PIONEERS of MICROBIOLOGY and the NOBEL PRIZE

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1 PIONEERS of MICROBIOLOGY and the NOBEL PRIZE

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3 PIONEERS of MICROBIOLOGY and the NOBEL PRIZE Ulf Lagerkvist Goteborg University, Sweden Vfe World Scientific wl New Jersey London Singapore Hong Kong

4 Published by World Scientific Publishing Co. Pte. Ltd. 5 Toh Tuck Link, Singapore USA office: Suite 202, 1060 Main Street, River Edge, NJ UK office: 57 Shelton Street, Covent Garden, London WC2H 9HE Library of Congress Cataloging-in-Publication Data Lagerkvist, Ulf. Pioneers of microbiology and the Nobel prize / Ulf Lagerkvist. p. cm. Includes bibliographical references and index. ISBN X (alk. paper) - ISBN (pbk.: alk. paper) 1. Microbiology History 19th century. 2. Microbiologists History 19th century. 3. Nobel Prizes-History-19th century. I. Title. QR21.L '.09034~dc British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library. Cover images courtesy of Nobel Foundation, Bonnierforlagen and Royal Swedish Academy of Sciences, Stockholm, Sweden. Copyright 2003 by World Scientific Publishing Co. Pte. Ltd. All rights reserved. This book, or parts thereof may not be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system now known or to be invented, without written permission from the Publisher. For photocopying of material in this volume, please pay a copying fee through the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, USA. In this case permission to photocopy is not required from the publisher. Printed in Singapore by Mainland Press

5 Contents Preface Introduction vii ix The Era of the Cell 1 The Sites of Diseases 3 Cellular Pathology 9 The New Physiology 16 Bankruptcy and a Gleam of Hope 23 A World Unknown 29 Contagion Versus Miasma 31 The Birth of Microbiology 39 Bacteriology and the Nemesis of Surgery 45 Robert Koch 59 The Spare Time of a District Medical Officer 61 The Great Anthrax Quarrel 67 Tuberculosis, An Infectious Disease 71 The Cholera Vibrio 73 A Regrettable Mistake 75 Global Bacteriologist 77 Honors 80 The Man 81 Emil von Behring 85 The Discerning Vicar 87 A Military Surgeon 89 Antibodies 91 The Serum Therapy 95 Active Immunization Against Diphteria Toxin 101 Honors and Conflicts 102 A Tormented Man 105 Paul Ehrlich 109 The Man Who Loved Colors 111 The Serum Institute 115 The Advent of Chemotherapy 117 V

6 VI Pioneers of Microbiology and the Nobel Prize Salvarsan Success and Trouble 121 Honors and a Premature Death 123 Elie Metchnikoff 125 A Sensitive Young Man 127 The Road to Paris 132 Aging and Death 136 Nobel Prizes and Nobel Committees In Defence of the Nobel Prize 168 Bibliography 173 Index 175

7 Preface This book is about four great pioneers of medical microbiology Emil von Behring, Robert Koch, Paul Ehrlich and Elie Metchnikoff and their scientific contributions. They were all awarded the Nobel Prize in physiology or medicine. Thus, it may be of interest to see what impression their discoveries have made on contemporary science and particularly on colleagues at the Karolinska Institutet in Stockholm, who had been charged with the responsibility of evaluating the candidates for the early medical Nobel prizes. To appreciate their achievements, it is necessary to give the reader a short account of the breakthrough of scientific medicine in the 19th century and in particular the advent of medical microbiology. The book is primarily intended for an audience of laymen and I have tried to avoid being too scientifically ambitious, without falling into the trap of presenting only entertaining chatter. I am greatly indebted to the Nobel Assembly/Nobel Committee of the Karolinska Institutet for generously giving me access to their archive with information on Behring, Koch, Ehrlich and Metchnikoff. VH

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9 Introduction The teachings of Hippocrates dominated medical thinking from the 4th century B.C. to the beginning of the 19th century. They first spread to Rome, where the Greek physician Galen (A.D ) was active in all fields of medicine. His writings were studied by physicians also in the Arab world empire, where Hippocratic medicine found a refuge from the harsh cultural climate that prevailed in Western Europe during the Middle Ages. As Islamic medicine, it re-entered Southern Europe in the 10th century and established itself at the famous medical school of Salerno and the medical faculties of the universities of Bologna and Montpellier. It was not the acute clinical perception of the Hippocratic physicians, which we nowadays admire so much, that gave classic medicine its amazing power of survival. Instead it was the doctrine of the four body humors. Their correct proportions determined the health of the individual and all diseases could ultimately be traced to a disturbance of the delicate balance between blood, phlegm, yellow and black bile. Hippocratic medicine was therefore rather indifferent to a correct diagnosis, which we consider to be all-important. In the final analysis, all diseases had the same origin, disturbances of the body fluids, and the treatment was always the same different kinds of blood-letting, emetics and laxatives. It was all aimed at restoring the correct balance between the body humors. Not even during the renaissance and the scientific revolution of the 17th century, when Andreas Vesalius ( ) rejuvenated anatomy and William Harvey ( ) laid the foundation of modern physiology with his discovery of the circulation of the blood, was there any change in the uncritical reliance of clinical medicine on Hippocrates and Galen. It was not until the beginning of the 19th century that scientifically based medicine started to emerge not only in the laboratories but also to some extent on the clinics. Towards the middle of the century, medical thinking becomes more and more centered around the structural element that seemed to be the ultimate building stone of all living organisms the cell. IX