Tuberculosis was long considered to be hereditary because no causative agent had been identified. Therefore, it carried a social stigma although the disease was so common that almost every family had at least one “consumptive” member.

Identifying the cause. This began to change in 1868 when the French physician Jean-Antoine Villemin proved that TB was contagious. He showed that it was spread through sputum and blood and could spread from humans to animals. Many did not believe his research, however, until the German microbiologist Robert Koch isolated the causative agent in 1882: a rod-shaped bacterium now called Mycobacterium tuberculosis, or simply, the tubercle bacillus.

Although it would be decades before a cure was found, these discoveries changed the way health professionals and the public viewed the disease. Now it was clear that even a single cough or sneeze might contain hundreds of bacilli, which would manifest independently of morality or cleanliness.

Preventing TB. Long before Koch isolated the tubercle bacillus, physicians had tried to identify preventive methods to limit the disease. Faced with new information about tuberculosis as an infectious disease, people now saw the possibility of contagion everywhere they looked.

One approach was positive: to adopt healthful habits and avoid spreading the disease. The other approach had some unfortunate social consequences: to avoid people infected with tuberculosis and further alienate them from society.

Clean air, healthy food, sleep. Physicians and public health officials promoted healthful habits that could help prevent tuberculosis. These healthful habits were also promoted by the National Tuberculosis Association, the Virginia Anti-Tuberculosis Association, and many other public health organizations across the country.

Anti-spitting campaigns. Because the tubercle bacillus could survive a whole day in sputum, it was immediately clear that the widespread habit of spitting was dangerous to public health. Across the country, cities and local governments began campaigns to wipe out the habit.

 

Anti-spitting posters: "For My Sake, Don't Spit," 1920 [left]; "Spitting is Dangerous and Illegal," 1943 [Above, Right]

American Lung Association of Virginia (ALAV) Collection.
Historical Collection & Services, Claude Moore Health Sciences Library, University of Virginia.

Further Information:

• “Don’t Spit on the Sidewalks”
• Public Health Campaigns