"Day We Discovered Cause of 'White Death'"
by Dr. Howard Markel
In many respects, the modern era of tuberculosis began in the mind of a 29-year-old German physician named Robert Koch, who in 1872 was appointed the district medical officer in Wollstein (a tiny village in West Prussia, now Wolsztyn, Poland). The Koch family lived in a four-room wooden-frame home, and the doctor’s consulting area was situated in the house’s parlor. Using a simple curtain to divide this room in half, Dr. Koch set up a laboratory that consisted of little more than a brand new, brass microscope he had specially ordered from Berlin, an incubator, sundry glass tubes, culture plates and retorts, and a camera he had rigged to the microscope to photograph the microbes he wished to study.
Like many young physicians of this era, Koch was struck by an intense fascination with all things microscopic, a fixation some medical critics derided as “bacteriomania.” Unlike his senior colleagues who ascribed epidemics to the contamination of the air with foul or unpleasant emanations, a notion referred to as the miasmatic theory, Dr. Koch sided with those who would become the scientific revolutionaries of their day by asserting and ultimately proving that specific microbes were the cause of specific infectious diseases.
Because Dr. Koch practiced in an agricultural district where wool production was a major industry, he saw his share of anthrax patients. Most of the cases he treated were what we call cutaneous anthrax, painful coal-black sores (hence, the name anthrax, from anthracite) on the fingers or hands resulting from physical contact with the microbes, which resided in the wool of the sheep they tended. In the most severe situations, or inhalational anthrax, the anthrax microbes entered the lungs of unsuspecting woolgatherers who soon succumbed to raging fevers, hemorrhaging and death.
Dr. Koch hypothesized that these workers were somehow ingesting a microscopic organism living on the hides of animal carcasses but his knowledge ended there. Helpless at his patients’ bedside, Koch was determined to figure out anthrax’s cause and, if possible, find a cure. So every evening, after the last patient left his consulting room, the young physician retired behind his curtain, sat at his makeshift laboratory bench, peered through the barrel of his microscope and conducted his search. Within a few months after he began this work, and countless mice later, Koch had his answer. A microbe named Bacillus anthracis, he painstakingly determined, caused the disease of anthrax.
Serendipity is often one of the most important components of a scientific discovery, yet as another great bacteriologist, Louis Pasteur, often observed, “chance favors only the prepared mind.” Three physical characteristics of Bacillus anthracis favored Koch’s discovery. The microbe has a distinctive appearance under a microscope; it is a large germ that forms even larger and hardy spores that can survive almost any manner of physical manipulation; and it is relatively easy to grow in the laboratory.
Despite his remarkable achievement of scientifically linking a specific germ to a specific disease and the ringing endorsements of many illustrious professors across Europe, the young Dr. Koch was unable to find a university position that allowed him the time and facilities to pursue his research full-time. And so he remained in Wollstein for another four years, until 1880, when he was appointed government advisor to the Imperial Department of Health in Berlin.
It was there that Robert Koch began a series of path-breaking discoveries that led to his winning the Nobel Prize for medicine or physiology in 1905. With a superb laboratory, powerful microscopes and all the assistants, experimental animals and materials he could ask for, Koch decided to investigate one of the major killers of his day: tuberculosis. His research focus was quite controversial at the time because most experts insisted that tuberculosis was a hereditary disease; after all, it did tend to “run” in families. Nevertheless, Dr. Koch was convinced that TB was infectious in nature. Working alone, without telling his colleagues, he locked himself in his laboratory every day for almost six months until he definitively isolated and figured out how to grow, or culture, the germ that we now know causes the disease: the tubercle bacillus, or Mycobacterium tuberculosis.
Never a commanding lecturer, Koch had a thin, reedy voice and tended to interject his phrases with an annoying amount of “ums” and “ers.” But on March 24, 1882, when he presented his findings at a monthly meeting of the Physiological Society of Berlin, he did so with clarity and elegant logic. The medical men present were dumbstruck by Koch’s address. So spellbound and conscious of the fact that they were witnesses to scientific history, the audience could not even applaud, let alone engage in the traditional scientific attack on another colleague’s work. In the room that night was a 28-year-old dermatologist named Paul Ehrlich, who ultimately achieved great fame as the discoverer of Salvarsan 606, the first “magic bullet” against syphilis. Ehrlich later recalled the evening as “the most gripping experience” of his scientific life, and as soon as the lecture was completed he rushed home to his makeshift laboratory, where he spent the night developing a novel staining technique for the tubercle bacillus.
Seventeen days later, on April 10, 1882, Koch published his lecture, “Die Aetiologie der Tuberculose” (The Etiology, or Cause, of Tuberculosis) in the The Berlin Clinical Weekly. Given the deadly command this once mysterious disease had so long wielded over human beings, news of its cause was reported not only in all of the major medical journals of the day but also as front page news in leading newspapers all around the world. Within a few weeks, “Koch,” literally, became a household name.
Robert Koch went on to even greater heights when he discovered the cause of cholera and not a few lows, such as in 1890 when he announced a potential cure for tuberculosis he called “tuberculin.” It turned out to be not at all therapeutic, much to Koch’s embarrassment, but, in later years, tuberculin emerged as a diagnostic tool to determine those who were infected with the TB bacillus. Along the way, he made many more discoveries, mentored some of the finest bacteriologists of his era, and, in keeping with the rough and tumble world of academia, made quite a few scientific enemies.
Question
Use the passages to answer the question. Select Passage 1 and Passage 2.
Using both texts, use evidence to support the inference that the medical profession benefits
1 answer
From the information provided in Passage 1, we can infer that the medical profession benefits significantly from scientific discoveries and advancements made by individuals like Robert Koch. The passage highlights several key points that support this inference:
Scientific Revolution: Dr. Koch's rejection of the miasmatic theory in favor of proving that specific microbes cause specific diseases reflects a significant shift in medical understanding. This transition to the germ theory of disease was crucial for the medical profession, leading to improved diagnosis and treatment methods.
Discovery of the Anthrax Microbe: Koch's meticulous research led to the identification of Bacillus anthracis as the cause of anthrax. This discovery provided a clear cause-and-effect framework that allowed subsequent medical professionals to understand, treat, and prevent this deadly disease.
Nobel Prize and Influence: Koch's eventual recognition with the Nobel Prize for his contributions to the understanding of tuberculosis demonstrates the long-term benefits of his research, not just for himself but for the entire field of medicine. His findings on tuberculosis changed the way healthcare systems approached infectious diseases.
In summary, the advancements made by pioneers like Koch directly benefited the medical profession by enhancing the understanding of infectious diseases, providing foundations for future research, and improving public health outcomes.
To support this inference with evidence from Passage 1, we could cite Koch's rigorous research methodology and the pivotal moments of discovery he achieved, as well as the recognition and accolades he received that highlighted the impact of his work on the medical field.
