Tuberculin

This was originally considered a cure for tuberculosis, given to patients in subcutaneous doses of a brownish, transparent liquid that was gathered through cultured filtrates.

[citation needed] At the Tenth International Medical Congress held in 1890 in Berlin, Koch unexpectedly introduced a cure for tuberculosis, which he called tuberculin.

He demanded that the Ministry of Culture finance an institute to be used exclusively for tuberculin production, and estimated the annual profit at 4.5 million marks.

[10]: 106  He seemed unconcerned by the evidence that humans had a more dramatic reaction to tuberculin versus his laboratory animals, exhibiting fever, pains in their joints, and nausea.

[9] In February 1891, a medical trial was performed on 1769 patients to whom tuberculin was administered, and the results made clear that it was not a true cure.

Before tuberculin was released to the public, Koch had initially tested the treatment on himself to determine its toxicity to the human body, which is no longer considered a reliable or acceptable method for establishing drug safety.

[clarification needed] Koch asked the Prussian Minister of Culture for time off and went to Egypt, which was interpreted as an attempt to escape from the German public.

This presentation, and numerous other indications, suggest that he did not intend to commit a "tuberculin scam" (a common accusation), but that he had deluded himself.

[citation needed] The medical historian Christoph Gradmann has reconstructed Koch's beliefs regarding the function of tuberculin: the medicine did not kill the bacteria but rather initiated a necrosis of the tubercular tissue, thus "starving" the tuberculosis pathogen.

Emil von Behring's introduction of his diphtheria antitoxin in 1893 had been preceded by lengthy clinical testing, and the serum was only slowly introduced into practical use, accompanied by a critical discussion among qualified experts.

[11] Paul Ehrlich also proceeded with conspicuous caution in 1909 when introducing the first synthetically produced chemotherapeutic agent, Salvarsan, as a cure for an infectious disease, syphilis.

[citation needed] In 1907, Clemens von Pirquet further developed tuberculin as a testing agent for diagnosing tuberculosis, but this was his own achievement, independent of any of Robert Koch's ideas.

With the various clinical trials and observations made through the differing responses to tuberculin in patients with and without tuberculosis, new methods that corresponded to the backbone of this treatment began to arise.

The continued use of new methods that further eliminated systemic symptoms that were caused by a local reaction at the injection site allowed for other medical advances.

[6] With experience gained from the tuberculin skin test during the greater part of the last century, the current body of medical knowledge and advances were made possible by Robert Koch.

[13] Coupled with that, there has been more profound research and discoveries on the immune systems of humans and animals as the idea of skin testing broadened.