Introduction: The Door of the Sadiki

Summary

The center of my observations was the indigenous hospital in Tunis. Often, when I was at the hospital, I would walk over the typhus-ridden bodies [of patients] who had come to be admitted, but fell, extinguished, before the door… .The typhus patients were treated in the hospital's common rooms. Up to the door of these rooms, they spread contagion… .Yet, once admitted into the common room, the patient contaminated none of the patients in neighboring beds… . This observation guided me. I wondered what happened between the door of the hospital and the hospital room. What happened was this: the typhus patient was stripped of his clothing and undergarments, shaved, and washed. The agent of the contagion was thus something attached to the skin, to the undergarments, which the soap and water removed. It could only be the louse. It was the louse.

—Charles Nicolle, 1928

Charles Nicolle is remembered today as the man who won the 1928 Nobel Prize in Physiology or Medicine, largely for his demonstration that the louse transmitted typhus. Outside France and Tunisia, he is principally remembered through his Nobel speech—and, from it, for the above discovery narrative.The “hospital” to which he referred was the Sadiki Hospital in Tunis, where Tunisian patients were treated.The moment when his revelatory walk took place is less clear. It may have been any time between 1903 and 1909. The best guess is 1906, but Nicolle never really specified. Also unclear is when Nicolle first came up with the “Door of the Sadiki” discovery narrative. He had published the articles demonstrating the louse's role as typhus vector in 1909, but he did not relate the discovery as a grand intuitive flash. Instead, he described it as the product of a collaborative effort between laboratory, clinic, and field, resting on multiple layers of evidence. It was only in the 1920s that Nicolle told the Sadiki story as a coherent public narrative about the “genius” of scientific discovery. It emerged in this “telescoped” form, I believe, out of an awkward convergence of personal ambition (fueled by assorted successes), colonial location (he was director of the Pasteur Institute of Tunis), and a kind of socioreligious displacement that occurred in the wake of world war and that desperately sought new definitions for old faiths.