Emil von Behring: Infectious Disease, Immunology, Serum Therapy
http://www.100md.com
《新英格兰医药杂志》
The first Nobel Prize in Physiology or Medicine, awarded in 1901, bypassed the premier microbiologist of the period, Robert Koch, who identified the causes of tuberculosis and anthrax, as well as the key architects of the new field of immunology, Elie Metchnikoff and Paul Ehrlich. The prize was bestowed instead on Emil von Behring for his successful treatment, with the use of serotherapy, of diphtheria and tetanus. The choice was an inspired one: Behring represented the successful synthesis of basic research and its application to yield a therapeutic triumph. The context of that award offers a glimpse at a level of excitement similar to what we are witnessing today with the allure of stem-cell research and gene therapy.
(Figure)
Emil von Behring, circa 1906.
Wellcome Library, London.
The clinical field of infectious diseases was born at the end of the 19th century as the progeny of two disciplines — microbiology and immunology. In a series of dramatic discoveries, various pathogens were established as the causes of specific clinical syndromes, and the pathology of those diseases was narrowed to the problem of defining how the body defended itself once invaded. The struggle, formulated as a Darwinian one between competing species, dramatically focused the imagination of the public. Vaccination had been established, but its mechanism was not understood, and its application was limited. Immunology emerged in the effort to understand host defenses and then to establish therapies to augment natural mechanisms.
Two rival theories quickly framed research efforts. The "cellularists," led by Metchnikoff at the Pasteur Institute, argued that phagocytes devoured microbes and thus actively protected the organism. The opposing "humoral" theory, led by German scientists, maintained that phagocytes were scavengers of dead bacteria and that the primary defense mechanism was afforded by factors in the blood. With three seminal reports, Behring decisively shifted the balance of the argument in favor of the humoral school. The first report (with Shibasaburo Kitasato, in 1890) showed that animals immunized with tetanus or diphtheria toxin generated a humoral factor that neutralized bacterial exotoxin; the next (with Erich Wernicke, in 1892) showed that protection was afforded by the passive transfer of immune serum; and the third demonstrated that such immune serum cured diphtheria infection. Indeed, the first successful treatment of this childhood scourge made Behring a celebrity.
Derek Linton's book is the first scientific biography of Behring in English. It is meticulously researched and well balanced. Behring emerges as a complex man whose many contributions and relationships are explored with an eye toward understanding the intellectual climate in which he worked. This book is an "internalist" history, with a strong emphasis on understanding the evolution of ideas and the experiments that supported them. Despite the emphasis on the laboratory, Linton amply describes the institutional support and competitive character of the research, which makes his book a vivid portrait of biomedical research of the period. He has also provided 13 of Behring's papers, most of which are available in English translation for the first time. They give the reader an opportunity to study firsthand the character of scientific reports of the period and to marvel at the clarity of those experiments, many of which are true classics.
Emil von Behring is a throwback to an older type of biography, one that focuses on the subject's achievements and the character of his scientific imagination. These are difficult qualities to measure; indeed, histories of this nature have been largely abandoned in our postmodern period. By assuming a more circumspect posture, today's historian typically suffers self-conscious angst about his own interpretation. Thus, existential studies compete with social-dynamic analyses to capture the elusive balance of all the influences that determine "success" and "failure," which in turn are scrutinized for judgmental bias. Linton is at peace with his historiography and provides a critical yet sympathetic portrait of Behring. In that effort, he offers a reliable and insightful glimpse of what is undoubtedly one of the most complex stories in modern medicine.
Alfred I. Tauber, M.D.
Boston University
Boston, MA 02215
ait@bu.edu((Memoirs of the American )
(Figure)
Emil von Behring, circa 1906.
Wellcome Library, London.
The clinical field of infectious diseases was born at the end of the 19th century as the progeny of two disciplines — microbiology and immunology. In a series of dramatic discoveries, various pathogens were established as the causes of specific clinical syndromes, and the pathology of those diseases was narrowed to the problem of defining how the body defended itself once invaded. The struggle, formulated as a Darwinian one between competing species, dramatically focused the imagination of the public. Vaccination had been established, but its mechanism was not understood, and its application was limited. Immunology emerged in the effort to understand host defenses and then to establish therapies to augment natural mechanisms.
Two rival theories quickly framed research efforts. The "cellularists," led by Metchnikoff at the Pasteur Institute, argued that phagocytes devoured microbes and thus actively protected the organism. The opposing "humoral" theory, led by German scientists, maintained that phagocytes were scavengers of dead bacteria and that the primary defense mechanism was afforded by factors in the blood. With three seminal reports, Behring decisively shifted the balance of the argument in favor of the humoral school. The first report (with Shibasaburo Kitasato, in 1890) showed that animals immunized with tetanus or diphtheria toxin generated a humoral factor that neutralized bacterial exotoxin; the next (with Erich Wernicke, in 1892) showed that protection was afforded by the passive transfer of immune serum; and the third demonstrated that such immune serum cured diphtheria infection. Indeed, the first successful treatment of this childhood scourge made Behring a celebrity.
Derek Linton's book is the first scientific biography of Behring in English. It is meticulously researched and well balanced. Behring emerges as a complex man whose many contributions and relationships are explored with an eye toward understanding the intellectual climate in which he worked. This book is an "internalist" history, with a strong emphasis on understanding the evolution of ideas and the experiments that supported them. Despite the emphasis on the laboratory, Linton amply describes the institutional support and competitive character of the research, which makes his book a vivid portrait of biomedical research of the period. He has also provided 13 of Behring's papers, most of which are available in English translation for the first time. They give the reader an opportunity to study firsthand the character of scientific reports of the period and to marvel at the clarity of those experiments, many of which are true classics.
Emil von Behring is a throwback to an older type of biography, one that focuses on the subject's achievements and the character of his scientific imagination. These are difficult qualities to measure; indeed, histories of this nature have been largely abandoned in our postmodern period. By assuming a more circumspect posture, today's historian typically suffers self-conscious angst about his own interpretation. Thus, existential studies compete with social-dynamic analyses to capture the elusive balance of all the influences that determine "success" and "failure," which in turn are scrutinized for judgmental bias. Linton is at peace with his historiography and provides a critical yet sympathetic portrait of Behring. In that effort, he offers a reliable and insightful glimpse of what is undoubtedly one of the most complex stories in modern medicine.
Alfred I. Tauber, M.D.
Boston University
Boston, MA 02215
ait@bu.edu((Memoirs of the American )