Makers of Modern Medicine
by James J. Walsh · English · Gutenberg #35477 · 631,668 chars · public domain (US)
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Title: Makers of Modern Medicine
Author: James J. Walsh
Release date: March 3, 2011 [eBook #35477]
Most recently updated: January 7, 2021
Language: English
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[Transcriber's notes]
This is derived from a copy on the Internet Archive:
http://www.archive.org/details/cu31924012267013
Page numbers in this book are indicated by numbers enclosed in curly
braces, e.g. {99}. They have been located where page breaks occurred
in the original book.
Obvious spelling errors have been corrected but "inventive" and
inconsistent spelling is left unchanged.
Extended quotations and citations are indented.
Footnotes have been renumbered to avoid ambiguity, and relocated
to the end of the enclosing paragraph.
There are several occurrences of square brackets used by the author.
They do not begin with "Transcriber's note", "Footnote", or
"Illustration".
[End Transcriber's notes]
_By the Same author_.
Catholic Churchmen in Science. Cloth,
gilt top, with portraits. The Dolphin
Press, Philadelphia, 1906. $1.00, _net_.
History of the Medical Society of the
State of New York (appearing serially
in _New York State Journal of Medicine_,
beginning February, 1906).
_In Press_.
The Thirteenth the Greatest of Centuries.
_In Preparation_.
The Popes in Medical History.
_In Collaboration_.
Essays in Pastoral Medicine. O'Malley
and Walsh. Longmans, Green & Co.,
New York, 1906. $2.50, _net_.
[Illustration: PASTEUR]
MAKERS of Modern Medicine
BY
JAMES J. WALSH, M.D., Ph.D., LL.D.
ACTING DEAN AND PROFESSOR OF THE HISTORY OF MEDICINE AND OF NERVOUS
DISEASES, FORDHAM UNIVERSITY MEDICAL SCHOOL, AND ADJUNCT PROFESSOR
OF MEDICINE AT THE NEW YORK POLYCLINIC SCHOOL FOR GRADUATES
IN MEDICINE; PROFESSOR OF PHYSIOLOGICAL PSYCHOLOGY
AT ST. FRANCIS XAVIER'S COLLEGE
IN NEW YORK.
FORDHAM UNIVERSITY PRESS
NEW YORK
1907
COPYRIGHT, 1907,
FORDHAM UNIVERSITY PRESS,
NEW YORK.
TO
DR. WILLIAM OSLER
WHO EXEMPLIFIES FOR THIS GENERATION THE FINEST QUALITIES OF
THESE MAKERS OF OUR MODERN MEDICINE, THIS VOLUME IS
WITH HIS KIND PERMISSION DEDICATED AS A
SLIGHT TOKEN OF THE ADMIRATION
OF A DISTANT DISCIPLE.
"If in some things I dissent from others, whose wit, industry,
diligence and judgment I look up at and admire, let me not therefore
hear presently of ingratitude and rashness. For I thank those that
have taught me, and will ever; but yet dare not think the scope of
their labor and inquiry was to envy their posterity what they also
could add and find out. If I err, pardon me. I do not desire to be
equal with those that went before; but to have my reasons examined
with theirs, and so much faith to be given them, or me, as those shall
evict. I am neither author or fautor of any sect. I will have no man
addict himself to me; but if I have anything right, defend it as
Truth's, not mine, save as it conduceth to a common good. It profits
not me to have any man fence or fight for me, to follow or take my
part. Stand for truth, and 'tis enough."
{vii}
PREFACE.
The present volume is published at the solicitation of many friends
who have read the articles contained in it as they appeared at various
times in magazines and who deemed that they were worth preservation in
a more permanent form. The only possible claim for its filling a want
lies in the fact that it presents these workers in medicine not only
as scientists but also and especially as men, in relation to their
environment, social, religious and educational. I have to thank the
editors of the _Messenger, Donahoe's Magazine, The Catholic World_ and
the _Records of the American Catholic Historical Society_, for
permission to reprint the articles which appeared in their
periodicals.
The opening chapter, The Making of Medicine, is an abstract from the
introductory lecture of the course in the history of medicine at the
Fordham University Medical School, New York. Much of the material for
the article on the Irish School of Medicine was gathered for a lecture
before the Historical Club of Johns Hopkins University and the
District Medical Society of the District of Columbia. The sketch of
the life of Dr. Jenner has not hitherto been published. All of the
other articles have been considerably lengthened and revised.
There are other makers of modern medicine who deserve a place beside
those mentioned here, but as the material had reached the amount that
would make a good-sized volume it {viii} was thought better to proceed
with the publication of the first series of sketches, which will be
followed by others if conditions conspire to encourage any further
additions to our not very copious English medical biography. A
subsequent volume will contain sketches of the lives of old-time
makers of medicine in the fifteenth, sixteenth and seventeenth
centuries, the men who laid the firm foundations of our medical
science of the present day.
I have to thank my friend of many years and brother alumnus of Fordham
University, Dr. Austin O'Malley, of Philadelphia, for reading the
proofs and for suggestions while the book was going through the press.
{9}
CONTENTS.
PAGE
The Making of Medicine 11
Morgagni, Father of Pathology 27
Auenbrugger, Inventor of Percussion 53
Jenner, Discoverer of Vaccination 87
Galvani, Founder of Animal Electricity 113
Laennec, Father of Physical Diagnosis 133
The Irish School of Medicine--Graves, Stokes, Corrigan 165
Mueller, Father of German Medicine 215
Schwann, Founder of the Cell Doctrine 251
Claude Bernard, Discoverer in Physiology 269
Pasteur, Father of Preventive Medicine 291
O'Dwyer, Inventor of Intubation 323
{10}
{11}
THE MAKING OF MEDICINE
{12}
Without History a man's soul is purblind, seeing only the things
which almost touch his eyes.
--Fuller, _Holy and Profane State_, 1641.
{13}
THE MAKING OF MEDICINE.
Our generation, in this no more self-concentrated than many another,
has prided itself so much on the progress it has achieved in science
that it has in its interest in the insistent present rather neglected
the claims of the history of science. There has been the feeling that
our contemporaries and immediate predecessors have accomplished so
much as to put us far beyond the past and its workers, so that it
would seem almost a waste of time to rehearse the crude notions with
which they occupied themselves. In no one of the sciences is this
truer than in medicine. Yet it seems likely that no more chastening
influence on the zeal for the novel in science, which so often has led
this generation astray, could possibly be exerted than that which will
surely follow from adequate knowledge of scientific history. In
medicine there is no doubt at all that an intimate acquaintance with
the work of the great medical men of the past would save many a
useless investigation into problems that have already been thoroughly
investigated, or at least would help modern workers to begin at a
place much farther on in their researches than is often the custom.
There are other reasons why the knowledge of the history of medicine
cannot but prove of great service to the present generation. We are
entering upon a time when original research as the main business of
selected lives, in contra-distinction to the few hours a day or even a
week that the medical practitioners of a few generations ago could
steal from their busy lives, is becoming more and more the rule. A
consideration then of the methods by which advances in {14} medicine
were made in the past, of the character of the men to whom we owe the
ground-breaking discoveries, of the way in which such discoveries were
accepted or rather rejected by contemporaries, for rejection was
almost the rule, will serve as a mirror for reflections that will
surely be helpful in this day of great institutions of research. It
must not be forgotten, however, that only too often in the past it is
in the large institutions that routine work has been done, while the
occasional genius has sprung up in circumstances that seemed quite
unlikely to be the fostering mother of originality, and there has
taken for the world the precious step into the unknown which
represents a new departure in medical science.
Prof. Osier's declaration that the world's best work was mainly done
by young men was not well received, but no one knew better than he
that this is the most salient fact in the history of medical progress.
There is practically not a single great discovery in medicine that was
not made by a young man under thirty-five. As a rule, indeed, the new
departures in medicine came from men who were well under thirty, some
of them in fact only at the beginning of their third decade of life.
Morgagni's great germinal idea, which made him the father of modern
pathology, came to him when he was a student scarcely more than
twenty. He then began to take notes on all the morbid appearances that
he found in bodies, recognizing very clearly that he must trace out
not only the main cause of the disease, but also the subsidiary
pathological factors that were at work in the production of the
various symptoms of the special case as he had studied it clinically.
This idea is so obvious now as to seem impossible to be missed; yet
scarcely a century ago it constituted the foundation-stone of modern
pathology.
{15}
Auenbrugger, who laid the foundation of modern physical diagnosis by
his observations upon percussion, began the work when he was under
twenty-five, at the Spanish Hospital in Vienna, and carried it out to
a completely successful issue absolutely without any encouragement
from the great masters of the Vienna school. As a matter of fact, they
rather pooh-poohed the idea that this foolish drumming, as one of them
is said to have termed it, could ever amount to anything in enabling
physicians to recognize pathological conditions within the chest. For
twenty-five years after the publication of his little book,
Auenbrugger's discovery attracted no attention. Laennec, who followed
Auenbrugger in the development of physical diagnosis, set himself the
much harder problem of constructing a system of auscultation when he
was in his early twenties, studied the subject for twelve years and
then published the book on it when he was as yet scarcely thirty-five.
He accomplished the revolution in medicine that is due to him, though
he was never strong and died at the early age of forty-six.
These are only striking examples which show what the young man has
accomplished. The same thing was true in other countries. Corrigan
wrote his famous essay on the "Permanent Patency of the Aortic Valve"
when he was only twenty-nine years of age, and the work for it had
been done during the preceding three years, at a hospital in which
there were beds for only six medical patients. Trousseau declared this
the greatest medical work, from a clinical standpoint, that had ever
been accomplished, and hailed young Corrigan as one of the masters of
clinical medicine. He maintained that disease of the aortic valve
should receive the name Corrigan's disease. Stokes, Corrigan's
contemporary and friend in Dublin, wrote his little book on the
stethoscope when he was not yet twenty-one, and at a time when the
{16} distinguished clinicians of the day were all asking if these
young men expected the old physicians to carry this toy about with
them and use it for any serious purpose. Graves, also of the Irish
school of medicine, made some of the clinical observations on which
his reputation is founded, including a short description of
characteristic cases of the affection that still bears his name, when
he was well under thirty-five.
Further examples might well be cited, but they will be met with in the
course of this book. The history of most of the sciences is like
medicine in this respect, and it is to young men that the great
ground-breaking ideas come. How true this is in biology can be noted
even from the lives of the physician-biologists that are included in
this volume. Theodore Schwann, the father of the cell doctrine, did
all the work for which he deserves the name of founder of modern
biology when he was scarcely more than thirty. Part of the best of it
was accomplished before he was twenty-five. Claude Bernard had shown
the precious metal of his originality before he was far on in his
twenties. Pasteur, the most original genius of them all, began his
work when he was scarcely more than a boy, and though every five years
of a long life was filled with original observations of the most
precious kind, his genius had received the bent which it was to follow
from the successful accomplishment of observations during his third
and fourth decades.
In these modern days, when the education of the young man for medicine
is not supposed to be finished until he is nearly thirty, it is easy
to understand that perhaps the precious years in which originality
might manifest itself are already past before he gets out of the
swaddling clothes of enforced instruction from others. As has been
very well said, it is possible to smother whatever of the
investigating {17} spirit and original initiative there may be in a
young man by attempting to teach him too much of what the present
generation knows. Unfortunately, it happens only too often even in
this wise generation of ours that it is not so much the ignorance of
mankind that makes them ridiculous as the knowing so many things that
are not so. The number of things that the young man has to learn and
that are taught him, often with the assurance that they are almost
gospel truth in medicine, and yet that he finds before he has been
long out of school or indeed sometimes before he leaves school, to be
at best opinions, is entirely too great. The saving grace for the
correction of this constantly recurring fault in education is
undoubtedly a knowledge of the development of medicine in the past and
a recognition of the fact that the accepted truth of any one
generation proves after all often enough to be only apparent.
After the false impression that it is to older men we owe progress in
medicine, perhaps the most universally accepted apparent truth is that
the investigating spirit is communicable, and that the pupils of a
great master may be expected to carry on his work and add almost as
much as he has done to the great body of medical knowledge during the
generation immediately following his work. It would naturally be
expected, for instance, that Morgagni having laid the foundations of
modern pathology and connected pathological observation with clinical
observation the great development in modern diagnosis would have come
down in Italy. This was not true, however. The next great step
connecting bedside observations with postmortem appearances was made
by Auenbrugger in Vienna in distant Austria. Auenbrugger's work having
been successfully accomplished it might reasonably be supposed that he
himself or some of those who had seen his successful diagnosis of
thoracic conditions {18} by percussion would take the next step and
discover auscultation. This, however, did not happen in Germany, but
in France. It is true that Laennec's work was done under the influence
of Corvisart, who revived Auenbrugger's work and gave it to the world
once more, and that in a way, therefore, Laennec may be considered an
indirect pupil of Auenbrugger; but the fact stands that the two
discoveries of percussion and auscultation were made at an interval of
nearly fifty years and at a distance of more than a thousand miles
from each other.
On the other hand, Laennec having solved the wonderful mystery of the
significance of the sounds within the chest as far as they concern
pulmonary diseases might have been expected to do as much also for
heart disease. Even genius, however, is able it seems to take only one
step into the unknown. Auenbrugger did not discover auscultation,
though it apparently lay so near at hand. Laennec did not solve the
riddle of heart murmurs, though for most of us they do not present any
more difficulty than the wonderfully successful recognition of the
significance of _rales_ of various kinds in which Laennec never
failed. The problem of heart diagnosis was to be solved by Corrigan
and the Irish school of medicine hundreds of miles away, though they
were doing their work about the same time that Laennec was making his
observations in Paris. Curiously enough just during the same decade
Richard Bright, in England, was studying out the problem of kidney
disease, and, as a young man, teaching the world nearly as much about
it as it has ever learned, though, in the seventy-five years that have
passed since, so much of investigation has been devoted to the
subject.
No one nation can claim the palm of superiority in the matter of
original investigation. The spirit of genius breathes where it will,
and unfortunately it is incommunicable. {19} Students may think they
absorb all that the master has to give them, and that they are ready
to go on with his work where he left it. They do actually seem to
their own generation to make distinct progress in medicine. When the
situation is analyzed fifty or a hundred years afterward, however, it
is found that only the master's work counts, and that much of what
seems to be advance was only a skirmishing here and there along the
lines laid down by him, but without any material progress for true
science.
This same peculiarity is manifest, also, not only in the history of
sciences allied to medicine, but in that of all the physical sciences.
A very striking example is to be found in the story of the rise of
electrical science, which took place almost at the same period as that
which saw the rise of clinical medicine. Origins in electricity date
from Franklin's work here in America and Galvani and Volta's
observations in Italy. It might quite naturally have been expected
that the further progress of electrical science would come in either
of these countries. The next great discoveries, however, were
separated by long distances and a considerable interval of time. After
Volta came the demonstration by Oersted, in Denmark, of the identity
of magnetism with electricity. It was not in Denmark, however, that
the problems connected with this principle were worked out, but by
Ampere in France. In the mean time, Cavendish and Faraday, working
quite independently of their Continental colleagues, were making
significant strides in electricity in England.
When the problem of the resistance to the passage of electricity in a
conductor was to be studied, another nation supplied the man for the
opportunity. Ohm had never been in contact with any of these great
contemporaries and did his work entirely by himself. It is a curious
confirmation of what we have stated with regard to the young man in
{20} medicine and the making of great discoveries that practically all
these founders in electricity were under thirty-five when their best
original work was accomplished.
From a series of biographies of great medical discoverers, certain
salient traits stand out so as to attract attention even from the
cursory reader. The essence of significant work in medicine consists
of observation, not theory. It has always been the custom to theorize
much and unfortunately to observe but little. Long ago John Ruskin
said that the hardest thing in the world for a man to do is to see
something and to tell it simply as he saw it. Certainly this has been
true in medicine. The men who have had eyes, and have used them, have
impressed their names upon the history of progressive scientific
advance. The theorists have never contributed anything worth while to
the body of medical truth.
While this is readily acknowledged by every generation, with regard to
the past, it is curious to note how different is the appreciation of
each generation for the theorist as opposed to the observer. Medical
theorists have always been honored by their contemporaries unless
their theories were utterly outlandish, and even then they have had
many disciples, and have seldom been without honor and never, with
sorrow for the foolishness of men be it said, without emolument. The
observer, however, has but rarely been in favor with his
contemporaries. Not infrequently the observation that he made appeared
to be so obvious that his fellows could not think that it represented
a great truth. As a consequence they have usually derided him for
attempting to make them see a significance in his observation that
they could not think was there. Huxley once stated the phases through
which a new scientific truth ordinarily passes. At first it is said to
be trivial and insignificant, then as it attracts more attention {21}
it is declared to be in contradiction with hitherto known truth.
Finally it is declared to be after all only in other terms what the
world has always believed in the matter. Certainly through these
stages all the great discoveries in medicine have gone. So true is
this, that if what seems to be a new truth in medicine is accepted at
once, and willingly, there is more than a suspicion that it is not
really a new discovery but only a modification of something hitherto
well known.
All the great discoverers in medicine have practically without
exception met, if not with opposition, surely with neglect of their
work. We smile complacently now at the generation that considered the
stethoscope a toy, and asked derisively if they should be expected to
carry it about with them. The next generation, however, having grown
accustomed to the stethoscope, refused quite as inconsequentially to
have anything to do with the thermometer. They refused to carry these
glass things around with them in order to test the fever that patients
might have, since they claimed they were able to accomplish this
purpose quite as well by means of their educated touch. The generation
of medical men is not yet passed who refused to credit the thought
that the diagnosis of diphtheria would ever be made only by the
microscope and culture methods, and who considered that they could
tell very well what was diphtheria, and what not, from the appearance
of the throat.
Of course similar opposition was the fate meted out to every
distinguished scientific discoverer, and so I suppose medical men
cannot complain. His contemporaries said of Galvani that he had made
of himself a dancing master for frogs, because he continued his
observations on the legs of these animals in order to solve the
problems of animal {22} electricity. Pasteur's demonstration that
there was no such thing as spontaneous generation, served at first
only to bring down on his devoted head the aspersions of most of the
distinguished scientific men in Europe. When that genius, the
physician Robert Mayer, discovered the conservation of energy as the
result of his acute observation, that blood drawn by venesection in
the tropics was redder than that drawn in colder climates, he found
that scientific circles were not only not ready to accept his
demonstration, but that he was looked upon as a visionary, somewhat as
one who thought that he had solved the problem of squaring the circle
or the endless puzzle of perpetual motion.
Fortunately these men have as a rule had a physical and mental force
that enabled them to go on in spite of the opposition or derision of
their contemporaries. It is rather a curious fact that most of the
great medical discoverers were born in the country and were as a rule
the sons of rather poor parents. Many of them were so situated that
they had to begin to make their own livelihood to some extent at least
at the beginning of their third decade of life. Far from proving a
hindrance to their original work, this necessity seems rather to have
been one of the sources of inspiration that spurred them on to
successful efforts in their investigations.
Most of them were what would be called handy men, in the sense that
they could use their hands to work out their ideas mechanically. This
was typically true of Galvani, who had to construct his own first
electrical instruments, and of Laennec, who took pride in making his
own stethoscopes. So many of them made by his own hands are still
extant, that a number of museums have the opportunity to hold
specimens of his handiwork. Auenbrugger and Johann Mueller and Pasteur
are further examples of this same handiness. Claude {23} Bernard
exhibited this quality very early in life and continued to exercise it
all during his career.
Nor was their ingenuity limited to material things. Many of them were
interested in literary and artistic work of various kinds. Morgagni
was considered a literary light in his generation. Auenbrugger
composed a musical comedy which had a distinct success, even in music
loving Vienna. The Empress Maria Theresa said that she supposed he
would now continue to write musical comedies; but Auenbrugger replied,
with more candor than gallantry, that he had something better to do.
Claude Bernard composed a play that shows distinct evidence of
literary talent. It seems fortunate indeed that he was diverted from
his original intention of following literature as a career, and took
up medicine. Many of the others, as, for instance, Graves and Stokes,
were excellent judges of art, critics of real knowledge and genuine
appreciation; and indeed it may be said that none of them was ever so
absorbed in his vocation of medicine as not to have much more than a
passing interest in some of the great phases of intellectual activity
quite apart from his professional work, or from scientific knowledge:
an avocation to which he turned for the only true recreation of mind
there is--a change of work.
This seems all the more worth while calling attention to in our
strenuous age, because it is sometimes considered a mistake for a
physician to show that he is interested in intellectual pursuits of
any kind apart from his professional work. It is supposed that no one
is capable of dividing his attention in this way and yet do justice to
his profession and his patients. As a matter of fact it has well been
said that no really great physician has ever been a narrow specialist
in the sense that he knew only medicine well; there was always at
least one other department of intellectual {24} attainment with which
he had made himself so familiar as to be an authority in it. It is not
the lopsided who make great athletes, and it is not the one-sided man
who succeeds in doing really great work. Practically all the great
physicians have had favorite hobbies to which they have turned for
relaxation, for surely no one understands better than physicians that
recreation consists not in that impossibility, the doing of nothing,
but in resting the mind by doing something quite different from what
it has been engaged at before.
There is another phase of the lives of these great men of medicine
that is so different from what is ordinarily thought to be the rule
with physicians, that it seems worth while emphasizing at the end of
this introduction. All these great discoverers have been men of
constructive imagination, men who might have been distinguished
litterateurs very probably, had they applied themselves in that field.
All of them have had too much imagination to be materialists, that is,
to consider that they could know nothing except what they learned from
the matter with which their studies were taken up. All these great
discoverers in medicine have been simple, sincere, faithful believers,
ready to express their trust in an overruling Providence, and in a
hereafter that they knew only by faith, it is true, but which was for
that reason none the less distinctly recognized. While it is usually
considered that medicine leads men's minds away from orthodox thinking
in the great matter of the relationship of the creature to the
Creator, all these men have been not only ready to acknowledge their
personal obligations to Him, but have furnished exemplary models of
what the recognition of such obligations can make of human lives.
There is an old proverb that runs _Ubi tres medici ibi duo
athei_,--where there are three physicians there are at least two
atheists. This has made many a heartache for fond mothers {25} when
they found their sons had determined on becoming physicians. If the
present series of sketches is to be taken as any argument, however, it
is only the small minds among physicians who become atheists. They are
not able to see their way clearly from the material they work in to
the higher things that prove a source of strength and consolation to
the great minds while they are busy making medicine for their own and
subsequent generations. Certainly no more thoroughly representative
group of the makers of nineteenth century clinical medicine could have
been selected than those whose sketches are here given. They are from
all the nations who have contributed materially to modern medical
advance, yet all of them were deeply religious men. There is another
and equally important point with regard to them. It is their relations
to their fellows. Without exception they were men beloved by those
around them for their unselfish devotion not only to science, but also
to their brother men. In the midst of their occupations the thought
that has been the profoundest consolation for all of them without
exception has been that they were accomplishing something by which
their fellow-men would be saved suffering and by which human life
would be made more happy. A study of their careers cannot fail to show
the young physician the ideals he must cherish if he would have real
and not apparent success and happiness in life.
{26}
{27}
MORGAGNI, THE FATHER OF PATHOLOGY
{28}
Let us then blush, in this so ample and so wonderful field of nature
(where performance still exceeds what is promised), to credit other
men's traditions only, and thence come uncertain problems to spin
out thorny and captious questions. Nature herselfe must be our
adviser; the path she chalks must be our walk; for so while we
confer with our own eies, and take our rise from meaner things to
higher, we shall at length be received into her closet-secrets.
--Preface to _Anatomical Exercitations concerning the Generation
of Living Creatures_, 1653. William Harvey.
{29}
MORGAGNI, THE FATHER OF PATHOLOGY.
"VIR INGENII, MEMORIAE, STUDII, INCOMPARABILIS."
--HALLER.
In 1894, when the International Medical Congress met at Rome, Prof.
Virchow of Berlin, the greatest living pathologist at the time, was
asked to deliver the principal address. He chose as his subject John
Baptist Morgagni, the distinguished Italian physician and original
investigator of the eighteenth century, whom he hailed as the Father
of Pathology. No medical scientist of the nineteenth century was in a
better position than Virchow to judge who had been the founder of the
science for which he himself did so much. Virchow besides, through
long and faithful study of the history of medicine, knew well whereof
he spoke. In pathology especially modern medicine has made its sure
advances, so that Morgagni's ground-breaking work may well be
considered the beginning of the most recent epoch in medical science.
As a matter of fact, medicine lost much of its obscurity by losing all
its vagueness when Morgagni's methods came into general use.
As a medical student scarcely twenty years of age, he revolutionized
medical observation by studying his fatal cases with a comparative
investigation of their clinical symptoms and the postmortem findings.
This had been done before, but mainly with the idea of finding out the
cause of death and the principal reasons for the illness which {30}
preceded. Morgagni's investigations in pathology consisted in tracing
side by side all the clinical symptoms to their causes as far as that
might be possible. This looks so simple now as to be quite obvious, as
all great discoveries are both simple and obvious once they have been
made; but it takes a genius to make them, since their very nearness
causes them to be overlooked by the ordinary observer so prone to seek
something strange and different from the common.
How much Morgagni's studies from this new viewpoint of the
investigation of all the symptoms of disease has meant for modern
medicine, may be best appreciated by a quotation from an address
delivered before the Glasgow Pathological and Clinical Society in
1864, by Professor Gairdner, who thus tersely describes the character
of the distinguished Italian pathologist's work:
"In investigating the seats of disease, Morgagni is not content to
record the coincidence of a lesion in an organ with the symptoms
apparently due to disordered function in that organ.
"For the first time almost in medical inquiry, he insists on
examining every organ, as well as the one suspected to be chiefly
implicated; not only so, he marshals with the utmost care, from his
own experience and that of his predecessors, all the instances in
which the symptoms have existed apart from the lesion, or the lesion
apart from the symptoms. He discusses each of these incidents with
severe exactness in the interest of truth, and only after an
exhaustive investigation will he allow the inference either that the
organ referred to is or is not the seat of the disease.
"And in like manner in dealing with causes: a group of symptoms may
be caused by certain organic changes--it may be even probable that
it is so--but, according to Morgagni's method, we must first inquire
into all the lesions of {31} organs which occur in connection with
such symptoms; in the second place, we must know if such lesions
ever occur without the symptoms; and again if such symptoms can be
attributed in any cases to other causes in the absence of such
lesions."
During over sixty years of a long life Morgagni continued to follow
out the idea that he had developed as a boy, and his works contain the
first definite account of pathological lesions and clinical
manifestations that attracted attention.
As a proof of the striking difference between the value of observation
and theory in medicine, it may be said that many hundreds of volumes
containing the most elaborate medical theories were published during
the eighteenth century, and that practically none of these is ever
read now, except for curiosity's sake by some seeker after the quaint
and distant in medicine, while Morgagni's books still contain a
precious fund of information, to which pathologists at least, and not
a few clinicians, turn often with interest and come away always with
profit. They are not infrequently quoted from, and, as we shall see,
have been highly appreciated by some of the best medical authorities
of the present and the immediately preceding generations.
To the modern thinker, accustomed to look rather to the northern
nations or to France for great advances in science, it may prove
somewhat of a surprise to have an Italian thus put forward as the
founder of modern medicine, and especially of the most scientific
department of it. Those who are familiar with the history of medicine
since the revival of civilization after the Dark Ages will realize
what a prominent place Italy has always held in the development of
medical science. The first great Christian medical school was founded
at Salerno, not far from Naples, in the tenth century. The first
regular practical teaching of anatomy by means of {32} dissections of
human bodies and demonstrations on the cadaver was done at Bologna by
Mondino at the beginning of the fourteenth century. The great Father
of Modern Anatomy, Vesalius, was a Belgian, but he did all the work
for his epoch-making book, the _De Fabrica Humani Corporis_, at the
Universities of North Italy, especially at Padua, Bologna and Pisa,
during the first half of the sixteenth century. Every student of
medicine in those times who was desirous to secure wider opportunities
for medical education went down into Italy, and on the rosters of the
Italian medical schools of the sixteenth century are to be found the
names of most of the men who in all the countries of Europe became
famous for their medical attainments.
Morgagni only forms a final link in the chain of great Italian medical
scientists, connecting medieval with modern medicine. From the time of
Vesalius to that of Morgagni there was never a period when Italy did
not possess the leading medical investigator of Europe. We need only
mention such names as those of Fallopius, who added so much to our
knowledge of abdominal anatomy; Eustachius, to whom we owe many
important details of the anatomy of the head; Spigelius, whose name is
forever associated with the liver, and Malpighi, to whom the whole
round of the biological sciences allied most closely to medicine owes
more than perhaps to any other single investigator, to show the
complete justification for this claim. As a matter of fact, every
encouragement to the progress of medicine was extended both by the
secular and the ecclesiastical authorities in Italy during these
centuries, and the Italian peninsula was from the beginning of the
sixteenth to the end of the eighteenth centuries the mecca for ardent
medical students desirous of exhausting the medical knowledge of their
time, quite as Germany has been in our day.
{33}
John Baptist Morgagni was born on February 25, 1682. His birthplace
was Forli in Romagna. It was the capital of a little papal state,
lying at the foot of the Apennines to the southeast of Bologna. The
modern American traveler is likely to know something about it, because
it is one of the principal stopping places on the road from Bologna to
Rimini, for at least the feminine portion of any travelling party will
want to make a pilgrimage to the home of Dante's poor Francesca and to
the scene of the heroic exploits of Catarina Sforza, the great woman
of the Renaissance, to whom in all honor, and without any tinge of the
discredit it has since come to convey, was given the proud title of
the Virago of Forli. The little town is noted for the beauty of its
situation, and well deserves a visit for itself, for it contains a
famous palace built after designs made by Michael Angelo. The town had
decreased in importance and population at the end of the seventeenth
century, when Morgagni was born there, but it was favorably known for
the high standard of cultivation among its inhabitants, possessed a
good library, a number of schools and a well-known college.
Like many another great man, Morgagni seems to have been especially
fortunate in his mother. He was left an orphan at a very early age.
His mother, however, whose maiden name was Maria Tornieli, not only
bore her loss bravely, but devoted her life and talents to the
education of her gifted son. She seems to have been a woman of
uncommon good sense and remarkable understanding. Morgagni often spoke
of her during the course of his life, and attributed much of his
success to the training he had received from her. It is the custom
sometimes to think that women have come to exert great cultural
influence only in these latter days. Nothing could be more untrue. All
through history are abundant traces of women exerting the {34} highest
intellectual influences in their own sphere, and the North Italians in
their era of highest cultural development seem to have been happier in
nothing more than their recognition of the possibilities that lay in
providing educational facilities for women.
These times and this part of Italy are famous in history for some of
the opportunities afforded women in the matter of higher education. It
has been suggested that it is perhaps to the liberal culture of the
mothers we owe the fact that this part of Italy furnished for one
hundred and fifty years about this time the greatest men in science of
the time. It is well known that women occasionally held professorships
at the University of Bologna, not far from Morgagni's birthplace. The
general culture of the women of this section was very high. Modern
masculine historians have even been ungenerous enough to point out
that Bologna was famous for two things--the opportunities provided for
the higher education of women and the extensive manufacture of various
forms of prepared food, the best known of which, the classical Bologna
sausage, has come down as a precious heritage to hurried housekeepers
in our own time.
After an excellent preliminary education at Forli, always under the
careful supervision and enlightened encouragement of his mother,
Morgagni, as might have been expected from the place of his birth,
went to the neighboring university town of Bologna for his higher
studies. Bologna was at this time at the very acme of its reputation
as the greatest of existent medical schools. The science of anatomy
had been especially developed here as the result of important
investigations and discoveries made by some of the greatest men in the
history of medical science. Mondino had, very early in the fourteenth
century, recreated the modern science of anatomy as we know it. He was
the first to realize the importance {35} and urge the necessity for
the dissection of human bodies, if any real lasting progress in human
anatomy was to be made. Medical teaching before this time had been
largely by lectures and disputations upon the work of Aristotle,
Hippocrates and Galen, but actual observation on human tissues and
organs now replaced the older method. Bologna became a papal city in
1512, and it is especially after this date that, under the fostering
care of the Popes, the University of Bologna became the centre of
medical teaching for the whole world for several centuries.
As the result of actual observation and patient study instead of idle
theorizing there came a large number of great discoveries in anatomy.
From Mondino to Morgagni there is a continuous series of great men in
connection with the University of Bologna such as no other institution
can show. About midway between the first and last came the great
Vesalius, who taught at Bologna as well as at Padua and Pisa, and
whose work on anatomy was to be a treasure for anatomists of all
countries for many generations. It was while teaching at Bologna that
Vesalius made the famous series of dissections which formed the
subjects of the illustrations for his great work on anatomy. Titian,
the celebrated Venetian artist, who had come down from Venice in order
to study anatomy for artistic purposes at the famous school of anatomy
and under the supervision of its great teachers, is said to have
executed the plates for the book. The work remains a worthy monument
of the two great masters in their respective professions whose
collaboration created it.
During the century before Morgagni's entrance into the University of
Bologna, the distinguished English physician Harvey, who was to lay
the foundation of modern physiology by the discovery of the
circulation of the blood, was attracted to Bologna because of the
opportunities it presented for {36} advanced work in the studies in
which he was so much interested. While repeating some of the
dissecting work that Vesalius had done Harvey was led to suspect the
existence of the circulation and had his thoughts directed in the
channel which finally led to his masterly exposition of the subject.
In a word, here at Bologna the study of the physical side of life, so
important a characteristic of latter-day science, became a distinct
and recognized branch of science. As Professor Benjamin Ward
Richardson said, in his sketch of the life of Morgagni, "Since that
time there has been no decline in interest in these studies and
medicine has been developed in a manner as daring in project as it has
been useful in application."
Bologna was, at the time, certainly an excellent place for Morgagni.
He went there as an inquiring youth of fifteen and began his medical
studies at once. He became a student of two of the most celebrated
professors of the time--Albertini, a leader in his day, though since
more or less forgotten, and Valsalva, whose investigations into the
anatomy of the ear assure him a permanent place in the science of
anatomy for all time. When Morgagni went to the university, Valsalva
was at the zenith of his brilliant career as an anatomist. He was in
the midst of his great work on the organ of hearing. This extremely
intricate piece of human mechanism had never been understood before
his time, and the working out of its details proved a time-taking but
intensely interesting investigation.
It was not long before the genial insight of Valsalva picked out
Morgagni as a person excellently fitted to assist him in his
dissecting work. Morgagni had not only an enthusiasm for the work, but
had, what is much more precious under the circumstances, untiring
patience and industry and unswerving perseverance. These were the
qualities that were {37} afterward to prove the foundation of his
reputation. His genius consisted certainly in the faculty for hard
work, and his special talent was an infinite capacity for taking
pains. Nearly all of the dissections which Valsalva required for his
demonstrations during lecture hours, or for the illustrations of his
books, are said to have been made by Morgagni under the master's
personal supervision.
After four years of this precious training and study at the
university, Morgagni took his degree as Doctor of Medicine and of
Philosophy. The late Benjamin Ward Richardson, one of the great
English medical men of the end of the nineteenth century, says that
this is a happy combination of qualifications which might, with great
advantage, be required of the graduate in the present day, when so
much of medicine and so little of philosophy is demanded of the
student, to the manifest detriment of both departments of knowledge.
Some idea of the estimation in which Morgagni was held at this time
may be gathered from the fact that, though scarcely more than
twenty-one years of age, he was sometimes allowed to assume Valsalva's
lecture obligations during the master's absence. After graduation he
spent some time at the university doing special work in connection
with the science of anatomy, in which he was so much interested, and
as an assistant professor and tutor. Bologna at this time enjoyed as
wide a European reputation as at any period of its history. Students
from all countries in Europe flocked here, especially to make their
legal and medical studies. Among the medical students Morgagni was
always a moving spirit, a leader in the phases of thought in many
lines that were occupying students' minds at the time.
He was the founder and director of a society of young professors and
maturer students, whose object was the discussion of scientific
subjects of many kinds. The standard of the {38} new society was
personal investigation and observation as a means of arriving at
scientific truth. The principal maxim that guided their discussions
seems to have been that nothing was to be accepted on authority,
merely because it was authority. In the physical sciences thought had
been frequently cramped to fit the old theories inherited from Galen
and Pliny and Aristotle and Hippocrates. A quotation from one of these
classic authors on a point at issue was supposed to throw light on any
difficulty that might be the subject of discussion.
Morgagni's society was called the Academia Inquietorum--"The Academy
of the Restless"--the idea of the curious name being that the members
were not satisfied to rest peacefully in the knowledge to be gleaned
from the older authors, but preferred to get at science for themselves
by direct observation and planned experiment. Morgagni's idea in
founding the society seems to have been premature. The fate of the
Academy of the Restless is involved in some obscurity, but biographers
seem to hint that it failed of its purpose. Neither the university nor
the times were yet ready for such freedom of thought as this. Even in
our own day such a scheme would be considered radical and chimerical.
The discouragement met with finally led to the abandonment of the
meetings, and Morgagni gave up his attempt to inspire others with his
own industry and enthusiasm for original investigation in the physical
sciences.
For some years after this he seems to have been absent from Bologna.
His time was spent especially at the medical schools of the great
universities of Pisa and of Padua. Students who wished to make some
special branch of medicine such as physiology, or anatomy, or the,
then as yet scarcely known, science of pathology, their prime object
in life, had to visit various universities in order to find
opportunity and {39} suggestion for study. Morgagni devoted himself so
faithfully to his work that his eyesight failed him for a time and
very probably his general health also. For some years he returned to
his native town to recuperate. Here he took up the active practice of
medicine. As so often happens, this period of rest after years of
study proved especially broadening in its influence upon Morgagni.
After his rest his contemporaries begin to realize his great
possibilities as a scientist.
His first publication was a series of notes on anatomy. These were
published in the form of collected essays, with the title _Adversaria
Anatomica_. The title has a pugnacious sound, but Morgagni did not
indulge in controversy and _adversaria_ is only the Latin name for
note-books. The first articles thus collected were really
communications made by Morgagni to the "Academy of the Restless"
during his presidency of that body. This opened his career as a
writer, and it is interesting to note that his last book was to be
published some sixty-three years later--a period of fecund authorship
almost unprecedented.
As the result of the reputation gained by this work he was offered a
teaching position at the University of Padua and later was transferred
to the chair of the second professorship of anatomy. After a few years
he succeeded to the first professorship of anatomy at the university,
at that time the most important post in the medical school. This gave
him, at the age of about thirty-five, one of the greatest university
professorships in the world. Opportunities for research were now amply
provided. He was in a position where his communications would be
received with due attention and his reputation was secure.
A university professorship in those days was a position of more
importance than even in our own, and Morgagni was {40} especially
favored in the fact that it had come early in life, so as to enable
him to round out his career. His work was eminently congenial to him,
and the labor it involved was that which constituted for Morgagni the
highest form of recreation. He made many friends among professors and
students. The lectures which Morgagni delivered to the university
became so popular that his lecture-room was overcrowded and new
quarters had to be provided. Many foreign students were attracted to
the university by his wide-spread reputation as a great and suggestive
teacher. These students came in great numbers especially from the
northern countries of Europe. At one time there were over a thousand
German students at the University of Padua, and when they organized
into a guild for mutual help and social purposes, Morgagni was chosen
by them to act as their patron.
Here at the University of Padua Morgagni was to found the new science
of pathological anatomy. Normal anatomy had received its development
at the hands of the other great masters in the schools of North Italy.
To Morgagni was to be given to describe the changes which take place
in organs as the result of disease. Needless to say, this is the most
important practical branch of modern medical science. The symptoms of
disease mean very little unless we know just what organs are affected
and what changes have taken place. Morgagni's work on _The Seats and
Causes of Disease_ contains the foundation of modern pathology. Modern
advances might seem to put it out of date, but the acuity of its
author's observations and the truth of his investigations make it an
enduring classic.
Of this work of Morgagni's, Professor Benjamin Ward Richardson, said:
"To this day no medical scholar can help being delighted and
instructed by the study of this wonderful book. To move into it from
the midst of a body {41} of current medical literature, is like
passing from the periodical flux of current general literature to the
perusal of a Shakespearean drama, the _Pilgrim's Progress_, or
_Paradise Lost_. It is a transition from the mediocrity of incessant
repetition of well-known truths told in long and hackneyed terms, back
to descriptions derived direct from nature and fresh from her
treasury. It matters not where the book is opened, it is always good
and instructive reading, full of suggestion and rich in original
narrative."
Some of Morgagni's work in clinical medicine and in pathology, as
detailed in these volumes, remains of perennial interest and is often
referred to. Many an after-time discovery, proclaimed loudly by its
author, will be found, at times only in embryo but often enough in
entirety, in its pages. There are frequent surprises to the reader in
the anticipation of what are supposedly much later thoughts in
medicine. Some of these passages of more general interest I venture to
present here.
It was Morgagni who first realized that minute connections between
parts of the nervous system might very easily provide the basis for
symptoms quite distant from the site of actual disease. He gives, for
instance, a detailed account of a curiously interesting case in which
the patient, a man somewhat beyond middle life, was annoyed on a
number of occasions by violent sneezing. These attacks of sneezing
became more and more frequent and finally were accompanied by
difficulty of breathing and a sense of pressure over the chest. These
symptoms became more and more marked, until finally, during an
especially violent attack of sneezing, the man suddenly died.
Up to this time anatomists generally had declared that there was no
direct nervous connection between the mucous membrane of the nose and
the diaphragm. Sneezing is {42} due to a violent contraction of the
diaphragm and is almost invariably caused by the presence of an
irritant in the nose. This is, in fact, nature's method of getting rid
of irritant material on the sensitive nasal mucous membranes by an
explosive expulsion of air through the nose. This expulsion of air is
brought about by a convulsive contraction of the diaphragm. It had
always been supposed that the sneezing was due to irritation
transmitted through the brain to the diaphragm.
Morgagni, in discussing the reason why the diaphragm should be excited
into sympathetic reaction by the presence of an irritant in the nose,
pointed out a fact that had been forgotten or the significance of
which had not been appreciated. The membrane of the nose concerned in
smell is supplied by the first pair of cranial nerves, the so-called
olfactory nerves. Between this olfactory nerve and the nerve which
supplies the diaphragm, the phrenic nerve, which is a cervical and not
a cranial nerve, that is to say, comes from the central nervous system
through the spinal cord in the neck and not directly from the brain,
the older anatomists declared there was no connection. Morgagni
pointed out that the mucous membrane of the nose is partly supplied
also from the fifth pair of cranial nerves. From the fifth nerve,
small branches of connection with the cervical nerves, as low even as
the intercostal nerves, had been traced by Meckel. This shows the
possibility of a nervous reflex; that is, of a communication of nerve
impulses without the necessity for the intervention of the central
nervous system.
This was the first direct tracing of distant reflex nervous action in
human physiology. The problem of nervous reflexes was to remain
obscure for more than a century later, until light was thrown upon it
by the investigation of the French physiologist, Claude Bernard. Here,
however, was {43} the pregnant suggestion of the explanation of the
seeming mystery. In subsequent cases Morgagni looked for the
confirmation of his theory in this matter and found it. He pointed out
that there was a relationship between the abdominal viscera and the
olfactory mucous membrane of the nose. In one of his cases an
epileptic seizure was always accompanied by a sense of discomfort in
the upper abdominal region and a fetid odor. This odor was entirely
subjective; that is, though extremely annoying to the patient it could
not be noticed by any one else, even though the patient was close at
hand and exhaled his breath at the moment of the observation.
This would seem to point to the fact that Morgagni suspected there
were other connections between the special senses and important organs
besides those which had been discovered by anatomists up to that time.
As a matter of fact the so-called sympathetic nervous system does
place all the organs of special sense in direct connection with the
other important organs of the body. Morgagni's suspicions were to be
confirmed by the discoveries made in this sympathetic system during
the succeeding century.
Morgagni first of all seems to have realized what was the mechanism by
which alcohol injures the human system. He pointed out that the
excitation of the heart due to the action of alcohol was reflected in
an overdistention of the arteries. This overdistention gradually led
to degenerations in the arterial walls. The loss of elasticity thus
induced brought on a disturbance of the circulation in the important
organs of the body, and so gave rise to symptoms of wide-spread
interference with organic functions.
Morgagni's studies in aneurism, that is, in the dilatation of
bloodvessels, show how thoroughly he understood the mechanism of the
formation of this serious pathological {44} condition. He pointed out
that the first noticeable disease change that occurs is a degeneration
of the inner coat of the artery. This leads to the formation of
furrows on the inner wall of the vessels and finally brings on
weakness of the middle coat of the artery. He realized that the
progress of these arterial changes is due to a large extent to blood
pressure within the arteries. He felt, too, that blood pressure could
be kept from being dangerously high by strict attention to diet
limitation. If aneurisms are discovered in early stages the patient's
life may well be prolonged by these simple measures. This idea
contains the germ of the Tufnell treatment, which has been the most
successful therapeutic measure for the treatment of aneurism in the
nineteenth century.
The Italian anatomist's acumen led him to appreciate better than ever
before in medical history the influence of the mind on the
circulation. He pointed out that emotions have a powerful influence on
the circulatory system in all its parts. How much the peripheral
bloodvessels are affected can be seen in the tendency to blushing
during certain forms of excitement, involving shame or embarrassment;
on the contrary, pallor in anger, or indignation, or fright. He
pointed out, too, that the heart is affected by such emotions and is
sometimes strenuously excited and sometimes very much retarded.
Morgagni understood that the influence of such emotions in especially
excitable individuals leads to wear and tear on the bloodvessels and
so to a shortening of lives. He thought of some aneurisms, even those
affecting the large bloodvessels, might be caused by sudden intense
emotions, and especially by violent efforts to suppress or conceal
emotions. We know now, however, that these pathological conditions are
due to human passions, but quite other than those which Morgagni had
in mind.
It is interesting to note that comparative {45} pathology--that is,
the study of the diseases of animals as illustrating corresponding
conditions in human beings--had already attracted the attention of the
Bolognese school of medicine. Albertini, who had been a professor of
Morgagni's, pointed out that aneurisms are rarely found in animals,
because brutes were not subject to emotions as are human beings.
Morgagni made still further observations in this line to confirm his
own conclusions in the matter. For a time in his earlier life he
devoted himself to the study of fishes, because they seemed to promise
to throw light on certain problems in human anatomy and pathology.
How closely he studied pathological changes in tissues can be gathered
from the fact that his observations led him to point out that aneurism
of the aorta occurs most frequently at that part of the curvature of
the aorta against which blood is constantly projected by the heart.
The realization of the importance of this mechanical factor in the
production of aneurism is one of the first successful results of
carefully applied observation and knowledge of physical laws in the
causation of changes in the tissues as opposed to elaborate theories
with very little foundation in fact.
Variations in the pulse attracted his attention, and he was among the
first to point out that the occurrence of flatulency is liable to
cause disturbance of the heart's action and to bring on noticeable
cardiac palpitation in the absence of any organic affection of the
heart itself. Morgagni also pointed out that intermittence of the
pulse may be due to nervous conditions. He showed that severe mental
shock or trying emotions may cause irregularity of the heart's action
and pulse intermittency. Some of his observations in this matter show
an intuition with regard to the nerve supply of the heart that is
quite beyond the anatomy of his time, and seems to indicate that he
suspected the existence and {46} function of the sympathetic system
and also the existence of a special nerve supply to the small
arteries.
Perhaps Morgagni's most penetrating evidence of insight in pathology
and its relations to clinical medicine is with regard to tuberculosis.
Over a century and a half ago he insisted on its contagiousness. He
refused to make autopsies on patients who had died of tuberculosis,
and his position in the matter was undoubtedly of the greatest service
in directing the attention of his contemporaries, and especially those
closely in contact with him, to the important question of intimate
association with tuberculous patients as a potent factor in the
acquirement of the disease, more potent even than heredity which then
occupied all men's minds on this subject.
It might be deemed that this advanced position of Morgagni was due
rather to intuitive abhorrence of the disease than to the conviction
of actual observation, and that his conclusions were the result more
of prejudice than of real knowledge. Any such opinion, however, is
absolutely contradicted by the fact that he knew and understood better
than any one of his generation the pathology of consumption. He
pointed out at a time when any chronic affection of the lungs was
liable to be considered consumption that there are a number of forms
of chronic bronchitis that are not due to pthisis pulmonalis, but to
other slow-running conditions within the lungs.
He anticipated very completely the present position of surgery with
regard to the treatment of cancer. He advised the operative removal of
these malignant tumors whenever possible. As Benjamin Ward Richardson
points out, this advice was given evidently not with the idea that the
disease could be always thus completely cured, but because early
operation gave speediest relief of annoying {47} symptoms and assured
the greatest prolongation of life. Many other methods of removal of
cancerous growths were suggested in Morgagni's time, as in our own,
and many false promises made and false hopes raised by their
advocates. He pointed out that the quickest, the safest, the surest
and in the end, for the patient, the easiest method of removal is by
the knife in the hands of the bold and skilful surgeon. After a
century and a half of vauntedly great advance, especially in surgery,
we are practically in the same position as when Morgagni's advice was
penned, and his opinion remains practically as valuable to-day as
then.
In another important point of medicine Morgagni seems to have
anticipated the opinion of our own time. It was the custom to practise
venesection very freely. On one or two occasions in his own lifetime
Morgagni fell ill and venesection was recommended. His biographer says
that he constantly refused this method of treatment, adding very
naively, "and he who had often cured others by venesection would never
allow this remedy to be used upon himself because, as I believe, he
had a natural abhorrence to it."
It was an index of thoroughgoing independence of thought in those days
to stand out, even for personal reasons, against the overwhelming
tradition in favor of blood-letting. But Morgagni had well-grounded
doubts as to the remedial efficacy of abstraction of blood, and at
least avoided it in his own case.
Besides his skill in practical and theoretic medicine, Morgagni was a
man of cultivated taste in art, and he was conversant not only with
the literature of his own language, but also of French, Latin and
Greek. He was always welcomed in the literary circles of the cities of
Northern Italy, and counted among his friends many of the great
writers of the time. His success in winning the friendship of rulers
was especially {48} noteworthy, and had not a little influence for the
advantage of education and science. The patricians of Venice were
proud to consider him as a personal friend, and to the Venetian Senate
he owed his professorship at Padua. The King of Sardinia, Emanuel III,
looked upon him as an intimate acquaintance. All the Popes, five in
number, of the second half of his life were on terms of personal
intimacy with him, and his advice was asked on many important
questions with regard to educational matters in his own day.
Some of these Popes are among the most influential pontiffs that ever
occupied the Roman See. The great Benedict XIV, himself a native of
Bologna and an intimate friend of the scientist, in his classic work
"De Beatificatione Servorum Dei" mentions Morgagni in terms of special
commendation. His scarcely less famous successor, Clement XIII, had
often consulted Morgagni professionally at Padua before his elevation
to the See of Rome. After his election as Pope he assures Morgagni of
his continued esteem and friendship, and asks him to consider the
Vatican always open to him on his visits to Rome. In an extant letter
Clement praises his wisdom, his culture, his courtesy, his charity to
God and men, and holds him up as an example to others, since with all
his good qualities he had not aroused the enmity or envy of those
around him.
Morgagni's life must have been in many ways ideally happy. Rewards for
his scientific success began early in life, even before his
professorship, and continued all during his long career. The Royal
Society of England elected him a fellow in 1724; the Academy of
Sciences of Paris made him a member in 1731. In 1735 the Imperial
Academy of St. Petersburg conferred a like honor upon him. In 1754 the
Academy of Berlin elected him to honorary membership.
His English biographer, Dr. William Cook, says quaintly {49} that all
the learned and great who came into his neighborhood did not depart
without a visit to Morgagni. He was in correspondence with most of the
great men of his time, and the terms of intimate relationship that
this correspondence reveals are the best evidence of the estimation in
which Morgagni was held, especially by the prominent scientists of his
time. Among them were such men as Ruysch, Boerhaave, Sir Richard Mead,
Haller and Meckel. This wide acquaintanceship of itself was a great
distinction at a time when the means of communication were so much
more limited than at present.
It is gratifying to think that Morgagni must have been enviably
content in his private life, though, as usually happens when this is
the case, very little is said explicitly on this subject. His untiring
labor deserved the compensation of a loving domestic circle. During
his retirement at Forli, after his graduation from the university and
when, from overwork, his health failed him for a time, he married the
descendant of a noble family of the town, Paola Vergieri by name, a
companion for him who, biographers declare, could not have been
surpassed in judgment or in affection. They had a family of fifteen
children, eight of whom survived their father though he lived to the
ripe age of eighty-seven years. There were three sons, one of whom
died in childhood; another became a Jesuit and taught in the famous
Jesuit school at Bologna whose magnificent building has now become the
municipal museum, the Accademia delle Belle Arte. The third followed
his father's profession, married and settled in Bologna, but died
before his father, who assumed the care of his grandchildren. All
Morgagni's daughters who grew up to womanhood, eight in number, became
nuns in various religious orders.
The spirit of science had not disturbed the development {50} of a
homely simple faith in the family. The great Father of Pathology, far
from being disturbed by the unselfish self-sacrifice of so many of his
children, bore it not only with equanimity but even rejoiced at it.
His relations to his children were ever most tender. After the
suppression of the Jesuits, his son, who had been a member of the
order, worked at science with his father at the University of Bologna
and not without distinction.
The estimation in which Morgagni was held by his contemporaries can be
judged from the fact that twice when invading armies had entered the
Emilia and laid siege to Bologna, their commanders, as in old Greek
history did the Grecian generals with regard to Pindar and Archimedes,
gave strict orders that special care was to be taken that no harm come
to Morgagni, and that his work was not to be hampered. Having lived
his long life amidst the reverent respect of all who knew him, he died
full of day and honors.
Succeeding generations have not been backward in acknowledging
Morgagni's merits. I have already spoken of Virchow's tribute to his
greatness. The Italians have long considered him as one of their most
brilliant names in medicine. One of the best known of the
representative Italian medical journals is _Il Morgagni_, published at
Milan. To its pages the foreigner seeking to know the progress of
Italian medicine turns almost as the first resort. _Il Morgagni_ was
founded some fifty years ago, and continues to uphold its reputation
as one of the world-known medical periodicals.
The great medical scientist whose work was to prove the foundation of
modern pathology, and thus be the source of more blessings to mankind
than ever even he dreamed of, remained in the midst of the reverence
and gratitude of his generation, one of those beautifully simple
characters whom all the world delights to honor. As a teacher he was
the {51} idol of his students. No great scientist who came to Italy
felt that his journey had been quite complete unless he had had the
privilege of an interview with Morgagni. This friend of Popes and of
many of the European rulers was the happy father of a houseful of
members of religious orders, and considered himself blest that so many
of them had chosen the better part. He was himself all during his long
life the ardent seeker after truth, who did well the work that came to
his hand and followed his conscience in sincere simplicity of heart
and reaped his personal reward in the peace that is beyond
understanding to those who have not the gift of faith to appreciate
the things that are beyond the domain of sense.
{52}
{53}
AUENBRUGGER, THE INVENTOR OF PHYSICAL DIAGNOSIS
{54}
While medicine is your vocation, or calling, see to it that you have
also an avocation--some intellectual pastime which may serve to keep
you in touch with the world of art, of science, or of letters. Begin
at once the cultivation of some interest other than the purely
professional. The difficulty is in a selection and the choice will
be different according to your tastes and training.
--Osler, _Aequanimitas and other Addresses_.
{55}
AUENBRUGGER,
THE INVENTOR OF PHYSICAL DIAGNOSIS.
At the present time the most interesting development in medicine is
the gradual reduction of the death rate from tuberculosis. This is
entirely due to the fact that the disease can now be recognized very
early in its course, and that, as a consequence, the treatment may be
begun before serious damage has been inflicted on the lungs. Under the
circumstances, the disease formerly supposed incurable has become
according to all the best modern authorities one of the most tractable
of infectious diseases. In their recent lectures in Philadelphia,
before the Phipps Institute for the Prevention and Cure of
Consumption, such distinguished medical authorities as Dr. Trudeau, of
Saranac; Professor Osler, of Johns Hopkins, and Professor G. Simms
Woodhead, of Cambridge, England, insist on the absolute curability of
tuberculosis when it is taken in time. Professor Woodhead particularly
asserts that there has been entirely too much pessimism in this
matter, even among physicians.
This present confidence with regard to the successful treatment of
pulmonary consumption is due to the fact that the diagnosis can be
made early. The glory of this early recognition depends entirely on
two men--Auenbrugger, of Vienna, and Laennec, of Paris. To
Auenbrugger, whose work was done nearly half a century before that of
Laennec, must be given the credit of having first approached the
problem of differentiating diseases of the lungs from one {56} another
by methods which were so objectively practical that every practitioner
of medicine could, after having become expert in their employment, use
them with absolute confidence in his diagnosis.
Modern medical science and practice acknowledges very gratefully its
deep obligations to what is known as the Vienna school of medicine. It
is not a little surprising to find that it was the practical side of
medicine particularly which was developed at Vienna, since the
inhabitants of the Austrian capital, while supposed to have artistic
tastes far above the average, are usually considered to be among the
most impractical people in Europe. For over one hundred and fifty
years, however, the medical department of the University of Vienna has
always ranked among the first in the world. Many of the Viennese
professors of medicine have been acknowledged as the greatest teachers
of their time. Beginning with Van Swieten and De Haen during the
second half of the eighteenth century, the medical department of the
University of Vienna has scarcely ever been without at least one of
the leading lights of medicine in Europe. Wunderlich, Rokitansky and
Skoda were, in the middle of the nineteenth century, the greatest
medical men of their time. Hebra, Billroth and Nothnagel worthily
continued the tradition of medical greatness in the Austrian capital.
Even at the present time, notwithstanding the great advance in
medicine and medical teaching that has come over all Europe, it is
generally conceded that the best place in the world to study clinical
medicine--that is, to study illness at the bedside of the patient--is
the famous Allgemeines Krankenhaus, the General Hospital of Vienna.
The clinical teaching of medicine developed much later in the history
of medical education than might naturally have been expected. There is
a tradition of bedside instruction {57} in medicine in old Grecian
times at the various shrines of AEsculapius, but this is not well
authenticated. Early in the sixteenth century came the modern birth of
clinical medical instruction at St. Francis's Hospital, in Padua, in
connection with the University there, which in every line did so much
for modern medicine. The first clinic that attracted widespread
attention, however, did not come until Boerhaave's time, at the end of
the seventeenth and the beginning of the eighteenth century. The
bedside instruction in medicine by this distinguished master drew
hosts of students to the hitherto comparatively unimportant University
of Leyden, in Holland. Two rulers--just the two who, to modern minds,
would perhaps appear least likely to do so--at once recognized the
immense practical value of this innovation in medical teaching and
immediately set about securing its benefits for their people. Pope
Benedict XIII and the Empress of Austria put themselves in
communication with Boerhaave, and the Pope was the first to avail
himself of the advice in the matter which the great Dutch master gave.
The Roman clinic became, in the first half of the eighteenth century,
under the direction of the distinguished Lancisi, one of the best
known in Europe.
The Austrian Empress, Maria Theresa, interested in everything that
could prove to be for the benefit of her people, invited the
distinguished pupil of Boerhaave, Van Swieten, to become her family
physician, and encouraged him in the foundation of a clinical medical
school at Vienna. Van Swieten soon came to occupy a very prominent
place at Court. When he was invited from Holland, on the
recommendation of the sister of the Empress, there was no heir to the
Austrian crown, though one had been anxiously looked for for several
years. Heirs to the number of sixteen in all blessed the imperial
family in the next twenty-five years, {58} and Van Swieten became the
confidential adviser of the reigning monarchs in polity as well as in
medicine. Accordingly, when he suggested the invitation of De Haen,
who had also been a pupil of Boerhaave, the suggestion was promptly
accepted, and the Leyden colleagues became the founders of the Old
Vienna School of Medicine, as it is called. They established the
tradition of bedside teaching, of actual practical experience in the
treatment of patients, and of the collection of detailed information
of every feature of cases that could possibly be helpful for
diagnosis. They also established the custom of demonstrations on
pathological material with confrontation of the diagnostic conclusions
during life and the findings of the postmortem examination in fatal
cases, which, down to our own day, makes Vienna an ideal place for
serious post-graduate work in clinical medicine.
It was not long after the establishment of the clinic on these broad
lines at Vienna before the first important fruit of the new teaching
method was to be gathered. Curiously enough, however, this initial
advance in practical medicine did not come from one of the
distinguished heads of the clinic, but from a comparatively young man
of no previous reputation. The greatest discovery ever made at Vienna
is due to Auenbrugger, an unassuming practitioner of medicine, who
came from the Austrian province of Styria, or, as it is called in
German, the Steiermark, about the middle of the eighteenth century. He
was the son of a small hotel keeper of Gratz, and, after making his
medical studies in Vienna, he remained at the capital for some years,
doing hospital work.
While thus engaged, the young Styrian, who attracted very little
attention except for his affability, and who made no pretension to
special knowledge or genius in observation, {59} laid the first stone
in the structure of modern exact diagnosis of pulmonary disease, and
cleared up many of the obscurities in which all affections of the
chest had been shrouded before his time. Having accomplished this
noteworthy achievement before he was forty years of age, Auenbrugger
then quietly settled down to be an ordinary medical practitioner in
the Austrian capital, with a special reputation for his knowledge of
chest diseases, and for kindly ways that gave him as much interest in
his poor patients as in those that could afford to pay handsomely for
his services.
Leopold Auenbrugger, afterward Edler von Auenbrug--a term about
equivalent to the English "Knight of Auenbrug"--who thus stands at the
head of modern medical diagnosis, was born on the 19th of November,
1722, at Gratz, in Lower Austria. His early education was received at
Gratz, and it seems to have been of rather a comprehensive character,
for Auenbrugger, later in life, was a member of the elegant literary
circles in Vienna and a welcome friend at the tables of cultured and
distinguished fellow-townsmen. It will be recalled, by those who
remember German literature, that at this time Vienna was the centre of
culture in Germany, attracting many literary men--as, for instance,
the two Schlegels--from other parts of Germany.
Auenbrugger's father was of the lower middle class, the proprietor of
the Gasthaus Zum Schwarzen Mohren, in one of the suburbs of the city
of Gratz, but also the owner of another hotel in the city itself, so
that he was able, by making some sacrifices, to afford his son a
university and medical education in Vienna. The family were not in
very affluent circumstances, however, and in this Auenbrugger was in
the same condition as many other of the distinguished medical men who
have made important original discoveries. Volta, Laennec, Johann
Mueller, Helmholtz, Pasteur and {60} Virchow were all the sons of
comparatively poor parents, and had to eke out their university
education by doing teaching work as soon as they were considered
capable.
Auenbrugger's studies in medicine were pursued under the well-known
Baron Van Swieten. Van Swieten was, as has been said, one of the most
distinguished of Boerhaave's pupils, and devoted most of his life to
writing a set of commentaries on Boerhaave's aphorisms and editing his
master's work. Van Swieten's greatest ambition was to make the
Austrian capital the home of the great clinical school of medicine and
a pilgrimage at least as attractive for physicians seeking to study
practical medicine at the bedside as had been his own alma mater at
Leyden. He was of so great administrative ability that Maria Theresa
made him one of her state counsellors.
With all the influence of the government behind him, then, it is not
surprising that Van Swieten succeeded in his very laudable project of
establishing a great medical school at Vienna.
It was fortunate that Auenbrugger made his medical studies under such
good auspices. We have no details of his student life nor of his
success in his examinations. Even as a student his engagement of
marriage to Marianna von Priesterberg was announced. The formal
marriage ceremony took place in 1754, when Auenbrugger was about
thirty-two years of age. His wife seems to have had a dowry, and this
enabled Auenbrugger to begin his medical career in Vienna. Some years
before this, as a young graduate physician, he had accepted the
position of resident medical attendant at the Spanish military
hospital of the Holy Trinity in Vienna. This hospital was large and
important and provided manifold opportunities for clinical study. Its
wards were frequently drawn on by the {61} clinical department of the
University of Vienna for cases to be demonstrated before the students.
This fact was sufficient to make Auenbrugger's position of great
educative value for him. Mistakes in diagnosis would be apt to be
discovered, since the interesting cases were reviewed by some of the
best physicians of the time in Europe. His position carried with it no
salary beyond his maintenance, but proved well worth the time he gave
it, since it developed in him habits of careful investigation. Just
ten years after he began his work at this hospital he published the
little book called "Inventum Novum," or new discovery, on which his
reputation depends. It was written in Latin, and its full title ran:
"A New Discovery that Enables the Physician, from the Percussion of
the Human Thorax, to Detect the Diseases Hidden within the Chest."
Altogether his little manual probably does not contain much more than
ten thousand words. It is perhaps two or three times as long as
thousands of medical articles published every year in our modern
medical journals. It contains, however, one of the most important
discoveries in the whole history of medicine. One of the best
diagnosticians of the nineteenth century, Skoda, the distinguished
head of the Vienna school of sixty years ago, calls the discovery that
Auenbrugger outlined so unpretentiously "the beginning of modern
diagnosis," and hailed Auenbrugger himself as the founder of the new
science of diagnosis that was to prove so fruitful of good in the
prevention of human suffering.
It is interesting to compare Auenbrugger's little book with Van
Swieten's commentaries on Boerhaave's works, which were published in
some eight huge volumes. Van Swieten's successor, De Haen, an equally
illustrious contemporary of Auenbrugger, published about the same time
some eighteen volumes on the science of medicine. Neither {62} of
these works is ever consulted now, except by some enthusiastic student
of the history of medicine, who wishes to clear up a point in medical
historical development; but Auenbrugger's unpretending monograph is,
and will ever remain, a classic. Practically nothing has been needed
to complete the clinical usefulness of his discovery. Like Laennec,
whose work was done just half a century later, he had the genius to
realize what the possibilities and the limitations of his discovery
are, and he completed it in all its details before giving it to the
public.
Auenbrugger's discovery consisted in recognizing that diseases of the
chest can be distinguished from one another and their varying
character differentiated by the sounds elicited when the chest is
tapped with the finger. To this tapping he gave the technical name,
since become classic in medicine, of percussion. Wherever there is air
in the chest, that is all over the healthy lungs, the sound elicited
by percussion resembles that given out by a drum over which a thick
woolen cloth has been placed. Over the heart, where there is no air,
the sound given out, when the chest is percussed, corresponds very
nearly to the sound produced when the thigh is tapped. The sound
elicited by percussion of the thigh Auenbrugger took as the standard
of dulness and applied to it the term Schenkel-ton, or thigh sound.
When the lungs become consolidated because of an inflammatory process
such as pneumonia or tuberculosis, then the percussion note over the
consolidated area resembles the sound over the leg or that found over
the heart. As a rule the heart is somewhat covered by the lungs, and
the sound produced by percussion over it is not quite as dull as that
over the solid muscular structures of the legs. Whenever fluid finds
its way into the thorax, as in pleurisy, then the sound produced on
percussion is very dull.
{63}
Auenbrugger further showed that by means of the sound thus obtained he
could demonstrate the size of the heart under varying conditions, and
so determine whether it is larger than normal or not. This gave the
first inkling as to the discernment of hypertrophy and dilatation of
the heart, and was the first step in the modern differential diagnosis
of heart diseases. He showed, moreover, that he could, by percussion,
outline very exactly the extent to which a consolidation of the lung
has taken place, or the height to which an effusion into the pleural
cavity reaches. These conclusions and demonstrations require not only
the greatest care but the most deliberate confirmation of every detail
by comparison of the diagnosis during life with the condition found
after death in fatal cases.
Auenbrugger seems to have spared neither time nor labor in this work
of confirmation. He made a number of experiments upon dead bodies,
injecting fluid into the pleural cavity and then demonstrating by
percussion the line of demarcation that indicated the level of the
fluid within the chest, as well as the pulmonary conditions that
developed because of its presence. In the study of pneumonia and
tuberculosis particularly, Auenbrugger spent many hours of patient
investigation during his ten years of hospital service. He succeeded
not only in demonstrating the presence of consolidation, but also the
existence of cavities in the lungs and their size and general
character.
Vienna was an ideal place for the development of Auenbrugger's ideas
of confirmation. At this time, it must have been one of the most
unhealthy places in Europe as regards pulmonary diseases. The city was
surrounded by walls that occupied the ground now taken up by the
magnificent Ring Strasse and the inhabitants were packed into
extremely narrow quarters, The modern municipal sanitary {64}
conscience is lax enough in our own day, but at that time it had not
been awakened to the slightest sense of duty toward the citizens.
Narrow, wandering streets lined by high buildings that made an attache
of the British Legation of Vienna speak of the houses of the city,
scarcely more than fifty years ago, as "well-like," were the universal
rule.
It must be remembered that the present magnificent Austrian capital,
containing, perhaps, the handsomest single street and some of the
finest buildings in the world, is entirely a creation of the last
half-century. The old city had every cause to be unsanitary. Situated
in the valley of the Danube, liable in the spring-time to serious
floodings from the capricious, mighty river, which has been brought
under control only in recent years at great expense; in an exposed
situation, which makes it a veritable temple of the winds during the
autumn and winter; it is not surprising that tuberculosis should have
been very frequent. Even with all its improvements in recent years,
sanitary, hygienic, municipal and domiciliary, Vienna has at the
present time one of the highest death rates from tuberculosis in
Europe. In Auenbrugger's time there must have been practically
unlimited opportunity for the study of pulmonary diseases of all
kinds.
How well the brilliant young medical observer took advantage of the
opportunities thus afforded him can be judged very well from the
passages of his book that refer to chronic pulmonary diseases. He
divides the chronic diseases of the thorax in which abnormal
percussion sounds are heard into two classes. In the first place, he
places those in which the thoracic organs are rendered less capable of
resisting disease and become actually affected, because of insidious
influences, such as hereditary conditions, depressing circumstances,
poverty and poor nutrition. Without really calling it tuberculosis, it
is evident that in this group pulmonary {65} consumption is included.
The second class consists of affections in which the thoracic organs
become diseased from definite, easily recognizable causes. Such are
disturbances of the general health in pulmonary affections that follow
thoracic disease not completely recovered from. By these diseases
Auenbrugger evidently intends cases of pneumonia or other affections
of the lungs, or trauma and the like, which are followed by
tuberculous processes.
With regard to cavities in the lungs, Auenbrugger was able not only to
demonstrate their presence and to show by autopsy records that his
localization and determination of their approximate form and size were
correct, but he also understood the method of their formation and
explains the reasons for certain varieties of cavities that occur. He
speaks of two classes of cavity formations. From one kind there is an
ichorous discharge; from the other variety the evacuations are
purulent. Cavities with non-purulent secretions are situated only in
the lung. Abscesses of various kinds--that is, cavities with purulent
secretions--may occur in any part, or in any of the organs of the
thorax. The lung cavities are usually due to the breaking down of what
he calls crude tubercles. Both kinds of cavities may either be closed
or have an opening into the bronchi.
Auenbrugger showed very well how to distinguish, by percussion,
cavities of various kinds, and set it down as a principle, that before
the evacuation of the contents of the cavity percussion over it gave a
distinctly dull note, resembling that obtained when the thigh is
percussed, while after evacuation, as by copious expectoration, a
distinctly resonant note occurred. It is clear from his discussion of
the symptoms noted in cavities (at least in the opinion of Dr.
Merbach, who wrote a sketch of Auenbrugger's life for the
Jahresbericht der Gesellschaft fuer Natur und Heilkunde in Dresden,
{66} in 1861), that Auenbrugger was very near the discovery of
auscultation in his study of pulmonary cavities. Auenbrugger says that
when a cavity has been located by means of percussion, if the hand be
laid over the place beneath which it lies and the patient is asked to
cough, the fremitus produced by the pus in the cavity can be felt as
it moves under the coughing impulse. This is what we now know as
palpation. If instead of using his hand Auenbrugger had applied his
ear to the chest, auscultation would have been discovered nearly half
a century before Laennec began his work upon the subject. Perhaps
Merbach, who was himself a native of Styria and a professor at the
University of Gratz, was for patriotic motives more ready than others
might be to give Auenbrugger credit for practically discovering
auscultation.
Auenbrugger's and Laennec's observations were made on exactly the same
sort of clinical material. They were both studying advanced cases of
tuberculosis in the hospitals of a great city. Laennec's work was
actually not anticipated in the slightest degree however. How
Auenbrugger could have made the careful examinations of the chest that
he did in thoracic diseases without acquiring some knowledge of the
value of the further application of the sense of hearing, which
Laennec was to employ so fruitfully in the diagnosis of affections of
the lungs and heart, seems to us almost impossible to understand.
Discoveries once made, however, always seem so obvious that the wonder
is they were not made long before. It takes genius to cross the line
into the realm of the hitherto unknown, and the contemporary
generation usually occupies itself mainly with making little of the
new discovery. Even genius very rarely makes more than one original
observation in a lifetime, and it would be too much to expect more
from Auenbrugger.
{67}
The preface to Auenbrugger's little book is a model of concise
directness typical of the man and his ways. As the modest introduction
to a work that will ever be a classic in medicine it seems to deserve
a place here:
"I present to you, kind reader, a new sign for the detection of
diseases of the chest, which I have discovered. It consists in the
percussion of the human thorax and the determination of the internal
condition of this cavity by the varying resonance of the sounds thus
produced. My discoveries in this subject are not committed to paper
because of an itch for writing, nor an inordinate desire for
theorizing. Seven years of observation have put the subject in order
and have clarified it for myself and now I feel that it should be
published.
"I foresee very well that I shall encounter no little opposition to
my views and I put my invention before the public with that
anticipation. I realize, however, that envy and blame and even
hatred and calumny have never failed to come to men who have
illuminated art or science by discoveries or have added to their
perfection. I expect to have to submit to this danger myself, but I
think that no one will be able to call any of my observations to
account. I have written only what I have myself learned by personal
observation over and over again, and what my senses have taught me
during long hours of toil. I have never permitted myself to add or
subtract anything from my observations because of the seductions of
preconceived theory.
"I would not wish, however, that any one should think that this
method of diagnosis, which I suggest, has been developed to its
utmost perfection. I confess with all candor that there are defects
in the system which conscientious observation will, I hope, amend
with time. It is possible that there are even other important truths
for the recognition {68} of disease still hidden from this method of
diagnosis. Some of these may prove of great usefulness for the
differentiation, prognosis and cure of diseases of the chest.
"This was the reason why in my personal experience, after I had
succeeded in finding the signs in the chest and proceeded further to
the investigation of their causes so far as my own observation could
help me, I have always afterward had recourse to the commentaries of
the illustrious Baron Van Swieten, since I have considered that
whatever can be desired by an observant man is sure to be found in
his work. I have thus been able to spare you a long disquisition. I
have found in his work a sure basis of knowledge on which my slight
superstructure may be raised up to view.
"I do not doubt, however, that I have accomplished a work which will
earn the gratitude of all true devotees of the art of medicine,
since I have succeeded in making clear certain things which shed not
a little light on our knowledge of the obscure diseases of the
chest, a subject hitherto very imperfectly understood.
"I have omitted many things that seem doubtful because they are as
yet not sufficiently elaborated. I shall endeavor, however,
faithfully to devote myself to [literally to sweat over] the further
development of these points. Finally, it has not been my effort to
write in any elegant diction. I have chosen a style in which I may
be thoroughly understood.
_Vale;_
"December 31, 1760."
Auenbrugger's own realization of the importance of his work and of its
significant value for medicine kept him faithfully investigating his
chosen subject, though he seems to have met with very little
encouragement from members of {69} the medical profession near him. It
is extremely difficult to understand how his practical observations
and thoroughly conservative claim failed to attract more attention
than they did from really great physicians who were deeply interested
in the progress of medicine. At least two distinguished writers on
medicine, Van Swieten and De Haen, compiled treatises on medical
subjects that included the consideration of diseases of the chest
within a few years after Auenbrugger's _Inventum Novum_ appeared, and
yet neither of them devotes any space to the question of percussion
nor hints at its possible value.
Van Swieten's work consisted of commentaries upon the aphorisms of
Boerhaave. The Vienna professor did not, however, limit himself to the
consideration of the aphorisms alone, but made his work also a
compendium of his own clinical experiences with acute and chronic
diseases. As a matter of fact his commentaries on the aphorisms are
each a monograph on some special disease. The two last volumes of this
commentary appear after the publication of Auenbrugger's book on
percussion, one volume being published in 1772, the other in 1774.
The first of these articles contains a long article on pulmonary
consumption, and the other an almost equally long chapter on pleurisy
with effusion. In neither of the volumes, however, is there any
mention of percussion, or of Auenbrugger's work, though if Van Swieten
had given any serious attention to the subject, he must have become
convinced how valuable Auenbrugger's invention was in the diagnosis of
these conditions.
This omission is all the more surprising as Auenbrugger was a pupil of
Van Swieten's and practically dedicated his _Inventum Novum_ to his
master. He mentions Van Swieten's work several times in his little
book. Auenbrugger's {70} investigations were not unknown to Van
Swieten then, and the only conclusion to be drawn from his neglect to
mention Auenbrugger's methods is that he deliberately omitted
reference to them because of his failure to recognize the value of the
discovery. This constitutes one of the most serious blots on Van
Swieten's medical career. He was succeeded as the head of the clinic
in Vienna by De Haen, who also came from Leyden and brought with him
the methods of Boerhaave's clinical school. As the time during which
Auenbrugger was making his valuable observations at the Spanish
military hospital coincides with the years when De Haen was professor
of clinical medicine, and when he was frequently indebted to his
colleague of the Spanish hospital for his cases for demonstration, it
is impossible to conceive that Auenbrugger or his work should have
remained unknown to the distinguished head of the clinic.
There is not a single mention, however, to be found anywhere in De
Haen's voluminous writings of Auenbrugger or his work. De Haen's
principal work is his _Ratio Medendi_ (_System of Medicine_),
published at Vienna during the years from 1757 to 1779. It consists of
eighteen volumes, in which all the important forms of disease as well
as the rarer types of affections that came to the clinic are
thoroughly discussed. De Haen treated of pneumonia, of consumption, of
pleurisy with effusion, which he calls dropsy of the chest, but never
suggests the use of percussion. On the contrary, he complains in a
number of places how very obscure and difficult of diagnosis are
thoracic diseases and especially dropsy of the chest, pleuritic and
pericardial exudates, and insists on the ease with which errors of
diagnosis may be made in these subjects. He failed completely to
recognize how much light had just been thrown on this subject by
Auenbrugger's work, and how much easier the differential {71}
diagnoses of these conditions were to be as the result of systematic
percussion.
Some of the commentaries on Auenbrugger's work are not entirely
depreciative, however. In Ludwig's _Commentaria de Rebus in Scientia
Naturali et Medicina Gestis_ for the year 1762, published at Leipzig,
there is an excellent notice of Auenbrugger's work within a year after
its appearance. It is not known who the reviewer was, but he calls
Auenbrugger's discovery "a torch that was designed to illumine the
darkness in which diseases of the thorax had up to this time lain
concealed." A brilliant future was prophesied for the new method of
examination. It is evident that the writer not only thoroughly
comprehended Auenbrugger's work, but had himself applied the
percussion method for purposes of diagnosis.
This is almost the only favorable and reasonably intelligent review of
Auenbrugger's work to be found in the medical journals of the time. In
the new Medical Library, issued by Rudolph Vogel, Professor of
Medicine in Goettingen, published in six volumes in 1766, there is a
short mention of Auenbrugger's book and his new discovery. This
reference is, however, an extremely curious affair. The good professor
completely failed to understand in what the new discovery really
consists. It is clear that he had never read Auenbrugger's book. He
seems to have heard of the subject from some medical friend, and to
have obtained an entirely wrong notion. He talks of Auenbrugger's new
diagnostic method as if it were an imitation of Hippocrates's
succussion method of recognizing the presence of fluid in the chest by
shaking the patient till the liquid gave the characteristic splash.
Other medical writers of the time perhaps, as the result of reading
Professor Vogel's book, made the same mistake {72} in their
appreciation of Auenbrugger's work. Vogel himself insisted that
Auenbrugger did wrong to claim any originality for his invention,
since it had been used so long before by Hippocrates. He adds that
what is original with Auenbrugger is of very little value, the older
ideas being the only ones worth while considering with regard to the
application of this so-called new method of diagnosis. Vogel was an
authority in medicine at the time and other commentators took the key
note from him in this matter, and in many parts of Germany it was
generally accepted that Auenbrugger's method of percussion was only an
elaborated method of the so-called succussion of Hippocrates.
Under these circumstances it is perhaps not surprising that
Auenbrugger's work attracted very little attention in the
German-speaking countries. In Vienna itself, as we have already said,
Van Swieten and De Haen failed utterly to recognize its value. Outside
of Vienna their example was naturally followed, for the Vienna school
was considered authoritative, and surely, if any one, the professors
of the University of Vienna might be expected to know whether
Auenbrugger's new discovery was really of any value or not.
It is interesting to compare Auenbrugger's state of mind, with regard
to the neglect of his discovery, with Laennec's remark in the preface
of his book. Laennec said: "For our generation is not inquisitive as
to what is being accomplished by its own sons. Claims of new
discoveries made by contemporaries are apt for the most part to be met
by smiles and mocking remarks. It is always easier to condemn than to
test by actual experience." Auenbrugger seems to have suffered from
more than the neglect of which Laennec complains. When he speaks of
envy and calumny in no uncertain terms, the only conclusion possible
is that his representations as to his discoveries must have been set
{73} down as pretensions that his contemporaries considered
unjustified by what they knew of his work.
It is interesting also to note that both men found their prospects of
reward, not in the good will of their contemporaries, nor even the
prospect of fame, but in the hope that their work would be useful in
lessening the sum of human suffering. Laennec said: "It suffices for
me if I can only feel sure that this method will commend itself to a
few worthy and learned men who will make it of use to many patients. I
shall consider it ample, yea more than sufficient reward for my labor,
if it should prove the means by which a single human being is snatched
from untimely death."
Laennec's words are almost an echo fifty years afterward of
Auenbrugger's expressions, just quoted: "I console myself," he said,
"with the thought that I have accomplished a work which will earn the
gratitude of all true devotees of the art of medicine, since I have
succeeded in making clear many things which shed not a little light on
the chapter of the obscure diseases of the chest, in which our
knowledge has hitherto been so very incomplete."
As a rule it may be said that medical observers whose genius leads
them to step across the narrow line that separates the known from the
unknown are likely to lack the appreciation of their own generation.
Long before Auenbrugger or Laennec, Harvey, the discoverer of the
circulation of the blood, said to friends that he did not expect any
one of his generation to accept the new doctrine, and it is well known
that the great medical men of the time did not accept it. Harvey is
not an isolated example, and even in our own time real medical
progress sometimes waits for years for recognition, while
well-advertised pretended advances are occupying the centre of the
stage. Auenbrugger's discovery made its impress, however, and was
never entirely lost to sight. Even {74} before his death there was the
consoling prospect of its meeting with adequate attention.
De Haen's successor in Vienna, Maximilian Stoll, treated Auenbrugger's
work very differently from his predecessors, and was the first to
introduce it practically into clinical medical training. Stoll did not
hesitate in his clinic, on the strength of what was discovered by
means of percussion, to attempt the evacuation of fluid from the
pleural cavity on a number of occasions. It can be easily understood
that with their lack of knowledge of the necessity for thorough
cleanliness in the surgical sense, such an operation might readily be
followed by discouragingly fatal results. This actually happened in
Stoll's own experience. He does not, however, seem to have abandoned
his practice of tapping the chest because of this. He insisted to his
students that Auenbrugger more than anyone else had experience in
removing fluid, and especially purulent collections, from the chest,
and he recommended the practice to them. He added that medicine owed
as much to Auenbrugger for his rational method of treating effusions
into the pleural cavity, whether of pus or serum, as for his
diagnostic sign by which the presence of the fluid could surely be
recognized.
Some of Stoll's pupils took up the work of commending Auenbrugger's
method, and a little book written by one of them, Eyerel, came into
the hands of the distinguished French physician, Corvisart. Eyerel did
not hesitate to say, in his treatise on empyema, that the practice of
percussion of the thorax, a diagnostic method introduced by the very
distinguished Vienna physician, Auenbrugger, had been of great help to
them in the study of this disease.
Once the great French professor of medicine, Corvisart, took it up,
the new method of diagnosis was destined to have an immediate and
world-wide vogue. Corvisart was not {75} only a power in medicine
because of his faculty of observation and his thorough appreciation of
the work of others, but he was the court physician of the first
Napoleon, and this gave any ideas that he favored many adventitious
chances for publicity. Napoleon's well-known faculty for selecting men
for special positions whose genius was calculated to be of service to
him was never less at fault than when he violated most of the court
medical traditions in Paris and chose Corvisart for the imperial
physician. Corvisart's selection was the result of Napoleon's
appreciation of his new method of diagnosis, namely, that of
percussion, in chest diseases.
The Emperor himself was suffering from a persistent cold and was told
that Corvisart, instead of following the traditional method of feeling
the pulse, looking very wisely at the tongue and then gazing learnedly
into space, conducted an actual examination of the chest and sounded
it carefully all over, in order to determine where abnormal conditions
might exist. This struck Napoleon as a very practical and possibly
valuable feature of diagnosis. Accordingly Corvisart was summoned to
give his professional opinion. After the consultation he was made the
Emperor's private physician. When Corvisart took up the subject of
percussion of the chest, it was practically unknown in Europe outside
of Vienna. Even in the city of its origin, as we have seen, it was not
well appreciated. Auenbrugger's little book had fallen into oblivion.
Corvisart obtained his hint as to the possible value of percussion
from Stoll's and Eyerel's appreciative remarks with regard to it. The
Frenchman used the method to some extent and, realizing its value,
resolved to call the attention of his countrymen and the medical world
to this very helpful aid in diagnosis. It was at this time that he
came upon Auenbrugger's original monograph. Instead then of writing
himself on the subject, he translated {76} Auenbrugger's little book
into French and made a commentary on it.
Corvisart was Laennec's patron in medicine, his favorite teacher, and
the man to whom the great French physician owed much of his early
inspiration. It is no little merit in Corvisart's career thus to have
been the connecting link between the men who did most for the
practical science of medicine, and especially for the important but
obscure chapter of diseases of the chest. He did not attempt at all to
claim for himself any of the merit that he felt should rightfully go
to Auenbrugger, and while his own observations and writings
established percussion upon a firm basis and extended its knowledge,
he shares the immortality of his discoverer, and comes down to us in
medical history as an example of the reward of having rendered
faithfully what was due, where it was due. It has been the custom to
praise Corvisart for his justice toward Auenbrugger. Mere justice
seems scarcely a worthy reason for praise of a great man, yet the
history of medicine is so full of failures on the part of subsequent
observers to acknowledge priority of discovery, that perhaps the
praise does not seem quite as futile as it otherwise would.
It is not surprising then that Corvisart's pupil Laennec should have
appreciated very thoroughly the value of Auenbrugger's discovery. In
the preface of his book on Mediate Auscultation, Laennec bewails the
fact that men are generally neglectful of discoveries made in their
own time, and fail to give them the attention they deserve. He
attributes this neglect rather to the well-known carelessness of men
than to any deliberate failure to recognize the merit of contemporary
work. He says:
"Lack of attention is an extremely common failing of all men. What
it takes years and hard labor to acquire, is not {77} infrequently
passed over without notice. Auenbrugger's method, published some
fifty years ago, though capable of being learned in a few days, and
without difficulty, and of being put into practice without the use
of any instruments, although snatched from oblivion by my
illustrious preceptor, Professor Corvisart, and made clearer than it
had been left even by the author himself, is not as yet in ordinary
use among physicians. Even the wonderful invention of the
illustrious Jenner, though received with so much praise, and with
regard to whose efficaciousness numberless confirmatory observations
have been made, is already somewhat less prominent in the minds of
men than it should be, or at least it would be, only for the fact
that the governments of many countries, provinces and cities, the
foresight of the clergy, of the authorities of all kinds, and the
advice of the best physicians have exerted all their influence to
keep it at public expense constantly in practice."
After about ten years of service at the Spanish military hospital,
Auenbrugger resigned his position there and took up private practice.
In this he was eminently successful, being, as might be expected,
especially in demand for cases involving affections of the thorax. His
practice appears to have been to a great extent among the better class
of people, but he seems never to have neglected the poorer patients
whom he had come to know during his hospital experience. There are
traditions in Vienna of his unfailing willingness to assist the poor
and even to put himself to considerable inconvenience in order to be
of service to them.
Tradition tells that he was very conscientious in the pursuit of his
vocation as a physician, and among the family relics there is
preserved a small lantern which he kept always by his bedside, to
light him on his visits to the sick when called out at night. It must
not be forgotten that city streets {78} were not regularly lighted at
the end of the eighteenth century, and night calls even in city work
must have been a source of great annoyance and discomfort. There is a
family tradition, too, that the night bell at his house was connected
directly with Auenbrugger's room, so that the others of the household
might not be disturbed when night callers came for him. Every
tradition points to him as a man among men in his unselfish readiness
to save others trouble, and do all the good in his power.
Auenbrugger was, according to well-grounded traditions, especially
admirable in his relations toward other members of the medical
profession. This may not seem a very significant sign of amiability to
those outside the profession, but it is well recognized that even
great physicians have not always been known to get on well with
brother practitioners. Auenbrugger has, besides, the pleasant
reputation of having been of great material assistance to a number of
needy medical students during the time of their university careers,
and to have frequently lent a helping hand to young practitioners in
the city, who probably found it quite as discouraging, beginning
practice in those days, as any of their young confreres of this
generation find it at the present time.
To physicians and medical students when ill, Auenbrugger was almost
unceasing in attention. Two or three physicians of the generation
immediately after his attributed to his unselfish care and devotion to
them their recovery from what would otherwise have been mortal
illnesses. In this way Auenbrugger seems to have been a man whom
everyone who came to know him, even slightly, learned to love and
respect. His relations to his family and relatives were always of the
most happy, kind character, and family traditions show that his
fatherly care was befittingly returned to him in his old age. The
number of his friends was very great, {79} and he counted among them
some of the most distinguished inhabitants of the Austrian capital.
Notwithstanding his devotion to his practice, Auenbrugger did not
cease to make observations that occasionally he considered worthy of
being committed to paper. He was especially careful in the study of
his cases, and left fully written records of over 400 important cases
that he had studied very faithfully. His attention seems to have been
attracted particularly to certain mental diseases. This work was done
half a century before even the first beginnings of the modern
classifications of mental diseases were attempted. He wrote a short
article with regard to mania and its treatment, and a longer article
on melancholia. How well he recognized the essential feature of this
latter affection and the main symptom that must be guarded against,
can be gathered very well from the title of his paper, which he called
"The Still Madness, or the Impulse to Self-Murder."
It is about the time that he was engaged in the study of melancholia,
perhaps as a contrast to sadder things, that he wrote a comic opera,
of which we shall have more to say presently. His description of the
conditions that he saw during an epidemic of dysentery that occurred
in Vienna show how exact and careful a clinical observer he could be,
and that the demands of his practice did not absorb all his attention
to the detriment of his faculty for observation. He seems himself to
have suffered from a severe attack of typhus fever which raged
epidemically in Vienna in 1798.
Auenbrugger had a wide circle of interests beyond the subject of
medicine. There is a family tradition that he had a magnificent
library. He seems with true Viennese spirit to have been a great
devotee of the opera, and to have had an especial liking for music. He
wrote the text, {80} score, and libretto of a comic opera with the
title, "The Chimney Sweep." This operetta evidently enjoyed more than
a _succes d'estime_, and further writing in this line was confidently
expected from him by his friends. There is even a story to the effect
that the Empress Maria Theresa, of whom he was an intimate friend, and
who made use, it is said, of his counsel in political matters more
than once, asked him why he did not follow up his first success in
operatic writing. His blunt reply shows how intimate must have been
his relations with the great empress. He said he had things much
better with which to occupy himself than the writing of comic operas.
Seeing that he was so favored at court, it is not surprising to find
the family tradition that Auenbrugger was associated with many of the
most prominent persons in the Austrian capital during his lifetime. He
was a special friend of and spent a great deal of time with the famous
philosopher, Werner. As he grew older he delighted especially in
music, and spent many hours at the house of Baron Zois, where many of
the distinguished European musicians were to be found and where famous
matinee concerts were given every Sunday from twelve to two. The day
and the time may seem strange to foreigners, but Vienna still has
concerts at this time on Sunday, and after the Viennese have gone to
Mass in the morning they think that they could not occupy themselves
better than with listening to good music in the middle of the day.
Toward the end of his life, Auenbrugger lived during the summer time
in the suburb of Rossau and cultivated a little garden, taking the
greatest pleasure in spending his time at this simple occupation. It
is a source of satisfaction to find that though Auenbrugger's medical
work failed during his life to attract the attention it deserved, he
had his reward, {81} for his patient investigations in earlier life,
in a peaceful and contented ending to a career that had been so worthy
of what was best in the man. He lived to celebrate his golden wedding
in 1804 and was especially happy in the almost constant companionship
of the good wife who had proved so faithful a helpmate during her long
life. After her death, which took place the year following the
celebration of their jubilee, his vitality and his contentment with
life seemed to abandon him. He was a changed man and kept himself for
the most part to his room. He went to bed very early and did not care
to see anyone but his near relatives. His last illness was the result
of a cold, and his advanced age, eighty-seven, left him little
resistive vitality. He retained his consciousness until the very end,
and said the day before his death that the next day would be his last.
Shortly before noon of the day of his death he looked at the clock in
his room and said that when the hands would point to two o'clock he
would be no more. His prophecy came true.
Vienna has never had the reputation of honoring its great geniuses
during their lifetime, unless they happened to belong to the higher
nobility. The exclusiveness of court society at the capital made
itself felt in all circles, and the consequence was that genius sprung
from the lower orders was almost sure not to receive its due share of
attention. The comparative neglect of Auenbrugger does not seem so bad
when we recall the case of Mozart. Music has always been one of the
special fads of the Austrian and the Viennese pride themselves on
their appreciation of it. Mozart, however, perhaps the greatest
musical genius that ever lived, received some attention during his
life, but passed away almost unnoticed at the early age of
thirty-five, was buried in a common trench with the poor people of the
city, and now Vienna cannot {82} find his resting place. There is a
magnificent monument to him, but his bones lie with his own people
forever.
Outside the circle of his personal friends Auenbrugger did not receive
much attention, so that even the year of his death was until recently
more or less uncertain and the resting place of his remains continues
to be unknown. The present generation of medical men has done more to
afford the due meed of praise to Auenbrugger than any preceding
generation. The interest in tuberculosis particularly has led medical
men to appreciate all the significance of Auenbrugger's work, and the
practical importance of his discovery for the early recognition and
consequently for the cure of the disease. The appreciation of
Auenbrugger in our time has been so flattering as quite to make up for
previous neglect. His name has been linked with that of Laennec as the
great discoverers of physical diagnosis in chest diseases.
At the opening of his address as President of the American
Climatological Association, some five years ago, Dr. Edward O. Otis,
of Boston, said:
"It is quite improbable, I think, that we should be here to-day, or,
indeed, have an existence as a society largely devoted to the
consideration of diseases of the chest, were it not for the methods
of thoracic examination which Auenbrugger and Laennec have given us
in their discoveries of percussion and auscultation. Without these
two precious methods of investigation we could scarcely have arrived
at any degree of precision or certainty in thoracic pathology and
might have been not unlike the old physicians and surgeons, 'who
would swear,' as Morgagni says, 'that there was fluid in the chest
when in reality there was not a single drachm, or perform
paracentesis of the thorax upon a duke for an empyema which did not
exist.'"
His tribute is only an echo of many others not less {83} appreciative
of Auenbrugger's important original work than have been expressed by
modern medical men of all nations. The simple old German practitioner,
who had the annoyance of seeing his discovery neglected by his
contemporaries for so many years, has at last come into his own. There
is scarcely an important medical meeting held anywhere in the world in
which diseases of the chest are discussed without a mention of
Auenbrugger's name. This is not surprising in Germany, but is quite as
true of France, and England, and America. As Dr. Otis said, in closing
the address from which we have just quoted:
"Although we possess but meagre and fragmentary records of
Auenbrugger's life, there is yet enough to enable us to fill in the
lines and gain a distinct idea of his personality and character.
With some persons one does not need to be acquainted with much of
the detail of their lives in order to know what manner of men they
are; a few characteristic illustrations here and there in their
career redeem the spirit and motives of their lives, and show the
kind of men just as they are, quite as well and clearly as an
extended and continuous biographical narrative. Always
enthusiastically devoted to the study of disease, Auenbrugger
escaped the not infrequent misfortune of the student, a loss of
sympathy with one's kind. His love for his fellow-men, for suffering
humanity, for struggling students in his own profession, kept pace
with his love for medical study. He never sacrificed the man for the
scientist, nor did he lose his interest for other things in life, as
happens sometimes with men intensely devoted to one pursuit. A man
of original powers, as some one has truly remarked, can never be
confined within the limits of a single field of activity.
"He was interested in music, philosophy and the drama, and well
illustrates what Dr. Da Costa has so happily styled {84} 'the
scholar in medicine.' With dignity, sympathy, enthusiasm in his
profession, even to the last; ever seeking to improve and add to his
art; modest, like most great men; never refusing to give what is
best to suffering humanity, he richly lived out his long life. As we
teach our students percussion, as a matter of just recognition and
due honor let us tell them something of the life of the discoverer,
and at least his name, which I fear but few, who avail themselves of
the result of his long and arduous labors, know."
Auenbrugger's German biographer, Professor Clar, of Gratz, says of his
early life that from his parents he received an excellent early
training, especially edifying because of the exemplary Christian
family life he saw about him, the piety of his father and mother, and
of the other members of the family. The baptismal register of the
parish church at Gratz is one of the important documents in his life
history, for there is some dispute as to the exact date of his birth,
as there is also with regard to his death. In 1798 he suffered from a
severe attack of typhus fever, which at the time was epidemic in
Vienna, and some of his biographers report his death in this year as a
consequence of it. His descendants, however, have shown, by the burial
register of the parish church in Vienna, that his death did not take
place until May 17, 1807; from this church, of which he had been for
half a century a faithful member, he was buried.
Few of the lives of the great discoverers in medicine have in them
more of encouragement for the busy practitioner of medicine than that
of Auenbrugger. He began his medical career by a series of practical
observations that stamped him for all time as one of the great
geniuses. When his discoveries failed to meet with the acceptance they
deserved, he was not disturbed, and, above all, he did not insist on
acrid controversy. He took up the practice of medicine and {85}
demonstrated how much his discovery could help in the diagnosis of the
obscure chapter of the diseases of the chest. In the mean time he went
on his way placidly doing the good that he found to do, taking care of
his poor patients and faithfully tending brother-physicians who
happened to be ill. He found an avocation to fill the moments spent
apart from his vocation, and added to the pleasure of humanity by his
work in music. All the time he remained a simple, faithful believer in
the relation of Providence to man, and considered that somehow the
inexplicable things of this life would find an explanation in the
hereafter. He was probably the best-liked member of the profession in
Vienna during his lifetime, and the profession of his native town are
very proud to recall the example that he sets physicians generally in
all the ethical qualities that make a physician's life not only
successful in the material sense, but also in inspiration for those
around him to do their duty rather than seek the fulfilment of merely
selfish aims.
{86}
{87}
EDWARD JENNER, THE DISCOVERER OF VACCINATION
{88}
"It helps a man immensely to be a bit of a hero worshipper, and the
stories of the lives of the masters of medicine do much to stimulate
our ambition and rouse our sympathies. If the life and work of such
men as Bichat and Laennec will not stir the blood of a young man and
make him feel proud of France and of Frenchmen, he must be a dull
and muddy-mettled rascal. In reading the life of Hunter, of Jenner,
who thinks of the nationality which is merged and lost in our
interest in the man and in his work! In the halcyon days of the
Renaissance there was no nationalism in medicine, but a fine
catholic spirit made great leaders like Vesalius, Eustachius,
Stenson and others at home in every country in Europe."
--Osler, _Aequanimitas and other Essays_.
{89}
EDWARD JENNER, THE DISCOVERER OF VACCINATION.
A very striking life in its lessons for the serious student of medical
problems is that of Edward Jenner, who first demonstrated to the world
that a simple attack of mild, never fatal, cowpox, deliberately
acquired, might serve as a protective agent against the deadly
smallpox, which before that time raged so violently all over the
civilized world. His successful solution of this problem has probably
saved more lives and suffering than any other single accomplishment in
the whole history of medicine. While this fact is apparently not
generally appreciated, Jenner's discovery did not come by mere chance,
but was the result of his genius for original investigation, which led
him to make many other valuable observations covering nearly the whole
range of medicine; nor indeed was his activity limited to medicine
alone, but extended itself to many of the allied sciences, and even to
scientific departments quite beyond the domain of medicine.
In medicine we owe to Jenner the first hint of the possible connection
between rheumatism and heart disease. He pointed out, at a discussion
in a little English medical society, how often affections of the heart
occurred in those who had suffered from previous attacks of
rheumatism. He was among the first, perhaps the very first, to hint at
the pathological basis of angina pectoris. While Heberden's name is
usually connected with this discovery, there seems good reason to
think that already Jenner had independently noted and called attention
to the frequency with which {90} degenerative affections of the
arteries within the heart muscle itself were to be found where during
life heart-pang had been a prominent and annoying symptom.
Besides these important advances in medicine made by him, and his
great discovery of the identity of cowpox and smallpox, Dr. Jenner was
an interesting observer of phenomena in all the biological sciences,
and in geology and palaeontology. He was a great friend of Dr. John
Hunter, who frequently suggested to him the making of such experiments
and observations as were more likely to succeed in the country than in
the city, and one cannot help but be struck with the determination
evinced all his life to take nothing on authority, but to test
everything by actual observation, and above all not to theorize where
he did not have the actual data necessary for assured conclusions; and
even where he thought he had them, his wonderful faculty for waiting
until they had properly matured, and their true significance had
become evident, stamped him for all time as a model for scientific
investigators.
Undoubtedly Jenner's greatest work was that of determining the value
of vaccination. His patient investigation of this subject, the
thorough conservatism with which he guarded himself from publishing
his conclusions until he had tested them in every way, the absence of
that haste to rush into print so characteristic of most present-day
medical investigators, and which is the cause of so much
disappointment in modern medicine, all distinguished this country
physician as one of the greatest investigating geniuses that medicine
has produced. His life is a mirror for the medical student and the
investigating practitioner of medicine. His discovery was so complete
when he finally announced it that but very little has been added to it
since. His invention came from his mind as Minerva from the brain {91}
of Jove fully armed for the conflict that was sure to come. In this
Jenner resembled very much Laennec and the other investigating
geniuses in medicine. As a matter of fact only one improvement has
been made in the preparation of vaccine material since Jenner's time,
and that is the incorporation of glycerin in very recent years, which
gradually destroys any micro-organisms that may be present, leaving
the vaccine virus itself unimpaired in its efficacy, though without
the possibility of inflicting those secondary infections which for so
long cast a shadow on vaccination.
Dr. Edward Jenner was the third son of an Anglican clergyman, his
mother being the daughter of a clergyman who had been at one time
prebend in the cathedral of Bristol. The family held considerable
property in Gloucestershire. He received his early education at
Wotton-under-Edge and later at Cirencester, the old Roman town in
Gloucestershire. While he acquired a good working knowledge of the
classics, from his earliest years he was interested in natural
history. Before he was nine he made a collection of the nests of the
dormouse. The hours that other boys spent at play he devoted to
searching for fossils or other interesting natural curiosities.
After his preliminary education had been finished he was apprenticed
to Mr. Ludlow, an eminent surgeon at Bristol, and after two years here
he went to London, where he had the privilege of residing as a
favorite pupil in the family of John Hunter for two years. At this
time Jenner was in his twenty-first year, John Hunter in his
forty-second. Hunter was not then a public lecturer, but he had been
for two years surgeon to St. George's Hospital, and for nearly five
years had been engaged in studying the habits and structure of animals
in a menagerie and laboratory which he had established at Brompton.
The inspiration of Hunter's original {92} genius meant much for young
Jenner. He learned not only to respect the teacher but to love the
man. In Hunter's unquenchable desire for knowledge and love of truth
there was something very congenial to the spirit of Jenner, who was
himself, above all things, an inquirer.
After completing his two years of work with Hunter he still remained
intimately associated with him by letter. Though later in life
Jenner's correspondence became very voluminous, these letters from
Hunter were always very carefully preserved in a special cover, and
they serve to show how stimulating to the young man must have been
Hunter's virile enthusiasm for truth as it could be deduced by
observation and experiment.
It was to Hunter that Jenner once wrote that he had heard it said in
Gloucestershire that the dairy workers who suffered from a certain
disease caught from the udders of cows and called cowpox were
protected thereafter from attacks of smallpox. He added that this
tradition interested him very much and that he intended to think about
it. "Don't think," wrote Hunter to him, in return; "make observations,
investigate for yourself the truth of the tradition." Jenner did so,
and the result is now known to all.
These letters from Hunter contained many other interesting
suggestions. For instance, it was under Hunter's direction that Jenner
succeeded in finding out that in hibernating animals the temperature
is very much reduced and the respirations are very slow, while the
rate and force of the pulse are often so much diminished as to be
scarcely more than noticeable at the extremities. Between Hunter and
Jenner it had already been discovered that the sap in trees will not
freeze at temperatures much lower than that at which the same fluid
freezes when withdrawn from the tree, and the same thing seemed to be
true with regard to {93} the blood of hibernating animals. He learned
that notwithstanding the low temperature to which it is reduced the
animals are not affected particularly by the cold, though their store
of fat is consumed and they awake very hungry in the spring-time.
Besides hibernation Jenner also investigated the habits of the cuckoo,
that crux of the biologist which insists on foisting its eggs upon
other birds and allowing its orphan young to be brought up in alien
nests, while the real young of the deceived foster-parents are often
pushed out of their nests by this burly intruder which grows so fast
and strong. It is needless to say, this subject interested John Hunter
very much and there are a number of letters which passed between them
on the subject.
It must not be supposed, however, that young Jenner was entirely
occupied with his scientific work to the exclusion of social life and
recreation. He was one of the best-known men of the county, and was
looked upon as a genial companion from whom might be expected on
almost any occasion pleasant jests and epigrams, not too biting, with
regard to friends and acquaintances. Some of these have been preserved
and we quote several of them as indicative of his special vein of
humor.
ON THE DEATH OF A MISER.
"Tom at last has laid by his old niggardly forms,
And now gives good dinners; to whom pray?--the worms."
ON LORD BERKELEY'S HUNTSMAN, WHO DIED IN THE CHASE.
"Determined much higher to hoist up his name,
Than Nimrod the hunter, in annals of fame,
'Hark forward!' cried Charles, and gallantly whirled
His high-mettled steed o'er the gates of the world."
{94}
DEATH AND MR. PEACH.
A Short Dialogue. N. B.--Mr. P. died in April.
"P.--Awhile forbear thy horrid gripe,
Do pray, dread Sir! remember
Peaches are never fairly ripe
'Till August or September."
"D.--To gratify my longing taste,
And make thy flavour fine,
I had thee in a hot-house placed,
And moistened well with wine."
"Mr. Peach had shortened his life by the too free use of the bottle."
We have said that Dr. Jenner's supreme accomplishment in science was
the working out of the vaccination problem to a great humane
conclusion. His discovery was no mere accident, nor chance
confirmation of a medical tradition. He devoted himself for many years
to the study of cowpox, as he had the opportunity to see it, and it is
what we know of this investigation, his patience and care in
eliminating all the factors of error, that stamped Jenner as a medical
scientist worthy of honor. When he began practice in Berkeley, he made
many inquiries among his professional brethren, with regard to their
opinion of the protecting power of cowpox, but most of them had either
paid no attention to such reports, or shook their heads at once, and
said they were at most popular traditions, due merely to coincidences
and unsupported by any credible evidence. In the face of this, Jenner
began to follow John Hunter's advice to investigate. The first careful
investigation dates from about 1775, and it took him more than five
years to clear away the difficulties surrounding the solution of the
question, in which he was interested.
As Pasteur found in the next century, when investigating the silkworm
disease, Jenner soon learned that there was {95} more than one disease
called cowpox, and that the confusion consequent upon the existence of
at least two specific diseases and a number of skin affections of the
hands of various kinds, which existed among dairy workers, made the
recognition of the protective power of true cowpox extremely
difficult. After he had differentiated genuine cowpox, however, there
was no difficulty in tracing its apparent protective power. He soon
found, however, that the protection was not afforded unless the cowpox
had been communicated at a particular stage of the disease. In other
words, after the true vaccinia has run its course, secondary
affections of the skin of the cows usually take place, and if dairy
workers became infected from these lesions, then no protection against
smallpox is afforded them. Another important observation that Jenner
made at this time was that the disease known as grease in horses is
the same affection as cowpox, and that both of these diseases are
smallpox as modified by the organism in which they develop. It may be
said at once that this opinion so difficult to arrive at, more than a
century ago, when so little was known of comparative pathology, is
held at the present day, and was confirmed by the last series of
investigations made under the auspices of the Jenner Society, in
England.
One difficulty that confronted Jenner in his researches was the fact
that cowpox was scarce in his part of the country, and he had no
opportunity of making inoculations with the disease in a proper stage,
so as to put his suspicions to an absolute test. He collected much
information, however, and stimulated others to the making of
observations, so that when his discovery was announced the mind of the
medical profession was more ready to receive it. In 1788 he carried a
carefully made drawing of a case of cowpox as it occurred on the hands
of a Gloucester milkmaid to London, and {96} showed it to a number of
medical men, whose opinions he wished to obtain. Among these was Sir
Edward Holme, who agreed that there was a distinct similarity between
it and certain stages of smallpox and considered that the question of
a connection between the two diseases was an interesting and curious
subject. He did not share any of Jenner's views, however, with regard
to the practical importance of his discovery in this matter, and gave
little encouragement to the idea that a possible prophylactic for
smallpox might be discovered.
Something of Jenner's enthusiasm for experiment may be gathered from
the fact that he did not hesitate even to inject various materials
related to cowpox into the arm of his own children. We know Mrs.
Jenner to have been a very wonderful woman, quite as deeply interested
as the doctor himself in securing the great benefit to humanity that
would result from the demonstration that cowpox protected against
smallpox, but it is a little bit difficult for us in these days to
understand how her mother-heart could have permitted some of the
experiments which Dr. Jenner's biographer, Dr. Baron, describes.
[Footnote 1]
[Footnote 1: The life of Edward Jenner, M.D., F.R.S., Physician
Extraordinary to His Majesty Geo. IV, Foreign Associate of the
National Institute of France, &c. &c. &c. With illustrations of his
doctrines, and selections from his Correspondence by John Baron,
M.D., F.R.S., Late Senior Physician to the General Infirmary,
Consulting Physician to the Lunatic Asylum at Gloucester, and Fellow
of the Royal Medical and Chirurgical Society of London. In two
Volumes. London: Henry Colburn, 1838.]
The subject is indeed so surprising that I prefer to quote
the passage with regard to these experiments directly from
Dr. Baron:
"In November, 1789, he inoculated his eldest son Edward, who was
then about one year and a half old, with swine-pox matter. The
progress of the disease seemed similar to that which arises from the
insertion of true smallpox matter when {97} the disease is very
slight. He sickened on the eighth day: a few pustules appeared; they
were late and slow in their progress, and small. Variolous matter
(this would mean material from a smallpox patient calculated to give
that disease) was carefully inserted into his arms at five or six
different periods, subsequently without the slightest inflammation
being excited in the part.
"On Thursday, April 7th, 1791, variolous matter was again inserted
by two small incisions through the cutis, [beneath the skin]. Then
the following notes of observed conditions day after day are made:
9th, Evidently inflamed. 10th, An efflorescence of the size of a
shilling spread round the inferior wound. 11th, The incision assumed
a kind of erysipelatous elevation: the efflorescence much increased.
12th, These appearances much advanced. 13th, A vesicle, containing a
brownish fluid, and transparent, about the size of a large split-pea
on the superior incision, the inferior about twice as big; the
surrounding parts affected with erysipelas. The erysipelas extended
to the shoulder, and then pretty quickly went off. The child showed
no signs of indisposition the whole time."
"March, 1792. E. Jenner was again inoculated: the matter was taken
from a child that caught the disease in the natural way, and had it
pretty full. It was inserted fresh from the pustule. The same
evening an inflammation appeared round the incision, which, at the
end of twenty hours, increased to the diameter of a sixpence, and
some fluid had already been collected on the lips of the scratch,
which the child had rubbed off."
It was not for five years after this time, however, that Jenner was
able to make his crucial experiments in the matter. On the 14th of
May, 1796 (the date is still recalled as Vaccination Day in Germany,
especially in Berlin), vaccine {98} matter was taken from the hand of
a dairy maid, Sarah Nelmes, and inserted by two superficial incisions
in the arms of James Phipps, a healthy boy of about eight years of
age. The boy went through an attack of cowpox in a regularly
satisfactory manner. After this, however, it was necessary to
determine whether he was protected from smallpox. After waiting two
months Jenner inoculated him with variolous material. The result of
this experiment can best be learned from the following letter written
to his friend Gardner:
"Dear Gardner:
"As I promised to let you know how I proceeded in my inquiry into
the nature of that singular disease the Cow Pox, and being fully
satisfied how much you feel interested in its success, you will be
gratified in hearing that I have at length accomplished what I have
been so long waiting for, the passing of the Vaccine Virus from one
human being to another by the ordinary mode of inoculation.
"A boy of the name of Phipps was inoculated in the arm from a
pustule on the hand of a young woman who was infected by her
master's cows. Having never seen the disease but in its casual way
before; that is, when communicated from the cow to the hand of the
milker, I was astonished at the close resemblance of the pustules,
in some of their stages, to the variolous pustules. But now listen
to the most delightful part of my story. The boy has since been
inoculated for the smallpox which, as I ventured to predict,
produced no effect. I shall now pursue my experiments with redoubled
ardour.
"Believe me yours, very sincerely,
"Edward Jenner.
"Berkeley, July 19, 1796."
{99}
Notwithstanding the complete success of this experiment, Jenner did
not rush into print with it. Two years later, at the end of June,
1798, his "Inquiry into the Causes and Effects of the Variolae
Vaccinae" was published. In the mean time Jenner had succeeded in
demonstrating the protective quality against smallpox of vaccination,
contracted either casually or by direct inoculation, in some
twenty-three cases. Sixteen of these had occurred accidentally in the
course of occupations connected with cows and horses; the rest were
done under Jenner's directions. Among the persons inoculated was
Jenner's own little second son, Robert Fitts Harding Jenner, an infant
eleven months old. Jenner demonstrated conclusively that the cowpox
protects the human constitution from the infection of smallpox.
After Dr. Jenner had made his tests he prepared a pamphlet for
publication. Before publishing, however, he thought it better to make
a visit to London, so that he might have the opportunity to introduce
the subject personally to friends, and demonstrate the truth of his
assertion to them. He remained in London for nearly three months
without being able to find any one who would submit to vaccination.
The medical profession generally took very little interest in the
subject and seemed to consider him sadly visionary. Under the
circumstances it is not surprising that Jenner went back to
Gloucestershire, and his country practice, rather disappointed. It
happened, however, that soon after his return home, a distinguished
London surgeon named Cline resolved to make a trial of the vaccine
material which Jenner had left with his friends. The surgeon's purpose
in using it, however, was not altogether to test its efficacy as a
prophylactic against smallpox, but with the notion that the
counterirritation thus obtained might be useful in a case which he had
under treatment. Those {100} were the days when the seton and the
issue were still in common use, and counterirritation was considered
one of the most important remedial measures at the command of the
surgeon.
The patient was a child suffering from a form of chronic hip-joint
disease that at this distance of time, and with rather incomplete
descriptions, seems to have been the ordinary tuberculosis of the hip.
The vaccine material was inoculated over the joint and, surprising
though it may appear now, the vaccine vesicle ran rather a normal
course and healed kindly. The little patient was afterward inoculated
with smallpox and found to be incapable of acquiring that disease.
This case attracted considerable attention. It is not, however, a
matter for congratulation as regards the openness of mind of the
medical men of the period to find that this was the only sort of a
case that was considered suitable for such an experiment. It is very
easy to understand that in a child in a run-down condition the vaccine
material might very well have provoked a rather serious local
reaction. In a way, the fate of vaccination hung in the balance and
good luck was in its favor. Mr. Cline, however, after this, became a
strong advocate of vaccination, and brought it very decidedly before
the London physicians. There was still a feeling of opposition, as
indeed there always is against any novelty in medicine, but this
gradually disappeared, to give place to a suspension of judgment,
until more accurate and detailed information could be obtained from
further observations and tests.
It was not long before the opposition to the practice of vaccination
took definite form. One of the best-known London physicians of the
time, Dr. Ingenhouz, became the leader of a strong faction of the
medical profession of London, who not only would have nothing to do
with vaccination, {101} but proclaimed openly that it was a dangerous
innovation, absolutely unjustifiable, and communicated a disease
without protecting against any other. On the other hand, there were
overzealous advocates of vaccination, who insisted on its value but
did not know how to recognize the true cowpox from other lesions
sometimes confounded with it, nor the exact stage of the disease in
which the vaccine material obtained would prove effectively
protective. A number of these used vaccine material so contaminated by
secondary infections of one kind or another that no wonder serious
sores were reported as a result.
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 {102} 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 {103} 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 {104} 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 {105} 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 {106} 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. {107} 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.
{108} 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.
{109}
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 {110} 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 {111} 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.
{112}
{113}
GALVANI, FOUNDER OF ANIMAL ELECTRICITY
{114}
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.
{115}
GALVANI, FOUNDER OF ANIMAL ELECTRICITY.
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 {116} 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; Hauey, 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 {117} 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.
{118}
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 {119} 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 {120}
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 {121} glad to attribute his discovery, or at
least the suggestive hint that led up to it, to his wife.
After these first discoveries on the influence of artificial
electricity, nothing seemed more interesting than to investigate
whether ordinary atmospheric electricity as manifested in lightning
would produce the same effects on muscular movements. In this matter
Galvani showed much courage as an inventive genius. He dared to place
an atmospheric conductor on the highest point of his house and to this
conductor he attached a wire, which ran down to his laboratory. During
a storm he suspended on this metallic circuit by means of their
sciatic nerves frogs' legs and the legs of other animals prepared for
the purpose. To the feet of the animals he attached another wire
sufficiently long to reach down to the bottom of a well, thus
completing a current to the ground.
All the phenomena took place exactly as if with artificial
electricity. Whenever lightning flashed from the clouds the limbs of
the animals experimented with underwent violent contractions, which
were noticeable before the noise of the thunder, and were, so to say,
the signal for it. These contractions took place, although there were
no conductors from the muscles, and although the nerve conductors were
not isolated. The muscular contractions were greater in proportion
than the intensity of the lightning and the proximity of the storm.
The phenomena were manifest whether the animal was in the open air or
if, for greater convenience, it was enclosed in a room, or even in a
vessel. The muscular contractions could even be noticed despite the
fact that the nerves were separated somewhat from their conductor,
especially whenever the lightning was violent. The sparks would leap
over a small gap almost as in the case of artificial electricity, the
muscular contraction of the animal {122} being proportioned to the
energy and the nearness of the sparks.
It is almost needless to say, these experiments upon the frog were not
accomplished in a few days or a few weeks. Galvani had his duties as
Professor of Anatomy to attend to, besides the obligations imposed
upon him as a busy practitioner of medicine and surgery. At that time
it was not nearly so much the custom as it is at present, to use frogs
for experiments, with the idea that conclusions might be obtained of
value for the biological sciences generally, and especially for
medicine. There has always been an undercurrent of feeling that such
experiments are more or less a beating of the air. Galvani found
opposition not only to his views with regard to animal electricity as
enunciated after experimental demonstration, but also met with no
little ridicule because of the supposed waste of time at occupations
that could not be expected to lead to any practical results. It was
the custom among scientific men to laugh somewhat scornfully at his
patient persistence in studying out every detail of electrical action
on the frog, and one of the supposedly prominent scientists of the
time even dubbed him the frog dancing master. This did not, however,
deter Galvani from his work, though some of the bitter things must
have proved cutting enough, and might have discouraged a smaller man,
less confident of the scientific value of the work that he was doing.
There were even phases of physical science quite apart from physiology
or animal electricity, which he was able to illustrate by his
experiments. He called special attention, for instance, to the fact
that the lightning does not excite a single contraction of the muscle
as is the case with a spark of artificial electricity, but that there
are a series of muscular contractions succeeding one another rapidly
in diminishing {123} energy and somewhat corresponding to the
reiterated reports of thunder. This was Galvani's expression for the
dying away of the electrical influence upon the muscle. He had thus
evidently reached a hint of the pendulum-like swing with which
electrical equilibrium is restored after its violent disturbance
immediately following the lightning stroke. He noted, moreover, that
for the production of muscular contractions the absolute appearance of
lightning was not indispensable. Muscular twitchings were noted
whenever the heavens were overclouded by a storm, or whenever clouds
charged with electricity were passed above the conductor.
These experiments were made upon living frogs, as well as upon the
separated legs, and in both cases the results obtained were very
similar to those observed on the employment of some form of artificial
electricity. In some of these observations, Galvani was anticipating
ideas that became current truth in electrical science only many years
after his time. In his observations upon the effects of lightning, he
was forestalling Franklin's works to a certain extent. Both of these
great scientists, however, had been anticipated by a clergyman in
Austria; whose work attracted very little attention, however, because
he was not in touch with the scientific bodies of the day. The
demonstration of the identity of ordinary terrestrial artificial
electricity and the lightning was in the air, as it were, and many
workers, as is usually the case with any great discovery, came very
close to it, and deserve at least a portion of the credit for it.
It is almost needless to say, many of these experiments with lightning
thus conducted by Galvani were not without an element of serious
personal danger. Not long after this time a Russian savant, Richman by
name, while repeating Franklin's experiments with the kite, was struck
dead by the charge received from his apparatus. Galvani, however,
{124} devoted himself only in passing to the physical problems
involved, and kept always in view the physiological aspects of the
problem of animal electricity; and, accordingly, made a series of most
interesting observations on the ray fish or torpedo, as it is
sometimes called, the fish which gives electrical shocks. His idea was
to demonstrate that the shocks felt when this animal is touched are
really due to sparks of electricity similar to those which can be
obtained by artificial means. This had never been determined, and
Galvani succeeded in showing the presence of sparks exactly as if the
animal were one of the apparatuses by which the sparks of frictional
electricity are developed. At this time this seemed surprising enough.
Galvani also endeavored to demonstrate that the electricity in the
electric torpedo differed only in degree, but not in quality, from
certain electric manifestations that he had noted in the bodies of
other animals, especially the frog. His idea always was to show the
existence of a natural animal electricity, by means of which some of
the complex mechanism of life was accomplished. He seems to have had
some notion of the theory that has been suggested often enough since,
and is not yet entirely disproved, that there is some very close
relationship between nerve impulses and the electric current. In this,
of course, he was far ahead of his time, and utterly unable to make
absolute demonstration, because of the lack of proper apparatus.
The most interesting quality of Galvani's scientific career is the
thoroughly experimental character of all his researches into natural
phenomena. Few men have known so well how to vary their experiments so
as to bring out new details of scientific knowledge. His experimental
skill was of the highest order, and it is to this that we owe the
development in his hands of the nascent science of electricity to a
point {125} where it became easy to continue its natural evolution.
Galvani's work furnished the necessary stimulus to Volta, and then the
real foundation of modern electricity was laid.
Almost more interesting than Galvani the scientist, however, is
Galvani the man. As one of his biographers said of him, he joined to
the most eminent intellectual genius a group of very precious
qualities of the heart. Utterly unselfish in his relationship to
others, he was known to be extremely sympathetic and had a large
number of friends. His friends, too, he bound to him by even more than
the proverbial hoops of steel, so that when they passed out of life
they left him unconsolable. While it was very hard to get him to take
part in social functions at which numbers of people were gathered, he
was by no means a recluse, and liked to be in the company of a few
friends. He seemed to care very little for the renown that his
discoveries gave him, and refused, as far as possible, to be made the
object of public congratulations and testimonials.
His relations with his patients--for during all of his long career he
continued to practise, especially surgery and obstetrics--were of the
friendliest character. While his distinction as a professor at the
university gave him many opportunities for practice among the rich, he
was always ready and willing to help the poor, and, indeed, seemed to
feel more at home among poor patients than in the society of the
wealthy and noble. Even towards the end of his life, when the loss of
many friends, and especially his wife, made him retire within himself
much more than before, he continued to exercise his professional skill
for the benefit of the poor, though he often refused to take cases
that might have proved sources of considerable gain to him. Early in
life, when he was very busy between his professional work and his
practice, he remarked more than once, on refusing {126} to take the
cases of wealthy patients, that they had the money with which to
obtain other physicians, while the poor did not, and he would prefer
to keep some time for his services for them.
Toward the end of his life Galvani was not a little perturbed by the
course of events around him and by the sweeping away of faith in old
beliefs, consequent upon the French Revolution and the philosophic
movement that had led up to it. Seeing around him, too, the abuses to
which this supposed liberty and assertion of the rights of man led, it
used to be a favorite expression of Galvani that "A little philosophy
led men away from God, but a good deal of it led them back to Him
again." Especially did he consider this true with regard to younger
men, whose lack of wisdom in the difficult phases of life made them
think their philosophy of things was complete, until sad experience
had taught them the necessity for lifting men's minds above any mere
religion of humanity, any mere stoic resignation to the inevitable, if
what was best in them was to be brought out.
A very interesting phase of the Italian university life of that time
is revealed in two important incidents of Galvani's university career.
One of his professors, one, by the way, for whom he seems to have had
a great deal of respect, and to whose lectures he devoted much
attention, was Laura Caterina Maria Bassi, the distinguished woman
professor of philosophy at the University of Bologna, about the middle
of the eighteenth century. It is doubtless to her teaching that
Galvani owes some of his thoroughgoing conservatism in philosophic
speculation, a conservatism that was of great service to him later on
in life, in the midst of the ultra-radical principles which became
fashionable just before and during the French Revolution. Madame Bassi
seems to have had her influence on him for good not only during his
student {127} career, but also later in life, for she was the wife of
a prominent physician in Bologna, and Galvani was often in social
contact with her during his years of connection with the university.
As might, perhaps, be expected, seeing that his own happy domestic
life showed him that an educated woman might be the centre of
intellectual influence, Galvani seems to have had no spirit of
opposition to even the highest education for women. This is very well
illustrated by the first formal lecture in his course on anatomy at
the university, which had for its subject the models for the teaching
of anatomy that had been made by Madame Manzolini. In the early part
of the eighteenth century Madame Manzolini had been the professor of
anatomy at the University of Bologna, and in order to make the
teaching of this difficult subject easier and more definite she
modelled with great care and delicate attention to every detail, so
that they imitated actual dissections of the human body very closely,
a set of wax figures which replaced the human body for demonstration
purposes at least at the beginning of the anatomical course.
Galvani, in taking up the work of lecturer on anatomy, appreciated how
much such a set of models would help in making the introduction to
anatomical study easy, yet at the same time without detracting from
its exactness, and, accordingly, introduced his students to Madame
Manzolini's set of models in his very first lecture. At the time there
were those connected with the teaching of anatomy who considered the
use of these models as rather an effeminate proceeding. Galvani's lack
of prejudice in the matter shows the readiness of the man to accept
the best wherever he found it without regard to persons or feelings.
He was one of the most popular professors that the University of
Bologna has ever had. He was not in the ordinary {128} sense of the
word an orator, but he was a born teacher. The source of the
enthusiasm which he aroused in his hearers was undoubtedly his own
love for teaching and the power it gave him to express even intricate
problems in simple, straightforward language. More than any of his
predecessors he understood that experiments and demonstrations must be
the real groundwork of the teaching of science. Accordingly, very few
of his lectures were given without the aid of these material helps to
attract attention. Besides he was known to be one who delighted to
answer questions and was perfectly frank about the limitations of his
knowledge whenever there was no real answer to be given to a question
that had been proposed. Though an original discoverer of the first
rank, he was extremely modest, particularly when talking about the
details of his discoveries, or subjects relating to them.
The most striking proof of the thorough conscientiousness with which
he faced the duties of life is to be found in his conduct after the
establishment of the so-called Cis-Alpine Republic in Italy. This was
a government established merely by force of arms without the consent
of the people and a plain usurpation of the rights of the previous
government. He considered himself bound in duty to the authority under
which he had lived all his previous life and to which he had sworn
fealty. When the University of Bologna was reor
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