Pharmageddon. David Healy

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СКАЧАТЬ In France, Louis Pasteur provided the first evidence that germs, later called bacteria, were the causative factors in a series of infections such as rabies,¹⁰ and he supplied both evidence and a rationale for vaccinations and antiseptic procedures.¹¹ In Germany, Robert Koch set up the first laboratory dedicated to the pursuit of the microbial causes of disease, and his most famous protégé, Paul Ehrlich, who more than anyone else developed the dyes that helped distinguish among bacteria, later developed the drugs that killed some of them. It was Ehrlich who coined the term magic bullet, for a drug that would specifically target the cause of an illness and leave the patient otherwise unaffected.¹² For generations afterward, until the 1960s, the glamour and importance of their discoveries and those of their successors, written up in books such as the Microbe Hunters, attracted students to medicine.¹³

      In 1877, Koch transmitted the lethal disease anthrax by injecting noninfected animals with the blood of infected animals; he then isolated anthrax spores and demonstrated that these spores, if grown in the eye of an ox for several generations, could also cause the infection. Where Lister met resistance for recommending an antiseptic approach in surgery on the basis of a comparison of the numbers of infections with and without antiseptic conditions, Koch could show the existence of bacilli under a microscope and later growing on a Petri dish, and then demonstrate the efficacy of sterilization in killing the bacillus. Where it had been difficult to overcome resistance to revolutionary ideas about antiseptics using only comparative numbers, for many seeing was believing.

      The impact on medicine of this new science of bacteriology and the germ theory of disease can be seen with wonderful clarity in the case of cholera. From the 1830s to the 1860s, before the role of germs in disease was recognized, a series of cholera epidemics struck Europe, killing tens of thousands. Because no one knew what caused this plague or how to protect themselves from a grisly death, there was widespread public panic. In 1856, in a now-celebrated series of investigations John Snow, a London physician, mapped the appearances of the disease around London. He made a connection between clusters of those with the disease and contamination of the water supply and famously recommended removal of the handle from the pump in Broad Street so residents would get their water from other sources.¹⁴

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