Johannes Andreas Grib Fibiger (23 April 1867 – 30 January 1928) was a Danish physician and professor of anatomical pathology at the University of Copenhagen. He was the recipient of the 1926 Nobel Prize in Physiology or Medicine "for his discovery of the Spiroptera carcinoma". He claimed to have shown that the roundworm which he called Spiroptera carcinoma (but is correctly named Gongylonema neoplasticum) could cause stomach cancer (squamous cell carcinoma) in rats and mice. His experimental results were later proven to be a case of mistaken conclusion. While working at the Institute of Pathological Anatomy of University of Copenhagen, Fibiger discovered new roundworms in 1907 from wild rats. He suspected that the roundworms were responsible for stomach cancer in those rats. In 1913, he reported that he could experimentally induce cancer in healthy rats using the roundworms. His discovery was considered "the greatest contribution to experimental medicine" at the time. In 1926, he was nominated for the Nobel Prize in Physiology or Medicine along with Katsusaburo Yamagiwa, who had experimentally induced carcinoma by painting crude coal tar on the inner surface of rabbits' ears in 1915. However, they were considered undeserving, and the 1926 prize was not given. In the next year Fibiger alone was retrospectively chosen for the 1926 Nobel Prize. After his death, independent researches proved that G. neoplasticum cannot cause cancer. Tumours and cancer produced by Fibiger were due to vitamin A deficiency. Historical reassessment of Fibiger's data revealed that he had mistaken non-cancerous tumours for cancerous tumours. Erling Norrby, who had served as the Permanent Secretary of the Royal Swedish Academy of Sciences and Professor and Chairman of Virology at the Karolinska Institute, in 2010 declared Fibiger's Nobel Prize as "one of the biggest blunders made by the Karolinska Institute." Fibiger's research method on diphtheria is regarded as the origin of an important research methodology in medicine known as controlled clinical trial.
Biography Fibiger was born in Silkeborg, Midtjylland, Denmark. He was the second son of Christian Ludvig Wilhelm Fibiger and Elfride Fibiger (née Müller). His father was a local physician and his mother, an author. He was named after his uncle, who was a clergyman and a poet. His father died of internal bleeding when he was three years of age, after which the family moved to Copenhagen where his mother earned their living by writing. His mother established there the first cooking school, the Copenhagen Cooking School. His namesake uncle supported Fibiger for his education. In 1883, at age 16, he passed his matriculation and was enrolled at the University of Copenhagen to study zoology and botany. He self-supported by teaching and working at the laboratories. He graduated in 1883. He continued for a medicine course and earned his medical degree in 1890. For a few months he worked as a physician at different hospitals, and also continued to study under Robert Koch and Emil Adolf von Behring in Berlin. Between 1891 and 1894, he was assistant to C. J. Salomonsen at the Department of Bacteriology of Copenhagen University. From 1894 he joined the Royal Danish Army Medical Corps, where he served till 1897. It was during his army service that he completed his doctoral thesis Research into the bacteriology of diphtheria. The University of Copenhagen awarded him a doctorate degree in 1895. He continued the diphtheria research at Blegdamshospitalet in Copenhagen, working as a Junior Physician. In 1897, he was appointed prosector at the Institute of Pathological Anatomy of University of Copenhagen. He was promoted to full Professor and eventually its Director in 1900. He also served as Principal of the Laboratory of Clinical Bacteriology of the Army from 1890 to 1905), and Director of the Central Laboratory of the Army and Consultant Physician to the Army Medical Service in 1905. Fibiger died of cardiac arrest in Copenhagen on 30 January 1928.
Contributions
Diphtheria research Fibiger's doctoral research was on diphtheria. He developed more efficient method of growing bacteria in a laboratory setting. He discovered that there were two different forms (strains) of the diphtheria bacillus (Corynebacterium diphtheriae) that produce two different symptoms, now called nasopharyngeal and cutaneous diphtheria. He also produced a blood serum against the disease. He was known for his methodological system of research. One of his experiments from 1898 in which he tested the blood serum for diphtheria is regarded by some as the first controlled clinical trial. While working as a Junior Physician in Blegdamshospitalet, he tested his diphtheria serum among hundreds (484) patients. As would be in modern clinical trial, he separated serum-treated and untreated patients, and found that more of untreated patients died than the treated ones. According to an article in The British Medical Journal in 1998:
[Fibiger's experiment in 1898] was the first clinical trial in which random allocation was used and emphasised as a pivotal methodological principle. This pioneering improvement in methodology, combined with a large number of patients and rigorous planning, conduct, and reporting, makes the trial a milestone in the history of clinical trials.
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