Cudowny lek. Robert Koch, Ludwik Pasteur i prątki gruźlicy

by Thomas Goetz, Robert Śmietana (Translator)

Opowieść o wielkim przełomie w medycynie i walce z najgroźniejszą chorobą świata
RYWALIZACJA DWÓCH WIELKICH NAUKOWCÓW O SŁAWĘ, PIENIĄDZE i PRESTIŻ

„Napływali do Berlina całymi dniami, tygodniami i miesiącami (…). Berlińczyków musiała zdumiewać ta istna pielgrzymka zombie: tłumy żywych trupów z całej Europy przybywały do ich miasta w poszukiwaniu czegoś, co oficjalnie jeszcze nie istniało”.

Pierwsze pogłoski o tym, że Robert Koch wynalazł cudowny lek na gruźlicę, ściągnęły na niemiecką stolicę prawdziwą inwazję chorych. Nieuleczalna choroba była w XIX wieku powodem jednej trzeciej wszystkich zgonów, więc zdesperowani ludzie pokonywali tysiące kilometrów w nadziei na ratunek. Jednak czy rzeczywiście lekarstwo Kocha było skuteczne?

Poszukiwaniom leku od lat towarzyszył wyścig między dwoma największymi naukowcami tamtych czasów. Robert Koch i Ludwik Pasteur, Niemiec i Francuz, skromny doktor z prowincji i zamożny badacz. Ich starciu przyglądał się inny lekarz – Arthur Conan Doyle, przyszły autor legendarnych powieści o Sherlocku Holmesie, który rozpaczliwie liczył na ocalenie życia swojej ciężko chorej żony.

Książka Thomasa Goetza to opowieść o wielkiej XIX-wiecznej rewolucji, dzięki której medycyna, dotychczas prymitywna, oparta w dużej mierze na zabobonach i półprawdach, zmieniła się w prawdziwą naukę.

Genres: Nonfiction, History, Science, Medicine, Medical, Biography, Audiobook

384 pages, Paperback

First published April 3, 2014

About the author

Thomas Goetz is the author of the new book, The Remedy: Robert Koch, Arthur Conan Doyle, & the Quest to Cure Tuberculosis. He is also co-founder of Iodine, a health technology company based in San Francisco. His previous book, The Decision Tree, was chosen by the Wall Street Journal as a Best Health book of 2010, and widely hailed as offering a new vision for healthcare in the United States.

Thomas also serves as the Enterpreneur in Residence for the Robert Wood Johnson Foundation, the nation’s leading force for better health and healthcare.

He was previously the executive editor at WIRED, where he led the magazine to a dozen National Magazine Awards from 2001 through 2012. In 2010, under Goetz’s leadership, WIRED was chosen as AdWeek’s “Magazine of the Decade.” His writing there explored topics from the riddle of behavior change to the paradox of cancer screening, and was selected for the Best American Science Writing, Best American Science & Nature Writing, and Best Technology Writing anthologies.

He has been a Curator-in-Residence for the Adobe Digital Museum, and a council member for NASA’s Launch challenge. In 2011, he served as executive producer for the award-winning Discovery Channel documentary Earth 2050: The Future of Energy. His TED talk on redesigning medical data has been viewed 400,000 times.

Goetz holds a Master of Public Health degree from the University of California, Berkeley, and a Master's in American literature from the University of Virginia. He graduated from Bates College, where he learned to juggle five balls at once (he’s
now back down to three).

Reviews

[Mindy · Rating 3 out of 5]

When I read the premise of this book, I was intrigued. What could Sir Arthur Conan Doyle have to do with Robert Koch's efforts to cure Tuberculosis? Not a lot, as it turns out. The effort of the author to hang the story on the current popularity of Sherlock Holmes turns this otherwise interesting and well-sourced book into a cheap bait-and-switch.

The Remedy starts off with a very promising first half. The history of Germ Theory was fascinating, and it was very edifying to read about the effect that Tuberculosis and other infectious diseases had on the general population in the mid to late 1800s. It was also eye-opening to see just how much we take for granted in modern times, like the idea that a doctor should wash his hands before surgery.

This interesting book is hijacked into a biography of Sir Arthur Conan Doyle. While his life is indeed worth reading about, his story seems truncated in order to fit. When I realized exactly how little Doyle's involvement amounted to in comparison to the time spent on him, I felt very ripped off. I wondered why so many interesting subjects were reduced to short asides in the first half of the book, only to make room for a part of the story that didn't really matter. I understand the desire in non-fiction to shape history into a narrative, but the battles of Germ Theory vs Miasma Theory or the vicious public throw-down between Luis Pasteur and Robert Koch had conflict and story in spades.

Pinning the crux of the book on Doyle's investigation of Koch was beyond anticlimactic. They never met, Doyle didn't even get in to the demonstration he was to write about, and his paper on Koch's quackery didn't even come off as that important. The sea change in public opinion about Koch seemed like more of an accumulation of the many negative writings in the wake of his 'cure' being completely ineffectual. There were also some asides that made me feel like the author was stretching the Doyle portion pretty thin, like the page listing a bunch of slang terms for different kinds of criminals of the age.

Sadly, The Remedy ended up feeling fractured and unsatisfying. I find this to be a shame, since the writing was engaging and rarely dry. If a more prose-like passage said Koch or Doyle felt a certain way or had a certain thought, it was backed up by a personal correspondence. The author did not seem to take many of the liberties that you often find in non-fiction for a popular audience. Overall, I think that readers interested in early medical microbiology or Sir Arthur Conan Doyle would be better served by reading about them separately in more focused books.

[Maria · Rating 5 out of 5]

“The physician must be able to tell the antecedents, know the present, and foretell the future — must mediate these things, and have two special objects in view with regard to disease, namely, to do good or to do no harm.”
Hippocrates

The history of medicine is a fascinating one and of very ancient origin. The quest to fully understand the human body and disease has been a long journey where the work of many brilliant minds devoted to science continue searching for answers in order to offer the possibility of a cure and mitigate the suffering. If we go back as far as ancient Greek medicine, we would find theories that played a fundamental role in health care such as "humorism" (in which the four humors, phlegm, blood, black bile and yellow bile needed to be in balance in order to be in good health), or the theory of "miasma" (the idea that diseases originated from "bad air"). Surprisingly, these ideas persisted for over two millennia up to the 19th century, until the "Germ theory" of disease came to offer a new answer that linked microorganisms as the causative agents of many diseases.

In "The Remedy", the author Thomas Goetz offers us a wonderful narrative about the history of one of the greatest battles in science, the battle between chemistry and medicine, between France and Germany, the rivalry between Louis Pasteur and Robert Koch on one of the oldest and greatest killers of all time: Mycobacterium tuberculosis. An illness that in the early 19th century accounted for up to 20 percent of all deaths. Both scientists made amazing contributions, many which are still useful today in labs or in clinical practice also, but in their quest to find treatments or vaccines to prevent illness their rivalry just continued to grow and in this book (which is almost impossible to put down), you will find such an amazing and thrilling story on this golden age of bacteriology.

"He wasn't waiting for science to reach him. He saw like few other researchers at the time, where science needed to go"....



Inspired by Charles Darwin's life full of romance and adventure, Robert Koch studied medicine at Göttingen University where he would meet George Meissner, an innovator in animal experiments, and Friedrich Henle, a pioneer in microbiology  "The contagion is not itself the disease, but the inducer of the disease"; both scientist obviously became a great influence to Koch's work. This meticulous and somehow introvert scientist made wonderful contributions such as a writing on the "etiology of wound infections" as well as establishing the famous Koch's postulates (criteria used to establish an infectious agent to a disease but not quite effective today anymore as it does not apply to infectious agents like a virus or prions) that helped him identify and isolate the microorganisms of bacteria induced illnesses like anthrax and cholera. He also established quinine as the prophylactic treatment of malaria which is still used today. Another innovation was the use of microphotography and the "white lab mouse" among many other useful techniques used today at a lab. But, in between of so many amazing discoveries, Tuberculosis became Koch's nemesis. In the struggle and competition against Pasteur to become the first one to develop a cure for TB, his "remedy" became his biggest blunder. Robert Koch had that peculiar personality and qualities of a good researcher and has my admiration since I first became familiar with this story at another magnificent book titled "Microbe Hunters". Still Goetz offers a more extended and detailed side of the story, highly entertaining and very pleasant to read.

On the other side, we have Louis Pasteur, who studied chemistry, optics and crystallography, but unlike Koch, Pasteur was an extrovert, a great performer of his findings. His work on crystals and silkworms led him first to demonstrate the role bacteria on fermentation and eventually developed  the process we are all familiar with: pasteurization. With this in hand, Pasteur became a strong supporter of the "Germ theory of disease". On his speech entitled "Germ Theory and Its applications to Medicine and Surgery" at the Académie Nationale de Médecine he stated:

        "If it is terrifying that life may be at the mercy of the multiplication of those infinitesimally small creatures, it is also consoling to hope that Science will not always remain powerless before such enemies... I am not a surgeon but I'm here to suggest to only make use of bandages and sponges which had previously been raised to a heat of 130 - 150 C if you want your patients to improve by avoiding infections"

Arthur Conan Doyle, who probably does not need introduction among you, was also an admired of the Germ Theory and idolized Robert Koch's work, he identified with him. Like his most beloved and famous fictional character, he became the "Sherlock Holmes" behind Koch's "remedy" uncovering the truth behind this treatment. Tuberculin did not cure TB, but Koch's blunder was really mistaking a reaction for a remedy. "What Koch accomplished in lab, Conan Doyle in literature. What Koch proved to science, Doyle to Society" Did Conan Doyle or Louis Pasteur became the Professor Moriarty in the real life of Robert Koch? Today Tuberculin has a different application, NOT as a treatment but as a diagnostic tool. PPD is a useful skin test that helps identify a TB infection.



In this book, you will not only read a fantastic narrative on the rivalry between Louis Pasteur and Robert Koch but you will also be introduced to many other scientific accomplishments by Paul Ehrlich, John Snow, Julius Richard Petri, Edward Jenner, Emile Roux, Georg Gaffky, Friedrich Loeffle, Kitasato Shibasaburo and Joseph Lister as well as the birth of new fields of science such Immunology.

Today TB is still one of the most common infectious diseases worldwide according to the CDC. Also, the in latest report of WHO, TB remain a major health problem stating: "It is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent and the leading killer of patients with HIV.In 2012, there were an estimated 8.6 million incident cases of TB AND 1.3 million died from the disease". What makes a new discovery so amazing is not only the satisfaction of finding the ultimate answer, the real etiology behind a specific disease, but also the challenge that comes next. Prevention, vaccines, treatments and patient education are all part of a team from scientists to nurses and doctors taking action in offering humanity a better quality of life.



It is true, TB and other infectious diseases continue to represent a challenge worldwide but it is thanks to the work of many superb scientists like Louis Pasteur and Robert Koch that many other fatal diseases are now preventable or controlled. The reason I deeply enjoy this type of reading is simply because it reminds us where are we standing today and how far we have become regarding health care. Still, science has a long way to go and has much more to offer humankind.

“Wherever the art of Medicine is loved, there is also a love of Humanity. ” — Hippocrates

I highly recommended "The Remedy" to any healthcare worker or any one of you who simply loves the history of medicine and the main characters who played a fundamental role in the quest to solve the riddle of one of the deadliest diseases of all time: Tuberculosis.

For more information on TB please visit:
-WHO: http://www.who.int/tb/en/
-CDC:http://www.cdc.gov/tb/
-NEJM articles on TB:  http://www.nejm.org/doi/full/10.1056/...

[Watchingthewords · Rating 5 out of 5]

In the nineteenth century twenty-two out of every thousand people died each year, more than 2% of the population– today only 5 out of a thousand people die each year. In the nineteenth century the average lifespan was thirty-six years – today it’s about eighty. The biggest killer in the nineteenth century? Tuberculosis. Also known as consumption, this disease was rampant, believed to be hereditary, and in spite of numerous claims of ways to cure the disease, no cure or effective treatment was available.

Then in 1882 a German doctor, Robert Koch, presented to the world the cause of tuberculosis. It was not hereditary, but caused by bacteria. Using unparalleled and unprecedented scientific methods, Dr. Koch had identified, isolated and replicated the deadly bacteria, injected it into healthy animals, watched as the animals developed tuberculosis, found the bacteria in their blood and tissue, isolated it, and repeated the process, proving without a doubt the cause of the world’s number one killer. Spurred on by a professional and contentious rivalry with Louis Pasteur, Koch tackled the next problem, finding a cure. In his haste to satisfy both his professional pride and national pressures, driven by a desire for recognition, Koch threw aside the very scientific methods which had made him well-regarded and presented the world with the cure that was not.

Enter Arthur Conan Doyle, a young small-town English doctor and writer, headed towards Berlin to cover the announcement of Koch’s cure. When he sees the German doctor’s cure at work he is horrified and quickly returns to England to report on the farce. While Koch stubbornly insists that his cure will work, the ill descend upon Berlin desperate for help where none can be found. Koch’s reputation destroyed, in spite of his groundbreaking work in germ theory and discovering the cause of tuberculosis, flees to other parts of the world to work away from the scrutiny of his critics. Meanwhile, Arthur Conan Doyle, unsuccessful as a doctor, ironically employs the very scientific methods that made Koch famous in the creation of Doyle’s most famous character, Sherlock Holmes.

The epilogue is as interesting and terrifying as the rest of the book. Tuberculosis, once thought to have been cured, is coming back in new and drug-resistant forms as a whole new generation of scientist begin to look at how microbes affect our health in other ways including heart disease and cancer. Smart, insightful, and interesting, this book is the tale of the egos of ambitious men, an unparalleled time of scientific discovery, and the resulting societal changes. It leaves one to ponder where we will go from here…

“The bacteria precede us. The outnumber us. And they will outlast us.”

See more on my blog at www.watchingthewords.wordpress.com

[Hannah · Rating 3 out of 5]

ARC edition as part of GRs First Reads Giveaway.

I had written an absolutely **STELLAR** review a few days back, and my *@#%$%&& laptop decided to crash during the final wrap-up paragraph. I wanted to cry.

Needless to say, all my brilliant thoughts, observations and analysis of this book have vanished, never to return. Instead, I will just say that I enjoyed author Thomas Goetz book and all the information relating to Dr. Koch and his medical research and supposed "remedy" for TB. For the layman reader, the writing was clear and concise and not dry at all. I learned some very cool trivia about 19th century medicine and was generally pleased with the overall tone of the book. My only quibble (and the reason why I rated this 3 stars) was due to the fact that I felt Goetz' inclusion of Sir Arthur Conan Doyle into the narrative was a stretch, and didn't work with the rest on the story. Yes, I did see the connection between Doyle and Koch, but it was extremely thin IMO. I would have personally preferred just a book focusing on Koch and his rise to fame and the fall that came afterwards. But that's me - perhaps others will enjoy the two intertwined stories.

Recommended for readers of medical non-fiction.

[Rebecca · Rating 4 out of 5]

The Remedy is well-paced: it reads like mystery or true crime, not like a history book. It is not only a history of attempts to isolate the cause of tuberculosis and develop a cure for it, but also a dual biography of Dr. Robert Koch, the microbiologist who proved the bacterial origin of TB, and of Arthur Conan Doyle, creator of Sherlock Holmes and a medical man in his own right. Goetz’s book is more than the sum of its parts: it reveals the scientific inquisitiveness of an era, and portrays the modern shift from superstition into hard science. As Goetz succinctly remarks, Koch and Doyle “shared a trajectory from the nineteenth century of leeches and cod-liver oil to the twentieth century of microscopes and antibiotics.”

(An excerpt of my full review is available to non-subscribers at BookBrowse.)

[K. · Rating 4 out of 5]

Trigger warnings: nineteenth century medical treatments, really graphic descriptions of tuberculosis and what it does to you. Not for the squeamish.

Y'all probably know by now that I'm TRASH for medical history books. So obviously I bought this when I came across it, especially seeing as I'd never read anything about tuberculosis before.

And for the most part, this was pretty fascinating. Koch's story was intriguing, the treatments for tuberculosis in the nineteenth century were HORRIFYING ("lemme just stab you in the chest until your lung collapses, which will give it relief and allow it to recover. What do you mean you can't breathe?!"), and while the Conan Doyle stuff felt sliiiiiightly shoe-horned in, it was still fascinating to see how he balanced his medical and writing careers.

So yeah. Gruesome, but compelling.

[Maureen Wynn · Rating 3 out of 5]

Let’s just start with the bait-and-switch, and get that out of the way: Dr. Arthur Conan Doyle had NOTHING to do with Dr. Robert Koch’s research into the causes and potential cures for tuberculosis. They had one point of commonality, in November of 1890, when Doyle traveled from Southsea, England to Berlin to try to attend Koch’s demonstration of a “cure” for consumption. As it turned out, the two men never even met – Dr. Doyle was turned away from Dr. Koch’s house because the doctor was too busy to meet with a stranger from England, and Doyle was not even able to get a ticket into the presentation. Doyle went back home and wrote up an account of Koch’s presumed discovery based on information passed on to him by one of the attendees who took pity on Doyle and passed on his notes.

The book turns on that point in time – everything before that date focuses on Dr. Koch’s history and research leading up to that moment, and after that date focuses on Dr. Doyle’s history, leading through his career as a doctor to his career as a writer and his creation of Sherlock Holmes. If you’re reading this book (as I did) hoping for some heretofore unknown collaboration between Doyle and Koch, you will be disappointed. However, if you read the book for insights into the turning point of medicine when the much-debated germ theory of disease was finally proven as scientific fact, you will be amply rewarded. The explanations of the differing methods and results of Lister, Pasteur, Koch, and other doctors, scientists, and microbiologists are well-written and understandable to non-scientists. It’s difficult for modern readers, who are well versed in the realities of germs as the cause for disease and illness, to look back at a time when even the most learned of scientists considered germ-theory as a crackpot idea. But this book explains clearly why it was so difficult to provide proof of that theory, until technology developed enough to provide a way to see the germs and track their growth, both in the lab and in human beings. In that respect, this book is a fascinating look at a specific point in medical history. As far as Doyle and Sherlock Holmes are concerned, it’s less fascinating, and more of a re-hash of already common knowledge.

[Amy · Rating 4 out of 5]

Books like this truly make history and science come alive. It balanced biography, scientific discovery, and big picture themes such as the role of science in society, all while remaining highly enjoyable and engaging.
I definitely recommend.

[Aiyana · Rating 3 out of 5]

A fascinating scientific history about the development of germ theory and the remarkable researcher who discovered the tuberculosis bacteria (and, perhaps more importantly, laid down many basic rules for good research that are still used today). His story is both remarkable and tragic, and so is the history of medicine is. This book is set at a time of great scientific progress, but also at a time when scientists were becoming more aware of just how much we don't understand, and Koch was a brilliant man who found himself in the unenviable position of having made a great discovery but having no way to actually help people. As a result, he strayed from hard science in his increasingly desperate search for a way to kill the disease he had isolated.

While the story is incredible, I found the writing itself a bit on the dry side. I feel like the link between Koch and Conan Doyle was a bit tenuous: certainly, Conan Doyle was a science enthusiast who followed Koch's work avidly and critiqued it in his writings, but that's about it. I feel like he was included in the narrative more because his name is so famous than because he played any major role in the controversy over Koch's work.

This being said, I still recommend the book to anyone interested in the history of science in the later 1800s.

quotes:
If there's one caution to this tale, it's this; Avoid the temptation to read the story, and the science within it, as the inevitable march of progress, a predetermined direction for human history. Especially where scientific investigations are concerned, it's a fallacy to treat history as an unstoppable trajectory away from ignorance and towards insight. Though we can, retrospectively, catalog science along a tidy arc from one discovery to another, the actual course of research is marked more by darkness than by light, more by failure than by triumph." Introduction, p xix-xx

"'In science the credit goes to the man who convinces the world, not to the man to whom the idea first occurs.'" Quoting Francis Darwin (Charles's son) p 105

"The magic of randomization is that it greatly reduces methodological biases, and it makes room for statistics. Statistical analysis is the lifeblood of contemporary science. It provides the foundation for evaluating the validity of an experiment's results and a common language for other scientists to pursue their own analogous experiments." p 192

[Sebastien · Rating 3 out of 5]

Well-written and very readable. This amounts to very interesting biographies of two men: Robert Koch, one of the architects of germ theory. And Arthur Conan Doyle, an MD who wrote the pioneering works featuring Sherlock Holmes.

The material in the book was all very interesting. There were some great parallels between Koch and Conan Doyle, especially in their respect for rational logic and intense scrutiny of detail and adherence to rigorous process.

The part where this book doesn't work was that the tie-ins between the Koch and Conan Doyle were rather tangential and at times ludicrously paper thin. They never actually met, the writer tries to use the whole tuberculosis thing to somehow tie Robert Koch and Conan Doyle together, but it is just too dang flimsy to work.

I learned some cool stuff in reading this, I knew nothing of Conan Doyle's background as an MD, and didn't know anything about Koch's failed tuberculosis treatment. So while I'd recommend the book, I'd say that the overall framework is flawed.

[Amy H. Sturgis · Rating 5 out of 5]

The Remedy is a thoroughly fascinating and satisfying portrait of a transformative moment in intellectual history. Goetz traces the hazardous paths of those who championed the germ theory of disease and follows their habits of thought to the work of Arthur Conan Doyle. This is not to be missed by those with an interest in the history of science, detection, and/or modernity.

To quote Goetz, "Conan Doyle took what medical scientists a generation older than he - Joseph Bell, Lord Lister, and Robert Koch - had accomplished and mythologized their methods, turning their innovations into popular entertainment based on the singular principle that little observations can build into larger conclusions. Through Holmes, Conan Doyle helped people see how from a thousand small observations can come a profound and lasting change."

Highly recommended.

[Todd · Rating 5 out of 5]

What a satisfying read! This book is great - it has amazing historical sweep on the development of the germ theory (fascinating) and the various personalities involved (Pasteur-the original germaphobe and many others), mini-novelistic biographies on two titans (Koch in science and Conan Doyle in literature), their conflict over tuberculosis, and the impacts this incredible disease had on both men and the society they lived in. The Remedy is engaging, amazing storytelling, I learned a ton, and I recommend it highly.

[wade · Rating 5 out of 5]

This is a fascinating look into the discovery of cures for a wide variety of contagious illnesses. The holy grail in all this is tuberculosis - the largest killer of the 1800 and early 1900's Much time is spent on Robert Koch and Louis Pasteur and the competition in the world of medical research of that time. Arthur Conan Doyle is drawn into the story as he was a medical doctor who was deeply interested in their progress and used the research techniques he learned to construct his Sherlock Holmes mysteries. A somewhat narrow audience will really love this book.

[Whitney Wright · Rating 5 out of 5]

I adore books that find a thread of history and manage to pull many different seams together into a coherent narrative. Even better if it can captivate my attention and keep me reading when I'm in material I wouldn't normally be drawn to. This is why I love this book - it found a story that helped me understand and appreciate the role of science in our world. I can't wait for the movie!!!

[Bonnie · Rating 5 out of 5]

The description did not lie when it said this was "the riveting history of tuberculosis." Before reading this book, I did not appreciate how endemic TB was - it was like cancer is today, where everyone knew someone who had died from the disease, and class and wealth could not protect you from it. This is also the story of the discovery and acceptance of germ theory - back in the day (and not even that far back in the day in the span of human history!) people with TB or other very, very contagious disease thought nothing of coughing on someone else or spitting anywhere they pleased, because no one thought it was spreading infection! In fact, if you ever find yourself romanticizing, say, Regency England (Jane Austen!) or colonial America (the Founding Fathers!), just remember that in 1853, English writer Alfred Bunn wrote of the US:

"They spit, as a matter of course, upon floors, and even costly carpets covering them...in all public conveyances, all the stretts, in shops, on the decks and in the cabins of all vessels, in theatres and other places of amusement...in passages and bedrooms, which makes it an impossibility to cross them, without either putting on slippers or 'putting your foot in it'..."

And it was not only Americans who were spitting everywhere.

I also learned that the initial push to pasteurize milk was not to prevent food poisoning, as I had always assumed, but to prevent the spread of TB among children (passing from cows to children through the milk).

Goetz frames this book through the lives of two major personalities: Robert Koch, a German physician and microbiologist who was a pioneer in germ theory and established that germs could cause a specific disease - including TB; and Arthur Conan Doyle, a physician and author who is most famous for his Sherlock Holmes stories. Along wiht a biography of these men, Goetz examines TB, public health, the scientific community in the late 19th century, and other related topics.

Doyle and Goetz never met and Doyle is really only tangentially related to Goetz and his work - Doyle reported on Goetz's alleged "cure" for TB (Goetz flew too close to the sun later on in his career), but that is about it. So, yes, I agree with other reviews that technically Doyle's biography could have been cut and was probably only included for the name recognition. But I don't care, I was fascinated by Doyle and his life and his brush with Goetz's work.

This is an incredibly readable history of a subject I had barely thought about but which I am now so happy I know more about. Highly recommended to both science and history lovers, or anyone who enjoyed Polio: An American Story.

[wilk_elektryczny · Rating 3 out of 5]

Z początku pomysł połączenia historii obu panów (*) wydał mi się dziwny - obaj zajmowali się zupełnie różnymi rzeczami, a A. C. Doyle nie tylko nie miał nic wspólnego z badaniami gruźlicy, ale nawet w ogóle medycyną zajmował się niezbyt wiele, a przynajmniej nie z tego go znamy. Jeśli jednak spojrzy się na tę książkę nie tyle jako historię medycyny, ale bardziej historię rozwoju myśli naukowej w XIX w., podobieństwa między bohaterami zaczynają być widoczne, a cały pomysł nabiera nieco sensu. Ja dałem się na ten trik nabrać, a niespodziewane zapoznanie się z historią narodzin (i śmierci) Sherlocka Holmesa traktuję jako miły bonus i okazję do powiększenia kupki "do przeczytania".

Szkoda, że kwestia badań Kocha, Pasteura i innych została potraktowana bardzo powierzchownie, bez zagłębienia się w jakiekolwiek technikalia, przez co czytanie trzeba było wspomagać na własną rękę zasobami z internetów. Styl pisania kojarzący się nieco z szukaniem sensacji na siłę również nie pomaga.

Najjaśniejszą dla mnie gwiazdką w tej książce jest ostatni, krótki rozdział dotyczący obecnej sytuacji (XX/XXI w.) - skłaniający do przemyśleń i otwierający oczy na to jak niewiele różni się nasza sytuacja od "mrocznych" wieków wcześniejszych, pomimo ogromnych postępów w nauce. Dałbym ze względu na niego 3,5 gdyby się dało, ale się nie da, więc nie dam. A 4 gwiazdki to jednak trochę za dużo.

(*) Nie wiem jaki geniusz wpadł na pomysł, aby zmienić treść podtytułu książki w polskim tłumaczeniu, ale głównymi bohaterami są Robert Koch i Arthur Conan Doyle.

[Elizabeth · Rating 4 out of 5]

I appreciate how the author took the time to really explain how revolutionary germ theory was and how radical. It seems so obvious to us now and we do easily forget that it wasn’t instinct or in our nature to be aware of germs as the way disease spreads.

Some of the author’s comments about the modern world not having experience with mass disease and it is not something we can comprehend, are amusing in light of COVID-19. The book was published in 2014 so it makes sense. Just places the writing of the book in a distinctly pre-pandemic period. The discussion of early vaccinations both comforting and despairing to know that the anti-vaxxer arguments are nothing new from the beginning.

I didn’t know that Conan Doyle was a doctor with a medical practice and knowing that casts his literary work in a new light. I feel like I have gained a new understanding and appreciation for Sherlock Holmes because of reading this book.

[AdiTurbo · Rating 5 out of 5]

It's interesting at this time to be reminded of how vaccines first came into our world, how what we now take for granted is actually a marvel that has taken much effort and decades of struggles to achieve. Goetz writes clearly, and the result is fascinating and readable. Any reader can enjoy this book, even with no prior knowledge of medicine or biology. The author has done a great job in presenting the figures who took part in the medical profession's search for a way to fight disease, in all their faults and merits. Taking on the period's axioms and accepted perceptions on how disease happens was no easy feat, and these men were courageous enough to face the ridicule, disbelief and sheer envy that followed their discoveries, even as they sometimes dealt those back to their competitors. It's a story of genius, high passions, perseverance and standing for what you know to be true, a lesson to many in our days.

[Sydney · Rating 3 out of 5]

This book would have been 5 stars without the Arthur Conan Doyle shoehorning. I was at the edge of my seat for eight of the ten hours of this audiobook, wondering how I got so wrapped up in a history lesson about bacteriology, when I was absolutely clotheslined by the tangentially relevant life of Doyle and a summary of the irrelevant life and publishing of Sherlock Homes. If all the Conan Doyle bits were removed, the drama wouldn't have changed, and the book would have been the stronger for it.

[panda · Rating 3 out of 5]

I love medical history and this was overall an interesting tale. However, there were a couple things that gave me pause and made me question the author's research... He referred to sepsis as being caused by "staphylococcus" when in fact it can be caused by any number of bacteria or even fungi. His definition of holistic medicine was more revealing of his bias than the actual practice. There were some rather dry sections that I found myself pushing through, but it was overall entertaining.

[Mari Sim · Rating 4 out of 5]

That was enlightening and entertaining.
The cut of history from 3 different perspectives, covering stories about Louis Pasteur, Robert Koch and (unexpectedly) Sir Arthur Conan Doyle.

[Denise · Rating 3 out of 5]

I wanted to pick up this book after hearing about it in John Green's recent "Everything is Tuberculosis" to get more details on the intersection of these two famous men. It was well enough done, but I sometimes wondered if we could spend less time discussing their personal lives (unrelated side quests and scandalous affairs) and focus on why we are here. It's still a decent read if you want to dive into where the science was in the late 1800s.

[Adam · Rating 4 out of 5]

More like my notes, made narrative, and less an opinionated review. No flourishing ending of my own, and I didn’t have time to write something shorter. But you may still enjoy:


It all began with the microscope, which literary Sherlock Holmes uses more than the magnifying glass flourished by his American theatrical avatar. Three Germanish men (Dutch, etc) added improvements that made it more powerful, reliable and affordable. They disrupted the market, along with a flurry of new -scopes. Most physicians hated them all, as they do with most scientific breakthroughs.

But not Robert Koch, young veteran of the Franco-Prussian war -- triage medicine for the winning side. The country doctor received a microscope as a gift from his wife. (He’d later divorce her for a young mistress, when he was awarded the institute that would bear his name.) From that lens he drew, then photographed, the swole but elusive anthrax bacillus. To the surprise of Berlin academia (admiring or disdainful) he *proved* this germ caused the disease. His experimental design -- enshrined as Koch’s postulates -- allowed scientists to pull causation from correlation.

It’s hard to imagine how big a breakthrough that was, after centuries when Galen -- the Dr. Phil of ancient medicine -- still held sway among witch-doctors with bonesaws, leeches, boiling baths and poisons, preaching a spiritualism of miasma and spontaneous generation. They were little better than the priests leading last rites and barefoot pilgrimages to remedy the plague.

Which is to say: for most of human existence they could do nothing to cure.

But Koch turned that around. He injected anthrax-infected blood to kill white mice, rabbits and other rodents, obliterating his daughter’s pets in traumatic scenes from an unwritten biography. For the culture, he sealed it in paraffin with a drop of fluid from a cow’s eye and watched his future grow. Everything precise, redundant, over-careful and documented for all to repeat.

The great irony would come at the end of his tale, when all this is put on its head: with his tuberculosis remedy he was unobservant, scattered, wildly unsafe and secretive. The irony is deliciously bittersweet in Koch’s polemical open letter to his French nemesis Pasteur: ‘In business it may be acceptable or necessary to hide one’s methods, hide the bad data and only present the good, but science must reject that!’ Yet when German state money was flowing, that’s what Koch did. Just as pharmaceutical science continues to.

But with his unassailable method, Koch found the smaller bacillus behind tuberculosis, the pandemic wasting disease that lurked in protective shells and killed 1 in 7 human beings, when you counted all the parts of the body where it had made its home since humans made homes. (“Consumption” is infection of the lungs; “scrofula” for the neck. I kind of want a “Count Scrofula” parody novel.)

Finding the tubercle bacillus (TB) was a true bombshell, powerful enough to blow a hole in the redoubts of the physicians of humor and miasma. Against “an unrelenting dirge of infectious disease with no treatment or cure” they were no better than patent medicine con artists. The suite of TB diseases were the worst, with a huge R0 infection rate, since consumptives would often breathe out the bacteria for many sorrowful years. Arthur Conan Doyle’s lived a decade or more from diagnosis, delaying consummation with the other woman he came to love and later marry.

There was vast TB exposure but -- part of the mystery -- in the vast majority of exposures, the immune system walls off what it can’t kill, building granuloma shells around the germs, leaving the infection latent. But for 10% of the population, the walls don’t hold and it “gallops,” as it did in Mrs. Conan Doyle. Then it’s a 2/3 chance of dying from TB... eventually.

Arthur Conan Doyle enters the story in Book 2, a big Scotsman of Irish stock, back from sail-about in the imperial tropics to a tiny, uninspiring medical practice. A scientifically minded man of the age, he published observations in the British Medical Journal like read like an Erowid post: ‘I increased the dosage till I shat myself.’ But his story is one of popularization.

That’s no easy task. Even when a new solution or improvement is definitively proven, it still takes 17 years to be accepted by the medical community. They’re risk-averse, like the farmers of another study who took years to accept a new weed killer. Doctors were also flimflam artists who depend on obscurity like any priestly class. There’s also the factor of homopholy, where people only listen to others who recite what they already believe. To overcome that, the solution must work, there must be trust, and there must be a system of common cause.

For reasons I can’t recall, the author detoured to a growing public outrage over the cruelty of medical experiments on animals and grotesque vivisections. It reminds me of [Maladies of Empire], where science prospered on the measured suffering of institutionalized humans. Joined to this, somehow, was the anti-vaccination movement, rising almost as soon as Jenner injected his farmer’s son with the smallpox serum.

Both movements expressed deep distrust at the apparently medieval practice of medicine, even as European states claimed new authority to intervene in individuals’ lives and bodies for the sake of public health. Even as Koch and Conan Doyle let the world see the germ through the microscope -- as Galileo had let the world see the moons of Jupiter through the telescope -- the public was still ill-equipped to evaluate the science. People knew the paradigm had shifted, but they couldn’t work out the math.

This all worked to build up the biggest medical scam we’ve encountered in two years of our Plaguetime Bookclub: Koch’s remedy for TB. He injected all sorts of things into grave multitudes of hamsters, before trying a combo of dead tuberculosis bacteria in a glycerine solution. It didn’t cure the hamsters’ TB, but instead melted the infected tissue.

Did he really think that “amplification” of the disease and the violent immune response were signs of a remedy? Was it willful ignorance, in the face of a German kaiser demanding something big for the next high-stakes medical conference? Was it his new young lover and the urge to feel like a heroic man of science, not just a bland bureaucrat overseeing research teams? Was the country doctor ready to demand the success his genius deserved? Whatever the cause, Koch “failed to apply his own microscopic techniques” and didn’t notice the hamsters were still riddled with TB.

Conan Doyle, rushing over to Berlin for the big show, rightly dismissed Koch’s remedy in a dispatch for a London review. He never reached out for it, either, even as his wife wasted away and the rest of the world scrambled for doses of the scarce and secretive stuff as much as people sough AZT in the days of the plague.

It worked out as a massive uncontrolled, unrandomized study of the drug’s effectiveness. And the results were dismal: 28 patients cured and 2000+ inconclusive or worse. As medical students snickered about the tuberculin swindle, Koch revealed the formula opaquely, which caused more controversy. He escaped to Egypt for 3 months, saying he won’t return until Germany funds his research and tuberculin-manufacturing institute. And he’d like 100% of the proceeds for the first 6 years, thanks. Eventually he got the institute and the divorce, and but not the money. Koch then disappeared into global tourism, young bride in tow.

Back with Conan Doyle’s story: Study in Scarlet sold like hot cakes, as did year after year of novellas published in The Strand and in a best-selling compilation. The hero of the zeitgeist, Sherlock was science in action, righting wrongs as an amateur who put the unseen clues together. It fed a public hunger for a new way of understanding the world: deduction of germs and other invisibles, which we can ultimately conquer. A surging spirit claimed it is “not possible the 20th century should surpass the scientific discovery of our times.” And as Conan Doyle lectured medical students: only expose the source of a malady and “the forces of law and order may be put upon him and he can be broken into that human system which he has so long defied.”

This also serves as a handy replacement for Christianity as the moral heart of empire: We bring you the light of truth, if only you will accept and behave.

One scene from Conan Doyle’s story resonates with a scene from [Pale Horse, Pale Rider], Katherine Porter’s brilliant memoir of the 1918 influenza. Conan Doyle, struck down for a week by the disease, emerged with his epiphany: the turn to full-time writing. (He closed his medical practice months later.) Did his sickbed carry him to a fever dream as vivid and potent as Porter describes? I like to think so.

The author ends with great flourish, calling on scientists to explore the microbiome of complex interactions in which our health ebbs and flows (like the way gut bacteria output lots of TMAO from a diet rich in eggs and lecithin; the TMAO prevents cell walls from expelling cholesterol, which clogs arteries). The author calls out the minority of scientists advocating anhiliation of all microbes, but that is folly.

“There cannot be war against the microbes. They preceded us. They outnumber us. They will outlast us.” The vast time between the first prokaryotic life, our time, humanity’s end, and the last of the microbes is captured elegantly by Paul Ramirez Jonas’s “[Long Time](https://www.flickr.com/photos/garrett...)” sculpture, set into the Hudson River by hubby’s school. I’ll need to go back and get a photo.

[Tarissa · Rating 5 out of 5]

In "The Remedy" you will find out the shocking tale of a tiny slice of medical history that has been tucked away in the vast volumes of bygone times.

When I first found out about Thomas Goetz's book, I immediately became intrigued with the fact that the beloved Arthur Conan Doyle (author of the world's favorite detective stories!) somehow involved himself in the cure for such a tremendous disease as Tuberculosis. And how did he do it?

In the 19th century, consumption (or TB) took 25% of all deaths in America and England. For someone to locate a medicine for it would be life-changing for hundreds of thousands.

While reading, I became simply amazed with all the information contained in this one book. Somehow the author fits in everything you need to know about medical science of the 1800s, the emerging germ theories of the time, the physicians and scientists that got us to where we are today, and 2 very important men at the center of the story... Dr. Robert Koch, a German physician who discovers the TB bacteria. Sir Arthur Conan Doyle, a doctor from the UK, with a hand for writing, and an eye for spotting details. (No wonder Conan Doyle created Sherlock Holmes... for you will see Holmes's methods at work in the real world, utilized by Conan Doyle himself.)

"To grasp the significance of Koch's discovery, we must first get our heads around this: To live in the nineteenth century was to experience infectious disease as a constant, to have unexplained illnesses afflict and dispatch loved ones without warning. Simply put, more people died of more things back then than do now...." (Page 89)

Goetz is a master on the subjects he brings out in the book. He has put together many facts about science and medicine, and draws the parallels of history well.

So as not to build your hopes too high before reading "The Remedy"... Conan Doyle does not come up with the astounding elixir for an incurable disease himself. But I think he helped bring details to the public eye that others hadn't taken the time to notice.

Cons: The one thing I disapprove of is the author's use of a couple words in the text. Usually I would deduct a star in my review for this type of foul language, but I still love the book so much because of the infinite information it offers. However, I do wish the text wasn't marred at all.

In the end, "The Remedy" is an amazing story to be told. It's a fantastic "mix of literature and history and science" (Goetz's words). I think it will be a while before I can find another historic tale as gripping as this one.

[Beth · Rating 5 out of 5]

When I was in school I always hated the way science class began each year with yet another rehashing of "the scientific method." Could anything be more dull than hearing once again of hypotheses and theorems, of peer review and survey of the literature? I have now come to believe that the scientific method was the most important thing I ever learned in school. In an age where one group of people who believes that everything said in the Bible is literally true faces off against another group who claim to be "scientific" because they believe what "scientists" say (whoever those scientist are) we are in need of greater understanding of the scientific method and the search for truth.

Robert Koch was a champion and developer of germ theory in an age that still believed in the "four humours" and that disease was result of hereditary frailness meeting up with tainted air. Though just a country doctor and not a trained chemist like his eventual rival, Louis Pasteur, Koch worked to discover the bacteria responsible for tuberculosis. Along the way he made many technical improvements in laboratory technique, including adapting photography for microscopic investigation.

At this time, tuberculosis caused the death of one in four people in Europe. Koch was hailed as a genius and the pressure was on him to come up with a cure. And here is where he met his downfall. Having been so meticulous in his discovery of the microbe, Koch turned his back on the scientific method when he tried to deliver the remedy. He concocted a serum called "tuberculin" that he rushed to provide to the eager public, without proper trials. Indeed, tuberculin was a secret formula, and no one but Koch could provide it, or profit from it.

Another obscure physician, Arthur Conan Doyle, became intrigued by the new germ theory and the brilliant Dr. Koch. He raced to Berlin to attempt to hear Koch speak on the new cure, and was quickly disappointed. Conan Doyle wrote about the fraud that was being perpetrated on the public. He also started writing works of fiction during his spare time as his medical practice was not very successful. His fictional character, Sherlock Holmes, would be the rational, scientific mind for a new era.

This is a well researched book and an excellent sleuth story. And if you never understood why it was important to learn about the scientific method, Goetz explains clearly how truth is discovered, how old ideas die hard and how fame and fortune can tempt those who know better.

[Cristael Bengtson · Rating 5 out of 5]

'Remedy' tells a medical detective story that involves Arthur Conan Doyle, author of the Sherlock Holmes mysteries, and a deeply flawed German genius named Dr. Robert Koch, and their involvement with the most deadly disease of the 19th century, tuberculosis. I started reading this book last night, and I finished it today. I could not put it down.
The story is a mystery story. What was causing tuberculosis, which was killing 25 per cent of the population of Europe, America, Russia, and other nations around the world. Doctors of the day still thought all illness was caused by an imbalance of the humors of the body. Those few radicals, like Koch, were regarded as being deluded lightweights. Koch, a small-town doctor, had a simple laboratory where he was able to not only isolate the bacteria that caused the disease, he actually invented a way to photograph them.
But discovering the cause of this deadliest of diseases was one thing. Getting the world to hear him was another. And finding a cure for this dreadful disease was still another impossible challenge. in
In November of 1890, Dr. Arthur Conan Doyle, another modest practitioner, traveled to Berlin to hear the now-famous Robert Koch speak on his new cure for tuberculosis. Doyle was unable to get into the hall where Dr. Robert Koch spoke, but he made friends with another physician who agreed to share his notes with Doyle. And the young British doctor wrote a dispatch to 'The Daily Telegraph' in London. While the editors titled the dispatch 'The Consumption Cure', Doyle's skepticism debunked Koch's ideas of a cure. And Doyle turned out to be right.
The twists and turns of this story, the endless hunt for a cure for TB, and the humanity of all the men involved, including Louis Pasteur and many others, makes for an fascinating and true.
I highly recommend it.

[Robert Miller · Rating 4 out of 5]

At first, the author's discussion of early pioneering scientific efforts involving such terms as microbes, Steptococcus, microbiologists, flagellations of bacteria, Bacillus anthracis, and the like, immediately gives cause for pause; is this a treatise with boring scientific jargon? However, this book is anything but boring. It is easy to follow and reads like a novel only it is informative too. Goetz traces the early developments of scientific breakthroughs regarding proof of diseases caused by bacteria (germs). He nicely summarizes the important discoveries of the late 1800's focusing mainly on Louis Pasteur and Robert Koch and their competitive efforts to upstage one another. Koch appeared to have the upper hand when he discovered that tuberculosis (believed to have caused more than a billion lives since it was first discovered in ancient Greece)was caused by germs. Meanwhile, Pasteur had been taking center stage with his discovery of pasteurization, rabies vaccines and anthrax research. Notwithstanding their obvious and open competitive styles, both men made exceptional contributions to science. Goetz interweaves Arthur Conan Doyle's stories about Sherlock Holmes into the book demonstrating how Doyle used scientific evidence to enhance Holme's ability to solve crimes using the "Science of Deduction". Much can be learned from this book and it is fun to read.

[Alexandra Warren · Rating 4 out of 5]

Goetz uses the narratives of two important men to convey how science emerged from miasma of the 19th century. The stories are interesting and the science is illuminating without being technical or heavy.

Robert Koch's and Arthur Conan Doyle's stories both start as small town doctors, and both are transformed by science. Koch story tells how he basically invented the modern scientific method. Conan Doyle's character, Sherlock Holmes, popularized the the scientific method, and its benefits, to a the pop audience of his day. Each man's arc is compelling, from their humble beginnings, to great successes and beyond.

I've known how science transformed the world at the end of the 19th century, but the stories in this book illuminate how science overcame the accepted conventions of previous centuries. The idea of infectious 'germs' is not novel today, but before Koch it was utterly radical and controversial.

The book transformed my understanding of how the world changed from one without sewers, antiseptic, or germs into the modern world of purell, MRSA, and the microbiome.

Really interesting book that tells an important historical tale through the life of two interesting and flawed men.

[Nancy · Rating 4 out of 5]

Who would have thought a book about the search for a cure for Tuberculosis could be so exciting and so interesting. Sounded pretty dull to me at first, but reads like a mystery novel and held my interest.
Then you have the scientists vying for prominence with their discoveries. You have those who believe in the germ theory and those who can't believe in something they can't see. Study takes years and years because scientists protect their findings as secrets.

Enter A. Conan Doyle. He was a doctor who eventually decided he didn't want to be one and turned to novels and detective stories. Doyle, of course, developed the iconic Sherlock Holmes. While Doyle wished he could kill off his creation, Holmes, in his wisdom, has outlived his creator. As a doctor, Doyle was determined to hear Robert Koch's lecture, but was turned away because of large crowds and had to "hear" it through notes shared by a fellow physician.

The section about Doyle is most interesting as tuberculosis touches his family closer than he ever thought possible.

This book also contains the keys to why research into man's worst diseases takes so long to come to cures and why we are still battling illnesses identified centuries ago.

[Linda · Rating 3 out of 5]

I liked it. The author takes us on a most interesting, historical and informative journey into the 19th century.

One horrid epidemic or another was a fact of life in the 1800’s killing millions. Consumption or Tuberculosis (TB) proved to be the deadliest disease in history. But this is the tale of ambition. It is one of discovery and a profound shift to scientific methods and inventions from the old practices of leeches and cod-liver oil. Dr. Robert Koch, a German country doctor would introduce the Germ Theory in which he claimed bacteria was the cause. You will recognize many famous names sprinkled throughout, one being the French chemist, Louis Pasteur. A fierce competition between these two produced medical results that may have otherwise been undiscovered.

I smiled at the entrance of Dr. Conan Doyle the famous author of Sherlock Holmes. What Koch proved in the laboratory Dr. Doyle brought to the world through his literature, especially the scientific detective.

If you are at all interested in medicine, the how’s and whys, the origin of todays methods, or even just the history of the time, I highly recommend this book.