• Andy Robson

Why did so many of our Ancestors die from TB?

Cause of death TB

As family historians we all too frequently come across death certificates showing 'pulmonary tuberculosis' as the cause of death. But what was tuberculosis and why were so many of our ancestor's lives cut short because of it?

Tuberculosis (TB) was the most common cause of death in Britain in the early 1900’s. It was commonly called consumption because of the extreme weight loss suffered by those infected, or simply the ‘White Plague’ because of the extreme anaemic pallor of those affected.

Although the disease can infect several parts of the body, by far the most common form is in the lungs; Pulmonary Tuberculosis. Sufferers also experience a high temperature, fatigue, and breathlessness. The most characteristic symptom, however, is a wet ‘hacking’ cough, which often results in a bloody phlegm being brought up.

Gradually the lungs are broken down by the infection and begin filling with liquid. The sufferer is unable to get enough oxygen into their system – hence the breathlessness and fatigue - and, if left untreated, will eventually die from respiratory failure. It is a prolonged and painful way to go.

TB Bacillus

The act of coughing, along with sneezing, propels air loaded with Mycobacterium Tuberculosis bacteria into the environment. Others breathing in this bacteria can themselves then become infected. For most people, their natural immune system is able to kill the bacteria before it takes hold. For those whose immune system is weakened, however, such as the old, the very young, the sick or the undernourished, the risk of becoming infected becomes much higher. Most of those infected show no symptoms – Latent Tuberculosis – and are not infectious. In a minority of cases, however, the disease progresses to an Active stage. This can take weeks, or even years, to occur and is also generally aided by a weakening of the immune system.

A good example of this is the Brontë literary siblings. Several of the sisters had become infected while attending Cowan Bridge Boarding School in 1825 and two, Maria and Elizabeth, had died soon. The surviving sisters later recalled that conditions at the School had been grim, with insufficient heating, damp and poor diet. Which undoubtedly would have weakened the immune

system of the Boarders. At the time TB was not thought to pass from one person to another, so there was no attempt to isolate those who were ill and the infection was allowed to spread freely. Once the surviving sisters had returned home, the infection seems to have spread among the rest of the Brontë family though only some developed Active TB in later life. Branwell, the only son, and Emily both died in 1848, and Anne in 1849; more than two decades after the initial infection. In Branwell’s case his immune system would have been weakened by his dependency on alcohol and narcotics.

TB has existed in the human population since the Stone Age, but it reached epidemic proportions in the overcrowded, insanitary industrial cities of the 1700’s. Poor living conditions and a diet which was deficient in both quantity and nutrition helped to make the population vulnerable.

For Centuries the disease was considered to be incurable. Not until the 1880’s was it recognised that the condition was contagious and could be passed between people.

TB Public Health Poster

There were various initiatives subsequently launched in Britain to limit the spread; spitting, for example, was discouraged.

In the early part of the 1900’s, Sanatoria began to appear in Britain to treat those infected. Rest, access to fresh air and a good diet was the foundation for all TB treatments. Patients would spend many hours each day outdoors in beds or chairs wheeled onto porches or verandas irrespective of the temperature. However, even in the best of Sanatoria, 50% of those who entered were dead within five years.

Antibiotics were used to treat the disease from the 1940’s and the ‘death sentence’ imposed by TB was finally lifted. In the 1950’s a vaccine was finally developed to prevent people becoming infected. Hopes of eradicating the disease altogether, however, have ended with the rise of drug-resistant strains in the 1980’s and TB remains a potent threat in the Third World where the same overcrowding, unsanitary conditions and poor diet are prevalent that characterised Britain’s industrial towns and cities in the 1700’s and 1800’s.