The Story of Koch and Waksman - Two Superstars Who Saved Mankind from the Menace of Tuberculosis
Prologue
Today, I’m going to tell you the story of an ancient and once incurable disease, tuberculosis, and of two scientific superstars who helped humanity fight back. Their discoveries changed the course of medical history and saved countless lives across the world.
Lithographed advertising poster against tuberculosis by Leonetto Cappiello (1875-1942)
An Ancient Disease That Haunted Humanity
Tuberculosis (TB) is far older than modern medicine. According to modern archaeological surveys, TB has existed for nearly 9,000 years. Evidence of TB has been found in Neolithic skeletons, and deformities typical of spinal tuberculosis, known as Pott’s disease, have been discovered in Egyptian mummies dating from about 2400 to 3400 BCE. In ancient India, descriptions of a TB-like disease appear in Ayurvedic texts from about 3500 years ago. In China, signs of tuberculosis exist in writings and bone samples from about 2500 years ago. In Europe and the USA, 25% of all deaths between 1600 and 1800 were due to TB; a figure that shows just how devastating this disease was in the pre-modern world.
The modern term tuberculosis comes from the Latin word tuberculum, which means a small swelling. Long before doctors knew its cause, they recognized the wasting effect of this illness, which was often called consumption. Treatment for consumption relied on guesswork and traditional beliefs. Physicians recommended long rest, rich food, and plenty of fresh air, which later inspired the rise of sanatoriums. Remedies such as herbal tonics, cod liver oil, mineral waters, and bloodletting were commonly tried, although none cured the disease. Some healers introduced spiritual or psychological methods, and mesmerism was one such approach. Practitioners believed that animal magnetism could rebalance the body and restore health. These methods reflected the limited medical knowledge of the time, and most patients continued to decline despite the many treatments offered.
Treatment of consumption (tuberculosis) by mesmerism
Famous People Lost to Tuberculosis
Throughout history, many influential figures succumbed to TB. Among them were:
King Henry VII of England
King Louis XIII of France
King Edward VI of England
James Monroe, 5th President of the USA
Andrew Jackson, 7th President of the USA
Other renowned personalities who died due to TB included:
John Keats, the English poet, who died at age twenty-five
Robert Louis Stevenson, the Scottish novelist
Charlotte Brontë, the English author
Sukanta Bhattacharya, the Bengali poet
Dr Norman Bethune, the Canadian physician
Ho Chi Minh, the Vietnamese revolutionary leader
These deaths show how widespread and deadly the disease once was.
Advertising postcard for the National Association for the Prevention of Tuberculosis
Is Tuberculosis Curable Today
A question that strikes many minds is whether TB is completely curable today. The honest answer is that most cases of TB are curable, but MDR (Multi-Drug Resistant) cases are not totally curable.
The World Health Organization has announced that India is on the path toward eliminating tuberculosis. In public health terms, elimination means that the number of TB cases should fall to fewer than 1 patient per 1 million population.
Advertising postcard for the National Association for the Prevention of Tuberculosis. Publication: Chicago, 1940
The Two Groups of Heroes Who Fought TB
The heroes of this story belong to two different groups.
Group One: Those who helped identify the germ
Franz Ziehl
Friedrich Neelsen
Hans Christian Gram
Dr Robert Koch (the first superstar of our story)
Group Two: Those who discovered the treatment for the disease
Albert Calmette
Jean Marie Camille Guérin
Selman Abraham Waksman (the second superstar of our story)
Advertising postcard for the National Association for the Prevention of Tuberculosis. Publication: Chicago, 1940
Ziehl, Neelsen, and Gram: The Men Who Revealed the Hidden World of Bacteria by Discovering Staining Techniques
Staining is a laboratory technique used to color microorganisms such as bacteria, which are often transparent and nearly invisible under a microscope. By applying specific dyes, scientists can clearly observe the shape, size, and structural features of bacteria. Staining serves several key purposes: it reveals bacterial morphology (rod, cocci, spiral) and arrangement (chains, clusters), helps identify species for accurate diagnosis, highlights structural features such as cell walls, capsules, or spores, and assists in research by allowing observation of bacterial behavior and responses to treatment. Without staining, microorganisms would remain nearly invisible under a microscope, making the study, diagnosis, and treatment of infections like tuberculosis extremely difficult. There are two main types of bacterial staining methods:
Simple Staining - This uses a single dye to color bacterial cells. It helps reveal the shape, size, and basic arrangement of bacteria.
Differential Staining - This uses more than one dye, so different bacteria react differently. It helps classify bacteria based on their structural or chemical properties. The two most important differential stains are:
Acid-fast stain
Gram stain
Acid-fast staining method
Gram staining method
Introduction of Acid-Fast Bacterial Staining
In 1882, German scientist Paul Ehrlich introduced an early form of acid-fast staining for bacteria. Soon after, another two German scientists, Franz Ziehl and Friedrich Neelsen (in 1882 - 1883), modified Ehrlich’s technique to improve staining quality. This improved method, known as the Ziehl-Neelsen stain, is an acid-fast technique that Robert Koch later used to identify Mycobacterium tuberculosis, the causative agent of tuberculosis.
Paul Ehrlich
Franz Ziehl
Friedrich Neelsen
Development of Gram Staining
Two years later, in 1884, Danish bacteriologist Hans Christian Gram developed the Gram staining method, which classifies bacteria according to the thickness of their cell walls. Bacteria with thick peptidoglycan layers retain the violet dye and are called Gram-positive, while those with thinner layers lose the violet and take up a counterstain, becoming Gram-negative. This method remains one of the most widely used techniques in microbiology laboratories around the world.
Hans Christian Gram
Dr Robert Koch: The Superstar Who Identified the TB Bacterium using the Staining Techniques
Early Life
Robert Koch was born in Clausthal-Zellerfeld in Germany. His father was a mining engineer. After his schooling, Koch studied natural sciences at the University of Göttingen, then shifted to medicine and completed his MD in 1866. In 1870, he joined the Franco-Prussian War as a medical officer. In 1872, he became the District Medical Officer of Wollstein. This allowed him to pursue research in his small home laboratory.
Robert Koch
Culture of Anthrax Bacillus
One of his early achievements was the culture of the anthrax bacillus during the 1870s. He experimented by placing the bacteria in the aqueous humor (clear fluid in the eye that nourishes the cornea and lens and helps maintain intraocular pressure) of a living ox. He noticed that the bacteria multiplied rapidly. When he reduced the oxygen level, the bacilli turned into spores and became inactive. When he increased the oxygen level again, the spores reactivated and became infectious bacilli. Koch even photographed these findings, which greatly impressed Professor Ferdinand Cohn, a leading botanist and journal editor, who then published Koch’s work in 1876. This recognition turned Koch into a prominent scientist.
To know more about how Louis Pasteur developed the Anthrax vaccine later in 1881, please read our article Louis Pasteur and the History of Rabies Vaccination Development.
Anthrax bacillus discovered by Robert Koch
Formulation of Koch’s Postulates
In the 1880s, Koch established a set of criteria to prove a causal relationship between a microbe and a disease. These became known as Koch’s Postulates, and they remain fundamental in microbiology even today.
The postulates include four key steps:
Presence of the Microbe (Smear) – The suspected microorganism must be found in every case of the disease, but should not be present in healthy individuals. This is usually observed by preparing a stained smear of tissue or fluid from the infected host.
Isolation in Pure Culture (Culture) – The microorganism must be isolated from the diseased host and grown in a pure culture in the laboratory. This ensures that the disease is linked to a single microbe and not a mixture of organisms.
Reproduction of Disease (Animal Inoculation) – A sample from the pure culture should cause the same disease when introduced into a healthy, susceptible animal. This step demonstrates that the microorganism is indeed capable of producing the disease.
Re-isolation (Confirmation) – The microorganism must be re-isolated from the newly infected animal and shown to be identical to the original microbe. This step confirms that the same organism causes the disease consistently.
Koch applied these principles to identify Mycobacterium tuberculosis as the cause of tuberculosis, revolutionizing the study of infectious diseases. Although modern microbiology has adapted and expanded upon these postulates for viruses and non-culturable organisms, they remain a cornerstone in understanding disease causation.
Robert Koch working in his laboratory
Discovery of Tuberculosis Bacterium
On 24 March 1882, Koch announced his discovery of Mycobacterium tuberculosis, the bacterium responsible for causing Tuberculosis. He also demonstrated the acid-fast staining method that helped visualize it. This news spread across the world and earned Koch the Nobel Prize in 1905. This event became so significant that the World Health Organization declared the date World Tuberculosis Day.
Koch’s discovery proved that tuberculosis was not inherited. It was caused by a specific bacterium. This supported the growing idea that many diseases were caused by microbes, a concept known as the germ theory of disease. To know more about how Louis Pasteur gave the germ theory of disease in 1861, please read our article Louis Pasteur and the History of Rabies Vaccination Development.
Koch’s work became a foundation of modern microbiology. He is often called the ‘Father of Culture Media’ because of his contributions to laboratory methods.
Robert Koch presenting his discovery of Mycobacterium tuberculosis
Discovery of the Cholera Bacillus
When Koch was working on TB, there was a cholera epidemic in Egypt. He was sent there, discovered Vibrio cholerae, and named the germ of cholera in 1883. After that job, he returned to Germany, resumed his research, and made more findings. He realized that Mycobacterium tuberculosis hominis infects humans but not cows, whereas Mycobacterium bovis can infect both humans and bovines. He therefore recommended that common people boil milk before drinking; a simple but powerful public-health advice.
Visitors to the gardens of the Horticultural Society of London in Chiswick, among whom is a man who rushes off believing he has an attack of cholera. Coloured etching by H. Heath, 1831.
Attempt to Create Tuberculosis Vaccination
After discovering Mycobacterium tuberculosis, Dr. Robert Koch devoted himself to finding a solution for the deadly disease. In 1890, he introduced tuberculin, a purified protein derivative extracted from the TB bacterium, presenting it as a potential treatment and diagnostic tool. Koch initially believed that tuberculin could stimulate the immune system to fight tuberculosis, offering hope for a cure to a disease that had claimed millions of lives across the globe.
Early experiments generated tremendous public and scientific excitement, and many saw Koch’s announcement as a monumental breakthrough. However, clinical trials soon revealed that tuberculin was ineffective as a treatment. Some patients even experienced severe reactions, and the results were inconsistent. This failure was a major disappointment for both Koch and the medical community, temporarily tarnishing his reputation. Despite this setback, tuberculin was not a total loss. It proved invaluable as a diagnostic tool, leading to the development of the tuberculin skin test (Mantoux test), which remains a cornerstone in detecting latent TB infection.
Personal Life
Koch married Emma Adolfine Josephine Fraatz in 1867 and had a daughter, Gertrude. The marriage ended in 1893, the same year he married an actress named Hedwig Freiberg. Many of his admirers were shocked, but they kept quiet because it was a private matter. In 1910, Koch died at the age of 66. He was buried in the headquarters of what is now the Robert Koch Institute in Berlin. Whether his admirers felt joy or sadness at his personal decisions remains a mystery; history does not record their emotions.
Medal portrait of Robert Koch
Albert Calmette and Jean Marie Camille Guérin: Men Who Discovered Tuberculosis Vaccination
While Koch laid the groundwork for understanding TB, the fight against it took a giant leap forward in 1921, when French scientists Albert Calmette and Jean Marie Camille Guérin introduced the world’s first vaccine against tuberculosis, named the Bacillus Calmette-Guérin (BCG) vaccine. They developed it by attenuating Mycobacterium bovis (cattle tuberculosis bacteria), a bacterium closely related to Mycobacterium tuberculosis, over 13 years, producing a strain safe for humans but still able to trigger protective immunity. The first human dose was administered on March 18, 1921, marking a historic milestone in public health.
Even today, the BCG vaccine remains the only widely used TB vaccine. While it does not completely prevent pulmonary TB in adults, it effectively protects children from severe forms like TB meningitis and miliary TB, saving millions of lives globally.
Left to right: Jean Marie Camille Guérin and Albert Calmette
Selman Abraham Waksman: The Superstar Who Gave the Cure for TB
Early Life
The second superstar of our story is Professor Selman Abraham Waksman, whose work brought the world the first effective medicine for TB. Waksman was born in a Jewish family in Ukraine on 22 July 1888. He migrated to the United States in 1910 and became a citizen in 1916. By then, he had completed his bachelor’s and master’s degrees in Agricultural Science at Rutgers University. In 1918, he obtained his PhD in biochemistry from the University of California in Berkeley.
Selman Waksman
Discovery of Streptomycin: The First Anti-tubercular Drug
After completing his PhD at the University of California, Berkeley, in 1918, Waksman returned to Rutgers University as a researcher and teacher in the Department of Biochemistry and Microbiology. This became the turning point of his career. Over the next forty years, he discovered many antibiotics such as actinomycin, clavacin, streptothricin, grisein, neomycin, fradicin, candicidin, and most importantly, streptomycin. He secured patents for all the discoveries he made, and the income generated from these patents was reinvested into establishing the Waksman Institute of Microbiology in New Jersey, USA. He served as the Institute’s first president from 1954 to 1958. In 1931, Professor Waksman was invited by the Woods Hole Oceanographic Institution to join the Department of Bacteriology as a professor. He accepted the offer and worked there until 1942, contributing significantly to research in microbiology and antibiotics during his tenure.
Streptomycin became the first anti-tubercular medicine which also effective against many Gram-negative organisms. Prof. Walksman was also the first microbiologist to give the correct definition of antibiotics. He stated that antibiotics are substances derived from living organisms and are used to destroy other living organisms.
Injection cartridges of Streptolin '50' streptomycin, Middlesex, England, 1964
The Nobel Controversy
In the meantime, the Nobel Committee of 1952 was considering Professor Waksman for the Nobel Prize when they were suddenly informed that Albert Schatz, a PhD student we mentioned earlier, had filed a legal case against both Professor Waksman and the Nobel Committee. Schatz claimed that he had also played a major role in the discovery of streptomycin, but his contribution had been ignored. The court agreed with Schatz’s version, and as a result, the 1952 Nobel Prize was temporarily withheld.
Supporters of Professor Waksman advised him that pursuing a legal battle would take a long time and suggested reaching a mutual settlement with Schatz outside the court. Waksman considered this advice and agreed. He paid a substantial sum to Schatz for the patent rights, along with 3% of royalties, and formally recognized him as co-inventor of streptomycin. In return, Schatz withdrew the case against Waksman and the Nobel Committee.
Left to right: Albert Schatz and Selman Waksman
Awards and Recognition
After this settlement, Professor Waksman was officially declared the discoverer of streptomycin, with Albert Schatz as co-inventor. The Nobel Committee also acknowledged the discovery as Waksman’s greatest contribution to humanity. Among the many awards he received, two were especially significant: the 1952 Nobel Prize and a certificate from the King of Japan, honoring him as the “Star of the Rising Sun.”
Scientists at the Nobel ceremony referred to Waksman as the ‘Father of Antibiotics.’ When asked how this affects the legacy of Sir Alexander Fleming, most responded that Fleming is still regarded as the ‘King of Bacteriology.’ To know more about Sir Alexander Fleming’s contribution to the world of antibiotics, please read our article The Dawn of the Antibiotic Era | The History of Sir Alexander Fleming’s Accidental Discovery and Development of Penicillin.
Personal Life
Waksman married his childhood friend Bertha Deborah Mitnik in 1916. Their only son was Byron Halsted Waksman (1919 - 2012). He was very brilliant academically and held positions of Associate Professor at Harvard University Medical School, Professor of Microbiology at Yale University Medical School, and president at Waksman Foundation for Microbiology from 1970 to 2000. Waksman died in 1973, and his wife passed away in 1974. He was buried in Woods Hole, Massachusetts. His discoveries saved countless lives. Humanity remains deeply grateful for his contributions.
Epilogue
Tuberculosis once seemed unbeatable. It spread across continents, claimed millions of lives, and terrified entire societies. The turning point came when two extraordinary scientists, Robert Koch and Selman Abraham Waksman, revealed the cause of the disease and discovered its cure. Their brilliance, perseverance, and dedication reshaped medical science and continue to save lives every day.
This article is authored by my father Dr. Kamal Kumar Sengupta. He is a retired doctor with a five-decade-long career as an eye surgeon, a patented inventor of ophthalmic surgical instruments, and an author of ocular pharmacology textbooks. Post-retirement, he decided to invest his time in writing motivational stories from across the globe that will inspire future generations to experience the world, explore ideas, and follow their dreams. I hope you liked this article and if you did, don’t forget to let us know in the comments below!
All images in the article are royalty-free images from jstor.org and commons.wikimedia.org used for visualization purposes only. We hold no copyright on the images.
Advertising postcard for the National Association for the Prevention of Tuberculosis. Publication: New York, 1924
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