Emil von Behring

German physiologist

• Born: March 15, 1854
• Birthplace: Hansdorf, West Prussia (now Jankowa Żagańska, Poland)
• Died: March 31, 1917
• Place of death: Marburg, Germany

Behring’s development of effective vaccinations against tetanus and diphtheria saved great numbers of lives, and Behring also did important work in bacteriology that led to the modern understanding of infectious disease.

Early Life

August George Behring (BAHR-ihng) had four children from his first marriage. Emil Adolf von Behring was the eldest of the nine additional children he had from his second marriage to Augustine Zech, the daughter of a teacher. Teaching was a family tradition on both sides of Emil’s family. His great-grandfather had been appointed as a teacher by Frederick the Great, and his grandfather and father had followed the same profession. Emil stood out as the best student among the village children in Hansdorf, prompting his father to seek a better education for him than was locally available. Emil attended the City School of Eylau (now in Poland), and a local minister tutored him for free in preparation for his admission to the gymnasium in Hohenstein, which was later renamed in his honor.

Behring’s parents ran out of money before he completed his course of instruction at the gymnasium, but the faculty members were so impressed with his abilities as a science student that they insisted he continue, although he could not pay the tuition. Financial difficulties continued to be an obstacle, and he determined that he could not pursue the career in medicine that he had hoped for. He was on the point of leaving for the University of Königsberg to begin a course as a prospective minister when one of his teachers sent for him to come and discuss another option. The teacher’s nephew, a military doctor, was visiting and had become interested in the story of the poor but brilliant student. He helped Behring receive an appointment at the Friedrich Wilhelms Institute in Berlin as a medical student in 1874. The appointment meant that Behring was committing himself to ten years of service as a military doctor after he received his degree, but it was the only way he could achieve his ambition.

Behring received his medical doctorate in 1878 and was licensed in 1880. After a brief period as an intern at the Charité hospital in Berlin, he began service with the Fifty-ninth Fusilier Battalion in Wohlau in June, 1880. In 1881 he was transferred to the Second Hussars in Posen. During the same year, he wrote his first paper on sepsis and antisepsis in theory and practice, but it was not published. His next paper was on the use of iodoform, which had been adopted as a disinfectant for wounds in 1880. He had the idea that taking iodoform internally might be more effective as a disinfectant than applying it externally. However, he was forced to conclude that the poisonous effect produced by taking iodoform internally was too great to make any disinfecting it might do worthwhile. This line of inquiry seemed to be a dead end, but it was to bear significant results, as it led to his interest in antitoxins and subsequent successes.

Life’s Work

In 1887 Behring was promoted to captain and sent to the Pharmacological Institute in Bonn, but his military career was nearing an end. He was already studying for the civil service medical exam because he intended to apply to the Prussian Public Health Service as soon as his ten-year military obligation was over. His duties at the Pharmacological Institute changed the direction of his life, and he turned from the life of a practicing physician with an interest in research to that of a full-time researcher. While at the institute, Behring acquired the necessary skills for a life in research and continued his work on the disinfecting effects of iodoform and acetylene. In 1888 he served at the Academy for Military Medicine in Berlin and established a working relationship with Robert Koch at the Institute of Hygiene at the Berlin University. When his term of military service was over in 1889, he went to work as Koch’s assistant.

Behring’s first serious research as a civilian was in partnership with Japanese scientist Kitasato Shibasaburo. They were trying to discover what made serum extracted from white rats that were immune to tetanus neutralize anthrax toxins. Their work finally led to the publication of a paper in late 1890 in which they suggested that antitoxins formed in the blood against particular diseases and that these antitoxins could be transferred to other organisms to fight the same disease. This led to some controversy with other scientists who proposed different mechanisms and explanations for the way bacteria cause disease.

The basic argument centered on the question of whether all disease-producing bacteria produce the same harmful substance, which is more or less virulent depending on the quantity present, or whether each type of bacteria produces a unique toxin. Paul Ehrlich, who was a colleague of Behring at the Institute of Hygiene, showed in 1891 that Behring and Kitasato were correct by proving that organisms could form antitoxins to vegetable poisons in addition to bacteria. The vegetable poisons could not have the protein produced by bacteria that Behring’s opponents believed caused disease.

Behring seems to have had a rather irritating personality. He was constantly involved in controversy about his theories and attacked others who claimed to have made some of his discoveries before he did. Many of his addresses and papers contained harsh words for his opponents. One of the pamphlets he published was titled “Streitschrift und Verteidigungsschrift gegenuber meinen medizinischen Gegnem” (attack and defense in response to my medical opponents). He made few friends and did not warm up to people very readily. His reputation for arrogance and coldness is illustrated by an encounter with a young assistant on his staff who saw him in a café and approached to ask if he could sit at his table. Behring’s response was a harsh “No!” The assistant recalled the incident with bitterness for the rest of his life.

When some of Behring’s claims appeared to be exaggerated, his lack of personal charm probably increased the number of his critics. By 1894, he was not getting along very well with his employer, Koch, and he accepted a position on the faculty of the University of Halle. He was not well received there and obtained a professorship at the Marburg University with the help of a friend in the Prussian Ministry of Education, despite the objections of the faculty at Marburg.

Behring is best known for his work on diphtheria. He was a significant, if not the most important, developer of the serum used to treat the disease and later produced the vaccine to prevent it. Popular accounts suggested that he first used the serum on Christmas Eve of 1891 in the surgical clinic of Berlin University, but there is some doubt that he had enough serum to use that early. He collected serum from guinea pigs and, later, from sheep, which he then used to treat the disease in other animals. His friends Andre Martin and Émile Roux successfully immunized horses against diphtheria in 1894, and Behring extended their work to humans. Many others were involved in the development of the serum. Albrecht Kossel reported that serum therapy had reduced the mortality rate in diphtheria cases from 52 to 25 percent. In both England and the United States, further experiments were under way when Behring published two books on infectious disease; his work brought him international attention.

Behring had less success with his attempt to apply the methods used to develop a diphtheria serum to finding a serum that would be effective against tuberculosis. From 1899 to 1900, he devoted much of his time to the effort. Although he was unsuccessful, his work had important results when he showed that milk was a major vehicle for the transmission of the disease to infants. He suggested several ways to kill the tuberculosis bacillus in milk, but none proved practical. A major obstacle in his work on tuberculosis was his mistaken belief that the same bacillus produced the disease in both humans and cattle. This led him down so many dead-end lines of investigation that finally, in 1900, he announced he was giving up on the project.

Behring ultimately achieved success and lasting fame with a diphtheria preventative vaccination in 1913. His view of “serum therapy” was that low levels of a toxin could lead to the production of antitoxins in an organism, and this led him to the diphtheria vaccination. During World War I, he applied the theory to tetanus and developed a successful tetanus vaccine. Even before these accomplishments, he had received a number of honors and awards for his work. This vaccine was almost as important in saving the lives of German soldiers during World War I as the diphtheria vaccine had been in saving the lives of children.

All of his work brought him a considerable amount of recognition. The French awarded him the Legion of Honor in 1895 as well as 100,000 francs, which he shared with Roux. In 1901 he received the first Nobel Prize in Physiology or Medicine. Within his own country, he was made a German hereditary noble. He used his wealth and position to lead a comfortable life. In 1896 he married Else Spinola, the daughter of a physician. They had six sons, and their house in Marburg became a center for local society. Behring enjoyed visiting his other house on the island of Capri, but he suffered from bouts of depression that required him to be institutionalized in Switzerland from time to time. A broken thigh led to complications that weakened him, and he died of pneumonia in Marburg in March, 1917.

Significance

Together with Louis Pasteur, Robert Koch, and Paul Ehrlich, Emil Behring was one of the most important people in the story of human success against infectious disease during the late nineteenth and twentieth centuries. Even more important than their development of treatments for use against individual diseases were their discoveries about the mechanism of bacterial disease. Often working against the conventional wisdom of the day, they established ways of thinking about and dealing with microorganisms that continue to form the basis of the understanding of disease and its causes.

In addition to his fundamental theoretical and laboratory scientific work, Behring saved millions of lives and showed the way to save millions more with his vaccines and serum therapy. His difficult and contentious personality notwithstanding, his contributions to humanity and medical science are indisputable. The knowledge of the way antitoxins work and are formed is one of the most valuable discoveries in all of medical science, and Behring played an important role in that discovery. Toward the end of his life, he was described as “The Children’s Savior.” If he had accomplished nothing else, his development of the diphtheria vaccine was enough to assure him of a place among the most honored of medical researchers.

Bibliography

Behring, Emil. Gesammelte Abhandlungen zur ätiologischen Therapie von ansteckenden Krankenheiten. Leipzig, Germany: Thieme, 1893. This book contains most of Behring’s scientific papers to 1893. In German.

Behring, Emil. Gesammelte Abhandlungen. Neue Folge. Bonn, Germany: A. Marcus & E. Webers, 1915. This volume contains the scientific papers that Behring wrote between 1893 and 1915. In German.

De Kruif, Paul. Microbe Hunters. New York: Harcourt, Brace & World, 1953. In a very enthusiastic and easy-to-read manner, De Kruif describes the scientific adventures of twelve men who played significant roles in the war on disease. One chapter deals specifically with diphtheria (Roux and Behring), and others give important supporting information.

Lagerkvist, Ulf. Pioneers of Microbiology and the Nobel Prize. River Edge, N.J.: World Scientific, 2003. Behring is one of the scientists prominently featured in this book about Nobel Prize-winning microbiologists. The book contains a section about Behring’s life and his scientific discoveries. One of the few books about Behring written in English.

Satter, Heinrich. Emil von Behring. Bad Godesberg, Germany: Inter Nationes, 1967. Written fifty years after Behring’s death, this short (fifty-page), very readable biography provides a wealth of detail about his life and work. The author clearly had access to a considerable amount of original material. In German.

Unger, Hellmuth. Emil von Behring: Sein Lebenswerk als unvergangliches Erbe. Hamburg: Hoffman und Campe, 1948. This is an interesting biographical novel. In German.

Waller, John. The Discovery of the Germ: Twenty Years That Transformed the Way We Think About Disease. New York: Columbia University Press, 2002. Waller examines the breakthroughs in microbiology that occurred between 1879 and 1900, including the discoveries of Koch and Pasteur. Places Behring in a larger medical and historical context.

Zeiss, Heinz, and Richard Bieling. Behring: Gestalt und Werk. Berlin: B. Schultz, 1940. Other accounts of Behring depend on this standard biography, although the style is a bit dated and flowery. In German.