Tuberculosis has had one of the more remarkable careers of any disease that preys on humans. Once called phthisis—derived from a Greek word for wasting away—it was later designated “the King’s evil,” “white plague,” “white death,” “captain of death” and “consumption,” as in a British medical text of the 16th century that noted, with the lack of comprehension that attended the disease until deep into the 19th century, “Swete wynes be good for them the whiche be in consumption.”

How long the disease has been around is a matter of contention, with claims ranging from 20,000 to 70,000 years. What is not in doubt is that evidence of tuberculosis has been found in two sets of 9,000-year-old human bones buried together on the site of a now submerged village off the coast of Israel. Poignantly and tellingly, the bones are those of a woman and an infant, a reminder that tuberculosis has done so well for so long because it doesn’t rely on mosquitoes, rats, sexual congress, or fouled water as transmission vectors, but on the dependable human habits of community and intimacy, and that is why the infection was once near universal and why two billion people—one third of the world’s population—carry the disease today.

While it’s impossible to know how many have succumbed to TB through the ages, it’s believed that a billion or so sufferers have died over the past two centuries alone (including 1.5 million in 2014, mostly in Africa, Asia, and wherever AIDS continues to thrive). Among its more notable victims were Tutankhamun and Ho Chi Minh, Cardinal Richelieu and Thérèse of Lisieux, Chopin as well as Tom Fogerty of Creedence Clearwater Revival, Jane Austen and Kahlil Gibran, Louis XIII and XVII and Eleanor Roosevelt, Baruch Spinoza and Henry David Thoreau, and Dred Scott along with that singularly ardent cheerleader for the “positive good” of slavery, John C. Calhoun.

In the United States during the 19th century—the last in which tuberculosis was the nation’s leading killer—the disease is estimated to have been responsible for one in five deaths, a contention borne out by an 1811 census in Boston, which found that of 942 registered decedents, 221 were taken down by consumption. “Flux infantile” was the next most significant cause, linked to 57 deaths. Cancer, by contrast, caused a mere five deaths, not a great many more than the two ascribed that year to “Drinking cold water.”

And as terrifying as TB’s prevalence were the conditions it imposed on sufferers: which included a phlegmy cough that over time became a “graveyard rattle”; an unnaturally ruddy complexion that alternated with ethereal paleness; “hectic fevers” and glittering eyes; exhaustion; dramatic weight loss; and emissions of bloody sputum that spotted handkerchiefs and shirtfronts and bed sheets to begin with and, once the disease was well set, emerged as eruptions of frank blood sometimes sufficient to fill a teacup over the course of an attack.

How it spread was not known of course, though observers over centuries had for obvious reasons come to the conclusion that the disease was inherent in families. As to treatment, there was none that could be counted on, though hundreds were proffered both by medical professionals and by what George Bernard Shaw declared “a huge commercial system of quackery and poison.” Donkey’s milk was once said to offer advantages, as was bed rest, chair rest, vigorous exercise, moderate exercise, naps, peas, animal blood, insect blood, honey, breast milk, cold climates, warm climates, mountain climates, seaside climates, any place where coal isn’t burned, pregnancy for women and sexual restraint for men, teetotalism, “grit and a good stiff backbone,” and surgeries that don’t bear description. And of course “swete wynes.”

Serendipity has played a remarkable role in medical breakthroughs. Edward Jenner’s smallpox vaccine was engendered by a milkmaid who told him that those who contracted the harmless (to humans) cowpox never contracted smallpox. The role of the pancreas in diabetes was discovered by two researchers who had surgically removed a dog’s pancreas for study and later noted that flies were swarming in the dog’s (sugar-laden) urine. And penicillin, most famously, came to light when Alexander Fleming examined a petri dish of Staphylococcus and observed that the bacteria prospered everywhere but alongside a mold contaminant, Penicillium notatum, thought to have wandered in from an adjoining lab.

So too with tuberculosis—albeit 61 years after Robert Koch identified the mycobacterium that caused it. In 1943, soil expert Selman Waksman was a Rutgers professor working with the New Jersey Agricultural Experiment Station. As he recalled, he received a visit from a farmer with a chicken that was having breathing problems. A swab of the chicken’s throat delivered, among other things, a previously undiscovered microorganism—which the bird likely picked up pecking the ground—that turned out to produce a ferocious bacteria slayer later dubbed streptomycin.

Our story on the interplay of preparedness, serendipity, and passion in the life of medical researcher Kevin Tracey ’79 begins here.