K. Codell Carter - Böcker

This collection of translations of some of Koch's important essays represents an important first. It includes three of his essays on anthrax, three on tuberculosis, two on cholera, one on wound infections, and a relective essay entitled On Bacteriological Research. These papers clearly reflect the coherence and inter-connectedness of Koch's thought. They include the initial presentation of his ideas and also provide examples of his tenacious and devasting responses to his critics. While they only represent some of the many areas of Koch's interests, they serve as excellent samples of his finest contributions. The volume also includes a long introduction which establishes the historical context of Koch's work and of the particular essays translated here.

Much of contemporary medical theory and practice focuses on the identification of specific causes of disease. However, this has not always been the case: until the early nineteenth century physicians thought of diseases in quite different terms. The modern quest for causes of disease can be seen as a single Lakatosian research programme. One can track the rise and elaboration of this programme by a series of case histories. The success of work on bacterial diseases such as cholera and tuberculosis tends to eclipse the broad context in which those studies were embedded. Yet, in the 1830s, fifty years before Koch's publications on tuberculosis, specific causes were already being identified for several non-bacterial diseases including scabies, muscardine and ringworm. Moreover, by the end of the century, the quest for specific causes had spread well beyond bacterial diseases. The expanding research programme included Freud's early work on psychopathology, the discovery of viruses, the discovery of vitamins, and the recognition of genetic disorders such as Down's syndrome. Existing historical discussions of research in these areas, for example, histories of work on the deficiencies diseases, take the view that success in bacteriology was a positive obstacle to the identification of causes for other kinds of diseases. Treating the quest for causes as a single coherent research programme provides a better understanding of the disease concepts that characterise the last 150 years of medical thought.

Much of contemporary medical theory and practice focuses on the identification of specific causes of disease. However, this has not always been the case: until the early nineteenth century physicians thought of diseases in quite different terms. The modern quest for causes of disease can be seen as a single Lakatosian research programme. One can track the rise and elaboration of this programme by a series of case histories. The success of work on bacterial diseases such as cholera and tuberculosis tends to eclipse the broad context in which those studies were embedded. Yet, in the 1830s, fifty years before Koch's publications on tuberculosis, specific causes were already being identified for several non-bacterial diseases including scabies, muscardine and ringworm. Moreover, by the end of the century, the quest for specific causes had spread well beyond bacterial diseases. The expanding research programme included Freud's early work on psychopathology, the discovery of viruses, the discovery of vitamins, and the recognition of genetic disorders such as Down's syndrome. Existing historical discussions of research in these areas, for example, histories of work on the deficiencies diseases, take the view that success in bacteriology was a positive obstacle to the identification of causes for other kinds of diseases. Treating the quest for causes as a single coherent research programme provides a better understanding of the disease concepts that characterise the last 150 years of medical thought.

Over the course of a single generation, without significant discussion or debate, a key practice of traditional medicine was almost completely abandoned in mid-nineteenth-century Europe. K. Codell Carter's book describes how and why bloodletting was abandoned, noting that it was part of a process in which innovation was required so that modern scientific medicine could begin. This book is a masterful study on the collapse of a traditional medical practice.Bloodletting had been a prominent medical therapy in early nineteenth-century Europe and can be traced back to Greek and Roman physicians. The Hippocratic corpus contains several discussions of bloodletting. Galen, the most famous physician in classical antiquity, wrote tracts explaining and defending the practice. It was employed in ancient Egypt and is the most commonly mentioned therapy in the Babylonian Talmud. Indeed, it was practiced in virtually every part of the ancient world.Even though the practice abruptly ceased, there was little argument against it or reason to believe it ineffective. In reality, bloodletting actually worked. However, the rise of modern medicine required not just a change in how disease and causation were conceived, but also a change in the role of medicine in society. It has been claimed that the collapse of traditional medicine was a precondition for the rise of modern medicine, but there has been little support for this assertion before now. Carter provides this missing support. The result is a fascinating study in the history of medical practice and social expectations.

The life and work of Ignaz Semmelweis is among the most engaging and moving stories in the history of science. Childbed Fever makes the Semmelweis story available to a general audience, while placing his life, and his discovery, in the context of his times. In 1846 Vienna, as what would now be called a head resident of obstetrics, Semmelweis confronted the terrible reality of childbed fever, which killed prodigious numbers of women throughout Europe and America. In May 1847 Semmelweis was struck by the realization that, in his clinic, these women had probably been infected by the decaying remains of human tissue. He believed that infection occurred because medical personnel did not wash their hands thoroughly after conducting autopsies in the morgue. He immediately began requiring everyone working in his clinic to wash their hands in a chlorine solution. The mortality rate fell to about one percent. While everyone at the time rejected his account of the cause of the disease because his theory was fundamentally inconsistent with existing medical beliefs about how diseases were transmitted, in time Semmelweis was proven to be correct. His work led to the adoption of a new way of thinking about disease, thus helping to create an entirely new theory - the etiological standpoint - that still dominates medicine today.

The life and work of Ignaz Semmelweis is among the most engaging and moving stories in the history of science. Childbed Fever makes the Semmelweis story available to a general audience, while placing his life, and his discovery, in the context of his times. In 1846 Vienna, as what would now be called a head resident of obstetrics, Semmelweis confronted the terrible reality of childbed fever, which killed prodigious numbers of women throughout Europe and America. In May 1847 Semmelweis was struck by the realization that, in his clinic, these women had probably been infected by the decaying remains of human tissue. He believed that infection occurred because medical personnel did not wash their hands thoroughly after conducting autopsies in the morgue. He immediately began requiring everyone working in his clinic to wash their hands in a chlorine solution. The mortality rate fell to about one percent. While everyone at the time rejected his account of the cause of the disease because his theory was fundamentally inconsistent with existing medical beliefs about how diseases were transmitted, in time Semmelweis was proven to be correct. His work led to the adoption of a new way of thinking about disease, thus helping to create an entirely new theory - the etiological standpoint - that still dominates medicine today.