Singing and Consumption: La Boheme's Portrayal of Tuberculosis


AJ Cann 2006
Before drug therapy was available in 1946, nearly half of the people infected with tuberculosis [TB] died.  This death was horrific, yet romanticized due to it's purity--it was an "above the waist" disease. It struck wealthy and poor alike, but was worse for the poor since malnutrition, overcrowding, and poor living conditions hastened the disease process.  Doctors and medicines to lessen the pain were also less available to the poor.

Head and shoulders portrait in heavy shadow, depicting a dark-haired man with a curling moustache, wearing a winged collar with a tie and with a handkerchief protruding from the top pocket
Giacomo Puccini; courtesy
of  Wikipedia
In 1896, Puccini's magnificent opera La Bohème opened in Turin, Italy, directed by Arturo Toscanini. The two main characters Rodolfo and Mimi, living the Bohemian life, meet and fall in love.  Through trials and tribulations and a sustained absence their love does not waver.  The problem is that Mimi is dying of consumption.

The masses loved the opera, but the critics were not so enthusiastic.  They didn't like the life-style portrayed in the opera, didn't feel it measured up to what Italian Opera should be.  The people thought differently.  They came in droves to see this story of life and love, the Bohemian life, and all the complications of both.  Puccini's score and the libretto of Giuseppe Giacosa and Luigi Illica wove together an amusing, rowdy, sad, and mostly intense story.

At the end, Mimi sings about how cold her hands are and that she needs to sleep, becomes unconscious and quietly dies.  Rodolfo eventually becomes aware of her death and is understandably upset.  The opera ends with him crying "Mimi! Mimi!"--a most emotional scene to bear:

Recognizing that La Bohème was written before there was understanding of the cause of TB, was this an accurate portrayal?  Pulmonary TB can be asymptomatic for a number of years, but poor appetite, fatigue, weight loss, chills, fever and night sweats are common non-specific constitutional symptoms. Early in the opera, it appears that Mimi has limited energy, is frail and has chilled hands, but otherwise is able to live all right.  She is pale and has a cough that gets worse by Act 3.  At her end, she is weak, coughs a lot, has cold hands, but is able to belt out a song until the last few minutes. In advanced pulmonary disease one would expect a productive, phlegmy cough, and possibly blood-tinged sputum.  Painful pharyngeal [throat] ulcerations and hoarseness along with other dreadful symptoms could also be expected.  The patients, when close to death  [half of them died before there was drug treatment] would suffocate, leading to wild anxiety and hallucinations, often accompanied by severe pain.  Obviously, this would be an awful death. Perhaps too awful to stage accurately.  Mimi's death was awful in that it caused great pain to Rodolfo, her love, but was relatively peaceful, without medication except a cordial, for her.

Now, I can overlook all the inaccuracies and just enjoy the acting and music, even if a woman whose lungs are filled with infection, blood and fluid can sing wonderfully. Obviously others feel the same way.  Other books and productions with similar themes are Henry Murger's short story La Vie de Bohème; his play La Vie de Bohème written in 1848 with Théodore Barrière; Murger's 1849 book Scenes de la Vie de Bohème; La Bohème silent film in 1926 starring Lillian Gish; La Dames aux Camélias written by Alexandre Dumas in 1848; La Traviata by Giuseppi Verdi in 1853; La Bohème by Ruggiero Leoncavallo in 1897; 1936 movie Camille starring Greta Garbo; 1974 Charles Ludlam play Camille; RENT by Jonathon Larson in 1996--portrayal of AIDS instead of TB; and Moulin Rouge! written by Baz Luhrmann in 2001.  Luhrmann is also responsible for the Australian version of La Bohème.

For TB there are now multiple medications used in combination to treat it. That is another story--perhaps the next version of La Bohème.  I'd like to see Puccini's La Bohème unaltered, except the Mimi understudy should come out in the last scene and do what the original Mimi can no longer do--sing.


Black Dog Opera Library: La Bohème

La Bohème and dying/courtesan themed works


  1. Well, yeah, the "I have tuberculosis but I can still sing opera" thing is a little weak. But it's an opera- they communicate by singing - so what is she supposed to do - hold up cue cards a la Bob Dylan? I think the implausibility is topped by Massenet's Werther, in which the hero shoots himself in the head but keeps on singing for 20 minutes : )

  2. @artmonger--thanks for your comment..I love learning from readers!. I'll have to see Massenet's Werther....perhaps the understudy should come out like I suggested in the last 3 lines of this represent the person, but not actually be the person. I admit, it would be harder to sing with bullet in head.


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