'The captain of all these men of death' : aspects of the medical history of tuberculosis : a thesis presented in partial fulfilment of the requirements for the degree of Master of Public Health at Massey University, Manawatu, New Zealand
Current evidence suggests that some time in pre-history the ancestor of the modern tubercle bacillus evolved from a soil organism into a human pathogen. Since that time it has caused death and misery to millions of human beings by causing the infectious disease we now call tuberculosis.
This dissertation examines some of the aspects of the history of tuberculosis and specifically how it has affected humans from early times not only medically but socially. It looks at mankind’s struggle to overcome the disease, those who introduced scientific methods in attempts to halt and defeat the organism and its associated infectious disease. There are descriptions of the effects of the disease on prominent people and how the disease often cut short their productive lives. Stress is placed also on the organism’s ability to adapt and survive in a latent form and to develop virulence factors as and when necessary for its own survival. The advent of the co-infection with HIV/AIDS has caused a major setback in control methods and our attempts to halt the progress of the disease and these are factors in the resultant worldwide epidemic of tuberculosis.
Particular importance is placed on the public health measures used in the past and the importance of continued and improved control measures at the community level now and in the future.
The implementation of the knowledge gained about the disease and the organism to date, the avoidance of the errors made in the past, is emphasised if we are to make progress in the future. To totally defeat the organism remains the major goal of public health agencies, medical researchers and social scientists so we can say that, at last, tuberculosis is no longer the ‘Captain of all these Men of Death’.