Human Impact of Tuberculosis

"Unsanitary conditions are vividly displayed in the reports of reformers working on the Commission on Conservation. For example, Dr C.A. Hodgetts reported on the lack of refuse collection and disposal in Toronto, a problem that led to the storage of solid wastes in barrels. Critical of civic authorities interest in the problem, he wrote that the city’s clean-up week was really the health authorities admission that there was no system for collection or disposal of refuse during most of the year, and that the annual display of ridding itself of the decomposing refuse showed their inefficiency.

In these early times Toronto was described:

"In our city at the present time there is scarcely a vacant house fit to live in that is not inhabited, and in many cases by numerous families, respectable people have had to live in stables, tents, old cars, sheds (others in damp cellars), where we would not place a valued animal, let alone a human being."

Conditions in factories were no better. Most were overheated, dirty, smoky, and had no ventilation. Health and living conditions were becoming inseparably linked, with the result that government authorities were being attacked from all sides for ineptitude and even callous indifference. The grave concern over the living conditions of the poor was compounded, of course, by the medical advances in the last quarter of the century which confirmed to the world that tuberculosis was indeed infectious.

As early as 1877 the Canadian Medical Association was tossing around the concept of a ’germ theory’ for the disease and in 1879 the Sanitary Journal reported that from numerous recent experiments,

"it appears that pulmonary consumption may be regarded as contagious; it is probable that a healthy person may contract this fatal disease directly by breathing the seeds of it – minute particles of tuberculosis, exhaled from the lungs of another suffering from it."

Throughout the 1880s and 1890s the medical profession stressed the infectious nature of tuberculosis.

Doctors feared for the survival of the race, and termed it a national disease as public concern in health matters rose to a new level. The problem became one of major concern, not only to those affected with the disease but to those who feared developing it. Anti-consumption leagues soared into existence, and the problem of cleaning up the slums received a great shot in the arm because of the new interest. Suddenly consumptives found themselves to be a type of ’leper’ with whom none wanted contact. Shunned by their friends, their strength weakening every day and their chances for employment steadily diminishing, the sufferers were, indeed, a pitiable lot. Wealthy consumptives could afford to enter a sanatorium where they would receive proper care and, if the disease was stopped early enough, perhaps cured. To the poor, however, there was no answer. Hospital wards closed their doors along with the rest of society.

All had excuses for non-action: provincial authorities claimed to lack finances, charities said it was hopeless to attempt a task so big without government help, and municipal and federal governments claimed it was not their responsibility or under their jurisdiction. It may be wondered why the pressure of public opinion itself did not force the governments to action, but the opinions presented concerning the nature of consumption and the remedies required were those of the educated, not those of the people.

True literature on sanitation had gone far, but the problem of tuberculosis was a distinct one, not like that of diseases such as cholera, which could be cured. Remembering the lack of education, the old pseudo-religious beliefs concerning disease and the wrath of God, and the general confusion of the time, it is understandable that the populace did not believe everything they heard about tuberculosis."