Moderns

The family of John and Elizabeth was indeed a tragic one. Of their twelve children, only four reached the age of eighteen. The ages of death of the eight children were - 0, 0, 2, 4, 8, 12, 13 and 17. Between 1872 and 1894 the last three of these died from phthisis, presumably due to the conditions in the towns of the 'Industrial Revolution', and also from the cramped living conditions.

The following is extracted from the programme notes to the play "The Doctor's Dilemma" by George Bernard Shaw, which was produced at the Festival Theatre, Niagara on the Lake, Canada as part of the Shaw Festival in 2000.

"The Artists' Disease"

What we now call tuberculosis was known to the ancient Greeks as phthisis ("decay"), and its effects have been found in mummies and skeletal remains up to 7000 years old. Although the disease may attack various parts of the body, over 90% of infections are in the lungs ("pulmonary tuberculosis"). For many centuries the disease was not considered contagious, though we know now it is commonly transmitted in tiny airborne droplets from coughs or sneezes. In the nineteenth century, scientists began to theorize that some diseases might be caused by micro-organisms or "germs", and in 1882 the German bacteriologist Robert Koch was able to isolate one of these as the specific cause of tuberculosis.

In 1908 the BCG vaccine was invented, though its effectiveness remains controversial; in the 1940s scientists developed streptomycin and other antibiotics that could cure tubucular infections.

In the nineteenth century, consumption (as this slow wasting disease was called) was a leading cause of death in Europe. Environmental effects associated with the uncontrolled growth of cities, such as widespread pollution and overcrowded living conditions, were contributing factors. In 1881, the year before Koch's discovery, a medical textbook described the causes of consumption as hereditary disposition, unfavourable climate, sedentary indoor life, defective ventilation, deficiency of light, and "depressing emotions". While we now know that these did not cause the disease, they might help to explain why some people contracted it and others did not.

In the nineteenth century, the symptoms of consumption became associated with Romantic conceptions of love, death and beauty. "For more than a century and a half," says Susan Sontag in her book 'Illness as Metaphor' (1978), "tuberculosis provided a metaphoric equivalent for delicacy, sensitivity, sadness, powerlessness." She quotes the diary of art student Marie Bashkirtsev, who died of consumption at age 24: "I cough continually! But for a wonder, far from making me look ugly, this gives me an air of languor that is very becoming." A female doctor in 1876 described consumption as "the most flattering of all diseases, as well as the most insidious and fatal". According to Sontag, "twentieth-century women's fashions (with their cult of thinness) are the last stronghold of the metaphors associated with the romanticizing of TB in the late eighteenth and early nineteenth centuries."

A persistent myth about consumption is its association with creativity, even genius. The poet Keats, who died of consumption at age 25, was perhaps the archetypal "youth [who] grows spectre-thin, and dies". But the list of creative artists who died of consumption, relatively young, is staggering - composer Frédéric Chopin (age 39), illustrator Aubrey Beardsley (25) and such writers as Anton Chekov (44), Franz Kafka (40), D.H.Lawrence (44), Katherine Mansfield (35), Edgar Allan Poe (40), Robert Louis Stevenson(44), Henry David Thoreau (44), and a trio of Brontes: Emily (30), Anne (29) and Branwell (31). Eugene O'Neill wrote of his own affliction with the disease in 'A Long Day's Journey into Night', and it occupies a central place in such works of nineteenth-cenrury fiction as Dombey and Son, Uncle Tom's Cabin, Les Misérables, and of course the operas La Traviata and La Bohème. In her book 'Fevered Lives: Tuberculosis in American Culture Since 1870', Katherine Ott explains that this association is more apparent than real, given the prevalence of the disease: "The publicity given to the deaths of celebrated people tended to create the false impression of a pattern." Nonetheless, it is impossible to disprove or dispel the myth of comsumption as the artist's disease.