Tuberculosis: Sick Chic

Aliases: tuberculosis, TB, consumption

At first glance, tuberculosis (TB) seems an odd choice for May’s theme, language, but in fact, the disease has a distinguished literary lineage. As early as the mid-1700s, TB gained a reputation as a romantic disease. Socially the illness was understood as a disease of passion, an idea that the Romantics (Byron, Shelley, and their compatriots) enthusiastically built upon, coopting TB into a sort of nineteenth century emo cliché: a disease afflicting the sensitive and soulful. This linked TB and creativity, contributing to the literary concept of “romantic agony”, and providing an early example of the tortured artist stereotype that (tragically) still persists.

The portrayal of TB as a relatively painless death that elevated the dying, connecting them to the sublime and granting them an aura of grace became widespread and pervaded the literature of the 1800s. Writers from Dickens to Brontë used TB’s spiritual significance to craft beatific ends for their characters, especially the young, and poignant demise by TB remained a literary mainstay for over a century.

The fictional accounts of TB reflected contemporary fashion. In the 1800s, it was in vogue to appear tubercular, meaning thin, pale and delicate. The disease was associated with gentility and vulnerability, and was considered particularly attractive in women. The impact of this inversion of illness as beauty continues to be felt in modern culture and is evidenced in trends like the “heroin chic” look of the 1990s and the societal fixation with female thinness2.

How emo can you go?

Cause: TB is caused by Mycobacterium tuberculosis, a bacteria that generally infects the lungs, but can affect all parts of the body. The bacteria are transmitted when a naïve (not previously exposed) person breathes in the bacteria released by an infected person when s/he coughs, sneezes, speaks, or sings. Although TB is quite infectious, it is possible to have close contact with someone who is sick without contracting the disease; the CDC states that TB is not transmitted by shaking hands, kissing, sharing food, drink, or toothbrushes (WHY WOULD YOU SHARE A TOOTHBRUSH? IS THERE NO DECENCY LEFT IN THE WORLD?). If exposed, you’re more likely to develop TB if you have an impaired immune system1.

Consequence: There are two types of TB: latent infection and disease. Most instances of TB infection result in latent TB infection, which is asymptomatic (has no symptoms) and noninfectious (it can’t be transmitted). However, if the infected person’s immune systems stops suppressing the growth of the offending bacteria, the infection may become active disease (where the bacteria multiply unchecked). TB disease results in both general and respiratory symptoms, including chest pain, a cough that lasts 3 or more weeks, coughing up blood, weight loss, chills, fever, night sweats, weakness, and fatigue1.

Cure: There are two tests used to determine TB infection status: a skin test and a blood test. If TB is detected, further tests are done to determine if it is latent infection or active disease. Latent TB infections may be treated, if they are deemed at high risk of progressing into an active infection. Treatment for both latent infection and TB disease depend on a cocktail of antimycobacterial drugs; treatment of latent TB is usually short, while TB disease requires a 6-9 month course of medication1.

Finally, a PSA: if you are interested in the topics covered in this post and have not read Susan Sontag’s book, Illness as Metaphor, get out there and get a copy. It is fantastic.


1. Division of Tuberculosis Elimination. “Tuberculosis (TB)”. Centers for Disease Control and Prevention. 13 March 2012. Web. 14 May 2014.

2. Sontag, S. Illness as Metaphor. New York: Vintage Books, 1978. Print.

Image source: Portrait of Lord Byron by Thomas Phillips,

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Suzi Claflin

I am a postdoctoral fellow studying chronic disease epidemiology.

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