Sunshine, Hygiene and the Sun Cure:
Part 2 -Tuberculosis and Heliotherapy
With the story of rickets we examined a disease that was largely hidden from history until it was made visible by a conjunction of factors. These included: the trajectories of emergence associated with the complexities of the new vitamins; the rise of new professional groupings, first around paediatrics and then the new 'science' of actinotherapy; and public disputes between experts over the correlations between sunlight, vitamins and diet. In contrast the history of tuberculosis reveals a disease that, throughout the nineteenth and early twentieth centuries, was both a growing public health concern and was prominent in the public imagination. It killed significant numbers of people largely, but not exclusively, among the urban poor. In addition it was regularly portrayed in fictional genres such as opera (e.g. Puccini's opera La Bohème and Verdi's La Traviatd) and literature (e.g. in Jane Eyre, Celestine, Nicholas Nickleby, and tuberculosis sufferers were frequently referred to in nineteenth-century Russian literature). However the relative visibility of the tuberculosis epidemics in the late nineteenth and early twentieth centuries does not mean that the disease followed a single and easily defined trajectory. Nowadays in the West, with the luxury of both temporal and geographic distance from major epidemics, we can often view tuberculosis as if it is a single and immutable entity - the 'further one stands from the disease of tuberculosis, the more it appears to be a single, uniform phenomenon' (Bowker and Star 1999:165).
Yet this disease, like many other chronic conditions, becomes an elusive and fragmented entity when closely encountered, for example; it was known by a variety of both colloquial and scientific names, including: consumption, phthisis, miliary tuberculosis, prosector's wart, wasting disease, white plague, scrofula, king's evil and graveyard cough; it presented in different ways, sometimes acute or chronic, or sometimes intermittent with varied symptoms (e.g. loss of weight, fever, pallor, cough, unstable pulse, night sweats, irregular appetite, and spitting of mucoid phlegm and blood); and while an infection of the lung or pulmonary tuberculosis was the most common form, tuberculosis also infected the lymph nodes ('king's evil), the skin ('lupus vulgaris), the bones, joints or spine and the brain ('tubercular meningitis). Indeed up until the 1890s these various