5IO 



NATURE 



[September 23, 1897 



Antiseptic Surgery. 



To take but one example, I will cite the application of 

 microbial theories to surgery. 



There was a time when erysipelas, purulent infection, and 

 hospital gangrene decimated those upon whom operations had 

 been performed, when puerperal infection claimed a terrible 

 number of victims. It seems to us nowadays that the medical 

 profession before 1868 were blindfolded, and that their blindness 

 was almost criminal. These are now no more than historic 

 memories. A sad history, doubtless, but one which we must 

 look at coolly in order to understand what science can do for 

 medicine. Left to their own resources, practitioners of medi- 

 cine during long centuries could do nothing against erysipelas, 

 against purulent infection, against puerperal infection ; but, 

 basing itself upon science, surgery has been able to triumph 

 over these odious diseases, and to relegate them to the past. 



Let me here introduce a reminiscence. When on the occa- 

 sion of his jubilee, a great celebration was prepared for Pasteur 

 in the Sorbonne, in the presence of the leading men of science 

 of the world, there was a moment when all hearts were softened 

 — the moment when the great surgeon who was first to perceive 

 how to apply to the practice of his heart the theory of patho- 

 genic parasites, when Lord Lister drew near to Pasteur and 

 gave him a fraternal embrace. These two great benefactors of 

 humanity, united in their common work, afforded a spectacle 

 never to be forgotten, a striking reconciliation of medicine with 

 science. 



But the apogee of the glory of Pasteur was the discovery of 

 the new treatment of hydrophobia. No one of his scientific 

 conquests was more popular, and from France and from the 

 whole world there arose a long cry of admiration. Perhaps in 

 the eyes of biologists this discovery possesses less importance 

 than his labours with reference to the fermentations and to 

 vaccination, but for the public this was the chief part of Pas- 

 teur's work. And men of science also were forced to admire 

 the scientific courage of Pasteur, who, putting aside the precise 

 methods which he had taught and discovered, knew how to 

 ■devise new methods to meet the exigencies of the circumstances, 

 and how to put them victoriously into practice. 



Thus was finished the work of Pasteur. He was spared to 

 take part in the triumph of his ideas, and to be a witness of his 

 own glory. If, like so many creators, he had sometimes in his 

 ■earlier days known conflicts and hatreds and petty quarrels and 

 foolish objections, nevertheless he had not to deplore the in- 

 gratitude of mankind. He died full of honours, surrounded by 

 admiration, respect, and love. For him posterity had already 

 commenced when he died. 



The Union of Medicine and Science. 

 And now let us turn back to consider the indisputable union 

 of medicine and of science. This, in fact, is what ought to 

 strike us in the work of Pasteur. It is not only in general 

 biology and in the progress of our knowledge that his work is 

 great ; it is still more in its immediate practical applications. 

 The great biologists of our century, Lavoisier, Claude Bernard, 

 Darwin, have, without doubt, left behind them work which by 

 reason of its conquest of new truths is not inferior to the work 

 of Pasteur, but these new truths do not lead to any such 

 immediate application as antisepsis, the treatment of hydro- 

 phobia, anthrax-vaccination, or the prophylaxis of infectious 

 diseases. Pasteur was not only a man of science, he was also 

 a philanthropist, and there is scarcely one who can be com- 

 pared with him as a benefactor of suffering humanity except 

 Jenner, who found out how to preserve thousands and 

 thousands of human beings from the most hideous of all 



Further, Pasteur brought back medicine into the true way 

 of science. Even after Magendie, Miiller, Schwann, and Claude 

 Bernard, it might still have been asked whether all these ex- 

 periments establishing so many important truths had really 

 been of any advantage for the relief of the sick. To discover, 

 as did Schwann, that living beings are an aggregate of cells ; to 

 prove, as did Claude Bernard, that the liver forms sugar ; to 

 establish, as did Darwin, that living species can be transformed 

 by the influence of long-accumulated variations in the environ- 

 ments — these are admirable pieces of work, but work in pure 

 science which had not any immediate therapeutic results. 

 Strictly speaking, then, it was possible to maintain that clinical 

 medicine did not derive any benefit from such investigations. I 

 do not for a moment believe that this opinion had a shadow of 



NO. 1456, VOL. 56] 



j a foundation, but before the time of Pasteur it was not so 



I absurd as it has become since Pasteur. Since Pasteur no man 



can, without incurring the charge of monstrous ineptitude, refuse 



the rights of citizenship in medicine to experiment and to 



biology. 



And to speak the truth, men of science and biologists, as 

 though their ardour had been redoubled by the renovation of 

 medical ideas, have during these last ten years made discoveries 

 which have introduced into medical science new elements 

 which clinical observation alone had been absolutely incapable 

 of discovering. I will cite a few examples — the action of the 

 thyroid gland, the Rontgen rays, pancreatic diabetes, and serum 

 therapeutics. 



Thyroid in Therapeutics. 

 Physiologists had shown long ago that the ablation of the 

 thyroid gland led to serious results. Schiff had proved this as 

 long ago as 1857, but the explanation of the phenomenon did 

 not become clear until Claude Bernard, but especially Brown- 

 Sequard, had demonstrated the existence of internal secretions 

 of glands pouring into the blood their products which probably 

 neutralise certain toxic substances. This very naturally led 

 Vassale and Gley to inject into animals from whom the thyroid 

 gland had been removed the juice of the thyroid, and thus 

 prolong their lives. The therapeutic conclusion to be drawn 

 was obvious, namely, to treat the unfortunate subjects of 

 cretinism or of diseases of the thyroid gland by injection of 

 extracts of the thyroid body. You know that the result has 

 been most happy. 



This new treatment was a true experiment, and as is the 

 case with so many experiments, the actual result has been a 

 little different from that which was expected. The ingestion of 

 thyroidin is not only a means of curing goitre and cretinism, 

 but is only a treatment, sometimes remarkably efficacious, for 

 obesity. 



The Rontgen Rays. 

 The discovery of the Rontgen rays excited general enthusiasm, 

 and as a matter of fact it is one of the greatest conquests of 

 contemporary physics. Most assuredly medicine had nothing to 

 do with it. The research was made and the success was ob- 

 tained in a physical laboratory. Now you are not unaware that 

 these Rontgen rays have been called to play a part, if not in 

 the treatment at least in the diagnosis of diseases — a part the 

 importance of which goes on increasing from day to day. 

 Physicists have discovered the principle, it is for medical men 

 to follow up its application. 



Pancreatic Diabetes. 

 The existence of pancreatic diabetes was suspected vaguely 

 by a clinical physician, Lancereaux ; but the means which 

 clinical medicine and pathological anatomy placed at his dis- 

 posal did not give him the power to solve the problem. In 

 spite of his perspicacity, he could do no more than note a 

 certain correspondence between diabetes and lesions of the 

 pancreas. How could more have been learnt if we had not the 

 resource of experiment ? Two physiologists, Mering and Min- 

 kowski, have had the good fortune to show that ablation of the 

 pancreas determines glycosuria, to show that there is a pan- 

 creatic diabetes, and they have studied its various conditions 

 with great ability. 



Serum Therapeutics. 



I come now to serum therapeutics, a direct consequence of 

 the labours of Pasteur. This is a mode of treatment born of the 

 experimental method alone. Here, again, science has done for 

 the art of medicine that which clinical observation, left to its 

 own resources, could never have accomplished. 



Permit me now to show how serum therapeutics is derived 

 directly from physiology and experiment, and pardon me if I 

 am forced to speak of my own work ; I shall do so I hope 

 without any vanity. I know very well that we always owe to 

 our predecessors and to our rivals much more than our pride 

 admits, and that the experiments and the ideas which suc- 

 ceed are not always those which have been conceived most 

 methodically. 



About 1887 M. Chauveau had shown that French sheep 

 could contract anthrax, and that they are very easily infected 

 by the bacillus anthracis, the microbe of anthrax, if small 

 quantities of the bacillus be injected under the skin. But 

 Algerian sheep seem to be safe from the disease. In vain is 

 the bacillus anthracis injected into them ; they do not contract 



