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Germ Theory: Medical Pioneers in Infectious Diseases
Author: Robert P. Gaynes1
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1: Emory University School of Medicine, Atlanta, Georgia
Content Type: Trade
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Electronic
Publication Year:
2011
Category: General Interest; History of Science
Print ISBN
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9781555815295
e-ISBN
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9781555817220
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Named as Choice Outstanding Academic Title 2012
From Hippocrates to Lillian Wald-the stories of scientists whose work changed the way we think about and treat infection.
- Describes the genesis of the germ theory of disease by a dozen seminal thinkers such as Jenner, Lister, and Ehrlich.
- Presents the “inside stories” of these pioneers’ struggles to have their work accepted, which can inform strategies for tackling current crises in infectious diseases and motivate and support today’s scientists.
- Relevant to anyone interested in microbiology, infectious disease, or how medical discoveries shape our modern understanding
Paperback, 329 pages, illustrations, index.
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Chapter 1 : Introduction
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Abstract:
This is an introductory chapter of Germ Theory: Medical Pioneers in Infectious Diseases. Once declared "conquered," infectious diseases have emerged or reemerged to devastate our modern world. In 1981, no one imagined how one of these newly emerged diseases, AIDS, which is caused by human immunodeficiency virus (HIV), would change the human landscape of entire continents, alter our conceptual framework of how we treat or even think about an infectious disease, and completely confound our understanding of the human immune system and vaccine development. The world desperately needs an effective immunization for HIV as the means to control or even eliminate AIDS. Immunizations have been one of the most effective methods for control of disease, even eradicating the scourge of smallpox. Recent discoveries of vancomycin-resistant Staphylococcus aureus and bacteria containing enzymes called carbapenemases that degrade some of the most potent antibiotics, the carbapenems, are but two examples of the difficulties facing contemporary treatment of infectious diseases. We should look back to our initial advances in understanding infectious diseases. The author in the closing section of the chapter makes a few qualifying remarks. First, the conceptual framework for the practice of infectious diseases is from Western medicine. Second, there will be those who question the choice of the individuals who were included. While the author doubts that one can argue against those persons included in this book, the persons excluded from any discussion will no doubt generate controversy.
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Chapter 2 : Hippocrates, the Father of Modern Medicine
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This chapter talks about Hippocrates, the first individual in Western civilization to be known for his contributions to medicine from the ancient Greek civilization. Hippocrates is said to have learned medicine from his father, Heraclides. Although medical knowledge was extended during the next 20 centuries, progress in Western medicine was hampered by the steadfast adherence to humoral theory and the Coan approach to disease. Elements of the germ theory of infectious diseases were discovered during these 2,000 years of waiting but could not be incorporated into medicine until the holistic approach of the humoral theory of disease was fully abandoned. Prior to the time of Hippocrates, medicine was taught father to son. In the centuries following the death of Hippocrates, little was added to the practice of medicine, even with notables such as Plato and Aristotle writing extensively on the workings of the human body. Galen's role in the history of medicine is one of paradox. Galen's advances were the result of experimentation; he was one of the first physicians to advocate and use the experimental approach in medicine. Galen combined two methods to describe disease that seemingly had nothing to do with each other: the humoral theory from Hippocrates and the study of anatomy that was acquired from the Alexandrian school.
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Chapter 3 : Avicenna, a Thousand Years Ahead of His Time
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The critical importance of translation of medical texts from a variety of cultures, but notably ancient Greek, led to the emergence of medieval Islamic medicine. Also, the system for delivering medical care and training doctors took on a new and distinctive quality. The first comprehensive medical reference, the Canon of Medicine, was written, which was the culmination of medical thought to date. In Isfahan, Avicenna completed two major works, the Book of Healing and the Canon of Medicine. Avicenna wrote many medical texts, but the Canon of Medicine stands alone. Even though the Canon is largely an extension of Greco-Roman medical thought, the book contains Avicenna's remarkably insightful observations, such as his recommendations for dealing with malignancy. Avicenna gave medicine its first codified lessons on evidence-based clinical trials when he listed principles for reliable experimental investigations of drugs in humans. The Canon provides additional food for thought for infectious disease practice. It distinguishes mediastinitis from pleurisy, describes the contagious nature of sexual diseases, and proposes the use of quarantine to limit the spread of phthisis (an archaic term for tuberculosis). One outbreak became synonymous with disease in the Middle Ages in Western Europe: bubonic plague. The contradictory advice that physicians offered during outbreaks of the plague was indicative of the chaotic medical thinking of the age. Avicenna wrote extensively about the interplay between the mind and body in the Canon of Medicine. The Canon of Medicine contains the most extraordinary supposition about the contagious nature of phthisis.
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Chapter 4 : Girolamo Fracastoro and Contagion in Renaissance Medicine
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By the mid-1500s, accessibility to Latin-translated, ancient Greek medical texts and the commentaries condemning Avicenna led to a decreased reliance on his work in Western Europe, although by no means was the Canon of Medicine disregarded. The decreased dependence on the Canon led to disregard of many of its innovative concepts, including contagion, in Western Europe. To the modern reader, a disregard of the concept of contagion seems hard to reconcile with the presence of two diseases of the period: plague and syphilis. The Black Death continued its periodic appearances during the Renaissance. In 1525 Girolamo Fracastoro completed an earlier version of the poem, Syphilis sive morbus Gallicus. For the next 16 years after the publication of Syphilis sive morbus Gallicus, Fracastoro worked on a book that he asserted was "not as a poet but as a doctor," De Contagione et Contagiosis Morbis et Eorum Cura-tione, or On Contagion, Contagious Disease and Their Cure, published in 1546. Precisely where his ideas emerged for De Contagione is in doubt. Fracastoro's fame from his epic poem helped ensure the initial publication in 1546 and at least two additional printings of De Contagione by 1555. The reaction to Fracastoro's De Contagione in his own time ranged from hostile to favorable, but even the positive responses were tepid. For all De Contagione's limitations, it is extraordinary how well Fracastoro described modes of transmission for microorganisms, having no idea of their existence.
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Chapter 5 : Antony van Leeuwenhoek and the Birth of Microscopy
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Antony van Leeuwenhoek dabbled in his newly discovered world of microscopy with no direction or refinement, scribbling images in his notebooks without ever presenting them to the outside world. Recent investigations into van Leeuwenhoek's life have shown him to be "one of the most imperfectly understood figures" in the history of science. While a new world of microorganisms had been revealed, van Leeuwenhoek did not make any connection between these microorganisms and disease. While van Leeuwenhoek was the first to witness the living organisms, bacteria, in association with humans, these persons were not ill. Some historians have taken van Leeuwenhoek to task for not making an association between microorganisms and the nature of infectious illnesses. For all his discoveries, the academic climate in Europe in the 18th century lacked the spark to include microscopy in research. Some universities, including Leiden in Holland, had included microscopes among their teaching instruments, but medical instruction in microscopy appeared to actually decline during the 18th century. The waning interest in microscopy in the 18th century cannot diminish van Leeuwenhoek's 50 years of pioneering contributions that changed the way we think of the living world.
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Chapter 6 : The Demise of the Humoral Theory of Medicine
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For centuries, physicians were trained in the basic humoral theory of disease according to Galen. The scientific method and introduction of quantitative evidence into physiological problems were William Harvey’s greatest contribution to medicine. Such investigations eventually led to the 1628 publication of one of the great books in Western medicine, Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, or Anatomical Studies on the Motion of the Heart and Blood in Animals-often referred to simply as De Motu Cordis. The bleeding, cupping, emetics, or other treatments dictated by the long-held humoral theory were still used on patients. For doctors to completely discard the humoral theory with its attention to humors, innate heat, or pneuma, some viable alternative was needed to not just reject Galenic anatomy and physiology but to explain disease processes or, more specifically, the seat or starting place for disease. The anatomic concept of disease sent the humoral theory packing. Symptoms were of little use to the humoral theory of medicine. With the demise of the humoral theory, medicine moved towards a more modern age in the late 18th century.
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Chapter 7 : Edward Jenner and the Discovery of Vaccination
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Understanding the theories about smallpox in the 18th century helps to explain what Edward Jenner and others were up against in order to hypothesize, test, and prove the theory of vaccination to a skeptical and critical medical world. Jenner invented the phrase variolae vaccinae to support his notion that the diseases smallpox and cowpox were related. His book, An Inquiry into the Causes and Effects of the Variolae Vaccinae, had three parts. The first part discussed what Jenner considered to be the origin of cowpox, a hypothesis that was quickly discredited. The second part discussed the hypothesis that cowpox protects against smallpox. Importantly, he used material from the deliberately induced cowpox infection in one person to vaccinate another case. He concluded by stating that cowpox protects the human constitution from the infection of the smallpox. Jenner believed that vaccination was safer than variolation and that the protection imparted by cowpox vaccination would be lifelong. The technique that Jenner used, placing material from a cowpox pustule into cuts in the forearm, was discarded in 1858 in favor of the use of lancets, the technique still in use for smallpox vaccination. Within 10 years of its inception, vaccination had reached around the globe. Vaccinia virus represents a hybrid virus whose precise origin is unclear but which likely arose from inadvertent mixing of cowpox and smallpox viruses in those early days of vaccination. Genetically, vaccinia virus is more closely related to smallpox than cowpox virus.
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Chapter 8 : Ignaz Semmelweis and the Control of Puerperal Sepsis
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The institutional clustering of women in childbirth, usually poor women, in Europe during the 18th and 19th centuries changed the frequency of puerperal sepsis. Ignaz Semmelweis tried to distinguish childbed fever from a contagious disease and stated that childbed fever is a transmissible, but not a contagious disease. Before one can fully understand Semmelweis's contribution to infectious disease, the control of puerperal sepsis, one has to have an appreciation of the history of the University of Vienna Hospital at the time Semmelweis began working there. The willingness to consider that medical personnel were in any way responsible for puerperal sepsis suggests some evolution in thinking towards an external cause of puerperal fever, even among the most conservative. In early 1847, Semmelweis observed that no epidemic of puerperal fever was evident outside the walls of the University of Vienna Hospital, in home deliveries by either midwives or private doctors. Even street births rarely had puerperal fever following delivery. Semmelweis’s theory suggested that physicians had been responsible for killing their patients. Infectious diseases in the 1840s were thought to strike people at random via miasma. Semmelweis was clear that there was no randomness or miasma involved. While he took great pains to distinguish childbed fever from a contagious disease such as smallpox, Semmelweis had actually bridged the gulf in 19th-century thought that distinguished between contagion and infection.
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Chapter 9 : Louis Pasteur and the Germ Theory of Disease
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Louis Pasteur related certain microorganisms to certain fermentation processes and determined that if competing microorganisms entered the picture, the desired fermentation process would be "diseased." His logical thinking and, more importantly, his experiments had defined the germ theory of fermentation. Resolution of the debate over spontaneous generation of microorganisms was an essential step in the development of the germ theory of human disease. Pasteur determined the attenuation of the chicken cholera bacillus to be from the harmful effect of air, specifically oxygen, on an aging culture. Pasteurization was successfully applied to wine, beer, cider, vinegar, and, of course, milk. Pasteur conducted a very public experiment of his anthrax vaccine in May 1881, where the sheep, goat and cows that had received the vaccinations of the attenuated anthrax, all appeared healthy. The filtrate induced identical agglutination of fresh red blood cells, suggesting that a soluble toxin from anthrax bacilli was capable of producing disease. The study of rabies presented great difficulties for Pasteur and his colleagues. The impact of Pasteur's work goes beyond the germ theory of disease. Pasteur linked basic research and applications in a multidisciplinary approach, what today might be called translational research.
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Chapter 10 : Robert Koch and the Rise of Bacteriology
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Robert Koch is noted for his postulates that still serve as a guide for determining if a microorganism is the cause of a disease. Koch began to study anthrax, a public health problem among livestock in the area around Wöllstein. As Koch was about to discover, the causative organism, Mycobacterium tuberculosis, was (and still is) difficult to grow and stain, requiring demanding patience. Such patience made its discovery by Koch the crowning achievement of his lifetime. An 1884 Koch publication entitled “The Etiology of Tuberculosis” contained a more expansive explanation of his work on isolating the tubercle bacillus but is best remembered as the formal presentation of what we now call Koch’s postulates. The postulates are known to most students who study microbiology as the guide to determination that a microorganism is the cause of a disease. Despite the efforts of John Snow and earlier work by Koch, the transmission of cholera when outbreaks occurred in cities was still the subject of controversy. The 1892 cholera outbreak proved to be an ideal “experiment” for Koch to prove that cholera was indeed waterborne. Koch’s plating techniques provided definitive proof for the effectiveness of the filtration of the water supply. Even though Koch had tired of his public health work, his work on the Hamburg cholera outbreak ranked as one of the most important public health contributions of the last century. In 1905, he received the Nobel Prize for Medicine for his discovery of the tuberculosis bacterium.
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Chapter 11 : Joseph Lister, the Man Who Made Surgery Safe
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The first great American contribution, the discovery of anesthesia, to the field of medicine ended the pain of surgery. More importantly, the discovery of anesthesia did not make surgery safe, only painless. In the 20 years between the introduction of anesthesia and Lister’s innovations, the problem of surgical infection and its associated mortality remained. To fully understand Joseph Lister's contribution, one must consider the state of surgery immediately before his efforts. Infection was the anticipated result of surgery. The postoperative mess was the most desirable result of mid-19th-century surgery and was termed "laudable pus." Today, one can identify this outcome as an infection from Staphylococcus aureus. While British surgeons bickered over the value of antiseptic surgery, the 1870-1871 Franco-Prussian war produced, literally, an army of believers. The first part of Lister's process to disappear was the carbolic acid spray in 1887. Asepsis is the process that does not allow microorganisms access to the wound in the first place. In reality, the processes are complementary, not antagonistic. The initial architects of asepsis were German. Lister focused on antisepsis-killing microorganisms when they got into the wound, initially. But soon, Lister recognized the importance of not allowing the microorganisms access to the wound at all.
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Chapter 12 : Paul Ehrlich and the Magic Bullet
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The link between the development of dyes and therapy for infectious diseases is a curious one. Paul Ehrlich is found right in the middle of it. To understand this connection, one has to go back to the origin of the European dye industry and then to the life of Paul Ehrlich and his early theories. After several years in his position in Berlin, Ehrlich attended a meeting of the Physiological Society of Berlin in 1882. It was at this sensational event that Robert Koch announced his discovery of the tubercle bacillus. Modern therapy for infectious diseases did not begin with penicillin, sulfa drugs, or even chemical/drug therapies. It started with a serum treatment for diphtheria. Phagocytosis finding led to the concept of cellular immunity. Ehrlich’s quantitative approach to standardizing the diphtheria antitoxin had a lasting effect. Ehrlich determined the maximal tolerated dose and its activity against syphilis in animals and then humans. While its activity was not as great as that of Salvarsan, compound 914, or Neosalvarsan, as it became known, was more soluble and much easier to produce and handle. To be sure, Neosalvarsan was an effective treatment for human syphilis.
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Chapter 13 : Alexander Fleming and the Discovery of Penicillin
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The story of Prontosil and its related compounds intertwined during the first few decades of the 20th century with the story of penicillin, although the contrasts between the developments of these two antibacterial drugs are striking. Penicillin was discovered entirely by accident rather than by the methodical trial and error process leading to Prontosil. Alexander Fleming's discovery of penicillin was preceded by another discovery, that of lysozyme. Due to its importance in medicine, the story of penicillin's discovery has become shrouded in legend and distorted truths. Fleming gave the substance in his "mould broth filtrate" the name penicillin in a manuscript he prepared for British Journal of Experimental Pathology, deriving it from the name of the mold. A part of the Prontosil molecule, sulfanilamide, was an effective antimicrobial agent itself. Prontosil broke down in an animal (or human) body to derivatives; one was sulfanilamide, which was toxic to bacteria. With the entry of the United States into World War II, the U.S. government took over penicillin production, which rapidly escalated. The adoration in the media and the distorted truths about penicillin's discovery did not endear Fleming to the members of the Oxford team. The introduction of penicillin into clinical practice led to the modern antibiotic era, with the discovery in the 1940s and 1950s of many drugs that were isolated from other microorganisms. Fleming devised experiments to study antiseptics’ action on bacteria and on white blood cells.
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Chapter 14 : Lillian Wald and the Foundations of Modern Public Health
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Infectious diseases are not chance events but events that occur as a result of the infected host’s contact with their environment. As the germ theory of disease was taking shape in the latter part of the 19th century, deplorable living conditions in major European and American cities made them rife for tuberculosis (TB), typhoid fever, and even cholera. Lillian Wald coined the term “public health nurse” in 1893 for nurses who worked outside hospitals in poor and middle-class communities. Specializing in both preventative care and the preservation of health, these nurses responded to referrals from physicians and patients, giving free treatment or charging according to the resources of the patient. The school nurse is the one who ultimately certifies that children have had the required immunizations before school entrance. Jacob Schiff recognized the immense value of Wald and her nurses to the neighborhood. In 1895, Schiff found a larger and more suitable place than their previous residences in the Lower East Side of the city, a home on Henry Street. In 1909 there were about 1,400 public health nurses in the United States. In 1912, Lillian Wald was elected as the first president of the National Organization for Public Health Nursing. In health care and public health, times have changed, but today’s underserved, uninsured populations who have needs similar to those of those residents of the Lower East Side of New York would welcome another Angel of Henry Street.
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Chapter 15 : Conclusions
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This is the conclusory chapter of Germ Theory: Medical Pioneers in Infectious Diseases. Each of the individuals profiled in this book was responsible, directly or indirectly, for a paradigm shift in medical thought. The problems of infections with new or reemerging pathogens and the difficulties with antibiotic resistance are threatening not only the progress in the practice of infectious diseases but all medical advances. We have squandered these wonder drugs and need to find ways to conserve the effectiveness of the antibiotics that we currently have. We have successfully altered the human body's immune system to prolong the survival of transplant recipients. We would do well to remember the rigor and meticulousness with which Pasteur and Koch worked out the methods to prove causal role of microorganisms in human disease. For the HIV vaccine, new concepts and approaches to our fundamental understanding of immunity and vaccine formation are needed. The complex task of trying new formulations for an HIV vaccine will hopefully build on the modest success of the Thai trial. We often focus only on the scientific issues related to infectious diseases and need to be reminded that social and economic problems will continue to lead to countless infectious disease problems. As we struggle with health care reform, the strength, passion, and single-mindedness of Lillian Wald should serve as an inspiring example of creative ways to fund the path for progress in combating not just the microorganisms but societal ills.
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Microbe Magazine
02 August 2013
The idea of telling the history of medicine through a series of biographies is hardly new. The use of this model goes back at least to Henry Sigerist's Great Doctors, which was fırst published in German in 1932. A more recent example is Sherwin Neuland's Doctors: The Biography of Medicine (1988). One might also seek the antecedents of this book in Paul DeKruif's romanticized telling of the history of medical microbiology, The Microbe Hunters (1926).
The appeal of this biographical approach is easy to understand. It permits the reader, and the author as well, to focus on a series of famous individuals rather than on the more complex dynamics of a research or professional community. In the present case Robert Gaynes gives us a series of chapters on famous and influential fıgures in the history of medicine, among them Edward Jenner, Ignaz Semmelweis, Louis Pasteur, Robert Koch, Paul Ehrlich, and Alexander Fleming. A pleasant surprise is to fınd a fınal chapter on Lillian Wald, a woman, a nurse, an American, and a founder of public health nursing. In general the chapters are written in a lively style, and they clearly set before the reader the achievements for which the chapter's subject is remembered today. The book is a pleasant read that tells a familiar story. Unfortunately it has several substantial weaknesses.
Since this is such a broad synthesis, the author can be forgiven for relying exclusively on translations of European scientifıc works and on English-language histories. He can be expected, however, to have incorporated the results of recent English-language historical scholarship. Unfortunately, the author ignores the most relevant historical scholarship of the past 40 years. This is a great pity, because the research of Codell Carter, Margaret Pe ling, Michael Worboys, Gerald Geison, Bruno Latour, and others has a great deal to tell us about both the content and the context of the research that constructed the modern germ theory of disease. By studying the publications of a broader segment of the scientifıc and medical communities and by using manuscript sources previously unconsulted, these scholars have helped us understand how the concepts and research problems of the 19th century were understood and framed at the time, keeping us from reading our modern understandings back onto the past. This modern scholarship also throws much light on how the research of the most famous fıgures was conducted by broadening our focus from the single individual researcher to a research community populated by nowforgotten scientists who made crucial, sometimes unacknowledged, contributions, where rival germ theories of disease existed, and where the results of research were not always interpreted initially the way they would be subsequently understood. The failure to come to terms with this research and to incorporate it into this synthesis is a great opportunity missed.
Some readers will legitimately wonder what chapters on Hippocrates, Avicenna, or Fracastoro are doing in a book on the history of the germ theory. A critical reader will object to the author's anachronistic use of "humoral theory" in discussing the 18th and 19th centuries. The unwary reader may infer that the concept of contagion had its origin in a minor 16th-century literary work by the Girolamo Fracastoro from which it evolved steadily to gain acceptance in the 19th century. Scholarship since the 1940s, on the other hand, has shown its more probable origins in the practices of quarantine fırst for leprosy and later bubonic plague. Moreover, far from steadily gaining scientifıc credibility, the theory of contagion reached its scientifıc nadir in the early 19th century among some of the age's most prominent scientists, including the pathologists and physiologists who we remember today for their roles in making medicine modern.
In short, we have here a pleasantly written book that tells a familiar story. Unfortunately, it could have been a better, more informative synthesis.
Microbe Magazine
Reviewer: John M. Eyler, University of Minnesota
Review Date: July 2012
The Quarterly Review of Biology
14 July 2013
HUMAN BIOLOGY AND HEALTH
In this volume, the author recounts the circuitous paths by which germs have become recognized as pervasive causes of disease, and the effects of this enlightenment on human health. The book focuses on the contributions of about 15 historic figures from Hippocrates to Alexander Fleming. For each, Gaynes masterfully weaves together key discoveries and insights with personal histories, philosophical clashes, and the tone of the times.
The author follows the threads of the three great practical applications of the germ theory: vaccination, therapeutics, and improved hygiene. His extension of hygienic applications beyond the hospital environment is, however, a bit rickety. When he discusses waterborne disease, for example, he invests more text on Koch’s secondary study of cholera transmission than the more powerful, pioneering studies conducted decades earlier in London by John Snow; moreover, he fails to mention the most critical part of Snow’s work, namely the comparison of cholera among residents provisioned by two water companies before and after one of them began providing safe water. In one swoop, Snow showed how cholera could be transmitted and controlled, launched the discipline of epidemiology and, as Snow himself recognized, provided strong evidence that the disease was caused by an invisible, living agent.
Gaynes’s historical tour peters out by the middle of the 20th century. This truncation is unfortunate because one of most exciting developments of the germ theory has been unfolding since then: the recognition that germs cause a broad spectrum of chronic diseases and do so by recently clarified mechanisms of pathogenesis. The author devotes some attention to AIDS, but the recent development of the germ theory spans much more broadly; it now incorporates peptic ulcers, numerous cancers, gingivitis, periodontitis, and type 1 diabetes, and may eventually include diseases such as atherosclerosis, stroke, Alzheimer’s disease, multiple sclerosis, and schizophrenia. It is ironic that Gaynes paid so little attention to this great new phase of the germ theory. It appears that he, like critics of the germ theory he brings to life in his book, has been constrained by tradition.
The Quarterly Review of Biology
Vol. 88, No. 2, p. 151
Reviewer: Paul W. Ewald, Biology, University of Louisville, Louisville, Kentucky
Review Date: June 2013
Key Reporter
23 June 2013
Robert P. Gaynes succeeds in depicting in large brushes the history of infectious diseases, placed into the context of concepts and ideas as they evolved from the time of Hippocrates in ancient Greece 2,500 years ago to the present. He does so by presenting lively biographies of twelve pioneers selected for changing the prevailing view of the time and for contributing major advances in the understanding, diagnosis, prevention, and treatment of infectious diseases. One appealing aspect of the book lies on the personal background of each individual, providing insight on how upbringing and world affairs affected the way discoveries were made and progress achieved. A portrait of the twelve scholars and their character helps the reader understand what it took to overcome preconceived ideas and why some important innovations failed to enter current practice until much later. The book’s captivation also stems from Gaynes’ description of contemporaneous innovations in other fields such as the appearance of medical schools and hospitals, advances in anatomy (Vesalius’ dissection of cadavers), and the broader dissemination of information with the advent of the printing press.
I found the story of Avicenna particularly fascinating. This brilliant scholar who lived a tumultuous life was way ahead of his time when he postulated the contagious nature of tuberculosis in his Canon of Medicine. But prejudice tragically prevented Western medicine from embracing this innovation that countered the then prevailing Galenic view that disease was internal to the human body. The concept of contagion would resurface only during the Renaissance with Girolamo Fracastoro who witnessed the beginning of a syphilis outbreak and its terrifying effect on the population.
While most biographies are from physicians, there are exceptions. Antony van Leeuwenhook was a draper with great skills for making microscopes of great magnification power to which he added light to illuminate carefully prepared specimens, allowing for the first time the observation of bacteria and other single-celled organisms. Louis Pasteur was a chemist and Lillian Wald a nurse whose contributions served as the underlying foundation of the public health infrastructure.
A large part of the book is devoted to advances achieved between the second half of the eighteenth century and the beginning of the twentieth century. For contributions to the prevention of infectious diseases, Gaynes singles out work by Edward Jenner (smallpox vaccination), Ignaz Semmelweis (statistics used to show that hand washing reduced childbed fever), Louis Pasteur (immunity to microorganisms by attenuation of pathogenic microbes), Robert Koch (bacteriological causes of disease), and Joseph Lister (antiseptic surgery). His biographies of Paul Ehrlich (antibody production) and Alexander Fleming (penicillin) illustrate major breakthroughs in the treatment of infectious diseases. Despite these advances, the author cautions against complacency and highlights some of the challenges ahead. Even today, scourges such as cholera are not completely eradicated and may recur in cycles, as Alexander Chizhevsky proposed by revealing associations with space weather, another factor usually dismissed in the West but worthy of further investigation.
This is a fascinating book that will captivate anyone with an interest in microbiology, infectious disease, and medical history.
Key Reporter
Reviewer: Germaine Cornelissen-Guillaume, Halberg Chronobiology Center at the University of Minnesota, Twin Cities.
Review Date: October 2012
Journal of Microbiology & Biology Education
23 June 2013
From Medieval Microbiology to Modern Medicine: A Concise History of How We Got to Where We Are Today
If one studies microbiology or medicine at all, prominent names and stories promptly rise to the surface. In this concise history of microbiology and medicine, the author brings those familiar stories to life. This is a well-written—even intriguing—historical chronicle of medical advances and microbial understanding. Robert Gaynes’ illuminating discussion ranges from Hippocrates’ foundational concepts of medicine to the challenges of creating an effective HIV vaccine.
Being a 'late adopter' of a lover for history, I now find books such as this informative and enlightening sources of accurate historical insight. Having taught microbial history to untold numbers of undergraduate students, many names and details were very familiar. Within the pages of this well-crafted discourse, Gaynes includes curious and sometimes intimate details about the people and discoveries which have sculpted the faces of microbiology and modern medicine.
Including detailed chapters on the thoughtful discoveries, lives and sometime even peculiar habits of Hippocrates, Avicenna, Fracastoro, van Leeuwenhoek, Jenner, Semmelweis, Pasteur, Koch, Lister, Ehrlich, Fleming, and Wald, the book provides an interesting read through thousands of years of medical history. In Gaynes’ own words, “This book is intended not just for the physicians or students of medicine but to be accessible to anyone with an interest inmicrobiology, infectious disease, (and) medical history.” Thelanguage and style Gaynes has chosen make this book an excellent historical source for introductory undergraduate microbiology students. Likewise, medical students and public health professionals will undoubtedly learn much about the history behind their chosen profession by reading this book.
The book is packed with details which I found new and enlightening, even after over 30 years of studying and teaching microbiology. One salient example surrounds the development and promotion of the smallpox vaccine by Edward Jenner. I had not realized the personal financial investment and travel commitments which Jenner necessarily made in the promotion and adoption of his newly developed vaccine.I had not known that the British government was hesitant to finance the production and distribution of the vaccine.
Gaynes includes the text of a personal letter written by United States President Thomas Jefferson to Edward Jenner. Jefferson wrote, “Having been among the early converts, in this part of the globe, to (your vaccine's) efficiency, I took early part in recommending it to my countrymen.” In that same letter Jefferson continues his communication to Jenner: "Yours is the comfortable reflection that mankind can never forget that you lived.”
Gaynes’ elucidation throughout the chapters of this book should ensure the same outcome for each discovery, contribution, and scientist discussed.
Gayes has crafted a book which I certainly will find myself reading again and again. It is a book in which anyone, from medical professionals to introductory microbiology students, will discover 'new' scientific and medical intrigue. This book is highly recommended for any educator or student of microbiology, public health or medicine. Educators at the high school, undergraduate, graduate, and medical school levels will benefit from reading Germ Theory. It is similarly well-suited for microbiology, biology, and medical students at these same levels.
Find a copy soon. You will have your eyes opened, and be glad you did.
JMBE: Journal of Microbiology and Biology Education
Volume 13, Number 1
Reviewer: Gregory D. Frederick, University of Mary Hardin-Baylor, Belton, TX
Review Date: May 2012
CHOICE
04 December 2012
Gaynes (Emory Univ. School of Medicine) presents a well-researched, inspiring narrative of the most important discoveries in the history of medical science. He weaves the origins of the germ theory of disease and the biographies of those who made significant discoveries together into intriguing, informative stories. The author provides vivid accounts of individuals such as van Leeuwenhoek, Jenner, Pasteur, Fleming, et al. who challenged the prevailing views of the times with their innovation and persistence, and highlights the struggles they encountered in the long processes of discovery. The book's 15 chapters are well written, thorough, and engaging, providing readers with a significant appreciation for the interplay of social, economic, and cultural forces, as well as good luck, which allowed for medical breakthroughs. This is an insightful book that serves as an excellent resource for understanding developments in medical history, how they evolved, and the details of their impact on all people. The volume includes references at the end of each chapter and an easy to use index.
Summing Up: Highly recommended. Upper-division undergraduates through researchers/faculty and physicians; medical students; general readers.
CHOICE Current Reviews for Academic Libraries
SCIENCE AND TECHNOLOGY Health Sciences
Vol. 49 No. 11
Reviewer: D.C. Anderson, Massachusetts College of Pharmacy and Health Sciences
Review Date: July 2012
Reprinted with permission from CHOICE http://www.cro2.org, copyright by the American Library Association
