Part 3
By 1885, the germ theory of disease was beginning to make life better. Pasteur’s vaccines saved millions of animals from anthrax and cholera. Understanding the dangers of bacteria-fouled milk and water led to pasteurization of milk and, at great civic expense, to cleaner water and better sewers. Antiseptic surgery saved patients from infection; clean hands and instruments saved mothers from lethal childbirth fever. In Berlin, Robert Koch, another great analyst of infection, identified the agents of cholera, diphtheria and tuberculosis. Readers should not imagine that this 19th century march of the scientists happened with cooperation and bonhomie; Pasteur and Koch, two authoritarian personalities, detested one another.
In 1885, the application of science to medicine had not yet gripped the general population — once a person had an infection there was little to be done. That fatalism started to change when a rabid dog attacked a boy named Joseph Meister. People were terrified of rabies because the disease could take weeks to appear and once it did, an anguished death was inevitable.
Young Joseph had a formidable mother who learned that Pasteur was working on a rabies treatment in Paris. Six days after the attack, she and Joseph left Alsace and appeared at Pasteur’s laboratory in Paris to ask for help.
Pasteur was not ready. Rabies was a confounding disease. He and his assistants thought they had found a bacterium in the saliva of rabid dogs, but it was not the cause of rabies. Nevertheless, they developed a procedure in which a bit of brain tissue from a rabid animal was inoculated into a rabbit brain and in eight days that rabbit developed rabies. But how could they weaken or attenuate the unseen agent of rabies so that it would provide immunity in other animals?
Emile Roux, one of Pasteur’s assistants, came up with the answer — he dissected out the brainstems of rabbits that had the disease and suspended them in a special bottle to dry for 14 days. He ground up the dried cord and injected it into fresh rabbits. Over the following days he injected stronger doses of dried brain material. He then injected a lethal dose of rabies virus, which the rabbit survived. Rabbits without the vaccination died. They moved on to dogs, which, treated in the same way, also survived a lethal dose of rabies virus. It is astonishing the experimenters survived — harvesting contaminated spinal cords from rabbits or retrieving saliva from rabid dogs was dangerous work.
What of Madame Meister and her son Joseph? Pasteur was not a medical doctor and could not make the decision to treat. Emile Roux was an MD, but refused to treat Joseph on ethical grounds. Two other physicians considered the depths of Joseph’s wounds, the certainty that the dog that had attacked him was rabid, and the horrific prospects for the child. At Madame Meister’s pleading, they decided to go ahead. For 14 days, Joseph got increasingly potent injections under the skin of his belly. He survived to become the concierge at the soon-to-be built Pasteur Institute.
The whole experiment was based on a wing and a prayer. They had not found any visible infectious agent — viruses as we now know them would not be defined until 1898 or seen until the electron microscope was available in the 1940s. The preliminary experiments had been successful but inadequate. There was quality control, but not much. With humans, there could be no unvaccinated controls, leaving the results open to critics, of which there were many. Under today’s regulations the experiment would not have been done.
But it was done. A shepherd named Jean-Baptiste Jupille had protected children against a rabid dog, but had been bitten on the arm and Jupille was soon under treatment. He also survived to work at the Pasteur Institute, which has a bronze statue of him fighting a dog with his shepherd’s staff. After these two cases Pasteur reported his results at the Institute of Medicine to much acclaim and serious criticism.
Soon victims from all over the world arrived at the laboratory, including four young boys from Newark who had been attacked. The New York Herald Tribune raised money and the boys were immediately put on a fast ship to France. They all survived treatment. Nineteen Russian peasants with serious wounds arrived, bitten by a wolf. Sixteen survived. That started an avalanche of patients and donations leading to construction of the Pasteur Institute. Pasteur brought science into medicine and charged it with the hope that infections could be stopped. The discovery of antibiotics, covered in column four, was the next major step in the control of infection.
Richard Kessin is professor emeritus of pathology and cell biology at Columbia University. He lives in Norfolk. The other columns in this series can be found at www.tricornernews.com/category/opinion-author/body-scientific.
