Laboratory Disease: Robert Koch's Medical Bacteriology (review)

Laboratory Disease tells the story of German bacteriology between 1840 and 1910 by investigating the science as constructed by Robert Koch. The book examines Koch's life in episodes in order to examine the process by which the science of bacteriology developed.

The first section situates bacteriology in a longer history of pathology and botany, and Gradmann starts as he means to go on; this is not a hagiographical account of the Nobel Prize-winning doctor but a deconstruction of his work and mind. However, this concentrates on bacteriology—not his complicated love life. Gradmann explores the influences on Koch's research, including existing theories and techniques. Gradmann finds a decisive change in Koch's research methodology following his publication on anthrax bacilli life cycles in 1876, which led to his ability to network and learn from the laboratory of Ferdinand Cohn in Breslau. This change is particularly evident in Koch's use of laboratory animals as cultures, ranging from guinea pigs and mice to monkeys and turtles, in his research on traumatic infections and tuberculosis.

The following two chapters mainly focus on Koch's work on tuberculosis. Chapter 3 examines the evolving methodology and technology of Koch's laboratory. Chapter 4 looks at the introduction of bacteriology into therapeutic clinical practice and is particularly interesting in examining two topics. First is the euphoria surrounding Koch's development and release of the new therapy of tuberculin in 1890, which, because of Koch's celebrity status, was accepted and used even though it was a "secret nostrum" (p. 138) and not approved in the usual legal manner. Second is the development of medical ethics in relation to the transition of drug trials on animals to patients and the difference the danger of tuberculin made for trials and reception of future therapies in Germany. Yet, even after a Prussian decree on the subject, Koch and his team still covertly experimented on a laboratory colleague who had apparently contracted sleeping sickness, not even telling the patient his diagnosis.

Chapter 5 interrogates how Koch's passion for travel affected his research goals, starting with his famed work on cholera in Egypt and India and later work in East Africa on epizootics, parasitology, and vector-borne diseases. He was attracted to this research by the opportunity to travel to warm climes, to study his original interest of determining pathogens, and to escape from his colleagues in Berlin. Gradmann also examines Koch's travel writing. In relation to sleeping sickness, the theme of ethics continues with the coercion of patients to take experimental drugs.

The book serves as a history of practice and methodology of German bacteriology in addition to a story of Robert Koch. In addition, in chapters 4 and 5 this also extends to an examination of reception, both in the medical and scientific literature but also in the popular response to tuberculin and cholera research and to Koch's heroic travels. Laboratory Disease excels in examining the mentality and work of Koch, and the introduction successfully prepares the reader for these fascinating sections of the book, from his decisions based on a drive for fame and concern about rivals to his travels in Africa and India. Much of chapter 2, therefore, distracts from the main thread of the story, although it is an excellent reference chapter for the development of German bacteriology.

Gradmann's book was originally published in 2005 in German, and this 2009 English edition is very welcome. It complements Gerald Geison's Private Science of Louis Pasteur by using similar methodology of drawing on a wide range of sources, particularly laboratory notes and diaries, in order to see how a science was constructed in practice rather than in theory.¹ In addition to archival sources, it synthesizes existing biographies of Koch and research on the history of bacteriology in Germany to produce a cohesive account of his life in relation to identifying...