Pasteur, Lister, Koch, and colleagues identified, nurtured, decoded, and
short-circuited the kingdom of germs.
Practically, the exposé of germs led to an immediate decrease in the
scope of epidemics. TB was curtailed within years through the simple
steps of pasteurization of milk and the alteration of public behavior of
coughing and spitting. Even before the introduction of antibiotics that
were effective against TB, it was in decline. More important, the discovery
of germs, the description of their life cycles, and the attenuation of their
impact on our lives was the greatest unraveling of any disease mystery
that society had ever contemplated. Fathoming germs meant that man
could explain illness and, for the first time ever, made it worth an invalid’s
time to submit to a doctor.
Morgagni, Louis, Rokitansky, and Virchow had made death
understandable, but disease could not be explained until germs could be
discerned. And for this we have Semmelweis, Lister, Krebs, and Koch to
thank.
In Wöllstein, in Koch’s upstairs parlor, where he tended to patients (and
could gaze out the back windows to his animal cages and horse barn),
there is a curious demarcation in the pinewood floor. We know that Koch
was so preoccupied with his bacterial research that he partitioned this
room with a heavy curtain, so that he could treat his patients upstairs
without having to take the only (and very public) stairway to his
downstairs simple laboratory. In the middle of the floor is a slightly angled
strip of wood running across the grain of the rest of the floorboards. This
is the border between his clinical and research space. In this tiny little
town, hours and hours from the closest academic bastion, a self-funded
and eccentric young voyager laid the foundation for modern medicine.
Perhaps more profoundly, Lister laid the cornerstone for modernity.
Lister was the first to propose a therapeutic intervention—and then to
evaluate and alter his technique—and achieve a significant therapeutic
benefit. (One could argue that anesthesia is the first effective medical
ministration, but prior to Listerism, anesthesia did little to improve
outcomes.) “It is striking that it is surgery, the least theoretical of the
medical disciplines, that was the first to be transformed,”^43 and it was the
scientific inclinations of Joseph Lister (later emulated by Langenbeck,
Billroth, Frederick Treves, Edoardo Bassini, and William Stewart
Halsted), that led the transformation. The new order of things, with