This is a long post but it is a really big subject - thanks for asking about it. I am focusing on Ireland but there is a lot of work done on TB worldwide. (Spitting Blood: The history of tuberculosis by Helen Bynum is a good survey)

There are two strands to the history of TB in Ireland. It was largely treated as a political history charting the development of treatment and campaigns culminating in the 1948-51 period when Minister for Health Noel Browne focused on the disease and was popularly credited with defeating it. More recently Greta Jones has written extensively on it and has questioned some of those narratives.

You are quite correct that TB was one of the most serious health issues in Ireland until the mid-1950s. It was the leading cause of death in nineteenth century Ireland (excepting extreme crises like the Famine). It was not addressed because it was incurable, slow acting and poorly understood. This was true throughout Europe and America in this period. The disease was widely thought to be hereditary and caused a great deal of social stigma especially regarding marriage prospects. A person can contract TB but not display symptoms for some time so it was hard for people to associate it with particular areas or risks. In 1882 the Tuberculosis Bacillus was identified but there was still no cure. In the 1880s 45% of all deaths of people between 25 and 35 years old in Ireland were from TB. The discovery that it was contagious increased social stigma.

From the 1890s charitable societies emerged to combat the disease. They focused on hygiene, education and segregating TB sufferers in separate wings of hospitals, poor houses or special sanatoria. For most ordinary sufferers, however, treatment at home was the norm.

Mortality did begin to fall from around 1905 – before the campaigns could reasonably have had a effect. There is some debate about why this was. Reasons may have included improvements in working conditions and a natural increase in immunity as the epidemic continued.

Ireland’s post independence record on treating TB was not especially impressive. There had been substantial damage to the country’s infrastructure and administration during the War of Independence and a requirement that state employee be able to speak Irish hindered medical recruitment. Evidence from the Rockefeller Foundation which helped fund TB treatment was critical of the Irish system and by the mid-1920s the 26 county Free State had slipped behind Northern Ireland in mortality from TB. Control of bovine TB was problematic due to the power of the farming industry. In addition the BCG vaccine was not widely adopted in the UK or Ireland for a variety of reasons.

By the post war period, the government was becoming increasingly interventionist. The 1945 Tuberculosis Act allowed the Minister for Health to build sanatoria and the 1947 Health Act gave him further powers to deal with the disease. In 1948 the new Minister for Health, Noel Browne, began a substantial campaign. The legend and reality of Browne is fascinating in its own right. He suffered from TB and had lost his parents and several siblings to the disease. He was a medical doctor and had worked in England and Ireland in TB sanatoria. He entered politics with the express intent of improving Irish TB care. He increased spending on TB fourfold and instigated a huge programme of building specialist hospitals and sanatoria. He also began a massive propaganda campaign to educate people about the disease.

In the popular imagination Browne was a hero. He was later forced from office when his plans to provide free ante-natal care to mothers and health care to children fell foul of the medical profession and the Catholic Church. His memoires are powerful but somewhat self-serving. The reality is that antibiotic treatment in the form of streptomycin was coming in just as his building programme began. By the mid-1950s, most of his hospitals had surplus beds which were used for geriatric care. In common with the rest of Europe, antibiotics proved decisive in defeating TB and the death rate fell rapidly through the 1950s.

Sources Clare Griffiths and Anita Brock, Office for National Statistics, ‘Twentieth Century Mortality Trends in England and Wales’, Health Statistics Quarterly 18 Summer 2003

Tuberculosis in Europe and North America, 1800–1922 http://ocp.hul.harvard.edu/contagion/tuberculosis.html Harvard Open Collections Programme

Marie Coleman 'The Irish sweep' : a history of the Irish hospitals sweepstake, 1930-1987

By Greta Jones

• Captain of All These Men of Death": The History of Tuberculosis in nineteenth and twentieth century Ireland

• Social History of Medicine Virtual Issue: Tuberculosis (http://www.oxfordjournals.org/our_journals/sochis/tuberculosis_virtual_issue_introduction.pdf)

• ‘The campaign against Tuberculosis in Ireland’ in Medicine, Disease and the State in Ireland, 1650-1940 edited by Greta Jones, Elizabeth Malcolm

• ‘Women and Tuberculosis in Ireland’ in Gender and Medicine in Ireland, 1700-1950 edited by Margaret Helen Preston, Margaret Ó hÓgartaigh