Tubercular landscape: land use change and Mycobacterium in Melbourne, Australia, 1837–1900

Abstract

In the late nineteenth century, the city of Melbourne, Australia, experienced unusually high tuberculosis mortality. Dr. William Thomson, whose statistical methods uncovered the epidemiological trend, argued that at least one in three of the adult population of Melbourne between the ages of twenty and forty-five died of tuberculosis. While Thomson’s research challenged existing epistemologies of medicine, advocating sanitary rather than climatological aetiology, he was ultimately incapable of identifying the major factors in the spread of tuberculosis. Drawing on recent public health scholarship, which suggests a firm link between land use change and emerging infectious diseases, this paper examines the role of cultural, political, economic, and ecological activities of nineteenth-century Melbournians in constructing a niche suited to the success of Mycobacterium tuberculosis. Using epidemiological techniques, GIS, and historical records, this paper analyzes the city’s ability to handle waste, stagnant water, and other vectors of disease, and considers how manipulations of the landscape to accommodate the growing city’s sanitary and commercial needs exacerbated transmissibility of tuberculosis. It concludes that the imported characteristics of the British colonial city fostered land use change uniquely suited to the perpetuation of one of the most prolific diseases of the modern era.