An Old Menace, TB, Strikes Again in New Form

By Dan Hurley

The case of Andrew Speaker, who contracted a drug-resistant form of tuberculosis, focuses attention on a disease that once plagued society but has generally disappeared from the popular imagination.

In 1910, Cincinnati recorded 151 people who died from typhoid, scarlet fever, measles, diphtheria, croup, whooping cough and smallpox combined. In that same year, 1,025 Cincinnatians died of tuberculosis, or what was popularly referred to as consumption.

No one knew the source of the disease until 1882 when Robert Koch isolated the bacteria that caused tuberculosis. But knowing the cause did not provide any simple answers for either how to prevent it or how to treat people who contracted it. The popular view was that it was somehow caused by filthy conditions and “bad air.”

A 1911 Cincinnati Anti-Tuberculosis League pamphlet for school children stated that the “surest way to avoid disease is to avoid dirt.”

The pamphlet was especially concerned about the residue left from the “careless spitter” on crowded city streetcars during the winter when their windows were closed and claimed that doctors chose to ride in the open air of the back platform.

Before the identification of the bacterial cause of the disease, and for decades afterwards, doctors believed that the environment directly caused the disease. In 1878, Thomas C. Minor, the city’s health officer, observed that “workers in iron, exposed to clouds of fine dust and minute particles of metal, suffer from phthisis (wasting away of the body, e.g. lungs) in the case of tuberculosis to a marked degree.”

The dependence of industrializing Cincinnati on soft coal to fuel the area’s factories, warm its houses, and power its steamboat and railroads, left the densely packed Basin tenement districts cloaked by an unhealthy cloud of soot.

Common wisdom held that tuberculosis was a disease of the slums, and certainly the data showed that it was the poor working class who suffered the worst. A 1914 study found that of the 1,035 tuberculosis victims that year, 222 laborers made up the single biggest occupational group.

Every study produced data that demonstrated that African Americans, who occupied the lowest rungs of the economic and social ladders, were disproportionately impacted. In 1914, while 26.8 percent of white males and 19.9 percent of white females hospitalized with tuberculosis died, 46.7 and 45.8 percent of black men and women respectively died.

Though tuberculosis flourished in the slums, “the middle class as well as the leisure class are subject to the dangers of the same infections, no matter how careful their personal hygiene may be,” concluded the annual report of the Anti-Tuberculosis League in 1910.

The universal reach of the disease was shown in the lives of George Ward Nichols and Maria Longworth Nichols, a couple at the pinnacle of the city’s “leisure class.” Together, they led the effort to create the May Festival. Collaborating with Rueben Springer, Nichols then helped build Music Hall and establish the College of Music.

But shortly after the birth of his second child in 1872, Nichols contracted tuberculosis. Out of fear that he would infect his wife and children, for the next 14 years he lived isolated in a specially built extension of their home.

Although he had the best private medical care available at the time, and continued to go to work at Music Hall when well enough, Nichols spent days and even months in bed. During this long illness, Maria threw herself into the creation of the Rookwood Pottery. Nichols died in 1885.

Only someone as wealthy as Nichols could afford the medical care that would allow him to stay at home. For the typical working class TB victim, a contagious ambulance wagon delivered the patient to the tuberculosis wards of General Hospital.

Beginning in 1897, as the contagious character of the disease became better understood, TB patients were moved to what was known as the “Branch Hospital for Contagious Disease” on Guerley Road. Over the next 30 years, the hospital expanded to 14 buildings capable of housing nearly 600 patients. The sanitarium was taken over by Hamilton County in 1927 and renamed Dunham Hospital in 1945 for its long-time medical director, Dr. Henry Dunham.

Dunham played dual roles of isolating infected patients from the general population, and also providing treatment in the form of rest, fresh air and good food. Porches were the principal architectural feature of the sanitarium buildings, allowing residents to spend their days and nights resting in the fresh air year around.

Not until 1944, when streptomycin was first administered to a TB patient, did doctors have an effective agent that could cure TB. Although tuberculosis almost immediately showed an ability to mutate and lessen the effectiveness of streptomycin, doctors responded with combinations of drugs that could defeat tuberculosis. By 1967, only 168 patients remained at the hospital and, in 1971, it was closed.

Andrew Speaker’s case reminds us that although those of us alive today have lived through an amazing era of “wonder drugs,” bacteria and viruses have the ability to mutate and strike back. And because of the global character of the world today, resistant strains can be potentially transmitted to vulnerable populations halfway around the world in the matter of hours.

Dan Hurley is the assistant vice president for history and research at the Cincinnati Museum Center. He is also the staff historian for Channel 12 News and the executive producer of Local 12 Newsmakers. Reach him at dhurley@cincymuseum.org

(c) 2007 Cincinnati Post. Provided by ProQuest Information and Learning. All rights Reserved.