Tuberculosis Testing

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Slide, 'Tubercle Bacillus in Sputum.'

Slide, “Tubercle Bacillus in Sputum.” Showing the disease-causing bacteria, Mycobacterium tuberculosis. Made for educational and research purposes by the New York City Public Health Department, late 19th–early 20th century.

Tuberculosis (TB) is a disease that dates back at least to ancient Egypt and likely has been with humanity much longer. The bacterial infection can attack many parts of the body, including the kidneys, brain, and spine. It most commonly presents itself, however, as an infection of the lungs. When active, its symptoms include coughing, chest pain, weight loss, night sweats, and fever. If untreated, it can be fatal.

Although no effective cure for tuberculosis existed until the discovery of streptomycin in the 1940s, people have long endeavored to prevent, treat, and test for TB.

The hallmark symptom of pulmonary tuberculosis is the production of thick and sometimes bloody discharge from the lungs. For both discreteness and sanitary purposes, TB patients in the late-19th and early-20th centuries sometimes used sputum cups or flasks to collect their mucus. Glass or metal flasks were rinsed and reused, while disposable paper cups could be burned after use.

 

 

Glass screw top sputum flask, early 1900s

Glass screw top sputum flask, early 1900s

Paper sputum cup, about 1900

Paper sputum cup, about 1900

Fresh air was long considered a beneficial treatment for TB. Starting in the mid-19th century, sanatoria in countryside locales became popular sites for patients to retreat and rest.

A man rests on a roof in New York City at the Bellevue Tuberculosis Clinic, 1909.
Vase, Arequipa Pottery, circa 1913–1916

Left: A man rests on a roof in New York City at the Bellevue Tuberculosis Clinic, 1909. Right: Vase, Arequipa Pottery, circa 1913–1916. Arequipa Pottery was established as a Progressive Era experiment in occupational therapy for tuberculosis patients at Dr. Philip King Brown's private Arequipa Sanatorium near Fairfax, California. King argued that requiring his patients to work in the pottery provided them with moral and physical benefits, and allowed people of limited financial means to pay for the healthcare provided by his facility.

With the success of serum treatment for diphtheria and tetanus in the late 19th century, researchers developed anti-tubercle serum. Unfortunately, the anti-tubercle treatment proved ineffective. Earlier, in 1890, German bacteriologist Robert Koch had introduced tuberculin, which also failed as a TB cure. Koch’s injectable tuberculosis derivative found another important purpose, however, as the basis for diagnosing the disease. By 1907, use of the test led to the discovery that patients could be infected with TB without exhibiting symptoms, a condition known as latent TB.

Anti-tubercle serum, 1898

Anti-tubercle serum, 1898

Lederle TB tine test, about 1976.

Lederle TB tine test, about 1976. A pure, standardized TB test would not become available until the 1940s.

In 1921, French researchers Albert Calmette and Camille Guérin conducted the first trial of their TB vaccine. It came to be known as the BCG vaccine (Bacillus Camille-Guérin), a reference to their work to grow a weakened strain of the tuberculosis bacillus appropriate for use in a vaccine. Although the vaccine does not prevent infection, it does provide protection against the spread of the disease beyond the lungs and into the brain. Vaccination with BCG is not common in the United States, where TB levels are relatively low, but remains important in other countries.

It took researchers nearly twenty years after the first use of the BCG vaccine to develop effective tuberculosis cures. Several of these drugs are still in use today. Streptomycin, the first widely successful antibiotic against tuberculosis, was isolated from a soil sample at Rutgers University in 1943 by Albert Schatz in the laboratory of Selman Waksman.

A sample of streptomycin in a sealed test tube

A sample of streptomycin in a sealed test tube from the first lot produced at Rutgers University and sent to the Mayo Clinic in Rochester, Minnesota, for the first animal trials.

Currently not on view
Location
Currently not on view
date made
ca 1935 - 1968
maker
National Tuberculosis Association
ID Number
2012.0165.609
accession number
2012.0165
catalog number
2012.0165.609
Currently not on view
Location
Currently not on view
date made
ca 1961
expiration date
1961-04-01
maker
Parke, Davis and Company
ID Number
1982.0043.047A
accession number
1982.0043
catalog number
1982.0043.047A
Inscriptions on the commemorative display read:"This brick was laid in a Kansas sidewalk in the early day campaign against tuberculosis and other communicable diseases. Dr. S.J.
Description
Inscriptions on the commemorative display read:
"This brick was laid in a Kansas sidewalk in the early day campaign against tuberculosis and other communicable diseases. Dr. S.J. Crumbine's slogan, "Don't Spit on the Sidewalk', spearheaded the early voluntary Christmas Seal fight to keep Kansans healthy and free from tuberculosis and should be a constant reminder to all citizens that tuberculosis is a contagious disease.
This brick was presented by your Tuberculosis and Health Association in 1958, the 50th anniversary of the founding of the Kansas Tuberculosis and Health Association.
Made by patients of the Southeast Kansas Tuberculosis Hospital, Chanute, Kansas"
Location
Currently not on view
date made
ca 1958
maker
Southeast Kansas Tuberculosis Hospital
American Lung Association
ID Number
MG.M-11152
catalog number
M-11152
accession number
259205
Currently not on view
Location
Currently not on view
date made
ca 1939
expiration date
1942-09-25
maker
Parke, Davis and Company
ID Number
MG.M-04848
catalog number
M-04848
accession number
154611
Currently not on view
Location
Currently not on view
date made
ca 1973
expiration date
1973-04-01
maker
Parke, Davis and Company
ID Number
1982.0043.017A
accession number
1982.0043
catalog number
1982.0043.017A
Disposable cup marked “POCKET SPUTUM FLASK ‘XL’ / Patented / BURNITOL MANUFACTURING CO. / BOSTON, CHICAGO, SAN FRANCISCO.” The inscription on the cardboard box reads “ONE / BUGTITE CUP HOLDER / For The Pocket Cup / D. R. Bulla Co.
Description
Disposable cup marked “POCKET SPUTUM FLASK ‘XL’ / Patented / BURNITOL MANUFACTURING CO. / BOSTON, CHICAGO, SAN FRANCISCO.” The inscription on the cardboard box reads “ONE / BUGTITE CUP HOLDER / For The Pocket Cup / D. R. Bulla Co. / Sophia, N.C.” The Aseptic Drinking Cup Co., of Cambridge, Ma., introduced the term “BURNITOL” to commerce and obtained a trademark in 1906.
Ref: Harry J. Potter, “Collapsible Receptacle,” U.S. Patent 888,653 (May 26, 1908), assigned to Burnitol Manufacturing Co.
Harry J. Potter, “Sputum-Cup,” U.S. Patent 920,180 (May 4, 1909), assigned to Burnitol Manufacturing Co.
Location
Currently not on view
maker
Burnitol Manufacturing Company
ID Number
MG.M-11458.01
catalog number
M-11458.01
accession number
260557
In the 1800s and early 1900s, pulmonary tuberculosis was a major health concern. Those suspected of suffering from the disease might be ostracized, ridiculed, and denied certain civil rights.
Description
In the 1800s and early 1900s, pulmonary tuberculosis was a major health concern. Those suspected of suffering from the disease might be ostracized, ridiculed, and denied certain civil rights. One of the signs of tuberculosis was the production of large amounts of viscous, sometimes bloody, matter from the lungs. As a result, sufferers used objects like this glass pocket flask to dispose of the coughed up mass, without drawing attention to themselves by spitting.
Location
Currently not on view
date made
early 1900s
ID Number
1990.0526.01
catalog number
1990.0526.01
accession number
1990.0526
Currently not on view
Location
Currently not on view
date made
ca 1973
expiration date
1973-05-01
maker
Parke, Davis and Company
ID Number
1982.0043.048A
catalog number
1982.0043.048A
accession number
1982.0043
Currently not on view
Location
Currently not on view
date made
ca 1973
expiration date
1973-05-01
maker
Parke, Davis and Company
ID Number
1982.0043.048B
catalog number
1982.0043.048B
accession number
1982.0043
Currently not on view
Location
Currently not on view
date made
ca 1938
expiration date
1942-09-09
maker
Parke, Davis and Company
ID Number
MG.M-04677
catalog number
M-04677
accession number
147292
Currently not on view
Location
Currently not on view
date made
ca 1905-1935
ID Number
2012.0165.561
accession number
2012.0165
catalog number
2012.0165.561
Currently not on view
Location
Currently not on view
ID Number
2002.0137.027
accession number
2002.0137
catalog number
2002.0137.027
Currently not on view
Location
Currently not on view
date made
ca 1999
maker
Bio-Medical Products Corporation
ID Number
1999.0171.3
catalog number
1999.0171.3
accession number
1999.0171
Currently not on view
Location
Currently not on view
date made
ca 1975
expiration date
1975-04-30
maker
Parke, Davis and Company
ID Number
1982.0043.007B
accession number
1982.0043
catalog number
1982.0043.007B
Currently not on view
Location
Currently not on view
Date made
1939
artist
Kent, Rockwell
maker
National Tuberculosis Association
ID Number
1993.0499.01
catalog number
1993.0499.01
accession number
1993.0499
Currently not on view
Location
Currently not on view
date made
ca 1975
expiration date
1975-04-30
maker
Parke, Davis and Company
ID Number
1982.0043.007C
accession number
1982.0043
catalog number
1982.0043.007C
Currently not on view
Location
Currently not on view
date made
ca 1975
expiration date
1975-04-30
maker
Parke, Davis and Company
ID Number
1982.0043.007D
accession number
1982.0043
catalog number
1982.0043.007D
This appears to be a “Discreet” sputum flask of the sort that was on the market by 1909. An inscription inside the lid reads "GERMANY."Ref: “The ‘Discreet’ Sputum Flask,” Detroit Medical Journal 13 (1913): 71.Arnold Carl Klebs (ed.), Tuberculosis (1909), p.
Description
This appears to be a “Discreet” sputum flask of the sort that was on the market by 1909. An inscription inside the lid reads "GERMANY."
Ref: “The ‘Discreet’ Sputum Flask,” Detroit Medical Journal 13 (1913): 71.
Arnold Carl Klebs (ed.), Tuberculosis (1909), p. 834.
Location
Currently not on view
date made
1890s - early 1900s
ID Number
MG.M-11458.02
catalog number
M-11458.02
accession number
260557
Currently not on view
Location
Currently not on view
date made
ca 1973
expiration date
1973-04-01
maker
Parke, Davis and Company
ID Number
1982.0043.017B
accession number
1982.0043
catalog number
1982.0043.017B
Currently not on view
Location
Currently not on view
date made
ca 1982
product expiration date
1982-08
maker
Lederle Laboratories, Division of American Cyanamid Company
ID Number
2012.0165.746
catalog number
2012.0165.746
accession number
2012.0165
Currently not on view
Location
Currently not on view
date made
ca 1975
expiration date
1975-04-30
maker
Parke, Davis and Company
ID Number
1982.0043.007A
catalog number
1982.0043.007A
accession number
1982.0043
Currently not on view
Location
Currently not on view
maker
Parke, Davis and Company
ID Number
1978.0882.91
accession number
1978.0882
catalog number
1978.0882.91
Currently not on view
Location
Currently not on view
date made
ca 1984
product expiration date
1984-10-04
maker
Connaught Laboratories Limited
ID Number
2012.0165.809
catalog number
2012.0165.809
accession number
2012.0165
Currently not on view
Location
Currently not on view
maker
Mercer Glass Works, Inc.
ID Number
2012.0165.154
catalog number
2012.0165.154
accession number
2012.0165

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