Rather than people lying in their beds in romantically pale and waiting to die, the reality was that there were thousands of infected people. But tuberculosis was a selective killer. A study of urban postmortem examinations in the 1890s showed that the majority of adults were infected by tuberculosis but only ten percent went on to develop symptoms and die of the disease. Tuberculosis could lay dormant and never become active or it could activate and kill within weeks or disappear and come back again. In England active cases of tuberculosis had been at their peak from 1790 to 1840, in lock step with the Industrial Revolution which ensconced people in poorly ventilated factories for long hours and housed them in inadequate tenements, both breeding grounds for disease.
Although tuberculosis incidence was on the downswing by 1840, it was still a major killer. While poor and densely populated areas had higher rates of the disease so did certain occupations such as bakers, tailors, printers, seamstresses and shoemakers; where industrial processes produced dust or vapours which would affect the lungs.This occupational hazard fit in with the first tuberculosis related death my grandfather's family. In 1888 his uncle, John Thomas Chambers, died from phthisis. He was a shoe manufacturer and was 34 when he died. Had his occupation triggered a genetic predisposition to the active form of the disease and had he brought it home to his family?
Thomas Dormandy, White Death: A History of Tuberculosis. (New York: New York University Press, 2000).
F.B. Smith, The Retreat of Tuberculosis 1850-1950. (London, New York, Sydney: Croom Helm, 1988).
Michael Worboys, “Before McKeown: Explaining the Decline of Tuberculosis in Britain, 1880-1930.” In Tuberculosis Then and Now, ed Flurin Condrau and Michael Worboys (Montreal & Kingston: McGill-Queen's University Press, 2010).