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means "waning like the moon." During their long, slow decline many sufferers, like Laennec, went on to leave their mark on history. When the great American philosopher Ralph Waldo Emerson was just a divinity school student he wrote that he felt "luke-sick", as one might say "lukewarm", and as if a "mouse was gnawing at his chest." Emerson continued to suffer from symptoms of chronic tuberculosis throughout his life - although he lived to the age of seventy-nine. The philosopher Henry David Thoreau lived and worked with tuberculosis. A tubercular Chopin was still able to write his renowned music. And many writers had TB: Robert Louis Stevenson wrote Treasure Island and Dr. Jekyll and Mr Hyde, and Stephen Crane wrote The Red Badge of Courage, while harboring Mycobacterium Tuberculosis. The Bronte sisters suffered from tuberculosis, as did their whole family, but the managed to give the world the classic novels Jane Eyre and Wuthering Heights. One wonders what more these people would have done if they had not been luke-sick.
In fact, so many brilliant young artists suffered from tuberculosis that people began to think that either genius made on susceptible to the disease or the disease itself gave one particular insight. In literature, characters with tuberculosis were likely to suffer as much from their passionate nature as from the disease. In the classic eighteenth-century Chinese novel The Dream of the Red Chamber, beautiful, young Black Jade dies of tuberculosis at the very moment her love is married to another woman.
In fact, a more likely reason passionate artists were dying was that tuberculosis was a disease of the city: the close contact between people that made the cities so stimulating for artists provided the perfect opportunity for the tuberculosis bacillus to travel from lung to lung. Droplets of TB germs exhaled out of doors could dry out before finding a lung, but in the crowded rooms of the city, people breathed in one another's breath again and again.
And among the poor, who were contnually overworked and underfed, tuberculosis found one vulnerable host after another. So it was that tuberculosis, which had infected humans for thousands of years, had its change to flourish only when people lived in cities. When the Scottish explorer David Livingstone traveled through rural Africa in the mid-nineteenth century, he found very few people with tuberculosis. The same was true of Native Americans when Europeans first came to America. The disease was not unknown, the way smallpox was, but among fairly healthy people living in scattered small groups, like the Native Americans, tuberculosis did not flourish. But after Native Americans were moved to crowded reservations, it ran rampant. And today in African cities, larger and more crowded than anything Livingstone saw, tuberculosis is a leading killer, especially where there are large populations infected with human immunodeficiency virus, or HIV, the virus that causes AIDs. HIV makes one especially vulnerable to TB.
In Japan, from 1910 to 1950, the growth of cities brought about a tuberculosis epidemic that was to be the country's worst experience with infectious disease in the twentieth century. The stage of the epidemic was set at the turn of the century as the country's six largest cities - Tokyo, Yokohama, Nagoya, Osaka, Kyoto, and Kobe - swelled with people from the villages seeking work. They arrived from the countryside penniless and desperate for any kind of work to save them from the poverty they knew at home. Mnay found jobs in the Japanese silk and cotton industries. They stayed in crowded factory dorms an put in fifteen- or sixteen-hour days in crowded, unventialted factories. they were given no more than thirty minutes to eat and no time to wash before meals. As the workers slept and worked in shifts, their futons were never empty, their shared bedding never given time to air out. When tuberculosis found these factories, it thrived. When workers got sick,