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common during the early years of the epidemic and, in some cases, persisted into the 1990s.

Similar views of the relationship between social conditions and disease characterized the construction of tuberculosis (TB), the nineteenth century’s most devastating chronic disease. TB is typically a chronic disease whose symptoms include fatigue, weight loss, chills, aches, fevers, and a characteristic violent cough that sometimes brings up bloody sputum. It most commonly affects people, such as the urban poor, whose nutrition is inadequate and who live and work in crowded conditions. By the eighteenth century, physicians and the lay public believed that climate and “dissolute and immoral” living made people susceptible to the disease. Tubercular patients were often urged to take up physically active lives in areas with salubrious weather. Rest cures in sanatoriums were common, and treatment often varied according to the gender and class of the sufferer. Only when Robert Koch discovered in 1882 that TB is caused by a bacterium did the stereotypes that its sufferers were inherently weak or tainted begin to fade away.