Technology & Medicine › Atomic & space age › Penicillin and antibiotics
Streptomycin and the cure for TB
1943 (Schatz, Waksman; credit disputed)· Invention or discovery· Germs, drugs & genetics
DebatedHistorians or scientists disagree about what happened, when, or why.
Streptomycin, found in a soil microbe in 1943, was the first antibiotic that worked against tuberculosis.
See it on the Technology & Medicine map →How it works
Penicillin did nothing against TB. At Rutgers University in New Jersey, graduate student Albert Schatz, working in Selman Waksman's lab, isolated streptomycin from soil bacteria (Streptomyces griseus) in 1943. Mayo Clinic doctors showed it cured TB in patients, and Britain's Medical Research Council tested it in a trial published in 1948, usually called the first modern randomized controlled trial. TB germs soon resisted it when used alone, so from the 1950s doctors combined it with other drugs.
Why it mattered
TB, a leading killer in many countries, became curable, and the streptomycin trial set the standard way to test new drugs.
How we know
The 1944 paper by Schatz, Bugie and Waksman, Mayo Clinic case reports, and the 1948 trial report in the British Medical Journal. Waksman alone won the 1952 Nobel Prize.
Still unknown or debated
Schatz sued Waksman in 1950; a settlement gave him co-discoverer status and a share of royalties, but the Nobel ignored him. How to split the credit is still argued.
Connections (4)
▸Robert Koch identified the TB germ targeted by Streptomycin and the cure for TBWell documented
The connection
In 1882 Koch identified Mycobacterium tuberculosis as the cause of TB, then the deadliest disease in Europe. Knowing the exact germ meant drugs could be tested against it in the lab. Waksman's team checked soil microbes against the TB bacterium, and streptomycin was the first they found that stopped it and was safe enough to treat patients.
When and how
Berlin, March 24, 1882 (Koch's announcement, now marked as World TB Day); Rutgers University and the Mayo Clinic, 1943–45.
How we know
Koch's 1882 paper and the 1944 streptomycin papers, which report lab tests against the TB germ Koch had described.
Debates and open questions
Koch's own TB 'cure', tuberculin (1890), failed badly. Why the TB germ resists drugs so well, partly thanks to its waxy cell wall, still shapes research.
▸Penicillin and antibiotics was followed by Streptomycin and the cure for TBWell documented
The connection
René Dubos's gramicidin (1939) and penicillin's revival at Oxford (1940–41) showed that microbes make powerful germ-killers. Waksman, Dubos's former teacher, systematically screened thousands of soil microbes, with backing from the drug company Merck, and in 1943 his lab found streptomycin, which killed TB and other bacteria that penicillin could not.
When and how
Oxford, 1940–41; Rutgers University, New Jersey, 1939–43, where Waksman's lab also found actinomycin (1940) before streptomycin.
How we know
Lab papers and patent records show the sequence; Waksman popularized the word 'antibiotic' in the early 1940s, as penicillin's results made the field urgent.
Debates and open questions
Waksman had studied soil microbes for decades; historians weigh how much Dubos's gramicidin, penicillin's success and Merck's money each drove his search.
▸Streptomycin and the cure for TB now cures the plague behind the Black Death (bubonic plague)Well documented
The connection
Plague is caused by the bacterium Yersinia pestis, and streptomycin, discovered in 1943 and first used against tuberculosis, also kills it. Since the late 1940s, prompt treatment with streptomycin or newer antibiotics has cut bubonic plague deaths from roughly half of cases to a small fraction.
When and how
Discovered by Albert Schatz in Selman Waksman's lab at Rutgers, New Jersey, in 1943; used against plague in India and elsewhere from the late 1940s.
How we know
Clinical studies from the 1940s onward and modern WHO and CDC data show its effectiveness; plague still occurs, notably in Madagascar and the Democratic Republic of the Congo.
Debates and open questions
Antibiotic-resistant plague strains have been found in Madagascar; how widely resistance could spread is a public health concern.
▸James Lind's scurvy trial anticipated the randomised trial of Streptomycin and the cure for TBWell documented
The connection
Lind compared matched patients given different treatments. Two centuries later, Britain's Medical Research Council tested streptomycin against tuberculosis by assigning 107 patients to the drug or bed rest using random numbers, adding chance to Lind's comparison. Published in 1948, it is widely considered the first modern randomized controlled trial.
When and how
HMS Salisbury, 1747; the streptomycin trial ran in British hospitals from 1947, designed by statistician Austin Bradford Hill and published in the British Medical Journal in 1948.
How we know
Both trials are documented in their published reports; histories of clinical trials consistently trace this line from Lind to Bradford Hill.
Debates and open questions
Whether the 1948 trial was truly first is debated: a 1931 American tuberculosis study assigned its two groups by coin toss.