Ehrlich, Paul (1854-1915)
German physician
Paul Ehrlich's pioneering experiments with cells and body tissue revealed the fundamental principles of the immune system and established the legitimacy of chemotherapy—the use of chemical drugs to treat disease. His discovery of a drug that cured syphilis saved many lives and demonstrated the potential of systematic drug research. Ehrlich's studies of dye reactions in blood cells helped establish hematology, the scientific field concerned with blood and blood-forming organs, as a recognized discipline. Many of the new terms he coined as a way to describe his innovative research, including "chemotherapy," are still in use. From 1877 to 1914, Ehrlich published 232 papers and books, won numerous awards, and received five honorary degrees. In 1908, Ehrlich received the Nobel Prize in medicine or physiology.
Ehrlich was born on March 14, 1854, in Strehlen, Silesia, once a part of Germany, but now a part of Poland known as Strzelin. He was the fourth child after three sisters in a Jewish family. His father, Ismar Ehrlich, and mother, Rosa Weigert, were both innkeepers. As a boy, Ehrlich was influenced by several relatives who studied science. His paternal grandfather, Heimann Ehrlich, made a living as a liquor merchant but kept a private laboratory and gave lectures on science to the citizens of Strehlen. Karl Weigert, cousin of Ehrlich's mother, became a well-known pathologist. Ehrlich, who was close friends with Weigert, often joined his cousin in his lab, where he learned how to stain cells with dye in order to see them better under the microscope. Ehrlich's research into the dye reactions of cells continued during his time as a university student. He studied science and medicine at the universities of Breslau, Strasbourg, Freiburg, and Leipzig. Although Ehrlich conducted most of his course work at Breslau, he submitted his final dissertation to the University of Leipzig, which awarded him a medical degree in 1878.
Ehrlich's 1878 doctoral thesis, "Contributions to the Theory and Practice of Histological Staining," suggests that even at this early stage in his career he recognized the depth of possibility and discovery in his chosen research field. In his experiments with many dyes, Ehrlich had learned how to manipulate chemicals in order to obtain specific effects: Methylene blue dye, for example, stained nerve cells without discoloring the tissue around them. These experiments with dye reactions formed the backbone of Ehrlich's career and led to two important contributions to science. First, improvements in staining permitted scientists to examine cells, healthy or unhealthy, and microorganisms, including those that caused disease. Ehrlich's work ushered in a new era of medical diagnosis and histology (the study of cells), which alone would have guaranteed Ehrlich a place in scientific history. Secondly, and more significantly from a scientific standpoint, Ehrlich's early experiments revealed that certain cells have an affinity to certain dyes. To Ehrlich, it was clear that chemical and physical reactions were taking place in the stained tissue. He theorized that chemical reactions governed all biological life processes. If this were true, Ehrlich reasoned, then chemicals could perhaps be used to heal diseased cells and to attack harmful microorganisms. Ehrlich began studying the chemical structure of the dyes he used and postulated theories for what chemical reactions might be taking place in the body in the presence of dyes and other chemical agents. These efforts would eventually lead Ehrlich to study the immune system.
Upon Ehrlich's graduation, medical clinic director Friedrich von Frerichs immediately offered the young scientist a position as head physician at the Charite Hospital in Berlin. Von Frerichs recognized that Ehrlich, with his penchant for strong cigars and mineral water, was a unique talent, one that should be excused from clinical work and be allowed to pursue his research uninterrupted. The late nineteenth century was a time when infectious diseases like cholera and typhoid fever were incurable and fatal. Syphilis, a sexually transmitted disease caused by a then unidentified microorganism, was an epidemic, as was tuberculosis, another disease whose cause had yet to be named. To treat human disease, medical scientists knew they needed a better understanding of harmful microorganisms.
At the Charite Hospital, Ehrlich studied blood cells under the microscope. Although blood cells can be found in a perplexing multiplicity of forms, Ehrlich was with his dyes able to begin identifying them. His systematic cataloging of the cells laid the groundwork for what would become the field of hematology. Ehrlich also furthered his understanding of chemistry by meeting with professionals from the chemical industry. These contacts gave him information about the structure and preparation of new chemicals and kept him supplied with new dyes and chemicals.
Ehrlich's slow and steady work with stains resulted in a sudden and spectacular achievement. On March 24, 1882, Ehrlich had heard Robert Koch announce to the Berlin Physiological Society that he had identified the bacillus causing tuberculosis under the microscope. Koch's method of staining the bacillus for study, however, was less than ideal. Ehrlich immediately began experimenting and was soon able to show Koch an improved method of staining the tubercle bacillus. The technique has since remained in use.
On April 14, 1883, Ehrlich married 19-year-old Hedwig Pinkus in the Neustadt Synagogue. Ehrlich had met Pinkus, the daughter of an affluent textile manufacturer of Neustadt, while visiting relatives in Berlin. The marriage brought two daughters. In March, 1885, von Frerichs committed suicide and Ehrlich suddenly found himself without a mentor. Von Frerichs's successor as director of Charite Hospital, Karl Gerhardt, was far less impressed with Ehrlich and forced him to focus on clinical work rather than research. Though complying, Ehrlich was highly dissatisfied with the change. Two years later, Ehrlich resigned from the Charite Hospital, ostensibly because he wished to relocate to a dry climate to cure himself of tuberculosis. The mild case of the disease, which Ehrlich had diagnosed using his staining techniques, was almost certainly contracted from cultures in his lab. In September of 1888, Ehrlich and his wife embarked on an extended journey to southern Europe and Egypt and returned to Berlin in the spring of 1889 with Ehrlich's health improved.
In Berlin, Ehrlich set up a small private laboratory with financial help from his father-in-law, and in 1890, he was honored with an appointment as Extraordinary Professor at the University of Berlin. In 1891, Ehrlich accepted Robert Koch's invitation to join him at the Institute for Infectious Diseases, newly created for Koch by the Prussian government. At the institute, Koch began his immunological research by demonstrating that mice fed or injected with the toxins ricin and abrin developed antitoxins. He also proved that antibodies were passed from mother to offspring through breast milk. Ehrlich joined forces with Koch and Emil Adolf von Behring to find a cure for diphtheria, a deadly childhood disease. Although von Behring had identified the antibodies to diphtheria, he still faced great difficulties transforming the discovery into a potent yet safe cure for humans. Using blood drawn from horses and goats infected with the disease, the scientists worked together to concentrate and purify an effective antitoxin. Ehrlich's particular contribution to the cure was his method of measuring an effective dose.
The commercialization of a diphtheria antitoxin began in 1892 and was manufactured by Höchst Chemical Works. Royalties from the drug profits promised to make Ehrlich and von Behring wealthy men. But Ehrlich, possibly at von Behring's urging, accepted a government position in 1885 to monitor the production of the diphtheria serum. Conflict-of-interest clauses obligated Ehrlich to withdraw from his profit-sharing agreement. Forced to stand by as the diphtheria antitoxin made von Behring a wealthy man, he and von Behring quarreled and eventually parted. Although it is unclear whether bitterness over the royalty agreement sparked the quarrel, it certainly couldn't have helped a relationship that was often tumultuous. Although the two scientists continued to exchange news in letters, both scientific and personal, the two scientists never met again.
In June of 1896, the Prussian government invited Ehrlich to direct its newly created Royal Institute for Serum Research and Testing in Steglitz, a suburb of Berlin. For the first time, Ehrlich had his own institute. In 1896, Ehrlich was invited by Franz Adickes, the mayor of Frankfurt, and by Friedrich Althoff, the Prussian Minister of Educational and Medical Affairs, to move his research to Frankfurt. Ehrlich accepted and the Royal Institute for Experimental Therapy opened on November 8, 1899. Ehrlich was to remain as its director until his death sixteen years later. The years in Frankfurt would prove to be among Ehrlich's most productive.
In his speech at the opening of the Institute for Experimental Therapy, Ehrlich seized the opportunity to describe in detail his "side-chain theory" of how antibodies worked. "Side-chain" is the name given to the appendages on benzene molecules that allow it to react with other chemicals. Ehrlich believed all molecules had similar side-chains that allowed them to link with molecules, nutrients, infectious toxins and other substances. Although Ehrlich's theory is false, his efforts to prove it led to a host of new discoveries and guided much of his future research.
The move to Frankfurt marked the dawn of chemotherapy as Ehrlich erected various chemical agents against a host of dangerous microorganisms. In 1903, scientists had discovered that the cause of sleeping sickness, a deadly disease prevalent in Africa, was a species of trypanosomes (parasitic protozoans). With help from Japanese scientist Kiyoshi Shiga, Ehrlich worked to find a dye that destroyed trypanosomes in infected mice. In 1904, he discovered such a dye, which was dubbed "trypan red."
Success with trypan red spurred Ehrlich to begin testing other chemicals against disease. To conduct his methodical and painstaking experiments with an enormous range of chemicals, Ehrlich relied heavily on his assistants. To direct their work, he made up a series of instructions on colored cards in the evening and handed them out each morning. Although such a management strategy did not endear him to his lab associates, and did not allow them opportunity for their own research, Ehrlich's approach was often successful. In one famous instance, Ehrlich ordered his staff to disregard the accepted notion of the chemical structure of atoxyl and to instead proceed in their work based on his specifications of the chemical. Two of the three medical scientists working with Ehrlich were appalled at his scientific heresy and ended their employment at the laboratory. Ehrlich's hypothesis concerning atoxyl turned out to have been correct and would eventually lead to the discovery of a chemical cure for syphilis.
In September of 1906, Ehrlich's laboratory became a division of the new Georg Speyer Haus for Chemotherapeutical Research. The research institute, endowed by the wealthy widow of Georg Speyer for the exclusive purpose of continuing Ehrlich's work in chemotherapy, was built next to Ehrlich's existing laboratory. In a speech at the opening of the new institute, Ehrlich used the phrase "magic bullets" to illustrate his hope of finding chemical compounds that would enter the body, attack only the offending microorganisms or malignant cells, and leave healthy tissue untouched. In 1908, Ehrlich's work on immunity, particularly his contribution to the diphtheria antitoxin, was honored with the Nobel Prize in medicine or physiology. He shared the prize with Russian bacteriologist Élie Metchnikoff.
By the time Ehrlich's lab formally joined the Speyer Haus, he had already tested over 300 chemical compounds against trypanosomes and the syphilis spirochete (distinguished as slender and spirally undulating bacteria). With each test given a laboratory number, Ehrlich was testing compounds numbering in the nine hundreds before realizing that "compound 606" was a highly potent drug effective against relapsing fever and syphilis. Due to an assistant's error, the potential of compound 606 had been overlooked for nearly two years until Ehrlich's associate, Sahashiro Hata, experimented with it again. On June 10, 1909, Ehrlich and Hata filed a patent for 606 for its use against relapsing fever.
The first favorable results of 606 against syphilis were announced at the Congress for Internal Medicine held at Wiesbaden in April 1910. Although Ehrlich emphasized he was reporting only preliminary results, news of a cure for the devastating and widespread disease swept through the European and American medical communities and Ehrlich was besieged with requests for the drug. Physicians and victims of the disease clamored at his doors. Ehrlich, painfully aware that mishandled dosages could blind or even kill patients, begged physicians to wait until he could test 606 on ten or twenty thousand more patients. There was no halting the demand, however, and the Georg Speyer Haus ultimately manufactured and distributed 65,000 units of 606 to physicians all over the globe free of charge. Eventually, the large-scale production of 606, under the commercial name "Salvarsan," was taken over by Höchst Chemical Works. The next four years, although largely triumphant, were also filled with reports of patients' deaths and maiming at the hands of doctors who failed to administer Salvarsan properly.
In 1913, in an address to the International Medical Congress in London, Ehrlich cited trypan red and Salvarsan as examples of the power of chemotherapy and described his vision of chemotherapy's future. The City of Frankfurt honored Ehrlich by renaming the street in front of the Georg Speyer Haus "Paul Ehrlichstrasse." Yet in 1914, Ehrlich was forced to defend himself against claims made by a Frankfurt newspaper, Die Wahrheit (The Truth), that Ehrlich was testing Salvarsan on prostitutes against their will, that the drug was a fraud, and that Ehrlich's motivation for promoting it was personal monetary gain. In June 1914, Frankfurt city authorities took action against the newspaper and Ehrlich testified in court as an expert witness. Ehrlich's name was finally cleared and the newspaper's publisher sentenced to a year in jail, but the trial left Ehrlich deeply depressed. In December, 1914, he suffered a mild stroke.
Ehrlich's health failed to improve and the start of World War I had further discouraged him. Afflicted with arteriosclerosis, his health deteriorated rapidly. He died in Bad Homburg, Prussia (now Germany), on August 20, 1915, after a second stroke. Ehrlich was buried in Frankfurt. Following the German Nazi era, during which time Ehrlich's widow and daughters were persecuted as Jews before fleeing the country and the sign marking Paul Ehrlichstrasse was torn down, Frankfurt once again honored its famous resident. The Institute for Experimental Therapy changed its name to the Paul Ehrlich Institute and began offering the biennial Paul Ehrlich Prize in one of Ehrlich's fields of research as a memorial to its founder.