Loe raamatut: «Makers of Modern Medicine», lehekülg 6

Physicians who have for many years known how difficult it is to bring certain people to a recognition of the benefits that have been conferred on modern civilization by vaccination, will appreciate how many difficulties and prejudices and misunderstandings Jenner himself must have encountered during the original introduction of vaccination. Some of the supposed objections to vaccination wear a very modern air, and come from physicians whose only purpose apparently is to bring out the truth, and yet who are evidently led to the drawing of conclusions much wider than their premises by the fact that they know they will have an attentive audience among the anti-vaccinationists at least.

A fair example of one of these old-time objections against vaccination may be found in the following passage from a letter by Dr. Jenner written to Mr. Moore. Corresponding objections have been made in much more modern times, and the passage will arouse the sympathetic amusement of present-day physicians:

"You probably may not have seen a pamphlet lately published by Dr. Watt of Glasgow, as there is nothing in its title that develops its purport or evil tendency: 'An Inquiry into the Relative Mortality of the Principal Diseases of Children,' &c. The measles, it seems, have been extremely fatal in the city of Glasgow for the last four or five years among children, and during this period vaccination was practised almost universally. Previously to this, the measles was considered as a mild disease. Hence Dr. Watt infers that the smallpox is a kind of preparative for the measles, rendering the disease more mild. In short, he says, or seems to say, that we have gained nothing by the introduction of the cow-pox; for that the measles and small-pox have now changed places with regard to their fatal tendency. Is not this very shocking? Here is a new and unexpected twig shot forth for the sinking anti-vaccinist to cling to. But mark me–should this absurdity of Mr. Watt take possession of the minds of the people, I am already prepared with the means of destroying its effects, having instituted an inquiry through this populous town and the circumjacent villages, where, on the smallest computation, 20,000 children must have been vaccinated in the course of the last twelve years by myself and others. Now it appears that, during this period, there has been no such occurrence as a fatal epidemic of measles. You would greatly oblige me in making this communication to the Board, with my respectful compliments."

Fortunately only a few colleagues were so illogical, and an excellent idea of how much Jenner's discovery was appreciated by his contemporaries may be obtained from the number of honors, diplomas, addresses and communications from public bodies and distinguished individuals which he received. A chronological list of these may be found at the end of Dr. Baron's Life of Jenner. Among them may be noted the diploma of LL.D. from the Senate of Harvard University, Cambridge, Mass., under the presidency of Dr. Willard; also the Diploma of Doctor in Medicine, honoris causa, which Jenner especially appreciated, as he says in one of his letters, because he understood that the University conferred this degree in this way only once or twice in a century. There is a diploma as Fellow of the American Society of Arts and Sciences in Massachusetts, as well as a Diploma as a member of the American Philosophical Society at Philadelphia. The diploma from Boston bears the signature of John Adams as president, that from Philadelphia the signature of Thomas Jefferson. Most of the prominent medical and scientific societies of Europe had elected him a member or had sent him some special token of recognition.

One of these documents, expressive of the gratitude of the senders for the great benefit his work had conferred upon the human race, which Jenner valued the highest, was an address from the Five Indian Nations which, with a Wampum Belt, was delivered to him on November 8, 1807. In reply to this Dr. Jenner wrote to the American agent through whom the insignia had been forwarded:

"Sir:

"Your kindness in delivering to the Five Nations of Indians my Treatise on vaccination, and in transmitting to me their reply, demands my warmest thanks.

"I beg you to make known to the Five Nations the sincere gratification which I feel at finding that the practice of vaccination has been so universally received among their tribes, and proved so beneficial to them; at the same time, be pleased to assure them of the great thankfulness with which I received the belt and string of Wampum, with which they condescended to honour me, and of the high estimation in which I shall for ever hold it. May the active benevolence which their chiefs have displayed in preserving the lives of their people be crowned with the success it deserves; and may that destructive pestilence, the smallpox, be no more known among them.

"You also, Sir, are entitled to the most grateful acknowledgments, not only from me, but from every friend of humanity, for the philanthropic manner in which you originally introduced the vaccine among these tribes of Indians.

"I have the honor to remain, &c,

"E. Jenner."

The general trend of American appreciation for Dr. Jenner's work, at least among the intelligent classes, may be gathered from the following letter sent to Dr. Jenner by Thomas Jefferson while he was president, May 14, 1806:

"Monticello, Virginia, May 14, 1806.

"Sir:

"I have received the copy of the evidence at large respecting the discovery of the vaccine inoculation, which you have been pleased to send me, and for which I return you my thanks. Having been among the early converts in this part of the globe to its efficacy, I took an early part in recommending it to my countrymen. I avail myself of this occasion to render you my portion of the tribute of gratitude due to you from the whole human family. Medicine has never before produced any single improvement of such utility. Harvey's discovery of the circulation of the blood was a beautiful addition to our knowledge of the human economy; but on a review of the practice of medicine before and since that epoch, I do not see any great amelioration which has been derived from that discovery. You have erased from the calender of human afflictions one of its greatest. Yours is the comfortable reflection that mankind can never forget that you have lived; future nations will know by history only that the loathsome small-pox has existed, and by you has been extirpated. Accept the most fervent wishes for your health and happiness, and assurances of the greatest respect and consideration.

"Th. Jefferson."

Almost more interesting than the story of Jenner, the experimental scientist, the true harbinger of modern experimental medicine, the founder of experimental pathology, and the discoverer of the pregnant idea which was to mean so much for nineteenth century medicine in the hands of Pasteur and his successors, is the story of Jenner the man, the husband, the friend, and the physician of the poor. In spite of his intense preoccupation in his experimental work and the amount of time it must have required to make his observations, he found opportunities to care for the poor and to interest himself in all their concerns as well as their health. He made many firm friends among people of his own social status and generally was considered a most amiable, as well as a liberal, and humanitarian man. He was deeply religious, and, as we shall allow his earliest biographer Dr. Baron to tell, was not ashamed to exhibit his religious feelings by word and deed when the proper occasion presented itself. This part of his life deserves to be studied as carefully and remembered as faithfully as that in which he made his discoveries, since it is the complement that shows the character of the man in its entirety.

Jenner's personal character may be very well understood from a paragraph of his biographer, who had been his bosom friend for many years. He says:

"But Dr. Jenner was not only humble in all that concerned this, the greatest incident of his life (the successful discovery of vaccination); he continued so after success had crowned his labors, and after applause greater than most men can bear had been bestowed upon him. This most estimable quality was visible at all times; but it was particularly conspicuous when he was living in familiar intercourse with the inhabitants of his native village. If the reader could in imagination accompany me with him to the dwellings of the poor, and see him kindly and heartily inquiring into their wants, and entering into all the little details of their domestic economy; or if he could have witnessed him listening with perfect patience and good humor to the history of their maladies, he would have seen an engaging instance of untiring benevolence. He never was unwilling to receive any one, however unseasonable the time may have been. Such were his habits, even to the latest period of his life. I scarcely know any part of his character that was more worthy of imitation and unqualified respect than that to which I have alluded. I have never seen any person in any station of life in whom it was equally manifest; and when it is remembered that he was well 'stricken in years;' that he had been a most indefatigable and successful laborer in the cause of humanity; and that he might have sought for a season of repose, and the uncontrolled disposal of his own time, the sacrifices which he made are the more to be valued. In the active and unostentatious exercise of kindness and charity he spent his days; and he seemed ever to feel that he was one of those 'qui se natos ad homines juvandos, tutandos, conservandos arbitrantur,' who consider themselves born to help, protect, and cherish their fellow men.

"His kindness and condescension to the poor was equalled by his most considerate respect and regard to the feelings and character of the humblest of his professional brethren. I have often been struck with the total absence of everything that could bear the semblance of loftiness of demeanor. Few men were more entitled to deliver their sentiments in a confident or authoritative tone; but his whole deportment was opposed to everything of that description, and he did not hesitate to seek knowledge from persons in all respects his inferiors. All his younger brethren who have ever had the happiness to meet him in practice, must have been deeply impressed with this part of his character."

Many a member of the medical profession who is not a genius will find an excuse for allowing disorder about his rooms from the example which is said to have been set by Jenner. He was interested in nearly every branch of science and specimens from many departments were constantly around him. He himself, it is said, had the key to the apparent confusion. Most of the others who allow themselves to drift into careless habits in the same direction insist that they too have the key. Some of their friends, however, are inclined to doubt it. It is curiously interesting under these circumstances to have Jenner's biographer tell of the confused state of affairs that existed in his room and yet his defence of it. Perhaps in this matter it is well to remember what Augustin Birrell says at the end of his essay on Carlisle:

"Don't let us quarrel with genius; we have none of it ourselves and the worst of it is we cannot get along without it."

"The objects of his studies generally lay scattered around him; and, as he used often to say himself, seemingly in chaotic confusion. Fossils, and other specimens of natural history, anatomical preparations, books, papers, letters–all presented themselves in strange disorder; but every article bore the impress of the genius that presided there. The fossils were marked by small pieces of paper pasted on them, having their names and the places where they were found inscribed in his own plain and distinct handwriting. His materials for thought and conversation were thus constantly before him; and a visitor, on entering his apartment, would find in abundance traces of all his private occupations. He seemed to have no secrets of any kind; and, notwithstanding a long experience with the world, he acted to the last as if all mankind were as trustworthy and free from selfishness as himself. He had a working head, being never idle, and accumulated a great store of original observations. These treasures he imparted most generously and liberally. Indeed his chief pleasure seemed to be in pouring out the ample riches of his mind to everyone who enjoyed his acquaintance. He had often reason to lament this undoubted confidence; but such ungrateful returns neither chilled his ardor nor ruffled his temper."

It is interesting to note what was Jenner's opinion with regard to two subjects that are very much discussed at the present time. These are the questions of religious training in education, and the advisability of making nature study a part of the course for children. Jenner considered that no education could possibly be complete which did not include both of these subjects. Religious training he deemed absolutely indispensable. Nature study he advised for somewhat different reasons from those for which it is now urged. He thought there was a depth of interest in the study of the objects of nature that could scarcely fail to lessen the burden of education for the child, but the main reason for its study to his mind was that children intent on the wonders of nature could scarcely help but realize the power of the Creator and, learning to admire Him more and more, be thus drawn to respect His laws, to acknowledge His supremacy and to devote themselves to bringing about the fulfilment of His will in this world to the fullest extent in their power.

Jenner's religious opinions and beliefs must be left to the expression of the biographer already mentioned, who gives them very fully. He says:

"One of the most remarkable features in Jenner's character, when treating of questions of a moral or scientific nature, was a devout expression of his consciousness of the omnipresence of the Deity. He believed that this great truth was too much overlooked in our systems of education; that it ought to be constantly impressed upon the youthful heart, and that the obligations which it implied, as well as the inward truth and purity which it required, should be rendered more familiar to all. Mrs. Jenner was constantly occupied in teaching these lessons to the poor around her, in schools which she established for the purpose of affording a scriptural education. He, building upon this foundation, wished to add instruction of a more practical description, deduced from their daily experience, and illustrated by a reference to those works of wisdom and beauty which the universe supplies. He always contended that some aid of of this kind was necessary to impress completely upon the character of the lower ranks those maxims which they derived from their teachers. He had other views, too, in recommending such a plan; he thought that the lot of the poor might be ameliorated, and many sources of amusement and information laid open to them which they are at present deprived of; that the flowers of the field and the wonders of the animal creation might supply them with subjects of useful knowledge and pious meditation."

His wife, as is often, though unfortunately not always, the case, seems to have had that precious uplifting influence over him which served continually as an incentive to higher things and kept him from the sterile materialism which an exclusive absorption in scientific studies, with lack of the exercise of faith and of association with human suffering, seems to bring to many men. Dr. Baron says on this point:

"I remember, when discussing with him certain questions touching the conditions of man in this life, and dwelling upon his hopes, his fears, his pains, and his joys, and coming to the conclusions which merely human reason discloses to us; and when dwelling on the deformity of the heart, our blindness, our ignorance, the evils connected with our physical structures, our crimes, our calamities, and our unfathomable capacity both for suffering and for enjoyment; he observed, Mrs. Jenner can explain all these things: they cause no difficulties to her."

Toward the end of his life Jenner's feelings with regard to the importance of a confident other worldliness as the only fitting explanation for the mysteries of this, became emphasized. To quote his biographer once more:

"As he approached nearer to his own end, his conversations with myself were generally more or less tinged with such views as occur to the serious mind when contemplating the handiwork of the Creator. In all the confusion and disorder which appears in the physical world, and in all the anomalies and errors which deface the moral, he saw convincing demonstration that He who formed all things out of nothing still wields and guides the machinery of his mighty creation."

Jenner's feelings with regard to the relative importance of medical and religious ministrations may be very well appreciated from an expression of his on the occasion when he was being presented to a distinguished nobleman by the famous missionary, Roland Hill. The Reverend Mr. Hill said: "Allow me to present your Lordship my friend, Dr. Jenner, who has been the means of saving more lives than any other man." "Ah," responded Jenner, "were I like you I could save souls." In his sketch of Jenner's life in "The Disciples of AEsculapius," Sir Benjamin Ward Richardson considers that this incident shows a lack of appreciation of the dignity of the medical profession and a humility rather difficult to understand. Anyone who will place himself in Jenner's position of fervent belief that the one thing necessary is the salvation of souls will not fail to recognize, however, his sincerity or fail to appreciate its true significance.

After all, Jenner was so deeply impressed with the importance of other worldly things and the comparative insignificance of this that he found it even a little difficult to understand why men should not see the direct action of the Creator and all His providence in even some of the minutest details of life. Once he said, "I do not marvel that men are grateful to me, but I am surprised that they do not feel grateful to God for making me a medium of good."

Few men who have accomplished so much have felt so little vainglory over it as Jenner. There was not a jot or tittle of what is so rightly called conceit in him. He well deserves a place beside such beautiful characters as Morgagni, Auenbrugger, Laennec and Pasteur, whose work was done for others, not for themselves, and after all the most striking definition of a saint is one who thinks first of others and only second of himself.

GALVANI, FOUNDER OF ANIMAL ELECTRICITY

The world that I regard is myself; it is the Microcosm of my own frame that I cast mine eye on; for the other, I use it but like my Globe, and turn it round sometimes for my recreation. Men that look upon my outside, perusing only my condition and Fortunes, do err in my Altitude; for I am above Atlas his shoulders. The earth is a point not only in respect of the Heaven above us, but of that heavenly and celestial part within us; that mass of Flesh that circumscribes me, limits not my mind; that surface that tells the Heavens it hath an end, cannot persuade me I have any: I take my circle to be above three hundred and sixty; though the number of the Arc do measure my body, it comprehendeth not my mind; whilst I study to find how I am a Microcosm, or little World, I find myself something more than the great one. There is surely a piece of Divinity in us, something that was before the Elements, and owes no homage unto the Sun.

--Sir Thos. Browne, M.D.

It is often thought and only too often stated that the impetus to the rise of our modern science which came during the last half of the eighteenth century was due to the spirit of the French Revolution, making itself felt long before the actual declaration of the rights of man, by the French Encyclopedists. It is the custom to conclude that the spirit of liberty which was abroad infected the minds of the rising generation to such an extent that they cast off the fetters of old traditional modes of thinking, refused to accept supposed truths on the strength of tradition or on authority as before, tested knowledge for themselves, and as a consequence made true progress in the sciences. Something doubtless there is in this, and yet a careful investigation of the lives of the men to whom especially the beginnings of the biological sciences are due, will show that not only were they men with the deepest respect for authority, the greatest reverence for old modes of thinking, but also they were typical representatives of the developing influence of methods of education which are sometimes unfortunately deemed to be narrowing in the extreme.

We have already studied the life of Morgagni, the great Father of Modern Pathology, to find that he least of all, in his generation, was affected by any of the liberalizing tendencies that are supposed to have led up to the freedom of the human mind and the consequent successful broadening of human science. We shall see that there were many others who did their work at the end of the eighteenth century of whom this same thing can be said, and no more striking examples of this can be found than the lives of two great Italians, Volta and Galvani, to whom the modern world has paid the tribute of acknowledging them as founders in electricity by taking their names to express important basic distinctions in the science.

It was not in Italy alone, however, that this adhesion of great scientific minds to the old orthodox teachings of Christianity constituted a notable characteristic of the history of eighteenth century science. Everywhere the same thing was true. Cavendish, Sir Humphrey Davy and Faraday, the great English scientists, to whom so much of progress in electricity and in physics is due, were very similar in this respect to their Italian colleagues. Oersted the Dane belongs in the same category. In France such distinguished names as Lamarck, the great founder of modern biology and the first to broach the theory of evolution; Haüy, the father of crystallography; Laplace, and many others might be mentioned. The lives of the men who were contemporary workers in medicine as sketched in the present volume will show this same thing to be true also in their cases.

A glance at the life of Aloysius Galvani will illustrate how little the spirit of the revolution had to do with the rise of electricity and the first discussions of its relations to life. He was born at Bologna, September 9, 1737. A number of his immediate relatives had been distinguished as clergymen. The early years of Galvani's life were spent in association with religious, and as a youth he wished to become a member of a religious order whose special function it was to assist the dying at their last hour. His father, however, was opposed to his entrance into religion, and so Galvani devoted himself to medicine at the University of Bologna, and at length became a professor of anatomy in his Alma Mater. Professor Galeazzi, who was at the time one of the most distinguished professors in anatomy in Italy, was very much attracted to young Galvani and became his friend and patron in his student days. Galvani became a member of Galeazzi's household, and finally having fallen in love with one of his daughters, won her father's consent to their early marriage. The happiness in life that he thus prepared for himself became one of the often quoted exemplars of domestic felicity in Bologna, where Galvani's life was passed.

Medici, in his panegyric of Galvani, which we shall have occasion to quote from more than once, gives a very pretty story of the doctor's wooing and marriage with Lucia Galeazzi, which we prefer to repeat in the naive simplicity with which it is related by the Italian panegyrist.

Galvani had been seriously thinking of matrimony for some time and had, it seems (strange as that might be considered in a rising young scientist in our day), even prayed for counsel in the matter. One of his favorite saints was St. Francis of Sales, the Archbishop of Geneva, the gentleman saint as he has been called, for whose charming personal character Galvani had a very devout admiration. One day while praying in one of the churches of Bologna before a statue of St. Francis of Sales he looked up after some moments of abstraction to find a young woman's face between him and the altar. The face proved to be that of Lucia. Galvani looked upon it as a sign from heaven of approval of some of his wishes, and applied for the hand of the fair Lucia. Anyone who has seen the offerings at the shrine of St. Anthony of Padua, not so far from Bologna, and has realized that the good patron of things lost seems also to be a special subject of recourse in cases of lost hearts among the northern Italians even at the present day, will realize that probably the story as told is the simple truth without any tincture of romance.

Galvani began original work of a high order very early in his medical career. His graduation thesis with regard to bones, treating specially their formation and development, attracted no little attention and is especially noteworthy because of the breadth of view in it, for it touches on the various questions relative to bones from the standpoint of physics and chemistry as well as medicine and surgery. It was sufficient to obtain for its author the place of lecturer in anatomy in the University of Bologna, besides the post of director of the teaching of anatomy in the Institute of Sciences, a subsidiary institution. From the very beginning his course was popular. Galvani was an easy, interesting talker, and he was one of the first who introduced experimental demonstrations into his lectures.

At this time the science of comparative anatomy was just beginning to attract widespread attention. John Hunter in London was doing a great work in this line which has placed him in the front rank of contributors to biology and collectors of important facts in all the sciences allied to anatomy and physiology. Galvani took up this work with enthusiasm and began the study particularly of birds. These animals, the farthest removed from man of the beings that have warm blood, present by that very fact many interesting contrasts and analogies, which furnish important suggestions for the explanation of difficult problems in human anatomy and physiology.

His experimental work in comparative anatomy, strange as it might appear and apparently not to be expected, led him into the domain of electricity through the observation of certain phenomena of animal electricity and the effect of electrical current on animals.

Like so many other great discoveries in science, his first and most important observations in electrical phenomena were results of an accident. Of course, it is easy to talk of accidents in these cases. The fall of the apple for Newton, Laennec's observation of the little boys tapping on a log in the courtyard of the Louvre, from which he got his idea for the invention of the stethoscope, were apparently merest accidents. Without the inventive scientific genius ready to take advantage of them, however, these accidents would not have been raised to the higher planes of important incidents in history. They would have meant nothing. The phenomena had probably occurred under men's eyes hundreds of times before, but there was no great mind ready to receive the seeds of thought it suggested and go on to follow out the conclusions so obviously indicated. Galvani's observation of the twitching of the muscles of the frog under the influence of electricity may be called one of the happy accidents of scientific development, but it was Galvani's own genius that made the accident happy.

There are two stories told as to the method of the first observation in this matter. Both of them make his wife an important factor in the discovery. According to the more popular form of the history, Galvani was engaged in preparing some frog's legs as a special dainty for his wife, who was ill and who liked this delicacy very much. He thought so much of her that he was doing this himself in the hope that she would be thus more readily tempted to eat them. While so engaged he exposed the large nerve of the animals' hind legs and at the same time split the skin covering the muscles. In doing this he touched the nerve-muscle preparation, as this has come to be called, with the scalpel and little forceps simultaneously, with the result that twitchings occurred. While seeking for the cause of these twitchings the idea of animal electricity came to him.

The other form of the story of his original discovery is not less interesting and is perhaps a little more authentic. One evening he was engaged in his laboratory in making some experiments while some friends and his wife were present. By chance some frogs, the hind legs of which had been stripped of skin, were placed upon the table not far from an apparatus for the generation of frictional electricity. They were not in contact with this apparatus at any point, however, though they were not far distant from the conductor. While the apparatus was being used to produce a series of sparks, a laboratory assistant, without thinking of any possible results, touched with the point of a scalpel the sciatic nerves of one of the animals. Just as soon as he did this all the muscles of this limb went into convulsive movement. It was Galvani's wife who noticed what had happened and who had the assistant use the scalpel once more with the same result.

She was herself a woman of well-developed intellect, and her association with her father and husband made her well acquainted with the anatomy and physiology of the day. She realized that what had occurred was quite out of the ordinary. Accordingly, she called the attention of her husband to the phenomena, and is even said to have suggested their possible connection with the presence and action of the electric apparatus. Husband and wife then together, by means of a series of observations, determined that whenever the apparatus was not in use the phenomenon of the conclusive movements of the frog's legs did not take place, notwithstanding irritation by the scalpel. Whenever the electric apparatus was working, however, then the phenomenon in question always took place. According to either form of the story it is clear that Madame Galvani had an important part in the discovery, and Galvani himself, far from making little of what she had accomplished, was always glad to attribute his discovery, or at least the suggestive hint that led up to it, to his wife.