Editing Tuberculosis (section)

=== Development of treatments ===
In Europe, rates of tuberculosis began to rise in the early 1600s to a peak level in the 1800s, when it caused nearly 25% of all deaths.<ref name="Bloom_1994">{{cite book| vauthors = Bloom BR |title= Tuberculosis: pathogenesis, protection, and control|year= 1994|publisher= ASM Press|location= Washington, DC|isbn= 978-1-55581-072-6|url-access= registration|url= https://archive.org/details/tuberculosispath0000unse}}</ref> In the 18th and 19th century, [[History of tuberculosis#Epidemic tuberculosis|tuberculosis had become epidemic in Europe]], showing a seasonal pattern.<ref>{{Cite web| vauthors = Frith J |title=History of Tuberculosis. Part 1 – Phthisis, consumption and the White Plague|url=https://jmvh.org/article/history-of-tuberculosis-part-1-phthisis-consumption-and-the-white-plague/|url-status=live|access-date=26 February 2021|website=Journal of Military and Veterans' Health|archive-date=8 April 2021|archive-url=https://web.archive.org/web/20210408050305/https://jmvh.org/article/history-of-tuberculosis-part-1-phthisis-consumption-and-the-white-plague/}}</ref><ref name="Zürcher_2016">{{cite journal | vauthors = Zürcher K, Zwahlen M, Ballif M, Rieder HL, Egger M, Fenner L | title = Influenza Pandemics and Tuberculosis Mortality in 1889 and 1918: Analysis of Historical Data from Switzerland | journal = PLOS ONE | volume = 11 | issue = 10 | pages = e0162575 | date = 5 October 2016 | pmid = 27706149 | pmc = 5051959 | doi = 10.1371/journal.pone.0162575 | doi-access = free | bibcode = 2016PLoSO..1162575Z }}</ref> Tuberculosis caused widespread public concern in the 19th and early 20th centuries as the disease became common among the urban poor. In 1815, one in four deaths in England was due to "consumption". By 1918, TB still caused one in six deaths in France.{{Citation needed|date=August 2020}}

After TB was determined to be contagious, in the 1880s, it was put on a [[List of notifiable diseases|notifiable-disease]] list in Britain. Campaigns started to stop people from spitting in public places, and the infected poor were "encouraged" to enter [[sanatorium|sanatoria]] that resembled prisons. The sanatoria for the middle and upper classes offered excellent care and constant medical attention.<ref name="McCarthy-2001"/> What later became known as the [[Alexandra Hospital for Children with Hip Disease]] (tuberculous arthritis) was opened in London in 1867.<ref>{{Cite web |title=Lost Hospitals of London |url=https://ezitis.myzen.co.uk/alexandra.html |access-date=2024-06-27 |website=ezitis.myzen.co.uk}}</ref> Whatever the benefits of the "fresh air" and labor in the sanatoria, even under the best conditions, 50% of those who entered died within five years ({{circa}} 1916).<ref name="McCarthy-2001"/>

Robert Koch did not believe the cattle and human tuberculosis diseases were similar, which delayed the recognition of infected milk as a source of infection. During the first half of the 1900s, the risk of transmission from this source was dramatically reduced after the application of the [[pasteurization]] process. Koch announced a [[glycerine]] extract of the tubercle bacilli as a "remedy" for tuberculosis in 1890, calling it "tuberculin". Although it was not effective, it was later successfully adapted as a screening test for the presence of pre-symptomatic tuberculosis.<ref>{{cite journal | vauthors = Waddington K | title = To stamp out 'so terrible a malady': bovine tuberculosis and tuberculin testing in Britain, 1890–1939 | journal = Medical History | volume = 48 | issue = 1 | pages = 29–48 | date = January 2004 | pmid = 14968644 | pmc = 546294 | doi = 10.1017/S0025727300007043 }}</ref> [[World Tuberculosis Day]] is marked on 24 March each year, the anniversary of Koch's original scientific announcement. When the [[Medical Research Council (UK)|Medical Research Council]] formed in Britain in 1913, it initially focused on tuberculosis research.<ref>{{cite book | vauthors = Hannaway C |title= Biomedicine in the twentieth century: practices, policies, and politics|year= 2008|publisher= IOS Press|location= Amsterdam|isbn=978-1-58603-832-8|page= 233|url= https://books.google.com/books?id=o5HBxyg5APIC&pg=PA233|url-status=live|archive-url= https://web.archive.org/web/20150907185226/https://books.google.com/books?id=o5HBxyg5APIC&pg=PA233|archive-date= 7 September 2015}}</ref>

[[Albert Calmette]] and [[Camille Guérin]] achieved the first genuine success in immunization against tuberculosis in 1906, using attenuated bovine-strain tuberculosis. It was called [[BCG vaccine|bacille Calmette–Guérin]] (BCG). The BCG vaccine was first used on humans in 1921 in France,<ref>{{cite journal | vauthors = Bonah C | title = The 'experimental stable' of the BCG vaccine: safety, efficacy, proof, and standards, 1921–1933 | journal = Studies in History and Philosophy of Biological and Biomedical Sciences | volume = 36 | issue = 4 | pages = 696–721 | date = December 2005 | pmid = 16337557 | doi = 10.1016/j.shpsc.2005.09.003 }}</ref> but achieved widespread acceptance in the US, Great Britain, and Germany only after World War II.<ref>{{cite journal | vauthors = Comstock GW | title = The International Tuberculosis Campaign: a pioneering venture in mass vaccination and research | journal = Clinical Infectious Diseases | volume = 19 | issue = 3 | pages = 528–40 | date = September 1994 | pmid = 7811874 | doi = 10.1093/clinids/19.3.528 }}</ref>

In 1946, the development of the antibiotic [[streptomycin]] made effective treatment and cure of TB a reality. Prior to the introduction of this medication, the only treatment was surgical intervention, including the "[[pneumothorax]] technique", which involved collapsing an infected lung to "rest" it and to allow tuberculous lesions to heal.<ref>{{cite book |url=https://books.google.com/books?id=bVEEHmpU-1wC&pg=PA792 |title=General thoracic surgery |vauthors=Shields T |publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins |year=2009 |isbn=978-0-7817-7982-1 |edition=7th |location=Philadelphia |page=792 |archive-url=https://web.archive.org/web/20150906212146/https://books.google.com/books?id=bVEEHmpU-1wC&pg=PA792 |archive-date=6 September 2015 |url-status=live}}</ref>

By the 1950s mortality in Europe had decreased about 90%. Improvements in sanitation, vaccination, and other public-health measures began significantly reducing rates of tuberculosis even before the arrival of streptomycin and other antibiotics, although the disease remained a significant threat.{{Cn|date=March 2025}}