Today's Magic Bullet

Part of a Salvarsan kit, c.1910s. On loan courtesy the Dittrick Medical History Center.

102 years ago today, after more than 600 experiments, Paul Ehrlich finally developed a chemical compound to effectively treat the scourge of his day: syphilis. Syphilis infections during the nineteenth century were becoming more and more prominent in the U.S. and Europe, and treatments for the disease were often worse than the disease itself (particularly those involving mercury).

Syphilis is a bacterial infection primarily spread through sexual contact. A small chancre is usually the first sign of infection, followed by a pustular rash that can spread all over the body. In its late stage, syphilis can attack the central nervous system; the worst cases result in paralytic dementia, seizure disorder, and loss of motor function (suspected syphilitics throughout history include Henry VIII, Vincent van Gogh, and Adolf Hitler).

Ehrlich’s compound, a derivative of arsenic called Salvarsan, was also the first successful chemotherapeutic agent. While today “chemotherapy” almost exclusively refers to treatments for cancer, the term’s historical meaning was broader: chemotherapy was any chemical treatment for a disease or ailment, particularly those caused by micro-organisms. Because Salvarsan attacked only the bacteria that caused syphilis and not its human host, Ehrlich referred to his drug as a “magic bullet,” and it soon became the treatment of choice for syphilis. But the compound was not without problems: Salvarsan was highly unstable in air, making its production and administration a difficult business. When antibiotics became widely available beginning in the 1940s, the drug was quickly abandoned.

With better treatment and large public health campaigns, syphilis infections declined in the U.S. throughout the twentieth century, and the life-threatening tertiary stage of syphilis became almost unheard of. But since the early 2000s syphilis rates have been increasing, particularly among men, and the disease is now the third most common sexually transmitted infection in the U.S. Some researchers suspect that improvements in medical treatment have created a false sense of security in the population: “magic bullets,” it seems, can still do harm, especially when they gloss over the need for prevention. But Ehrlich’s discovery remains a milestone in the history of targeted drug therapies.

Gigi Naglak is Outreach Coordinator for CHF’s Eddleman Institute.

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