genitals. Potentially, therefore, TB can appear in a wide array of guises, enabling it to mimic other diseases and making physical diagnosis notoriously difficult.

A 2023 paper in the Journal of Benefit-Cost Analysis (there's a journal for everything) calculated an even higher return, finding that every dollar invested in TB yields 46 US dollars in benefits. The report also found that between 2023 and 2050, there could be almost one million averted deaths per year on average. Interventions to address TB represent exceptional value for money. But of course, people are not just their economic productivity. We do not exist primarily to be plugged into cost-benefit analyses. We are here to love and be loved, to understand and be understood. TB intervention is an exceptionally good global health investment. But that is not why I care about TB.

A 2024 study commissioned by the WHO found that every dollar spent on tuberculosis care generates around thirty-nine dollars in benefit by reducing the number (and expense) of future TB cases, and through more people being able to work rather than being chronically ill or caring for their chronically ill loved ones

But randomized control trials have found that directly observed therapy is no more effective than giving patients their pills to take home in two-week or monthlong cycles, provided the patients are adequately supported. DOTS also failed to address the growing crisis of drug-resistant tuberculosis, and failed to identify many cases of TB because smear microscopy is so much less sensitive than chest X-rays. But even in 2025, DOTS remains standard practice in much of the world.

TB in the twenty-first century is really caused by those social determinants of health, which at their core are about human-built systems for extracting and allocating resources. The real cause of contemporary tuberculosis is, for lack of a better term, us.

Shreya’s sister had given her the novel after Shreya became too breathless to leave her bed, the result not only of an infectious TB pathogen but of a society’s unwillingness to help her survive.

I care about TB because of Henry.

In Europe and the U.S., most white doctors believed that phthisis—as it was inherited by those with great sensitivity and intelligence—could only affect white people, and it was sometimes known as “The White Man’s Plague.” One American doctor, for instance, called it, “a disease of the master race not of the slave race.” As Snowden writes, “In the United States, the prevailing wisdom was that African Americans contracted a different disease. The disinclination even to give it a name speaks volumes with regard to the prevailing racial hierarchy and the lack of access to medical care by people of color.” This phenomenon extended to all colonial empires. Many European colonialists believed that TB did not exist in South Asia or Africa, even though physicians working in colonized communities knew otherwise.

We see the profound shift from an inherited disease of intellect to a contracted disease of filth in the racialization of tuberculosis. As late as 1880, white American physicians still argued that consumption did not occur among Black Americans, who, it was claimed, lacked the intellectual superiority and calm temperament to be affected by the White Plague. But after Koch identified Mycobacterium tuberculosis in 1882, all that changed. Racialized medicine no longer maintained that high rates of consumption among white people was a sign of white superiority; instead, racialized medicine maintained that high rates of consumption among Black people was a sign of white superiority. One white doctor’s 1896 treatise asserted that African Americans were disproportionately dying of tuberculosis due to their smaller chest capacity and increased rate of respiration, for example. None of this was true, of course. Black people were not more susceptible to TB because of factors inherent to race; they were more susceptible to tuberculosis because of racism. Because of racism, Black Americans were more likely to live in crowded housing, an important risk factor for TB. Because of racism, Black Americans were more likely to be malnourished, another risk factor. Because of racism, Black Americans were more likely to experience intense stress, and they were less likely to be able to access healthcare.

It’s hard to overstate how profound the link between consumption and creative genius was in eighteenth- and nineteenth-century Europe and the U.S.[*] When TB rates declined in the U.S. toward the end of the nineteenth century, some physicians worried it would harm the quality of American literature, with one writing, “By way of compensation for good health we may lack certain cultural joys.

And so, as historian Christian McMillen has written, “The terms ‘compliance’ and ‘adherence’ or whatever other term might be deployed are all too confining. What does a national TB program’s inability to keep track of patients on treatment have, necessarily, to do with patient compliance or adherence? When a program loses a large percentage of its patients, is this a compliance problem or a surveillance problem? Is it a patient’s fault when he or she cannot afford the food necessary to ward off the hunger brought on by the drugs?” More broadly, is it a patient’s fault if they are too disabled by depression and isolation to follow through on treatment? Is it a patient’s fault if they or their children become so hungry that they feel obliged to sell their medication for food? Is it a patient’s fault if their living conditions, or concomitant diagnoses, or drug use disorder, or unmanaged side effects, or societal stigma result in them abandoning treatment? Why must we treat what are obviously systemic problems as failures of individual morality? Many patients have described the experience of receiving their drugs as humiliating—they may be handed their medicine while being told that this only happened because they were unclean or poor or otherwise lesser.[*] This is often not an environment patients are excited to return to—and yet somehow we always seem to blame the patient for noncompliance, rather than blaming the structures of the social order that make compliance more difficult.

But there’s a problem: M. tuberculosis grows so slowly because it takes a long time to build its unusually fatty, thick cell wall, which is a formidable enemy to the immune system. White blood cells struggle to penetrate the cell wall and kill the bacteria from within. In fact, it’s so hard for infection-fighting cells to penetrate the bacteria’s cell wall that, instead, white blood cells usually surround it, creating a ball of calcifying tissue known as a tubercle.[*3] The TB bacteria can survive within these tubercles, replicating very slowly, consuming dead tissue as food. This type of infection, sometimes known as latent tuberculosis, will often last a lifetime without ever making a person sick.

Johnson & Johnson would later say, “It is false to suggest—as some recently have—that our patents are being used to prevent access to SIRTURO (bedaquiline), our medicine for MDR-TB.” But I would challenge them to look into Isatu’s eyes and tell her that J&J’s price gouging had nothing to do with a medicine funded primarily by the public being unavailable to the most vulnerable members of that public.

Indigenous people were more than ten times as likely to die of TB than white Canadians. But in residential schools, the rate was 8,000 per 100,000—meaning that 8 percent of all kids confined in these schools died of tuberculosis each year. And these inequities persist—today, Inuit people are over 400 times more likely to contract tuberculosis than white Canadians. As Lena Faust and Courtney Heffernan have written, “These deaths should not be dismissed as an unavoidable consequence of a long-standing epidemic, but as the result of deliberate neglect and mistreatment on the part of the architects of the residential-school system.

Tuberculosis is so often, and in so many ways, a disease of vicious cycles: It’s an illness of poverty that worsens poverty. It’s an illness that worsens other illnesses—from HIV to diabetes. It’s an illness of weak healthcare systems that weakens healthcare systems. It’s an illness of malnutrition that worsens malnutrition. And it’s an illness of the stigmatized that worsens stigmatization. In the face of all this, it’s easy to despair. TB doesn’t just flow through the meandering river of injustice; TB broadens and deepens that river.

And so here is Shreya, saying “Polo” to me from across the great divide. But she is also saying “Marco.” She is also telling me to hear her voice, and answer her call. People often ask me why I’m obsessed with tuberculosis. I’m a novelist, not a historian of medicine. TB is rare where I live. It doesn’t affect me. And that’s all true. But I hear Shreya, and Henry, and so many others calling to me: Marco. Marco. Marco.

To cite one story among thousands, Thomas Albert White, a Black veteran of World War I, saw his TB infection turn into active disease after a chemical warfare attack. He returned to the U.S. and was sent by the federal government to a series of TB hospitals throughout the country, all of which denied him entry despite government orders to admit him. White eventually died of his illness without access to care.

Fear of TB germs getting caught in beards led to what Harper’s Weekly called “The Revolt against the Whisker,” ushering in an era of clean shaves.

TB is both a form and expression of injustice. And I learned that how we imagine illness shapes our societies and our priorities.

Covid-19 displaced tuberculosis as the world’s deadliest infectious disease from 2020 through 2022, but in 2023, TB regained the status it has held for most of what we know of human history. Killing 1,250,000 people, TB once again became our deadliest infection.

Still, over a million people died of tuberculosis in 2023. That year, in fact, more people died of TB than died of malaria, typhoid, and war combined.

The Canadian Public Health Association has estimated that in First Nations communities, around 700 of every 100,000 people died annually of tuberculosis in the 1930s and 1940s. Indigenous people were more than ten times as likely to die of TB than white Canadians. But in residential schools, the rate was 8,000 per 100,000—meaning that 8 percent of all kids confined in these schools died of tuberculosis each year. And these inequities persist—today, Inuit people are over 400 times more likely to contract tuberculosis than white Canadians.

The reclining wood-slatted chair known as the Adirondack Chair was invented for TB patients, allowing them to rest outdoors without needing their beds wheeled outside.

Conan Doyle immediately saw what Koch did not: that the serum tuberculin caused a strong immune response in people who’d been infected by TB, but that this immune response did not improve the body’s ability to fight off the disease. As a result, tuberculin often made TB patients more sick, not less.

While tuberculin cannot treat TB, it can identify TB, because only those who are infected with M. tuberculosis will have an immune response to tuberculin.

There is no way of computing the number of bacteria and noxious germs that may lurk in the Amazonian jungles of a well-whiskered face, but their numbers must be legion,” argued Dr. Edwin F. Bowers in a 1916 magazine article called “The Menace of Whiskers.” Fear of TB germs getting caught in beards led to what Harper’s Weekly called “The Revolt against the Whisker,” ushering in an era of clean shaves. For

Even in the 1940s, TB infections and disease remained common—twentieth-century TB survivors include Beatle Ringo Starr (who was institutionalized with TB as a teenager), the novelist George Orwell (who died of TB in 1950, just as curative treatment was becoming available), the writer Thomas Wolfe (who died of tuberculous meningitis in 1938), and the actor Vivian Leigh (who lived with TB for over twenty-five years).