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Phthisiotherapy & Preventoria

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DVD Smith
1271033.  Wed Jan 17, 2018 9:04 pm Reply with quote

When was the last time you saw your local phthisiotherapist?

That's not a typo – phthisiotherapy is the treatment of tuberculosis, with the term dating back to at least 1889. [1] Along with "phthisiology" and similar words, it comes from the Greek phthisis, meaning "consumption", the historical term for TB. If you’re struggling with the pronunciation of the phth- sound, you can either pretend the ph is silent and say “thisiotherapy”, or use the alternative American pronunciation which reduces it down to a hard t (for “tisiotherapy”). [2]

Phthisiotherapy is responsible for the modern-day obsession with sunbathing and tanning. [3][4] Medical professionals in the early 20th century recommended exposure to sunlight as a treatment for TB (known as heliotherapy or phototherapy). In fact, the 1903 Nobel Prize for Medicine was awarded to Niels Finsen for his contribution to the treatment of lupus vulgaris, a particular strain of TB, using light radiation. [5] The use of sunlight and ultraviolet (UV) rays became more popular as the 20th century unfolded, and eventually it was being touted as a treatment for loads of illnesses, which led to the perception that having tanned skin was a symbol of someone who was healthy and attractive. The cultural shift from pale skin to tanned skin seems to have happened over the 1920s – a study of magazine articles and ads from 1920 to 1929 showed a marked decrease in mentions of the popularity of pale/bleached skin, and a marked increase in mentions of tanned skin being fashionable. Exposure to sunlight and UV rays remained the primary recommended treatment for TB and other diseases until the discovery of antibiotics in the 1940s. [3]

Tuberculosis is also thought to have shaped UK/US fashion in quite a significant way. [4] The symptoms of TB can be linked to the conventional perceptions of feminine beauty that developed in the 1800s, including thinness, pale skin, rosy cheeks, red lips and silky hair. This led to women wearing corsets and wide long skirts to enhance their narrow waists, and use make-up to give themselves rosy cheeks and red lips. When it was discovered that TB came from a contagious bacterium, phthisiologists encouraged women to wear shorter skirts so that they didn’t drag on the floor and drag TB-infested filth into their house (as seen in campaigns such as this poster, depicting a woman with a long skirt and the Grim Reaper standing behind her). When skirts became shorter, women’s feet became more visible - and so shoes became a more important component of women’s fashion, and they still are to this day. And as for men, the Victorian fashion of big beards, sideburns and moustaches fell by the wayside at the turn of the 20th century, as abundant facial hair was considered too unhygienic and too likely to house bacteria. [4]

Starting in 1909 in the US, children thought to be infected with a dormant strain of TB would often be sent to a “preventorium” to make sure they had access to clean food, exercise, clean air and enough sunlight. Children aged between 6-15 would often stay at preventoria for months or even years at a time, with parents only allowed intermittent visits. These weren’t small facilities either – in 1926, the Blue Ridge preventorium in Virginia had room for 210 children. [6]

The name “preventorium” comes from the aim of the institute to stop any dormant TB from manifesting itself as symptoms, and to stop the children from contracting the disease later in life. For this reason, most preventoria were located in rural areas alongside adult TB treatment facilities, miles away from the populous, polluted cities. Exposure to fresh air was considered critical, and so most nights the children would sleep outside in what were called “sleeping porches” - regardless of the weather!

The practice of preventoria died out in the 1940s-50s, when it was decided that rather than taking children away from their parents for months at a time, it might just be better to eradicate the TB at the source instead. [6]

[The section on preventoria above could also be used for the Q series under "Quarantines".]

1271079.  Thu Jan 18, 2018 7:04 am Reply with quote

I can remember people suffering from TB being sent to German/Swiss Kurorter (pron Koor-orter) - I'm talking 1950s-60s. These were often lengthy stays. Kurort is usually translated into English as spa, but that is not really correct. Spas are considered luxurious places where you can get yourself pampered, enjoy the clean air, etc.
Kurorter are originally more of a medicinal nature; it was serious business. Especially children were sent there to recover, usually for weeks. They often would have to sleep out in the open (regardless of the weather!). It did seem to work.

DVD Smith
1271081.  Thu Jan 18, 2018 7:16 am Reply with quote

That's curious that the Kurorter were still open after antibiotics became available, you'd think they'd close down around the same time as the American equivalents.

Was availability/cost of the medicine an issue? Or did they just think the Kurorter was more effective as a treatment?

1271084.  Thu Jan 18, 2018 7:21 am Reply with quote

Were still open? They are still open (and flourishing), but probably more luxurious than in the old days, where medicinal spas and clean air were the main things on offer.

I don't really know the details - we'll wait for AFB to butt in. :-)

DVD Smith
1271085.  Thu Jan 18, 2018 7:24 am Reply with quote

Wow, didn't realise they were still open! I'm guessing not as a TB clinic though, lot less demand in Central Europe these days :)

1271091.  Thu Jan 18, 2018 7:41 am Reply with quote

Straight after WW2, thousands of children from all over Europe were ferried to Switzerland by the Swiss Red Cross, so they could regain their health. Here's an article (in German) but scroll down to the pictures - you should be able to make out where the various groups hailed from. And there's one picture of a row of children indeed laying outside, wrapped up in blankets.


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