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completely historical cause for the cure. They argue that it is a matter of natural selection, and that what has happened is simply that those humans most susceptible to the disease are now dead. This sort of "local global" is an increasing problem in much science and medical research (Bowker 1994, Latour 1993, Serres 1990). There is a "global truth" heretuberculosis incidence has declined. There are several explanations: the "fit survived" (the susceptible members died out) or human environments changed (better living conditions) or there is now a traditional allopathic cure. It is very difficultif indeed possibleto decide among these three causes. According to the first two, humanity before the "cure" (whichever cure one backs) is not the same thing as humanity after the cure. Either the race will have changed biologically or the infrastructure that makes us what we are will have altered. To complicate matters further, tuberculosis is once again on the rise as its fate intertwines with that of AIDS, global poverty, viral mutation, and international travel. |
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Not only is humanity in motion, carrying the disease with it along this broken and contested path. The disease has its own history. In a series of works put out by the National Tuberculosis Association from 1950 to the present, tuberculosis often figures wryly as an actor in the text; much as Roy Porter (1994) has noted that gout in the eighteenth century had a character of its own. Thus the 1961 edition of the Diagnostic Standards and Classification of Tuberculosis noted that: |
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For our present purposes, therefore, tuberculosis is defined as that infectious disease caused by one of several closely related mycobacteria, including M. tuberculosis, M. bovis, and M. avium. It usually involves the lungs, but it also involves and sometimes produces gross lesions in other organs and tissues. The clinical and pathologic pictures may range from acute to chronic. Its increasing predilection for middle-aged males makes careful study for differential diagnosis [between the strains of TB] more necessary than ever. (vi) |
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There is no need to comment on the irony of the passage's naive faith that middle-aged men were naturally the most important. Tuberculosis taken as an agent traverses history and human bodies, taking hold in some and leaving others in a contingent historical progression. The way it is treated and represented affirms the uneven, hierarchical value given to different patient's lives (Glaser and Strauss 1965). Primary infection used to be associated with children, but now that the disease has become less common it has become rather an adult phenomenon. The disease can hit at different points in the life cycle. It becomes here a mirror composed of nature, culture, discourse, and infrastructure. |
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