500 



NATURE 



[January 2, 1913 



It was fully 4'ecognised that, if one could discover 

 the cause of this excessive inflammation, it would be 

 the first step toward eradicating the serious conditions 

 attending wound healing. The minds of men, how- 

 ever, were obscured by an initial error of fundamental 

 importance, which warped their vision, and for which 

 the doctrine inculcated at the time was responsible. 

 The error lay in the belief that, with the exception 

 of healing by what was known as primary union, 

 inflammation was necessary for wound healing, and 

 that in the process of healing the phenomena of in- 

 flammation were always present. 



Wound healing was treated in the text-books under 

 the heading of inflammation. .So that, instead of 

 inflammation being regarded, ah initio, as a noxious 

 process, it was looked upon as a necessary and bene- 

 ficent one. It was only when it became excessive 

 that it was regarded as baneful, and efforts were 

 made to lessen it. 



The trend of inquiry was therefore directed toward 

 the elucidation of the phenomena produced by in- 

 flammation on the tissues, instead of endeavouring to 

 discover the cause of inflammation and how it could 

 be prevented. 



Saviotti and Lister on the Nerve Control on the 

 Blood-vessels in the Early Stages of Inflammation. 



Much time was devoted by many observers to the 

 elucidation of the effect of reflex' action upon the 

 blood-vessels, in the early stage of inflammation. The 

 investigations of Saviotti - and Lister proved that reflex 

 action, to which alone active hyperaemia had been pre- 

 viously attributed, was not the only factor in the pro- 

 duction oj increased local blood supply. From observa- 

 tion on the cutaneous pigmentary cells of the frog, it 

 was evident that they were controlled by reflex action, 

 as exhibited when the pigment in them contracted to 

 the centre of the cell, under the influence of a beam 

 of light, passing through the eye of the animal. It 

 was also seen that limited areas could be taken out 

 of the control of this general reflex action, by the 

 application of certain irritants applied locally. 



In order to account for this latter phenomenon, it 

 was deduced that peripheral nerve ganglia must exist, 

 having control of limited areas, and that when these 

 ganglia were paralysed, they would no longer transmit 

 th'- general nerve impulses. 



liranting this conclusion, it was further deduced 

 that a similar local nerve control might regulate the 

 smaller blood-vessels under topical irritation of the 

 jiarts and in the earlier stages of inflammation. If 

 these ganglia were paralysed, the arteries would 

 dilate, as is seen in active hyperaemia. 



These communications were interesting and impor- 

 tant, yet, though highly appreciated by all who valued 

 science for itself and admired it for the truth it aimed 

 at, they did not directly appeal to those who look 

 lightly upon investigations the results of which are 

 not immediately productive of direct and tangible 

 benefits. 



Microbes Discovered to be the Cause of Putrefaction 

 and Fermentation (Cagniard-Latour and Schwann). 



While darkness still brooded over the realm of 

 medicine and surgery, notwithstanding endeavours to 

 reach the light, investigations had been conducted iri 

 quite other fields, which were not only important in 

 themselves, but were destined to lead to the revelation 

 of multitudes of hitherto invisible organisms, every- 

 where existing, and playing a very potent part in the 

 economy of the world. 



More than thirty years previously, 1835-37, Cagnlard- 



■■: ■• Virchow Archiv," vo'. i. 



NO. 2253, VOL. 90] 



Latour in papers to the French Academy ^ recognised 

 that alcoholic fermentation was due to the presence || 

 of a living organism. He found that grape-juice con- ■ ¥ 

 tained numerous globular bodies which he considered 

 to be of vegetable nature, and which reproduced them- 

 selves by budding. These were always present when 

 fermentation occurred, and in their absence fermenta- 

 tion did not take place. 



In the following year, Schwann, of Berlin,* pub- 

 lished the results of an investigation into the causes 

 of putrefaction, in the course of which he also in- 

 dependently discovered the yeast plant. 



What was of equal importance, he demonstrated 

 that a putrescible fluid, such as a decoction of meat, 

 could be freely and indefinitely exposed to the action 

 of pure air — air free from dust and organisms — with- 

 out putrefaction ensuing in it. 



Those views of Schwann that putrefaction is due 

 to the action of living organisms, and those of Cag- 

 niard-Latour showing that fermentation is caused by 

 the yeast plant, did not, for more than thirty years, 

 yield the fruit which, viewed from present knowledge, 

 might have been expected from them. 



Cagniard-Latour and Schwann's Observations con- 

 firmed by Pasteur, 1858. 

 Pasteur, when in the University of Lille, had 

 abundant opportunity of studying alcoholic fermenta- 

 tion, as alcohol was the staple article of manufacture 

 in that town. He became thoroughly convinced of 

 the correctness of the observations and deductions 

 previously made by Schwann and by Cagniard-Latour. 

 He verified and extended those observations showing 

 that fermentation was due to micro-organisms, and 

 confirmed the observations of Schwann that pure air 

 had no effect in producing putrefaction. 



An Organism found to be the Cause of a Disease by 

 Davaine, 1850. 



In 185S Pasteur reasoned from analogy that the 

 relation of mjcro-organisms to disease was highly 

 probable, and that the changes taking place in the 

 secretion of a wound were probably due to a some- 

 what similar process to that of fermentation. The 

 probability of micro-organisms being the cause of 

 disease was greatly increased by a momentous dis- 

 covery from a totally different quarter, an organism 

 having been constantly found invading the tissues 

 and blood-vessels of animals which had died of splenic 

 fever. This was the Bacillus anthracis, discovered 

 by two observers, Davaine ' and Rayer in 1850, 

 though it was ten years later before the complete 

 identification of the relationship of this germ to the 

 disease was definitely established. 



Chronologically this was the first pathogenic 

 bacillus discovered. 



Other Theories of Fermentation. 



Those observations and conclusions of Schwann, 

 Cagniard-Latour, Pasteur, and Davaine were not 

 generally known, and, where known, were not gener- 

 ally accepted, other theories being still in the field. 



Besides the chemical theory of fermentation and 

 putrefaction, the believers in heterogeneous and spon- 

 taneous generation were still many. Pouchet,' in 

 1859, made a systematised attempt to prove the pos- 

 sibility of spontaneous generation, and even after the 

 antiseptic theory had been formulated, spontaneous 



3 .^tiiialfs dc Chim!,- et rle P/iysifut, t. I.wiii., 2nd series, p. 206, 1838 ; 

 Comf'tcs rcndus, t. iv., p. 905, 1837. 



■* PoggeudorffAnnatcK. .tii., p. 1S4, 1837. 



5 Davaine, " Recherchcs expirimentales sur la Maladie Charbonneuse," 

 p.ir H. Tous,aint. (Pari^ : Asselin and Co.) 



" Pouchel, " Hitcrogenie ou Trail* de la Generation spontanee basi sur 

 des nouvelles experiences." (Paris, 1859.) 



