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
Nothing illustrates more clearly the interdependence of the sciences
than the reciprocal impulse given to new researches in pathology
and entomology by the discovery of the part played by insects in the
transmission of disease. The flea, the louse, the bedbug, the house fly,
the mosquito, the tick, have all within a few years taken their places
as important transmitters of disease. The fly population may be taken
as the sanitary index of a place. The discovery, too, that insects are
porters of disease has led to a great extension of our knowledge of
their life history. Early in the nineties, when Dr. Thayer and I were
busy with the study of malaria in Baltimore, we began experiments on
the possible transmission of the parasites, and a tramp, who had been
a medical student, offered himself as a subject. Before we began, Dr.
Thayer sought information as to the varieties of mosquitoes known in
America, but sought in vain: there had at that time been no systematic
study. The fundamental study which set us on the track was a
demonstration by Patrick Manson,(3) in 1879, of the association of
filarian disease with the mosquito. Many observations had already
been made, and were made subsequently, on the importance of insects as
intermediary hosts in the animal parasites, but the first really great
scientific demonstration of a widespread infection through insects was
by Theobald Smith, now of Harvard University, in 1889, in a study of
Texas fever of cattle.(4) I well remember the deep impression made upon
me by his original communication, which in completeness, in accuracy of
detail, in Harveian precision and in practical results remains one of
the most brilliant pieces of experimental work ever undertaken. It is
difficult to draw comparisons in pathology; but I think, if a census
were taken among the world's workers on disease, the judgment to be
based on the damage to health and direct mortality, the votes would be
given to malaria as the greatest single destroyer of the human race.
Cholera kills its thousands, plague, in its bad years, its hundreds of
thousands, yellow fever, hookworm disease, pneumonia, tuberculosis,
are all terribly destructive, some only in the tropics, others in more
temperate regions: but malaria is today, as it ever was, a disease to
which the word pandemic is specially applicable. In this country and in
Europe, its ravages have lessened enormously during the past century,
but in the tropics it is everywhere and always present, the greatest
single foe of the white man, and at times and places it assumes the
proportions of a terrible epidemic. In one district of India alone,
during the last four months of 1908, one quarter of the total population
suffered from the disease and there were 400,000 deaths--practically
all from malaria. Today, the control of this terrible scourge is in our
hands, and, as I shall tell you in a few minutes, largely because of
this control, the Panama Canal is being built. No disease illustrates
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