Spitting Blood: The History of Tuberculosis, Helen Bynum
I was enthusiastic for this book, because I’m enthusiastic about tuberculosis, but my actual research for my dissertation only extended to the current state of affairs in the UK (with a sprinkling of context from other countries that helped explain patterns of prevalence). Unfortunately, it’s very dry, and kinda lacking in real… judgements about the narrative. Like it’ll discuss a particular type of treatment, but only historically, without reference to whether it actually worked, what the off-target effects might be, why it might work on the occasions that it did actually work.
It does have some scientific detail, but it’s more along the lines of why people thought x and y. As the narrative gets toward the present day, there are some more details — and some I didn’t know, like the fact that the need for multi-drug regimens was known pretty early on. I thought the reason resistance arose was because monotherapy was used exclusively until quite recently, but it’s a bit more complicated than that.
(Part of the complication is that TB is just really very tricky, without any need for monotherapies giving it the chance to mutate. It has great efflux systems to pump most types of antibiotics out of the cell, it gets inside your macrophages and then makes the phagosome unable to fuse with the lysosome so it can sit pretty inside your cells, and it has a whole bunch of potential mutations that allow it to neutralise the main antibiotics in some way or another. This info isn’t in the book, this is from my dissertation, though.)
Anyway, it filled in some of the background knowledge I lacked, but it was dry and lacked urgency. I found Kathryn Lougheed’s Catching Breath far better back when I first read it, when it was the book that got me interested in TB to begin with!
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