Diagnosis

Methods of diagnosis changed massively during the course of the 19th century.

1. René Laennec (France: 1816) invented the stethoscope and started the practice of 'auscultation' (listening to the patient's chest).
2. Pierre Louis (France: 1834) argued that symptoms were irrelevant, and that what was happening inside the body was much more important when it came to diagnosing illness. As a result, doctors made diagnoses on the basis of a full clinical examination of the 'signs' made by the disease on the body.
3. Carl Ruge (Germany: 1878) developed the technique of biopsy (removing cells to determine if they were cancerous).
4. Doctors used machines to measure the functions of the body precisely:
   • Carl Ludwig (Germany: 1847) invented the kymograph (which measured the pulse).
   • Wilhelm Roentgen (Germany: 1895) discovered x-rays.
   • Willem Einthoven (Holland: 1900) invented the electrocardiograph (which measures heart activity).

Treatment - inoculation, magic bullets

The search for new ways to cure disease also gained momentum in the 19th century, and included the discovery of how inoculation [Inoculation: Usually a medical injection, which introduces a weakened dose of harmful disease-causing organisms into a patient's body. This induces the body to develop an immunity to the disease, which protects the patient from the full-blown sickness. ] could prevent disease.

Charles Chamberland (France: 1880) discovered by chance (when he left bacteria exposed to air) that injecting chickens with an attenuated (weakened) form of chicken cholera gave them immunity to the disease (ie he discovered the principle of inoculation).

Charles Chamberland, with chicken

That realisation was the start of an important chain of events.

• Louis Pasteur developed an effective inoculation against anthrax (1881), and rabies (1885).
• Albert Calmette and Camille Guérin (France: 1906) developed the BCG injection against TB.
• Emil von Behring (Germany: 1913) developed an anti-toxin against diphtheria.

Magic bullets

• Paul Ehrlich (Germany: 1890s) reasoned that, if certain dyes could stain bacteria, perhaps certain chemicals could kill them. He set up a private laboratory and a team of scientists. By 1914 they had discovered several 'magic bullets' - compounds that would have a specific attraction to disease-causing microorganisms in the body, and that would target and kill them. These were methylene blue (for malaria), trypan red (for sleeping sickness) and Salvarsan (for syphilis) - although Salvarsan was more effective than the other two.

Most vaccinesVaccines: substances containing disabled antigens of a particular disease, usually administered via injection. Vaccines stimulate the body to produce antibodies to provide immunity against that disease., however (eg one developed by Robert Koch against TB in 1891), were not successful. And against acute infectious disease, doctors were largely powerless. They carried, as one medical historian wrote, 'a box of blanks'. So people looked elsewhere for their cures - sometimes in strange places.

Outlandish or alternative cures

• A home medicine encyclopaedia of 1910 recommended cures that included electrical shocks, injection with animal hormones, and a range of harmful substances including cocaine, mercury, creosote and strychnine.
• Other alternative medical treatments included mesmerism (hypnotism), homeopathy (taking tiny doses of poisons), 'health reform' (a religious movement which recommended a healthy lifestyle - it was run by John Kellogg whose brother invented cornflakes) and Christian Science (which taught that disease only existed in the mind).
• Travelling 'quacks' sold patent medicines (such as Lily the Pink's medicinal compound).

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