Berlin, 1890. Doctors crowd the theatre's lobby, they've come to see history made. Tickets are impossible to get. One British physician,
a man who dabbles in writing, and is there on behalf
of a London newspaper, begs for a seat. When he fails to secure one, he first tries bribery and then stealth to make it past the ushers. Both attempts fail. The doors close, and he admits defeat. Arthur Conan Doyle will remain outside, but inside, the great German scientist Robert Koch begins to demonstrate his cure for Tuberculosis. Intro music [Birth of the People] This series is brought to you
by Child and Teen Checkups program. Every child needs a check up
at least once a year. If you live in Minnesota, they can help. Learn more at getctc.com The nineteenth century had many names for Tuberculosis. The most popular was 'Consumption', named after patients' dramatic weight loss. Another, 'The White Death', because of how pale sufferers became. And also 'The Captain of the Men of Death' due to its prolific body count. To live in nineteenth century
Europe and America, was to live among tubercular death. During that century, up to one in seven Germans
died of the disease. And, during some years, a full quarter of London's deaths
were attributed to TB. The crowded and unclean nature
of cities and factories, both on the rise, proved an ideal environment
for transmission. And in an era
before public hygiene campaigns, or the widespread belief
in germ theory, coughing, sneezing,
and spitting in public were the norm. Spitting was especially commonplace though, and considered healthy, given the amount of coal smoke
that coated city dwellers' sinuses. People freely spit on street cars, or even the floor
of the United States Congress, gross. It came on slow, lodging deep into the patient's lungs
and lying dormant for months or years. First, the patient would present
a cough that came and went. Then weight loss,
and weakness. One day, they might find
a telltale drop of blood in their handkerchief. Frailness and death would follow. There was little to do. Cod liver oil, Opium and Quinine
eased the suffering, but didn't fight the disease. Many patients chose to visit sanitoriums
and places with "good air": Alpine regions or particularly dry climates, while others subscribe
to unproven regimens of cold baths or immobility. Some, seeking any kind of relief, underwent surgeries too gruesome to describe here. Mostly though, people found a way to live
for as long as they could. After all, it killed slowly, and in this,
it was almost considered "merciful", providing the "good death"
surrounded by friends and family that was so desired
in the Victorian Era. The disease even
became fashionable, associated with Bohemians and Romanticists. After several prominent artists
died from the disease, women powdered their faces
to mimic the pale look. Novels and operas
told of doomed lovers destined to be separated
by the White Plague. Enter Doctor Robert Koch, Hero of the German Empire. He was *exactly* the kind of person
you'd expect to cure Tuberculosis. He'd come from humble beginnings, serving as a surgeon
during the Franco-Prussian War, and later opening a country medical practice, using his profits to build a home laboratory. He kept a menagerie of test animals in his backyard, ranging from chickens to rabbits
to guinea pigs and white mice. And it was there that he began to study a disease that ravaged his rural community: Anthrax. His big break came
when he developed, and demonstrated a process for isolating
and growing bacteria in pure laboratory cultures, techniques he used to identify the anthrax bacteria. And, that done, Koch forged ahead
with his research on microbes, quickly gaining a reputation
as a meticulous scientist. And when he lacked the tools
to prove what he needed, he just invented new ones! Finding novel ways to grow bacteria
on gelatin and agar, and developing
a photographic microscope, so doctors need not rely on drawings. But these discoveries
were no mere accomplishments. By identifying a specific bacteria as the cause of anthrax, And proving he could use that bacteria
to infect healthy animals, he had conclusively proved
the 'Germ Theory of Disease.' Moreover, he turned these initial experiments
into his four postulates. Criteria to demonstrate
whether a specific microbe caused a specific disease. This country doctor had, essentially, helped found Bacteriology. He would go on
to use these postulates to isolate Cholera bacteria in Bombay, and in a blockbuster 1882 announcement, revealed that he'd found the pathogen
that caused Tuberculosis. And that last declaration caused a sensation. Tuberculosis was the greatest killer in Europe, and identifying its cause suggested that a cure might be on the way. After all, that's what had happened when Koch first isolated Anthrax bacteria. And five years later,
Louis Pasteur had produced a vaccine. And that, in many ways, was why Koch was pursuing tuberculosis. He was annoyed that Pasteur had found a cure for Anthrax before he could. And furious that Pasteur had barely cited his research in doing so. Instead of jointly celebrating the discovery, the two entered a bitter lifetime feud, trading barbs in scientific journals. Koch seethed that Pasteur, who he saw as sloppy and self-aggrandizing, had encroached on his territory. Besides, Koch was German, and Pasteur, French. There was national pride on the line. Tuberculosis, Koch decided,
would be his greatest prize. If he could find an effective treatment
for the White Plague, his legacy would be assured. He might even get his own institute, like his hated rival, Pasteur. And after eight years, he finally had a breakthrough. A substance that, when injected into guinea pigs, starved the pathogen to death, by killing the infected flesh it fed on, allowing the dead flesh to detach and patients to expel it via cough. It didn't directly kill the disease, though, but it took away the ability to spread. He tested it on animals, then gave doses to healthy subjects including himself. None had a bad reaction, But, when he gave it to tubercular patients, it brought on severe fever, chills, and an apparent slowing of the disease. In patients who experienced growth
in their lymph nodes, the growths became necrotic. It was a lucky result. The Tenth Medical Congress was coming up, and he was under pressure to deliver
a great scientific victory for Germany. So, in 1890, Koch stood in a hall full of doctors at the Tenth Medical Congress in Berlin, and unveiled his new wonder remedy, Tuberculin. He stressed that his research was not complete, and that the substance worked best in patients whose cases were not too advanced. And, he insisted, the precise nature of the substance
must remain a secret at present. But here at last, was a remedy that could halt the progress of Consumption. There would be a demonstration in a few months. The news exploded. Newspapers announced that Koch
had found a cure. The Kaiser presented him
with Germany's highest award: The Grand Cross of the Order of the Red Eagle. Letters from all over the world
flooded his home and laboratory, begging for doses of tuberculin. And sensing an end to their misery, thousands of consumptives flocked to Berlin, creating a public health crisis that necessitated police intervention
to keep them away from the populace. And Koch got his wish: his own infectious disease institute, with a whole section researching tuberculin. They began producing the substance
and conducting human trials. The public demonstration was a success. The house was so packed,
that doctors without tickets, like Conan Doyle, were turned away. Luckily for Conan Doyle, however, he managed to copy notes
from a man who attended, and the next day, got to visit a ward where tuberculin was being tested on patients. His newspaper article was saved! But Conan Doyle was shocked at what he saw. Patients shivering, thrashing, burning with fever, The term had not been invented yet, but he was witnessing them going into shock. This was no cure. "The whole thing was experimental and premature," he warned in a piece
for the London Daily Telegraph. In a follow-up, he said that while the injection
may kill diseased tissue, it undoubtedly left the pathogen. Due to the swelling at the injection site, however, in low doses, it might serve as a test to diagnose TB. Conan Doyle was one of the few temperate voices. And within months,
the first trial doses began going out. Not just to Berlin, but to London, Paris, and Edinburgh, to private practices
and sanatoriums, as well as hospitals. Newspaper reporters and crowds gather to watch the first injections. There were no controls
about how much each patient would receive, and over two thousand people,
of all ages, received tuberculin. But the composition remained a secret. Koch still wouldn't reveal what was in tuberculin. This was unusual, even uncomfortable. But Koch was a genius
with a world-renowned reputation. Some patients appeared to improve, others, die. At first, the latter were dismissed as dire cases that would've expired anyway. But, as tests continue, the numbers began to tell a different story. Though some seemed to improve, only around two dozen (24) people were actually cured. Thirty (30) had died. It was a failure. And, more than that, news leaked that Koch had been in talks to patent tuberculin, using the profits to fund his new institute. Worse, a study revealed that killing infected tissue didn't actually stop TB from spreading. Under public pressure, Koch revealed the ingredients of tuberculin: dead tuberculosis microbes, in glycerin extract. ...and traveled to Egypt to avoid the firestorm. It was clear this was not the cure. Though as Conan Doyle predicted, the swelling around the injection area proved a very good test to diagnose TB patients who were allergic to the substance. Koch's mistake was one of pride and process. In his eagerness to secure a win for self and country, he'd abandoned the methodical practices
that were his hallmark. He'd bought into the myth of a scientist
as a heroic, singular figure, rather than as a part of a community that advances by building on each other's work. And as we'll see next time, it would take that kind of teamwork and incremental innovations to finally cure The White Plague. [Postulate 5 by Sean and Dean Kiner] Once again, thanks so much to Child and Teen Checkups programs for sponsoring this series. Tuberculosis isn't as common as it once was, but it does still exist. Children should receive a health checkup every year. And doctors can ask questions
to find out if your child is at risk. If you live in Minnesota, learn more at getctc.com If you don't (live in Minnesota), click the link in the description below.
Hearing about his beef with Pasteur reminds me of the Bone Wars, which would also be an excellent series.
Sucks that he let his jealously goad him into compromising his own standards. Who knows how many people died bc of that feud.