Thomas Goetz - The Remedy: Robert Koch, Arthur Conan Doyle, and the Quest to Cure Tuberculosis

Robert Koch, as depicted at the height of his fame, 1890

I n train after train, consumptives filled the passenger cars, their hacks and coughs competing with steam whistles and screaming brakes as the engines came to a halt in Potsdamer Platz. They came to Berlin without any sense of where to go or what to do once they arrived. And they kept coming, for days, weeks, and months. It must have struck Berliners as a sort of zombie pilgrimage: Here were the walking dead of Europe, all suddenly flocking to their city in search of somethingsome fantastic substance that did not yet officially exist.

They began arriving in August 1890, when rumors first began to circulate that a treatment, a remedy, for consumption, or tuberculosis, had been discovered by Europes greatest scientist, Robert Koch. Koch made no promises; he had only hinted at a substance that seemed to arrest the disease. But a hint was all it took. This was the deadliest disease in the world, and these were the most desperate souls. If there was hope to be had in Berlin, they would seek it out.

Tuberculosis was a cunning disease, coming on slowly, almost casually. At first it seemed innocuous, beginning with a cough; a cold, perhaps, or a touch of bad air. But then that cough turned malevolent, becoming stronger and more painful and extracting blood with each spasm. Then the appetite would go, replaced by fatigue, a deep dullness that would pull the sufferers into lethargy. Eventually, bodies would begin to wither and dissipate from within. For most consumptives, this played out over months and years. Even when the end seemed imminent, it was as if the consumptives could not muster the energy to dieuntil, finally, they did, by the thousands and hundreds of thousands and millions. In the last half of the nineteenth century, at least one-quarter of all deaths were due to tuberculosis, a steady pall that loomed over every country in Europe, over the United States, and indeed worldwide.

So the consumptives came to Berlin, and inevitably, death came with them. They died in the passenger cars on the way to the city, they died in the hotels, and they died in the clinics and hospitals where they waited for a dose of this extraordinary remedy. The city didnt know what to do with them all. Hotels and hospitals filled up. Coffeehouses were converted into sanitariums.

With concern rising that Berlins own population was at an increased risk of infection, the Berlin police department began instituting emergency measures to control the onslaught. Joseph Lister himself, one of the most famous physicians in Europe and a pioneer of the germ theory of disease, suggested that the horde created a serious danger to the public health of this city likely to arise from the sudden invasion of patients suffering from every form of tuberculosis and coming from all the corners of the earth.

The tide grew still larger after November 13, when Koch finally offered some specifics for his remedy. A public demonstration of the substance was scheduled for November 17 in Berlin, and now scientists crowded among the consumptives on the trains. The finest medical men in Europe were all eager to see firsthand how Kochs substance could destroy the worst disease humanity had ever known.

On one of those trains was a young English physician, making the pilgrimage not for the cure, but to scrutinize the evidence behind it. This man, an unknown provincial doctor who yearned to become something greater, was en route to play detective and to assess what Dr. Koch had created. He idolized Koch, but his years in practice had hardened him to the promise of quick cures and easy fixes. He was headed to Berlin to discern whether this remedy might really work. And this trip would change his life: He would arrive as an observer of history but leave as a figure in it. He would arrive as a physician but leave as a writer.

This doctors name was Arthur Conan Doyle.

D EADLY AS IT WAS, HORRIBLE AS IT WAS, TUBERCULOSIS WAS ALSO entirely ordinary in the last decades of the nineteenth century. For that entire century, the numbers are staggering. In England, as many as a quarter of all deaths were due to consumption. In the United States, the disease was the leading cause of death; in German towns, tuberculosis was the second-largest killer, after gastrointestinal diseasesbut when one includes deaths attributed to generic lung conditions, most of which are likely to have been TB, it accounts for a plurality of deaths by far.