The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913Osler, William, Sir
History
The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913
Osler, William, Sir
Medicine -- History
The next great advance was the discovery by Pasteur of the possibility
of so attenuating, or weakening, the poison that an animal inoculated
had a slight attack, recovered and was then protected against the
disease. More than eighty years had passed since on May 14, 1796, Jenner
had vaccinated a child with cowpox and proved that a slight attack of
one disease protected the body from a disease of an allied nature. An
occasion equally famous in the history of medicine was a day in 1881,
when Pasteur determined that a flock of sheep vaccinated with the
attenuated virus of anthrax remained well, when every one of the
unvaccinated infected from the same material had died. Meanwhile, from
Pasteur's researches on fermentation and spontaneous generation, a
transformation had been initiated in the practice of surgery, which,
it is not too much to say, has proved one of the greatest boons ever
conferred upon humanity. It had long been recognized that, now and
again, a wound healed without the formation of pus, that is, without
suppuration, but both spontaneous and operative wounds were almost
invariably associated with that process; and, moreover, they frequently
became putrid, as it was then called,--infected, as we should say,--the
general system became involved and the patient died of blood poisoning.
So common was this, particularly in old, ill-equipped hospitals, that
many surgeons feared to operate, and the general mortality in all
surgical cases was very high. Believing that it was from outside that
the germs came which caused the decomposition of wounds, just as
from the atmosphere the sugar solution got the germs which caused the
fermentation, a young surgeon in Glasgow, Joseph Lister, applied the
principles of Pasteur's experiments to their treatment. From Lister's
original paper(*) I quote the following: "Turning now to the question
how the atmosphere produces decomposition of organic substances, we find
that a flood of light has been thrown upon this most important subject
by the philosophic researches of M. Pasteur, who has demonstrated by
thoroughly convincing evidence that it is not to its oxygen or to any of
its gaseous constituents that the air owes this property, but to minute
particles suspended in it, which are the germs of various low forms
of life, long since revealed by the microscope, and regarded as merely
accidental concomitants of putrescence, but now shown by Pasteur to
be its essential cause, resolving the complex organic compounds into
substances of simpler chemical constitution, just as the yeast-plant
converts sugar into alcohol and carbonic acid." From these beginnings
modern surgery took its rise, and the whole subject of wound infection,
not only in relation to surgical diseases, but to child-bed fever, forms
now one of the most brilliant chapters in the history of preventive
medicine.
(*) Lancet, March 16, 1867. (Cf. Camac: Epoch-making
Contributions, etc., 1909, p. 7.--Ed.)
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