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The Art of JAMA
October 8, 2014

Journey in Thick Wood: ChildhoodHenry Norman Bethune

Author Affiliations
  • 1Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Health System, Ann Arbor; Associate Editor, JAMA
  • 2Department of Cardiac Surgery, Frankel Cardiovascular Center; University of Michigan Health System, Ann Arbor
JAMA. 2014;312(14):1380-1382. doi:10.1001/jama.2014.13198

Infection due to Mycobacterium tuberculosis has been recognized since antiquity. Mycobacterial DNA has been identified in Egyptian mummies dating back to 3000 bce. Hippocrates described tuberculosis or “phthisis” as a great plague for mankind—and a challenge for physicians. The disease later became epidemic among the urban poor during the 19th century, with industrialization, poverty, overcrowding, and poor nutrition contributing to the sharp rise in cases. Closed windows in cool climates also facilitated person-to-person spread of the bacterium first described by Robert Heinrich Koch in 1882. An estimated 20% of all deaths in Europe were secondary to tuberculosis between the late 1800s and 1930s. Although the incidence of tuberculosis has dropped dramatically, the disease remains a leading cause of infection-related death worldwide, with 1.3 million deaths attributed to tuberculosis in 2012.

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