A 19th Century Killer Disease: Tuberculosis
In 1882, Robert Koch, a German country doctor, succeeded in isolating the bacillus of tuberculosis. This discovery came at a time when this disease was the greatest single killer of the human race.
All during the IQ4 century, it had spread remorselessly with the growth of cities, until it had reached epidemic proportions throughout the industrialized world.
Its record in the United States was one of frightful devastation. Immigrants from Europe, many of them debilitated from famines at home, flooded into the poorest and dirtiest sections of cities, there to die of the disease by the thousand. Working children were infected in staggering numbers. Hundreds of thousands of children worked twelve hours a day, six days a week. Chronically exhausted and undernourished, they made particularly susceptible victims. Since tuberculosis was not considered contagious, its victims spread the disease amongst those about them as they coughed, spat and drank from communal cups.
It is now known that tuberculosis is chiefly spread by droplet infection. It can also occur as a result of drinking unpasteurized milk from tubercular cows, where the pathogen penetrates the body through the alimentary canal. However, entry of the bacillus into the body is not necessarily followed by a clinical illness, the development of which depends on several other factors. Many people, for instance, seem to have a high natural resistance and although the acquired immunity is not fully understood, it has been proved that if a person contracts and recovers from a primary tuberculosis infection, he is less likely to develop active tuberculosis on subsequent exposure to the tubercle bacillus than a patient who has not previously been infected.
Tuberculosis has notoriously been associated with poverty, with its accompanying malnutrition, overcrowding and stress, and while the exact role of nutrition is uncertain, it seems that a diet based on cheap carbohydrate and a lack of protein and vitamins is another contributing factor.
In addition, a condition such as diabetes mellitus also leads to increased risk of developing the disease, and statistics from certain mining areas in Africa show that sufferers of respiratory' disorders, such as silicosis, are especially vulnerable to attacks of pulmonary tuberculosis.
The introduction of mass immunization against TB by the use of BCG vaccine, and of mass radiography, where it is possible to screen large numbers of people for early signs of tuberculosis, has dramatically reduced the incidence of the disease in the last few decades.
Despite the fact that tuberculosis was the number one in the 19th century, it was not proved that the disease was until 1882 when Robert Koch succeeded in isolating the tubercle bacillus. While it is now well known that tuberculosis is spread by infection, it is also evident that entry of the tubercle bacillus does not lead to development of the disease. Although we do not yet fully understand there is evidence to show that a person who has contracted and recovered from the disease is likely to develop active tuberculosis on subsequent exposure to the bacillus than a patient who has not been infected. As with all diseases spread by droplet infection, living in overcrowded insanitary conditions greatly increases the risk of . It is obvious, therefore, that in crowded cities the risk of contracting tuberculosis is far higher than in rural areas. Inadequate diet also seems to be a , and sufferers of conditions such as diabetes mellitus or appear to have a lower effective degree of . In the last thirty years or so. many thousands of people throughout the world have been substantially protected from developing tuberculosis largely as a result of programmes.
AI explanationShows the answer. Tap to open.
Question Focus: Synonym match - summary says 'number one' and passage says 'greatest single killer'
Correct Answer: killer
Why this is correct: The passage clearly describes tuberculosis as the greatest single killer at that time. The summary paraphrases this as 'number one', so the word killer fits perfectly.
Passage Reference: This discovery came at a time when this disease was the greatest single killer of the human race.
Common Mistake: Students sometimes write disease because tuberculosis is mentioned, but that misses the idea of being the main cause of death. This is a paraphrase trap.
Paraphrasing: Passage: 'greatest single killer' = Summary: 'number one ___'
Tips: When you see phrases like 'number one', look for ranking words in the passage.
Key Vocabulary:
- killer = cause of death
Question Focus: Direct match with negative statement in passage
Correct Answer: contagious
Passage Reference: Since tuberculosis was not considered contagious, its victims spread the disease amongst those about them as they coughed, spat and drank from communal cups.
Why this is correct: The passage says tuberculosis was not considered contagious at that time. The summary uses the same idea, so contagious is the correct word to complete it.
Common Mistake: Some students write infectious, which is similar in meaning but not the exact word. This is a synonym trap.
Paraphrasing: Passage: 'not considered contagious' = Summary: 'was not proved that the disease was ___'
Tips: Always copy the exact word from the passage, not a synonym.
Key Vocabulary:
- contagious = can spread between people
Question Focus: Exact phrase match
Correct Answer: droplet
Passage Reference: It is now known that tuberculosis is chiefly spread by droplet infection.
Why this is correct: The passage states that tuberculosis is spread by droplet infection. The summary already includes 'infection', so the missing word is droplet.
Common Mistake: Students sometimes write airborne, which changes the wording. This is a synonym trap.
Paraphrasing: Passage: 'spread by droplet infection' = Summary: 'spread by ___ infection'
Tips: If part of the phrase is already given, copy only the missing word.
Key Vocabulary:
- droplet = tiny drop of liquid
Question Focus: Grammar and meaning match
Correct Answer: necessarily
Passage Reference: However, entry of the bacillus into the body is not necessarily followed by a clinical illness
Why this is correct: The passage explains that entry of the bacillus is not necessarily followed by illness. The summary copies this structure, so necessarily is correct.
Common Mistake: Students sometimes omit this word, but that changes the meaning. This is a partial truth trap.
Paraphrasing: Passage: 'not necessarily followed' = Summary: 'does not ___ lead'
Tips: Watch for adverbs that limit meaning like 'necessarily'.
Key Vocabulary:
- necessarily = always, in every case
Question Focus: Exact phrase match
Correct Answer: acquired immunity
Passage Reference: although the acquired immunity is not fully understood
Why this is correct: The passage directly says the acquired immunity is not fully understood. The summary paraphrases this exactly.
Common Mistake: Writing only immunity loses the specific meaning. This is a partial truth trap.
Paraphrasing: Passage: 'acquired immunity is not fully understood' = Summary: 'do not yet fully understand ___'
Tips: If the passage uses a two-word technical term, copy both words.
Key Vocabulary:
- acquired = developed over time
- immunity = ability to resist disease
Question Focus: Comparative form
Correct Answer: less
Passage Reference: he is less likely to develop active tuberculosis on subsequent exposure to the tubercle bacillus than a patient who has not previously been infected.
Why this is correct: The passage states that someone who recovered is less likely to develop active tuberculosis again. The summary keeps the same comparison.
Common Mistake: Some students write more, reversing the meaning. This is a contradiction trap.
Paraphrasing: Passage: 'less likely to develop' = Summary: 'is ___ likely to develop'
Tips: Always check comparison words like more or less carefully.
Key Vocabulary:
- likely = probable
Question Focus: Time reference
Correct Answer: previously
Passage Reference: who has not previously been infected.
Why this is correct: The passage contrasts people infected before with those not previously infected. The summary keeps this time idea.
Common Mistake: Students sometimes omit this word, which weakens the comparison. This is a time/tense trap.
Paraphrasing: Passage: 'not previously been infected' = Summary: 'has not been ___ infected'
Tips: Pay attention to time words that show before or after.
Key Vocabulary:
- previously = before
Question Focus: Noun form required
Correct Answer: infection
Passage Reference: Tuberculosis has notoriously been associated with poverty, with its accompanying malnutrition, overcrowding and stress
Why this is correct: The passage links overcrowding with the spread of disease. The summary correctly concludes that overcrowding increases the risk of infection.
Common Mistake: Writing disease is too general. This is a paraphrase trap.
Paraphrasing: Passage: 'spread by droplet infection' = Summary: 'risk of ___'
Tips: After 'risk of', always expect a noun.
Key Vocabulary:
- infection = invasion by germs
Question Focus: Exact phrase match
Correct Answer: contributing factor
Passage Reference: it seems that a diet based on cheap carbohydrate and a lack of protein and vitamins is another contributing factor.
Why this is correct: The passage describes poor diet as another contributing factor. The summary copies this idea directly.
Common Mistake: Students sometimes write cause, which is stronger than the passage. This is a causation trap.
Paraphrasing: Passage: 'another contributing factor' = Summary: 'seems to be a ___'
Tips: Do not replace cautious language with strong cause words.
Key Vocabulary:
- contributing = helping to cause
Question Focus: Specific example
Correct Answer: silicosis
Passage Reference: such as silicosis, are especially vulnerable to attacks of pulmonary tuberculosis.
Why this is correct: The passage names silicosis as a respiratory disorder that increases risk. The summary uses the same example.
Common Mistake: Students may write respiratory disorders, which is too general. This is a partial truth trap.
Paraphrasing: Passage: 'respiratory disorders, such as silicosis' = Summary: 'conditions such as diabetes mellitus or ___'
Tips: When the passage gives 'such as', the example is often the answer.
Key Vocabulary:
- silicosis = lung disease from dust
Question Focus: Synonym match allowed
Correct Answer: immunity
Passage Reference: Many people, for instance, seem to have a high natural resistance
Why this is correct: The passage explains that some people have natural resistance, which matches the idea of immunity. Both answers are accepted.
Common Mistake: Students sometimes write health, which is too vague. This is a paraphrase trap.
Paraphrasing: Passage: 'high natural resistance' = Summary: 'degree of ___'
Tips: Check the answer list carefully. Sometimes two synonyms are accepted.
Key Vocabulary:
- resistance = ability to fight disease
Question Focus: Cause of reduction
Correct Answer: immunization
Passage Reference: The introduction of mass immunization against TB by the use of BCG vaccine, and of mass radiography, where it is possible to screen large numbers of people for early signs of tuberculosis, has dramatically reduced the incidence of the disease in the last few decade
Why this is correct: The passage states that mass immunization has reduced tuberculosis. The summary refers to these protection programmes.
Common Mistake: Writing vaccination programmes changes the wording. This is a synonym trap.
Paraphrasing: Passage: 'introduction of mass immunization' = Summary: 'result of ___ programmes'
Tips: If the passage already names a programme, use the same wording.
Key Vocabulary:
- immunization = vaccination process
General Tips:
- FIB answers follow passage order. Once you find gap 1, keep reading forward for the next answers.
- Always check the word limit. Extra words automatically make the answer wrong.
- Copy the exact word or phrase from the passage. Do not use your own synonyms.
- Use grammar clues like articles, prepositions, and comparison words to guide you.
The rest of this explanation is for members. Sign in free to read why the other options are wrong, key words and tips.
Sign in to read the full explanation