How did the rise of consumption cause media frenzy? Photo credit: Hannah Smith via Unsplash
I wasn’t sad to say goodbye to GCSE Biology. No more antibodies, no more flashcards on symptoms of malaria, no more labelling of cells. Just long, luxurious sixth form and university years filled with French and English. Unfortunately, a few things put a stop to this fantasy. Firstly, I have ended up living with a biologist, a biochemist and a human scientist, and so discussion of proteins at the breakfast table is inevitable; secondly, my degree itself has conspired against with me by making me read dozens of texts filled with illness.
It is hard to forget my first reading of Jane Eyre—I was struck by poor Helen, wasting away from consumption at school.
In hindsight, I should have known that biology and disease would weave their way through my academics. It is hard to forget my first reading of Jane Eyre—I was struck by poor Helen, wasting away from consumption at school. Whether Beth’s scarlet fever in Little Women, typhus in Little House on the Prairie, or the various coughs and colds of Pride and Prejudice, it was hard to escape infection in my childhood and teenage reading. The most inescapable of those illnesses was Helen’s consumption, or, as we now call it, tuberculosis (TB).
This is unsurprising. Tuberculosis killed 1 in 8 people in the 19th and 20th centuries and was second only to heart disease as the greatest killer of women. Though it took until the late 18th century for the disease to reach epidemic status, it has been with us for millennia. Some estimate that strains of TB bacteria arose as early as 20,000 years ago. Written evidence of TB has been found from ancient China and ancient India—suggesting, perhaps, that if a disease exists, humans are going to write about it. As rates of TB picked up pace in the 18th century, attempts to explain such an illness fed into folkloric beliefs, with the withered victims leading to fears of vampirism in New England. However, it didn’t occupy a major role in literature and life until the beginning of the 19th century.
Tuberculosis killed 1 in 8 people in the 19th and 20th centuries and was second only to heart disease as the greatest killer of women.
In England, the industrial revolution began to gather momentum, bringing with it crowded and unhygienic urban spaces. Tuberculosis started to ravage poorer communities. Highly contagious, it also spread quickly through the middle and upper classes. Though the identification of the bacteria Mycobacterium tuberculosis by Robert Koch in 1882 would lead to better hygiene practices and the development of sanatorium to isolate patients, the earlier part of the century had fewer resources to deal with the rapidly developing epidemic. Perhaps it is unsurprising that TB led to such literary and cultural obsession. Its pervasiveness and danger may inevitably lead to attempts to give reason to the inexplicable through myths of vampires and ideas of poetic beauty.
Its symptoms fit neatly alongside beauty standards of the time, from sparkling eyes to rosy cheeks…
This wasn’t helped by the supposedly attractive qualities of TB. Its symptoms fit neatly alongside beauty standards of the time, from sparkling eyes to rosy cheeks, and, of course, significant weight loss. This physical attractiveness was exacerbated by the disease’s apparent tendency to afflict attractive intellectuals—from Chopin to Keats, Dostoevsky to Goethe, it seemed that all the most luminous artistic figures had a touch of TB. Byron went so far as to say he should like ‘to die of consumption … because then the women would all say, “see that poor Byron—how interesting he looks in dying!’’’ (In the end, he died from a cold as he prepared to help the Greeks fight the Ottomans, which is an interesting death in its own right.) As well as the alluring physical symptoms, some believed that the disease sparked mental and artistic capacity as well: just as we try to turn Van Gogh’s depression into the inspiration for his sunflowers, the feverish tubercular state was seen as catalyst to, for example, Keats’ ‘Ode to a Nightingale’.
Whether the literary focus on the disease led to its romanticisation or whether popular feeling led to a literary obsession is a typically impossible chicken-and-egg scenario. What is clear, however, is that TB has had a disproportionate impact on the artistic output from the 19th century up to the present day. Aside from aforementioned Jane Eyre, tuberculosis has played a major role in opera (La Traviata and La bohème), art (such as Munch’s depictions of his sister), and writing, whether Russian, American, French or English. Consumptive characters haunt several of the great giants of the literary canon, from Crime and Punishment, to Les Misérables and Dickens’ Nicholas Nickleby. Just as the artworks were afflicted with TB, so too were the artists. A startling array of figures were killed by some form of TB, from Emily and Anne Brontë to Katherine Mansfield, Franz Kafka, and Amadeo Modigliani.
Consumptive characters haunt several of the great giants of the literary canon…
As a disease that was visibly recognisable (heart disease is perhaps harder to spot in rosy cheeks and sparkling eyes), aesthetically appealing, and epidemically pervasive, it is no wonder tuberculosis exercised such sway over art and culture. Just as we are slowly but surely seeing references to COVID-19 trickle cautiously into the media (the Dr Who Christmas special, Margaret Atwood’s Fourteen Days, Sarah Moss’ The Fell), TB, as a disease which killed 1 in 8 of the population between the 19th and 20th century, cannot easily be swept under the fictive carpet.
Women wore corsets to achieve the ‘consumptive look’, but they weren’t actively trying to be sneezed or coughed on.
For all that tuberculosis was romanticised in those times, I couldn’t find any significant evidence of people actually trying to catch it. Women wore corsets to achieve the ‘consumptive look’, but they weren’t actively trying to be sneezed or coughed on. TB was a serious disease and remains so—although it may seem like a fixture only of the 19th century, it is far from being eradicated. 1.25 million people died worldwide from TB in 2023, with 80% of those cases occurring in low- and middle-income countries. Ending the epidemic by 2030 is one of the health targets outlined in the UN Sustainable Development Goals (SDGs). We might like to view TB as a relic of a past era, one which was aestheticised and firmly fixed in time, but it continues, both in the pages of my reading list, and in the realities of people around the world.
