The Bacteriological Revolution

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The Bacteriological Revolution
a revolution in etiologya new kind of proof,
a new kind of truth the presumptive analogy of
microbial contagion the promise/mirage of
magic bullets(specific prophylactic and/or
therapeutic agents) result a new science, a
new industry, a new way of understanding health
and disease
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The Golden Age of Etiology
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Kochs Postulates

• In order to establish that a microbe is the cause
  of a disease
• Microbe must be present in every case of the
  disease
• Microbe must not be present in the absence of
  the disease
• Isolated from diseased tissue and grown in pure
  culture, microbe must reproduce the disease when
  introduced into a healthy (animal) subject
• Microbe must then be found in and cultured from
  diseased tissue of experimental subject.

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A Tangible Parasite
"My studies have been conducted in the interest
of public health, and my hope is that public
health will derive the greatest benefit from
them. Tuberculosis has so far been habitually
considered to be a manifestation of social
misery, and it has been hoped that an improvement
in the latter would reduce the disease. Measures
specifically directed against tuberculosis are
not known to preventive medicine. But in the
future the fight against this terrible plague of
mankind will deal no longer with an undetermined
something, but with a tangible parasite, whose
living conditions are for the most part known and
can be investigated further. This fact
warrants a particularly favorable outlook for
success in the fight against tuberculosis.
There is hope that it can be overcome." Koch,
On the Etiology of Tuberculosis (1882)
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The Mirage of Magic Bullets
"A new science has been born. It has caused a
veritable revolution in our knowledge of virulent
and contagious diseases. Destroy the microbes
of typhoid fever, of diphtheria, of scarlet
fever, of measles, of glanders, of anthrax, of
cholera, etc., or place them in conditions where
they can no longer do harm, and you will never
see a single case of these diseases. No matter
what the living conditions or physiological
poverty of an individual, never on his own will
he be able to create these diseases nor will
he be affected by them to any degree whatsoever.
The science of health must, by all the means in
our power today, be preoccupied with destroying
the germs of which I speak, or with annihilating
their disastrous influence. Louis Pasteur, 1888
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When Chadwick Met Pasteur

• germs
• laboratories
• testing
• promise of control (through lab. science)
• search for magic bullets

• cleanliness
• morality
• order
• (language of) disgust

SBS
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The Sanitary-Bacteriological Synthesis

• a new way of understanding, explaining, and
  combatting the problem of disease in modern
  society
• gradually negotiated over a period of decades
  (esp. 1880-1900) among scientists, physicians,
  public-health experts, government officials, and
  the general public
• in which the overriding concerns of the early
  and mid-19th-century sanitary movement
  (filth/contamination, cleanliness and morality)
• were integrated through the language of
  bacteriology, with a persistent overlay of
  moralizing disgust, into a new set of meanings
  and practices
• alongside a new germ-centered focus on
• (1) the danger of contact with sick or suspect
  bodies and bodily substances,
• (2) tests for the presence of potentially
  pathogenic microbes, and
• (3) the promise of their control through
  laboratory science.

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The McKeown Thesis

• selected books by Thomas McKeown
• The Modern Rise of Population (1976)
• The Role of Medicine Dream, Mirage, or Nemesis
  (1979)
• The Origins of Human Disease (1988)

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Infection and Resistance Who's Healthy? Who's
Sick?
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Infection and Resistance Who's Healthy? Who's
Sick?
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Infection and Resistance Who's Healthy? Who's
Sick?
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Infection and Resistance Who's Healthy? Who's
Sick?
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Infection and Resistance Who's Healthy? Who's
Sick?