Introduction: Confronting Hereditary Phthisis, 1714-1830

“What is then to be done? Has Nature been so unkind,
particularly to the inhabitants of this island, as to afflict
us with a disease for which there is no remedy?”

-Philip Stern, Medical Advice to the Consumptive and Asthmatic People of England, 1776.

The history of tuberculosis has often been portrayed in light of medical triumphalism, with all the tragedies of consumption—its sorrow, romanticism, delicacy, and wasting—eradicated with Koch’s discovery of the tubercle bacillus in 1882.[1] Yet, René and Jean Dubos reminds us tuberculosis is a social disease, a disease that modifies the emotional and intellectual climate of the societies it attacks.[2] Recent scholarly attention has emphasized Dubos and Dubos’ thesis, turning to the social dimension of tuberculosis, factoring in politics, ideology, patient care, and suffering in a wider context. Linda Bryder’s Below the Magic Mountain (1988), F.B. Smith’s The Retreat of Tuberculosis, 1850-1950 (1988), David Barnes’ The Making of a Social Disease (1995), and Greta Jones’ “Captain of all these men of death:” The History of Tuberculosis (2001) are but a few authorities texts on consumption’s social history. The historiography has not only captured the social relevance of the disease, or questioned the authority of the triumph-and-consensus model,[3] but has given the historian a wider range for conceptualizing what might be called a history of ideology for the disease.[4]

In part, the history of ideology has questioned the reception and understanding of the meaning of tuberculosis prior to the onset of the Germ Theory. As Carlos López-Beltrán describes, eighteenth century medical disputes over hereditary ideas of phthisis, including definitions of predispositions, developed into theoretical and ideological preoccupations with the general workings of l’hérédité in the nineteenth century.[5] In the clamorous period between the early continental phthisiologists in France and the emergence of late nineteenth century sanatoriums, medical men slowly began to weave together the foundation of a theory of inheritance based on biological heredity. Instead of a structured domain governed by laws of inheritance, l’hérédité was metaphorically used by physicians under the general adjective les maladies héréditaries to fashion physiological rationale for social and moral degeneracy. A fully comprehensive history of heredity is thus incomplete without an understanding of heredity’s early explanatory force as medical hereditarianism. This series is an attempt to impart a historiography of medical hereditarianism, by examining the reasons for its emerging popularity between the years 1714 and 1830 in France and Britain, with a particular focus on ideas of hereditary phthisis.