Hektoen International

A Journal of Medical Humanities

Emil von Behring and passive antibody therapy

Emil von Behring, 1913. Via Wikimedia.

In a March 1929 editorial, the British Medical Journal referred to Emil von Behring (1854–1917) as one of the greatest benefactors of humanity. Recipient of the first-ever Nobel Prize in Physiology or Medicine and awarded a title of nobility, the German physiologist who developed a serum for treating diphtheria and tetanus was showered with orders and distinctions by the learned societies of all European countries.

Von Behring was born in 1854 in the town of Hansdorf, now in Poland, the son of a schoolmaster who was the father of twelve other children. He attended local municipal and secondary schools, receiving an education in history, physical sciences, ancient and modern languages, and mathematics. After 1874, he attended the Army Medical College in Berlin, took his doctor’s degree in 1878, passed the state examination in 1880, and served first as an army medical officer and later as a military surgeon. In 1882, he published his first scientific work on the action of iodoform as an antiseptic.

Though intending at first to stay in the army, von Behring fell under the spell of the research of Louis Pasteur and Robert Koch. In 1888, he left the army to become Koch’s research assistant at the Institute of Hygiene in Berlin. By then the bacillus causing diphtheria had been discovered by Edwin Klebs (1883) and by Edwin Loeffler (1884), and two scientists at the Pasteur Institute (Émile Roux and Alexandre Yersin) had found that cultures of Bacillus diphtheriae remained toxic even after the bacteria had been removed by filtration. This showed that a filterable toxin caused the symptoms and complications of diphtheria. The idea of using the serum of immunized animals to combat toxins produced by pathogenic bacteria had been considered by several workers in France and Germany. In 1890, von Behring, in collaboration with the Japanese bacteriologist Shibasaburo Kitasato, successfully isolated the antitoxins against tetanus and diphtheria and confirmed the critical observations made in hog cholera that even giving tiny amounts of a bacterial product to an animal could produce immunity to that infection. This process was based on the formation of antibodies—substances that could be induced artificially, extracted, and transferred to other individuals to render them immune to the effects of the toxin, at least for some time.

In 1891, von Behring and his colleagues applied this technique to humans, using serum from horses immunized against diphtheria. On Christmas 1891, they conducted the first trial of diphtheria antitoxin in the Berlin clinic of von Bergmann and Heubner, administering it to a girl who was seriously ill from diphtheria and who made a full recovery. In 1894, von Bergman began to produce the new remedy on a large scale. The use of serum therapy spread rapidly throughout Europe and the United States, leading to a decline in diphtheria-related deaths from 5–7% to zero. The impact was most remarkable in children’s hospitals, where wards had previously been filled with young patients suffering from the disease, dying from suffocation, paralysis, or heart failure. Thus, the concept of “passive immunity” was given a practical application in that an individual, given pre-formed antibodies against a toxin, generates them on his own through vaccination. This concept has remained central to treating many other diseases, including tetanus, rabies, and snake venom poisoning.

During the next few years, von Behring worked on preventing bovine tuberculosis, collecting milk by aseptic methods, water supply, serum therapy, and controlling diphtheria and other infectious diseases. In 1894, he received the title of “Professor” in recognition of his scientific work and was appointed to the chair of hygiene at the University of Halle; in the following year, he accepted a call to Marburg, where he held the post of professor and director of the Institute of Hygiene. In 1895 the title of Medical Privy Councillor was conferred on him. At the one-hundredth anniversary of the birth of von Behring and Paul Ehrlich, born coincidentally on successive days in 1854, they were recognized as the two most outstanding scientists of their century in the fight against infectious diseases.

Further reading

  • Editorial. Emil von Behring. BMJ March 16, 1929: 517.
  • Editorial. Ehrlich and von Behring Centenaries. BMJ March 29: 691.
  • Botting JH. Animals and Medicine. The Contribution of Animal Experiments to the Control of Disease. Open Book Publishers, 2015.
  • Luttenberger F. Excellence and Chance: The Nobel Prize Case of E. von Behring and É. Roux. History and Philosophy of the Life Sciences 1996;18(2):225-39. Stazione Zoologica Anton Dohrn – Napoli.
  • Obituary. Professor Emil von Behring. BMJ April 14, 1917, 498.

GEORGE DUNEA, MD, Editor-in-Chief

Fall 2024

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