At the start of the nineteenth century consumption, also called "phthysis", was one of the most dreaded illnesses along with cancer. The term usually referred to the widespread "pulmonary consumption". Metaphorical descriptions of the disease demonstrate the strong cultural significance attached to this medical, and also lay-medical, concept. Based on handwritten case histories and letters from Kaiserswerth deaconesses in the first half of the nineteenth century the author establishes the cultural implications with which sufferers met in the social practice. Consumption was seen as the visible manifestation of deviance. It was assumed that sufferers were also to blame for contracting the disease due to a lifestyle that was "excessive" in dietetic as well as Christian terms. The paper aims to analyze how the attribution of an "immoral" and "sinful" lifestyle was presented to sufferers by physicians and nurses and how this affected them. The attribution of moral implications to dietetic concepts -- as the first thesis of the paper will suggest -- originated from demographically motivated health policies prevalent around 1800. The paper will further try to show how, in the early nineteenth century, the idea arose that consumption was the disease of the proletariat suffering from metropolitan life.
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