A Short History of Disease by Sean Martin

Author:Sean Martin [Martin, Sean]
Language: eng
Format: epub, azw3
ISBN: 9781843444206
Publisher: Oldcastle Books
Published: 2015-06-09T23:00:00+00:00

The Age of Breakthroughs

The last major European outbreak of cholera occurred in Hamburg in 1892, a city whose port had played a prominent role in spreading the disease during the second pandemic. But the sixty years between the two outbreaks had seen a paradigm shift of almost unimaginable proportions when it came to the understanding – and treatment – of disease. What had started with virtually mediaeval responses – the day of penance in Britain and Ireland, the Paris mob lynching anyone thought to be spreading cholera through ‘powders’ – had ended with modern: the disease had been shown to be caused by the bacillus V. cholerae, spread by water.

The medical, political and social effects of cholera were immense. The likes of Chadwick, Shattuck and Virchow had made an indelible mark on public health, whose development would contribute to a significant drop in disease in the developed world as the nineteenth century turned into the twentieth. In identifying the bacillus, the new sciences of epidemiology and bacteriology had played decisive roles, aided by developments in laboratory technology such as better microscopes, the introduction of solid substances in culture media and the use of industrial dyes to better identify microbes.

Robert Koch also played a pivotal role in science’s thinking about disease. Convinced that diseases were caused by germs, he formulated a set of rules that became known as Koch’s Postulates:

1. The bacterium must be present in every case of the disease.

2. The bacterium must be capable of being isolated and grown in pure culture.

3. The specific disease must occur when the culture-grown bacillus is injected or inoculated into a host.

4. The bacterium must then be recoverable from the experimentally infected hosts.

These strictures, as John Waller noted, ‘soon acquired an authority on a par with the rules Moses brought down from Mount Sinai’.335 The increased rigour demanded by Koch’s postulates meant that, while it might take time for the causative agent of a disease to become proven, such as in the case of cholera, when that agent was found, it was definitive; there could be no going back to miasmas and tainted soil. Humoural theory had at last been laid to rest. It had had a good run, dominating medical thinking since Galen’s time. What replaced it was germ theory.

In addition to Koch, the other great name of the period was the Frenchman Louis Pasteur (1822–95). The two men could be regarded as among the principal architects of germ theory, although they did not invent it. As early as the sixteenth century, Girolamo Fracastoro had proposed that diseases were caused by ‘seeds’, and the invention of the microscope in the following century suggested that the great Italian doctor was correct. Englishman Robert Hooke (1635–1703) and Dutchman Antonie van Leeuwenhoek (1632–1723) reported seeing microbes beneath their instruments, and thus virtually invented the science of microbiology. Nicolas Andry (1658–1742) and Richard Bradley (1688–1732) both believed that the small organisms seen under Hooke’s and Leeuwenhoek’s microscopes caused disease, although they had no way of proving it.

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