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Infectious diseases and chemotherapyIn the 20th century, ongoing research concentrated on the nature of infectious diseases and their means of transmission. Increasing numbers of pathogenic organisms were discovered and classified. Some, such as the rickettsias, which cause diseases like typhus, are smaller than bacteria; some are larger, such as the protozoans that engender malaria and other tropical diseases. The smallest to be identified were the viruses, producers of many diseases, among them mumps, measles, German measles, and polio. In 1910 Peyton Rous showed that a virus could also cause a malignant tumour, a sarcoma in chickens.There was still little to be done for the victims of most infectious organisms beyond drainage, poultices, and ointments, in the case of local infections, and rest and nourishment for severe diseases. The search for treatments was aimed at both vaccines and chemical remedies.

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Ehrlich and arsphenamineGermany was well to the forefront in medical progress. The scientific approach to medicine had been developed there long before it spread to other countries, and postgraduates flocked to German medical schools from all over the world. The opening decade of the 20th century has been well described as the golden age of German medicine. Outstanding among its leaders was Paul Ehrlich.While still a student, Ehrlich carried out work on lead poisoning from which he evolved the theory that was to guide much of his subsequent work—that certain tissues have a selective affinity for certain chemicals. He experimented with the effects of various chemical substances on disease organisms. In 1910, with his colleague Sahachiro Hata, he conducted tests on arsphenamine, once sold under the commercial name Salvarsan. Their success inaugurated the chemotherapeutic era, which was to revolutionize the treatment and control of infectious diseases. Salvarsan, a synthetic preparation containing arsenic, is lethal to the microorganism responsible for syphilis. Until the introduction of the antibiotic penicillin, Salvarsan or one of its modifications remained the standard treatment of syphilis and went far toward bringing this social and medical scourge under control.