The word “tuberculosis” was not introduced as a classification term until 1834 by the German physician Johann Lukas Schönlein (1793-1864),[1] though it was first used by the British physician Richard Morton (1637-1698) in 1689. Commonly named by the medical community as “phthisis,” or “consumption,” signifying the wasting characteristics of the chronic disease, this “white plague” was the single largest killer of all adults in the eighteenth and nineteenth centuries and served as a representation of the heightened sensibility idiosyncratic of an enlightened culture of “high-living.”[2] Often at odds with reality, phthisis was a chronic, symptomatic disease without a distinctive cause, and as a result, “its nonepidemic nature also increased its appeal for the enlightened, since the patient was able to die individually, not amidst the countless dead.”[3] However, as David Barnes points out, the illness was not merely a metaphor, “not just a sign through which social relations or anxieties expressed themselves.”[4] It was a real disease that killed real people and despite descriptions of romantic imagery and snobbish aspirations towards sensibility, it was a disease that doctors struggled to cure.

In 1720, English physician Benjamin Marten (1704-1782) wrote, “of all the Distempers that afflict Mankind, there’s not one, for the Cure of which more Remedies have been appropriated and invented than a Phthisis, or Consumption of the Lungs.”[5] In the search of remedies, William Lambe (1765-1847) agrees “the treasures of nature have been exhausted by the experiments of benevolence, or the audacity of empiricism.”[6] Thomas Beddoes (1760-1808) echoed similar words in 1803: “For the treatment of consumption…a great deal more remains to be done than to add to the mass of unexceptionable evidence, lately produced. No uniform method, and no single medicine is capable of effecting a cure in all the cases, referred to any denomination of disease.”[7] The long incubation period and occasionally asymptomatic nature of phthisis, along with its flexible and complex etiological model, led physicians to concentrate on developing cures for visible symptoms.

A mixture of medicine and dietetics were advised for consumptive patients, with an emphasis on proper diet, since “the patient in general should…eat food of easy Digestion”[8] to limit any obstructions in the bodily fluids. Edward Barry (1696-1776) advocated a popular milk diet, which he believed to be the “most fit to repair the great Decays of Consumptive Persons.”[9] Although Marten agreed with the theoretical benefits of a milk diet, he noted that he not “been able to discern such good Effects from it, in a true Phthisis, as to merit its being rely’d on for Course.”[10] Other physicians were more particular about outlining a dietary regime for consumptives. Philip Stern, for example, outlines a diet that allows a consumptive to “eat as often as he has an appetite, but never much at a time.”[11] No eggs or other animal foods were allowed, although a small quantity of veal or chicken broth was acceptable if the patient was weak. In addition, “potatoes, turnips, carrots, parsneps, beans, spinach, broccoli, fallets, bread and rice” was to constitute the general bill of fare, along with almond milk, barley water, or milk and water.[12]

Combined with diet, medicines were recommended to promise relief for the consumptive, “as they defend the Blood from the purulent Matter mixed with it and are mild and penetrating, as not to obstruct or irritate the Lungs in passing through them.”[13] Samuel Foart Simmons (1750-1813) advised the use of the elixir of vitriol, Peruvian bark, balsams, and periodic bleeding, and notes that “the use of blisters and issues, opiates, a milk and vegetable diet, exercise, and change of air, are pretty generally recommended by all.”[14] Other symptomatic cures, such as emertics, catharites, sorbefacients, epispastics, sudorifics, expectorants, demurcents, narcotics, suppuratories, astringents, tonics, angostura, lichen, were also advised. Beddoes in particular was fond of the foxglove. There were also other unique treatment methods. Many physicians advised Thomas Sydenham’s recommendation of country air and horseback riding. Lambe was fond of distilled water,[15] and Simmons wrote about “earth bath,” an old and common remedy in Genada and some parts of Andalusia.[16]