Research of Pthisis - Essay Example

Research of Phthisis Introduction Phthisis is a distinct for tuberculosis. It is a Greek term that emerged in Greek literature around 460 BCE. At the rise of the term, it was said that it resulted to too many illnesses. According to Greek literature, the term was used to define an illness of the lungs that involved progressive wastage of the body as a whole. It was a fatal disease and the highly infected were those aged between 18 and 35 (McNeill, pp. 12). Due to the increased deaths from the disease, physicians were highly touched and they started undertaking researches to get control and mitigation ways of the disease. The first thing that the physicians wanted to know was the cause of the disease. There was a strong argument as some said that it was a hereditary disease while others said that it was a contagious disease. Hippocrates was the first Greek physician to get interest in research of the disease as he considered as a risk to the society. After Hippocrates, other great Greek physicians like Galen gave a better definition of the term (McNeill, pp. 17). Galen defined phthisis as an ulceration of the lungs that was followed by a cough, fever, and development of pus on different parts of the body. Since the dawn of the disease, extensive research has been carried out with the main aim been identification of the cause of the disease. Currently there is still research on progress on the disease. Phthisis in Ancient French In French physicians made their own names to refer to phthisis. They were very innovative when it came to the disease and their innovations were linked to their diagnostic innovations. This was the disease that was most written about and it was common among patients in the French hospitals. The disease was the leading cause of death not only in French but also in the whole of Europe. More knowledge on the disease was got in the 18th century. In 1882, the disease received its modern definition from Robert Koch who identified the bacterium, tubercle bacillus, as the causative agent of the disease (McNeill, pp. 20). Physicians tried to diagnose the disease through different ways and most notably were the work of Laennec who claimed that he was able to diagnose the disease using his stethoscope. Laennec argued on both clinical and post-mortem grounds that pathognomonic was the hallmark of phthisis. Through the knowledge he had on the cause and location of the disease he identified different diagnoses like scrofula and tuberculosis meningitis. A challenge that was common among the French physicians was the identification of the disease. There are different types of diseases that existed in their vocabulary thus; it was hard to know a disease. They relied mostly on correlations between clinical signs and pathological changes to differentiate diseases and with future developments; criteria of identifying a disease have been developed (McNeill, pp. 22). This saw the improvement of the diagnosis to patients as it was easy to identify the disease a patient was suffering from. Something that troubled the physicians was fever and this was solved in 19th century when they came to identify fever as a sign of a disease. Phthisis in Early Civilization A discovery of human remains in 2008 showed that tuberculosis existed 9000 years ago in a settlement in the eastern Mediterranean during the Neolithic era (McNeill, pp. 24). This is the oldest ever reported evidence of TB infection in human beings and it was confirmed by morphological and molecular methods. Some authors have identified tuberculosis to be the first disease to be known to humankind. More evidence on tuberculosis during the Neolithic era was also discovered in a cemetery in close proximity to Heidelberg. Signs of the disease have also been discovered among Egyptian mummies in the period between 3000 and 2400 BCE. This shows that the disease has been in existence for many centuries and this is why extensive research has been done on the same. In 1881 Grebart discovered a convincing case in mummy of priest Nesperehen and the case featured evidence of spinal tuberculosis. Similar features were discovered among other mummies and more of them were in the cemeteries of Thebes. Hospitals for tuberculosis have been in existence since before and in Egypt research has showed that such hospitals were in existence as early as 1500 BCE (McNeill, pp. 26). The main method of treatment that was used was surgical lancing of the cyst and the application of a ground mixture of acacia seyal, peas, salt, honey, and animal blood. In the Old Testament, a disease with the same signs as tuberculosis is mentioned among the Jewish people and they got affected when they strayed from God. This provides more justification for long history of the disease. The disease was given more attention than even other severe diseases like cancer. Classical Antiquity There are different classical texts that have been written to describe phthisis and the first one was Herodotus’ Histories. Hippocrates did more research on this and he identified some signs of the disease in his first book. Some of the signs he mentioned are fever, colorless urine, cough, and loss of appetite. Hippocrates and many of the physicians of his time believed that phthisis was hereditary in nature. There are other physicians who arose and disagreed with the hereditary nature of phthisis and they argued that it was a contagious disease. As the physicians tried to challenge one another, this intensified the research that was been done. Phthisis was also been related with other diseases like typhoid that phthisis aided in increasing research on other human diseases. The physicians identified treatment methods of phthisis and some of them became useful as they are even used today in treatment of various diseases. At this time, the physicians were mostly interested in identifying the signs of the disease. Some additional signs that were indentified were emaciation of the victims and fever attacks. The disease was also related with the environment. Vitruvius noted that the disease was common in areas were the wind blew from north to northwest and he advised people to built their shelters from the wind (McNeill, pp. 28). This showed the increased research and knowledge on the disease. What was commonly observed during the era was that most of the signs identified by the doctors were similar. Aretaeus summarized all the signs of the disease in his text. The disease was also related with diet. It was evident from some physicians that eating good diet and drinking plenty of milk were a way of preventing the disease. Phthisis during the Middle Ages and Renaissance During the middle ages, the advances that were made on tuberculosis were minimal. The number that suffered from the disease increased phenomenally and this disease was considered to the most threatening disease taking the position of leprosy that had been a threat to human life. The peak of the disease was in the 18th and 19th centuries when laborers moved to cities looking for work. Urbanization during the renaissance saw the increase of the disease among human beings as they continued to interact in the cities. During this, period physicians continued to consider phthisis as a contagious disease and they understood that it was hard to treat the disease. Many physicians who arose during this period and they relied much on the work of Hippocrates. They analyzed the body of human beings from the head into the lungs. In the 12th century, religion was used to explain the cause of tuberculosis among human beings as some argued that the sinners were the ones who got affected by the disease. Pagans were also judged to be the cause of the disease. Others said that the disease originated from other mammals like dogs when they barked or killed a victim and ate his or her lungs (McNeill, pp. 29). As Christianity continued to spread, monarchs were seen as religions leaders with magical powers to cure victims of phthisis. This was under the royal touch whereby it was believed that when one was touched by the monarchs he was cured from the disease. This royal touch was sovereign in France. King Henry IV of France was one of the leaders believed to have such powers and it was said that he performed the rite once a week after taking communion. In France, this became common as the major form of treatment for tuberculosis. At first the kind of touching that was been done by the king was informal as he could touch sick people during his walkabout. However, with the increased spread of the disease in France and England, the touching was made formal and this was highly supported through funds. This was in the church as the Anglican church contained the royal touch ceremony. This was in the Book of Common Prayer for the Anglican church. Shakespeare in his work also recognized the royal touch that was happening in England and France. The touch had no medical value as it was argued that the treatment was a miraculous one. It took a few days and then the touched victims were cured. The royal touch was popular in the 18th century as records of baptisms, marriages and deaths together with those eligible for the royal touch been kept well (McNeill, pp. 31). During this period, they were also interested in understanding contagion of the disease. The common rumor was that there was an invisible virus that transmitted the disease. The virus was said to survive for a period of two or three years on the clothes of victims and from there it was transmitted through direct contact with discharged fluids of the infected. In the same century, Paracelsus came up with a process that was called Paracelsus’s tartaric process (McNeill, pp. 33). He advanced the belief that phthisis was caused by failure of an internal organ and when this failure occurred in the lungs stony precipitates would easily develop resulting to tuberculosis. This is what he called the tartaric process. Continued in the 17th and 18th Centuries There was increased research on tuberculosis in the 17th and 18th centuries as the disease continued to spread and claim more lives. Technology was also improving in the world and this facilitated the kind of research that was been carried out. At the dawn of the 17th century, Franciscus Sylvius differentiated various forms of tuberculosis. He categorized pulmonary and ganglion types of tuberculosis. He also noted that skin ulcers caused by scrofula had a resemblance with tubercles that was seen in phthisis. He also noted that phthisis is scrofula of the lung and this was evident in his book, which was published early in 1679 (McNeill, pp. 27). The doctors of the century were curios to understand the disease and they did this by relating it with other diseases. Therefore, the curiosity to understand phthisis better led to increased knowledge on other diseases. This saw the reduction of deaths from some common diseases since mistakes like wrong treatment were mitigated. Other doctors of the 17th century as Thomas Willis said that all disease related to the chest were caused by sugar or acidity of the blood. Around the same period Richard Morton published, a book that emphasized that tubercle was the cause of phthisis. At the dawn of the 17th century, the disease had spread widely and doctors intensified their research to mitigate the deaths that resulted from the same. In 1720, Benjamin Marten claimed that tuberculosis was caused by microscopic organisms that were able to survive in the new environment. This had been noted before in 1695 by Anton van Leeuwenhoek (McNeill, pp. 34). At that time, the theory was rejected but after many years, Robert Koch demonstrated the truth of the theory. The first clinical description of tuberculosis meningitis was given in 1768 by Robert Whytt although the percussion method of diagnosing the disease had already been developed in 1761 by Leopold Auenbrugger who was an Australian physician. Research had spread from Europe to other continents and this was caused by the increased cause of the disease. In other continents like Africa, this was a killer disease and it claimed many lives as they relied on traditional medicines that at times did not work out positively. Different communities came together as they discussed solutions to the disease. This led to increased interactions between the different communities as they challenged one another on the knowledge they had on the disease. Knowledge that was found useful was changed to French and written down for future research. French was known as the academic community since medical research on phthisis began there and most of the physicians were from France and England. Another physician, William Stark argued that the different forms of tuberculosis were different signs of the same ailment. This was an important observation that could have improved knowledge on the disease but it became useless when Stark died at thirty years while studying scurvy (McNeill, pp. 37). The peak of tuberculosis was in the 18th century and this is well explained under the renaissance. Phthisis in the 19th Century The distinct name of tuberculosis, white plague, was dubbed in the 19th century. At this period, tuberculosis was referred to as a romantic disease. The progress of the disease among victims was slow and they died what were called a good death. Sufferers were able to arrange their affairs before they died since death was determined by the progress of the disease. It was a popular disease and suffering from it was something normal. It was not feared as it was in the previous centuries. More books were published discussing the disease. In France, there were five novels that were written expressing the ideals of tuberculosis (McNeill, pp. 38). More literature on the disease led to increased knowledge on the disease and it was perceived from a spiritual perspective by some people. There were increased scientific advances in the nineteenth century. There was a move from the cultural movement. With the increased scientific advances in the 19th century there was hope that the cause and cure of tuberculosis would be got. There was increased study of the disease as it was been referred to pthisisology. Rene Laennec was one of the physicians who were dedicated to do the study but he died at the age of 45 suffering from the same disease. In his study, Laennec invented the stethoscope that he used to corroborate his auscultatory findings. This was a crucial discovery and it was backed up by the discovery of the utility of pulmonary auscultation in diagnosing tuberculosis. Laennec was a great physician and he was described with different titles due to his great works as a physician. In books, he is recognized as the greatest French physicians to exist. He met with other physicians in his study that had their own ways of treating the disease thus they compared notes. This saw the increase of scientific research on tuberculosis. There were other physicians who did extensive research and they were able to come up with their own methods. For instance, Pierre Charles Alexandre Louis used statistical methods to evaluate the different aspects of the progression of the disease. He published an article that explained more about the different methods that he used. A co-worker of Laennec who was called Gaspard Laurent Bayle published an article that divided phthisis into six types: tubercular phthisis, cancerous phthisis, glandular phthisis, ulcerous phthisis, calculous phthisis and phthisis with melanosis (McNeill, pp. 41). This showed that he had done extensive research that was based on more than 900 autopsies. Experiments were done and among the major ones was the one that showed that tuberculosis was a contagious disease. The experiment was done by Jean Antoine Villemin by taking tuberculosis matter from human cadavers and injecting it into laboratory rabbits that became infected. In 1895, Wilhelm Roentgen discovered the X-ray, which made it easy for physicians to diagnose and track the progress of the disease. With this discovery, the mortality and incidence of tuberculosis started to reduce. This was evident from a study that was carried out in new York in the 19th century that showed that blacks were more prone to the disease than whites were. Discovery of the Cause of Tuberculosis Many experiments had been done and they showed that phthisis was a contagious disease however; none of the experiments had showed the real cause of the disease. The medical community had already accepted from Villemins’ experiments that tuberculosis was a contagious disease. Robert Koch, a Prussian physician, discovered the cause of tuberculosis in 1882. He utilized the staining method and applied it to the sputum of tuberculosis patients where he discovered that the cause of tuberculosis is Mycobacterium tuberculosis. Koch in his experiments relied more on previous works that had been done by some physicians like Villemin. Koch had done many experiments on other diseases that he had wide knowledge on different diseases. He did collaborations with other physicians who helped him much in making the discoveries. His ideas on tuberculosis are highly relied today as the cause of the disease has still remained right from his discovery. Many of the researchers in the field on tuberculosis rely much on knowledge from the work of Koch. He made his discoveries public in 1882 and books were published explaining the discovery. Since the discovery of the cause of tuberculosis in 1882, 24 March has been called World Tuberculosis Day (McNeill, pp. 44). From the discovery of the cause of the disease, the next discovery would be an effective means of immunization and Charles Mantoux worked hard to discover this. Sanatorium Movement With increased scientific understanding of tuberculosis and understanding of its contagious nature, there was a need of institutions to house victims. This would mitigate the spread of the disease. George Bodington made the first proposal of a tuberculosis facility. He did this in a paper where he proposed a rest, dietary and medical care program for a health facility. This proposal was against the will of many physicians and in turn, Bodington changed his proposal to have a facility for the insane. In united states, physicians tried the housing of victims in caves from where they could be supplied with all the necessities. This however did not work since some victims died in the facilities and the rest left. Those who departed also died a few days later as they tried to get home (McNeill, pp. 45). A Germany physician named Hermann Brehmer convinced the medical community that tuberculosis came about due the difficulty of the heart to work in tandem with the lungs. “He therefore proposed that regions above sea level would help the heart to function well since atmospheric pressure was less” (McNeill, 45). An explorer, Alexander von Humboldt and his teacher J.L. Schonlein established the first tuberculosis sanatorium in 1854, which was 650 meters above sea level. Later they published their findings three years after setting up the sanatorium. In 1877, sanatoriums began to spread in the whole of Germany with the Brehmer and one of his patients becoming the proponents for the sanatorium movement (McNeill, pp. 46). In united states, this also spread with the first sanatorium been created in 1885 at Saranac Lake, new York. Many patients were cured after staying in the sanatoriums and later dispensaries acted as special sanatoriums. In dispensaries, the victims who were housed were the ones who were at early stages of the disease and they were used more by lower income individuals. Relation of hospitals, dispensaries, and sanatoriums in the treatment of tuberculosis became known as the ‘Edinburgh Anti-tuberculosis Scheme.’ Phthisis in the 20th Century At the genesis of the 20th century, tuberculosis was a major health problem in united kingdom. A commission name, The Royal Commission was appointed to inquire relation of tuberculosis between human beings and other animals. The commission was set up in 1901. The main aim of the commission was to find whether animals and human beings could transmit the disease among one another. The commission grew to a big commission and by 1919; it had been named UK’s Medical Research Council. Meetings were held in different places to discuss the way forward with tuberculosis. There was an international conference that was held in 1902 in Berlin to address tuberculosis (McNeill, pp. 48). In the conference, it was “proposed that the Cross of Lorraine would act as the international symbol of the fight against tuberculosis” (McNeill, pp. 49). National campaigns also spread across Europe and Americas to tamp down the increased spread of the disease. In Britain, tuberculosis was made a notifiable disease after it was discovered to be contagious. Campaigns were also run in Britain against spitting in the public and the victims were pressured to enter the nursing centers. There were sanatoria of different categories as the lower class, middle class, and upper class had their own. Most notably was that half of those who entered the care units died within five years despite the best conditions they enjoyed. Tuberculosis programs began in different countries and among them was Denmark whereby the programs raised money to cater for the needs of the victims. Associations were also begun to fight the disease and this was evident in united states and Canada in 1907-1908. In 1906, Albert Calmette and Camille Guerin were able to develop the first genuine success in immunizing against tuberculosis from attenuated bovine-strain tuberculosis. This vaccine was called BCG, Bacille Calmette-Guerin, and it was first used on humans in 1921 in France (McNeill, pp. 45). It did not spread until after world war II where it spread to united states, Germany and Britain. With the progress of the 20th century, different surgical interventions among them pneumothorax technique were used to treat tuberculosis. The techniques that were used were not new since they had been in use in the previous centuries with some advancements been done on the same. Different books and articles were written by different physicians explaining the different forms of treatment. After 1950, the cases of tuberculosis began to reduce with a good percentage. Most of the victims could survive after undergoing the treatment. This marked a great improvement from the previous centuries (McNeill, pp. 51). This motivated physicians to engage in extensive research and this was been done in organizations. Society and Culture Through international organizations like world health, organization fight against tuberculosis has been enhanced. In third world countries where the number of those passing away because of the disease is increasing rapidly, supportive measures have been employed and they are playing a crucial role. The society has accepted tuberculosis as a killer disease and they have developed their own ways of mitigating the disease. Different societies have different cultures on the treatment of tuberculosis and this is helping to reduce the numbers that die from the disease. India is known to have the highest total number of tuberculosis cases per annum and different programs have been put in place in the country to save on the situation (McNeill, pp. 55). The private health care sector in the country has also intervened and they are trying to help reduce the number that die per year from TB. The society has also accepted that tuberculosis can be carried by other mammals more so the domesticated animals like dogs and cats. Wild animals are said to be carriers of the disease. Regulations have been put in different countries to ensure that pets do not lead to increased spread of the disease. This is evident in united states more so in California where there are regulations on domesticating animals. In cattle, Mycobacterium bovis causes TB and there are efforts to eradicate the bacteria from cattle. in Australia and new Zealand where animals are more, prone to the bacteria different methods have been employed to mitigate the spread of the disease among animals. Current Research Since the discovery of tuberculosis as a killer disease, research on the same has never stopped. Currently, there is an ongoing research to develop new TB vaccines. This is aimed to address the limitation of BCG as the only vaccine. Vaccines are the best ways of mitigating the disease and this is been enhanced via research. There are potential candidates who have taken the task. There are two approaches they are trying to improve on and the first one is adding subunit vaccines to BCG and creation of new better vaccines. In south Africa, the candidates are in phase II trials and they are relying on genetically modified vaccines. There are different economic models of vaccine development that are been employed to encourage further discovery. Different models are been put in place involving animals from different places with the ultimate goal of accelerating the discovery of a good and long-lasting vaccine of the disease. Conclusion Since the discovery of tuberculosis as a killer disease, extensive research has been done on the same. The research has continued to advance with more discoveries that are helping to mitigate the disease. Through research of tuberculosis, physicians have also been able to research on other diseases. There are other diseases that are closely related to TB like typhoid and medical researchers have been able to differentiate TB from other diseases. All the signs of the disease at the fingertips of physicians and this have helped to mitigate the cases of wrong treatment. Through research on tuberculosis, physicians were able to discover that fever is a sign of a disease and not a disease by itself. This discovery better research and from there physicians were able to discover other diseases like yellow fever. The discovery of the vaccine on the 20th century was of great importance. BCG has played a vital role in curbing TB and more so in third world and densely populated countries. Despite the efforts that are been made through international organizations, TB has remained to be a threat of human life and currently India marks the highest deaths from TB per annum. There is need of research on specific countries like china and India so that ways of mitigating the disease in such countries can be developed. This should be done through organizations and the governments of different countries should be ready to finance such organizations. Developed countries can also play a key role in this by helping developing countries to recover from the situation. Works cited McNeill, William. Plague and Peoples. New York: Anchor Books, 1998. Pp. 10-60. Read More