document_title: History of tuberculosis

question_text: when was the first cure for tuberculosis found

question_tokens: when was the first cure for tuberculosis found

text: History of tuberculosis

text: Origins[edit]

text: Scientific work investigating the evolutionary origins of the Mycobacterium tuberculosis complex has concluded that the most recent common ancestor of the complex was a human-specific pathogen, which underwent a population bottleneck. Analysis of mycobacterial interspersed repetitive units has allowed dating of the bottleneck to approximately 40,000 years ago, which corresponds to the period subsequent to the expansion of Homo sapiens sapiens out of Africa. This analysis of mycobacterial interspersed repetitive units also dated the Mycobacterium bovis lineage as dispersing approximately 6,000 years ago, which may be linked to animal domestication and early farming.[3]

text: Human bones from the Neolithic show a presence of the bacteria. There have also been a claim of evidence of lesions characteristic of tuberculosis in a 500,000 years old Homo erectus fossile, although this finding is controversial.[4]

text: Results of a genome study reported in 2014 suggest that tuberculosis is newer than previously thought. Scientists were able to recreate the genome of the bacteria from remains of 1,000-year-old skeletons in southern Peru. In dating the DNA, they found it was less than 6,000 years old. They also found it related most closely to a tuberculosis strain in seals, and have theorized that these animals were the mode of transmission from Africa to South America.[1] The team from University of Tubingen believe that humans acquired the disease in Africa about 5,000 years ago.[1] Their domesticated animals, such as goats and cows, contracted it from them. Seals acquired it when coming up on African beaches for breeding, and carried it across the Atlantic. In addition, TB spread via humans on the trade routes of the Old World. Other researchers have argued there is other evidence that suggests the tuberculosis bacteria is older than 6,000 years.[1] This TB strain found in Peru is different from that prevalent today in the Americas, which is more closely related to a later Eurasian strain likely brought by European colonists.[5] However, this result is criticised by other experts from the field,[1] for instance because there is evidence of the presence of Mycobacterium tuberculosis in 9000 year old skeletal remains.[2]

text: Although relatively little is known about its frequency before the 19th century, its incidence is thought to have peaked between the end of the 18th century and the end of the 19th century. Over time, the various cultures of the world gave the illness different names: phthisis (Greek), consumptione (Latin), yaksma (India), and chaky oncay (Incan), each of which make reference to the "drying" or "consuming" affect of the illness, cachexia.

text: In the 19th century, TB's high mortality rate among young and middle-aged adults and the surge of Romanticism, which stressed feeling over reason, caused many to refer to the disease as the "romantic disease".

text: Tuberculosis in early civilization[edit]

text:
External video

 Michael Carson Persistence of the White Plague, TB, UCI Open, 50 minutes

text: In 2008, evidence for tuberculosis infection was discovered in human remains from the Neolithic era dating from 9,000 years ago, in Atlit Yam, a settlement in the eastern Mediterranean.[6] This finding was confirmed by morphological and molecular methods; to date it is the oldest evidence of tuberculosis infection in humans.

text: Evidence of the infection in humans was also found in a cemetery near Heidelberg, in the Neolithic bone remains that show evidence of the type of angulation often seen with spinal tuberculosis.[7] Some authors call tuberculosis the first disease known to mankind.

text: Signs of the disease have also been found in Egyptian mummies dated between 3000 and 2400 BC.[8] The most convincing case was found in the mummy of priest Nesperehen, discovered by Grebart in 1881, which featured evidence of spinal tuberculosis with the characteristic psoas abscesses.[9] Similar features were discovered on other mummies like that of the priest Philoc and throughout the cemeteries of Thebes. It appears likely that Akhenaten and his wife Nefertiti both died from tuberculosis, and evidence indicates that hospitals for tuberculosis existed in Egypt as early as 1500 BC.[10]

text: The Ebers papyrus, an important Egyptian medical treatise from around 1550 BC, describes a pulmonary consumption associated with the cervical lymph nodes. It recommended that it be treated with the surgical lancing of the cyst and the application of a ground mixture of acacia seyal, peas, fruits, animal blood, insect blood, honey and salt.

text: The Old Testament mentions a consumptive illness that would affect the Jewish people if they stray from God. It is listed in the section of curses given before they enter the land of Canaan.[11]

text: The East[edit]

text: Ancient India[edit]

text: The first references to tuberculosis in non-European civilization is found in the Vedas. The oldest of them (Rigveda, 1500 BC) calls the disease yaksma.[12] The Atharvaveda calls it balasa. It is in the Atharvaveda that the first description of scrofula is given.[13] The Sushruta Samhita, written around 600 BC, recommends that the disease be treated with breast milk, various meats, alcohol and rest.[14] The Yajurveda advises sufferers to move to higher altitudes.[14]

text: Ancient China[edit]

text: The Classical Chinese word ao 癆 "consumption; tuberculosis" was the common name in traditional Chinese medicine and fèijiéhé 肺結核 (lit. "lung knot kernel") "pulmonary tuberculosis" is the modern medical term. Lao is compounded in names like xulao 虛癆 with "empty; void", láobìng 癆病 with "sickness", láozhài 癆瘵 with "[archaic] sickness", and feilao 肺癆 with "lungs". Zhang and Unschuld explain that the medical term xulao 虛癆 "depletion exhaustion" includes infectious and consumptive pathologies, such as laozhai 癆瘵 "exhaustion with consumption" or laozhaichong 癆瘵蟲 "exhaustion consumption bugs/worms".[15] They retrospectively identify feilao 肺癆 "lung exhaustion" and infectious feilao chuanshi 肺癆傳尸 "lung exhaustion by corpse [evil] transmission as "consumption/tuberculosis".[16] Describing foreign loanwords in early medical terminology, Zhang and Unschuld note the phonetic similarity between Chinese feixiao 肺消 (from Old Chinese **pʰot-ssew) "lung consumption" and ancient Greek phthisis "pulmonary tuberculosis".[17]

text: The (c. 400 BCE – 260 CE) Huangdi Neijing classic Chinese medical text, traditionally attributed to the mythical Yellow Emperor, describes a disease believed to be tuberculosis, called xulao bing (虛癆病 "weak consumptive disease"), characterized by persistent cough, abnormal appearance, fever, a weak and fast pulse, chest obstructions, and shortness of breath.[18][verification needed]

text: The Huangdi Neijing describes an incurable disease called huaifu 壞府 "bad palace", which commentators interpret as tuberculous. "As for a string which is cut, its sound is hoarse. As for wood which has become old, its leaves are shed. As for a disease which is in the depth [of the body], the sound it [generates] is hiccup. When a man has these three [states], this is called 'destroyed palace'. Toxic drugs do not bring a cure; short needles cannot seize [the disease].[19] Wang Bing's commentary explains that fu 府 "palace" stands for xiong 胸 "chest", and huai "destroy" implies "injure the palace and seize the disease". The Huangdi Neijing compiler Yang Shangshan notes, "The [disease] proposed here very much resembles tuberculosis ... Hence [the text] states: poisonous drugs bring no cure; it cannot be seized with short needles."[20]

text: The (c. 200–250 CE) Shennong Bencaojing pharmacopeia, attributed to the legendary inventor of agriculture Shennong "Divine Farmer", also refers to tuberculosis[21]

text: The Zhouhou beiji fang 肘后备急方 "Handbook of Prescriptions for Emergencies", attributed to the Daoist scholar Ge Hong (263-420), uses the name of shizhu 尸疰 "corpse disease; tuberculosis" and describes the symptoms and contagion: "This disease has many changing symptoms varying from thirty-six to ninety-nine different kinds. Generally it gives rise to a high fever, sweating, asthenia, unlocalised pains, making all positions difficult. Gradually, after months and years of suffering, this lingering disease brings about death to the sufferer. Afterwards it is transferred to others until the whole family is wiped out."[22]

text: Song dynasty (920–1279) Daoist priest-doctors first recorded that tuberculosis, called shīzhài 尸瘵 (lit. "corpse disease") "disease which changes a living being into a corpse",[23] was caused by a specific parasite or pathogen, centuries earlier than their contemporaries in other countries. The Duanchu shizhai pin 斷除尸瘵品 "On the Extermination of the Corpse Disease" is the 23rd chapter in Daoist collection Wushang xuanyuan santian Yutang dafa 無上玄元三天玉堂大法 "Great Rites of the Jade Hall of the Three Heavens of the Supreme Mysterious Origins" (Daozang number 103). The text has a preface dated 1126, written by the Song dynasty Zhengyi Dao master Lu Shizhong 路時中, who founded the Yutang dafa 玉堂大法 tradition, but internal evidence reveals that the text could not have been written before 1158.[24]

text: The disaster of the contagious disease, which changes a living being into a corpse, is caused by the infectious [nature] of the nine [kinds of] parasites (ch'ung 蟲). It is also caused by overworking one's mind and exhausting one's energy, injuring one's ch'i and loosening one's sperm—all of which happen to common folk. When the original vitality is being [gradually] exhausted, the evil aura begins to be transmitted through the affected vital ch'i [of the sick body]. ... The aspects of the illness vary, and the causes of contamination are different. Rooms and food are capable of gradual contamination, and the clothes worn by the indisposed are twined easily with the infectious ch'i and these two become inseparable. ... The symptoms of the disease: When it begins, the sufferer coughs and pants; he spits blood [pulmonary hemorrhage]; he is emaciated and skinny; cold and fever affect him intermittently, and his dreams are morbid. This is the evidence that this person is suffering from the disease which is also known as wu-ch'uan 屋傳 [contagious disease contracted from a sick-room]. ... The disease may be contracted by a healthy person who happens to have slept in the same bed with the patient, or worn his clothes. After the death of the sufferer, the clothes, curtains, bed or couch, vessels and utensils used by him are known to have been contaminated by and saturated with the polluted ch'i in which the noxious ku 蠱 [parasites or germs] take their abode. Stingy people wish to keep them for further use, and the poorer families cannot afford to get rid of them and buy everything anew. Isn't this lamentable, since it creates the cause of the great misfortune yet to come![25]

text: This passage refers to the cause of TB in ancient medical terminology of jiuchong 九蟲 "Nine Worms" and gu 蠱 "supernatural agents causing disease", and qi. The Nine Worms generically meant "bodily parasites; intestinal worms" and were associated with the sanshi 三尸 "Three Corpses" or sanchong 三蟲 "Three Worms", which were believed to be biospiritual parasites that live in the human body and seek to hasten their host's death. Daoist medical texts give different lists and descriptions of the Nine Worms. The Boji fang 博濟方 "Prescriptions for Universal Dispensation", collected by Wang Gun王袞 (fl. 1041), calls the supposed TB pathogen laochong 癆蟲 "tuberculosis worms".[26]

text: This Duanchu shizhai pin chapter (23/7b-8b) explains that the present Nine Worms does not refer to the intestinal weichong 胃蟲 "stomach worms", huichong 蛔蟲 "coiling worm; roundworm", or cun baichong 寸白蟲 "inch-long white worm; nematode", and says the supposed six TB worms are "six kinds" of parasites, but the next chapter (24/20a-21b) says they are "six stages/generations" of reproduction.[27] Daoist priests allegedly cured tuberculosis through drugs, acupuncture, and burning fulu "supernatural talismans/charms". Burning magic talismans would cause the TB patient to cough, which was considered an effective treatment.

text: To cure the disease, it is necessary to produce a spout of smoke by burning off thirty-six charms, and instruct the patient to inhale and to swallow up its fumes, whether he likes it or not. By the time all charms are used up, the smoke should also be dispersed. It may be difficult for the patient to bear the odour of the smoke at first, but once he gets used to such a smell, it does not really matter. Whenever the patient feels that there is phlegm in his throat, he is advised to cough and spit it out. If the patient is greatly affected by the symptoms, it will be good if his spittle is thick and if he can spit it out. When the patient is less affected by the wicked ch'i, he does not have much phlegm to eject, but if he is deeply affected, he tends to vomit and to expectorate heavily until everything is cleared up, and then his illness is cured. When the wicked element is rooted out, it does not need to be fumigated any more [with charms].[28]

text: In addition, Daoist healers would burn talismans in order to fumigate the clothes and belongings of the deceased, and would warn the family of the tuberculosis victim's family to throw away everything into a changliu shui 長流水 "everflowing stream". According to Liu Ts'un-yan,[29] "This proves that the priests of the time actually wanted to destroy all the belongings of the deceased, using charms as a camouflage."

text: Classical antiquity[edit]

text: The first classical text to mention the disease is Herodotus' Histories in which he relates how a Persian general, Pharnouches, abandoned Xerxes' campaign against the Spartans due to consumption.[30]

text: Hippocrates, in Book 1 of his Of the Epidemics, describes the characteristics of the disease: fever, colorless urine, cough resulting in a thick sputa, and loss of thirst and appetite. He notes that most of the sufferers became delirious before they succumbed to the disease.[31] Hippocrates and many other at the time believed phthisis to be hereditary in nature.[32] Aristotle disagreed, believing the disease was contagious.

text: Pliny the Younger wrote a letter to Priscus in which he details the symptoms of phthisis as he saw them in Fannia:

text: The attacks of fever stick to her, her cough grows upon her, she is in the highest degree emaciated and enfeebled.

text: Galen proposed a series of therapeutic treatments for the disease, including: opium as a sleeping agent and painkiller; blood letting; a diet of barley water, fish, and fruit. He also described the phyma (tumor) of the lungs, which is thought to correspond to the tubercles that form on the lung as a result of the disease.[33]

text: Vitruvius noted that "cold in the windpipe, cough, plurisy, phthisis, [and] spitting blood", were common diseases in regions where the wind blew from north to northwest, and advised that walls be so built as to shelter individuals from the winds.[34]

text: Aretaeus was the first person to rigorously describe the symptoms of the disease in his text De causis et signis diuturnorum morborum:[35]

text: Voice hoarse; neck slightly bent, tender, not flexible, somewhat extended; fingers slender, but joints thick; of the bones alone the figure remains, for the fleshy parts are wasted; the nails of the fingers crooked, their pulps are shrivelled and flat...Nose sharp, slender; cheeks prominent and red; eyes hollow, brilliant and glittering; swollen, pale or livid in countenance; the slender parts of the jaws rest on the teeth as, as if smiling; otherwise of cadaverous aspect...

text: In his other book De curatione diuturnorum morborum, he recommends that sufferers travel to high altitudes, travel by sea, eat a good diet and drink plenty of milk.[36]

text: Pre-Columbian America[edit]

text: In South America, reports of a study in August 2014 revealed that TB had likely been spread via seals that contracted it on beaches of Africa, from humans via domesticated animals, and carried it across the Atlantic. A team at the University of Tubingen analyzed tuberculosis DNA in 1,000-year-old skeletons of the Chiribaya culture in southern Peru; so much genetic material was recovered that they could reconstruct the genome. They learned that this TB strain was related most closely to a form found only in seals.[1] In South America, it was likely contracted first by hunters who handled contaminated meat. This TB is a different strain from that prevalent today in the Americas, which is more closely related to a later Eurasian strain.[5][37]

text: Prior to this study, the first evidence of the disease in South America was found in remains of the Arawak culture around 1050 BC.[38] The most significant finding belongs to the mummy of an 8 to 10-year-old Nascan child from Hacienda Agua Sala, dated to 700 AD. Scientists were able to isolate evidence of the bacillus.[38]

text: Europe: Middle Ages and Renaissance[edit]

text: During the Middle Ages, no significant advances were made regarding tuberculosis. Avicenna and Rhazes continued to consider to believe the disease was both contagious and difficult to treat. Arnaldus de Villa Nova described etiopathogenic theory directly related to that of Hippocrates, in which a cold humor dripped from the head into the lungs.

text: In Medieval Hungary, the Inquisition recorded the trials of pagans. A document from the 12th century recorded an explanation of the cause of illness. The pagans said that tuberculosis was produced when a dog-shaped demon occupied the person's body and started to eat his lungs. When the possessed person coughed, then the demon was barking, and getting close to his objective, which was to kill the victim.[39]

text: Royal touch[edit]

text: With the spread of Christianity, monarchs were seen as religious figures with magical or curative powers. It was believed that royal touch, the touch of the sovereign of England or France, could cure diseases due to the divine right of sovereigns.[40] King Henry IV of France usually performed the rite once a week, after taking communion.[41] So common was this practice of royal healing in France, that scrofula became known as the "mal du roi" or the "King's Evil".

text: Initially, the touching ceremony was an informal process. Sickly individuals could petition the court for a royal touch and the touch would be performed at the King's earliest convenience. At times, the King of France would touch afflicted subjects during his royal walkabout. The rapid spread of tuberculosis across France and England, however, necessitated a more formal and efficient touching process. By the time of Louis XIV of France, placards indicating the days and times the King would be available for royal touches were posted regularly; sums of money were doled out as charitable support.[41][42] In England, the process was extremely formal and efficient. As late as 1633, the Book of Common Prayer of the Anglican Church contained a Royal Touch ceremony.[43] The monarch (king or queen), sitting upon a canopied throne, touched the afflicted individual, and presented that individual with a coin – usually an Angel, a gold coin the value of which varied from about 6 shillings to about 10 shillings – by pressing it against the afflicted's neck.[41]

text: Although the ceremony was of no medical value, members of the royal courts often propagandized that those receiving the royal touch were miraculously healed. André du Laurens, the senior physician of Henry IV, publicized findings that at least half of those that received the royal touch were cured within a few days.[44] The royal touch remained popular into the 18th century. Parish registers from Oxfordshire, England include not only records of baptisms, marriages, and deaths, but also records of those eligible for the royal touch.[40]

text: Contagion[edit]

text: Girolamo Fracastoro became the first person to propose, in his work De contagione, that phthisis was transmitted by an invisible virus. Among his assertions were that the virus could survive between two or three years on the clothes of those suffering from the disease and that it was usually transmitted through direct contact or the discharged fluids of the infected, what he called fomes. He noted that phthisis could be contracted without either direct contact or fomes, but was unsure of the process by which the disease propagated across distances.[45]

text: Paracelsus's tartaric process[edit]

text: Paracelsus advanced the belief that tuberculosis was caused by a failure of an internal organ to accomplish its alchemical duties. When this occurred in the lungs, stony precipitates would develop causing tuberculosis in what he called the tartaric process.[46]

text: Seventeenth and eighteenth centuries[edit]

text: Franciscus Sylvius began differentiating between the various forms of tuberculosis (pulmonary, ganglion). He was the first person to recognize that the skin ulcers caused by scrofula resembled tubercles seen in phthisis,[47] noting that "phthisis is the scrofula of the lung" in his book Opera Medica, published posthumously in 1679. Around the same time, Thomas Willis concluded that all diseases of the chest must ultimately lead to consumption.[48] Willis did not know the exact cause of the disease but he blamed it on sugar[49] or an acidity of the blood.[47] Richard Morton published Phthisiologia, seu exercitationes de Phthisi tribus libris comprehensae in 1689, in which he emphasized the tubercle as the true cause of the disease. So common was the disease at the time that Morton is quoted as saying "I cannot sufficiently admire that anyone, at least after he comes to the flower of his youth, can [sic] dye without a touch of consumption."[50]

text: In 1720, Benjamin Marten proposed in A New Theory of Consumptions more Especially of Phthisis or Consumption of the Lungs that the cause of tuberculosis was some type of animalcula—microscopic living beings that are able to survive in a new body (similar to the ones described by Anton van Leeuwenhoek in 1695).[51] The theory was roundly rejected and it took another 162 years before Robert Koch demonstrated it to be true.

text: In 1768, Robert Whytt gave the first clinical description of tuberculosis meningitis[52] and in 1779, Percivall Pott, an English surgeon, described the vertebral lesions that carry his name.[42] In 1761, Leopold Auenbrugger, an Austrian physician, developed the percussion method of diagnosing tuberculosis,[53] a method rediscovered some years later in 1797 by Jean-Nicolas Corvisart of France. After finding it useful, Corvisart made it readily available to the academic community by translating it into French.[54]

text: William Stark proposed that ordinary lung tubercles could eventually evolve into ulcers and cavities, believing that the different forms of tuberculosis were simply different manifestations of the same disease. Unfortunately, Stark died at the age of thirty (while studying scurvy) and his observations were discounted.[55] In his Systematik de speziellen Pathologie und Therapie, J. L. Schönlein, Professor of Medicine in Zurich, proposed that the word "tuberculosis" be used to describe the affliction of tubercles.[56][57]

text: The incidence of tuberculosis grew progressively during the Middle Ages and Renaissance, displacing leprosy, peaking between the 18th and 19th century as field workers moved to the cities looking for work.[42] When he released his study in 1808, William Woolcombe was astonished at the prevalence of tuberculosis in 18th-century England.[58] Of the 1,571 deaths in the English city of Bristol between 1790 and 1796, 683 were due to tuberculosis.[59] Remote towns, initially isolated from the disease, slowly succumbed. The consumption deaths in the village of Holycross in Shropshire between 1750 and 1759 were one in six (1:6); ten years later, 1:3. In the metropolis of London, 1:7 died from consumption at the dawn of the 18th century, by 1750 that proportion grew to 1:5.25 and surged to 1:4.2 by around the start of the 19th century.[60] The Industrial Revolution coupled with poverty and squalor created the optimal environment for the propagation of the disease.

text: Nineteenth century[edit]

text: A romantic disease[edit]

text:
"Chopin coughs with infinite grace."

—George Sand in a letter to Madame d'Agoult

text: It was during this century that tuberculosis was dubbed the White Plague,[61] mal de vivre, and mal du siècle. It was seen as a "romantic disease". Suffering from tuberculosis was thought to bestow upon the sufferer heightened sensitivity. The slow progress of the disease allowed for a "good death" as sufferers could arrange their affairs.[62] The disease began to represent spiritual purity and temporal wealth, leading many young, upper-class women to purposefully pale their skin to achieve the consumptive appearance. British poet Lord Byron wrote, "I should like to die from consumption", helping to popularize the disease as the disease of artists.[63] George Sand doted on her phthisic lover, Frédéric Chopin, calling him her "poor melancholy angel".[64]

text: In France, at least five novels were published expressing the ideals of tuberculosis: Dumas's La Dame aux camélias, Murger's Scènes de la vie de Bohème, Hugo's Les Misérables, the Goncourt brothers' Madame Gervaisais and Germinie Lacerteux, and Rostand's L'Aiglon. The portrayals by Dumas and Murger in turn inspired operatic depictions of consumption in Verdi's La traviata and Puccini's La bohème. Even after medical knowledge of the disease had accumulated, the redemptive-spiritual perspective of the disease has remained popular[65] (as seen in the 2001 film Moulin Rouge based in part on La traviata and the musical adaptations of Les Misérables).

text: In large cities the poor had high rates of tuberculosis. Public-health physicians and politicians typically blamed both the poor themselves and their ramshackle tenement houses (conventillos) for the spread of the dreaded disease. People ignored public-health campaigns to limit the spread of contagious diseases, such as the prohibition of spitting on the streets, the strict guidelines to care for infants and young children, and quarantines that separated families from ill loved ones.[66]

text: Scientific advances[edit]

text: Though removed from the cultural movement, the scientific understanding advanced considerably. By the end of the 19th century, several major breakthroughs gave hope that a cause and cure might be found.

text: One of the most important physicians dedicated to the study of phthisiology was René Laennec, who died from the disease at the age of 45, after contracting tuberculosis while studying contagious patients and infected bodies.[67] Laennec invented the stethoscope[53] which he used to corroborate his auscultatory findings and prove the correspondence between the pulmonary lesions found on the lungs of autopsied tuberculosis patients and the respiratory symptoms seen in living patients. His most important work was Traité de l’Auscultación Mediate which detailed his discoveries on the utility of pulmonary auscultation in diagnosing tuberculosis. This book was promptly translated into English by John Forbes in 1821; it represents the beginning of the modern scientific understanding of tuberculosis.[64] Laennec was named professional chair of Hôpital Necker in September 1816 and today he is considered the greatest French clinician.[68][69]

text: Laennec's work put him in contact with the vanguard of the French medical establishment, including Pierre Charles Alexandre Louis. Louis would go on to use statistical methods to evaluate the different aspects of the disease's progression, the efficacy of various therapies and individuals' susceptibility, publishing an article in the Annales d'hygiène publique entitled "Note on the Relative Frequency of Phthisis in the Two Sexes".[70] Another good friend and co-worker of Laennec, Gaspard Laurent Bayle, published an article in 1810 entitled Recherches sur la Pthisie Pulmonaire, in which he divided pthisis into six types: tubercular phthisis, glandular phthisis, ulcerous phthisis, phthisis with melanosis, calculous phthisis, and cancerous phthisis. He based his findings on more than 900 autopsies.[61][71]

text: In 1869, Jean Antoine Villemin demonstrated that the disease was indeed contagious, conducting an experiment in which tuberculous matter from human cadavers was injected into laboratory rabbits, which then became infected.[72]

text: On 24 March 1882, Robert Koch revealed the disease was caused by an infectious agent.[64] In 1895, Wilhelm Roentgen discovered the X-ray, which allowed physicians to diagnose and track the progression of the disease,[73] and although an effective medical treatment would not come for another fifty years, the incidence and mortality of tuberculosis began to decline.[74]

text:
19th-century tuberculosis mortality rate for New York and New Orleans[75]

Deaths/Year/1000 people

Year
Population
Whites
Blacks

1821
New York City
5.3
9.6

1830
New York City
4.4
12.0

1844
New York City
3.6
8.2

1849
New Orleans
4.9
5.2

1855
New York City
3.1
12.0

1860
New York City
2.4
6.7

1865
New York City
2.8
6.7

1880
New Orleans
3.3
6.0

1890
New Orleans
2.5
5.9

text: Robert Koch[edit]

text: Villemin's experiments had confirmed the contagious nature of the disease and had forced the medical community to accept that tuberculosis was indeed an infectious disease, transmitted by some etiological agent of unknown origin. In 1882, Prussian physician Robert Koch utilized a new staining method and applied it to the sputum of tuberculosis patients, revealing for the first time the causal agent of the disease: Mycobacterium tuberculosis, or Koch's bacillus.[76]

text: When he began his investigation, Koch knew of the work of Villemin and others who had continued his experiments like Julius Conheim and Carl Salmosen. He also had access to the "pthisis ward" at the Berlin Charité Hospital.[77] Before he confronted the problem of tuberculosis, he worked with the disease caused by anthrax and had discovered the causal agent to be Bacillus anthracis. During this investigation he became friends with Ferdinand Cohn, the director of the Institute of Vegetable Physiology. Together they worked to develop methods of culturing tissue samples. 18 August 1881, while staining tuberculous material with methylene blue, he noticed oblong structures, though he was not able to ascertain whether it was just a result of the coloring. To improve the contrast, he decide to add Bismarck Brown, after which the oblong structures were rendered bright and transparent. He improved the technique by varying the concentration of alkali in the staining solution until the ideal viewing conditions for the bacilli was achieved.

text: After numerous attempts he was able to incubate the bacteria in coagulated blood serum at 37 degrees Celsius. He then inoculated laboratory rabbits with the bacteria and observed that they died while exhibiting symptoms of tuberculosis, proving that the bacillus, which he named tuberculosis bacillus, was in fact the cause of tuberculosis.[78]

text: He made his result public at the Physiological Society of Berlin on 24 March 1882, in a famous lecture entitled Über Tuberculose, which was published three weeks later. Since 1882, 24 March has been known as World Tuberculosis Day.[79]

text: On 20 April 1882, Koch presented an article entitled Die Ätiologie der Tuberculose in which he demonstrated that Mycobacterium was the single cause of tuberculosis in all of its forms.[78]

text: In 1890 Koch developed tuberculin, a purified protein derivative of the bacteria.[80] It proved to be an ineffective means of immunization but in 1908, Charles Mantoux found it was an effective intradermic test for diagnosing tuberculosis.[81]

text: If the importance of a disease for mankind is measured from the number of fatalities which are due to it, then tuberculosis must be considered much more important than those most feared infectious diseases, plague, cholera, and the like. Statistics have shown that 1/7 of all humans die of tuberculosis.

text: Sanatorium movement[edit]

text: The advancement of scientific understanding of tuberculosis, and its contagious nature created the need for institutions to house sufferers.

text: The first proposal for a tuberculosis facility was made in paper by George Bodington entitled An essay on the treatment and cure of pulmonary consumption, on principles natural, rational and successful in 1840. In this paper, he proposed a dietary, rest, and medical care program for a hospital he planned to found in Maney.[82] Attacks from numerous medical experts, especially articles in The Lancet, disheartened Bodington and he turned to plans for housing the insane.[83]

text: Around the same time in the United States, in late October and early November 1842, Dr. John Croghan, the owner of Mammoth Cave, brought 15 tuberculosis sufferers into the cave in the hope of curing the disease with the constant temperature and purity of the cave air.[84] Patients were lodged in stone huts, and each was supplied with a slave to bring meals.[85] One patient, A. H. P. Anderson, wrote glowing reviews of the cave experience:[86]

text: [S]ome of the invalids eat at their pavillions while others in better health attend regularly the table d'hote which is very good indeed, having a considerable variety and being almost daily (I've noted but 2-3 omissions) graced with a saddle of venison or other game.

text: By late January, early February 1843, two patients were dead and the rest had left. Departing patients died anywhere from three days to three weeks after resurfacing; John Croghan died of tuberculosis at his Louisville residence in 1849.[87]

text: Hermann Brehmer, a German physician, was convinced that tuberculosis arose from the difficulty of the heart to correctly irrigate the lungs. He therefore proposed that regions well above sea level, where the atmospheric pressure was less, would help the heart function more effectively. With the encouragement of explorer Alexander von Humboldt and his teacher J. L. Schönlein, the first anti-tuberculosis sanatorium was established in 1854, 650 meters above sea level, at Görbersdorf.[88] Three years later he published his findings in a paper Die chronische Lungenschwindsucht und Tuberkulose der Lunge: Ihre Ursache und ihre Heilung.

text: Brehmer and one of his patients, Peter Dettweiler, became proponents for the sanatorium movement, and by 1877, sanatoriums began to spread beyond Germany and throughout Europe. Dr. Edward Livingston Trudeau subsequently founded the Adirondack Cottage Sanitorium in Saranac Lake, New York in 1884. One of Trudeau's early patients was author Robert Louis Stevenson; his fame helped establish Saranac Lake as a center for the treatment of tuberculosis. In 1894, after a fire destroyed Trudeau's small home laboratory, he organized the Saranac Laboratory for the Study of Tuberculosis; renamed the Trudeau Institute, the laboratory continues to study infectious diseases.[89]

text: Peter Dettweiler went on to found his own sanatorium at Falkenstein in 1877 and in 1886 published findings claiming that 132 of his 1022 patients had been completely cured after staying at his institution.[90] Eventually, sanatoriums began to appear near large cities and at low altitudes, like the Sharon Sanatorium in 1890 near Boston.[91]

text: Sanatoriums were not the only treatment facilities. Specialized tuberculosis clinics began to develop in major metropolitan areas. Sir Robert Philip established the Royal Victoria Dispensary for Consumption in Edinburgh in 1887. Dispensaries acted as special sanatoriums for early tuberculosis cases and were opened to lower income individuals. The use of dispensaries to treat middle and lower-class individuals in major metropolitan areas and the coordination between various levels of health services programs like hospitals, sanatoriums, and tuberculosis colonies became known as the "Edinburgh Anti-tuberculosis Scheme".[92]

text: Twentieth century[edit]

text: Containment[edit]

text: At the beginning of the 20th century, tuberculosis was one of the UK's most urgent health problems. A royal commission was set up in 1901, The Royal Commission Appointed to Inquire into the Relations of Human and Animal Tuberculosis. Its remit was to find out whether tuberculosis in animals and humans was the same disease, and whether animals and humans could infect each other. By 1919, the Commission had evolved into the UK's Medical Research Council.

text: In 1902, the International Conference on Tuberculosis convened in Berlin. Among various other acts, the conference proposed the Cross of Lorraine be the international symbol of the fight against tuberculosis. National campaigns spread across Europe and the United States to tamp down on the continued prevalence of tuberculosis.

text: After the establishment in the 1880s that the disease was contagious, TB was made a notifiable disease in Britain; there were campaigns to stop spitting in public places, and the infected poor were pressured to enter sanatoria that resembled prisons; the sanatoria for the middle and upper classes offered excellent care and constant medical attention.[93] Whatever the purported benefits of the fresh air and labor in the sanatoria, even under the best conditions, 50% of those who entered were dead within five years (1916).[93]

text: The promotion of Christmas Seals began in Denmark during 1904 as a way to raise money for tuberculosis programs. It expanded to the United States and Canada in 1907–1908 to help the National Tuberculosis Association (later called the American Lung Association).

text: In the United States, concern about the spread of tuberculosis played a role in the movement to prohibit public spitting except into spittoons.

text: Vaccines[edit]

text: The first genuine success in immunizing against tuberculosis was developed from attenuated bovine-strain tuberculosis by Albert Calmette and Camille Guérin in 1906. It was called "BCG" (Bacille Calmette-Guérin). The BCG vaccine was first used on humans in 1921 in France,[94] but it was not until after World War II that BCG received widespread acceptance in Great Britain, and Germany.[95] In the early days of the British National Health Service X-ray examination for TB increased dramatically but rates of vaccination were initially very low. In 1953 it was agreed that secondary school pupils should be vaccinated, but by the end of 1954 only 250,000 people had been vaccinated. By 1956 this had risen to 600,000, about half being school children.[96]

text: Treatments[edit]

text: As the century progressed, some surgical interventions, including the pneumothorax or plombage technique—collapsing an infected lung to "rest" it and allow the lesions to heal—were used to treat tuberculosis.[97] Pneumothorax was not a new technique by any means. In 1696, Giorgio Baglivi reported a general improvement in tuberculosis sufferers after they received sword wounds to the chest. F.H. Ramadge induced the first successful therapeutic pneumothorax in 1834, and reported subsequently the patient was cured. It was in the 20th century, however, that scientists sought to rigorously investigate the effectiveness of such procedures. In 1939, the British Journal of Tuberculosis published a study by Oli Hjaltested and Kjeld Törning on 191 patients undergoing the procedure between 1925 and 1931; in 1951, Roger Mitchell published several articles on the therapeutic outcomes of 557 patients treated between 1930 and 1939 at Trudeau Sanatorium in Saranac Lake.[98] The search for a medicinal cure, however, continued in earnest.

text: During the Nazi occupation of Poland, SS-Obergruppenführer Wilhelm Koppe organized the execution of more than 30,000 Polish patients suffering from tuberculosis - little knowing or caring that a cure was nearly at hand.

text: In 1944 Albert Schatz, Elizabeth Bugie, and Selman Waksman isolated streptomycin produced by a bacterial strain Streptomyces griseus. Streptomycin was the first effective antibiotic against M. tuberculosis.[99] This discovery is generally considered the beginning of the modern era of tuberculosis, although the true revolution began some years later, in 1952, with the development of isoniazid, the first oral mycobactericidal drug.[99] The advent of rifampin in the 1970s hastened recovery times, and significantly reduced the number of tuberculosis cases until the 1980s.

text: The British epidemiologist Thomas McKeown had shown that 'treatment by streptomycin reduced the number of deaths since it was introduced (1948-71) by 51 per cent...'.[100] However, he also showed that the mortality from TB in England and Wales had already declined by 90 to 95% before streptomycin and BCG-vaccination were widely available, and that the contribution of antibiotics to the decline of mortality from TB was actually very small: '...for the total period since cause of death was first recorded (1848–71) the reduction was 3.2 per cent'.[100]:82 These figures have since been confirmed for all western countries (see for example the decline in TB mortality in the USA) and for all then known infectious diseases. McKeown explained the decline in mortality from infectious diseases by an improved standard of living, particularly by better nutrition, and by better hygiene, and less by medical intervention. McKeown, who is considered as the father of social medicine,[101] has advocated for many years, that with drugs and vaccines we may win the battle but will lose the war against Diseases of Poverty.[102] Thereto, efforts and resources should be primarily directed toward improving the standard of living of people in low resource countries, and toward improving their environment by providing clean water, sanitation, better housing, education, safety and justice, and access to medical care. Particularly the work of Noble laureates Robert W. Fogel (1993)[103][104][105][106] and Angus Deaton (2015)[101] have greatly contributed to the recent reappreciation of the McKeown thesis. A negative confirmation of the McKeown thesis was that increased pressure on wages by IMF loans to post-communist Eastern European were strongly associated with a rise in TB incidence, prevalence and mortality.[107]

text: Tuberculosis resurgence[edit]

text: Hopes that the disease could be completely eliminated were dashed in the 1980s with the rise of drug-resistant strains. Tuberculosis cases in Britain, numbering around 117,000 in 1913, had fallen to around 5,000 in 1987, but cases rose again, reaching 6,300 in 2000 and 7,600 cases in 2005.[108] Due to the elimination of public health facilities in New York and the emergence of HIV, there was a resurgence of TB in the late 1980s.[109] The number of patients failing to complete their course of drugs is high. New York had to cope with more than 20,000 TB patients with multidrug-resistant strains (resistant to, at least, both rifampin and isoniazid).

text: In response to the resurgence of tuberculosis, the World Health Organization issued a declaration of a global health emergency in 1993.[110] Every year, nearly half a million new cases of multidrug-resistant tuberculosis (MDR-TB) are estimated to occur worldwide.[111]


document_title: Anita Barone

question_text: why did the actress who played carol in friends change

root

text: Anita Barone

text: Life and career[edit]

text: Barone was born in St. Louis, Missouri. She earned her BFA from the University of Detroit Mercy,[1] followed by an MFA from Wayne State University where she was taught by director/professor Robert T. Hazzard.[2]

tag: p

text: Barone appeared in the fourth-season Seinfeld episode "The Shoes" as Gail Cunningham, a chef who wanted Elaine Benes' shoes. In the early 1990s, she was a regular cast member of Carol & Company with actress Carol Burnett. Barone also played Carol Willick, Ross Geller's ex-wife, in the character's first appearance in Friends. She left the show as she wanted to pursue a more full-time role; she was replaced by Jane Sibbett. She starred on The Jeff Foxworthy Show for the first season (1995–1996) and in The War at Home[3] from 2005 to 2007. In 2000, Barone also co-starred in the sitcom Daddio.[4]

text: Barone's other television credits include Curb Your Enthusiasm, Quantum Leap, Empty Nest, Chicago Hope, Castle, Do Not Disturb, Ally McBeal, Caroline in the City, Party of Five and The Larry Sanders Show.[4]

text: In 2004, she was the recipient of the 2005 Methodfest Best Supporting Actress Award for her work in feature film, One Last Ride.[5]

text: In 2010, three years after The War at Home ended its run, Barone began her recurring role in the Disney Channel sitcom Shake It Up as Officer Georgia Jones, the mother of Bella Thorne's character CeCe Jones. Barone's husband, actor Matthew Glave, guest starred in two episodes of Shake It Up as J.J. Jones, the ex-husband of Barone's character.

text: Personal life[edit]

text: Barone is married to actor Matthew Glave, with whom she has two daughters, Madeline and Roxanne. She currently lives in Los Angeles with her family.

text: Filmography[edit]

text: Films[edit]

text:
The Rosary Murders (1987)
Ricochet (1991)
The Takeover (1995)
Just Friends (1996)
Running Time (1997)
Just Write (1997)
Dream with the Fishes (1997)
Santa's Little Helper (1999)
The Sex Monster (1999)
Buttleman (2002)
One Last Ride (2003)

tag: ul

text: Television[edit]

text:
Seinfeld – Gail Cunningham (one episode, 1993)
Friends – Carol Willick, Ross' ex-wife (one episode, 1994)
The Jeff Foxworthy Show – Karen Foxworthy (1995–1996)
Party of Five – Frannie (1997)
Daddio – Linda Woods (2000)
The War at Home – Vicky Gold (2005–2007)
Castle – Janice Freeman (2009)
Desperate Housewives - Doreen Vance (one episode, "Come On Over for Dinner", 2011)
Shake It Up – Georgia Jones (2010–2013) (recurring role)
The Exes - Julia (one episode, 2013)
K.C. Undercover - Lucy Miller (one episode, K.C. Times Three, 2018)


document_title: List of Olympic Games host cities

question_text: where have winter olympics been in the us

text: List of Olympic Games host cities

text: Olympic Games host cities[edit]

text:
City
Country
Continent
Summer (Olympiad)
Winter
Year
Opening Ceremony
Closing Ceremony

Athens
 Greece
Europe
S005I
—
1896
000000002018-04-06-0000April 6
000000002018-04-15-0000April 15

Paris
 France
Europe
S005II
—
1900
000000002018-05-14-0000May 14
000000002018-10-28-0000October 28

St. Louis[a]
 United States
North America
S005III
—
1904
000000002018-07-01-0000July 1
000000002018-11-23-0000November 23

London[c]
 United Kingdom
Europe
S005IV
—
1908
000000002018-04-27-0000April 27
000000002018-10-31-0000October 31

Stockholm
 Sweden
Europe
S005V
—
1912
000000002018-05-05-0000May 5
000000002018-07-22-0000July 22

Berlin
 Germany
Europe
S006VI
—
1916
Cancelled due to WWI[4]

Antwerp[d]
 Belgium
Europe
S007VII
—
1920
000000002018-04-20-0000April 20
000000002018-09-12-0000September 12[5]

Chamonix
 France
Europe
—
W001I
1924
000000002018-01-25-0000January 25
000000002018-02-04-0000February 4[6]

Paris
 France
Europe
S008VIII
—
000000002018-05-04-0000May 4
000000002018-07-27-0000July 27[7]

St. Moritz
  Switzerland
Europe
—
W002II
1928
000000002018-02-11-0000February 11
000000002018-02-19-0000February 19[8]

Amsterdam
 Netherlands
Europe
S009IX
—
000000002018-05-17-0000May 17
000000002018-08-12-0000August 12[9]

Lake Placid
 United States
North America
—
W003III
1932
000000002018-02-04-0000February 4
000000002018-02-15-0000February 15[10]

Los Angeles
 United States
North America
S010X
—
000000002018-07-30-0000July 30
000000002018-08-14-0000August 14[11]

Garmisch-Partenkirchen
 Nazi Germany
Europe
—
W004IV
1936
000000002018-02-06-0000February 6
000000002018-02-16-0000February 16[12]

Berlin
 Nazi Germany
Europe
S011XI
—
000000002018-08-01-0000August 1
000000002018-08-16-0000August 16[13]

Sapporo
Garmisch-Partenkirchen[e]
 Empire of Japan
 Nazi Germany
Asia
Europe
—
W005aV
1940
Cancelled due to WWII[4]

Tokyo
Helsinki[f]
 Empire of Japan
 Finland
Asia
Europe
S012XII
—

Cortina d'Ampezzo
 Italy
Europe
—
W005bV
1944

London
 United Kingdom
Europe
S013XIII
—

St. Moritz
  Switzerland
Europe
—
W005cV
1948
000000002018-01-30-0000January 30
000000002018-02-08-0000February 8

London
 United Kingdom
Europe
S014XIV
—
000000002018-07-29-0000July 29
000000002018-08-14-0000August 14

Oslo
 Norway
Europe
—
W006VI
1952
000000002018-02-14-0000February 14
000000002018-02-25-0000February 25

Helsinki
 Finland
Europe
S015XV
—
000000002018-07-19-0000July 19
000000002018-08-03-0000August 3

Cortina d'Ampezzo
 Italy
Europe
—
W007VII
1956
000000002018-01-26-0000January 26
000000002018-02-05-0000February 5

Melbourne
Stockholm[g]
 Australia
 Sweden
Oceania
Europe
S016XVI
—
000000002018-11-22-0000November 22
000000002018-06-10-0000June 10
000000002018-12-08-0000December 8
000000002018-06-17-0000June 17

Squaw Valley
 United States
North America
—
W008VIII
1960
000000002018-02-18-0000February 18
000000002018-02-28-0000February 28

Rome
 Italy
Europe
S017XVII
—
000000002018-08-25-0000August 25
000000002018-09-11-0000September 11

Innsbruck
 Austria
Europe
—
W009IX
1964
000000002018-01-29-0000January 29
000000002018-02-09-0000February 9

Tokyo
 Japan
Asia
S018XVIII
—
000000002018-10-10-0000October 10
000000002018-10-24-0000October 24

Grenoble
 France
Europe
—
W010X
1968
000000002018-02-06-0000February 6
000000002018-02-18-0000February 18

Mexico City
 Mexico
North America
S019XIX
—
000000002018-10-12-0000October 12
000000002018-10-27-0000October 27

Sapporo
 Japan
Asia
—
W011XI
1972
000000002018-02-03-0000February 3
000000002018-02-13-0000February 13

Munich
 West Germany
Europe
S020XX
—
000000002018-08-26-0000August 26
000000002018-09-11-0000September 11

Innsbruck
 Austria
Europe
—
W012XII
1976
000000002018-02-04-0000February 4
000000002018-02-15-0000February 15

Montreal
 Canada
North America
S021XXI
—
000000002018-07-17-0000July 17
000000002018-08-01-0000August 1

Lake Placid
 United States
North America
—
W013XIII
1980
000000002018-02-12-0000February 12
000000002018-02-24-0000February 24

Moscow
 Soviet Union
Europe[h]
S022XXII
—
000000002018-07-19-0000July 19
000000002018-08-03-0000August 3

Sarajevo
 Yugoslavia
Europe
—
W014XIV
1984
000000002018-02-07-0000February 7
000000002018-02-19-0000February 19

Los Angeles
 United States
North America
S023XXIII
—
000000002018-07-28-0000July 28
000000002018-08-12-0000August 12

Calgary
 Canada
North America
—
W015XV
1988
000000002018-02-13-0000February 13
000000002018-02-28-0000February 28

Seoul
 South Korea
Asia
S024XXIV
—
000000002018-09-17-0000September 17
000000002018-10-02-0000October 2

Albertville
 France
Europe
—
W016XVI
1992
000000002018-02-08-0000February 8
000000002018-02-23-0000February 23

Barcelona
 Spain
Europe
S025XXV
—
000000002018-07-25-0000July 25
000000002018-08-09-0000August 9

Lillehammer
 Norway
Europe
—
W017XVII
1994
000000002018-02-12-0000February 12
000000002018-02-27-0000February 27

Atlanta
 United States
North America
S026XXVI
—
1996
000000002018-07-19-0000July 19
000000002018-08-04-0000August 4

Nagano
 Japan
Asia
—
W018XVIII
1998
000000002018-02-07-0000February 7
000000002018-02-22-0000February 22

Sydney
 Australia
Oceania
S027XXVII
—
2000
000000002018-09-15-0000September 15
000000002018-10-01-0000October 1

Salt Lake City
 United States
North America
—
W019XIX
2002
000000002018-02-08-0000February 8
000000002018-02-24-0000February 24

Athens
 Greece
Europe
S028XXVIII
—
2004
000000002018-08-13-0000August 13
000000002018-08-29-0000August 29

Torino
 Italy
Europe
—
W020XX
2006
000000002018-02-10-0000February 10
000000002018-02-26-0000February 26

Beijing[i]
 China
Asia
S029XXIX
—
2008
000000002018-08-08-0000August 8
000000002018-08-24-0000August 24

Vancouver
 Canada
North America
—
W021XXI
2010
000000002018-02-12-0000February 12
000000002018-02-28-0000February 28

London
 United Kingdom
Europe
S030XXX
—
2012
000000002018-07-27-0000July 27
000000002018-08-12-0000August 12

Sochi
 Russia
Europe[h]
—
W022XXII
2014
000000002018-02-07-0000February 7
000000002018-02-23-0000February 23

Rio de Janeiro
 Brazil
South America
S031XXXI
—
2016
000000002018-08-05-0000August 5
000000002018-08-21-0000August 21

Pyeongchang
 South Korea
Asia
—
W023XXIII
2018
000000002018-02-09-0000February 9
000000002018-02-25-0000February 25

Tokyo
 Japan
Asia
S032XXXII
—
2020
000000002018-07-24-0000July 24
000000002018-08-09-0000August 9

Beijing
 China
Asia
—
W024XXIV
2022
000000002018-02-04-0000February 4
000000002018-02-20-0000February 20

Paris
 France
Europe
S033XXXIII
—
2024
000000002018-07-26-0000July 26
000000002018-08-11-0000August 11

TBD
TBD

—
W025XXV
2026
(TBD)

Los Angeles
 United States
North America
S034XXXIV
—
2028
000000002018-07-21-0000July 21
000000002018-08-06-0000August 6

TBD
TBD

—
W026XXVI
2030
(TBD)

tag: table

text: Host cities for multiple Summer and Winter Olympic Games[edit]

text:
List of cities that hosted multiple editions of the Olympic Games

City
Country
Continent
Summer Olympics
Winter Olympics
Total

London
 United Kingdom
Europe
3 (1908, 1948, 2012)
0
3

Paris
 France
Europe
3 (1900, 1924, 2024)
0

Los Angeles
 United States
North America
3 (1932, 1984, 2028)
0

Athens
 Greece
Europe
2 (1896, 2004)
0
2

Tokyo
 Japan
Asia
2 (1964, 2020)
0

Beijing
 China
Asia
1 (2008)
1 (2022)

St. Moritz
  Switzerland
Europe
0
2 (1928, 1948)

Innsbruck
 Austria
Europe
0
2 (1964, 1976)

Lake Placid
 United States
North America
0
2 (1932, 1980)

text: The 1906 Intercalated Games are not officially recognized by the IOC as an official Olympic Games.

text: Number of Olympic Games by country[edit]

text:
List of countries ranked by the number of times they hosted the Olympic Games

Rank
Country
Continent
Summer Olympics
Winter Olympics
Total

1
 United States
North America
5 (1904, 1932, 1984, 1996, 2028)
4 (1932, 1960, 1980, 2002)
9

2
 France
Europe
3 (1900, 1924, 2024)
3 (1924, 1968, 1992)
6

3
 Japan
Asia
2 (1940, 1964, 2020)
2 (1940, 1972, 1998)
4

4
 United Kingdom
Europe
3 (1908, 1944, 1948, 2012)
0
3

 Canada
North America
1 (1976)
2 (1988, 2010)

 Italy
Europe
1 (1960)
2 (1944, 1956, 2006)

 German Empire/ Nazi Germany/ West Germany/ Germany
Europe
2 (1916, 1936, 1972)
1 (1936, 1940)

8
 China
Asia
1 (2008)
1 (2022)
2

 South Korea
Asia
1 (1988)
1 (2018)

 Soviet Union/ Russia
Europe
1 (1980)
1 (2014)

 Greece
Europe
2 (1896, 2004)
0

 Australia
Oceania
2 (1956, 2000)
0

 Norway
Europe
0
2 (1952, 1994)

 Austria
Europe
0
2 (1964, 1976)

  Switzerland
Europe
0
2 (1928, 1940, 1948)

 Sweden
Europe
2 (1912, 1956 (equestrian events only))
0

17
 Brazil
South America
1 (2016)
0
1

 Spain
Europe
1 (1992)
0

 SFR Yugoslavia/ Bosnia and Herzegovina
Europe
0
1 (1984)

 Mexico
North America
1 (1968)
0

 Finland
Europe
1 (1940, 1952)
0

 Netherlands
Europe
1 (1928)
0

 Belgium
Europe
1 (1920)
0

text: Number of Olympic Games by continent[edit]

text:
Rank
Continent
Summer Olympics
Winter Olympics
Total

1
Europe
17 (1896, 1900, 1908, 1912, 1920, 1924, 1928, 1936, 1940, 1944, 1948, 1952, 1960, 1972, 1980, 1992, 2004, 2012, 2024)
14 (1924, 1928, 1936, 1940, 1944, 1948, 1952, 1956, 1964, 1968, 1976, 1984, 1992, 1994, 2006, 2014)
31

2
North America
7 (1904, 1932, 1968, 1976, 1984, 1996, 2028)
6 (1932, 1960, 1980, 1988, 2002, 2010)
13

3
Asia
4 (1940, 1964, 1988, 2008, 2020)
4 (1940, 1972, 1998, 2018, 2022)
8

4
Oceania
2 (1956, 2000)
0
2

5
South America
1 (2016)
0
1

6
Africa
0
0
0

text: Unsuccessful cities[edit]

text: This section does not cite any sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (February 2018) (Learn how and when to remove this template message)

text:
Country
City
Bids

 United States
Detroit
7

 Hungary
Budapest
6

 Turkey
Istanbul
5

 Spain
Madrid
4

 Argentina
Buenos Aires
4

  Switzerland
Lausanne
4

 United States
Philadelphia
5

 United States
Chicago
4

 United States
Minneapolis
3

 Cuba
Havana
3

 Belgium
Brussels
3

 Azerbaijan
Baku
2

 Qatar
Doha
2

 Spain
Seville
2

 Yugoslavia
Belgrade
2

 Puerto Rico
San Juan
1

 Australia
Brisbane
1

 Slovakia
Poprad
1

 United States
Boston
1


document_title: Victoria & Abdul

question_text: who plays the prince of wales in victoria and abdul

text: Victoria & Abdul

text: Plot[edit]

text: Abdul Karim, a young prison clerk from Agra, India, is instructed to travel to England for Queen Victoria's Golden Jubilee in 1887 to present her with a mohur, a gold coin which has been minted as a token of appreciation from British-ruled India.

text: The Queen, who is lonely and tired of her fawning courtiers, develops an interest in and later a friendship with Abdul. She spends time with him alone, and promotes him to become her Munshi as his guardian. She asks him to teach her Urdu and the Qur'an. When Victoria discovers that he is married, she invites his wife and mother-in-law to join him to England. They arrive wearing black Burqas, to the consternation of the household.

text: While Victoria treats Abdul as a son, his preferment is resented by her household and inner circle, including her son Bertie and the Prime Minister. The household plots to undermine their relationship, hoping that Abdul will be sent home. When Victoria embarrasses herself by recounting to the court the one-sided account of the Indian Mutiny that Abdul had told her, Victoria's faith and trust in him are shaken and she decides he must go home. But the following day she changes her mind and asks him to stay. She gives Abdul a bejewelled locket with her photograph.

text: Victoria's interest in India grows, and at her Isle of Wight home of Osborne House, she has the Durbar Room built for state functions, elaborately decorated with carvings by Bhai Ram Singh in an intricate style, and with a carpet from Agra. She hangs portraits of Indians in the House. She tells the household that she intends to give Abdul a knighthood.

text: The Prime Minister is adamant that the royal household must find a way to get rid of Abdul. They research his family background in India, and present Victoria with a dossier to show that his family is more ordinary and poor than Abdul has told her. When Victoria insists her doctor examine Abdul to find out why his wife has not fallen pregnant, he discovers that Abdul has gonorrhea, and rushes to tell the Queen, expecting her to dismiss him in disgust. However, Victoria remains loyal to Abdul and admonishes her courtiers for plotting against him.

text: Eventually the household decides that, if Victoria does not break with Abdul, they will all resign. They also threaten to certify Victoria as insane. When Victoria is told, she angrily summons the entire household to the Durbar Room and demands that anyone who wants to resign step forward. When none do so, she tells them she has decided not to make Abdul a knight, but to include him in her next honours list as a Commander of the Royal Victorian Order.

text: When Victoria falls ill, she urges Abdul to return to India, while she can still provide him with protection. She warns him that when she dies, the court will turn on him, but Abdul insists that he will stay with Victoria until the end of her life. In 1901, Victoria dies, and her son Bertie, now Edward VII, rejects Abdul, burning all the gifts and papers he has received from the Queen, and sending him and his family back to India. Abdul's wife manages to save the locket for him. It is revealed that Abdul lived in India until his death eight years later in 1909. The film ends with Abdul kneeling at a large statue of the Queen close to the Taj Mahal, talking to it and kissing its feet in respect.

text: Cast[edit]

text:
Judi Dench as Queen Victoria
Ali Fazal as Abdul Karim
Eddie Izzard as Bertie, Prince of Wales
Tim Pigott-Smith as Sir Henry Ponsonby
Adeel Akhtar as Mohammed
Simon Callow as Mr. Puccini
Michael Gambon as Lord Salisbury
Julian Wadham as Alick Yorke
Olivia Williams as Jane Spencer, Baroness Churchill
Fenella Woolgar as Miss Phipps
Jonathan Harden as The Kaiser
Paul Higgins as Sir James Reid, Physician to the Queen
Robin Soans as Arthur Bigge
Sukh Ojla as Mrs. Karim

text: Production[edit]

text: On 17 June 2016, it was reported that Judi Dench would play Queen Victoria (reprising her role as the Queen from the 1997 film Mrs Brown) in Victoria & Abdul, a film based on the book of the same name by Shrabani Basu. Stephen Frears was set to direct.[3] On 5 August 2016, it was announced that Ali Fazal would play Victoria's confidant Abdul Karim, while the film would be co-produced by Working Title Films and BBC Films, and co-financed by BBC and Focus Features.[4] Focus also handles U.S. distribution rights, while Universal Pictures International handles all other countries. The script was written by Lee Hall, and the producers are Beeban Kidron, Tracey Seaward, Tim Bevan, and Eric Fellner, while the other cast includes Eddie Izzard, Michael Gambon, Tim Pigott-Smith, and Adeel Akhtar.[4]

text: Principal photography on the film began on 15 September 2016, at Victoria's former royal residence Osborne House on the Isle of Wight in the United Kingdom.[5][6]

text: Costumes from the production were on display at Osborne House, from 24 July until 30 September 2017.[7] To capitalise on the renewed interest in Victoria arising from both the film and the concurrent second season of ITV's Victoria television series, the Isle of Wight Tourist Board has created a 'Victoria's Island Trail' encouraging tourists to visit the key locations on the island that have connections to the Queen.[8]

text: The production also filmed at The Chatham Historic Dockyard, Kent on The HMS Gannet and the quayside adjacent to the ship. [9]

text: Release[edit]

text: Victoria & Abdul was released for audiences in the United Kingdom on 15 September 2017, followed by a U.S. general release on 22 September.

text: Reception[edit]

text: On review aggregator website Rotten Tomatoes, the film has an approval rating of 66% based on 175 reviews, with an average rating of 6.2/10. The site’s critical consensus reads, "Victoria & Abdul reunites Dame Judi Dench with the role of Queen Victoria — which is all this period drama needs to overcome its imbalanced narrative."[10] On Metacritic, the film has a weighted average score of 58 out of 100, based on 34 critics, indicating "mixed or average reviews".[11]

text: In the Women's Voices for Change, Alexandra MacAaron, who rated the movie eight out of ten, wrote that "Judi Dench's Oscar-worthy second turn as Queen Victoria is a poignant portrait of fading power and human connection."[12] Christopher Orr's response from The Atlantic was positive, and he wrote "Victoria & Abdul is worth seeing for Dench's magisterial performance and for Frears's light but sure directorial touch. Just don't mistake it for actual history."[13]

text: Writing for The Independent, Amrou Al-Kadhi was highly critical: "Films like Victoria & Abdul seek to absolve our barbaric behaviour in colonised countries." He criticised the white-washing of the British Raj and the "offensive two-dimensionality" of Abdul's character, who is shown kissing the feet of Queen Victoria and expressing gratitude for being among the "glorious people" of the British Empire.[14]

text: In the Daily Express, critic Andy Lea rated the film two out of five, describing Abdul's character as "disappointingly servile" and criticising the plot as "decent material for a knockabout farce", but praising Dench as "predictably brilliant".[15] In his 4-out-of-4-rated review, Rex Reed in the New York Observer wrote: "Judi Dench gives a touching, majestic performance" and, complimenting the script and direction, he said that "every scene is gorgeous to look at, every shot magnificently detailed and richly framed. And the exemplary performances are as good as it gets in movies today."[16]

text: Accolades[edit]

text:
Year
Award/Festival
Category
Nominee
Result

2017

26th Heartland Film Festival
Truly Moving Picture Award

Stephen Frears

Won

21st Hollywood Film Awards
Hollywood Film Composer Award

Thomas Newman

Won

2018

14th North Texas Film Critics Association
Best Actress

Judi Dench

Nominated

7th AACTA International Awards
Best Actress
Nominated

75th Golden Globe Awards
Best Actress in a Motion Picture – Musical or Comedy
Nominated

24th Screen Actors Guild Awards
Outstanding Performance by a Female Actor in a Leading Role
Nominated

38th London Film Critics Circle Awards
British/Irish Actress of the Year
Nominated

22nd Satellite Awards
Best Actress
Nominated

Best Adapted Screenplay

Lee Hall

Nominated

Best Costume Design

Consolata Boyle

Nominated

71st British Academy Film Awards
Best Makeup and Hair

Daniel Phillips and Lou Sheppard

Nominated

90th Academy Awards
Best Makeup and Hairstyling
Pending

Best Costume Design

Consolata Boyle

Pending


document_title: Deaf education

question_text: who is given the credit for establishing deaf education

text: Deaf education

text: Identifying deaf students[edit]

text: This section needs expansion. You can help by adding to it. (January 2013)

text: Children may be identified as candidates for deaf education from their audiogram or medical history. Hearing loss is generally described as slight, mild, moderate, severe, or profound, depending upon how well a person can hear the intensities of frequencies.[1] Of the children identified as deaf, only 10% are born to deaf parents.[not in citation given] This percent of deaf students may have a linguistic advantage when entering the education system due to more extensive exposure to a first language.[2]

text: Individual needs[edit]

text: Deaf education programs must be customized to each student's needs, and deaf educators provide a continuum of services to deaf students based on individual needs.[3] For instance, if a student is in a regular class, a note taker or interpreter might be an accommodation provided in their education plan.[4] In the United States, Canada and the UK, education professionals use the acronym IEP when referring to a student’s individualized education plan.

text: Methods[edit]

text: Schools use a number of approaches to provide deaf-educational services to identified students. These may be grouped into four categories, according to whether (and how much) the deaf student has contact with non-deaf students (using North American terminology):

text:
Inclusion: Deaf students spend all, or most, of the school day with non-deaf students. Since inclusion requires considerable curriculum modification, it is considered best practice only for mildly-to-moderately deaf students.[5][6]  Specialized services may be provided inside or outside the regular classroom, and students may leave the regular classroom to attend smaller, intensive instructional sessions in a resource room or to receive other services requiring specialized equipment or which might be disruptive to the rest of the class (such as speech and language therapy).[7]
Mainstreaming refers to the education of deaf students in classes with non-deaf students for specified time periods, based on the deaf students' skills; deaf students learn in separate classes for the remainder of the school day.[8]
Segregation (in a separate classroom or school): In this model, deaf students spend no time in non-deaf classes or with non-deaf students. Segregated students may attend a school where non-deaf classes are provided, but spend their time in a separate classroom for students with special needs. If their special-needs class is in a mainstream school, they may have opportunities for social integration (for example, eating meals with non-deaf students);[9] alternatively, deaf students may attend a special school.[8]
Exclusion:  A student unable to receive instruction in any school is excluded from school. Most deaf students have historically been excluded from school,[10] and exclusion may still occur where there is no legal mandate for special-education services (such as developing countries). It may also occur when a student is in hospital or housebound.[8] Excluded students may receive individual or group instruction, and students who have been suspended or expelled are not considered "excluded" in this sense.

text: The difference between mainstreaming and inclusion is not made explicit in the law, and use may vary from district to district.[11] Further, within the Deaf community, the term 'mainstreaming' often refers to any educational setting outside of a residential school.[12]

text: Bilingual-bicultural education[edit]

text: In this method, deafness is approached as a cultural, not a medical, issue.[13] In a bilingual-bicultural program, deaf children are recommended to learn sign language such as American Sign Language (ASL) as a first language, followed by a written or spoken language such as English as a second language.[13][14] Bilingual-bicultural programs consider spoken or written language and sign language equal languages, helping children develop age-appropriate fluency in both.[14] The bilingual-bicultural approach believes that since deaf children learn visually, rather than by ear,[13] classes should be conducted in a visual language. To avoid harming the students' accuracy and fluency in either language, sign language and spoken language are not used simultaneously, since they use different grammar, syntax, and vocabulary; sign language is usually used as the language of instruction, though some bilingual-bicultural schools use spoken language in some contexts with some students.[citation needed] Many bilingual-bicultural schools have dormitories; students may either commute to school or stay in a dormitory as part of a residential program, visiting their families on weekends, holidays and school vacations.

text: Auditory-oral and auditory-verbal education[edit]

text: The auditory-oral and auditory-verbal methods, known collectively as listening and spoken language, are forms of oral education.[15] These methods are based on the belief that a deaf child can learn to listen and speak.[16][17] These methods, presented as communication options, rely on parental involvement.[16][17] Children using this option may be placed in a continuum of educational placement, including oral schools (such as the Clarke Schools for Hearing and Speech), classrooms for deaf students in public schools or mainstream classrooms with hearing students.[16][17][18]

text: Simultaneous or Total Communication[edit]

text: There is great variety in programs that label themselves as using simultaneous communication or total communication. Some programs consist of teachers and children speaking and signing at the same time, known as simultaneous communication.[19] In these programs, grammatically-correct English is available when speech is paired with Signing Exact English. This method is used in many programs in Texas and in the state of Washington at Northwest School for Deaf and Hard-of-Hearing Children. In total communication programs, however, teachers emphasize learning language and utilizing all means of communication.[19] Most often these programs do not use a grammatically correct form of either English or American Sign Language. Rather, professionals use a mixture of oral languages and signed languages or systems, including natural gestures, fingerspelling, body language, and lip-reading—most often paired with some degree of listening and speaking practice.[20]

text: Mainstreaming and inclusion[edit]

text: Using this educational method, a deaf child attends public school in regular classes for at least part of the school day.[21] Students may receive accommodation, such as itinerant teachers, interpreters, assistive technology, note-takers and aides.[22][23] The deaf/hard-of-hearing children that go to mainstream programs have daily interaction with hearing students and typically live at home; drawbacks include isolation and limited support.[22]

text: History[edit]

text:
John Bulwer, an English physician,
[24] wrote five works on bodily human communication (particularly gestures). He was the first person in England to propose educating deaf people,
[25] outlining plans for an academy in Philocophus and The Dumbe mans academie.

text: France[edit]

text: Charles-Michel de l'Épée pioneered deaf education in France. He did charitable work for the poor, and on one trip into the Paris slums saw two young, deaf sisters who communicated with a sign language. Épée then decided to dedicate himself to the education of the deaf, and founded a school in 1760. In line with the philosophy of the time, Épée believed that deaf people were capable of language and developed a system of teaching  French and religion. During the early 1760s his shelter became the Institut National de Jeunes Sourds de Paris, the world's first public school for deaf children.[26]

text: Great Britain[edit]

text: The first school for teaching the deaf to speak and read in Britain was Thomas Braidwood's Academy for the Deaf and Dumb in Edinburgh, established during the 1760s. The school moved to London in 1783, and was known as the Asylum for the Support and Education of the Deaf and Dumb Children of the Poor. Braidwood used an early form of sign language: the combined system, forerunner of British Sign Language (recognized as a language in 2003). Under the management of Braidwood's nephew the school expanded, encouraging the establishment of an Institution for the Instruction of the Deaf and Dumb in Edgbaston in 1814 and others in Liverpool, Edinburgh, Exeter, Manchester and Doncaster.[citation needed]

text: United States[edit]

text: Deaf education in the United States began during the early 1800s, when the Cobbs School (an oral school) was established by William Bolling and John Braidwood and the Connecticut Asylum for the Deaf and Dumb (a manual school) was established by Thomas Hopkins Gallaudet and Laurent Clerc. When the Cobbs School closed in 1816, the manual method (which used American Sign Language) became common in deaf schools for most of the rest of the century. During the late 1800s schools began using the oral method, which only allowed the use of speech (in contrast to the manual method previously in place). The oral method was used for many years, until sign-language instruction gradually returned to deaf education.

text: Issues[edit]

text: Two general methods of deaf education are manualism and oralism. Manualism is instruction using sign language, and oralism uses spoken language. Although controversy has existed since the early eighteenth century about which method is more effective, many deaf-educational facilities attempt to integrate both approaches.  The National Association of the Deaf advocates a bilingual approach, to best support deaf students in their education.[27]

text: National approaches[edit]

text: This section needs expansion with: more worldwide coverage. You can help by adding to it. (January 2013)

text: United States[edit]

text: Some deaf students receive an individualized education program (IEP) outlining how the school will meet the student's individual needs. The Individuals with Disabilities Education Act (IDEA) requires that students with special needs be provided with Free Appropriate Public Education in the least restrictive environment appropriate to the student's needs.  Government-run schools provide deaf education in varying degrees, from the least-restrictive setting (full inclusion) to the most restrictive (segregation in a deaf school).[8] Education offered by the school must be appropriate to the student's individual needs; however, schools are not required to maximize the student's potential or provide the best possible services. Like most developed countries, American schools are  required to provide medical services (such as speech therapy) if the student needs those services.

text: Nepal[edit]

text: Deaf children in Nepal have the right to free, qualified education in line with  provisions of the UN Convention on the Rights of Persons with Disabilities (UNCRPD). However, education in a school for the deaf is limited to 13 dedicated schools for the deaf and a slightly-higher number of deaf resource classes in regular schools. All schools and classes are bilingual, with Nepali Sign Language and written Nepali the media of instruction.

text: Teacher training[edit]

text: This section needs expansion with: explanations of teacher training in respective countries. You can help by adding to it. (April 2014)

text: Deaf education majors and degree programs offer training and certification in the education of students with a variety of hearing abilities, addressing students' individual differences and needs. Deaf education also includes the study of special education, Deaf studies, education, sign language and Deaf culture (not all programs include the latter two).

text: Canada[edit]

text:
Additional Qualification:
York University
University of Ottawa

text: United States[edit]

text:
Doctoral program:
Gallaudet University[28] Washington, D.C.
Masters program:
Boston University[29]
National Center on Deafness, California State University, Northridge,[30] Northridge, California

text: United Kingdom[edit]

text:
University of Central Lancashire,[31] Lancashire, England
University of Bristol,[32] Bristol
University of Edinburgh[33] Edinburgh

text: New Zealand[edit]

text: Victoria University of Wellington[34]

text: The Netherlands[edit]

text: Visual Language, Signs and Gestures, Max Planck Institute for Psycholinguistics, Nijmegen

text: Deaf education associations[edit]

text:
United States
National Association of the Deaf (United States)
The Conference of Educational Administrators of Schools and Programs for the Deaf (CEASD)
The American Society for Deaf Children (ASDC)
Alexander Graham Bell Association for the Deaf and Hard of Hearing
Volta Bureau
United Kingdom
British Association of Teachers of the Deaf (BATOD)