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Spitting Blood: The History of Tuberculosis
Tuberculosis is characterized as a social disease and few have been more inextricably linked with human history. There is evidence from the archaeological record that Mycobacterium tuberculosis and its human hosts have been together for a very long time. The very mention of tuberculosis brings
to mind romantic images of great literary figures pouring out their souls in creative works as their bodies were being decimated by consumption. It is a disease that at various times has had a certain glamour associated with it.
From the medieval period to the modern day, Helen Bynum explores the history and development of tuberculosis throughout the world, touching on the various discoveries that have emerged about the disease over time, and focusing on the experimental approaches of Rene Laennec (1781-1826) and Robert
Koch (1842-1910). Bynum also examines the place tuberculosis holds in the popular imagination and its role in various forms of the dramatic arts.
The story of tuberculosis since the 1950s is complex, and Bynum describes the picture emerging from the World Health Organization of the difficulties that attended the management of the disease in the developing world. In the meantime, tuberculosis has emerged again in the West, both among the urban
underclass and in association with a new infection - HIV. The disease has returned with a vengeance - in drug-resistant form. The story of tuberculosis is far from over.
to mind romantic images of great literary figures pouring out their souls in creative works as their bodies were being decimated by consumption. It is a disease that at various times has had a certain glamour associated with it.
From the medieval period to the modern day, Helen Bynum explores the history and development of tuberculosis throughout the world, touching on the various discoveries that have emerged about the disease over time, and focusing on the experimental approaches of Rene Laennec (1781-1826) and Robert
Koch (1842-1910). Bynum also examines the place tuberculosis holds in the popular imagination and its role in various forms of the dramatic arts.
The story of tuberculosis since the 1950s is complex, and Bynum describes the picture emerging from the World Health Organization of the difficulties that attended the management of the disease in the developing world. In the meantime, tuberculosis has emerged again in the West, both among the urban
underclass and in association with a new infection - HIV. The disease has returned with a vengeance - in drug-resistant form. The story of tuberculosis is far from over.
320 pages, Hardcover
First published March 8, 2012
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Displaying 1 - 27 of 27 reviews
January 17, 2014
This book started out very strongly with a brief account of George Orwell's experience with tuberculosis, but I found that it went a little downhill after that. It became fairly dry and technical. I was expecting it to pick up steam when the author got to the recognition of germ theory in the tuberculosis timeline, but it really didn't. I was hoping for more personal accounts of the disease, and while there were some, those accounts made up only a very small fraction of the book.
A few pros and cons:
Pros: The book is well-organized. I never felt "lost" in the timeline of this history of tuberculosis. It also explains in great detail the various phases of tuberculosis treatment, beginning with some of the more ridiculous so-called remedies before the arrival of modern medicine, progressing through the sanitarium phase, and ending with some of the modern approaches to the disease and the influence of drug resistance in modern treatment. The author also discusses the changing perception of tuberculosis, including the periods of time when TB or TB-like symptoms were considered almost fashionable and the role of TB in the eugenics movement.
Cons: Like I said above, pretty dry and a little too technical. I am not a medical professional, and while I found the book to be understandable, some of the nuances of the disease or the development of a TB antibiotic were extremely boring to me. (And I do not bore easily - I have read other books about disease and have largely found the science to be interesting, but this time I couldn't muster up a lot of excitement for it.) In fairness, part of the reason the book and the science discussion felt boring to me may be due to the fact that TB is a chronic disease and not usually acute, so the the disease tends to be protracted, whereas other illnesses I have read about (ebola, smallpox) are shorter-lived but very intense.
Another con is that the editing (on the Kindle version at least) was a little lacking. I noticed a lot of typos, which I found disappointing for a ~$14 Kindle book.
And the last con: There is only a very brief mention of XDRTB (Extensively Drug Resistant TB), which is the latest major stumbling block in the fight against TB. This book was published in 2012, and XDRTB has been a confirmed problem for many years. I thought it deserved more than a mention in the epilogue, especially since it is a problem that stems from people not completing the prolonged treatments required for the effective management of TB.
Overall, this is a good book if you are interested in the history of tuberculosis. It does not contain a lot of anecdotes from people who have had the disease and is instead largely focused on the evolution of treatment.
A few pros and cons:
Pros: The book is well-organized. I never felt "lost" in the timeline of this history of tuberculosis. It also explains in great detail the various phases of tuberculosis treatment, beginning with some of the more ridiculous so-called remedies before the arrival of modern medicine, progressing through the sanitarium phase, and ending with some of the modern approaches to the disease and the influence of drug resistance in modern treatment. The author also discusses the changing perception of tuberculosis, including the periods of time when TB or TB-like symptoms were considered almost fashionable and the role of TB in the eugenics movement.
Cons: Like I said above, pretty dry and a little too technical. I am not a medical professional, and while I found the book to be understandable, some of the nuances of the disease or the development of a TB antibiotic were extremely boring to me. (And I do not bore easily - I have read other books about disease and have largely found the science to be interesting, but this time I couldn't muster up a lot of excitement for it.) In fairness, part of the reason the book and the science discussion felt boring to me may be due to the fact that TB is a chronic disease and not usually acute, so the the disease tends to be protracted, whereas other illnesses I have read about (ebola, smallpox) are shorter-lived but very intense.
Another con is that the editing (on the Kindle version at least) was a little lacking. I noticed a lot of typos, which I found disappointing for a ~$14 Kindle book.
And the last con: There is only a very brief mention of XDRTB (Extensively Drug Resistant TB), which is the latest major stumbling block in the fight against TB. This book was published in 2012, and XDRTB has been a confirmed problem for many years. I thought it deserved more than a mention in the epilogue, especially since it is a problem that stems from people not completing the prolonged treatments required for the effective management of TB.
Overall, this is a good book if you are interested in the history of tuberculosis. It does not contain a lot of anecdotes from people who have had the disease and is instead largely focused on the evolution of treatment.
August 5, 2023
Not an obvious choice, but fascinating and informative. I heard the author interviewed on the radio and went out to get the book. It starts with a case history of George Orwell's progression of TB, and then traces TB through history as well as forecasts the rise of drug-resistant TB. It's not a gripping read in the way a murder mystery is for me, but it is quite gripping. But beware, there are a few really disgusting bits (as I discovered to my cost when I was reading and eating at the same time.... And I'm not normally squeamish.).
February 27, 2018
I've read a number of books on diseases. The history of polio - a horror we've totally forgotten about. The history of the Spanish Flu was fascinating. The history of smallpox was fascinating AND informative. I think I read the book by Betty MacDonald that she references, and it wasn't boring. But this book, for whatever reason, was a doorstop sleeping pill. Is it that tuberculosis is a boring disease? Was it that the writer was boring as a dried cow turd in the middle of the street? There was absolutely no excitement about this disease. For something that's been around for thousands of years and kills relentlessly and is super-drug-resistant, this book was awful. I'm sorry. I'm sorry a tree died for it. I'm sorry she might hear me say this, because she certainly did her research and tried her best. I can't fault her there. Read the first chapter about Orwell. And then put the book back. I'm so sorry.
October 12, 2020
Helen Bynum takes us through the history of Tuberculosis in Spitting Blood. Tuberculosis is an ancient disease. While we might never find its exact origins, it has coexisted with humanity for millennia.
While the book covers the same topic as Catching Breath, I don't have an opinion of which one is better. My Catching Breath review is far more specific than this one. Spitting Blood predates Catching Breath, though.
This book has some graphic descriptions of the illness. It still explains the medical part of the disease, but it also contains personal stories of treatments.
While the book covers the same topic as Catching Breath, I don't have an opinion of which one is better. My Catching Breath review is far more specific than this one. Spitting Blood predates Catching Breath, though.
This book has some graphic descriptions of the illness. It still explains the medical part of the disease, but it also contains personal stories of treatments.
August 12, 2015
I am going to say right upfront, this book is not written in the same great manner in which The Emperor of All Maladies was done. Bynum did a worthwhile presentation of tuberculosis. There was some history in it, some cases, a lot of medical information, just like there is in 'Maladies'. But it is presented way too dryly. And the author did not become intimately involved in her topic, which is what Mukherjee who wrote 'Maladies' did. He had a personal relationship with his cancer patients and it came across in his writing. There is no emotional involvement with this disease by the author, merely a recitation of facts that make up tuberculosis as an ailment.
I'm not saying the book is not readable. Most of it was. At the end I was a little bored because it felt like the recitation of facts of how TB and AIDS are being handled today was worse than the other chapters prior to the final ones. And the thing is, I would have liked to read more personal histories about HIV/AIDS and TB, because I worked in an HIV lab for several years, and I'm from San Francisco.
I think if people are going to write histories of diseases, they need to become a bit emotionally involved in their topic. Why are you writing this book? Merely to fill a gap in current knowledge? That's fine if you are writing to doctors and other medical personnel. But if you want to share information about a disease and how it impacts people for the public at large, you need to share stories, not just statistics.
I'm not saying the book is not readable. Most of it was. At the end I was a little bored because it felt like the recitation of facts of how TB and AIDS are being handled today was worse than the other chapters prior to the final ones. And the thing is, I would have liked to read more personal histories about HIV/AIDS and TB, because I worked in an HIV lab for several years, and I'm from San Francisco.
I think if people are going to write histories of diseases, they need to become a bit emotionally involved in their topic. Why are you writing this book? Merely to fill a gap in current knowledge? That's fine if you are writing to doctors and other medical personnel. But if you want to share information about a disease and how it impacts people for the public at large, you need to share stories, not just statistics.
February 10, 2019
This book, part of Oxford University Press's series on "biographies" of diseases, highlights one disease the haunted humankind for millennia - tuberculosis/consumption. This battle, like its infectious disease brethren of malaria and yellow fever, is as old as recorded civilization. Like most infectious diseases, it has become a victim of its success in that its prevalence is now only among some of the "less desirables" of humanity: The developing world, the homeless, those with HIV/AIDS, and displaced persons.
As with malaria, one can wonder whether tuberculosis (in its MDRTB form - multi-drug resistant tuberculosis) might make a "comeback" someday in the form of a epidemic in the West. All that it would take is a little lackadaisical behavior on the part of a few public health centers in urban environments. Educational works like Bynum's help combat such human tendencies by keeping us aware of these challenges.
Current therapy involves direct observation of ingestion of four medicines which have significant side effects. Communities like immigrants, who face the double whammy of coming from countries with endemic TB and of living in crowded environments which are conducive to TB, can benefit from a dose of preventative medicine in being coached how to be sanitary when living in close quarters.
As with malaria, one can wonder whether tuberculosis (in its MDRTB form - multi-drug resistant tuberculosis) might make a "comeback" someday in the form of a epidemic in the West. All that it would take is a little lackadaisical behavior on the part of a few public health centers in urban environments. Educational works like Bynum's help combat such human tendencies by keeping us aware of these challenges.
Current therapy involves direct observation of ingestion of four medicines which have significant side effects. Communities like immigrants, who face the double whammy of coming from countries with endemic TB and of living in crowded environments which are conducive to TB, can benefit from a dose of preventative medicine in being coached how to be sanitary when living in close quarters.
August 20, 2014
This book was a fairly good retelling of the history of M. tuberculosis, but none of it was particularly new to me (this has more to do with the fact that I read a lot of books about tuberculosis...hey, it's my thing, alright? Deal with it). My main problem was this author's writing style - so, so, soooo dry. My God it was like reading dust. My other main complaint is how she basically cuts off the history at around the year 2002. I mean...come on, this came out in 2012, other things have been happening with TB in the 10 years since then. I want modern history, damn it! I want to know more about what's being done about the fact that people with XDR-TB must needs take about 21 pills a day and receive an injection...Come on, writer! Satisfy my desperate need for more TB-related information now that I no longer have access to e-journals!
Still, a fairly good, comprehensible history of TB. You should read it!
Still, a fairly good, comprehensible history of TB. You should read it!
March 25, 2015
Nice brief history of this ancient disease. It should have been longer as there were many areas that could have been expanded. Conversational style with citations and suggestions for future reading.A few illustrations.
June 28, 2022
I work in the TB Clinic at my hospital, and so I'm overly familiar with the disease. This was an excellent read, and one I would recommend. We all benefit from understanding how TB continues to survive and thrive, and be better about addressing the social determinants of health both locally and globally.
June 15, 2013
A perfectly competent study of TB, from ancient times to modern, with a look at how, in the age of global upheaval (and global travel)the disease has spread, become resistant to various wonder drugs and remained a scourge - even as most of us consider it "cured."
Despite the fact that I have previously enjoyed reading books about disease, I found this one frustrating. I inially felt it was because Bynum is not gifted with an especially fluid style of writing. I later felt that - although this hasn't happened with other books I've read by UK authors -her British style (spelling, sentence structure, slang) was perhaps, an impediment for me, an American reader.
By the time I had finished the book, I wasn't sure which was applicable. But I often had to read full paragraphs at least twice just to follow her thoughts. I can't recall the last time I had such an experience.
Recommended only to those who are truly driven to know more about this subject.
Despite the fact that I have previously enjoyed reading books about disease, I found this one frustrating. I inially felt it was because Bynum is not gifted with an especially fluid style of writing. I later felt that - although this hasn't happened with other books I've read by UK authors -her British style (spelling, sentence structure, slang) was perhaps, an impediment for me, an American reader.
By the time I had finished the book, I wasn't sure which was applicable. But I often had to read full paragraphs at least twice just to follow her thoughts. I can't recall the last time I had such an experience.
Recommended only to those who are truly driven to know more about this subject.
March 11, 2017
Starts well, but drags
I have two basic issues with this otherwise good book. First, the pathology of TB is discussed in less detail than I'd like, and that section would have benefitted from illustrations and discussion of the infection process, which would make what comes next more interesting. Knowing that m. Tuberculosis is aerobic, for instance, explains how it infects the body. I ended up googling for a few hours to fill in the gaps. Second, the second half of the book became a tedious recital of every 20th century plan to control TB, can it lost the human faces that carried the first half. But the bit about ancient medicine was quite good for a nonspecialist, though you could tell sometimes which Loeb she was using by the archaic English. Anyway, worth reading!
I have two basic issues with this otherwise good book. First, the pathology of TB is discussed in less detail than I'd like, and that section would have benefitted from illustrations and discussion of the infection process, which would make what comes next more interesting. Knowing that m. Tuberculosis is aerobic, for instance, explains how it infects the body. I ended up googling for a few hours to fill in the gaps. Second, the second half of the book became a tedious recital of every 20th century plan to control TB, can it lost the human faces that carried the first half. But the bit about ancient medicine was quite good for a nonspecialist, though you could tell sometimes which Loeb she was using by the archaic English. Anyway, worth reading!
November 13, 2014
The writing was not great but the content was interesting and I enjoyed reading it. There were a few confusing parts, where things were not explained clearly (I wonder if the author knew what they meant) and in the early parts it was sometimes hard to understand if the author was stating facts or things that were believed at the time. I wouldn't recommend it if you're not particularly interested in TB, but if you are, it's a good overview of the history of TB from a medical but mostly social perspective.
April 16, 2013
Reasons to read this book:
According to the World Health Organization, tuberculosis (TB) ranks as the second leading cause of death from an infectious disease worldwide, after HIV.
Although the TB death rate is declining, cases of multi-drug resistant TB are on the rise. No one should assume they are safe from infection.
Bynum has written a comprehensive history of tuberculosis, and she avoids the biases that exist in previous publications. Doctors and researchers are not the only heroes, and TB history includes the world, not just Europe and the U.S.
January 6, 2018
3 1/2 stars
A fascinating "memoir" of a disease that has grown alongside humanity since time immemorial. Although it reads as dry as an academic paper at times, the book really shines when it focuses on the daily reality of the TB sufferers and the socio-economic forces responsible for the care, and later treatment, of the disease.
A fascinating "memoir" of a disease that has grown alongside humanity since time immemorial. Although it reads as dry as an academic paper at times, the book really shines when it focuses on the daily reality of the TB sufferers and the socio-economic forces responsible for the care, and later treatment, of the disease.
January 6, 2014
This book takes a fascinating topic and makes it quite tedious. The writing was scattered and there was too much of a focus on the epidemiology of the disease. Would have liked to read more about the pathology of the disease and how the patients experienced the disease.
September 24, 2015
Riveting account of an old fashioned and resurgent disease
The core of the book, relating the past and present of a defining social disease is a page turner. It could do with a different prologue and epilogue.
The core of the book, relating the past and present of a defining social disease is a page turner. It could do with a different prologue and epilogue.
March 22, 2013
Right when we think TB is not a problem, it becomes a problem. This book reminds us to never remove a cautious eye from infectious disease. History repeats itself.
August 3, 2015
Very interesting read. It only took me too Lollapoloozas to read it.
May 9, 2015
very very dull
October 14, 2018
Interesting journey through the history of TB! Also really enjoyed the way the chapters were structured and the examples of ceratin TB cases that the book has in it :)
January 28, 2021
Lots of interesting stuff here, but the style really was quite dry. It’s a shame, because the subject is fascinating and involves so much gritty social history. It’s so relevant to our times too, as the incidence of TB rises again - and I dread to think what the Covid-19 pandemic will have done to reduce access to TB treatment, particularly in developing countries. All in all, I learnt a lot from this book but I wish the writing style had been more engaging - it was a bit of a slog at times.
June 29, 2020
This is more of a medical perspective than a public health perspective so some of the medical concepts and terms were way over my head. Still an interesting read. Just not one of the most compelling books I've read on disease.
March 5, 2023
DNF is a very dense medical text.
August 6, 2025
So dense, dry, and without a shred of personality. Ironically, quite suffocating.
October 10, 2019
For informational purposes, this book is wonderful. It covers all the bases. But for readability? A bit too stiff and technical, not unlike a dry cough.
October 21, 2025
Required reading for HISTORY 2590.
Displaying 1 - 27 of 27 reviews