gradually become more painful and dysfunctional. In 1720, Benjamin
Marten, while living in London, theorized that consumption was caused by
an infection of the lungs, and that the provocative agent to be blamed was
an animalcule, small enough that it couldn’t be seen with the microscopes
of the day. It was Robert Koch who finally identified the bacterium that
causes TB in 1882, which ended up earning him the Nobel Prize in
Medicine. It surprisingly wasn’t until the 1880s that there was a consensus
on the germ theory among learned men; prior to that time simple issues of
sanitation and hygiene were mocked. With no medicines to control
patients’ TB infections (streptomycin wasn’t discovered until 1943), it
was left to surgeons to intervene bravely, if not cavalierly, in the lives of
advanced TB sufferers.
Themistocles Gluck (1853–1942) started practicing medicine in 1882,
just when the European medical community was awakening to the linkage
of germs (bacteria, parasites, and viruses), infections, and illness. Gluck
had trained in Berlin under legendary surgeon Bernhard von Langenbeck
and pioneering pathologist Rudolf Virchow. Like thinking about genetics
without knowing about DNA, it’s difficult to conceive of practicing
medicine without believing in microbes. The newly minted Dr. Gluck was
launching his career in the months that Koch elucidated the bacterium that
causes TB; while no pharmacologic treatment would be identified for over
half a century, Gluck became obsessed with the orthopedic treatment of
those afflicted with bony TB. Appointed head of surgery at Berlin’s
Emperor and Empress Friedrich Paediatric Hospital, Gluck initially
practiced in an era where there were no X-rays. Flying blindly, he and his
colleagues had to imagine what they would find once they incised the skin
and dissected deeper.
Gluck’s early animal experimentation focused on organ resection and
transplantation. Vastly ahead of his time, experimenting on animals, he
made the observation that the loss of one kidney would result in the other
kidney redoubling its function, heralding the body’s ability to adapt to
loss. If Prometheus, one of the Greek mythological Titans, could
regenerate his liver nightly after having it pecked at during the day by an
eagle, and if Mary Shelley’s Victor Frankenstein (published, amazingly, in
1818) could create a creature ex nihilo, what was a German surgeon
capable of now that anesthesia was becoming practical? As a veteran war
surgeon, Gluck and his colleagues had seen the success of treating
marcin
(Marcin)
#1