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Tuberculosis: Why "The White Plague"?

The imprints that diseases leave upon the societies they have descended upon are reflected in the various terms that have been applied to them historically. Tuberculosis, for example, has frequently been referred to as the "white plague" in years past, although both components of that designation may be called into question. To my way of thinking, tuberculosis has never constituted a plague, and ascribing whiteness to it also raises serious doubts in my mind. According to Merriam-Webster, a plague (from the Latin "to blow or strike") is "an epidemic disease causing a high rate of mortality: pestilence." Although tuberculosis can be traced back to prehistoric times, the most important early descriptions of tuberculosis come from the ancient Greeks, and it is unlikely that they ever considered it a plague. Rest assured they knew a plague when it hit them, the plague of Athens (430-426 bc) being the most famous. It claimed over 130,000 lives in a five-year period and included almost one-third of the city's foot soldiers and cavalrymen. Hippocrates (460-370 bc), who is credited with the best early descriptions of tuberculosis, was alive in Greece during this plague but, fortunately for him, not located in that stricken city. He and other Greeks of the time used the term "phthisis" (from the Greek for "to decay or waste away") to describe the final manifestations of tuberculosis. This emphasized the fact that although the rapidly progressive pulmonary form of the disease, which later came to be called "galloping consumption," could take off a victim in a relatively short time, many patients lived for a great number of years, sometimes as many as 20 or 30, before succumbing. The terminal phase of phthisis, with extreme weight loss, was, at least in some patients, probably due to malabsorption of foodstuffs and diarrhea secondary to intestinal involvement; these symptoms