The transmission of disease from person to person was recognized by the ancients of European and Asiatic countries. Inoculation of smallpox was practiced in China and India probably several thousand years ago and was introduced by Lady Mary Wortley Montague into England in 1721, from Constantinople. These beliefs and practices do not seem to have been associated with any speculations or theories as to the cause of the disease.
Apparently the first writer on this subject was Varo, about B.C. 70, who suggested that fevers in swampy places were due to invisible organisms. The treatment of wounds during the thirteenth and fourteenth centuries by hot wine fomentations and by the application of plasters was based on the theory that the air brought about conditions in the wounds which led to suppuration. These practices were indeed primitive antisepsis, yet were not based on a germ theory of the conditions which were partially prevented. Fracastorius (1484–1553), in a work published in 1546, elaborated a theory of “disease germs” and “direct and indirect contagion” very similar to modern views, though based on no direct pathological knowledge. Nevertheless Kircher (mentioned already) is usually given undeserved credit for the “contagium vivum” theory. In 1657 by the use of simple lenses he observed “worms” in decaying substances, in blood and in the pus from bubonic plague patients (probably rouleaux of corpuscles in the blood, certainly not bacteria in any case). Based on these observations and possibly also on reading the work of Fracastorius, his theory of a “living cause” for various diseases was published in 1671, but received little support.
The discoveries of Leeuwenhoek which proved the existence of microscopic organisms soon revived the “contagium vivum” idea of Kircher. Nicolas Andry in a work published in 1701 upheld this view. Lancisi in 1718 advanced the idea that “animalcules” were responsible for malaria, a view not proved until Laveran discovered the malarial parasite in 1880.[1] Physicians ascribed the plague which visited Southern France in 1721 to the same cause, and many even went so far as to attribute all disease to animalcules, which brought the theory into ridicule. Nevertheless the “contagium vivum” theory survived, and even Linnaeus in his Systema Naturæ (1753–6) recognized it by placing the organisms of Leeuwenhoek, the contagia of diseases and the causes of putrefaction and fermentation in one class called “Chaos.”
Plenciz, a prominent physician and professor in the Vienna Medical School, published in 1762 a work in which he gave strong arguments for the “living cause” theory for transmissable diseases. He taught that the agent is evidently transmitted through the air and that there is a certain period of incubation pointing to a multiplication within the body. He also believed that there was a specific agent for each disease. His writings attracted little attention at the time and the “contagium vivum” theory seems to have been almost lost sight of for more than fifty years. Indeed, Oznam, in 1820, said it was no use to waste time in refuting hypotheses as to the animal nature of contagium.
Isolated observers, were, however, keeping the idea alive, each in his own locality. In 1787 Wollstein, of Vienna, showed that the pus from horses with glanders could infect other horses if inoculated into the skin. Abilgaard, of Copenhagen, made similar experiments at about the same time. In 1797 Eric Viborg, a pupil of Abilgaard’s, published experiments in which he showed the infectious nature not only of the pus but also of the nasal discharges, saliva, urine, etc., of glandered horses. Jenner in 1795–98 introduced vaccination as a method of preventing smallpox. This epoch-making discovery attracted world wide attention and led to the overcoming of this scourge which had devastated
Europe for centuries, but contributed little or nothing to the question of the causation of disease. Prevost’s discovery of the cause of grain rust (Puccinia graminis) in 1807 was the first instance of an infectious disease of plants shown to be due to a microscopic plant organism, though not a bacterium in this case.
Doubtless one reason why the work on glanders and grain rust attracted little attention among the practitioners of human medicine was owing to the prevalent belief in man’s complete separation from all lower forms of life. The evolutionists had not yet paved the way for experimental medicine.
In 1822 Gaspard showed the poisonous nature of material from infected wounds by injecting it into animals and causing their death. Tiedemann (1822), Peacock (1828) described “little bodies” in the muscles of human cadavers which Hilton (1832) considered to be parasitic in nature. Paget (1835) showed that these bodies were round worms and Owen (1835) described them more accurately and gave the name Trichina spiralis to them. Leidy (1846) found organisms in the muscles of hogs which he considered to be the same as Owen’s Trichina and paved the way for the work of Zenker (1860) in showing the pathological relation between the Trichina of pork and human Trichinosis. Bearing on the “contagium vivum” theory was the rediscovery of the “itch mite” (Sarcoptes scabiei) by Renucci (1834), an Italian medical student. This had been declared several hundred years before but had been lost sight of. Chevreuil and Pasteur, in 1836, showed that putrefaction did not occur in meat protected from contamination, and suggested that wound infection probably resulted from entrance of germs from without. Bassi, investigating a disease of silkworms in Italy, demonstrated that a certain mold-like fungus (Botrytis bassiana) was the cause in 1837. This was the first instance of a microscopic vegetable organism proved to be capable of causing disease in an animal.
Boehm, in 1838, observed minute organisms in the stools of cholera patients and conjectured that they might have a causal connection with the disease. Dubini of Milan in 1838 discovered the Ankylostoma duodenale which later was further described by Omodei in 1843 and shown to be the cause of Egyptian chlorosis by Griesinger (1851). The fungous nature of favus, a scalp disease, was recognized by Schönlein in 1839, and the organism was afterward called “Achorion schoenleinii.” Berg, in 1839–41, showed that thrush is likewise due to a fungus, “Oidium albicans.”
These discoveries led Henle, in 1840, to publish a work in which he maintained that all contagious diseases must be due to living organisms, and to propound certain postulates (afterward restated by Koch and now known as “Koch’s postulates” [p. 233]) which must be demonstrated before one can be sure that a given organism is the specific cause of a given disease. The methods then in vogue and the instruments of that period did not enable Henle to prove his claims, but he must be given the credit for establishing the “contagium vivum” theory on a good basis and pointing the way for men better equipped to prove its soundness in after years.