Emil von Behring: Infectious Disease, Immunology, Serum Therapy (review)

In the medical world of the late 1890s, only Louis Pasteur commanded greater admiration and respect than did Emil Behring. Whereas Pasteur had pointed with his vaccination program to how infectious diseases might be prevented, Behring's discovery of serotherapy showed how a disease, once under way, might be cured. Thus it appeared that a new golden age for mankind was at hand. Pasteur had died, but Behring was acclaimed for having saved the lives of countless children with his diphtheria antiserum. His recognition was capped by the award in 1901 of the first Nobel Prize for Medicine or Physiology.

But Pasteur's name and fame live on, joined now in the medical pantheon by two other "greats" from the period, Robert Koch (Behring's sometime chief) and Paul Ehrlich (Behring's sometime colleague), while Behring seems to have been quite forgotten. It is the stated aim of the author of this interesting book to explore why this should be so, and to correct this historical error. To this end he has written the first biography of Behring in the English language, provided an English translation of a number of Behring's most significant publications, and included a very useful bibliography of Behring's writings.

The author's introductory statement (p. 15) that, "rather than highlighting his inner demons and glaring character defects, numerous though they were, I instead focus on his quite real achievements" might suggest that this is yet another hagiography in which the author has become a prisoner of his subject. But not so! Derek Linton is generally refreshingly objective in his assessment of Behring's successes and failures. In addition, as a Germanist rather than a historian of bacteriology or immunology, he is able to add additional social and intellectual context to Behring's activities and thoughts during this most interesting period of rapid progress in the medical sciences.

Emil Behring was trained for and served as a Prussian military staff physician, fortunate during his early career in having been permitted to pursue some modest research on the chemotherapy of infectious diseases. It was this that brought him to the attention of Berlin and an assignment in 1889 to work as an assistant to the famous Robert Koch in the Institute of Hygiene, where the emphasis was very much on the new bacteriology and infectious-disease etiology and therapy. Behring worked initially on the nature of natural immunity and on the disinfection of pathogens. What precisely caused him to begin diphtheria studies in the summer of 1890 is unclear, although he apparently did this in parallel with Shibasaburo Kitasato's studies on tetanus.

In what must be a record for progress from the start of a project to the publication of Nobel Prize–worthy results, on 4 December 1890 Behring and Kitasato published their work on tetanus, and one week later Behring published on diphtheria. What they had discovered was that antitoxic immunity was carried by an "anti-body" in the serum that could be transferred to a naive recipient to protect it from disease and death. Here were two remarkable breakthroughs: a conceptual one that first identified a physical agent as the carrier of immunity, and a more immediately important and practical consequence: the demonstration that disease might be cured using therapeutic immune serum.

Behring rapidly became famous as "the savior of children" and received many honors thenceforth, but scientifically his career was downhill from that point. The strength of antisera was variable, and it was Paul Ehrlich and his colleagues who showed how to produce high-titer sera and how to measure them. Behring then worked on tetanus, on streptococcal infection, on anaphylaxis, and extensively on tuberculosis, but in none of these did he make significant and widely accepted contributions. Rather, he became known more for his disputes...