The man who found it was Paul Ehrlich (1854–1915). Born in Strehlen, Upper Silesia, he had an intimate experience of infectious diseases: while studying tuberculosis as a young doctor, he had contracted the illness and been forced to convalesce in Egypt.72 As so often happens in science, Ehrlich’s initial contribution was to make deductions from observations available to everyone. He observed that, as one bacillus after another was discovered, associated with different diseases, the cells that had been infected also varied in their response to staining techniques. Clearly, the biochemistry of these cells was affected according to the bacillus that had been introduced. It was this deduction that gave Ehrlich the idea of the antitoxin – what he called the ‘magic bullet’ – a special substance secreted by the body to counteract invasions. Ehrlich had in effect discovered the principle of both antibiotics and the human immune response.73 He went on to identify what antitoxins he could, manufacture them, and employ them in patients via the principle of inoculation. Besides syphilis he continued to work on tuberculosis and diphtheria, and in 1908 he was awarded the Nobel Prize for his work on immunity.74
By 1907 Ehrlich had produced no fewer than 606 different substances or ‘magic bullets’ designed to counteract a variety of diseases. Most of them worked no magic at all, but ‘Preparation 606,’ as it was known in Ehrlich’s laboratory, was eventually found to be effective in the treatment of syphilis. This was the hydrochloride of dioxydiaminoarsenobenzene, in other words an arsenic-based salt. Though it had severe toxic side effects, arsenic was a traditional remedy for syphilis, and doctors had for some time been experimenting with different compounds with an arsenic base. Ehrlich’s assistant was given the job of assessing the efficacy of 606, and reported that it had no effect whatsoever on syphilis-infected animals. Preparation 606 therefore was discarded. Shortly afterward the assistant who had worked on 606, a relatively junior but fully trained doctor, was dismissed from the laboratory, and in the spring of 1909 a Japanese colleague of Ehrlich, Professor Kitasato of Tokyo, sent a pupil to Europe to study with him. Dr Sachachiro Hata was interested in syphilis and familiar with Ehrlich’s concept of ‘magic bullets.’75 Although Ehrlich had by this stage moved on from experimenting with Preparation 606, he gave Hata the salt to try out again. Why? Was the verdict of his former (dismissed) assistant still rankling two years later? Whatever the reason, Hata was given a substance that had been already studied and discarded. A few weeks later he presented Ehrlich with his laboratory book, saying, ‘Only first trials – only preliminary general view.’76
Ehrlich leafed through the pages and nodded. ‘Very nice … very nice.’ Then he came across the final experiment Hata had conducted only a few days before. With a touch of surprise in his voice he read out loud from what Hata had written: ‘Believe 606 very effacious.’ Ehrlich frowned and looked up. ‘No, surely not? Wieso denn … wieso denn? It was all minutely tested by Dr R. and he found nothing – nothing!’
Hata didn’t even blink. ‘I found that.’
Ehrlich thought for a moment. As a pupil of Professor Kitasato, Hata wouldn’t come all the way from Japan and then lie about his results. Then Ehrlich remembered that Dr R had been dismissed for not adhering to strict scientific practice. Could it be that, thanks to Dr R, they had missed something? Ehrlich turned to Hata and urged him to repeat the experiments. Over the next few weeks Ehrlich’s study, always untidy, became clogged with files and other documents showing the results of Hata’s experiments. There were bar charts, tables of figures, diagrams, but most convincing were the photographs of chickens, mice, and rabbits, all of which had been deliberately infected with syphilis to begin with and, after being given Preparation 606, showed progressive healing. The photographs didn’t lie but, to be on the safe side, Ehrlich and Hata sent Preparation 606 to several other labs later in the year to see if different researchers would get the same results. Boxes of this particular magic bullet were sent to colleagues in Saint Petersburg, Sicily, and Magdeburg. At the Congress for Internal Medicine held at Wiesbaden on 19 April 1910, Ehrlich delivered the first public paper on his research, but by then it had evolved one crucial stage further. He told the congress that in October 1909 twenty-four human syphilitics had been successfully treated with Preparation 606. Ehrlich called his magic bullet Salvarsen, which had the chemical name of asphen-amine.77
The discovery of Salvarsen was not only a hugely significant medical breakthrough but also produced a social change that would in years to come influence the way we think in more ways than one. For example, one aspect of the intellectual history of the century that has been inadequately explored is the link between syphilis and psychoanalysis. As a result of syphilis, as we have seen, the fear and guilt surrounding illicit sex was much greater at the beginning of the century than it is now, and helped account for the climate in which Freudianism could grow and thrive. Freud himself acknowledged this. In his Three Essays on the Theory of Sexuality, published in 1905, he wrote, ‘In more than half of the severe cases of hysteria, obsessional neurosis, etc., which I have treated, I have observed that the patient’s father suffered from syphilis which had been recognised and treated before marriage…. I should like to make it perfectly clear that the children who later became neurotic bore no physical signs of hereditary syphilis…. Though I am far from wishing to assert that descent from syphilitic parents is an invariable or necessary etiological condition of a neuropathic constitution, I believe that the coincidences which I have observed are neither accidental nor unimportant.’78
This paragraph appears to have been forgotten in later years, but it is crucial. The chronic fear of syphilis in those who didn’t have it, and the chronic guilt in those who did, created in the turn-of-the-century Western world a psychological landscape ready to spawn what came to be called depth psychology. The notion of germs, spirochaetes, and bacilli was not all that dissimilar from the idea of electrons and atoms, which were not pathogenic but couldn’t be seen either. Together, this hidden side of nature made the psychoanalytic concept of the unconscious acceptable. The advances made by the sciences in the nineteenth century, together with the decline in support for organised religion, helped to produce a climate where ‘a scientific mysticism’ met the needs of many people. This was scientism reaching its apogee. Syphilis played its part.