Last night I saw a magnificent ENO production of La Bohème at the London Coliseum. During the tear-wrenching death of Mimi in the last act, it occurred to me that if we had taken advice from homeopaths and the like, people would still be dying young from tuberculosis.

Death of Mimi

For me, Verdi beats even Puccini with the pathos and drama of the death of Violetta from consumption in La Traviata.Listen to the last minute of La Traviata (the Joan Sutherland and Carlo Bergonzi recording): click to listen

Look at the excellent ENO ‘insideout’ web site about the production.

Opera Desire, Disease, Death (University of Nebraska Press), by Michael and Linda Hutcheon is about disease in Opera. A review of the book by Roger Burford Mason appeared in the Canadian Medical Association Journal (1996, 154, 821-823). La Traviata appeared in 1853, and at that time the cause of tuberculosis was not known.

“Generations of languishing, beautiful women were not considered dangerous or infectious, but only glamorously frail, their short lives akin to the beauty of moths fluttering around a candle flame.”

According to J. F. Murray

“Some experts advocated contagion, others a constitutional hereditary defect, atmospheric imbalances, the depredations of stress, or an inevitable consequence of the degeneration of the human race; even the role of divine retribution was occasionally evoked”

But by the time La Bohème was first performed in 1896, things were quite different. In 1882 Robert Koch had discovered the real cause of the disease, Mycobacterium tuberculosis (Koch R., Die Aetiologie der Tuberculose: Berlin klin. Wochschr. 1882;19:221-230: translation in Am. Rev. Tuberc. 1932;25:298-323). Paul Ehrlich is quoted as saying of Koch’s talk to the Berlin Physiological Society, on March 24th 1882, “This evening remains imprinted on my memory as the most awe-inspiring scientific event I have ever attended”

The Hutcheons suggested that the reason that Rodolfo abandoned Mimi was because it was known by the time of La Bohème that tuberculosis was contagious, and he didn’t want to die too. In subsequent correspondence, a letter from Mimi Divinski MD (yes, Mimi) mounted a defence of Rodolfo: “Rodolfo knows that Mimi is dying and cannot bear to watch her and feel so helpless”. “Rodolfo is a hero”. You can read that letter, and the Hutcheons’ response, here.

Homeopaths poison your mind, not your body

It is often said that homeopathy, and some other forms of quackery, though not effective, are at least harmless. This history shows otherwise. Sugar pills do not, of course, poison your body. They poison your mind. Belief in their crude and irrational delusions inhibits search for the real causes of disease and for real cures.

Robert Koch in 1883 Medical genius

Like creationists, homeopathists and their ilk take the lazy approach. Don’t do the work, it’s much easier to read the holy book. If we had listened to them, people would still be dying of tuberculosis and cholera.

Samuel Hahnemann Medical dim-wit

This is not just historical either. At the present time, alternative medicine practitioners endanger the lives of children and adults by consistently advising against vaccination (download Schmidt & Ernst, 2003),Tuberculosis continued to kill long after Robert Koch, and long after La Bohème.

Streptomycin was discovered in 1943, and shortly afterwards, a simple synthetic drug, isoniazid, was discovered in the labs of the pharmaceutical companies Hoffman La Roche, Farbenfabriken Bayer, and Squibb Institute for Medical Research. The first clinical trial was in 1952. And they came just in time to save my own sister who was diagnosed with tuberculosis in 1954 at the age of 14. She did not become another Violetta. Between them these drugs ended a centuries-old scourge.

Chemical structure of isoniazid