Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Tuberculosis

Episode Date: February 11, 2014

Welcome to Sawbones, where Dr. Sydnee McElroy and her husband Justin McElroy take you on a whimsical tour of the dumb ways in which we've tried to fix people. This week: We store some lungers in a cave. Music: "Medicines" by The Taxpayers (http://thetaxpayers.net)

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books.

One, two, one, two, three, four. We came across a pharmacy with a toy and that's lost it out. We were shot through the broken glass and had ourselves a look around. The medicines, the medicines, the escalators, my cop, for the mouth We're ready and welcome to saw bones and marital tour this guy medicine. I am your first just a macaron And I'm Sydney, mafroid. I'm Sydney. I got good news. I know it's only February But I have settled on my own costume It's kind of early for that, but okay, I'll bite doc holiday Well, okay, I'll bite. Doc holiday. Well, okay, I mean, I love Doc holiday. Okay, girl.

Tombstone. Yeah. Doc holiday. Great character, great. So, okay, do you think you're all ready? Yeah, I think I'm pretty much set. Do you have like your costume, like, you know, what you're gonna wear?

Nope. Can you shoot again? Nope. Can you like twirl it around like he does? No, no, no, no. Uh, have you worked on your poker game? Nope, terrible. Do you play the piano? Not a bit speak Latin. Not a lick Are you a doctor? Not in any way shape or form. We've proven that pretty succinctly So it doesn't sound like you're exactly ready in any way not no no in retrospect. No. I'm not ready at all

Well, I mean since we do have a lot of time before Halloween, there is something you could get started on right now, and then you'd probably be good and ready by the time it came around. What's that? Well, I mean, you could go ahead and try to catch TB. Hmm, catch TB, I don't know much about it,

but it sounds pretty good, sounds easy. I mean, doc holiday was a famous longer as it, as it were. Okay. Well, I'll give it a shot. Now, I warn you, I don't know much about TB. So maybe you could educate me and then I'll get cracking. Well, maybe the problem is you just don't know it by the name TB. Oh.

Perhaps you've heard of consumption. No. Or scruffula. Yeah. Pots disease. No. Thesis. No. Maybe the white plague. No. Or scruffula. Pots disease. Thicis. Maybe the white plague. No.

I'm not familiar with any of these names. Well, these are all other names for TB. In addition, for a while, it was called the Romantic disease. Oh. It's kind of sweet Valentine's Day is just around the corner. There you go. Hey, do you have a gift for your girlfriend? Have you considered TB?

She'll love it. Hey. She keeps on giving. Or your boyfriend. He might like TB? She'll love it. Hey. She keeps on giving. Or your boyfriend, he might like it. I don't know. Don't settle for a girl that comes from the heart. Look for a girl that comes from the lungs. Just cough right in her face.

So yeah, it was called the romantic disease, mainly because of how prevalent it was during the period of romanticism. All right, that's not as good, but. No, but it did not come about in the romantic period. It has been around for a really long time. Like Larry King levels of existence. Perhaps even longer.

Nah. It was found. It has been found. The bacteria that causes tuberculosis, mycobacterium tuberculosis, has been found in bones that date from the Neolithic period. Wow. It's been found in Egyptian mum date from the Neolithic period. Wow. It's been found in Egyptian mummies.

It may actually be the first disease known to man. Wow. That's a hard thing to quantify, but it may be. That's right. It's interesting. They weren't sure for a long time. One really important thing to figure out, and I think I've mentioned this before, about any kind of disease, is does it live in humans, animals, both, and who first?

And to try to calculate? Yeah, that can be really hard to figure out, but it's important because if you're going to try to get rid of it, like with smallpox, you really need to know if it only exists in humans. It's really hard to do if it also lives in animals. The interesting thing about TB is that we thought we got it from animals, because there's a strained micro-bacterium bovis, which you probably could imagine is from cows. And we thought maybe it jumped over to humans, but we figured out through dating like the

evolution of the bacteria that it actually originated in humans like 40,000 years ago. Well, so I'm assuming that when we say it's the oldest disease known to man that we're obviously not counting the Mondays. Garfield started those. Garfield was the San Francisco cat. That's true. I think there was a cartoon like that, right? Cave painting, actually.

A cave painting? A Garfield cave painting. Where did you find that? Odie was a, girlfriend was a safety tiger, and Odie was a holy mammoth. Even back then, he was a annoying Garfield. No, because the comic honestly got better after Lasagna was invented before that it was harder to follow. With the evolution of Lasagna.

And text that helped a lot But let's be honest before normal. Come on. Oh, yeah, pre-normal the pre-normal era So thanks for joining us for the Garfield podcast Coming up next an interview with John Davis So anyway, I just think it's really interesting that they can date back the human pathogen for 40,000 years and the cow pathogen for 6,000 years so we cow pathogen for 6,000 years, so we know that we gave it to cows probably about the time that we started farming and brazing animals. Sorry, cows.

It's the only bad thing we've ever done to you though, so... So that's really it. I guess you had it coming. They know attention to McDonald's or Burger King or any other fast food restaurant. Anything leather, the whole bit. Football, and that's pigs. So you probably have some idea about tuberculosis TB that it is an infection that you pass it to people probably through coughing.

I think a lot of people are aware of the idea that like you cough and little droplets of mucus go to the other person and then you can get disease. Gross, yeah. People kind of kind of know that. It mainly causes like a pulmonary disease along disease. Everybody knows that, but it can cause disease all throughout the body in various forms. So that's kind of what TB is.

Interestingly, Nefertiti probably died of TB. Oh. And in her time, there were already TB hospitals. Wow, so prevalent. If we go back to like the Ebers Papyrus, then it's an old Egyptian like text. Where we've mentioned it before. There's all kinds of old infections and things mentioned on it. It talks about an infection that was probably TB, although they didn't call it that at the time. And they advise, as treatment for tuberculosis,

like you can get these giant enlarged lymph nodes. And they would advise cutting them open and then putting a mixture on in them of Acacia, peas, fruit, animal blood, insect blood, honey, and salt. Delicious. Except for the insect blood. No, it does not cure TB. That is not cure TB. That one's official. That's been mistbusted.

We tried it earlier. Don't tell anybody. No. No, especially not the patient's fan. It makes a delightful reduction though. Should we put that in my in my tea later? What? My throat's a bit sore. The old testament talks about a consumptive illness, consumptive because it consumed the body, consumed the lungs, and then also you

get really thin and scrawny, consumes the body. And theive because it consumed the body, consumed the lungs, and then also you get really thin and scrawny, it consumes the body. And the treatment for it in the Old Testament is just try not to stray from God. Okay, done. That's easy. Once you've gotten it, I don't know what you, I don't know if you maybe pray really hard. Pray, yeah, just apologize. Try to find God. So God listen, wherever you are, please come out my thirters.

Please, I keep coughing so much blood. The Vedic texts mention it. We've talked about those before. Those are old Hindu texts, Indian texts. They mention it, they call balasa or yaksma. They literally call it scrofula. And they say you should treat it with breast milk, meat, alcohol, rest, and just move to a high altitude. Because that's what you feel like doing, right? Well, you might have fun hanging out on a hill, eating some meat and drinking some booze, resting. Resting? I don't know about the breast milk.

I don't know how you're gonna score that. It's a theme really with TB, the idea of moving to different climates because several times you find repeated the advice to move to a higher altitude and then later if you remember in doc holidays time, we recommended that people move to drier climates. Neither of which is effective in medicine. No, neither of those things will cure TB. Okay. Hypocrites was a one to first call it thysus in 460 BC and His best advice was that if you're a doctor stay away from patients with it He knew that it was almost always fatal and he didn't know how to cure it So he just said just try to stay away just like yeah, don't mess with it. Yeah, you've got other people to heal

We've got some other wacky cures to stay away from those people He and many physicians at the time thought it was hereditary, but Aristotle was actually the first one to say you know what? I think it's contagious And Galen followed in their footsteps and he advised he actually had some treatments of course bloodletting sure Why not get the DB out? Eat some barley and fish and fruit and I don't know some healthy stuff and then when you're dying try some opium. Yeah I mean yeah that was a common theme for a while was as the disease advanced the main treatment was opium which I maybe was the beginning of palliative care. Not it yeah well I was gonna say it

probably was I mean that you probably knew you were dying at that point that probably just trying to easier easier passage into the into the great beyond in Valhalla. Exactly it was accepted pretty early on that we didn't have a you were dying at that point, the proba just trying to easier passage into the end of the great beyond. Eva Hala. Exactly. It was accepted pretty early on that we didn't have a treatment or a cure and that TB was a slow but certain death. I really liked during the inquisition.

So a lot of people had TB during the inquisition, but because pagans were being persecuted for being pagans, they began to believe that they were evil and that some of them that they had fallen away from God, and that was why they were the victim of all this persecution. They thought that maybe a demon dog had infected their bodies. That was a commonly held belief that there was a dog inside them that was of satanic origin. It was eating their lungs. And that whenever they would cough, that was the dog barking. And I meant it was getting closer to its goal, which was, you know, of course, to kill them.

Whenever I, that one time I caught TB that I really wanted bacon and synthetic bacon strips and I ran around the house brooding for bacon and that way explain a lot actually. I always want bacon. Bacon, bacon, bacon, bacon, where? On the back with the saying, I can't read. Remember that hilarious stuff for bacon strips. I remember that hilarious stuff. This week's episode is brought to you by Bacon Strips.

Dolls so no, it's not bacon. It's bacon. Now you just really made me want bacon. It's all. Maybe you not want bacon. Never. I always want bacon. I think my favorite treatment for TB

is we kind of move through the, through the ages. We're getting closer to the now is what was called the Royal Touch. You got the touch. Justin has it. Please tell my TAP. As you can tell. It was popular all throughout Europe, but particularly in France at first and then to England. And the idea was that there was this association with the monarchy and like the the idea that they were kind of chosen by God.

So because they were holy in a sense, you know, not holy like the Pope's holy, but holy like God let them be king. Be divine. Yeah. Something better than us. Yeah. touch something better than us. Yeah, that's commoners. Um, so the idea was that maybe they had some special powers from God. And maybe if they touched sick people, it would cure them. This sounds like a trick that poor people came up with to get the king sick. Doesn't it? It sounds like they were running a scam. If it is, it's, that's a great idea. You're so powerful.

I just figured maybe you could take a look at my nephew with TV. Like you seemed to be really powerful and divine and stuff. I just thought maybe. Maybe you just get right way down in his face there. Yeah, I'm there close. Touch his face with your face. It's really.

All right, cough ready. Cough on it. Cough on yield king. That's a whole time you move a him. Cough on Ye old king. That's a old time illegal dog. Cough on Ye old king. Cough on Ye old king, horseshoe and stuff. Initially, this was kind of informal. People would stop by with family members, you know, loved ones who were very ill and just say, I don't know what else to do.

Would you touch them? Maybe it'll help. Eventually, it became kind of an official ceremony. The kings would become so overrun in the queen with visitors who were requesting to be touched that they had to like set up certain times, like the king will be available to touch you. So on Wednesday, between the hours of three and six.

You know, Prince does that now ironically. Just you can line up outside without. I have a plan for Prince to touch me for seven hours. This is ridiculous. Can I get a fast pass? Can I get a fast pass? Prince touch me? Touch the hem of his carot.

You could apply for the privilege eventually. Since so many people wanted to do it, there were like, I guess, freebie hours where you could just first come for a serve and then you could apply for it. In France, it was mainly just they would touch you. In England, it became this whole like very efficient process where they would just like line them up and whip them right through there and the queen had a certain way of doing it where she would touch them and then press a gold coin against their neck.

Do they get to keep the gold coin? Because that would probably help. They did get to keep the gold coin. Whoa. We're going to get the line. Yeah. So if nothing, maybe you should like fake having TB just so you can get some cash. So like you're still cough and lop it, you have a gold kubarad.

Or maybe get TB, don't fake it. Don't fake it, get it. How bad do you want this gold cooperat. Or maybe get TB, don't fake it. Don't fake it. Get it. How bad do you want this gold coin? This was a really big deal. Records of your royal touch experience were kept right along with like birth and death records like in a family. You would keep track of all that. You don't want to be touched for the same disease because then you get it again.

Now I've been touched for the play. I've been touched for chicken pox. I've been touched for measles. I've I'm covered. I've been touched for syphilis that didn't go over well. No. Oh, it actually became so popular in France that TB became known as the King's evil or Maldu Roy. Maldu Roy. I think just the association with getting touched by the King. Now we still don't know why people were getting TB. There were a lot of different theories. A lot of them were silly. We thought maybe evil, humor and balance, very popular.

Perhaps just organ failure. It seemed like these people were just kind of decaying from the inside. So maybe maybe they were just shutting down. There were some people who thought maybe there was a contagion. Some people thought maybe sugar was to blame. Not a great idea. And signs still haven't figured this out to this day. So if you have any ideas, please let us know. No, no, that's not true at all. Jerry's still up. No, that's not true at all. I think it's, it's kind of neat inside of the 20, somebody actually, Benjamin Martin proposed the idea that there was some kind of

anemacula by which I mean, I think he meant a tiny animal. That was causing it, which actually was the closest to the truth at the time. I mean, a very tiny animal. Okay. But everybody kind of laughed at him. It was like, that's ridiculous. It's clearly humorous and evil. And you stop. It's clearly all the sugar. So forget it. That's a silly idea. Little man. In the 17th century, it just spread all over Europe. And that's when it was finally called the white plague as opposed to the black plague or the black death. And that was because there

were a lot of people who were living close together. You know, there were centers of population density with lots of people in poor sanitation. And actually in 1650, the leading cause of death was TB. Wow. This is when we start to enter the era of the romantic disease. TB became this kind of inevitability. You were going to get it. Most people did. So it was just thought, well, you know, you're going to die some way. And you got to think about it. At the time, there were some pretty terrible ways that you might die. Yeah, a lot of gruesome tramplings just to just for start.

There were lots of, yeah, there were lots of gruesome traumatic ways that you could die. There were a lot of diseases that we didn't have any cures for and TB by comparison. Yeah. Wasn't that bad? I get thrown into a grinder at the surf factory. That happened all the time. You could fall and trip into a Bible printing press.

Just get smushed into the pages. Who's bad back then? Maybe you spend your days just worn out as an orphan picking pockets for fagin' and then drop dead in the streets. It was a hard time. I don't even think that's the right time period. Yeah.

People listen to this shit, I don't know. They're so smart, they could read a book. It was, so the thing that they thought, okay, they thought TB was a good death, why? I mean, that's my question. Why I've seen TB, I don't know why you would think, hey, that seems like a great way to die. But it was because it was slow.

It gave you time to prepare yourself for the afterlife. So you could get your affairs in order. You could make your peace with your maker. Yeah, time to sort of fade away. Exactly. And the way that people looked while they were dying of TB. They looked great. It was a coveted look at the time.

I'm very cool, very chic. They became pale and thin. They were always coughing politely into a handkerchief that they would then quickly hide because it would be covered with blood. They were seen as angelic. So it was supposed to be a really great, holy, pure way to die. A great way to die. And it was a, if you remember, we talked about this, I think in one of the skin cream episodes or one of our beauty, opium, my laptop. Oh, maybe it was that we talked

about different facial creams. And there was a lot of people who wanted to look like they had TB. The TB look. Yeah, you want it, you want to look like they had TB. The TB look. Yeah, you want it. You want to look like you have TB because it's just infected look. That's actually Lord Byron wrote about it and wrote that he really wanted to die that way. That's a problem with the if you wanted though, it'll never happen. You have to just let it let it have the universe bring it to you organically literally. And this is actually what inspired the book that would later become

La Boa. La Boa. I'm familiar and Les Mis the book that the musical Les Mis was based on were both written out of this time period about holy people dying of TV and if you think about in Les Mines, like it's really presented that way. Like it's a death of redemption and you know purity. So there were some treatments available at the time although I mean why would you want them because you're dying the holiest death available. And you look fantastic. I can't underline that enough. Like this look I mean think about it in the 90s. This is what you wanted to look like, right?

Right. Kate Moss had that TB look. Did Kate Moss have TB? Does Kate Moss have TB? What isn't she telling us? Next up on TMZ. Miss Moss, Miss Moss. Is it true you have TB?

Show us your handkerchief. If you did want to get rid of your TB, you could try drinking some dog fat and garlic. Sounds pretty good. What's dog fat? You know dog fat. Just fat from a dog. Fat from a dog.

Okay. Don't think about how they got that. Mm-hmm. You could inhale some smoke from burning cow dung. Good. They're just thinking about the least pleasant thing you'd like in context of your disease, like, oh, you're coughing a lot.

Maybe inhale smoke from burning cowbung. Maybe it was like this way the doctor could never be proven wrong because you're going to tell your patient to do that. They absolutely are not going to try it. Listen, if you're serious about getting well, I told you what you needed to do. So you clearly just didn't want to get better. Because if you had done it, it would have worked. And then you could always fall back on like, well, I know you did it, but you really didn't

do it long enough. Or maybe there wasn't enough cow dung. Or it wasn't smelling enough. Yeah. You could always fall back on that. They did suggest maybe you could take a sea voyage. Again, I think based on the idea that by the time you got back, you'd be dead and you couldn't blame the doctor for getting it wrong. You could vomit a whole lot to try to work out your chest muscles.

Well, I think with in hate like diseases of the respiratory system, like it's very tempting to think that like, air that we as humans find cleansing would be useful, right? Like you're getting bad air somehow. Especially in this age, when we're starting to see, fine cleansing would be useful, right? Like you're getting bad air somehow, you, especially in this age, when we're starting to see, you know, industrialization step up, it would have been very tempting to think, well, you need to get fresh air, you need to get out of the city and get into some place cleaner where there is more pure.

That's a really good point. And that actually, that comes up a lot as we move forward. The theory that it has, you're exactly like you said, if it's a respiratory illness, it has something to do with the air. So cleaner air might work. Or I think that's actually the theory behind the burning cow dung, is that an even more offensive smell would actually destroy what was going on in your lungs. Or you could just, if you couldn't actually take a sea voyage,

they did say you could just put some seaweed under your bed. It's kind of have measure, but sure. But the stricter laws of the time were attempting to quarantine these people. This was when we first started to understand, we didn't know why, but we thought maybe it was contagious, we thought we were passing it from people to people. So they started making laws, again, trying to quarantine them. This didn't work very well. They tried to avoid infant exposure by making laws about who could handle babies, who could work with babies.

And then it was very popular to spit in the streets and then spittoons followed later. And both of those were banned in a lot of places and folks above all we can't There's enough avoid spitting on infants That's a good rule now just it's a great yeah anytime, you know what don't spit on streets now because it's gross Don't spit any time just don't spit spits the one thing that bothers me. That's the bodily fluid You can't handle it. It's the only bodily fluid. I can't. Anything else, but please don't show me what you're spitting up. I'll take your word for it. Whatever color you say it is, I'll believe you.

Well what came after this, of course, was what comes after all of our misunderstanding, which is science. Ray science. Science showed up. I think this is really cool because if you chart the door, they did. They stopped spitting on that baby now Let's be honest science politely knocks on the door waited for somebody to open it and then asked if they could please come in I know you're all

I'm actually enjoying Not spitting on babies and the cow dung and what have you but anyone like to be right would anyone like to know the right thing to Okay, no, I will just see myself out oh you are okay you're putting my head in an old-timey toilet and you're flushing this is you're inventing a swirly right now of course I showed up the angry mob shouted it down for another several hundred years and then they came back now not really Renee Laneck invented the stethoscope to help him study TV I think that's very cool that the history of the stethoscope is linked to the history of TB

Yeah, well, I mean cool. I'm doing air quotes cool. Cool. I think it's cool. It's cool It was proven that it was contagious by John Velliman and then Coke of Coke's postulates found the organism in 1882 He was the one who was like, Hey, we've got a disease. And if I put it in the animal, it gets the disease. You know, that kind of thing. And then it's funny how, so it's funny how so,

I don't know lots of fields like this. Like, it's funny how many of our medical pioneers, like because now it's so obvious in retrospect, just like aren't that impressive. Like, yeah, yeah, I think when you give TV from one thing to another, but things have TV, it's like, yeah, I would think so. It's great, because that was a huge theory.

Like the dude that had been in the combustion engine, I would still be like, I don't know, I don't know, how can you, but like that makes me feel like a genius. Like yeah, I know, you can give it a frame, like, I'm on get it. You know how many people TV was killing? This is a big deal.

I know it's a big deal, I'm just saying that I could have done it if I was sent back in time. I don't know, look at how many years people were just, you know, betting on like bad air and... Spitting on babies, sugar. 13 years after that, the X-ray was invented. So that obviously helped a lot, because we could correlate the things that we saw in lungs with the things we heard in lungs with our stethoscope, and then the disease that we

were seeing in the patient. And then on March 24th of 1882, Coke gave this big groundbreaking lecture on the cause of tuberculosis and how it's spread and whatnot. And that to this day is World Tuberculosis Day. So if you're wondering why you get into Disney World free, if you have a really bad cough I'm actually before it that's what's up. Because we're quarantining you all at Disney World.

We're all in the giant globe. We're going to keep you at the happiest place and that's not too bad. Yeah. No. You all right. Then we're going to force you to be treated. Paying for your food and drink is going to break the bank, but just sneak in a little packet of cool aid and the water fountain. Never did that. Never did that. I mean, it's a good trick. You could drink the water flowing down the matter horn, I guess. It's a few trick. You could drink the water flowing down in the matter horn, I guess. It could be a few days. If you want hepatitis. Hepatitis to match your tuberculosis.

Perfect. And in 1908, the PPD, which is the, some of you probably had this test before, when they're like, you gotta get tested for TB. And so they stick a little needle in your arm and make a bubble. And then look at it two days later to see if it turned red. Yeah.

Or the Manto skin test. That was invented. So then we could test for it. Unfortunately with our understanding of the contagious nature of the disease and what caused it and now that we really had a good hold on it, we started creating sanatoriums or you know places basically to keep people with TB, not to quarantine them off. One of the first ones, I think this is really cool, or sad, and it would depend on how you want to look at it. And I'd probably, I would love to read a book

about this someday. A guy named John Krogan, who owned the, who owned mammoth cave, if you're familiar with mammoth cave, or is that in like Kentucky, Tennessee? I'm sure. Somewhere nearby. Anyway, so it's a big cave. And he said, you know what,

this would be a great place to house TB patients. So in 1852, he opened it up to 15 TB patients to come live there away from the populace. They stayed in stone huts that were kind of scattered throughout the cave. Okay. They were each given an African slave to wait on them while they lived in the cave.

That's not a cool part. No, that's not a whole... I just think that he housed TB people in a cave is kind of interesting. Yeah, and that, as it turns out, is what lost was about. But they only were there for about four months and then at that point, all of them had either died or left.

And then Krogan later died of TB as well. Oh. So not a happy ending, but I just think it's really weird that he was like, hey, I have this big cave, I can help. So I mean, I guess, I wouldn't have thought of that. I own a cave. Hey, there's a TB epidemic. There's worse uses for a cave.

Except for the slavery, not too hot on that. No, that was a really bad thing all around. Yeah, we can all agree on that. But storing patients with TB and a cave. Yeah, they liked it. By all accounts, they wrote really nice things about it. I mean, until they died of TB, which was inevitable, let's be honest.

Yeah, they had slaves, so it's like sort of bad. Well, yeah, of course, I'm just saying, like it wasn't like the TB patients were mistreated. You just enjoy the idea of humans being stored in a cave. No, I just think it's creative. Who would think like I own a cave? I know I can help with TB.

Yeah, big ups to the guy that stored TB patients in a cave and then made black people work for them for free. Okay. So, all right, in retrospect, it was all a really bad thing. I just think it's an interesting story. Fair. The history of disease can get really dry sometimes. And this is a point where people were stored in a cave

because they had TB. I think that's interesting. The next time you go to mammoth cave, you're you tell me you're not gonna think about this. I am I don't think oh cool. This is where I made slaves get TB. I'm not a monster I'm not a monster Maybe they didn't I don't know how they fared. I just know all the people who had TB eventually died There there were lots of sanatoriums in that time period, all across the Europe and US,

and they pretty much just housed patients. It would be great if they were like trying to cure them, but nobody knew how to cure it at the time. So, fresh air was the number one thing they kept recommending to people. So they would have like... Give it one, listen, trust me. I know Terry Gross can be a little presumptuous

from time to time, but she is an immensely talented interviewer. That's all they did. They were housed in a giant building, just listen to fresh air 24-7. Go to food, sunlight, or other treatments. There was also cod liver oil. Treatments, sunlight was a big deal. But overall, there was no effective treatment for TB, so you kind of moved to a sanatorium with the understanding that you were going to die there. The, there were people who were trying for cures, a surgical cure was experimented with for a while, where you'd actually try to create what's called a pneumothorax, or a space of air outside the lung, like within the thoracic cavity, but

outside the lung, which is a bad thing now that we try to fix if we see one. But pretty much this was not a very helpful cure. It was actually based on case reports of a soldier who had been stabbed in the chest and then survived TB afterwards. So they thought, well, maybe there's a correlation between getting stabbed in the chest and then survived TB afterwards. So they thought, well, maybe there's a correlation between getting stabbed in the chest and surviving TB. Something when I'm expressing, I think it was just a lucky guy. Yeah.

Except for the staff on it. Well, he survived it all. That's true. You just don't ever look on the bright side. That's my problem. The Invinitive Vaccine BC BCG Vaccine in 1921. We don't use it in this country in the US. Largely because, actually, the US, the UK, or Canada

because of the low prevalence of disease. It works, but it wanes after about 10 years. And more importantly, once you've had it, you cannot get a PPD. It is useless. It will always be positive. So whether you have the disease, you've get a PPD. It is useless. It will always be positive. So whether you have the disease, you got the vaccine, it'll be positive. In 1944, we invented Streptomycin, which was the first anti-TB drug

Isoniazid came later and then refampin. And we thought for a while with these drugs that we had, we were going to see the end of TB, the end of the white plague. Great. However, in the 80s, we started seeing multi-drug resistance strains of tuberculosis. Most TB patients are treated with like a four drug regimen for a long time period. That's the big thing about TB.

You've got to treat people with a lot of meds for a long time, and a lot of people don't comply with it and don't finish it. And as a result, people with a lot of meds for a long time and a lot of people don't comply with it and don't finish it. And as a result, we got a bunch of resistance strains. The rise of HIV also led to the rise of more infections, which burculosis because HIV patients are more susceptible to any infection, including TB. Now the incidence and prevalence overall is dropping. Okay. But one third of the world's population has been infected.

Wow. They're not, now that does not mean that they're carrying like the active disease, you can just have it and be latent. And then you wouldn't know you had unless you got a PPD. But a tenth of those who are infected will progress, to progress to active disease, which is why it's so important if you're ever in a healthcare field, why we check you with a PPD. Because you can, you can spread it later on.

It is more common in the developing world, of course, I think we know that, but in this country, it's becoming more common among certain at risk populations. And like I said, it's just really hard to treat. It's really hard to diagnose, actually. And like I said, there's not a great vaccine. There is a vaccine that's used all over the world, but not here. So... So tuberculosis back and harder to cure than ever. Sleep tight, everybody. Unfortunately, that's true. I will say this, that was one little hopeful thing. The drugs that we use to treat TB

are one of the things that, while not available everywhere, certainly as much as we wish they were, they are more widely available than you'd think. When I worked in Malawi, I dealt with lots and lots of patients who had active TB. And there were many drugs available to treat them. And actually we had a lot less drug resistance there. Of course, that could change over time.

But there's hope, there's drugs, and we can treat you if you have TB. So if you've got TB, get treated. Now, let's take to it. Don't give up. Yeah, don't don't buy into that whole Sheek pale, you know, it's not worth the look angelic look. I don't care how romantic it sounds TB is not a great way to die. TB is a terrible way to die, but a great way to die is listening to our show Forever until you eventually die of old old age a terrible way to die, but a great way to die is listening to our show forever until you eventually die. A old old age.

A old age. A old old age. And edge. In your bed. Oh, surrounded by loved ones. Thank you to everyone tweeting about the show this week. People like Camman May, Maggie, Torto Show, Bat, Andy Dick, Tell, Andrew Booth, Chris, Normandow, Mitch Reader, V.

Claus Tyler Ellsworth, Elizabeth Layd Law, Joshua Montana, John Gardner, Chastity Ellsworth. Thank you so much to everybody. We really appreciate you spreading the word about our program. You can just link people to solbonaetho.com if you can't remember our web address. You can email us if you have suggestions for shows. Sobonaetho.com at maximumfun.org. And you can review us on iTunes. I want to mention something real quick

before we close out the show. We had several folks after our episode about the father of Homi Apathy who suggested that we maybe pulled some punches when it came to Homi Apathy itself, the actual style. Which is a fair suggestion, I would say. Yeah, I think that's fair. And we've also gotten people who suggested we do things about Phrenology or reflexology Acupuncture things that there are people that believe in currently that are popular forms of treatment And we just want to say for the future so you know We're not super interested on sobbes about making people feel bad about the stuff that they might believe

No, we try to be happy and positive and talk about things that we can all pretty much agree today weren't good ideas from yesterday. From yesterday. So if we skewed towards trying to keep things light and positive, we hope you will forgive us, but that's kind of show we're interested in making. And if you want to find, you know, like actually, you shouldn't take any actual treatment recommendations

from this program, we're pretty clear about it. Absolutely, because as we may have pointed out many times before, um, who knows if the stuff we're doing today will not end up on a very similar podcast. Yeah, we don't want to get too high in my, because that'll come back to get you. It's about 100, 200 years where they'll be making fun of us. So anyway, that programming note aside, we hope you all continue to listen and enjoy the show. We appreciate you so much for listening. We're here every Tuesday, weather permitting. So we hope you'll come back and join us again. Or whether or not permitting.

No, no, they're not permitting. We don't care. Next week, I think we're going to talk about pregnancy, Sid. I think that seems appropriate, Justin. Now, why is that? Well, I've taken this moment now that I've told all of the internet to tell you that I'm pregnant. Fantastic. That's your reaction. Congratulations.

That's the best you've got. I'm going to be a dad. OK, he already knew. I knew. Sorry, but yeah, it's serious. Maybe we should talk about it next week. Exciting, so we'll talk about pregnancy next week. And make sure you join us for that special episode

and tell everybody you know to listen because we appreciate it. Make sure to join us again next Tuesday. Until then, I am Justin McAroy. I'm Sydney McAroy. And as always, don't you lollily, your head. Maximumfund.org Comedy and Culture, Artist-owned Listener Supported