Chapter 3 : Tuberculosis and Dilemmas of Modern Medicine

Abstract:

As early as 1942, Dubos warned that bacterial resistance to antibiotics should be expected. His prediction was based in large part on almost twenty years of research on bacterial responses to environmental factors. When Dubos wrote The Bacterial Cell he criticized germ theory bacteriologists for their “blind acceptance” of the doctrine of monomorphism because it had “discouraged for many years the study of the problems of morphology, inheritance, and variation in bacteria.” In a chapter devoted to bacterial variability, he discussed numerous investigations giving evidence that bacterial species vary in form, function, and chemical and antigenic composition. Bacterial transformations, he concluded, whether they are “permanent or transient—not only of a quantitative but often of a qualitative nature—appear in an unpredictable manner under conditions where the ‘purity’ of the culture cannot be doubted. Scientific discussions of antibiotics focused on the medical cures they produced. Incidents of resistance, when reported, were buried in medical scientific literature read by few laboratory scientists and fewer physicians. Scientists who predicted that tuberculosis could be eradicated were overlooking the fact that this goal depended not only on rigorous medical therapy but on a relentless endeavor of early detection, segregation, and education to prevent infection and halt the spread of the contagious pathogen. During the 1920s, pathologist James B. Murphy showed that when leukocytes are destroyed by radiation from X rays, the hosts become much more susceptible to tuberculosis. By 1951, Dubos decided that learning more about the biology of the tubercle bacillus was unproductive.