Blue Henry and guinea pigs
"The Magic Mountain" is about many things... but it is above all about people who have contracted tuberculosis (or are suspected of having contracted it) living at close quarters in a sanatorium over 1,500 metres up in the Swiss Alps.
Tuberculosis is a highly infectious disease caused by the tubercle bacillus, Mycobacterium tuberculosis. Most forms of the disease affect the lungs, creating hard nodules (tubercles) and cheese-like masses that make breathing laboured and form cavities. The trademark coughing-up of blood is caused by the fact that the disease also erodes the blood vessels.
Tuberculosis was the main killer in all age groups of Western society from the surge in industrialisation and urbanisation in the 18th and 19th centuries of rapid industrialisation and urbanisation until the early 20th century. High population density facilitated its spread, which is one of the reasons that sufferers were sent, if possible, to rural and high-mountain areas where the air was purer. I've seen pictures of sanatoria in Australia, the United States and the UK (one of the first was built in Sutton Coldfield in 1836), and there is of course the one in Görbersdorf in Silesia (1863) that served as an inspiration for Davos and is the setting of Olga Tokarczuk's novel "Empuzjon".
In Switzerland, each canton had medical insurance arrangements for its TB sufferers to stay at specified sanatoria. In "An Tuberkulose erkrankt: Briefe der Geschwister Fröhlich aus dem Sanatorium Davos-Clavadel, 1928–1935 (2022), the subject of many of the letters between the Fröhlich siblings is when the authorities will allow the brother to leave his relatively simple sanatorium in the canton of Glarus for the higher, more promising environment of Arosa. As so often, the delay was due to bureaucracy entangled with financial issues.
One of the first questions that occurs to us as readers when Hans Castorp arrives at the Berghof International sanatorium and we accompany him to his room (fumigated after the death of an American woman the previous day) and then down to a crowded breakfast room the next morning is: if TB is so infectious, why are all these people allowed to socialise so much?
I put this to Timothy Howes, a former consultant respiratory physician at Colchester Hospital in the UK, an expert to whom I owe a great deal for his insights as a fan of medical history. He was presented with a copy of "The Magic Mountain" (in Helen Lowe-Porter's translation) by a German trainee of his a long time ago and told me that he was just as nonplussed by the close cohabitation of supposedly sick patients.
This led us on to the origins of the English saying about people being "guinea pigs" for something (as my class was described before taking the first ever GCSE exams in 1988). Apparently, there was a TB sanatorium in the UK where the patients were isolated from one another in wards that had an airlock at the back, the outer door leading into a corridor where nurses acted as sentries to ensure that no one could exit without authorisation.
Source: The Spruce/Kristie Lee
The air from each room was evacuated through a pipe leading to a unit where a guinea pig would was posted. Well, actually, many guinea pigs were consecutively posted, because these animals are highly sensitive to tuberculosis – as canaries are to gas fumes in a coalmine – and would die in large numbers. They naturally had to be bred in large numbers too. When the guinea pigs in a particular unit stopped dying, the patient was free of the disease and could be discharged.
No socialising there. But no Magic Mountain-like erotic, intellectual and cultural rite of passage either...
Anyway, if you've got this far, you may be wondering what the blue bottle at the top of this post is. Well, it's a "Blauer Heinrich", or "Blue Henry". A little bottle to spit into...
We are introduced to this little helper when Joachim Ziemssen comes to Davos railway station in the very first chapter:
‘I still cough up sputum though,’ [Joachim] said with a simultaneously casual and violent shrug of his shoulders that seemed out of character. He gave his cousin a glimpse of something he pulled halfway out of his overcoat pocket on Hans Castorp’s side and immediately stowed away again—a flat blue-glass bottle with curving sides and a metal cap. ‘Most of us up here have one,’ he said. ‘It has its own name too. A cheery little nickname. Taking in the scenery, are you?’
Note that he doesn't utter the name, which is not provided until page 120, and even then only due to an indiscretion:
‘Such a poor man!’ [Frau Stöhr] said. ‘He’s on his last legs. He has another rendezvous with Blue Henry.’ Quite casually, her face a picture of stubborn ignorance, she uttered the grotesque name ‘Blue Henry’, and her words prompted horror in Hans Castorp and also an urge to laugh. Incidentally, Dr Blumenkohl returned a few minutes later with the same demure attitude with which he had departed, sat down again and resumed his meal.
And yes, this very sick patient is genuinely called Dr Cauliflower. And yes, the discretion extends to spiriting the dead away during mealtimes and by bobsleigh under cover of darkness!
The next mention of 'Blue Henry' is as a carnival disguise in the 'Walpurgis Night' scene I read and discussed in a previous post. Blue Henry turns up with the Silent Sister – an unmarked thermometer to prevent people cheating on their temperature graphs!
Of course, antibiotics were not widely available at the time "The Magic Mountain" was written, let alone when it was set, although the Bacillus-Calmette-Guérin (BCG) vaccine was invented in 1921 by Albert Calmette and Camille Guérin, and Alexander Fleming discovered penicillin in 1928. Penicillin is inactive against the tubercle bacillus, and the sulphonamide drugs invented by Gerhard Domagk in Germany in 1932 were almost as ineffective. Sulphonamides are not true antibiotics, but they exploit differences in the mechanisms of cell division between bacteria and humans involving folic acid. They were chemically synthesised from azo dyes in the laboratories of the German chemical company I.G.Farben. Theoretically they could work on the tubercle bacteria, but the thick waxy coat (the term “myco” in the Latin name for tuberculosis means "wax") stops the sulphonamides getting in. Penicillin blocks n-acetyl muramic acid, which stops conventional bacteria making their cell membranes, and this means it won’t work on TB either because of its waxy cell membrane.
The classic anti-tuberculosis drug is streptomycin, which inhibits bacterial protein synthesis and is fat soluble enough to get into the tubercle bacillus. This was invented by Selam Waksman and Albert Schatz in the USA in the 1930s. Waksman was Ukrainian and German Jewish; Schatz was a German-American farmer, and streptomycin was extracted from soil bacteria. (The full story can be read in "Experiment Eleven" by Peter Pringle (2012).
It took a while for streptomycin to become widespread enough to sound the death knell of the sanatorium. The Schatzalp in Davos, which partly inspired Thomas Mann's "Berghof" in the novel, closed for TB business in 1953 and has since operated as a hotel.
Another thing that Tim Howes told me, apart from helping me out with the customary English terms used when ausculting TB patients – "Coarse!", "Vesicular", "Patch of coarse breath sound", "an area of crackles" – was that it was/is often very difficult to tell the difference on X-rays between a case of pulmonary tuberculosis and lung cancer. Which obviously begs the question: how many of the patients in the Berghof can be said, with any certainty, to have TB? There is in any case outrage when Herr Albin smokes in the communal rest room... although much of that has to do with the fact that he is wielding a gun and threatening to shoot himself!!