In Moulin Rouge, set at the turn of the 19th century, Nicole Kidman plays Satine, a courtesan who looks great while suffering from a cough caused by consumption. Just what is consumption, how deadly is it, and is it still around?
The word “consumption” first appeared in the 14th century to describe any potentially fatal wasting disease–that is, any condition that “consumed” the body. But over time it came to apply more specifically to tuberculosis. Although the word “tuberculosis” first appeared in 1860, it wasn’t until 1882 that German physician Robert Koch identified the rod-shaped bacterium that caused the illness. While tuberculosis can affect many parts of the body, such as the bones or digestive tract, its greatest affinity is for the lungs. When actively infected people cough or sneeze, they spread droplets that can be inhaled by others. It usually takes prolonged contact to contract an infection, and even then the immune systems of healthy people can effectively contain the exposure. But in people with an active, late-stage case of TB, the lung tissue gets eaten away by rapidly expanding colonies of bacteria. Victims may experience weight loss, fever, night sweats, and coughing up of blood-filled sputum. Despite the movies, it is not a pretty way to die.
Tuberculosis was a great killer at the time Moulin Rouge is set as many poor people crowded together in rapidly expanding cities. Occurrence began to decrease with better sanitation, housing, nutrition, and understanding of how to control the spread of the disease. Then, in the 1940s, antibiotic treatment brought a cure and rapid decline of TB incidence. But it remains deadly, particularly in many parts of the developing world. The 1980s also brought a resurgence in the West with the occurrence of AIDS, which damages the body’s ability to fight TB, and with the advent of antibiotic-resistant strains of the disease.
TB has a long artistic pedigree. Greta Garbo was a consumptive courtesan who expired exquisitely in the movie Camille in 1936. That film was based on Dumas’ La Dame aux Camelias, which also inspired the Verdi opera La Traviata. Puccini’s La Boheme also features a heroine dying of consumption. Thomas Mann’s novel The Magic Mountain is set in a tuberculosis sanitarium, and Chekov, in his first play, Ivanov, features a wife dying of the disease. TB also ended many artistic lives, including those of Chekov, Chopin, Kafka, Keats, and Orwell.