Bodies of knowledge

Have you ever wondered...

• when vitamins were found to be important for our health?
• when the electrical activity of the brain was discovered?
• what were the major killer diseases over 100 years ago?

Read on to find out more discoveries that have benefited us today.

A golden age

Modern medical science advances quickly: announcements of discoveries in genetics, in the processes of ageing, in the treatment of cancers seem to come thick and fast. But a century ago, medical science was progressing even more rapidly. The last decade of the 19^th century and the first two of the 20^th were a golden age of medicine, with fundamental discoveries in body function, in the causes of disease, and in their diagnosis and treatment. These advances were made possible by the application of new scientific knowledge and techniques to medicine, and by increased funding for research from governments and philanthropists.

The most striking features of this research are the fundamental nature of the discoveries and their sheer range, as scientists uncovered the workings of the body and some of the essential processes of life. For the first time, experimental research revealed the function of many glands. The existence of these small structures had been known from antiquity but between 1890 and 1910, the ability of the pituitary, thyroid and adrenal glands and the pancreas to secrete hormones – ‘chemical messengers’ – which coordinate growth and metabolism were revealed.

Understanding the human body

vitamins A, B1, B12, C, D and E were all identified by 1930

There were also major discoveries in the field of diet, with the realisation of the role of vitamins in maintaining health. By manipulating the diet of animals, researchers realised that the absence of tiny amounts of chemicals could produce disease or death. In the 1910s and 1920s, the role of these ‘accessory food factors’ or vitamins was gradually teased out and vitamins A, B1, B12, C, D and E were all identified by 1930. Knowledge of the working of the nervous system also advanced rapidly. For the first time, workers in the new field of neurology revealed the fine structure of nerve cells, the electrical activity of the brain, the transmission of impulses between nerve cells and the role of reflexes in coordinating body function.

Researchers did not confine their work to the human body. The microbes responsible for disease were also under close scrutiny. Louis Pasteur’s work in identifying microorganisms is well known, but he was just one of a group of ‘microbe hunters’. The development of a set of basic laboratory techniques to isolate, grow and identify bacteria and viruses led to a flood of discoveries. Between 1879 and 1900 the causative agents of over 20 major diseases were discovered – roughly one per year – including those of tuberculosis and cholera, which were major killers. Knowledge of bacteria allowed accurate diagnosis and prompt action to reduce the spread of disease. In the case of tuberculosis, it also led to a fundamental shift in the understanding of the illness – from a chronic condition associated with poor housing to an infectious disease.

Thinkstock
A microscopic image of a tuberculosis-infected lung [Thinkstock]

Trial and error

New understandings of the body and of disease opened up the prospect of better treatments, but concrete results came very slowly. Identifying disease-causing microorganisms allowed the creation of vaccines from weakened forms of the bacteria and viruses. Pasteur enjoyed huge acclaim when he developed a vaccine against rabies – a rare condition. But attempts to repeat the process for more common diseases proved problematic. Robert Koch’s vaccine against tuberculosis proved to be a failure and vaccines against colds and even acne proved useless. There was a further spectacular success in the treatment of diphtheria. This disease of children often proved fatal, not as a direct result of the diphtheria bacterium, but from a toxin produced by the bacteria which caused severe choking. In 1891, Emil Behring successfully treated the symptoms with an anti-toxin derived from animal antibodies.

Prontosil had the unfortunate side effect of turning patients red

Efforts to find chemical drugs which targeted invading microbes in the same way as the body’s own defence mechanisms also proved elusive. Researchers systematically investigated the huge range of organic compounds developed by the new chemical industries in the late 19^th century, but a new therapy did not appear until 1909 when the 606^th drug tested against syphilis proved effective. Salvarsan, as the new compound was called, did not herald a new era in drug treatment. The next chemical drug, Prontosil, did not appear on the market until 1932, over 20 years later. Developed from a chemical dye, Prontosil had the unfortunate side effect of turning patients red but it cured them of previously fatal bacterial infections.

Fashionable surgery

Practitioners therefore had to continue to manage illness using a small range of effective medicines which (fortunately) included a number of painkillers such as aspirin, morphine and chloroform. The exceptions to this rule were conditions that could be treated through surgery. Surgery was benefitting from the ever more sophisticated application of antisepsis, with operating theatres that provided a completely sterile environment, and new medical technologies such as x-rays and the electrocardiograph which allowed practitioners to ‘see’ inside the body. From around 1900, surgeons were no longer limited to dealing with damaged bones and joints but began to routinely open the abdomen to remove appendices and gallstones or to repair perforated ulcers. Such was the confidence in surgery that it became almost fashionable, with thousands of children enduring the removal of their tonsils for what would now be seen as very dubious reasons.

Wiki NoCopyright WilhelmRöntgen http://en.wikipedia.org/wiki/File:Anna_Berthe_Roentgen.gif
Print of one of the first X-rays by Wilhelm Röntgen of the hand of his wife Anna
(taken on 22-12-1895)

Even as faith in science and medicine increased, there were dissenting voices. Practitioners worried that medicine was becoming too scientific, too ready to focus on diseased parts and not on the whole patient. Clinicians worried that overly specialist practitioners, skilled in dealing with one part of the body, might overlook crucial symptoms in another. A century ago, medicine enjoyed unprecedented success and a confidence in the power of science which has never really declined, but it also saw the beginnings of a critical attitude which also remains to this day.

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