Modern Mind: An Intellectual History of the 20th Century (21 page)

The evidence suggested that messenger substances were being secreted by the body’s ductless glands. Various laboratories, including the Pasteur Institute in New York and the medical school of University College in London, began experimenting with extracts from glands. The most important of these trials was conducted by George Oliver and E. A. Sharpy-Shafer at University College, London, in 1895, during which they found that the ‘juice’ obtained by crushing adrenal glands made blood pressure go up. Since patients suffering from Addison’s disease were prone to have low blood pressure, this confirmed a link between the gland and the heart. This messenger substance was named adrenaline. John Abel, at Johns Hopkins University in Baltimore, was the first person to identify its chemical structure. He announced his breakthrough in June 1903 in a two-page article in the
American Journal of Physiology.
The chemistry of adrenaline was surprisingly straightforward; hence the brevity of the article. It comprised only a small number of molecules, each consisting of just twenty-two atoms.
⁶³
It took a while for the way
adrenaline
worked to be fully understood and for the correct dosages for patients to be worked out. But adrenaline’s discovery came not a moment too soon. As the century wore on, and thanks to the stresses of modern life, more and more people became prone to heart disease and blood pressure problems.

At the beginning of the twentieth century people’s health was still dominated by a ‘savage trinity’ of diseases that disfigured the developed world: tuberculosis, alcoholism, and
syphilis,
all of which proved intractable to treatment for many years. TB lent itself to drama and fiction. It afflicted the young as well as the old, the well-off and the poor, and it was for the most part a slow, lingering
death – as consumption it features in
La Bohème, Death in Venice,
and
The Magic Mountain.
Anton Chekhov, Katherine Mansfield, and Franz Kafka all died of the disease. Alcoholism and syphilis posed acute problems because they were not simply constellations of symptoms to be treated but the charged centre of conflicting beliefs, attitudes, and myths that had as much to do with morals as medicine. Syphilis, in particular, was caught in this moral maze.
⁶⁴

The fear and moral disapproval surrounding syphilis a century ago mingled so much that despite the extent of the problem, it was scarcely talked about. Writing in the
Journal of the American Medical Association
in October 1906, for example, one author expressed the view that ‘it is a greater violation of the proprieties of public life publicly to mention venereal disease than privately to contract it.’
⁶⁵
In the same year, when Edward Bok, editor of the
Ladies’ Journal,
published a series of articles on venereal diseases, the magazine’s circulation slumped overnight by 75,000. Dentists were sometimes blamed for spreading the disease, as was the barber’s razor and wet nurses. Some argued it had been brought back from the newly discovered Americas in the sixteenth century; in France a strong strand of anticlericalism blamed ‘holy water.’
⁶⁶
Prostitution didn’t help keep track of the disease either, nor Victorian medical ethics that prevented doctors from telling one fiancée anything about the other’s infections unless the sufferer allowed it. On top of it all, no one knew whether syphilis was hereditary or congenital. Warnings about syphilis sometimes verged on the hysterical.
Vénus,
a ‘physiological novel,’ appeared in 1901, the same year as a play called
Les Avariés
(The Rotting or Damaged Ones), by Eugène Brieux, a well-known playwright.
⁶⁷
Each night, before the curtain went up at the Théâtre Antoine in Paris, the stage manager addressed the audience: ‘Ladies and Gentlemen, the author and director are pleased to inform you that this play is a study of the relationship between syphilis and marriage. It contains no cause for scandal, no unpleasant scenes, not a single obscene word, and it can be understood by all, if we acknowledge that women need have absolutely no need to be foolish and ignorant in order to be virtuous.’
⁶⁸
Nonetheless,
Les Avariés
was quickly banned by the censor, causing dismay and amazement in the editorials of medical journals, which complained that blatantly licentious plays were being shown in café concerts all across Paris with ‘complete impunity’.
⁶⁹

Following the first international conference for the prevention of syphilis and venereal diseases in Brussels in 1899, Dr Alfred Fournier established the medical speciality of syphilology, using epidemiological and statistical techniques to underline the fact that the disease affected not just the demimonde but all levels of society, that women caught it earlier than men, and that it was ‘overwhelming’ among girls whose poor background had forced them into prostitution. As a result of Fournier’s work, journals were established that specialised in syphilis, and this paved the way for clinical research, which before long produced results. On 3 March 1905 in Berlin, Fritz Schaudinn, a zoologist, noticed under the microscope ‘a very small spirochaete, mobile and very difficult to study’ in a blood sample taken from a syphilitic. A week later Schaudinn and Eric Achille Hoffmann, a bacteriologist, observed the same
spirochaete in samples taken from different parts of the body of a patient who only later developed roseolae, the purple patches that disfigure the skin of syphilitics.
⁷⁰
Difficult as it was to study, because it was so small, the spirochaete was clearly the syphilis microbe, and it was labelled
Treponema
(it resembled a twisted thread)
pallidum
(a reference to its pale colour). The invention of the ultramicroscope in 1906 meant that the spirochaete was now easier to experiment on than Schaudinn had predicted, and before the year was out a diagnostic staining test had been identified by August Wassermann. This meant that syphilis could now be identified early, which helped prevent its spread. But a cure was still needed.
⁷¹

The man who found it was Paul Ehrlich (1854–1915). Born in Strehlen, Upper Silesia, he had an intimate experience of infectious diseases: while studying tuberculosis as a young doctor, he had contracted the illness and been forced to convalesce in Egypt.
⁷²
As so often happens in science, Ehrlich’s initial contribution was to make deductions from observations available to everyone. He observed that, as one bacillus after another was discovered, associated with different diseases, the cells that had been infected also varied in their response to staining techniques. Clearly, the biochemistry of these cells was affected according to the bacillus that had been introduced. It was this deduction that gave Ehrlich the idea of the antitoxin – what he called the ‘magic bullet’ – a special substance secreted by the body to counteract invasions. Ehrlich had in effect discovered the principle of both antibiotics and the human immune response.
⁷³
He went on to identify what antitoxins he could, manufacture them, and employ them in patients via the principle of inoculation. Besides syphilis he continued to work on tuberculosis and diphtheria, and in 1908 he was awarded the Nobel Prize for his work on immunity.
⁷⁴

By 1907 Ehrlich had produced no fewer than 606 different substances or ‘magic bullets’ designed to counteract a variety of diseases. Most of them worked no magic at all, but ‘Preparation 606,’ as it was known in Ehrlich’s laboratory, was eventually found to be effective in the treatment of syphilis. This was the hydrochloride of dioxydiaminoarsenobenzene, in other words an arsenic-based salt. Though it had severe toxic side effects, arsenic was a traditional remedy for syphilis, and doctors had for some time been experimenting with different compounds with an arsenic base. Ehrlich’s assistant was given the job of assessing the efficacy of 606, and reported that it had no effect whatsoever on syphilis-infected animals. Preparation 606 therefore was discarded. Shortly afterward the assistant who had worked on 606, a relatively junior but fully trained doctor, was dismissed from the laboratory, and in the spring of 1909 a Japanese colleague of Ehrlich, Professor Kitasato of Tokyo, sent a pupil to Europe to study with him. Dr Sachachiro Hata was interested in syphilis and familiar with Ehrlich’s concept of ‘magic bullets.’
⁷⁵
Although Ehrlich had by this stage moved on from experimenting with Preparation 606, he gave Hata the salt to try out again. Why? Was the verdict of his former (dismissed) assistant still rankling two years later? Whatever the reason, Hata was given a substance that had been already studied and discarded. A few weeks
later he presented Ehrlich with his laboratory book, saying, ‘Only first trials – only preliminary general view.’
⁷⁶

Ehrlich leafed through the pages and nodded. ‘Very nice … very nice.’ Then he came across the final experiment Hata had conducted only a few days before. With a touch of surprise in his voice he read out loud from what Hata had written: ‘Believe 606
very
effacious.’ Ehrlich frowned and looked up. ‘No, surely not?
Wieso denn … wieso denn?
It was all minutely tested by Dr R. and he found nothing –
nothing!’

Hata didn’t even blink. ‘I found
that.’

Ehrlich thought for a moment. As a pupil of Professor Kitasato, Hata wouldn’t come all the way from Japan and then lie about his results. Then Ehrlich remembered that Dr R had been dismissed for not adhering to strict scientific practice. Could it be that, thanks to Dr R, they had missed something? Ehrlich turned to Hata and urged him to repeat the experiments. Over the next few weeks Ehrlich’s study, always untidy, became clogged with files and other documents showing the results of Hata’s experiments. There were bar charts, tables of figures, diagrams, but most convincing were the photographs of chickens, mice, and rabbits, all of which had been deliberately infected with syphilis to begin with and, after being given Preparation 606, showed progressive healing. The photographs didn’t lie but, to be on the safe side, Ehrlich and Hata sent Preparation 606 to several other labs later in the year to see if different researchers would get the same results. Boxes of this particular magic bullet were sent to colleagues in Saint Petersburg, Sicily, and Magdeburg. At the Congress for Internal Medicine held at Wiesbaden on 19 April 1910, Ehrlich delivered the first public paper on his research, but by then it had evolved one crucial stage further. He told the congress that in October 1909 twenty-four human syphilitics had been successfully treated with Preparation 606. Ehrlich called his magic bullet
Salvarsen,
which had the chemical name of asphen-amine.
⁷⁷

The discovery of Salvarsen was not only a hugely significant medical breakthrough but also produced a social change that would in years to come influence the way we think in more ways than one. For example, one aspect of the intellectual history of the century that has been inadequately explored is the link between syphilis and psychoanalysis. As a result of syphilis, as we have seen, the fear and guilt surrounding illicit sex was much greater at the beginning of the century than it is now, and helped account for the climate in which Freudianism could grow and thrive. Freud himself acknowledged this. In his
Three Essays on the Theory of Sexuality,
published in 1905, he wrote, ‘In more than half of the severe cases of hysteria, obsessional neurosis, etc., which I have treated, I have observed that the patient’s father suffered from syphilis which had been recognised and treated before marriage…. I should like to make it perfectly clear that the children who later became neurotic bore no physical signs of hereditary syphilis…. Though I am far from wishing to assert that descent from syphilitic parents is an invariable or necessary etiological condition of a neuropathic constitution, I believe that the coincidences which I have observed are neither accidental nor unimportant.’
⁷⁸

This paragraph appears to have been forgotten in later years, but it is crucial. The chronic fear of syphilis in those who didn’t have it, and the chronic guilt in those who did, created in the turn-of-the-century Western world a psychological landscape ready to spawn what came to be called depth psychology. The notion of germs, spirochaetes, and bacilli was not all that dissimilar from the idea of electrons and atoms, which were not pathogenic but couldn’t be seen either. Together, this hidden side of nature made the psychoanalytic concept of the unconscious acceptable. The advances made by the sciences in the nineteenth century, together with the decline in support for organised religion, helped to produce a climate where ‘a scientific mysticism’ met the needs of many people. This was scientism reaching its apogee. Syphilis played its part.

One should not try too hard to fit all these scientists and their theories into one mould. It is, however, noticeable that one characteristic does link most of these figures: with the possible exception of Russell, each was fairly solitary. Einstein, Rutherford, Ehrlich, and Baekeland, early in their careers, ploughed their own furrow – not for them the Café Griensteidl or the Moulin de la Galette. Getting their work across to people, whether at conferences or in professional journals, was what counted. This was – and would remain – a significant difference between scientific ‘culture’ and the arts, and may well have contributed to the animosity toward science felt by many people as the decades went by. The self-sufficiency of science, the self-absorption of scientists, the sheer
difficulty
of so much science, made it inaccessible in a way that the arts weren’t. In the arts, the concept of the avant-garde, though controversial, became familiar and stabilised: what the avant-garde liked one year, the bourgeoisie would buy the next. But new ideas in science were different; very few of the bourgeoisie would ever fully comprehend the minutiae of science. Hard science and, later, weird science, were hard and/or weird in a way that the arts were not.