Emil Behring's Medical Culture: From Disinfection to Serotherapy

Abstract

The introduction of the first serum therapies for the treatment of diphtheria and tetanus in the mid-1890s constitutes an important development in the history of medicine. The technique-pioneered by Emil Behring (1854-1917)-involved the injection of bloodserum extracted from animals after they had been rendered immune to the disease in question. In retrospect, it is easy to identify this approach as providing the first effective specific biological-as opposed to chemical-treatment for infectious diseases. Such a retrospective assessment is, however, deceptive on several accounts; first, extracts of animals-usually derived from blood, individual organs or specific glands-abounded in this period and were used in all manner of indications both general and specific, from extract of testicles for male impotence to extract of pancreas for problems of digestion or diabetes. Thus, while it is easy to think of sera as distinct from these other ''quack'' medicines, because of their efficacy against specific diseases, this was far from clear for doctors at the turn of the nineteenth and twentieth centuries. Second, it is quite natural today to think of the function of such sera in terms of immunology and the harnessing of the specificity of an animal's immune response for curative or even preventive purposes, but treatment using sera was introduced without any clear theoretical vision of how it might work. To see how general the understanding of the serum's action was at the time, we need only recall Behring's famous reflection on the purported value of blood transfusion that concluded the first experimental success with this serum therapy: ''Blood is a very special juice''. 1 Indeed, all the classic histories of bacteriology and immunology seek, quite legitimately, to place Behring's discovery within the early history of immunology. 2 In this context, the development of serotherapy in Germany finds its principal role as an assault on Metchnikoff's phagocytic theory, setting the stage for the clash between German humoral and French cellular theories of immunity that is regarded as the discipline's