The "white plague" of the 19th century - tuberculosis "pale, emaciated, a burst of heart-rending cough ...... "There is no shortage of 19th-century novels and plays depicting these people in such a state of affairs, caused by tuberculosis, also known as consumption, which was known as the "white plague" at the time.
Thousands of people lost loved ones in the 19th century to this relentless and virulent infection, and while the availability of effective antibiotics and preventive medicines in the 20th century has led to a rapid decline in tuberculosis cases worldwide, it would be a mistake to let your guard down. The World Health Organization warns that TB has made a global comeback in recent years, and that there is no room for complacency in the fight against this infectious disease.
In 1882, the German scientist Robert Koch announced the discovery of the tubercle bacillus, and will be divided into human type, cattle type, bird type and rodent type 4, which human type bacteria is the main pathogen of human tuberculosis. Tuberculosis is a highly infectious chronic wasting disease caused mainly by the invasion of the lungs by human-type Mycobacterium tuberculosis. Common clinical manifestations are cough, sputum, hemoptysis, chest pain, fever, fatigue, loss of appetite and other local and systemic symptoms. More than 90% of tuberculosis is transmitted through the respiratory tract, the patient through coughing, sneezing, loud noise and so on to make the bacteria liquid spray out of the body, healthy people will be infected after inhalation.
In 1945, the introduction of streptomycin, a potent drug, made tuberculosis no longer an incurable disease. Since then, the successive synthesis of drugs such as Remifentan, Rifampicin and Ethambutol has further reduced the number of TB patients worldwide significantly. In terms of prevention, the main focus is on Bacillus Calmette-Guérin (BCG) vaccination and chemoprophylaxis. The introduction of isoniazid in 1952 made chemoprophylaxis a success. Isoniazid has strong bactericidal power, few side effects, and is economical, so it is easy to take, and taking it for 6 to 12 months can reduce the incidence of disease by 50% to 60% in 10 years.
The introduction of antibiotics, BCG, and chemotherapy drugs was a landmark victory in the history of mankind's fight against tuberculosis, for which the United States in the early 1980s even thought it could be eliminated by the end of the 20th century. However, this stubborn "consumptive disease" has launched a new round of challenges to mankind. According to the report of the World Health Organization, in recent years, tuberculosis has been resurgent all over the world, and in 1995, 3 million people died of this disease, which is the largest number of deaths of this disease, greatly exceeding the year 1900, when tuberculosis was prevalent. On the occasion of World TB Day on March 24, 2003, the World Action to Stop TB released figures showing that 5,000 people still die of TB every day worldwide, and more than 8 million people develop the disease each year.
The main reasons for this situation are the policy neglect in many parts of the world in the past 20 years, which has led to the destruction or even disappearance of the tuberculosis control system; people with AIDS are 30 times more likely to be infected with tuberculosis than normal people, and most people with AIDS have died of tuberculosis, and with the spread of AIDS globally, there has been a rapid increase in the number of tuberculosis patients; and the emergence of multi-drug-resistant strains of tuberculosis, which makes the prevention and treatment of tuberculosis more difficult. the difficulty of TB prevention and treatment, etc.
To this end, the World Health Organization has declared a "global tuberculosis emergency". In order to further promote global tuberculosis prevention and control campaigns, the organization decided at the end of 1995 to designate March 24 each year as "World Tuberculosis Day," and in 1997 announced an action plan known as the "Directly Observed Short Course" (DOTS), with the goal of curing 95 percent of tuberculosis cases. In 1997, it announced an action plan called the "Directly Observed Short Course" (DOTS), with the goal of curing 95 per cent of tuberculosis patients. At the heart of this program is the direct supervision of patients by medical workers in order to avoid delays in treatment, which could lead to widespread spread of the disease. The latest results of the social evaluation of China's tuberculosis prevention and treatment, released by the Ministry of Health, show that citizens in China have a low level of awareness that tuberculosis is contagious and can be cured, a low rate of knowledge of tuberculosis prevention and treatment organizations and the provision of free diagnosis and treatment, and a high level of concern about social discrimination against tuberculosis patients.
First of all, although bone tuberculosis and meningeal tuberculosis are not contagious, some common types of tuberculosis are. However, only TB patients whose tuberculosis bacilli can be detected in their sputum are contagious, and these patients may become infectious when they cough, sneeze, or speak loudly and spray spittle in others' faces.
Secondly, except for a few multidrug-resistant tuberculosis, the vast majority of tuberculosis can be cured. However, it should be emphasized that the regular and complete treatment of tuberculosis must have a course of treatment of six to eight months, and requires a combination of multiple drugs in order to be completely cured. The modern TB control strategy proposed by the World Health Organization for this purpose requires patients to take each dose of medication in the presence of medical personnel. Many patients take their condition lightly or stop taking their medication because of side effects, failing to receive scientific and standardized treatment, which may lead to the emergence of drug-resistant strains of bacteria and increase the difficulty of treatment. Thirdly, medical and health institutions at and above the county level, towns and cities in China have specialized institutions for the examination and treatment of tuberculosis, and the State provides anti-tuberculosis medicines and major examinations free of charge to patients with infectious tuberculosis. In order to strengthen the management of the national tuberculosis epidemic and to ensure that patients receive scientific and standardized treatment, the People's Republic of China *** and the State Law on Prevention and Control of Infectious Diseases stipulates that patients with tuberculosis and suspected patients are to undergo a unified examination, supervised chemotherapy and management at tuberculosis prevention and treatment institutions.
Finally, only tuberculosis patients with a positive sputum smear test for Mycobacterium tuberculosis are infectious. Two to three weeks after a TB patient begins regular drug treatment, he or she is generally not contagious and can participate in normal social activities. Society should give care and attention to TB patients and should not discriminate against TB patients.
Toward the end of 1995, the World Health Organization designated March 24 of each year as World Tuberculosis Day in honor of Robert Cohoe, the discoverer of the tuberculosis bacillus. Taking the "D" with TB
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Myth 1: TB is curable
When antibiotics were widely used in the middle of this century, Mycobacterium tuberculosis was also decimated. Curbed tuberculosis cruelty to the human hand, greatly reduced the death rate of murder tuberculosis patients, so that people breathed a sigh of relief, no longer talk about "consumption" gas changed. So in people's consciousness formed the "tuberculosis is good" impression.
Since the 1980s, due to the abuse of antibiotics and treatment irregularities, a large number of tuberculosis patients with drug-resistant phenomenon. According to statistics, drug-resistant TB patients account for about 28-41 percent of the total number of first-time treatments. This is a wake-up call for people: tuberculosis is not curable anymore, and 1/3 of the patients cannot be cured at one time. This is a very worrying situation.
Myth 2: TB outbreaks only occur in backward rural areas
In the past, it was widely believed that TB was a poor disease and only occurred in poor rural areas. Today this impression is broken by the harsh reality. In the past decade, the number of urban tuberculosis patients in China has soared, mainly due to the deteriorating quality of the environment, people's daily life necessary water, air, food and other industrial pollution, people's resistance to the decline of airborne tuberculosis has resurgence of the trend.
In fact, because the incidence of hepatitis and AIDS, the number of carriers has risen sharply, but also to the incidence of tuberculosis to bring a ride on the smooth car, hepatitis and tuberculosis, AIDS and tuberculosis has become a new form of infection. China's existing tuberculosis patients 5.9 million, according to expert analysis, 5.9 million tuberculosis patients, infectious people accounted for about half. According to the World Health Organization, there are outbreaks of tuberculosis epidemics in certain large cities in developed countries, with incidence rates much higher than those in developing countries. There is now an anomaly where urban TB is spreading faster than rural areas.
Myth 3: Tuberculosis can't kill a few people
People used to think that cancer was the most terrible thing, and once you got it, it was a death sentence, so you were scared to death of cancer. As for tuberculosis, it is widely believed that it is not a terminal disease, even if a cure can not be, but also can not die. This view is very wrong. China's existing tuberculosis patients 5.9 million people, 250,000 people die of tuberculosis every year, equivalent to an earthquake in Tangshan every year.
Myth 4: refractory tuberculosis is not curable
The formation of refractory tuberculosis due to drug resistance, allergies, severe comorbidities and other reasons is listed as a problem in world medicine. Because this part of the patient only accounted for about 6% of all patients receiving chemotherapy, and a large part of the patients in a short period of time due to the failure of treatment and death, so in the medical profession has not attracted enough attention. Is refractory TB really untreatable? No. Clinical studies have proven that refractory TB can be cured with the right treatment.
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-Chinese medicine prescription for treating tuberculosis
Smoking and tuberculosis
-Smoking promotes the development and activity of tuberculosis. The incidence of tuberculosis is significantly higher in smokers than in non-smokers
-As the number of cigarettes smoked increases, the number of people suffering from tuberculosis also increases
-Smoking often delays the discovery and diagnosis of tuberculosis
-Smoking affects the treatment of pulmonary tuberculosis
AIDS and Tuberculosis
-Tuberculosis occurs in people with AIDS when they are immune to the disease, and the chance of developing tuberculosis is higher than that of the general population. The chance of developing tuberculosis is 30 times higher than that of the general population
-1/3 of AIDS patients die from tuberculosis
-Once AIDS patients have concurrent tuberculosis, they interact with each other to promote the progress and deterioration of the disease, which finally leads to death
Diabetes and tuberculosis
-Diabetic patients are susceptible to tuberculosis due to metabolic disorders, malnutrition, and low resistance, about 4 times as much as those without diabetes. It is about 4 times more than those without diabetes. Diabetic patients should be checked for the presence of tuberculosis
-When diabetes is complicated by tuberculosis, the tuberculosis foci progress rapidly, are more extensive, and are prone to form cavities. Tuberculosis also affects the development of diabetes
-Early detection and timely treatment is the key to controlling both diseases. To be alert to the combination of diabetes and tuberculosis, tuberculosis treatment is not effective to be alert to the presence of diabetes. Once diagnosed, both diseases should be treated at the same time.
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If someone brings the famous French 19th-century writer Alexandre Dumas together with Lin Daiyu of "Dream of Red Mansions," and says that the fate of the last Russian czar at the beginning of the 20th century has something to do with Britain's formidable Queen Victoria at the beginning of the 19th century, you'd think it was absurd. But there is an incredible connection between human disease and literature and art, and one of the most common is tuberculosis, which on the one hand withers beauty and takes life away, and on the other hand makes the whole world romantic and elegant. This is an inexplicable myth brought to us by "Drifting Autumn Leaves - A Cultural History of Tuberculosis".
"The Captain of Human Death"
Keats, the great English poet, wrote a poem in 1819: "At a young age, he grows pale, and his thin bones are merciful, and he does not return to Dawson's Hill for a long time ...... "Two years later, he died of tuberculosis at the age of only 26, that poem is a reflection of himself. Keats survived in an era when tuberculosis was at its most rampant, and it was the bane of the causes of illness and death in those days. For this reason, Keats specifically nicknamed tuberculosis, "the captain of human death."
Is tuberculosis really that bad? According to the information, since the German scientist Koch discovered the tuberculosis bacteria in 1882, the number of deaths due to tuberculosis has reached 200 million so far. And the latest information shows that the number of deaths of tuberculosis patients around the world has increased from 2.5 million in 1990 to 3.5 million in 2000. 75% of tuberculosis deaths occur in the most productive age group (15 to 45 years), 2 billion people have been infected by tuberculosis globally, and the infection rate of 1% each year, that is, there are about 65 million people infected by tuberculosis each year.
It is interesting to note that TB seems to favor those in the literary and artistic world. In addition to Keats, such well-known literary figures as Shelley, the English poet who shared his name, Stevenson, the author of "Treasure Island," Chopin, the pianist, and Paganini, the violinist, all had TB. In addition, from the 15th-century model Simonetta Vespucci to the 1920s writer Katherine Mansfield and the movie star Vivien Leigh more than 30 years ago, these senders and creators of beauty have been struck by this disease and have wilted and faded like flowers, which is a cause for sighs of dismay and immense nostalgia. The book is a profound analysis of their characteristics: most of these people are intellectually intelligent, talented, and often sentimental, especially feelings are particularly strong and delicate, even to the point of over-sensitivity and over-fragility. Perhaps it is due to the existence of this reason, tuberculosis was able to in their body more cruel rampage.
Beautiful myths
If you've ever read an 18th- or 19th-century novel or watched a story about that era in a movie or on TV, you'll often find one ****ing similarity: there's almost always a "consumptive" character - a sick child who tries to make the most of his or her illness. -The sick child, the dying artist struggling to complete his masterpiece, the bedridden mother unable to take care of the family ...... They are pale and weak, often coughing up blood, and slowly wasting away. This is a typical depiction of TB symptoms.
Why did writers of that era favor tuberculosis so much? The answer is interesting and makes perfect sense. TB seems to have become the "artist's disease" at a time when mankind was powerless to control it. This is due to the mechanism of the disease and the personality traits of artists. When the myth of tuberculosis was widely spread, it was a sign of elegance, slenderness, and richness of sensibility for the vulgar and the rich. Moreover, at a time when aristocracy was no longer a right but a mere symbol, the face of a tuberculosis patient became a new model for the aristocratic face. What is more interesting is that tuberculosis, judged with considerable medical and literary rigor, had a "morbid beauty" that suited the passionate projections and plotting needs of the author of the romance. What's more, Byron said, "I wish I had died of lung disease," while the robust, energetic Dumas tried to pretend he had it. They did so because tuberculosis was the fashion of the age.
It is clear that tuberculosis, though a bad disease, was a disease of leisure and comfort. Because of this nature of tuberculosis, most of the patients with this disease will eventually die, as well as during the illness of the formation of pathological beauty, of course, is the pursuit of romantic artists, Alexandre Dumas's The Lady of the Camellias, Cao Xueqin's Dream of Red Mansions in the Lin Daiyu, are examples of this. Take "The Lady of the Camellias" as an example, Dumas focuses on the description of the characteristics of the heroine, a tuberculosis patient, and writes that her body appears "long and slim" due to the consumption of the disease; her cheeks are deep red because of the low-grade fever and "rose color". He writes that her body is "long and slender" because of the exertion of the disease; that her cheeks are a deep reddish "rosy color" because of the low fever, which is a sickly blush; and that her nose, which is "fine and straight" because of the fever and the overactive libido, is "slightly bulbous, as if it were intensely eager for the sexual life". ...... all show the writer's romanticism. It is not difficult to understand, in the creation of "The Lady of the Camellias", the writer catharsis of their own pent-up emotions, to relive a more intense than the reality of love, and play the romantic feelings, so that Dumas, as he said, "I feel ...... seems to experience the ...... painter's pleasure in expressing himself through the depiction of his characters."
Illness creates a need for catharsis in man himself, a need to soothe the human heart, a need to overcome the fear of illness, and psychologically speaking literature fits into these programs of expression. Literature, music and other arts can not only express the normal psychology of human beings, but also express the abnormal psychology of human beings, the weakness of human nature, the dark side, literature has a specificity that cannot be achieved by other media. This is the reason why many writers and artists "like" to suffer from tuberculosis "art disease" is understandable. Because only literature and art can release them.
The title of the book, "Fallen Autumn Leaves," is a profound implication of the true meaning of the book. Since ancient times, people have regarded autumn as the season of maturity and harvest, which makes them see the mountain full of red leaves in the golden sunshine, with endless beauty. But the same autumn, in the eyes of the Romantic writers, its beauty is not due to the fact that it is a season of maturity and abundance, but due to the withered and falling autumn leaves that come with the season. No wonder the German naturalist Alexander von Humboldt said, "The ancients really found the beauty of nature only when it smiled, showed friendship and was useful to them. The Romantics, on the contrary: they found nature most beautiful in its barbarous state, or when it aroused in them a vague sense of horror."
This is perhaps the mythic cultural context that characterizes tuberculosis.
"Drifting Autumn Leaves - A Cultural History of Tuberculosis" by Yu Fenggao
Shandong Pictorial Press, August 2004 edition Price: 17.5 yuan