‘Koch’s Lymph’ – A story by I. T. Mera

Browsing through the pages of Foaia Ilustrată (Illustrated Sheet), a nineteenth-century periodical published in the town of Sibiu, in what is now Romania, I came across a serialized ‘novella’ carrying an intriguing title: ‘Limfa lui Koch’ (Koch’s Lymph). The author, Iuliu Traian Mera (1861-1909), was born into a clerical family in the picturesque village of Şiria in Arad County. He studied medicine in Vienna and went on to become a balneologist of some repute, establishing a practice in Carlsbad/Karlovy Vary, in the present Czech Republic, a place well known for its hot springs. He was also a writer and journalist and became involved in the Romanian national movement, most prominently through his association with the cultural and literary society Romania Jună (Young Romania), which was established in Vienna in 1871.

The story was published in five consecutive issues of Foaia Ilustrată in March-April 1891. It is a moving account of the devastation wrought by tuberculosis in the nineteenth century and the hopes invested in the possibility of a cure. The protagonist, a young lady called Aniţa, is the daughter of a well-to-do ‘proprietor’: Mr Ioan Zamfirescu, a man who has already lost his wife and two other children to pulmonary tuberculosis. Aniţa is engaged to be married to the young lawyer Dimitrescu, when the first signs of illness appear: a burning sensation in her chest, an unpleasant, ‘salty’ taste in her mouth, followed by a cough and the familiar spitting of ‘red, warm’ blood. Despite the fact that Dimitrescu cowardly abandons her—the news of Aniţa’s illness soon becomes the talk of the whole town, illustrating the stigma associated with this disease—she decides to fight for her life and for the happiness that seems to have eluded her all her life.

Aniţa’s story is a grim reminder that even the most economically privileged members of society were not immune to the dangers of tuberculosis. [1] Her father does not spare any effort in an attempt to save his last surviving child. He first takes her to Bad Gleichenberg in the southern part of what is now Austria, in the hope that its clean air and spring waters would provide a ‘complete cure’ for his daughter. Her condition improves temporarily, only to deteriorate again upon her return home in September 1890.

Robert Koch

Foaia Ilustrată, 13/25 January 1891

By the beginning of November, the ailing girl’s hopes are pinned on a new form of treatment, as the ‘political newspapers’ announce that Prof Koch, the ‘eminent bacteriologist of the Faculty of Medicine in Berlin’, has discovered a method that can ‘absolutely cure’ tuberculosis. The story of Koch’s 1890 announcement of the discovery of tuberculin—also known as lymph—and its subsequent failure as a therapeutic agent is well documented [2]. What is interesting about Mera’s story is that it beautifully captures the public expectations associated with the new treatment and illustrates the ways in which the public accessed scientific knowledge and research. The above reference to ‘political newspapers’ is not haphazard. On the contrary, it suggests that this type of publications were usually the first to disseminate new scientific ‘discoveries’ to a broad public. But the reliability of their reports was subject to questions. When Aniţa asks her doctor if he has read the latest newspapers and whether the ‘news about Koch’ might be true, his response reveals some of the concerns associated with daily journalism:

Let’s wait, my dear young lady; the political newspapers publish so much news. They have many columns and issues to fill. Let’s wait until the medical journals and Koch himself speak.

While her doctor continues to remain sceptical about the efficacy of the lymph, Aniţa’s hopes flourish with the increase in press coverage. Her life revolves around the reading of newspapers; she naively believes that ‘European’ newspapers are more deserving of trust than local publications, on account of their ‘reliable correspondents all over the world, who would not endanger the reputation of their newspapers by publishing a false piece of news’. She even begins to question the professional ability of her doctor, whose more advanced age appears to make him less inclined to accept ‘the newer progress of science’ than younger practitioners.

The much awaited confirmation finally arrives on the 13th of November, when a medical journal from Berlin publishes Koch’s testimony about the new treatment of tuberculosis. Among those afflicted with the disease, the euphoria is general:

How many sweet and great hopes awoke in the hearts of thousands and perhaps hundreds of thousands of patients, who had believed themselves to be standing at the gates of death. And suddenly, as if by some mysterious miracle, they saw themselves saved, saved—returned to the world and to this worldly life.

The announcement of the new cure causes an exodus of patients and doctors to Berlin:

Only two days later, there was a great migration of people towards the capital of the German Empire. Doctors went to study the new method, patients to regain their lost health. Some of them, who could not endure the travails of the long winter journey died on the road or in one of Berlin’s hotels, far away from their country and their relatives. But they died with Koch’s name on their lips, with a smiling face, cheered by the hope of recovery.

Aniţa is among those who attempt the trip abroad, in search of the ‘miraculous lymph’. She is in a privileged position, since her father’s influence and money allow her to make the trip to Vienna, where injections of tuberculin were already available. The first injection triggered powerful side-effects: chills, fever, nausea, headaches, pangs of pain in her joints. The second and the third seemed to bring some amelioration in her symptoms, easing her cough and breathing. But the next three injections did not bring about the much desired relief: on the contrary, her symptoms worsened. Life finally leaves her body around the same time that ‘doubting voices began to be heard about the effect of Koch’s treatment and the poor patients began to understand from the doctors’ conversations, from the evolution of their disease, that the hopes that had animated them were nothing more than a treacherous dream, an illusion that they could no longer reach’. Aniţa breathes her last in the arms of her inconsolable parent, her final words, ‘Father, please don’t be upset’, a sad reminder of the many forgotten tragedies of tuberculosis in the nineteenth century.

It is a  tragedy that continues to unfold. Far from being consigned to the history books, tuberculosis remains a very real problem in Romania, which has the highest incidence of this disease among EU countries. Multidrug-resistant tuberculosis, the outcome of an inefficient public health system, improper treatment and lack of public awareness is a particular problem, whose full extent and social impact is yet to be properly acknowledged and tackled.

[1] In Illness as Metaphor (1978), Susan Sontag writes about the romanticization of tuberculosis since the eighteenth century and how, despite the fact that it was ‘often imagined as a disease of poverty and deprivation—of thin garments, thin bodies, unheated rooms, poor hygiene, inadequate food’, it was also an ‘index of being genteel, delicate, sensitive’.

[2] See Christoph Gradmann’s work: ‘Robert Koch and the Pressures of Scientific Research: Tuberculosis and Tuberculin’, Medical History, 45 (2001): 1-32; ‘Robert Koch and the White Death: from Tuberculosis to Tuberculin’, Microbes and Infection, 8 (2006): 294-301.

Amelia Bonea

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