L i t t le Ma s te rp i ec e

o f Sc ienc e

E d i t e d by Ge o r g e Ile s

By

Si rJa m es P g t M D P tric k G ed d e a n d
a e , . . a s

S i ] R B n n ett M D J Arthur Th m son

r . . e ,
. . . o

T M Pr d de M D
. . u n, . .

G M S t rnb g M D Buel P C o lt n
. . e er , . . . o

Rob o n R o e M D
s J S Billi gs M D
os , . . . . n , . .

N EW 'O R'

1 90 2
 C ig ht 9 b D bl d P g 8 C
opy r . 1 02 , y ou e ay , a e 5 0.

C i h t 894 b H
op y r g 8 B th, 1 . y ar p e r : ro e rs

C i ht
op y r g b P, l S i M th l
1 90 1 , y o p u ar c en ce on y
C i ht
op y r b D C H th
g C
, 1 9 00 , y . . ea o .

C i h t 9 b E i P t P b li h i C
op y r g , 1 01, y ve n n g os u s ng o .

C i ht 9 b G P P t m S
op y r g , 1 01, y . . u na
’
s ons
 P RE 'AC E

W H E N w e r e m e mb e r that sound h e alth is t h e

foundation o f e ve ry oth e r good of all work fr uit ,

ful and e nj oy e d w e s e e tha t in this fi e ld

,
ew n

knowl e dge and n e w skill hav e wo n the ir most

t e llin g victori e s Pain long d e e m e d as ine vitabl e
.
,

as wint e r s old has vanish e d at t h e C he mist s

’
c
,
’

bidding : t h e study of minut e st life is r e sulting

in m e asure s which promise to rid t h e world of
consumption itse lf Dr Billings s mast e rly . .
’

r e vi e w o f m e di al progre ss during t h e nin e t ee nth

c

c ntury foll wing upon chapt e rs from oth e r

e ,
o

m e dical writ e rs of t h e firs t rank strike s Pr ve n ,

e

tion as its dominant not e T day t h e aim o f . 0-

t h e gr e at physi ians is not simply to r e stor e

c

h e alth wh e n l st but t h e maint e nanc e of he alth

o ,

whil e still unimpaire d .

Worthy of r e mar k i s t h e c o Op e ration in this -

good task which t h e physi ian r e c eive s at t h e c

hands o f t h e inv e ntor and t h e man of busin e ss .

To da y t h e railroad quick and ch ap d isp e rs e s

-
,
e ,

crowd e d citi e s into country fi e lds : e ve n t h e

poore st of t h e poor may take a summ e r outing
on mountain 510 p e s on t h e shore s of lake o r s e a
,
.

As e asily may t h e invalid e sc p e t h e rig rs o f a a o

North e rn wint e r as h e j ourn e ys to t h e Gulf o f

M e xico For those who stay at hom e t h e rail
.

road is just as faithfully t work It e x chang s a . e

t h e orange s of Flo ri da for t h e i c e of Main e and ,

 P r e fac e

brings figs and p e ach e s from California to N ew

England and N e w York Th e se toge th e r with
.
,

t h e cold storage war e hous e and t h e cann e r y ,

have give n t h e orchard and t h e kitch e n garde n

all s e asons for th eir own Nor must w e forge t
.

t h e mills that o ffe r a doz e n palatabl e c e r e als fo r

t h e bre a kf ast tabl e ,
most of t h e dru d ge r y o f
pre paration shift e d from t h e kitch e n to t h e
factory B e cause food is thus va r ious and
.

whol e som e as n e v e r b fore t h e h e alth and

e ,

str ngth of t h e p e opl e st e adily gains whil e

e ,

m e dicin e falls into l e ss and l e ss r e qu e st ; for what

is m e dicin e thre e tim e s in t e n but a corr e ctive
for a poor or ill balanc e d di e t '
-

B ut if t h e b e st h e alth possibl e is to b e e njoy d e

by e v e ry body t h e c o op e ration with t h e physi

,
-

e ian must includ e e v ry body e Alre ady a c o

. n

s i d e r a b le and incre asing numb e r o f m e n and

wom e n und e rstand this If th e y hav e an y.

re ason to susp e ct organi w e akn e ss o f any kind

c ,

th e y hav e re course to t h e physician s advi c e to ’

t h e e n d that a s u itabl e r e gi m e n or a l e ss e xacting

,

mode o f live lihood may fore fe nd all thr e at e n e d

,

harm A fe w page s of this volum e s e t forth t h e

.

d u e care o f t h e e ye s : t h e work from which thos e

page s is tak e n give s hints o f e qual valu e re gard
ing t h e care o f t h e e ars t h e lungs and oth e r
,

bodil y organs s o much more e asily ke pt soun d

,

than r e store d to soundn e ss aft e r t h e assail o f

di se as e .

GE O R G E I L E S .
 CON T E N TS

PA G ET JA M E S M D , S IR , . .

E S CA P E FR O M P A I N TH E H I S T O R' O ' A .

D I S C O V ER '
Ab ut 8 H um phry D y xp rim nt d w ith nitr u
o 1 00 av e e e e o s

xid
o g d sugg s t d it s
e in surg ry H r
as an e e u se e . o ace

W lls d ntist f H rtf rd C nn us s t h g f

e , a e o a o , o .
,
e e as or

th p inl ss xtr ti n f t th S ul phu i th r ls

e a e e ac o o ee . r c e e a o

bs r d t p r du ins nsibili t y t p in Dr Cr u f rd
O e ve o o ce e o a . . a o

L ng f J ff rs n G us s i t in 84 f t h x isi n
o , o e e o , a .
, e 1 2 or e e c o

f t m
O a W m T G M rt n B st n m p l y s
u ou r . . . . o o , o o ,
e o

th r in d ntistry d Dr W rr n in surg ry Dr
e e e , an . a e e . .

S im p s n E di nburg h intr du s hl r f rm t p
o , , o ce c o o o o re

nt t h p ins f hild birth An sth si t nl y

ve e a o c -
. ae e a no o

b lish s p in it br d ns t h s p f surg ry d
a
‘

o e a , oa e e co e o e an

m k s p r ti ns s f whi h f rm rl y w r m s t
a e O e a o a e c o e e e o

p ril use o .

B E NNETT S I R J R M D ,
. .
,
.

J ENN E R A N D P A S T EU R
'nn r s ind bt dn ss t J hn H unt r 'nn r s
’ ’
e e e e e o o e . e e

rl y bs r ti ns in n tur l hist ry H h rs
ea o e va o a a o . e ea a

untryw m n y I n t t k sm llp f I h
co o a sa ,
“
ca
’
a e a ox or av e

h d a wp x Th is s t s him thin king H finds

Co o .
'
e . e

th t f i us f rms f w p x but
a o v ar o gi s p o o co o one ve ro

t ecti g inst sm llp x I n 7 6 su ssfull y

on a a a o . 1 9 cce v ac

ic nat p ti n t H lds t h t sm ll p x d wp x
es a a e . o a a o an co o

are m difi ti ns f t h s m dis s d th t i f t h

o ca o o e a e ea e an a e

s yst m b im pr g n t d wi th t h mild r dis s i m

e e e a e e e ea e,

munit y fr m t h s r r is n f rr d I mm ns o e ev e e co e e . e e

s ing f li f by
av in ti n o e v acc a o .

vi i
 Co n t e n t s

P st ur
a e h mist studi s f rm nt ti n whi h is
a c e e e e a o , c

d t t h r p id multi p li
ue o ti n f rg ni sms S imi l r
e a ca o o o a a
o rg nisms h d t t s
a th us f t h silkw rm
e e ec as e ca e o e o

dis s d
ea e f nthr x in tt l H d pt s t h
an o a a ca e . e a o e

m th d f J n r p r p r s
e o o tt nu t d i rus d
en e , e a e an a e a e v an

pr t t s ttl fr m nthr
o ec ca e o a ax .

G E D DE S PATRI C K AN D J A RTH U R , , .

TH O M S O N
PA S T E UR A N D H I S WO R '
Distinguish s m i nut f t s t b f r
e bs r d in e a ce ,
no e o e o e ve

cert in h mi l m p unds Pr s th t t h f m
a c e ca co o . ov e a e er en

t ti a f t rtr t
on o f lim is d t a i t rg nisma e o e ue o a rn n n e o a

an d th t imil r g n y und rli s m n y th r k inds

a a S a a e c e e a o e

f f rm n t t i n
O e Pr t t s win fr m f rm nt ti n
e a o . o ec e o e e a o

b y h ting i t f ea minut t 5 C Dispr s t h or a e o 0

°
. ov e e

th ry f s p nt n us g n r ti n Dis rs
eo o o a eo e e a o . c ov e an

anti t xin f h y dr p h bi
o or o o a .

PRU DD E N T M M D ,
. .
,
. .

TU B ER C U L O S I S A N D ITS P RE V EN T I O N
I n N a t ure tr m l y im p rt nt p rt is p l y d b y
an ex e e o a a a e

minut rg ni sms S m f th m t k p th ir b d
e o a . o e o e a e u e a o e

in t h hum n b d y d th r t u p di s s s f wh h
e a o an e e se ea e o i c

co nsum pti n is t h hi f Th t ub r l b illus is

o e c e . e e c e ac

th es l us f nsum pti n i t s ntr n m y b

o e ca e o co o : e a ce a e

pr nt d m inl y by d str ying t h s pi ttl f p ti nt s

ev e e , a e o e e o a e .

S us p tibili t y t
ce nsum pti n m y b inh rit d t h o co o a e e e : e

di s s i t s lf is
ea e t An y us w hi h l w rs it lit y
e no . ca e c o e v a

in r s s sus tibi lit y Dust is s ur f d ng r

c ea e c ep . a o ce o a e

b th t f d rs d in Dust in h us s h uld
o Ou -
o -
oo an . o e s o

b e r m d t sim p l y sti rr d u p E n ur g m n t
e ov e , no e . co a e e

for suff r rs in rl y st g s f dis s

e e ea a e o ea e .

viii
 Co n t e n t s

S TE RN B E RG G M M D ,
. .
,
. .

M A LA R I A A N D M O S 'U I T O E S
M l ri l ng b li
a a d t b d t b d i is r ll y
a , o e ev e o e ue o a a r, ea

h rg bl t m squi t dis r d b y D L r n
c a ea e o a o o c ov e e r . ave a ,

881 d first d t t d in A m ri
0 , an b y D r St rnb rg e ec e e ca . e e ,

886
1 H lth y indi idu ls in ul t d wi t h bl d
. ea v a oc a e oo c on

t ining t h p ar sit d l p m l i l f r Th
a e a e ev e o a ar a ev e . e

m squit th ry f in f ti n w d n d b y Dr
o o eo o ec o as a va ce .

A ' A 'ing W shingt n 8 8 3 D M ns n d

. . .
, a o , 1 .
A
r . a o an

Dr R ss nfirm d t h th ry b y bs r ti n d
. o co e e eo o e va o an

ex p rim nt 'i indi idu ls p s d t t h J ul y i

e e . ve v a ex o e o e a r

of th R m n C m p gn s p m l ri b y using
e o a a a a e ca e a a a

s r ns
c d rs d w ind w s d n t s
ee on r th i r oo an o an e ov e e

b dse .

R O O S E RO B S O N M D , ,
. .

O F P R O L O NG I N G L I F E
TH E A R T

Wh t is t h n tur l t rm f li f ' O hun dr d y rs

a e a a e o e ne e ea

th xtr m
e e limit L ng it y runs in f mili s C l r
e e . o ev a e . e

gy m l n g li d Abst m i usn ss s und dig s

en are o - ve . e o e , o e

ti n p it y f sl p usu ll y f und in th l ng li d
o , ca ac or ee a o e o - ve .

W rk is h lth y s p i lly int ll tu l w rk R s n

o ea , e ec a e ec a o . ea o

bl h bbi s
a e g d B y nd middl li f x r is
o e are oo . e o e e e e c e

h uld b judi i us D i t sh uld b di g stibl d

S o e c o . e o e e e an

m d r t C l thing sh uld b s nsibl d l n lin ss

o e a e . o o e e e an c ea e

h bitu l
a a .

R ICHARD S O N B W M D ,
. .
,
. .

N A T U R AL L I FE A N D D E A T H
Ma n sh uld b un ns i us f d th
o f bi rt h e as co c o o ea as o .

T this d l t him bs r t h rul s f H lth

0 en e o e ve e e o ea .

RU L E S O F H E A LT H
Th h lth f th
e eaunb rn h uld b nsur d M n y o e o S o e e e . a

dis s s usu l in hildr n m y b

ea e id d by is l ti n a c e a e av o e o a o

ix
 Co n t e n t s

an d sin f ti n An qu bl t m p r tur sh uld b

di ec o . e a e e e a e o e

m in t in d
a R gul r d
a ri us m nt l l b ur is
e . e a an va o e a a o a.

b n fit P h y si l r is sh uld b m d r t Th
e e . ca e xe c e o e o e a e . e

p ssi ns sh uld b y t h r s n Al h l d t b
a o o o e e ea o . co o an o acco

a reh rmful O p ium d th r n r ti s sh uld b

a . an o e a co c o e

shunn d N t t mu h m t W t r t h n tur l
e . o oo c ea . a e e a a

b r g Ai h uld b p ur d t d m p R st
ev e a e. r S o e e an n o a . e

an d r r ti n g in f ul ecI dl n ss injuri us S l p
ea o a . e e o . ee

sh uld b d qu t
o e a e a e .

C O LT O N B UE L P , .

C A RE O F T H E E ' E S
Li g ht h uld f ll fr m b hind d b
S o i t sh uld b a o e an a ov e : o e

e qu l f b th y s A n A g nd l m p is b st R d
a or o e e . r a a e . ea

i gn t f d rs is h rm ful Th r ng f t h y
ou -o - oo a . e a e o e e e

sh uld t b t sh rt 'r qu nt r st s d g d
o no e oo o . e e e o oo .

Lig ht h uld b str ng n ug h Th

S o si st r di ng e o e o . e ea e ea

sh uld b s d f t h
o ning R di n g during
e av e or e ev e . ea

l is hu tf ul H w t r m f r ign sub
c on v a e s en c e r . o o e ov e o e

st n s fr m t h y C l n lin ss ss nti l
a ce o e e e . ea e e e a .

B I LLI NG S ' s M D , , .
, . .

P R O GRE S S O F M E D I C I N E I N T H E N I N E
TE N TH C EN T U R 'E

M r m di l pr gr ss in t h nin t n th
o e e ca n t u ry t h n o e e e ee ce a

in t h t w th us nd y rs pr d ing Th surg n
e o o a ea ece . e eo

d s m r d b tt r w rk th n r h
oe o e an l t e e o a ev e : e can oc a e

a tum ur f t h br in D f rmi ti s m li r t d
o o e a . e o e a e o a e .

P rils f m t rnit y r du d B li nd ss in m n y
e o a e e ce . ne a

ca s s p r nt d H um n li f l ngth ning Th
e ev e e . a e e e . e

pr nti n f dis s h m d g r t strid s P ur

ev e o o ea e as a e ea e . e

w t r su pp l y
a e pr p r dr in g
-
d s w r g Di p h
, o e a a e an e e a e .

th i t yp h id d nsump ti n
er a , l rg l y pr nt
o an co o a re a e ev e

a bl S i ntifi nursing intr du d I m pr m nt s

e . c e c o ce . ov e e

in h sp it l nstru ti n d m n g m nt
o a co c o an a a e e .

'
HEAL T H AN D HE ALIN G
E S CA P E F R O M PA I N : TH E H I STO RY O F
A D I S C O VE RY
S IR J A M E S P A GE T M D ,
. .

Sir J a m e s
' P g tw of t h m st min nt E nglish sur
a e as on e e o e e

g ns f t h l st ntury his wri tings surgi l th m s

eo o e a ce : on ca e e are

of th first uth rit y Th ss y t h hi f p rti ns f

e a o . e e a ,
e c e o o o

whi h f ll w
c pp r d in t h e N i t th C t y M g i
o o ,
a ea e n e e en en u r a az ne ,

D mb r 8 7 9 Th di t r s p rmissi n t r p rint is th n k
ece e ,
1 . e e o
’
e o o e a

full y k n wl dg d Th ss y is nt in d in S l t d
ac o e e . e e a . co a e
“
e ec e

E ss y s a d A ddr ss s
an b y S ir J m s P g t p ublish d b y
e e , a e a e , e

L gm
on Gr nans , C 9 Th s m firm p blish s
ee o .
,
1 0 2 . e a e u e

M m i rs d L tt rs f S i r J m s P g t
e o an dit d by St p h n
e e o a e a e ,
”
e e e e

P gta e f his s n u
,
one o o s

TH E history of t h e discove ry of m e thods for t h e

pr e v e ntion of pain in surgical op e rations d e s e rve s
to b e conside re d by all who study e ith e r t h e
m e ans by which kn owl e dge is advanc e d o r t h e
live s o f thos e by whom b e n e ficial discove ri e s a r e
made And this history ma y b e st b e trac e d in
.

t h e e v e nts which le d to and follow e d t h e u s e of

nitrous oxide gas of sulphuric e th e r and of , ,

chloroform as an aesth e tics— that is as m e ans by ,

which c ompl e t e inse nsibility may b e safe ly pro

d u c e d and s o long maintain e d that a surgical
op e ration o f what e v e r se ve rity and how e v e r p r o
,

longe d may b e absolut e ly painl e ss

, .

In 7 9 8 Mr Humphry Davy an appr e ntic e to

1 , .
,

Mr B orlase a surge on at B odmin had s o dis

.
, ,

t i n gu i s h e d hims e lf b y z e al and pow e r in t h e

3
 Ma s t e r p i e c e s o f S c i e n c e

study o f ch e mist r y and natural p hilosoph y ,

that h e w as in v it e d by Dr B e ddo e s o f B ristol .

, ,

to b e com e t h e sup e rint e nde nt o f t h e Pn e u

“

matic Institution which had b ee n e stabli sh e d

at Clifton for t h e pur pose o f trying t h e m e dicinal
e ffe cts o f di ff e r e nt gas e s H e obtain e d re l e as e
”
.

from hi s appr e ntic e ship acc e pt e d t h e appoi nt

,

m ent and d e vot e d hims e lf to t h e study of gas e s

, ,

not only in th e ir m e di cinal e ff e cts but much ,

more in all th e ir ch e mical and physical re lations .

Aft e r two y e ars work h e publish e d hi s Re

’

s ea rc h es
,
C h em i c l a d P h i los op h i c a l c h i efly c o m
a n ,

c er n i n g N i tr o s O xi d
u an e ssay pro v ing a trul y
e ,

marv e lous inge nui ty pati e nc e and courage, ,

i n e xp e r i e m e t s and such a pow e r of obs e rving

n ,

and o f thi nki n g as has rar e ly if e v e r b ee n s u r

pass e d by any sci e ntific man of Davy s a ge ; for ’

h e was th e n only tw e nty two -

.

In h i s inhalations of t h e nitrous oxi d e g a s h e

obse rv e d all t h e ph e nom e na of m e ntal e xcit e m e nt ,

o f e xalt e d ima gi nation e nthusiasm ,

m e rrim ent , ,

r e stl e ssne ss from whi ch it gain e d its popular

,

nam e o f laughing ga s ; a n d h e s a w p e opl e made

“ ”
,

at l e ast for som e Sho r t tim e and in som e m e asur e ,

ins ensibl e by it S o among oth e r sugge stions

.
,

o r gu e ss e s about probabl e m e dicinal us e s o f i n

halation of gase s h e wrot e n e ar t h e e n d of his

, ,

e ssay :
“
As nitrous oxid e in its xt e nsiv e o pe ra e

tion app e ars capabl e of d e stro y ing physical pain ,

it may probably b e use d with advantage duri ng

surgi cal op e rations in which no gr e at e ffusion o f
blood take s plac e ”
.
 E s cap e fr om Pa in

It s ee ms strange t hat n o on e caught a t a s u g

ge sti on such as this Tru e t h e e vid enc e o n which
.
,

it was founde d w a s v e ry slight ; it w a s with a rare

sci e ntific p owe r that Davy had though t o u t so
far b e yond his facts ; but h e had thought cl e arly ,

and as cl e arly told his b eli f 'e t no o e e a r e . n

n e s t ly r e gard e d it Th e nitrous oxid e might hav e

.

b ee n of as littl e ge n e ral int e re st as t h e carbonic

o r any oth e r had i t not b ee n f r t h e strang e and
,
o

various e xcit e m e nts p roduc e d b y its inhalation .

Th e se made it a favouri t e subj e ct with ch e mical

l e ctur e rs and y e ar aft e r y e ar in n e arl y e ve ry
~

, ,

ch emical th e atre it was fun to inhal e it aft e r t h e

,

l e cture o n t h e gas e ous compounds of nitroge n ;

and among those who inhal e d it th e r e must hav e
b e e n many who in th e ir intoxication r e c e iv e d
, ,

Sharp and h e av y blows but at t h e tim e fe lt , , ,

no pain A nd this we nt on for more than forty

.

y e ars e xciting nothing worth y to b e call e d

,

thought or obs e rvation till in D e c e mb e r 8 4 4, , 1 ,

Mr Colton a po p ular it i ne rant l cture r o n

.
,
e

ch e mistry d elive re d a l ctur e n laughing gas

,
e
”
o
“

in Hartford Co nn e cticut Among his auditors

, .

was Mr Horac e We lls an e nt e rprising d e ntist

.
,

in that town a man o f som e powe r in m e chanical

,

inve ntion A ft e r t h e l e cture cam e t h e usual

.

amus em e nt o f inhali ng t h e gas and We lls in , ,

whom long wishing had bre d a kind o f b e li e f that

som e thing might b e found to mak e tooth draw -

ing painl e ss obs e rv e d that o e o f t h e m e n e x

, n

c it e d by t h e gas was not cons ious o f hurting c

h ims e lf wh e n h e fe ll on t h e b e nch e s and bruis e d

5
 Ma s t e rp i e c es of S c ie n c e

and cut hi s kn ee s Eve n wh e n h e b e cam e calm

.

and C l e ar h e ade d t h e man was sur e that h e did

-

not fee l pain at t h e tim e o f his fall We lls w a s at .

onc e convinc e d— more e asil y convinc e d than

a man of more sci e ntific mind would hav e be e n
-
that duri ng S imilar inse nsibility in a stat e o f
, ,

int e ns e n e rvous e xcit e m e nt t ee t h might b e ,

drawn wi thout pain and h e de t e r mi n e d that ,

himself and o n e of hi s own large st t ee th S houl d

b e t h e first for t rial N e xt morning Colton .

gav e him t h e gas and hi s fri e nd Dr Riggs ex , .

t ract e d his tooth He r e main e d un conscious .

for a fe w mom e nts and th e n e xclaim e d A n ew , ,

“

e r a in tooth p u lli g l -
It di d not hurt m e more
n

than t h e prick of a p i n I t is t h e gr e at e st di s .

c o v e r y e v e r mad e .

In t h e n e xt t h r e e w e e k s We lls e xtract e d t e e th
'

from som e tw lve or fift e en p e rsons und e r t h e

e

influen e of t h e ni trous oxid e and gave pain t o

c ,

only two o r t h re e Dr Riggs also use d it with

. .
, ,

t h e sam e succ e ss and t h e practic e was w e ll known

,

and talk e d of in Ha r tford .

E ncourage d b y his succ e ss W lls w e nt to B os e

ton wi shing to e nlarge t h e r e putation of hi s di s

,

c o v e r y and to hav e an Oppo r t u ni ty o f gi vi ng t h e

g as t o som e o n e und e rgoing a sur gi cal Ope ration .

Dr J C Wa r r e n t h e s enior S urge on of t h e
. . .
,

Massachus tt s Ge n e ral Hospital to whom h e

e ,

appli e d for this purpose ask d him to show ,

e

fir st it s e fie c t s on som e o n e from whom h e wo u ld

draw a tooth He u n d e rtook to do t hi s in t h e
.

th e atr e o f t h e m e di cal coll e ge b e fore a large class

6
 E s cap e fr o m Pa i n

of st ude nts to whom h e had o n a pre vious day

, , ,

e xplain e d his plan Unluckily t h e bag o f gas

.
,

from which t h e pati e nt was inhaling was take n

away t o o soon ; h e cri e d o u t wh e n his tooth w a s
drawn ; t h e stu de nts hisse d and hoot e d ; and
t h e discov e ry was d e nounc e d as an impostur e .

We lls l e ft B oston disappoint e d and dish e art

e n e d ; h e fe ll ill and was for man y months u n
,

abl e t o practic e his profe ssion S oon aft e r .

wards h e gave up d entistry and n e gl e ct e d t h e ,

u s e and stud y of t h e nitrous oxid e till h e was ,

r e call e d to it by a discove ry e v e n more impor

tant than his o wn .

Th e thr e ad o f t h e histor y o f nitrous oxid e ma y

b e brok e n h e re .

Th e inhalation o f sulphuric e th e r was oft e n ,

e v e n in t h e e ight e e nth c e ntury use d for t h e ,

r e li e f o f spasmodic asthma phthisis and som e

, ,

oth e r dis e ase s o f t h e C h e st Dr B e ddo e s and

. .

oth e rs thus wrot e o f it : but its utilit y was not

gr e at and the re i s no e vide nc e that this u s e o f it
,

had any in fl ue nc e o n t h e discov e ry o f its high e r

value unl e ss it we re v e ry indire ctl y in i t s hav
, , ,

ing le d to its b e ing found use ful fo r soothing

t h e irritation produc e d by inhalin g chlorin e .

Much more w a s d u e to its b e ing us e d li ke nitrous ,

oxide fo r t h e fun o f t h e e xcit e m e nt which its

,

dilut e d vapor would produc e in those who free l y

inhal e d it .

Th e b e ginning o f its u s e for this pu r pos e is n o t

cl e ar I n t h e j o n m a l of S c i n c e a n d th e A r ts
.
'
e ,

publish e d in 1 8 8 at t h e Royal Institution

1 ,
 Ma s t e r p i e c e s of S c i e n c e

th e re is a short anonymous stat e m e n t among

t h e Misc e llan e a in which i t i s said Wh e n t h e
“ “
, ,

vapor o f e th e r m i xe d with common air is inhal e d ,

it produc e s e ffe cts ve ry similar to thos e occa

”
s i o n e d b y nitrous oxid e Th e m e thod o f i n .

haling and its e ffe cts a r e d e scrib e d and th e n ,

i t i s n e e ssary to u s e caution in ma king e xp e r i

“
c

m e nts o f thi s kind B y t h e imprude nt inspiration

.

o f e th e r a g e ntl e man w a s thrown into a v e r y

l e thargic stat e whi ch continu e d with occasiona l

,

p e riods of int e rmission for more than thirt y

hours and a gre at d e pr e ssion of spi ri ts ; fo r
,

many days t h e puls e was S o much low e re d that

”
conside rabl e fe ars we re e nt e rtain e d for his life .

Th e stat e m nt of th e s e facts has b ee n as

e

c ri b e d t Faraday un d e r whos e managem e nt

o ,

t h e j our nal was at that tim e publish e d B ut .

,

who e ve r wrot e or who e ve r may hav e re ad t h e

stat e m e nt it was for all us e ful purpos e s as
, , ,

much n e gl ct e d as was Davy s sugge stion of

e
’

t h e utility f t h e nitr us oxid e

o Th e last s
o . en

t e nc e quot e d
, s it w a s by P e r e ira and oth e rs
a

wr iting o n t h e us e s of e th e r e xcit e d much mor e ,

fe ar o f d e ath than hop e o f e as e fro m e th e r

inhal ation S uch e ffe cts as a r e de scrib e d in i t
.

a r e o f e xc ee di ng ra r ity ; th e ir dange r was gr e atl y

ove r e stimat e d ; but th e acco u nt o f th e m was

-

e nough to discourage all us e ful r e s e arch .

B ut as t h e sulphuric e th e r would produc e

,

e ffe cts v er y similar to thos e occasion e d b y

”
nitrous oxid e and was much t h e more e as y
,

t p
o rocur e i t cam,
e to b e oft e n inhal e d fo r amu s e~
,

8
 E s cap e fr om Pa in

m en t b y C h emists l ads and b y pupils in t h e

,
’

disp e nsari e s o f surge ons I t was oft e n thus us e d .

by y oung p e opl e in many plac e s o f t h e Unit e d

S tat e s Th e y had what th e y call e d e th e r
.
“

frolics in which th ey inhal e d e th e r till th ey

,

b e cam e m e r ry o r in som e oth e r way absurdl y

,

e xcit e d o r som e tim e s compl e t e ly ins ensibl e

.

.
, ,

Among thos e who had j oin e d in th e s e e th e r

frolics was Dr Wilhit e o f And e rson S outh .
,

C arolina In o e o f th e m in 1 8 3 9 wh e n n e arly
. n , ,

all o f t h e party had b ee n inhaling and som e had

b een laughing som e crying som e figh t i n g , ,

j ust as th e y might have don e if th e y had had

t h e nitrous oxid e gas — Wilhit e th e n a lad o f ,

s e ve nt ee n s a w a n e gr o boy at t h e door and

,

tri e d to p e rsuade hi m to inhal e He r e fuse d

and re sist e d all att empts to make him do it ,

till th e y s eiz e d him h e ld him down and ke pt , ,

a handke rchi e f we t with eth e r clos e ov e r his

mouth P re se ntly his st r uggl e s c e ase d ; h e la y
.

ins e nsibl e sno r ing past all arousing ; h e s ee m e d

, ,

to b e dying And thus h e lay for an hour till

.
,

m e dical h elp cam e and with Shaking slappin g , , ,

and cold S plashing h e wa s awak e n e d and s u f ,

fe r e d no harm .

Th e fright at havi ng it was sup p os e d s o , ,

n e arly kille d t h e bo y p u t an en d to e th e r ,

fr lics in that n e ighbourhood ; but in 1 8 4 Wil

o 2

hit e had b e com e a pupil o f Dr Crauford Long .

,

p ractising at that tim e at J e ff e rson (J ackson

Coun ty Ge orgia) H e re h e and Dr L ong and
, . .

t h ree fe llow pupils oft e n amus e d th emse lv es

-

9
 Ma st e r pi e c e s of S c i e n c e
‘

with th e e th e r inhalation and Dr Long o h

-
,
.

s er v e d that wh e n h e b e cam e furiously e xcit e d ,

as h e oft e n did h e was unconscious of t h e blows

,

whi ch h e b y chanc e r e c e iv e d as h e r ush e d

, ,

o r tumbl e d about H e obs e r ve d t h e sam e in

.

his p upils ; and thin king ov e r this and em ,

bold en e d by what Mr Wilhit e told him of t h e.

n e gro boy r e cove ring aft e r an hour s i s e s i ’

n n

b i li t y h e d e t e n n i n e d t o try wh e th e r t h e e th e r
,

inhalation would mak e any o e ins e nsibl e o f n

t h e p ain of an Op e ration S o in March 8 4 .

, ,
1 2 ,

n e arl y thr e e y e ars b ef ore We lls s obse rvations ’

with t h e nitrous oxid e h e induc e d Mr Ve nabl e

, .
,

who had b ee n v e ry fond o f inhali ng e th e r to ,

inhal e it till h e was qu i t e ins e nsibl e Th e n h e .

diss e ct e d a tum our from his n e ck ; no pain was

fe lt and no harm follow e d Thr ee months lat e r
,
.
,

h e similarly r e mov e d anoth e r tumour from him

and aga in in 8 4 and 8 4 5 h e op e rat e d o n
,
1 2 1 ,

t h r ee oth r pati ents and non e fe lt pain H is

e , .

Op e rations we re known and talke d of in his

n eighbourhood ; but t h e n e ighbour hood was
onl y that o f an obscur e littl e town ; and h e
did not publish an y o f hi s obs rvations Th e e .

r e cord of his fir s t Op e ration was only e nt e re d

in hi s l e dge r
Jam e s Ve nabl e 8 4 ,
Eth e r and e xcising
1 2 .

tumour ,

He wait e d to t e st t h e e th e r more thoroughl y

i n s om e gre at e r Op e ration than thos e in which
h e had y e t t r i e d it ; and th e n h e woul d hav e
p ublish e d his account o f it Whil e h e was wai t .

10
 E s cap e fr o m Pa i n

ing oth e rs b e gan to stir more ctive ly in busi e r

,
a

plac e s wh e re his work was qui t e unknown

, ,

not e v e n h ard of e .

Among th s e with whom in his unlucky

o ,

visit to Boston We lls talke d of his u s e o f t h e

,

nitrous oxide and o f t h e gr e a t discov e ry which

,

h e b e li e v e d that h e had mad e w e r e Dr Morton , .

and Dr Charl e s Jackson m en wide ly di ffe rent

.
,

in charact e r and pursuit but ins e parabl e in ,

t h e n e xt chapt e r of t h e histo r y o f an ae sth e tics .

Mo r ton was a r e stl e ss e ne rge tic d e ntist a , ,

r ough man r solut e to g et practic e and make

,
e

his for tun e Jackson was a qui e t sci e ntific

.
,

ge ntl e man un practical and uns e lfish in good

, ,

re put e as a ch e mist ge ologist and mine ral ,

o g i s t At
. t h e tim e of W e lls s visi t Morton who ’

, ,

had b e e n his pupil in 8 4 and for a short tim e 1 2 ,

in 1 8 4 3 his partne r was studying m e dicine ,

and anatom y at t h e Massachuse tts M e dica l

Colle ge and was living in Jackson s ho u s e
,
’
.

Ne ith e r Morton nor Jackson put much if an y

faith in We lls s story and Morton witn e ss e d
’

his failur e in t h e m e dical th atre S till Mor e .

,

ton had it in his h e ad that tooth drawing might -

som e how b e made painl e ss and e v e n aft e r ,

W lls had re tire d from practi e h e talke d with

e c ,

him about it and made som e e xp e rim e nts

, ,

but having no sci e ntific skill o r knowl e dge

, ,

th e y le d to nothing S till h e would n o t r e st .

, ,

and h e was guide d to succ e ss by Jackson whom ,

W lls advise d him to ask to make som nitrous

e e

oxide gas for him .

11
 Ma st er p i e c e s of S c i e n c e

Jac k son had l ong known as many oth er s ,

had of sulphuri c th e r b ei g inhal e d for a m us e

,
e n

m e nt and Of its producing e ff e cts l ike thos e o f

,

nitrous oxid e : h e kn ew also of its e mploym ent

as a r em e dy for t h e i r ri tation caus e d by i n h a l
ing chlorin e He had hims elf us e d it for thi s
.

purpos e and onc e in 8 4 whil e using it h e

, ,
1 2 , ,

b e cam compl e t e l y insensibl e He had thu s

e .

b ee n le d to think that t h e p ur e e th e r might

b e us e d for t h e pr e v nti n of pai n in sur gica l e o

op e rati ns ; h e spoke of it with som e sci e ntific

o

fri e nds and som etim e s advise d a t ri al o f it ;

,

but h e di d not urg it r take any active st e p s e o

t o promot e e v n t h e t r i l O e e ve ning Mo r
e a . n ,

ton who was now in p ractic e as a d en t i s t

, ,

call e d on him ful l of som e sch e m e wh ich h e

,

di d not di vulge and urg e nt f r succ e ss in p ain

,
o

l e ss tooth drawing -
Jacks n advis e d hi m to . o

u s e t h e e th r and taught him how to u s e it

e , .

O n that sam e e v ni ng t h e g t h o f S e pt e m e ,
o

b er 1 8 4 6 Morton inhal e d t h e e th e r put him

, , ,

s e lf to sl e p and wh e n h e awoke foun d tha t

e , , ,

h e had b e e n asl ee p for e ight minut e s Instantl y .

,

as h e t e lls h e look e d for an opportunit y o f

,

giving it to a pati e nt ; and o e j ust th e n coming n

i n a stout h e althy man h e induc e d hi m to

, ,

inh al e mad e hi m q ui t e I ns e nsibl e and dr ew

, ,

his tooth without hi s having t h e l e ast con

s c i o u s n e s s of what was d on e

B ut t h e gre at st e p had y e t to b e made—

.

th e
st e p which We lls wo ul d have tri e d to make
if his t e st e x p e i m e nt had not fail e d Cl e arl y
r .
,

12
 E s cap e fr o m Pa in

op e rati ons as swift as that o f tooth drawin g -

mi ght b e r e nde re d p ainl e ss but could it b e ,

r ight to incur t h e risk o f ins ensibilit y long

e nough and d e p e nough for a large s u rgi cal
e

o p e ration ' I t was ge n e rally b e lie ve d that in

such insensibilit y th e re was s e rious dang r e

t o life Was it re all y s o ' Jackson advise d M or

.

t on to as k Dr J C Warre n to le t him try and

. . .
,

War r en dare d to let him It is hard now to .

thi n k how bold t h e e nt e rpris e must have s e em e d

to thos e who w re capabl of thinki ng accu e e

r a t ely on th facts th e n known

e .

Th e fir st trial was mad e on t h e 1 6 th of O c

t ob e r 1 8 4 6
,
Morton gav e t h e e th e r to a p ati e nt
.

in th e Massachuse tts G e n e ral Hospital and ,

Dr W arr e n r e move d a tumour from his

.

n e c k Th e re sult was not compl e t e succ e ss ;

.

t h e pati e nt hardl y f lt t h e pain of cutting e ,

but h e was awar e that t h e Op e ration was b e ing

p e rform e d O n t h e n e xt da y in a s e v e r r
.
,
e

Op eration by Dr Hayward th e succ e ss was p e r

.
,

fe e t ; t h e p ati e nt fe lt nothing and in l ong i n ,

s ensibilit y th e re was no app e aranc e o f dange r

to life .

Th e discove ry might alr ad y b e d e e m e d e

com pl et e for t h e trials o f t h e n xt following

, e

days had t h e sam e succ e ss and th enc e o n ,

wards t h e u s e o f t h e e th r e xt nd e d ov e r con e e

s t a n t ly wid ning fi lds e A coars e but fee bl e

e .

Opposition wa s rais d by s om e Am e ri can d en e

t i s t s ; a fe w surg e ons w r e ov e r cautious in e -

th e ir warni ngs against susp e ct e d dangers ; a

13
 Ma s t e r p i e c e s of S c i e n c e

few mai nt in e d that pain was v e ry use ful

a
,

n e c e ssary p e rhaps to sound h e aling ; som e w er e

hi nd e r e d by th e ir dislik e of t h e pat e nt whi ch
M or on and Jackson took o u t ; but as fas t a s
t

t h e n e ws could b carri e d from o n e cont i n ent

e

to anothe r and from town to town s o fast di d

, ,

t h e u s e o f e th e r S pr e ad I t might almost b e
.

sai d that i n e v e r y plac e at l e ast i n Euro p e , ,

wh e r e t h e di scov e ry was promot e d more quic kl y

than in Am eri ca t h e month might b e nam e d
,

b for e which al l op e rativ e su r ger y was agoni z ing

e
,

and aft e r which it was p ai nl e ss .

But th e re w e re oth r gre at pains y e t to b e

e

pr e ve nt e d t h e pai ns of chi ldb i rth For e sca p e

,
.

from th e s t h e honour and d e e p gr a t i t t e a r e

e u

d u e t o S ir Jam e s S impson No e ne rgy o r knowl

.
,

e dg e o r pow e r o f langu ag e l e ss than hi s could

,

have ov e rcom e t h e f ars that t h e i ns e nsibilit y

e ,

which w a s prov e d to b e harmle ss in su r gical

Op e ra t ions and th e ir cons e que nc e s should b e ,

oft e n fatal or v r v mischi e vous i n parturition

e .

And to th e s e fe ars w e r e adde d a crowd of pious

prot e sts ( raise d for t h e most part by m e n )
, ,

against s o gr oss an int e rfe r enc e as this s ee m e d

w ith t h e ordain e d cour s e o f hum an natur e S imp .

s on , with e qual forc e o f words and work b e at ,

all down ; and by his adoption of chloroform

a s a substitut e for e th e r promot e d t h e whol e u s e o f

an aesth e tics .

Eth e r and chloroform s e e m e d to sup p l y all

that coul d b e wish e d from an ms t h et i c s Th e .

r ang e o f th e ir u tilit y e xt e nd e d ; t h e only qu e s

14
 Es cap e fr o m Pa in

ti on was as to th e ir re sp ctiv e a d a n t a ge s a e v ,

que stion still uns e ttl e d Th e ir pot ency was .

found absolut e th eir safe ty ve ry n e arly c o m

,
~

p le t e,
and aft r t h e d e ath of We lls in
,
e 8 48 1 ,

nitrous oxid e was soon n egl e ct d and almost e

forgott e n Thus it r main e d till 8 6 n e arly

. e 1 2 ,

s eve nt e e n y e ars wh n Mr Colton who still ,

e .
,

continue d l e cturing and giving t h e gas for “

fun was at N ew Have n Conn e cticut

,
”
He ,
.

had oft en told what W lls had don e with nitrous e

oxide at Hartford and h e want e d oth e r d e ntists ,

to u s e it but non e s ee m e d to care for it till at

, ,

N ew B r itain Dr Dunham aske d him to gi v e

,
.

it to a pati nt to whom it was thought t h e

e

e th e r might b e dange rous Th e r e sult was e x .

c elle n t and in 8 6 3 Dr S mith of N e w Have n

,
1 .

substitut e d t h e nitrous oxide for e th e r in his

practic e and use d it v e ry fre qu entl y In t h e .

nine months following his first u s e of it h e ,

’

e xtract e d without pain n e rly t ee th a .

Colton in t h e following y e ar associat e d him

, ,

s e lf with a d ntist in N e w York and e stablish e d

e

t h e Colton D e ntal Association wh e r e t h e gas ,

was give n to many thousands more S till its .

,

u s e was v e r y slowly admitt e d S om e call e d it .

dange rous oth e rs w e re cont e nt with chloro

,

form and e th r oth e rs said that t h e Short pangs

e ,

o f tooth drawing h d b e tt e r b e e ndu r e d

-
But in a .

1 8 6 7 Mr Colton cam e to Paris and Dr Evans

. .

a t onc e promot e d his plan In 8 6 8 h e cam e . 1

to London and aft e r care ful study of it at t h e

,

D e ntal Hospital t h e nitrous oxid e was sp e e dil y

,

15
 Ma st e r p i e c e s of S c i e n c e

adopt e d both b y d e ntists and by t h e admin

,

i s t a t o r s of an aesth e tics
r B y this tim e it h a s .

sav e d hundre ds o f thous nds o f p e opl e from a

t h e sharp pains of all ki nds o f op e rations o n

t h e t e th and of a gr e at numb e r o f t h e surgi cal
e

Op e rations that can b e quickl y don e .

S uch is t h e histor y of t h discove r y o f t h e e

u s e o f an ae sth e tics P robably non e h a s e v e r .

,

adde d s o larg ly to tha t part o f h a p pi ne ss which

e

c o nsists in t h e scap e from pain Past all count e .

ing is t h e sum of happine ss e nj oy d b y t h e e

millions who in t h e last three and th i rty y e ars

,
- -
,

have e s p d t h e pai s that w ere in e vitabl e

ca e n

in surgi al op rations ; pains made more t e r

c e

ribl e by appre h e nsion more k e n by close a t ,

e

t e ntion ; som e ti m e s awful in a swift agony ,

s om e tim e s prolong d b yond e ve n t h e most e e

p ti e nt e ndur anc e and th e n r n w e d in m emor y

a ,
e e

a nd t e rribl e in dre ams Th s will n e ve r b e . e e

fe l t again B ut t h e value of t h e discove ry is

.

not limit e d by t h e abolition of th s e pains o r e

th e p ins of childbi r th It would n e e d a long

a .

e ssay to t e ll how it has e nlarg d t h e fi e ld of e

us ful surge ry making many thi gs e asy that

e ,
n

w e re difficult many safe that w r e too p e ril

,
e

ous many practicabl e that we re n e arly i m

,

possibl e An d y et mor e variously t h e di s

.
, ,

c o e r y has brought
v happin ss in t h e r e li e f o f e

som e of t h int e ns e st pains o f sickn e ss in qui e t

e ,

ing convulsion in h lping to t h e discrimina ,

e

tion o f Obscure dis e as e s Th e tal e of its utilit y .

would not en d h e re ; anoth e r e ssay might t e ll

16
 E s cap e fr o m Pa in

its multiform us s in t h e study of physiology e ,

r e aching e v n to that of t h e l m e ntal proc e sse s

e e e

in plants for th e s e as Claud B rnard h s , ,

e e a

shown may b e compl e t ly for a tim e susp e nd e d

,
e

in t h e sl e p produc e d by chloroform or e th r
e e .

And now what of t h e discove r e rs What

did tim e bri ng to thos e who brought S O gr e at
happin e ss to mankind '

Probably most p e opl e would agre e tha t

Long Wells Morton and Jackson d e s e rv e d
, ,

r e wards which non e o f t h e four re c e ive d

. .

Th s nl y h r r k n d dis r rs fr m w h s
'
'
o e o a re e e ec o e as c ov e e o o e

w rk m y b tr
o a d t m r l y wh t might h b n t h b
e ace no e e a av e ee e e

ginning f t h dis ry but t h ntinu us hist ry f nt

o e c ov e , e co o o o ev e s

co ns qu nt u p n t h id n f it s truth L ng it is tru
e e o e ev e ce o . o , e,

might und r this rul b lud d ; y t his w rk nn ot

e e e e xc e e o ca

f irl y b s p r t d fr m t h hist ry Of urs in this in

a e e a a e o e o . co e, , as

ev e ry simil r s th r w r s m wh m int in d th t
a ca e, e e e e o e o a a e a

th r w n th ing w in i t B f r 8 4 th r w r m n y
e e as o ne . e o e 1 2 e e e e a

inst n s in whi h p rs ns und rw nt p r ti ns during i

a ce c e o e e o e a o n

s nsibili t y Th r m y b ry r s n b l d ubt s b ut
e . e e a e ve ea o a e o a o

wh t is t ld f t h
a n i nt us s f I ndi n h m p d m
o o e a c e e o a e ,
an an

d g ra ; b ut m s t f t h s w h
or a w mu h surg ry b f r
o 8 6o o e o sa c e e o e 1 4
must h s n p r ti ns d nave p ti nt s d i g ins n
ee o e a o o e on a e uI n e

si b i li t y p r du d b y n r ti s d d drun k nn ss m sm r
o ce a co c ,
ea -
e e , e e

ism l rg l ss s f b l d
, a e th r un rt in d ft n i m
o e o oo or o e ce a an o e

pr ti bl m th ds B sid s th r w r m n y gu ss s d
ac ca e e o . e e ,
e e e e a e e an

sugg sti ns f m king p r ti ns p inl ss B ut th y w r

e o or a o e a o a e . e e e

a ll fruit l ss ; d th y f il t t h t w hi h m y b
e an f ir t s t e a a a c a e a a e

f or m st f t h l ims f dis r rs— t h t st f ns qu nt

o o e c a o c ov e e e e o co e e

an d ntinu us hist ry Wh n h n ur is l im d f t h
co o o . e o o c a e or e

a uth rs f su h fruitl ss w rk s th s it m y f i rl y b s id
o o c e o as e e, a a e a

th t bl m r th r th n pr is is d t th m H ing s n
a a e a e a a e ue o e . av ee

so f th y pr f ss th y sh uld t h r st d till th y
ar as e o e ,
e o no av e e e e

co uld mu h f urth r
s ee c e .

17
 Ma st e rp i e c e s o f S c i e n c e

B ut that which t h e controve rsy and t h e pat ent

and t h e e mploym e nt o f l e gal advis e rs mad e
it n e c e ssary to d et rmin e was wh eth e r more
e ,

than o n e d e s e r ve d r eward and if mor e than ,

one, t h e proportion t o b e ass i gn e d to e ach .

H r e was t h e di fficult y Th e Fr e nch Acade my

e .

o f S ci e nc e s in 1 8 50 grant e d e qual Share s in

t h e Monthyon P riz e to Jackson and to Morton ;
but Long w a s un k nown to th e m and at t h e , ,

tim e o f t h e award t h e value o f ni trous oxid e

,

w as s o hi dd e n b y t h e gr e at e r value of e th e r
that We lls s claim was s et aside A m e morial
’
.

colum n was e re ct e d at B oston soon aft e r Mor , ,

ton s d e ath in 8 6 8 and h r e t h e di fficulty was

’
1 ,
e

S hirke d by d e di cating t h e column to t h e d i s

c o v e r y o f e th e r and not naming t h e discov e r e rs
,
.

Th e di fficulty co ul d not b e thus s ettl e d ; and ,

in all probability our suppose d council of four

,

o r fi e would not solv e it

v On e woul d pr e fe r
.

t h e claims of absolut e priority ; anoth e r thos e

o f sugg e stiv e sci e nc e ; anoth e r t h e courage of
bold adve nture ; s e ntim e nt and sympathy woul d
variousl y a ffe ct th e ir j udgm e nts And if w e .

suppos e that the y like t h Am e rican Congre ss

,
e ,

had to discuss th eir diff e renc e s within so u nd

o f such controv e rsi e s as follow e d Morton s first
’

u s e o f e th e r ,
o r duri ng a war o f pamphl e ts or ,

un d e r burde ns o f parliam e ntary pap e rs we ,

shoul d e xp e ct that th e ir cl e ar e st d e cision would

b e that a j ust d e cision could not b e gi v e n and ,

that gratitude must d i e if it had to wait till

di st ri butiv e j ustic e could b e satisfi e d Th e .

18
 E s cap e fr o m Pa in

gloom y fat e o f th e Am e rican discove re rs ma kes

o n e wish that gratitude could hav e b e e n let
fl o w o f its o wn impuls e ; it would hav e don e
l e ss wrong than t h e d e sir e for justic e did A .

l e sson o f t h e whol e story is that gr atitud e and

justic e a r e oft e n incompatibl e ; and that wh e n
th e y conflict th en usuall y t h e more r ight
, , ,
“

”
t h e mor e hur t .

Anoth e r l e sson which has b e en taught in t h e

,

histo r y of many oth e r discove ri e s is cl e ar in ,

this— th e l e sson that gre at tru ths may b e v e r y

n e ar us and y e t b e not disc e rn e d O f cours e t h e .
,

way t o t h e discove ry o f anaesthe tics was much

mor e di fficult than it now s e ems I t was ve ry .

di fficult to produc e compl et e ins e nsibilit y with

nitrous oxid e till it could b e give n undilut e d
and unmixe d ; this r equire d much b ett e r a p
paratus than Davy o r We lls had ; and it was
hardly possibl to make such apparatus till
e

india— rubb e r manufacture s were improve d It .

was ve ry di fficult to b eli e ve that profound

and long ins e nsibility could b e safe o r that ,

t h e app e aranc e s o f imp e nding d e ath w e r e alto

ge th er fallacious B old as Davy was bold e ve n
.
,

to r e ckl e ssn e ss in his e xp e rim e nts o n himse lf ,

h e would not hav e v e ntur e d to produc e d e

li b er a t ely in any o n e a stat e s o lik e a final s u ffo
cation as w e now look a t unmove d It was a .

boldne ss not o f knowl e dge that first mad e light

o f such signs o f dying and found t hat what
,

l ooke d l ike a S l e e p of d e ath was as safe as th e

b egi nning o f a night s re st S till with all fair
’
.
,

19
 Ma s t e r p i e c e s of S c ie n c e

allowanc e for th s e and oth e r di ffi culti e s w e can

e ,

not but s and wonde r that for more than fort y

ee

y e ars o f t h e nine t e enth c e ntury a gre at truth

lay unob se rve d though it was cove re d with
,

onl y s o t h in a v e il that a ar ful physiological c e

r s rch must have discov r d it

e ea Th e dis e e .

c o e r y ought to hav e b ee n mad e by followi ng

v

t h e sugg e stion of Davy Th e b ok in which

. o

he wro te that nitrous

“
oxi d e— ca b b l of d a e e

stro y ing physical p ai n— ma y probably b e us e d

w ith adv ntage duri ng sur gical Op e rations
a ,

was wid ely r e ad and it would b e h ar d to nam e a

,

man of sci e nc e m re wi dely known and t alk d

o e

o f than h e w as Withi n two ye ars of t h e pub

.

li c a t i o n of hi s R s e r c h s h e was appoint e d
a e e

to a profe ss orshi p in t h e Royal Institution ;

and in t h e n e xt y ar h e was a favour it e in t h e
e

f shi onabl e as we ll a s i n t h e Sci e ntific world ;

a

and all hi s lif through h e w a s intim t ly as so

e a e

c i a t e d wi th thos e among who m a ll t h e vari ous

motive s for d siri ng to find som e m e ans cap

e
“

abl e o f d stro y ing physical pain would b e

e
”

most strongly fe lt Cur iosity t h e love of truth

.
, ,

t h e lov e of marv e ls t h e d e sir e of e as e

,
s e lf ,

i nt e r e st b e n e vol e nc — all
, we re al rt i n t h e
e, e

mi nds of m e and wom e n who kn w and t r ust e d

n e

whate ve r Davy sai d or wrote but not o n e mind ,

was e arn e stly dir e ct e d to t h e rare pro m is e which

h i s words contain e d
,
His o wn mind was turn e d
.

with i t s full force to oth e r studie s ; t h e i nt e re st

in s u rge ry whi ch h e may hav e f lt durin g his e

a ppr e ntic e shi p at B odmin w as lost in h i s d e

20
 E s cap e fr o m Pa in

v o ti on to po etry philosophy and natural

, ,

sci ence and th re is no e vid e nc e that h e urge d

,
e

oth e rs to und rtake t h e study which h e l e ft

e .

Eve n his biograph e rs his broth e r Dr John , ,

.

Davy and his intimat e fri nd Dr Pa ri s both

,
e , .
,

o f whom we re v ery capabl e physicians and

m en o f activ int e ll e ct s a y nothing o f hi s
e ,

sugge stion o f t h e u s e o f nitrous oxid e It was .

ove rlooke d and utt e rly forgott e n till t h e p r o p h

ecy was fulfill e d by thos e who had n e ver
h e ard o f it Th e sam e ma y b e said o f what
.

Faraday if it w e r e h e wrot e o f t h e influ e nc e

, ,

o f sulphuric e th e r Al l was soon forgott e n

.
,

and t h e clue to t h e discov e ry which would ,

have b ee n far e asi e r wi th e th r than with nitrous e

oxid e for it n ee d e d no apparatus and e ve n

,

re quir e d mixtur e with air was again lost On e , .

could have wish e d that t h e honour o f bringing

so gr e at a boon to m en and s o gre at a h e lp
‘

in t h e pursuit o f kn owl e dge had b e e n won by ,

some o f thos e who we re gi ving th ems e lve s wit h

car e ful cultivation to t h e S e arch for truth as
fo r its o wn sak e B ut it was not s o : sci e nc e was
.

utt e rly at fault ; and it was Shown that in t h e

s e arch for truth th e r e a e continge nci e s in r

which m en o f r e ady b eli e f and rough e nt e r

prise s ee ki ng for m e re utilit y e ve n with s e lfish
,

purpos e s can achi e v e mor e than thos e who

,

r e strain th e ms e lv s within t h e range o f what

e

seems r e asonabl e .

S uch instanc e s of d elay in t h e discov e ry o f

truth a r e alway s wonde re d at but th e y a r e n o t ,

21
 Ma st e r p i e c e s o f S c i e n c e

un common Long b e fore J e nn e r d e monstrat e d

.

t h e u tility of vaccination it was known in Glo u

c e s t e r s hi r e that th e y who had had c o w pox -

could not ca tch t h e small p o x F or som e y e ars -

.

b fore t h e inve ntion o f e l ctric t e l e graphy

e e ,

P rof ssor Cummi ng of Cambridge wh e n d e

e ,

scribi ng to hi s class t h e then re c e nt discov e ry

b y O rst e d of t h powe r of an e l e ctric curr e nt
e e

to d fl e ct a m gne t us e d to s a y H r e th e n
e a , ,
“
e , ,

a e t h e e l e m e nts whi h woul d e xc e ll ntl y s e rv e

r c e

for a syst e m of t e l e graphy 'et non e of h i s

”
.

h e ar rs a tive and cul tivat e d a s th e y w e r e

e ,
c ,

w e re move d from t h e routin of study La e nn c e . e

quot s a s e nt e nc e from Hippocrat s which if

e e ,

it had b n worthily studi d might have l d

ee e ,
e

to t h e full di scove ry o f auscultation ' train d e

list e ning t o soun ds] Thus it oft n has b ee n ;. e

and f w proph e ci e s c a n b e safe r than that o u r

e

succ ssors will wonde r at us a s w e do at thos e

e

b for e us ; will w nd e r that w e di d not disc e rn t h e

e o

gr t truths wh ich th y will s a y we r e a ll around

ea e

us wi thi n r e ach of any cl e ar e arne st mind

, ,
.

Th e y will wond e r too as w e may wh e n w e , , ,

study t h history of t h e di scov e ry of a n ms

e

th etics at t h e qui e tud e with whi ch habitu al

,

m i se ri s a r e born ; at t h e v e ry faint impulse

e e

to action whi ch is gi ve n by e ve n gre at n e c e s

siti e s wh e n th e y a e habitual Thinki ng o f
r .

t h e pain of sur gi cal p e r tions o n e woul d thi k

o a ,
n

that m e n would have rush e d aft r t h e bar st e e

chanc e o f putting an e d to it as th e y would n

have r ushe d t o e sca p e from starving B ut it .

22
 E s cap e fr o m Pain

was not s o ; t h e mise ry w a s s o fre que nt s o ,

n e a r ly customary de m e d s o in e vitabl e that

,
e , ,

though it e xcit e d ho r ror wh e n it was talke d

o f it did not e xcit e t o stre nuous action
,
Re m e
.

d i e s w e re wi sh e d for and som e tim e s tri e d but

°

all was don e vague ly and faintly ; th e re was

n e ith e r hop e e nough to e xcit e int ens e de sire ,

nor d e sire e nough to e ncour age hop e ; t h e mi se ry

”
was put up with just as w e n o w put up
“

with t y phoid fe v e r and s e a sic kn e ss with local

-
,

fl oods and droughts with t h e wast e o f h e alth

,

and we alth in t h e pollution o f r ive rs with ,

hi d e ous nois e s and foul sm e lls and man y oth e r

,

mis er i e s O ur succe ssors wh e n th e y hav e

.
,

r e m e di e d or preve nt e d th em will look bac k

,

o n t h e m with horror ,and on us with wonde r

and cont e mpt for what th e y will C all o u r idl e
n e ss o r blindn e ss o r indi ffe r enc e t o s u ffe r ing .

23
 JENNER AN D PA STEU R
S I R J R I S D O N B ENNE T T M D
.
,
. .

'S i r J Risd n B nn tt w
. o l ding p h ysi i n f L n d
e e as a ea c a o o on

f
or m n y y rs h ldi ng t h high st ffi s
a ea , o du t r e e o ce as an e ca o

an d a dministr t r Th rti l fr m whi h t h f ll wi ng

a o . e a c e o c e o o

e xtrac t s h b n t k n pp r d in t h L i
ave ee a H e 88 a ea e e e s u re ou r , 1 2

No de partm e nt o f m e dical sci e nc e has made

gre at e r advanc e s in mod rn tim e s than that e
”
whi ch is t e rm e d Pre v e ntive M e dicin e “
N or .

is th e re any in which t h e public at large is more

d ee ply int e r e st e d and t h e knowl e dge of which
,

it is of more importanc should b e di ffus e d as e

wide ly a s possibl e Th e d e vot e d and z e alous

s e r vi e re nde re d by t h e m e dical profe ssion
c

in all que stions r e lating to t h e maint e nanc e

o f h e alth and t h e pr e v e ntion of dis e as e is a

suffici e nt answe r if a n y b e n e e de d to t h e i gn o
, ,

rant and prejudic e d stat e m ents that a r e som e

ti m e s made that in support o f various s c i en
,

t i fic th e ori e s and proc e e dings m e dical m en a r e

actuat e d by int e re st e d and s e lfish motive s .

No nam e stands o r will e v e r stand ou t more , ,

brilliant among t h e b en e factors o f mankind

than that o f Edward J e nn e r b y whose genius ,

and labours untold multitude s of human live s

hav e b ee n save d and an incalculabl e amount ,

of human su ff e ring and mis e ry pre ve nt e d At .

t h e pre s e nt tim e various circumstanc e s both ,

social and sci e ntific hav e combin e d to r e call ,

25
 Ma s t e r p i e c e s of S c i e n c e

att e ntion t this illustrious man and hi s r emark

o

abl e sci e ntific and b e n e ficial labou r s It is not .

,

howe ve r o u r int e ntion on t h e pre se nt occasion

,

to gi ve e ith e r a compl e t e sk tch o f his life r e ,

o

a d etail d acco u nt of his work But in ord e r to

e .

Show t h e conn e ction b e twee n his di scov e r i s e

and mor e r e c e nt advanc e s in t h e sam e fi e ld

of sci e ntific inv e stigation it will b e n e c es s a , rv

to gi v e a bri e f r es m of J en n e r s life work

u e
’
-
,

and t h e b e n fits whi ch h e c nfe rre d on t h e

e o

human rac e t h roughout t h world e .

H e was born on t h e 7 th May 7 4 9 at 1 ,

1 ,

B e rkel e y in Glouc st r shire of which pla e

,
e e , c

hi s fath e r w a s t h e vi ar O n l e aving Dr Wash

c . .

bourn s school at Cire nc e st e r h e was a p p r e

’

, , n

tice d to Mr Lu dl ow a gentl e man in practic e

.
,

a s a surge on at S udbury n e ar Bristol O n t h e , .

compl e tion of h i s appr ntic e shi p h e cam e to e

London and had t h e good fortun e to b e plac e d

,

unde r t h e care of t h e c e l e brat e d John Hunt e r ,

with whom h e re sid d for two y e a r s Th e o be .

s rving pow rs and tast e for natural history

e e

which J e n n e r had e arly Shown as a boy w re , , e

quicke n e d and fost re d by t h daily e xampl e

e e

and fri e ndshi p of t h e illustrious man who as ,

surge on and l e ctur e r at S t Ge orge s Hospital .

’

was carrying on thos e laborious sci entific i n

v es ti ga t i o n s and building up that ma r ve lous
,

monum e nt of his ge nius whi ch have r e nd e re d ,

his nam e and fam e immortal S O much skil l .

and knowl e dge had b ee n shown by J e nn e r in

a r ranging t h e natur al history coll e ction o f S ir
26
 J e nn e r a nd Pa st e ur

J . B an k s to
,
whom h e had b ee n r e comm e nd e d

by Hunt e r that h e was ffe re d t h e appoint

,
o

m e nt of natur list to Captain Co k s s e cond

a o
’ '

e xp e dition He howe v e r d e clin e d this and

, ,

oth e r flatt e ring prop sals in ord r to re tur n to o ,

e

t h e rural sc e n e s of his boyh ood and b e n e ar ,

an e lde r broth e r who had b ee n t h e guid e o f his

orphanhood He rapidly acquire d an e xt e nsive
.

busine ss as a ge n e ral practition e r whil e h i s ,

polish e d mann rs wid e culture and kind and

e , ,

g nial social qualifications se cure d him w e lcom e

e ,

admission to t h e first soci e ty of his n eighbour

hood Hi s consci e ntious d e voti n to his pro
. o .

fe s s i o a l duti e s did not how e v e r

n qu ll his , ,
e

e nthusiastic love of natural histo r y o r p e ,

r

clud e him from gaining a distinguish e d r e pu

t a t i o n as a naturalist A remarkabl e pap e r .

on t h e cuckoo re ad b e f r t h R yal S oci e ty

,
o e e o

and print e d in t h T ti s g ine d him t h e

e ran sac on ,
a

fe llowship o f that illustrious body J e nne r s .

’

pap e r e stablish e d what has b e e n prop rly t e rm e d e

th e
“
parasitic ”
haract er of t h e cuck o i
c o ,
. e .
,

it d e posits i t s e ggs in t h e n e sts of oth e r birds by ,

whose warmth th e y a r e hatche d and by whom ,

t h e young a e fe d rHis obs e rvations hav e r e

.

c i ed
e v ge n e ral confi r mation by subs e qu ent
o bse r v e rs m re e sp e ci lly t h e r emarkabl e facts
,
o a

that t h e pare nt cuckoo s e l e cts t h e n sts of e

thos e birds whos e e ggs r e quir e t h e sam p riod e e

of tim e for th ir incubation as its own (which

e

a e much larg r)
r and t h e food of whose young
e

is t h e sam e vi z ins e cts which t h e young

,
.
, ,

27
 Ma st e r pi e c e s of S c i e n c e

cuckoo ultimat e l y monopoli z e s by ousting

t h e youn g of t h e rightful own e r of t h e n e st .

B y thi s and similar stu di e s was J e nne r p r e

pa ri ng his acut e pow rs o f inv e stigation for e

t h e gr e at purpos e of h i s life For this h e S e .

cur e d more tim e and more e xt e nd e d O p p o r

t u n i ti e s for inquir by abandoni ng gen e ral y

practic e and c nfini ng hi mse lf to m e di ci n e

,
o

prop e r having obt i d in 7 9 t h e d e gr e e

,
a ne ,
1 2 ,

of M . D from t h e Univ rsity of S t Andr ews

. e . .

In conjun ction with t h e d e ar man a s h e “

us e d to call his gr e at mast r John Hunt e r e , ,

h e car i e d on h i s e xp e ri m e nts illustrativ e of

r

t h e stru tur e and functions of animals

c With .
’

gre at industry and ing nuity h e e x plain e d som e e

of t h e un ac ou tabl e probl ems in ornithology ;

c n

h e asc e rtain e d t h e laws which r e gu lat e t h e

migration o f birds ; mad e consid rabl e ad e

vanc e s in ge ology and in our kn owl e dge of o r

gani e re m ai ns ; h e am end e d va r ious pharma
c eu t i c a l proc e ss s ; h w a s an acut e anatomi st
e e

and path lo gi st a nd in v e stigat d

o ,
d ex e an

plain e d o e of t h e most painful a ffe tions of

n c

t h e h e art and man y of t h e dis e as e s to which

,

animals a e liabl r B y s c h labours h e e stab

e . .
u

b li s h e d a just claim to distinction as a m dical e

philosoph e r apart from his laims to t h e grati

. c

tud e and admiration of mankind by h i s s e lf

d e nying and d e vot e d labours in conn e ction
with his gr e at dis ov e ry ; but lik oth e r gre at
c e

m e n absorb e d in t h e stablishing of impo r tant e

t r uths h e was r e gar dl e ss o f p e rsonal obj e ct s

, ,

28
 J e nn er a nd Pa s t e ur

and n e v e r ost e ntatiously promulgat e d his claims

to public distinction .

It was whil e still a y outh living with his ,

mast e r at S udbury that his mind first b e cam e

,

d e e pl y impre ss e d o n t h e subj e ct of t h e cow

pox A young count r y woman cam e to s ee k
.

advic e wh e n t h e subj e t of small pox was

,
c -

incid e ntally m ention e d in h e r pre se nc e n d ,

a

sh e imm e diat e ly obse r v e d I cannot take ,

that dis e ase for I hav e had cow p x

,
”
This -
o .

was a popular noti n pre val ent in t h e district

o ,

and not unkn own to J enn e r but from this time ,

h e n v e r c e as e d to think on t h e subj e ct
e On .

coming to London h e m e ntion e d it to s e v ral e

p e rsons and among oth rs to Hun t e r ; but all

,
e

thought his notion Of g tting rid of small pox e -

Utopian and gav e him littl e o no e ncourage

,
r

m e nt . Hunt e r howe v e r who n ev e r lik e d to

, ,

daunt t h e e nthusiasm of i nq ui r rs said in his e , ,

charact e ristic way : Don t th i k but t y ; b e “ ’

n ,
r

pati ent b e accur t

,
About t h e y e ar 7 7 5
a e . 1 ,

som tim aft e r his r e tur n to t h e country h e first

e e ,

had t h e Opportunity of e xamining into t h e tr uth

o f t h e common traditions r e garding c o wpox -
,

but i t was n o t until 7 8 aft e r much study 1 0 ,

and care ful inqui r y that h e was abl e to n ,

u

rave l t h e various obscuriti e s and c o t r a d i c n

tions with which t h e subj e ct was involv e d and ,

in that y e ar h e first discl s e d his hop e s and his o

fe ars to his fri e nd Edward Gardn e r His mind

,
.

s eems to have caught a glimpse of t h e re pu

t a t i on a waitin g him and h e fe lt that in G od s
’

, ,

29
 Ma s t e r p i e c e s of S c i e n c e

good provide nc e it might b e hi s lo t to stand

,

b twe en t h e living and t h e d e ad and that through

e ,

h i m a gre at plagu e m i ght b e stay e d .

It would b e impossibl e in t h e b ri e f spac e

at o ur di sposal to r e coun t t h e va ri ous di rfi
c ul t i e s and sourc e s of r ror that J e nn e r e n
e

count e re d . It may how e ve r b e m e ntion e d

, ,

that h e as c e rtain e d that th e r e was more than

o e form o f local dise as e wi th whi ch cows a e
n r

a fflict e d and whi ch may gi v e ris e to sore s on

,

t h e hands of mi lkm aids but that o n e onl y of ,

th e s e was t h e true cow pox gi ing origi n t o -

,
v

constitutional as we ll as local dise as e , and whi h c

prov e s prot e ctive against small p o x He also -

.

foun d r e ason t o b e li e v that it was nly in a

e o

partic ul ar stage of its d e v e lopm e nt that t h e

t r u e cow pox v e sicl was capabl e of b e ing trans
-
e

m i t t e d s o as t o prov e a prophyla tic 'pre ve ntive ] c .

H e was awar e that though as a rule p e rsons di d , ,

not hav e small pox a s cond tim e y e t th e r e

-
e ,

a re instanc s wh e r e from p e c u li arity of c o

e , n

s t i tu t i o
n or oth e r caus e s small pox occurs a ,
-

s e cond tim e in t h e sam e indi vidual S uch con .

side rations as th e s ch e r e d hi m to continu e

e e

hi s inqui ri e s wh e n appar e nt e x e ptions oc c

curr e d t o t h prot e ctiv e in fl ue nc e o f t rue c o w

e

pox .

Having a t l e ngth satisfi e d hi s own m i nd ,

and indee d succ d e d in convincing oth e rs

, ,
ee

also r e sp e cting t h e important prot e ctiv e i n

,

fl u en c e e x e rt e d o n t h e constitutions o f thos e
who had r e c eive d t h e t r ue cow pox in t h e ca sual -

30
 J e nn e r a nd Pa s t e ur

way h e sought to prove wh e th e r it was pos

,

sibl e to propagat e t h dise as e by inoculation e

from o e human b ing to anoth e r

n On th e e

1 9 th May 7 9 6 an opportunity
,
1 occurr ed,
of
making t h e e xp e rim nt Matt e r was take n from e .

t h e hand o f S arah N e lm e s who had b e n i ,

e n

fec t e d by h e r mast e r s cows and ins e rt e d into

’

t h e arm o f Jam s Phipps a h e althy boy eight

e ,

y e ars of a ge He w nt through t h e dis ase. e e

in a re gular and p rfe ctly satisfactory way e .

But was h e s e cure against t h e contagion of

small p x ' It is n ee dl e ss to say how full of
-
o

anxi ety J e nn e r was wh e n in July following ,

h e p u t this to t h e t st by inoculating t h e b y e o

with matt e r take n from t h e pustul e of a sm all

pox pati e nt N O dis e as e followe d ' This his
.
,

first crucial e xp rim e nt J e nn e r re lat e d to his

e ,

fri e nd Gardn e r and said : I shall now pursue ,

my e xp rim e nts with r e doubl d ardour This

e e .

e v e r to b e re m e mb e r e d
- - -
day 9 t h May 7 9 6 ,
1 ,
1 ,

is comm e morat e d by an annual fe stival in

B e rlin wh e re in 8 9 littl e more than twe nty
, ,
1 1 ,

ye ars aft e r it was o fficially r e port e d that 3 7 59 6

, 0 ,

p e rsons had b e e n vaccinat e d in t h e P r ussian

dominions alon e Th e account which J e nn e r .

has give n of his o wn fe e lings at this tim e is

dee ply int e re sting Whil e th e v accin e dis .
“

c o v e r y was progr e ssing h e says t h e joy I

“
, ,

fe lt at t h e prosp e ct b e for e m e of b eing t h e

inst rum e nt d e stine d to take away from t h e
world o n e o f its gre at e st calamiti e s bl ende d ,

with t h e fond hop e of enjoying inde p ende nc e

31
 Ma s t e r p i e c e s of S c i e n c e

and dom e stic p e ac e a d happin e ss was oft e n

n ,

s o e xc e ssiv e that in pursui g my favourit e s u b n

j c t among t h e m e adows I hav e som e tim e s

e

found mys e lf in a kind of r e v e ri e It is pl e asant .

to m to r e oll e ct that th e s e r fl e ctions always

e c e

e nd d in d vout acknowl e dgm nts to that

e e e

B ei g fr m whom this and all o th e r m e rci e s

n o

fl ow .
”
Having obtain e d furth e r corroboration
o f t h e t ruth o f his conclusions by t h e vaccina

tion o f his own s o n and s e v e ral othe rs h pub ,

e

li s h d in t h e fo r m of a quarto pamphl e t all e d

e c
“
An I nquiry a bri e f and mod st but c o m
”
,
e

p le t e accoun t f h i s inve stigations and dis

o

c o v er i e s B y this t h e att e ntion of t h e whol e

.

m e dical world and ge ne ral publi was call e d c

to t h e subj e ct His doctrin e s w e re put to t h e

.

t e st and abundantly confirm e d s o that Mr ,

.

Cliv e t h c e l e brat e d surge on o f t h e day urge d

,
e ,

him to com e to London and promis e d him an ,

incom e of a y ar J e nn r howe v e r
e . e , ,

d e clin e d t h e r qu e st saying Admitting as a

e , ,

c e rtainty that I obtain both fortun e and fam e ,

what stock should I add to my fund o f littl e

happin e ss ' And as for fam e what is it ' A ,

gild d butt for ve r pi e rc e d by t h e arrows of

e e

malignancy .

J e nn e r always maintain e d that small — pox

and cow pox we re modifications o f t h e sam e
-

dise as e and hat in e mploying vaccine lymph

,
t

we only mak u s e o f m e ans to impr e gnat e t h e

e

syst em with t h e dis e ase in its milde st form ,

inst e ad o f propagating it in its virul e nt and

32
 J e nn er a nd Pa s t e ur

contagi ous form as is don e wh e n small pox is

,
-

inoculat e d He f lt also that th re was this

. e , ,
e

obj e ction to t h e latt r practic e which had e ,

obtain e d pre val e nc e sinc e its introduction t o

this country by Lady Mary Wortl y Montagu e ,

that t h e dis e as e was thus spre ad among t h e

community He had howe v e r at that tim e t o
.
, ,

cont nd against t h e pre val e nt notions that

e

e pid e mic dis e as e s affe cting t h e human rac e

a r e p e culiar to man and hav e no influ e nc e on

t h e lowe r animals and that t h e dise as e s o f

,

oth e r animals a r e not communicabl e to man .

B ut we hav e n o w abundant e vid enc e that both

th e s e notions a r e e rr n e ous J e nn e r hims elf
o .
,

inde e d had shown what was we ll known in

,

various parts of t h e country that t h e gr e as e ,

” “

o f t h e h ee l of t h e hors e was fre qu ently com

m u n i c a t e d to thos e who had t h e care of hors e s ,

wh e th e r o r not it was t h e s am e dise as e as that

which a ffe ct e d t h e c o w It is su ffici e nt onl y
.

furth e r t o adduc e anothe r dise as e o f horse s ,

call e d farcy which is not infre qu entl y fatal

“

t o grooms and oth e rs not to m ention t h e still

,

m ore dre ad e d hydrophobia communicat e d by

dogs and a imals of t h e felin e sp ecie s
n .

Th e rapid acc e ptanc e and spr e ad o f J enn e r s

’

doctrin e s sp ee dily sil enc e d all cavill e rs e xc e pt

that small mino r ity of incre dulous and fanat
ical oppon e nts who a r e always to b e found
r e fusing to acc ept any truth that do e s not c o
i ncid e with th e ir own ignorant and pre j udic e d
vi ews Th e fri ghtful mortality and ap p alling
.

33
 Ma st e r p i e c e s of S c i e n c e

e ffe cts of small pox p i or to t h e introduction o f

-
r

v a ccination w e r e indee d such as to imp e l] m n e

to gr sp at any m ans that he ld out a proba

a e

b i li t y of e scap e from t h e scour ge In t h e pre se nt .

day t h e public c a n form but a faint id e a of t h e

r age s of small pox b e fore J nn e r s tim e Th e
av -
e
’
.

re cords f hi storians not only of our o wn count r y

o , ,

but t h roughout t h e world t m with t h e most ,

ee

a ppa lli ng accoun ts Dr Let t s o m calculat e d . .

that f ll victims to it nually in E u rop e

2 e an .

B rnoui lli an Italian b e li e v e d that not l e ss

e , ,

than of hu man victims w e re d e

p r i e dvof lif e by it e v e ry t w e nty fi e y e ars -
v ,

i e . .
,
annually In Russia w e re .

c u t o ff in o e e ar In Asia Afri ca and S outh

n y .
, ,

Am e rica whol e citi e s and distri ts w e re d e

,
c

pop ul at e d Nor w a s it onl y t h e actual mortality

.

whi ch r e nd e r e d it s o appalling Th e r e cords .

of t h e Institution for t h e Indigent Blind in our

own country show d that thr e e fourths f t h e e -
o

obj e cts re li e v e d had lost th e ir sight by small

pox whil t h e numb e r o f p e rsons with pitt e d
,
e

and scarr e d fac e s and d e fo r m d f atur e s that e e

we r e m et with in t h e stre ts t e stifi e d to t h e e

fri ghtful orde al that th e y had pass e d through .

Multitud e s di e d of di s as s s e t up by this plagu e e e ,

or from rui e d constitutions which it e ntail e d

n .

And what of all t hi s it m a y b e aske d do w e

, , ,

now se e ' Is it not a rare thi ng to m e e t a pe r son

whose fac e is sc a re d a n d his fe ature s d e forme d
r

by small p o x ' How few p e rsons c a n cit e i

-
n

stanc e s among th eir acquaintanc e o f those who

34
 J e nn e r a nd Pa s t e ur

have di e d o f small pox aft e r having b een prop

-

e rly vaccinat e d ' Is it n e c e ssary to go into

statistics and e laborat e inve stigations o f t h e
bills of mortality of t h e pre se n t day in ord e r
to b e convinc e d that as compare d with t h e ,

re cords o f a nti vaccine tim e s w e have inde e d

-
,

caus e to bl e ss th e m mory o f J enn e r ' e

We d not ignore t h e fact that small pox

o -
,

like oth e r similar dis ase s having an e pid e mic e

charact e r may b e absent for a lengt h o f tim e

,

from c e rtain d istricts and th e n bre ak o u t again ;

nor that e ach e pid emic has its p er iod o f in cre
m e nt and d e cre m ent and vari e s in its de gr ee
,

o f malignancy . But a full and care ful re vi e w

o f t h e whol e histo r y of small pox sinc e t h e i n -

t r o d u c t i o n o f vaccination prov e s to e v e ry u n ,

pr ejudic e d mind that e v e ry r e curring e pide mic

finds its victims with comparative ly fe w e x
,

c e p ti o n s
,
among th e unva in t e d that its cc a ,

S pre ad is a r r st e d by ren e we d att e ntion to

e

vaccination and its vi gorous e nf rc e m e nt and o ,

that e ve n taking into account t h e count r i e s

,

and localiti e s wh e re from various cause s it

has b ee n n e gl e ct e d t h e mortality from this
,

foul and fatal dis e as e small pox has b e e n e nor

,
-
,

rn o u s ly re duc e d Human live s have b ee n

.

save d and hu man life prolonge d to such an

,

e xt e nt that it i s impossibl e to e stimat e t h e

b en e fits that mankind has d e ri ve d from t h e
genius and de vot e d patriotic labours o f o n e man .

That doubts and di fficulti e s in conn e ction

with this subj ect involvi g t h e we ll b eing o f
,
n -

35
 Ma st er p i e c e s of S c i e n c e

th e whol e human rac e have lat ely arise n must , ,

b e adm itt e d B ut the re is good re ason t o b e

.

li e ve that by mode rn r e se arch e s on t h e s u b

,

jec t of e pid e mic di s e a e s and t h e g am th e ory s e

o f dis e a s e th e se doubts a e alr e ady b e ing dis

,
r

p e lle d and,
that t h e d i f
f ic u l ti e s will b e sp e e dily
obv iat e d .

Th e groun ds for this b e li e f w i ll b e nd e r u

stood by t h e conside ration o f those sci e ntific

inv e stigations to a bri f d e tail o f which w e e

now proc e d Th e re ade r will th n also b e b e tt e r

e . e

abl e to judge of t h e pr pri ty and n e c e ssity o e

o f c e rt in m e as ur s which t t h e uninf orme d

a e ,
o ,

must app e ar obj e ctionabl e r e v n re p ul sive o e

a n d arbitrary .

We now th e n tur n to t h e r e markabl e e xp e ri

, ,

m e nts and di scove ri e s of M Past ur whi ch

‘

. e ,

have gain d for hi m a world—wi de re putat i on

e ,

and th b aring of whi ch on t h e s i e nc e of p e

e e c r

ve n t i e m e dicin e is commanding t h e att e ntion

v

and admiration f t h e whol e s i ntific worl d o c e ,

and ind d w e may sav of mankind at large

ee .

M Pas t ur is not a m di al man

. e r indee d e c ,
no , ,

a physiologi st H is simply a Fre ch ch mist . e n e ,

a mod e st r e ti i ng l bo u re r in t h e fi e ld of sci e nc e
,
r a

w hos e sol e obj e ct has b ee n t h e discov e r y O f

truth and whos e c h e m i c o physical re s e arch e s
,
-

gain d for him t h e Ru rn f r d M dal of t h e Royal

e o e

S oci ety in 856 Having d evot e d himse lf

1 .

sp e ci lly t o t h e ch e mistry of organi substanc e s

a c ,

h e w a s natur ll y attra t e d by t h e discov e ry o f

a c

C a gn i a d d e la Tour th t ye ast is re ally a plant

r ,
a ,

36
 J e nn e r a nd Pa s t e ur

a S p e cie s o f fungus whose ve ge tative action ,

in fe rm e ntabl e liquids is t h e tru e cause o f th eir

fe rme nta tion This was s o oppose d to t h e
.

the o ri e s o f all t h e ch e mists o f t h e day among ,

whom may particularly b m e ntion e d t h e c e l e e

b r a t e d Li e big that it m e t with th eir warm

,

Opposition Wh e n howe ve r H e lmholt z and

.
, ,

oth rs succ ee de d in showing that by pre ve nting

e

t h e passage of t h e minut e organisms consti

tuting t h e y e ast plant into fe rm entabl e liq u ids ,

no fe rm entation took plac e t h e doctrine soon ,

b e cam e stablish e d that t h e first st e p in t h e

e

proc e ss of alcoholic f rm e ntation is d u e not to e ,

ordinary ch e mical hang s but to t h e pre se nc e c e ,

o f living organisms In lik e mann e r t h e putr e

.

faction and d composition of various liquids c on

e

t ining org ic matt e r was found to b e d u e

a an ,

not to t h e Simpl e action of t h e oxyge n of t h e

atmosph e r e but to t h e introduction fr m
, o

without of m i r O S C O p i c ge r ms which found

c

mat eri al for th e ir de ve lopm e nt in such liquids .

S O that if by m e chanical filtration O f t h e air

.

t h e e ntranc e of such g e rms c a b e pre v nt e d n e ,

or if by h at or othe r me ans th e y can b e d e

e

stroye d any fluid howe ve r r adily it may

, ,
e

unde rgo putre f ction in ordin ary circumstanc e s

a
,

will r emain p e rfe ctly swee t though free ly e x ,

pose d to t h e air And t h sam e fluid will unde rgo

. e

a di ffe rent kind of fe rm ntation according as e

it is subj e ct e d to t h action of di ffe re t S pe ci e s e n

of ge ms The s e and th e r fa ts o f scarc e ly

r . o c

l e ss impo rtanc e which cannot h e re b e d e tail e d

, ,

37
 Ma st er p i e c e s of S c i e n c e

induc e d Past e ur to t e st t h e application o f t h e

doct ri ne s de duc e d from th e m to t h e study o f
di s e as e in living ani mals .

His att e ntion was first dire ct e d to t h e di se as e

affe cting t h e silkworm and known as t h e P e ,

br i n e whi ch at o n e tim e s ee m e d lik e ly to d e stroy

,

t h e si lk cultivation both in F ranc e and Italy .

It had b ee n asc e rtain e d that t h e bodi e s o f t h e

silkworm in all its stage s o f C hrysalis moth
, , ,

and worm we re in this dise ase infe st e d by mi

,

nut e corp uscl e s which e ve n obtain e d e ntranc e

into t h e unde ve lop e d e ggs Aft e r a prolonge d .

and di ffi cult inqui ry P st e ur found that th e s e

,
a

mi nut e corpuscl e s we r e re ally i nd e p e nde nt ,

s e lf propagating organisms introduc d from

-
,
e

wi thout and we re not m e re ly a Sign o f t h e

,

di s e as e but its r e al caus e

,
As a r e sult o f th e .

application of th e s e discov e ri e s t h e silk worm ,

dis e ase has b ee n e xtingu ish e d or s o controll e d ,

as to hav e save d a most important and valuabl e

cultur e .

B e twe e n t h e y e ars 8 6 7 and 8 7 abov e 1 1 0

d e aths from a dis e as e var iously de signat e d

as anthrax o r carbuncular dis e ase and
“
,
“

spl enic fe ve r and in Franc e kn own by t h e

,

t e rms charbon o r pustul e malign e

“ ”
,
” “
a e ,
r

stat e d to have occurr e d among hors e s cattl e , ,

and sh e e p in o n e di st r i t of Russia Novgorod c , ,

occasioning also t h e d e aths o f 5 8 among t h e 2

human population It occur s in two for ms

.
,

on e more malignant and rapid in its action

than t h e othe r In Franc e t h e dis e as e app e ar s
.

38
 J e nn e r a nd Pa s t e u r

to be scarc ely e ve r abse nt and is e stimat e d ,

t o e ntail o n t h e bre e d e rs o f cattl e an annual

loss o f many millions o f francs AS a mild e r .

e pide mic it has pre vail e d in this countr y and ,

t h e dis e as e which has lat e ly brok e n o u t in B rad

f rd and som e oth e r towns in t h e north among
o

wool sort e rs has n o w b ee n shown to b e a modi

-
,

fi a t i o n o f t h e sam e dis e as e C ommunicat e d

c

by t h e wool of sh ee p tha t have b ee n infe ct e d .

O n e xamining t h e blood of animals t h e ,

subj e cts o f spl eni c fe ve r som e Fre nch path

“ ”
,

ologi sts had discov e re d t h e pre s e nc e o f c ertain

minut e transpare nt filam e nts which by t h e ,

inv e stigations o f a G e rman physician nam e d

Koch we re prove d to b e a fungoid plant d e
,

v e lo p e d from ge rm particl e s of m i c O S C Op i c r

minut e ne ss B y gradual e xt e nsion th e s e minut e

.

”
particl e s t e rm e d microb e s attain t h e form
,
“

o f small thr e ads o r rods to which t h e nam e o f ,

“
bacilli has b e e n give n from t h e Latin ba ci llu s
, ,

a rod or sta ff Th e se rods we re found to b e in

.

fact hollow tub e s divide d at int e rvals by par

,

t i t i o n s which on attaining full gr owth bre ak

, , ,

up into fragm nts t h e int e riors o f which a e

e ,
r

found to b e full of minut e ge rms si m ilar to

those fr m whi h t h e rods we re at first de ve l
o c

Op e d The se ger ms w e re foun d by Koch and

.

his collaborat urs to b e capabl e o f cultivation

e

b y b eing imme rse d in som e suitabl e organic

liquid k e pt at a prop e r t emp e rature and t h e ,

s upply could b e k e pt up by introducing e v en

a few drops of su ch impre gnat e d fluids into o the r

39
 Ma st er p i e c e s of S c i e n c e

fl uids and rep ating t h e proc ss again and

,
e e

again Th n xt st p to t s t t h e pot ncy o f th s

. e e e e e e e

g rms to g n rat t h dis as in animals wh nc

e e e e e e e e e

th y w r ori gi nall y obtain d was to a c i

e e e e ,
v c

nat animals with a f w drops o f t h fl uid thus

e e e

artificially inf ct d Accordingly it was fou nd e e .

that t h bodi s of guin e a pigs rabbits and

e e -
, ,

mic e thus inoculat d b e cam e inf ct e d and e e ,

d v lop d all t h C haract ristic sy m ptoms f

e e e e e o

S pl e nic f v r o r carbun cular dis as e

e e e .

Past eur whos nthusiasm in t h e pursuit o f

, e e

inve stigations which had alre ady b n crown d ee e

with such signal succ ss k pt him awak e to all e e

that was b ing don by oth r inquir rs and e e e e ,

mad him watchful f e ve ry e v nt that trans

e o e

p i red r lativ e to t h
e pid mic dis as e s o f cattl e e e e e ,

was st r uck with t h fact that som e o f t h e mos t e

fatal outbr aks of charbon among flocks f e o

sh p occurr d in t h midst o f appar ntly t h

ee e e e e

mos t h althy pastur s His S agacity le d him

e e .

to inquir what had b n don with t h e c a

e ee e r

casse s of animals that had di d from pre vious e

outbr aks of t h dis as in th s localiti e s wh e n

e e e e e e ,

h e found that th y had b e n bu i e d in t h soil e e r e

and oft n at gr at d pths f t h sam e pastur s

e e e ,
o e e .

But how could t h dise as g rms mak e th ir e e e e

way to t h surfac e from a d e pth f e ight or t e

e o n

f et ' Earthworms h gue ss d might have

e ,
e e ,

conve y d th em e And notwithstan di ng t h .

e

incr dulity wi th which his xplanation was

e e

rec eive d h forthwi th proc d d to v e rify his

,
e ee e

supposition Having coll ct d a numb e r o f

. e e

40
 J e nn e r a nd Pa s t e ur

worms from t h e ground of t h e pasture s in qu s e

tion h e made an x tract of t h e cont nts of t h e

,
e e

alim e ntary canal o f t h e worms and with this ,

h e inoculat e d rabbits and guin e a pigs gav e th m -

,
e

th e charbo in its most fatal form and prove d

”
n ,

t h e id e ntity o f t h e malady by d e monstrating

that t h e blood of t h e victims swarm e d with th e m
d e adl y bacillus
“
And h re we cannot but
. e

stop to notic e t h e re markabl e confirmation

that is thus give n to t h e wonderful and b e autiful
obse rvations of Darwin as s e t forth in his last
work o n Th e Formation o f Ve getabl e Mould
“

Through t h e Action of Worms Darwin has .

shown b e yond all disput e as t h e r e sult o f his i ,

n

comparabl e r e s e arch s that though t h e plough e ,

“

is o n e o f t h e most anci e nt and most valuabl e o f

man s inve ntions long b e fore h e e xist e d t h e
’

land was in fact re gularly plough d a d still e ,

n

continue s to b e plough e d by e arthwor ms , .

He has Shown us that t h e smoothn e ss which

we admire in a wid e turf cov e re d e xpans e is “
-
,

mainly d u e t o all t h e in e qualiti e s having b e e n

slowly l ve l e d by worms and that t h e whol e
e ,

o f t h e sup e rficial mould ov e r any such e xpans e

h as pass e d and will pass again eve ry few

, ,

ye ars through t h e bodi e s of worms ' It was

,
”

l e ft for Past e ur to Show that the s e i n u m e r n

abl e and inde fatigabl e plowm e n whilst r e nde r ,

ing to man such e ffi i e t s e rvic e may also b e t h e

c n ,

carri e rs of t h e se e ds of dis e as e a n d de ath .

In proc ee d i g wi th our bri e f histori al account

n c

o f Past e ur s and alli e d r e se arch e s w e a e ar

’

,
r

41
 Ma st e rp i e c e s o f S c i e n c e

ri ve d at t h e point wh e re th ir analogy to 'e n e

n e r s b e com e s manife st and wh e re th e ir dire ct

’

b e aring on t h e we lfare o f m nkin d C om e s into a

vi e w S o soon as it was known that th e s e dis

.

e as e g rms we re low forms o f ve getation and

e ,

that lik othe r ve ge tabl e s th y could b e cul

,
e , e

ti v ated it was natural to ask wh th e r lik e

,
e ,

oth e r v e getabl e s th eir charact e rs and prop

,

er t i e s could not b e so modifi e d as to ren d r e

th em at l e ast l e ss d el e t e r ious Ev e ry o n e knows .

t h e diff e re nc e b e twee n t h e crab appl e a d its -

n

cultivat e d vari ty t h e slo e and t h e plum t h e

e , ,

wild and t h e cul t ivat e d c e l e r y It is all t h e .

di ff e re nc e b e twe n unwhol e som e and whol e som e

e

food .

Two m ethods of cu ltivation with a vi e w ,

to obtaining t h e d e sire d modi fication o f t h e

powe r e x e rcise d by t h e bacilli and oth e r s i m
i la r g e rms pr e s en t d th e ms e lv e s t h e o n e anal
,
e ,

o g o u s to that r e ally pursu e d by J e nn e r wh e r e

small pox o r t h e gr e as e o f t h e hors e was pass e d

-
, ,

through t h e syst e m of t h e c ow and th e n from ,

o n e human b e ing to anoth e r ; and t h e s cond e

b y carrying o n t h e cultivation o u t of t h e living

body Both th e s e plans hav e b een adopt e d
.
,

with t h e r e sul t o f proving that t h e pot e ncy o f

t h e g e rms can b e s o di minish e d as to re nd e r t h e
dis e ase produc e d by th eir introduction s o mi ld
as t o b e o f no import anc e Past e ur cul tivat e d .

t h e bacillus in chick e n broth or m e at juic e and ,

allowe d a c e rtain tim e to e laps e b e fore h e mad e

u s e o f t h e mi xtur e Aft e r allowing onl y two
.

42
 J e nn e r a nd Pa s t e ur

months to e lapse t h e virul e nc e o f t h e ge rms

,

s e em e d to b e but littl e imp ir d but aft e r thre e

a e ,

or four months animals inoculat e d with t h e

flui d though th e y took t h e disease had it in
, ,

s o mild a form that t h e gr e at e r numb e r r e c o v

e re d . Aft e r a long p e riod of s i x o r e ight months

t h e e ng nd e r e d dis e as e w a s s o mild that all
e

t h e animals sp e e dily r e cove re d and r e gaine d

h e alth and stre ngth .

And n o w t h e que stion will natur ally a r ise ,

Did animals which had passe d through t h e

mild dis as e thus induc e d acqui re a prot e ction
e

against t h e ori gi nal dise as e if brought in c on

,

tact with i t in subs eque nt e pide mics in t h e ,

sam e way that J e nn e r s vaccinat e d pati e nts

’

we re prot e ct e d against small pox ' -

An answe r in t h e affirmative may now b e

g i ve n with t h e utmost confide nc e Exp e rim e nts .

conduct e d both,
Inthis country and abroad ,

by both m e thods o f proc e dur e have abun ,

d a n t ly prov e d that animals may b e prot e ct e d

by inoculation S O as to r e nd r th e m insusc e ptibl e
e

o f any form o f t h e d e structiv e anthrax dis e as e .

From a r emarkabl e pap e r re ad by Past e ur

b e fore t h e Int e rnational M e dical Congre ss we
e xtract t h e concluding par graph Aft e r d e
a .

t iling t h e m e thod pursu d to Obtain t h e r e qui

a e

site att e nuation o f t h e virus and stating that ,

by c e rtain physiological a t i fic e s it may b e

r

mad e again to assum e its original vi r ul e nc e h e ,

proc e e ds : Th e m ethod I have just e xplaine d

“

o f Obtaining t h e vac ine o f S pl e nic fe v e r

c wa s ,

43
 Ma s t e r p i e c e s of S c i e n c e

no soon e r mad e known th n it was ve ry e x e .

t en s i v ely mploy e d to pre ve nt t h e spl e nic a ffec

e

tion In Franc e w e los e e v e r y y e r by spl enic

. a

fe v e r animals to t h e valu e o f francs ,

and e v e n according to o n e o f t h e p e rsons in

,

t h e o ffic e of t h e Minist r of Agr i cultur e more e,

than francs but e xact statistics a r e

,

sti ll wanting I was aske d to giv e a public

.

d e monstration at Pouilly le Fort n e ar M e lun - -

, ,

o f t h e r e s ul ts alr e ady m e ntion e d T hi s exp er i .

m e nt I may r e lat e in a few words Fifty sh ee p .

we r e pl c e d at my di sposition of which twe nty

a ,

fi e w e r e va cinat e d and t h e re mai ning twe nty

v c ,

fi e und rwe nt no tr e atm e nt

v e A fortnight .

aft er wards t h e fifty sh ee p w e re inoculat e d w ith

t h e most virul nt anthracoid microb e (or g e m)
e r .

Th e twe nty fi e vaccinat e d S h e e p r e sist d t h e

-
v e

infe ction t h e twe nty fiv e unvaccinat e d di e d o f

,
-

S pl e nic fe v e r within fifty hours .

S inc that tim e t h e c pabiliti e s of my labora

e a

to r y have b e n inade quat e to m ee t t h e d e mands

e

of farm e rs f r suppli e s of this vaccin e In t h e

o .

spac e of fift e e n days w e have vaccinat e d in t h e

d e partm e nts surroun ding Pa r is more than ,

sh ee p and a large numb e r of cattl e and

,

hors s This e xp e rim e nt was re p e at e d last month

e .

at t h e F e rm e d e Lamb e rt n e ar Chartr e s It ,
.

de s e rv e s sp e cial m e ntion .

“
Th e v e ry vi r ul e nt inoculation practic e d at
Pouilly le Fo r t in orde r to prove t h e immunity
- -
,

p roduc e d by vacc i nation h a d b ee n e ff e ct e d by

,

th e aid of anthracoid g e rms d posit e d in a c u l e

44
 J enn e r a nd Pa s t e ur

ture which had b ee n pre s e rve d in my labora

to r y more than four y e ars that is to s a y from , ,

th e 2 r st March 8 7 7 ,
Th e r e was assure dly
1 .

n o doubt about its virul e nc e S inc e in fifty hours ,

it kill e d twe nt y fi e sh ee p out o f twe nty fiv e

-
v -
.

Ne ve rthe l e ss a commission of doctors surge ons

, , ,

and v et e rinary surge ons o f Chartre s p r eju

-
,
-
,

dic e d with t h e ide a that virus obtaine d from

infe ctious blood must have a virul e nc e capabl e
o f d e fyi n g t h e action o f what I call cultur e s of

vi rus institut e d a omparison of t h e e ffe ct s

,
c

upon vaccinat e d Sh ee p and upon unvaccinat e d

sh e e p of inoculation with t h e bl ood of an animal
which had di e d of spl e nic fe v e r Th e r e sul t .

was identical with that Obtain e d at Pouilly le -

Fort — absolut e r e sistanc e of t h e vaccinat e d

and d e aths of t h e unvaccinat e d If I we r e not .

pre ss ed for tim e I should bring to your notic e

oth e r kinds of virus att enuat e d b v S imilar
m e ans The s e e xp e rim e nts will b e communi
.

c a t e d b y and b y to t h e public
- -
.

Th e b e aring o f th e s e r e s e arch e s o f Past e ur

on vaccination with c o w pox and t h e whol e -
,

o f th e J e nn e rian doctrin e s will b e e vide nt , .

The y throw a fl ood of light both o n t h e e fficacy

o f vaccination and t h e many suppos e d failur e s

which have g ive n a handl e to t h e unscrupulous

fanatical de tractors of J e nn e r and his doctrin e s .

Th e y go far toward e stablishing t h e C orr e ct

n e ss of t h e vi e w e nt e rtain e d b y J e nne r as to
t h e id e ntity o f small pox and cow pox S howing
- -
,

how gr e a t ma y b e t h e modifications e ffe c te d

45
 Ma s t er p i e c e s o f S c i e n c e

in t h e original virus b y r e p e at e d transmission ,

e ith e r through t h e animal or t h e h u man Syst e m .

B ut apart from t h e que stion o f id e ntit y o r

dive rsity o f small pox and vaccinia Past e ur s
-
,
’

re s e arch e s prove b e yond all que stion that a

dise as e vi rus may b e both dimini sh e d and
augme nt e d in powe r by physiological d e vi c e s ,

and that th e r e fore t h e e ffi cacy of t h e vaccine

ly m ph may in various ways b e s o dimini sh e d
, ,

a s to los e i t s prot e ctiv e pow e r without shaking ,

our faith in t h e principl e o f vaccination or

d e tracting in t h e l e ast from t h e ine stimabl e
value of J enn e r s discov e ry Th e att e ntion of
’
.

t h e sci e ntific world will now b e and is dir e ct e d , ,

to t h e important inq ui r y How far h a s t h e

,

o r iginal vacci ni a of J e nne r lost i t s prot e ctive

powe r ' If s o how has thi s b ee n brought about
, ,

and by what m e ans can it b e r e store d ' Must

w e again r e v e rt to t h e cow for a e w supply ' n

N ee d w e onl y b e more scrupulous in t h e s e

l e ction o f t h e v e sicl e s and t h e p articul ar stage
,

of th e ir d e ve lopm e nt and in t h e mode in which

,

th e op e ration of vaccination is p e rform e d '

Th e s e and num e rous oth e r S imilar qu e stions a r e
now b eing discuss e d and inv e stigat e d but ,

none probably is more important than t h e

qu e stion how far t h e prot e ctive infl u e nc e in
e ach in di vidual is dissipat e d by tim e and h e nc e ,

t h e principl e of r e vaccination i s
-
now b e ing
e nforc e d. Th ere c a n b e no doubt that diffe r e nt
e pid e mics poss e ss di ff e r e nt d e gr e e s o f virul e nc e ,

and what prove s a su ffici ent prot e ction in a

46
 J e nn e r a n d Pa s t e ur

mi ld e pidemic o f small pox may not b e suffici e nt

-

in a more vi r ul e nt o n e In c e rtain s e asons and

.

in c e rtain conditions of t h e atmosph e r e t h e ,

human syst e m is more pron e to c e rtain dis e as e

than at oth e r tim e s Past e ur s e xp e rime nts o n
.
’

c ul tivat e d virus or ge rms show that in t h e

course of time and in c e rtain conditions o f e x
,

p o s u r e to t h e action o f oxyge n o r oth e r ag e nts ,

t h e vitality o r constitution s o to sp e a k o f t h e
, , ,

ge rms may b e s o change d as mat e rially to alt e r

th eir action o n t h e animal syst e m We have .
,

th e re fore sci entific grounds for r e ver ting from

tim e to t i m e to t h e h e ife r for a n e w stock rath e r ,

than continui ng to r e ly o n t h e p e rp etual trans

mission from o n e human bod y to a o t h r n

This is not t h e plac e to e nt e r o n t h e who le

qu e stion o f t h e ge rm th e ory of dis as e but who e ,

do e s not s ee how wid e is t h e fi e ld for inve sti

g a t i o n op e n e d up b y Past e ur and oth e rs ' Al
r e ady t h e application of t h e p r incipl e o f v a c c i
nation has b e n succ e ssfully appli e d by Past e ur
e

to a ve r y fatal e pide mic dis e ase attac king fowls ,

and known b y t h e nam e of chicke n chol e ra “ ”

.

B y inoculating chick e ns with t h e cultivat e d

”
vari ety of t h e particular bacillus h e has “

a fford e d to the m compl e t e prot e ction Th e .

e conomic valu e of this to Franc e may in som e

m e asure b e e stimat e d by t h e man y millions of
e ggs which a r e e xport e d fr m Franc e to o

this country alon e How many oth e r dise as e s

.
,

such as scarlatina and diphth e ria which n o w ,

c ar r y o ff annually thousands o f childr e n ma y ,

47
 Ma s t e r p i e c e s of S c i e n c e

not er e l ong b e e xtingui she d by lik e m e ans who

shall say ' I v e ntur e stat e s Mr S imon in
“

, .
,

his addr e ss to t h e H e alth S e ction of t h e Int e r

n ational Congr e ss to s a y that in t h e r e cords
,
“

o f human industr y it would b e impossibl e t o

point to work of more promis e to t h e world

than th e s e various contribut i ons to t h e k nowl
e dg e o f dis e as e and o f its cur e and pr e v e ntion ,

and th e y a r e cont r ibutions which from t h e ,

natur e o f t h e cas e have com e and co ul d only

, ,

hav e com e from t h e p erformanc e o f e xp e r i

,

”
m e nts on living ani mals .

Comp ul sory vaccination is no doubt a strong , ,

m e asur e and o e which might in this land

,
n ,

o f individual lib e rt y b e e xp e ct e d to giv

,
ris e e

both to que stion and opposition It c a n onl y .

b e justifi e d by proving that it is to t h e int e r e st o f

t h e in di vidual as w e ll as of t h e whol e commun it y
t hat it Should b e e nforc e d O f its propri e ty .

a n d n e c e ssity w e b e li e v e it n e e ds only a calm

and unpre judi c e d inqui ry to b e convinc d e .

Most of t h e obj e ctions rais e d against it a r e

e ith e r bas el e ss o r admit of b e ing obviat e d .

That som e o f t h e ob j e ctions a r e of a charact er

that co m mand o u r r e sp e ct may b e admitt e d
but m e re s e ntim e nt o r pre judic e d and ill founde d -

o b je ctions must giv e plac e to sound argum e nts

,

a n d w ell e stablish e d e vid e nc e

-
In this as in .
,

man y S i m ilar cas e s Opposition and discussion

,

Op en up e ntranc e s for light by which t h e clouds

o f ignoranc e and darkn e ss a r e sur e to b e dis
p e lle.d B ut e v e n as this whol e qu e stion o f
48
 J e nn e r and Pa s t e ur

vaccination now stands t h e r e sponsibilit y o f

,

t hos e who a r e p e rsist e ntl y misr e pr e s e nting facts

and misl e ading t h e p ublic is gr e at nay crimi
, ,

nal wh e n we re fl e ct how many liv e s a r e sac r i

,

fic e d b y t h e n e gl e ct o f p re cautiona r y m e ans
within t h e r e ach o f a ll
.

49
 L O UI S PA S T E UR AN D HIS WO R'
P A T R I C ' G E DD E S A N D J A R T H U R T H O M S O N .

' Pr f ss r G dd s is Pr f ss r f B t n y t Uni rsit y

o e o e e o e o o o a a ve

C ll g D und H h w i tt n Ch p t rs in M d rn “
o e e, ee . e as r e a e o e

B t n y d m n y b t ni l rti l s d p p rs Pr f ss r
o a an a o a ca a c e an a e . o e o

Th ms n is R gi us Pr f ss r f N tur l H ist ry Ab rd n
o o e o e o o a a o ,
e ee

Uni rsi t y H is w rk s in lud Th Stud y f A im l “

ve . o c e e o n a

Li f e,
”
O utli n s f
'
Th N t ur l H ist ry f t h
e o
“
e a a o o e

Y r d Th S i n f Li f
ea an
“
Th E luti n f S x
e c e ce o e .
” “
e vo o o e
”

was wri tt n j int l y by b t h t h s

e uth rs Th rti l
o o e e a o . e a c e

fr m whi h xtr t s f ll w w p ublish d in t h C t m

o c e ac o o as e e on e

y R i w di t r s p rmissi n t r print is ’

por a r 89 5 t h
ev e , 1 : e e o e o o e

gr t full y k n wl dg d Th Li f f L uis P st ur by M
a e ac o e e . e e o o a e .

R d t
a o ,
ls w r p ublish d by M Cl P hi lli p s C
2 vo .
,
e e e c u re, o .
,

N w Y rk
e o ,

TH E cours e o f Past eur s sci e ntific wor k is o n e ’

o f r e markably natural and logical se que nc e .

As t h e ve t e ran M Ch e vre uil long ago said in .

t h e Acad e m y o f S ci e nc e s It is by first e xam “

ining in t h ir chronological ord e r t h e re s e arch e s

e

of M Past e ur and th e n consid e r ing th e m as a

.
,

whol e that we appr e ciat e t h e rigor o f his c o n

,

e lusions and t h e p e rspicacity o f a mind which

, ,

strong in t h e truths which it has alr e ady dis

cove re d swe e ps forward to t h e e stablishm e nt
,

of what is n e w ”
We shall th e re for e summari z e .

t h e r e cord o f his gr e at e st achi e v e m e nts .

As was natural in a pupil of Dumas B a la r d , ,

and D e lafoss e Past e ur s first important pi ec e ,

’

o f wor k was ch e mical and crystallographic and ,

we ma y b e st und e rstand its spirit b y r e calling

51
 Mast er p i e c e s o f S c i e n c e

th e work of mas t e r in m i n e ral ogy

D e la fo s s e
’
s ,

t h e Ab b e Hauy who is still r e m e mb e r e d for

,

that bold att e mpt to visualiz e t h e ul timat e

structur e o f t h e crystal to p e ne trat e t h e inmost ,

s e cre t of i t s archit e ctur e whi ch also r e app e ars ,

-

i n anoth e r way in t h e wor k o f Men d e lje ff .

P ast eur s puz z l e conc e r n e d t h e ta r trat e s and

’

p a r a t a r t r a t es of soda and a m mo ni a Th e se .

two sa lts a r e alik e in ch e mical composition in ,

cryst alli n e form in sp e cific gr avity and s o o n

, , ,

but th e y di ff e r i n b e hav iour Thus as B iot had .

,

s hown ,
a solution of tartrat e d e fl e ct s t h e plan e
o f polari ze d light pass e d through it whil e a ,

solution o f t h e p a r a t a t r a t e do e s not Th e salts

r .

a r e t h e sam e y e t th e y b e hav e di ff e r e ntly

,
A .

not e to t h e Acade my from t h e famous ch e mist

Mi t s c h e r li c h e mph a si ze d t h e e ntir e simila ri ty
o f t h e two salts and this act d as an additional
,
e

sti mul us to Past e ur He succ ee d e d in distinguish

.

i n g t h e minut e fac e ts whi ch e v e n Mi t sc h e li c h had r

misse d ; h e prove d that t h e p a r a t a r t a t e is a r

combination O f a l e ft hand e d and a right hande d

- -

tartrat e and d i d much e lse which only t h e ex

,

p e rt ch emi st coul d dul y e xplain Biot wa s .

fir st doubtful th e n d e light e d ; Ar a go who had

, ,

also busi e d hi ms e lf with th e s e matt e rs mov e d ,

t h at Past e ur s pap r b e print e d in t h e m e moi r s

’
e

o f t h e Acad e my and Mi t s c h e r li c h hims e lf c o n

,

grat ul at e d t h e y oung di scove re r who had tripp e d

Alre ady th en in this min ut e and laborious

, ,

pi e c e of work we may d et e ct ul tra microscopic

,
-

52
 Lo ui s Pa st e ur a nd Hi s Wo r k

m e ntal vision and that rigorous accurac y s o

,

charact e ristic of t h e man 'e t it is int e re sting

.

to obse rv e that at this e arly stage h e was s ow

ing his wild o ts o f sp e culation Impre sse d by
a .

t h e strange rotation o f t h e plan e o f polari z ation

e xhibit e d by th e s e organic salts h e d e duc e d ,

th e re from an hypoth e sis of mol cular d i s y m e

m etry and hazard e d t h e vi e w that this was a

,

fundam e nt l distinction b e twe e n t h e organic and

a

t h e inorganic For various r e asons n e ith r

.
,
e

ch e mist nor biologist would nowadays acc e pt

this distinction ; but it is hard to t e ll what Past e ur
might have made o f this inquiry had o t cir n

c um s t a n c e s r gr e tt e d at t h e tim e dire ct e d his

,
e ,

att e ntion to v e ry di ff e re nt subj e cts .

B e ing thus known in conn e ction with tar

trat e s Past eur was o e day consult e d s o t h e
,
n ,

sto r y go s by a G rman manufacture r of C h em

e ,
e

i c a ls who was puzzl e d by t h e f rm entation of

,
e

his comm e rcial tartrat e of lim e which c on ,

t a i e d som e admixture o f organ i c impuri ti e s

n .

Past e ur unde rtook to loo k into t h e matt e r and ,

probably d r iving som e hint from t h e pr e vious

e

work o f Ca gn i a r d Latour and S chwann who ,

had demonstrat e d t h e y e ast plant which cause s -

alcoholic f rm e ntation h e de monstrat e d t h e

e ,

micro organism which fe rm e nt e d t h e tartrat e

-

o f lim e He e xt e nd e d this discov e ry to oth e r

.

tartrat e s and mad e t h e n e at e xp e rim e nt o f

,

Showing how t h e common blu e mould (P en i c i l

li ni g l u c u m ) sown in p a r a t a r t r a t e of ammonia
u a , ,

us e s up all t h e right hande d tar trat e and -

53
 Ma st e r p i e c e s o f S c i e n c e

le av e s t h e l e ft hand e d salt alon e its ide n

-
,

tical ch e mical composition not withstanding .

Th e s e and similar inquiri e s le d him t o tackl e t h e

whol e que stion of fe rm e ntation but hi s trans ,

fe re nc e to Lill e had probably much t o do with

t h is For a s o n e of t h e chi e f indust r i e s o f t h e
.
,

district is making alcohol from b e e t root and -

grain Past e ur s practical s e ns l d him to d e vot e

,
’
e e

som e of his l ctur s to fe rm e ntation ; h e r e as

e e ,

always as his biograph e r r eminds us wishful

, ,

to mak e hi ms e lf di r e ctly us eful to his h e are rs .

Th e pr val e nt th e o r y o f fer m e ntation b e for e

e ,

Past e ur took t h e subj e ct in hand was that of ,

Wi llis and S tahl r e vis e d and e laborat d by ,

e

L i e big .According to thi s th e ory nitroge nous ,

substanc e s in a stat e of d e composition ups e t t h e

mol e cular e qui lib ri um of fe rm e ntabl e matt e r

with which th y a r e in contact What Past e ur
e .

did w a s to Show that lactic buty r ic ac e tic and , , ,

som e oth e r f rm e ntations w e re d u e to t h e vital

e ,

activity of micro organisms In spit e of Li e b i g s

-
.
’

prolonge d Opposition Past e ur carri e d his point ; ,

and although som e of his d e tail e d int e rpre ta

tions have sinc e b e n r e vise d it is uni ve rsally e ,

admitt e d that h e chang d t h e whol e compl e xion e

of t h e fe rm e nt ation probl em It must o f cours e .

, ,

b e born e in mind that his th e ory of t h vital e

natur e of many f rm e ntations do e s not apply e

to solubl e fe r m e nts o r e n z ym e s— such as di a stas e

and p e psin— which a r e ch emical substanc e s not ,

livi ng organisms Part i nd ee d o f t h e Opposi

.
, ,

t ion to Past e ur s vi e ws was d u e to t h e fact that

’

54
 Lo uis Pa s t e ur a nd Hi s Wo r k

this distinction b e twe e n organiz e d and unor

g a n i z e d f e rm e nts was not at t h e tim e l arl y c e

drawn P e rhaps ind ee d we a r e as y et by no

.
, ,

m e ans out of t h e woods .

In t h e course of his work o n fe r m en t a t i o n ‘

Past e ur made an important th e or e tical st e p b y

distingui shing t h e micro organisms which r e -

quire t h e pre s e nc e o f free oxyg n from forms e ,

which a r e abl e to live apart from free oxyge n ,

Obtaining what th y r e quire by spli tting up

e

oxyge n C ontaining compounds in t h e surround

-

ing m e dium Th e s e h e t e rm e d aerobic and

.

an ae robic r e sp e ctive ly Practi ally this pi e c e

. c ,

o f work i m m e diat e ly le d to what is known as

th e O rl e ans proc e ss of making vin e gar S om e .

ye ars lat e r aft e r h e had r e tu r n e d to Paris h e

, ,

followe d this up by his studi e s on win e in t h e ,

cours e of which h e track e d various win e dis e ase s -

t o th e ir sourc e s and show e d how d e t e rioration

,

might b e pre v nt e d by raising t h e win e for a

e

minut e to a t e mp e rature o f 5 C Th e wine 0

°

tast e rs of Paris gave th ir v e rdict in his favou r

e .

Th e o ld notion o f spontan e ous ge n e ration sti ll

lingere d in som e quart e rs and in 8 58 P o u c h et, 1

had gi v e n n ew life to t h e qu e stion by claiming

b e for e t h e Acad e my o f S ci e nc e s that h e had
succ ee d e d in proving t h e origin o f microscopic
organisms apart from p r e e xisting ge rms B ut -
.

Past eur kn e w more than P o u c h e t as to t h e i n

s i d i o u s ways of ge rms : h e showe d t h e we a k
point o f his antagonist s e xp e rim e nts and ’

gain e d t h e pri z e o ffe re d in 8 6 by t h e Acad e m y

,
1 0 ,

55
 Ma st e r p i e c e s of S c i e n c e

for well cont r ive d e xp e rim e nts to throw n e w

-

light upon t h e qu e stion of spontan e ous ge n e ra

tion .
”
As e ve r y o n e knows t h e victory was ,

with Past e ur but t h id e a is an o ld and re cur

,
e

re nt o n and di e s hard Thus not many y e ars

e, .
,

aft e rward Past e ur and Tyn dall had to fight t h e

,

battl e ov e r again with B astian Th e important .

re sult o f what s ee ms at first S ight an abstract dis

c u s s i o n h a s b ee n not onl y an incr e as e d knowl e dg e

o f t h e distribution and diss e mination o f bac

t e r ia but t h e e stablishm e nt o f t h e fundam e ntal

,

condi tions and m e thods of e xp er im e ntal bac

t e r i o lo gy .

H e r e follows substantiall y
' sam e na r rativ e
th e
as that give n by S ir J Risdon B e nn e tt on page s
.

3 6 t o 4 9 of t hi s volum e It r e cit e s h o w Pas

.

t eu r d e vis e d pr e v e ntiv e s for t h e dis e as e which

was d e stroying t h e S ilkworms ; p r ev e ntive s for
spl e nic fe ve r or anthrax ]
O pposition was an e ve r re cur r e nt factor in -

P ast e ur s life H e had to fight for hi s c r ystal

’
.

lo gr a p h i c and ch e mical th e o r i e s and for hi s fe r ,

m e ntation th ory ; h e had to fight against t h e

e

th e ory of spontan e ous g n e ration and for his e ,

practic e of inoc ul ating as a pr e ve ntive against

spl e nic fe v e r ; h e had to fight for e ach st e p B ut .

no part of his work has m e t with s o much 0 p

position and adv e rs e criticism as that conc e rning
hydr ophobia though it is e asy to e xagge rat e t h e
,

importanc e of t h e di scussion in which Past e ur ,

hi ms e lf took littl e p ar t F e e lin g ran high in

.

thi s country ; h e nc e wh e n it was announc e d

,

56
 Lo uis Pa s t e ur and Hi s Wor k
that Past e ur— sur e ly b e st qualifi e d to sp e a k
was to writ e t h e articl e Hv d r O p h o b i a in Cham '

b e r s E c y CIO p md i a a Show r of l e tt e rs inun

’
n
”
,
e

dat e d t h e o ffic e ; h e n e t h e articl e in que stion c

include s an e dito ri all y d e mand e d summary o f

t h e grounds of t h e opposition b y o e o f o u r n

s e lve s and to which th e re fore we ma y r e fe r t h e

,

re ade r .

Whil e avoiding controve rs y and partisanship

as far as may b e t h e que stion re mains What , ,

di d Past e ur do in re gard to hydrophobia ' H is

claims a r e to have prove d firs t of all tha t t h e , ,

dise as was particularly associat e d with t h e

e

n e rvous syst e m Th e virus is usuall y spre ad

.

through t h e saliva but it is not found in t h e ,

blood o r lymph and it has its S p e cial s e at in

,

t h e n e rv e s brain and S pinal cord

, ,
S e condly .
,

h e showe d that t h e vi r us might b e att e nuat e d

in its vi r ul e nc e Th e Spinal cord of a rabbit
.

which has di d of rabi e s i s wh e n fre sh powe r

e , , ,

fully vi r ul e nt but wh e n e xpos e d for a coup l e

,

o f w ee ks to d r y air at a constant t e mp e ratur e

of 2
°
3
— 4 C 2it los
°
e s its virul
. e nc e T h irdly h e .
,

showe d that inoculation with t h e att e nuat e d

virus r e nde re d an animal immun e from infe ction
with rabi e s To mak e t h e animal immun e it
.

has first t o b e inoculat e d wi t h inf ct e d spinal e

cord fourt e e n days o ld th e n with that o f thir ,

t e e n days and s o o n till inoc ul ation with almos t

,

fre shly infe ct e d spinal cord is possibl e In this .

way t h e animal b e com e s r e fractory to t h e i n

fe c t i o n and if it b e bitt e n it will n o t d i e
,
Fourth .

57
 Ma s t e r p i e c e s o f S c i e n c e

ly ,
Showe d that ve n if t h e organism had
he e

b ee n bitt n it was still possibl to sav e it unl ss

e ,
e ,
e

t h e wounds w r n ar t h e h e ad— that is w i thin e e e ,

clos r a h of t h c ntral n rvous syst e m 'o r

e e c e e e .

in t h cas of a sup e rficial wound s y on hand o r

e e ,
a

le g t h e virus tak e s som e consid e rabl t i m to

,
e e

spr ad and duri ng t hi s p riod of spre ading and

e ,
e

incubatio n it is possibl to for e stall t h e virus b y e

inoculation with that which has b e n t t

,

e a en u

at e d In this cas th e r is obvi ous truth in t h e

. e e
”
prov rb He gi ve s twic e who gi v s quickly
e ,
“
e .

And t h e outcom w a s that whi l e out of a hun e ,

dr e d p rsons bitt n nin t n or tw nt y w ill

e e ,
e ee e

in or di n ary circumstanc e s di t h e mortalit y e,

“

among cas s tr at d at t h P as t e ur Institut e h as

e e e e

fall e n to l ss than p e r c nt Accor di ng to

e 1 -2 e .

anoth r s t f st tistics a mortality of 4 p er

e e o a ,
0

c nt has b n r duc d to
e .
p r c nt ; and of ee e e e e .

6 7 3 pati nts tr at d by Past ur s m thod onl y

’
1 e e e e e

t hi rt e n di d e e .

As to t h e adv rs criticism of Past ur s i o u e e e

’
n c

lation aga i nst rabi s it consists first and s cond e , ,

e ,

o f t h e g en e ral argum nt of t h anti vaccina e e -

t i o i t s and thi rdly of S p cific ob j ctions

n s ,
To ,
e e .

th e two form r t h school of Past e ur o f cours e e ,

e,

r pli e s that t h e valu

e of human lif answ rs t h e e e e

on e and t h e r sul ts of e xp r i enc e t h e oth r ;

,
e e e

but on th es e controv rs i s w e cannot e nt r h r e e e e e .

Th e main sp e cific obj ctions w e take to b e thr e e e

that a s t h e micro organism of rabi e s has o t - n

r e ally b e n s e n th e th ory and practic e of

e e ,
e

P ast e ur s anti rabic m e thod lack that stabilit y

’
-

58
 L oui s Pa s t e u r a nd Hi s Wo r k

which is d e sirabl e ; that t h e statistics in favor of

th e Past e ur proce dur e have b ee n insuffici e ntly
criticis e d ; that th e r have b ee n failu r e s and e

casualti e s sometim e s o f a tragic natur e In

,
.

re gard to this last point — that de aths have o c

curre d a s t h e re sult o f t h e suppose d cure i n ,

st e ad o f from t h e ori gi nal infe ction— we may

not e that t h e p os s i bi li ty o f such casualti e s was
admitt e d b y t h e English Inv e stigation Com
m i t t ee whil e o n t h e othe r hand Dr , ,
.

Armand Ruffe r who sp e aks with much authority , ,

d e ni e s wi th all d e lib e rat en e ss that th e re is any

known case in which de ath followe d as t h e r e
sult o f Past e ur s tr e atm e nt ’
.

Mi c r o s c 0 p i c v e rification is of cours e most , ,

de sirabl e and statistics a r e prov e rbiall y d i ffi

,

c ult o f criticism B ut o n t h e whol e w e thin k .

, ,

it like ly that thos e who like ours lve s a r e not ,

e

m e di cal e xp e rts will incline to b e li e ve that S ir

Jam s Page t Dr Laude r B runton Profe ssor
e ,
.
,

G e orge Fl e ming S ir Jose ph List e r Dr Richard , ,

.

'uain S ir H e nry Rosco e and Pr fe ssor B urdon

, ,
o

S and e rson must have had grounds for s a y

i g in t h e r e port which th e y pr e s e nt e d to Parlia
n ,

m e nt in 88 7 It may h e nc e b d e e me d c e r
1 ,
“

, ,
e

tain that M Past e ur has discove re d a m e thod

.

of prot e ction from rabi e s comparabl e with that

which vaccination a ffords against infe ction from
small pox -
.

S O far a summary o f Past eu r s p e rsonal life

’

and S ci e ntific work but is it not possibl e to make ,

a more ge n e ral and rational e stimat e o f th e s e '

59
 Ma s t e r p i e c e s o f S c i e n c e

SO much was hi s life c e ntre d in Pa r is that most

p e opl e a r e probably accustom d to t hi nk o f hi m e

a s a townsman ; but it is mor e biologi all y accurat e c

to re co gniz e him as a r ustic S p r un g from a ,

strong thrifty stoc k o f mountain p e asants

, .

Nor c a h i s r ustic e arly e nvironm e nt o f tanyard

n

and farm of village and co u nt r y sid b e ov e r

,
-
e ,

l ook e d as a factor in d e v e loping that practica l

s e ns e and e conomic insight whi ch we r s o c o e n

s p i c u o u s in hi s life work Th e tann e r s s o n ’

.

b e com e s t h e sp e cia list in fe rm e ntation ; t h e

coun t r y bo y is n e ve r thr oughout his life b e yond
hail of t h e poult r y y ard and t h e fa r m st e ading
- -
,

t h e win e pr ss and t h e silk nur s e r y ; brought up

e

in t h e rur al Fr nch atmosph e re of car e ful t h rift

e

and minut e e conomi e s all c e ntr e d not round ,

t h e m e chanism or e xchange of town industri e s ,

but round t h e actual maint e nanc e o f h u man

and organic life h e b e com e s a gr e at life save r
,
-

in his gen e ration .

In short as w e might almost di agrammaticall y

,

sum it up t h e shr e wd minut e ly car ful y e t i n

, ,
e ,

q ui ri ng r ustic e age r t o un de rstand and th e n to

,

improv e what h e s e e s passe s in an e ve r wid e n ,

-

ing S piral from his rural c e ntre upward from ,

tan pit to vat and vin tage from manur e

-
,

h e aps e arthworms and wat e r supply to t h e

, ,
-

probl e ms o f civic sanitation Th e r ustic .

trage di e s of t h e d e ad cow and t h e mad

dog e xcit e t h e e xplanation and sugge st t h e
pr e v e ntion o f th e se disast e rs ; from t h e p oison
ing of rats and mic e h e passe s to sugge sti v e
60
 Lo ui s Pa s t eu r a nd His Wo r k

e x e rim e nts as to t h e rabbit p e st of Australi a

-

p ,

and so in oth e r cas e s from b e as t to man from ,

village t stat e And on e ach radius on which

o .

h e paus d h e l e ft e ith e r a m e thod or a cl w and

e e ,

s et som e oth e r inquire r at work O n e ach .

radius of work h e has l ft his discipl s ; for h e e e

found e d not only an Institut but a living e ,

school or inde d whol e schools o f work rs We

,
e e .

think of him th e n not only as thinking rustic

, , ,

but as o e o f t h e gre at e st e xampl s in sci e nc e

n e

o f t h e Rustic Think r
— a typ e o f think e r t o o e

rar in our m e chanical and urban ge n e ration

e ,

y e t for whom t h e n xt g e n e ration waits e .

As to his actual l e gacy to t h e world le t u s ,

s u m it up bri e fly Th e r is t h e impulse whic h

. e

h e gav e aft e r t h e succ ssful organization o f h i s

,
e

o wn Institut e to t h e e stablishm e nt in oth e r

,

countri e s of similar laborat ri e s o f pre v e ntiv e o

m e dicin e and o n e may also s a y of e xp eri m e nta l

, , ,

e volution Th re is h i s e ducative work a t

. e

S trasburg and Lill at t h e Ec l e Normal e a n d e, o

t h e S orbonn e and abov e all in t h e small e r

, , ,

y e t world wid e circl e o f his imm e diat e discipl e s

-
.

T ge n e ral biology his chi f contribution has

o e .

b e e n t h e d e monstration o f t h e part which bac

t e ria play not only in pathological and physio
,
~

l o gi cal proc e ss s but in t h e wide r drama of e v o

e ,

lu t i o n . To t h e ch e mist h e has give n a n ew

th e ory of fe rm e ntation ; to t h e physician man y
a sugge stive l e sson in t h e e tiology ' inquiry
into t h e caus e s] of dise ase s and a s e ri s o f bol d , e

e xp e rim e nts in pre ve nt i ve and curativ e i n

61
 M a st e r p i e c e s of S c i e n c e

o eula t i o n of which Roux s tre at me nt o f di p h

,
’

the ri a and Profe ssor Frase r s n e w r e m e d y fo r

’

snake bit e a e e xampl e s at pr e se nt b e fore t h e

- r

public ; to t h e surge on a stabl e foundation as ,

List e r acknowle dge d for antis e ptic tre atm e nt ;

,

to t h e hygi e nist a multitude o f p rac t ical s u g

ge stions conc e r ni ng wat e r suppl y and drainage
-
,

di sinf cti n and burial

e o O n bre we r di still e r
.
, ,

an d w in e mak e r h e has forc e d t h e microscop e

-

and its r e sults ; and h e h a s Shown both a gri c ul

turi st and stock bree de r h o w som e at l e ast o f
-
, ,

th ei r man y more than t e n plagu e s ma y b e ei t h er

a v e rt e d o r all e via t e d .

62
TUB E R CUL O S I S A N D IT S PRE V E N T I O N
T M I T C H E L L P RU D D EN M D
.
, . .

Dr
' Prudd n is Pr f ss r f P th l g y in t h C ll g f
. e o e o o a o o e o e e o

P h ysi i ns d S urg ns N w Y rk H h b st w d
c a an eo ,
e o . e as e o e

e s p i l tt nti n u p n t h m ns f p r nting dis s in

ec a a e o o e ea o ev e ea e:

th t im p rt nt fi ld h h writt n thr
a o a pit l m nu ls
e e as e ee ca a a a ,

ll p ublish d b y G P P u t n m s S ns N w Y rk S t ry ’ “
a e . . a o ,
e o : o

o f t h B t ri
e D ust d I t s D ng rs W t r d I
ac e a ,
” “
an a e ,
” '
a e an ce

S u p p li s H is th r w rk s int nd d f
e .
”
th pr f ssi n l
o e o ,
e e or e o e o a

r drea e f t h hi g h st uth ri t y
,
a re o Th rti l h r gi n
e e a o . e a c e e e ve

a pp r d in H p M g i M r h 89 4 ; p y right b y
ea e ar er s
’
a a z n e, a c , 1 co

H rp r
a B r t h rs wh h
e gr nt d p rmissi n t r print
o e ,
o ave a e e o o e .

I n M y 9 th s p g s w r r i s d b y D r P d d fl
a ,
1 0 2 ,
e e a e e e ev e . ru en

is commonly n e ith e r wise nor n e c e ssary

IT
for p e opl e not profe ssionally conc e rn e d t o
think much about dise ase or w e igh anxiously ,

t h e chanc e or mod e o f its acquir m e nt B ut e .

n o w and th e n conditions aris e which d e mand

ge n e ral att e ntion and instruction re garding c er

tain dis e ase s in orde r that a gre at thre at e ning ,

calamity may b e ave rt e d S u c h a condition .

fac e s t h e p e opl e in all lands to day in t h e a p -

palling pre val e nc e o f tub e rculosis A dis e ase .

which in mild o r s ev e re form a ff ects at l e ast

o e half of t h e whol e human rac e
n -
and which ,

cause s t h e d e ath of full o n e s e ve nth o f all who -

pass away killing about o n e third o f those ,

-

who p e rish b twe e n t h e age s of fift e e n and e

fo r t y fiv e—a dis e ase which is most insidious

-

63
 Ma st e r p i e c e s of S c i e n c e

in its onse t and oft e n r e l entl e ss in its course

, ,

and which may b e large ly pre v nt d— is o e e e n

about whi ch w e cannot b e in di ffe re nt and ,

shoul d not b e longe r inactiv e .

The re has long b ee n r e ason for b e li evi ng that

tub e rculosis is a communi cabl e di se ase Its .

pre val enc e in c e rt ain famili e s and commun iti es ,

its fre qu nt occurr e nc e i n those wh o hav e p er

e

s o a lly a t t e nd e d upon its victims

n its onse t in
,

thos e who hav e occupi e d apartm e nts vacat e d

by consumptive s— such facts obse rve d ov e r and
ov e r again abundantly justify t h e b eli e f in its
communicabili ty Up to t h e comm e nc em ent
.

o f t h e last d e c d e t h e caus e of t h e di se as e w a s
a

altogeth e r u n known and no de finit e data we re

,

at hand which could e nabl e us to fix upon a

fe asibl e plan for li mi tin g i t s ravage s B ut in .

th e s e lat e r y e ars a gre at light h as b ee n thrown

upon this and oth r ki ndr e d di se ase s
e .

Most int e llige nt p opl e a r e awar e that within

e

t h e past d e cad e a n e w fi e ld in t h e domain o f

l i fe h a s b ee n r v e al e d and wide ly e xplore d It
e .

h as b ee n l e arn d that in e arth and air and

e

wat e r the re e xist countl e ss myriads of livin g

things s o minut e as to li e far b e yond t h e limits
o f t h e un aid e d vision and y e t in t h e aggre gat e
.

s o pot e nt in t h e maint e nanc e o f t h e cycl e of

’

life upon e arth that without th e ir activity

all life would soon c e as e to b e and t h e e le ,

h e nts which for a short span fall un d e r t h e

sway o f t h e life forc e s in all hi gh e r animals and

plants would laps e finally and irr e vocabl y
64
 Tub er c ul o sis a nd It s P r e v e n t i o n

into th eir primal stat e Th e s e tin y organism s .

a e
r call d g rms microb e s or micro organ
e e , ,
-

isms O e gr at and important group of th e m

. n e

b e longs among t h e m i c r o s c 0 p i e plants call e d

bact e ria Th e s bact e ria a s a class a e i m
. e r

po r tant in the ir e conomy of nature b e cau se ,

th e y liv e for t h e most part on d e ad organic

—
mat rial that is such mat e rial as has onc e
e ,

form e d a portion of som e livi ng thing .

Th e world s stor e of availabl e oxyge n h y

’

droge n carbon and nitrogen out of which all

, ,

living b e ings a e larg ly form e d is limit e d and

r e , ,

if aft e r th e se hav e s rv e d th ir t mporary use s e e e ,

as t h e m e dium through which that myst e riou s

pot e ncy call d life alon can find e xpre ssion
e e ,

th e y we re not sp ee dily r l as e d n ew ge ne rations e e ,

of li ing b ings could n e ith e r assum e nor main

v e

tain th eir plac e in t h e gre at cycl e of life And .

s o th e s e tiny plants y e ar in y e ar out by day, , ,

and by night unse e n and mostly unh ee de d

, ,

a r e busy always in making possibl e t h e r e turn

o f e ach y e ar s visibl v e ge tation and t h e main

’
e

t en a c e of an unbrok e n succ e ssion of g e n e ration s

n

in man and b e ast .

Di ff e r nt groups and rac e s among t h e bact e ria

e

hav e di ffe r nt habit ations and vary wide ly in

e ,

th eir sp e cial powers Compl e x and powe rful .

as is t h e aggr e gat e re sult which th e y ae com

p li sh in t h e world t h e p e rformanc e s of t h
,
e

indi vidual a r e comparativ ly S impl e Th e y a e e . r

most lib e rally e ndowe d with t h e capacity fo r

multiplication and e ach ge rm acts as a tiny
,

65
 Ma st e rp i e c e s o f S c i e n c e

ch e mical labo rato r y taki ng into its e lf t h e o r ,

gani e matt r on which it fee ds and re solvi ng

e ,

it into n ew compoun ds S om e of t h e latt e r a r e .

use d in building up and maintaining i t s o wn

body whil e othe rs a e gi ve n o ff into t h e s u r
,
r

roun di ng m e dia .

We a r e but j ust b e ginning t o p ee r at t h e

myst e rious proc e sse s whi ch go o n unde r t h e
infl ue nc e o f t h e bact e r ia in thi s un der world
o f life and to r e aliz e that all t h e lore whi ch
,

unwe ari e d toil e rs i n t h e past have gath e re d in

th ir studi e s of t h e visibl e fo r ms of animals
e

and plants mak e s but o e of t h e man y chapt e rs

,
n

in natur e s story book of l i fe

’
-
.

B ut thi s n e w and stimulating point o f vi e w ,

toward which t h e studi e s o f t h e past de cade

hav e le d us doe s not look s o large ly into t h e
,

domai n of t h e practical that it would gre atl y

attract t h e majo r ity o f busin e ss and pl e asure and
ennu i ri dd e n manki nd w e re it not for o e v e ry n

p ractical fact whi ch th e se r e c e nt stu di e s have r e

v e al e d Thi s i s that among t h e myr iads of

.
,

altogeth e r b en e fic en t bact e ria which p e opl e t h e

e arth and a i r and wat e r
, th e re a r e a few fo r ms
, ,

which have chose n out of all t h e world a s th ei r

most conge nial r e side nc e t h e bodi e s o f m en .

B ut e ve n this wo ul d b e of onl y p assin g int e r

e s t t o most p e opl e w e re it not still fur th e r u n

fortunat e l y true that i n t h e p e rformanc e o f

th e ir simpl e life proc e sse s th e s e man loving -
o
-

bact eri a fee ding o n t h e tissue s o f th eir host

, ,

and se tting fre e c e rtain subtl e p oisons in h i s

66
 Tub e r c ulos is an d It s P r e v e nt ion

blood e ach aft e r its kind can induc e those

, ,

di sturbanc e s Of t h e body s functions and thos e

’

change s in its structure which we call dis e as e .

Th e dis e as e s caus ed b y t h e growth o f ge r ms

in t h e bo dy a r e call e d infe ctious Th e ger ms .

c ausing som e of t h e infe ctious di se ase s a r e

giv en o ff from t h e bodi e s o f th e ir victims in
such form as to b e re adily transmitt e d through
t h e air to oth e rs in whom th e y may incit e
,

similar dis e ase S uch dis e as e s a r e sp o k e n o f

.

as re a di ly communicabl e though it is not actu ,

all y t h e dis ase its elf but only t h e ger m causing

e ,

i t , w h i ch is transmitt e d In oth er infe ctious .

dise ase s transmission but rare l y occurs Many .

i nfectious dis e as e s a r e v e r y e asily communi ‘

c a t e d from t h e sic k to t h e w e ll un d e r un sanita r y

and uncl e anly conditions which with p r o p er ,

care a r e v e ry littl e liabl e to spre ad .

I ne e d not h e re put o n parade t h e who le

uncann y list of ge rm di s e as e s in which tub er ,

c u lo s i s stands fore most followe d b y pn eu ,

monia diphth e ria typhoid fe ve r scarl atina

, , , ,

ch ol era small po x and t h e re st N o r n ee d I

i

-
, , .

call to mind t h e m e ans by which o u r g r owin g

knowl e dge in this domain has b een day b y da y
laid unde r tribut e for sugg e stions of h O p e and
safe t y for t h e strick e n It is a re cord of brilliant
.

conque st in nature and alre ad y o f far—

, re aching
b en e fic en c e to man .

B ut t h e gre at fundam ental advance which

S ignaliz e s t h e past d e cade is t h e lifting o f thi s
whol e class o f fat e ful ge rm dis e ase s o u t o f t h e
67
 Ma s t e r p i e c e s o f S c i e n c e

re gion of t h e intangi bl e and myst e rious and ,

th e ir e stablishm e nt on t h e basis o f positive

,

e xp e ri m e ntal r e s arch in t h e domain of t h e

e ,

c ompr e h e sibl e and d e finit e

n Th e things which .

c aus e th e m a r e no long r for us myst e r ious e

e manations from t h e sick or incorporat e e x ,

pre ssions o f malign forc e s against which con

j u r a t i on s o r pray e rs could alon e promis e pro
t ec t i o n ,
but th e y a r e particulat e b e ings n e v e r ,

s e lf e ng e nd e r e d
-
n v e r e volve d in t h e body
,
e ,

always e nt ring from without things which

e —
w e can s ee and handl e and ki ll .

L e t us now glanc e at t h e g e rm call e d t h e

tub e rcl e bacillus t h e ger m which induc e s and
,

which alon e can induc e tub e rculosis It do es .

not e xist and t h r iv e in t h e body of m en o r a ni

mals in h e alth Without t h e ntranc e of this
. e

particular ger m into t h e human body from with

o u t tub e rculosis cannot d e v e lop in it
,
Without .

t h e trans m ission of t hi s g e rm in som e wa y o r

o th e r in a living condition from t h e S ick to t h e
w e ll tub e r ulosis cannot Spre ad In t h e life
,
c .

s t ory of thi s tiny ge rm li e both t h e pot enc y

fo r misch i e f which w e d plore and t h e s e cr e t o f e

o ur r el e as e from i t s bondage .

Th e tub e rcl e bacillus is a littl e colourl e ss ,

rod like plant s o small that e v en many thou

-
,

s ands O f th e m pil e d toge th e r wo ul d mak e a h e ap

far too small to b e visibl e to t h e nak e d ey e .

It cannot mov e about nor c a n it grow without ,

moistur e nor at a t e mp e rature much abov e

,

o r much b e low that o f t h e human bod y Th e .

68
 Tub e r c ul o sis a nd It s P r e v e nt i o n

mat e rial o n which it fe e ds must b e v e ry nic e ly

a dapt e d t o its r e quir e m e nts and it has no lurk ,

ing and growing plac e s in natur e outsid e o f

t h e bodi e s o f m e n and a few warm blood d -
e

animals .It c a n b e cultivat e d artificially in

t h e laboratory and we know mor e about its
,

life and p e culiariti e s than about almost a v n

o th e r ge rm Whil e it c a n r emain alive in a

.

d ri e d stat e for man y w e e ks it is r e adily kill e d ,

b y h e at by sunlight and b y many of thos e

, ,

c h e mical substanc e s which w e call disinfe ctants .

It do e s not flour ish e quall y w ell in t h e bodi e s

o f all human b e ings .

Wh en onc e it gains lodgm ent in a body

suit e d to its growth it multipli e s slowly e ach ,

g e rm dividing and subdividing taking from ,

t h e tissu e s mat e rial for its growth and r e turn ,

ing to th e m c e rtain subtl e poisons which it s ets

free Th action of t h e tub e rcl e bacillus is p ec u
. e

liar i n that it stimulat e s t h e c e lls o f t h e body ,

wh e r ve r it may lodge and grow to t h e forma

e ,

tion of littl e mass e s o f n ew tissue which we ,

call tub e rcl e s Th e s e tub e rcl e s a r e as a rul e

.

short live d and if t h e dis e as e progr e sse s t e nd

-
, , ,

to disint grat e If t h e tub rcl e s hav e grown

e . e

in such situations as to mak e this possibl e as ,

in t h e int e stinal canal or t h e lungs t h e dis ,

int e grat e d and broken down mat e rial Oft e n -

,

containing myriads of t h e living ge rms may ,

b e cast o ff from t h body In tub rculosis o f

e . e

t h e lungs or consumption this wast e mat e rial

.
, ,

is thrown o ff with t h e sputum ' spittl e ] Whil e .

69
 Ma s t e r p i e c e s of S c i e n c e

almost any part o f t h e body may b e a ffe ct e d ,

tub e rculosis o f t h lungs i s by far t h e most

e

common form of t h e dis as e e .

It follows from what has b ee n said that t h e

only way in which we c a n acqui r e tub e rculosis
i s by g e tting into our bodi e s tub e rcl e bacilli
from tub e rculous m en or animals Th e only .

animals liabl e to conv e y t h e dise as e to man a r e

tub e rculous cattl e and th e s e through t h e u s e
,

of eith e r m e at or milk Th e dange r from t h e

.

u s e of unc o ok e d m e at or t h e un boil e d mil k from

tub e rculous cattl e is r e al and s e rious but it ,

will not b e consid e re d h e re at l e ngth b e caus e ,

t h e gr e at and pr e vailing dang e r of infe ction

com e s fro m anoth e r sour c e .

Almost as soon as t h e s i gn i fic en c e o f t h e
tub e rcl e bacillus was e stablish e d a s e ri e s o f ,

studi e s was un d e rtak e n on t h e possibility of

t h e spr e ad of t h e dis as e by t h e bre ath o r e x
e

halations of t h e p rsons of consumptiv e s Th e s e

e .

studi e s at onc e show e d that t h e tub e rcl e bacillus

cannot b e give n o ff into t h e air of t h e br e ath
from t h e moist surfac e s of t h e mouth and air
passage s nor from any mat e rial which may
,

com e from th e m whil this mat e rial r emains

e

moist nor from h e althy unsoil e d surfac e s o f

,

t h e body . Th e e stablishm e nt of this fact is of

far re aching cons qu enc e b e caus e it Shows that
-
e ,

n eith e r t h e p erson nor t h e bre ath of t h e C o n

s u m p t i v e is a dir e ct sourc e o f dang e r e v e n to ,

t h e most constant and intimat e att e ndants .

Whil e th e discharge s from t h e bowe ls in p e r

70
 Tub e r c ul o si s a nd It s P r e v en t ion

sons su ffe ring from tub e rculosis o f t h e i n

t e s t i n a l tract may contain man y living bacilli ,

t h e usual mod e of disposal of th e s e di scharg e s

prot e cts us from any conside rabl e dange r from
this source .

It is t h e S putum aft e r its discharge from t h e

bo dy o n whic h our att e ntion must b e fix e d .

Whil e t h e sp u tum is moist it c a as a r ul e n , ,

do no h arm unl e ss it Should b e dir e ctly trans

,

m i t t e d to those who a r e w e ll by viol e nt cough

ing snee zing e t c by t h e u s e o f uncl e anse d
, ,
.
,

coo king o r e ating ut e nsils by soil e d hands , ,

o r by such intimat e p e rsonal C ontact as kissing

o r fondling B ut if in any way t h e sputum

b e com e s dri e d on floors or walls or b e dding o n
, ,

handke rchi e fs or towe ls or on th e p e rson o f

,

t h e pati e nt it may s o on b e com e diss e minat e d

,

in t h e air as dust and c a n thus b e bre ath e d

,

into t h e lungs o f e xpose d p e rsons .

Th e wid e distribution of tub e rcl e bacilli in

t h e air o f living rooms -
and in oth e r dust y
,

plac e s wh e re p e opl e go is d u e partl y to t h e

,

fre qu enc y o f t h e dis e ase and t h e large numb e rs

o f living bacilli which a r e c a s t O ff in t h e S putum

( som e tim e s millions in a day) and partl y t o ,

t h e fact that many o f t h e victims o f c on s u m p

tion go about among the ir fellows for purp ose s
o f busin e ss or pl e asure for months o r y e ars .

S O e ach consumptiv e if not int e llige ntl y car e ful

, ,

may ye ar aft e r y e ar b e to his fe llow m en a -

sourc e o f active and s e rious and continual i n

71
 Ma s t er p i e c e s o f S c i e n c e

This th e n t h e dri e d uncar e d for sput u m

, , ,
-

of those su ff e ring from pulmonary tub e rc ul osis ,

is t h e gr e at sourc of dange r ; this t h e m e ans

e

s o long conc e al e d by wh i ch a larg e part of t h e

human rac e pr ematurely p eri sh e s Le t but this .

di scharge d mat e rial b e r e nd e r e d harml e ss o r

d e stroy e d b e for e it dri e s in all cas e s and t h e ,

ravage s of thi s scourge wo ul d large ly c e ase .

This i s not a th e or tic matt r only for agai ne e ,

and agai n have t h e living and viru l ent ge rms

b ee n foun d clingi ng to t h e w lls and furni tur e a

and b e dding and han dk e rchi e fs o f c o n su m p

tiv e p e rsons and in t h e dust o f t h e rooms in
,

which th e y dwe ll A malady whos e vi tims far

. c

outnumb e r those of all oth e r infe ctious dis

e ase s put togeth e r sparing n eith e r rich nor,

poor se izi ng upon life whil e it is as y e t only a

,

promise but most in e xorabl e in t h e fuln e ss of

its tide—this malady can b e large ly pr e v e nt e d
,

by t h e uni ve rsal and p e rsist e nt practi c e of

int ellige nt cl e a lin e ss n .

We hav e l e arn e d in t h e past few y e a r s o n e

fact about tub rculosis which is of incalculabl e
e

comfort to many and that is that t h e dise ase

,

is not h e re ditary It is v e ry important that

“

w e should und e r stand this b ecaus e it se ems ,

t o contradict a long pre val e nt tra di tion and

.
-
,

a be li e f still wid e ly and sorro w fully e nt e r t ai n e d .

B act er ia and e sp cially most dis e as e producin g

, e -

b act eria a e v e r y s e nsiti e in t h e matt e r of

,
r v

gr owt h an d r e production to t h e con di tions

un der whi ch th e y a e plac e d and e spe cia lly r ,

72
 Tub er c ul o s is a n d It s P r e v e nt i o n

to th e mat e rial o n which th e y fee d S o that a .

ge rm which can induc e s e rious di s e as e in o e n

S p e ci e s o f animal is harml e ss in t h e body of a

di ffe re nt though clos e ly alli e d form More than .

this di ffe re nt individuals o f t h e sam e S p e ci e s

, ,

or t h e sam e individual at di ff e re nt tim e s may ,

have t h e most marke d di ffe re nc e s in s u s c e p t i

b i li t y in t h e pre s e nc e o f disease producing -

ge rms What this subtl e di ffe re nc e is we do

.

not know Whe the r t h e body at o n e tim e a ffords

.

a conge nial soil to t h e invading ge rms and at

anothe r do e s not wh e the r its marve lous and
,

compl e x powe rs of re sisting t h e virul e nt t en

d e n c i e s of di s e as e producing bact e ria at o n e
-

p e riod or in o n e individual a r e more vigorous

than in anoth e r and vary at di ff e re nt tim e s
, ,

w e do n o t c e rtainly know This howe ve r w e

.
, ,

do know that c e rtain individuals a e more

,
r

like l y than oth e rs to yi e ld to t h e incursions of

t h e tub e rcl e ba illus c This vuln rability in
. e

t h e pre s e nc e o f invadi ng ge rms we call s u s

c e t i b i li t y
p and susc
,
e ptibility to t h e action o f

t h e tub e rcl e bacillus is h e r e dita r y It is not .

t h e dis e as e t u b e rculosis which com e s into t h e

.
,

world with c e rtain individuals o r with succ e s

siv e children o f t h e sam e famil y but t h e apti ,

tude to contract it should ext e rn al conditions

favour What subtl e impre ss on t h e c e lls which
.

a r e to d e v e lop into t h e n e w individual r e nd e rs

him more than anothe r an e asy pre y to t h e

t ub e rcl e bacillus should it lat e r find lodgm ent
in his body we do not know and we ma y n o t ,

73
 Ma st er pi e c e s of S c ren c e

hop e soon to b e e nlight e n e d s i nce all t h e i n ,

t ri c a t e myst e ri e s o f h e re dity s ee m involv e d in

t h e probl e m But this w e do know that how
.
,

e v e r much t h e c hi ld of tube rculous pare nts o r

a m emb e r of a tube rcu l ous famil y may b e p r e

di spos e d to t h e dise as e h e cannot acqui r e tub e r
,

c u lo s i s unl e s s by som e mischanc e t h e fat e ful

ge r m ent e rs his b o d v from wi thout Wh at h a s .

be e n all t h rough th e se y e ars r e gard e d a s t h e

strong st pro of o f t h e h e re dita r y transmission
e

o f tube rcul o sis — a m e lv nt h e occurre nc e of t h e

,

dise se i n s v e ral m emb rs of t h e sam e house

a e e

hold— is in t h e n ew light simpl y t h e re sul t

,
,

of hous ehold infe ction — t h e bre athin g of air

e sp e cially li abl e t cont ain t h e noxious ge rms
o ,

or th eir e ntranc e in som e oth e r way into t h e

bodi s of p rsons e sp e cially se nsitive to th e ir
e e

pre s nc
e e I do not m e an to impl y that unde r
.

no conditions can t h e tub e rcl e bacillus b e trans

m i t t d from t h e moth r to t h e child b e for e
e e

i t s b i rth .In a f w inst anc e s this is be li e ve d

e

t o ha e happ en e d B ut its occurr e nc e is so

v .

e xtr e m e l y infr e que nt that it may b e r e gard e d

as accide nt al and of n o se ri ous impo r tance
,

from o u r pr s ent poi nt of vi e w

e .

But it will p rhaps b e said If t h e tube rcl e

e ,

baci lli a r e s o wi d e ly di ff se d why do w e not u ,

all acqui re tub e rculosis and wh y w a s t h e world

,

not long Sinc e d e populat e d '

In ord e r t o ex
pl a in this matt e r I must ask t h e r e ad e r to look
with m e for a mom e nt at som e of t h e body s ’

natur al safe guards against bact e rial and othe r

74
 Tub er c u l osi s a nd It s P r e v e nt i o n

i nvad e rs from t h e air It has b ee n found that

.

a p e rson bre athing in ge r m and dust lade n air -

through t h e nose br e ath e s ou t again air which

is both dust and ge rm free Th e air passage s .

o f t h e nose a r tortuous and lin e d with a moist

e ,

m e mbran e against which t h e air impinge s in

,

i t s passage . O n th e se moist surfac e s most o f

t h e solid susp e nd e d particl e s t h e g e rms among ,

th e m a r e caught and he ld fast and may b e

, ,

t hrown o ff again by s e cr e tion In bre athing .

through t h e mouth this safe guard is not util

i ed
z . Again t h e upp e r p assage s l e ading to
,

t h e lungs a r e lin e d with a d e licat e m e mbran e

o f c e lls ,
whos e fre e surfac e s a r e thickly b e se t
with tiny hairlik e proj e ctions Th e s e p r o .

j e c t i o n s a r e constantly moving bac k and forth

with a quick swee p in such a wa y that th e y

,

carry small particl e s which may hav e e scap e d

t h e barri e rs abov e up into t h e mouth from ,

which th e y may b e r e adily discharge d In thi s .

way much of t h e e vil of bre athing dust and

ge rm lade n air is ave rt e d B ut in S pit e of the se
-
.

natural safe guards a gre at d e al of foreign mat e rial

doe s und e r t h e ordinary conditions of life i
, n

doors o r in dust y plac e s find lodgm e nt in t h e

,

d elicat e r e c e sse s of t h e lungs Th e body tol e r .

at e s a good d e al of t h e de l et e rious mat e rial ,

but its ov e rt aske d tol e ration fails at last wh en ,

s e rious dise ase may e nsue .

Wh e n ordinary forms of living bact e ria g e t

into t h e tissue s of t h e body a v e r y compl e x ,

c e llular m echanism not full y unde rstood usually

, ,

75
 Ma s t e r p i e c e s of S c i e n c e

re sults in th e ir de struction and u ltimat e r e

moval In t h e pr e s e n e o f t h e tub e rcl e bacillus
. c

t h e body c e lls a r e oft e n abl e to build a d e ns e

e nclosing wall around t h e a ffe ct e d re gion ,

shutting it o ff from t h e r e st o f t h e body This .

i s o n e of t h e mod e s o f natural cur e Th e body .

c e lls a r e som e tim e s abl e if sustain e d by nour ,

i s h i g food and an abundanc e o f fre sh air to

n ,

car ry on y e ar aft e r y e ar a succe ssful st r uggle

, ,

w ith t h invading g rms s o that t h e us e fuln ss

e e , e

and e njoym e nt o f life a r e b u t littl e int e rfe re d

with Finally a c e rt a in proportion of human
.
,

b e ings s eem to b e e ndowe d at birth wi th som e

as y e t unknow n quality in t h c e lls o r fluids e

of t h body which naturally u n fit s th e m for

e

t h e life us e s of t h e tub e rcl e bacillus and s o ,

r ende rs t h e in di vidual for longe r o r short e r

p e riods practically immun e .

O th e rs on t h e contrary a e as w e have s een

, ,
r , ,

from birth unusually susc e ptibl e This inh e rit e d .

susc ptibility to t h incursions of t h e tub e rcl e

e e

bacillus should th i s find lodgm e nt in t h e body

,

from without by no m e ans always re v e als

,

its e lf in any appare nt lack o f vigour o r robust

n e ss of t h e body S till any habit or mode o f
.
,

life which diminish e s t h e bodily vigour wh eth er ,

in those pre dispos e d to this malady o r in t h e

appare ntly immun e and give s it a l e aning to
,

ward dis e ase di minish e s as a rul e t h e chanc e s

, , ,

o f a succ e ssful cont e st with t h e bacillus An d .

s o it is that in spit e of t h e wid e dist r ibution

of th e s e fat e ful ger ms in fre que nt e d p l ac e s ,

76
 Tub e r c ul o sis a nd It s P r e v e nt i o n

and t h e t en d e ncy o f c e rtain vuln r bl p e rson s e a e

to su umb t th ir ravage s so many p opl e

cc o e ,
e

r
a e not a ffe ct e d by th em d so ma y a l ,
an n ,

though not altoge th e r scaping the ir malign e

influe nc e a , y t abl e t
re wre st at le ast a
e o

m o i t v of life from t h e h nd
e f t h e gr at a o e

d e stroy e r .

Th e d e gr e e of succ e ss which may att e nd o u r

crusad e ag inst tub e r ul s s will large ly d e p e nd
a c o i

upon t h e wid e di ffusion of t h e knowl e dge of

i t s communicability by m e ans f t h e sputum o

dri e d and powd r e d and floating in t h e air as

e

dust and t h e int e llige nt p e rsist e nc e w ith which

,

t h e morbid mat e rial may b e saf ly are d f r e c o

at its sour s Th e re solut e avoidan e by c o n

ce . c

s u m p t i e s of t h e not only filthy but dange rous

v

pra ti e of spitting upon floors or str ts or

c c ee ,

anyw h e re e ls e xc e pt into prop r r e c e ptacl e s ;

e e

th e u s of re c e pta l e s which may b e and a e

e c r

fre qu ntly and thoroughly cl e a s e d and b e st

e n , ,

o f all of wat e r proof pap e r cups which with

,
-
,

th e ir cont e nts may b e burn e d ; or wh e n cir ,

c u m s t a n c e s r e quir e t h re c iving f t h e dange r

,
e e o

ous mat e rial o cloths nJapan e s e pap e r n p

or a

kins which may b e de stroy d by fi e and t

,
e r ,
no

on more valuabl e handke rchi e fs o n which

th e sputum is allowe d to dry whil e in u s e or
b e fore disinfe ction and washi g ; scrupulous n

care by othe rs of t h e sputum o f those too ill

to care for it th e mse lve s— th e se a r e t h e o m c

p a r a t i v e ly S impl e m e ans from which w e may

most confid entl y e xp e ct r eli e f Th e d e tails o f .

77
 Ma st er p i e c e s of S c i e n c e

th e se pre cautions and th e ir adaptation to t h e

sp e cial cir umstan e s o f those su ffe ring from
c c

th edis e as e can b most wis e ly l e ft to t h e phy

e

si i an
c and though of paramoun t importanc
,
e,

n e d n o t furth e r e ngage our att e ntion h e r e

e .

To t h e onsu mptive hims lf th e s e m e asur e s

c e

a r e not wi thout a vital significanc e For his .

cha c e s f r e cove ry may b e in no small d gr e

n o e e

di m i nish e d if h e b e mor e o r l ss const ntly e a

liabl e to a fr sh inf ction from m t ri al whi ch

e e a e

h e has onc e got rid of and which shoul d hav e ,

b ee n de stroy e d .

Th e gr e at volum s f fr e sh moving air which e o ,

w e e ncoun t r out o f doors i n prop e rly cl e ans d

e - -
e

str ee t s usually s o gr e atly d i lu t s t h dust of e ,

what e v e r k ind that littl e appre h e nsion n e e d

,

b e fe lt from its pr e s e nc e Wh e n howe ve r in .

, ,

crowde d citi e s t h e stree ts a r e as is n e arly a l

, ,

ways t h e case sav e for a few favor e d localiti s

,
e ,

filthy and but fit fu lly car e d for ; wh e n choki n g

,

dust clouds must b e e ncoun t e re d by t h e citiz e n

duri ng t h e haphazard and slatt er nly e ssays at
cl e aning made b y untrain e d and irre sponsibl e
swe p rs ; w e cannot ignore a dange r fr om stree t
e e

dust whi h may w e ll incit e grav e appre h e nsion

c .

Th e citiz e n c a n if h e must run from t h e pr e s

, ,

e nc e of cloud e w a p p e d machi n e s fur iousl y

-
n r

whirl e d along half sp r inkl e d pav e m e nts ; h e may

-

avoid a block o n whi ch t h e hand swe e p e rs in -

,

t h e abs e nc e o r in disre gard of rule s ply th ir ,

e

n e farious brooms ove r unwe t surfac e s b e cause ,

t o o i ndo le nt o r in di ff e r e nt t o sprin kl e th e m
78
 Tub er c ulo si s a nd It s P r e v en t i o n

th e se t hi ngs h e c a n do if h e b e not wil ling o r

r e ady to appl y t h e citi z e n s re m e dy fo r munici
’

pal misrul e .

B ut it is in rooms e ith e r of dwe lli ng o r ass e m

bling plac e s that t h e ill e ff e cts of infe ctious
dust a r e most pot e n t b e caus e t h e a i r is h e re
,

not s o constantly ren e we d as i t i s o t o f doors u - -

,

and is liabl e to b e bre ath d ove r and ov e r again

e .

Dust whi ch ge ts into house s do e s not re adil y

l e av e th e m unl e ss sp e cial and int e llige nt m e ans
,

b e dir e ct e d to its r e moval We do not usuall y

.

r ali z e that though t h e air its e lf in inhabit e d

e ,

rooms is constantl y changing more o r l e ss

rapidly by di ffusion by draughts o r by p u r
, ,

pose d v e ntilation fi e dust particl e s a r e not

,
n

r e move d unde r t h e sam e in fl ue nc e s in propor

t i o n a t e d e gr ee . Th e y cling more or l e ss t en
a c i o u s ly to all surfac e s on which th e y hav e
s e ttl e d and e sp e cially to fabrics so that c u r
, ,

r e nts o f abundant forc e and su ffici nt d i s t r i b u e

tion to change t h e air may a d usually do n

l e ave t h e lodge d dust particl e s almost e ntire ly

undi sturb e d .

O e of t h e most thr e at e ning t e nd e nci e s of

n

mode r n tim e s in matt e rs o f h e alth is that of

ov e rcrowding in citi e s and t h e gr e at e l e m e nt
,

of dange r from this ov rcrowding is not onl y

e

and not chi e fly t h e insuffici e nc y o f air i n livi ng

rooms and t h e lac k o f re ad y m e ans fo r i t s r e
n ewal but t he accumulation in this a i r of i n
,

fe c t i o u s g e r ms fl o ating with t h e dust Abundant .

wat e r supply and go o d s e w e ra ge hav e r e nde re d

79
 Ma s t e r p i e c e s of S c i e n c e

p ossibl e and m e asurably safe s o far as t h e ,

ordina r y wast e of life is conc er n e d t h e buildi ng ,

of vast t e n e m e nts which swarm with p e opl e .

B ut t h e m e ans of ge tting pure air and e sp e ciall y ,

o f di sposing of infe ctious mat ri al oft e n fl oating e

in it wh e n it is confin d have not at all k e pt e ,

pac e with t h e d e mands o f h e alth and c le a n li ~

n e ss
.

B ut wh e n w return to large r and more lib e r

e

a lly fu r nish e d dw e llings of t h e w e ll to do class e s - -

,

w e a e not r assur d for in som e r sp cts t h e

r e e ,
e e

rich a e sadly handi app e d by t h e tyranny

r c

o f things O f ours e long and thick pil e d car

. c ,

p e ts a ff ord p e rsist e nt lurking plac e s f r infe ctious -

o

a s w e ll as oth e r dust C e rt i nly h e avy hang .

a

ings in a m e asur e hi nd e r t h e de t e rge nt action

of t h e sunlight Shut t h e us d air in and t h e
,
e

fr e sh a i r out and sh e lt e r floating matt e r which

,

might oth e rw ise e scap TVi t h o t doubt c o m e .

’
u ,

pl e x upholst e r y with rough n e d fabrics i n e

cr e as e s t h e d i fli c u lt i e s in t h e maint e nanc e of
cl e anlin e ss B ut t h e usage of t h e hous e hold e r
.

in th e s e matt e rs w ill aft r all d e p e nd upon ,

e ,

wh e th e r his practical d votion b e most at e

Fashi on s o r H y g i a s shrin e ‘ e may hop e

’
e
’
.
V

fo r t h e coming of a tim e wh e n cl e an cl ar ,
e ,

a-iry S imply furni sh e d li ing rooms shall re plac e

,
v -

t h e stu ffy f bric stre wn apartm e nts in which

,
a

t h e fashi onabl e citiz e n s o much d e lights to

da y .

I n o n e particular how v e r t h e d e votion to

,
e ,

c l e anlin e ss ma y b e unr e s e rv e dly insist e nt and ,

80
 Tub e r c ul o s is a n d It s P r e ve nt ion

that is that in t h e cl e anin g o f living rooms -

,

wh e th e r occupi e d by t h e S ick or t h e w e ll t h e ,

distin t and r n o gn i e d purpos e o f t h e Op e ra

c e z

tion shall b e to r e mov e and not simply to stir ,

up t h e e v e r gath e ring dust Th e past fe w y e ars

,
-
.
’

so b e e fic e t ly S ignaliz e d by t h e e xp lo i t a t i bn
n n

of th n e w ge rm lor e
e hav e s ee n mark e d d e part
,

ure s from t h e traditional sw ee pings and dust

ings of a past e r a ; and t h e e mancipation o f t h e
house k ee p e r and incid e ntally of t h e hous ehold
, ,

from t h e thrall of t h e p e stife rous fe ath e r dust e r

s e e ms fairly und e r way S till som e o f t h e old
.
,

barbarous trav e sti s upon cl e aning wid e l y p e r

e

sist Th e d r y broom still s e ks out in t h e d ee p

.
e

r c ss e s o f t h e car p e ts not t h e coars e r particl e s

e e

o f dirt alon e but t h e hord e s of living germs

,

which we re for t h e tim e safely e nsconc e d and ,

amon g the s e such malign ant forms as t h e

chanc e s of t h e day have gath e r e d Th e se all .

a r e s e t awhirl in t h e air ; som e coll e ct upon sali e nt

points of t h e fittings and fu nishings ; many r

stay with t h e Op e rator to v e x for hours t h e ,

d e licat e bre athing passage s or t h e d ee p er r e

c sse s of t h e lungs The n in t h e lull which fol
e .

lows gravity r e ass e rts i t s sway and t h e myriad

, ,

particl e s both t h e living and t h e d e ad slowly

, ,

s e ttl e to t h e ho r izontal surfac e s e sp eciall y ,

to t h e carp e ts Th e n t h e fe ath e r dust e r com e s

.

upon t h e sc e n e and anoth e r cyclon e b e falls

,
.

Th e r sult o f it all is that t h e dust h a s finall y

e

b e e n f rc e d to mor e or l e ss C ompl e t e l y abandon

o

t h e smooth and shining surfac e s wh e r e it would

.

81
 Ma s t e r p i e c e s of S c i e n c e

be visibl e and is large ly caught in t h e sur fac e

,

r ughn e ss of t h e ca r p e ts or upholst e ry or hang

o

ings r e ady at t h li ght e st footfall or t h e char i e st

,
e

touch t o danc e into t h e ai r again and b e tak en ,

into t h e lungs of t h e victims of t h e pre vailing d e

l s i o — t h e d e lusion that t h e way to care for
u n

al w ays obnoxious and o ff e nsive and oft e n

dange rous dust is not to ge t it out o f t h e
house but to k e p it stirri ng in t h e air unti l
,
e

at last it has s e ttl e d wh re it do e s not v ex e

:

th e ey e .

B y t h e s e of moist t e a l e ave s in t h e sw ee p
u

ing of carp e ts by t h e u s of soft t e xtur e d fabrics

,
e -
,

fre que ntly Shak e n out o f doors or by moist - -

,

c loths o r C hamois in dusting much us e l e ss ,

dust S catt er in g may b e avoide d B ut no matt e r

-
.

what t h e m e ans e mploye d t h e fin al pur pose ,

o f e v e ry hous e hold C l e aning sho ul d b e to g t

e

t h e dust not afloat but away

,
.

Probabl y t h most s e rious sour c e o f infe ction

e

which o e is liabl e to e ncounte r in t h e usual

n

ways of life is t h e occupancy at hot e ls of

b e dr ooms vacat e d by consu mptive s without
subse quent e ffi ci e nt cl e ansing and trav l in ,
e

sl ee ping cars I n ee d not e nt e r h e re into t h e

.

har rowing de tails of d e sp e rat e un cl e ann e ss whi ch

t h e ordinary r ai lway trav l brings to light It e .

is to b e hop e d that popular d e mand for r efo r m

in t h e routi n e o f hot e l kee p e rs and railroad -

manage rs in t h e matt e r o f ordina r y swee ping

and dusting and i n t h e pre cautions against
,

t h e spr ea d o f tub e rculosis may soon u s h e r i n ,

~

82
 Tub e r c ul o sis a nd It s Pr e v e nt i o n

among th em a day of r e asonabl e sanitary i n~

t elli ge n c e .

A b eli e f in th e com m unicability of t u b e r c u

lo s i s is b e coming wid e ly di ff us e d and it would ,

s ee m t b e d e sirabl e on t h e ground o f policy

o ,

alon e f r t h e manage rs of summ e r and e sp e

,
o ,

c i a lly of wint e r r e sorts fr e qu e nt e d by c o n s u m p

tiy s to l t it b e known in no unc e rtain wa y

e ,
e

that th e ir pr cautions against t h e spre ad of

e

infe ctious dise ase s a r e e ff e ctually in line with

t h e d mands e f mod e rn sanitary s i e nc e
o c .

Th e m e mb e rs of famili e s b e aring a h e re d
i ta r y susce ptibility to t h e acquire m e nt of
this dis e s e Should strive to fost e r thos e c o
a n

d i t i o s which favour a h e althy vigorous life

n ,

in occupation f od e x e r ise and amuse m e nt

,
o ,
c

and r m e mb e r that for th m mor e than for

e e

othe rs it is important t avoid such occupa o

tions and p lac e s as fav ur t h e distribution in o ,

th e air or oth rwis e of t h e tub e rcl e bacillus

e ,
.

But wh e n t h e i ndividual has don e what h e

c a n in ma ki ng his surroundings cl e an and in ,

thus limiting t h e spr e ad of t h e tub e rcl e bacillus ,

th e re still r e mai s w rk for municipal and S tat e

n o

and national authoriti e s in di ffusing t h e e c e s n

sary k owl e dge of t h e dise as e and i t s mode s

n

Of pr e v e ti n ; in dire ctly caring for thos e u n

n o

abl e to care for th e mse lv e s ; in s e curing for all

such fre e dom from cont ct with sourc e s o f t h e a

dise as e as t h e dictat e s of sci e nc e and humanit y

ma y r e quire .

To h e alth boards e ith e r national o r local, ,

83
 Ma s t erp i e c e s of S c i e n c e

must b e large l y ntrust e d t h e primary p r o t e c

e

tion of t h e p opl e ag inst t h e dange r from

e a

tub rcul ous cattl e

e .

A national bur e au of h e alth might b e of in

calc ul abl s rv ic e in stimulating and h a r m o
e e

ni i g z n m asu r e s for t h suppre ssion o f tub e r

e e
‘

c u lo s i s in various part s of t h e land and in ,

fost eri ng r e se arch in lin e s w hich promise large

p ractical r e turn in t h e sa ing of lif e v .

Tub rculosis has in thi s coun t ry b e e n offi

e

c i a lly almost e ntir l y ignor d in thos e practical

e e

m sur s w hi ch h e alth boards uni v rsally r e cog

ea e e

niz e as e ffi ci e nt i t h e suppre ssion of this class

n

of mal di e s Physicians a e not now ge n e rally

a . r

r e q u i r e d to r e port it to t h e local h alth boards e .

S yst e matic o ffi cial m e asur e s of disinfe ction a e r

n o t wid e ly practis e d But such o fii i a l m e asur e s

. c

have b e n found e xtre m e ly us e ful in t h e limi

e

t a t i on of oth e r commun icabl e dis e s e s Whil e a .

c onsum ption must logi cally b e class e d with

diphth e ria and scarlatina and small pox as a -

c mmun icabl e ge rm dis e ase it is in fact in t h e

o , , ,

light of o ur pr e s e nt knowl e dge whe n i t e lli , n

ge ntly car d f s littl e liabl e to spre ad that

e or , o

it is prop e rly e xe mpt from som e o f thos e sum ‘

mary m e asur s which h e alth authoriti e s a r e

e

justifi e d in adopting with t h e mor e r e adi l y

and l e ss avoidably comm unicabl e maladi e s .

More ov e r consumption is apt to involve such

,

prolonge d illn e ss and s o oft e n p e rmits a ffe ct e d

,

p e rsons for months and y e ars to go about th eir

usual avocations that ge n e ral isolation wo ul d
,
'

84
 Tub e r c ul o sis a nd It s P r e v e n t i o n

be both impracticabl e and inhuman e More .

ove r fo r r e asons whi h i t is hop e d a e e vide nt

,
c r

to t h e r e ade r isolation among those capabl e

,

o f caring fo r th e ms e lv e s is a t pre s e nt e ntir e ly

unne c e ssary .

B ut whil e e xtre m e m e asure s a r e not call e d

for local h e alth boards must soon act in t h e
,

pre v e ntion o f tub e rculosis 'o r t h e pr e s e nt

.

the wise st and most humane cours e would

s ee m to b e to att e mpt to s e cure t h e d e sire d
e nds rath e r by instruction and couns e l and
h e lp than by dire ct and summary proc e dur s e .

Th e re is no mor e pitiabl e sp e ctacl e in this land

to day than that o f hundr ds o f victims of
- e

advanc e d tub e rculosis in e ve ry large town

who cannot b e comfortably o r safe ly car d e

for in t h e dwellings of t h e poor and y t who , e

are always unwe lcom e applicants at most

o f o u r hospitals and at many a r e d e ni e d admis

sion altoge th e r The y a e victims of ignoranc e

. r

and of vicious social and hygi e nic conditions

for which th y a e not large ly re sponsibl e
e r ,

and S tat e s and municipaliti e s which a r e most,

to blam e o we th e m at l e ast a sh e lt e r and a

,

plac e to d i e Unqu e stionabl y o e o f t h e urge nt

. n

duti e s imm e diat e l y b e fore us in all parts o f

t h e land wh e r e tub e rculosis pr e vails is t h e
e stablishm e nt o f S p e cial h O S i t a ls in which this
p
dis e as e c a n b e tre at e d and its victims safe ly
care d for
And now at las t r emains to b e S po ke n what
word o f ch e e r and hop e ou r n e w outlooks ma y
85
 Ma s t e r p i e c e s o f S c i en c e

hav e giv e n us for t h ose who a e alre ady under r

t h e shadow of this sorrowful affliction Th e

dr e ams and aspiration s and stre nuous labours
of th e stud e nt s of this di s e as e have looke d
st e adi l y t oward t h e discov e ry of som e de finit e
and positi e m e ans of cur e but as y et full
v ,

succ e ss linge rs b e y ond th e ir gr asp Th e m e thods .

for t h e e a l d t ction of tub e rculosis which

r v e e

sci enc e has poin t e d out mak e it possible for

affe ct e d pe rsons to plan such mod s of life an d e

e arl y s e k such salubrious climat s as prom

e e

i s e a h O p e of r cov e ry We hav studi 'd clos e l y

e . e

t h e wa s in which t h e c lls of t h e body oft e n

y e

s e ssfull r e sist t h e in c u rsions of t h e alr ady

u cc y e

se at e d ge r ms and l arn e d how in many way s

,
e

t h e natural forc e s of cur e may b e sustain e d

and stre ngth e n e d We have l e arn e d mu h about
. c

c rt ain compli catin g occur r e nc e s which oft e n

e

form t h e most s e rious f atur e s i n t h e pro gr e ss e

of tub e rc ul osis of t h e lu gs and how th e y ma y n ,

b e be st av id d o And so to day t h e outloo k

e .
-

for t hos e in t h e e arli e r stage s of this dis e as e

is in a consid e rabl proportion of cas s e x e e

t e m e lv e ncour a gi ng
r It is no longe r for us
.

t h e hop e l e ss malady whi h it w a s e arli e r b e c

li e e d to b e
v It is not n e c e ssarily a bitt e r
.

losing fight upon which o e e nt e rs who b e com e s n

aware that t h e finge r of thi s dis e ase is upon

hi m . A long and happ y and use ful life may
still b e h i s if t h e c onditions whi ch favour h i s
cur e b e e arly and i nt e lligentl fix e d upon y ,

and pati e ntl y and faithfully p e rsist e d in Th e .

86
 Tub e r c u l o si s a nd It s P r e v e n t io n

wise p hysician s h e re t h e b e st a p v i s e r in c li
i

mat e and r e gim en as we ll as in t h e prop er

,

s l e ction o f r eme dial m e asure s and t h e e arli e r

e ,

his counse l is sought and act e d o n t h e b r ight er ,

will usually b e t h e outloo k for re cove ry .

R e s e arch in tub e rculosis and t h e ministra

tion of t h e physician should and ge ne rall y ,

do go hand in hand and no tim e should b e

, ,

lost in bringing to t h e aid of t h e strick e n what

light and promis e t h e studi e s of t h e laboratory
day b y da y may yi e ld Th e gre at and b en e fi
‘
.
~

c e nt work which has b ee n accomplish e d b y

Trude au in t h e Adirondack woods in at onc e ,

wide ning t h e bounds of knowl e dge o f tub e r

c u lo s i s and in carrying to a succ e ssful issue
in so man y t h e vari e d and d e licat e proc e sse s
o f cur e is a ch ee ring e xampl e of what ma y b e
,

accomplish e d wi th p e rsist e nt d e votion by t h e ,

light o f our n e w knowl e dge in mast e ring a

, .

malad y s o long conside r e d ho p el e ss .

87
 M A LA R I A AN D M O S 'UIT O E S
G E O RGE M S T E R N B E R G M .
, . D .
,
LL . D .

' Dr St rnb rg S urg n G n r l f t h Unit d St t s

. e e ,
eo - e e a o e e a e

Arm y is in stig t r d uth r f distin ti n H is

,
an ve a o an a o o c o .

w rk s in lud
o M nu l f B t ri l gy
c T xt B k f
e a a a o ac e o o ,
a e -
oo o

B t ri l g y
ac e d I mmu i t y Pr t ti
o o I n ul ti ns
,
”
an
“
n , o ec ve oc a o

and S rum Th r py e ll p u b lish d b y Willi m W

- d C e a , a e a oo o .
,

N w ' rk
e Th ddr ss whi h f ll ws w s d li r d b y
o . e a e c o o a e ve e

Dr St rn b rg pr si d nt f th P hil s p hi l S i t y f
. e e as e e o e o o ca oc e o

W shingt n D mb r 8 9
a oIt pp r d in t h P p l
,
ece e ,
1 00 . a ea e e o u ar

S i M th ly ' bru ry
c en c e 9 pyright d is h r
on ,
e a ,
1 01 , co ,
an e e

r p i nt d b y t h kind p rmissi n f th dit r f th M th ly

e r e e e o o e e o o e on

an d th u th r e a o .

A b k w ll w rth r ding in this nn ti n is M

oo e o ea co ec o os

q itu by L l nd 0 H w rd Chi f f t h Di isi n f

oe s , e a . o a ,
e o e v o o

E nt m l g y Uni t d S t t s D p rt m n t
o o o ,f Ag ri ult ur e a e e a e o c e,

W shi ngt n D C
a d p u b lish d b y M Cl
o , Ph illi p s. .
, an e c u re,

C o N w Y rk '
.
, ) e o

INm y addre ss as Pre siden t of t h e Biological

S oci e ty in 8 9 6 t h e subj e ct chos e n was Th e
,
1 ,
“

Malarial Parasit e and O th e r Pathogenic Proto

z oa ”
This addre ss was publish e d in March
.
,

1 8 9 7 in t h e P o p u la r S c i en c e Al o th ly
,
and I n ,

must r e fe r you to this illustrat e d pap e r for a

d etail e d account of t h e morphological charact e r
o f t h e malarial parasit e It is my int e ntion .

at t h e pre s e nt time to sp e ak o f Malaria in a ” “

more ge n e ral way and of t h e r e c e nt e xp e ri ,

m e ntal e vide nc e in support of Manson s s u gge s ’

t ion first mad e in 8 9 4 that t h e mosquito s e rv e s

,
1 ,

89
 Ma st e r p i e c e s o f S c i e n c e

as an i nt e rm e di at e host for t h e parasit e Th e .

di scove r y of t hi s parasit e ma y j ustl y b e c o n

s i d er e d n o e of t h e gr e at e st achi e v e m e nts of
sci e ntific r e se arch dur ing t h e nin e t ee nt h c en
t ur y. Twe nty fi e ye a r s ago t h e b e st info r m e d
-
v

ph y sicians e nt e rtain e d e rron e ous ide as with r ef

e re nc e t o t h e natur e of mala r ia and t h e e tiology

' inq u i r y into t h e cause s] of t h e malarial fe v e rs .

O bse rvation h a s t aught th e m that th e re w as

s om e thin g in t h e a i r in t h e vicin i t y of marsh e s

i n tropical r e gi ons and dur in g t h e sum m e r and

,

autumn i n s emi tropical and t e m p e rat e r e gi ons

-
,

whi ch gave rise t o p e riodic fe v e rs i n thos e ex

p o s e d i n such localiti e s and .t h e usua l inferen c e

w as that this som e thi ng was of gas e ous form

t hat it was a sp e cial kin d of bad ai r g e n e rat e d
i n swampy locali ti e s un d e r favourabl e m e t e oro
l ogi cal condi tions It was r e cogni z e d at t h e
.

sam e tim e that th e re a r e oth e r k i nds of bad ai r ,

such as t h e o ff e nsive e manations from s ewe r s and

t h e products of r e spiration of man and animals ,

but t h e t e rm malaria was r e s e rve d e sp e ciall y fo r

t h e ki d of bad ai r which w a s suppos e d to giv e
n

r is e to t h e s o call e d malar ial fe v e rs

-
In t h e light
.

o f our pr e s e nt knowl e dge it is e vi d e nt that thi s

t e rm is a mi snom e r The re is no good r e ason

.

for be li e ving that t h e a i r of swamps is an y mor e

d e l et e rious to those who bre ath e it than t h e a i r
o f t h e s e a coast or that in t h e vicinity o f in l and

lak e s and ponds More ove r t h e stagnant p oo ls

.
, ,

which a r e cove re d with a gr e e n scum and fro m

“ '

which bubble s of g a s a e giv e n o ff have l ost all

r ,

90
 Ma l a r i a a nd M o s quit o e s

t er rors for t h e w e ll inform e d man e xc e pt in s o

-
,

far as th e y s e rv e as bre e ding plac e s for mosquito e s

of th e ge nus A op h el s Th e gr e e n scum is
n e .

made up of harml e ss algae such as S pirogyra ,

'ygn e ma Protococ us Eugl e na e t c ; and t h e

c , , .

g a s which i s giv e n o ff from t h e mud at t h e bot

tom of such stagnant pools is for t h e most part
a w e ll known and comparativ e ly harml e ss com
-

ound o f hydrog e n and carbon — m e than e o r

p
marsh gas . In short w e now know that t h e
,

air in t h e vicinity of marsh e s is not d e l e t e rious

b e cause of any sp e cial kind c f bad air pr e s e nt
in such localiti s but b e caus e it contains m o s
e ,

u i t o e s infe ct e d with a parasit e known to b e t h e

q
S p cific cause of t h e s e call e d malarial fe v e rs
e -
.

This parasit e was discov e r d in t h e blood of

e

pati e nts su ff e ring from int e rmitt e nt fe v e rs by

Laveran a surge on in t h e Fr nch army whose
,
e ,

inve stigations w e re conduct e d in Al gi e rs This .

famous discove ry was made toward t h e e d n

o f t h e y e ar 1 880 but it was s e ve ral y e ars lat e r

,

b e fore t h e profe ssion ge n e rally b e gan to attach

much importanc e to t h e all e ge d discov e ry It .

was first confirm e d by Ri chard in 8 8 ; th e n 1 2

by t h e Italian inv e stigators Marchiafava C e lli

, , ,

Golgi and B ignami ; by Councilman O sl e r and ,

Thay e r in this country and by many oth e r com

,

p e t e nt obs e rv e rs in various pa r ts of t h e world .

Th e Italian inv e stigators nam e d not only con

fi r m e d t h e pre se nc e o f t h e parasit e discov e re d
b y Lave ran in t h e blood of thos e su ff ring from e

malarial fe ve rs but th e y d e monstrat e d i t s

,

91
 Ma st er p i e c e s of S c i e n c e

e tiological r ol e by inoculation e xpe r im ents and

adde d gr e atly to o u r knowl e dge o f i t s lif e hi story
( 88 3
1 Th e fa c t that t h e life history o f
~

t h e parasit e i nclud e s a p e riod o f e xist e nc e i n t h e

body o f t h e mosquito as an int e rm e diat e host , ,

has re c e ntly b e e n d e monstrat e d by t h e English

army surge ons Manson and Ross and c o n ,

firm e d by num e rous obse rv e rs including t h e ,

famous Ge rman bact e riologi st Koch ,

.

Th e discov eri e s re fe rr e d to a s i s usual hav e , ,

had to wi thstand t h e criticism o f cons e rvativ e

physicians who having adopt e d t h e pre vai ling
. ,

th e or i e s with r e fe re nc e t o t h e e tiology o f pe ri
odic fe v e rs w e re natur ally sk e ptical a s to t h e
,

re liability of t h e obs e rvations mad e b y Lave ran

and tho s e who claim e d to have c o fir rn e d h i s n
’

discove r y Th e first cont e nti on was that t h e

.

bo di e s d e scrib e d a s pre se nt in t h e blood we re not

parasit e s but d e form e d blood corpuscl e s Thi s
, .

obj e ction was soon s e t at re st by t h e de monstra

ti n r e p e at e dl y mad e that t h e intra corp u scu lar
o , ,
-

fo r ms un de rwe nt distinct amoeboid mov e m en t s

' re sembling those of t h e amoeba a j e lly like organ ,
-

i s m o f simpl e ty p e ] No o e witn e ssing the se

. n

mov m e nts coul d doubt that h e was obse rv ing a

e

living micro organism Th e sam e w a s t r ue o f

-
.

t h e e xtra co r pusc ul ar fl a g e lla t e bo di e s '

-
re se m
bling a whip lash] whi ch may b e s ee n to und e rgo
-
,

v er active move m e nts as a r e sult o f which

y
,

t h e r e d blood co r puscl e s a r e vi ol e ntl y displac e d

and t h e fl a ge lla t e body itse lf dashe s about i n th e
fi e ld o f vi e w .

92
 Ma l a r i a a nd Mo squi t o e s

Th e first confi r mation in this country o f

L av e ran s dis ov e r y of amoeboid parasit e s in t h e
’
c

blood of malarial fe ve r pati e nts was made by

mys e lf in t h e pathological laboratory of t h e
Joh s Hopkins Unive rsity in March 8 8 6 In
n , 1 .

May 8 8 5 I had vi sit e d Rom e as a de l e gat e

,
1 ,

to t h e Int e rnational S anitary Conf re nc e c o e ,

n

v e n e d in that city und r t h e auspic e s o f t h e

e

Italian Gove rnm e nt and whi l e th e re I vi sit e d

,

t h e S anto S pi ri to Hospital for t h e purpos e of

witn e ssing a de monstration by D r s Marchia ,
.

fava and C e lli o f that cit y o f t h e pr e s e nc e of

, ,

t h e p la s m od i u m m o la r i ce in t h e blood of p e rsons
/

su ffe ring from int e rmitt e nt fe ve r B lood was .

drawn from t h e finge r during t h e fe bril e ' fe v e r ish ]

attack and from in di viduals to whom quinin e
had not b ee n admi ni st e re d Th e d e monstration .

was e ntire ly satisfactory and no doubt was l e ft ,

in m y mind that I s a w li ving parasitic micro

organisms i n t h e int e rior of r e d blood corpuscl e s
obtain e d from t h e circulation o f malarial fe ve r
pati ents Th motions w e re qui t e S low and
. e ,

we re manife st e d by a gradual change o f outlin e

rath e r than by visibl e mov em e nt Aft e r a .

p e riod of amoeboid activity o f gr e at e r or l e ss

duration t h e body again assum e d an oval o r
,

S ph erical form and remain e d qu ei s c e n t for a

tim e Whil e in this form it w a s e asily re cogniz e d
.
,

as t h e S ph e rical Sha p e caus e d t h e light passing

through it to b e re fract e d and gave t h e i m
pre ssion o f a body having a dark contour and a
c e ntral vacuol e ' minut e cavi ty] ; but wh e n it was
93
 Ma st er pi e c e s of S c i e n c e

fl att e n e d and unde rgoing amoeb oid change s

ou t

in for m it wa s n e ce ssary t o focus ve r y c a r efu llv

,

and t o have a good illumination in orde r to s e e

it Th e obj e ctive use d w a s a 'eiss s o n e twel fth
.
’
-

inch homoge n eo us o i l imm e r sion .

B u t v e ry prop e rl y ske pticism with re fe r e nc e

, ,

t o t h e causal r e lation o f th e s e bodi e s t o t h e

d ise as e wi th which th e y a r e associat e d w a s n o t
r e mov e d b y t h e d e monstration that th e y a r e in

f ac t blood parasit e s that th e y a r e pre se nt in

,

conside rabl e numbe rs dur ing t h e fe b r il e p a r o x

y s m s
. Th e se facts howe ve r gi ve strong s u p
, ,

po rt t o t h e inf e re nc e that th e y a r e inde e d t h e

cause o f t h e di se a s e This infe re nc e is fur th e r
.

s uppo r t e d b y t h e e vid e nt .
de struction o f r e d
blood cor p uscl e s by t h e paras it e as shown by ,

t h e pre s e nc e o f grains o f blac k pigm e nt in t h e

amoeba like mi cro organi sms obse r ve d in th e se
- -

c o r puscl e s and t h e accumulation o f this insolubl e

blood pigm e nt in t h e live r and spl ee n o f those

wh o hav e s u ffe re d r e p e at e d attacks o f int e r
mitt e nt fe ve r Th e e no r mous loss o f r e d blood
.

co r puscl e s as a r e su lt o f s u c h attacks i s shown

b y t h e an aemic con di tion o f t h e pati e nt and also
b y actual e num e ration According to K elsch .
,

a pat i e n t o f vigorous constitution in t h e first

four days o f a quotidi an ' daily re curre nt ] int e r

mitt ent fe ve r o r a r ern i t t en t o f first invasion may
, ,

s uffe r a loss o f r e d blood co r puscl e s

p er c u b i c millim e t e r o f blood and in c e rtain

, c a se s

a loss o f h a s b ee n v e r ifi e d at t h e en d o f
t w en t y fo ur hour s
- In cas e s o f int e rmitt e nt
.

94
 Ma l a r i a a nd Mo s q u it o e s

fe ve r hav i ng a duration o f twe nt y to thi r t y

days t h e numb e r o f r e d blood c ells may b e r e
”

d u c e d from t h e normal which is abou t ,

p e r cubic millim ete r to ,

o r e v e n l e ss .

In vi ew o f this de st r uction o f t h e r ed blood c ell s

a n d t h e d e monstrat e d fact that a c ert ain num
b e r a t l e ast ar e d e stroy e d dur ing t h e fe b r il e
, ,

paroxysms b y a blood parasit e which invades ,

t h e c e lls and grows at t h e e xp e ns e o f t h e c on

t i n u e d h aemoglobin ' t h e r e d substanc e in t h e
blood] i t ma y b e thought that t h e e tiological
,

r ol e o f t h e parasit e should b e conc e d e d B u t .

sci e ntific cons e rvatism d e mands mor e than this ,

and t h e final proof has b e e n a fford e d by t h e e x

e r i m e n t s o f G e rhardt and o f Marchiafava and
p
C e lli— sinc e confi r m e d by many othe rs This .

proof consists in t h e exp e r im e ntal inoculati on

o f h e althy individuals with bl od co n taining t h
o e

parasit e and t h e de ve lopm e nt o f a typical a t

tack o f p e ri odic fe v e r as a r e sult of such i n o c u
lation Marchiafava and B ignami in th eir
.
,

e laborat e articl e upon Malaria publish e d in

” “
,

th e Twen ti eth C en tu r y P r ac ti c e o f M ed i c i n e s a y : ,

Th e transmission o f t h e dis e as e occurs e qually

w h e th e r t h e
blood is ta ken duri ng t h e ap yr e tic
'aguish] p e riod o r dur ing a fe bril e ' fe ve rish] p a r
o xy s m wh e th e r it contains young parasit e s o r
,

thos e in proc e ss o f d e ve lopm e nt o r whe th e r i t ,

contains S po r ulation ' minut e spore like ] forms -

.

O nly t h e cre sc e nt fo r ms wh e n inj e ct e d alon e ,

do not transmi t t h e i n fe c t 1o n as h a s b ee n d e mon

,

strated b y B astian elli B ign ami and Thay er

, ,

95
 Ma s t e r p i e c e s o f S c i e n c e

and a s can b e re adily und e rstood wh e n w e r e

m e mbe r t h e biologi cal sign ificanc e o f the se forms .

“
In ord e r that t h e di s e as e b e re prod uc e d in
t h e inoculat e d subj e ct it i s o t n e c e ssary t o i n
n

je c t t h e malarial blood into a v e in of t h e re cipi e nt ,

a s h a s b e e n don e i n most of t h e e xpe ri m e nts ; a

subcutane ous inj e ction is all s u ffic i en t N or is -

.

it n e c e ssary to inj e ct se ve ral c u b i c c e ntim et e rs ,

a s was don e e sp e ciall y in t h e e arli e r e xp e r im e nts ;

a fraction o f a cubic c e ntim e t e r will suffic e an d ,

e v e n l e ss than o n e drop as Bignami has shown

, .

Aft e r t h e inoculation of a h e althy indivi dual

w ith blood containi ng t h e parasite a pe riod
varying from four to twe nty o n e days e lapse s -

be for t h e occur re nc e of a fe bril e paroxysm

e .

T hi s is t h e s e calle d p eri od of incubation during

-
,

which no doubt t h e parasit e is un de rgoing

, ,

multiplication in t h e blood o f t h e inoculat e d

in di v idual Th e duration of this pe r iod d e p e nds
.

t o som e e xt e nt upon t h e quantity of blood use d

for t h e inocul ation and its richn e ss in parasit e s .

It also d e p e nds upon t h e particular vari e ty o f t h e

parasit pr s e nt for it has be e n asc e rtain e d that
e e ,

th e re a e at l e ast thr e e distinct vari eti e s o f t h e

r

malarial parasit e—o n e w hi ch produc e s t h e

quartan typ e of fe ve r in whi ch the re is a paroxysm
,

e v e r y third dav and in which in e xp eri m e ntal

,

inoculations made t h e p e riod of incubation has

,

vari e d from e l e ve n to e ight ee n days ; in t h e

t e rtian typ e or s e cond day fe v e r t h e p e riod o f
, ,

incubation not e d has b ee n fr o m n i n e to twe lve .

days ; and in t h e ae s t i v o autumnal type t h e dura

-

96
 Ma l a r i a a nd Mo squi t o e s

tion has usually not e xc e e d e d fi e days Th e v .

parasit e ass ciat e d with e ach of th e se typ e s of

o

f v e r may b e r ogniz e d by an xp e rt and th e re

e ec e ,

is no longe r any doubt that t h e di ffe r nc e in e

typ e is d u e to t h e fa t that di ffe re nt vari eti e s

c

or sp e ci e s f t h e malari l parasit e e xist e ach

“ ”
o a ,

having a di ffe re nt p e riod of d v e lopm e nt B lood e .

drawn during a fe brile paroxysm S hows t h e

parasit e in its di ffe re nt stage s of intra c o r p u s c u -

lar de ve lopm e nt Th e final r e sult o f this d e

.

v e lo p m e t is a s gm e nting body
n e having pig ,

m e nt granul e s at its c nt e r whi h occ u pi e s t h e

e , c

gre at e r part of t h int rior of t h e e d corpuscl e

e e r .

Th e numb e r of s e gm e nts into which thi s body

di id e s di ffe rs in t h e di ffe re nt typ e s of fe v e r and
v ,

th e r e a r e oth e r points of di ffe re nc by which t h e e

s e ral vari e ti e s may b e distinguish e d o e from

ev n

t h e oth e r but which it i s not n c e ssa r y to m en

,
e

tion at t h e pre se nt tim e Th e important point .

is that t h e re sult of t h e s e gm e ntation of t h e ’

adult parasit e s contain e d in t h e r e d corpuscl e s

is t h e formation o f a large numb e r of spore lik e -

bodi e s which a e s et fr e by t h e disint e gration

,
r e

of t h e r e mains o f t h e blood corpuscl e s and which

constitut e a n ew brood of re productiv e e l e m e nts ,

which in th eir turn invade h e althy blood cor

u s c le s and e ffe ct th e ir d e struction This cycl e
p .

o f d e v e lopm e nt without doubt accounts for t h e

p e riodicity of t h e charact e ristic fe bril e p a o x r

y s m s ; and as stat e d t h e di ff e r e nt vari e ti e s c o m

, ,

p le t e th e ir cycl e of d e v e lopm e nt in di ff e r e nt
p e riod of tim e thus accounting for t h e r ec u r
,
f

97
 Ma s t e r p i e c e s of S c i e n c e

re nc e o f t h e parox y sms at int e r vals o f forty

e ight hours in o e typ e o f fe ve r and o f thr ee
,
n ,

d ays in anoth e r typ e Wh e n a daily paroxysm .

o ccu r s this is b e li e v e d t o b e d e t o t h e alt e r nat e

,
u

d e v e lopm e nt o f two groups o f parasit e s o f t h e

t e rtian vari ety as it h a s n o t be e n po ssibl e t o
,

di stinguish t h e paras it e found in t h e blood o f

pe rsons su ff e ring fr om a quotidi an fo r m o f int e r
mitt e nt fe ve r from that o f t h e t e rtian fo r m .

V e ry oft e n also t h e daily paroxysm occ u rs o n

, ,

s ucc ee di ng days at a di ffe r e nt hour whil e t h e ,

paroxysm e ve r y alt e r nat e day at t h e sam e

hour is a fact which sustai ns t h e vi e w that w e
hav e t o de al in such case s with t wo b e e d s o f
, ,
r

t h e t e rtian parasit e which matur o n alt e rnat e e

d ays . In oth e r cas e s th e r e may b e t wo di s

tinct paroxysms o n t h e sam e day and none o ,
n

t h e following day indicating t h e pre s e nc e o f

,

two broods o f t e rtian parasit e s maturing at

d i fie r e t hours e v e ry se cond day
n .

Th e hy p oth e sis that malarial inf ction r e sults e

from t h e bit e s o f mosquito e s was advanc ed and

a bly support e d by Dr A F A King o f Wash . . . .
,

i n gt o n D C in a pap e r r e ad b e for e t h e Philo

,
. .
,

s ophi cal S oci e ty o n F e bruary 8 8 3 and pub 1 0 ,

1 ,

li s h e d in t h e P o p la S c i e nc e o thly in S e p t e m
u r n

b e r o f t h e sam e y e ar In 8 9 4 Manson support e d

. 1 ,

t h e sam e hypoth e sis in a pap e r publish e d in t h e

B i ti s h M ed i c l f o u n a l ( D e c e mbe r
r a and t h e
r

follo wing y e ar ( 8 9 5) Ross mad e t h e import ant

1

di scov e r y that wh e n blood containing t h e cre s

c en ti c bodi e s was inge st e d b y t h e mosquito ,

98
 Ma l a r i a a nd Mo s qui t o e s

th e s e cre sc e nts rapidly und e rw n t change s simi l a r e

to thos e h e re tofor e d scrib e d re sulting in t h ee ,

formation of motil e ' S pontane ously moving] fila

m e nts which b e com e de tach e d from t h e par e nt
,

body and continue to e xhibi t active move m e nts .

In 8 9 7 Ross asc e rtain e d furth e r that wh e n

1 , , ,

blood containing cre sc nts w a s fe d to a p a t i c u e r

lar sp e i s o f mosquito living pigm nt e d para

c e ,
e

sit e s could b e found i n t h e stomach walls o f

t h e ins e ct Continuing his re se arch e s with a
.

parasit e o f t h same class whi h is found in birds

e c ,

and in which t h e mosquito als s e r v e s as an int r o e

m diat e host Ross f und that this parasit e

e ,
o

e nt e rs t h stomach w all of t h e ins e ct and as a

e , ,

r e sult of its d e v e lopm e nt in that locality form s ,

re productive bodi e s (sporozoit e s) whi h s u b s e ,

c

que ntly find th e ir way to t h e v e n e no salivar y -

'poisonous salivary] glands of t h e inse ct which

is n o w capabl e of infe cting oth e r birds of t h e sam e
sp ci s as that from which t h e bl od was o b
e e o

t ai n ed in t h e first instanc e Ross furth e r .

showe d that t h mosquito which s e rve d a s an

e

int rm e diat e host for this parasit e could n o t

e

tra smit t h e m larial parasit e of man o r anoth e r

n a

similar parasit e o f birds (halt ridium) Th e s e e .

discove ri e s o f Ross hav e b ee n confirm e d b y

Grassi Ko h and oth e rs and it has b ee n shown
, c ,

that t h e mosquito e s which s e rve as int e r m e diat e

host fo r t h e malarial parasit e s o f man b e long
to t h e g nus A n o ph eles and e sp e ciall y t o t h e
e ,

S p e ci e s known as A o ph eles c la v i ger n .

Th e que stion wh e th e r mosquito e s infe ct e d

99
 Ma st e r p i e c e s of S c i e n c e

with t h e malarial parasit e invariabl y b e com e

infe ct e d as a re sult o f t h e inge stion ' t aking in]
o f hum an bl oo d containing this parasit e has
n o t b ee n s e ttl e d in a d e finit e mann e r but c e r ,

tain facts indicat e that this is not t h e cas e Thus .

th e r a r e loca liti s not e d fo r b e ing e xtrem e ly

e e

dange rous o n account o f t h e malar ial fe v e rs

contract d b y thos e who visit th e m which o
e ,
n

this v e ry account a r e rare ly visit e d by man .

'e t th r e must b e a gre at abundanc of infe ct d

e e e

mosquito e s in th s e localiti s and e sp e cially

e e ,

in low swampy r gi ons in t h e tropics If m an

e .

and t h e m squito e s a e alon e conc e rn e d in t h e

o r

propagation o f thi s parasit e how shall w e a c ,

count f r t h e abundanc e o f infe ct e d mos quito es

o

in uninhabit e d marsh e s ' It app e ars probabl e

that som e oth e r v e rt e brat e a imal s er v s in plac e n e

o f man to maintain t h e life cycl e o f t h e parasit e ,

o r that it may b e pr pagat e d through succ e ssiv e

o

gen e r tions o f mosquito e s

a .

It is w e ll kn own that p e rsons e ngage d in dig

ging c nals railroad cuts e t c in malarious
a , , .
,

r e gions a e e sp cially liabl e to b e attac ke d with

r e

o n e o r t h e oth e r o f t h e fo r ms o f malarial fe v e r .

T hi s may b e d u e to t h e fact that t h e di gging

Op e rations r e sult in t h e formation o f littl e poo ls
suitabl e for t h e d e v e lopm e nt o f t h e e ggs of A o n

p h eles,
but anoth e r e xplanation has b ee n o f
f e re d .

Ross and oth e rs hav e found in infe ct e d m o s qu i

to e s c e r tain bodi e s d e scrib e d by Ross as black
,

spore s which r e sist d e composition and which

,

may b e r e sting S pore s capabl e of r e taini ng th e ir

100
 Ma l a r i a a nd Mo s qui t o e s

vitality for a long tim e Th e sugge stion is that .

th e se black sp r e s o oth r incyst e d 'ncl se d

o r e e o

in a small v e ss l ] re pr du tiv bodi e s m y hav e

e o c e a

b ee n d e posit e d in t h e soil by mosquito e s long

sinc e d fu ct and that in moving t h e soil th e s e
e n ,

dormant parasit e s a e s e t at lib e rty a d s o in r , n ,

air in wat e r or oth e rwis e gain a c e ss to t h e

, ,
c

workm e n e ngage d (Manson) This hypoth sis '

. e

is n o t support e d by re c e nt obs rvations which e ,

indicat e that infe ction in man occurs onl y as a

re sul t o f inoculati n through t h e bit e o f an i n
o

f c te d
e mosquito Th qu stion is wh the r . e e e

malarial fe v e rs can b ontract e d in marshy e c

localiti e s ind p e nd ntly o f t h e mosq u ito which

e e ,

has b e e n d e monstrat e d to b e an int rm e diat e e

host o f t h e malari al p rasit ' Is this parasit e a e

pre s e nt in t h e air o r wat e r in such local i ti e s as

we ll as in t h e bodi s of i f ct e d m squito e s ' Its
e n e o

pr e s e nc has n v r b n d monstrat d by t h e mi
e e e ee e e

c o s c 0 p e ; but th i s f ct has littl e valu e in vi e w of

r a

t h e gr e at vari e ty f mi ro organisms pr e s e nt in
o c -

marsh wat r o susp e nd d in t h e i r e v rywh e r e

e r e a e

n ar th surfac e of t h e ground and t h e diffi culty

e e ,

of r e cognizing t h e e l e m nta r y r productiv e e e

bodi s by which t h e va r ious S p ci e s a e main

e e r

ta i ne d through suc e ssiv g n rations c It would e e e .

app e ar that a rucial xp e r im e nt for t h e d e t e r m i

c e

nation o f this qu stion would b e to e xpose e

h e althy individuals in a malarious r e gion and

to e xclud e t h e mosquito by som e appropriat e
m e ans This e xp e rim e nt has b e n mad e during
. e

t h e past summ e r and t h e sul t up to t h e pre s e n t

,
r
e

101
 Ma s t er pi e c es of S c i e n c e

tim e h a s be e n re p ort e d by Manson in t h e Lo n

don L nc et o f S e pt e mbe r 9 9
a Five h e alth y 2 ,
1 00 .

in di viduals hav e li e d in a b u t o n t h e Romanv

Campagn a sinc arly in t h e month o f July

e e .

Th e y have b ee n prot e ct e d agai st mosquit o n

bit e s by mosquito n tting scree ns in t h e d o o r s

-
e

and win dows and b mosquito bars ov e r t h e y

b e ds The y go about free ly duri ng t h e day

.

tim e but r emain in th ei r prot e ct e d b u t from

sunse t to sun r ise At t h e tim e Manson mad e
.

h i s r e port all th se indi iduals r e main e d in p e r

e v

f e t h e alth It h a s long b ee n known that labour

e .

e rs could c o m e fr o m t h e vill ag s in t h e moun

’

t a i n o s re gion n e ar t h e Roman C ampa gna and

u

work dur ing t h e day re turni ng to th e ir hom e s ,

at night wi thout gr e at dange r o f contracting

.

t h e fe e r whi l e those wh o re main e d o t h e n

“

v ,

Campagna at night ran gr e at risk o f falling sic k

with fe ve r a s a r sult of e xposure to t h e nigh t
,
e
“

ai r . What has alr e ady b e e n said make s it a p

pe ar e xtr e m e ly probable that t h e night air “

,
”

by i t s e lf is no more dange rous than t h e day air

, ,

but that t h e re al dange r consists in t h e pre se nc e

o f in fe ct e d mosquitoe s o f a S p e ci e s which se e ks

it s food at night As point e d out by King .

,

in his pap e r alre ady r e fe r e d to i t has r e p e at e dly r ,

be e n claim d b v trav l e rs in malarious r e gi ons

e e

that sl e ping und e r a mosquito bar is an e ffe ctual

e

m e thod o f prophylaxis ' pre ve ntion ] against int e r

mit t e nt fe ve r s .

That mala r ial fe v e rs may b e transmitte d by

mosquitoe s o f t h e ge nus A o ph ele s w as firs t n

102
 Ma l a r i a a nd Mo squi t o e s

d emonstrat e d b y t h e I talian physician B ignami ,

whose e xp e rim e nts w e re mad e n t h e S anto i

S pi r ito Hospital in Rome Th e subj e cts o f t h e .

e xp e r im e nt with th e ir full conse nt w e re plac e d

, ,

in a suitabl e room and e xpose d to t h e b i e s o f t

mosquito e s brough t from Maccare s e a marshy ,

“

plac e wi t h a n e vil but d e s e rve d re putation for

”
t h e int e nsit y o f its fe v e rs It has b ee n obj e ct e d
.

t o th e s e e xp e rim e nts tha t th e y w e r e mad e in

R ome a t a s e ason o f t h e y e ar wh e n malarial
,

fe ver s p r evail t o a gre at e r o r l e ss e xt e nt in tha t

cit y b u t Ma r c h i fa v a and Bignami s a y
,

It is w e ll known to all physicians h e re tha t

“
,

although the re a e som e c e nt e rs o f mala r ia in

r

c e r t ain po rtions o f t h e suburbs t h e cit y prop r ,

e

is entire ly free from malaria as long e xpe r i e nc e ,

has de monstrat e d and a t no s e ason o f t h e y e ar

,

do e s o n e acquire t h e dise as e in Rome ”

.

In vi e w o f t h e obj e ction mad e a crucial e x ,

e r i m e n t has re c e n t ly b ee n mad in t h e cit y o f e

p
London Th e re sult i s re port e d by Manson
.
,

as follows :
Mosquito e s infe ct e d W ith t h e parasit e O f
b enign t e rtian malarial fe v e r we re s e nt from
Rome to England and we re allowe d to fee d,

upon t h e blood o f a p e rfe ctly h e althy individual

( Dr Manson s s o n who had n e v e r had malarial
’
.
,

d i se ase ) Forty mosquito e s in all w re a l

.
, ,
e

lowe d to bit e h i m b e twe n Augus t 9 and S e p e 2

t e mb e r 1 2O n S e pt e mbe r 4 h e had a ris e o f

. 1

t empe rature with h e adach e and slight chilline ss

, ,

b u t n o organisms w e re found in his blood A .

103
 Ma s t e r p i e c e s of S c i e n c e

fe bril e p a r o x s m o c rr d daily th e re aft e r but

v c u e ,

t h e parasit e s d i d not app e ar in t h e blood until

S e pt e mbe r 7 w h e n large numb e rs o f typical
1 ,

t e rtian parasit s w re found The y soon dis e e .

~

appe are d un d e r t h e influe n of quinine ce .

We h ve still to consi d r t h e qu e stion o f t h e

a e

transmission of m lari l f e rs by t h e inge stion a a ev

o f w at r fr m e mala ious localiti s Num e rous

o r e .

me dical authors ha e r cord d facts which th e y v e e

d e m d c nvinci g s sho w ing th t m larial

e e o n a a a

fe ve rs m a y b e c ntra t d i this way I have o c e n .

long b e n of t h e opinion th t whil e t h e o bse r v e d

e a

facts mav for t h e m st pa r t b e authe ntic t h e

,
o , ,

i f re nc is bas e d upon a mistake in di gnosis

n e e a

' d t rmin tion] That i tr th t h e fe ve rs which

e e a .
,
n u ,

can justl b e asc r ib d to t h e inge stion '

y taking e

into t h e body] of a cont minat e d wat e r supply a

a e not tru e m lari al f v e rs — i

r th e y a e n o t
a e . e .
,
r

d e to t h e pr s e nc e of t h e mala ri al parasit e in
u e

t h e blood Thi s vi w was sust ine d by m e

. e a ,

in m work on Malaria and Malarial Dis ase s

y e ,

p blish e d in 8 8 3 Th e fe e rs suppose d to
u 1 . v

have b ee n contracte d in this way a e as a r ul e r , ,

continue d o r r mitt nt in chara t e r a n d the y e e c ,

a e kno w n und r a va ri e t
r of nam e s Thus w e e y .

ha e Roman f r
v Napl e s f ve r remit ev e ,
” “
e ,
“

t e nt fe v r mountain fe r
e ,
typho malarial
” “
v e ,
” “
-

fe v e r e t c Th e l e ading ph y sicia s and path

, . n

ologi sts in re gi ons wh r th e s fe v rs pre vai l a r e

,
e e e e ,

n o w con inc e d that th e y a e not malarial fe v e rs

v r ,

but a r e sim p ly more r l ss typical va r i e ti e s o f o e

typhoid fe e r a dis e ase d u t o a sp e cific b a c i l

v , e

104
 Ma l a r i a a nd M o s qui t o e s

lu s 'minut e comma shap e d plant] and which is

-
,

commonly contract e d as a r e sult o f t h e inge stion

o f contaminat d w t r e r food
a eTh e e rror in
o .

diagnosis upon which t h e infe r e nc e has b ee n

,

base d that malarial fe ve rs may b e contract e d

through d inking wat e r has b ee n wid spr e ad
r , e

in this country in Europ e and in t h e B ritish pos

,

s e ssions in In d ia It vitiat d our m dical s t a

. e e

t i s t i c s of t h e Civil W and of t h e re c e nt war

ar

with S pain In my work alr e ady r e fe rre d to

.
,

I say
“
Probably o n e of t h e most common mistake s
in diagnosis mad e in all parts o f t h e world wh e re
,

malarial and ent e ric ' int e stinal] f e v e rs a e e r n

d emic ' charact e ristic of t h e locality] is that o f ,

calli ng an attack of fe v e r b e longing to t h e las t ,

m e ntion e d cat e gory malarial r mitt e nt This

,
e .

arise s from t h e di fficulti e s att e nding a di ff re ntial e

diagn osis at t h e outs et and from t h fact that ,

e

having nc e mad e a diagnosis of malarial fe ver

o ,

t h e physician e v e n if
,
convinc d lat e r that a e

mistake has b ee n mad e do e s not always fe e l ,

willing to confe ss it Th e cas e th e re for e app e ars

.

in t h e mortality re turns if it prove fatal or in , ,

t h e statistical r e ports o f dis e as e if mad e b y .

an army or navy surge on a s at first diagnos e d , .

 T HE A RT O F PR O L O N G I N G LI F E
RO B S O N RO O S E M D ,
. .

Dr
' .bs n R s
Ro min nt p h y si i n f L nd n is
o oo e , an e e c a o o o

the a uth r f st nd rd w rk s G ut N r Pr str ti n

o o a a o on o on e ve o a o ,

on W st a d R p i r in M d rn L i f
e an e Th ' t gh tly
a o e e . e or n i

R ev i ew 889 ,
nt in d t h dmir bl rti l whi h f ll w s
1 , co a e e a a e a c e c o o :

i t is r print d with t h kind p rmissi n f t h uth r d

e e e e o o e a o an

th e

TH E doctrin e that a short life is a S ign o f

d ivin favour has n e v e r b e e n acc e pt e d by t h e
e

majorit y o f mankind Philosoph e rs have vi e d .

with ach oth e r in d e picting t h e e vils and mis

e

e ri e s incid e ntal to e xist e nc e and t h e t r uth o f ,

th e ir d e scriptions h a s oft en b ee n sorrowfull y a d

m i tt e d b u t th e y hav e fail e d to dislodg e o r e v e n
, ,

s e riousl y diminish that d e sir e for long life

'

which h a s b e e n de e ply implant e d within t h e

h e arts o f m en Th e que stion wh e th e r life b e
.

worth living has b ee n d e cid e d by a majority

far too gr e at to admit o f any doubt upon t h e s u b
je c t and t h e voic e s o f those who would fain re ply
,

i n t h e n e gativ e a e drown e d amid t h e chorus o f

r

asse nt Longe vity ind e e d has com e to b e r e

.
, ,

garde d a s o n e o f t h e grand priz e s o f human e xist

e nc e and r e ason has again and a a i n s u
g g ge s t e d
'

t h e inqui r y wh e th e r care o r skill c a n incr e as e t h e

chanc e s o f acquiring it and c a n make o ld a ge , ,

wh e n grant e d a s comfortabl e and happy a s

,

any oth e r stage o f o u r e xist e nc e .

107
 Ma s t e r p i e c e s of S c i e n c e

Prom v e ry e arly tim e s t h e art o f prolongi ng

life and t h e subj e ct o f long e vity hav e e ngag e d
, ,

t h e att e ntion of think e rs and e ssayists ; and som e

may p e rh a ps cont e nd that th e se topics admitt e d ,

ly full of int e re st h a v e b e e n thoroughly e x

,

h au sted It is true that t h e art in que stion has

.

lo ng b ee n r e cogniz e d and practic e d but t h e ,

sci e nc e upon which it r e ally d e p e nds i s o f q ui t e

mode rn origin N e w facts conne ct e d with
.

l o nge vity ha e more ov e r b e e n colle ct e d within

v , ,

t h e last fe w y e ars and som e o f th e s e I propos e

,

to e xamin e and furth e r to inquire whe th e r

,

th e y t e ach us any fre sh m e ans whe re by life

may b e m a intain e d a n d prolonge d .

B ut b e fo re e t e ring up o n t h e imm e diat e

,
n

subj e ct the re a r e s e v e ral pr e liminar y qu e stions

,

whi c h d e mand a b r i e f e x a mination and t h e ,

first th a t sugge sts itself i s What is t h e natural ,

duration of human life ' This oft re p e at e d -

qu e sti o n h a s re c e iv e d m a ny diffe re nt answe rs ;

and inq i r y has b e e n stimulat e d by ske p ticism
u

as to th e ir t ruth Th e lat e S ir G e orge Co r n e

.

wall L e wis e xpr e ss e d t h e Opinion that o n e hun

dr e d y e ars must b e re gard e d as a limit which
v e ry fe w if ind ee d any human b eings succ ee d
, ,

in re aching and h e support e d this vi ew by s e ve ral

,

coge n t r e asons He point e d out that almost

.

all t h e all e ge d instanc e s of abnormal longe vity

occurr e d among t h e hum b l e r class e s and that ,

it was di fficult if not impossibl e to Obtain any

, ,

e xact info r mation as to t h e dat e o f birth and ,

to ide ntify t h e individuals w i th any writt e n

108
 Th e Ar t of P r o l o nging L i fe

st at e m e nts th t migh t b e f rthcoming He

a o .

laid particul r str ss upon t h e fact that similar

a e

insta c e s w r altoge th e r abs ent among t h e

n e e

high e r classe s with re gard to whom trustworthy

,

docum e ntary e vid nc e w s almos t al w ays o b e a

t a i a b le
n He thought that t h e high e r t h e rank
.

t h more favourabl e would t h

e onditi ns b for e c o e

t h e attainm e nt o f a long lif In this latt r e . e

supposition howe v r S ir G e orge L e wis was

,
e ,

probably mistak e n : t h comforts and luxuri s e e

app rtaining to w lth and high social rank a e

e ea r

too Oft e n count e rb lanc e d by car s and an x i ti s

a e e e ,

and by mod s of livi g inconsist e nt with t h e

e n

maint e nanc of h e alth n d the re fore wit h t h

e ,
a e

prolong tion f lif

a In t h introdu tion to
o e . e c

his work on Human Long vity Easton says

“
e , ,

It is not t h e r ich or gr at t hat b e e

com e O ld but such as u s e much e x r is e a e

,
e c ,
r

e xpos d to t h e fr sh air and wh s e fo d is plain

e e ,
o o

and mod e rat e— a s farm e rs g rd en e rs fis h ,

a ,
er

m en lab ure rs so ldi rs

,
o d such m e
,
as p e ,
an n er

haps n e ve r e mploy d the ir thoughts o n t h e e

m e ans used to promot longe vity ”

e .

Th e Fre nch naturalist B u ff on b e li e v e d that , ,

if accid e ntal caus e s c uld b e xclud e d t h e normalo e ,

duration of human life would b e b e t w e n ni ty e ne

an d o n e hundr d y e ars and h e sugg st d tha t

e ,
e e

it might b e m e asur d (in animal as we ll as in e

man) by t h p riod of growth to which it stood

e e ,

in a c e rtain proportion H i magin e d tha t . e

e v er y animal m i ght liv e f r s i x or s e v e n tim e s o

as man y y e ars as we re r e quisit e for t h e c o m

109
 Ma s te r p i e c e s of S c i e n c e

p le t i o nOf its growt h B ut this calculation is .

n o t in harmony with facts s o far at l e ast a s , , ,

man is conce rn e d Hi s p e r iod o f gr owth c a

. n

not b e e stimat e d a t l e ss than tw e nty y e a r s ; and

if w e take t h low r o f t h e t wo mul tipli e rs w e
e e ,

g e t a numb e r which in t h e light o f mod

,
er n

e vid e nc e can n o t b e acc e pt e d a s attainabl e

, .

If th e pe riod o f growt h b e m ul tiplie d by fiv e ,

t h e r e sul t wi ll in a ll probabilit y n o t b e far fr om

t h e t r uth .

If w e s ee k histo r ical e vid e nc e and from it ,

att e mpt to disc ove r t h e e xtr m e limit o f human e

li fe w e a r e puz zl e d at t h e di ff e re nce s in t h e age s

,

s aid to hav e be e n attai n e d Th e long vity Of . e

t h e an t e di luvian pat r iarchs wh e n contrast e d

with ou r mode r n e xpe r i enc e se e ms incre di bl e .

Wh e n w e look at an i ndi vidual say nin e ty y e ars ,

of a ge taking e ve n t h e most favourabl e s pe ci

,

m en a prolongation of life t o t e n tim e s that

,

numbe r o f e a r s would app e ar too absurd e ve n t o

y

dre am about Th re is ce rtain l y no physiologi cal

. e

r e ason why t h e age s ass ign e d t o t h e pat ri archs

sho ul d n o t have bee n attain e d and it is use l e ss ,

to di scuss t h e subj e ct for w e k now v e ry littl e o f

,

t h e condi tions und e r whi ch th e y liv e d It is .

int e re sting to notic e that aft e r t h e Flood the re

w a s a gradual d e cr e ase in t h e duration o f life .

Abraham i s re cord e d to hav e di e d at o n e h u ndr e d

and se ve nty fiv e ; Joshua som e fiv e hundr e d
-
,

”
y e ars lat e r wax e d Old and strick e n in a ge
,
“

shortly be fore his d e ath at o n e h u ndr e d and t e n

y e ar s ; and his pre de c e ssor Mose s t o whom on e , ,

110
 Th e Ar t of P r o l o nging Li f e

hundre d and tw nty y e ars a r e assign e d is b e

e ,

li e v e d to hav e e stimat e d t h e life o f man at thre e

score y e ars and t e n — a m e asur e nowadays pre tty

ge n e rally ac e pt e d c .

Th ere is n o re ason for b e li e ving tha t t h e e x

t r e m e limit o f human lif e in t h e tim e o f t h e
Gree ks and Romans di ffe re d mat e rially fr m o

that which agr s with mod e rn e xp e ri e nc e ee .

S tori e s o f t h e attainm e nt of such age s as o e n

hundre d and t wnt y y e ars and upward may b e e

plac e d in t h sam e cat e gory as t h e r e put e d lon

e

ge i t y Of H e nry J e nkins Th mas Pa r r Lady

v ,
o ,

D e smond and a host o f oth e rs With re gard

, .

to lat e r tim e s such as t h e middl e age s th e r e a r e

, ,

no pre cis d ata up n whi h any stat e m e nts c a n

e o c

b e bas e d but th e r e is e ve ry r e ason to b e li e v e

,

that t h e a v r a g duration of life was d e cide dly

e e

l e ss th n it is at pre s e nt Th e e xtre m e limit

a .
,

indee d thre e o r four c e nturi e s a go would a p

, ,

p e ar t o have b e e n much lowe r than in t h e nin e

t e en t h c e ntury At t h e re que st o f Mr Thoms
. .
,

S ir J Du ffus Hardy inv e stigat e d t h e subj e t of

. c

t h e longe vity f man in t h e thirt e e nth four

o ,

tee n th fift e nth and sixt e e nth c e nturi s and

,
e ,
e ,

his re se arch e s le d him to b e li e ve that p e rsons

se ldom r e ach e d t h e a ge o f e ighty He n e v e r .

m e t with a trustworthy r e cord o f a p e rson who

e xc ee d e d that a ge .

To bring t h e inve stigation down to quit e re c e nt

tim e s I can not do b e tt r than utiliz e t h e r e
, e

s e arch e s O f Dr Humphry Profe ssor o f S urge ry

.
,

at Cambridge In 8 8 6 h e Obtain e d p a r t i c u
. 1

111
 Ma s t e r p ie c e s of S c i e n c e

lars r e lating to fift y two individuals th e n livi ng

-

and said to b e o e hundre d y e ars o ld and upward

n .

Th e old e st among th e m cl ai m e d t b e o n e hun o

dre d and e ight t h e n e xt o e hun dr d and s i x

,
n e ,

whi l e t h e av e rage amount e d to a littl e mor e than

o e hun dr e d and two y e ars
n Many int e re sting .

facts conn e ct e d with t h e habits and mod e o f

life o f th e s e individuals w re o btain e d b y Dr e .

Hum ph r y and will b e r f rre d t o in s u b se

,
e e

que nt paragraphs .

A Short accoun t o f t h e e xp e ri e nc e o f a few

life assuranc e compani e s wi ll c nclud e this part
-
o

o f my subj ct Mr Tho rn s t e lls us that down

e . .

t o 8 7 t h e r e cords o f t h e compani e s showe d

1 2

that o n e d e ath am ng t h e assur e d h d occur re d

o a

at o n e hun dr e d and thr e e o n e in t h e o e h u n ,

n

d r e d t h and thr e e in t h e nin e ty ninth y e ar

,
Th e -
.

e xp e ri e nc e of t h e National D e bt O ffi c e accord i ng ,

to t h e sam e author it y gave two case s in whi ch ,

t h e e vid e nc e could b e r e gard e d as p e rf ct ; o n e e

of th e s e di e d in t h e o n e hundr e d and s e cond

y e ar and t h e oth e r had j ust compl e t e d that
,

numb e r In t h e table s publi sh e d by t h e Insti

.

tut e o f A ctuari s and giving t h e mortality e x

e ,

e r i en c e down to 8 6 3 o f tw e nt y life assur anc e

1
p
-

compani e s t h e high e st a ge at d e ath is re corde d

,

a s nin e ty ni n e and I am info r m e d by t h e s e cre

-

tary o f t h e E d n b u r gh Life O ffi c e that from 1 8 6 3

l

onward that a ge had n o t b e e n e xc ee d e d in his

e xp e i e nc e
r In t h e valuation sch e dul e s which
.
,

Show t h e high e st age s o f e xisting live s in various

o ffi c e s t h e age s range from nin e t y t wo t o nin e t y
,
-

112
 T h e Ar t of P r o l o nging L i fe

fiv e . It is tru e that o n e o ffi e which has a large c

busine ss among t h e industrial class e s r e p rts o

live s at o hundre d and three and in o i

ne ,
ne h ~

stanc e at o e hundr d and s e v e n ; but it must b

n e e

r e m e mb e re d that among thos clas s t h e age s e se

a r e not n arly so w e ll auth nti at e d as among

‘
e e c

thos who assure for substantial sums Th e re

e .

is more ov r anothe r sourc e of e rror conn e ct e d

,
e ,

with t h e valuation sch e dul e s Wh e n a giv e n .

life is t conside r e d to b e qual t t h e av e rage

no e o ,

a c e rtain numb e r of y e rs i s add d to t h e a ge a e ,

and t h pre mium is charg d at t h e a ge which

e e

re sults from this addition I t follows th e r e .

,

for that in som e cas e s t h e a ge giv e n in t h

e, e

sch e dul s a r e gre at e r by som e y e ars than th e y

e

r e ally a e r .

Taking into onsid e ration t h e facts thus c

rapidly pass d und e r r e vi e w it m ust I think

e , , ,

b e admitt e d that t h e natura l limit of human

e xist e nc e is that assign e d to it in t h e book of

Ec cl e siasticus Th e numb e r of a man s days at

,
“ ’

t h e most a e an hundre d y e ars ch pt r xviii

”
r
( a e .

In a v e ry sm ll numb e r of cas e s this lim i t a

is e xc ee de d but only by a v e ry fe w y e ars Mr

,
. .

Th o m s s inv e stigations con lusiv e ly S how that

’
c

trustworthy e vid e nc e o f o n e hundre d and t en

y e ars having b ee n r e a h e d is altog th e r abs e nt c e .

Futur e g n r ti ns will b e abl e to V e rify o r r e

e e a o

jc e t stat e m nts in all all e ge d cas s of longe vity

e e .

I t must b e r m e mb e re d that pre vious to t h e

e

ye ar 8 3 6 th re was no r e gistration o f births

1 e ,

but only o f b ptisms an d that t h e re gist e rs a

,

1 13
 Ma s te r p i e ce s of Sc ie n c e

We r e k e pt in t h e churche s and contain e d onl y

,

t h e nam e s o f thos e th e r e in baptiz e d .

What e ve r numb e r of y e ar s may b e take n as

r e pre se nting t h e natural t e rm o f h u man life ,

whe th e r thre e s core and t en or a c e ntury b e r e

gar d e d as such w e a confront e d b y t h e fact
,
re

that only o n e fourth o f our population att ai ns

-

t h e fo r m e r a ge and that only about fif t e e n in

,

one hundr e d thousand b e om e c e nt e na ri ans c .

I t is be yond t h e scop e o f this articl e t o discu ss

t h e cause s of pre mature mortality but t h e c o ,

n

di t i o n s favourabl e to longe vity and t h e cause s ,

t o whi ch l e ngth O f days h a s be e n assign e d a e ,

r

clos e ly conn e ct e d with its subj e ct .

A capability of attaining o ld a ge is v e ry Oft e n

hand e d down from o e ge n e ration t o anothe r
n ,

and h re dit y is probabl y t h e most p owe r ful

e

factor in conn e ction with longe vit y A me c e s ,

sary condi tion o f re aching advanc e d a ge is t h e

posse ssio n Of sound bodily organs and su ch an ,

e ndowm e nt is e min e ntl y capabl e o f transmi ssion .

Instanc e s Of longe vity charact e riz i ng se ve ral

ge ne rations a e fre que ntly brought to notic e A
r .

re c e nt and most int e r e sting e xampl e o f trans

m i t t e d longe vity is that Of t h e v e t e ran guardian
o f t h e public h e alth S ir Edwin Chadwick wh o
'

, ,

w a s e nt e rtain e d at a public d inn e r a fe w w ee ks

a go o n t h e o ccasion of h i s r e aching his nin e ti e th

ye ar He inform e d his e nt e rtai ne r s that his

.

fath e r di e d at t h e a ge of e ighty four o n e Of his -

,

grandfath er s at nin e ty fiv e and that two more

-
,

re mot e anc e stors we re c e nt e na r ians .

1 14
 Th e Ar t of P r o l o ngin g L i fe

It is di fficult to stimat e t h e influe nc e Of oth e r

e

continge nci e s which affe ct long vity With r e e .

gard t s ex Hu fe la d s Opi ni on was that wom n

o ,
n
’
e

w re more like ly than m e to b e com e o ld but

e n ,

that instanc s of e xtre m longe vity w e re more

e e

fre que nt among m e n This Opinion i s to som e .

e x t e nt born e out by Dr Humph r y s statistics : ’

.

o f fift y two c e nt e na r ians thirty six w e re wom e n

-
,
-
.

Ma r riage would app ar t o b e conducive to lon e

ge v i t y .A w e ll known Fre nch s a t Dr B e r

-
av n ,
.

t i llon stat e s that a bach lor o f twe nty fiv e is not

,
e -

a b e tt e r lif than a marri e d man of forty fi e

e -
v ,

and h e attribut s t h e di ffe re nc e in favour o f

e

marri e d p opl e to t h e fact that th e y take more

e

car f th e mse lve s and l e ad m r re gular liv e s

e o ,
o e

than those who have no such t i e It must .

,

howe ve r b e re me mb r d that t h e m e re fact

,
e e

o f marr ying indicat e s sup e rior vitality and vigour ,

and t h e ranks of t h e un marri e d a r e large ly fill e d

by t h e physically unfit .

In conside ring occupations as th e y a r e like ly

t o e ff e ct longe vity thos e which obviously t e nd
,

to Short e n life n e e d not b e conside re d With .

r e sp e ct to t h e l e arn e d profe ssions it would a p ,

p e ar that among t h e cl rgy t h e ave rage O f life e

is b e yond that o f any similar cl ss It i s i m a .

probabl e that this av e rage will b e maintain e d

fo r t h e future ; t h duti e s and anxi e ti s impos e d
e e

upon t h e cl e rgy o f t h e pre s e nt ge n e ration pla e c

th e m in a v e r y di ffe r nt position from that of e

th eir pre d e c e ssors Among lawye rs th e re have

.

b e e n s e ve ral e min e nt judge s who attain e d a gr e at

115
 Ma s te r p i e c e s of S c i e n c e

a ge , and t h e rank d file of t h e profe ssion a e an r

also charact e ri z d by a d id e d t nd ncy t o e ec e e

longe vity Th e m e dical profe ssion suppli e s but

.

fe w insta c s f xt r e m e Old a g
n e and t h e a e rage
o e e, v

duration f life a m ong its m e mb e rs is d eci d e dly

o

low a fact which c a b e

, sily accoun t e d for n ea .

B roke n r st hard w ork anxi e ti e s e xposur e to

e , , ,

w e ath e r and to t h ri sks of inf ction c a n o t fail e e n

t o e x e rt an injuri ous influ e nc e upon h e alth .

No d finit e onclusi s c a n b e arrive d at with

e c on

re gard to t h ave rag longe vity o f lit rary and

e e e

sci ntific m e but it mi ght b suppos d that

e n ,
e e

t hose among th m w h a e ot harasse d by e o r n

anxi e ti e s and e njo y fair h e lth woul d probably a

re a ch Old a ge AS a ge n ral r ule t h e dur ati n

. e ,
o

of life is not short e n e d by lit e rary pur s ui ts A .

man ma y worry himse lf to d e ath ove r his books ,

or ,
wh e n tire d o f th e m may s e k r cre ation in ,
e e

pursuits d e st r uctiv t o h e alth ; but appli cation e

to lit r ry work t nds t produc e h rf ln e ss

e a e o c ee u ,

and t prolong rath e r th n short n t h e life e v n

o a e e

o f an i firm man In Prof Humph r y s Re ’

n . .

port o Age d P e rsons contai ing an account

n
”
,
n

of ight hundr d and tw e nty four individuals

e e -

of both s e x e s and b twee n t h e age s o f e ighty

,
e

and o n e hundr d it is Stat e d that forty ight e ,

-
e

p e r c nt w e r e poor
e .forty two p e c e nt w e r e in ,
-
r .

comfor tabl e circumstanc s n d nly t e n p r e ,

a o e

c e nt w e re d esc ri b e d as b ing in a fflue nt circum

. e

stanc s Dr Hum ph r y points

e . t that th e se ou

ratios must not b e re garde d re pre s e nting as

t h e re lations of p o v er t v and a fflu e e t o lon nc

1 16
 Th e Ar t of P r o l o n ging L i fe

gev i t y , b e cause in t h e first plac e t h e poor at all

, ,

age s and in all distri ts b ar a larg proportion c e e

to t h e a fflu ent ; and s e condly t h r turns a r e , ,

e e

large ly made from t h e lowe r and middl e class e s ,

and in many insta c e s fr m t h e inmat e s of n o

u ion work hous s wh e re a go d numb e r o f

n -
e ,
o
”
age d p e opl e a r e found It must also b e notic e d .

that t h e pas t life history o f th e se individuals

-

S how e d that t h e gr at r proportion (fift y fiv e e e -

r c e nt ) had liv d in comfortabl circum

“
e e e
p .

stanc e s and tha t only thirty fiv e p e r c e nt had

.
-
.

b ee n poor .

M e r e ly t o e num e rat e t h e cause s to which lon

g e v i t y has b e e n attri but e d in att e mpting to a c
count for individual case s would b e a task of som e
magnitude ; it will b e su ffi i e nt to m e ntion a c

fe w som e what probabl e th e ori e s Mod e ration .

in e ating and drinking is Oft n d lar e d to b e a e ec

caus e o f longe vity and t h e ass e rtion is fully

,

corroborat e d by Dr Humphry s inquiri e s O f ’

his fift y two c e nt e narians t w

. .

-
e lv e w r e r cord e d ,
e e

as total abstain e rs from alcoholic drinks through

o t life
u ,
o r for long p e riods ; tw e nty had tak e n

v e ry littl e alcohol ; e ight w e r e r e port e d as mod

e a t e in th e ir u s e o f it ; and only thr ee habitually
r

indulge d in i t It is quit e tru e that a few p e r

.

sons who must b e classifi e d as dru kards live

°

to b e v e ry o ld ; but th e s e a e e xc e ptions to t h r e

ge n e ral rul e and such cas e s app e ar to b e more

,

fr qu e nt than th e y r e ally a r e b e caus e th e y a r e

e ,

oft e n brought to notic e by thos e who find e h

c o u r a g em e n t from such e xampl e s Th e habit .

1 17
 Ma s t e r p i e c e s of S c i e n c e

of t em p e ranc e in food good powe rs o f dige sti on

, ,

and soundn e ss o f sl e e p a r e oth e r main charact e r

i s t i c s o f most of th s e who attain advanc e d y e ar s
o ,

and may b e r e gard e d a s caus e s o f longe vity .

Not a few o ld p e rsons a r e found o n inqui ry t o

t ake cre dit to th e mse lv e s for th e ir wn c o n o

dition and t o attribut it t o som e r markabl e

,
e e

p e c uliarity in th i r habits or mode o f life It

e .

is said that Lord Mansfi e ld wh o re ache d t h e ,

a g e o f e igh ty nin e was wont t o inq u i r e into t h e

-
,

habits Of life o f all ag d witn e sse s wh o appe ar e de

be fore him and that nly in o n e habit nam e ly

,
o , ,

that o f e arly rising w s th e r e an y ge n e ral c on

,
a

c u re nce H e alth is d ubtl e ss oft e n prom ot e d

r . o

by e arly r ising but t h e habit is n o t n e c e ssari ly

,

conducive to longe vit y It i s a s S ir H Ho lland .

, .

points o u t mor e probabl e that t h e vigour o f t h e

,

indi viduals m ai ntai ns t h e habi t than that t h e

latt e r alon e mai ntain s t h e vitalit y .

If w e pas s from probabl e to improbabl e cause s

o f long e vity w e a r e confr ont e d by man y e xt r a v a

gant assumptio s Thu s t o take onl y a fe w

n .
,

e xampl e s t h e imm d e rat

,
u s e o f sugar h a s be e n
o e

re gard e d not onl y as a panac e a but a s d e cide dl y ,

conducive to l e ngth o f days Dr S lar e a phy . .

,

s i c i a n o f t h e las t c e ntury has r e corde d t h e case ,

o f a c e nt e narian who use d to m i x sug a r wi th all

h i s food and t h e doctor himse lf was s o c o n
,

v i n ced of th e b al sami c virtu e o f this s u b

“

stanc e that h e adopt e d t h e practic e and bo a st e d ,

o f h i s h e alth and str e ngth in his Old a g e An .

oth e r m e mb e r o f t h e sam e profe ssion use d t o

1 18
 Th e Ar t o f P r o l o nging L ife

ta ke dai ly dose s o f tannin (t h e substanc e e m

ploye d t harde n and pr s rv l ath r) und r
o e e e e e , e

t h e impr ssion that t h tissu e s f t h body would

e e o e

b th r b y prot e ct d from d e cay

e e e His life was e .

protrac t d b yond t h ordinary span but it is

e e e ,

que stionabl wh e th r t h e tannin act d in t h e

e e e

d e sir d dire ction Lord Comb rm e r thought

e . e e

that his good h alth and advance d ye ars w e re e

d u e in part at l e ast to t h fact that h e always

, ,
e

wore a tight b lt round his waist Hi s lord e .

ship s app tit e was doubtl e ss th e re by k pt

’
e e

wi thin bounds ; w a e furth r told that h e wa s e r e

ver y mod rat e in t h e s e o f all fluids a s drin k

e u .

Cl e anlin ss migh t b e suppos d to aid in p o e e r

l on ging life y t a M s L w who die d in t h e

,
e r . e s on ,

e arly p art o f this c ntur y ag d e hundr d and e ,

e on e

si x must have b n a si ngularly dirty p e rson

,
ee .

We a e told that inst e ad of washing h sm are d

r s e e

h er fac with lard and ass rt e d that p e opl e “

e ,
e

wh o wash d always caught cold e This lady .

,

n o doubt was fully p rsuad d that s h

,
had dis e e e

cove re d t h e unive rs a l m dicin e e .

Many o f t h alch e mists attribut e d t h pow e r e e

o f prolonging lif to c rtain pre parations f e e o

gold probably und e r t h id a that t h e p rma

,
e e e

n en c e o f t h e m e tal might b impart e d to t h e h u e

man syst m D scart s is said to hav favour d

e . e e e e

such Opinions ; h told S ir K n lm Digby that e e e ,

although h e would not v e ntur to promis e i m e

mortality h was c e rtain that h i s life might b e

,
e

l e n g th n d to t h p riod of that njoy e d b y

e e e e e

th e pat iarchs His plan how e ve r s ee ms to

r .
, ,

1 19
 Ma s te r p i e c e s o f S c i e n c e

have b ee n t h e v e ry rational and simpl e on e o f

che cking all e xc e ss e s and e njoining pun ctual and
frugal m e als .

Having thus e nd e avour e d to Show t he e xt e nt

to which human lif may b e prolonge d and e ,

having e xamin e d som e of t h e cause s or ant e

c e d e nts of longe vity t h e last subj e ct for inquiry
,

is t h e m e ans by which it may b e attain e d .

Ce rtai n pr liminary conditions a r e obvi ously

e

r e q ui sit e ; in t h e first plac e th r e must b e a sound e

constitution d e rive d from h e althy anc e stors ,

and in t h e s e c nd the re must b e a fre e dom from

o

organi c di s as e of important organs Give n

e .

an individual who has r ach e d t h e grand c li m a c

e

t e r i c or thre e score and t n and in whom th e s e

,
e ,

two conditions a e fulfill e d t h e m e ans b e st

r ,

adapt e d to maint in and prolong hi s life con

a

s t i t u t e t h e qu e stion to b e solv e d It has b ee n .

said that h w h would long to b e an O ld man

e o

must b e gi n arly t b e o e but v e ry fe w p er

e o n ,

sons d sign e dly t ak m e asur e s in arly life in

e e e

orde r that th e y may live longe r than th e ir

f llows
e .

Th e whol e t e r m o f lif may b e divid e d into e

t h e thr e e main p e riods f gr wth and d e v e lop

o o

m e nt of maturity and of d clin e No hard and

, ,
e .

fast lin e c a b e dr awn b e twee n th e s e two latt e r

n

phas e s of e xist e nc e : t h e o e S hould pass gradu n

ally into t h e oth e r un til t h e e ntir e picture is

change d Dimini she d cons e rvativ e powe r and
.

t h e cons e qu e nt triumph of disint e grating forc e s

are t h e promi n e nt fe atur e s of t h e third p e riod ,

120
 Th e Ar t of P r o l o ngi n g L i f e

which b e gins at di ffe r e nt tim e s in di ffe re nt i h

d i i d a ls its adv e nt b e ing mainly controll e d by
v u ,

t h e ge n e ral cours e o f t h e pr e c e ding y e ars Th e .

“
turning p e riod also kn own as t h e c li m a c
”
,

t er i e
”
or middl e a g e li e s b e twe e n forty fiv e
,
-

and sixty ; t h e p e riod b e yond may b e consid re d e

as b e longing to advanc e d life o r o ld a g e Th e .

majority of t h change s charact e r istic of th s e

e e

last stage s a r e e asily r e cognizabl e It is hardly .

n e ce ssar y to m e ntion t h e wrinkl e d skin t h e ,

furrowe d fac e t h e crow s f e t b e n e ath t h e

,
“ ’
e

e ye s ,
t h e stooping gait a n d t h e wasting of t h e
,

fram e Th e s e nse s notably vision and h e aring

. , ,

b e com e l e ss acut e ; t h e powe r of dige stion is

l e sse n e d ; t h e forc e o f t h e h e art is diminishe d ;
t h e lungs a r e l e ss p e rm e abl e ; many o f t h e air
c e lls lose th e ir e lasticity and m e rge into e ach
oth e r s o that th e re is l ss br athing surfac e as
,
e e

w e ll as l e ss powe r S imultan e ously with th e s e

.

change s t h e mind ma y pre s e nt signs of e n

fe e b le m e t ; but in many instanc e s its pow e rs

n

long re main in marke d contrast with thos e o f

t h e body O e fact conn e ct e d with advanc e d
. n

life is t o o Oft e n n e gl e ct e d It should n e ve r b e

forgott e n that whil e t h e forc e s in u s e at that
”

p e riod a r e e asily e xhaust e d t h e forc e s in r e ,

“

s e rv e a r e oft e n s o slight as to b e unabl e to m e et

t h e small e st d e mand In youth t h e re s e rve
.
,

powe rs a r e sup e rabundant ; in advanc e d life ,

th e y a r e re duc e d to a minimum and in some ,

instanc e s a r e practicall y non exist e nt Th e -

.

re cognition o f this diffe re nc e is an all important -

121
 Ma s t e r p i e c e s o f S c i e n c e

gu ide in laying down r ule s for conduct in Old

a ge .

In ord e r t o prolong life and at t h e sam e tim e

to en j oy it occupation o f some ki nd is a b s o
,

lu t ely n e c e ssary ; it is a gr e at mi stak e t o suppose

that idl e n e ss is conducive t o lo nge vity It is .

at all tim e s be tt e r to w e ar o u t than t o r u s t o u t ,

and t h e latt e r proc e ss is apt t o b e S pee di ly a c

complish e d Eve r y o e must have m et with i h
. n

di v i d u a ls who whi l e fully oc cupi e d ti ll Sixty o r

,

e v e n se v e nty y e a r s o f a g e re main e d hal e and

,

st rong but age d with ma r ve lous rapi di ty aft e r

,

r e linq ui shi ng work a change i n th e ir m e ntal

,

condi tion be comi ng e spe cially promin e nt Th e r e .

is an Obvious le ss on to b e l e arn e d from such i h

stanc e s but c e rtai n quali fications a r e n e c e s
,

sa r y in orde r t o appl y it pro p e rly With r e gard .

to m ental activity th e re is abundant e videnc e

,

that t h e more t h e int e ll e ctual faculti e s a e e x er r

c i s e d t h e gr e at e r t h e probability o f th e ir lasting .

Th e y Oft e n b e com e stronge r aft e r t h e vital force

h as p a sse d i t s culminating point ; and this r e
t e ntion o f m e ntal po w e r is t h e t r u e compe nsa

tion for t h e d eclin e in bodi l y stre ngth Did .

spac e pe rmi t many i llustrations coul d b e a d

,

d u c e d t o Show that t h e pow e r o f t h e min d can

b e pre se rv e d almost un impaire d t o t h e most
a dvanc e d a g e Ev e n m e mor y t h e fai lur e o f
.
,

whi ch is som etim e s r e garde d as a n e c e ss a r y c o n

comitant o f o ld a ge is not infr e que ntly p r e s e rv e d
,

almost up to t h e e n d of li fe All pe rsons o f .

middle a ge should take s pe cial pains t o kee p t h e

122
 Th e Ar t of P r o lo n ging L i fe

faculti e s and e n e rgi e s of t h e mind in a vigorous

condition ; th e y Should not simply d r ift o n in a
haphazard fashion but should s e e k and find
,

pl e asure in t h attainm e nt o f d e finit e obj e cts

e .

Ev e n if t h e mind has n o t b ee n e sp e cially culti

v at d
e ,
o r r e c e iv e d any d cid e d b e nt
e the re is at ,

t h e pre s e nt day no lack of subj e cts o n which it

c an b e agre e ably and profitably e x e rcis e d .

Many sci e nc e s which twe nty o r thirty y e ars ago

, ,

w e re acc e ssibl only to t h e fe w and w e r e at b e st

e ,

a som e what uninviting garb have b e e n re nde re d

,

n o t m e re ly int e lligibl e but e v e n attractiv e to t h e

many ; and in t h e domain o f ge n e ral lit e rature

t h e di fficulty o f making a choic e among t h e host f o

allure m e nts i s t h e only ground fo r complaint .

To in re ase t h e tast e for th e se and kindre d s u b

c

j ec t s i s worth a consid e rabl e e ffort if such b e ,

n e c e ssa r y ; but t h e app e tit e will ge n e rally com e

with t h e e ating Th e posse ssion o f som e r e a
.

sonabl e hobby which c a n b e cultivat e d indoors

is a gr e at advantage in Old a ge and th e re a e ,
r

many pursuits o f this charact e r b e side s thos e

conn e ct e d with lit e rature and sci e nc e Tall e y .

rand l ai d gre at stre ss o n a knowl e dge o f whist as

indisp ensabl e to a happy o ld a g e and doubt ,

l e ss t o man y o ld p e opl e that particular gam e

a ff ords n o t only re cre ation but a pl e asant e x
e r c i s e to t h e mind . It i s howe v e r an unwort h y
, ,

substitut e fo r highe r obj ects and should b e r e

,

gard e d only as an amuse m en t and n ot as an

occupation .

What e ve r b e t h e sp h e re o f m ental ac t ivit y ,

123
 Ma s t e r p ie c e s of S c i e n c e

no kind o f strain must b e put upon t h e mind by a

e rson who h a s r e ach d S ixty fiv e o r s v nty
p e e e -

y e ars Th e fe e ling that m e ntal powe r is l e s s

.

t han it onc e w a s not infre que ntly stimul at e s

a man to incre as e d e x e rtions which may pro
voke st r uctur al change s in t h e brain and will ,

c e rtainly acc e l e rat e t h e progre ss of any that

may e xi st in that organ Whe n a man finds .

that a gre at e ff ort i s r e quir d to accomplish e

any m e ntal task that was onc e e asy h e should ,

de sist from t h e att e mpt and r e gulat e his work

,

accordi ng to hi s pow r With this limita e .

tion it may b e take n for grant d that t h e m e ntal

,
e

fac ul ti e s will b far b e tt e r pre s e r v e d by th e ir

e

e x rcis e than by th ir disus e

e e .

S om e what di ffe re nt advic e must b e gi v e n with

re gard to bodily e x e rcis e s in th e ir r fe re nc e to e

longe vity Ex rcis e is e ss ntial to t h e pre s e rva

. e e

tion of h e alth ; inactivity is a pot e nt cause o f

w a sting and d ge e ration Th e vigour and
e n .

e quality o f t h e circulation t h e functions o f t h e ,

skin and t h e a ration f t h blood a e all pro

,
e o e ,
r

mot e d by mus ular activity which thus k ee ps up

c ,

a prop r balanc e and r e lation b e tw e e n t h e i m

e

portant organs o f t h e body In youth t h e .

,

vigo u r of t h e syst e m is Oft e n s o gre at that if o n e

organ b e sluggish anoth e r part will make am e nds
for t h e d e fici e ncy by acti g vica r iously and n ,

without any cons e que nt damage to its e lf In .

O ld a e
g t h e
,
tasks can o t b e thus shift e d from
n

o e organ t o anoth e r ; t h e work allott e d to e ach

“

su ffici e ntly tax e s its stre ngth and vicarious ,

124
 Th e Ar t of P r o l o nging L i fe

aci ton can not b e p e rform e d without mischi e f .

H enc e t h e importanc e o f mai ntaining a s far as ,

possibl e t h e e quabl e action o f all t h e bodily

,

organs s o t h at t h e S hare of t h e vital proc e sse s

,

assigne d to e ach shall b e prop e rly accomplish e d .

For this r e ason e x rcis e i s an important part of

e

t h e conduct o f life in o ld a g e ; but discre tion is

absolut e ly n e c e ssa r y An old man should dis
.

cov e r by e xp e ri e nc e how much x e rcis h e can e e

take without e xhausting his powe rs and S hould ,

b e care ful n e v e r to e xc e e d t h e limit O ld p e r .

sons a r e apt to forge t that th ir staying pow rs e e

a e much l e ss than th e y onc e w r

r and that e e, ,

whil e a walk o f two o r thre e mil s may prove e

e asy and pl asurabl e e t h e addition of a r e turn

,

j ourn e y o f similar l e ngth will s e riously ove r tax

t h e stre ngth Abov e all things sudde n and
.
,

rapid e xe rtion should b e scrupulously avoid e d

by p e rsons o f advanc e d a ge Th e machin e .

which might go on working for y ars at a gentle e

pac e Oft e n bre aks down altoge th e r wh en i t s

move m ents a r e sudde nly acc e l e rat e d Th e se .

cautions may app e ar sup e rfluous but instanc e s ,

in which th e ir disre gard is f ll we d by v e ry o o

s e rious conse que nc e s a r e by no m e ans i n fr e

qu e nt .

N O fix e d rul e c a n b e laid do wn as to t h e kind

o f e x e rcis e most suitabl e for advanc e d a g e .

Much must de p e nd upon individual circum

stanc e s and p e culia r iti e s ; but walking in t h e

Op e n air should always b e k pt up and practic e d

e

dail y e xc e pt in unfavourabl e we athe r Walking

, .

125
 Ma s t er p i e c e s of S c i e n c e

is a natural form o f e x e rcise and su bs e rv e s

many import ant purpos e s : n o t a few o ld pe opl e
o w e t h e maint e nanc e o f th e ir h e alth and vigour

t o th e ir daily constitutional
“ ”
R iding is an .

e xc e ll e nt fo r m o f e x e rcise but availabl e only by

,

a few ; t h e habit if acqui r e d i n e arly life should

, ,

b e k e pt up as long as poss ibl e subj e ct t o t h e ,

caution alre ad y gi ve n a s t o viol e nt e x e rcise .

O ld p e rsons o f both s e x e s fond o f gard e ni ng and ,

s o situat e d that th e y may gratify th e ir t a st e s ,

a e much to b e e nvi e d
r B ody and mi nd a r e
.

a lik e e x e rcis e d b y what Lo rd B acon j ustly

t e rm e d t h e pure st o f hu man pl e asure s
“
Dr . .

Parke s goe s s o far a s to s a y that light gard e n o r

agr icultur al work i s a v e r y good e xe rcise for
m e n p a st se v e nty : It calls into play t h e muscl e s
“

o f t h e abdom e n and back which in Old m en a r e ,

oft e n but littl e us e d and t h e work is s o va r i e d

,

that no muscle i s k e pt long in action A few

r e marks must b e made in conclusion with r e
, ,

gard to a n ew form o f e x e rcise som etim e s i h

d u lg e d in e v e n by e ld e rly m en I allude to .

s o call e d tricycling Exhi larating and pl e as

-
”
.

ant as i t may b e to glide ov e r t h e gr ound with

comparativ e ly littl e e ffort t h e e x e rcise is fraught
,

with dange r for m e n who have pass e d t h e grand

c limact e r ic .Th e t e mptation t o mak e a S pur t
must b e Oft e n irr e sistibl e ; hills must b e en c o u n
t e r e d som e p e rhaps s o smooth and gradual as t o
,

r e qui re n o S p e cial e x e rtion non e at l e ast that , , ,

is notic e d in t h e triumph o f surmoun ting th e m .

N ow if t h e h e art and lungs b e p er fe ctl y sound

, ,

126
“
 T h e Ar t of P r o lo nging L i fe

such e xe rcis e s may b e practic e d for som e tim e

with a p pa r en t impunity ; but if (as is v er y like ly
t o b e t h e cas e) th e s e Organs b e not quit e stru e
t u r a lly p e rfe c t e v e n t h e slight e st change s will
, ,

u n de r such e xcit em e nt rapidly progr e ss and

,

l e ad t o v e r y s e r ious r e sults Ex e rcise unsuit e d

.

to t h e stat e o f t h e syst e m will assure dl y n o t

t e nd t o t h e prolongation o f life .

With re gard to food we find from Dr Hum

,
.

r y s re po r t that nin e ty e r c e nt o f t h e age d

’

p h p .

”
p ersons we re e ith e r mode rat e o r small “

e at e rs ,
and such mode ration is quit e in accord ,

with t h e t e achi gs o f physiolog y In o ld a ge t h e

n .

change s in t h e bodily tissue s gradually b e com e

l e ss and l e ss active and l e ss food is r e quire d to
,

make up fo r t h e daily wast e Th e app etit e and .

t h e pow e r o f dige stion a r e corr e spondingl y di

minish e d and although for t h e attainm ent o f a
,

g r e at a ge a consid e rabl e amount o f dige stiv e

powe r is absolut e ly n e c e ssary its p e rfe ction , ,

wh e n e x e rcis e d upon prop e r articl e s o f di et is ,

t h e most importan t charact e ristic Indulge nc e .

in t h e pl e asure s o f t h e tabl e is o e o f t h e c o m n

m on e rrors o f advanc e d life and is not i n f e ,

r

que nt in p e rsons who up to that p e riod w e re

, ,

mod e rat e o r e ve n small ea t e r s Luxuri e s in .

t h e wa y o f food a r e apt to b e r e gard e d as r e

wards that have b ee n fully a r n e d by a life o f e

labour and ma y the re for e b e lawfully e nj oy e d

, , ,
.

H e nc e aris e many o f t h e e vils and troubl e s o f

Old a ge and notably indige stion and gout y
,

symptoms in var ious fo r ms b e side s m e ntal d i s ,

127
 M a s t erp i ec es o f S c i e n c e

c omfor t N O h a rd and fast r ule s c a n b e laid

.

down but strict mod e ration shoul d b e t h e gu id

,

ing maxim Th e di e t su i tabl e fo r most age d

. .

p e r so ns is that which cont ai ns much nut ri tive

mat e rial i n a sm a ll b ulk and its quantity should
,

b e in pro p o r t ion t o t h e appe tit e and pow er o f

di ge st ion Ani mal food w e ll coo k e d
. , sho ul d ,

b e t ak e n S paringly and n o t mor e ofte n t han

twice a da y e xc e pt unde r Spe cial circum stanc e s
, .

Dr P ar ke s advocat e s ri c e a s a part ial su b s t i

.

tut e fo r m e at wh e n t h e latt e r is found t o di s

agr ee with Old p e rs ons Its starch grains a r e
.
“
-

v er y dige stibl e and it suppli e s nitroge n in

,

moder at e amount we ll fitt e d to t h e wor n and

,

slowl y r e pair e d tiss u e s o f t h e age d Its bulk ,

how ev e r is som e t i m e s a di sadvantage ; in small

,

quantiti e s it is a valuabl e ad di tion t o mi lk and

t o st e w e d fr ui ts .

Th e amount O f food ta k e n S hould b e divi de d

be twee n thr ee o r four m e als at fair l y r e gul ar
int e rvals A s e ns e o f fu lln e ss o r Oppre ssion
.

aft e r e ating ought n o t t o b e di sr e garde d I t .

in di c a t e s that t h e food tak e n h as b een e ith e r

t oo abun dant o r o f improp e r qualit y 'o r m any .

e ld e rly p e opl e t h e most su i tabl e tim e fo r t h e p r i n

ci p a l m e al is b e tw e e n and P M AS t h e da y
1 2 . .

advanc e s t h e dige stive powe rs b e com e l e ss and ,

e v e n a mod e rat e ly substantial m e al t ak en in t h e

e v e ning ma y s e riously ov e rtask th e m Undi .

ge st e d foo d is a pot e nt cause o f distur be d sl ee p ,

an e vil oft e n v e ry troubl e som e to o ld p e o p le a n d ,

o n e whi ch ought t o b e car e fully guar d e d again st .

128
 Th e Ar t o f P r o l o nging L i f e

It i s an e asi e r tas k to lay down rul e s with r e

gard to t h e u s e o f alcoholic liquors by e ld e rly
p e ople Th e Colle ctiv Inve stigation Com
. e

m i tt e e o f t h e B ritish M e dical Association has

lat e l y issue d a Re port o n t h e Conne ction o f
'
“

”
Dise ase with Habits of Int e mp e ranc e and two ,

at l e ast o f t h e conclusions arrive d at a r e worth

quoting : Habitual indulge nc e in alcoholic
“

liquors b e yond t h e most mod e rat e amount has

, ,

a distinc t t e nde nc y to short e n life t h e av e rage ,

shor t e ning b e ing roughl y proportiona l t o t h e

de gre e o f indulge nc e Total abstin enc e and .

habitual t e mp e ranc e augm e nt consid e rabl y t h e

chanc e o f d e ath from O ld a ge o r natural d e cay ,
”
without S p e cial pathological l e sion S ubj e ct ,

howe ve r to a few e xc e ptions it is not advisabl e

, ,

t hat a man sixty fi e o r s e v e nt y y e ars o f a ge

-
v ,

wh o has tak e n alc hol in mod e ration all his life

o ,

should sudd e nl y b e com e an abstain e r O ld .

a g e can n o t r e adily accommodat e its e lf to chang e s

o f any kind and to many old p e opl e a littl e good

,

win e with th e ir m e als is a sourc e o f gre at c o m

fo r t T0 quot e again from Eccl e siasticus Win e
.
,

i s as good as life to a man if it b e d r unk mod e r ,

at e ly for it was made to make m e n glad

, .

Elde rly p e rs ns particularly at t h e clos e o f t h e

o ,

day Oft e n find that th e ir n e rvous e n e rgy is ex

,

h a u s t e d and r e quire a littl e stimula t to in

,
n

duc e th e m to take a n e c e ssary supply o f prop r e

nourishm e nt and p e rhaps to aid t h e dige stiv e

,

pow e rs to conve r t th eir food to a us e ful purpos e .

In t h e d e bilit y o f o ld a ge and e sp e cially wh e n ,

129
 M a s t e r p i e c e s of S c ie n c e

sl ee pl e ssn e s s is accompani e d by slow and i m

e rfe c t di ge stion a small quantity o f a g e n er ous
p ,

and po t e nt wi n e containi ng much e the r ofte n

, ,

doe s good ser vi c e Ev e n a littl e b e e r imp r ove s

.

di ge stion i n som e Old p e opl e ; oth e rs find that

spirits large l y di lut e d fulfill t h e sa m e purpos e
, ,
.

Individual pe culiariti e s must b e allowe d fo r ;

t h e only ge n e ral rule is that wh i ch pre sc r ibe s
strict mod e r ation .

It is not t o b e infe rre d from t h e hi nts gi v en

in t h e pre ce di ng par agr aphs that t h e pre se rva
t ion o f h e alth should b e t h pr e dominant thought e

i n t h e mi nds of e ld e rly pe rsons who d e sir e t hat

th ei r live s shoul d b e prolonge d To b e always .

gu ardi ng agai nst di se as e and t o live in a stat e o f

,

con stant f ar and wat chfuln e ss wou l d make

e ,

e xi ste nc e mise rabl e and has t e n t h e progr e ss o f

dec a y Se lfish and un due solicitud e w ith r e gard

.

to h e alth not only fail s to att a i n i t s Obj e ct ,

but is apt t o i nduc e that di se ase d con di tion

o f mi nd known a s h yp och ndr iasis 't h e
“
o ,

t h e vi t i ms o f which a r e always a burd e n and a

c

nui sanc if n o t to th emse lve s at l e as t t o all

e , ,

conn e c t e d wi th the m Ad di son in t h e S pec

.
,

ta tor, afte r de scribing t h val etudi narian who e

cons t antly we igh e d hi mse lf and h i s food and ,

y e t be ca m e S ick and langu ishing aptly r e marks , ,

A continu l anxi e ty for life vi tiat e s all t h e

a

r e lish e s o f it and casts a gloom ove r t h e whol e

,

fa e of natur e as it is impo s sibl e that w e should

c
,

ta k e d e li ght in an yt hing that w e a r e e v e r y m o ~

m e nt afraid o f losing ”
.

130
 Th e Ar t of P r o l o nging L i fe

S l e e p is clos e ly conn e ct e d with t h e qu e stion of

die t good sl ee ping was a noticabl e f ature in

“ ”
e

t h e l arg e majority o f Dr Humph r y s cas e s ’

. .

S o u nd r e fre shing sl e e p is o f t h e utmost c o s e

, n

qu e c e to t h e h e alth of t h e body and no s u b

n ,

s ti tu t e c a b e found for it as a r e stor e r f vital

n o

e n e rgy S l ee pl e ssne ss i s howe ve r oft e n a

.
, ,

sourc e o f gre at troubl e to e ld e rly p e opl e and ,

on e which is not e asily r li ve d Narcotic e e .

r e m e di e s a r e ge ne rally mischi e vous ; th e ir first

e ff cts may b e pl e asant
e but t h e habit o f d e ,

p e nding upon th e m rapidly grows until th e y

b e com e indisp e nsabl e When this stage has .

b ee n r e ach e d t h e su ff r r i s in a far wors e plight

,
e e

than b e fore In al l case s t h e e nd e avo u r should

.

b e mad e to discov e r wh e th e r t h e sl e e pl e ssn e ss

b e d u e to any r e movabl e caus e — such as indi
ge stion cold want of e xe rcise and t h e like In
, , ,
.

r e gard to sl e e ping in t h e daytim e th e re is som e ,

thing to b e said both for and against that pra e

tic e A nap o f forty W i nks in t h e aft e rnoon
.
“ ”

e nabl e s many age d p e opl e to g t through t h e e

re s t o f t h e day in comfort wh e re as the y fee l ,

tire d and we a k wh e n de p r ive d o f this r e fre sh

m e nt If th e y r e st we ll at night th e re c a n b e
.

no obj e ction to t h e aft e r noon nap ; but if sl ee p

l e ssne ss b e complain e d of t h e latt e r should b e ,

discontinue d for a tim e Most O ld p e opl e find .

that a re clining posture with t h fe e t and l e gs ,

e

rais e d i s b e tt e r than t h e horizontal position fo r

,

t h e aft e rnoon nap Dige stion proc e e ds with more

.

e as e than wh e n t h e body is re cumb e nt .

13 1
 Ma s te r p i e c e s of S c ie n c e

Warmth is ve ry import ant for t h e age d ; ex

o s u r e to chills should b e scrup ul ously avoid e d
p .

B ronchitis is t h e malady most to b e fe are d ,

and its attacks a r e v e ry e as ily provok e d Many .

o ld p e opl e su ff e r from mor e o r l e ss co ugh during

t h e wint e r months and t hi s sympto m may r e cur
,

y e ar aft e r y e ar and b e almost u n h e e d e d At

, .

last p e rhaps a f w mi nut e s e xposur e t o a cold

,
e
’

wi nd incr e as e s t h e irritation in t h e lun gs t h e ,

c ough b e com e s wors e and t h e di ff culty o f ,

i

bre athi ng incr e as e s until su ff ocation t e rminat e s

in d e ath To obviat such risk t h e skin shoul d
. e

b e car e fully pr t e ct d b y warm fl ann e l cloth e s

o e ,

t h e outdoor th e rmom e t e r sho u ld b e notic e d

an d wint e r garm e nts sho ul d always b e at hand .

In cold w e ath e r t h e lun gs should b e prot e ct e d by

br e at hi n g through t h nose as much as possibl e
e ,

and by w e aring a light w ol e n o r silke n mu ffle r o

ov e r t h e mouth Th e t e mp e ratur e o f t h e
.

sitting a n d b e d rooms is noth e r point which

-
a

r e quire s att e nt i n S om e old p e opl e pride th e m

o .

s e lv e s o n n e v e r r e quiring a fir e in th e ir b e d
r oms It is how v r a risky practic e to ex
o .
,
e e ,

change a t e mp e ratur e o f 6 5 or 7 for o n e fif °

0
°

t e e n O r tw e nty d e gr ee s low e r As a ge n e ral r ule .

,

for p e rsons Sixty fiv e y e ars o f a g e and upward

-
,

t h e t e mp e ratur e o f t h e b e d room S hould not b e -

b e low and wh e n th e r e a e any symptoms r

o f bronchitis it S ho ul d b e rais e d from fiv e to t e n

d e gr ee s hi gh e r .

Care ful cl e ansing o f t h e skin is t h e last p oint

which n ee ds t o b e m e ntione d in an article li ke
132
 Th e Ar t of P r o l o nging L i f e

th e pr e se nt Att e ntion to cl e anlin e ss is d e

.

c i d e d ly conduciv e to long e vit y and w e may c o , n

gratulat e ours e lve s o n t h e ge n e ral improv e m e nt

in our habits in this r e sp e ct Fre que nt washing .

with warm wat e r is v e ry advantage ous for o ld

p e opl e in whom t h e skin is only t o o apt to b e
,

com e hard and dry ; and t h e b en e fit will b e i h

cr e ase d i f t h e ablutions b e succ e e de d by friction
with coars e fl ann e l o r lin e n glov e s o r with a ,

fl e s h brush
-
. Ev er y part o f t h e skin should b e
thus wash e d and rubb e d daily Th e friction .

r e mov e s wo r n o u t particl e s o f t h e skin and t h e

-
,

e x e rcis e promot e s warmth and e xcit e s p e s p i r a r

tion TO O much att ntion c a n hard l y b e paid

.
e

to t h e stat e o f t h e skin ; t h e comfort o f t h e age d

is gr e atly de p e nd e nt upon t h e prop e r discharge
o f its functions .

S uch th e n a r e t h e principal m e asure s b y

, ,

which life may b e prolonge d and h e alth main

t a i n e d down to t h e closing sc e n e I It r e mains
to b e s ee n wh e th e r as a r e sult of progr ss o f
, e

knowl e dge and civilization life will e v e r b e p r o

,

tract e d b e yond t h e limit assi gn e d to it in a p e r

c e ding paragraph Th e re is no doubt tha t t h e

.

a ver a ge d u r a ti on o f human life i s capabl e o f v e ry

gr e at e xt e nsion and that t h e sam e caus e s which

,

s e rv e to prolong life mat e rially contribut e to

ward t h e happin e ss o f mankind Th e e xp er i .

e nc e o f t h e last f w d e cad e s abundantly t e stifi e s

e

to t h e mark e d improv e m e nt which has take n

plac e in t h e public h e alth S tatisti s Show . c

that at t h e en d of t h e s e pt e nnial p e riod 88 ,

1 1

133
 Ma s t e r p i e c e s of S c ie n c e

p e rsons w e re alive in England and Wal e s

whos e d e ath would hav e tak e n plac e had t h e m o r
talit y b e e n in t h e sam e propo r tion a s during t h e
pr e vious de cade It may b e re as onably e x
.

e c t e d that as tim e go e s o n th e r e will b e an

p
incre ase in t h e p roportion o f c e nt e narians t o t h e
p op u l ation as a whol e .

Th e qu e stion wh e th e r long life is aft e r all , ,

des irabl e do e s n o t admit o f an y ge n e ral answ er .

Much d e p e nds upon t h e pre vious histo r y o f t h e

individual and his bodily and m e ntal condition
, .

Th e las t stage s o f a w e ll sp e nt life ma y b e t h e

happi e st t h e shu ffling o ff o f t h e mortal coil
,
-
,

though calmly e xp e ct e d n e e d not b e wi sh e d ,

fo r . Th e pictur e a fford e d by ch ee r ful and

m e llow O ld a g e is a l e sson to younge r ge ne rations .

Eld e rly p e opl e may if th e y choo se b e com e

, ,

c e nt e rs o f improving and r e fining in fl ue nc e .

O n t h e oth e r hand old a ge c a n not b e re gard e d

,

as a bl e ssing whe n it is accompani e d by pro

found de cre pitude and disorde r o f mind and
body S e nil e d e m e ntia o r s e cond childishn e ss
. , ,

is o f all conditions p e rhaps t h e most mise rabl e

, , ,

though n o t s o painful to t h e suffe re r as to those

who s u r round hi m Its adv en t may b e a c c e le r
.

at e d by ignoranc e and n e gl e ct and almost a s ,

s u r e dly r e tard e d o r pr e v nt e d by such S impl ee

m e asure s as have b ee n sugge st e d N o o n e who .

h a s had Opportuniti e s of studying o ld p e opl e

c a n shut his e y e s t o t h e fact tha t many o f t h e

incapabiliti e s o f a ge may b e pre ve nt e d by a t

t e ntion to a fe w simpl e rul e s t h e obs er vanc e o f ,

134
 Th e Ar t of P r o l o nging L i f e

which wi ll n o t only prolong life and mak e i t

happi e r and more comfortabl e b u t will r e duc e
,

to a minimum t h e p e riod o f d e cre pitud e O ld

.

a ge ma y b e an incurabl e dis e as e admitting o f

,

but o n e t e rmination but t h e mann e r o f that

,

e d
n ,
and t h e condition which pre c e d e s it a r e
, ,

t hough n o t altoge th e r c e rtainly to a v e r y gre at

,

e xt e nt,
withi n ou r o wn powe r .

135
 N A T URA L I FE AN D DE A TH
L : AN D
R UL E S F O R H E A LT H

B EN J A MI N W A R D R I C H A R D S O N M , . D .

Dr
' h rd s n wa E nglish p h y si i n f un mm
. Ri c a o s an c a o co on

ori gin li t y a d bili ty H f un d d d f s m y r

an a . e o e an or o e ea s

e dit d t h y
e l f P bli H lth
e hi fl y di r t d t w rd
ou r n a o u c ea , c e ec e o a

th p nti n f di s s I n 8 7 5 h
e re v e o o t d wi d s pr d
ea e. 1 e cr ea e e ea

int r st by k t hing im gin ry M d l Cit y f H lth

e e S e c an a a o e o ea

t b
o ll d H yg i H wr t s r l im p rt nt b k s
e ca e e a . e o e ev e a o a oo

fr m Th Dis s s f M d rn Li f p ublish d b y D App l

o
“
e ea e o o e e,
”
e . e

t on C N w ' rk
o .
,
t k n t h xtr t s whi h f ll w j
e o , a re a e e e ac c o o

B ' th e strict law o f Nature a man should di e

as unconscious o f his d e ath as o f his birth .

S ub j e ct e d a t birth t o what would b e in t h e ,

aft er conscious stat e an orde al to which t h e mos t

-
,

cruel o f de aths w e re not p ossibl y more s eve re h e ,

sl e e ps through t h e proc e ss and on ly up on t h e ,

subse qu e nt awake ning fe e ls t h e imp r e ssi on s p ain ,

ful o r pl e asant o f t h e world into which h e is,

delive re d I n t hi s instanc e t h e p e r fe ct la w is
.

fulfill e d b e caus e t h e ca r rying o f i t o u t is re taine d

by Nature h e rs e lf : human free wi ll and t h e c a -

p r ic e that springs from it hav e n o in fl ue nc e .

By t h e hand o f Nature d e ath we re e quall y a

painl e ss portion Th e cyc le o f life compl e t e d .
,

t h e l ivi ng b e ing sl ee ps into d e at h wh e n N atur e

has h er wa y .

This pure l y painl e s s proc e ss this de sc e n t b y ,

137
 Ma s t e r pi e c e s of S c i e n c e

o b livious tranc e into oblivion this natur al p hys ,

ical d e ath is t h e t r ue Euthanasia ; and i t is t h e

,

dut y o f t hos e we cal l physicians t o s e cure fo r

man such good h e alth a s sh all be a r hi m in activit y
and happin e ss onward in his cours e t o this goal .

'o r Eut hanas ia though it b e op e n t o e v e r y o n e

,

bo r n o f e ve r y r ac e is n o t to b e had by an y save
,

through Ob e di e nc e to thos e laws which i t is t h e

mi ssion o f t h e ph y si ian to l e ar n to t e ach and to
c , ,

e nfo r c e
. E uthanasia is t h e s e qu e l o f h e al th ,

t h e happ y d e ath e ngraft e d o n t h e p e r fe ct life .

Wh e n t h e physician h a s taught t h e wo r ld h o w
this b e ni gn proc e ss o f Natur e may b e s e cure d ,

and t h e wo r ld h a s acc e pt e d t h e l e sson d e ath itse lf ,

will b e p racticall y banish e d ; it will b e div e st e d

e qually o f fe ar o f so r row o f su ffe r ing
, ,
It will .

com e as a sl ee p .

If y o u a s k m e what proof th e re is o f t h e p o s
s i b ili t y o f such a consummation I point t o our
knowle dge o f t h e natur al ph enom e na o f o n e fo r m
,

o f di ssolution r e v e al e d t o us e v e n now in p e r fe ct ,

t hough e xc e ptional illustration ,

We hav e all .

s e e n Natur e in r ar e instance s vindi cating h e r

, ,

s e lf d e spit e t h e s ocial Opposition t o h e r and ,

showi ng h ow t e nde rl y how soothi ngl y h o w li ke

, ,

a moth er with h er foot o n t h e cradl e s h e woul d , ,

if s h e w e re p er mitt e d roc k us all gen t l y o u t o f

,

t h e world . Ho w if t h e free will with which s h e

,
-

has ar m e d u s we re brought into acco r d wi t h h e r

d e signs s h e would gi ve u s t h e rich e s t h e be auti e s
, , ,

t h e wond e r s o f t h e Univ e rs e fo r o u r po r tion s o

long a s we cou l d r e c e ive and e n j o y th e m ; and at
138
 N a t ur a l L i fe a nd De a th

last would ge ntly withdraw u s fr o m th e m se nse b y ,

se nse with such imp e rc e ption that th e pain o f t h e

,

withdrawal would b e u n fe lt and ind ee d unknown .

Te n tim e s in my o wn Obs e rvation I r e m emb e r

witn e ssing wi th att e ntive mind th e s e ph e nom
, ,

en a of natural Euthanasia Without pain .

,

ange r o r sorrow t h e int e ll e ctual faculti e s o f t h e

, ,

fat e d man los e th e ir brightne ss Ambition .

c e ase s o r Sinks into d sir fo r re pose Id e a of

,
e e .

time o f S pac e o f duty linge ringly pass away

, , , .

To S l e e p and not t o dr e am i s t h e pre ssing and ,

st e p by st e p still pre ssing n ee d ; until at l e ngt h

,

it while s away n e arly all t h e hours Th e awak e n .

ings a r e short e r and short e r ; painl e ss car e l e ss , ,

happy awak enings to t h e hum o f a busy world ,

to t h e m rry sounds o f childr e n at play t o t h e

e ,

sound o f voic s o ff ring aid ; to t h e e ffort o f talk

e e

ing on Simpl e topi s and r e calling ev e nts that hav e

c

dwe lt longe st o t h e m emory ; and th e n again t h e

n

ov e rpowe ring sl e e p Thus o n and o until at . n ,

l e ngth t h e int e ll e ctual n atur e lost t h e i n s ti n c

, ,

tiv e and m e re l y animal function s n o w n o longe r ,

r equire d t o sust ain t h e high e r faculti e s in th e ir ,

turn succumb and fall into in e rtia .

This is d e ath by Nature and wh e n man k ind ,

has l e arn e d t h e t r uth wh e n t h e tim e Shall com e ,

a s com e it will— that the re Shall b e n o more an “

infant o f days nor an Old man who hath n o t,

”
fill e d his days this act o f de ath n o w as a r ul e
, , , ,

s o dre ad e d b e caus e s o pr e matur e shall arr ivi ng , ,

onl y at its appoint e d hour sugge s t no t er ror i h , ,

fl i c t no agony .

139
 Ma st e r p i e c e s of S c ie n c e

Th e sharp ne ss o f d e ath re move d from those

who d i e t h e poignanc y o f g r i e f woul d b e almost
,

e quall y r e mov e d from thos e who su r viv e wer ,

e

natural E uthanasia t h e pr e vailing fact O ur .

s e nsibi liti e s a e gove r ne d b y t h e ob se r vanc e of

r

natural law and t h bre ach o f it I t is only e .

wh e n natur e is v e h e m e ntly i nt e r rupt e d that w e

e ith e r wond r o r w ee p e Thus t h e o ld G ree ks
.
,

fathe r s o f t r ue mirth who looke d upon prolonge d ,

gr i e f a s an O ffe nc e and attach d t h e word mad

,
e

n e ss to m e lancholy — e v e n th e y w e r e s o far i m
,

bue d with so row wh e n t h child o r t h e y outh

r e

di e d that th e y bore t h e life l e ss body to t h e

,

p y r e in t h e br e a k o f t h mo r ning l e st t h e s u n
e ,

shoul d b e hold s o s a d a sight as t h e y oung d e ad ;

whil e w e who court rath e r than s e e k to di smiss
,

m e lancholy who find po e try and pi e t y in m e l

,

a n c h o li c r e v e ri and who indulge t o o Oft e n in

e,

what aft e r a tim b e com e s t h e luxury o f w oe e x

,
e , ,

p e r i en c e a gr adation of su ff e ri ng a s w e witn e ss t h e
work o f d e ath 'o r t h e l oss of t h e child and t h e
.

youth w e mour n in t h e p e rf ct purity o f sorrow ; e

for t h e loss o f t h e man in his activity w e f l ee

gri e f mingl d with s e lfish re gr e t that s o much that

e

was us e ful has c e ase d to b e In t h e loss of t h e .

age d in th e ir days o f s e cond childi shn e ss and

,

m e re Oblivion w e sympathiz e fo r som e thing

,

that has passe d away and for a mom e nt ,

r e call e v e nts sadd e ning to t h e me mo r y ; but

h o w soon thi s consoling thought succ ee ds and
—
conque r s that t h e rac e of t h e life that has
gon e was run and that f its o wn sake t h e
,
or

140
 N a tur a l Li fe a nd De a t h

disp e nsation o f its re moval was most m e rciful

and most wise .

To t h e rul e of natural d e ath th e re a r e a fe w

e xc e ptions Unswe r ving in h e r gre at purpos e
.

f r t h e univ e rsal good N tur h a s impos e d

o ,
a e on

t h e world of life h e storms e arthquak e s light

r , ,

h ings ,
and all those sublim e manife stations of
h er supr e m e pow e r which in t h e infant days o f ,

t h e univ e rs e cow e d t h e bold e st and implant e d

,

in t h e human h e art fe ars and sup e rstitions which

in h e re ditary pr gre ssion hav e passe d down e ve n
o

t o t h e pr e s e nt g e n e rations Thus s h e has e x .

pose d u S all to accid e nts o f pr e matur e d e ath ,

but with infinit e wisdom and as if to t e ll us that

, ,

h e r d e sign is to provid e for th e s e in ev itabl e

calamiti e s s h e has gi ve n a pre ponde ranc e of
,

numb e r at birth to thos e o f h er childre n who by

r e ason o f masculin e str e ngth and courage S hall

have most fr e que ntl y to fac e h e r e l e m e nts o f

de struction Furth e r S h e h a s provid e d that
. ,

d e ath by h r b y accid ntal c llision with h e rs e lf

e ,
e o

shall from its v e ry quickn e ss b e fr e d o f pain

, ,
e .

'or p ain is a product o f tim e To e xp e ri e nc e .

p ain t h e impr ssion producing it must b e trans

e

m i t t e d from t h e injur e d part o f t h e living body

to t h e conscious c e ntre must b e r e c e ive d at t h e
,

consci o us c e ntre and must b e r e cogniz e d by t h e

,

mind as a re c e ption ; t h e last act in truth b e ing

t h e conscious act In t h e gr e at majority o f
.

d e aths from natural accid e nts th e re i s n o t su ffi

ci e nt tim e for t h e accomplishm e nt o f the s e p r o
gr e s s i v e st e ps by which t h e consciousn e ss i s
141
 Ma s te r pi e c e s of S c i e n c e

r e ach e d Th e unconsciousn e ss o f e xist e nc e is

.

t h e first and last fac t inflict e d upon t h e stric k e n

organism : t h e d e st r uction is s o might y tha t t h e ,

s e ns e o f it is not re v e al e d .

Th e duration o f tim e int e nd e d b y Nat u r e t o

e xt e nd b e tw e e n t h e birth o f t h e individual and

his natural Euthanasia is und e t e rmin e d e xc e pt ,

i n an approximat e d e gr ee From t h e first t h e

.
,

st e ad y s te alth y attraction o f t h e e arth is e ve r

,

t e lling upon t h e living body S om e forc e lib .

crat e d from t h e body during life e nabl e s it by ,

s e lf controll e d r e sistanc e to ove rcom e i t s o wn

-
,

weight 'o r a give n part o f it s c y cl e t h e fo r c e

.

produc e d is S O e ffi ci e nt that t h e body grows a s

,

well a s mov e s by its age ncy against we ight ; but

this sp e cial stage is limit e d t o an e xtre m e s a y o f , ,

thirty ye a r s Th e re is th e n anoth e r p er iod

.
,

l imit e d probably also t o thirt y y e ars dur ing ,

which t h e living st r uctur e in i t s full d e ve lop

m e nt maintains i t s r e sist anc e t o its w ight e .

Finall y th e re com e s a tim e wh e n t hi s r e sistanc e

,

b e gins t o fail s o that t h e e arth which n e ve r for

, ,

a mom e n t los e s h e r gr asp comm e nc e s and c o n

,

t i n u e s to pre vail and aft e r a struggl e e xt e nd e d

, ,

from twe nty to thi r t y y e ars conque rs b r inging, ,

t h e e xhaust e d organism which h a s dail y a p

p r o a c h e d n e ar e r and n e ar e r t o h e r d e ad s e lf into ,

h e r d e ad bosom .

Wh y t h e e xc e ss o f powe r d e v e lop e d du r ing

growth o r asc e nt o f life should b e limi t e d a s to
tim e ; why t h e powe r that maintains t h e d e
v elo p e d bod y o n t h e l e v e l plain shoul d b e l imit e d

142
 Ru l e s fo r H e a l t h

as t o tim e ; why t h e powe r should d e clin e so that

t h e e arth should b e allow e d t o pr e vail and b r ing
d e sc e nt o f life a r e probl ems as y et unsolve d
,
.

We call t h e forc e that r e sists t h e e ar th Vital .

We s a y i t r e sists d ath ; we S p e ak o f it as stronge r

e

in t h e y oung than in t h e o ld ; but w e know nothing

mor e Of it r e all y from a physical point o f vi e w
, ,

than t hat whil e it e xists it Oppos e s t er r e strial

we ight su ffici e ntly to e nable t h e body to mov e
with fre e dom o n t h e sur fac e o f t h e e arth .

Th e s e facts w e acc e pt as ultimat e facts To .

sa y that t h e animal is at birth e ndowe d with

som e r e s e rv e forc e som e thing ove r and above
,

what it Obtains from food and air would s ee m ,

a r e as nabl e conclusion ; but we hav e n o proofs

o

that it is t r ue save that t h e young re sist b e tt e r

,

than t h e Old We must th e re fore r e st cont e nt

.

with o u r knowl e dge in its simpl e fo r m gath e ring ,

from it t h e l e sson that d e ath a par t o f t h e sch e m e

,

o f life
,
is ordain e d upon a natural t e rm o f life ,

is b e ne ficially plann e d is round e d with a Sl ee p

,
“
.

'Th e n follow chapt e rs on dis e as e l e ading up ,

t o r ul e s fo r h e alth ]

R U L E S F OR H E AL T H
I
Th e first st e p towards t h e re duction o f dis e as e
is b e gi nning at t h e b e ginning to provid e fo r t h e
, ,

h e alth o f t h e unbo r n Th e e rro r commonly

.
,

e nt e r t ain e d that marriag e abl e m e n and wom e n

,

have n othing t o con side r e xc e p t we alth station , ,

o r social r e lationships d e mands corr e ction

,
Th e .

143
 Ma s t e r p i e c e s of S c ie n c e

O ffspr ing o f mar riag t h e m o st pre cious o f all e,

fortun e s d se rv s sur e ly as mu h for e thought

,
e e c

as is be stowe d o t h O ff spring o f t h e lowe r

n e

animals If t h e int e rmarriage o f dise ase we re

.

conside r e d in t h e sam e light a s t h e int e rm a r r iage

o f pov e r ty t h e h e r e dit ary transmission o f di se as e
, ,

t h e basis o f s o much mise ry in t h e world ,

w o ul d b e at an e n d in thr e e o r at mos t four

ge n e rations .

11

Gr e at e r care than is at pr e s e nt manife st e d

o ught to b take n w ith wom n who a e about t o
e e r

b e com e moth e rs W al thy wom e n in thi s con

. e

dition a e oft e n t o much indulge d in r e st and

r o

a r e t o o ri chl y fe d Poor wom e n in this condition

.

a e commo nl y und e rfe d and mad e t o toil t oo

r

se v e r e l y Th e p oor a s we have s ee n far e t h e

. , ,

be st but both p ractically a r e badly c are d fo r

, , , .

Nothing that is e xtraor di n ary is r equire d fo r t h e

woman during this condition nam e d S h e .

n e ds onl y t o live by natural r ule S h e Should

e .

r e tire t o r e st e arly ; t ak e nine hour s sl ee p ; p e r ’

fo r m walkin g or similar e x e rcise to an e xt e nt ,

sho r t of actual fatigu e during t h e day ; partak e ,

m d e rat e l y o f food and o f ani mal food n o t O f

o ,

t n e r than twi c e in t h e day ; avoid al l alcoholic

e

drinks ; take t e a in limit e d quantiti e s ; fore go all

sce n e s that e xcit e t h e passions ; h e ar n o viol e nc e
o f l a nguag e s b e cloth e d in warm light loose
, , ,

garm e nts ; and shun with sc r upul ous car e e ver y , ,

e xposur e t o inf e ctious di s e as e .

144
 Ru l e s fo r H e a l t h

III
I n m ee ting t h e uncontrollabl e caus e s o f dise as e
t h e sp e cial influ nc e of s e ason d e s e rv e s pa r ticular
e

r e gard It should always b e r e m e mb re d that

. e ,

oth e r things b e ing e qual during wint e r t h e body

,

los e s during summ e r gains in w e ight Furth e r

,
.
,

it should b e r e m mbe re d that th e s e change s a r e

e

abrupt : that usually t h e loss comm enc e s sharp l y , ,

in S e pt e mbe r and lasts until Ap r il and that ,

t h e gain comm e nc e s in April an d lasts un til

S e pt e mbe r In S pt e mb e r though t h e w e ath e r
. e ,

e v e n b e wa r m it is right th e r e for e to add to t h

, , , e

clothing and to comme nc e a littl e e xc e ss o f fo od .

In summ e r it is right not onl y to r e duc e t h e

clothing but to e a t l e ss fo od than in wint e r
, .

IV
Th e b e st m e ans o f pr e v e nting t h e S pre ad o f t h e
communicabl e dise ase s is p e rfe ct and instant
isolation o f t h e a ff ct e d and r e moval and thor
e ,

ough p urifying o f all clothing and b e dding with

which t h e a ffe ct e d have com e in contact It is .

a vulgar e r ror to suppos e that e v e ry child must

n e c e ssa ri l y su ffe r from t h e contagious maladi e s ,

and that t h e risk of e xposure t o infe ction i s ,

the re fo r e o f littl e mom e nt Th e chanc e of i

,
. n

fe c t i o n l ss e ns with advanc e o f life and that p e r

e ,

son is stron ge st who has n e ve r pass d through e

a cont agious malady Against small p o x vaccina

.
-

tion is t h e grand safe guard but eve n va cination ,

c

ought n e ve r to pre ve nt t h e isolation of thos e wh o

su ff r from small pox
e -
.

145
 Ma st er p i e c e s o f S c i e n c e

V
Th emo r t alit y from t h e uncontrollab e caus e s l

o f di se as e amongst pe rsons o f advanc e d life is

be st pre v e nt e d b y provi di ng against sudd e n
vicissitude s o f h e at and cold Th e primar y care .

is t o guard against sudde n change o f vas c ul ar

t e nsion from e xposur e to h e at whe n t h e blood
v sse ls a r e we ak n e d by cold S uch e xposur e
e e .

i s t h e ca u s e o f n e ar ly all t h e conge stions which

occur dur ing wint e r and which carr y o ff t h e
,
.

e nf ee bl e d Th e s ound practic e is to m ainta i n

.

t h e body at a ll hour s and se a sons but e spe cially

, ,

duri ng t h e hours o f sl ee p at an e quabl e t e m ,

pe r a tu r e . Th e t e mp e ratur e o f 6 F ah may b e 0
°
.

conside r e d a safe st andard .

VI
Th e tru e dan ge r o f e v e ry fo r m o f m e ntal
e x e rcise is t h e addition o f w r ry Laborious o .

m e ntal e x e r ise is h althy un l e ss it b e mad e

c e

anxious by n e c e ssary or un n e c e ssary diffi culti e s .

Re g ular m e nt al labour is be st carri e d o n by intro

d u c i n g into it som e vari ty N e w work giv e s
e .

tim e for r e pair b e tt e r than att empt at compl e t e

re st sinc e t h e active mi nd finds it impossibl e to
,

e vad e its partic ul ar work unl e ss its ac t ivit y b e

di v e rt e d into som e n e w chann e l Duri ng t h e .

n e w work a fr e sh po r tion o f t h e brain com e s into

play and t h e ove r wrought s e at o f m e ntal fa cult y

is s e cur e d r e pose and r e cov e ry Exc e ss ive c o m .

p tition in m e ntal labour is r ui nous at all age s o f

e

146
 Rul e s fo r H e a l t h

VI I
Th e ide a t hat e xc e s siv e physica l e x e rcis e is a
sound m e ans o f prom oting h e alth i s e r ron e ous .

Man is not construct e d t o b e a running o r a l e ap

ing animal li ke a d ee r o r a cat and to rais e t h e,

physical above t h e m e ntal culture w e r e t o r e turn

to t h e shortn e ss and mis e r y o f savage life P h y .

s i c a l training whil e it should b e mod e rat e l y e n

,

c o u r a g e d sho ul d b e r e fin e d and mad e s e condary

,

to m e ntal training Eve ry rash and viol e nt fe at

.

of comp e titive prowe ss sho ul d b e d i s c o u n t e

h anc e d.

VI I I
Th e combination o f m e ntal and physical
fatigu e as it is practis e d in man y p ursuits a t
,

this tim e a r e e xc ee dingly dange rous Long

, .

j ourn e ys e ach day to and from t h e sph e r e o f

,

profe ssion o r busin e ss a r hurtful Th e ide a that

,
e .

m e ntal labour m y b e advantage ousl y suppl e

a

m en t e d by viol e nt muscular e x e rcis e such as ,

is impli e d in long and fatiguing walks o r labori

O u s e x e rcis e o n hors e back is an e r ror ,
Mod e rat e.

and r egu lar e xe rcise at t h e sam e tim e favours

, ,

m e ntal work Th e practical point is to r e gulat e

.

t h e physical labour that it shall n o t induc e

fatigue .

IX
O n e o f t h e sure st m e ans fo r k ee ping t h e body
and mind in p e rfe ct h e alth consists in l e arning
to hold t h e passions in subs e rvi e nc e to t h e re ason
147
 Ma s t e r p i e c e s of S c i e n c e

ing facul ti e s This rul e appli e s to e ve r y p assion

. .

M an distinguish e d from all oth er animals b y

,

t h e p e culiarit y o f his r e ason is plac e d abov e his

,

passions to b e t h e dir e ctor o f his will c a n prot e ct ,

hims e lf from e v e ry m e re animal de gradation r e

s u lt i n g from passionat e e xcit e m e nt Th e e duca
.

tion o f t h e man should b e dir e ct e d n o t to s u p ,

pre ss such passions as a r e e nnobling b u t t o ,

bring und r gov er nanc e an d e sp e cially to subdu e

e , ,

thos e most d e structive p assions ange r hat e , , ,

and fe ar ,

X
To e scap e t h e e vils a r ising from t h e us e o f
alcohol th e re i s onl y o n e p e rfe ct cours e nam ely , ,

to abstain from alcohol altoge the r N 0 fe ar .

n e e d b e e nt e rtain e d o f any physical o r m e nta l

har m from such abstin e nc e Eve ry good may .

b e xp e ct e d from it
e Tr ue a c e rtain v er y quali
.
,

fie d t e mp e ranc e a t e mp e ranc e that k ee ps t h e

,

adult t o a st r ict allowanc e of o n e ounc e and a

half o f alcohol in e ach twe nty four hours may -
,
-

possibly b e compatibl e with a h e althy life ; but

such indulge nc e is un n e c e ssary and e ncourage s
t h e dang e rous d e sir e to furth e r ind ul ge nc e A .

man o r woman who abstains i s h e alth y and safe .

A man o r woman who indulge s at all is unsafe .

A man o r woman wh o r e li e s o n alcohol fo r sup

port is lost .

XI
S moking tobacco and t h e u s e o f tobacco in
,

e v e ry form i s a habit b e tt e r not acquir e d and

, ,

148
 Ru l e s fo r H e a l t h

wh e n acquire d is b e tt e r abandon e d Th e y oung .

should e sp e ciall y avoid t h e habit It giv e s a ,

doubtful pl e asure fo r a c e rtain p e nalt y L e ss .

d e st r uctiv e than al cohol it induc e s various n e rv

,

ou s change s som e o f which pass into organic

,

modifications of fun tion S o long as t h e p r a c

c .

tic e o f smoking is continue d t h e smok e r is t e m

o r a r i ly ou t o f h e alth W h en t h e odour o f
p .

tobacco hangs long o n t h e br e ath and oth e r s e cre

tions o f t h e smok e r that smok e r is in danger
, .

Exc e ssive smoking has prov e d dir e ctl y fatal .

XII
I ndulge nc e in narcotics Opium chloral chloro
, , ,

dyn e e th e r absinth e and all oth e rs o f t h e class

, , , ,

is an en tire d e pa r ture from natural law E xc e pt .

unde r t h e dire ction o f s k ill e d Opinion and fo r t h e

c u r e o f dis e as e t h e u s e o f th e s e ag e nts is s u b v e r
'

sive o f t h e animal functions and is a c e rt ain

,

m e ans o f e mbitt e ring and sho r t e ning life It is .

doubtfu l wh e th e r t h e free dom o f t h e sub j e ct

ought t o b e p e rmitt e d to e xt e nd t o t h e u n c o n
troll e d s e lf indulge nc e in th e s e poisons Th e
-
.

indulge nc e indicat e s an unsound r e ason which r e

quir e s to b e gov er ne d b y sound r e ason t e m p e r ,

at el y e nforc e d .

XI I I
Th e food o n which t h e man who would b e
h e alth y should live should b e s el e ct e d s o a s t o
e nsur e vari e t y without e xc e ss Animal food
.

should not b e t ake n oft e ne r than twic e daily .

149
 Ma s te r p ie c e s o f S c i e n c e

Th e amount o f animal and v e getabl e foo d c om

b i n e d S houl d n o t e xc ee d thir t y oun c e s in t h e
twe nty four hours and fo r t h e majo ri t y o f p e r
-
,

sons an ave rage o f twe nty four oun ces o f mixe d -

solid foo d a thi rd only o f whi ch sho ul d b e ani m al

, ,

is suffi ci e nt All ani mal foods sho ul d b e e at e n

.

whi l e the y a re fre sh and aft e r th e y a r e we ll

c o oke d Th e habit o f e ati ng unde rdon e fl e sh
.

is an almost c e r tain ca use o f p a ras i t ic di se ase .

Th e amount o f fl uid ta ke n in any fo r m S houl d , ,

n o t e x cee d an av e rage o f tw e nt y four oun ces -

daily Wat er is t h e only natur al be ver age

. .

X IV
To e s ca p e t h e i nju ri e s arising from impur e ai r
it is n ec e ssar y to att e nd t o t h e follo wing r ule s :
To avoid t h e admission into close d apart m e nts
o f a i r char g e d with any substance that O fien d s t h e

se nse o f sme ll To avoid surchargin g t h e a i r

.

wi th vap our o f wat e r To ke e p t h e t e m p e r atur e

.

i n e v er y ro om as n e arl y a s possibl e at t h e safe

s t andard o f 6 Fah To take ampl e m e ans o f
0
°
.

all owing ai r to e scap e from t h e room by e v e ry

avail abl e outward draught by t h e chimn e y fl u e ,

e s p e ciall y To a d mit a i r fr ee l y at all tim e s and

. , ,

wh e n a roo m is n o t in u s e and t h e e xt e r nal air i s

n o t charg e d with moistur e t o allow t h e e ntran c e
,

o f a i r fr om without t h rough e v e r y window and

doo r .

O ccupations o f e v ry kind how e v r var i e d

e ,
e

th e y ma y b e r e quir e to b e alt rnat e d fairl y wi th

,
e , ,

150
 Ru l e s fo r H e a l th

re st and r ecre ation It i s t h e wo r s t mis t a ke t o

.

suppos e t hat mos t and b e st work c a n b e don e

whe n t h e s e aids a r e omitt e d S t r ictly n o o c c u
.
,

p a t i o n that calls forth S p e cial m e ntal and ph y sical

wor k should fill more than o n e third o f t h e daily -

l ife Th e minds o f m en o f all class e s ought n o w

.

t o b e d e vot e d t o t h e promotion o f a syst e matic

m et hod b y which t h e productive labo u r o f e ve ry
life shoul d b e c arr i e d o n within t h e limit e d t er m
o f e igh t ho u r s in t h e t w e nty four Th e body o f
-
.

man i s n ot const r uct e d t o run its compl e t e d circl e

u nd er a h e a vi er b u r d e n o f labour .

Enfo r ce d idl ene ss b y t hose wh o have acquire d

,

w e al t h i s always an e rror s o long as t h e h e alth

,

is good Men o f busine ss should n e ver actually

.

re tire whil e t h e y r e tain fai r bodil y and physical

fac ul t y It i s o n e o f t h e grave s t o f e r rors to
.

att e mp t t o e nforc e idl e ne ss o n oth e rs from t h e

mistak e n s entim e n t o f wishing to plac e th e m
b e yond t h e n e c e ssity fo r work This is against .

nature Th e e arth which is itse lf e ve r in motion

.
, ,

de mands e v e r th e motion o f cultivation from

i t s inhabitants that it ma y b e a gard e n prop e rly
arrange d from a ge t o a ge Thos e t he re fore who
.
, ,

hav e idl e n e ss thrust upon th e m by th e ir pro ,

ge nitors should throw it o ff as if som e n e c e ssit y

,

for wor k w e re e qually th e irs B y this plan th e y

.

will live longe st to e nj o y t h e gre at e st hap

p i n ess .

151
 M a s te r p i e c e s o f S ci e n c e

'V I I
Th e natur a l dur ation o f sl eep i s ei gh t h ou rs
ou t o f t h e tw e n t y four and those wh o can se cure
-
,

t hi s l e ad t h e so u nd e st l iv es It i s be s t t ak e n .

fr om t e n o cloc k ti ll s i x and i t is most r e adily

’

obtain e d b y cu l tivati ng it a s an autom ati c p ro

ce d ur e All stimul ants a ll e xcit e m e n t s all e x
.
, ,

c e s s i v e fa t igu e s a ll exhaust ions pe r ve r t

,
sl ee p
e v e n i f th e y do n o t p r ev e nt it Th e r oom in .

whi ch slee p is ta ken should b e t h e be s t v en ti la t e d

a n d t h e most e quabl y warm e d room in t h e house .

Th e a i r o f t h e r oo m shou l d b e maintain ed a t t h e
natur al standard o f 6 0 Fah and t h e bod y o f t h e
°
.
,

s l ee e r sho ul d alwa y s b e k e pt compl e t e l y w a r m

p .

Th e b e d shoul d b e so ft a n d yi e l di ng A r e gu l ar .

t e nd e nc y to sl ee p a t oth e r hours than t h e natural

is a sur e sign o f er r or o f habit or o f n er vous d e
r ang e m e nt .

XV I I I
Dr e ss t o b e pe r fectl y com p atibl e with h ealthy
,

life sho ul d fit lo o s e ly sho ul d b e light warm and

, , , ,

p o rous shou
,
l d b e adapt e d t o t h e se ason a s t o

c olour ,
should b e thr oughout e v e r y p art o f t h e
c l othi ng uppe r as w e ll as un d e r fr e que ntl y
, ,

change d and shoul d b e at a ll tim e s scrupul ously

, , ,

cl e a n Th e w e ari ng o f cloth e s until th e y a r e

.

thr e adbar e is an invariabl e e rror in a ll that

,

re s pe cts t h e h e alth t o s a y nothing of t h e c o m

,

fort o f t h e we ar e r All bands or co r se ts which

.

in any wa y r e st r ict t h e course o f t h e blood in

an y par t o f t h e bod y a e di re ctly inj uri ous r .

152
 Ru l e s fo r H e a l t h

Dre sse s dye d with irritating dye stu ffs ought t o

b e car e full y avoid e d .

XIX
Conne ct e d with c l e anlin e ss o f clothing as a ,

m e ans o f h e alth i s p e rsonal cl e anlin e ss P er

, .

fe c t e d action o f t h e skin s o e ss e ntial to t h e p er

,

fe c t life c a n only b e obtain e d by thorough ablu

,

tion o f t h e whol e body Th e ablution ought

.
,

strictly t o b e p e rform e d onc e in e v e r y tw e nty

,

four hours It is b e st to train t h e body to t h e u s e

.

o f cold wat e r through all s e asons s o that t h e

,

r e quire m e nt for wat e r o f rais e d t e mp e ratur e

ma y not b e com e a ne c e ssit y Th e simpl e st and
.

b e st bath is t h e ordinary sponge bath Plung -

.

ings S plashings show e rs and t h e lik e a r e m e re

, , ,

pastime s Th e occasional u s e of t h e hot air

.

or Turkish bath is an important adjunct t o t h e

m e ans o f maintai ni ng h e alth .

153
 CA R E O F THE E Y E S

B U EL P . . CO L T O N
P h y si l g y E xp rim nt l d D s ri pti
o o , by B u l e e a an e c v e, e

P C lt n Pr f ss r f N tur l S i n
o o , o e in t h I llin is St t
o o a a c e ce e o a e

N rm l Uni rsit y is
o a p it l t xt b k whi h m y b r d
ve . a ca a e - oo c a e ea

as g i f ull y t h m in s h l t ll g Thr ugh ut

a n a o e as c oo or a co e e . o o

i t s h p t rs
c a x ll n t dir ti ns f t h r f h lth d
e a re e ce e ec o or e ca e o ea an

str ngth
e I t is p ublish d by D C H th
. C B st n e . . ea o .
, o o .

1 89 8 Th f ll wing xtr t w e o r is d by D C y A
o e ac as ev e r. a se .

W d oo min nt ulist f Chi g I]

, an e e oc o ca o

INre ading we wish light from t h e p r int e d

page H e nc e we should avoid light e nt e ring
.

t h e e y e from any oth e r sourc e at this tim e W hil e .

re ading th n d o n o t fac e a window anoth e r

,
e , ,

light a mirror o r whit e wall if it c a n b e avoid e d

, , ,
.

In a room whit e walls a r e like ly t o injure t h e

,

e ye s Choose a dark colour for a cov e ring fo r a

.

re ading t abl e S e wing against t h e background .

o f a whi t e apron has wor k e d s e rious mischi e f .

Dire ct sunshine n e ar t h e book or o n t h e tabl e is

like l y t o d o har m .

Pre fe rabl y have t h e light from b ehind and

a bov e Many authors s a y from t h e l e ft o r
.
”
,

”
ove r t h e l e ft shoulde r In writing with t h e .

usual slant o f t h e l e tt e rs this may b e d e sirabl e .

B ut v e rtical writing i s n o w strongly advocat e d as ,

it e nabl e s o n e t o s i t e re c t and hav e t h e light ,

from above and e quall y t o t h e t wo ey e s H av .

155
 Ma s te r p i e c e s of S c ie n c e

ing stronge r light for o n e e y e than fo r t h e oth e r

is bad S itting unde r and a littl e forward o f a
.

hanging lamp will gi ve t h e light e qually t o t h e

two e y e s and s end no ligh t dire ct into t h e fac e .

In r e adi ng b y daylight avoid cross lights as -

much a s possibl e Th e incand e sc e nt e l e ctric

.

light h as an advantage in b e ing re adi ly light e d

without match e s and in giving out littl e h e at
, ,

thus maki ng it valuabl e for hous e lighting ; but -

owing to its irre g ular illumination (d u e to t h e

shadow c ast by t h e wire or filam e nt) it is n o t ,

w e ll suit e d for study or oth e r n e ar work 'o r .

this purp os e an Argand gas o r k e rose n e burn e r

i s much to b e pr e fer r e d sinc e it throws a soft , ,

uniform and agr ee abl e light upon t h e work

, .

Re adi ng out o f doors is like ly t o injure t h e

- -

e ye s ,
e sp e cially wh e n lying down To t r y to .

re ad whi l e lying in a hammock is bad in many

ways To o much light dire ctly e nt e rs t h e e y e
.
,

and oft e n too littl e falls upon t h e print e d page .

D o n o t hold t h e book or work n e ar r t h e e y s e e

than is n e c e ssary S o far as possibl e avoid c o n

.

t i n u o u s re ading in lar ge or h e avy boo k s by

artificial light S uch books b e ing hard to hold
.
,

t h e e lbows graduall y s e ttl e down against t h e

side s o f t h e body and thus without thi nking
, ,

about it t h e book is h e ld too close t o t h e e y e s o r

, ,

at a bad angle or t h e body assum e s a bad posi

,

tion .

Fr e qu e ntly re st t h e e y e s by looking up and

away from t h e work e s p e cially at som e di stant
,

ob j e ct On e ma y re st t h e e y e s whi l e thin ki ng
.

156
 Ca r e of th e E yes

ove r e ach page or paragraph and thus re ally gain ,

t im e inst e ad o f losing i t .

Have light that i s strong e nough Re m e mb e r .

t hat t h e law o f t h e int e nsity o f light as affe ct e d

by distanc e i s that at twic e t h e distanc e from t h e
source o f light t h e light is only o e fourth as n -

strong Re ading just b e fore suns e t is risky

. .

O e i s t e mpt e d t o go o n not noticing t h e gradual

n ,

diminution o f light .

S ave t h e e asi e st re ading for t h e e ve ning .

N e wspap e rs a s a rul e have n e ith e r good print

, ,

nor good pap e r If t h e e ye s have much work to

.

d o finish this kind o f re ading by daylight if

,

possibl e and by artificial light r e ad books which

, ,

usually hav e b e tt e r type and b ett e r pap e r .

I n all ways e n de avour to favour t h e e ye s by

doing t h e most difficult re ading by daylight and ,

saving t h e b e tt e r print and t h e books that a e r

e asi e r to hold for work b y artificial light Wri t .

ing is usually much more trying to t h e e ye s than

r e ading B y care fully planning his work t h e
.

stud e nt may e conomi z e e y e sight and i t is d e sir ,

able that p e rsons bl e sse d with good e ye s should

b e care ful as w e ll as thos e who hav e a natural
,

we a kn e ss in t h e e ye s ; for it oft e n re sults that

those inh er iting we a k organs by taking prop e r ,

care may outlast and do more and b e tt e r wor k

,

than those naturally stronge r but who through ,

carel e ssne ss injure organs b y improp e r u s e o r

wrong u s e .

Re ading b e fore bre ak fast by artificial light i s

usually bad
157
 Ma s t e r p i e c e s o f S c i e n c e

Man y e ye s a r e r ui n ed duri ng conval e sc e nc e .

At this tim e t h e whol e syst e m is oft e n w e ak i n ,

cludi ng t h e e y es S ti ll th e r e is a st r ong t e m p t a
.
,

tion t o r e ad pe rh aps t o whi l e away t h e time

, ,

pe rhaps t o make up for los t time in sc hool wor k .

Thi s is a tim e whe n a fri e nd may show h i s fri e nd

ship by re ading aloud to t h e conv ale sc e nt .

If o n e finds hi mse lf r ubbing h i s e y e s i t is a ,

cl e ar sign that th e y a e i r ri tat e d It ma y b e r .

t i m e t o stop re adi ng At any rat e o n e should

.
,

find t h e cause and o t proce e d wi th t h e wor k

,
n

until t h e irr itation c e ase s If any fore ign obj e ct .

gets into t h e e y e as a ci nde r it is b e tt e r n o t t o

, ,

t h e e y e but t o dr aw t h e li d away from t h e

ru
b ,

e y e ball and win k r e pe ate dly ; t h e incr e ase d fl o w

of t e ars may di ssolve and wash t h e matt e r o u t .

If you must r u b rub t h e othe r e y e If it b e a

, .

sh a r p corn e re d cind e r r ubbing may m e re ly se r ve

-
,

to fix it mo r e firml y in t h e cor n e a o r t h e mucous

m embran e o f t h e i nn e r sur fac e o f t h e e y e lid If .

it does n o t soon com e o u t t h e lid may b e r olle d ,

ove r a pe ncil t aking hold o f t h e lash e s o r t h e

,

e dg e o f t h e lid Th e poin t o f a blunt l e ad p e ncil

.

is a conveni e nt a n d s afe instrum e n t wi th which

t o r e mov e t h e particl e S om e tim e s be i ng o u t.

in t h e wi nd (e spe cially if un use d t o it ) toget h er ,

wi th b r ight su n light may irr itat e t h e e ye s I f

, .

aft e r such e xp os ure o n e finds lamplight irri ta ti ng ,

h e will d o w e ll t o go to b e d e ar l y o r t o r e main in ,

a dark ro om .

B e car e ful t o k ee p t h e e y e s cl e a n Do n o t .

r u b t h e e y e s with t h e finge rs Asid e fr om c o n .

158
 Ca r e of th e E y es

sid e rations o f e tiqu e tt e th e re is dange r o f intro

,

d u c i g for e ign matt e r that may b e ha r mful

n It
.

is v e ry de sirable that e ach p e rson have h i s indi

vidual fac e towe l B y n o t obs e rving this rul e
.
,

c e rtain contagi ous di s e as e s o f t h e e y e oft e n

S pre ad rapidl y .

If th e re is any continuous troubl e with t h e

e ye s
,
consult a re liabl e oculist Many p e rsons
.

in j ur e t h e e y e s by n o t we aring suitabl e gl asse s

‘

O n t h e othe r hand do n o t buy glass e s of p e ddl e rs

,

or o f any but re liabl e sp e cialists On e may

.

r uin t h e e y e s by w e a ri ng glass e s wh e n th e y a r e

n o t n e e de d
. S ight is pric e l e ss .

159
T H E PR O G RE SS O F ME DI CI NE I N TH E
NI NETEE NTH CE NTURY
' B I LL I NG S M D
O HN S H AW , . .

'Dr B illings is surg n d dministr t r f th first

. a eo an a a o o e

r n k H is w dir t r f t h N w Y rk P ubli Li br ry
a . e no a ec o o e e o c a .

Am ng his m n y p ublish d w rk s
o Prin i p l s f V ntil
a e o a re c e o e a

ti n d H ting issu d by t h E g
o an ea i g R d N w.
'
e e n i n eer n ec or , e

Y rk Th ss y w hi h f ll ws pp r d in t h E i g
o . e e a c o o a ea e e ven n

P t N w Y rk J nu ry
os ,
e
9 pyright d I t is
o , a a 1 2 , 1 01 , co e . re

p i nt d in
r e lum ntitl d Th N in t nth C ntury
a vo e e e
“
e e ee e :a

R i w f Pr gr ss D uring t h P st O H undr d Y rs '

ev e o o e e a ne e ea ,

p u b li sh d b y G P P u tn m s S ns N w Y rk 9
e . py . a
'
o , e o . 1 01 , co

right d I t is pr s nt d h r by t h k ind p rmissi n f Dr

e . e e e e e e e o o .

B illings t h p ublish r f t h E i g P t d G P P ut
, e e o e v en n os , an . .

n m s S l]
a
’
on s

TH E word m dicin e as use d in t h e titl e e ,

o f this pap r includ s all branch e s o f t h e art

e ,
e

o f pr e v e ntion and tr atm ent o f dis e as and e e

injur i e s ; all discov e ri e s o f m thods o f di e

minishing physical pain and o f prolongi ng

lif and also that part f mode rn sci nc e which
e, o e

is conc e rn d with accurat knowl d g o f t h

”

e e e e e

structur and functions no r mal and abnormal

e , ,

of t h e human body and o f t h e caus s o f dis as s , e e e .

In oth r words it includ e s not only th rap eutics

e , e ,

m e dical and surgi cal but also physiology path , ,

ology and hygi en e , .

In all th s e branch e s o f m e dicin gr e at e r p o

e e r

gr ss has b e n m ad e during t h last c ntury than

e e e e

had b een made during t h e p r eu i ou s two thousand

16 1
 Ma s te r p i e c e s o f S c i e n c e

y e ars . This p r ogr e ss

bee n lar ge ly d u e t o i m
h as
p ro v e m e t s i n m
n e thods o f inv e stigation and
di agnos i s re sulti ng from i ncrea s e o f knowl e dge
,

in ch e mist r y and physics ; to be t te r microsco p e s

and n ew i nst r u m e nts o f p r e cision ; t o e x p e r i
m e ntal work i n laborato r i e s an d to t h e applica
ti on o f sci e ntific m e thod and syste m in t h e o h
se r vati on and r e cordi ng of case s o f dis e ase and
o f t h e r e sul t s o f di ff e r e nt mod e s o f tr e atm e nt .

Th e i ntroduction o f statisti ca l me th o ds in t h e
study o f case s o f di se a se and o f cause s o f de ath ;
t h e di scov e r y of g e n e r al anaesth e tics ; t h e adop
tion o f antis ptic ' e xclud i ng mi cr obe s ] and as e ptic
e

' un i n fe ctive] m e thods in surge ry an d t h e d e ve l ,

o p m cn t o f mod e r n bacte riolo

gy
— e ach marks a

point i n t h e h i sto r y o f m e dicin e in t h e n i ne t ee n th

c e ntur y .

Th e sc i e ntific d e monstration that som e di s

e a s e s a e d u e t o t h e gr o wt h and d e v e lopm e nt o f
r

c e rt ain S p e cific mi c r o o rganisms i n t h e human

-

bod y dat e s from about twe nty y e a r s a go a l ,

though t h e th eo r y of such causal r elation is

much old e r S ince 8 8 i t h a s be e n p r ove d that
. 1 0

anthr ax Asiatic chol e ra c e r e bro S pinal m e n i n

, ,
-

gi tis diphth e ria o n e form o f dyse nt e r y e r y

, , ,

si p e las gland e rs gonorrhoe a in fl ue nza c e rtain

, , , ,

e pi d e mics o f m e at
p o isoning p y a mi a a n d s p
- u
,

p u r a t i o n in g en e ral pn e umoni a ,
t e t anus re , ,

lapsing fe v e r tub e rculosis bubonic plague

, , ,

and typhoid fe ve r a r e d u e t o minut e ve ge tabl e

o r gani sms known as bact e ria ; that malarial
fe ve rs T e xas cattle fe ve r and c e r t a i n forms o f
, ,

162
 Th e P r o gr e s s o f M e di c in e

dysent e ry a e d u e to forms of mi c r o s 00 p i c a ni
r

mal organisms kn own as microzoa ; and for most

o f th e s e dis e ase s t h e mod e o f d e v e lopm e nt and

m e ans o f intro duction o f t h e micro organism -

into t h e body a r e fairly we ll unde rst o od To .

t h e info r mation thus obtain e d w e o w e t h e t ri

umphs of antise ptic and ase ptic surge ry a gre at ,

incre ase o f precision in diagn osis t h e u s e o f ,

spe cific antitoxins ' an tidot e s t o organic i fe ction ] n

as re m e di e s and a s pre ve ntive s and som e o f t h e ,

b st practical work in public hygi e n e

e .

Th e e vide nc e as to t h e incr e ase d powe rs o f

m e di in e t o gi ve re li e f from su ffe r ing and to p ro
c

long life is most cl e ar and di r e ct in t h e re cords o f

moder n surge ry— particularly in so m e o f its
spe cial branch es In a large proportion o f c er
.

tain cas e s in which t h e surge on now Ope rat e s

with a fair chanc e o f succ e ss su ch as calculus in
,

t h e k idn e y or gall bladd r shot wounds o f t h e

-
e ,
-

abdome n and tumours o f various kinds the re

, ,

was no h O p e in t h e y e ar 1 8 and t h e unhappy

00 ,

su ffe re r could only e xp e ct a c e rtain though ,

oft e n a linge ring and painful d e ath In cas e s ,

.

o f cance r o f t h e fac e to ngu e bre ast o r ut e rus

, , , ,

t h e p e rsist e nt pain e xtre m e disfigur m nt and

,
e e ,

o ffensiv e odors which att e nde d th e m made

de ath a bo on to b e praye d for if not d e lib e rat e l y ,

sought while n o w such case s if brought in tim e

, ,

to t h e surge on c a n o ft e n b e e nti re ly re lie v e d

, .

Th e knowl e dge o f this fact has be com e ge n e ra l

with th e public and pati e nts no longe r d e fe r an
,
.

Op e ration a s long as p ossibl e as was th e ir custom

,

163
 M a s t e r p i e c e s of S c i e n c e

in day s o f old I nst e ad o f having t o loo k fo r

.

ward t o t h e to r ture o f incisions manipul ations, ,

and stit chi n g with but small hop e o f survivi ng

,

t h e e xhausting suppuration and blood poison -

ing which w e re such common r e sults t h e pati e nt ,

n o w knows that h e will inhal e a li ttl e S w e e t

.

vapour and sl ee p unconscious o f t h e stroke s o f

,

t h e surge on s knife o r t h e pricks o f his n ee dl e

’
.

He ma y dr e am wondrous dr e ams but h e will ,

soon awake to fin d hims e lf in h i s b e d st a ring at

t h e train e d nurs e stan di ng b y his sid e and ,

wonde ring vagu e ly why t h e Op e ration h a s n o t

b e gun He doe s n o t hav e t o look fo r ward t o
.

wee ks and e ve n months o f daily dre ssings Th e .

surge on wi ll glanc e at his t e m pe ratur e re cord

and at t h e outside o f his bandage s b u t will ,

probably not touch the m for a wee k ; an d wh e n

h e doe s re mov e th e m nothing will b e s e e n but
a narrow r e d lin e without a trac e o f su ppuration .

Th e s e improve d m ethods n o t only pre s e rv e t h e

moth e r for h e r childr e n and t h e bre ad winn e r
,
-

fo r t h e famil y but th e y gr e atly contri but e to t h e

,

public good by short ening t h e p e ri od o f em

forc e d i dle n e ss and unproductivit y aft e r Op e ra
tions .

S om e o f t h e gre at e st triumphs o f moder n

surge ry a r e obtaine d in case s o f dis e as e o r i n
jury o f t h e ab d ominal organs Th e r e moval .

o f ova r ian and ut e rin e tumour s is n o w s o c o m

m o n and succ e ssful that it is n o t e as y t o r e ali z e

that a hundr e d y e ars ago th e r e w a s practically
n o h e lp o r h O p e fo r such cas e s In fo r m e r days
.
,

164
 Th e P r o gr e ss of M e di c in e

th e lists o f de aths containe d man y case s re port d e

as inflammation o r obstruction o f t h e bowe ls ,

o r as p e ritonitis It is n o w w e ll und e rstood tha t

.

most o f the s e case s a r e d u e to dis e as e o f a littl e

wo r m like app e ndix conn e ct e d with t h e large
-

int e stine o n t h e r igh t sid e o f t h e lowe r part o f t h e

abdom e n in fl ammation o f which known as
, ,

app e ndicitis cause s e xcruciating pain and oft e n

, ,

produc e s int er nal absc e sse s and d e ath An .

Op e ration for t h e r emoval o f such a dis e ase d

appe ndix is n o w common and in mos t cas e s ,

succ e ssful Th e O p e ration for t h e re moval o f

.

calculus o r ston e from t h e urinary bladde r

, ,

dat e s from ove r twe nty fiv e hundre d y e ars -

a go ,
and no o n e knows who first p er form e d it .

Within t h e last c e ntury it has b e e n large l y

sup e rs e d e d by an Op e ration which crush e s t h e
ston e t o powde r within t h e bladd e r and r e ,

mov e s this powde r without t h e u s e o f t h e knife .

Th e re moval o f calculi fr Om t h e kidn e y o r from

t h e gall bladd e r and t h e r e moval o f a dis e as e d
,

kidne y a r e n ew op e rations made possibl e by

,

improve d m e ans o f diagnos i s an aesth e sia and , ,

antise psis ' de t e rmin ing di s e ase causing i , n

s e nsibility and e xcluding microb e s] Wounds

, .

o f t h e int e stin e s w e r e form e rly thought to b e

almost n e c e ssari ly fatal and nothing was don e ,

for th e m e xc e p t to stupify t h e pati e nt

with Opium N o w in such case s t h e abdom e n
.

is Op e ne d t h e lac e rations o f t h e bowe l a r e close d

, ,

t h e e ffus e d blood and oth e r matt e rs a r e r e mov e d ,

and in many case s life has thus b ee n pre ser ve d .

165
 Ma s t e r p i e c e s of S c ie n c e

B y incr as f knowl e dge o f t h anatom y

e e o e

o f t h e brain and o f t h distribution f n r ve s

,
e o e

conn e ct e d with it it has bec om e p o s sibl e i n a ,

c rtain numbe r f cas s to d t rmin what

e o e e e e

part o f t h e brain is suff ring from i r ri tation e

or pre ssur e and to O pe rat e for t h e re mo a l

,
v

o f t h e tumour o r oth r substanc causing t h e e e

troubl with consid rabl e h p e o f giving p er

e ,
e O

man nt r li f A branch f surg ry which has

e e e . o e

d v lop e d into an important sp cialty du i ng

e e e r

th last c e ntury is that known a s plastic and

e

orthop dic surge ry 'ae ame liorating d formiti e s] e .

Th e r placing f a lost nose by e ngrafting oth e r

e o

tissue in its plac e is a v ry ld t r iumph of sur e o

gi l art but O p e rations o f this ki nd hav be e n

ca ,
e

gre atly e xt nde d and pe rf ct d within t h e last

e e e

hund d y ars and much a

re e w b don e
, c n no e

to mitigat e t h e d formity and w akn ss d e e e e u

to club f t bandy l gs contract d joints t c

ee ,
e ,
e ,
e .
,

which form rly w re consid r d to b e b e yond

e e e e

r e m dy e .

Many f t h dis as s pe culiar to wom n hav

o e e e e e

b ee n d priv d o f much f th ir t rr o r s within a

e e o e e

hundr d y ars In 8e for ve r y thousand

e . 1 00 ,
e

chi ldr n born from t n to tw nty moth rs

e ,
e e e

di d Pu e rp ral f v r occurr d in e pid mics

e . e e e e e ,

following c rtain physicians and nurs e s but

e ,

nothing was known as to its cause s o nature r .

To day pu rp ral f v r is almost unknown in

-
e e e e
t
h e hospitals in t h practic o f a s kill d or e e e

physician Th d ath rat

. f moth rs is e e -
e o e

l ss than fi e p r thousand births and t h e

e v e ,

166
 Th e P r o gr e ss of M e di c in e

m e chanical obstructions which a c e ntu r y ago

would almost ce rtainly have brought about
t h e d e ath o f both moth e r and child a e now , r

s o d e alt with that mor e than half of both moth e rs

and childre n a e save d r .

Th e study o f t h e dise as e s o f t h e e y e has gre atly

d e ve lop e d anoth e r S p e cialty d uring t h e c tu r y en ,

viz Ophthalmology
.
,
Th e inv e stigation s o f
.

H e lmholtz in physiological Optics with h i s ,

inv e ntion o f t h e ophthalmoscop e in 8 5 1 2 ,

e ffe ct e d a r volution in this br nch o f m e dical

e a

s ci e nc e a d art a nd have add e d gre atly to

,
n

human comfort and happine ss A hundre d .

ye ars a g wh e n t h physi ian s a w t h e e ye lids

o ,
e c

o f a n e w bo rn bab e r dd n and sw ll and y e llow

-
e e e ,

matt e r ooz e from b tw e n th e m h e kn e w that e e ,

in a fe w days or w e e ks t h e child would b e par

.

t i a lly or wholly blind but h e kn e w nothing

,

o f t h e simpl e m e ans by which t h e skill e d phy

si c i an c an n w pre v e nt su h a calamity It
o c

is unfortunat e ly t r u e that this knowl e dge is

n o t e v e n now su ffi ci e ntly wid ly diffus e d and e ,

that o u r blind asylums must for som e tim e ,

to com continue to re ce ive those tha t hav

e ,
e

b ee n de p r ive d o f sight during t h e first months

o f th e ir life through t h ignoranc e or n e gl e ct e

o f thos e who should have prop e rly care d for

th em .

Whil e it is c rtai n that t h e d e ath rat e s in t h e

e -

last c e ntury we re gre at e r than those o f t h e

pre se nt day it is o t possible to make pre cis e
,
n

c omparisons Th e r e cord of d e aths in t h e city

.

167
 Ma s t e r p ie c e s of S c i e n c e

of N ew York be gins with 8 4 and wa s n e c e s 1 0 ,

sa ri ly v e ry im pe rfe ct until t h e law o f 8 5 1 1 ,

which r e qui re d t h e r e gi stration o f a ll de aths ;

but it shows a de ath rat e o f -
p er in
1 8 5 whi ch m e an s that t h e true d e ath rat e
0 ,
-

must have be e n be twe e n 3 5 and 4 At pres en t 0 .

,

fo r a se ri e s o f fi e y e ars it would b e about

v ,

20 ,
having be e n be low 9 in 8 9 9 s o that t h e 1 1 ,

de ath rat e h a s be e n diminish e d b y at le ast

-

o n e third
-
Ho w much o f this is d u e t o i mprov e d
.

sani tary condi tions it is imposs ibl e t o sa y .

A compari so n o f t h e list of cause s o f d e ath i n

1 8 5 with t h e list o f cause s fo r
0 9 shows 1 00

gr e at di ffe re nc e s but much of this is d u e to

,

change s in nam e and to more a ccurat e diag

nosis .

Malign ant sore throat and croup w e re

we ll known to anx ious par e nts i n 1 8 but 00 ,

di phth ria cause d no anxi ety In fl a m

“ “
e .

mation o f t h e bo we ls w a s common and fatal ,

”
but appe n di citis had not bee n h e ard o f
“
.

N e rvous fe ve r continue d fe v e r and low

,
”
,

”
fe v e r w e re o n t h e lists but not typhoid which , ,

w as not cl e arly distin gu ish e d a s a s p e cial fo r m

of dise as e unt i l 8 3 7 wh e n Dr Ge rhard an
1 , .
,

Am e rican physician point e d o u t t h e di ffe r

,

e n c e s be tw ee n it and t y phus which also p r e ,

va i l e d at t h e comm e nc e m e nt o f t h e c e ntury .

On e hun dr e d y e ars a go t h e gr e at topic o f di s

c u ss i o n i n o ur citi es o n t h e North Atlantic coas t

wa s t h e m e ans o f pre v e nting y e llow fe v e r which ,

had be e n e pid emic in N e w Yor k a n d Ph ila

168
 Th e P r o gr e ss of M e di c in e

d e lphia for two ye ars Physicians we r e dis

.

puting as to wh th r t h e dise as e was contagious

e e

and import e d and ; th e r fore p rhaps p r e

,
e ,
e ,

v en t a b le by quarantin e and disinfe ction o r ,

was d e to som e occult condition o f t h e atmos

u

p h e
er (whi ch was t h e vi e w tak e n by Noah
We bst e r in his Histor y o f Epid e mic and P e sti
“

”
le t i a l Dis e as e s
n a work which app e are d about
,

t h e middl e o f t h e y e ar 8 although i t is dat e d

1 00 ,

Th e discussions r e mind o e o f t h e r e n ~

mark that a rtain pat e nt e d form o f e l e ct r ic

ce

light was surrounde d by a cloud o f n o n luminous -

ve rbosity 'o r e xampl e t h e Committ e e o f t h e

.
,

M e dical S oci e t y o f t h e S tat e o f N e w York r e

po r t e d that y e llow fe ve r may b e produc e d in
any country b y p e stil e ntial e fflu v i a ; and Webst e r
conclude d that t y phus and n e r vous fe v e rs
we re d u e to a conve rsion o f t h e p e rspirabl e
fl uids of t h e body into s e ptic ' poisonous] mat
t er -
all o f which m e ans tha t t he y kn e w noth
ing about it Eve n n o w we do n ot kn ow t h e
.

cause o f y e llow fe ve r or t h e pre cis e mod e o f

,

its S pre ad ; but we a r e su ffici ently c e rtain that

i t is d u e t o a sp e cific micro organism to b e
‘

confide nt that its spre ad c a n b e ch e cke d b y i s o

l ation and disinfe ction prop e rly appli e d— and
M emphis and N e w O rle ans a r e witn e sse s t o
t h e truth o f this .

In t h e y e ar 8 t h e majorit y o f p e rsons ove r

1 00 ,

t w ent y y e ars o ld we re more o r l e ss pitt e d b y

s mall p o x b e ing t h e survivors o f a much gr e at e r
-
,

n u mb er wh o had su ffe re d from this dis e a se .

169
 Ma s t er p i e c e s of S c i e n c e

Dr Mill e r in N e w York had just r e c e ive d from

.

Engl an d a thre ad whi ch had bee n st ee pe d in

t h e n e wly discov e r e d vaccin e matt e r and w as

a b out t o be gin vaccination in this city To —

,

day .

th ere a re many physicians wh o have n e ve r see n

a case o f sm all pox and a face pitt e d with t h
-
, t

marks o f thi s dise as e is rare ly se e n .

M g h e c e ntur y th e re hav e ap p e are d i n c i v

t .

i li e d co u ntri e s two stran ge and unf amiliar

z

fo r ms o f e pide mic dise as e nam e ly Asiatic chol e ra

, ,

and t h e plagu e t h e firs t coming from t h e v al l e y

,

o f t h e Gang e s t h e se cond fr om t h e vall e y o f t h e

,

Euphr t e s and e ach havin g a long history

a , .

A re ally n ew di se ase was t h e outbre ak in Pari s

in 8 9 o f a S pe c ific contagious di se ase trans
1 2

m i tt e d from si k parr ots and known as p s i t t a

c ,

c o si s
‘

. This littl e e pide mic a ffe ct e d fo r ty ni ne -

pe rsons and cause d si xt ee n d e aths

,
T yphus .

fe v e r has almost di sappe a re d whil e Som e di se ase s ,

hav e incr ea se d in r e lativ e f e qu en c y i n part r j ,

at l e as t bec ause o f m e di cal progre ss

,
Th e .

childr e n who wou l d have di e d o f small p o x in -

t h e e ight ee nth c e ntur y now liv e t o b e aff ec t e d

with diphth e ria o r sc arl e t fe ve r and t h e incre ase ,

in t h e numbe r o f de aths re port e d as d u e to

canc e r i s par tly d u e t o t h e fact tha t a gr e at e r
propo r tion o f pe opl e liv e t o t h e a g e most su bj e ct
to this di se ase .

A lar ge pa rt o f mod e rn progr e ss i n m e dici n e

i s d u e t o i mp r ov e d m e thods o f diagnosis a n d ,

t o t h e u se o f inst r u m en ts o f pre cisi on fo r r e

co r di n g t h e r e sul t s o f e xaminations Th e u s e .

17 0
 Th e P r o gr e s s o f M e di c in e

of th e clinical th e rmom e t e r has e ff ct e d a r e vo

e

lu t i o n in m e dical practic e . O u r knowl e dg e of

dise ase s of t h e h e art and lungs has b e e n gr e atly
e xpand e d during t h e c e ntury by auscultation
' train e d list e ning to sounds] and p e rcussion ,

and e spe cially by t h e u s e o f t h e st e thoscop e .

Th e t e st tub e and t h e microscop e wa r n us of

-

kidne y trouble s which fo r m e rly would not hav e

b ee n susp e ct e d and t h e myst e rious R ontge n
,

rays a r e calle d in to aid t h e s urge on in locating

foreign bodi e s and in d t e rmining t h e pre cise
e

nat u re o f c e rtain injur i e s o f t h e bo n e s B ac .

t er i o lo gi c a l e xamination has b e com e a n ec e s -

sa r y part o f t h e e xamination in case s o f sus

p e c t e d diphth e ria
,
tube rculosis or
,
typ h oid ,

and a minut e drop of blood und e r t h e micro

scop e may furnish data whi ch will e nabl e t h e
s kill ed physician to pre dict t h e re sult in c e rtain
case s o f an aemia ' bloodle ssn e ss] o r to make a
,

positive diagnosis a s b e twee n malaria and oth e r

obsc u re fo r ms o f p e riodic fe ve r .

Th e m e ans at t h e comman d o f t h e physician

for t h e r e li e f o f pain now includ e n o t only t h e
,

gene ral —c hl oroform e the r and, ,

nitrous oxide — but also t h e hypode rmic u s e o f

,

th e conc e ntrat e d alkaloids o f Opium b e lla ,

donna and othe r narcotics and t h e local u s e

, ,

o f cocain e ; and re stful sl ee p for t h e we ary

brain ma y b e obtaine d by sulphon al chloral , ,

et c . S ome agoni z ing forms o f n e uralgi c pain a r e

n o w promptly re li e v e d by t h e s e ction o r e x
c rsi o n o f a po r tion o f t h e affe ct e d n e r v e ; o r i t

17 1
 M a s t e r p i e c e s of S c i e n c e

ma y b e forcibl y stretche d into a condition o f

innocuous de sue tude Re li e f t o t h e su ffe ri ngs
.

o f thousands o f n e urotic wom e n and o f th e ir ,

famili e s and fri e nds h as b e e n produc e d by ,

th e syst e matic sci e ntific application o f t h e

re s t cur e o f Dr We ir Mitch e ll
. .

A hundre d ye ars ago t h e m e di cal advert is e

m e nt whi ch w a s most promin e nt in N ew York
and Philade lphi a n e wspap e r s wa s o n e o f a r em
edy fo r worms Many symptoms o f n er vous
.

and dige stive troubl e s in c hi ldr e n we re in those

days wrongly att r ibut e d to wo r ms N ev er t h e .

l e ss th e re i s good re ason t o b e lie v e that para

,

s i t i c dis e as e s d e riv e d from ani mals w e r e in thos e

days much more pre val e nt in this count r y

than th e y a r e to day O ur knowl e dge o f t h e
-
.

mode o f origin and de ve lopm e nt o f t h e tape

wo r m t h e tr i c h i n a s p i r a li s t h e live r fl uk e
, , ,

and t h e itch inse ct has b ee n gain e d during t h e

nin et ee nth c e ntur y Much t h e sam e may b e
.

said with r e gard to t h e p e c uliar wo r m known

as a nc h y los tn m t h e caus e o f Egyptian chlo
,

r osis ,
and o f t h e S t Gothard tunn e l di se ase
.
,

although pre sc r iptions for t h is paras i te ar e

found in t h e P a p y o s Eb e rs wri tt e n b e fo r e
r ,

t h e tim e o f Pharoah .

Th e l imits o f t h is a rt icl e p e r mi t o f b u t a
bri e f r e fe re nc e t o t h e progre ss in p re ve ntive
m e dicine d ui i n g t h e c e ntur y Th e studi e s mad e .

in E nglan d o f t h e re sults o f t h e chol e ra e pide mi c

o f 1 84 9 and t h e e xp e r i e nc e gaine d in t h e Eng
,

li s h a r m y du ri ng t h e Cr ime an war le d t o s om e ,

17 2
 Th e P r o g r e s s of M e di c in e

of th e most impo r tant advanc e s in sanitar y

sci e nc e more e sp e cially t o t h e d e monstration
,

of t h e import anc e o f pur e wat e r suppli e s and ,

o f prop e r drainag e and s e w e rage During our .

R e volutionary War and t h e Napol e onic wars

, ,

t h e loss e s to t h e armi e s from dis e as e gr e atly

e xc e e d e d thos e from wounds ; and hospital
fe ve r— i n oth r words typhus— was dre ad e d
e ,

by a ge ne ral almos t more than t h e opposing

forc e s During t h e wars of t h last tw e nty
. e

fiv e y e ars typhus and hospital gangr e n e hav e

,

b ee n unknown but som e e xt e nsive outbr e aks

,

o f typhoid f v e r hav e occurr e d

e Showing that ,

o u r knowl e dge o f t h e caus e s and mod e o f trans

mission o f this dise as e has not b e n pra tically e c

applie d to t h e e xt e nt to which it should hav e

b ee n ; this r e mark appli e s also to som e o f t h e
most fatal dise as e s in civil life In t h e Unit e d .

S tat e s diphth e ri a and typhoid fe v e r e ach caus e s

from tw nty to thirty thousand d e aths a y e ar
e ,

whil e more than o n e hundre d thousand d e aths

a r e annually d u e to consumption 'e t for e ach .

o f t he se dis e as e s we know t h sp e cific ge r m

.
e ,

t h e chann e ls through which it is usually c o n

v ey e d
,
and t h e m e ans by which this conv e y
anc e c a n b e to a gr e at e xt nt pre v e nt e d Th e
e .

rava g e s o f th e se dise as e s a r e th e re for e largely

, ,

d u e to t h e fact that t h e gr e at mass o f t h e p e opl e

a r e still ignorant o f th e s e subj e cts A ntitoxin .

is not y et us e d for e ithe r pre ve ntion o r tre at

m e nt i diphthe r ia t o anythi ng like t h e e xt ent
n

which o u r knowl e dge o f i t s pow e rs de mands .

17 3
 Ma s t e r p ie c e s of S c i e n c e

O ur b e tt e r kn owl e dge o f t h e caus e s o f c e rt ain

infe ctious and contagious dis e as e s and o f t h e
,

mod e o f the ir spre ad has b ee n o f gr e at impor

,

tanc e to t h e world from a pure l y comm e rcial

point Of vi e w sinc e it h a s le d t o t h e doing away
,

wit h man y unn e c e ssar y obst r uctions t o tra ffic

and trave l whi ch w e re conn e ct e d with t h e o ld
syst e ms o f quarantin e whil e t h e s e c u i i t y whi ch
,

has b ee n gaine d from t h e mode rn m e thod o f

cle ansing and disinfe ction is de cide dl y gr e at e r
than that s e cur e d b y t h e o ld m e thods A st r i k
.

ing illustration o f t h e e ffe c t o f th e s e improve

m e nts is s ee n in t h e mann e r in whi ch t h e n ews
o f t h e r e c e nt outbre a k o f plague in Glasgow
was r e c e ive d in England and throughout Euro pe .

On e hun dr e d y e ars ago t h e cit y wo ul d hav e

b ee n almost de s e r t e d and t e rro r woul d have
,

r eign e d in all England To da y it is w ell un de r

.
-

stood that t h e dis e as e S pre ads b y a baci l lus

which is n o t conve ye d through t h e a i r N o o n e .

fe ars a r e p etition of t h e ghastl y sc e n e s o f t h e

B lac k D e ath in t h e fourt ee nth c e ntur y In
.

like manne r and fo r t h e sam e r e asons Asiatic

, ,

chol e ra has lost mos t o f its t er rors .

Th e b e n e fits to t h e public o f mod er n p r o

gr e ss in m e dicin e have b e e n gr e at l y enlarge d
by t h e e stablishm e nt o f many small hospitals ,

and by t h e st e ad y incre ase in t h e emplo ym e nt

o f sp e cially train e d nur s e s in privat e p ractic e ,

e v e n in r ural di stricts Th e r e sult s o f a cas e

.

of typ hoid o r of pne umonia oft e n dep e nd

a s much upo n t h e nurs e as upon t h e doctor ;

17 4
 Th e P r o gr e ss of M e di c i ne

an d a fie c t i o n canno t ta ke t h e plac e o f s kill

i n e i t h er
. 'o r t h e gr e a t mass o f t h e p e o p l e ,

case s o f s e ve r e i llne ss o r in j ur y o r t hos e r e

'

qui r ing ma j or sur gica l Op e rations c a n b e tre at e d

,

mo r e succ e ssfull y in w e ll appoint e d hosp itals

-

than in p r ivat e hous e s and as this is b e coming

,

ge n e rall y unde rstood t h e o ld fee ling again st

e n t er ing a h ospita l fo r tre atm e nt is r apidl y
disapp e ar ing .I mprov e m e nt in hospita l c on
struction and manage m e nt has ke p t pac e with
progr ess in m e dica l knowle dge ; and in futur e
such insti t utions s ee m de stine d to play an
incre asingl y im p ortant p art in muni ci p al and
v i ll ag e life .

All p rogr e ss in civi lization i s att e nd e d with

inj ur y t o som e individuals Traine d nurs e s
.

hav e dep rive d som e u n ski lle d l abour o f em

plo ym ent ; h OS p i t a ls have inj ure d t h e busin e s s
o f som e
p h y sicians ; pur e wat e r su
-
pp l i es goo d ,

s ewer s food insp e ction vaccination — i n sho r t

, , , ,

all e ffe ctive m e asur e s in public h y gi e n e int er ,

-

fe re with t h e trad e side o f m e dical p ractic e ;

b u t upon t h e whol e t h e p ublic a t l arge b e n e fit s
b y all the s e t hi ngs I n o n e sens e th e y s ee m
.

oppos e d to t h e ge ne ral l aw o f e volution in that ,

th e y p rolong t h e life o f t h e unfit ; but in a broad er

s e nse t he y wor k in accordanc e with this law
b y in c re asi ng t h e powe r o f t h e strong t o p r o
t e et and care fo r t h e we a k .

All t o l d t h e mos t importan t fe at ur e i n t h e

,

progr e s s o f m e dicin e dur ing t h e c e ntury h a s

b een t h e discove r y of n ew m e thods o f s ei e n
17 5
 Ma s te r p i e c e s of S c i e n c e

t i fic inve stigation mo r e e sp e ciall y in t h e fi e lds

,

o f bact e ri ology and patholog y . The se m e thods

h av e be e n a s y e t only pa r t i ally appli e d and,

gre at re su lts a r e to b e hope d from th eir e xte n

sion in t h e n e ar futur e Th e y will n o t l e ad t o
.

t h e discov e r y o f an e li xir o f life ,

and t h e i n
cre a sing fee bl en e ss o f o ld a ge wi ll cont i nue
t o b e t h e c e rtain r e sult o f livi ng a long t i m e ,

for t h e tissu e s and o r gans o f e ach man have

a d e fin i t e l y lim i t e d t e rm o f duration pec ulia r
t o hi mse lf ; but many o f t h e di sorde r s whi ch
mak e life a bur de n i n adv an cing y e ar s can n ow
b e palli at e d o r so d e alt with as t o se cur e c o m
,

p a a t i v e comfort t o t h e pati e nt s o that if

“
r ,

b y re ason o f str e ngth life c an b e p r olonge d

be yond thr ee s core y e ar s and t en it n o longe r
n e c es s ar il y i nvolve s l a bour and