This series of artworks by Anna Dumitriu investigates mankind’s strange relationship with Mycobacterium tuberculosis, the bacterium responsible for tuberculosis (TB) from early superstitions about the disease, through to the development of antibiotics, and the latest research into whole genome sequencing of bacteria. It explores the changing face of healthcare over history and the cultural impacts of TB, once called ‘the romantic disease’ because of its association with artists, poets and writers. Through juxtapositions between altered historical artefacts and stories woven by the artist around our changing beliefs it throws our idea of knowledge into question.

Blue Henry, 2014
Antique sputum cup, engraving

This unusual altered object is an engraved “Blue Henry”, a sputum flask carried by Mycobacterium tuberculosis (TB) patients in order to collect infected sputum coughed up from their lungs, rather than spit it out.

The engraving shows a transmission network of TB patients revealed through new research by the Modernising Medical Microbiology Project using whole genome sequencing. A collection of TB samples taken from patients from the English Midlands between 1994 and 2011 was sequenced and the method revealed many previously unrecognised links between patients. By identifying minor changes in the bacteria’s genome as it moves between people it is possible to reveal who passed the disease to whom. This diagram shows the possible occurrence of what is known as a “super spreader”, numbered “1”, who caught the disease from patient “0” and proceeded to spread it widely. Patient 1 is known to be a drug dealer and therefore a member of a recognised high-risk group for TB.

Pneumothorax Machine, 2014
Altered antique medical device with engraving and carving

This altered Pneumothorax Machine was originally used to collapse the lung of a Mycobacterium tuberculosis (TB) patient. The therapy was intended to give the lung “a proper rest” in the belief that this would give it a chance to repair itself, and also that it would cut off the oxygen supply to the TB bacteria and kill them. Around one third of pulmonary (lung) TB patients underwent some form of so-called “collapse therapy” between the 1930s and 1950s until antibiotic treatments replaced this unpleasant procedure. The object is transformed through intricate carving and engraving. The carved case represents the texture of the lung tissue as the immune system attempts to ‘wall off’ the “foreign” TB bacteria that it cannot eliminate. The engraving represents a positive sputum smear test made using a Ziehl–Neelsen staining technique. This rapid diagnostic test can be used to diagnose patients with active pulmonary TB. The bacteria stain red with Carbol Fuchsin against a background of Methylene Blue and may give the appearance of scattered red ribbons. The rise of drug resistant tuberculosis has seen new trials of artificial pneumothorax treatments.

Rest, Rest, Rest!, 2014
Metal and cloth stained with madder root and walnut with extracted DNA of tuberculosis

This tiny altered antique hospital bed and screen are impregnated with the extracted DNA of Mycobacterium tuberculosis (TB) and dyed with natural dyes, which were historically used as treatments for TB. However, until the discovery of the antibiotic Streptomycin in 1943, there was no effective treatment for TB and medical treatments were directed towards enhancing the immune systems of sufferers through a regime of regular meals and rest and fresh air. Some of the rest regimes were very extreme, such as artificially collapsing lungs in order to rest them. Calculations were made as to the number of breaths required to perform specific tasks and patients would be confined to bed, sometimes in just one position until they recovered, rebelled or succumbed.

Where there's dust, there's danger, 2014
Needle felted wool and dust with extracted DNA of tuberculosis, plus framed magic lantern
slide, vintage magazine article, drawing mounted in glazed wooden frame

These tiny needle-felted lungs are made from wool and household dust impregnated with the extracted DNA of killed Mycobacterium tuberculosis (TB). The organisms have been rendered sterile using a validated process used in whole genome sequencing of TB. The lungs show various stages of the disease and forms of treatment. Around the turn of the 20th century, it was widely believed that household dust was one of the main transmission vectors. Sufferers would cough up sputum from their lungs and spit it out. The sputum would dry and become mixed with dust. But it is not possible that the disease could be spread effectively in this manner, as the particles are far too large.

The Romantic Disease Dress, 2014
Antique Dress, natural dyes and extracted DNA of tuberculosis

Many natural dyes have also traditionally been used as medicines. This altered antique romantic era maternity dress has been stained with walnut husks, and embroidered with safflower and madder root dyed silk (front and hem). The neckline is decorated with madder root dyed flowers and the cuffs are trimmed with safflower dyed bows. These ancient dyes were used as ancient treatments for TB. The dress is impregnated with the extracted DNA of killed Mycobacterium tuberculosis (TB). The organisms have been rendered sterile using a validated process used in whole genome sequencing of TB. In the past TB was considered to be hereditary and couples ‘tainted’ by the disease were not permitted to marry or have children. The complex relationship between our genetic make-up and TB continues to raise difficult ethical questions.

Burden, 2015
Hand carved and polished fruit stone and opal stone, madder root dye, embroidery, and
extracted DNA of tuberculosis

This work focusses on the global health “burden” of tuberculosis (TB) and was hand carved in the form of lungs by artist using lemon opal and cobalt serpentine from Zimbabwe, with an additional textile element made from embroidered cotton calico which has been dyed with madder root (an ancient “treatment” for TB), and impregnated with TB DNA. Tuberculosis currently infects around one third of the world’s population, mainly in low to middle income countries but may spread as it becomes more resistant to our antibiotic treatments. The piece was inspired by discussion with a Zimbabwean sculptor who spoke about powerful impact of the disease on his country and his family.