Koch is Really our Medical Galileo – Robert Koch
Robert Koch was born on 11th December, 1843 in Clausthal, a village in the mountainous terrain of Harz in the State of Hannover. He was the son of a miner and was one of 13 in the family.
The family of the scientist was set in rural surroundings, with hand to mouth existence. His boyhood days were spent in an atmosphere of poverty, struggle and hope — all mingled in mixed proportions, yet with a happy turnover, on the overall.
Scientist Robert Koch had his schooling at Gottingen where he studied mathematics and natural sciences. Subsequently he became a pupil of Henle (1809-1885).
Koch qualified for M.D. cum extreme lauda in 1866 at age of 23, the laudable qualification heralding the future genius in him. He studied under the famous Rudolf Ludwig Karl Virchow (1821-1902), the renowned pathologist of his times.
Scientist Robert Koch settled in practice in his rural surroundings after his qualification. He volunteered to serve in his country’s army in 1870 but was rejected because of defective eyesight, but his tenacity of purpose made him pursue military service at a later date.
Scientist Robert Koch was highly patriotic in his views and was greatly enthusiastic about the then German Victory; he was harbouring pungent anti-French feelings (loc.cit).
Scientist Robert Koch obtained Diploma in Public Health in 1872. His wife (first one) by name Emmy Fratz who herself was a keen naturalist, presented him with a microscope on his birthday.
From his younger days he showed a strong passion for scientific research. The seeds of the ‘would-be’ genius were planted in right earnest. In 1876 he made the epoch-making discovery of anthrax bacilli, their sporulation, life cycle etc., after examining numerous samples of infected material, skin and hides, meat, etc.
Scientist Robert Koch’s colleagues in this study were Julius Fredrich Cohnheim (1839-84) and Carl Weigert (1840-1904). He consulted the renowned botanist of his times, F. Cohn and got the study approved by him.
Scientist Robert Koch was doing animal experiments on mice infected with anthrax; examined their blood and other tissues.
By 1877 Koch developed techniques of fixing smears, staining for bacteria and invented the hanging drop method of observing microorganisms. He demonstrated strepto – and staphylo-cocci as causes of wound infections in 1878.
Scientist Robert Koch was appointed in the Imperial Health Office in Berlin in 1880. He demonstrated his solid media for the first time in the first International Medical Conference in 1881.
Louis Pasteur who was 20 years older than Robert Koch praised him, “C’est un grand progress,” though Koch harboured animosity with his in-born anti-French feelings towards Pasteur (loc.cit).
In the epidemiology of tuberculosis, Koch was distressed to observe the worldwide ravages of the disease. As the situation was expressed in those times, one in seven used to die of tuberculosis on a world average; in 1840s one in four was succumbing to the disease in France.
Scientist Koch was perturbed as well as stimulated by this horrid scene and was incessantly on the search for the causative agent of tuberculosis.
Till then, undernutrition, overcrowding, belief in mysticism, etc., were supposed to be factors incriminated in the outcome of tuberculosis.
On one fine morning on 24th March, 1882, a memorable day, Robert Koch demonstrated tubercle bacilli in infected issue (not in sputum, of course).
Scientist Koch published his paper ‘Die Aetiologie der Tuberkulose’ in 1882, which attracted the admiration of Virchow. He proclaimed the exciting cause of a formidable disease, tuberculosis, to the Berlin Physiological Society and in turn, to the entire world.
He was able to prove that consumption (phthisis; TB of lungs) was not, as had been widely supposed, a chronic disorder of nutrition, but an infectious disease that runs a chronic course.
It is pertinent to note that Henle made the predictions in 1840 that microorganisms are responsible for diseases; they are not visualized not because of their size being infinitesimally small, but because they are embedded in the tissues so inextricably as to become unrecognizable.
These predictions were proved by his pupil, Robert Koch 40 years later. It is to be construed as a red letter day in the life-time of Henle to have produced a pupil of such a high eminence, excelling the master.
The following four postulates of Koch followed suit and were widely accepted thenceforth in medical circles.
1. A particular bacillus always causes a particular disease.
2. The microorganisms must be present in all cases of the disease.
3. They must be cultured artificially on media in the laboratory.
4. Inoculation of these must produce the same disease in susceptible animals. Injection of pure culture into a healthy animal must reproduce the original illness.
Koch’s bacilli Koch’s disease became familiar terms in the medical history of tuberculosis.
Contemporaries of Robert Koch were Carl Joseph Eberth (1836-1926) who demonstrated typhoid bacilli; George Gaffky (1850-1918), military doctor who cultured typhoid bacilli in the year 1884 and Frederich August Johann Loffler (1852-1915) who discovered glanders bacilli in 1882 and diphtheria bacilli in 1884.
Scientist Koch was appointed as Chief of German Cholera Commission in 1883. He spent a considerable part of his life in travel to Egypt and India; isolated cholera vibrio and postulated its transmission through contamination in drinking water. He was awarded national prize of one lakh marks for this venture.
The discovery of Koch-Week’s bacillus in 1866 opened the way for understanding the pathogenesis of ophthalmic infections — the so-called “pink eye”.
Scientist Robert Koch was elevated to the post of Professor of Hygiene and Bacteriology at the Friedrich Wilhelm University in Berlin and Adviser, Imperial Health Office, in 1885. By temperament, he was wholly devoted and dedicated to research.
With the constant pursuit of passion towards discoveries and inventions, he added information of immense value for the understanding of communicable diseases which human flesh is heir to.
During 1891-1904 he functioned as Director of Institute of Infectious Diseases in Nordufen in Wedding district, North Berlin. Later from 1900-1906 he was also associated with Rudolf Virchow Hospital.
Other illustrious workers associated with Koch were the following :
- Emil Adolf von Behring (1854-1917) who discovered idiphtheria antitoxin, a pupil of Koch and became his co-worker. The success of serum treatment of diphtheria was amazing.
- Richard Friedrich Johannes Pfeiffer (1858-1945) who did work on influenza bacillus.
- William Henry Welch (1850-1934) whose name is associated with gas gangrene bacilli discovered in 1892.
- Shibasabura Kitasato (1856-1931), his pupil and later became his fellow-worker, who studied about plague bacilli in 1894.
- Paul Ehrlich (1854-1915), the father of modern chemotherapy.
- August von Wassermann (1866-1925).
Countless thousands were still dying with the ravages of tuberculosis. Koch’s discovery of old tuberculin following his discovery of the tubercle bacilli in 1882 was thought to be a miraculous cure.
However, hopes failed and frustration filled the void; it looked as though this disappointment was a follyof the scientist. Koch introduced new tuberculin in 1887 with a rejuvenating effect on the enthusiasm dwindled with old tuberculin. Hopes were raised again.
The final results were again disappointing. Thus, tuberculin alternately raised and lowered the hopes of the world in trying to conquer the universal scourge of tuberculosis.
Alas! tuberculin failed to fulfill expectations which were prematurely entertained by the enthusiast, Koch. Nevertheless, as a diagnostic test/tool, it has been proved to be of immense value.
The period 1880-1890 turned a dark chapter in Koch’s personal life. His family life turned adverse. His wife divorced him. His only daughter did not care for him; Koch became depressed and paranoid. At the age of 50 he married a young actress, Hedwig, consequent on which act he became socially ‘persona non grata’.
His close relatives and bosom friends deserted him, public furore went to the extent of mutilating the tablet of honour erected in his name in the institute, his house in Clausthal was raided and he was looked down as a social outcaste.
Environmental circles criticised him for his remarriage, but Koch exhibited lot of restraint in controlling himself against explosion of emotions and conducted himself with dignity.
He remained impervious to criticism amongst his close circles. As a diversion to this unpleasant situation, he took recourse to taking long tours from 1896 onwards, which were doubly beneficial, in the sense that he could forget his family worries as well as pursue his mission of scientific achievements.
The zeal of purpose to achieve the goal of advance in research, reigned supreme in his thought.
He went to South Africa to study rinderpest (in cattle). In 1898-99 he toured Italy, Indonesia and New Guinea studying childhood malaria, a protozoan infestation. Koch was obliged to travel far and abroad on useful missions aiming to better the lot of the ailing.
During his itinerary he used to give his home address in Berlin and Clausthal — such was his patriotic fervour and love for motherland! In India, he supplemented the work done by previous pioneers in the field of control of plague.
His dynamic presence was noteworthy and praiseworthy when bubonic plague bursted in Bombay round about 1898. He marched to East Africa in 1906 to patiently observe the glossina species in the epidemiology of trypanasomiasis. He established Atoxyl as a cure for the sleeping sickness.
During the sessions in London Tuberculosis Congress in 1900 Koch had the courage to say that bovine tuberculosis was not a problem in humans; he vehemently declared that we have little to fear against bovine tubercle bacilli.
The chief foe of man is not the infected cow, but his infected fellow human being. Theobald Smith (1859-1934) was of course, the one who differentiated between bovine and human tubercle bacilli.
A dignified aspect of the personality of Koch is that he is respected not only in his country but all the world over.
Figureheads in France acknowledged his worth. He was duly honoured by Kitasato of Japan, his old pupil and associate — a sincere scientist expressing gratitude for the association, and tribute for his excellence.
In Tokyo, a Shinto shrine was erected in honour of Koch. Annual tribute is paid till today in commemoration of the splendid soul of R. Koch.
In 1904 at the age of 61 Koch retired from the Institute. Koch was the recipient of Nobel Prize for Medicine in 1905; the title “Excellenz” was awarded for his outstanding contribution in tuberculosis.
On 27th May, 1910 his chin dropped and his head was lowered, while sitting in a balcony in a hotel observing agorgeous sunset. He breathed his last in peace and tranquility without being subjected to any torture in deathbed.
The body was cremated, and the ashes deposited in the institute which he founded. Over the urn is inscribed the inspiring maxim — ‘Nunquam otiosus’ — meaning, “May it ever animate the workers in science.”
In the warfare of man versus microbe, to achieve the welfare of man, we march to battle under the banner of Koch.
“Robert Koch’s influence in medicine was surpassed by no man of his century, and equalled only by Lister and Pasteur.”
“He invaded continents, not for the conquest of his fellowmen, but to lead the warriors of science against plague and pestilence. He uncovered the source of anthrax and tuberculosis and cholera and Egyptian opthalmia, and gained victories over typhoid and rinderpest and trypanasomiasis. In 1898 when typhoid bacilli proved far more deadly to the American soldiers than Spanish bullets, the mystery about the disease was uncovered by R. Koch.”
“Whole empires have flourished and perished without contributing as much to the sum of human knowledge as that one man, reverend Scientist Robert Koch.”
Fitting tribute : translated inscription of a plaque presented to Koch in 1908 by the physicians of Berlin
“From the world in little
You created your greatness
And conquered the globe
Which full of thanks crowns you
With the unfading wreath of immortality.”
Startling statistics about TB
Global scenario : TB is the single largest cause of adult death in the world.
- In 1995, 9 million new cases of TB with 3 million deaths— a death every 10 seconds.
- Reemergence of TB in the West, due to increase in co-morbid HIV infection.
- An estimated 2.3 million died of AIDS in 1997.
- 30 million living with HIV in their bodies.
Indian scenario : TB is a public health enemy ‘number one’.
- Each untreated case of TB can infect 20 normal individuals.
- Half a million die of it every year, i.e. ‘a death a minute’.
Warning signals of pulmonary TB, i.e. TB of lungs
Persistent cough; fever, especially rise of temperature late in the day, sweats accompanying fever during night;
blood-streaked sputum, pain in the chest;
exhaustion, losing weight; loss of appetite and disinclination to work.
TUBERCULOSIS is a Treacherous disease Ubiquitous in nature Burdening the bread-winner Erasing his finances and Remnants in life. Cruel is its Unpredictable course Lurking in the body Overwhelming its defenses Sure you can conquer If you make no truce and Send the germ away.