Hitler killed 10 million people. Stalin: perhaps 30. Now imagine an implacable enemy that has killed 1000 million over the last two centuries. A foe that has traveled under many names -- the white plague, phthisis, Pott's disease, scrofula, Koch's disease, consumption, "wasting disease." An illness that conjures up the very image of human suffering, and has even today silently infiltrated more than a third of the human race. Perhaps you even have it right now.
The disease is called Tuberculosis.
It begins with a cough. The bacteria of Mycobacterium tuberculosis embed themselves within quiet granulomas of inflammatory tissue in your lungs. Although engulfed by your infection-fighting macrophages, the indigestible germs linger, protected from your immune system, sometimes quiescent, sometimes slowly spreading to lymph nodes or spilling into your blood stream where they can spread explosively throughout your brain, kidneys and other organs. Continuous bloody coughing spreads the germ to children, lovers and family, as the oxygen-loving bacteria accumulate in the apex of your lung and eat cavitating, cheesy holes in the upper lobes. Victims develop a famished, breathless red-cheeked appearance as they turn into skeletons and finally die -- sometimes drowning in their own blood.
Doctors have tried many tricks to fight the illness -- surgically removing or collapsing lungs, forcing patients to live on mountain tops or deep inside caves. Even today Tuberculosis can be only cured with years of treatment with toxic antibiotics that can damage the liver, hearing or eyesight of those who finally recover -- and the insidious specter of drug-resistant tuberculosis is slowly spreading, causing sleepless nights for epidemiologists in every country of the world.
Fortunately a simple skin test is sufficient for most of us to know if we have been exposed to the disease, and a normal chest x-ray is a powerfully reassuring sign. There is also relief in knowing the slow onset of the illness gives many of us time to seek modern treatment -- something that wasn't available for the 5000-year old infected mummies of the Egyptian pharaohs or the strangling consumptives of Dostoevski's novels.