In the book Now We Are Six, first published in 1927, A.A. Milne includes a charming poem called “Sneezles.” In it, Christopher Robin has come down with a cold, which causes his parents to fuss and fret and call the doctors. “All sorts and conditions of famous physicians/ Came hurrying round at a run,” and they warned that “If he freezles in draughts and in breezles/ The PHTHEEZLES may even ensue.” When I read this poem as a kid, I assumed that phtheezles was an entirely made-up word, meant to sound like an important and therefore unpronouncable medical condition. It wasn’t until much later that I realized this poem, in however silly a way, reflects a very real fear of many parents in Christopher Robin’s time: that the cough their darling child wakes up with one morning may in fact be the first sign of pulmonary tuberculosis and its accompanying slow death.
The term phthisis (I’ve mostly heard it said as THIGH-sis, and sometimes as TIE-sis; liveforever says it's f'thEEsis) is first recorded in the writings of Hippocrates in the fifth century B.C., who described the condition as the most common single affliction among his country men, and the most often fatal, and gives a very accurate clinical description of tuberculosis:
“Most of them were affected by these diseases in the following manner: fevers accompanied with rigors, of the continual type, acute, having no complete intermissions… constant sweats, but not diffused over the whole body; extremities very cold, and warmed with difficulty… sputa small, dense, concocted, but brought up rarely and with difficulty… they were soon wasted and became worse, having no appetite for any kind of food throughout; no thirst; most persons delirious when near death.”
Hippocrates may have coined the name for the disease himself, from the verb phthinein, to waste away (the root phthi- is related to the Sanskrit ksitih-, meaning “destruction”). Medieval medicine, owing much to Greek and Latin scholarship, used the term phthisis, and later medical traditions adopted it as well. It was, until the word tuberculosis came in vogue in the late nineteenth century, the primary ‘technical’ name for consumption.
It should be noted that, like many ancient disease terms (leprosy, in particular, comes to mind), phthisis has, over the ages, referred to more than one modern illness. While in general, phthisis meant tuberculosis, it also was applied to other diseases that looked similar—that is, progressive wasting diseases, particularly if they involved coughing or breathing trouble. One noteworthy example is that of what came to be called pneumoconiosis or ‘black lung’. When doctors began autopsying dead patients in the early 1800s, they found that most people who died of phthisis had characteristically tubercular lungs: they were full of lesions called tubercles, the tissue soft and cheesy in texture. But a number of them showed a markedly different phenomena: the lungs were black or dark in color, or full of fibrous gunk. In time, doctors realized that the men and women dying of this different, ‘fibroid,’ phthisis all had in common certain places of employment: mainly coal mines, textile factories, and ceramic factories. What looked on the outside like tuberculosis was in fact caused by the inhalation of irritants that lodged in the lungs. In the long term, this, like a tuberculosis infection, resulted in too little oxygen reaching the body, and the living tissues slowly withered and died.
Barnes, Emm. "Dust and Lungs: The Case of 'Phthisis.'" University of Manchester Centre for the History of Science, Technology, and Medicine, 2004.
Daniel, Thomas M. Captain of Death: The Story of Tuberculosis. Rochester, NY: University of Rochester Press, 1997.
The Internet Classics Archive: Of The Epidemics, by Hippocrates. Translated by Francis Adams. Maintained by Daniel C. Stevenson, Web Atomics. 17 May 2005. http://classics.mit.edu/Hippocrates/epidemics.1.i.html
Online Etymology Dictionary. Maintained by Douglas Harper. 17 May 2005. etymonline.com