The best remedy: good nourishment and congenial circumstance
Tuberculosis made the news again in March, when the WHO announced that inadequate treatment across the world was enabling drug-resistant strains of the germ to multiply.
Dr Mansfield recalls reading about the village of Papworth Everard in Cambridgeshire. The policy of the day was to relocate families afflicted with TB in settlements designed to restore them. Papworth was one, opened in 1917 and active until about 1970. He writes:
“Residents there were much blessed, particularly for the times. Their homes were airy, bright and spacious. All had gardens. The schools were generously designed in the same way, with rest periods during the day for those who needed them. There were factories, too, providing similarly congenial work for the breadwinners. And the Settlement had its own hospital.
“So why did Papworth close as a Settlement, and become an ordinary village with an extra-ordinary heart hospital? For the best of all reasons – it cured people. So did the other Settlements around the country, aided of course by improved public hygiene, nourishment, and pharmaceutical treatment. So we ran out of candidates to resettle.
“Drugs were by no means the primary driver. The Settlements had grown out of a movement for Garden Cities, begun about the same time. Salt, Leverhulme and Cadbury can be credited for their Model Villages, but the Garden Cities Movement recognised the need everyone (not just employees and the sick) has for congenial living conditions, which would prevent TB and other public health scourges in the first place. Letchworth and Welwyn were the only two to be built, but they led to the New Towns movement along similar lines. Many more of these were spawned, the best known being Wythenshawe in Manchester and Speke in Liverpool. Basildon and Milton Keynes are just two large modern settlements originating in these ideas. This impulse eventually led in 1961 to the Parker Morris Standards for the construction of houses, now incorporated into the Building Regulations.
“The Settlements proved dramatically that TB is a disease primarily of nutritional and environmental disadvantage. Well-founded bodies dealt decisively with TB on their first encounter, usually marked by a small calcified nodule in the lung called a Ghon focus. For most people this is a source of immunity far more effective than BCG vaccination. Provided it is created against a background of good nourishment and congenial circumstance, nothing more comes of it.
A message to make drug companies quake
“TB never went away. Throughout the 60s men could be found living on the street who proved to have TB, and mens hostels were a fertile recruiting ground for chest hospitals. Feed these men and find them a life, and the disease paled away.
“We should be ashamed that these simple hygienic benefits have not by now filtered down to everyone. Drug firms may quake at the thought of their products losing their grip, but we need not. It is just another reason to appreciate, grow, buy and eat the very best that we can.”