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October 12, 1994

Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History

Author Affiliations

PSL Center for Health Sciences Education Denver, Colo

JAMA. 1994;272(14):1143. doi:10.1001/jama.1994.03520140073042

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Now that tuberculosis is returning with a new vengeance, the public and professionals alike have a heightened interest in this fascinating disease. Tuberculosis has plagued mankind since the Paleolithic (Old Stone Age) period. It was present mostly in animals, with only sporadic human infections. The domestication of cattle in the 18th century would crowd them together, and the fact that people commonly lived above animal quarters to benefit from the heat led to 18th-century epidemics in Europe. A human mutant variant can be traced to that time. Tuberculosis was dubbed "the captain of all these men of death" by John Bunyan in 1680. It was another 200 years before knowledge of the infectiousness of tuberculosis was established by the momentous demonstration by Robert Koch in 1882 that it was a bacterial infection. In the prebacteriologic era, tuberculosis had been considered an inheritable disease, since it was found in many family

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