Pneumococcal Pneumonia: History of medicine

Once upon a time, pneumococcal pneumonia was a killer, mainly of the old but also the young.

And in the 1930's, the big breakthrough was anti serum.

Then came sulfa, and later penicillin.

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In 1892, William Osler famously wrote of pneumonia, “It is a self-limited disease, and has its course uninfluenced in any way by medicine.”3 One year earlier, however, the first attempt to treat pneumococcal pneumonia with rabbit serum (generated through inoculating rabbits with pneumococci) had taken place in Germany.4

By 1913, after 2 decades of mixed results, serotherapy directed against the pneumococcus would be redefined through the efforts of Rufus Cole and his colleagues at the newly constructed Hospital of the Rockefeller Institute. Reclassifying pneumococci into 4 serological “types,”5 they argued that serologically specific pneumococci apparently called for type-specific therapy; focusing on the treatment of the lethal and prevalent type I pneumococcus with type-specific horse serum, Cole and his colleagues could report a reduction in mortality from more than 25% to 7.5%.6

By the late 1920s, type I–specific antipneumococcal serotherapy had been proved efficacious in the large hospitals of the northeast—especially if given early in the disease’s course—through one of the first collaborative controlled clinical trials performed in this country (in part funded by the Metropolitan Life Insurance Company, which had lost more than $24 million in excess death benefits in the wake of the 1918–1919 influenza epidemic and had become one of the leading contributors to the campaign against respiratory disease in the first half of the 20th century).7

Nevertheless, at the very least, the treatment was labor intensive, expensive, and seemingly hospital dependent (to say nothing of the potential for serum reactions).

an interesting item now only remembered if one watches old time movies, but maybe with the advent of antibiotic disease, it will have a come back...