Disastrous epidemics always plagued humanity, and then medicine made great breakthroughs in the “Golden Age”. Expert Ronald D. Gerste explains why Corona has now surprised us so much.
t-online: Mr. Barley, today we are afraid of the coronavirus and its mutants, not so long ago numerous other infectious diseases plagued humanity. Which pathogens posed the greatest threat?
Ronald D. Barley: The re was no shortage of devastating epidemics, the world was a very dangerous place from today’s perspective. Around 150 years ago, for example, smallpox raged in Germany; it was a terrible epidemic that caused far more than 100,000 deaths at the time.
As early as 1796, however, the British doctor Edward Jenner had developed the modern vaccination against smallpox.
It was a groundbreaking discovery. But it took time before the smallpox vaccination was able to protect the population comprehensively.
In 1874 the German Empire introduced compulsory vaccination against smallpox. Police officers sometimes took children to be vaccinated against their parents’ wishes for violations.
Smallpox was rightly seen as a formidable threat. Even those who survived were often disfigured by scars. In fact, with the help of extensive vaccination programs, it was finally possible to eradicate the disease worldwide by 1980 at the latest. It was a milestone in medicine. But as successful as the fight against this pathogen was, it was just as difficult against other diseases.
For example, what were these?
The so-called white plague was extremely feared, as was the “Asian hydra”.
Ronald D. Barley, Born in Magdeburg in 1957, is a doctor of medicine and historian. He lives near the American capital Washington, DC and writes regularly as a correspondent for German-language media. Barley is also the author of numerous books on US history as well as the history of medicine. His latest work has just been released “
The Golden Age of Medicine 1840–1914“.
So tuberculosis and cholera?
I agree. In the 19th century there were repeated outbreaks of cholera in Germany, in 1892 it could only be contained in Hamburg with the strictest hygiene measures. Tuberculosis, on the other hand, has almost disappeared from our consciousness today: it used to be considered a disease, especially of the young and beautiful, who in a sense disappeared when it broke out. Hence the name consumption. But in reality death from tuberculosis was just as pathetic as death from any other infectious disease. And the disease, of course, killed rich and poor without distinction.
While tuberculosis was a major social issue, another dangerous disease tended to remain silent.
The re is an interesting anecdote in the wonderful Hollywood classic “Dr. Ehrlich’s Magic Bullet” (German: “Paul Ehrlich – A Life for Research”): Paul Ehrlich, who as a doctor wanted to develop a treatment for syphilis, once planned on one Reception with wealthy people to raise funds for his research.
The re he was asked what disease he wanted to fight. “Syphilis,” said Ehrlich. Whereupon everyone present quickly ran away.
The historian and physician is the author of numerous books. (Source: Jacqueline Gerste)
Ehrlich was able to develop his drug “Salvarsan”, in principle the first chemotherapy, until it was ready for the market in 1910, thus making syphilis treatable.
Yes. But the price was high. Salvarsan contains arsenic, which in turn is toxic.
The year 1910 almost marks the end of the “Golden Age of Medicine” from 1840 to 1914, which you describe in your new book. An age in which the development of all medical disciplines has made groundbreaking progress. Which achievements particularly impressed you?
Outstanding is an event that took place in Boston on October 16, 1846. William Thomas Green Morton, actually a dentist, did something completely new that day on a young man named Gilbert Abbot, who suffered from a benign tumor of the jaw and was operated on by the famous surgeon John Collins Warren.
What was so special about it?
Morton had previously successfully anesthetized Gilbert with ether. As natural as anesthesia seems to us today, it was a revolution back then. Today we hardly have any idea how painful and risky operations used to be for patients who had to endure them without anesthesia. Morton is rightly revered as the founder of modern anesthesia. But also many other medical professionals deserve respect.
Who, for example?
The name Ignaz Semmelweis should be mentioned here, a surgeon and obstetrician who introduced a revolutionary innovation to the maternity ward of his clinic in Vienna in the mid-19th century: the doctors had to wash their hands before touching their patients. Because Semmelweis had noticed that there was a blatant connection between poor hygiene on the part of doctors and the high death rate of mothers from so-called child bed fever.
Semmelweis later became famous as the “savior of mothers”.
Rightly. Everyone undergoing surgery today should also be grateful to Joseph Lister. In 1865 a young boy was brought to him who had suffered an open fracture in his leg. Normally the doctor would have used a bone saw, the boy would have been an invalid with an amputated leg all his life.
Because otherwise the dreaded gangrene would have set in with a high probability if the leg had not been removed?
I agree. Lister kept cleaning the wound with carbolic acid, and the bandage was also soaked with it. And the miracle happened: there was no gangrene, the boy’s leg was saved. It was the birth of antisepsis.
By taking many steps like this, doctors and biologists also tracked down the actual threat: the tiny pathogens that can make us humans sick.
It was simply the time of great discoveries in medicine and biology. It used to be believed, among other things, that so-called miasms would make people sick. In other words, pathogenic substances that arise from putrefactive processes in water and air. As the microscopes became more sophisticated, the real culprits were identified: tiny bacteria and viruses.
Robert Koch became even more famous in 1882 when he identified the tubercle bacillus as the causative agent of tuberculosis.
The n the emperor said in a sense that the enemy had now been recognized. But how can you defeat him? That was expressed in very Prussian terms, but in principle of course correct.
The anesthesia was a great relief for patients. (Source: Roger-Viollet / ullstein bild)
In fact, the tiny “enemies” were fought more and more sustainably: there has been a vaccination against rabies since 1885, against typhus since 1896 …
… and this list goes on and on. Fortunately, for example, nobody today has to see young children suffocate miserably from diphtheria in their beds. Humanity owes this above all to Emil von Behring, who developed a healing serum around 1890. Around 50,000 children in the German Reich had died of diphtheria every year up to then.
It is amazing how many groundbreaking discoveries and developments medicine has made during this time.
The railroad alone changed the world to an unprecedented degree; industrialization was a revolution in the truest sense of the word. It was like a gigantic rush of adrenaline for the whole of society, which always produced new knowledge. Today we look back on an age of unbelievable belief in progress, to which the fear of life of later generations was completely alien. However, we should not forget that some scientists have also clearly exceeded the boundaries of ethics and morals.
Like Robert Koch, who is very controversial today for his compulsory treatment of Africans suffering from sleeping sickness?
This sad chapter would be an example.
How much did chance and luck play a role back then?
A not to be underestimated. Sigmund Freud, the founder of psychoanalysis, once pointed out to his friend Carl Koller that cocaine numbs the tongue. Both have tried the drug in self-experiment, if you can put it that way. Koller then had a good idea: Because cocaine has the same numbing effect if you put it on your eyes. This justified the local anesthesia. And operations on the eye are very simplified, which are very risky without anesthesia.
Spanish flu 1918: the pandemic killed millions of people. (Source: Photo12 / Ann Ronan / imago images)
The coronavirus is now making it clear to us that we are far less armed against a pandemic than we would like.
Corona shows us how naive we were. We no longer had any sense of how blatantly viruses and bacteria can affect our lives. We had no idea what microorganisms can do to us. As much as humanity dominates this planet, a small virus is now showing us the limits. In my book I come to the famous novel by HG Wells …
… “War of the Worlds” from 1898?
The price our ancestors paid for it are billions of dead who have fallen victim to all conceivable diseases over the course of millennia.
Now science has achieved incredible achievements in the fight against Corona within a very short time.
The pharmaceutical industry is often scolded, and always justified, but that is an unquestionably great achievement. But now the next big challenge lies ahead: Billions of people have to be vaccinated. In the case of the corona pandemic, in comparison to the Spanish flu from 1918 to 1920, despite all the cuts, we also see how far our knowledge has advanced: At that time there were no comparable measures, neither with regard to lockdowns nor vaccinations. You didn’t even know that a virus was the trigger. Today, however, we can save many human lives.
Will we then learn a sustainable lesson from the corona pandemic when it is over?
Shaking hands will be a thing of the past, I suspect.
Mr Barley, thank you for the interview.