#千IP创科学popularization# Tuberculosis: The White Plague of the 19th Century

#千IP创科学popularization# Tuberculosis: The White Plague of the 19th Century

Chopin was a representative figure of European romantic music in the 19th century. His untimely death at the age of 39 was caused by tuberculosis, a deadly infectious disease that had lasted for 200 years throughout Europe.

Tuberculosis is a chronic infectious disease caused by infection with Mycobacterium tuberculosis and mainly spread through the respiratory tract. It is an ancient disease and has been recorded in many historical documents. Influenced by historical scientific conditions, these records are not completely correct about tuberculosis, but they also reflect people's deepening understanding of tuberculosis.

(Pictures from the Internet)

1. Western medicine’s understanding of tuberculosis

Clay tablet sculptures from ancient Egypt dating back to 3000 BC record the classic "hump back" spinal deformation, which is very consistent with the spinal deformation caused by Mycobacterium tuberculosis destroying the spine. Evidence of spinal tuberculosis has also been found in Egyptian mummies.

(Pictures from the Internet)

Hippocrates, the father of ancient Greek medicine, defined tuberculosis as a fatal disease. He recorded the characteristics of tuberculosis in his book Epidemiology: fever, colorless urine, cough with thick sputum, thirst and loss of appetite. However, due to the lack of relevant medical knowledge, some people, including Hippocrates, believed that tuberculosis was hereditary. People in medieval Europe generally believed that monarchs had divine power and that patients would be cured after being "touched by the king."

In the 19th century, the West began to use "Consumption" to name tuberculosis, which literally means "consumption", which is similar to the Chinese word "pulmonary tuberculosis", meaning that the disease will slowly consume a person's life.

On March 24, 1882, German scientist Koch announced for the first time the Mycobacterium tuberculosis he found under a microscope, opening a new era in human prevention and control of tuberculosis.

2. TCM’s understanding of tuberculosis

The "Chuancheng" recorded in "Huangdi Neijing Suwen" written in my country more than 2,000 years ago has the following symptoms: "large bones become dry and withered, large muscles become sunken, the chest becomes full of air, breathing becomes difficult, internal pain extends to the shoulders and neck, the body becomes hot, and the flesh falls off and the popliteal fossa is broken."

In the Eastern Han Dynasty, Zhang Zhongjing described "Xulao" in "Golden Chamber Synopsis" as "hot hands and feet, night sweats, insomnia" and "saber-like goiter", which are similar to the symptoms of pulmonary tuberculosis and lymphadenopathy. Although it is difficult to confirm that "Chuancheng" and "Xulao" are pulmonary tuberculosis, they include pulmonary tuberculosis.

From the Han Dynasty to the Tang Dynasty, it was believed that the disease was contagious. Ge Hong of the Jin Dynasty had already initially realized in his "Emergency Prescriptions for the Elbow" that tuberculosis was a chronic infectious disease that was transmitted in families.

The first book specifically for the treatment of tuberculosis, "The Divine Book of Ten Medicines", written by Ge Kejiu in the Yuan Dynasty, records ten important prescriptions for the treatment of consumptive disease and vomiting blood, laying the foundation for the systematic use of medicines for tuberculosis.

During the Ming and Qing Dynasties, doctors realized that the treatment of tuberculosis was closely related to the nutritional conditions of the patients, so "Tanhuo Dianxue" detailed various medicinal and dietary materials suitable for tuberculosis patients. In the Qing Dynasty, Li Yongcui's "Zhengzhi Huibu" described tuberculosis as follows: "External symptoms of tuberculosis, night sweats during sleep, fever in the afternoon, irritability and cough, fatigue and weakness, poor appetite, blood in sputum, spitting and bleeding, muscle wasting", etc., which was a relatively complete description of the symptoms of tuberculosis.

3. Prevention and treatment of tuberculosis

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis invading the human lungs. Patients with infectious pulmonary tuberculosis spread Mycobacterium tuberculosis into the air through coughing, sputum and sneezing.

Healthy people may be infected by inhaling droplets containing tuberculosis bacteria. The probability of an infected person developing the disease in his or her lifetime is about 5-10%.

The main symptoms of pulmonary tuberculosis are coughing, expectoration for ≥ 2 weeks or hemoptysis. Some people may also have low-grade fever, night sweats, afternoon fever, chest pain, fatigue, weight loss or difficulty breathing. Pulmonary tuberculosis is seriously harmful to the human body. As the disease progresses, patients lose their ability to work or even die. It is called the white plague.

After the emergence of anti-tuberculosis drugs in the 20th century, tuberculosis is no longer an incurable disease. More than 95% of patients can be cured if they take the medicine regularly according to the doctor's instructions. If the treatment is not standardized, drug resistance is likely to occur, resulting in a significant reduction in the cure rate and high treatment costs, which brings a heavy economic burden to patients and their families.

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