- - Thursday, April 17, 2014

THE REMEDY: ROBERT KOCH, ARTHUR CONAN DOYLE, AND THE QUEST TO CURE TUBERCULOSIS
By Thomas Goetz
Gotham Books, $27, 289 pages, illustrated

If almost everyone knows Arthur Conan Doyle as the creator of Sherlock Holmes, few remember today that he was actually a medical practitioner, even though his training and experience permeate the stories. Indeed, putting parts of himself into both the forensic detective and his cohort, Dr. Watson, he infused them and the narrative with the scientific way of thinking he had acquired in his studies.

Thomas Goetz, a science journalist whose own exposure to its methodology is evident throughout his book, rightly says that these words of Conan Doyle’s “could have been spoken by Sherlock Holmes himself”: “[Medical training] tinges the whole philosophy of life and furnishes the whole basis of thought. The healthy skepticism which medical training induces, the desire to prove every fact, and only to reason from such proved facts — these are the finest foundations for all thought.”

Conan Doyle, like much of the medical world, was galvanized by the announcement in 1890 by the world famous German scientist Robert Koch that he had discovered a remedy for tuberculosis, “Tuberculin.” Still a practicing physician who dabbled in literature, he secured a journalistic assignment to cover the story and rushed to Berlin. His published article drew upon that medical training, as well as on a healthy native skepticism, expressing doubt about this “miraculous cure.”

Koch’s claim was soon dramatically disproved, tarnishing, if not destroying, the great reputation of this premier man of science in his time. It is a gripping story, and Mr. Goetz tells it with great verve, painting word pictures full of color and telling detail, whether about issues, controversies or personalities. He vividly evokes the rivalries rife in the scientific world, fed not just by the obvious suspects of ego and personal gain, but by such extraneous forces as nationalism.

Who could have imagined that the shadow of the Franco-Prussian War of 1870-71 lay so darkly on the rivalry between the French patriot Louis Pasteur and Koch, who had served as a doctor with the victorious army? After a clash at an international congress in neutral Switzerland that Pasteur thought he had won, he wrote, “It was a triumph for France. That is all I wanted.”

Mr. Goetz sets his story against the immense breakthroughs happening in these final years of the 19th century: the development of anesthesia, with its beneficial effect on surgery; the identification of microbes and other features visible only through microscopes, only one of the range of scopes being developed as diagnostic tools; the understanding of antisepsis in surgery and treatment; and the development of germ theory, in which both Pasteur and Koch were key players.

However, dwarfing everything in Mr. Goetz’s packed narrative is the scourge of tuberculosis and his account of its significance at the time stands out in boldface: “Though it had afflicted humanity for millennia, in the nineteenth century tuberculosis went on a rampage, a tide of death known at the time as the White Plague. As Koch noted the disease was the largest killer by far in the United States and Europe . All told, the pervasiveness of tuberculosis and the impotence of medicine to treat it created a specter of misery in nineteenth-century Europe and America.”

“The Remedy” provides a roll call of 19th-century writers who died from it and cites a description by a non-sufferer, Charles Dickens, in “Nicholas Nickleby” that with characteristic economical precision, Mr. Goetz parses: “The experience of the disease was, as Dickens described, typically a slow, dispiriting decline.”

My only quarrel with this book is that it somewhat enhances Conan Doyle’s role in the Koch Tuberculin affair and overstates its importance as a catalyst in the creation of Sherlock Holmes. To write, as Mr. Goetz does, that “Koch’s undoing was put in motion” by the Scottish physician is questionable.

The newspaper article he wrote on his return from seeing Koch’s performance was certainly an early expression of doubt about this “remedy” for tuberculosis, but how influential was it and how much effect did it actually have?

It was the medical establishment in Germany, led by the prominent pathologist Rudolf Virchow, already deeply skeptical about Koch’s claim, which scientifically established its invalidity.

As for Sherlock Holmes, his richness as a character, his protean complexity, springs from his creator’s imagination as well as from his life experience as a doctor and a man. Was his encounter with Koch really all that crucial?

Martin Rubin is a writer and critic in Pasadena, Calif.