Fascinated by the inner self and the state of the soul, hoping to escape from material, vulgar, and corrupt life. Autumn is a recurring and thought-provoking trope in Romantic literature.

Many important themes in romantic literature express feelings close to the worldview influenced by tuberculosis : a deep appreciation of the perishability of youth; ubiquitous sadness; nostalgia for people and things that have passed away; The pursuit of sublimity and transcendence; the worship of geniuses and heroic individuals; the fascination with the inner self and soul state (i.e. the essence mentioned by Laenek), hoping to escape from the material, vulgar and corrupt life. Autumn is a recurring and thought-provoking trope in Romantic literature. Autumn is no longer a season of harvest and gifts. Along with the sadness of premature death, autumn has become a season of fallen leaves and withered flowers.

"Epidemic and Society" Author: (U.S.) Frank M. Snowden Translator: Ji Shanshan Version: Central Compilation and Compilation Press May 2022

Romanticism

The cultural resonance of tuberculosis is reflected in its influence on romanticism Emotion, metaphor and symbolism on the contribution of . Not all major epidemics will have a significant impact on culture and art, such as influenza and Asiatic cholera, which have very limited contributions to culture, but as we have seen, the Black Death has had a profound impact on culture. a disruptive impact. Consumption is another example of a disease that had a huge impact on art, but it was very different from other plagues. In the minds of Europeans, plague was first and foremost a nightmare that caused sudden mass deaths.

However, for patients with tuberculosis, the pain of illness does not come unknowingly, and they also have enough time to clarify their complicated situations and emotions. Consumption, therefore, evoked in them something entirely different from sudden death and terror. Consumption evoked a sadness about the brevity of life and the fleeting nature of time, especially as talented artists died in their prime. Consumption, unlike the plague, was uplifting, touching the realm of the soul, sounding a wake-up call to those afflicted by death, and giving them time to process their relationships with God and those around them. Keats expressed his melancholy about the shortness of life in a famous sonnet :

Before my pen collects rich ideas

I fear that life will stop here,

too late to turn words into high The stacked books,

are like the well-stored and mature grains in a fertile barn;

When I stare at the starry night sky,

the extraordinary charm symbolized by the vast clouds,

Even if there is a stroke of genius,

I am in this life. Nor can I describe their cloud shadows;

When I realize that fleeting beauty,

I may never see you again,

I cannot appreciate the dreamy charm driven by love

- So, on the shore of the vast world

I stood alone, thinking about

until love and reputation disappeared into nothingness.

Manuscript of Keats's "Ode to a Nightingale"

Many important themes in Romantic literature express feelings close to the worldview affected by consumption: a profound appreciation of the perishability of youth; the ubiquitous sadness; the loss of the past. Nostalgia for people and things; pursuit of sublimity and transcendence; admiration for geniuses and heroic individuals; fascination with the inner self and soul state (i.e., the essence according to Laenek), hoping to escape from materiality, vulgarity, and corruption outside of life. Autumn is a recurring and thought-provoking trope in Romantic literature. Autumn is no longer a season of harvest and gifts. Along with the sadness of premature death, autumn has become a season of fallen leaves and withered flowers.

In the elegy "Adonis", Shelley mourned for Keats, comparing him to "a pale delicate flower" - "the petals in bud have been cut off before dancing and swaying, Die with hope of results and disillusionment.” As far as the sad aesthetics of tuberculosis is concerned, Romantic artists often took tuberculosis as the core theme. Romanticism, in turn, placed lofty imagination over sordid facts and ignored the disgusting and undignified symptoms observed by today's empirical medicine. This is also a characteristic of romanticism 's social and cultural reconstruction of the phenomenon of tuberculosis. .

The impact of tuberculosis on society

By comparing two different infectious diseases in different eras, the Black Death and tuberculosis , we find that diseases bring more than just death. Rather, each disease has unique social repercussions. From the plague's first visit to Western Europe in 1347, to its last serious outbreaks, in Marseille from 1720 to 1722 and Messina in 1743. As we have seen, plague became synonymous with many phenomena, including mass hysteria, scapegoating, flight, economic collapse, and social dislocation.

In contrast, tuberculosis did not cause these phenomena. It continued to exist, spread at a slow speed, and never caused a significant increase in mortality, nor did it make people feel panic about external invasion. During tuberculosis epidemics, people did not need to flee and be subject to forced isolation, because the patients themselves were considered harmless, and whether they became sick or not depended on individual fate-after all, tuberculosis was a product of inheritance. In a city that was plagued by the "White Plague" rather than the Black Death, government departments would still stick to their posts, trade and commercial activities would not be affected at all, and public life would continue as before. Tuberculosis did have a profound impact on society, but it was unlikely to cause the dramatic recurrence of plague siege scenes. Tuberculosis usually triggers individual panic, not mass panic. In the words of historian Katherine Ott: "Consumption had higher cumulative morbidity and mortality than any epidemic, but because daily routines were not affected by it, few worried."

Chopin and LoversGeorge Sand

There is another reason why tuberculosis is difficult to arouse people's alarm. Compared with other diseases, the death caused by it is at least to some extent "beautiful". It does not disfigure the patient's face as hideously as smallpox. Although its symptoms are painful, it is more dignified than the diarrhea caused by Asiatic cholera. Compared with intestinal symptoms, pulmonary symptoms are obviously much more elegant and decent.

The frail, sick and disabled

One of the most obvious and widespread impacts of tuberculosis on society is that it leaves behind many frail, sick and disabled patients. As Abdel Omran put it in the 1970s, in the famous "epidemiological transition" or "health transition" theory, chronic diseases were rare and infectious diseases were the norm during this period, except for Apart from tuberculosis, other long-term diseases are also rare. As a result, tuberculosis has become the new standard for long-term chronic disease because of its lifelong course. Once diagnosed, the patient's future life becomes unpredictable. They have to face a series of painful choices in career, marriage and family, put aside the responsibilities, friendships and desires in normal life, and take on new tasks. The task consumes all their energy, and there are only two outcomes: recovery or death.

The essential characteristics of the life of a consumptive patient have many hints in the plays of Anton Chekhov (1860-1904). The Russian writer, who was also a doctor, was himself a victim of tuberculosis. After falling ill, he had to give up his theater career in Moscow and go to Crimea, trying to regain his health on the temperate Black Sea coast, but everything proved to be in vain. Chekhov completed five of his most famous plays during his illness - "Ivanov" (1887-1889), "The Seagull" (1896), "Uncle Vanya" (1897), "Three Times" Sisters" (1901) and "The Cherry Orchard" (1904). Only the first work "Ivanov" explicitly involves tuberculosis, but the other four works all use the frailty and disability caused by tuberculosis as an unexplained hidden theme. It is no coincidence that the five protagonists in the play are all as incapacitated and trapped in difficult situations as consumptive patients, unable to control their own outcome while waiting.

Chekhov's former residence is located in Yalta. Chekhov once convalesced here and wrote classic works such as "Three Sisters" and "The Black Monk".

In The Cherry Orchard, which Chekhov completed shortly before his death in 1904, he examines the fate of his characters: the mysterious and unchangeable stagnation they endure. The student Pyotr Trofimov could never complete his studies; the businessman Yermolay Robashin could never propose to his beloved; the female landowner Lyubov Ranevskaya had her property stolen by idlers. While the lover had it all to himself, he was unable to protect it from infringement; while the landowner Boris Simionovpisik watched his land being swallowed up by a mountain of debt and was unwilling to implement even a response plan. In the first act, the ailing Chekhov made a declaration for himself and all the other characters in the words of Simionov Pischik: "I thought that I had lost everything, that I was completely finished, Unexpectedly, they built another railway across my land... They gave me compensation. Things will always turn around, not today, but tomorrow. Dashenka will win 200,000, she has a lottery ticket." The patient, Chekhov, was a typical middle- and upper-class consumptive patient of the "long 19th century." Tuberculosis resulted in one of the largest population movements of the period, as patients moved out of their original surroundings and began their "journey to cure." Since the publication of Hippocrates 's famous work "On Air, Water, and Place", changing the external environment has been considered an effective measure of therapeutic intervention. Therefore, doctors' advice to tuberculosis patients is mostly "climate therapy": travel to healthy places.

The medical community has different opinions on the role of climate and how it works. Doctors often urged consumptive patients to stay in the mountains, where they could take deep breaths, lengthen their inhales, and make their exhales more complete. The thin air there also allows more sunlight to shine on the human body, tanning the skin and speeding up blood circulation. "The bright sunshine and the magnificent mountain scenery can inject new hope and courage into people." 20 It is said that living in the mountains can increase the patient's appetite, thus making up for the terrible weight loss caused by consumption. Other doctors prefer warm, dry weather near sea level, while still others feel a milder, calmer climate is more beneficial. One popular view is that climate change has a special effect on the recovery of tuberculosis patients; another view is that climate change is only an auxiliary means. Doctors will also make appropriate adjustments to different travel destinations based on the stage of the disease and the age of the patient. In addition, some doctors believe that the journey itself is more important than the destination. Travel has some healing power. Therefore, ocean voyages can "fully ventilate the lungs", while seasickness can cleanse dirty body fluids. Even long journeys on horseback were considered very beneficial.

There is a basic assumption behind these views: epidemics are essentially a state of "stimulation" and "excitement". Appropriate remedial measures through air and diet can achieve a debilitating "anti-irritation" effect. Thus, wealthy European consumptives once loved traveling to the Alps, the French Riviera, Italy and the Crimea. Keats and Shelley went to Rome, Tobias Smollett went to Nice, Elizabeth Browning and Robert Browning went to Florence, and Chopin went to Rome. Lorca , Paul Ehrlich went to Egypt, and Chekhov went to Crimea. This practice of seeking "cure" through migration was spread by word of mouth in a large number of medical books, rumors and celebrity anecdotes, triggering a "chain migration" effect, and became even more famous with the brochures issued by the Railway Bureau and the steam engine company.

In the United States, tuberculosis also triggered a raging wave of immigration, so much so that a new medical version of the "frontier hypothesis" appeared in American history, especially after the completion of the transcontinental railway network in the 1870s, in search of health. "Interstate migration" has become even more rampant. In the famous cities of Colorado Springs and Pasadena, communities established entirely by tuberculosis patients have appeared. Southern California , as a Mecca for healing diseases, is known as "Nature's Great Sanatorium" and "The Home of New Lungs".

Among the waves of immigrants who "went westward" due to tuberculosis, the most famous was the legendary hero of the classic Western shootout, the Great Duel at OKtown, and Wyatt Earp's friend—John Henry "Doc" Holliday. Holliday was originally a dentist in Georgia. With a persistent cough, he was diagnosed with tuberculosis. He then moved to Dodge City, Kansas, and then to Tombstone, Arizona. Attempts to relocate ultimately failed and failed to save his life. After settling in the American Southwest, Holliday lost many patients due to coughing, so he gave up his dental career and became addicted to gambling and guns. He tried to self-treat with alcohol and laudanum, but was ultimately unable to cure tuberculosis and died in 1887 at the age of 36.

Riviera originally refers to the coast of Liguria, Italy.

Those tuberculosis patients who do not have the conditions to move elsewhere have no choice but to adopt more convenient treatment methods. Among them, "inhalation therapy" brings the essence of life from a remote environment to the patient, and the patient can enjoy it at home or in the doctor's office. In order to make it easier for patients to sit down and receive treatment, doctors use inhalers, nebulizers or distillers to provide spray, smoke or water flow treatment to the patient's nasopharynx and lungs. Just as the concept of climatic therapy offers a variety of options for the patient's destination, so too does inhalation therapy with the addition of beneficial ingredients such as creosote, chloroform, iodine, turpentine, carbolic acid, and various Mercury-like compounds. There is also an alternative therapy, which is different from travel therapy and is more unique. It is called "altitude therapy". Patients sit in a hanging basket under a hot air balloon and can breathe the fresh air high in the mountains while eliminating the need for travel. Expensive expenses and a lot of inconvenience.

has an interesting speculation. Maybe people think that they have to undergo harsh treatment at home to enjoy travel therapy so much. As for inhalation treatment, it requires inhaling a large amount of acidic spray, which is a very painful process. Besides acting as a placebo, this treatment rarely relieves the condition. There were other standard home remedies in the 19th century, such as phlebotomy, cupping, and inducing vomiting to cleanse the body of impurities and adjust the body's humoral system; anti-inflammatory, Eat an anti-inflammatory diet and avoid other irritating meats; reduce exercise as much as possible and relieve stress as much as possible. Creosote, hydrochloric acid, ox bile and pepsin were once used as oral medications to stimulate appetite, increase patients' weight, and treat muscle relaxation. Even with the humoral theory gone, doctors have few practical alternatives to their time-honored therapies. Of course, some doctors have begun to adopt symptomatic treatment methods, using morphine and opium to relieve pain, using quinine, strychnine and atropine to cool down patients with fever, or using opium and coptis tea to treat hemoptysis.

original author/Frank M. Snowden

excerpt/Yuan Chunxi

editor/Zhu Tianyuan

proofreader/Zhao Lin