Thomas G. Benedek’s article discusses the history of gold therapy as a way to treat patients with pulmonary tuberculosis- that is, how it was introduced, the various clinical studies, and why it was eventually abandoned as a treatment. Benedek’s thesis he attempts to support is that the history of gold therapy illustrates chronic problems found in both historical and medical research. He examines the ways gold therapy was popularized despite the known risks and unsuccessful experiments.
This study takes place between 1912 and 1943 and is mainly set in Europe. Benedek writes this historical study on how gold therapy, despite negative experimental findings, became popularized as a treatment. The author leads one to believe it is the result of desperation for a cure for this highly prevalent and lethal disease. At the time of its introduction in the nineteenth century, tuberculosis lacked a medically proven treatment and was killing many people. The introduction of gold compounds as treatments for tuberculosis can be attributed to Robert Koch. In 1890 respectively, Koch had found that gold cyanide was effective in fighting against M. tuberculosis, the bacteria causing tuberculosis, in laboratory cultures. However, when experimentally infecting animals with the disease and treating them with the gold cyanide, the results were not successful. By the mid-1920s, the treatment of pulmonary tuberculosis with gold compounds became popularized by Danish physicians, who based their treatments on the work of Paul Ehrlich and his theories of anti-microbial drug effects, all while disregarding the negative experimental results by Koch. The risk of lethal toxicity from the gold compounds was eventually enough to outweigh the potential therapeutic benefits, and gold therapy was abandoned.
There are a few main points Benedek hopes to impart on the reader. One is that this study on gold therapy demonstrates that even though clinical trials influence the interpretation of experimental evidence negatively, research is still ongoing and there will always be hope for answers. Second, the article describes an example of the struggle and interpretation of experimental results and actual clinical experience and how that can lead to potential failures in treating patients. Lastly, Benedek shows a piece in the puzzle of how experimental design was being developed to analysis and find a treatment for a chronic ailment (Benedek 2004). All of these point show how the history of gold therapy influenced and progressed medical research.
The author of this article, Thomas G. Benedek, earned a medical degree and specialized in rheumatology. Today, Benedek is a retired rheumatologist and holds a professorship in the Department of Medicine at the University of Pittsburgh School of Medicine, while also retaining a position as an adjunct professor of history at the University of Pittsburgh. Benedek also held the position as a past president of the American Association for the History of Medicine. As a doctor and professor of history, Benedek has a good deal of authority in writing this paper from both a medical perspective and a historical one. Many of his sources are from scientific and medical journals, from recent times and several dating back to the nineteenth century. He included a lot of primary sources such as experimental studies and lectures, most of which are from the nineteenth and twentieth centuries. Benedek also used sources from different countries that were written in a foreign language. The range in sources used for this article aided Benedek’s telling of the history of gold therapy, as well as its influence on the history of medicine in general.
Thomas G. Benedek. “The History of Gold Therapy for Tuberculosis.” Journal of the History of Medicine and Allied Sciences 59, no. 1 (2004): 50-89.
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