The millennial flight against
tuberculosis has been characterized by several defeats. Roman physicians suggested to consumptives better nutrition, sea voyages and change of air, while, during the Middle Ages, 'royal touch' were considered as an effective remedy for
scrofula. In the following centuries, phthisis was cured using old
herbal preparations and new chemical compounds, mainly aimed at soothing symptoms; in addition, harmful approaches (for example,
bleeding and purging) were commonly accepted, according to medical theories of that time. In the second part of the nineteenth century, the discovery of the contagious nature of consumption (Villemin, Koch) addressed physicians and scientists toward often-unsuccessful remedies, such as
antiparasitic treatment, immunomodulants, vaccination and serum
therapy. In that period only sanatorium regimen--based on aerotherapy,
bed rest, better nutrition, sunbathing and moderate physical exercise--appeared to provide first partial successes. In these structures, more invasive approaches were also employed, such as
lung collapse surgical interventions (for example, phrenicotomy,
thoracoplasty) and
artificial pneumothorax. Since the second part of the twentieth century, the industrialization of
pharmacotherapy, the development of antimicrobial
chemotherapy and the introduction of new
antibiotics (
streptomycin,
isoniazid,
para-aminosalicylic acid,
ethambutol and
pyrazinamide) deeply revolutionized treatment for
tuberculosis, allowing to achieve important successes. In this same period, the figure of Piero Sensi (1920-2013) deserves to be recalled for his contribution in the development of
rifampicin that played a decisive role in the chemical fight against the white
plague. Nowadays, antibiotic resistance is an emerging problem, representing a new challenge for physicians and scientists who sometimes re-proposed old 'historical' approaches.