SYMHC Classics: Max von Pettenkofer

Summary

Stuff You Missed in History Class: Max von Pettenkofer

Hosts: Holly Frey & Tracy V. Wilson
Episode Date: September 13, 2025 (original air: March 23, 2020)
Podcast: iHeartPodcasts
Theme: The life, scientific contributions, controversies, and legacy of Max von Pettenkofer—an influential, if ultimately mistaken, 19th-century German hygienist and public health reformer.

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Episode Overview

In this episode, Holly and Tracy examine the complex and colorful life of Max von Pettenkofer. While his theories about the spread of disease, particularly cholera, were ultimately incorrect, his work significantly impacted the development of public health and hygiene. The hosts explore his journey from poverty to scientific prominence, how his ideas both clashed with and helped advance contemporary science, and his enduring legacy, highlighting both the progress and missteps in the history of epidemiology.

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Key Discussion Points & Insights

1. Early Life and Education

• Background: Born December 3, 1818, in Lichtenheim, Bavaria, in a poor Catholic family; one of eight children. Slept in a hallway due to cramped living conditions.

  • "[He] bedded down each night in the hallway... those early years of Max's life... were not particularly happy." (Holly, 06:07)

• Chance for Change: At age nine, sent to Munich to live with his well-off apothecary uncle, Dr. Franz Ex Pettenkofer.

  • "Whole new future of possibilities opened up for him." (Tracy, 06:46)

• Education Path:

  • Excelled in school, considered literary scholarship, wrote poetry.
  • Pursued university studies in pharmacy/chemistry to inherit the apothecary but hated the courses. Dabbled in law and theology, but “those eventually turned out not to hold his interest either.” (Tracy, 07:32)
  • Brief, unsuccessful stint as an actor—led to a rift with his uncle. Married his cousin Helene, which helped reconcile the family.

2. Scientific Career & Contributions

From Chemistry to Hygiene

• Initial Work:

  • Published on chemistry, including detection of arsenic (1842).
  • Medical thesis on South American plants; received doctorate in medicine, surgery, and obstetrics (1843).

• Lab Research:

  • Research on urine components; developed a test for bile salt still in use today.
    • “He showed that hippuric acid and sulfocyanic acid were present in urine... later chemists would identify that as creatine and creatinine.” (Holly, 10:24)

• Industrial Chemistry:

  • Co-developed copper amalgam for dental fillings; collaborated on creating meat extract for soup bases, which led to a commercial venture.

• Academic Appointments:

  • Became a professor of medical chemistry at the University of Munich (1847).
  • Taught courses on public health, sanitation, diet, hygiene, and chemistry.

Rise to Influence

• Inherited Court Apothecary Post: Enhanced influence and financial stability after uncle’s death in 1850.

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3. Cholera, Germ Theory, and the Water Controversy

Pettenkofer’s Theories

• Focus on Cholera:

  • “Starting in the 1850s, cholera became the focus of much of Pettenkofer’s work.” (Holly, 17:55)
  • Published “Investigations and Observations on the Method and Spread of Cholera” (1855).
  • Proposed that a microorganism needed specific local conditions (soil type, climate, personal susceptibility) to become dangerous. The equation: X (microorganism) + Y (local conditions) = Z (cholera outbreak).

• Opposition to Germ Theory:

  • Rejected the emerging view (advocated by Snow, Pasteur, Koch) that pathogens alone caused epidemics.
  • Asserted unsanitary environmental conditions enabled epidemics via “groundwater theory”—akin to a blend of miasma and emerging germ theory.
    • "He thought that general uncleanliness offered nutrients for that X microorganism to thrive... building on miasma theory, it would release infectious elements into the air. And this idea... came to be known as the groundwater theory." (Holly, 19:11)

The John Snow Divide

• Recognized John Snow’s waterborne transmission breakthrough ("no one in his right mind could dismiss that finding"), but dismissed the notion that diluted pathogens in water could cause disease.
• His stance contributed to prolonged debate between "contagionists" (germ theory supporters) and "anti-contagionists" (like Pettenkofer).

Impact & Legacy

• Fiercely defended his model for decades, even after Koch’s identification of Vibrio cholerae as the causative bacterium (1883).
• Despite being wrong about transmission, drove momentum for improved urban sanitation, clean water, and public hygiene.

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4. Broader Contributions to Public Health

• Foundational Work in Hygiene:

  • Developed the first breath analysis apparatus, laying groundwork for metabolic science.
  • Derived calorie requirements for different lifestyles.
  • Pioneered the “Pettenkofer number” for acceptable indoor CO₂ levels (0.1% or 1,000 ppm).
  • Championed clean air, water, soil, clothing, nutrition, and urban planning as keys to health.
    • "[His] teaching reflected his findings. He evangelized the importance of clean air, clean water, clean soil, a clean home, as well as good clothing and nutrition." (Tracy, 25:09)

• Institutional Reform:

  • Founded journals for hygiene research (“Zeitschrift für Biologie” in 1865, “Archive for Hygiene” in 1883).
  • Pressured the University of Munich to establish Germany’s first dedicated hygiene institute—a global prototype.

• Policy Impact:

  • Quantified how poor health impacted economic productivity, influencing modern public health economics.
    • “He calculated... if they developed a sewage system and they raised sanitation standards, the city could... save additional money every year.” (Holly, 24:26)

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5. Notable Anecdotes & Memorable Moments

Fieldwork, Stubbornness & The Ultimate Experiment

• Extensively visited epidemic sites to test his theories—e.g., Malta (limestone = porous = fits his model), Lyon (granite substrate = no cholera).
• Advocated for pure water, not out of fear for cholera, but simply for health:
  • “For good health, pure water is as necessary as pure air, good food, comfortable quarters, and so forth… I myself am an enthusiast in the matter of drinking water, but not from fear of cholera or typhoid fever, but simply from a pure love for the good.” (Holly, 33:49)

The Famous (and Gross) Bouillon Experiment

• At age 74, drank a glass of bouillon containing live Vibrio cholerae to prove that the bacterium alone wouldn’t cause cholera.
• He survived with only mild diarrhea, but others who attempted it became very ill.
  • “He was so convinced that a microorganism alone could not make you sick that he put his own life on the line to prove it… mixed it into bouillon and… drank it.” (Tracy, 35:29)
  • Pettenkofer’s own reflection:
    • “Even if I had deceived myself and the experiment endangered my life, I would have looked death quietly in the eye, for mine would have been no foolish or cowardly suicide. I would have died in the service of science, like a soldier on the field of honor.” (Holly, 36:07)

Later Years & Death

• Suffered personal losses—death of wife and three of five children; fell into depression, and died by suicide in 1901.
• Autopsy revealed chronic meningitis and cerebral calcification.

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6. Lasting Legacy & Epilogue

• Institutes & Publications:

  • Max von Pettenkofer Institute in Munich stands as a global leader in microbiology and epidemiology.
  • His periodical continues as the “International Journal of Hygiene and Environmental Health.”

• Modern Recognition:

  • While his disease theories were incorrect, his foresight in public health meaningfully improved urban living conditions and informed modern environmental health.
  • His emphasis on multifactorial causes is now reflected in nuanced epidemiological models.
    • “In modern epidemiology, there is a recognition that exposure and outcome can be influenced and modified by other factors.” (Tracy, 38:11)
  • His philosophy:
    • "Everyone who lives upon the earth deserves to be well, for a life without health is a misery, a martyrdom from which everyone longs for release, and when it may not be by other means, even by death." (Tracy, 38:44)

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Notable Quotes & Timestamps

• On Pettenkofer’s brilliance and his errors:

  • “...the most sophisticated and scientifically robust of those we might call wrong.” (Holly, citing Frank Snowden, 04:21)

• About dirty water and cholera theory:

  • “He felt as though it just could not possibly be a waterborne pathogen... anything that would have been in the water by the time it got to a human would have been far too diluted to actually be dangerous.” (Holly, 20:44)

• Justifying his controversial self-experiment:

  • “Even if I had deceived myself and the experiment endangered my life, I would have looked death quietly in the eye, for mine would have been no foolish or cowardly suicide. I would have died in the service of science, like a soldier on the field of honor.” (Holly, 36:07)

• On the importance of health:

  • “Everyone who lives upon the earth deserves to be well, for a life without health is a misery, a martyrdom from which everyone longs for release, and when it may not be by other means, even by death.” (Tracy, 38:44)

• Hosts' closing opinion:

  • “All of the other stuff he did was amazing... I had no idea about his work in metabolic science… if you are an athlete, you're depending on science that he developed to... maintain your optimal performance.” (Holly, 39:38)

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Important Segment Timestamps

• Max von Pettenkofer’s Unusual Path (Childhood–Early Career): 05:43–13:24
• Development of Hygiene and Medical Chemistry: 12:55–14:02
• Cholera Theories and the Great Debate: 17:55–24:26
• Impact on Public Health and Urban Planning: 24:26–25:43
• Famous Bouillon Experiment: 35:29–36:42
• Death and Posthumous Reputation: 37:00–38:44

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Tone and Language

The episode is conversational, lightly humorous, and compassionate—acknowledging Pettenkofer’s humanity, the quirks of scientific progress, and the “tragic charm” of historical wrongness. The hosts emphasize respect for Pettenkofer’s commitment, curiosity, and sincerity, even as his stubbornness and mistakes are examined.

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Conclusion

Max von Pettenkofer’s legacy is that of a flawed pioneer: he advanced hygiene and public health, shaping safer cities and the future of preventive medicine, while stubbornly clinging to ideas that posterity would disprove. The hosts underscore that scientific advancement is incremental and often nonlinear, and that even the “wrong” path can have transformative results for society.

Transcript

[Tracy V. Wilson]

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[Tracy V. Wilson]

Happy Saturday. After this week's name drop of Max von Petkofer, today's Saturday classic is our episode on him.

[Holly Fry]

This originally came out 3-23-2020. And you can tell that at that time, like a lot of people, based.

[Sponsor/Ad Voice]

On the information we were getting, we.

[Holly Fry]

Didn'T think the pandemic was going to last all that long. So that's a funny surprise.

[Tracy V. Wilson]

Yes, if you're thinking, oh, you sweet summer children. So is everyone. We don't need to be reminded of that, but enjoy this episode.

[Holly Fry]

Welcome to Stuff youf Missed in History.

[Sponsor/Ad Voice]

Class, a production of iHeartRadio.

[Holly Fry]

Hello and welcome to the podcast. I'm Holly Fry.

[Tracy V. Wilson]

And I'm Tracy V. Wilson.

[Holly Fry]

Hey, as we record this, we're in.

[Sponsor/Ad Voice]

The middle of a pandemic.

[Tracy V. Wilson]

We sure are. This is the first time that we have recorded the podcast with everyone involved in their houses.

[Holly Fry]

Yeah, we are entirely remote this go round. This is our first of those, as Tracy just said. So Tracy is usually at home, but today I am also at home. And Casey, our amazing super producer, also at home. So fingers crossed that our maiden voyage of doing it this way works out fine. We did a test, it worked out fine. But yeah, all of this that's going on, all of these changes to our day to day lives, however temporary they may be, and the virus that has caused all of this, got me to thinking about contagion and germ theory and the various points in history where people have been trying to figure out the science of disease. And as I kind of snorkeled around on the Internet looking for things related to that, it led me to Max von Pettenkofer. And one of the things that I found in my research for this was a lecture by Yale Professor Frank Snowden. It's part of their Open Yale courses. And he described Pettenkofer as, quote, the most sophisticated and scientifically robust of those we might call wrong. So Pettenkofer's ideas about specifically how cholera, but also other diseases spread were not exactly right. But even though he was kind of on the wrong track, his work still had some really beneficial impacts on the way that we live. And he also had a lot of twists and turns in his early life. And I'm hoping that those which are pretty entertaining, plus talking about these concepts in a way that's a little bit removed from what we are all currently living through, will offer a way to consider just how far we've come in figuring out epidemiology. We do need to offer a quick heads up. There is a brief mention of suicide in this episode.

[Tracy V. Wilson]

I'll add an additional heads up just because I was eating my breakfast when I got to this part of the outline toward the end of the episode, there's a little gross medical bit that, you know, it'll become clearer when we get closer to it.

[Holly Fry]

Yeah. No part of you will doubt. Was that it?

[Tracy V. Wilson]

So, Max von Pettenkofer was born at home on December 3, 1818, in Lichtenheim Bavari, near the Danube River. His father wasn't exactly a farmer. He worked the land, but really only to the point of subsistence. It was not a vocation, really, on his part.

[Sponsor/Ad Voice]

Yeah, they were very poor.

[Holly Fry]

His family was Catholic, and they were obviously of extremely modest means. Max was fifth in the birth order. He had a total of seven siblings. So that is a very busy and crowded house. It made for more people than could realistically fit in their living situation. Max, as a consequence, did not have a bedroom of his own. He actually bedded down each night in the hallway. There's kind of a landing at the top of the stairs that had a little crook to the side of it. And that is where he slept. Those early years of Max's life, unsurprisingly, were not particularly happy. The family's poverty took its toll, as the Pettenkofers just never had enough to make ends meet.

[Tracy V. Wilson]

When Max was nine, his fortunes changed, though. He was sent to Munich to live with an uncle, Dr. Franz ex Pettenkofer. Franz was a successful apothecary. He was in a way better financial position than Max's parents were. So that constant state of need was no longer part of Max's life. After he moved to Munich, there was just a whole new future of possibilities opened up for him. And this is a case where he definitely explored a lot of them.

[Holly Fry]

First off, he started a formal education, so he attended grammar school, and then he went on to high school. And he graduated in 1837. When he was 18, he graduated with honors. And he initially seemed to be leaning towards literary scholarship. He also wrote poetry, which was good enough to be published in a collection.

[Tracy V. Wilson]

He shifted his focus after he enrolled in college at the University of Munich. The idea on his uncle's part was that Max could study pharmacy and chemistry and then eventually take over the apothecary. And Max started his higher education with that as the plan. But there was also a problem, which was it turned out that he hated those courses. He also dabbled with the idea of law, maybe even theology. Those eventually turned out not to hold his interest either.

[Holly Fry]

Oh, if you've ever taken a class you hated, it's excruciating.

[Sponsor/Ad Voice]

So to have a bunch of them.

[Holly Fry]

I feel for him. So Naturally, with none of these other ideas about his future really being anything that was working for him, he decided.

[Sponsor/Ad Voice]

To become an actor.

[Holly Fry]

Perfectly normal path for a scientist. He remembered acting in school plays and loving it. So that seemed to him like a perfectly good option that he hadn't explored yet. As you may imagine, none of this went over particularly well with his uncle. Their relationship, as a consequence, did, on a serious note, become really, really tense. And eventually there was a physical altercation where Franz hit his nephew. And Max, at that point, disassociated himself from his uncle, which also meant that he was separating himself from his uncle's financial support.

[Tracy V. Wilson]

This whole theater thing actually seemed like it might play out for a little while. In 1840, he was appearing on stage as Max Tenkoff in various productions. He was handsome and smart, and his time studying literature in his younger years really served him well. But depending on which biographical account you read, it seems like his reviews might have been pretty mixed. And it became apparent that this was not going to be a way for Max to support himself.

[Holly Fry]

Yeah, some accounts say that he got pretty consistently. Not even panned. It wasn't even that. It was like people were like, eh, he's fine. Others say he did. He did quite well. So we don't really know, but clearly it was not a career that was going to work out. But he did make an important connection during this time as an actor. He met a young woman named Helene Pettenkofer. They have the same name because she was a cousin. And they fell in love. The two of them married, and it was actually this marriage that ended up reconnecting Max to his uncle. Franz and Helene helped encourage the two men to reconcile.

[Tracy V. Wilson]

In 1841, Max moved back to Munich with his new wife and with his uncle's support, started to study medicine. Just a year after that, he was publishing articles on chemistry, specifically on the detection and isolation of arsenic. In March of 1843, he was granted an apothecary degree. And then after completing his medical thesis on South American plants that were believed to have curative properties, he received the degree of Doctor of Medicine, Surgery and Obstetrics.

[Holly Fry]

Yeah, I'm not 100% clear on why this whole science thing worked for him this round, unless he was really just trying to step up and find a vocation in which he could support not only himself, but his new wife. He was very dedicated to Helene, but this time around it was like his curiosity kind of worked out and he got pretty into his medical career. Pettenkofer's medical education had Always focused primarily on chemistry. And his first position after completing his education was working in a lab in Wurzburg researching urine and isolating various substances in it. In this work, he showed that hippuric acid and sulfocyanic acid were present in urine. And he also noted a component that was high in nitrogen, although he didn't specifically identify it. Later chemists would identify that as creatine and creatinine. And he also developed a way to test urine for bile salt. And that test has actually continued to be used right up to the modern day.

[Tracy V. Wilson]

He then moved on to the University of Giessen in 1844 to continue his work as a chemist. But after working under mentor Justus van Liebig for a while there, it was apparent that he wasn't going to be offered a professorship, which is something he had hoped for. There just were not any open positions.

[Holly Fry]

Yeah, it wasn't an issue of him not doing good work, because though it did not lead to a full time job, his work with Liebig was quite fruitful. He developed a copper amalgam for dentists to use as a filling for teeth. He also developed a way, along with Liebig, to prepare meat extract as a soup base. That actually led to a company being started. And his interest and his skill in chemistry really suited industrial chemistry projects quite well.

[Tracy V. Wilson]

So he shifted away from medicine for a while. He was still using his chemistry knowledge on the job that he landed in, but it was very different from what he'd been doing before. He worked in a mint until 1847, and in his time there, it was his job to refine and improve the minting of coins so the most valuable metals used in their production could be stretched as far as possible.

[Holly Fry]

One of the other things that he worked on at this time in his life was developing a way to save paintings from mildew that formed as their varnish broke down. You know, I fell in love with him for this. He figured out a way to really carefully apply alcohol vapor to the surfaces of paintings and in doing so, reactivate the varnish so that it would kind of reseal the painting and protect its surface from mold and mildew.

[Tracy V. Wilson]

Pencofer had been made an associate in the Academy of Sciences in 1846. And in 1847 he was finally offered a professorship at the University of Munich. He taught medical chemistry there. This was a newly created position. He was paid a small yearly salary plus two measures of wheat and seven measures of rye. He had a research space at his disposal, and his lectures covered topics including public health, sanitation, diet, physical chemistry and hygiene.

[Holly Fry]

Yeah, his interest in all of those really, really continues throughout his life. And as we'll see, it becomes very important. Three years into this new position, Pettenkofer's responsibilities grew because his uncle Franz died in 1850, and as a consequence, Pettenkofer inherited Franz's position as court apothecary. So he was kind of advising the government on matters of chemistry. And this appointment included the residence that his uncle had lived in in which Max had lived in as a child. So he got a house out of the deal and he also got an additional salary for the apothecary position. So things are going quite well.

[Tracy V. Wilson]

We are about to get into the work that Pettenkofer did while trying to understand the spread of cholera. But first we will pause for a quick sponsor break.

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[Holly Fry]

That's washablesofas.com Listen to your elders, honey.

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[Holly Fry]

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[Holly Fry]

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[Holly Fry]

Starting in the 1850s, cholera became the focus of much of Pettencofer's work. In 1855, his fortunes continued to expand and his standing in the scientific community grew as well, and he was able to move his lab into the newly built Institute of Physiology, where he had more space to work. And this was also the year that he published a really important work, Investigations and Observations on the Method and Spread of Cholera. During this time, one of the important concepts that he wrote about was the idea of a healthy carrier. While he didn't agree with the contagion theories at the time, and we're gonna get into that in a moment, he did think that there could be people who showed no sign of illness whatsoever and yet helped spread certain elements of disease.

[Tracy V. Wilson]

Max von Pettenkofer started sharing his idea that cholera was linked to a microorganism, but he was also adamant that whatever that microorganism was wasn't enough to make someone sick by itself. He thought a series of conditions had to be met to cause an epidemic. There had to be the microorganism, specific local seasonal conditions, and individual susceptibility. He really didn't believe in the developing ideas that would eventually lead Louis Pasteur and Robert Koch to develop Germ theory.

[Holly Fry]

Yeah, germ theory had been kind of developing over time, but they really solidified it in the 1800s. Patton Cofer's idea was represented by the simple mathematical equation of X plus Y equals z. And in this model, the outcome Z was cholera. The variable X was the presence of a microorganism, which, again, on its own, he believed to be harmless. And the Y variable represented the local conditions that were contributing factors that would enable that microorganism to actually become infectious. He thought that general uncleanliness offered nutrients for that X microorganism to thrive, and that water and warm temperatures and porous soil were also important contributors. The microorganism needed to ferment, basically kind of the way a plant germinates. And then, building on miasma theory, it would release infectious elements into the air. And this idea of PET and Cofer's came to be known kind of colloquially as the groundwater theory. It's also sometimes called localization theory.

[Tracy V. Wilson]

This theory was in opposition to the work of British physician John Snow, who we have an episode on in the archive. Snow believed that whatever was causing cholera was something that was ingested and was not miasmatic. In 1849, Snow had written an essay entitled on the Mode and Communication of Cholera outlining this idea. And in 1854, it seemed like he had proven it when he identified a water pump in London's Broad street that seemed to be the source of multiple people's infections.

[Holly Fry]

That's the very short version of his story. Patton Cofer was pretty adamant that Snow was oversimplifying things. He acknowledged that John Snow had clearly identified some factor in this whole process in the water. And he actually wrote that no one in his right mind could dismiss that finding. But what exactly was it about the water that caused illness? He felt as though it just could not possibly be a waterborne pathogen. By the way, that word was not even in the vernacular at that time. It wasn't coined until later. But he thought that anything that would have been in the water by the time it got to a human would have been far too diluted to actually be dangerous.

[Tracy V. Wilson]

That big gap in understanding really drove Pettenkofer's work for the rest of his life. He wrote paper after paper over the next four decades, reiterating and refining his ideas. This stoked the fires of a long debate in the medical and scientific communities between the contagionists, who thought that Snow had identified the problem, and the anti contagionists who thought there were far more factors involved than simply passing some sort of germ from person to person.

[Holly Fry]

And though cholera was a concentration of his work, Pencover continued to develop theories and experiments in other fields. This is one of those things where you don't realize how much he worked on until you really dig in, because most of the biographies or the articles you find about him are just about his anticontaginism and cholera. But in 1861, he developed the first breath analysis apparatus. It was a chamber in which a subject's exhalation could be analyzed to determine how the body was consuming and using fats and carbohydrates, forming an important foundation of metabolic research. He was then able to use that data that he gathered to develop some of the earliest calculations of caloric needs that a person may require in various living conditions.

[Tracy V. Wilson]

In 1864, he became rector of the University of Munich. His influence and his work in hygiene led King Ludwig II of Bavaria to believe that hygiene research should be part of all of Bavaria's higher learning institutions. The King ensured that Bavaria's three universities all had chairs of hygiene. Pettenkofer filled that role at the University of Munich. Once these positions were established, hygiene became a required course in all their medical curriculums.

[Holly Fry]

And we're going to talk more about some of his work in hygiene as we go along. In 1865, Pettenkofer, frustrated at the lack of journals that were publishing studies of hygiene, just formed his own Sichriftver Biologie, which is Journal of Biology, was the result.

[Tracy V. Wilson]

In 1872, he was offered a very lucrative position. The University of Vienna was building a new hygiene institute. They asked him to run it. This was an enticing offer, but Pettenkofer really preferred to stay in Bavaria. So he used this offer to his advantage and told the University of Munich that Vienna really wanted him so that he would consider staying only if he had an institute of hygiene there in Munich. The university agreed to build him one, which took the next seven years. But it did get done, and Pettenkofer stayed, ran this hygienic institute at the University of Munich. Once it opened in 1879, the institute was highly influential. It served as a prototype for other education and research programs around the world. It was a direct inspiration for the Johns Hopkins School of Hygiene and Public Health in Baltimore that was founded in 1917.

[Holly Fry]

And one of the most important publications during this time, when he was really, really prolifically contributing to this idea of hygiene science, was a lecture titled the Value of Health to a City. And this work broke down in numbers. The cost of having a population that wasn't in good health. He noted the average number of sick days taken by a worker in Munich at the time, which was 20. And he calculated that those days cost the city 3.4 million gulden a year. And he then outlined how, if they developed a sewage system and they raised sanitation standards, the city could actually far exceed making up for those losses and actually save additional money every year.

[Tracy V. Wilson]

He studied how air quality impacted population health, how clothing impacted health, and the benefits of raising plants indoors. He examined how ventilation could contribute to or detract from overall health. The Pettenkofer number, which is a number that represents, quote, an absolute CO2 concentration of 0.1%, or 1,000 part parts per million, is still used today. His teaching reflected his findings. He evangelized the importance of clean air, clean water, clean soil, a clean home, as well as good clothing and nutrition.

[Holly Fry]

Thus, this idea of hygiene as a medical issue really became an interdisciplinary field. Pettenkofer really considered the role of environment in a person's health, and to him it was very clear that city planning should include this as a consideration. He was not obviously the first person to think about this. You can find texts going far, far back into ancient times, where there are some connections being made about living conditions and health. But his work to identify specific causal relationships between the way people live and their health beyond what could be considered common sense was pretty new. And he recognized that this was a field that would also have to be agile as civilization shifted over time. Writing quote, it is a peculiarity of hygiene to change its field of research and within certain limits, its field of study according to time and circumstances.

[Tracy V. Wilson]

Even as the Hygienic Institute was under construction, other job offers came in. When Pettenkofer was asked to become head of the German Empire health council in 1876, he turned it down, although he did serve in a smaller role as a consultant.

[Holly Fry]

We are about to head into the later years of Pettenkofer's life, including one very strange and risky experiment. But first we are going to pause for a word from the show's sponsors.

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[Holly Fry]

The 1880s were prolific for Pet & Co, who continued his examination of cholera and his defense of his theory of how disease spread. In 1882 he collaborated on a project titled Handbook for Hygiene with the German physician Hugo Wilhelm von Siemsen. And that handbook, which makes it sound like a handy thing you could put in your pocket, was actually published in five volumes.

[Tracy V. Wilson]

In 1883, Pettenkofer founded a second periodical, Archive for hygiene. This was in many ways an outlet for Pettenkofer to continue his writing about hygiene and disease. In 1886 and 1887, he wrote a total of 756 pages of content for this journal. The same year that he founded it, German microbiologist Robert Koch showed that vibrio cholerae was the bacterium responsible for cholera. Pettenkofer continued to believe that this was only part of the cause, though. Although Pettenkofer defended his ideas really to the end, Koch's work eclipsed his as it became the accepted scientific fact.

[Holly Fry]

One of the big drivers in his writing and research was fieldwork. Pettenkofer was never just postulating about all of his ideas about how disease was passed. He wasn't just sitting in his study. He actually made a point to travel to locations where there had been cholera outbreaks and study the conditions there, because he was always looking for additional data to add to his ever growing body of works, all in the hopes that he could crack this problem and bring an end to epidemic outbreaks.

[Tracy V. Wilson]

And that's an important side note that we should make here. The reason the debate between contagionists and anti contagionists was so impassioned was because these were serious matters of public health. How could scientists and the municipalities who took their counsel protect people? In 1849, a London cholera outbreak that had inspired Snow's work claimed the lives of more than 14,000 people. And this was only one issue that was in play. There were also leprosy, which is now more often called Hansen's disease, Typhus plague and yellow fever disease was something that everyone took seriously and that scientists were constantly trying to understand, Even if they came to drastically different conclusions.

[Holly Fry]

So going back to Max von Pettenkofer's field, epidemiology, Particularly in instances where the location of an outbreak didn't fit the model that he had developed, he was pretty quick to go there and try to figure out why. In most cases, these were instances where a city or a village that had had an outbreak was not built on porous soil, which was something that he felt was vital to how this whole system worked. For example, Malta. There had been a cholera epidemic on the island in 1837, but Malta was rock, which would seem to contradict Pettenkover's theory about porous soil. But when he actually went and visited the island, he saw that that rock was, in fact, porous. It's limestone. So he felt like this actually supported his idea.

[Tracy V. Wilson]

Conversely, he noted that the city of Lyon, France, had not had an outbreak, despite being a major metropolitan area that had two rivers that skirted the city center and a bustling trade business. Pettenkofer concluded that even though there were other factors that might contribute to an outbreak in Lyon, the fact the city's substrate was granite had saved it from epidemics.

[Holly Fry]

Yeah, he was like, this whole fermentation process cannot happen here because granite. And through all of this cholera study, he was also still advocating for a general improvement in hygiene. Everywhere is a key to good health and particularly drinking and just having good, clean water. Even though he didn't agree with the idea that contaminated water was what spread cholera, he thought everybody should just have clean water because that was best. He wrote, quote, for good health, pure water is as necessary as pure air, good food, comfortable quarters, and so forth. I myself am an enthusiast in the matter of drinking water, but not from fear of cholera or typhoid fever, but simply from a pure love for the good. For me, water is not only a necessary article of food, but a real pleasure, which I prefer and believe to be more healthful than good wine or good beer. He was a borderline teetotaler. He was not really a fan of alcohol at all. Boo.

[Tracy V. Wilson]

When Pettenkofer turned 70 in 1888, the cities of Munich and Leipzig each gave him cash gifts to be used for his Pettenkofer foundation of hygienic investigation. In 1890, he was elected as president of the Bavarian Academy of sciences. And in 1893, he was given Munich's highest honor, which was the Gold Burgess Medal. And that was in recognition of his lifetime of work.

[Holly Fry]

1890 also brought some sorrow. Max's wife, Helene, died that year, and the couple had also lost three of their five children over the years. And all of this loss really took a toll on the scientists. In his later life, the most dramatic.

[Tracy V. Wilson]

Story of Pettenkofer's life and work took place in 1892. It is the part that I referenced grossing me out when I read this outline during breakfast. He was so convinced that a microorganism alone could not make you sick that he put his own life on the line to prove it. On October 7, 1892, he got a culture of vibrio cholerae from a sick patient. He mixed it into bouillon, and he drank it. He experienced Quote light diarrhea with an enormous proliferation of the bacilli in the stool. But he recovered pretty quickly. Two of his students tried the same thing. They both survived, but also became very ill.

[Holly Fry]

These were Pettenkofer's thoughts on his rash experiment. Quote Even if I had deceived myself and the experiment endangered my life, I would have looked death quietly in the eye, for mine would have been no foolish or cowardly suicide. I would have died in the service of science, like a soldier on the field of honor. Health and life are, as I have so often said, very great earthly goods, but not the highest for man. Man, if he will rise above the animals, must sacrifice both life and health for the higher ideals.

[Tracy V. Wilson]

In 1894, Pettenkofer retired from teaching. Two years later, he also gave up his court apothecary position. And then finally, in 1899, he ended all his other professional obligations, retired primarily to Lake Starnberger in the southwest of Munich. We had a summer home there.

[Holly Fry]

In early 1901, Pettenkofer entered a serious depression triggered by a painful throat infection. On February 10, 1901, he shot and killed himself. His body was autopsied, and it revealed that he had been living with chronic meningitis, as well as symptoms that would later be recognized as cerebral calcification.

[Tracy V. Wilson]

Bettenkofer was buried in his beloved Munich in Thalkirchner Cemetery. Today there's a statue of him in Maximilian Square in Munich.

[Holly Fry]

The Hygienic Institute at the University of Munich, which Pettenkofer had leveraged his Vienna offer to get built, was destroyed in World War II when it was bombed on July 13, 1944. More than 20 years later, in 1967, it was finally rebuilt and it became the Max von Pettenkofer Institute. That institute continues today as a research and teaching organization focusing on microbiology, epidemiology and virology. And it also offers hygienic microbiological testing for clinical facilities.

[Tracy V. Wilson]

His periodical archive for hygiene still exists today, although it's now published under the name International Journal of Hygiene and Environmental Health.

[Holly Fry]

Max von Pettenkofer may have been wrong about the causes of epidemics, but he was obviously onto an important aspect of public health, with his staunch defense of hygiene as vital for the well being of all humankind. The work that he did, as we said, led to sanitary reform in a number of places, which significantly improved the community's quality of life. And in modern epidemiology, there is a recognition that exposure and outcome can be influenced and modified by other factors. Although it's not a cause and effect situation like he thought.

[Tracy V. Wilson]

Yeah, there's, there are definitely all kinds of things that can influence how easy it is for a pathogen to spread and infect people. But like, it's not like you, you would only contract cholera with these specific things happening like he thought. So to quote with a quote that nicely summarizes Pettenkofer's ideology about the importance of good health, quote everyone who lives upon the earth deserves to be well, for a life without health is a misery, a martyrdom from which everyone longs for release, and when it may not be by other means, even by death. I don't know that everyone would agree with that perspective, but it does, like, sum up his whole philosophy.

[Holly Fry]

Yeah, good health is the only way to live, and if you can't have it, it's not worth living. It's a little bit grim.

[Tracy V. Wilson]

Yeah, I like Ableist, right?

[Holly Fry]

Yeah, he's such an interesting creature and his position in all of this really does get eclipsed by Coke and by Louis Pasteur who were doing their stuff. And again, because he was fundamentally wrong about contagion. But all of the other stuff he did was amazing. I had no idea about his work in metabolic science until I had gotten pretty deep into research and I was like, wait a minute. Which is really fascinating because that's stuff that is still used all the time today and it's an important part of some people's lives. Like if you are an athlete, you're depending on science that he developed to like maintain your optimal performance. Because most athletes have a very serious like nutrition plan that's developed after measuring how they're burning carbohydrates and fat. And that is all part of this. I love that.

[Tracy V. Wilson]

Thanks so much for joining us on this Saturday. If you'd like to send us a note, our email address is history podcastheartradio.com and you can subscribe to the show on the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite show.

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[Tracy V. Wilson]

This is an I Heart podcast.