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Fevered Lives
     

Fevered Lives

by Katherine Ott
 

Consider two polar images of the same medical condition: the pale and fragile Camille ensconced on a chaise in a Victorian parlor, daintily coughing a small spot of blood onto her white lace pillow, and a wretched poor man in a Bowery flophouse spreading a dread and deadly infection. Now Katherine Ott chronicles how in one century a romantic, ambiguous

Overview

Consider two polar images of the same medical condition: the pale and fragile Camille ensconced on a chaise in a Victorian parlor, daintily coughing a small spot of blood onto her white lace pillow, and a wretched poor man in a Bowery flophouse spreading a dread and deadly infection. Now Katherine Ott chronicles how in one century a romantic, ambiguous affliction of the spirit was transformed into a disease that threatened public health and civic order. She persuasively argues that there was no constant identity to the disease over time, no "core" tuberculosis.

What we understand today as pulmonary tuberculosis would have been largely unintelligible to a physician or patient in the late nineteenth century. Although medically the two terms described the same disease of the lungs, Ott shows that "tuberculosis" and "consumption" were diagnosed, defined, and treated distinctively by both lay and professional health workers. Ott traces the shift from the pre-industrial world of 1870, in which consumption was conceived of primarily as a middle-class malaise that conferred virtue, heightened spirituality, and gentility on the sufferer, to the post-industrial world of today, in which tuberculosis is viewed as a microscopic enemy, fought on an urban battleground and attacking primarily the outcast poor and AIDS patients.

Ott's focus is the changing definition of the disease in different historical eras and environments. She explores its external trappings, from the symptoms doctors chose to notice (whether a pale complexion or a tubercle in a dish) to the significance of the economic and social circumstances of the patient. Emphasizing the material culture of disease—medical supplies, advertisements for faraway rest cures, outdoor sick porches, and invalid hammocks—Ott provides insight into people's understanding of illness and how to combat it. Fevered Lives underscores the shifting meanings of consumption/tuberculosis in an extraordinarily readable cultural history.

Editorial Reviews

Publishers Weekly - Publisher's Weekly
Historian of science, medicine and society at the Smithsonian, Ott gathers threads from cultural history, politics, social commentary and medicine in her consideration of the history of tuberculosis. Her narrative is an uncomfortable reminder that the practice of medicine has always been fallible. The parallels of last century's tuberculosis epidemic with this century's AIDS epidemic are unmistakable and are drawn explicitly in the final chapter, which deals with the current "reemergence" of tuberculosis and its intersection with AIDS. After Robert Koch (in 1882) demonstrated that a bacillus was the cause of tuberculosis, the romanticized "consumption" was metamorphosed into a feared epidemic disease. As Ott weaves her story of tuberculosis from the lives of those afflicted by it and the society that felt compelled to battle it, flashes of insight emerge: Why the dark, plush, musty Victorian interiors were replaced by bright, spare, ventilated "modern homes." How medical education was transformed in the early 1900s. Although generally objective, in the final chapter Ott allows herself some politically correct grandstanding. A few minor medical misconceptions crop up in the narrative. Extensive references accompany each chapter, making this an excellent resource as well as an interesting read. (Jan.)
Library Journal
Ott, an historian at the Smithsonian Institution, explores the changing cultural meanings of tuberculosis, supplementing the science-centered narrative of Frank Ryan's The Forgotten Plague (LJ 5/15/93). As Ott points out, 19th-century popular culture idealized "consumptives" as spiritual and artistic. Following Robert Koch's 1882 discovery of the tuberculosis bacterium, patients were urged to surrender their lives to medical experts' spartan and regimented cures. The recent emergence of drug-resistant tuberculosis in impoverished and isolated urban risk groups and the high-tech medical and scientific practice that attempts to identify and treat it has resulted in yet another metaphoric conceptualization. Ott's narrative expands Sheila Rothman's Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (LJ 1/94) by examining the changes in material culture-the scientific instruments, sick room equipment, and treatment facilities-that evolved as the germ theory of disease and the discovery of antibiotics transformed medical practice. Her work is a rewarding medical history. Recommended for scholarly and larger public libraries.-Kathleen Arsenault, Univ. of South Florida at St. Petersburg Lib.
Booknews
A fascinating history of changing perceptions toward tuberculosis containing insights into the powerful role class plays in the diagnosis and treatment of disease. Ott details the conflicting 19th century images of the romantic, poetic consumptive and the tubercular flophouse victim threatening public health. She explores the symptoms doctors chose to select depending on the economic and social circumstances of the patient, the "industry" of providing cures for the middle class, and relates this history to the contemporary appearance of tuberculosis among today's urban poor and AIDS patients. Annotation c. by Book News, Inc., Portland, Or.
Kirkus Reviews
An enlightening interdisciplinary look at how genteel consumptives have evolved into medicalized tuberculosis "cases."

Viewing illness as both a cultural and a physical phenomenon, Ott, a historian of science and medicine at the Smithsonian, considers perceptions of, and approaches to, pulmonary tuberculosis. In the mid19th century, consumption's pallid languor conferred an air of elegant beauty on women and one of sensitive genius on men, provided they were middle class and white. As medical theories came and went, consumptives were exhorted to head for the mountains, to exercise strenuously, to remain in bed. These approaches respected the autonomy of the patient, but by the 1890s, after the discovery of the tubercle bacillus, physicians came to see intervention as a "moral imperative," and Progressive Era faith in technology endorsed such approaches as deliberately (albeit dangerously) collapsing lungs and taking x-rays (even when the new machines produced blurry, useless images). About the time people appreciated that tuberculosis was contagious and scientists designated sputum and dust as disease carriers, physicians and laypeople alike blended science and prejudice to conclude that poor people, immigrants, and nonwhites offered particular sources of contagion. Socially ostracized, the patient became a ward of physicians and the state, dominated by "laboratory tests, peculiar instruments, and . . . jargon," while medical science falsely congratulated itself for conquering a disease that still has a grip on certain populations and is gaining a new one among AIDS patients. Remarkably unpreachy, Ott merely notes that various trends—e.g., promoting the latest medical technologies and stigmatizing people with certain illnesses—still play out today. The text generally supplies sufficient information to keep nonspecialist readers in the picture; however, those whose conversation seldom runs to "auscultation" and "phagocytic immune response" may occasionally pine for a glossary.

Ott's integrated, well-drawn picture offers food for thought to those interested in history and—one dearly hopes—medicine.

Product Details

ISBN-13:
9780674299108
Publisher:
Harvard University Press
Publication date:
11/28/1996
Pages:
252
Product dimensions:
6.39(w) x 9.49(h) x 0.97(d)

Meet the Author

Katherine Ott is a Historian in the Smithsonian's Division of Science, Medicine, and Society, National Museum of American History.

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