Sir John Crofton

The return of tuberculosis in epidemic numbers is just one of the many devastating consequences of AIDS. But at least patients suffering from recent TB outbreaks can depend on powerful combinations of antibiotics, a treatment recipe that owes a great debt to the pioneering work of Irish scientist Sir John Crofton.

The son of a family physician, Crofton, who died at 97 on Nov. 3 in Edinburgh, earned his medical credentials in the heat of battle, in field hospitals at Dunkirk and in the Middle East for the Royal Army Medical Corps during World War II. By 1946, TB was a leading cause of death among adults in Europe and North America, festering in the close quarters of military barracks and shelters accommodating displaced communities. There was no treatment other than rest and fresh air. An American scientist had purified an antibiotic, streptomycin, that raised hopes by showing a remarkable ability to kill tuberculosis bacteria in a lab dish. But nobody knew whether the compound would prove effective--or safe--in human patients.

It was Crofton, along with a team of doctors at London's Brompton Hospital, who finally answered the question in 1950. In a 15-month trial involving 107 patients, the physicians showed that streptomycin curbed the number of deaths from TB. That success was short-lived: the TB bacilli quickly became resistant to the drug, blossoming into raging infections. Crofton, however, had the insight to combine streptomycin with another new antibiotic--a formula that was to become the blueprint for combination therapy. That approach still forms the cornerstone of TB treatment and served as the inspiration for similar multipronged attacks on serious illnesses, like treating cancer with chemotherapy agents and battling HIV with antiviral drugs.