By Danielle Aloia, Special Projects Librarian

To mark World TB Day, we are going to tune in to the 1950s radio series “For Doctors Only.” Selections from this series and several others produced by The New York Academy of Medicine and WNYC were recently digitized and cataloged by the Academy and the New York Public Radio (NYPR) Archives.

The program “The Biological and Social Aspects of Tuberculosis” was the 26^th Hermann M. Biggs Memorial Lecture, held at the Academy in 1951.The lecture was given by Pulitzer Prize-winning author René Jules Dubos in honor of physician and public health champion Hermann Biggs and his contribution to the control and elimination of tuberculosis (TB).

At the beginning of his career, Dubos focused on developing antibiotics. But after his first wife, Marie-Louise, died of pulmonary TB in 1942, he changed the focus of his research. His lab determined a way to more quickly culture strains of tubercle bacilli, which led to a better understanding of their virulence and properties. In 1946, he married Jean Porter, who worked alongside him in his lab. Dubos likely based his lecture on the research he did for his book The White Plague, which he published with his wife in 1952.¹

In Moberg CL. René Dubos, Friend of the Good Earth: Microbiologist, Medical Scientist, Environmentalist. Washington, D.C.: ASM Press; 2005.

Oil portrait of Hermann M. Biggs by Renwick, held in our Oil Portrait Collection.

In the lecture, Dubos discussed Biggs’ contribution to tuberculosis prevention in the 1900s. Biggs graduated from Cornell in 1881. In his dissertation, “he expressed his conviction that filth and poor hygiene were the primary causes of contagious disease and microorganisms were only byproducts of disease.”²

Dubos pointed out in his lecture that when Robert Koch discovered the Tubercle bacillus in 1882, it revolutionized the perception of TB. It was no longer a social disease but a biological one. The bacteriological era had begun!

Biggs was quick to realize the profound effect of this germ theory. He formulated a practical way to control TB, shifting the emphasis from patients passively taking physicians’ orders to actively participating in the eradication of the disease as a community through the following formula:

1. Check the spread of the infection and minimize contacts
2. Help humans develop higher resistance
3. Educate to mobilize the community to take action

His TB-control formula began the anti-tuberculosis movement, which eventually led to the formation of the National Tuberculosis Association in 1905.³

In 1889 Biggs and his colleagues “presented to the Health Department of New York City a communication calling attention to the communicability of tuberculosis and recommending that measures be taken to prevent the spread of the disease.” As a result, the Health Department published and distributed a leaflet in large quantities. As noted in A History of the National Tuberculosis Association, “So far as we are able to ascertain, this is the first leaflet ever published for distribution among the general public. It is certainly the first one published and distributed by a health department, and as such marks an epoch in tuberculosis education.”⁴

The Health Department leaflet, reprinted in Knopf SA. A History of the National Tuberculosis Association: The Anti-Tuberculosis Movement in the United States. New York: National Tuberculosis Association; 1922.

Over the years, public-health measures helped reduce the spread of TB. Despite these efforts, the population was still susceptible to infection. Mortality rates had been falling faster than infection rates, which Dubos noted in The White Plague. He also showed a connection between industrialization and reduced mortality.

In Dubos, RJ, Dubos J. The white plague: Tuberculosis, man, and society. New Brunswick : Rutgers University Press; 1987.

Complete eradication of the disease was almost impossible. Instead, Dubos suggested two ways to attack the progression of the disease: 1) decreasing risk of infection and 2) boosting resistance. To do this, thought Dubos, researchers must focus on fostering new and unorthodox ways to determine resistance to infection and adventure into unexplored fields.

Dubos stressed in his lecture that it was imperative to investigate the human and environmental factors that determine resistance to infection. But according to the Global Tuberculosis Report 2014, “tuberculosis (TB) remains one of the world’s deadliest communicable diseases. In 2013, an estimated 9.0 million people developed TB and 1.5 million died from the disease.” Today, efforts to prevent and control TB infection are similar to those championed by Biggs and Dubos: drug-resistant surveillance, community-based TB activities, and collaboration across sectors in research and policy-making.

References

1. Hirsch JG, Moberg CL. Rene Jules Dubos 1901-1982. Washington, D.C.: National Academy of Sciences; 1989. Available at: http://www.nasonline.org/publications/biographical-memoirs/memoir-pdfs/dubos-rene.pdf. Accessed March 20, 2015.

2. Dubos RJ, WNYC (Radio station : New York NY). Biological and Social Aspects of Tuberculosis. New York : WNYC; 1951. http://www.wnyc.org/story/biological-and-social-aspects-of-tuberculosis-26th-hermann-m-biggs-memorial-lecture.

3. Knopf SA. A History of the National Tuberculosis Association: The Anti-Tuberculosis Movement in the United States. New York: National Tuberculosis Association; 1922.

4. Knopf SA. A History of the National Tuberculosis Association: The Anti-Tuberculosis Movement in the United States. New York: National Tuberculosis Association; 1922.