Tuberculosis (History)

The present investigation was carried out to determine the possible bioactive components of tuber of Ruellia tuberosa L. (Acanthaceae) using GC-MS analysis. Twenty five compounds were identified. The prevailing compounds in the ethanol extract of tuber of R. tuberosa were Lupeol (68.14%), Stigmasterol (8.89%), á-Sitosterol (3.99%), Sucrose (2.24%), Cholest-5-ene, 3-bromo-, (3á- (2.24%), Octadecane, 2-methyl- (2.10%), Nonadecane, 2-methyl- (1.93%), Eicosane, 2-methyl- (1.79%) Heptacosane (1.43%) and Heptacosane (1.29%).

The present PhD thesis aims to study architecture for tuberculosis in Portugal, in particular sanatoriums, from its context and project until its decline. This health equipment, distinguished from similar types, constitute a remarkable and singular presence in the universe of architecture between 1850 and 1970, and with which one can observe the mutations during more than one hundred years of existence. On the other hand, they are a mirror of scientific and programmatic changes to combat the disease that depended, to a great extent, from its architectures.
From construction of data scattered by several archives – since the National Assistance to Tuberculosis' own file was not found, which protected the sanatorium processes in Portugal – resulted in a set of information that justifies a thorough historiographical analysis, from several research lines or visions, to the architecture for the white plague.
Based on a broad picture of its evolution, from its origins (analyzing its assertion as sanatoriums, as well as its own functionality) until its dematerialization or reformulation, three fundamental points for the approach were constituted. A first one, constituted by the historiography of the architecture to combat the disease, related to the seemingly similar types, and where architects, the protagonists, are studied in their preponderance, constituted the necessary framework to the understanding of the phenomenon. Grammars and aesthetic languages, formal architectural approximations and spatial configurations, between sanitariums and other architectures of similar scope, are analyzed in the light of cause-effect processes and, where possible, with international relations. On the other hand, the same chapter is designed to build the influence of international panoramas and the construction of vector stipulations with Portuguese systems.
Each of the key architects is associated with their works, in constant comparative and associated reading. In addition to this focus, one travels between urban readings resulting from hygienic processes (notably at the hinge of the nineteenth and twentieth centuries) and the architectural scale of the various buildings, particularly hospital buildings. The bodies with decision-making power over architects and architectures are also analyzed, in particular with the eternal paradigms of the various modernities and possible interpretative readings of the various governmental moments to which sanatoriums are transversal. Between tradition and modernity, the various models are analyzed, for the typological consolidation of the sanatorium as architecture and as therapy.
A second chapter takes parallel structure but related to the history of tuberculosis, its evolution, therapeutics and consequences for the sanatorium program. From the first scientific considerations regarding tuberculosis, its definition and consolidation as a discipline, through its transitions and ending in the structuring of its fight, are revealed the multiple phases and layers of the organization and power, by the architects, doctors and political decision-makers. Meanwhile, and before the beginning of the end, a series of premises and definitions of devices, networks and systems that marked the path of the sanatorium as a system and as a device for the disease are stipulated.
In this way, a third chapter – the body of the thesis – takes place, where the points and the questions that are placed in these architectures are carefully studied. A first concept argues about the first sanatorial architectures in Portugal, with the particular cases of Madeira and Serra da Estrela, between the international pioneering spirit and the consolidation of a propagated treatment by sea and altitude. Subsequently, through the consolidation of treatment centres, we come to the comparative analysis of sanatoriums, architectures, architects, physicians and, necessarily, the constantly changing sphere of power that has surrounded them, from financing, planning, approval and execution. There is a concern about the consolidation of modern importance – both in programs and in buildings – and its evolution, especially with the hygiene rules of transition and during the “Estado Novo”, reflected in the institutions and as a mirror of the concerns of the pandemic without effective treatment.
Its differentiating elements, such as healing galleries, gardens, equipment and spatial configurations, are correlated between different categories or parallel to other systems, along with styles and architectural grammars, by the pencil of key architects and their works.
One concludes by highlighting the main ideas, the possible responses and consequent analysis of the results, providing clues to future research considerations.
The universe of research and consolidation of information is presented in the second body (annexes), with its own structure that allows the individual understanding of all sanatoriums studied, supported with the respective textual and graphic documentation, synthesized in their individual files.

This essay suggests that there is great value to be gained from looking at the history of the major threats to health that humans have endured throughout human (and even hominin) history.  The possibilities for multi-disciplinary work in the field of global health history have never been richer.  Work in genetics, paleopathology, and traditional forms of documentary History can now be combined to reconstruct the histories of the oldest global diseases (tuberculosis and leprosy) to the newest (HIV/AIDS).  All these narratives show the need to think systematically about the manifold forces that create and sustain diseases throughout the world. http://www.ashgate.com/isbn/9781409409243

In 2002, Margaret Gowen and Co. Ltd. undertook the excavation of a cemetery in the town lands of Augherskea, Knockmark, Co. Meath as part of the Bord Gáis Éireann Pipeline to the West project (NGR 251668.45/291678.5). Considerable disturbance to the site had occurred prior to any archaeological involvement. The site lay in the lowest terrace of the Derrypatrick River within an area of known medieval landscape. Three main areas were identified: a cemetery, agricultural areas to the east and habitation to the west. All were considered to be contemporaneous and early medieval to medieval in date. Geophysical survey indicated that the cemetery area extended beyond the north-south limits of the excavation. The east-west portion was fully excavated and measured 63m in width, resulting in an approximately square burial ground, bounded by ditches. A total of 187 burials were identified by the archaeologists; the majority were E-W aligned and supine.The recorded assemblage consisted of 18 juveniles and 101 adults for whom an age group could be determined. There were 51 “adult” and 6 “subadult” burials. Amongst the pathological conditions noted were a probable case of secondary hypertrophic osteoarthropathy, possible aget's disease of bone and a number of fractures, together with cranial (weapon) trauma and three (probably four) decapitated adult males.

Tuberculosis is a major problem aftd rapidly spread disease ift all over the world. Accurate diagftosis is the key to cofttrolliftg the disease. Traditioftal methods like tuberculift skift test (TST), Acid fast staiftiftg produce results that are iftaccurate or take m ore tim e to detect. This paper preseftts aft autom ated approach to detect tuberculosis usiftg chest radiographs. Chest radiographic images is choseft to detect tuberculosis. Ift the existiftg method, cavity detectioft, ribs aftd diaphragm elimiftatioft is difficult to examifte tuberculosis ift chest radiographs. To overcom e the difficulties luftg regioft is extracted by usiftg registratioft based segmefttatioft m ethods. Segmefttatioft of luftg regiofts is performed after the registratioft process to haftdle complex segmefttatioft problems. The perform aftce of our system is evaluated by usiftg two datasets: Mofttgom ery coufttry (M C) aftd Japaftese society of radiology(JSRT) dataset aftd compare the results with the existiftg m ethod to determifte the accurate results.

A tuberculose é o epítome, desde o dealbar do século XIX ao século XX, da hecatombe de óbitos em Portugal e Mundo. A constante experimentação de profilaxias e tratamentos é o rastilho da criação de uma arquitectura de sistema sanatorial evolutiva e metamórfica, perante o programa médico e social vigente.
A estereotomia e a morfologia funcional do sistema tipológico sanatorial assume-se com um possível carácter hoteleiro e de repouso, com o Hospício Princesa D. Amélia, no Funchal, mas apenas assume uma posição de charneira com os primeiros sanatórios de tuberculose respiratória com os dois grandes pólos sanatoriais na Serra da Estrela (Covilhã e Manteigas, c. 1890-1904).
As construções em blocos isolados, de carácter pavilionar, com base em princípios higiénicos que ainda aguardavam a sua prova científica, transformam-se de adaptações habitacionais a espaços com ventilação, orientação e espacialização muito própria, contrastando com os congéneres edifícios hospitalares já existentes.
O contexto histórico de experimentalismo e de exploração climatérica, geográfica e médica permitiu a Sousa Martins, entre outras importantes personalidades, fundamentar o desenvolvimento de uma “estância de tratamento e cura” capaz de suprimir as crescentes e preocupantes necessidades de solucionar o problema do isolamento e do tratamento dos tuberculosos, que assolavam – em catadupa – a população portuguesa. A partir da notícia, amplamente divulgada, que um antigo doente de Sousa Martins, que passara a habitar a Serra da Estrela, tinha sido comprovadamente curado e liberto de tal doença, e a impotência perante a medicina originam uma confluência para esta parte da montanha, onde foram criados os primeiros bairros para tratamento num suposto regime sanatorial empírico, aberto e onde as medidas de “estrangulamento social” que viriam a ser impostas pela peste branca não são ainda ratificadas.
Com os princípios altimétricos e climatéricos, e com o crescente tráfico e confluência de informação médica, a Guarda apresenta-se como uma solução mais completa, no que diz respeito às infra-estruturas existentes e no apoio de “metrópole” local, e cujas condições sanitárias são manifestamente superiores às da congénere Serra da Estrela.
É nesta cidade que arquitectos de renome nacional, e que vão marcar a historiografia da arquitectura portuguesa, como Raul Lino, e onde é erigido o Sanatório Sousa Martins (1905), e onde se experimenta afincadamente os falhados “milagres” médicos na pandemia sem cura. Por outro lado, assiste-se ao completo falecimento da Serra da Estrela, deixando cair a tão procurada cidade sanatorial.
O Sanatório Sousa Martins é a marca indelével de como a arquitectura poderá, então, ser concorrente desafiada do conhecimento e aplicação dos campos da medicina e da farmacologia. Por outro lado, é um conjunto de pavilhões isolados, quer do ponto de vista de estratificação social – ponto de vista que foi modificado pela recorrente mudança de princípios beneméritos, de sustentabilidade e, mais tarde, por uma eminente ocupação das classes abastadas – apresenta uma arquitectura claramente diferenciada, com galerias de cura completamente pensadas para o efeito (e também com as primeiras observações da medicina voltada para a helioterapia), com princípios higiénicos muito claros e modernos, baseados em literatura internacional, e onde Portugal perde o fôlego inicial de pioneirismo internacional. A arquitectura mostra já a sua disposição para mudar de plano, enquanto exterioriza fortemente uma futura controversa arquitectura nacional.
O sanatório de Portalegre (1907), dá origem a sanatórios de planície, preconizando a desvalorização do clima e da altitude, e impulsionando os primeiros dispositivos médicos e quimio-terapêuticos que, à revelia da grande importância publicitada pela imprensa médica e noticiosa da época, se mostra ineficaz a e até contraproducente. Os edifícios pavilionares, depois ligados, segregam a unicidade arquitectónica.
A profilaxia e terapêutica da tuberculose, no princípio do século XX, tem como grande (e único) pilar a arquitectura. para o controlo, por um lado, e para a possível condução assistida da doença e resquícios de cura, que podem ser estudados por estes primeiros sanatórios. Os equipamentos sanatoriais da Serra da Estrela, até agora desconhecidos, serão analisados neste artigo, tal como os posteriores e contrastantes sanatórios da Guarda e de Portalegre, nas principais confrontações da história da medicina, devidamente incorporadas no seu tempo e no seu contexto, para que esta abordagem multidisciplinar permita a descodificação da importância que a Arquitectura e Medicina, em conjunto, tiveram perante a doença, e como estes exercícios são marcantes e icónicos no plano da história e teoria da arquitectura em Portugal.

Actualización de la bacteriología clínica moderna, se describen las bacterias que producen patología infecciosas y se estudia cada género bacteriano de importancia médica desde la perspectiva de su reciente ubicación taxonómica.
ISBN: 958-683-052-7

A tuberculose em Portugal assolou grande parte da população, enquanto pandemia e flagelo social, conciliando um diagnóstico de morte eminente ou agonizante sofrimento com um alargado comprometimento entre medicina e arquitectura.
A arquitectura, disciplina aliada a esta doença desde os primórdios das tentativas de terapia – falhadas – desde a segunda metade do século XVIII aos anos 40 do século seguinte, assegurou um papel de protagonista nos métodos paliativos obrigatoriamente prosseguidos pelas vigentes técnicas e conhecimentos médicos, a nível nacional e internacional.
No caso de Portugal, não foi diferente: desde a Monarquia Constitucional ao Estado Novo tomaram lugar medidas de profilaxia e tratamento da doença, de mão dada com os médicos mais conceituados. As primeiras referem-se principalmente ao desenvolvimento da arquitectura como abrigo, passando pelo efeito de contentor meramente profiláctico, até ao grande desenvolvimento dos fármacos tuberculostáticos de grande espectro e com altas taxas de sucesso, em que a edificação e projecto de grandes e desenvolvidas estruturas arquitectónicas se transporta a segundo plano.
É neste contexto político, social e económico que é projectado o Grande Hospital Sanatório de Lisboa, pelo arquitecto Vasco Regaleira, edificação de grande porte, morfologia de monovolume e que experimenta, ao longo do desenvolvimento do projecto, vários conceitos, diversas configurações espaciais e funcionais, e é alvo de diversas modificações suturadas pelas grandes decisões centrais e ministeriais.
O manifesto interesse no estudo e futura edificação deste edifício data de 1936, pelo ministro Duarte Pacheco, e dá lugar a vários projectos, sendo o último de 1946, com indicações precisas dos médicos que acompanharam o processo, tal como as referências arquitectónicas e estilísticas que deveriam orientar tal projecto, “sóbrio de linhas, síntese das diferentes partes, suas componentes, e por simples marcação de planos (…) dentro das mais modernas prescrições e de harmonia com o programa estabelecido”, ao mesmo tempo que se modifica o normalizador carácter “pavilionar” para uma edificação única. Nunca chega a ser edificado, culminando na sua morte em 1946.
Pretende-se indagar sobre estas alterações, marcantes na história da arquitectura hospitalar e no programa médico vigente, tal como estudar o carácter arquitectónico deste peculiar edifício, nunca estudado, com capacidade para cerca de 1200 camas, comparando-o com a tipologia hospitalar polivalente, utilizando modelos dos contemporâneos Hospital de Sta. Maria e de S. João.
Avaliar-se-ão as ligações intrínsecas entre Medicina e Arquitectura, nos seus contextos e vicissitudes, as considerações políticas e decisórias, as orquestrações económicas da época e a sua consequente morte prematura.
(1) Memória descritiva e justificativa do Grande Hospital Sanatório de Lisboa (1940). IHRU, Arquivo da DGEM, ref. PT DGEMN: DSARH-013-0039/01, pp. 12-30

The Emotions of Internationalism follows a number of international people and institutions active in the Alps in the 1920s and 1930s, exploring how they understood emotions and how they tried to employ them to achieve their political and non-political goals. Through the analysis of a broad spectrum of unpublished archival materials in four languages (English, French, Italian, and German), this study takes readers on an evocative, historical journey through the Alps. A wide range of characters populate its pages, from Heidi and the protagonists of novels and films set on the mountains, to Woodrow Wilson and other high-level political figures active both inside and outside of the League of Nations, to the alpinists and climbers engaged in hikes and international congresses, to the many children involved in camping trips, to the countless patients of the sanatoria for the treatment of tuberculosis which for decades used to dot alpine villages and to excite the popular imagination.

At the centre of the volume are people's emotions-real and imagined-from the resentment left after the First World War to the 'friendship' evoked in speeches and concretely implemented in a number of alpine settings for a variety of purposes, to the 'joy' that contemporaries saw as the key to navigating the complexities of 'modernity' and to avoiding another war. The result is a compelling overview of the institutions and people involved in international cooperation in the 1920s and 1930s, understood through the lens of the history of emotions.

Chemotherapy is the most potent therapy for treatment of tuberculosis. In the chemotherapy of tuberculosis, resistance associated with treatment failures emerged and has become a common occurrence all around world. The multi-drug therapy is used to prevent the emergence of drug resistance mutants during the long duration of treatment. Resistance can be defined as single-drug, multi-drugs, depending on the number of drugs and/or which drugs are involved. The drug resistance tuberculosis more prevalent, lack the resources to implement adequate measures to control even the susceptible types of the disease. A high prevalence of primary multidrug-resistant tuberculosis, previous treatment for TB predisposes to the selection of multi drug resistance organisms and non-compliance is a major factor in allowing the resistant organisms to survive.

Tuberculosis is a complex disease that involves biological, genetic, physical, social, political and economic factors. The World Health Organisation estimates that two billion people have been exposed to Mycobacterium tuberculosis and carry a latent infection, while an estimated 10% of these people have an active tuberculosis disease. Antibiotics have moved treatment away from sanatoria, but surveillance of tuberculars continues. The availability of antibiotics has also extended the medical gaze to include people with a latent infection. From people with a latent tuberculosis infection to people with active tuberculosis disease and those with co-infection, this paper examines the constellations of pulmonary citizenship forged by medicalisation, treatment surveillance, and social stigma. While the discovery of antibiotics in the 1950s cemented medicine’s authority over tuberculosis, the process of medicalisation began in the 1870s with the characterisation of the mycobacterium and gained momentum in the 1920s with the production of a vaccine. In addition to a medical condition, tuberculosis fast became a moral category that gave force to norms of hygienic citizenship. In this context, people at-risk of developing the disease but not yet exhibiting symptoms have been encouraged to understand their bodies as a site of necessary sanitation. The differential sorting of groups by diagnostic categories, hygienic imperatives, and stigmatising labels has given rise to contested notions of patient rights and responsibilities. As medicine struggles to retain its authority with the rise of multidrug resistant strains of tuberculosis, the social model offers useful perspectives to examine cultural practices, structural violence, and moral obligations.

A group of 10,500 skeletons were archaeologically excavated from the cemetery of the medieval hospital and priory of St Mary-without-Bishopsgate (Spitalfields), London, England. The osteological analysis of the sample is ongoing until 2006 and this paper aims to report some of our initial findings, with particular reference to the prevalence of tuberculosis in the medieval population. In the sample of 1,654 skeletons studied so far, twenty-eight individuals were found to have the skeletal signs of tuberculosis (a crude prevalence rate of 1.7%). Initial trends suggest that the greatest prevalence was found in teenage and young adult individuals (12-25 years of age) and that more males were affected than females. The study of this un-paralleled sample from an urban medieval population has the potential to allow for a better understanding of tuberculosis throughout the entire life-course. In the future this bioarchaeological data, considered in combination with an un-rivalled understanding of the living conditions in medieval London, as derived from a wealth of literary and archaeological sources, will provide a unique opportunity to examine the prevalence and effects of this infectious disease within the urban environment.

Predominant aetiological beliefs about tuberculosis in the nineteenth century went from it being a chronic disease that was caused by a hereditary disposition, known as a diathesis, to a curable disease caused by a contagious bacterial pathogen, known as bacillus tuberculosis. The catalyst for this change is widely recognised as Koch’s discovery of the bacillus in 1882, but that change was not immediate. Other physicians argued that there was no evidence of its contagious nature, whilst proponents of a diathesic paradigm refuted all assertions that the disease could be passed from person to person. This paper looks at the transition from a diathesic paradigm of tuberculosis to one of contagion, and questions the widely held belief that the change was universally accepted and swiftly adopted. Through the quantitative analysis of cultural change using large-scale archives of digitised print culture, this paper aims to show that the simple narrative of key events that have altered our understanding of tuberculosis cannot be maintained. Only be reassessing the way we view change from an academic and popular perspective can we strive to fully appreciate the world in which this change was occurring, and the lives of the people whom this was affecting.