Tuberculosis was a main cause of distress, disablement, and death in England until the late 1950s. First published in 1988, The Retreat of Tuberculosis 1850–1950 is the first study of the personal, social, and economic consequences of the disease, changing fashions in treatment, and the response of government.
Sanatoria, revered in public memory as havens of healing, emerge from Dr Smith's scrutiny as establishments which housed only a tiny proportion of sufferers and rarely cured them. They absorbed money and skills that could have been deployed to better effect elsewhere, particularly in the Poor Law infirmaries and victims' dwellings where most cases languished. Protective measures such as efficient pasteurisation of milk and BCG vaccination were thwarted for a generation.
Meanwhile, mortality from tuberculosis fell steadily despite medical and political interventions. Dr Smith's investigation is a brilliant, wittily scarifying contribution to the history of ill-health and its consequences, and a compassionate survey of some of death's little ironies.