Editorial
References to tuberculosis in Greek popular music (Rebetico)
George E. Drakonakisa,⁎, Demosthenes Bourosb
a Pneumonology Department, Sitia Hospital and Health Centre, Sitia, Greece
b University Hospital of Alexandroupolis, University of Thrace, Alexandroupolis, Greece
Received 11 June 2006; received in revised form 1 February 2007; accepted 22 February 2007
Keywords: Tuberculosis; Phthisis; Rebetico; Popular music
Tuberculosis (TBC) was a major public health problem in
Greece before World War II. The incidence, morbidity, and
mortality rates of TBC were high, particularly amongst lowincome
groups exposed to poor living conditions and those
in the 20–29 year age range [1]. Many people were affected
and died from the disease, which was also known as the
“white plague” in the early 20th century.
There is little substantial research on the aforementioned
indicators in Greece. Bouros et al. mention that the incidence
of TBC is decreasing steadily in the Greek armed forces [2].
Yet, there has been a resurgence of TBC in Greece in recent
years. There has also been an increase in antituberculous,
drug-resistant TBC in association with the repatriation of
Greeks from the former Soviet Union and with the massive
influx of migrants from Central and Eastern Europe [3,4].
Rebetico is part of Greek popular music that was
introduced into Greece by war refugees after 1922. It
initially became popular in deprived city areas, where TBC
was most prevalent. Rebetico lyrics dealt with issues that
pre-occupied society at that time, one of which was TBC.
Reference to the disease is made in 41 rebetico songs
recorded between 1928 and 1952. Most of the songs refer to
the symptoms, complications, and outcome of the disease,
portraying TBC as a major killer; prevention, treatment, and
outlook for TBC are not mentioned.
Post-World War II, the incidence, morbidity, and
mortality rates for TBC decreased in Greece with the use
of vaccinations, other preventive measures against TBC, and
improved living conditions. The incidence has since
decreased and is no longer a major public health threat.
Thus, TBC references in rebetico gradually stopped [5].
Rebetico songs do not include words that provoke
revulsion, and TBC is not mentioned per se in the lyrics.
The disease was formerly referred to as “phthisis”, an ancient
Greek word associated with gradual weight loss [5]. In the
English literature, “phthisis” is synonymous with TBC and a
“phthisiologist” is a tuberculosis specialist.
Reference is made to the “cause” of the disease. Although
Robert Koch discovered Mycobacterium tuberculosis in
1882 [6,7], the event was ignored in rebetico lyrics, which
attribute the cause of the disease to destiny or even
punishment. Today, we know that a significant number of
mycobacteria that are classified as M. tuberculosis or Mycobacterium
avium-intracellulare complex can cause TBC
[8–10].
TBC symptoms were well known then as they are now.
Reference is made to paleness, gradual weight loss,
hemoptysis, and coughing. In two songs with references to
TBC, the singer is coughing, simulating someone afflicted
with the disease. Gradual weight loss and paleness caused by
the disease are referred to in the songs via popular Greek
metaphors such as “the body that melts like a candle”, “the
body that dies like a flower”, “the body that resembles dead
leaves, which fall from the tree” [5].
In a few rebetico songs, reference is made to the
contagiousness of TBC. One advises healthy relatives and
close friends to avoid any contact with the tuberculous
patient in order to avoid infection. Also, in other songs,
reference is made to the sanatorium. However, as the term
“sanatorium” causes revulsion, it is not mentioned per se in
European Journal of Internal Medicine 18 (2007) 357–358
⁎ Corresponding author. Ainou 91, GR-68100 Alexandroupolis, Greece.
Tel.: +30 6994873587, +30 2551038160; fax: +302551076106.
E-mail address: drakonakis@gmail.com (G.E. Drakonakis).
0953-6205/$ - see front matter © 2007 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
doi:10.1016/j.ejim.2007.02.008