MICROBIOLOGY. Vaccination. Antiseptic and aseptic. Immunology development

 

History of medicine

New time

MEDICAL AND BIOLOGICAL DIRECTION IN THE MEDICINE OF NEW TIME (1640-1918)

MICROBIOLOGY. Vaccination. Antiseptic and aseptic. Immunology development

 

Microbiology (from the Greek. Mikros - small) as the science of microorganisms, their structure and life, as well as the changes they cause in humans, animals, plants and inanimate nature, appeared in the second half of the XIX century. Its formation was carried out in close connection with practical human activity, historical development, general progress of science (biology, physics, chemistry) and technology (discovery and improvement of microscopy and other research methods). In the course of its development, microbiology differentiated into general, medical, agricultural, veterinary, sanitary, industrial, etc. Medical microbiology is of particular importance for the training of medical specialists. It is divided into bacteriology, virology, mycology, immunology, protozoology.

In the history of microbiology, there are two main periods: the empirical (until the second half of the XIX century) and the experimental one, the beginning of which is connected with the activity of L. Pasteur (see p. 247).

 

EMPIRICAL PERIOD

 

The idea of ​​the wildlife of a contagious beginning, which claimed thousands (and during large epidemics and pandemics millions) of human lives, has evolved over thousands of years. Empirical guesses about a lively pathogen were expressed in the writings of Titus Lucretius Cara (95–55 BC), Pliny the Elder (23–75 AD), Galen (c. 131 — c. 201 BC) . e.), Ibn Sina (980-1037) and other prominent thinkers of the past.

 

Frequent epidemics of general diseases in medieval Europe contributed to the accumulation of information about the pathways of infection. An outstanding generalization of this experience was the classic work of the Italian scholar of the Renaissance Girolamo Frakastoro (1478-1553) "On contagium, contagious diseases and treatment" (see p. 194).

 

The creation of the first optical devices at the beginning of the XVII century. opened a new era in the history of microbiology. A. van Leeuwenhoek (see p. 228) was the first researcher who discovered living microorganisms and described them in his work "The Secrets of Nature, discovered by Anthony Levenguk" (1695). Nevertheless, until the discovery of the first pathogenic microorganisms and a scientifically based method of combating them, almost two centuries of empirical research remained.

An important stage of this path was the activity of the Russian doctor D. S. Samoilovich (see p. 277), who for the first time expressed the idea of ​​the specificity of the plague. Convinced that the plague is caused by a “special and completely excellent creature,” he came to the idea of ​​preventing this disease by introducing into the body a weakened infectious principle. In confirmation of this, in 1803 D.S. Samoilovich introduced himself infectious material, taken from a person who had recovered from the plague of bubonic form.

 

Vaccination

 

“To investigate,” wrote the Canadian pathophysiologist and endocrinologist Hans Selye, “is to see what everyone sees and think like no one thought.” These words fully relate to the English doctor Edward Jenner (Jenner, Edward, 1749-1823), who noted that peasant women who milked cows with cowpox had vesicles resembling pustules on their hands. After a few days, they suppurate, dry out and scar, after which these peasant women never get smallpox.

For 25 years, Jenner checked his observations and, on May 14, 1796, conducted a public experiment on the vaccination method (from lat. Vacca — cow): instilled in an eight-year-old boy James Phipps James the contents of a pustule from the hand of a peasant Sarah Nelme (Nelmes Sarah) ), infected with cowpox (Fig. 122). A month and a half later, E. Jenner injected James with the contents of a small-pox patient's pustules — the boy did not get sick. A repeated attempt to infect the boy with smallpox five months later also failed to produce any results — James Phipps was immune to the disease. Having repeated this experiment 23 times, E. Jenner in 1798 published an article “Study of the causes and actions of cowpox.” In the same year, vaccination was introduced in the British army and navy, and in 1803 the Royal Jennerian Society was organized, headed by Jenner himself. Society set as its goal the widespread introduction of vaccination in England. Only in the first one and a half years of its activity, 12 thousand people were vaccinated, and mortality from smallpox decreased more than three times.

 

In 1808, opeprivivaniya in England became a state event. E. Jenner was elected an honorary member of almost all scientific societies in Europe. "Jenner's Lancet," wrote J. Simpson, "saved much more human lives than Napoleon's sword destroyed." Nevertheless, even in England, skepticism of the Jenner method was widely used for a long time: ignorant people believed that after vaccinating vaccinia patients' horns, hooves and other signs of anatomical cow structure would grow.

The fight against smallpox is an outstanding chapter in the history of mankind. For many centuries before the discovery of Jenner in the ancient East, a method of inoculation (variolation) was used: the contents of the pustules of a patient with small-pox of moderate severity were rubbed into the skin of the forearm of a healthy person who usually suffered from a mild form of smallpox, although deaths were also observed.

In the XVIII century. Mary Wortley Montague, the English Ambassador’s wife in Turkey, transferred the inoculation method from the East to England. Doctors were widely debated about the positive and negative aspects of inoculation, which is still widely distributed in Europe and America.

 

In Russia, Catherine II and her son Pavel in 1768 subjected themselves to inoculation, for which the doctor T. Dimsdal was discharged from England. In France in 1774, in the year of the death of the smallpox of Louis XV, his son Louis XVI was inoculated. In the USA, J. Washington ordered to inoculate all the soldiers of his army.

Jenner's discovery was a turning point in the history of the fight against smallpox. The first vaccination against smallpox in Russia according to his method was made in 1802 by Professor E. O. Mukhin to a boy Anton Petrov, who, in honor of this momentous event, received the name Vaccines. Simultaneously, in the Baltics, the Jenner vaccination was successfully introduced by I. Gun.

 

Vaccination at the time was significantly different from today's opeprevivanie. Antiseptics did not exist (they did not know about it until the end of the 19th century). The content of pustules of vaccinated children served as an inoculum; therefore, there was a danger of side contamination with erysipelas, syphilis, etc. Based on this, A. Negri in 1852 suggested receiving an anti-pox vaccine from vaccinated calves.

It took almost 200 years for mankind to travel from the discovery of Jenner to the discovery of the variola virus (E. Paschen, 1906) and achieve the complete elimination of this dangerous infectious disease throughout the globe.

 

The smallpox eradication program was proposed by the delegation of the USSR at the XI WHO Assembly in 1958 and carried out by the joint efforts of all countries of the world.

 

Antiseptic and aseptic

 

The empirical beginnings of antiseptics (from the Greek. Anti - against and septicos - putrid, causing suppuration) are associated with the name of the Hungarian doctor Ignaz Semmelweis (Semmelweis, Ignaz Philipp, 1818-1865). Working in the obstetric clinic of Professor Klein in Vienna, he drew attention to the fact that in one department where students studied, the death rate from fever gave 30%, and in the other where students were not allowed, the mortality rate was low. After a long search, not knowing yet about the role of microorganisms in the development of sepsis, Semmelweis showed that the fever was caused by dirty hands of students who come to the maternity ward after anatomy of corpses. Having explained the reason, he proposed a method of protection — washing hands with a solution of bleach, and the mortality rate dropped to 1-3% (1847). Nevertheless, during the life of Semmelweis, the largest Western European authorities in the field of obstetrics and gynecology did not recognize his discoveries.

 

In Russia, hand washing with disinfecting solutions was used by I. V. Buyalsky and N. I. Pirogov, who contributed to the development of antiseptics and asepsis.

Scientific substantiation of antiseptics and there was no aseptic technique until the works of L. Pastera, which showed that the processes fermentation and decay associated with life activities. microorganisms (1863). Pasteur's idea in surgery

The English surgeon Joseph Lister (Lister, Joseph, 1827–1912), who linked suppuration of wounds to the entry and development of bacteria in them, brought him for the first time. Having given a scientific explanation of a surgical infection, Lister for the first time developed theoretically grounded measures to combat it. His system was based on the use of 2-5% solutions of carbolic acid (water, oil and alcohol) and included elements of antiseptics (destruction of microbes in the wound itself) and asepsis (treatment of objects in contact with the wound: surgeon’s hands, instruments, dressing material). Attaching great importance to airborne infection, Lister sprayed carbolic acid in the air of the operating room (carbolic spray) (Fig. 123). In 1867, J. Lister published a series of articles in the journal Lancet (On the antiseptic principle iri the practice of surgery, etc. ). in which he described the essence of his method, which was described in detail in his subsequent works.

 

The teachings of J. Lister opened a new antiseptic era in surgery. J. Lister was elected an honorary member of many European scientific societies and was president of the Royal Society of London (1895–1900) (on the development of the method, see p. 297).

 

EXPERIMENTAL PERIOD

 

Medical microbiology as a science took shape in the second half of the nineteenth century. Its formation and the first important discoveries are connected with the activities of the eminent French scientist chemist and microbiologist Louis Pasteur (Pasteur, Louis, 1822–1895) —the founder of scientific microbiology and immunology (Fig. 124).

Advances in microbiology have opened up great prospects in the development of industry (from the manufacture of vinegar, wine and beer in Pasteur’s France to the synthesis of biologically active substances), agriculture (development of sericulture, control of epizootics, preservation of products), made possible the scientifically based fight against epidemics (production of vaccines, serums, etc.).

 

The successes of microbiology exacerbated the struggle in philosophy between supporters of materialism and idealism (for example, on the question of spontaneous generation) and once again drew the attention of scientists to the importance of social factors in the development of infectious diseases.

 

Immunology development

 

Even before the discovery of Pasteur, scientists from different countries have shown that some infectious diseases are caused by specific microorganisms. Nevertheless, as Robert Bril remarked in the 17th century, the one who explains the nature of fermentation will understand the nature of infectious diseases.

This scientist became Pater. At the age of 36, he defended his doctoral dissertation, presenting two works: on chemistry and crystal physics. The main discoveries of Pasteur are: the enzymatic nature of lactic acid (1857), alcohol (1860) and oil-sour (1861) fermentation, the study of diseases of wine and beer (since 1857), refutation of the hypothesis of spontaneous generation (1860, Prize of the French Academy of Sciences), the study of diseases of silkworms — pebrin (1865), the basics of ideas about artificial immunity (on the example of chicken cholera, 1880), the creation of a vaccine against anthrax (1881) by artificially changing the virulence of microorganisms, the creation of a rabies vaccine (1885). The dates of these great discoveries are sealed on the plaque of Pasteur’s house in Paris, where his first laboratory was located.

 

Their significance for the French economy was so great that the English naturalist and physician Thomas Huxley had every reason to say, “the profits that France received as a result of Pasteur’s discoveries exceeded the indemnity imposed on her by Prussia in 1871. However, only by the end of her life was L. Pasteur received worldwide recognition.

Pasteur's discoveries were the basis for the development of medical microbiology and the fight against infectious diseases. In 1885, Pasteur organized the first in the world anti-tirabic station in Paris. The second anti-rabies station was created by I.I. Mechnikov in Odessa in 1886. Then bacteriological stations began to be organized in St. Petersburg, Moscow, Warsaw, Samara and other cities of Russia earlier than in other countries.

 

In 1888, in Paris, a special institute for the fight against rabies and other infectious diseases was established with funds raised by international subscription. The Institute was led by Pasteur. Subsequently, the Pasteur Institute (as it was named at the suggestion of the French Academy of Sciences) became the largest center of scientific thought in the field of microbiology. Its walls were occupied by E. Ru, A. Yersen, E. Duclos, Russian scientists: I. I. Mechnikov (vice-director, 1904—1916), N.F. Gamaleya, A.M. Bezredka, D.K. Zabolotniy, F. Ya. Chistovich, G. N. Gabrichchevsky, L. A. Tarasevich, V. M. Khavkine and others.

Ilya Ilyich Mechnikov (1845–1916), an outstanding Rchus biologist, pathologist, immunologist and bacteriologist, founder of the phagocytic theory of immunity, one of the founders of evolutionary embryology, organized the first Pasteur station in Russia to combat rabies and other infectious diseases.

 

Studying the processes of intracellular digestion, I. I. Mechnikov discovered that mesodermal cells (leukocytes, cells of the spleen, bone marrow, etc., which he called phagocytes) perform the function of protecting the body against pathogens. The first report on the phagocytic theory "On the body's defensive forces" I. Mechnikov made at the VII Congress of Russian naturalists and doctors in Odessa in 1883. His theory was the basis for understanding the essence of the inflammation process.

 

I. Mechnikov created the largest school of Russian microbiologists, immunologists and pathologists. In his laboratory at the Pasteur Institute, there were constantly Russian scientists who became his students and followers. Among them is G. N. Gabrichevsky, who in 1892 began to read a course of microbiology at Moscow University and organized the production of anti-diphtheria serum in Moscow; DK Zabolotny, who founded the first department of microbiology in Russia (1898) at the St. Petersburg Women's Medical Institute and made a great contribution to the study of the epidemiology of plague; N.F. Gamaleya, involved in the prevention of typhus, smallpox and plague; A.M. Bezredka, L.A. Tarasevich and many others.

 

At the end of the XIX century. The German scientist Paul Ehrlich (Ehrlich, Paul, 1854–1915) initiated the study of antibodies as factors of humoral immunity. The stormy controversy and numerous studies undertaken after this discovery led to very fruitful results: it was found that immunity is determined by both cellular and humoral factors. Thus, the doctrine of immunity was created. Its authors I. I. Mechnikov and P. Erlich in 1908 were awarded the Nobel Prize.

 

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An important achievement of microbiological science was the discovery of filtering viruses (1892) by the Russian scientist Dmitry Iosifovich Ivanovsky (1864-1920), who laid the foundations of virology, a new direction in microbiological science.

 

Of great importance for the development of medical microbiology were the discoveries of the German scientist Robert Koch (Koch, Robert, 1843–1910, fig. 125) - the founder of bacteriology, winner of the 1905 Nobel Prize. Koch established a rule that was called the triad Gen-le-Koch: for evidence of the etiological role of the microorganism in the occurrence of this contagious disease is necessary: ​​1) to detect this microbe in each case of this disease (and for other diseases or in a healthy person it should not occur); 2) to isolate it from the body of the patient in a pure culture; 3) to cause the same disease in the experimental animal, infecting it with a pure culture of this microbe. Koch first proposed a method of growing pure bacterial cultures on solid nutrient media (1877), finally established the etiology of Anthrax (1876), discovered the causative agents of tuberculosis (1882) and cholera (1883).

 

Advances in microbiology for the study of infectious agents. diseases have made possible their successful specific prevention.

 

 

The history of medicine