We observe the end of World War I on Nov. 11, Armistice Day. For Americans, World War II is the more remembered event, but the calamity of World War I for Europeans was not only in casualties, but the end of an era of progress and optimism in industry, in art, and in science and medicine.
In medicine, the previous half-century had seen the origins of the germ theory of disease, thanks to Louis Pasteur, and its application to surgery and public health by many people, including the English surgeon Joseph Lister and the German bacteriologist Robert Koch. Many of the agents of diseases such as cholera, malaria, diphtheria, tetanus, anthrax and tuberculosis had been discovered. Ways to control some of these diseases, including the first vaccines, had been devised.
After 1914, however, this scientific effort was invested in warfare. Fritz Haber, the chemist who created a method to make nitrogen fertilizer from atmospheric nitrogen, commanded the chlorine gas attacks on the western and eastern fronts. His wife committed suicide in despair.
In Paris, as the German armies approached the Marne, a Russian immigrant named Elie Metchnikoff, whose laboratory was at the Pasteur Institute, was also depressed. He had received the Nobel Prize in 1908 for discovering one of the foundations of immunology and had written a book on the philosophy of optimism, many scientific papers, and a classic textbook, “Immunity in Infective Disease.” He discovered phagocytosis — the act by which certain cells, called macrophages (literally translated, big eaters), destroy invading bacteria by eating them. Without these macrophages patrolling our bodies, we would all die of infection. Many scientists, including myself, revere Metchnikoff.
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In 1914, Metchnikoff feared that rational medicine — that is, medicine based on contagion by microorganisms, antisepsis, and the use of weakened bacteria and viruses to produce vaccines — would be a casualty of World War I. He worried that medicine would revert to the unproductive ideas it had relied on for centuries, ideas about miasmas and disease as a product of the body rather than an affliction of it.
Much like the rebels in Ray Bradbury’s “Fahrenheit 451,” who when faced with the burning of all literature in a fascist state, each undertook to memorize and preserve a classical work, so Metchnikoff felt responsible for preserving medical and scientific knowledge. He wrote a small book to inspire students to keep the research and its results alive. He wrote a history of the discoveries of Pasteur, Lister and Koch, the 19th century’s greatest proponents of a scientific approach to medicine: “Three Founders of Modern Medicine, Pasteur-Lister-Koch.” Here is his Introduction, not (to my knowledge) previously translated into English:
“These pages have been written in special circumstances. If we do not yet hear the growling of cannons, it is in waiting for them that I have had to spend several weeks in Paris, in my laboratory, which has been put in a state of war. The state of war has been accompanied by a near complete cessation of all scientific activity at the Pasteur Institute. From fear of a lack of food for the experimental animals, we have had to kill them, which keeps us from doing our research. The stables of the Institute have been emptied of cows, whose milk was destined for hospitals and orphanages. The majority of young collaborators, assistants, and technicians have been mobilized and we now have only women and old men.
“I, as an old man, find myself unable to experiment and in possession of much free time. I have employed it to write this book, in the hope that it will be useful. It is not for doctors, but for young people looking for an orientation in their research.”
Metchnikoff had known all of the protagonists in the story of the germ theory of infection. Louis Pasteur gave him a lab. Metchnikoff knew Joseph Lister, a surgeon who was tormented by infection among his patients and, from reading Pasteur, came up with the idea of antiseptic surgery to kill infection-causing bacteria. Metchnikoff had a difficult meeting with Robert Koch, who had discovered the bacteria that cause tuberculosis and cholera. Koch didn’t care about macrophages and he despised Louis Pasteur, but Metchnikoff gave him a fair treatment anyway.
One hundred years ago last August, World War I came suddenly, unstoppable. Among the many things it destroyed was the optimistic outlook that fuels civilized institutions and industrial, artistic, and scientific progress. That it came after a period of life-saving progress shattered Metchnikoff. Still, as an elderly scientist, alone in an empty laboratory in Paris, listening for the guns at the battle of the Marne, he had the courage to write this lovely book.
Richard Kessin is professor of pathology and cell biology at the College of Physicians and Surgeons of Columbia University. “Three Founders of Modern Medicine, Pasteur-Lister-Koch,” (Librairie Félix Alcan, Paris, 1933) is worth reading for students of biology, medicine or the history of medicine. It was translated in 1939 (Walden) and copies can be found online. The passage quoted above was not included in the 1939 edition, but rather in the French 1933 edition. The writer will teach a course, “From Microbes to Molecular Biology and Why it Matters,” at the Taconic Learning Center beginning in January.
