Fyodor Dostoevsky incorporates tuberculosis (TB) into the plot of his 19th century novel Crime and Punishment as a subtle literary tool. This is something I was never able to fully recognize or understand until I became more educated on both this disease and on the social climate of Russia at the time that the novel was written. TB was very prevalent and a major killer during this time period, and so it is logically relevant to the story. However, its presence in the novel holds symbolic significance as well.
TB, more commonly referred to as “consumption” in the literature of Dostoevsky’s time, is a disease caused by the bacteria Mycobacterium tuberculosis. It is an airborne disease that can be transmitted from human to human by sneezing, coughing, or even speaking. If left untreated, a TB infection can be fatal1. TB can be present in the body without causing sickness; this is called a latent TB infection. When the immune system of this latently infected person cannot prevent the TB from multiplying, then disease and sickness begin1. In a sense, we can think of TB as an opportunistic pathogen. This infection is more likely if the person is not treated correctly for past TB infections, has other health problems that cause a weakened immune system, or if they abuse alcohol1.
So, what does this have to do with Crime and Punishment?
Fyodor Dostoevsky’s Crime and Punishment paints a vivid picture of life in St. Petersburg, Russia in the 1860’s. The main action of the plot is complex and beyond the scope of this post, but the mood that Dostoevsky sets out to create is what is relevant—claustrophobia and despair are underlying tones all throughout the novel.
At this time, the emancipation of the serfs had just happened in Russia, and there was a highly striated social class system—the upper classes were distinctly separated from the peasants2. As a result, the lower class in St. Petersburg was facing bleak living and social conditions in the city. Some major problems that these people faced were poverty, filth, overcrowding, inadequate nutrition, and alcohol dependency3.
These conditions are perfect for Mycobacterium tuberculosis searching for a host. Alcoholism and poor eating habits can both factor into a deficient immune system. Overcrowding is often a major factor in facilitating the spread of disease. Dirty living quarters are prime breeding grounds for bacteria. Poverty often rules out the possibility of quality health care.
TB is depicted as a disease of the poor and underprivileged in this novel. This is a fair analysis, but we know that the disease does not discriminate–when it finds an opportune time, it will infect regardless of social status or wealth.
Including anecdotal instances of TB in this work is an effective tool to personify this lower class and describe their social struggles, especially when one understands the historical context.