The Adventure of the Cure That Wasn’t

Published June 16, 2014 · Estimated reading time: 7 minutes · Share your thoughts
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The Remedy: Robert Koch, Arthur Conan Doyle, and the Quest to Cure Tuberculosis (2014)
Thomas Goetz
320 pages

*Originally published in Speaking of Medicine (PLOS).

Marzieh Ghiasi and Madhukar Pai from McGill University & McGill International TB Centre, Montreal, review “The Remedy” by Thomas Goetz

No image is more iconic of the Victorian age than that of a detective with a deerstalker cap, pipe, and magnifying glass roaming the dark streets of London in search of criminals and murderers. Hidden in plain sight, the real killers of the nineteenth century were infectious diseases such as tuberculosis, responsible for as many as a quarter of all deaths in that era.

In The Remedy (2014) science journalist Thomas Goetz recounts the stories of Robert Koch, the founder of modern bacteriology, and Arthur Conan Doyle, the physician-author of the Sherlock Holmes series. In two narratives that run in parallel and eventually intersect, Goetz introduces a cast of pioneering medical detectives, from Koch’s scientific rival Louise Pasteur, to Conan Doyle’s inspiration for Sherlock Holmes, Joseph Bell. We follow a search for causative agents, preventive vaccines, and remedies for some of the deadliest infections in the Victorian era. Goetz describes how the principles of evidence-based science and systematic experimentation guided these ground-breaking discoveries, and how overlooking these principles led to setbacks.

Robert Koch, Louis Pasteur and other microbiologists made a cast of pioneering medical detectives.  A mural at The Ohio State University Social Administration Building. Source: The Short North Gazette.

Robert Koch, Louise Pasteur and other microbiologists made a cast of pioneering medical detectives, illustrated in a mural at The Ohio State University. Source: The Short North Gazette.

The Remedy begins by tracking Robert Koch working as a town doctor in Germany. Limited by resources, but moved by his experience tending the wounded in the Franco-Prussian war, he investigated the causative agents of infections. Secluded from the continental scientific community, he developed tools and methods to study bacteria which we still use, from the white mouse lab to culture media. He also developed a set of postulates, a step-wise checklist for demonstrating that a disease is caused by an organism. These real as well as thinking tools allowed him to find and track the life course of the causative agent for anthrax—Bacillus anthracis, an irrefutable proof for the then-nascent germ theory.

The strength of the book is Goetz’s page-turning account of one of science’s greatest rivalries, between Koch and the French scientist Louise Pasteur who was gaining fame for his work on vaccinations for anthrax and rabies, microbial fermentation and pasteurization. Goetz masterfully weaves primary sources, including letters and conference notes, to describe a race driven by a clash of egos, nationalism, and ambition. This competition ended in a breakthrough for Koch, who became the first to identify the infectious agent for tuberculosis— Mycobacterium tuberculosis. According to Goetz, Koch’s ambitions went further as he sought to find a cure for tuberculosis.

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