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MOST IMPORTANT SCIENTIFIC DISCOVERIES
The causative agent of tuberculosis. History and essence of scientific discovery
Directory / The most important scientific discoveries In the second half of the nineteenth century, every seventh person in Germany died of tuberculosis. The doctors were powerless. Tuberculosis was generally considered a hereditary disease, and therefore no attempts were made to combat it. The patients were prescribed fresh air and good food. That's all treatment. “Most doctors considered tuberculosis to be a hereditary disease, aggravated by poor nutrition and poor living conditions,” M. Yanovskaya writes in her book. Hippocrates, the great physician of antiquity, wrote that "a consumptive is born from a consumptive", that for consumptive patients spring is a bad season, but autumn is even worse; that this disease is fatal, but, captured at the very beginning, it can be cured: by good nutrition, climate, laxatives, hydrotherapy, etc. And although popular rumor in those days spoke of the contagiousness of consumption, Hippocrates himself did not say a word in his writings mentions it. But already Galen speaks of the contagiousness of consumption, and the French scientist Gaspard Bayle argues that pulmonary consumption is not an isolated disease, that it is a suffering of the whole organism. Then another Frenchman - Laennec - creates a doctrine of the unity of pulmonary tuberculosis and tuberculosis in general, thoroughly studies consumption, establishes its identity with scrofula and categorically states: the disease is contagious, but recovery is possible. And he himself dies of transient consumption at the age of forty-five ... ...Disputes about whether tuberculosis is contagious or not contagious have been going on for centuries. Back in the XNUMXth century, Fracastoro from Verona wrote that the causative agent of the disease is special little bodies that are inaccessible to our senses; they are also carriers of infection. And although the majority of medical scientists objected to Fracastoro's statement, and some argued that it should not be about "calves" at all, but about poison, Fracastoro's teaching on the contagiousness of tuberculosis was of great benefit: in many places measures were taken against the spread of infection . In Provence, for example, special marks were made on the things of pulmonary patients; after their death, furniture was taken out of the room where the sick were lying, upholstery was torn off the walls, bedding and linen were burned. In Naples, a famous decree was issued, according to which all furniture belonging to a tuberculosis patient was taken out of the city and disinfected by fumigation and special washing. Already in the nineteenth century, the modest French physician Villemin in the Parisian hospital of Val-de-Grâce had been studying tuberculosis for several years. He came to the conclusion that this disease is contagious and there must be a microbe that causes it. But since Willemin did not find this microbe, it was easy to argue with him. Medical canons were reduced to the fact that tuberculosis occurs as a result of spontaneous changes in the blood or other body juices. The famous scientist Virchow believed that scrofula, pulmonary consumption, and bone tuberculosis are completely different diseases. He did not agree with the fact that tuberculosis is a specific disease; according to him, any inflammation can degenerate into tubercles. Meanwhile, it was Virchow who first studied and described in detail the millet tubercle, which underlies the disease of tuberculosis (otherwise, tubercle), although the causes that give rise to this tubercle remained unknown to him. “Tuberculosis is a complex disease,” said another well-known doctor at that time, Pidu. - It gives one end result: death, destruction of body tissues. Our duty is not to seek out the mythical microbe, but to stop the paths along which this destruction is taking place. "Specificity hinders the development of medicine!" advocates of self-infection and opponents of microbes kept repeating. "If all doctors start catching a non-existent pathogen, who will treat the sick?" The only proof of the correctness - the microbe - was not given to the hands, and doctors, who considered tuberculosis a contagious disease caused by a specific bacterium, were forced to remain silent. The last word in defense of the microbe was the experiments of Conheim, who always and in all organs affected by tuberculosis found tubercles, which consisted of decayed tissues and pus. Conheim came to the conclusion that tubercles are the cradle of causative agents of tuberculosis. This conclusion of Conheim served as the starting point for research Robert Kochwhen he first set about looking for the tuberculous microbe in the new Health Department laboratory. The German physician and bacteriologist Heinrich Hermann Robert Koch (1843–1910) was born in Clausthal-Zellerfeld. His parents were Hermann Koch, who worked in the mine administration, and Mathilde Julia Henriette Koch (Bivend). There were 13 children in the family, Robert was the third oldest child. When Robert entered the local elementary school in 1848, he already knew how to read and write. He easily studied and in 1851 entered the Clausthal Gymnasium. Four years later, he was already the first student in the class, and in 1862 he graduated from the gymnasium. Then Robert entered the University of Göttingen. In 1866, Robert received his medical degree. Koch settled in the German city of Rackwitz, where he began his medical practice as an assistant in a hospital for the insane. However, this work of Koch was interrupted when the Franco-Prussian War broke out in 1870. Despite severe myopia, Robert voluntarily became a field hospital doctor and here he gained great experience in the treatment of infectious diseases, in particular cholera and typhoid fever. At the same time, he studied algae and large microbes under a microscope, improving his skills in microphotography. In 1871, Koch was demobilized and the following year was appointed county health officer in Wolstein (now Wolsztyn in Poland). His wife gave him a microscope for his twenty-eighth birthday, and since then Robert spent whole days with him. He lost all interest in private practice and began to conduct research and experiments, having started a real horde of mice for this purpose. Koch discovered that anthrax, an endemic disease that spreads among cattle and sheep, affects the lungs, causes skin carbuncles and changes in the lymph nodes, is common in the vicinity of Wollstein. Koch knew about the experiments Louis Pasteur with animals suffering from anthrax, and also decided to observe these bacteria. With the help of a microscope, he traced the entire life cycle of bacteria, saw how millions arise from one stick. Through a series of careful, methodical experiments, Koch identified the bacterium that was the sole cause of anthrax. He also proved that the epidemiological features of anthrax, i.e., the relationship between various factors that determine the frequency and geographical distribution of an infectious disease, are due to the development cycle of this bacterium. Koch's research proved for the first time the bacterial origin of the disease. Koch's discoveries immediately made him widely known, and in 1880, thanks in large part to the efforts of Konheim, he became a government adviser at the Reich Health Office in Berlin. In 1881, Koch published Methods for the Study of Pathogenic Organisms, in which he described a method for growing microbes in solid media. This method was important for the isolation and study of pure bacterial cultures. Now Koch decides to try his luck and find the causative agent of tuberculosis. The proximity of the Charité, where there were plenty of tuberculosis patients, made it easier for him: unfortunately, there was as much material as he wanted. Every day he appeared early in the morning at the hospital and received from there a little sputum of a patient with consumption or a few drops of the blood of a sick child. Then he took the small vial to his laboratory, trying to hide it from the eyes of the assistants, and sat down at the microscope. Days, weeks, months passed... The scientist's hands turned black from paint - very quickly he realized that if there was a chance to see this tiny mysterious killer, then only with the help of coloring substances. But the colors must be too weak. I had to come up with something stronger. Koch grinds the tubercular tissue, stains it with methylene blue, then with "vesuvine" - a caustic red-brown dye used to finish the skin, and looks. He forces himself to look away from the lens, leans back in his chair, covers his eyes with his hand. After resting, he looks again. On the preparation, clearly visible are clearly blue, tiny, slightly curved rods of an unusually beautiful shade. Some of them float between the cellular substance, some sit inside the cells. Not believing himself, Koch turns the micrometer screw again, puts on and takes off his glasses again, presses his eye close to the eyepiece, gets up from his chair and looks standing up. The picture does not change. Finally!.. "Two hundred and seventy-first drug," Koch writes in his diary. He smiles. And only now it dawns on him what actually happened: he discovered the causative agent of tuberculosis - a universal scarecrow, about which there were so many disputes. Koch achieved his greatest triumph on March 24, 1882, when he announced that he had succeeded in isolating the bacterium that causes tuberculosis. In Koch's publications on the problems of tuberculosis, principles were first identified, which later became known as Koch's postulates. These principles of "obtaining conclusive evidence ... that a particular microorganism does indeed directly cause certain diseases" are still the theoretical foundations of medical microbiology. In 1885 Koch became a professor at the University of Berlin and director of the newly established Hygiene Institute. At the same time, he continued to research tuberculosis, focusing on finding ways to treat this disease. In 1890, he announced that such a method had been found. Koch isolated the so-called tuberculin (a sterile liquid containing substances produced by the tuberculosis bacillus during growth), which caused an allergic reaction in tuberculosis patients. However, in fact, tuberculin was not used to treat tuberculosis, because it did not have a special therapeutic effect, and its administration was accompanied by toxic reactions, which caused its sharpest criticism. Protests against the use of tuberculin subsided only when it was discovered that the tuberculin test could be used in the diagnosis of tuberculosis. This discovery, which played a major role in the fight against tuberculosis in cows, was the main reason for Koch's Nobel Prize in 1905. Author: Samin D.K.
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