In answer to an exam question I once set, a student described Campylobacter as ‘the most popular form of bacterial gastroenteritis in the UK’.
Despite a lurking suspicion that she did not choose quite the right word when crafting the otherwise well-honed prose of her answer, I can confirm that Campylobacter infections remain as ‘popular’ as ever with around 60,000 laboratory-confirmed reports a year. In these uncertain times we can also take some comfort from the fact that it enjoys this sort of popularity elsewhere in Europe as well.
A relative latecomer to the list of enteric bacterial pathogens, the association of Campylobacter with gastroenteritis in humans was not established until the 1970s, when techniques to culture it reliably from faecal samples were first developed. A species of Campylobacter, probably C. fetus, had however been described and cultured more than 60 years earlier during investigations into contagious abortion in animals conducted at the Royal Veterinary College (RVC) in London. The College still stands in Camden to the north of the British Library in Euston Road, quite near the rather more recent Francis Crick Institute for biomedical research, though most of the college buildings post-date this period.
In 1905, the UK’s Board of Agriculture and Fisheries invited John McFadyean, Principal of the RVC, to chair a committee to enquire into the causes of epizootic abortion in sheep and cattle. McFadyean was a Scot who trained as a veterinarian in Edinburgh but moved to London in 1895 to become Dean and Professor of Pathology and Bacteriology at the RVC, later rising to Principal. A year into their work, McFadyean with a fellow member of the committee Stewart Stockman (the Chief Veterinary Officer and, incidentally, McFadyean’s son-in-law) were examining samples from a flock of sheep suffering high rates of abortion. From tube cultures of a medium that had been solidified with agar after inoculation, they isolated an organism that grew just below the surface, in the microaerophilic zone. These conditions also favoured growth of another agent of contagious abortion in cattle, Brucella abortus, but this isolate was motile and possessed the now well-known aspects of Campylobacter morphology – the presence of spirillar and coccal forms. The organism was more fully described a little later by Theobald Smith and Marian Taylor in the United States where it was named Vibrio fetus, the genus Campylobacter not coming into common parlance until the 1960s.
Despite a considerable reputation as the founder of veterinary pathology in the UK, McFadyean is a somewhat neglected figure in the history of applied microbiology. Earlier in his career, in 1901, he had also made an important contribution at a major international congress on tuberculosis (TB) held in London. The principle venue for the meeting was St James’s Hall in Piccadilly. The building is long gone, having been demolished in 1905, and the site is now occupied by a large hotel, but at the time it had been the premier concert venue in London for 50 years and had hosted concerts, given by the likes of Tchaikovsky and Dvořák, and readings by Charles Dickens. In a plenary session on the second day of the congress, the near legendary figure of Robert Koch questioned the received wisdom that TB was transmissible from cattle to humans, and whether it was necessary to take measures against bovine tubercule bacilli in milk and meat, describing in support his lack of success in experiments to infect animals with human TB. His address was immortalised in a gouache painting by F. C. Dickinson now in the care of the Wellcome Collection. A written account of this address, and of McFadyean’s response 2 days later, appear in The War Against Consumption, a popular handbook describing the congress, published shortly after. In his talk, McFadyean systematically addressed the points Koch had raised with counter evidence and commentary. Although initially appearing very deferential to Koch, McFadyean ended his talk saying, ‘We ought not concede to the milkmen the right to sell us tubercle bacilli even if we were assured that – like Dr Koch’s experimental pigs – we had nothing to fear beyond the development of “little nodules here and there in the lymphatic glands” of our necks, and “a few grey tubercules in our lungs.”’ McFadyean’s was certainly not a lone voice criticising the master. He had some eminent allies including Lord Lister who had chaired the session at which Koch had spoken and had raised some objections at the time.
The War Against Consumption reflects contemporary knowledge and attitudes to a disease that, though very much still with us, loomed much more ominously over life in the pre-antibiotic era when the main treatment for TB was based on a combination of fresh air, sunshine, rest and good nutrition. The limited remedies available serve as a chilling reminder of the gravity of the threat currently posed by increasing antibiotic resistance. Novel chemotherapies discussed at the Congress included fearsome intratracheal injections of the disinfectant Izal and the inhalation of formaldehyde. At the back of the book there are a number of advertisements that give a further sense of how the war against TB was being waged at the time. These include the promotion of several sanatoriums, the ‘Sanichief’, a disinfected handkerchief for the receipt of sputum, a variety of inhalants and other patent medications, Scotch whisky and heroin! More prosaically, ‘Sanitas sawdust’ is advertised to be used ‘in all cuspidors’. Regardless of how useful this might have been, it must at least have been quite economical since the Sanitas company was based in Bethnal Green in the East End of London, which was then a centre for furniture manufacture, so sawdust would have been plentiful and almost certainly very cheap, if not free.