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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..6833f05 --- /dev/null +++ b/.gitattributes @@ -0,0 +1,3 @@ +* text=auto +*.txt text +*.md text diff --git a/5694.txt b/5694.txt new file mode 100644 index 0000000..1609e3a --- /dev/null +++ b/5694.txt @@ -0,0 +1,17310 @@ +The Project Gutenberg EBook of The Harvard Classics Volume 38, by Various + +Copyright laws are changing all over the world. Be sure to check the +copyright laws for your country before downloading or redistributing +this or any other Project Gutenberg eBook. + +This header should be the first thing seen when viewing this Project +Gutenberg file. Please do not remove it. Do not change or edit the +header without written permission. + +Please read the "legal small print," and other information about the +eBook and Project Gutenberg at the bottom of this file. Included is +important information about your specific rights and restrictions in +how the file may be used. You can also find out about how to make a +donation to Project Gutenberg, and how to get involved. + + +**Welcome To The World of Free Plain Vanilla Electronic Texts** + +**eBooks Readable By Both Humans and By Computers, Since 1971** + +*****These eBooks Were Prepared By Thousands of Volunteers!***** + + +Title: The Harvard Classics Volume 38 + Scientific Papers (Physiology, Medicine, Surgery, Geology) + +Author: Various + +Release Date: May, 2004 [EBook #5694] +[Yes, we are more than one year ahead of schedule] +[This file was first posted on August 9, 2002] + +Edition: 10 + +Language: English + +Character set encoding: ASCII + +*** START OF THE PROJECT GUTENBERG EBOOK HARVARD CLASSICS V.38 *** + + + + +Produced by David Turner, Charles Franks +and the Online Distributed Proofreading Team. + + + + +The Harvard Classics Volume 38 +Scientific Papers (Physiology, Medicine, Surgery, Geology) + + + + +CONTENTS + +THE OATH OF HIPPOCRATES + + +THE LAW OF HIPPOCRATES + +JOURNEYS IN DIVERSE PLACES ... AMBROISE PARE +TRANSLATED BY STEPHEN PAGET + +ON THE MOTION OF THE HEART AND BLOOD IN ANIMALS +WILLIAM HARVEY. . . TRANSLATED BY ROBERT WILLIS + +THE THREE ORIGINAL PUBLICATIONS ON VACCINATION +AGAINST SMALLPOX . ... .. EDWARD JENNER + +THE CONTAGIOUSNESS OF PUERPERAL FEVER +O. W. HOLMES + +ON THE ANTISEPTIC PRINCIPLE OF THE PRACTICE OF SURGERY +LORD LISTER + +THE PHYSIOLOGICAL THEORY OF FERMENTATION +LOUIS PASTEUR +TRANSLATED BY F. FAULKNER AND D. C. ROBB (Revised) + +THE GERM THEORY AND ITS APPLICATIONS TO MEDICINE AND +SURGERY (Revised) . ... .. LOUIS PASTEUR +TRANSLATED BY H. C. ERNST + +ON THE EXTENSION OF THE GERM THEORY TO THE ETIOLOGY +OF CERTAIN COMMON DISEASES (Revised) LOUIS PASTEUR +TRANSLATED BY H. C. ERNST + +PREJUDICES WHICH HAVE RETARDED THE PROGRESS OF +GEOLOGY. ... . ... .. SIR CHARLES LYELL + +UNIFORMITY IN THE SERIES OF PAST CHANGES IN THE +ANIMATE AND INANIMATE WORLD SIR CHARLES LYELL + + + + +INTRODUCTORY NOTE + +Hippocrates, the celebrated Greek physician, was a contemporary +of the historian Herodotus. He was born in the island of Cos +between 470 and 460 B. C., and belonged to the family that +claimed descent from the mythical AEsculapius, son of Apollo. +There was already a long medical tradition in Greece before his +day, and this he is supposed to have inherited chiefly through +his predecessor Herodicus; and he enlarged his education by +extensive travel. He is said, though the evidence is +unsatisfactory, to have taken part in the efforts to check the +great plague which devastated Athens at the beginning of the +Peloponnesian war. He died at Larissa between 380 and 360 B. C. + +The works attributed to Hippocrates are the earliest extant Greek +medical writings, but very many of them are certainly not his. +Some five or six, however, are generally granted to be genuine, +and among these is the famous "Oath." This interesting document +shows that in his time physicians were already organized into a +corporation or guild, with regulations for the training of +disciples, and with an esprit de corps and a professional ideal +which, with slight exceptions, can hardly yet be regarded as out +of date. + +One saying occurring in the words of Hippocrates has achieved +universal currency, though few who quote it to-day are aware that +it originally referred to the art of the physician. It is the +first of his "Aphorisms": "Life is short, and the Art long; the +occasion fleeting; experience fallacious, and judgment difficult. +The physician must not only be prepared to do what is right +himself, but also to make the patient, the attendants, and +externals cooperate." + + + + +THE OATH OF HIPPOCRATES + +I swear by Apollo the physician and AEsculapius, and Health, and +All-heal, and all the gods and goddesses, that, according to my +ability and judgment, I will keep this Oath and this stipulation +--to reckon him who taught me this Art equally dear to me as my +parents, to share my substance with him, and relieve his +necessities if required; to look upon his offspring in the same +footing as my own brothers, and to teach them this art, if they +shall wish to learn it, without fee or stipulation; and that by +precept, lecture, and every other mode of instruction, I will +impart a knowledge of the Art to my own sons, and those of my +teachers, and to disciples bound by a stipulation and oath +according to the law of medicine, but to none others. I will +follow that system of regimen which, according to my ability and +judgment, I consider for the benefit of my patients, and abstain +from whatever is deleterious and mischievous. I will give no +deadly medicine to any one if asked, nor suggest any such +counsel; and in like manner I will not give to a woman a pessary +to produce abortion. With purity and with holiness I will pass my +life and practice my Art. I will not cut persons labouring under +the stone, but will leave this to be done by men who are +practitioners of this work. Into whatever houses I enter, I will +go into them for the benefit of the sick, and will abstain from +every voluntary act of mischief and corruption; and, further, +from the seduction of females or males, of freemen and slaves. +Whatever, in connection with my professional practice, or not in +connection with it, I see or hear, in the life of men, which +ought not to be spoken of abroad, I will not divulge, as +reckoning that all such should be kept secret. While I continue +to keep this Oath unviolated, may it be granted to me to enjoy +life and the practice of the art, respected by all men, in all +times. But should I trespass and violate this Oath, may the +reverse be my lot. + + + + +THE LAW OF HIPPOCRATES + +Medicine is of all the arts the most noble; but, owing to the +ignorance of those who practice it, and of those who, +inconsiderately, form a judgment of them, it is at present far +behind all the other arts. Their mistake appears to me to arise +principally from this, that in the cities there is no punishment +connected with the practice of medicine (and with it alone) +except disgrace, and that does not hurt those who are familiar +with it. Such persons are like the figures which are introduced +in tragedies, for as they have the shape, and dress, and personal +appearance of an actor, but are not actors, so also physicians +are many in title but very few in reality. + +2. Whoever is to acquire a competent knowledge of medicine, ought +to be possessed of the following advantages: a natural +disposition; instruction; a favorable position for the study; +early tuition; love of labour; leisure. First of all, a natural +talent is required; for, when Nature leads the way to what is +most excellent, instruction in the art takes place, which the +student must try to appropriate to himself by reflection, +becoming an early pupil in a place well adapted for instruction. +He must also bring to the task a love of labour and perseverance, +so that the instruction taking root may bring forth proper and +abundant fruits. + +3. Instruction in medicine is like the culture of the productions +of the earth. For our natural disposition, is, as it were, the +soil; the tenets of our teacher are, as it were, the seed; +instruction in youth is like the planting of the seed in the +ground at the proper season; the place where the instruction is +communicated is like the food imparted to vegetables by the +atmosphere; diligent study is like the cultivation of the fields; +and it is time which imparts strength to all things and brings +them to maturity. + +4. Having brought all these requisites to the study of medicine, +and having acquired a true knowledge of it, we shall thus, in +travelling through the cities, be esteemed physicians not only in +name but in reality. But inexperience is a bad treasure, and a +bad fund to those who possess it, whether in opinion or reality, +being devoid of self-reliance and contentedness, and the nurse +both of timidity and audacity. For timidity betrays a want of +powers, and audacity a lack of skill. They are, indeed, two +things, knowledge and opinion, of which the one makes its +possessor really to know, the other to be ignorant. + +5. Those things which are sacred, are to be imparted only to +sacred persons; and it is not lawful to impart them to the +profane until they have been initiated in the mysteries of the +science. + + + + +JOURNEYS IN DIVERSE PLACES + +BY AMBROISE PARE + +TRANSLATED BY STEPHEN PAGET + + +Ambroise Pare was born in the village of Bourg-Hersent, near +Laval, in Maine, France, about 1510. He was trained as a barber- +surgeon at a time when a barber-surgeon was inferior to a surgeon +and the professions of surgeon and physician were kept apart by +the law of the Church that forbade a physician to shed blood. +Under whom he served his apprenticeship is unknown, but by 1533 +he was in Paris, where he received an appointment as house +surgeon at the Hotel Dieu. After three or four years of valuable +experience in this hospital, he set up in private practise in +Paris, but for the next thirty years he was there only in the +intervals of peace; the rest of the time he followed the army. He +became a master barber-surgeon in 1541. + +In Pare's time the armies of Europe were not regularly equipped +with a medical service. The great nobles were accompanied by +their private physicians; the common soldiers doctored +themselves, or used the services of barber-surgeons and quacks +who accompanied the army as adventurers. "When Pare joined the +army" says Paget, "he went simply as a follower of Colonel +Montejan, having neither rank, recognition, nor regular payment. +His fees make up in romance for their irregularity: a cask of +wine, fifty double ducats and a horse, a diamond, a collection of +crowns and half-crowns from the ranks, other honorable presents +and of great value'; from the King himself, three hundred crowns, +and a promise he would never let him be in want; another diamond, +this time from the finger of a duchess: and a soldier once +offered a bag of gold to him." + +When Pare was a man of seventy, the Dean of the Faculty of +Medicine in Paris made an attack on him on account of his use of +the ligature instead of cauterizing after amputation. In answer, +Pare appealed to his successful experience, and narrated the +"Journeys in Diverse Places" here printed. This entertaining +volume gives a vivid picture, not merely of the condition of +surgery in the sixteenth century, but of the military life of the +time; and reveals incidentally a personality of remarkable vigor +and charm. Pare's own achievements are recorded with modest +satisfaction: "I dressed him, and God healed him," is the +refrain. Pare died in Paris in December, 1590. + + + + +JOURNEYS IN DIVERSE PLACES + +[Footnote: The present translation is taken from Mr. Stephen +Paget's "Ambroise Pare and His Times" by arrangement with Messrs. +G. P. Putnam's Sons.] + + +1537-1569 + +THE JOURNEY TO TURIN. 1537 + + +I will here shew my readers the towns and places where I found a +way to learn the art of surgery: for the better instruction of +the young surgeon. + +And first, in the year 1536, the great King Francis sent a large +army to Turin, to recover the towns and castles that had been +taken by the Marquis du Guast, Lieutenant-General of the Emperor. +M. the Constable, then Grand Master, was Lieutenant-General of +the army, and M. de Montejan was Colonel-General of the infantry, +whose surgeon I was at this time. A great part of the army being +come to the Pass of Suze, we found the enemy occupying it; and +they had made forts and trenches, so that we had to fight to +dislodge them and drive them out. And there were many killed and +wounded on both sides,--but the enemy were forced to give way and +retreat into the castle, which was captured, part of it, by +Captain Le Rat, who was posted on a little hill with some of his +soldiers, whence they fired straight on the enemy. He received an +arquebus-shot in his right ankle, and fell to the ground at once, +and then said, "Now they have got the Rat." I dressed him, and +God healed him. + +We entered pell-mell into the city, and passed over the dead +bodies, and some not yet dead, hearing them cry under our horses' +feet; and they made my heart ache to hear them. And truly I +repented I had left Paris to see such a pitiful spectacle. Being +come into the city, I entered into a stable, thinking to lodge my +own and my man's horse, and found four dead soldiers, and three +propped against the wall, their features all changed, and they +neither saw, heard, nor spake, and their clothes were still +smouldering where the gunpowder had burned them. As I was looking +at them with pity, there came an old soldier who asked me if +there were any way to cure them; I said no. And then he went up +to them and cut their throats, gently, and without ill will +toward them. Seeing this great cruelty, I told him he was a +villain: he answered he prayed God, when he should be in such a +plight, he might find someone to do the same for him; that he +should not linger in misery. + +To come back to my story, the enemy were called on to surrender, +which they did, and left the city with only their lives saved, +and the white stick in their hands; and most of them went off to +the Chateau de Villane, where about two hundred Spaniards were +stationed. M. the Constable would not leave these behind him, +wishing to clear the road for our own men. The castle is seated +on a small hill; which gave great confidence to those within, +that we could not bring our artillery to bear upon them. They +were summoned to surrender, or they would be cut in pieces: they +answered that they would not, saying they were as good and +faithful servants of the Emperor, as M. the Constable could be of +the King his master. Thereupon our men by night hoisted up two +great cannons, with the help of the Swiss soldiers and the +lansquenets; but as ill luck would have it, when the cannons were +in position, a gunner stupidly set fire to a bag full of +gunpowder, whereby he was burned, with ten or twelve soldiers; +and the flame of the powder discovered our artillery, so that all +night long those within the castle fired their arquebuses at the +place where they had caught sight of the cannons, and many of our +men were killed and wounded. Next day, early in the morning, the +attack was begun, and we soon made a breach in their wall. Then +they demanded a parley; but it was too late, for meanwhile our +French infantry, seeing them taken by surprise, mounted the +breach, and cut them all in pieces, save one very fair young girl +of Piedmont, whom a great seigneur would have. ... The captain +and the ensign were taken alive, but soon afterward hanged and +strangled on the battlements of the gate of the city, to give +example and fear to the Emperor's soldiers, not to be so rash and +mad as to wish to hold such places against so great an army. + +The soldiers within the castle, seeing our men come on them with +great fury, did all they could to defend themselves, and killed +and wounded many of our soldiers with pikes, arquebuses, and +stones, whereby the surgeons had all their work cut out for them. +Now I was at this time a fresh-water soldier; I had not yet seen +wounds made by gunshot at the first dressing. It is true I had +read in John de Vigo, first book, Of Wounds in General, eighth +chapter, that wounds made by firearms partake of venenosity, by +reason of the powder; and for their cure he bids you cauterise +them with oil of elders scalding hot, mixed with a little +treacle. And to make no mistake, before I would use the said oil, +knowing this was to bring great pain to the patient, I asked +first before I applied it, what the other surgeons did for the +first dressing; which was to put the said oil, boiling well, into +the wounds, with tents and setons; wherefore I took courage to do +as they did. At last my oil ran short, and I was forced instead +thereof to apply a digestive made of the yolks of eggs, oil of +roses, and turpentine. In the night I could not sleep in quiet, +fearing some default in not cauterising, that I should find the +wounded to whom I had not used the said oil dead from the poison +of their wounds; which made me rise very early to visit them, +where beyond my expectation I found that those to whom I had +applied my digestive medicament had but little pain, and their +wounds without inflammation or swelling, having rested fairly +well that night; the others, to whom the boiling oil was used, I +found feverish, with great pain and swelling about the edges of +their wounds. Then I resolved never more to burn thus cruelly +poor men with gunshot wounds. + +While I was at Turin, I found a surgeon famed above all others +for his treatment of gunshot wounds; into whose favour I found +means to insinuate myself, to have the recipe of his balm, as he +called it, wherewith he dressed gunshot wounds. And he made me +pay my court to him for two years, before I could possibly draw +the recipe from him. In the end, thanks to my gifts and presents, +he gave it to me; which was to boil, in oil of lilies, young +whelps just born, and earth-worms prepared with Venetian +turpentine. Then I was joyful, and my heart made glad, that I had +understood his remedy, which was like that which I had obtained +by chance. + +See how I learned to treat gunshot wounds; not by books. + +My Lord Marshal Montejan remained Lieutenant-General for the King +in Piedmont, having ten or twelve thousand men in garrison in the +different cities and castles, who were often fighting among +themselves with swords and other weapons, even with arquebuses. +And if there were four wounded, I always had three of them; and +if there were question of cutting off an arm or a leg, or of +trepanning, or of reducing a fracture or a dislocation, I +accomplished it all. The Lord Marshal sent me now hire now there +to dress the soldiers committed to me who were wounded in other +cities beside Turin, so that I was always in the country, one way +or the other. + +M. the Marshal sent to Milan, to a physician of no less +reputation than the late M. le Grand for his success in practice, +to treat him for an hepatic flux, whereof in the end he died. +This physician was some while at Turin to treat him, and was +often called to visit the wounded, where always he found me; and +I was used to consult with him, and with some other surgeons; and +when we had resolved to do any serious work of surgery, it was +Ambroise Pare that put his hand thereto, which I would do +promptly and skilfully, and with great assurance, insomuch that +the physician wondered at me, to be so ready in the operations of +surgery, and I so young. One day, discoursing with the Lord +Marshal, he said to him: + +"Signor, tu hai un Chirurgico giovane di anni, ma egli e vecchio +di sapere e di esperientia: Guardato bene, perche egli ti fara +servicio et honore." That is to say, "Thou hast a surgeon young +in age, but he is old in knowledge and experience: take good +care, of him, for he will do thee service and honour." But the +good man did not know I had lived three years at the Hotel Dieu +in Paris, with the patients there. + +In the end, M. the Marshal died of his hepatic flux. He being +dead, the King sent M. the Marshal d'Annebaut to be in his place: +who did me the honour to ask me to live with him, and he would +treat me as well or better than M. the Marshal de Montejan. Which +I would not do, for grief at the loss of my master, who loved me +dearly; so I returned to Paris. + + + + +THE JOURNEY TO MAROLLE AND LOW BRITTANY. 1543 + + +I went to the Camp of Marolle, with the late M. de Rohan, as +surgeon of his company; where was the King himself. M. +d'Estampes, Governor of Brittany, had told the King how the +English had hoist sail to land in Low Brittany; and had prayed +him to send, to help him, MM. de Rohan and de Laval, because they +were the seigneurs of that country, and by their help the country +people would beat back the enemy, and keep them from landing. +Having heard this, the King sent these seigneurs to go in haste +to the help of their country; and to each was given as much power +as to the Governor, so that they were all three the King's +Lieutenants. They willingly took this charge upon them, and went +off posting with good speed, and took me with them as far as +Landreneau. There we found every one in arms, the tocsin sounding +on every side, for a good five or six leagues round the harbours, +Brent, Couquet, Crozon, le Fou, Doulac, Laudanec; each well +furnished with artillery, as cannons, demi-cannons, culverins, +muskets, falcons, arquebuses; in brief, all who came together +were well equipped with all sorts and kinds of artillery, and +with many soldiers, both Breton and French, to hinder the English +from landing as they had resolved at their parting from England. + +The enemy's army came right under our cannons: and when we +perceived them desiring to land, we saluted them with cannon- +shot, and unmasked our forces and our artillery. They fled to sea +again. I was right glad to see their ships set sail, which were +in good number and good order, and seemed to be a forest moving +upon the sea. I saw a thing also whereat I marvelled much, which +was, that the balls of the great cannons made long rebounds, and +grazed over the water as they do over the earth. Now to make the +matter short, our English did us no harm, and returned safe and +sound into England. And they leaving us in peace, we stayed in +that country in garrison until we were assured that their army +was dispersed. + +Now our soldiers used often to exercise themselves with running +at the ring, or with fencing, so that there was always some one +in trouble, and I had always something to employ me. M. +d'Estampes, to make pastime and pleasure for the Seigneurs de +Rohan and de Laval, and other gentlemen, got a number of village +girls to come to the sports, to sing songs in the tongue of Low +Brittany: wherein their harmony was like the croaking of frogs +when they are in love. Moreover, he made them dance the Brittany +triori, without moving feet or hips: he made the gentlemen see +and hear many good things. + +At other tunes they made the wrestlers of the towns and Villages +come, where there was a prize for the best: and the sport was not +ended but that one or other had a leg or arm broken, or the +shoulder or hip dislocated. + +There was a little man of Low Brittany, of a square body and well +set, who long held the credit of the field, and by his skill and +strength threw five or six to the ground. There came against him +a big man, one Dativo, a pedagogue, who was said to be one of the +best wrestlers in all Brittany: he entered into the lists, having +thrown off his long jacket, in hose and doublet: when he was near +the little man, it looked as though the little man had been tied +to his girdle. Nevertheless, when they gripped each other round +the neck, they were a long time without doing anything, and we +thought they would remain equal in force and skill: but the +little man suddenly leaped beneath this big Dativo, and took him +on his shoulder, and threw him to earth on his back all spread +out like a frog; and all the company laughed at the skill and +strength of the little fellow. The great Dativo was furious to +have been thus thrown to earth by so small a man: he rose again +in a rage, and would have his revenge. They took hold again round +the neck, and were again a good while at their hold without +falling to the ground: but at last the big man let himself fall +upon the little, and in falling put his elbow upon the pit of his +stomach, and burst his heart, and killed him stark dead. And +knowing he had given him his death's blow, took again his long +cassock, and went away with his tail between his legs, and +eclipsed himself. Seeing the little man came not again to +himself, either for wine, vinegar, or any other thing presented +to him, I drew near to him and felt his pulse, which did not beat +at all: then I said he was dead. Then the Bretons, who were +assisting at the wrestling, said aloud in their jargon, "Andraze +meuraquet enes rac un bloa so abeuduex henelep e barz an gouremon +enel ma hoa engoustun." That is to say, "That is not in the +sport." And someone said that this great Dativo was accustomed to +do so, and but a year past he had done the same at a wrestling. I +must needs open the body to know the cause of this sudden death. +I found much blood in the thorax. ... I tried to find some +internal opening whence it might have come, which I could not, +for all the diligence that I could use. ... The poor little +wrestler was buried. I took leave of MM. de Rohan, de Laval, and +d'Estampes. M. de Rohan made me a present of fifty double ducats +and a horse, M. de Laval gave me a nag for my man, and M. +d'Estampes gave me a diamond worth thirty crowns: and I returned +to my house in Paris. + + + + +THE JOURNEY TO PERPIGNAN. 1543 + + +Some while after, M. de Rohan took me with him posting to the +camp at Perpignan. While we were there, the enemy sallied out, +and surrounded three pieces of our artillery before they were +beaten back to the gates of the city. Which was not done without +many killed and wounded, among the others M. de Brissac, who was +then grand master of the artillery, with an arquebus-shot in the +shoulder. When he retired to his tent, all the wounded followed +him, hoping to be dressed by the surgeons who were to dress him. +Being come to his tent and laid on his bed, the bullet was +searched for by three or four of the best surgeons in the army, +who could not find it, but said it had entered into his body. + +At last he called for me, to see if I could be more skilful than +they, because he had known me in Piedmont. Then I made him rise +from his bed, and told him to put himself in the same posture +that he had when he was wounded, which he did, taking a javelin +in his hand just as he had held his pike to fight. I put my hand +around the wound, and found the bullet. ... Having found it, I +showed them the place where it was, and it was taken out by M. +Nicole Lavernot, surgeon of M. the Dauphin, who was the King's +Lieutenant in that army; all the same, the honour of finding it +belonged to me. + +I saw one very strange thing, which was this: a soldier in my +presence gave one of his fellows a blow on the head with a +halbard, penetrating to the left ventricle of the brain; yet the +man did not fall to the ground. He that struck him said he heard +that he had cheated at dice, and he had drawn a large sum of +money from him, and was accustomed to cheat. They called me to +dress him; which I did, as it were for the last time, knowing +that he would die soon. When I had dressed him, he returned all +alone to his quarters, which were at the least two hundred paces +away. I bade one of his companions send for a priest to dispose +the affairs of his soul; he got one for him, who stayed with him +to his last breath. The next day, the patient sent for me by his +girl, dressed in boy's apparel, to come and dress him; which I +would not, fearing he would die under my hands; and to be rid of +the matter I told her the dressing must not be removed before the +third day. But in truth he was sure to die, though he were never +touched again. The third day, he came staggering to find me in my +tent, and the girl with him, and prayed me most affectionately to +dress him, and showed me a purse wherein might be an hundred or +sixscore pieces of gold, and said he would give me my heart's +desire; nevertheless, for all that, I put off the removal of the +dressing, fearing lest he should die then and there. Certain +gentlemen desired me to go and dress him; which I did at their +request; but in dressing him he died under my hands in a +convulsion. The priest stayed with him till death, and seized his +purse, for fear another man should take it, saying he would say +masses for his poor soul. Also he took his clothes, and +everything else. + +I have told this case for the wonder of it, that the soldier, +having received this great blow, did not fall down, and kept his +reason to the end. + +Not long afterward, the camp was broken up from diverse causes: +one, because we were told that four companies of Spaniards were +entered into Perpignan: the other, that the plague was spreading +through the camp. Moreover, the country folk warned us there +would soon be a great overflowing of the sea, which might drown +us all. And the presage which they had, was a very great wind +from sea, which rose so high that there remained not a single +tent but was broken and thrown down, for all the care and +diligence we could give; and the kitchens being all uncovered, +the wind raised the dust and sand, which salted and powdered our +meats in such fashion that we could not eat them; and we had to +cook them in pots and other covered vessels. Nor was the camp so +quickly moved but that many carts and carters, mules and mule +drivers, were drowned in the sea, with great loss of baggage. + +When the camp was moved I returned to Paris. + + + + +THE JOURNEY TO LANDRESY. 1544 + + +The King raised a great army to victual Landresy. Against him the +Emperor had no fewer men, but many more, to wit, eighteen +thousand Germans, ten thousand Spaniards, six thousand Walloons, +ten thousand English, and from thirteen to fourteen thousand +horse. I saw the two armies near each other, within cannon-shot; +and we thought they could not withdraw without giving battle. +There were some foolish gentlemen who must needs approach the +enemy's camp; the enemy fired on them with light field pieces; +some died then and there, others had their arms or legs carried +away. The King having done what he wished, which was to victual +Landresy, withdrew his army to Guise, which was the day after All +Saints, 1544; and from there I returned to Paris. + +A little while after, we went to Boulogne; where the English, +seeing our army, left the forts which they were holding, +Moulanabert, le petit Paradis, Monplaisir, the fort of +Chastillon, le Portet, the fort of Dardelot. One day, as I was +going through the camp to dress my wounded men, the enemy who +were in the Tour d' Ordre fired a cannon against us, thinking to +kill two men-at-arms who had stopped to talk together. It +happened that the ball passed quite close to one of them, which +threw him to the ground, and it was thought the ball had touched +him, which it did not; but only the wind of the ball full against +his corselet, with such force that all the outer part of his +thigh became livid and black, and he could hardly stand. I +dressed him, and made diverse scarifications to let out the +bruised blood made by the wind of the ball; and by the rebounds +that it made on the ground it killed four soldiers, who remained +dead where they fell. + +I was not far from this shot, so that I could just feel the moved +air, without its doing me any harm save a fright, which made me +duck my head low enough; but the ball was already far away. The +soldiers laughed at me, to be afraid of a ball which had already +passed. Mon petit maistre, I think if you had been there, I +should not have been afraid all alone, and you would have had +your share of it. + +Monseigneur the Due de Guise, Francois de Lorraine, was wounded +before Boulogne with a thrust of a lance, which entered above the +right eye, toward the nose, and passed out on the other side +between the ear and the back of the neck, with so great violence +that the head of the lance, with a piece of the wood, was broken +and remained fast; so that it could not be drawn but save with +extreme force, with smith's pincers. Yet notwithstanding the +great violence of the blow, which was not without fracture of +bones, nerves, veins, and arteries, and other parts torn and +broken, my lord, by the grace of God, was healed. He was used to +go into battle always with his vizard raised: that is why the +lance passed right out on the other side. + + + + +THE JOURNEY TO GERMANY. 1552 + + +I went to Germany, in the year 1552, with M. de Rohan, captain of +fifty men-at-arms, where I was surgeon of his company, as I have +said before. On this expedition, M. the Constable was general of +the army; M. de Chastillon, afterward the Admiral, was chief +colonel of the infantry, with four regiments of lansquenets under +Captains Recrod and Ringrave, two under each; and every regiment +was of ten ensigns, and every ensign of five hundred men. And +beside these were Captain Chartel, who led the troops that the +Protestant princes had sent to the King (this infantry was very +fine, and was accompanied by fifteen hundred men-at-arms, with a +following of two archers apiece, which would make four thousand +five hundred horse); and two thousand light horse, and as many +mounted arquebusiers, of whom M. d'Aumalle was general; and a +great number of the nobility, who were come there for their +pleasure. Moreover, the King was accompanied by two hundred +gentlemen of his household, under the command of the Seigneurs de +Boisy and de Canappe, and by many other princes. For his +following, to escort him, there were the French and Scotch and +Swiss guards, amounting to six hundred foot soldiers; and the +companies of MM. the Dauphin, de 'Guise, d'Aumalle, and Marshal +Saint Andre, amounting to four hundred lances; which was a +marvellous thing, to see such a multitude; and with this equipage +the King entered into Toul and Metz. + +I must not omit to say that the companies of MM. de Rohan, the +Comte de Sancerre, and de Jarnac, which were each of them of +fifty horse, went upon the wings of the camp. And God knows how +scarce we were of victuals, and I protest before Him that at +three diverse times I thought to die of hunger; and it was not +for want of money, for I had enough of it; but we could not get +victuals save by force, because the country people collected them +all into the towns and castles. + +One of the servants of the captain-ensign of the company of M. de +Rohan went with others to enter a church where the peasants were +retreated, thinking to get victuals by love or by forces; but he +got the worst of it, as they all did, and came back with seven +sword wounds on the head, the least of which penetrated to the +inner table of the skull; and he had four other wounds upon the +arms, and one on the right shoulder, which cut more than half of +the bladebone. He was brought back to his master's lodging, who +seeing him so mutilated, and not hoping he could be cured, made +him a grave, and would have cast him therein, saying that else +the peasants would massacre and kill him: I in pity told him the +man might still be cured if he were well dressed. Diverse +gentlemen of the company prayed he would take him along with the +baggage, since I was willing to dress him; to which he agreed, +and after I had got the man ready, he was put in a cart, on a bed +well covered and well arranged, drawn by a horse. I did him the +office of physician, apothecary, surgeon, and cook. I dressed him +to the end of his case, and God healed him; insomuch that all the +three companies marvelled at this cure; The men-at-arms of the +company of M. de Rohan, the first muster that was made, gave me +each a crown, and the archers half a crown, + + + + +THE JOURNEY TO DANVILLIERS. 1552 + + +On his return from the expedition against the German camp, King +Henry besieged Danvilliers, and those within would not surrender. +They got the worst of it, but our powder failed us; so they had a +good shot at our men. There was a culverin-shot passed through +the tent of H. de Rohan, which hit a gentleman leg who was of his +household. I had to finish the cutting off of it, which I did +without applying the hot irons. + +The King sent for powder to Sedan, and when it came we began the +attack mere vigorously than before, so that a breach was made. +MM. de Guise and the Constable, being in the King's chamber, told +him, and they agreed that next day they would assault the town, +and were confident they would enter into it; and it must be kept +secret, for fear the enemy should come to hear of it; and each +promised not to speak of it to any man. Now there was a groom of +the King's chamber, who being laid under the King's camp-bed to +sleep, heard they were resolved to attack the town next day. So +he told the secret to a certain captain, saying that they would +make the attack next day for certain, and he had heard it from +the King, and prayed the said captain to speak of it to no man, +which he promised; but his promise did not hold, and forthwith he +disclosed it to a captain, and this captain to a captain, and the +captains to some of the soldiers, saying always, "Say nothing." +And it was just so much hid, that next day early in the morning +there was seen the greater part of the soldiers with their boots +and breeches cut loose at the knee for the better mounting of the +breach. The King was told of this rumour that ran through the +camp, that the attack was to be made; whereat he was astonished, +seeing there were but three in that advice, who had promised each +other to tell it to no man. The King sent for M. de Guise, to +know if he had spoken of this attack; he swore and affirmed to +him he had not told it to anybody; and M. the Constable said the +same, and told the King they must know for certain who had +declared this secret counsel, seeing they were but three. Inquiry +was made from captain to captain. In the end they found the +truth; for one said, "It was such an one told me," and another +said the same, till it came to the first of all, who declared he +had heard it from the groom of the King's chamber, called Guyard, +a native of Blois, son of a barber of the late King Francis. The +King sent for him into his tent, in the presence of MM. de Guise +and the Constable, to hear from him whence he had his knowledge, +and who had told him the attack was to be made; and said if he +did not speak the truth he would have him hanged. Then he +declared he lay down under the King's bed thinking to sleep, and +so having heard the plan he revealed it to a captain who was a +friend of his, to the end he might prepare himself with his +soldiers to be the first at the attack. Then the King knew the +truth, and told him he should never serve him again, and that he +deserved to be hanged, and forbade him ever to come again to the +Court. + +The groom of the chamber went away with this to swallow, and +slept that night with a surgeon-in-ordinary of the King, Master +Louis of Saint Andre; and in the night he gave himself six stabs +with a knife, and cut his throat Nor did the surgeon perceive it +till the morning, when he found his bed all bloody, and the dead +body by him. He marvelled at this sight on his awaking, and +feared they would say he was the cause of the murder; but he was +soon relieved, seeing the reason, which was despair at the loss +of the good friendship of the King. + +So Guyard was buried. And those of Danvilliers, when they saw the +breach large enough for us to enter, and our soldiers ready to +assault them, surrendered themselves to the mercy of the King. +Their leaders were taken prisoners, and their Soldiers were sent +away without arms. + +The camp being dispersed, I returned to Paris with my gentleman +whose leg I had cut off; I dressed him, and God healed him. I +sent him to his house merry with a wooden leg; and he was content +saying he had got off cheap, not to have been miserably burned to +stop the blood, as you write in your book, won petit matetre, + + + + +THE JOURNEY TO CHATEAU LE COMTE. 1552 + + +Some time after. King Henry raised an army of thirty thousand +men, to go and lay waste the country about Hesdin. The King of +Navarre, who was then called M. de Vendosme, was chief of the +army, and the King's Lieutenant. Being at St. Denis, in France, +waiting while the companies passed by, he sent to Paris for me to +speak with him. When I came he begged me (and his request was a +command) to follow him on this journey; and I, wishing to make my +excuses, saying my wife was sick in bed, he made answer there +were physicians in Pairs to cure her, and he, too, had left his +wife, who was of as good a house as mine, and he said he would +use me well, and forthwith ordered I should be attached to his +household. Seeing this great desire he had to take me with him, I +dared not refuse him. + +I went after him to Chateau le Comte, within three or four +leagues of Hesdin. The Emperor's soldiers were in garrison there, +with a number of peasants from the country road. M. de Vendosme +called on them to surrender; they made answer that he should +never take them, unless it were piecemeal; let him do his worst, +and they would do their best to defend themselves. They trusted +in their moats, which were full of water; but in two hours, with +plenty of faggots and casks, we made a way for our infantry to +pass over, when they had to advance to the assault; and the place +was attacked with five cannons, and a breach was made large +enough for our men to enter; where those within received the +attack very valiantly, and killed and wounded a great number of +our men with arquebuses, pikes, and stones. In the end, when they +saw themselves overpowered, they set fire to their powder and +ammunition, whereby many of our men were burned, and some of +their own. And they were almost all put to the sword; but some of +our soldiers had taken twenty or thirty, hoping to have ransom +for them: and so soon as this was known, orders were given to +proclaim by trumpet through the camp, that all soldiers who had +Spaniards for prisoners must kill them, on pain of being +themselves hanged and strangled: which was done in cold blood. + +Thence we went and burned several villages; and the barns were +all full of grain, to my very great regret. We came as far as +Tournahan, where there was a large tower, whither the enemy +withdrew, but we found the place empty: our men sacked it, and +blew up the tower with a mine of gunpowder, which turned it +upside down. After that, the camp was dispersed, and I returned +to Paris. And the day after Chateau le Comte was taken, M. de +Vendosme sent a gentleman under orders to the King, to report to +him all that had happened, and among other things he told the +King I had done very good work dressing the wounded, and had +showed him eighteen bullets that I had taken out of their bodies, +and there were many more that I had not been able to find or take +out; and he spoke more good of me than there was by half. Then +the King said he would take me into his service, and commanded M. +de Goguier, his first physician, to write me down in the King's +service as one of his surgeons-in-ordinary, and I was to meet him +at Rheims within ten or twelve days: which I did. And the King +did me the honour to command me to live near him, and he would be +a good friend to me. Then I thanked him most humbly for the +honour he was pleased to do me, in appointing me to serve him. + + + + +THE JOURNEY TO METZ. 1552 + + +The Emperor having besieged Metz with more than an hundred and +twenty thousand men, and in the hardest time of winter,--it is +still fresh in the minds of all--and there were five or six +thousand men in the town, and among them seven princes; MM. le +Duc de Guise, the King's Lieutenant, d'Enghien, de Conde, de la +Montpensier, de la Roche-sur-Yon, de Nemours, and many other +gentlemen, with a number of veteran captains and officers: who +often sallied out against the enemy (as I shall tell hereafter), +not without heavy loss on both sides. Our wounded died almost +all, and it was thought the drugs wherewith they were dressed had +been poisoned. Wherefore M. de Guise, and MM. the princes, went +so far as to beg the King that if it were possible I should be +sent to them with a supply of drugs, and they believed their +drugs were poisoned, seeing that few of their wounded escaped. My +belief is that there was no poison; but the severe cutlass and +arquebus wounds, and the extreme cold, were the cause why so many +died. The King wrote to M. the Marshal de Saint Andre, who was +his Lieutenant at Verdun, to find means to get me into Metz, +whatever way was possible. MM. the Marshal de Saint Andre, and +the Marshal de Vielleville, won over an Italian captain, who +promised to get me into the place, which he did (and for this he +had fifteen hundred crowns). The King having heard the promise +that the Italian captain had made, sent for me, and commanded me +to take of his apothecary, named Daigne, so many and such drugs +as I should think necessary for the wounded within the town; +which I did, as much as a post-horse could carry. The King gave +me messages to M. de Guise, and to the princes and the captains +that were in Metz. + +When I came to Verdun, some days after, M. the Marshal de Saint +Andre got horses for me and for my man, and for the Italian +captain, who spoke excellent German, Spanish, and Walloon, beside +his own mother-tongue. When we were within eight or ten leagues +of Metz, we began to go by night only; and when we came near the +enemy's camp I saw, more than a league and a half off, fires +lighted all round the town, as if the whole earth were burning; +and I believed we could never pass through these fires without +being discovered, and therefore hanged and strangled, or cut in +pieces, or made to pay a great ransom. To speak truth, I could +well and gladly have wished myself back in Paris, for the great +danger that I foresaw. God guided our business so well, that we +entered into the town at midnight, thanks to a signal the captain +had with another captain of the company of M. de Guise; to whom I +went, and found him in bed, and he received me with high favour, +being right glad at my coming. + +I gave him my message as the King had commanded me, and told him +I had a little letter for him, and the next day I would not fail +to deliver it. Then he ordered me a good lodging, and that I +should be well treated, and said I must not fail next morning to +be upon the breach, where I should find all the princes and +seigneurs, and many captains. Which I did, and they received me +with great joy, and did me the honour to embrace me, and tell me +I was welcome; adding they would no more be afraid of dying, if +they should happen to be wounded. + +M. le Prince de la Roche-sur-Yon was the first who entertained +me, and inquired what they were saying at the Court concerning +the town of Metz. I told him all that I chose to tell. Forthwith +he begged me to go and see one of his gentlemen named M. de +Magnane, now Chevalier of the Order of the King, and Lieutenant +of His Majesty's Guards, who had his leg broken by a cannon-shot. +I found him in bed, his leg bent and crooked, without any +dressing on it, because a gentleman promised to cure him, having +his name and his girdle, with certain words (and the poor patient +was weeping and crying out with pain, not sleeping day or night +for four days past). Then I laughed at such cheating and false +promises; and I reduced and dressed his leg so skilfully that he +was without pain, and slept all the night, and afterward, thanks +be to God, he was healed, and is still living now, in the King's +service. The Prince de la Roche-sur-Yon sent me a cask of wine, +bigger than a pipe of Anjou, to my lodging, and told me when it +was drunk, he would send me another; that was how he treated me, +most generously. + +After this, M, de Guise gave me a list of certain captains and +seigneurs, and bade me tell them what the King had charged me to +say; which I did, and this was to commend him to them, and give +them his thanks for the duty they had done and were doing in +holding his town of Metz, and that he would remember it. I was +more than eight days acquitting myself of this charge, because +they were many. First, to all the princes; then to others, as the +Duke Horace, the Count de Martigues, and his brother M. de Bauge, +the Seigneurs de Montmorency and d'Anville, now Marshal of +France, M. de la Chapelle aux Ursins, Bonnivet, Carouge, now +Governor of Rouen, the Vidasme de Chartres, the Count de Lude, M. +de Biron, now Marshal of France, M. de Randan, la Rochefoucaut, +Bordaille, d' Estres the younger, M. de Saint Jehan en pauphine, +and many others whom it would take too long to name; and also to +many captains, who had all done their duty well for the defence +of their lives and of the town. Afterward I asked M. de Guise +what it pleased him I should do with the drugs I had brought with +me; he bade me distribute them to the surgeons and apothecaries, +and principally to the poor wounded soldiers, who were in great +numbers in the Hospital. Which I did, and can truly say I could +not so much as go and see all the wounded, who kept sending for +me to visit and dress them. + +All the seigneurs within the town asked me to give special care, +above all the rest; to M. de Pienne, who had been wounded, while +on the breach, by a stone shot from a cannon, on the temple, with +fracture and depression of the bone. They told me that so soon as +he received the blow, he fell to the ground as dead, and cast +forth blood by the mouth, nose, and ears, with great vomiting, +and was fourteen days without being able to speak or reason; also +he had tremors of a spasmodic nature, and all his face was +swelled and livid, He was trepanned at the side of the temporal +muscle, over the frontal bone. I dressed him, with other +surgeons, and God healed him; and to-day he is still living, +thank God. + +The Emperor attacked the town with forty double cannons, and the +powder was not spared day or night. So soon as M. de Guise saw +the artillery set and pointed to make a breach, he had the +nearest houses pulled down and made into ramparts, and the beams +and joists were put end to end, and between them faggots, earth, +beds, and wool-packs; then they put above them other beams and +joists as before. And there was plenty of wood from the houses in +the suburbs; which had been razed to the ground, for fear the +enemy should get under cover of them, and make use of the wood; +it did very well for repairing the breach. Everybody was hard at +work carrying earth to repair it, day and night; MM. the princes, +the seigneurs, and captains, lieutenants, ensigns, were all +carrying the basket, to set an example to the soldiers and +citizens to do the like, which they did; even the ladies and +girls, and those who had not baskets, made use of cauldrons, +panniers, sacks, sheets, and all such things to carry the earth; +so that the enemy had no sooner broken down the wall than they +found behind it a yet stronger rampart. The wall having fallen, +our men cried out at those outside, "Fox, fox, fox," and they +vented a thousand insults against one another. M. de Guise +forbade any man on pain of death to speak with those outside, for +fear there should be some traitor who would betray what was being +done within the town. After this order, our men tied live cats to +the ends of their pikes, and put them over the wall and cried +with the cats, "Miaut, Miaut." + +Truly the Imperials were much enraged, having been so long making +a breach, at great loss, which was eighty paces wide, that fifty +men of their front rank should enter in, only to find a rampart +stronger than the wall. They threw themselves upon the poor cats, +and shot them with arquebuses as men shoot at the popinjay. + +Our men often ran out upon them, by order of M. de Guise; a few +days ago, our men had all made haste to enrol themselves in +sallying-parties, chiefly the young nobility, led by experienced +captains; and indeed it was doing them a great favour to let them +issue from the town and run upon the enemy. They went forth +always an hundred or six score men, well armed with cutlasses, +arquebuses, pistols, pikes, partisans, and halbards; and advanced +as far as the trenches, to take the enemy unawares. Then an +alarum would be sounded all through the enemy's camp, and their +drums would beat plan, plan, ta ti ta, ta ta ti ta, tou touf +touf. Likewise their trumpets and clarions rang and sounded, To +saddle, to saddle, to saddle, to horse, to horse, to horse, to +saddle, to horse, to horse. And all their soldiers cried, "Arm, +arm arm! to arms, to arms, to arms! arm, to arms, arm, to arms, +arm":--like the hue-and-cry after wolves; and all diverse +tongues, according to their nations; and you saw them come out of +their tents and little lodgings, as thick as little ants when you +uncover the ant-hills, to bring help to their comrades, who were +having their throats cut like sheep. Their cavalry also came from +all sides at full gallop, patati, patata, patati, patata, pa, ta, +ta, patata pata, ta, eager to be in the thick of the fighting, to +give and take their share of the blows. And when our men saw +themselves hard pressed, they would turn back into the town, +fighting all the way; and those pursuing them were driven back +with cannon-shots, and the cannons were loaded with flint-stones +and with big pieces of iron, square or three-sided. And our men +on the wall fired a volley, and rained bullets on them as thick +as hail, to send them back to their beds; whereas many remained +dead on the field: and our men also did not all come back with +whole skins, and there were always some left behind (as it were a +tax levied on us) who were joyful to die on the bed of honour. +And if there was a horse wounded, it was skinned and eaten by the +soldiers, instead of beef and bacon; and if a man was wounded, I +must run and dress him. Some days afterward there were other +sallies, which infuriated the enemy, that we would not let him +sleep a little in safety. + +M. de Guise played a trick upon them: he sent a peasant, who was +none of the wisest, with two letters to the King, and gave him +ten crowns, and promised the King would give him an hundred if he +got the letters to him. In the one letter M. de Guise told the +King that the enemy shewed no of retreating, and had put forth +all their strength made a great breach, which he hoped to defend, +even at the cost of his own life and of all who were in the town; +and that the enemy had planted their artillery so well in a +certain place (which he named) that it was with great difficulty +he could keep them from entering the town, seeing it was the +weakest place in the town; but soon he hoped to rebuild it well, +so that they should not be able to enter. This letter was sewed +in the lining of the man's doublet, and he was told to be very +careful not to speak of it to any person. And the other letter +was given to him, wherein M. de Guise told the King that he and +all those besieged with him hoped to guard the town well; and +other matters which I leave untold here. He sent out the man at +night, and he was taken by the enemy's guard and brought to the +Duke of Alva, that the Duke might hear what was doing in the +town; and the peasant was asked if he had any letters. He said +"Yes," and gave them the one; and they having seen it asked him +if he had not another. He said "No." Then he was searched, and +they found on him that which was sewed in his doubtlet; and the +poor messenger was handed and strangled. + +The letters were taken to the Emperor, who called his council, +where it was resolved, since they had been unable to do anything +at the first breach, the artillery should forthwith be set +against the place which they thought weakest, where they put +forth all their strength to make a fresh breach; and they sapped +and mined the wall, and tried hard to make a way into the Hell +Tower, but dared not assault it openly. + +The Duke of Alva represented to the Emperor that every day their +soldiers were dying, to the number of more than two hundred, and +there was so little hope of entering the town, seeing the time of +year and the great number of our soldiers who were in it. The +Emperor asked what men they were who were dying, and whether they +were gentlemen and men of mark; answer was made to him "They were +all poor soldiers." Then said he, "It was no great loss if they +died," comparing them to caterpillars, grasshoppers, and +cockchafers, which eat up the buds and other good things of the +earth; and if they were men of any worth they would not be in his +camp at six livres the month, and therefore it was no great harm +if they died. Moreover, he said he would never depart from the +town till he had taken it by force or by famine, though he should +lose all his army; because of the great number of princes who +were shut up in it, with the greater part of the nobility of +France, who he hoped would pay his expenses four times over; and +he would go yet again to Paris, to see the Parisians, and to make +himself King of all the kingdom of France. + +M. de Guise, with the princes, captains, and soldiers, and in +general all the citizens of the town, having heard the Emperor's +resolve to exterminate us all, forbade the soldiers and citizens, +and even the princes and seigneurs, to eat fresh fish or venison, +or partridges, woodcocks, larks, francolines, plovers, or other +game, for fear these had acquired any pestilential air which +could bring infection among us. So they had to content themselves +with the fare of the army; biscuit, beef, salt cow-beef, bacon, +cervelas, and Mayence hams; also fish, as haddock, salmon, shad, +tunny, whale, anchovy, sardines, herrings; also peas, beans, +rice, garlic, onions, prunes, cheeses, butter, oil, and salt; +pepper, ginger, nutmegs and other spices to put in our pies, +mostly of horses, which without the spice had a very bad taste. +Many citizens, having gardens in the town, had planted them with +fine radishes, turnips, carrots, and leeks, which they kept +flourishing and very dear, for the extreme necessity of the +famine. Now all these stores were distributed by weight, measure, +and justice, according to the quality of the persons, because we +knew not how long the siege would last. For after we heard the +Emperors words, how he would not depart from before Metz, till he +had taken it by force or by famine, the victuals were cut down; +and what they used to distribute to three soldiers was given to +four; and it was forbidden to them to sell the remains which +might be left after their meals; but they might give them to the +rabble. And they always rose from table with an appetite, for +fear they should be subject to take physick. + +And before we surrendered to the mercy of the enemy, we had +determined to eat the asses, mules, and horses, dogs, cats, and +rats, even our boots and collars, and other skins that we could +have softened and stewed. And, in a word, all the besieged were +resolved to defend themselves valiantly with all instruments of +war; to set the artillery at the entry of the breach, and load +with balls, stones, cart-nails, bars and chains of iron; also all +sorts and kinds of artificial fires, as barricadoes, grenades, +stink-pots, torches, squibs, fire-traps, burning faggots; with +boiling water, melted lead, and lime, to put out the enemy's +eyes. Also, they were to make holes right through their houses, +and put arquebusiers in them, to take the enemy in flank and +hasten his going, or else give him stop then and there. Also they +were to order the women to pull up the streets, and throw from +their windows billets, tables, trestles, benches, and stools, to +dash out the enemy's brains. Moreover, a little within the +breach, there was a great stronghold full of carts and palisades, +tuns and casks; and barricades of earth to serve as gabions, +interlaid with falconets, falcons, field-pieces, crooked +arquebuses, pistols, arquebuses, and wildfires, to break their +legs and thighs, so that they would be taken from above and on +the flank and from behind; and if they had carried this +stronghold, there were others where the streets crossed, every +hundred paces, which would have been as bad friends to them as +the first, or worse, and would have made many widows and orphans. +And if fortune had been so hard on us that they had stormed and +broken up our strongholds, there would yet have been seven great +companies, drawn up in square and in triangle, to fight them all +at once, each led by one of the princes, for the better +encouragement of our men to fight and die all together, even to +the last breath of their souls. And all were resolved to bring +their treasures, rings, and jewels, and their best and richest +and most beautiful household stuffs, and burn them to ashes in +the great square, lest the enemy should take them and make +trophies of them. Also there were men charged to set fire to all +the stores and burn them, and to stave in all the wine-casks; +others to set fire to every single house, to burn the enemy and +us together. The citizens thus were all of one mind, rather than +see the bloody knife at their throats, and their wives and +daughters ravished and taken by the cruel savage Spaniards. + +Now we had certain prisoners, who had been made secretly to +understand our last determination and desperation; these +prisoners M. de Guise sent away on parole, who being come to +their camp, lost no time in saying what we had told them; which +restrained the great and vehement desire of the enemy, so that +they were no longer eager to enter the town to cut our throats +and enrich themselves with the spoils. The Emperor, having heard +the decision of this great warrior, M. de Guise, put water in his +wine, and restrained his fury; saying that he could not enter the +town save with vast butchery and carnage, and shedding of much +blood, both of those defending and of those attacking, and they +would be all dead together, and in the end he would get nothing +but ashes; and afterward men might say it was a like destruction +to that of the town of Jerusalem, made of old time by Titus and +Vespasian. + +The Emperor thus having heard our last resolve, and seeing how +little he had gained by his attack, sappings, and mines, and the +great plague that was through all his camp, and the adverse time +of the year, and the want of victuals and of money, and how his +soldiers were disbanding themselves and going off in great +companies, decided at last to raise the siege and go away, with +the cavalry of his vanguard, and the greater part of the +artillery and engines of war. The Marquis of Brandebourg was the +last to budge from his place; he had with him some troops of +Spaniards and Bohemians, and his German regiments, and there he +stopped for a day and a half, to the great regret of M. de Guise, +who brought four pieces of artillery out of the town, which he +fired on him this side and that, to hurry him off: and off he +went, sure enough, and all his men with him. + +When he was a quarter of a league from Metz, he was seized with a +panic lest our cavalry should fall upon his tail; so he set fire +to his store of powder, and left behind him some pieces of +artillery, and a quantity of baggage, which he could not take +along with him, because their vanguard and their great cannons +had broken and torn tip the roads. Our cavalry were longing with +all their hearts to issue from the town and attack him behind; +but M. de Guise never let them, saying on the contrary we had +better make their way smooth for them, and build them gold and +silver bridges to let them go; like the good pastor and shepherd, +who will not lose one of his sheep. + +That is how our dear and well-beloved Imperials went away from +Metz, which was the day after Christmas Day, to the great content +of those within the walls, and the praise of the princes, +seigneurs, captains, and soldiers, who had endured the travail of +this siege for more than two months. Nevertheless, they did not +all go: there wanted more than twenty thousand of them, who were +dead, from our artillery and the fighting, or from plague, cold, +and starvation (and from spite and rage that they could not get +into the town to cut our throats and plunder us): and many of +their horses also died, the greater part whereof they had eaten +instead of beef and bacon. We went where their camp had been, +where we found many dead bodies not yet buried, and the earth all +worked up, as one sees in the Cemetery of the Holy Innocents +during some time of many deaths. In their tents, pavilions, and +lodgings were many sick people. Also cannon-shot, weapons, carts, +waggons, and other baggage, with a great quantity of soldier's +bread, spoiled and rotted by the snows and rains (yet the +soldiers had it but by weight and measure). Also they left a good +store of wood, all that remained of the houses they had +demolished and broken down in the villages for two or three +leagues around; also many other pleasure-houses, that had +belonged to our citizens, with gardens and fine orchards full of +diverse fruit-trees. And without all this, they would have been +benumbed and dead of the cold, and forced to raise the siege +sooner than they did. + +M. de Guise had their dead buried, and their sick people treated. +Also the enemy left behind them in the Abbey of Saint Arnoul many +of their wounded soldiers, whom they could not possibly take with +them. M. de Guise sent them all victuals enough, and ordered me +and the other surgeons to go dress and physick them, which we did +with good will; and I think they would not have done the like for +our men. For the Spaniard is very cruel, treacherous, and +inhuman, and so far enemy of all nations: which is proved by +Lopez the Spaniard, and Benzo of Milan, and others who have +written the history of America and the West Indies: who have had +to confess that the cruelty, avarice, blasphemies, and wickedness +of the Spaniards have utterly estranged the poor Indians from the +religion that these Spaniards professed. And all write that they +are of less worth than the idolatrous Indians, for their cruel +treatment of these Indians. + +And some days later M. de Guise sent a trumpet to Thionville to +the enemy, that they could send for their wounded in safety: +which they did with carts and waggons, but not enough. M. de +Guise gave them carts and carters, to help to take them to +Thionville. Our carters, when they returned, told us the roads +were all paved with dead bodies, and they never got half the men +there, for they died in their carts: and the Spaniards seeing +them at the point of death, before they had breathed their last, +threw them out of the carts and buried them in the mud and mire, +saying they had no orders to bring back dead men. Moreover, our +carters said they had found on the roads many carts stuck in the +mud, full of baggage, for which the enemy dared not send back, +lest we who were within Metz should run out upon them. + +I would return to the reason why so many of them died; which was +mostly starvation, the plague, and cold. For the snow was more +than two feet deep upon the ground, and they were lodged in pits +below the ground, covered only with a little thatch. +Nevertheless, each soldier had his camp-bed, and a coverlet all +strewed with stars, glittering and shining brighter than fine +gold, and every day they had white sheets, and lodged at the sign +of the Moon, and enjoyed themselves if only they had been able, +and paid their host so well over night that in the morning they +went off quits, shaking their ears; and they had no need of a +comb to get the down and feathers out of their beards and hair, +and they always found a white table-cloth, and would have enjoyed +good meals but for want of food. Also the greater part of them +had neither boots, half-boots, slippers, hose, nor shoes: and +most of them would rather have none than any, because they were +always in the mire up to mid-leg. And because they went bare- +foot, we called them the Emperor's Apostles. + +After the camp was wholly dispersed, I distributed my patients +into the hands of the surgeons of the town, to finish dressing +them: then I took leave of M. de Guise, and returned to the King, +who received me with great favour, and asked me how I had been +able to make my way into Metz. I told him fully all that I had +done. He gave me two hundred crowns, and an hundred which I had +when I set out: and said he would never leave me poor. Then I +thanked him very humbly for the good and the honour he was +pleased to do me. + + + + +THE JOURNEY TO HESDIN. 1553 + + +The Emperor Charles laid siege to the town of Therouenne; and M. +le Due de Savoie was General of his whole army. It was taken by +assault: and there was a great number of our men killed and taken +prisoners. + +The King, wishing to prevent the enemy from besieging the town +and castle of Hesdin also, sent thither MM. le Duc de Bouillon, +le Duc Horace, le Marquis de Villars, and a number of captains, +and about eighteen hundred soldiers: and during the siege of +Therouenne, these Seigneurs fortified the castle of Hesdin, so +that it seemed to be impregnable. The King sent me to the +Seigneurs, to help them with my art, if they should come to have +need of it. + +Soon after the capture of Therouenne, we were besieged in Hesdin. +There was a clear stream of running water within shot of our +cannon, and about it were fourscore or an hundred of the enemy's +rabble, drawing water. I was on a rampart watching the enemy +pitch their camp; and, seeing the crowd of idlers round the +stream, I asked M. du Pont, commissary of the artillery, to send +one cannon-shot among this canaille: he gave me a flat refusal, +saying that all this sort of people was not worth the powder +would be wasted on them. Again I begged him to level the cannon, +telling him, "The more dead, the fewer enemies;" which he did for +my sake: and the shot killed fifteen or sixteen, and wounded +many. Our men made sorties against the enemy, wherein many were +killed and wounded on both sides, with gunshot or with fighting +hand to hand; and our men often sallied out before their trenches +were made; so that I had my work cut out for me, and had no rest +either day or night for dressing the wounded. + +And here I would note that we had put many of them in a great +tower, laying them on a little straw: and their pillows were +stones, their coverlets were cloaks, those who had any. When the +attack was made, so often as the enemy's cannons were fired, our +wounded said they felt pain in their wounds, as if you had struck +them with a stick: one was crying out on his head, the other on +his arm, and so with the other parts of the body: and many had +their wounds bleed again, even more profusely than at the time +they were wounded, and then I had to run to staunch them. Mon +petit maistre, if you had been there, you would have been much +hindered with your hot irons; you would have wanted a lot of +charcoal to heat them red, and sure you would have been killed +like a calf for your cruelty. Many died of the diabolical storm +of the echo of these engines of artillery, and the vehement +agitation and severe shock of the air acting on their wounds; +others because they got no rest for the shouting and crying that +were made day and night, and for want of good food, and other +things needful for their treatment. Mon petit maistre, if you had +been there, no doubt you could have given them jelly, +restoratives, gravies, pressed meats, broth, barley-water, +almond-milk, blanc-mange, prunes, plums, and other food proper +for the sick; but your diet would have been only on paper, and in +fact they had nothing but beef of old shrunk cows, seized round +Hesdin for our provision, salted and half-cooked, so that he who +would eat it must drag at it with his teeth, as birds of prey +tear their food. Nor must I forget the linen for dressing their +wounds, which was only washed daily and dried at the fire, till +it was as hard as parchment: I leave you to think how their +wounds could do well. There were four big fat rascally women who +had charge to whiten the linen, and were kept at it with the +stick; and yet they had not water enough to do it, much less +soap. That is how the poor patients died, for want of food and +other necessary things. + +One day the enemy feigned a general attack, to draw our soldiers +into the breach, that they might see what we were like: every man +ran thither. We had made a great store of artificial fires to +defend the breach; a priest of M. le Duc de Bouillon took a +grenade, thinking to throw it at the enemy, and lighted it before +he ought: it burst, and set fire to all our store, which was in a +house near the breach. This was a terrible disaster for us, +because it burned many poor soldiers; it even caught the house, +and we had all been burned, but for help given to put it out; +there was only one well in the castle with any water in it, and +this was almost dry, and we took beer to put it out instead of +water; afterward we were in great want of water, and to drink +what was left we must strain it through napkins. + +The enemy, seeing the explosion and violence of the fires, which +made a wonderful flame and thundering, thought we had lit them on +purpose to defend the breach, and that we had many more of them. +This made them change their minds, to have us some other way than +by attack: they dug mines, and sapped the greater part of our +walls, till they came near turning our castle altogether upside +down; and when the sappers had finished their work, and their +artillery was fired, all the castle shook under our feet like an +earthquake, to our great astonishment. Moreover, they had +levelled five pieces of artillery, which they had placed on a +little hillock, so as to have us from behind when we were gone to +defend the breach. M. le Duc Horace had a cannonshot on the +elbow, which carried off his arm one way and his body the other, +before he could say a single word; his death was a great disaster +to us, for the high rank that he held in the town. Also M. de +Martigues had a gunshot wound which pierced his lungs: I dressed +him, as I shall tell hereafter. + +Then we asked leave to speak with the enemy; and a trumpet was +sent to the Prince of Piedmont, to know what terms he would give +us. He answered that all the leaders, such as gentlemen, +captains, lieutenants, and ensigns, would be taken prisoners for +ransom, and the soldiers would leave the town without their arms; +and if we refused this fair and honest offer, we might rest +assured they would take us next day, by attack or otherwise. + +A council was held, to which I was called, to know if I would +sign the surrender of the town; with many captains, gentlemen, +and others. I answered it was not possible to hold the town, and +I would sign the surrender with my own blood, for the little hope +I had we could resist the enemy's forces, and for the great +longing I had to be out of this hell and utter torture; for I +slept neither night nor day for the great number of the wounded, +who were about two hundred. The dead were advanced in +putrefaction, piled one upon the other like faggots, and not +covered with earth, because we had none. And if I went into a +soldier's lodging, there were soldiers waiting for me at the door +when I came out, for me to dress others; it was who should have +me, and they carried me like the body of a saint, with my feet +off the ground, fighting for me. I could not satisfy this great +number of wounded: nor had I got what I wanted for their +treatment. For it is not enough that the surgeon do his duty +toward his patients, but the patient also must do his; and the +assistants, and external things, must work together for him: see +Hippocrates, Aphorism the First. + +Having heard that we were to surrender the place, I knew our +business was not prospering; and for fear of being known, I gave +a velvet coat, a satin doublet, and a cloak of fine cloth trimmed +with velvet, to a soldier; who gave me a bad doublet all torn and +ragged with wear, and a frayed leather collar, and a bad hat, and +a short cloak; I dirtied the neck of my shirt with water mixed +with a little soot, I rubbed my hose with a stone at the knees +and over the heels, as though they had been long worn, I did the +same to my shoes, till one would have taken me for a chimney- +sweep rather than a King's surgeon. I went in this gear to M. de +Martigues, and prayed him to arrange I should stop with him to +dress him; which he granted very willingly, and was as glad I +should be near him as I was myself. + +Soon afterward, the commissioners who were to select the +prisoners entered the castle, the seventeenth day of July, 1553. +They took prisoners MM. le Due de Bouillon, le Marquis de +Villars, de Roze, le Baron de Culan, M. du Pont, commissary of +the artillery, and M. de Martigues; and me with him, because he +asked them; and all the gentlemen who they knew could pay ransom, +and most of the soldiers and the leaders of companies; so many +and such prisoners as they wished. And then the Spanish soldiers +entered by the breach, unresisted; our men thought they would +keep their faith and agreement that all lives should be spared. +They entered the town in a fury to kill, plunder, and ravage +everything: they took a few men, hoping to have ransom for them. +... If they saw they could not get it, they cruelly put them to +death in cold blood. ... And they killed them all with daggers, +and cut their throats. Such was their great cruelty and +treachery; let him trust them who will. + +To return to my story: when I was taken from the castle into the +town, with M. de Martigues, there was one of M. de Savoie's +gentlemen, who asked me if M. de Martigues's wound could be +cured. I told him no, that it was incurable: and off he went to +tell M. le Due de Savoie. I bethought myself they would send +physicians and surgeons to dress M. de Martigues; and I argued +within myself if I ought to play the simpleton, and not let +myself be known for a surgeon, lest they should keep me to dress +their wounded, and in the end I should be found to be the King's +surgeon, and they would make me pay a big ransom. On the other +hand, I feared, if I did not show I was a surgeon and had dressed +M. de Martigues skilfully, they would cut my throat. Forthwith I +made up my mind to show them he would not die for want of having +been well dressed and nursed. + +Soon after, sure enough, there came many gentlemen, with the +Emperor's physician, and his surgeon, and those belonging to M. +de Savoie, and six other surgeons of his army, to see M. de +Martigues's wound, and to know of me how I had dressed and +treated it. The Emperor's physician bade me declare the essential +nature of the wound, and what I had done for it. And all his +assistants kept their ears wide open, to know if the wound were +or were not mortal. I commenced my discourse to them, how M. +Martigues, looking over the wall to mark those who were sapping +it, was shot with an arquebus through the body, and I was called +of a sudden to dress him. I found blood coming from his mouth and +from his wounds. Moreover, he bad a great difficulty of breathing +in and out, and air came whistling from the wounds, so that it +would have put out a candle; and he said he had a very great +stabbing pain where the bullet had entered. ... I withdrew some +scales of bone, and put in each wound a tent with a large head, +fastened with a thread, lest on inspiration it should be drawn +into the cavity of the chest; which has happened with surgeons, +to the detriment of the poor wounded; for being fallen in, you +cannot get them out; and then they beget corruption, being +foreign bodies. The tents were anointed with a preparation of +yolk of egg, Venice turpentine, and a little oil of roses. ... I +put over the wounds a great plaster of diachylum, wherewith I had +mixed oil of roses, and vinegar, to avoid inflammation. Then I +applied great compresses steeped in oxycrate, and bandaged him, +not too tight, that he might breathe easily. Next, I drew five +basons of blood from his right arm, considering his youth and his +sanguine temperament. ... Fever took him, soon after he was +wounded, with feebleness of the heart. ... His diet was barley- +water, prunes with sugar, at other times broth: his drink was a +ptisane. He could lie only on his back. ... What more shall I +say? but that my Lord de Martigues never had an hour's rest after +he was wounded. ... These things considered, Gentlemen, no other +prognosis is possible, save that he will die in a few days, to my +great grief. + +Having finished my discourse, I dressed him as I was accustomed. +When I displayed his wounds, the physicians and surgeons, and +other assistants present, knew the truth of what I had said. The +physicians, having felt his pulse and seen that the vital forces +were depressed and spent, agreed with me that in a few days he +would die. Then they all went to the Duc de Savoie, and told him +M. de Martigues would die in a short time. He answered them, +"Possibly, if he had been well dressed, he might have escaped +death." Then they all with one voice said he had been very well +dressed and cared for altogether, and it could not be better, and +it was impossible to cure him, and his wound was of necessity +mortal. Then M. de Savoie was very angry with them, and cried, +and asked them again if for certain they all held his case +hopeless: they answered, yes. + +Then a Spanish impostor came forward, who promised on his life to +cure him; and if he did not, they should cut him in an hundred +pieces; but he would have no physicians, nor surgeons nor +apothecaries with him: and M. le Duc de Savoie forthwith bade the +physicians and surgeons not go near M. de Martigues; and sent a +gentleman to bid me, under pain of death, not so much as to touch +him. Which I promised, and was very glad, for now he would not +die under my hands; and the impostor was told to dress him, and +to have with him no other physicians or surgeons, but only +himself. By and bye he came, and said to M. de Martigues, "Senor +Cavallero, M. de Savoie has bid me come and dress your wound. I +swear to God, before eight days I will set you on horseback, +lance in hand, provided none touch you but I alone. You shall eat +and drink whatever you like. I will be dieted instead of you; and +you may trust me to perform what I promise. I have cured many who +had worse wounds than yours." And the Seigneurs answered him, +"God give you His grace for it." + +He asked for a shirt of M. de Martigues, and tore it in little +strips, which he laid cross-wise, muttering and murmuring certain +words over the wounds: having done this much for him, he let him +eat and drink all he would, saying he himself would be dieted in +his stead; which he did, eating but six prunes and six morsels of +bread for dinner, and drinking only beer. Nevertheless, two days +later, M. de Martigues died: and my friend the Spaniard, seeing +him at the point of death, eclipsed himself, and got away without +good-bye to any man. And I believe if he had been caught he would +have been hanged and strangled, for the false promise he made to +M. le Due de Savoie and many other gentlemen. M. de Martigues +died about ten o'clock in the morning; and after dinner M. de +Savoie sent the physicians and surgeons, and his apothecary, with +a store of drugs to embalm him. They came with many gentlemen and +captains of his army. + +The Emperor's surgeon came to me, and asked me in a very friendly +way to make, the embalmment; which I refused, saying that I was +not worthy to carry his instrument-box after him. He begged me +again to do it to please him, and that he would be very glad of +it...Seeing his kindness, and fearing to displease him, I then +decided to show them the anatomist that I was, expounding to them +many things, which would here be too long to recite... Our +discourse finished, I embalmed the body; and it was placed in a +coffin. Then the Emperor's surgeon drew me aside, and told me, if +I would stop with him, he would treat me well, and give me a new +suit of clothes, and set me on horseback. I gave him many thanks, +and said I had no wish to serve any country but my own. Then he +told me I was a fool, and if he were a prisoner as I was, he +would serve a devil to get his freedom. In the end I told him +flat I would not stop with him. The Emperor's physician then went +back to M. de Savoie, and explained to him the causes of M. de +Martigues' death, and that it was impossible for all the men in +the world to have cured him; and assured him again I had done all +that was to be done, and besought him to take me into his +service; saying much more good of me than there was. He having +been persuaded to do this, sent to me one of his stewards, M. du +Bouchet, to tell me, if I would serve him, he would use me well; +I sent back my very humble thanks, and that I had decided not to +take service under any foreigner. When he heard my answer he was +very angry, and said I ought to be sent to the galleys. + +M. de Vaudeville, Governor of Graveline, and colonel of seventeen +ensigns of infantry, asked him to send me to him, to dress an old +ulcer on his leg, that he had had for six or seven years. M. de +Savoie said he was willing, so far as I was concerned; and if I +used the cautery to his leg, it would serve him right. M. de +Vaudeville answered, if he saw me trying it, he would have my +throat cut. Soon after, he sent for me four German halberdiers of +his guard; and I was terrified, for I did not know where they +were taking me: they spoke no more French than I German. When I +was come to his lodging, he bade me welcome, and said, now I +belonged to him; and so soon as I had healed him, he would let me +go without ransom. I told him I had no means to pay any ransom. +He called his physician and his surgeon-in-ordinary, to show me +his leg; and when we had examined it, we withdrew into a room, +where I began my discourse to them. ... Then the physician left +me with the surgeon, and went back to M. de Vaudeville, and said +he was sure I could cure him, and told him all I had decided to +do; which pleased him vastly. He sent for me, and asked if I +thought I could cure him; I said yes, if he were obedient to what +was necessary. He promised to do only what I wished and ordered; +and so soon as he was healed, he would let me go home without +ransom. Then I asked him to make better terms with me, saying it +was too long to wait for my liberty: in fifteen days I hoped his +ulcer would be less than half its present size, and give no pain; +then his own surgeon and physician could finish the cure. He +granted this to me. Then I took a piece of paper to measure the +size of the ulcer, and gave it to him, and kept another by me; I +asked him to keep his promise, when I had done my work; he swore +by the faith of a gentleman he would. Then I set myself to dress +him properly, after the manner of Galen. ... He wished to know if +it were true, what I said of Galen, and bade his physician look +to it, for he would know it for himself; he had the book put on +the table, and found that what I said was true; so the physician +was ashamed, and I was glad. Within the fifteen days, it was +almost all healed; and I began to feel happy about the compact +made between us. He had me to eat and drink at his table, when +there were no more great persons than he and I only. He gave me a +big red scarf which I must wear; which made me feel something +like a dog when they give him a clog, to stop him eating the +grapes in the vineyards. His physician and surgeon took me +through the camp to visit their wounded; and I took care to +observe what our enemy was doing. I found they had no more great +cannons, but only twenty-five or thirty field-pieces. + +M. de Vaudeville held prisoner M. de Bauge, brother of M. de +Martigues who died at Hesdin. M. de Bauge was prisoner at Chateau +de La Motte au Bois, belonging to the Emperor; he had been +captured at Therouenne by two Spanish soldiers; and M. de +Vaudeville, when he saw him there, concluded he must be some +gentleman of good family: he made him pull off his stockings, and +seeing his clean legs and feet, and his fine white stockings, +knew he was one to pay a good ransom. He told the soldiers he +would give them thirty crowns down for their prisoner: they +agreed gladly, for they had no place to keep him, nor food for +him, nor did they know his value: so they gave their man into his +hands, and he sent him off at once, guarded by four of his own +soldiers, to Chateau de La Motte au Bois, with others of our +gentlemen who were prisoners. + +M. de Bauge would not tell who he was; and endured much hardship, +living on bread and water, with a little straw for his bed. When +Hesdin was taken, M. de Vaudeville sent the news of it to him and +to the other prisoners, and the list of the killed, and among +them M. de Martigues: and when M. de Bauge heard with his own +ears his brother was dead, he fell to crying, weeping, and +lamentation. His guards asked him why he was so miserable: he +told them, for love of M. de Martigues, his brother. When he +heard this, the captain of the castle sent straight to tell M. de +Vaudeville he had a good prisoner: who was delighted at this, and +sent me next day with four soldiers, and his own physician, to +the castle, to say that if M. de Bauge would pay him fifteen +thousand crowns ransom, he would send him home free: and he asked +only the security of two Antwerp merchants that he should name. +M. de Vaudeville persuaded me I should commend this offer to his +prisoner: that is why he sent me to the castle. He told the +captain to treat him well and put him in a room with hangings, +and strengthen his guard: and from that time onward they made a +great deal of him, at the expense of M. de Vaudeville. + +M. de Bauge answered that he could not pay his ransom himself: it +depended on M. d' Estampes his uncle, and Mlle. de Bressure his +aunt: he had no means to pay such a ransom. I went back with my +guards, and gave this answer to M. de Vaudeville; who said, +"Possibly he will not get away so cheap": which was true, for +they knew who he was. Then the Queen of Hungary and M. le Duc de +Savoie sent word to M. de Vaudeville that this mouthful was too +big for him, and he must send his prisoner to them (which he +did), and he had other prisoners enough without him. The ransom +paid was forty thousand crowns, without other expenses. + +On my way back to M. de Vaudeville, I passed by Saint Omer, where +I saw their great cannons, most of which were fouled and broken. +Also I passed by Therouenne, where I saw not one stone left on +another, save a vestige of the great church: for the Emperor +ordered the country people for five or six leagues round to clear +and take away the stones; so that now you may drive a cart over +the town: and the same at Hesdin, and no trace of castle and +fortress. Such is the evil that wars bring with them. + +To return to my story; M. de Vaudeville soon got the better of +his ulcer, and was nearly healed: so he let me go, and sent me by +a trumpet, with passport, as far as Abbeville. I posted from +here, and went to find my master, King Henry, at Aufimon, who +received me gladly and with good favour. He sent MM. de Guise, +the Constable, and d' Estres, to hear from me the capture of +Hesdin; and I made them a true report, and assured them I had +seen the great cannons they had taken to Saint Omer: and the King +was glad, for he had feared the enemy would come further into +France. He gave me two hundred crowns to take me home: and I was +thankful to be free, out of this great torment and thunder of the +diabolical artillery, and away from the soldiers, blasphemers and +deniers of God. I must add that after Hesdin was taken, the King +was told I was not killed but taken prisoner. He made M. Goguier, +his chief physician, write to my wife that I was living, and she +was not to be unhappy, and he would pay my ransom. + + + + +BATTLE OF SAINT QUENTIN. 1557 + + +After the battle of Saint Quentin, the King sent me to La Fere en +Tartenois, to M. le Marechal de Bourdillon, for a passport to M. +le Duc de Savoie, that I might go and dress the Constable, who +had been badly wounded in the back with a pistol-shot, whereof he +was like to die, and remained prisoner in the enemy's hands. But +never would M. le Duc de Savoie let me go to him, saying he would +not die for want of a surgeon; that he much doubted I would go +there only to dress him, and not rather to take some secret +information to him; and that he knew I was privy to other things +besides surgery, and remembered I had been his prisoner at +Hesdin. M. le Marechal told the King of this refusal: who wrote +to M. le Marechal, that if Mme. the Constable's Lady would send +some quick-witted man of her household I would give him a letter, +and had also something to say to him by word of mouth, entrusted +to me by the King and by M. le Cardinal de Lorraine. Two days +later there came one of the Constable's gentlemen of the +bedchamber, with his shirts and other linen, to whom M. le +Marechal gave a passport to go to the Constable. I was very glad, +and gave him my letter, and instructed him what his master must +do now he was prisoner. + +I thought, having finished my mission, to return to the King; but +M. le Marechal begged me to stop at La Fere with him, to dress a +very great number of wounded who had retreated there after the +battle, and he would write to the King to explain why I stopped; +which I did. Their wounds were very putrid, and full of worms, +with gangrene, and corruption; and I had to make free play with +the knife to cut off what was corrupt, which was not done without +amputation of arms and legs, and also sundry trepannings. They +found no store of drugs at La Fere, because the surgeons of the +camp had taken them all away; but I found the waggons of the +artillery there, and these had not been touched. I asked M. le +Marechal to let me have some of the drugs which were in them, +which he did; and I was given the half only at one time, and five +or six days later I had to take the rest; and yet it was not half +enough to dress the great number of wounded. And to correct and +stop the corruption, and kill the worms in their wounds, I washed +them with Aegyptiacum dissolved in wine and eau-de-vie, and did +all I could for them; but in spite of all my care many of them +died. + +There were at La Fere some gentlemen charged to find the dead +body of M. de Bois-Dauphin the elder, who had been killed in the +battle; they asked me to go with them to the camp, to pick him +out, if we could, among the dead; but it was not possible to +recognize him, the bodies being all far gone in corruption, and +their faces changed. We saw more than half a league round us the +earth all covered with the dead; and hardly stopped there, +because of the stench of the dead men and their horses; and so +many blue and green flies rose from them, bred of the moisture of +the bodies and the heat of the sun, that when they were up in the +air they hid the sun. It was wonderful to hear them buzzing; and +where they settled, there they infected the air, and brought the +plague with them. Mon petit maistre, I wish you had been there +with me, to experience the smells, and make report thereof to +them that were not there. + +I was very weary of the place; I prayed M. le Marechal to let me +leave it, and feared I should be ill there; for the wounded men +stank past all bearing, and they died nearly all, in spite of +everything we did. He got surgeons to finish the treatment of +them, and sent me away with his good favour. He wrote to the King +of the diligence I had shown toward the poor wounded. Then I +returned to Paris, where I found many more gentlemen, who had +been wounded and gone thither after the battle. + + + + +THE JOURNEY TO THE CAMP AT AMIENS. 1558 + + +The King sent me to Dourlan, under conduct of Captain Gouast; +with fifty men-at-arms, for fear I should be taken by the enemy; +and seeing we were always in alarms on the way, I made my man let +down, and made him the master; for I got on his horse, which +carried my valise, and could go well if we had to make our +escape, and I took his cloak and hat and gave him my mount, which +was a good little mare; he being in front, you would have taken +him for the master and me for the servant The garrison inside +Dourlan, when they saw us, thought we were the enemy, and fired +their cannon at us. Captain Gouast, my conductor, made signs to +them with his hat that we were not the enemy; at last they ceased +firing, and we entered Dourlan, to our great relief. + +Five or six days before this, a sortie had been made from +Dourlan; wherein many captains and brave soldiers had been killed +or wounded: and among the wounded was Captain Saint Aubin, +vaillant comme l' espce, a great friend of M. de Guise: for whose +sake chiefly the King had sent me there. Who, being attacked with +a quartan fever, yet left his bed to command the greater part of +his company. A Spaniard, seeing him in command, perceived he was +a captain, and shot him through the neck with an arquebus. +Captain Saint Aubin thought himself killed; and by this fright I +protest to God he lost his quartan fever, and was forever free of +it. I dressed him, with Antoine Portail, surgeon-in-ordinary of +the King; and many other soldiers. Some died, others got off with +the loss of an arm or a leg or an eye, and said they had got off +cheap, to be alive at all. Then, the enemy having broken up their +camp, I returned to Paris. + +I say nothing here of mon petit maistre, who was more comfortable +in his house than I at the wars. + + + + +THE JOURNEY TO BOURGES. 1562 + + +The King with his camp was but a short time at Bourges, till +those within the walls should surrender; and they came out with +their goods saved. I know nothing worth remembering, but that a +boy of the King's kitchen, having come near the walls of the town +before the agreement had been signed, cried with a loud voice, +"Huguenot, Huguenot, shoot here, shoot here," having his arm +thrown up and his hand spread out; a soldier shot his hand right +through with a bullet. When he was thus shot, he came to find me +to dress him. And the Constable seeing the boy in tears, with his +hand all bloody, asked who had wounded him: then a gentleman who +had seen him shot said it served him right, because he kept +calling "Huguenot, hit here, aim here." And then the Constable +said, this Huguenot was a good shot and a good fellow, for most +likely if he had chosen to fire at the boy's head, he would have +hit it even more easily than his hand. I dressed the kitchen boy, +who was very ill. He recovered, but with no power in his hand: +and from that time his comrades called him "Huguenot": he is +still living now. + + + + +THE JOURNEY TO ROUEN. 1562 + + +Now, as for the capture of Rouen, they killed many of our men +both before and at the attack: and the very next day after we had +entered the town, I trepanned eight or nine of our men, who had +been wounded with stones as they were on the breach. The air was +so malignant, that many died, even of quite small wounds, so that +some thought the bullets had been poisoned; and those within the +town said the like of us; for though they had within the town all +that was needful, yet all the same they died like those outside. + +The King of Navarre was wounded, some days before the attack, +with a bullet in the shoulder. I visited him, and helped to dress +him, with one of his own surgeons, Master Gilbert, one of the +chief men of Montpellier, and others. They could not find the +bullet. I searched for it very accurately, and found reason to +believe it had entered at the top of the arm, by the head of the +bone, and had passed into the hollow part of the bone, which was +why they could not find it; and most of them said it had entered +his body and was lost in it. M. le Prince de La Roche-sur-Yon, +who dearly loved the King of Navarre, drew me aside and asked if +the wound were mortal. I told him yes, because all wounds of +great joints, and especially contused wounds, were mortal, +according to all those who have written about them. He asked the +others what they thought of it, and chiefly Master Gilbert, who +told him he had great hope his Lord the King would recover; which +made the Prince very glad. + +Four days later, the King, and the Queen-mother, and M. le +Cardinal de Bourbon, his brother, and M. le Prince de la Roche- +sur-Yon, and M. de Guise, and other great persons, after we had +dressed the King of Navarre, wished us to hold a consultation in +their presence, all the physicians and surgeons together. Each of +them said what he thought, and there was not one but had good +hope, they said, that he would recover. I persisted always in the +contrary. M. le Prince, who loved me, drew me aside, and said I +was alone against the opinion of all the others, and prayed me +not to be obstinate against so many good men. I answered, When I +shall see good signs of recovery, I will change my mind. Many +consultations were held, and I never changed what I said, and the +prognosis I had made at the first dressing, and said always the +arm would fall into a gangrene: which it did, for all the care +they could give to it; and he rendered his spirit to God the +eighteenth day after his wound. + +M. le Prince, having heard of it, sent to me his surgeon, and his +physician, one Lefevre, now physician-in-ordinary to the King and +Queen-mother, to say he wished to have the bullet, and we were to +look for it, to see where it was. Then I was very glad, and +assured them I should quickly find it; which I did in their +presence, with many other gentlemen: it was just in the very +middle of the bone. M. le Prince took and showed it to the King +and to the Queen, who all said that my prognosis had come true. +The body was laid to rest at Chateau Gaillard: and I returned to +Paris, where I found many patients, who had been wounded on the +breach at Rouen, and chiefly Italians, who were very eager I +should dress them: which I did willingly. Many of them recovered: +the rest died. Mon petit maistre, I think you were called to +dress some, for the great number there was of them. + + + + +THE BATTLE OF DREUX. 1562 + + +The day after the battle of Dreux, the King bade me go and dress +M. le Comte d'Eu, who had been wounded in the right thigh, near +the hip-joint, with a pistol-shot: which had smashed and broken +the thigh-bone into many pieces: whereon many accidents +supervened, and at last death, to my great grief. The day after I +came, I would go to the camp where the battle had been, to see +the dead bodies. I saw, for a long league round, the earth all +covered: they estimated it at twenty-five thousand men or more; +and it was all done in less than two hours. I wish, mon petit +maistre, for the love I bear you, you had been there, to tell it +to your scholars and your children. + +Now while I was at Dreux, I visited and dressed a great number of +gentlemen, and poor soldiers, and among the rest many of the +Swiss captains. I dressed fourteen all in one room, all wounded +with pistol-shots and other diabolical firearms, and not one of +the fourteen died. M. le Comte d'Eu being dead, I made no long +stay at Dreux. Surgeons came from Paris, who fulfilled their duty +to the wounded, as Pigray, Cointeret, Hubert, and others; and I +returned to Paris, where I found many wounded gentlemen who had +retreated thither after the battle, to have their wounds dressed; +and I was not there without seeing many of them. + + + + +THE JOURNEY TO HAVRE DE GRACE. 1563 + + +And I will not omit to tell of the camp at Havre de Grace. When +our artillery came before the walls of the town, the English +within the walls killed some of our men, and several pioneers who +were making gabions. And seeing they were so wounded that there +was no hope of curing them, their comrades stripped them, and put +them still living inside the gabions, which served to fill them +up. When the English saw that they could not withstand our +attack, because they were hard hit by sickness, and especially by +the plague, they surrendered. The King gave them ships to return +to England, very glad to be out of this plague-stricken place. +The greater part of them died, and they took the plague to +England, and they have not got rid of it since. Captain +Sarlabous, master of the camp, was left in garrison, with six +ensigns of infantry, who had no fear of the plague; and they were +very glad to get into the town, hoping to enjoy themselves there, +Mon petit maistre, if you had been there, you would have done as +they did. + + + + +THE JOURNEY TO BAYONNE. 1564 + + +I went with the King on that journey to Bayonne, when we were two +years and more making the tour of well-nigh all this kingdom. And +in many towns and villages I was called in consultation over +sundry diseases, with the late M. Chapelain, chief physician to +the King, and M. Castellan, chief physician to the Queen-mother; +honorable men and very learned in medicine and surgery. During +this journey, I always inquired of the surgeons if they had noted +anything rare in their practices, so that I might learn something +new. While I was at Bayonne, two things happened worthy of remark +by young surgeons. The first is, I dressed a Spanish gentleman, +who had a great and enormous swelling of the throat. He had +lately been touched by the deceased King Charles for the king's +evil. I opened his swelling. ... I left him in the hands of a +surgeon of the town, to finish his cure. M. de Fontaine, Knight +of the Order of the King, had a severe continued pestilent fever, +accompanied with many inflammatory swellings in sundry parts of +the body. He had bleeding at the nose for two days, without +ceasing, nor could we staunch it: and after this haemorrhage the +fever ceased, with much sweating, and by and bye the swellings +suppurated, and he was dressed by me, and healed by the grace of +God. + + + + +BATTLE OF SAINT DENIS, 1567 + + +As for the battle of Saint Denis, there were many killed on both +sides. Our wounded withdrew to Paris to be dressed, with the +prisoners they had taken, and I dressed many of them. The King +ordered me, at the request of Mme. the Constable's Lady, to go to +her house to dress the Constable; who had a pistol-shot in the +middle of the spine of his back, whereby at once he lost all +feeling and movement in his thighs and legs ... because the +spinal cord, whence arise the nerves to give feeling and movement +to the parts below, was crushed, broken, and torn by the force of +the bullet. Also he lost understanding and reason, and in a few +days he died. The surgeons of Paris were hard put to it for many +days to treat all the wounded. I think, mon petit maistre, you +saw some of them. I beseech the great God of victories, that we +be never more employed in such misfortune and disaster. + + + + +VOYAGE OF THE BATTLE OF MONCONTOUR. 1569 + + +During the battle of Moncontour, King Charles was at Plessis-les- +Tours, where he heard the news of the victory. A great number of +gentlemen and soldiers retreated into the town and suburbs of +Tours, wounded, to be dressed and treated; and the King and the +Queen-mother bade me do my duty by them, with other surgeons who +were then on duty, as Pigray, du Bois, Portail, and one Siret, a +surgeon of Tours, a man well versed in surgery, who was at this +time surgeon to the King's brother. And for the multitude of bad +cases we had scarce any rest, nor the physicians either. + +M. le Comte de Mansfeld, Governor of the Duchy of Luxembourg, +Knight of the Order of the King, was severely wounded in the +battle, in the left arm, with a pistol-shot which broke a great +part of his elbow; and he withdrew to Borgueil near Tours. Then +he sent a gentleman to the King, to beg him to send one of his +surgeons, to help him of his wound. So they debated which surgeon +they should send. M. le Marechal de Montmorency told the King and +the Queen that they ought to send him their chief surgeon; and +urged that M. de Mansfeld had done much toward the victory. + +The King said flat, he would not have me go, and wished me to +stop with himself. Then the Queen-mother told him I would but go +and come back, and he must remember it was a foreign lord, who +had come, at the command of the King of Spain, to help him. then +he let me go, provided I came back very soon. So he sent for me, +and the Queen-mother with him, and bade me go and find the Lord +de Mansfeld, wherever he should be, to do all I could for him to +heal his wound. I went to him, with a letter from Their +Majesties. When he saw it, he received me with good-will, and +forthwith dismissed three or four surgeons who were dressing him; +which was to my very great regret, because his wound seemed to me +incurable. + +Now many gentlemen had retreated to Borgueil, having been +wounded: for they knew that M. de Guise was there, who also had +been badly wounded with a pistol-shot through the leg, and they +were sure that he would have good surgeons to dress him, and +would help them, as he is kindly and very generous, and would +relieve their wants. This he did with a will, both for their +eating and drinking, and for what else they needed: and for my +part, they had the comfort and help of my art: some died, others +recovered, according to their wounds. M. le Comte Ringrave died, +who was shot in the shoulder, like the King of Navarre before +Rouen. M. de Bassompierre, colonel of twelve hundred horse, was +wounded by a similar shot, in the same place, as M. de Mansfeld: +whom I dressed, and God healed. God blessed my work so well, that +in three weeks I sent them back to Paris: where I had still to +make incisions in M. de Mansfeld's arm, to remove some pieces of +the bones, which were badly splintered, broken, and carious. He +was healed by the grace of God, and made me a handsome present, +so I was well content with him, and he with me; as he has shown +me since. He wrote a letter to M. le Duc d' Ascot, how he was +healed of his wound, and also M. de Bassompierre of his, and many +others whom I had dressed after the battle of Moncontour; and +advised him to ask the King of France to let me visit M. le +Marquis d' Auret, his brother: which he did. + + + + +THE JOURNEY TO FLANDERS. 1569 + + +M. le Duc d' Ascot did not fail to send a gentleman to the King, +with a letter humbly asking he would do him so much kindness and +honour as to permit and command his chief surgeon to visit M. le +Marquis d' Auret, his brother, who had received a gunshot wound +near the knee, with fracture of the bone, about seven months ago, +and the physicians and surgeons all this time had not been able +to heal him. The King sent for me and bade me go and see M. d' +Auret, and give him all the help I could, to heal him of his +wound. I told him I would employ all the little knowledge it had +pleased God to give me. + +I went off, escorted by two gentlemen, to the Chateau d' Auret, +which is a league and a half from Mons in Hainault, where M. le +Marquis was lying. So soon as I had come, I visited him, and told +him the King had commanded me to come and see him and dress his +wound. He said he was very glad I had come, and was much beholden +to the King, who had done him so much honour as to send me to +him. + +I found him in a high fever, his eyes deep sunken, with a +moribund and yellowish face, his tongue dry and parched, and the +whole body much wasted and lean, the voice low as of a man very +near death: and I found his thigh much inflamed, suppurating, and +ulcerated, discharging a greenish and very offensive sanies. I +probed it with a silver probe, wherewith I found a large cavity +in the middle of the thigh, and others round the knee, sanious +and cuniculate: also several scales of bone, some loose, others +not. The leg was greatly swelled, and imbued with a pituitous +humor ... and bent and drawn back. There was a large bedsore; he +could rest neither day nor night; and had no appetite to eat, but +very thirsty. I was told he often fell into a faintness of the +heart, and sometimes as in epilepsy: and often he felt sick, with +such trembling he could not carry his hands to his mouth. Seeing +and considering all these great complications, and the vital +powers thus broken down, truly I was very sorry I had come to +him, because it seemed to me there was little hope he would +escape death. All the same, to give him courage and good hope, I +told him I would soon set him on his legs, by the grace of God, +and the help of his physicians and surgeons. + +Having seen him, I went a walk in a garden, and prayed God He +would show me this grace, that he should recover; and that He +would bless our hands and our medicaments, to fight such a +complication of diseases. I discussed in my mind the means I must +take to do this. They called me to dinner. I came into the +kitchen, and there I saw, taken out of a great pot, half a sheep, +a quarter of veal, three great pieces of beef, two fowls, and a +very big piece of bacon, with abundance of good herbs: then I +said to myself that the broth of the pot would be full of juices, +and very nourishing. + +After dinner, we began our consultation, all the physicians and +surgeons together, in the presence of M. le Duc d' Ascot and some +gentlemen who were with him. I began to say to the surgeons that +I was astonished they had not made incisions in M. le Marquis' +thigh, seeing that it was all suppurating, and the thick matter +in it very foetid and offensive, showing it had long been pent up +there; and that I had found with the probe caries of the bone, +and scales of bone, which were already loose. They answered me: +"Never would he consent to it"; indeed, it was near two months +since they had been able to get leave to put clean sheets on his +bed; and one scarce dared touch the coverlet, so great was his +pain. Then I said, "To heal him, we must touch something else +than the coverlet of his bed." Each said what he thought of the +malady of the patient, and in conclusion they all held it +hopeless. I told them there was still some hope, because he was +young, and God and Nature sometimes do things which seem to +physicians and surgeons impossible. + +To restore the warmth and nourishment of the body, general +frictions must be made with hot cloths, above, below, to right, +to left, and around, to draw the blood and the vital spirits from +within outward. ... For the bedsore, he must be put in a fresh, +soft bed, with clean shirt and sheets... Having discoursed of the +causes and complications of his malady, I said we must cure them +by their contraries; and must first ease the pain, making +openings in the thigh to let out the matter. ... Secondly, having +regard to the great swelling and coldness of the limb, we must +apply hot bricks round it, and sprinkle them with a decoction of +nerval herbs in wine and vinegar, and wrap them in napkins; and +to his feet, an earthenware bottle filled with the decoction, +corked, and wrapped in cloths. Then the thigh, and the whole of +the leg, must be fomented with a decoction made of sage, +rosemary, thyme, lavender, flowers of chamomile and melilot, red +roses boiled in white wine, with a drying powder made of oak-- +ashes and a little vinegar and half a handful of salt. ... +Thirdly, we must apply to the bedsore a large plaster made of the +desiccative red ointment and of Unguentum Comitissoe, equal +parts, mixed together, to ease his pain and dry the ulcer; and he +must have a little pillow of down, to keep all pressure off it. +... And for the strengthening of his heart, we must apply over it +a refrigerant of oil of waterlilies, ointment of roses, and a +little saffron, dissolved in rose-vinegar and treacle, spread on +a piece of red cloth. For the syncope, from exhaustion of the +natural forces, troubling the brain, he must have good +nourishment full of juices, as raw eggs, plums stewed in wine and +sugar, broth of the meat of the great pot, whereof I have already +spoken; the white meat of fowls, partridges' wings minced small, +and other roast meats easy to digest, as veal, kid, pigeons, +partridges, thrushes, and the like, with sauce of orange, +verjuice, sorrel, sharp pomegranates; or he may have them boiled +with good herbs, as lettuce, purslain, chicory, bugloss, +marigold, and the like. At night he can take barley-water, with +juice of sorrel and of waterlilies, of each two ounces, with four +or five grains of opium, and the four cold seeds crushed, of each +half an ounce; which is a good nourishing remedy and will make +him sleep. His bread to be farmhouse bread, neither too stale nor +too fresh. For the great pain in his head, his hair must be cut, +and his head rubbed with rose-vinegar just warm, and a double +cloth steeped in it and put there; also a forehead-cloth, of oil +of roses and water-lilies and poppies, and a little opium and +rose-vinegar, with a little camphor, and changed from time to +time. Moreover, we must allow him to smell flowers of henbane and +water-lilies, bruised with vinegar and rose-water, with a little +camphor, all wrapped in a handkerchief, to be held some time to +his nose. ... And we must make artificial rain, pouring water +from some high place into a cauldron, that he may hear the sound +of it; by which means sleep shall be provoked on him. As for the +contraction of his leg, there is hope of righting it when we have +let out the pus and other humors pent up in the thigh, and have +rubbed the whole knee with ointment of mallows, and oil of +lilies, and a little eau-de-vie, and wrapped it in black wool +with the grease left in it; and if we put under the knee a +feather pillow doubled, little by little we shall straighten the +leg. + +This my discourse was well approved by the physicians and +surgeons. + +The consultation ended, we went back to the patient, and I made +three openings in his thigh. ... Two or three hours later, I got +a bed made near his old one, with fair white sheets on it; then a +strong man put him in it, and he was thankful to be taken out of +his foul stinking bed. Soon after, he asked to sleep; which he +did for near four hours; and everybody in the house began to feel +happy, and especially M. le Duc d' Ascot, his brother. + +The following days, I made injections, into the depth and +cavities of the ulcers, of Aegyptiacum dissolved sometimes in +eau-de-vie, other times in wine, I applied compresses to the +bottom of the sinuous tracks, to cleanse and dry the soft spongy +flesh, and hollow leaden tents, that the sanies might always have +a way out; and above them a large plaster of Diacalcitheos +dissolved in wine. And I bandaged him so skilfully that he had no +pain; and when the pain was gone, the fever began at once to +abate. Then I gave him wine to drink moderately tempered with +water, knowing it would restore and quicken the vital forces. And +all that we agreed in consultation was done in due time and +order; and so soon as his pains and fever ceased, he began +steadily to amend. He dismissed two of his surgeons, and one of +his physicians, so that we were but three with him. + +Now I stopped there about two months, not without seeing many +patients, both rich and poor, who came to me from three or four +leagues round. He gave food and drink to the needy, and commended +them all to me, asking me to help them for his sake. I protest I +refused not one, and did for them all I could, to his great +pleasure. Then, when I saw him beginning to be well, I told him +we must have viols and violins, and a buffoon to make him laugh: +which he did. In one month, we got him into a chair, and he had +himself carried about in his garden and at the door of his +chateau, to see everybody passing by. + +The villagers of two or three leagues round, now they could have +sight of him, came on holidays to sing and dance, men and women, +pell-mell for a frolic, rejoiced at his good convalescence, all +glad to see him, not without plenty of laughter and plenty to +drink. He always gave them a hogshead of beer; and they all drank +merrily to his health. And the citizens of Mons in Hainault, and +other gentlemen, his neighbours, came to see him for the wonder +of it, as a man come out of the grave; and from the time he was +well, he was never without company. When one went out, another +came in to visit him; his table was always well covered. He was +dearly loved both by the nobility and by the common people; as +for his generosity, so for his handsome face and his courtesy: +with a kind look and a gracious word for everybody, so that all +who saw him had perforce to love him. + +The chief citizens of Mons came one Saturday, to beg him let me +go to Mons, where they wished to entertain me with a banquet, for +their love of him. He told them he would urge me to go, which he +did; but I said such great honour was not for me, moreover they +could not feast me better than he did. Again he urged me, with +much affection, to go there, to please him; and I agreed. The +next day, they came to fetch me with two carriages: and when we +got to Mons, we found the dinner ready, and the chief men of the +town, with their ladies, who attended me with great devotion. We +sat down to dinner, and they put me at the top of the table, and +all drank to me, and to the health of M. le Marquis d'Auret: +saying he was happy, and they with him, to have had me to put him +on his legs again; and truly the whole company were full of +honour and love for him. After dinner, they brought me back to +the Chateau d'Auret, where M. le Marquis was awaiting me; who +affectionately welcomed me, and would hear what we had done at +our banquet; and I told him all the company had drunk many times +to his health. + +In six weeks he began to stand a little on crutches, and to put +on fat and get a good natural colour. He would go to Beaumont, +his brother's place; and was taken there in a carrying-chair, by +eight men at a time. And the peasants in the villages through +which we passed, knowing it was M. le Marquis, fought who should +carry him, and would have us drink with them; but it was only +beer. Yet I believe if they had possessed wine, even hippocras, +they would have given it to us with a will. And all were right +glad to see him, and all prayed God for him. When we came to +Beaumont, everybody came out to meet us and pay their respects to +him, and prayed God bless him and keep him in good health. We +came to the chateau, and found there more than fifty gentlemen +whom M. le Duc d'Ascot had invited to come and be happy with his +brother; and he kept open house three whole days. After dinner, +the gentlemen used to tilt at the ring and play with the foils, +and were full of joy at the sight of M. d'Auret, for they had +heard he would never leave his bed or be healed of his wound. I +was always at the upper end of the table, and everybody drank to +him and to me, thinking to make me drunk, which they could not; +for I drank only as I always do. + +A few days later, we went back; and I took my leave of Mdme. la +Duchesse d'Ascot, who drew a diamond from her finger, and gave it +me in gratitude for my good care of her brother: and the diamond +was worth more than fifty crowns. M. d'Auret was ever getting +better, and was walking all alone on crutches round his garden. +Many times I asked him to let me go back to Paris, telling him +his physician and his surgeon could do all that was now wanted +for his wound: and to make a beginning to get away from him, I +asked him to let me go and see the town of Antwerp. To this he +agreed at once, and told his steward to escort me there, with two +pages. We passed through Malines and Brussels, where the chief +citizens of the town begged us to let them know of it when we +returned; for they too wished, like those of Mons, to have a +festival for me. I gave them very humble thanks, saying I did not +deserve such honour. I was two days and a half seeing the town of +Antwerp, where certain merchants, knowing the steward, prayed he +would let them have the honour of giving us a dinner or a supper: +it was who should have us, and they were all truly glad to hear +how well M. d' Auret was doing, and made more of me than I asked. + +On my return, I found M. le Marquis enjoying himself: and five or +six days later I asked his leave to go, which he gave, said he, +with great regret. And he made me a handsome present of great +value, and sent me back, with the steward, and two pages, to my +house in Paris. + +I forgot to say that the Spaniards have since ruined and +demolished his Chateau d' Auret, sacked, pillaged, and burned all +the houses and villages belonging to him: because he would not be +of their wicked party in their assassinations and ruin of the +Netherlands. + +I have published this Apologia, that all men may know on what +footing I have always gone: and sure there is no man so touchy +not to take in good part what I have said. For I have but told +the truth; and the purport of my discourse is plain for all men +to see, and the facts themselves are my guarantee against all +calumnies. + + + + +ON THE MOTION OF THE HEART AND BLOOD IN ANIMALS +BY WILLIAM HARVEY +TRANSLATED BY ROBERT WILLIS +AND REVISED BY ALEXANDER BOWIE + + +INTRODUCTORY NOTE + + +William Harvey, whose epoch-making treatise announcing and +demonstrating the ejaculation of the blood is here printed, was +born at Folkestone, Kent, England, April 1, 1578. He was educated +at the King's School, Canterbury, and at Gonville and Caius +College, Cambridge; and studied medicine on the Continent, +receiving the degree of M.D. from the University of Padua. He +took the same degree later at both the English universities. +After his return to England he became Fellow of the College of +Physicians, physician to St. Bartholomew's Hospital, and Lumleian +lecturer at the College of Physicians. It was in this last +capacity that he delivered, in 1616, the lectures in which he +first gave public notice of his theories on the circulation of +the blood. The notes of these lectures are still preserved in the +British Museum. + +In 1618 Harvey was appointed physician extraordinary to James I, +and he remained in close professional relations to the royal +family until the close of the Civil War, being present at the +battle of Edgehill. By mandate of Charles I, he was, for a short +time, Warden of Merton College, Oxford (1645-6), and, when he was +too infirm to undertake the duties, he was offered the Presidency +of the College of Physicians. He died on June 3, 1657. + +Harvey's famous "Exercitatio Anatomica de Motu Cordis et +Sanguinis in Animalibus" was published in Latin at Frankfort in +1628. The discovery was received with great interest, and in his +own country was accepted at once; on the Continent it won favor +more slowly. Before his death, however, the soundness of his +views was acknowledged by the medical profession throughout +Europe, and "it remains to this day the greatest of the +discoveries of physiology, and its whole honor belongs to +Harvey." + + + + +DEDICATION + +TO HIS VERY DEAR FRIEND, DOCTOR ARGENT, THE EXCELLENT AND +ACCOMPLISHED PRESIDENT OF THE ROYAL COLLEGE OF PHYSICIANS, AND TO +OTHER LEARNED PHYSICIANS, HIS MOST ESTEEMED COLLEAGUES. + + +I have already and repeatedly presented you, my learned friends, +with my new views of the motion and function of the heart, in my +anatomical lectures; but having now for more than nine years +confirmed these views by multiplied demonstrations in your +presence, illustrated them by arguments, and freed them from the +objections of the most learned and skilful anatomists, I at +length yield to the requests, I might say entreaties, of many, +and here present them for general consideration in this treatise. + +Were not the work indeed presented through you, my learned +friends, I should scarce hope that it could come out scatheless +and complete; for you have in general been the faithful witnesses +of almost all the instances from which I have either collected +the truth or confuted error. You have seen my dissections, and at +my demonstrations of all that I maintain to be objects of sense, +you have been accustomed to stand by and bear me out with your +testimony. And as this book alone declares the blood to course +and revolve by a new route, very different from the ancient and +beaten pathway trodden for so many ages, and illustrated by such +a host of learned and distinguished men, I was greatly afraid +lest I might be charged with presumption did I lay my work before +the public at home, or send it beyond seas for impression, unless +I had first proposed the subject to you, had confirmed its +conclusions by ocular demonstrations in your presence, had +replied to your doubts and objections, and secured the assent and +support of our distinguished President. For I was most intimately +persuaded, that if I could make good my proposition before you +and our College, illustrious by its numerous body of learned +individuals, I had less to fear from others. I even ventured to +hope that I should have the comfort of finding all that you +granted me in your sheer love of truth, conceded by others who +were philosophers like yourselves. True philosophers, who are +only eager for truth and knowledge, never regard themselves as +already so thoroughly informed, but that they welcome further +information from whomsoever and from wheresoever it may come; nor +are they so narrow-minded as to imagine any of the arts or +sciences transmitted to us by the ancients, in such a state of +forwardness or completeness, that nothing is left for the +ingenuity and industry of others. On the contrary, very many +maintain that all we know is still infinitely less than all that +still remains unknown; nor do philosophers pin their faith to +others' precepts in such wise that they lose their liberty, and +cease to give credence to the conclusions of their proper senses. +Neither do they swear such fealty to their mistress Antiquity, +that they openly, and in sight of all, deny and desert their +friend Truth. But even as they see that the credulous and vain +are disposed at the first blush to accept and believe everything +that is proposed to them, so do they observe that the dull and +unintellectual are indisposed to see what lies before their eyes, +and even deny the light of the noonday sun. They teach us in our +course of philosophy to sedulously avoid the fables of the poets +and the fancies of the vulgar, as the false conclusions of the +sceptics. And then the studious and good and true, never suffer +their minds to be warped by the passions of hatred and envy, +which unfit men duly to weigh the arguments that are advanced in +behalf of truth, or to appreciate the proposition that is even +fairly demonstrated. Neither do they think it unworthy of them to +change their opinion if truth and undoubted demonstration require +them to do so. They do not esteem it discreditable to desert +error, though sanctioned by the highest antiquity, for they know +full well that to err, to be deceived, is human; that many things +are discovered by accident and that many may be learned +indifferently from any quarter, by an old man from a youth, by a +person of understanding from one of inferior capacity. + +My dear colleagues, I had no purpose to swell this treatise into +a large volume by quoting the names and writings of anatomists, +or to make a parade of the strength of my memory, the extent of +my reading, and the amount of my pains; because I profess both to +learn and to teach anatomy, not from books but from dissections; +not from the positions of philosophers but from the fabric of +nature; and then because I do not think it right or proper to +strive to take from the ancients any honor that is their due, nor +yet to dispute with the moderns, and enter into controversy with +those who have excelled in anatomy and been my teachers. I would +not charge with wilful falsehood any one who was sincerely +anxious for truth, nor lay it to any one's door as a crime that +he had fallen into error. I avow myself the partisan of truth +alone; and I can indeed say that I have used all my endeavours, +bestowed all my pains on an attempt to produce something that +should be agreeable to the good, profitable to the learned, and +useful to letters. + +Farewell, most worthy Doctors, And think kindly of your +Anatomist, + +WILLIAM HARVEY. + + + + +INTRODUCTION + + +As we are about to discuss the motion, action, and use of the +heart and arteries, it is imperative on us first to state what +has been thought of these things by others in their writings, and +what has been held by the vulgar and by tradition, in order that +what is true may be confirmed, and what is false set right by +dissection, multiplied experience, and accurate observation. + +Almost all anatomists, physicians, and philosophers up to the +present time have supposed, with Galen, that the object of the +pulse was the same as that of respiration, and only differed in +one particular, this being conceived to depend on the animal, the +respiration on the vital faculty; the two, in all other respects, +whether with reference to purpose or to motion, comporting +themselves alike. Whence it is affirmed, as by Hieronymus +Fabricius of Aquapendente, in his book on "Respiration," which +has lately appeared, that as the pulsation of the heart and +arteries does not suffice for the ventilation and refrigeration +of the blood, therefore were the lungs fashioned to surround the +heart. From this it appears that whatever has hitherto been said +upon the systole and diastole, or on the motion of the heart and +arteries, has been said with especial reference to the lungs. + +But as the structure and movements of the heart differ from those +of the lungs, and the motions of the arteries from those of the +chest, so it seems likely that other ends and offices will thence +arise, and that the pulsations and uses of the heart, likewise of +the arteries, will differ in many respects from the heavings and +uses of the chest and lungs. For did the arterial pulse and the +respiration serve the same ends; did the arteries in their +diastole take air into their cavities, as commonly stated, and in +their systole emit fuliginous vapours by the same pores of the +flesh and skin; and further, did they, in the time intermediate +between the diastole and the systole, contain air, and at all +times either air or spirits, or fuliginous vapours, what should +then be said to Galen, who wrote a book on purpose to show that +by nature the arteries contained blood, and nothing but blood, +and consequently neither spirits nor air, as may readily be +gathered from the experiments and reasonings contained in the +same book? Now, if the arteries are filled in the diastole with +air then taken into them (a larger quantity of air penetrating +when the pulse is large and full), it must come to pass that if +you plunge into a bath of water or of oil when the pulse is +strong and full, it ought forthwith to become either smaller or +much slower, since the circumambient bath will render it either +difficult or impossible for the air to penetrate. In like manner, +as all the arteries, those that are deep-seated as well as those +that are superficial, are dilated at the same instant and with +the same rapidity, how is it possible that air should penetrate +to the deeper parts as freely and quickly through the skin, +flesh, and other structures, as through the cuticle alone? And +how should the arteries of the foetus draw air into their +cavities through the abdomen of the mother and the body of the +womb? And how should seals, whales, dolphins, and other +cetaceans, and fishes of every description, living in the depths +of the sea, take in and emit air by the diastole and systole of +their arteries through the infinite mass of water? For to say +that they absorb the air that is present in the water, and emit +their fumes into this medium, were to utter something like a +figment. And if the arteries in their systole expel fuliginous +vapours from their cavities through the pores of the flesh and +skin, why not the spirits, which are said to be contained in +those vessels, at the same time, since spirits are much more +subtile than fuliginous vapours or smoke? And if the arteries +take in and cast out air in the systole and diastole, like the +lungs in the process of respiration, why do they not do the same +thing when a wound is made in one of them, as in the operation of +arteriotomy? When the windpipe is divided, it is sufficiently +obvious that the air enters and returns through the wound by two +opposite movements; but when an artery is divided, it is equally +manifest that blood escapes in one continuous stream, and that no +air either enters or issues. If the pulsations of the arteries +fan and refrigerate the several parts of the body as the lungs do +the heart, how comes it, as is commonly said, that the arteries +carry the vital blood into the different parts, abundantly +charged with vital spirits, which cherish the heat of these +parts, sustain them when asleep, and recruit them when exhausted? +How should it happen that, if you tie the arteries, immediately +the parts not only become torpid, and frigid, and look pale, but +at length cease even to be nourished? This, according to Galen, +is because they are deprived of the heat which flowed through all +parts from the heart, as its source; whence it would appear that +the arteries rather carry warmth to the parts than serve for any +fanning or refrigeration. Besides, how can their diastole draw +spirits from the heart to warm the body and its parts, and means +of cooling them from without? Still further, although some affirm +that the lungs, arteries, and heart have all the same offices, +they yet maintain that the heart is the workshop of the spirits, +and that the arteries contain and transmit them; denying, +however, in opposition to the opinion of Columbus, that the lungs +can either make or contain spirits. They then assert, with Galen, +against Erasistratus, that it is the blood, not spirits, which is +contained in the arteries. + +These opinions are seen to be so incongruous and mutually +subversive, that every one of them is justly brought under +suspicion. That it is blood and blood alone which is contained in +the arteries is made manifest by the experiment of Galen, by +arteriotomy, and by wounds; for from a single divided artery, as +Galen himself affirms in more than one place, the whole of the +blood may be withdrawn in the course of half an hour or less. The +experiment of Galen alluded to is this: "If you include a portion +of an artery between two ligatures, and slit it open lengthwise +you will find nothing but blood"; and thus he proves that the +arteries contain only blood. And we too may be permitted to +proceed by a like train of reasoning: if we find the same blood +in the arteries as in the veins, after having tied them in the +same way, as I have myself repeatedly ascertained, both in the +dead body and in living animals, we may fairly conclude that the +arteries contain the same blood as the veins, and nothing but the +same blood. Some, whilst they attempt to lessen the difficulty, +affirm that the blood is spirituous and arterious, and virtually +concede that the office of the arteries is to carry blood from +the heart into the whole of the body, and that they are therefore +filled with blood; for spirituous blood is not the less blood on +that account. And no one denies the blood as such, even the +portion of it which flows in the veins, is imbued with spirits. +But if that portion of it which is contained in the arteries be +richer in spirits, it is still to be believed that these spirits +are inseparable from the blood, like those in the veins; that the +blood and spirits constitute one body (like whey and butter in +milk, or heat in hot water), with which the arteries are charged, +and for the distribution of which from the heart they are +provided. This body is nothing else than blood. But if this blood +be said to be drawn from the heart into the arteries by the +diastole of these vessels, it is then assumed that the arteries +by their distension are filled with blood, and not with the +surrounding air, as heretofore; for if they be said also to +become filled with air from the ambient atmosphere, how and when, +I ask, can they receive blood from the heart? If it be answered: +during the systole, I take it to be impossible: the arteries +would then have to fill while they contracted, to fill, and yet +not become distended. But if it be said: during diastole, they +would then, and for two opposite purposes, be receiving both +blood and air, and heat and cold, which is improbable. Further +when it is affirmed that the diastole of the heart and arteries +is simultaneous, and the systole of the two is also concurrent, +there is another incongruity. For how can two bodies mutually +connected, which are simultaneously distended, attract or draw +anything from one another? or being simultaneously contracted, +receive anything from each other? And then it seems impossible +that one body can thus attract another body into itself, so as to +become distended, seeing that to be distended is to be passive, +unless, in the manner of a sponge, which has been previously +compressed by an external force, it is returning to its natural +state. But it is difficult to conceive that there can be anything +of this kind in the arteries. The arteries dilate, because they +are filled like bladders or leathern bottles; they are not filled +because they expand like bellows. This I think easy of +demonstration, and indeed conceive that I have already proved it. +Nevertheless, in that book of Galen headed "Quod Sanguis +continetur in Arterus," he quotes an experiment to prove the +contrary. An artery having been exposed, is opened +longitudinally, and a reed or other pervious tube is inserted +into the vessel through the opening, by which the blood is +prevented from being lost, and the wound is closed. "So long," he +says, "as things are thus arranged, the whole artery will +pulsate; but if you now throw a ligature about the vessel and +tightly compress its wall over the tube, you will no longer see +the artery beating beyond the ligature." I have never performed +this experiment of Galen's nor do I think that it could very well +be performed in the living body, on account of the profuse flow +of blood that would take place from the vessel that was operated +on; neither would the tube effectually close the wound in the +vessel without a ligature; and I cannot doubt but that the blood +would be found to flow out between the tube and the vessel. Still +Galen appears by this experiment to prove both that the pulsative +property extends from the heart by the walls of the arteries, and +that the arteries, whilst they dilate, are filled by that +pulsific force, because they expand like bellows, and do not +dilate as if they are filled like skins, But the contrary is +obvious in arteriotomy and in wounds; for the blood spurting from +the arteries escapes with force, now farther, now not so far, +alternately, or in jets; and the jet always takes place with the +diastole of the artery, never with the systole. By which it +clearly appears that the artery is dilated with the impulse of +the blood; for of itself it would not throw the blood to such a +distance and whilst it was dilating; it ought rather to draw air +into its cavity through the wound, were those things true that +are commonly stated concerning the uses of the arteries. Do not +let the thickness of the arterial tunics impose upon us, and lead +us to conclude that the pulsative property proceeds along them +from the heart For in several animals the arteries do not +apparently differ from the veins; and in extreme parts of the +body where the arteries are minutely subdivided, as in the brain, +the hand, etc., no one could distinguish the arteries from the +veins by the dissimilar characters of their coats: the tunics of +both are identical. And then, in the aneurism proceeding from a +wounded or eroded artery, the pulsation is precisely the same as +in the other arteries, and yet it has no proper arterial +covering. To this the learned Riolanus testifies along with me, +in his Seventh Book. + +Nor let any one imagine that the uses of the pulse and the +respiration are the same, because, under the influences of the +same causes, such as running, anger, the warm bath, or any other +heating thing, as Galen says, they become more frequent and +forcible together. For not only is experience in opposition to +this idea, though Galen endeavours to explain it away, when we +see that with excessive repletion the pulse beats more forcibly, +whilst the respiration is diminished in amount;, but in young +persons the pulse is quick, whilst respiration is slow. So it is +also in alarm, and amidst care, and under anxiety of mind; +sometimes, too, in fevers, the pulse is rapid, but the +respiration is slower than usual. + +These and other objections of the same kind may be urged against +the opinions mentioned. Nor are the views that are entertained of +the offices and pulse of the heart, perhaps, less bound up with +great and most inextricable difficulties. The heart, it is +vulgarly said, is the fountain and workshop of the vital spirits, +the centre from which life is dispensed to the several parts of +the body. Yet it is denied that the right ventricle makes +spirits, which is rather held to supply nourishment to the lungs. +For these reasons it is maintained that fishes are without any +right ventricle (and indeed every animal wants a right ventricle +which is unfurnished with lungs), and that the right ventricle is +present solely for the sake of the lungs. + +1. Why, I ask, when we see that the structure of both ventricles +is almost identical, there being the same apparatus of fibres, +and braces, and valves, and vessels, and auricles, and both in +the same way in our dissections are found to be filled up with +blood similarly black in colour, and coagulated--why, I say, +should their uses be imagined to be different, when the action, +motion, and pulse of both are the same? If the three tricuspid +valves placed at the entrance into the right ventricle prove +obstacles to the reflux of the blood into the vena cava, and if +the three semilunar valves which are situated at the commencement +of the pulmonary artery be there, that they may prevent the +return of the blood into the ventricle; why, when we find similar +structures in connexion with the left ventricle, should we deny +that they are there for the same end, of preventing here the +egress, there the regurgitation, of the blood? + +2. And, when we have these structures, in points of size, form, +and situation, almost in every respect the same in the left as in +the right ventricle, why should it be said that things are +arranged in the former for the egress and regress of spirits, and +in the latter or right ventricle, for the blood? The same +arrangement cannot be held fitted to favour or impede the motion +of the blood and of spirits indifferently. + +3. And when we observe that the passages and vessels are +severally in relation to one another in point of size, viz., the +pulmonary artery to the pulmonary veins; why should the one be +destined to a private purpose, that of furnishing the lungs, the +other to a public function? + +4. And as Realdus Columbus says, is it probable that such a +quantity of blood should be required for the nutrition of the +lungs; the vessel that leads to them, the vena arteriosa or +pulmonary artery being of greater capacity than both the iliac +veins? + +5. And I ask, as the lungs are so close at hand, and in continual +motion, and the vessel that supplies them is of such dimensions, +what is the use or meaning of this pulse of the right ventricle? +and why was nature reduced to the necessity of adding another +ventricle for the sole purpose of nourishing the lungs? + +When it is said that the left ventricle draws materials for the +formation of spirits, air and blood, from the lungs and right +sinuses of the heart, and in like manner sends spirituous blood +into the aorta, drawing fuliginous vapours from there, and +sending them by the pulmonary vein into the lungs, whence spirits +are at the same time obtained for transmission into the aorta, I +ask how, and by what means is the separation effected? And how +comes it that spirits and fuliginous vapours can pass hither and +thither without admixture or confusion? If the mitral cuspidate +valves do not prevent the egress of fuliginous vapours to the +lungs, how should they oppose the escape of air? And how should +the semiluftars hinder the regress of spirits from the aorta upon +each supervening diastole of the heart? Above all, how can they +say that the spirituous blood is sent from the pulmonary veins by +the left ventricle into the lungs without any obstacle to its +passage from the mitral valves, when they have previously +asserted that the air entered by the same vessel from the lungs +into the left ventricle, and have brought forward these same +mitral valves as obstacles to its retrogression? Good God! how +should the mitral valves prevent the regurgitation of air and not +of blood? + +Moreover, when they appoint the pulmonary artery, a vessel of +great size, with the coverings of an artery, to none but a kind +of private and single purpose, that, namely, of nourishing the +lungs, why should the pulmonary vein, which is scarcely so large, +which has the coats of a vein, and is soft and lax, be presumed +to be made for many--three or four different--uses? For they will +have it that air passes through this vessel from the lungs into +the left ventricle; that fuliginous vapours escape by it from the +heart into the lungs; and that a portion of the spirituous blood +is distributed to the lungs for their refreshment. + +If they will have it that fumes and air--fumes flowing from, air +proceeding towards the heart--are transmitted by the same +conduit, I reply, that nature is not wont to construct but one +vessel, to contrive but one way for such contrary motions and +purposes, nor is anything of the kind seen elsewhere. + +If fumes or fuliginous vapours and air permeate this vessel, as +they do the pulmonary bronchia, wherefore do we find neither air +nor fuliginous vapours when we divide the pulmonary vein? Why do +we always find this vessel full of sluggish blood, never of air, +whilst in the lungs we find abundance of air remaining? + +If any one will perform Galen's experiment of dividing the +trachea of a living dog, forcibly distending the lungs with a +pair of bellows, and then tying the trachea securely, he will +find, when he has laid open the thorax, abundance of air in the +lungs, even to their extreme investing tunic, but none in either +the pulmonary veins or the left ventricle of the heart. But did +the heart either attract air from the lungs, or did the lungs +transmit any air to the heart, in the living dog, much more ought +this to be the case in the experiment just referred to. Who, +indeed, doubts that, did he inflate the lungs of a subject in the +dissecting--room, he would instantly see the air making its way +by this route, were there actually any such passage for it? But +this office of the pulmonary veins, namely, the ransference of +air from the lungs of the heart, is held of such importance, that +Hieronymus Fabricius of Aquapendente, contends that the lungs +were made for the sake of this vessel, and that it constitutes +the principal element in their structure. But I should like to be +informed why, if the pulmonary vein were destined for the +conveyance of air, it has the structure of a blood--vessel here. +Nature had rather need of annular tubes, such as those of the +bronchi in order that they might always remain open, and not be +liable to collapse; and that they might continue entirely free +from blood, lest the liquid should interfere with the passage of +the air, as it so obviously does when the lungs labour from being +either greatly oppressed or loaded in a less degree with phlegm, +as they are when the breathing is performed with a sibilous or +rattling noise. + +Still less is that opinion to be tolerated which, as a two-fold +material, one aerial, one sanguineous, is required for the +composition of vital spirits, supposes the blood to ooze through +the septum of the heart from the right to the left ventricle by +certain hidden porosities, and the air to be attracted from the +lungs through the great vessel, the pulmonary vein; and which, +consequently, will have it, that there are numerous porosities in +the septum of the heart adapted for the transmission of the +blood. But by Hercules! no such pores can be demonstrated, nor in +fact do any such exist. For the septum of the heart is of a +denser and more compact structure than any portion of the body, +except the bones and sinews. But even supposing that there were +foramina or pores in this situation, how could one of the +ventricles extract anything from the other--the left, e.g., +obtain blood from the right, when we see that both ventricles +contract and dilate simultaneously? Why should we not rather +believe that the right took spirits from the left, than that the +left obtained blood from the right ventricle through these +foramina? But it is certainly mysterious and incongruous that +blood should be supposed to be most commodiously drawn through a +set of obscure or invisible ducts, and air through perfectly open +passages, at one and the same moment. And why, I ask, is recourse +had to secret and invisible porosities, to uncertain and obscure +channels, to explain the passage of the blood into the left +ventricle, when there is so open a way through the pulmonary +veins? I own it has always appeared extraordinary to me that they +should have chosen to make, or rather to imagine, a way through +the thick, hard, dense, and most compact septum of the heart, +rather than take that by the open pulmonary vein, or even through +the lax, soft and spongy substance of the lungs at large. +Besides, if the blood could permeate the substance of the septum, +or could be imbibed from the ventricles, what use were there for +the coronary artery and vain, branches of which proceed to the +septum itself, to supply it with nourishment? And what is +especially worthy of notice is this: if in the foetus, where +everything is more lax and soft, nature saw herself reduced to +the necessity of bringing the blood from the right to the left +side of the heart by the foramen ovale, from the vena cava +through the pulmonary vein, how should it be likely that in the +adult she should pass it so commodiously, and without an effort +through the septum of the ventricles which has now become denser +by age? + +Andreas Laurentius, [Footnote: Lib. ix, cap. xi, quest. 12.] +resting on the authority of Galen [Footnote: De Locis Affectia. +lib. vi, cap. 7.] and the experience of Hollerius, asserts and +proves that the serum and pus in empyema, absorbed from the +cavities of the chest into the pulmonary vein may be expelled and +got rid of with the urine and feces through the left ventricle of +the heart and arteries. He quotes the case of a certain person +affected with melancholia, and who suffered from repeated +fainting fits, who was relieved from the paroxysms on passing a +quantity of turbid, fetid and acrid urine. But he died at last, +worn out by disease; and when the body came to be opened after +death, no fluid like that he had micturated was discovered either +in the bladder or the kidneys; but in the left ventricle of the +heart and cavity of the thorax plenty of it was met with. And +then Laurentius boasts that he had predicted the cause of the +symptoms. For my own part, however, I cannot but wonder, since he +had divined and predicted that heterogeneous matter could be +discharged by the course he indicates, why he could not or would +not perceive, and inform us that, in the natural state of things, +the blood might be commodiously transferred from the lungs to the +left ventricle of the heart by the very same route. + +Since, therefore, from the foregoing considerations and many +others to the same effect, it is plain that what has heretofore +been said concerning the motion and function of the heart and +arteries must appear obscure, inconsistent, or even impossible to +him who carefully considers the entire subject, it would be +proper to look more narrowly into the matter to contemplate the +motion of the heart and arteries, not only in man, but in all +animals that have hearts; and also, by frequent appeals to +vivisection, and much ocular inspection, to investigate and +discern the truth. + + + + +ON THE MOTION OF THE HEART AND BLOOD IN ANIMALS + + +CHAPTER I + +THE AUTHOR'S MOTIVES FOR WRITING + + +When I first gave my mind to vivisections, as a means of +discovering the motions and uses of the heart, and sought to +discover these from actual inspection, and not from the writings +of others, I found the task so truly arduous, so full of +difficulties, that I was almost tempted to think, with +Fracastorius, that the motion of the heart was only to be +comprehended by God. For I could neither rightly perceive at +first when the systole and when the diastole took place, nor when +and where dilatation and contraction occurred, by reason of the +rapidity of the motion, which in many animals is accomplished in +the twinkling of an eye, coming and going like a flash of +lightning; so that the systole presented itself to me now from +this point, now from that; the diastole the same; and then +everything was reversed, the motions occurring, as it seemed, +variously and confusedly together. My mind was therefore greatly +unsettled nor did I know what I should myself conclude, nor what +believe from others. I was not surprised that Andreas Laurentius +should have written that the motion of the heart was as +perplexing as the flux and reflux of Euripus had appeared to +Aristotle. + +At length, by using greater and daily diligence and +investigation, making frequent inspection of many and various +animals, and collating numerous observations, I thought that I +had attained to the truth, that I should extricate myself and +escape from this labyrinth, and that I had discovered what I so +much desired, both the motion and the use of the heart and +arteries. From that time I have not hesitated to expose my views +upon these subjects, not only in private to my friends, but also +in public, in my anatomical lectures, after the manner of the +Academy of old. + +These views as usual, pleased some more, others less; some chid +and calumniated me, and laid it to me as a crime that I had dared +to depart from the precepts and opinions of all anatomists; +others desired further explanations of the novelties, which they +said were both worthy of consideration, and might perchance be +found of signal use. At length, yielding to the requests of my +friends, that all might be made participators in my labors, and +partly moved by the envy of others, who, receiving my views with +uncandid minds and understanding them indifferently, have essayed +to traduce me publicly, I have moved to commit these things to +the press, in order that all may be enabled to form an opinion +both of me and my labours. This step I take all the more +willingly, seeing that Hieronymus Fabricius of Aquapendente, +although he has accurately and learnedly delineated almost every +one of the several parts of animals in a special work, has left +the heart alone untouched. Finally, if any use or benefit to this +department of the republic of letters should accrue from my +labours, it will, perhaps, be allowed that I have not lived idly, +and as the old man in the comedy says: + + For never yet hath any one attained + To such perfection, but that time, and place, + And use, have brought addition to his knowledge; + Or made correction, or admonished him, + That he was ignorant of much which he + Had thought he knew; or led him to reject + What he had once esteemed of highest price. + +So will it, perchance, be found with reference to the heart at +this time; or others, at least, starting hence, with the way +pointed out to them, advancing under the guidance of a happier +genius, may make occasion to proceed more fortunately, and to +inquire more accurately. + + + + +CHAPTER II + +ON THE MOTIONS OF THE HEART AS SEEN IN THE DISSECTION OF LIVING +ANIMALS + + +In the first place, then, when the chest of a living animal is +laid open and the capsule that immediately surrounds the heart is +slit up or removed, the organ is seen now to move, now to be at +rest; there is a time when it moves, and a time when it is +motionless. + +These things are more obvious in the colder animals, such as +toads, frogs, serpents, small fishes, crabs, shrimps, snails, and +shell-fish. They also become more distinct in warm-blooded +animals, such as the dog and hog, if they be attentively noted +when the heart begins to flag, to move more slowly, and, as it +were, to die: the movements then become slower and rarer, the +pauses longer, by which it is made much more easy to perceive and +unravel what the motions really are, and how they are performed. +In the pause, as in death, the heart is soft, flaccid, exhausted, +lying, as it were, at rest. + +In the motion, and interval in which this is accomplished, three +principal circumstances are to be noted: + +1. That the heart is erected, and rises upwards to a point, so +that at this time it strikes against the breast and the pulse is +felt externally. + +2. That it is everywhere contracted, but more especially towards +the sides so that it looks narrower, relatively longer, more +drawn together. The heart of an eel taken out of the body of the +animal and placed upon the table or the hand, shows these +particulars; but the same things are manifest in the hearts of +all small fishes and of those colder animals where the organ is +more conical or elongated. + +3. The heart being grasped in the hand, is felt to become harder +during its action. Now this hardness proceeds from tension, +precisely as when the forearm is grasped, its tendons are +perceived to become tense and resilient when the fingers are +moved. + +4. It may further be observed in fishes, and the colder blooded +animals, such as frogs, serpents, etc., that the heart, when it +moves, becomes of a paler color, when quiescent of a deeper +blood-red color. + +From these particulars it appears evident to me that the motion +of the heart consists in a certain universal tension--both +contraction in the line of its fibres, and constriction in every +sense. It becomes erect, hard, and of diminished size during its +action; the motion is plainly of the same nature as that of the +muscles when they contract in the line of their sinews and +fibres; for the muscles, when in action, acquire vigor and +tenseness, and from soft become hard, prominent, and thickened: +and in the same manner the heart. + +We are therefore authorized to conclude that the heart, at the +moment of its action, is at once constricted on all sides, +rendered thicker in its parietes and smaller in its ventricles, +and so made apt to project or expel its charge of blood. This, +indeed, is made sufficiently manifest by the preceding fourth +observation in which we have seen that the heart, by squeezing +out the blood that it contains, becomes paler, and then when it +sinks into repose and the ventricle is filled anew with blood, +that the deeper crimson colour returns. But no one need remain in +doubt of the fact, for if the ventricle be pierced the blood will +be seen to be forcibly projected outwards upon each motion or +pulsation when the heart is tense. + +These things, therefore, happen together or at the same instant: +the tension of the heart, the pulse of its apex, which is felt +externally by its striking against the chest, the thickening of +its parietes, and the forcible expulsion of the blood it contains +by the constriction of its ventricles. + +Hence the very opposite of the opinions commonly received appears +to be true; inasmuch as it is generally believed that when the +heart strikes the breast and the pulse is felt without, the heart +is dilated in its ventricles and is filled with blood; but the +contrary of this is the fact, and the heart, when it contracts +(and the impulse of the apex is conveyed through the chest wall), +is emptied. Whence the motion which is generally regarded as the +diastole of the heart, is in truth its systole. And in like +manner the intrinsic motion of the heart is not the diastole but +the systole; neither is it in the diastole that the heart grows +firm and tense, but in the systole, for then only, when tense, is +it moved and made vigorous. + +Neither is it by any means to be allowed that the heart only +moves in the lines of its straight fibres, although the great +Vesalius giving this notion countenance, quotes a bundle of +osiers bound in a pyramidal heap in illustration; meaning, that +as the apex is approached to the base, so are the sides made to +bulge out in the fashion of arches, the cavities to dilate, the +ventricles to acquire the form of a cupping-glass and so to suck +in the blood. But the true effect of every one of its fibres is +to constringe the heart at the same time they render it tense; +and this rather with the effect of thickening and amplifying the +walls and substance of the organ than enlarging its ventricles. +And, again, as the fibres run from the apex to the base, and draw +the apex towards the base, they do not tend to make the walls of +the heart bulge out in circles, but rather the contrary; inasmuch +as every fibre that is circularly disposed, tends to become +straight when it contracts; and is distended laterally and +thickened, as in the case of muscular fibres in general, when +they contract, that is, when they are shortened longitudinally, +as we see them in the bellies of the muscles of the body at +large. To all this let it be added, that not only are the +ventricles contracted in virtue of the direction and condensation +of their walls, but farther, that those fibres, or bands, styled +nerves by Aristotle, which are so conspicuous in the ventricles +of the larger animals, and contain all the straight fibres (the +parietes of the heart containing only circular ones), when they +contract simultaneously by an admirable adjustment all the +internal surfaces are drawn together as if with cords, and so is +the charge of blood expelled with force. + +Neither is it true, as vulgarly believed, that the heart by any +dilatation or motion of its own, has the power of drawing the +blood into the ventricles; for when it acts and becomes tense, +the blood is expelled; when it relaxes and sinks together it +receives the blood in the manner and wise which will by-and-by be +explained. + + + + +CHAPTER III + +OF THE MOTIONS OF THE ARTERIES, AS SEEN IN THE DISSECTION OF +LIVING ANIMALS + + +In connexion with the motions of the heart these things are +further to be observed having reference to the motions and pulses +of the arteries. + +1. At the moment the heart contracts, and when the breast is +struck, when in short the organ is in its state of systole, the +arteries are dilated, yield a pulse, and are in the state of +diastole. In like manner, when the right ventricle contracts and +propels its charge of blood, the pulmonary artery is distended at +the same time with the other arteries of the body. + +2. When the left ventricle ceases to act, to contract, to +pulsate, the pulse in the arteries also ceases; further, when +this ventricle contracts languidly, the pulse in the arteries is +scarcely perceptible. In like manner, the pulse in the right +ventricle failing, the pulse in the pulmonary artery ceases also. + +3. Further, when an artery is divided or punctured, the blood is +seen to be forcibly propelled from the wound the moment the left +ventricle contracts; and, again, when the pulmonary artery is +wounded, the blood will be seen spouting forth with violence at +the instant when the right ventricle contracts. + +So also in fishes, if the vessel which leads from the heart to +the gills be divided, at the moment when the heart becomes tense +and contracted, at the same moment does the blood flow with force +from the divided vessel. + +In the same way, when we see the blood in arteriotomy projected +now to a greater, now to a less distance, and that the greater +jet corresponds to the diastole of the artery and to the time +when the heart contracts and strikes the ribs, and is in its +state of systole, we understand that the blood is expelled by the +same movement. + +From these facts it is manifest, in opposition to commonly +received opinions, that the diastole of the arteries corresponds +with the time of the heart's systole; and that the arteries are +filled and distended by the blood forced into them by the +contraction of the ventricles; the arteries, therefore, are +distended, because they are filled like sacs or bladders, and are +not filled because they expand like bellows. It is in virtue of +one and the same cause, therefore, that all the arteries of the +body pulsate, viz., the contraction of the left ventricle; in the +same way as the pulmonary artery pulsates by the contraction of +the right ventricle. + +Finally, that the pulses of the arteries are due to the impulses +of the blood from the left ventricle, may be illustrated by +blowing into a glove, when the whole of the fingers will be found +to become distended at one and the same time, and in their +tension to bear some resemblance to the pulse. For in the ratio +of the tension is the pulse of the heart, fuller, stronger, and +more frequent as that acts more vigorously, still preserving the +rhythm and volume, and order of the heart's contractions. Nor is +it to be expected that because of the motion of the blood, the +time at which the contraction of the heart takes place, and that +at which the pulse in an artery (especially a distant one) is +felt, shall be otherwise than simultaneous: it is here the same +as in blowing up a glove or bladder; for in a plenum (as in a +drum, a long piece of timber, etc.) the stroke and the motion +occur at both extremities at the same time. Aristotle, [Footnote: +De Anim., iii, cap. 9.] too, has said, "the blood of all animals +palpitates within their veins (meaning the arteries), and by the +pulse is sent everywhere simultaneously." And further, [Footnote: +De Respir., cap. 20] "thus do all the veins pulsate together and +by successive strokes, because they all depend upon the heart; +and, as it is always in motion, so are they likewise always +moving together, but by successive movements." It is well to +observe with Galen, in this place, that the old philosophers +called the arteries veins. I happened upon one occasion to have a +particular case under my care, which plainly satisfied me of the +truth: A certain person was affected with a large pulsating +tumour on the right side of the neck, called an aneurism, just at +that part where the artery descends into the axilla, produced by +an erosion of the artery itself, and daily increasing in size; +this tumour was visibly distended as it received the charge of +blood brought to it by the artery, with each stroke of the heart; +the connexion of parts was obvious when the body of the patient +came to be opened after his death. The pulse in the corresponding +arm was small, in consequence of the greater portion of the blood +being diverted into the tumour and so intercepted. + +Whence it appears that whenever the motion of the blood through +the arteries is impeded, whether it be by compression or +infarction, or interception, there do the remote divisions of the +arteries beat less forcibly, seeing that the pulse of the +arteries is nothing more than the impulse or shock of the blood +in these vessels. + + + + +CHAPTER IV + +OF THE MOTION OF THE HEART AND ITS AURICLES, AS SEEN IN THE +BODIES OF LIVING ANIMALS + + +Besides the motions already spoken of, we have still to consider +those that appertain to the auricles. + +Caspar Bauhin and John Riolan, [Footnote: i Bauhin, lib. ii. cap. +II. Riolan. lib. viii, cap. I.] most learned men and skilful +anatomists, inform us that from their observations, that if we +carefully watch the movements of the heart in the vivisection of +an animal, we shall perceive four motions distinct in time and in +place, two of which are proper to the auricles, two to the +ventricles. With all deference to such authority I say that there +are four motions distinct in point of place, but not of time; for +the two auricles move together, and so also do the two +ventricles, in such wise that though the places be four, the +times are only two. And this occurs in the following manner: + +There are, as it were, two motions going on together: one of the +auricles, another of the ventricles; these by no means taking +place simultaneously, but the motion of the auricles preceding, +that of the heart following; the motion appearing to begin from +the auricles and to extend to the ventricles. When all things are +becoming languid, and the heart is dying, as also in fishes and +the colder blooded animals there is a short pause between these +two motions, so that the heart aroused, as it were, appears to +respond to the motion, now more quickly, now more tardily; and at +length, when near to death, it ceases to respond by its proper +motion, but seems, as it were, to nod the head, and is so +slightly moved that it appears rather to give signs of motion to +the pulsating auricles than actually to move. The heart, +therefore, ceases to pulsate sooner than the auricles, so that +the auricles have been said to outlive it, the left ventricle +ceasing to pulsate first of all; then its auricle, next the right +ventricle; and, finally, all the other parts being at rest and +dead, as Galen long since observed, the right auricle still +continues to beat; life, therefore, appears to linger longest in +the right auricle. Whilst the heart is gradually dying, it is +sometimes seen to reply, after two or three contractions of the +auricles, roused as it were to action, and making a single +pulsation, slowly, unwillingly, and with an effort. + +But this especially is to be noted, that after the heart has +ceased to beat, the auricles however still contracting, a finger +placed upon the ventricles perceives the several pulsations of +the auricles, precisely in the same way and for the same reason, +as we have said, that the pulses of the ventricles are felt in +the arteries, to wit, the distension produced by the jet of +blood. And if at this time, the auricles alone pulsating, the +point of the heart be cut off with a pair of scissors, you will +perceive the blood flowing out upon each contraction of the +auricles. Whence it is manifest that the blood enters the +ventricles, not by any attraction or dilatation of the heart, but +by being thrown into them by the pulses of the auricles. + +And here I would observe, that whenever I speak of pulsations as +occurring in the auricles or ventricles, I mean contractions: +first the auricles contract, and then and subsequently the heart +itself contracts. When the auricles contract they are seen to +become whiter, especially where they contain but little blood; +but they are filled as magazines or reservoirs of the blood, +which is tending spontaneously and, by its motion in the veins, +under pressure towards the centre; the whiteness indicated is +most conspicuous towards the extremities or edges of the auricles +at the time of their contractions. + +In fishes and frogs, and other animals which have hearts with but +a single ventricle, and for an auricle have a kind of bladder +much distended with blood, at the base of the organ, you may very +plainly perceive this bladder contracting first, and the +contraction of the heart or ventricle following afterwards. + +But I think it right to describe what I have observed of an +opposite character: the heart of an eel, of several fishes, and +even of some (of the higher) animals taken out of the body, +pulsates without auricles; nay, if it be cut in pieces the +several parts may still be seen contracting and relaxing; so that +in these creatures the body of the heart may be seen pulsating +and palpitating, after the cessation of all motion in the +auricle. But is not this perchance peculiar to animals more +tenacious of life, whose radical moisture is more glutinous, or +fat and sluggish, and less readily soluble? The same faculty +indeed appears in the flesh of eels, which even when skinned and +embowelled, and cut into pieces, are still seen to move. + +Experimenting with a pigeon upon one occasion, after the heart +had wholly ceased to pulsate, and the auricles too had become +motionless, I kept my finger wetted with saliva and warm for a +short time upon the heart, and observed that under the influence +of this fomentation it recovered new strength and life, so that +both ventricles and auricles pulsated, contracting and relaxing +alternately, recalled as it were from death to life. + +Besides this, however, I have occasionally observed, after the +heart and even its right auricle had ceased pulsating,--when it +was in articulo mortis in short,--that an obscure motion, an +undulation or palpitation, remained in the blood itself, which +was contained in the right auricle, this being apparent so long +as it was imbued with heat and spirit. And, indeed, a +circumstance of the same kind is extremely manifest in the course +of the generation of animals, as may be seen in the course of the +first seven days of the incubation of the chick: A drop of blood +makes its appearance which palpitates, as Aristotle had already +observed; from this, when the growth is further advanced and the +chick is fashioned, the auricles of the heart are formed, which +pulsating henceforth give constant signs of life. When at length, +and after the lapse of a few days, the outline of the body begins +to be distinguished, then is the ventricular part of the heart +also produced, but it continues for a time white and apparently +bloodless, like the rest of the animal; neither does it pulsate +or give signs of motion. I have seen a similar condition of the +heart in the human foetus about the beginning of the third month, +the heart then being whitish and bloodless, although its auricles +contained a considerable quantity of purple blood. In the same +way in the egg, when the chick was formed and had increased in +size, the heart too increased and acquired ventricles, which then +began to receive and to transmit blood. + +And this leads me to remark that he who inquires very +particularly into this matter will not conclude that the heart, +as a whole, is the primum vivens, ultimum moriens,--the first +part to live, the last to die,--but rather its auricles, or the +part which corresponds to the auricles in serpents, fishes, etc., +which both lives before the heart and dies after it. + +Nay, has not the blood itself or spirit an obscure palpitation +inherent in it, which it has even appeared to me to retain after +death? and it seems very questionable whether or not we are to +say that life begins with the palpitation or beating of the +heart. The seminal fluid of all animals--the prolific spirit, as +Aristotle observed, leaves their body with a bound and like a +living thing; and nature in death, as Aristotle [Footnote: De +Motu Animal., cap. 8.] further remarks, retracing her steps, +reverts to where she had set out, and returns at the end of her +course to the goal whence she had started. As animal generation +proceeds from that which is not animal, entity from nonentity, +so, by a retrograde course, entity, by corruption, is resolved +into nonentity, whence that in animals, which was last created, +fails first and that which was first, fails last. + +I have also observed that almost all animals have truly a heart, +not the larger creatures only, and those that have red blood, but +the smaller, and pale-blooded ones also, such as slugs, snails, +scallops, shrimps, crabs, crayfish, and many others; nay, even in +wasps, hornets, and flies, I have, with the aid of a magnifying +glass, and at the upper part of what is called the tail, both +seen the heart pulsating myself, and shown it to many others. + +But in the pale-blooded tribes the heart pulsates sluggishly and +deliberately, contracting slowly as in animals that are moribund, +a fact that may readily be seen in the snail, whose heart will be +found at the bottom of that orifice in the right side of the body +which is seen to be opened and shut in the course of respiration, +and whence saliva is discharged, the incision being made in the +upper aspect of the body, near the part which corresponds to the +liver. + +This, however, is to be observed: that in winter and the colder +season, exsanguine animals, such as the snail, show no pulsation; +they seem rather to live after the manner of vegetables, or of +those other productions which are therefore designated plant- +animals. + +It is also to be noted that all animals which have a heart have +also auricles, or something analogous to auricles; and, further, +that whenever the heart has a double ventricle, there are always +two auricles present, but not otherwise. If you turn to the +production of the chick in ovo, however, you will find at first +no more a vesicle or auricle, or pulsating drop of blood; it is +only by and by, when the development has made some progress, that +the heart is fashioned; even so in certain animals not destined +to attain to the highest perfection in their organization, such +as bees, wasps, snails, shrimps, crayfish, etc., we only find a +certain pulsating vesicle, like a sort of red or white +palpitating point, as the beginning or principle of their life. + +We have a small shrimp in these countries, which is taken in the +Thames and in the sea, the whole of whose body is transparent; +this creature, placed in a little water, has frequently afforded +myself and particular friends an opportunity of observing the +motions of the heart with the greatest distinctness, the external +parts of the body presenting no obstacle to our view, but the +heart being perceived as though it had been seen through a +window. + +I have also observed the first rudiments of the chick in the +course of the fourth or fifth day of the incubation, in the guise +of a little cloud, the shell having been removed and the egg +immersed in clear tepid water. In the midst of the cloudlet in +question there was a bloody point so small that it disappeared +during the contraction and escaped the sight, but in the +relaxation it reappeared again, red and like the point of a pin; +so that betwixt the visible and invisible, betwixt being and not +being, as it were, it gave by its pulses a kind of representation +of the commencement of life. + + + + +CHAPTER V + +OF THE MOTION, ACTION AND OFFICE OF THE HEART + + +From these and other observations of a similar nature, I am +persuaded it will be found that the motion of the heart is as +follows: + +First of all, the auricle contracts, and in the course of its +contraction forces the blood (which it contains in ample quantity +as the head of the veins, the store--house and cistern of the +blood) into the ventricle, which, being filled, the heart raises +itself straightway, makes all its fibres tense, contracts the +ventricles, and performs a beat, by which beat it immediately +sends the blood supplied to it by the auricle into the arteries. +The right ventricle sends its charge into the lungs by the vessel +which is called vena arteriosa, but which in structure and +function, and all other respects, is an artery. The left +ventricle sends its charge into the aorta, and through this by +the arteries to the body at large. + +These two motions, one of the ventricles, the other of the +auricles, take place consecutively, but in such a manner that +there is a kind of harmony or rhythm preserved between them, the +two concurring in such wise that but one motion is apparent, +especially in the warmer blooded animals, in which the movements +in question are rapid. Nor is this for any other reason than it +is in a piece of machinery, in which, though one wheel gives +motion to another, yet all the wheels seem to move +simultaneously; or in that mechanical contrivance which is +adapted to firearms, where, the trigger being touched, down comes +the flint, strikes against the steel, elicits a spark, which +falling among the powder, ignites it, when the flame extends, +enters the barrel, causes the explosion, propels the ball, and +the mark is attained--all of which incidents, by reason of the +celerity with which they happen, seem to take place in the +twinkling of an eye. So also in deglutition: by the elevation of +the root of the tongue, and the compression of the mouth, the +food or drink is pushed into the fauces, when the larynx is +closed by its muscles and by the epiglottis. The pharynx is then +raised and opened by its muscles in the same way as a sac that is +to be filled is lifted up and its mouth dilated. Upon the +mouthful being received, it is forced downwards by the transverse +muscles, and then carried farther by the longitudinal ones. Yet +all these motions, though executed by different and distinct +organs, are performed harmoniously, and in such order that they +seem to constitute but a single motion and act, which we call +deglutition. + +Even so does it come to pass with the motions and action of the +heart, which constitute a kind of deglutition, a transfusion of +the blood from the veins to the arteries. And if anyone, bearing +these things in mind, will carefully watch the motions of the +heart in the body of a living animal, he will perceive not only +all the particulars I have mentioned, viz., the heart becoming +erect, and making one continuous motion with its auricles; but +farther, a certain obscure undulation and lateral inclination in +the direction of the axis of the right ventricle, as if twisting +itself slightly in performing its work. And indeed everyone may +see, when a horse drinks, that the water is drawn in and +transmitted to the stomach at each movement of the throat, which +movement produces a sound and yields a pulse both to the ear and +the touch; in the same way it is with each motion of the heart, +when there is the delivery of a quantity of blood from the veins +to the arteries a pulse takes place, and can be heard within the +chest. + +The motion of the heart, then, is entirely of this description, +and the one action of the heart is the transmission of the blood +and its distribution, by means of the arteries, to the very +extremities of the body; so that the pulse which we feel in the +arteries is nothing more than the impulse of the blood derived +from the heart. + +Whether or not the heart, besides propelling the blood, giving it +motion locally, and distributing it to the body, adds anything +else to it--heat, spirit, perfection,--must be inquired into by-- +and--by, and decided upon other grounds. So much may suffice at +this time, when it is shown that by the action of the heart the +blood is transfused through the ventricles from the veins to the +arteries, and distributed by them to all parts of the body. + +The above, indeed, is admitted by all, both from the structure of +the heart and the arrangement and action of its valves. But still +they are like persons purblind or groping about in the dark, for +they give utterance to various, contradictory, and incoherent +sentiments, delivering many things upon conjecture, as we have +already shown. + +The grand cause of doubt and error in this subject appears to me +to have been the intimate connexion between the heart and the +lungs. When men saw both the pulmonary artery and the pulmonary +veins losing themselves in the lungs, of course it became a +puzzle to them to know how or by what means the right ventricle +should distribute the blood to the body, or the left draw it from +the venae cavae. This fact is borne witness to by Galen, whose +words, when writing against Erasistratus in regard to the origin +and use of the veins and the coction of the blood, are the +following [Footnote: De Placitis Hippocratis et Platonis, vi.]: +"You will reply," he says, "that the effect is so; that the blood +is prepared in the liver, and is thence transferred to the heart +to receive its proper form and last perfection; a statement which +does not appear devoid of reason; for no great and perfect work +is ever accomplished at a single effort, or receives its final +polish from one instrument. But if this be actually so, then show +us another vessel which draws the absolutely perfect blood from +the heart, and distributes it as the arteries do the spirits over +the whole body." Here then is a reasonable opinion not allowed, +because, forsooth, besides not seeing the true means of transit, +he could not discover the vessel which should transmit the blood +from the heart to the body at large! + +But had anyone been there in behalf of Erasistratus, and of that +opinion which we now espouse, and which Galen himself +acknowledges in other respects consonant with reason, to have +pointed to the aorta as the vessel which distributes the blood +from the heart to the rest of the body, I wonder what would have +been the answer of that most ingenious and learned man? Had he +said that the artery transmits spirits and not blood, he would +indeed sufficiently have answered Erasistratus, who imagined that +the arteries contained nothing but spirits; but then he would +have contradicted himself, and given a foul denial to that for +which he had keenly contended in his writings against this very +Erasistratus, to wit, that blood in substance is contained in the +arteries, and not spirits; a fact which he demonstrated not only +by many powerful arguments, but by experiments. + +But if the divine Galen will here allow, as in other places he +does, "that all the arteries of the body arise from the great +artery, and that this takes its origin from the heart; that all +these vessels naturally contain and carry blood; that the three +semilunar valves situated at the orifice of the aorta prevent the +return of the blood into the heart, and that nature never +connected them with this, the most noble viscus of the body, +unless for some important end"; if, I say, this father of +physicians concedes all these things,--and I quote his own +words,--I do not see how he can deny that the great artery is the +very vessel to carry the blood, when it has attained its highest +term for term of perfection, from the heart for distribution to +all parts of the body. Or would he perchance still hesitate, like +all who have come after him, even to the present hour, because he +did not perceive the route by which the blood was transferred +from the veins to the arteries, in consequence, as I have already +said, of the intimate connexion between the heart and the lungs? +And that this difficulty puzzled anatomists not a little, when in +their dissections they found the pulmonary artery and left +ventricle full of thick, black, and clotted blood, plainly +appears, when they felt themselves compelled to affirm that the +blood made its way from the right to the left ventricle by +transuding through the septum of the heart. But this fancy I +have already refuted. A new pathway for the blood must therefore +be prepared and thrown open, and being once exposed, no further +difficulty will, I believe, be experienced by anyone in admitting +what I have already proposed in regard to the pulse of the heart +and arteries, viz., the passage of the blood from the veins to +the arteries, and its distribution to the whole of the body by +means of these vessels. + + + + +CHAPTER VI + +OF THE COURSE BY WHICH THE BLOOD IS CARRIED FROM THE VENA CAVA +INTO THE ARTERIES, OR FROM THE RIGHT INTO THE LEFT VENTRICLE OF +THE HEART + + +Since the intimate connexion of the heart with the lungs, which +is apparent in the human subject, has been the probable cause of +the errors that have been committed on this point, they plainly +do amiss who, pretending to speak of the parts of animals +generally, as anatomists for the most part do, confine their +researches to the human body alone, and that when it is dead. +They obviously do not act otherwise than he who, having studied +the forms of a single commonwealth, should set about the +composition of a general system of polity; or who, having taken +cognizance of the nature of a single field, should imagine that +he had mastered the science of agriculture; or who, upon the +ground of one particular proposition, should proceed to draw +general conclusions. + +Had anatomists only been as conversant with the dissection of the +lower animals as they are with that of the human body, the +matters that have hitherto kept them in a perplexity of doubt +would, in my opinion, have met them freed from every kind of +difficulty. + +And first, in fishes, in which the heart consists of but a single +ventricle, being devoid of lungs, the thing is sufficiently +manifest. Here the sac, which is situated at the base of the +heart, and is the part analogous to the auricle in man, plainly +forces the blood into the heart, and the heart, in its turn, +conspicuously transmits it by a pipe or artery, or vessel +analogous to an artery; these are facts which are confirmed by +simple ocular inspection, as well as by a division of the vessel, +when the blood is seen to be projected by each pulsation of the +heart. + +The same thing is also not difficult of demonstration in those +animals that have, as it were, no more than a single ventricle to +the heart, such as toads, frogs, serpents, and lizards, which +have lungs in a certain sense, as they have a voice. I have many +observations by me on the admirable structure of the lungs of +these animals, and matters appertaining, which, however, I cannot +introduce in this place. Their anatomy plainly shows us that the +blood is transferred in them from the veins to the arteries in +the same manner as in higher animals, viz., by the action of the +heart; the way, in fact, is patent, open, manifest; there is no +difficulty, no room for doubt about it; for in them the matter +stands precisely as it would in man were the septum of his heart +perforated or removed, or one ventricle made out of two; and this +being the case, I imagine that no one will doubt as to the way by +which the blood may pass from the veins into the arteries. + +But as there are actually more animals which have no lungs than +there are furnished with them, and in like manner a greater +number which have only one ventricle than there are with two, it +is open to us to conclude, judging from the mass or multitude of +living creatures, that for the major part, and generally, there +is an open way by which the blood is transmitted from the veins +through the sinuses or cavities of the heart into the arteries. + +I have, however, cogitating with myself, seen further, that the +same thing obtained most obviously in the embryos of those +animals that have lungs; for in the foetus the four vessels +belonging to the heart, viz., the vena cava, the pulmonary +artery, the pulmonary vein, and the great artery or aorta, are +all connected otherwise than in the adult, a fact sufficiently +known to every anatomist. The first contact and union of the vena +cava with the pulmonary veins, which occurs before the cava opens +properly into the right ventricle of the heart, or gives off the +coronary vein, a little above its escape from the liver, is by a +lateral anastomosis; this is an ample foramen, of an oval form, +communicating between the cava and the pulmonary vein, so that +the blood is free to flow in the greatest abundance by that +foramen from the vena cava into the pulmonary vein, and left +auricle, and from thence into the left ventricle. Further, in +this foramen ovale, from that part which regards the pulmonary +vein, there is a thin tough membrane, larger than the opening, +extended like an operculum or cover; this membrane in the adult +blocking up the foramen, and adhering on all sides, finally +closes it up, and almost obliterates every trace of it. In the +foetus, however, this membrane is so contrived that falling +loosely upon itself, it permits a ready access to the lungs and +heart, yielding a passage to the blood which is streaming from +the cava, and hindering the tide at the same time from flowing +back into that vein. All things, in short, permit us to believe +that in the embryo the blood must constantly pass by this foramen +from the vena cava into the pulmonary vein, and from thence into +the left auricle of the heart; and having once entered there, it +can never regurgitate. + +Another union is that by the pulmonary artery, and is effected +when that vessel divides into two branches after its escape from +the right ventricle of the heart. It is as if to the two trunks +already mentioned a third were superadded, a kind of arterial +canal, carried obliquely from the pulmonary artery, to perforate +and terminate in the great artery or aorta. So that in the +dissection of the embryo, as it were, two aortas, or two roots of +the great artery, appear springing from the heart. This canal +shrinks gradually after birth, and after a time becomes withered, +and finally almost removed, like the umbilical vessels. + +The arterial canal contains no membrane or valve to direct or +impede the flow of blood in this or in that direction: for at the +root of the pulmonary artery, of which the arterial canal is the +continuation in the foetus, there are three semilunar valves, +which open from within outwards, and oppose no obstacle to the +blood flowing in this direction or from the right ventricle into +the pulmonary artery and aorta; but they prevent all +regurgitation from the aorta or pulmonic vessels back upon the +right ventricle; closing with perfect accuracy, they oppose an +effectual obstacle to everything of the kind in the embryo. So +that there is also reason to believe that when the heart +contracts, the blood is regularly propelled by the canal or +passage indicated from the right ventricle into the aorta. + +What is commonly said in regard to these two great +communications, to wit, that they exist for the nutrition of the +lungs, is both improbable and inconsistent; seeing that in the +adult they are closed up, abolished, and consolidated, although +the lungs, by reason of their heat and motion, must then be +presumed to require a larger supply of nourishment. The same may +be said in regard to the assertion that the heart in the embryo +does not pulsate, that it neither acts nor moves, so that nature +was forced to make these communications for the nutrition of the +lungs. This is plainly false; for simple inspection of the +incubated egg, and of embryos just taken out of the uterus, shows +that the heart moves in them precisely as in adults, and that +nature feels no such necessity. I have myself repeatedly seen +these motions, and Aristotle is likewise witness of their +reality. "The pulse," he observes, "inheres in the very +constitution of the heart, and appears from the beginning as is +learned both from the dissection of living animals and the +formation of the chick in the egg." [Footnote: Lib de Spiritu, +cap. v.] But we further observe that the passages in question are +not only pervious up to the period of birth in man, as well as in +other animals, as anatomists in general have described them, but +for several months subsequently, in some indeed for several +years, not to say for the whole course of life; as, for example, +in the goose, snipe, and various birds and many of the smaller +animals. And this circumstance it was, perhaps, that imposed upon +Botallus, who thought he had discovered a new passage for the +blood from the vena cava into the left ventricle of the heart; +and I own that when I met with the same arrangement in one of the +larger members of the mouse family, in the adult state, I was +myself at first led to something of a like conclusion. + +From this it will be understood that in the human embryo, and in +the embryos of animals in which the communications are not +closed, the same thing happens, namely, that the heart by its +motion propels the blood by obvious and open passages from the +vena cava into the aorta through the cavities of both the +ventricles, the right one receiving the blood from the auricle, +and propelling it by the pulmonary artery and its continuation, +named the ductus arteriosus, into the aorta; the left, in like +manner, charged by the contraction of its auricle, which has +received its supply through the foramen ovale from the vena cava, +contracting, and projecting the blood through the root of the +aorta into the trunk of that vessel. + +In embryos, consequently, whilst the lungs are yet in a state of +inaction, performing no function, subject to no motion any more +than if they had not been present, nature uses the two ventricles +of the heart as if they formed but one, for the transmission of +the blood. The condition of the embryos of those animals which +have lungs, whilst these organs are yet in abeyance and not +employed, is the same as that of those animals which have no +lungs. + +So it clearly appears in the case of the foetus that the heart by +its action transfers the blood from the vena cava into the aorta, +and that by a route as obvious and open, as if in the adult the +two ventricles were made to communicate by the removal of their +septum. We therefore find that in the greater number of animals-- +in all, indeed, at a certain period of their existence--the +channels for the transmission of the blood through the heart are +conspicuous. But we have to inquire why in some creatures--those, +namely, that have warm blood, and that have attained to the adult +age, man among the number--we should not conclude that the same +thing is accomplished through the substance of the lungs, which +in the embryo, and at a time when the function of these organs is +in abeyance, nature effects by the direct passages described, and +which, indeed, she seems compelled to adopt through want of a +passage by the lungs; or why it should be better (for nature +always does that which is best) that she should close up the +various open routes which she had formerly made use of in the +embryo and foetus, and still uses in all other animals. Not only +does she thereby open up no new apparent channels for the +passages of the blood, but she even shuts up those which formerly +existed. + +And now the discussion is brought to this point, that they who +inquire into the ways by which the blood reaches the left +ventricle of the heart: and pulmonary veins from the vena cava, +will pursue the wisest course if they seek by dissection to +discover the causes why in the larger and more perfect animals of +mature age nature has rather chosen to make the blood percolate +the parenchyma of the lungs, than, as in other instances, chosen +a direct and obvious course--for I assume that no other path or +mode of transit can be entertained. It must be because the larger +and more perfect animals are warmer, and when adult their heat +greater--ignited, as I might say, and requiring to be damped or +mitigated, that the blood is sent through the lungs, in order +that it may be tempered by the air that is inspired, and +prevented from boiling up, and so becoming extinguished, or +something else of the sort. But to determine these matters, and +explain them satisfactorily, were to enter on a speculation in +regard to the office of the lungs and the ends for which they +exist. Upon such a subject, as well as upon what pertains to +respiration, to the necessity and use of the air, etc., as also +to the variety and diversity of organs that exist in the bodies +of animals in connexion with these matters, although I have made +a vast number of observations, I shall not speak till I can more +conveniently set them forth in a treatise apart, lest I should be +held as wandering too wide of my present purpose, which is the +use and motion of the heart, and be charged with speaking of +things beside the question, and rather complicating and quitting +than illustrating it. And now returning to my immediate subject, +I go on with what yet remains for demonstration, viz., that in +the more perfect and warmer adult animals, and man, the blood +passes from the right ventricle of the heart by the pulmonary +artery, into the lungs, and thence by the pulmonary veins into +the left auricle, and from there into the left ventricle of the +heart. And, first, I shall show that this may be so, and then I +shall prove that it is so in fact. + + + + +CHAPTER VII + +THE BLOOD PASSES THROUGH THE SUBSTANCE OF THE LUNGS FROM THE +RIGHT VENTRICLE OF THE HEART INTO THE PULMONARY VEINS AND LEFT +VENTRICLE + + +That this is possible, and that there is nothing to prevent it +from being so, appears when we reflect on the way in which water +permeating the earth produces springs and rivulets, or when we +speculate on the means by which the sweat passes through the +skin, or the urine through the substance of the kidneys. It is +well known that persons who use the Spa waters or those of La +Madonna, in the territories of Padua, or others of an acidulous +or vitriolated nature, or who simply swallow drinks by the +gallon, pass all off again within an hour or two by the bladder. +Such a quantity of liquid must take some short time in the +concoction: it must pass through the liver (it is allowed by all +that the juices of the food we consume pass twice through this +organ in the course of the day); it must flow through the veins, +through the tissues of the kidneys, and through the ureters into +the bladder. + +To those, therefore, whom I hear denying that the blood, aye, the +whole mass of the blood, may pass through the substance of the +lungs, even as the nutritive juices percolate the liver, +asserting such a proposition to be impossible, and by no means to +be entertained as credible, I reply, with the poet, that they are +of that race of men who, when they will, assent full readily, and +when they will not, by no manner of means; who, when their assent +is wanted, fear, and when it is not, fear not to give it. + +The substance of the liver is extremely dense, so is that of the +kidney; the lungs, however, are of a much looser texture, and if +compared with the kidneys are absolutely spongy. In the liver +there is no forcing, no impelling power; in the lungs the blood +is forced on by the pulse of the right ventricle, the necessary +effect of whose impulse is the distension of the vessels and the +pores of the lungs. And then the lungs, in respiration, are +perpetually rising and falling: motions, the effect of which must +needs be to open and shut the pores and vessels, precisely as in +the case of a sponge, and of parts having a spongy structure, +when they are alternately compressed and again are suffered to +expand. The liver, on the contrary, remains at rest, and is never +seen to be dilated or constricted. Lastly, if no one denies the +possibility in man, oxen, and the larger animals generally, of +the whole of the ingested juices passing through the liver, in +order to reach the vena cava, for this reason, that if +nourishment is to go on, these juices must needs get into the +veins, and there is no other way but the one indicated, why +should not the same arguments be held of avail for the passage of +the blood in adults through the lungs? Why not maintain, with +Columbus, that skilful and learned anatomist, that it must be so +from the capacity and structure of the pulmonary vessels, and +from the fact of the pulmonary veins and ventricle corresponding +with them, being always found to contain blood, which must needs +have come from the veins, and by no other passage save through +the lungs? Columbus, and we also, from what precedes, from +dissections, and other arguments, conceive the thing to be clear. +But as there are some who admit nothing unless upon authority, +let them learn that the truth I am contending for can be +confirmed from Galen's own words, namely, that not only may the +blood be transmitted from the pulmonary artery into the pulmonary +veins, then into the left ventricle of the heart, and from thence +into the arteries of the body, but that this is effected by the +ceaseless pulsation of the heart and the motion of the lungs in +breathing. + +There are, as everyone knows, three sigmoid or semilunar valves +situated at the orifice of the pulmonary artery, which +effectually prevent the blood sent into the vessel from returning +into the cavity of the heart. Now Galen, explaining the use of +these valves, and the necessity for them, employs the following +language: [Footnote: De Usu partium, lib. vi, cap. 10] "There is +everywhere a mutual anastomosis and inosculation of the arteries +with the veins, and they severally transmit both blood and +spirit, by certain invisible and undoubtedly very narrow +passages. Now if the mouth of the pulmonary artery had stood in +like manner continually open, and nature had found no contrivance +for closing it when requisite, and opening it again, it would +have been impossible that the blood could ever have passed by the +invisible and delicate mouths, during the contractions of the +thorax, into the arteries; for all things are not alike readily +attracted or repelled; but that which is light is more readily +drawn in, the instrument being dilated, and forced out again when +it is contracted, than that which is heavy; and in like manner is +anything drawn more rapidly along an ample conduit, and again +driven forth, than it is through a narrow tube. But when the +thorax is contracted the pulmonary veins, which are in the lungs, +being driven inwardly, and powerfully compressed on every side, +immediately force out some of the spirit they contain, and at the +same time assume a certain portion of blood by those subtle +mouths, a thing that could never come to pass were the blood at +liberty to flow back into the heart through the great orifice of +the pulmonary artery. But its return through this great opening +being prevented, when it is compressed on every side, a certain +portion of it distils into the pulmonary veins by the minute +orifices mentioned." And shortly afterwards, in the next chapter, +he says: "The more the thorax contracts, the more it strives to +force out the blood, the more exactly do these membranes (viz., +the semilunar valves) close up the mouth of the vessel, and +suffer nothing to regurgitate." The same fact he has also alluded +to in a preceding part of the tenth chapter: "Were there no +valves, a three-fold inconvenience would result, so that the +blood would then perform this lengthened course in vain; it would +flow inwards during the disastoles of the lungs and fill all +their arteries; but in the systoles, in the manner of the tide, +it would ever and anon, like the Euripus, flow backwards and +forwards by the same way, with a reciprocating motion, which +would nowise suit the blood. This, however, may seem a matter of +little moment: but if it meantime appear that the function of +respiration suffer, then I think it would be looked upon as no +trifle, etc." Shortly afterwards he says: "And then a third +inconvenience, by no means to be thought lightly of, would +follow, were the blood moved backwards during the expirations, +had not our Maker instituted those supplementary membranes. "In +the eleventh chapter he concludes: "That they (the valves) have +all a common use, and that it is to prevent regurgitation or +backward motion; each, however, having a proper function, the one +set drawing matters from the heart, and preventing their return, +the other drawing matters into the heart, and preventing their +escape from it. For nature never intended to distress the heart +with needless labour, neither to bring aught into the organ which +it had been better to have kept away, nor to take from it again +aught which it was requisite should be brought. Since, then, +there are four orifices in all, two in either ventricle, one of +these induces, the other educes." And again he says: "Farther, +since there is one vessel, which consists of a simple covering +implanted in the heart, and another which is double, extending +from it (Galen is here speaking of the right side of the heart, +but I extend his observations to the left side also), a kind of +reservoir had to be provided, to which both belonging, the blood +should be drawn in by one, and sent out by the other." + +Galen adduces this argument for the transit of the blood by the +right ventricle from the vena cava into the lungs; but we can use +it with still greater propriety, merely changing the terms, for +the passage of the blood from the veins through the heart into +the arteries. From Galen, however, that great man, that father of +physicians, it clearly appears that the blood passes through the +lungs from the pulmonary artery into the minute branches of the +pulmonary veins, urged to this both by the pulses of the heart +and by the motions of the lungs and thorax; that the heart, +moreover, is incessantly receiving and expelling the blood by and +from its ventricles, as from a magazine or cistern, and for this +end it is furnished with four sets of valves, two serving for the +induction and two for the eduction of the blood, lest, like the +Euripus, it should be incommodiously sent hither and thither, or +flow back into the cavity which it should have quitted, or quit +the part where its presence was required, and so the heart might +be oppressed with labour in vain, and the office of the lungs be +interfered with. [Footnote: See the Commentary of the learned +Hofmann upon the Sixth Book of Galen, "De Usu partium," a work +which I first saw after I had written what precedes.] Finally, +our position that the blood is continually permeating from the +right to the left ventricle, from the vena cava into the aorta, +through the porosities of the lungs, plainly appears from this, +that since the blood is incessantly sent from the right ventricle +into the lungs by the pulmonary artery, and in like manner is +incessantly drawn from the lungs into the left ventricle, as +appears from what precedes and the position of the valves, it +cannot do otherwise than pass through continuously. And then, as +the blood is incessantly flowing into the right ventricle of the +heart, and is continually passed out from the left, as appears in +like manner, and as is obvious, both to sense and reason, it is +impossible that the blood can do otherwise than pass continually +from the vena cava into the aorta. + +Dissection consequently shows distinctly what takes place in the +majority of animals, and indeed in all, up to the period of their +maturity; and that the same thing occurs in adults is equally +certain, both from Galen's words, and what has already been said, +only that in the former the transit is effected by open and +obvious passages, in the latter by the hidden porosities of the +lungs and the minute inosculations of vessels. It therefore +appears that, although one ventricle of the heart, the left to +wit, would suffice for the distribution of the blood over the +body, and its eduction from the vena cava, as indeed is done in +those creatures that have no lungs, nature, nevertheless, when +she ordained that the same blood should also percolate the lungs, +saw herself obliged to add the right ventricle, the pulse of +which should force the blood from the vena cava through the lungs +into the cavity of the left ventricle. In this way, it may be +said, that the right ventricle is made for the sake of the lungs, +and for the transmission of the blood through them, not for their +nutrition; for it were unreasonable to suppose that the lungs +should require so much more copious a supply of nutriment, and +that of so much purer and more spirituous a nature as coming +immediately from the ventricle of the heart, that either the +brain, with its peculiarly pure substance, or the eyes, with +their lustrous and truly admirable structure, or the flesh of the +heart itself, which is more suitably nourished by the coronary +artery. + + + + +CHAPTER VIII + +OF THE QUANTITY OF BLOOD PASSING THROUGH THE HEART FROM THE VEINS +TO THE ARTERIES; AND OF THE CIRCULAR MOTION OF THE BLOOD + + +Thus far I have spoken of the passage of the blood from the veins +into the arteries, and of the manner in which it is transmitted +and distributed by the action of the heart; points to which some, +moved either by the authority of Galen or Columbus, or the +reasonings of others, will give in their adhesion. But what +remains to be said upon the quantity and source of the blood +which thus passes is of a character so novel and unheard-of that +I not only fear injury to myself from the envy of a few, but I +tremble lest I have mankind at large for my enemies, so much doth +wont and custom become a second nature. Doctrine once sown +strikes deep its root, and respect for antiquity influences all +men. Still the die is cast, and my trust is in my love of truth +and the candour of cultivated minds. And sooth to say, when I +surveyed my mass of evidence, whether derived from vivisections, +and my various reflections on them, or from the study of the +ventricles of the heart and the vessels that enter into and issue +from them, the symmetry and size of these conduits,--for nature +doing nothing in vain, would never have given them so large a +relative size without a purpose,--or from observing the +arrangement and intimate structure of the valves in particular, +and of the other parts of the heart in general, with many things +besides, I frequently and seriously bethought me, and long +revolved in my mind, what might be the quantity of blood which +was transmitted, in how short a time its passage might be +effected, and the like. But not finding it possible that this +could be supplied by the juices of the ingested aliment without +the veins on the one hand becoming drained, and the arteries on +the other getting ruptured through the excessive charge of blood, +unless the blood should somehow find its way from the arteries +into the veins, and so return to the right side of the heart, I +began to think whether there might not be a MOTION, AS IT WERE, +IN A CIRCLE. Now, this I afterwards found to be true; and I +finally saw that the blood, forced by the action of the left +ventricle into the arteries, was distributed to the body at +large, and its several parts, in the same manner as it is sent +through the lungs, impelled by the right ventricle into the +pulmonary artery, and that it: then passed through the veins and +along the vena cava, and so round to the left ventricle in the +manner already indicated. This motion we may be allowed to call +circular, in the same way as Aristotle says that the air and the +rain emulate the circular motion of the superior bodies; for the +moist earth, warmed by the sun, evaporates; the vapours drawn +upwards are condensed, and descending in the form of rain, +moisten the earth again. By this arrangement are generations of +living things produced; and in like manner are tempests and +meteors engendered by the circular motion, and by the approach +and recession of the sun. + +And similarly does it come to pass in the body, through the +motion of the blood, that the various parts are nourished, +cherished, quickened by the warmer, more perfect, vaporous, +spirituous, and, as I may say, alimentive blood; which, on the +other hand, owing to its contact with these parts, becomes +cooled, coagulated, and so to speak effete. It then returns to +its sovereign, the heart, as if to its source, or to the inmost +home of the body, there to recover its state of excellence or +perfection. Here it renews its fluidity, natural heat, and +becomes powerful, fervid, a kind of treasury of life, and +impregnated with spirits, it might be said with balsam. Thence it +is again dispersed. All this depends on the motion and action of +the heart. + +The heart, consequently, is the beginning of life; the sun of the +microcosm, even as the sun in his turn might well be designated +the heart of the world; for it is the heart by whose virtue and +pulse the blood is moved, perfected, and made nutrient, and is +preserved from corruption and coagulation; it is the household +divinity which, discharging its function, nourishes, cherishes, +quickens the whole body, and is indeed the foundation of life, +the source of all action. But of these things we shall speak more +opportunely when we come to speculate upon the final cause of +this motion of the heart. + +As the blood-vessels, therefore, are the canals and agents that +transport the blood, they are of two kinds, the cava and the +aorta; and this not by reason of there being two sides of the +body, as Aristotle has it, but because of the difference of +office, not, as is commonly said, in consequence of any diversity +of structure, for in many animals, as I have said, the vein does +not differ from the artery in the thickness of its walls, but +solely in virtue of their distinct functions and uses. A vein and +an artery, both styled veins by the ancients, and that not +without reason, as Galen has remarked, for the artery is the +vessel which carries the blood from the heart to the body at +large, the vein of the present day bringing it back from the +general system to the heart; the former is the conduit from, the +latter the channel to, the heart; the latter contains the cruder, +effete blood, rendered unfit for nutrition; the former transmits +the digested, perfect, peculiarly nutritive fluid. + + + + +CHAPTER IX + +THAT THERE IS A CIRCULATION OF THE BLOOD IS CONFIRMED FROM THE +FIRST PROPOSITION + + +But lest anyone should say that we give them words only, and make +mere specious assertions without any foundation, and desire to +innovate without sufficient cause, three points present +themselves for confirmation, which, being stated, I conceive that +the truth I contend for will follow necessarily, and appear as a +thing obvious to all. First, the blood is incessantly transmitted +by the action of the heart from the vena cava to the arteries in +such quantity that it cannot be supplied from the ingesta, and in +such a manner that the whole must very quickly pass through the +organ; second, the blood under the influence of the arterial +pulse enters and is impelled in a continuous, equable, and +incessant stream through every part and member of the body, in +much larger quantity than were sufficient for nutrition, or than +the whole mass of fluids could supply; third, the veins in like +manner return this blood incessantly to the heart from parts and +members of the body. These points proved, I conceive it will be +manifest that the blood circulates, revolves, propelled and then +returning, from the heart to the extremities, from the +extremities to the heart, and thus that it performs a kind of +circular motion. + +Let us assume, either arbitrarily or from experiment, the +quantity of blood which the left ventricle of the heart will +contain when distended, to be, say, two ounces, three ounces, or +one ounce and a half--in the dead body I have found it to hold +upwards of two ounces. Let us assume further how much less the +heart will hold in the contracted than in the dilated state; and +how much blood it will project into the aorta upon each +contraction; and all the world allows that with the systole +something is always projected, a necessary consequence +demonstrated in the third chapter, and obvious from the structure +of the valves; and let us suppose as approaching the truth that +the fourth, or fifth, or sixth, or even but the eighth part of +its charge is thrown into the artery at each contraction; this +would give either half an ounce, or three drachms, or one drachm +of blood as propelled by the heart at each pulse into the aorta; +which quantity, by reason of the valves at the root of the +vessel, can by no means return into the ventricle. Now, in the +course of half an hour, the heart will have made more than one +thousand beats, in some as many as two, three, and even four +thousand. Multiplying the number of drachms propelled by the +number of pulses, we shall have either one thousand half ounces, +or one thousand times three drachms, or a like proportional +quantity of blood, according to the amount which we assume as +propelled with each stroke of the heart, sent from this organ +into the artery--a larger quantity in every case than is +contained in the whole body! In the same way, in the sheep or +dog, say but a single scruple of blood passes with each stroke of +the heart, in one half-hour we should have one thousand scruples, +or about three pounds and a half, of blood injected into the +aorta; but the body of neither animal contains above four pounds +of blood, a fact which I have myself ascertained in the case of +the sheep. + +Upon this supposition, therefore, assumed merely as a ground for +reasoning, we see the whole mass of blood passing through the +heart, from the veins to the arteries, and in like manner through +the lungs. + +But let it be said that this does not take place in half an hour, +but in an hour, or even in a day; any way, it is still manifest +that more blood passes through the heart in consequence of its +action, than can either be supplied by the whole of the ingesta, +or than can be contained in the veins at the same moment. + +Nor can it be allowed that the heart in contracting sometimes +propels and sometimes does not propel, or at most propels but +very little, a mere nothing, or an imaginary something: all this, +indeed, has already been refuted, and is, besides, contrary both +to sense and reason. For if it be a necessary effect of the +dilatation of the heart that its ventricles become filled with +blood, it is equally so that, contracting, these cavities should +expel their contents; and this not in any trifling measure. For +neither are the conduits small, nor the contractions few in +number, but frequent, and always in some certain proportion, +whether it be a third or a sixth, or an eighth, to the total +capacity of the ventricles, so that a like proportion of blood +must be expelled, and a like proportion received with each stroke +of the heart, the capacity of the ventricle contracted always +bearing a certain relation to the capacity of the ventricle when +dilated. And since, in dilating, the ventricles cannot be +supposed to get filled with nothing, or with an imaginary +something, so in contracting they never expel nothing or aught +imaginary, but always a certain something, viz., blood, in +proportion to the amount of the contraction. Whence it is to be +concluded that if at one stroke the heart of man, the ox, or the +sheep, ejects but a single drachm of blood and there are one +thousand strokes in half an hour, in this interval there will +have been ten pounds five ounces expelled; if with each stroke +two drachms are expelled, the quantity would, of course, amount +to twenty pounds and ten ounces; if half an ounce, the quantity +would come to forty-one pounds and eight ounces; and were there +one ounce, it would be as much as eighty-three pounds and four +ounces; the whole of which, in the course of one-half hour, would +have been transfused from the veins to the arteries. The actual +quantity of blood expelled at each stroke of the heart, and the +circumstances under which it is either greater or less than +ordinary, I leave for particular determination afterwards, from +numerous observations which I have made on the subject. + +Meantime this much I know, and would here proclaim to all, that +the blood is transfused at one time in larger, at another in +smaller, quantity; and that the circuit of the blood is +accomplished now more rapidly, now more slowly, according to the +temperament, age, etc., of the individual, to external and +internal circumstances, to naturals and non-naturals--sleep, +rest, food, exercise, affections of the mind, and the like. But, +supposing even the smallest quantity of blood to be passed +through the heart and the lungs with each pulsation, a vastly +greater amount would still be thrown into the arteries and whole +body than could by any possibility be supplied by the food +consumed. It could be furnished in no other way than by making a +circuit and returning. + +This truth, indeed, presents itself obviously before us when we +consider what happens in the dissection of living animals; the +great artery need not be divided, but a very small branch only +(as Galen even proves in regard to man), to have the whole of the +blood in the body, as well that of the veins as of the arteries, +drained away in the course of no long time--some half-hour or +less. Butchers are well aware of the fact and can bear witness to +it; for, cutting the throat of an ox and so dividing the vessels +of the neck, in less than a quarter of an hour they have all the +vessels bloodless--the whole mass of blood has escaped. The same +thing also occasionally occurs with great rapidity in performing +amputations and removing tumors in the human subject. + +Nor would this argument lose of its force, did any one say that +in killing animals in the shambles, and performing amputations, +the blood escaped in equal, if not perchance in larger quantity +by the veins than by the arteries. The contrary of this +statement, indeed, is certainly the truth; the veins, in fact, +collapsing, and being without any propelling power, and further, +because of the impediment of the valves, as I shall show +immediately, pour out but very little blood; whilst the arteries +spout it forth with force abundantly, impetuously, and as if it +were propelled by a syringe. And then the experiment is easily +tried of leaving the vein untouched and only dividing the artery +in the neck of a sheep or dog, when it will be seen with what +force, in what abundance, and how quickly, the whole blood in the +body, of the veins as well as of the arteries, is emptied. But +the arteries receive blood from the veins in no other way than by +transmission through the heart, as we have already seen; so that +if the aorta be tied at the base of the heart, and the carotid or +any other artery be opened, no one will now be surprised to find +it empty, and the veins only replete with blood. + +And now the cause is manifest, why in our dissections we usually +find so large a quantity of blood in the veins, so little in the +arteries; why there is much in the right ventricle, little in the +left, which probably led the ancients to believe that the +arteries (as their name implies) contained nothing but spirits +during the life of an animal. The true cause of the difference is +perhaps this, that as there is no passage to the arteries, save +through the lungs and heart, when an animal has ceased to breathe +and the lungs to move, the blood in the pulmonary artery is +prevented from passing into the pulmonary veins, and from thence +into the left ventricle of the heart; just as we have already +seen the same transit prevented in the embryo, by the want of +movement in the lungs and the alternate opening, and shutting of +their hidden and invisible porosities and apertures. But the +heart not ceasing to act at the same precise moment as the lungs, +but surviving them and continuing to pulsate for a time, the left +ventricle and arteries go on distributing their blood to the body +at large and sending it into the veins; receiving none from the +lungs, however, they are soon exhausted, and left, as it were, +empty. But even this fact confirms our views, in no trifling +manner, seeing that it can be ascribed to no other than the cause +we have just assumed. + +Moreover, it appears from this that the more frequently or +forcibly the arteries pulsate, the more speedily will the body be +exhausted of its blood during hemorrhage. Hence, also, it +happens, that in fainting fits and in states of alarm, when the +heart beats more languidly and less forcibly, hemorrhages are +diminished and arrested. + +Still further, it is from this, that after death, when the heart +has ceased to beat, it is impossible, by dividing either the +jugular or femoral veins and arteries, by any effort, to force +out more than one-half of the whole mass of the blood. Neither +could the butchers ever bleed the carcass effectually did he +neglect to cut the throat of the ox which he has knocked on the +head and stunned, before the heart had ceased beating. + +Finally, we are now in a condition to suspect wherefore it is +that no one has yet said anything to the purpose upon the +anastomosis of the veins and arteries, either as to where or how +it is effected, or for what purpose. I now enter upon the +investigation of the subject. + + + + +CHAPTER X + +THE FIRST POSITION: OF THE QUANTITY OF BLOOD PASSING FROM THE +VEINS TO THE ARTERIES. AND THAT THERE IS A CIRCUIT OF THE BLOOD, +FREED FROM OBJECTIONS, AND FARTHER CONFIRMED BY EXPERIMENT + + +So far our first position is confirmed, whether the thing be +referred to calculation or to experiment and dissection, viz., +that the blood is incessantly poured into the arteries in larger +quantities than it can be supplied by the food; so that the whole +passing over in a short space of time, it is matter of necessity +that the blood perform a circuit, that it return to whence it set +out. + +But if anyone shall here object that a large quantity may pass +through and yet no necessity be found for a circulation, that all +may come from the meat and drink consumed, and quote as an +illustration the abundant supply of milk in the mammae--for a cow +will give three, four, and even seven gallons and more in a day, +and a woman two or three pints whilst nursing a child or twins, +which must manifestly be derived from the food consumed; it may +be answered that the heart by computation does as much and more +in the course of an hour or two. + +And if not yet convinced, he shall still insist that when an +artery is divided, a preternatural route is, as it were, opened, +and that so the blood escapes in torrents, but that the same +thing does not happen in the healthy and uninjured body when no +outlet is made; and that in arteries filled, or in their natural +state, so large a quantity of blood cannot pass in so short a +space of time as to make any return necessary--to all this it may +be answered that, from the calculation already made, and the +reasons assigned, it appears that by so much as the heart in its +dilated state contains, in addition to its contents in the state +of constriction, so much in a general way must it emit upon each +pulsation, and in such quantity must the blood pass, the body +being entire and naturally constituted. + +But in serpents, and several fishes, by tying the veins some way +below the heart you will perceive a space between the ligature +and the heart speedily to become empty; so that, unless you would +deny the evidence of your senses, you must needs admit the return +of the blood to the heart. The same thing will also plainly +appear when we come to discuss our second position. + +Let us here conclude with a single example, confirming all that +has been said, and from which everyone may obtain conviction +through the testimony of his own eyes. + +If a live snake be laid open, the heart will be seen pulsating +quietly, distinctly, for more than an hour, moving like a worm, +contracting in its longitudinal dimensions, (for it is of an +oblong shape), and propelling its contents. It becomes of a paler +colour in the systole, of a deeper tint in the diastole; and +almost all things else are seen by which I have already said that +the truth I contend for is established, only that here everything +takes place more slowly, and is more distinct. This point in +particular may be observed more clearly than the noonday sun: the +vena cava enters the heart at its lower part, the artery quits it +at the superior part; the vein being now seized either with +forceps or between the finger and the thumb, and the course of +the blood for some space below the heart interrupted, you will +perceive the part that intervenes between the fingers and the +heart almost immediately to become empty, the blood being +exhausted by the action of the heart; at the same time the heart +will become of a much paler colour, even in its state of +dilatation, than it was before; it is also smaller than at first, +from wanting blood: and then it begins to beat more slowly, so +that it seems at length as if it were about to die. But the +impediment to the flow of blood being removed, instantly the +colour and the size of the heart are restored. + +If, on the contrary, the artery instead of the vein be compressed +or tied, you will observe the part between the obstacle and the +heart, and the heart itself, to become inordinately distended, to +assume a deep purple or even livid colour, and at length to be so +much oppressed with blood that you will believe it about to be +choked; but the obstacle removed, all things immediately return +to their natural state and colour, size, and impulse. + +Here then we have evidence of two kinds of death: extinction from +deficiency, and suffocation from excess. Examples of both have +now been set before you, and you have had opportunity of viewing +the truth contended for with your own eyes in the heart. + + + + +CHAPTER XI + +THE SECOND POSITION IS DEMONSTRATED + + +That this may the more clearly appear to everyone, I have here to +cite certain experiments, from which it seems obvious that the +blood enters a limb by the arteries, and returns from it by the +veins; that the arteries are the vessels carrying the blood from +the heart, and the veins the returning channels of the blood to +the heart; that in the limbs and extreme parts of the body the +blood passes either immediately by anastomosis from the arteries +into the veins, or mediately by the porosities of the flesh, or +in both ways, as has already been said in speaking of the passage +of the blood through the lungs whence it appears manifest that in +the circuit the blood moves from that place to this place, and +from that point to this one; from the centre to the extremities, +to wit; and from the extreme parts back to the centre. Finally, +upon grounds of calculation, with the same elements as before, it +will be obvious that the quantity can neither be accounted for by +the ingeata, nor yet be held necessary to nutrition. + +The same thing will also appear in regard to ligatures, and +wherefore they are said to draw; though this is neither from the +heat, nor the pain, nor the vacuum they occasion, nor indeed from +any other cause yet thought of; it will also explain the uses and +advantages to be derived from ligatures in medicine, the +principle upon which they either suppress or occasion hemorrhage; +how they induce sloughing and more extensive mortification in +extremities; and how they act in the castration of animals and +the removal of warts and fleshy tumours. But it has come to pass, +from no one having duly weighed and understood the cause and +rationale of these various effects, that though almost all, upon +the faith of the old writers, recommend ligatures in the +treatment of disease, yet very few comprehend their proper +employment, or derive any real assistance from them in effecting +cures. + +Ligatures are either very tight or of medium tightness. A +ligature I designate as tight or perfect when it so constricts an +extremity that no vessel can be felt pulsating beyond it. Such a +ligature we use in amputations to control the flow of blood; and +such also are employed in the castration of animals and the +ablation of tumours. In the latter instances, all afflux of +nutriment and heat being prevented by the ligature, we see the +testes and large fleshy tumours dwindle, die, and finally fall +off. + +Ligatures of medium tightness I regard as those which compress a +limb firmly all round, but short of pain, and in such a way as +still suffers a certain degree of pulsation to be felt in the +artery beyond them. Such a ligature is in use in blood-letting, +an operation in which the fillet applied above the elbow is not +drawn so tight but that the arteries at the wrist may still be +felt beating under the finger. + +Now let anyone make an experiment upon the arm of a man, either +using such a fillet as is employed in blood-letting, or grasping +the limb lightly with his hand, the best subject for it being one +who is lean, and who has large veins, and the best time after +exercise, when the body is warm, the pulse is full, and the blood +carried in larger quantity to the extremities, for all then is +more conspicuous; under such circumstances let a ligature be +thrown about the extremity, and drawn as tightly as can be borne, +it will first be perceived that beyond the ligature, neither in +the wrist nor anywhere else, do the arteries pulsate, at the same +time that immediately above the ligature the artery begins to +rise higher at each diastole, to throb mere violently, and to +swell in its vicinity with a kind of tide, as if it strove to +break through and overcome the obstacle to its current; the +artery here, in short, appears as if it were preternaturally +full. The hand under such circumstances retains its natural +colour and appearance; in the course of time it begins to fall +somewhat in temperature, indeed, but nothing is drawn into it. + +After the bandage has been kept on for some short time in this +way, let it be slackened a little, brought to that state or term +of medium tightness which is used in bleeding, and it will be +seen that the whole hand and arm will instantly become deeply +coloured and distended, and the veins show themselves tumid and +knotted; after ten or twelve pulses of the artery, the hand will +be perceived excessively distended, injected, gorged with blood, +drawn, as it is said, by this medium ligature, without pain, or +heat, or any horror of a vacuum, or any other cause yet +indicated. + +If the finger be applied over the artery as it is pulsating by +the edge of the fillet, at the moment of slackening it, the blood +will be felt to glide through, as it were, underneath the finger; +and he, too, upon whose arm the experiment is made, when the +ligature is slackened, is distinctly conscious of a sensation of +warmth, and of something, viz., a stream of blood suddenly making +its way along the course of the vessels and diffusing itself +through the hand, which at the same time begins to feel hot, and +becomes distended. + +As we had noted, in connexion with the tight ligature, that the +artery above the bandage was distended and pulsated, not below +it, so, in the case of the moderately tight bandage, on the +contrary, do we find that the veins below, never above, the +fillet, swell, and become dilated, whilst the arteries shrink; +and such is the degree of distension of the veins here, that it +is only very strong pressure that will force the blood beyond the +fillet, and cause any of the veins in the upper part of the arm +to rise. + +From these facts it is easy for every careful observer to learn +that the blood enters an extremity by the arteries; for when they +are effectually compressed nothing is drawn to the member; the +hand preserves its colour; nothing flows into it, neither is it +distended; but when the pressure is diminished, as it is with the +bleeding fillet, it is manifest that the blood is instantly +thrown in with force, for then the hand begins to swell; which is +as much as to say, that when the arteries pulsate the blood is +flowing through them, as it is when the moderately tight ligature +is applied; but where they do not pulsate, as, when a tight +ligature is used, they cease from transmitting anything, they are +only distended above the part where the ligature is applied. The +veins again being compressed, nothing can flow through them; the +certain indication of which is, that below the ligature they are +much more tumid than above it, and than they usually appear when +there is no bandage upon the arm. + +It therefore plainly appears that the ligature prevents the +return of the blood through the veins to the parts above it, and +maintains those beneath it in a state of permanent distension. +But the arteries, in spite of its pressure, and under the force +and impulse of the heart, send on the blood from the internal +parts of the body to the parts beyond the ligature. And herein +consists the difference between the tight and the medium +ligature, that the former not only prevents the passage of the +blood in the veins, but in the arteries also; the latter, +however, whilst it does not prevent the force of the pulse from +extending beyond it, and so propelling the blood to the +extremities of the body, compresses the veins, and greatly or +altogether impedes the return of the blood through them. + +Seeing, therefore, that the moderately tight ligature renders the +veins turgid and distended, and the whole hand full of blood, I +ask, whence is this? Does the blood accumulate below the ligature +coming through the veins, or through the arteries, or passing by +certain hidden porosities? Through the veins it cannot come; +still less can it come through invisible channels; it must needs, +then, arrive by the arteries, in conformity with all that has +been already said. That it cannot flow in by the veins appears +plainly enough from the fact that the blood cannot be forced +towards the heart unless the ligature be removed; when this is +done suddenly all the veins collapse, and disgorge themselves of +their contents into the superior parts, the hand at the same time +resumes its natural pale colour, the tumefaction and the +stagnating blood having disappeared. + +Moreover, he whose arm or wrist has thus been bound for some +little time with the medium bandage, so that it has not only got +swollen and livid but cold, when the fillet is undone is aware of +something cold making its way upwards along with the returning +blood, and reaching the elbow or the axilla. And I have myself +been inclined to think that this cold blood rising upwards to the +heart was the cause of the fainting that often occurs after +blood-letting: fainting frequently supervenes even in robust +subjects, and mostly at the moment of undoing the fillet, as the +vulgar say, from the turning of the blood. + +Farther, when we see the veins below the ligature instantly swell +up and become gorged, when from extreme tightness it is somewhat +relaxed, the arteries meantime continuing unaffected, this is an +obvious indication that the blood passes from the arteries into +the veins, and not from the veins into the arteries, and that +there is either an anastomosis of the two orders of vessels, or +porosities in the flesh and solid parts generally that are +permeable to the blood It is farther an indication that the veins +have frequent communications with one another, because they all +become turgid together, whilst under the medium ligature applied +above the elbow; and if any single small vein be pricked with a +lancet, they all speedily shrink, and disburthening themselves +into this they subside almost simultaneously. + +These considerations will enable anyone to understand the nature +of the attraction that is exerted by ligatures, and perchance of +fluxes generally; how, for example, when the veins are compressed +by a bandage of medium tightness applied above the elbow, the +blood cannot escape, whilst it still continues to be driven in, +by the forcing power of the heart, by which the parts are of +necessity filled, gorged with blood. And how should it be +otherwise? Heat and pain and a vacuum draw, indeed; but in such +wise only that parts are filled, not preternaturally distended or +gorged, and not so suddenly and violently overwhelmed with the +charge of blood forced in upon them, that the flesh is lacerated +and the vessels ruptured. Nothing of the kind as an effect of +heat, or pain, or the vacuum force, is either credible or +demonstrable. + +Besides, the ligature is competent to occasion the afflux in +question without either pain, or heat, or a vacuum. Were pain in +any way the cause, how should it happen that, with the arm bound +above the elbow, the hand and fingers should swell being the +bandage, and their veins become distended? The pressure of the +bandage certainly prevents the blood from getting there by the +veins. And then, wherefore is there neither swelling nor +repletion of the veins, nor any sign or symptom of attraction or +afflux, above the ligature? But this is the obvious cause of the +preternatural attraction and swelling below the bandage, and in +the hand and fingers, that the blood is entering abundantly, and +with force, but cannot pass out again. + +Now is not this the cause of all tumefaction, as indeed Avicenna +has it, and of all oppressive redundancy in parts, that the +access to them is open, but the egress from them is. closed? +Whence it comes that they are gorged and tumefied. And may not +the same thing happen in local inflammations, where, so long as +the swelling is on the increase, and has not reached its extreme +term, a full pulse is felt in the part, especially when the +disease is of the more acute kind, and the swelling usually takes +place most rapidly. But these are matters for after discussion. +Or does this, which occurred in my own case, happen from the same +cause? Thrown from a carriage upon one occasion, I struck my +forehead a blow upon the place where a twig of the artery +advances from the temple, and immediately, within the time in +which twenty beats could have been made I felt a tumour the size +of an egg developed, without either heat or any great pain: the +near vicinity of the artery had caused the blood to be effused +into the bruised part with unusual force and velocity. + +And now, too, we understand why in phlebotomy we apply our +ligature above the part that is punctured, not below it; did the +flow come from above, not from below, the constriction in this +case would not only be of no service, but would prove a positive +hindrance; it would have to be applied below the orifice, in +order to have the flow more free, did the blood descend by the +veins from superior to inferior parts; but as it is elsewhere +forced through the extreme arteries into the extreme veins, and +the return in these last is opposed by the ligature, so do they +fill and swell, and being thus filled and distended, they are +made capable of projecting their charge with force, and to a +distance, when any one of them is suddenly punctured; but the +ligature being slackened, and the returning channels thus left +open, the blood forthwith no longer escapes, save by drops; and, +as all the world knows, if in performing phlebotomy the bandage +be either slackened too much or the limb be bound too tightly, +the blood escapes without force, because in the one case the +returning channels are not adequately obstructed; in other the +channels of influx, the arteries, are impeded. + + + + +CHAPTER XII + +THAT THERE IS A CIRCULATION OF THE BLOOD IS SHOWN FROM THE SECOND +POSITION DEMONSTRATED + + +If these things be so, another point which I have already +referred to, viz., the continual passage of the blood through the +heart will also be confirmed. We have seen, that the blood passes +from the arteries into the veins, not from the veins into the +arteries; we have seen, farther, that almost the whole of the +blood may be withdrawn from a puncture made in one of the +cutaneous veins of the arm if a bandage properly applied be used; +we have seen, still farther, that the blood flows so freely and +rapidly that not only is the whole quantity which was contained +in the arm beyond the ligature, and before the puncture was made, +discharged, but the whole which is contained in the body, both +that of the arteries and that of the veins. + +Whence we must admit, first, that the blood is sent along with an +impulse, and that it is urged with force below the ligature; for +it escapes with force, which force it receives from the pulse and +power of the heart; for the force and motion of the blood are +derived from the heart alone. Second, that the afflux proceeds +from the heart, and through the heart by a course from the great +veins; for it gets into the parts below the ligature through the +arteries, not through the veins; and the arteries nowhere receive +blood from the veins, nowhere receive blood save and except from +the left ventricle of the heart. Nor could so large a quantity of +blood be drawn from one vein (a ligature having been duly +applied), nor with such impetuousity, such readiness, such +celerity, unless through the medium of the impelling power of the +heart. + +But if all things be as they are now represented, we shall feel +ourselves at liberty to calculate the quantity of the blood, and +to reason on its circular motion. Should anyone, for instance, +performing phlebotomy, suffer the blood to flow in the manner it +usually does, with force and freely, for some half hour or so, no +question but that the greatest part of the blood being +abstracted, faintings and syncopes would ensue, and that not only +would the arteries but the great veins also be nearly emptied of +their contents. It is only consonant with reason to conclude that +in the course of the half hour hinted at, so much as has escaped +has also passed from the great veins through the heart into the +aorta. And further, if we calculate how many ounces flow through +one arm, or how many pass in twenty or thirty pulsations under +the medium ligature, we shall have some grounds for estimating +how much passes through the other arm in the same space of time: +how much through both lower extremities, how much through the +neck on either side, and through all the other arteries and veins +of the body, all of which have been supplied with fresh blood, +and as this blood must have passed through the lungs and +ventricles of the heart, and must have come from the great veins, +we shall perceive that a circulation is absolutely necessary, +seeing that the quantities hinted at cannot be supplied +immediately from the ingesta, and are vastly more than can be +requisite for the mere nutrition of the parts. + +It is still further to be observed, that in practising phlebotomy +the truths contended for are sometimes confirmed in another way; +for having tied up the arm properly, and made the puncture duly, +still, if from alarm or any other causes, a state of faintness +supervenes, in which the heart always pulsates more languidly, +the blood does not flow freely, but distils by drops only. The +reason is, that with a somewhat greater than usual resistance +offered to the transit of the blood by the bandage, coupled with +the weaker action of the heart, and its diminished impelling +power, the stream cannot make its way under the ligature; and +farther, owing to the weak and languishing state of the heart, +the blood is not transferred in such quantity as wont from the +veins to the arteries through the sinuses of that organ. So also, +and for the same reasons, are the menstrual fluxes of women, and +indeed hemorrhages of every kind, controlled. And now, a contrary +state of things occurring, the patient getting rid of his fear +and recovering his courage, the pulse strength is increased, the +arteries begin again to beat with greater force, and to drive the +blood even into the part that is bound; so that the blood now +springs from the puncture in the vein, and flows in continuous +stream. + + + + +CHAPTER XIII + +THE THIRD POSITION IS CONFIRMED: AND THE CIRCULATION OF THE BLOOD +IS DEMONSTRATED FROM IT + + +Thus far we have spoken of the quantity of blood passing through +the heart and the lungs in the centre of the body, and in like +manner from the arteries into the veins in the peripheral parts +and the body at large. We have yet to explain, however, in what +manner the blood finds its way back to the heart from the +extremities by the veins, and how and in what way these are the +only vessels that convey the blood from the external to the +central parts; which done, I conceive that the three fundamental +propositions laid down for the circulation of the blood will be +so plain, so well established, so obviously true, that they may +claim general credence. Now the remaining position will be made +sufficiently clear from the valves which are found in the +cavities of the veins themselves, from the uses of these, and +from experiments cognisable by the senses. + +The celebrated Hieronymus Fabricius of Aquapendente, a most +skilful anatomist, and venerable old man, or, as the learned +Riolan will have it, Jacobus Silvius, first gave representations +of the valves in the veins, which consist of raised or loose +portions of the inner membranes of these vessels, of extreme +delicacy, and a sigmoid or semilunar shape. They are situated at +different distances from one another, and diversely in different +individuals; they are connate at the sides of the veins; they are +directed upwards towards the trunks of the veins; the two--for +there are for the most part two together--regard each other, +mutually touch, and are so ready to come into contact by their +edges, that if anything attempts to pass from the trunks into the +branches of the veins, or from the greater vessels into the less, +they completely prevent it; they are farther so arranged, that +the horns of those that succeed are opposite the middle of the +convexity of those that and so on alternately. + +The discoverer of these valves did not rightly understand their +use, nor have succeeding anatomists added anything to our +knowledge: for their office is by no means explained when we are +told that it is to hinder the blood, by its weight, from all +flowing into inferior parts; for the edges of the valves in the +jugular veins hang downwards, and are so contrived that they +prevent the blood from rising upwards; the valves, in a word, do +not invariably look upwards, but always toward the trunks of the +veins, invariably towards the seat of the heart. I, and indeed +others, have sometimes found valves in the emulgent veins, and in +those of the mesentery, the edges of which were directed towards +the vena cava and vena portae. Let it be added that there are no +valves in the arteries, and that dogs, oxen, etc., have +invariably valves at the divisions of their crural veins, in the +veins that meet towards the top of the os sacrum, and in those +branches which come from the haunches, in which no such effect of +gravity from the erect position was to be apprehended. Neither +are there valves in the jugular veins for the purpose of guarding +against apoplexy, as some have said; because in sleep the head is +more apt to be influenced by the contents of the carotid +arteries. Neither are the valves present, in order that the blood +may be retained in the divarications or smaller trunks and +minuter branches, and not be suffered to flow entirely into the +more open and capacious channels; for they occur where there are +no divarications; although it must be owned that they are most +frequent at the points where branches join. Neither do they exist +for the purpose of rendering the current of blood more slow from +the centre of the body; for it seems likely that the blood would +be disposed to flow with sufficient slowness of its own accord, +as it would have to pass from larger into continually smaller +vessels, being separated from the mass and fountain head, and +attaining from warmer into colder places. + +But the valves are solely made and instituted lest the blood +should pass from the greater into the lesser veins, and either +rupture them or cause them to become varicose; lest, instead of +advancing from the extreme to the central parts of the body, the +blood should rather proceed along the veins from the centre to +the extremities; but the delicate valves, while they readily open +in the right direction, entirely prevent all such contrary +motion, being so situated and arranged, that if anything escapes, +or is less perfectly obstructed by the cornua of the one above, +the fluid passing, as it were, by the chinks between the cornua, +it is immediately received on the convexity of the one beneath, +which is placed transversely with reference to the former, and so +is effectually hindered from getting any farther. + +And this I have frequently experienced in my dissections of the +veins: if I attempted to pass a probe from the trunk of the veins +into one of the smaller branches, whatever care I took I found it +impossible to introduce it far any way, by reason of the valves; +whilst, on the contrary, it was most easy to push it along in the +opposite direction, from without inwards, or from the branches +towards the trunks and roots. In many places two valves are so +placed and fitted, that when raised they come exactly together in +the middle of the vein, and are there united by the contact of +their margins; and so accurate is the adaptation, that neither by +the eye nor by any other means of examination, can the slightest +chink along the line of contact be perceived. But if the probe be +now introduced from the extreme towards the more central parts, +the valves, like the floodgates of a river, give way, and are +most readily pushed aside. The effect of this arrangement plainly +is to prevent all motion of the blood from the heart and vena +cava, whether it be upwards towards the head, or downwards +towards the feet, or to either side towards the arms, not a drop +can pass; all motion of the blood, beginning; in the larger and +tending towards the smaller veins, is opposed and resisted by +them; whilst the motion that proceeds from the lesser to end in +the larger branches is favoured, or, at all events, a free and +open passage is left for it. + +But that this truth may be made the more apparent, let an arm be +tied up above the elbow as if for phlebotomy (A, A, fig. 1). At +intervals in the course of the veins, especially in labouring +people and those whose veins are large, certain knots or +elevations (B, C, D, E, F) will be perceived, and this not only +at the places where a branch is received (E, F), but also where +none enters (C, D): these knots or risings are all formed by +valves, which thus show themselves externally. And now if you +press the blood from the space above one of the valves, from H to +O, (fig. 2,) and keep the point of a finger upon the vein +inferiorly, you will see no influx of blood from above; the +portion of the vein between the point of the finger and the valve +O will be obliterated; yet will the vessel continue sufficiently +distended above the valve (O, G). The blood being thus pressed +out and the vein emptied, if you now apply a finger of the other +hand upon the distended part of the vein above the valve O, (fig. +3,) and press downwards, you will find that you cannot force the +blood through or beyond the valve; but the greater effort you +use, you will only see the portion of vein that is between the +finger and the valve become more distended, that portion of the +vein which is below the valve remaining all the while empty (H, +O, fig. 3). + +It would therefore appear that the function of the valves in the +veins is the same as that of the three sigmoid valves which we +find at the commencement of the aorta and pulmonary artery, viz., +to prevent all reflux of the blood that is passing over them. + +[NOTE.--Woodcuts of the veins of the arm to which these letters +and figures refer appear here in the original.--C. N. B. C] + +Farther, the arm being bound as before, and the veins looking +full and distended, if you press at one part in the course of a +vein with the point of a finger (L, fig. 4), and then with +another finger streak the blood upwards beyond the next valve +(N), you will perceive that this portion of the vein continues +empty (L, N), and that the blood cannot retrograde, precisely as +we have already seen the case to be in fig. 2; but the finger +first applied (H, fig. 2, L, fig. 4), being removed, immediately +the vein is filled from below, and the arm becomes as it appears +at D C, fig. 1. That the blood in the veins therefore proceeds +from inferior or more remote parts, and towards the heart, moving +in these vessels in this and not in the contrary direction, +appears most obviously. And although in some places the valves, +by not acting with such perfect accuracy, or where there is but a +single valve, do not seem totally to prevent the passage of the +blood from the centre, still the greater number of them plainly +do so; and then, where things appear contrived more negligently, +this is compensated either by the more frequent occurrence or +more perfect action of the succeeding valves, or in some other +way: the veins in short, as they are the free and open conduits +of the blood returning TO the heart, so are they effectually +prevented from serving as its channels of distribution FROM the +heart. + +But this other circumstance has to be noted: The arm being bound, +and the veins made turgid, and the valves prominent, as before, +apply the thumb or finger over a vein in the situation of one of +the valves in such a way as to compress it, and prevent any blood +from passing upwards from the hand; then, with a finger of the +other hand, streak the blood in the vein upwards till it has +passed the next valve above (N, fig. 4), the vessel now remains +empty; but the finger at L being removed for an instant, the vein +is immediately filled from below; apply the finger again, and +having in the same manner streaked the blood upwards, again +remove the finger below, and again the vessel becomes distended +as before; and this repeat, say a thousand times, in a short +space of time. And now compute the quantity of blood which you +have thus pressed up beyond the valve, and then multiplying the +assumed quantity by one thousand, you will find that so much +blood has passed through a certain portion of the vessel; and I +do now believe that you will find yourself convinced of the +circulation of the blood, and of its rapid motion. But if in this +experiment you say that a violence is done to nature, I do not +doubt but that, if you proceed in the same way, only taking as +great a length of vein as possible, and merely remark with what +rapidity the blood flows upwards, and fills the vessel from +below, you will come to the same conclusion. + + + + +CHAPTER XIV + +CONCLUSION OF THE DEMONSTRATION OF THE CIRCULATION + + +And now I may be allowed to give in brief my view of the +circulation of the blood, and to propose it for general adoption. + +Since all things, both argument and ocular demonstration, show +that the blood passes through the lungs, and heart by the force +of the ventricles, and is sent for distribution to all parts of +the body, where it makes its way into the veins and porosities of +the flesh, and then flows by the veins from the circumference on +every side to the centre, from the lesser to the greater veins, +and is by them finally discharged into the vena cava and right +auricle of the heart, and this in such a quantity or in such a +flux and reflux thither by the arteries, hither by the veins, as +cannot possibly be supplied by the ingesta, and is much greater +than can be required for mere purposes of nutrition; it is +absolutely necessary to conclude that the blood in the animal +body is impelled in a circle, and is in a state of ceaseless +motion; that this is the act or function which the heart performs +by means of its pulse; and that it is the sole and only end of +the motion and contraction of the heart. + + + + +CHAPTER XV + +THE CIRCULATION OF THE BLOOD IS FURTHER CONFIRMED BY PROBABLE +REASONS + + +It will not be foreign to the subject if I here show further, +from certain familiar reasonings, that the circulation is matter +both of convenience and necessity. In the first place, since +death is a corruption which takes place through deficiency of +heat, [Footnote: Aristoteles De Respirations, lib. ii et iii: De +Part. Animal. et alibi.] and since all living things are warm, +all dying things cold, there must be a particular seat and +fountain, a kind of home and hearth, where the cherisher of +nature, the original of the native fire, is stored and preserved; +from which heat and life are dispensed to all parts as from a +fountain head; from which sustenance may be derived; and upon +which concoction and nutrition, and all vegetative energy may +depend. Now, that the heart is this place, that the heart is the +principle of life, and that all passes in the manner just +mentioned, I trust no one will deny. + +The blood, therefore, required to have motion, and indeed such a +motion that it should return again to the heart; for sent to the +external parts of the body far from its fountain, as Aristotle +says, and without motion it would become congealed. For we see +motion generating and keeping up heat and spirits under ail +circumstances, and rest allowing them to escape and be +dissipated. The blood, therefore, becoming thick or congealed by +the cold of the extreme and outward parts, and robbed of its +spirits, just as it is in the dead, it was imperative that from +its fount and origin, it should again receive heat and spirits, +and all else requisite to its preservation--that, by returning, +it should be renovated and restored. + +We frequently see how the extremities are chilled by the external +cold, how the nose and cheeks and hands look blue, and how the +blood, stagnating in them as in the pendent or lower parts of a +corpse, becomes of a dusky hue; the limbs at the same time +getting torpid, so that they can scarcely be moved, and seem +almost to have lost their vitality. Now they can by no means be +so effectually, and especially so speedily restored to heat and +colour and life, as by a new efflux and contact of heat from its +source. But how can parts attract in which the heat and life are +almost extinct? Or how should they whose passages are filled with +condensed and frigid blood, admit fresh aliment--renovated blood +--unless they had first got rid of their old contents? Unless the +heart were truly that fountain where life and heat are restored +to the refrigerated fluid, and whence new blood, warm, imbued +with spirits, being sent out by the arteries, that which has +become cooled and effete is forced on, and all the particles +recover their heat which was failing, and their vital stimulus +wellnigh exhausted. + +Hence it is that if the heart be unaffected, life and health may +be restored to almost all the other parts of the body; but if the +heart be chilled, or smitten with any serious disease, it seems +matter of necessity that the whole animal fabric should suffer +and fall into decay. When the source is corrupted, there is +nothing, as Aristotle says, [Footnote: De Part. Animal., iii.] +which can be of service either to it or aught that depends on it. +And hence, by the way, it may perchance be why grief, and love, +and envy, and anxiety, and all affections of the mind of a +similar kind are accompanied with emaciation and decay, or with +disordered fluids and crudity, which engender all manner of +diseases and consume the body of man. For every affection of the +mind that is attended with either pain or pleasure, hope or fear, +is the cause of an agitation whose influence extends to the +heart, and there induces change from the natural constitution, in +the temperature, the pulse and the rest, which impairing all +nutrition in its source and abating the powers at large, it is no +wonder that various forms of incurable disease in the extremities +and in the trunk are the consequence, inasmuch as in such +circumstances the whole body labours under the effects of +vitiated nutrition and a want of native heat. + +Moreover, when we see that all animals live through food digested +in their interior, it is imperative that the digestion and +distribution be perfect, and, as a consequence, that there be a +place and receptacle where the aliment is perfected and whence it +is distributed to the several members. Now this place is the +heart, for it is the only organ in the body which contains blood +for the general use; all the others receive it merely for their +peculiar or private advantage, just as the heart also has a +supply for its own especial behoof in its coronary veins and +arteries. But it is of the store which the heart contains in its +auricles and ventricles that I here speak. Then the heart is the +only organ which is so situated and constituted that it can +distribute the blood in due proportion to the several parts of +the body, the quantity sent to each being according to the +dimensions of the artery which supplies it, the heart serving as +a magazine or fountain ready to meet its demands. + +Further, a certain impulse or force, as well as an impeller or +forcer, such as the heart, was required to effect this +distribution and motion of the blood; both because the blood is +disposed from slight causes, such as cold, alarm, horror, and the +like, to collect in its source, to concentrate like parts to a +whole, or the drops of water spilt upon a table to the mass of +liquid; and because it is forced from the capillary veins into +the smaller ramifications, and from these into the larger trunks +by the motion of the extremities and the compression of the +muscles generally. The blood is thus more disposed to move from +the circumference to the centre than in the opposite direction, +even were there no valves to oppose its motion; wherefore, that +it may leave its source and enter more confined and colder +channels, and flow against the direction to which it +spontaneously inclines, the blood requires both force and +impelling power. Now such is the heart and the heart alone, and +that in the way and manner already explained. + + + + +CHAPTER XVI + +THE CIRCULATION OF THE BLOOD IS FURTHER PROVED FROM CERTAIN +CONSEQUENCES + + +There are still certain problems, which, taken as consequences of +this truth assumed as proven, are not without their use in +exciting belief, as it were, a posteriore; and which, although +they may seem to be involved in much doubt and obscurity, +nevertheless readily admit of having reasons and causes assigned +for them. Of such a nature are those that present themselves in +connexion with contagions, poisoned wounds, the bites of serpents +and rabid animals, lues venerea and the like. We sometimes see +the whole system contaminated, though the part first infected +remains sound; the lues venerea has occasionally made its attack +with pains in the shoulders and head, and other symptoms, the +genital organs being all the while unaffected; and then we know +that the wound made by a rabid dog having healed, fever and a +train of disastrous symptoms may nevertheless supervene. Whence +it appears that the contagion impressed upon or deposited in a +particular part, is by-and-by carried by the returning current of +blood to the heart, and by that organ is sent to contaminate the +whole body. + +In tertian fever, the morbific cause seeking the heart in the +first instance, and hanging about the heart and lungs, renders +the patient short-winded, disposed to sighing, and indisposed to +exertion, because the vital principle is oppressed and the blood +forced into the lungs and rendered thick. It does not pass +through them, (as I have myself seen in opening the bodies of +those who had died in the beginning of the attack,) when the +pulse is always frequent, small, and occasionally irregular; but +the heat increasing, the matter becoming attenuated, the passages +forced, and the transit made, the whole body begins to rise in +temperature, and the pulse becomes fuller and stronger. The +febrile paroxysm is fully formed, whilst the preternatural heat +kindled in the heart is thence diffused by the arteries through +the whole body along with the morbific matter, which is in this +way overcome and dissolved by nature. + +When we perceive, further, that medicines applied externally +exert their influence on the body just as if they had been taken +internally, the truth we are contending for is confirmed. +Colocynth and aloes in this way move the belly, cantharides +excites the urine, garlic applied to the soles of the feet +assists expectoration, cordials strengthen, and an infinite +number of examples of the same kind might be cited. Perhaps it +will not, therefore, be found unreasonable, if we say that the +veins, by means of their orifices, absorb some of the things that +are applied externally and carry this inwards with the blood, not +otherwise, it may be, than those of the mesentery imbibe the +chyle from the intestines and carry it mixed with the blood to +the liver. For the blood entering the mesentery by the coeliac +artery, and the superior and inferior mesenteries, proceeds to +the intestines, from which, along with the chyle that has been +attracted into the veins, it returns by their numerous +ramifications into the vena portae of the liver, and from this +into the vena cava, and this in such wise that the blood in these +veins has the same colour and consistency as in other veins, in +opposition to what many believe to be the fact. Nor indeed can we +imagine two contrary motions in any capillary system--the chyle +upwards, the blood downwards. This could scarcely take place, and +must be held as altogether improbable. But is not the thing +rather arranged as it is by the consummate providence of nature? +For were the chyle mingled with the blood, the crude with the +digested, in equal proportions, the result would not be +concoction, transmutation, and sanguification, but rather, and +because they are severally active and passive, a mixture or +combination, or medium compound of the two, precisely as happens +when wine is mixed with water and syrup. But when a very minute +quantity of chyle is mingled with a very large quantity of +circulating blood, a quantity of chyle that bears no kind of +proportion to the mass of blood, the effect is the same, as +Aristotle says, as when a drop of water is added to a cask of +wine, or the contrary; the mass does not then present itself as a +mixture, but is still sensibly either wine or water. + +So in the mesenteric veins of an animal we do not find either +chyme or chyle and blood, blended together or distinct, but only +blood, the same in colour, consistency, and other sensible +properties, as it appears in the veins generally. Still as there +is a certain though small and inappreciable portion of chyle or +incompletely digested matter mingled with the blood, nature has +interposed the liver, in whose meandering channels it suffers +delay and undergoes additional change, lest arriving prematurely +and crude at the heart, it should oppress the vital principle. +Hence in the embryo, there is almost no use for the liver, but +the umbilical vein passes directly through, a foramen or an +anastomosis existing from the vena portae. The blood returns from +the intestines of the foetus, not through the liver, but into the +umbilical vein mentioned, and flows at once into the heart, +mingled with the natural blood which is returning from the +placenta; whence also it is that in the development of the foetus +the liver is one of the organs that is last formed. I have +observed all the members, perfectly marked out in the human +foetus, even the genital organs, whilst there was yet scarcely +any trace of the liver. And indeed at the period when all the +parts, like the heart itself in the beginning, are still white, +and except in the veins there is no appearance of redness, you +shall see nothing in the seat of the liver but a shapeless +collection, as it were, of extravasated blood, which you might +take for the effects of a contusion or ruptured vein. + +But in the incubated egg there are, as it were, two umbilical +vessels, one from the albumen passing entire through the liver, +and going straight to the heart; another from the yelk, ending in +the vena portae; for it appears that the chick, in the first +instance, is entirely formed and nourished by the white; but by +the yelk after it has come to perfection and is excluded from the +shell; for this part may still be found in the abdomen of the +chick many days after its exclusion, and is a substitute for the +milk to other animals. + +But these matters will be better spoken of in my observations on +the formation of the foetus, where many propositions, the +following among the number, will be discussed: Wherefore is this +part formed or perfected first, that last, and of the several +members, what part is the cause of another? And there are many +points having special reference to the heart, such as wherefore +does it first acquire consistency, and appear to possess life, +motion, sense, before any other part of the body is perfected, as +Aristotle says in his third book, "De partibus Animalium"? And so +also of the blood, wherefore does it precede all the rest? And in +what way does it possess the vital and animal principle, and show +a tendency to motion, and to be impelled hither and thither, the +end for which the heart appears to be made? In the same way, in +considering the pulse, why should one kind of pulse indicate +death, another recovery? And so of all the other kinds of pulse, +what may be the cause and indication of each? Likewise we must +consider the reason of crises and natural critical discharges; of +nutrition, and especially the distribution of the nutriment; and +of defluxions of every description. Finally, reflecting on every +part of medicine, physiology, pathology, semeiotics and +therapeutics, when I see how many questions can be answered, how +many doubts resolved, how much obscurity illustrated by the truth +we have declared, the light we have made to shine, I see a field +of such vast extent in which I might proceed so far, and +expatiate so widely, that this my tractate would not only swell +out into a volume, which was beyond my purpose, but my whole +life, perchance, would not suffice for its completion. + +In this place, therefore, and that indeed in a single chapter, I +shall only endeavour to refer the various particulars that +present themselves in the dissection of the heart and arteries to +their several uses and causes; for so I shall meet with many +things which receive light from the truth I have been contending +for, and which, in their turn, render it more obvious. And indeed +I would have it confirmed and illustrated by anatomical arguments +above all others. + +There is but a single point which indeed would be more correctly +placed among our observations on the use of the spleen, but which +it will not be altogether impertinent to notice in this place +incidentally. From the splenic branch which passes into the +pancreas, and from the upper part, arise the posterior coronary, +gastric, and gastroepiploic veins, all of which are distributed +upon the stomach in numerous branches and twigs, just as the +mesenteric vessels are upon the intestines. In a similar way, +from the inferior part of the same splenic branch, and along the +back of the colon and rectum proceed the hemorrhoidal veins. The +blood returning by these veins, and bringing the cruder juices +along with it, on the one hand from the stomach, where they are +thin, watery, and not yet perfectly chylified; on the other thick +and more earthy, as derived from the faeces, but all poured into +this splenic branch, are duly tempered by the admixture of +contraries; and nature mingling together these two kinds of +juices, difficult of coction by reason of most opposite defects, +and then diluting them with a large quantity of warm blood, (for +we see that the quantity returned from the spleen must be very +large when we contemplate the size of its arteries,) they are +brought to the porta of the liver in a state of higher +preparation. The defects of either extreme are supplied and +compensated by this arrangement of the veins. + + + + +CHAPTER XVII + +THE MOTION AND CIRCULATION OF THE BLOOD ARE CONFIRMED FROM THE +PARTICULARS APPARENT IN THE STRUCTURE OF THE HEART, AND FROM +THOSE THINGS WHICH DISSECTION UNFOLDS + + +I do not find the heart as a distinct and separate part in all +animals; some, indeed, such as the zoophytes, have no heart; this +is because these animals are coldest, of one great bulk, of soft +texture, or of a certain uniform sameness or simplicity of +structure; among the number I may instance grubs and earth-worms, +and those that are engendered of putrefaction and do not preserve +their species. These have no heart, as not requiring any impeller +of nourishment into the extreme parts; for they have bodies which +are connate and homogeneous and without limbs; so that by the +contraction and relaxation of the whole body they assume and +expel, move and remove, the aliment. Oysters, mussels, sponges, +and the whole genus of zoophytes or plant-animals have no heart, +for the whole body is used as a heart, or the whole animal is a +heart. In a great number of animals,--almost the whole tribe of +insects--we cannot see distinctly by reason of the smallness of +the body; still in bees, flies, hornets, and the like we can +perceive something pulsating with the help of a magnifying-glass; +in pediculi, also, the same thing may be seen, and as the body is +transparent, the passage of the food through the intestines, like +a black spot or stain, may be perceived by the aid of the same +magnifying-glass. + +But in some of the pale-blooded and colder animals, as in snails, +whelks, shrimps, and shell-fish, there is a part which pulsates, +--a kind of vesicle or auricle without a heart,--slowly, indeed, +and not to be perceived except in the warmer season of the year. +In these creatures this part is so contrived that it shall +pulsate, as there is here a necessity for some impulse to +distribute the nutritive fluid, by reason of the variety of +organic parts, or of the density of the substance; but the +pulsations occur unfrequently, and sometimes in consequence of +the cold not at all, an arrangement the best adapted to them as +being of a doubtful nature, so that sometimes they appear to +live, sometimes to die; sometimes they show the vitality of an +animal, sometimes of a vegetable. This seems also to be the case +with the insects which conceal themselves in winter, and lie, as +it were, defunct, or merely manifesting a kind of vegetative +existence. But whether the same thing happens in the case of +certain animals that have red blood, such as frogs, tortoises, +serpents, swallows, may be very properly doubted. + +In all the larger and warmer animals which have red blood, there +was need of an impeller of the nutritive fluid, and that, +perchance, possessing a considerable amount of power. In fishes, +serpents, lizards, tortoises, frogs, and others of the same kind +there is a heart present, furnished with both an auricle and a +ventricle, whence it is perfectly true, as Aristotle has +observed, [Footnote: De Part. Animal., lib. iii.] that no +sanguineous animal is without a heart, by the impelling power of +which the nutritive fluid is forced, both with greater vigour and +rapidity, to a greater distance; and not merely agitated by an +auricle, as it Is in lower forms. And then in regard to animals +that are yet larger, warmer, and more perfect, as they abound in +blood, which is always hotter and more spirituous, and which +possess bodies of greater size and consistency, these require a +larger, stronger, and more fleshy heart, in order that the +nutritive fluid may be propelled with yet greater force and +celerity. And further, inasmuch as the more perfect animals +require a still more perfect nutrition, and a larger supply of +native heat, in order that the aliment may be thoroughly +concocted and acquire the last degree of perfection, they +required both lungs and a second ventricle, which should force +the nutritive fluid through them. + +Every animal that has lungs has, therefore, two ventricles to its +heart--one right, the other left; and wherever there is a right, +there also is there a left ventricle; but the contrary of this +does not hold good: where there is a left there is not always a +right ventricle. The left ventricle I call that which is distinct +in office, not in place from the other, that one, namely, which +distributes the blood to the body at large, not to the lungs +only. Hence the left ventricle seems to form the principle part +of the heart; situated in the middle, more strongly marked, and +constructed with greater care, the heart seems formed for the +sake of the left ventricle, and the right but to minister to it. +The right neither reaches to the apex of the heart nor is it +nearly of such strength, being three times thinner in its walls, +and in some sort jointed on to the left (as Aristotle says), +though, indeed, it is of greater capacity, inasmuch as it has not +only to supply material to the left ventricle, but likewise to +furnish aliment to the lungs. + +It is to be observed, however, that all this is otherwise in the +embryo, where there is not such a difference between the two +ventricles. There, as in a double nut, they are nearly equal in +all respects, the apex of the right reaching to the apex of the +left, so that the heart presents itself as a sort of double- +pointed cone. And this is so, because in the foetus, as already +said, whilst the blood is not passing through the lungs from the +right to the left cavities of the heart, it flows by the foramen +ovale and ductus arteriosus directly from the vena cava into the +aorta, whence it is distributed to the whole body. Both +ventricles have, therefore, the same office to perform, whence +their equality of constitution. It is only when the lungs come to +be used and it is requisite that the passages indicated should be +blocked up that the difference in point of strength and other +things between the two ventricles begins to be apparent. In the +altered circumstances the right has only to drive the blood +through the lungs, whilst the left has to propel it through the +whole body. + +There are, moreover, within the heart numerous braces, in the +form of fleshy columns and fibrous bands, which Aristotle, in his +third book on "Respiration," and the "Parts of Animals," entitles +nerves. These are variously extended, and are either distinct or +contained in grooves in the walls and partition, where they +occasion numerous pits or depressions. They constitute a kind of +small muscles, which are superadded and supplementary to the +heart, assisting it to execute a more powerful and perfect +contraction, and so proving subservient to the complete expulsion +of the blood. They are, in some sort, like the elaborate and +artful arrangement of ropes in a ship, bracing the heart on every +side as it contracts, and so enabling it more effectually and +forcibly to expel the charge of blood from its ventricles. This +much is plain, at all events, that in some animals they are less +strongly marked than in others; and, in all that have them, they +are more numerous and stronger in the left than in the right +ventricle; and while some have them present in the left, yet they +are absent in the right ventricle. In man they are more numerous +in the left than in the right ventricle, more abundant in the +ventricles than in the auricles; and occasionally there appear to +be none present in the auricles. They are numerous in the large, +more muscular and hardier bodies of countrymen, but fewer in more +slender frames and in females. + +In those animals in which the ventricles of the heart are smooth +within and entirely without fibres of muscular bands, or anything +like hollow pits, as in almost all the smaller birds, the +partridge and the common fowl, serpents, frogs, tortoises, and +most fishes, there are no chordae tendineae, nor bundles of +fibres, neither are there any tricuspid valves in the ventricles. + +Some animals have the right ventricle smooth internally, but the +left provided with fibrous bands, such as the goose, swan, and +larger birds; and the reason is the same here as elsewhere. As +the lungs are spongy and loose and soft, no great amount of force +is required to force the blood through them; therefore the right +ventricle is either without the bundles in question, or they are +fewer and weaker, and not so fleshy or like muscles. Those of the +left ventricle, however, are both stronger and more numerous, +more fleshy and muscular, because the left ventricle requires to +be stronger, inasmuch as the blood which it propels has to be +driven through the whole body. And this, too, is the reason why +the left ventricle occupies the middle of the heart, and has +parietes three times thicker and stronger than those of the right +Hence all animals--and among men it is similar--that are endowed +with particularly strong frames, and with large and fleshy limbs +at a great distance from the heart, have this central organ of +greater thickness, strength, and muscularity. This is manifest +and necessary. Those, on the contrary, that are of softer and +more slender make have the heart more flaccid, softer, and +internally either less or not at all fibrous. Consider, farther, +the use of the several valves, which are all so arranged that the +blood, once received into the ventricles of the heart, shall +never regurgitate; once forced into the pulmonary artery and +aorta, shall not flow back upon the ventricles. When the valves +are raised and brought together, they form a three-cornered line, +such as is left by the bite of a leech; and the more they are +forced, the more firmly do they oppose the passage of the blood. +The tricuspid valves are placed, like gate-keepers, at the +entrance into the ventricles from the venae cavae and pulmonary +veins, lest the blood when most forcibly impelled should flow +back. It is for this reason that they are not found in all +animals, nor do they appear to have been constructed with equal +care, in all animals in which they are found. In some they are +more accurately fitted, in others more remissly or carelessly +contrived, and always with a view to their being closed under a +greater or a slighter force of the ventricle. In the left +ventricle, therefore, in order that the occlusion may be the more +perfect against the greater impulse, there are only two valves, +like a mitre, and produced into an elongated cone, so that they +come together and touch to their middle; a circumstance which +perhaps led Aristotle into the error of supposing this ventricle +to be double, the division taking place transversely. For the +same reason, and that the blood may not regurgitate upon the +pulmonary veins, and thus the force of the ventricle in +propelling the blood through the system at large come to be +neutralized, it is that these mitral valves excel those of the +right ventricle in size and strength and exactness of closing. +Hence it is essential that there can be no heart without a +ventricle, since this must be the source and store-house of the +blood. The same law does not hold good in reference to the brain. +For almost no genus of birds has a ventricle in the brain, as is +obvious in the goose and swan, the brains of which nearly equal +that of a rabbit in size; now rabbits have ventricles in the +brain, whilst the goose has none. In like manner, wherever the +heart has a single ventricle, there is an auricle appended, +flaccid, membranous, hollow, filled with blood; and where there +are two ventricles, there are likewise two auricles. On the other +hand, some animals have an auricle without any ventricle; or, at +all events, they have a sac analogous to an auricle; or the vein +itself, dilated at a particular part, performs pulsations, as is +seen in hornets, bees, and other insects, which certain +experiments of my own enable me to demonstrate, have not only a +pulse, but a respiration in that part which is called the tail, +whence it is that this part is elongated and contracted now more +rarely, now more frequently, as the creature appears to be blown +and to require a large quantity of air. But of these things, more +in our "Treatise On Respiration." + +It is in like manner evident that the auricles pulsate, contract, +as I have said before, and throw the blood into the ventricles; +so that wherever there is a ventricle, an auricle is necessary, +not merely that it may serve, according to the general belief, as +a source and magazine for the blood: for what were the use of its +pulsations had it only to contain? + +The auricles are prime movers of the blood, especially the right +auricle, which, as already said, is "the first to live, the last +to die"; whence they are subservient to sending the blood into +the ventricles, which, contracting continuously, more readily and +forcibly expel the blood already in motion; just as the ball- +player can strike the ball more forcibly and further if he takes +it on the rebound than if he simply threw it. Moreover, and +contrary to the general opinion, neither the heart nor anything +else can dilate or distend itself so as to draw anything into its +cavity during the diastole, unless, like a sponge, it has been +first compressed and is returning to its primary condition. But +in animals all local motion proceeds from, and has its origin in, +the contraction of some part; consequently it is by the +contraction of the auricles that the blood is thrown into the +ventricles, as I have already shown, and from there, by the +contraction of the ventricles, it is propelled and distributed. +Concerning local motions, it is true that the immediate moving +organ in every motion of an animal primarily endowed with a +motive spirit (as Aristotle has it [Footnote: In the book de +Spiritu, and elsewhere.]) is contractile; in which way the word +veopou is derived from veuw, nuto, contraho; and if I am +permitted to proceed in my purpose of making a particular +demonstration of the organs of motion in animals from +observations in my possession, I trust I shall be able to make +sufficiently plain how Aristotle was acquainted with the muscles, +and advisedly referred all motion in animals to the nerves, or to +the contractile element, and, therefore, called those little +bands in the heart nerves. + +But that we may proceed with the subject which we have in hand, +viz., the use of the auricles in filling the ventricles, we +should expect that the more dense and compact the heart, the +thicker its parietes, the stronger and more muscular must be the +auricle to force and fill it, and vice versa. Now this is +actually so: in some the auricle presents itself as a +sanguinolent vesicle, as a thin membrane containing blood, as in +fishes, in which the sac that stands in lieu of the auricles is +of such delicacy and ample capacity that it seems to be suspended +or to float above the heart. In those fishes in which the sac is +somewhat more fleshy, as in the carp, barbel, tench, and others, +it bears a wonderful and strong resemblance to the lungs. + +In some men of sturdier frame and stouter make the right auricle +is so strong, and so curiously constructed on its inner surface +of bands and variously interlacing fibres, that it seems to equal +in strength the ventricle of the heart in other subjects; and I +must say that I am astonished to find such diversity in this +particular in different individuals. It is to be observed, +however, that in the foetus the auricles are out of all +proportion large, which is because they are present before the +heart makes its appearance or suffices for its office even when +it has appeared, and they, therefore, have, as it were, the duty +of the whole heart committed to them, as has already been +demonstrated. But what I have observed in the formation of the +foetus, as before remarked (and Aristotle had already confirmed +all in studying the incubated egg), throws the greatest light and +likelihood upon the point. Whilst the foetus is yet in the form +of a soft worm, or, as is commonly said, in the milk, there is a +mere bloody point or pulsating vesicle, a portion apparently of +the umbilical vein, dilated at its commencement or base. +Afterwards, when the outline of the foetus is distinctly +indicated and it begins to have greater bodily consistence, the +vesicle in question becomes more fleshy and stronger, changes its +position, and passes into the auricles, above which the body of +the heart begins to sprout, though as yet it apparently performs +no office. When the foetus is farther advanced, when the bones +can be distinguished from the fleshy parts and movements take +place, then it also has a heart which pulsates, and, as I have +said, throws blood by either ventricle from the vena cava into +the arteries. + +Thus nature, ever perfect and divine, doing nothing in vain, has +neither given a heart where it was not required, nor produced it +before its office had become necessary; but by the same stages in +the development of every animal, passing through the forms of +all, as I may say (ovum, worm, foetus), it acquires perfection in +each. These points will be found elsewhere confirmed by numerous +observations on the formation of the foetus. + +Finally, it is not without good grounds that Hippocrates in his +book, "De Corde," entitles it a muscle; its action is the same; +so is its functions, viz., to contract and move something else-- +in this case the charge of the blood. + +Farther, we can infer the action and use of the heart from the +arrangement of its fibres and its general structures, as in +muscles generally. All anatomists admit with Galen that the body +of the heart is made up of various courses of fibres running +straight, obliquely, and transversely, with reference to one +another; but in a heart which has been boiled, the arrangement of +the fibres is seen to be different. All the fibres in the +parietes and septum are circular, as in the sphincters; those, +again, which are in the columns extend lengthwise, and are +oblique longitudinally; and so it comes to pass that when all the +fibres contract simultaneously, the apex of the cone is pulled +towards its base by the columns, the walls are drawn circularly +together into a globe--the whole heart, in short, is contracted +and the ventricles narrowed. It is, therefore, impossible not to +perceive that, as the action of the organ is so plainly +contraction, its function is to propel the blood into the +arteries. + +Nor are we the less to agree with Aristotle in regard to the +importance of the heart, or to question if it receives sense and +motion from the brain, blood from the liver, or whether it be the +origin of the veins and of the blood, and such like. They who +affirm these propositions overlook, or do not rightly understand, +the principal argument, to the effect that the heart is the first +part which exists, and that it contains within itself blood, +life, sensation, and motion, before either the brain or the liver +were created or had appeared distinctly, or, at all events, +before they could perform any function. The heart, ready +furnished with its proper organs of motion, like a kind of +internal creature, existed before the body. The first to be +formed, nature willed that it should afterwards fashion, nourish, +preserve, complete the entire animal, as its work and dwelling- +place: and as the prince in a kingdom, in whose hands lie the +chief and highest authority, rules over all, the heart is the +source and foundation from which all power is derived, on which +all power depends in the animal body. + +Many things having reference to the arteries farther illustrate +and confirm this truth. Why does not the pulmonary vein pulsate, +seeing that it is numbered among the arteries? Or wherefore is +there a pulse in the pulmonary artery? Because the pulse of the +arteries is derived from the impulse of the blood. Why does an +artery differ so much from a vein in the thickness and strength +of its coats? Because it sustains the shock of the impelling +heart and streaming blood. Hence, as perfect nature does nothing +in vain, and suffices under all circumstances, we find that the +nearer the arteries are to the heart, the more do they differ +from the veins in structure; here they are both stronger and more +ligamentous, whilst in extreme parts of the body, such as the +feet and hands, the brain, the mesentery, and the testicles, the +two orders of vessels are so much alike that it is impossible to +distinguish between them with the eye. Now this is for the +following very sufficient reasons: the more remote the vessels +are from the heart, with so much the less force are they +distended by the stroke of the heart, which is broken by the +great distance at which it is given. Add to this that the impulse +of the heart exerted upon the mass of blood, which must needs +fill the trunks and branches of the arteries, is diverted, +divided, as it were, and diminished at every subdivision, so that +the ultimate capillary divisions of the arteries look like veins, +and this not merely in constitution, but in function. They have +either no perceptible pulse, or they rarely exhibit one, and +never except where the heart beats more violently than usual, or +at a part where the minute vessel is more dilated or open than +elsewhere. It, therefore, happens that at times we are aware of a +pulse in the teeth, in inflammatory tumours, and in the fingers; +at another time we feel nothing of the sort. By this single +symptom I have ascertained for certain that young persons whose +pulses are naturally rapid were labouring under fever; and in +like manner, on compressing the fingers in youthful and delicate +subjects during a febrile paroxysm, I have readily perceived the +pulse there. On the other hand, when the heart pulsates more +languidly, it is often impossible to feel the pulse not merely in +the fingers, but the wrist, and even at the temple, as in persons +afflicted with lipothymiae asphyxia, or hysterical symptoms, and +in the debilitated and moribund. + +Here surgeons are to be advised that, when the blood escapes with +force in the amputation of limbs, in the removal of tumours, and +in wounds, it constantly comes from an artery; not always indeed +per saltum, because the smaller arteries do not pulsate, +especially if a tourniquet has been applied. + +For the same reason the pulmonary artery not only has the +structure of an artery, but it does not differ so widely from the +veins in the thickness of its walls as does the aorta. The aorta +sustains a more powerful shock from the left than the pulmonary +artery does from the right ventricle, and the walls of this last +vessel are thinner and softer than those of the aorta in the same +proportion as the walls of the right ventricle of the heart are +weaker and thinner than those of the left ventricle. In like +manner the lungs are softer and laxer in structure than the flesh +and other constituents of the body, and in a similar way the +walls of the branches of the pulmonary artery differ from those +of the vessels derived from the aorta. And the same proportion in +these particulars is universally preserved. The more muscular and +powerful men are, the firmer their flesh; the stronger, thicker, +denser, and more fibrous their hearts, the thicker, closer, and +stronger are the auricles and arteries. Again, in those animals +the ventricles of whose hearts are smooth on their inner surface, +without villi or valves, and the walls of which are thin, as in +fishes, serpents, birds, and very many genera of animals, the +arteries differ little or nothing in the thickness of their coats +from the veins. + +Moreover, the reason why the lungs have such ample vessels, both +arteries and veins (for the capacity of the pulmonary veins +exceeds that of both crural and jugular vessels), and why they +contain so large a quantity of blood, as by experience and ocular +inspection we know they do, admonished of the fact indeed by +Aristotle, and not led into error by the appearances found in +animals which have been bled to death, is, because the blood has +its fountain, and storehouse, and the workshop of its last +perfection, in the heart and lungs. Why, in the same way, we find +in the course of our anatomical dissections the pulmonary vein +and left ventricle so full of blood, of the same black colour and +clotted character as that with which the right ventricle and +pulmonary artery are filled, is because the blood is incessantly +passing from one side of the heart to the other through the +lungs. Wherefore, in fine, the pulmonary artery has the structure +of an artery, and the pulmonary veins have the structure of +veins. In function and constitution and everything else the first +is an artery, the others are veins, contrary to what is commonly +believed; and the reason why the pulmonary artery has so large an +orifice is because it transports much more blood than is +requisite for the nutrition of the lungs. + +All these appearances, and many others, to be noted in the course +of dissection, if rightly weighed, seem clearly to illustrate and +fully to confirm the truth contended for throughout these pages, +and at the same time to oppose the vulgar opinion; for it would +be very difficult to explain in any other way to what purpose all +is constructed and arranged as we have seen it to be. + + + + +THE THREE ORIGINAL PUBLICATIONS ON VACCINATION AGAINST SMALLPOX +BY EDWARD JENNER + + +INTRODUCTORY NOTE + + +Edward Jenner was born at his father's vicarage at Berkeley, +Gloucestershire, England, on May 17, 1749. After leaving school, +he was apprenticed to a local surgeon, and in 1770 he went to +London and became a resident pupil under the great surgeon and +anatomist, John Hunter, with whom he remained on intimate terms +for the rest of Hunter's life. In 1773 he took up practise at +Berkeley, where, except for numerous visits to London, he spent +the rest of his life. He died of apoplexy on January 26, 1823. + +Jenner's scientific interests were varied, but the importance of +his work in vaccination has overshadowed his other results. Early +in his career he had begun to observe the phenomena of cowpox, a +disease common in the rural parts of the western counties of +England, and he was familiar with the belief, current among the +peasantry, that a person who had suffered from the cowpox could +not take smallpox. Finally, in 1796, he made his first experiment +in vaccination, inoculating a boy of eight with cowpox, and, +after his recovery, with smallpox; with the result that the boy +did not take the latter disease. + +Jenner's first paper on his discovery was never printed; but in +1798 appeared the first of the following treatises. Its reception +by the medical profession was highly discouraging; but progress +began when Cline, the surgeon of St. Thomas's Hospital, used the +treatment with success. Jenner continued his investigations, +publishing his results from time to time, and gradually gaining +recognition; though opposition to his theory and practise was at +first vehement, and has never entirely disappeared. In 1802, +Parliament voted him 10,000 pounds, and in 1806, 20,000 pounds, in +recognition of the value of his services, and the sacrifices they +had entailed. As early as 1807, Bavaria made vaccination +compulsory; and since that date most of the European governments +have officially encouraged or compelled the practise; and +smallpox has ceased to be the almost universal scourge it was +before Jenner's discovery. + +To C.H. PARRY, M.D. AT BATH + +MY DEAR FRIEND: + +In the present age of scientific investigation it is remarkable +that a disease of so peculiar a nature as the cow-pox, which has +appeared in this and some of the neighbouring counties for such a +series of years, should so long have escaped particular +attention. Finding the prevailing notions on the subject, both +among men of our profession and others, extremely vague and +indeterminate, and conceiving that facts might appear at once +both curious and useful, I have instituted as strict an inquiry +into the causes and effects of this singular malady as local +circumstances would admit. + +The following pages are the result, which, from motives of the +most affectionate regard, are dedicated to you, by + +Your sincere friend, + +EDWARD JENNER. + +BERKELEY, GLOUCESTERSHIRE, June 21st, 1798. + + + + +VACCINATION AGAINST SMALLPOX + +I AN INQUIRY INTO THE CAUSES AND EFFECTS OF THE VARIOLE VACCINE, +OR COW-POX. 1798 + + +The deviation of man from the stage in which he was originally +placed by nature seems to have proved to him a prolific source of +diseases. From the love of splendour, from the indulgences of +luxury, and from his fondness for amusement he has familiarised +himself with a great number of animals, which may not originally +have been intended for his associates. + +The wolf, disarmed of ferocity, is now pillowed in the lady's +lap. [Footnote: The late Mr. John Hunter proved, by experiments, +that the dog is the wolf in a degenerate state.] The cat, the +little tiger of our island, whose natural home is the forest, is +equally domesticated and caressed. The cow, the hog, the sheep, +and the horse, are all, for a variety of purposes, brought under +his care and dominion. + +There is a disease to which the horse, from his state of +domestication, is frequently subject. The farriers have called it +the grease. It is an inflammation and swelling in the heel, from +which issues matter possessing properties of a very peculiar +kind, which seems capable of generating a disease in the human +body (after it has undergone the modification which I shall +presently speak of), which bears so strong a resemblance to the +smallpox that I think it highly probable it may be the source of +the disease. + +In this dairy country a great number of cows are kept, and the +office of milking is performed indiscriminately by men and maid +servants. One of the former having been appointed to apply +dressings to the heels of a horse affected with the grease, and +not paying due attention to cleanliness, incautiously bears his +part in milking the cows, with some particles of the infectious +matter adhering to his fingers. When this is the case, it +commonly happens that a disease is communicated to the cows, and +from the cows to the dairymaids, which spreads through the farm +until the most of the cattle and domestics feel its unpleasant +consequences. This disease has obtained the name of the cow-pox. +It appears on the nipples of the cows in the form of irregular +pustules. At their first appearance they are commonly of a palish +blue, or rather of a colour somewhat approaching to livid, and +are surrounded by an erysipelatous inflammation. These pustules, +unless a timely remedy be applied, frequently degenerate into +phagedenic ulcers, which prove extremely troublesome. [Footnote: +They who attend sick cattle in this country find a speedy remedy +for stopping the progress of this complaint in those applications +which act chemically upon the morbid matter, such as the +solutions of the vitriolum zinci and the vitriolum cupri, etc.] +The animals become indisposed, and the secretion of milk is much +lessened. Inflamed spots now begin to appear on different parts +of the hands of the domestics employed in milking, and sometimes +on the wrists, which quickly run on to suppuration, first +assuming the appearance of the small vesications produced by a +burn. Most commonly they appear about the joints of the fingers +and at their extremities; but whatever parts are affected, if the +situation will admit, these superficial suppurations put on a +circular form, with their edges more elevated than their centre, +and of a colour distantly approaching to blue. Absorption takes +place, and tumours appear in each axilla. The system becomes +affected--the pulse is quickened; and shiverings, succeeded by +heat, with general lassitude and pains about the loins and limbs, +with vomiting, come on. The head is painful, and the patient is +now and then even affected with delirium. These symptoms, varying +in their degrees of violence, generally continue from one day to +three or four, leaving ulcerated sores about the hands, which, +from the sensibility of the parts, are very troublesome, and +commonly heal slowly, frequently becoming phagedenic, like those +from whence they sprung. The lips, nostrils, eyelids, and other +parts of the body are sometimes affected with sores; but these +evidently arise from their being heedlessly rubbed or scratched +with the patient's infected fingers. No eruptions on the skin +have followed the decline of the feverish symptoms in any +instance that has come under my inspection, one only excepted, +and in this case a very few appeared on the arms: they were very +minute, of a vivid red colour, and soon died away without +advancing to maturation; so that I cannot determine whether they +had any connection with the preceding symptoms. + +Thus the disease makes its progress from the horse [Footnote: +Jenner's conclusion that "grease" and cow-pox were the same +disease has since been proved erroneous; but this error has not +invalidated his main conclusion as to the relation of cow-pox and +smallpox.--EDITOR.] to the nipple of the cow, and from the cow to +the human subject + +Morbid matter of various kinds, when absorbed into the system, +may produce effects in some degree similar; but what renders the +cow-pox virus so extremely singular is that the person who has +been thus affected is forever after secure from the infection of +the smallpox; neither exposure to the variolous effluvia, nor the +insertion of the matter into the skin, producing this distemper. + +In support of so extraordinary a fact, I shall lay before my +reader a great number of instances. [Footnote: It is necessary to +observe that pustulous sores frequently appear spontaneously on +the nipples of cows, and instances have occurred, though very +rarely, of the hands of the servants employed in milking being +affected with sores in consequence, and even of their feeling an +indisposition from absorption. These pustules arc of a much +milder nature than those which arise from that contagion which +constitutes the true cow-pox. They are always free from the +bluish or livid tint so conspicuous in the pustules in that +disease. No erysipelas attends them, nor do they shew any +phagedenic disposition as in the other case, but quickly +terminate in a scab without creating any apparent disorder in the +cow. This complaint appears at various seasons of the year, but +most commonly in the spring, when the cows are first taken from +their winter food and fed with grass. It is very apt to appear +also when they are suckling their young. But this disease is not +to be considered as similar in any respect to that of which I am +treating, as it is incapable of producing any specific effects on +the human constitution. However, it is of the greatest +consequence to point it out here, lest the want of discrimination +should occasion an idea of security from the infection of the +smallpox, which might prove delusive.] + +CASE I.--Joseph Merret, now an under gardener to the Earl of +Berkeley, lived as a servant with a farmer near this place in the +year 1770, and occasionally assisted in milking his master's +cows. Several horses belonging to the farm began to have sore +heels, which Merret frequently attended. The cows soon became +affected with the cow-pox, and soon after several sores appeared +on his hands. Swellings and stiffness in each axilla followed, +and he was so much indisposed for several days as to be incapable +of pursuing his ordinary employment. Previously to the appearance +of the distemper among the cows there was no fresh cow brought +into the farm, nor any servant employed who was affected with the +cow-pox. + +In April, 1795, a general inoculation taking place here, Merret +was inoculated with his family; so that a period of twenty-five +years had elapsed from his having the cow-pox to this time. +However, though the variolous matter was repeatedly inserted into +his arm, I found it impracticable to infect him with it; an +efflorescence only, taking on an erysipelatous look about the +centre, appearing on the skin near the punctured parts. During +the whole time that his family had the smallpox, one of whom had +it very full, he remained in the house with them, but received no +injury from exposure to the contagion. + +It is necessary to observe that the utmost care was taken to +ascertain, with the most scrupulous precision, that no one whose +case is here adduced had gone through the smallpox previous to +these attempts to produce that disease. + +Had these experiments been conducted in a large city, or in a +populous neighbourhood, some doubts might have been entertained; +but here, where population is thin, and where such an event as a +person's having had the smallpox is always faithfully recorded, +as risk of inaccuracy in this particular can arise. + +CASE II.--Sarah Portlock, of this place, was infected with the +cow-pox when a servant at a farmer's in the neighbourhood, +twenty-seven years ago. [Footnote: I have purposely selected +several cases in which the disease had appeared at a very distant +period previous to the experiments made with variolous matter, to +shew that the change produced in the constitution is not affected +by time.] + +In the year 1792, conceiving herself, from this circumstance, +secure from the infection of the smallpox, she nursed one of her +own children who had accidentally caught the disease, but no +indisposition ensued. During the time she remained in the +infected room, variolous matter was inserted into both her arms, +but without any further effect than in the preceding case. + +CASE III.--John Phillips, a tradesman of this town, had the cow- +pox at so early a period as nine years of age. At the age of +sixty-two I inoculated him, and was very careful in selecting +matter in its most active state. It was taken from the arm of a +boy just before the commencement of the eruptive fever, and +instantly inserted. It very speedily produced a sting-like feel +in the part. An efflorescence appeared, which on the fourth day +was rather extensive, and some degree of pain and stiffness were +felt about the shoulder; but on the fifth day these symptoms +began to disappear, and in a day or two after went entirely off, +without producing any effect on the system. + +CASE IV.--Mary Barge, of Woodford, in this parish, was inoculated +with variolous matter in the year 1791. An efflorescence of a +palish red colour soon appeared about the parts where the matter +was inserted, and spread itself rather extensively, but died away +in a few days without producing any variolous symptoms. +[Footnote: It is remarkable that variolous matter, when the +system is disposed to reject it, should excite inflammation on +the part to which it is applied more speedily than when it +produces the smallpox. Indeed, it becomes almost a criterion by +which we can determine whether the infection will be received or +not. It seems as if a change, which endures through life, had +been produced in the action, or disposition to action, in the +vessels of the skin; and it is remarkable, too, that whether this +change has been effected by the smallpox or the cow-pox that the +disposition to sudden cuticular inflammation is the same on the +application of variolous matter.] She has since been repeatedly +employed as a nurse to smallpox patients, without experiencing +any ill consequences. This woman had the cow-pox when she lived +in the service of a farmer in this parish thirty-one years +before. + +CASE V.--Mrs. H---, a respectable gentlewoman of this town, had +the cow-pox when very young. She received the infection in rather +an uncommon manner: it was given by means of her handling some of +the same utensils [Footnote: When the cow-pox has prevailed in +the dairy, it has often been communicated to those who have not +milked the cows, by the handle of the milk pail.] which were in +use among the servants of the family, who had the disease from +milking infected cows. Her hands had many of the cow-pox sores +upon them, and they were communicated to her nose, which became +inflamed and very much swollen. Soon after this event Mrs. H---- +was exposed to the contagion of the smallpox, where it was +scarcely possible for her to have escaped, had she been +susceptible of it, as she regularly attended a relative who had +the disease in so violent a degree that it proved fatal to him. + +In the year 1778 the smallpox prevailed very much at Berkeley, +and Mrs. H----, not feeling perfectly satisfied respecting her +safety (no indisposition having followed her exposure to the +smallpox), I inoculated her with active variolous matter. The +same appearance followed as in the preceding cases--an +efflorescence on the arm without any effect on the constitution. + +CASE VI.--It is a fact so well known among our dairy farmers that +those who have had the smallpox either escape the cow-pox or are +disposed to have it slightly, that as soon as the complaint shews +itself among the cattle, assistants are procured, if possible, +who are thus rendered less susceptible of it, otherwise the +business of the farm could scarcely go forward. + +In the month of May, 1796, the cow-pox broke out at Mr. Baker's, +a farmer who lives near this place. The disease was communicated +by means of a cow which was purchased in an infected state at a +neighbouring fair, and not one of the farmer's cows (consisting +of thirty) which were at that time milked escaped the contagion. +The family consisted of a man servant, two dairymaids, and a +servant boy, who, with the farmer himself, were twice a day +employed in milking the cattle. The whole of this family, except +Sarah Wynne, one of the dairymaids, had gone through the +smallpox. The consequence was that the farmer and the servant boy +escaped the infection of the cow-pox entirely, and the servant +man and one of the maid servants had each of them nothing more +then a sore on one of their fingers, which produced no disorder +in the system. But the other dairymaid, Sarah Wynne, who never +had the smallpox, did not escape in so easy a manner. She caught +the complaint from the cows, and was affected with the symptoms +described on page 154 in so violent a degree that she was +confined to her bed, and rendered incapable for several days of +pursuing her ordinary vocations in the farm. + +March 28, 1797, I inoculated this girl and carefully rubbed the +variolous matter into two slight incisions made upon the left +arm. A little inflammation appeared in the usual manner around +the parts where the matter was inserted, but so early as the +fifth day it vanished entirely without producing any effect on +the system. + +CASE VII.--Although the preceding history pretty clearly evinces +that the constitution is far less susceptible of the contagion of +the cow-pox after it has felt that of the smallpox, and although +in general, as I have observed, they who have had the smallpox, +and are employed in milking cows which are infected with the cow- +pox, either escape the disorder, or have sores on the hands +without feeling any general indisposition, yet the animal economy +is subject to some variation in this respect, which the following +relation will point out: + +In the summer of the year 1796 the cow-pox appeared at the farm +of Mr. Andrews, a considerable dairy adjoining to the town of +Berkeley. It was communicated, as in the preceding instance, by +an infected cow purchased at a fair in the neighbourhood. The +family consisted of the farmer, his wife, two sons, a man and a +maid servant; all of whom, except the farmer (who was fearful of +the consequences), bore a part in milking the cows. The whole of +them, exclusive of the man servant, had regularly gone through +the smallpox; but in this case no one who milked the cows escaped +the contagion. All of them had sores upon their hands, and some +degree of general indisposition, preceded by pains and tumours in +the axillas: but there was no comparison in the severity of the +disease as it was felt by the servant man, who had escaped the +smallpox, and by those of the family who had not, for, while he +was confined to his bed, they were able, without much +inconvenience, to follow their ordinary business. + +February the 13th, 1797, I availed myself of an opportunity of +inoculating William Rodway, the servant man above alluded to. +Variolous matter was inserted into both his arms: in the right, +by means of superficial incisions, and into the left by slight +punctures into the cutis. Both were perceptibly inflamed on the +third day. After this the inflammation about the punctures soon +died away, but a small appearance of erysipelas was manifest +about the edges of the incisions till the eighth day, when a +little uneasiness was felt for the space of half an hour in the +right axilla. The inflammation then hastily disappeared without +producing the most distant mark of affection of the system. + +CASE VIII.--Elizabeth Wynne, aged fifty-seven, lived as a servant +with a neighbouring farmer thirty-eight years ago. She was then a +dairymaid, and the cow-pox broke out among the cows. She caught +the disease with the rest of the family, but, compared with them, +had it in a very slight degree, one very small sore only breaking +out on the little finger of her left hand, and scarcely any +perceptible indisposition, following it. + +As the malady had shewn itself in so slight a manner, and as it +had taken place at so distant a period of her life, I was happy +with the opportunity of trying the effects of variolous matter +upon her constitution, and on the 28th of March, 1797, I +inoculated her by making two superficial incisions on the left +arm, on which the matter was cautiously rubbed. A little +efflorescence soon appeared, and a tingling sensation was felt +about the parts where the matter was inserted until the third +day, when both began to subside, and so early as the fifth day it +was evident that no indisposition would follow. + +CASE IX.--Although the cow-pox shields the constitution from the +smallpox, and the smallpox proves a protection against its own +future poison, yet it appears that the human body is again and +again susceptible of the infectious matter of the cow-pox, as the +following history will demonstrate. + +William Smith, of Pyrton in this parish, contracted this disease +when he lived with a neighbouring farmer in the year 1780. One of +the horses belonging to the farm had sore heels, and it fell to +his lot to attend him. By these means the infection was carried +to the cows, and from the cows it was communicated to Smith. On +one of his hands were several ulcerated sores, and he was +affected with such symptoms as have been before described. + +In the year 1791 the cow-pox broke out at another farm where he +then lived as a servant, and he became affected with it a second +time; and in the year 1794 he was so unfortunate as to catch it +again. The disease was equally as severe the second and third +time as it was on the first. [Footnote: This is not the case in +general--a second attack is commonly very slight, and so, I am +informed, it is among the cows.] + +In the spring of the year 1795 he was twice inoculated, but no +affection of the system could be produced from the variolous +matter; and he has since associated with those who had the +smallpox in its most contagious state without feeling any effect +from it. + +CASE X.--Simon Nichols lived as a servant with Mr. Bromedge, a +gentleman who resides on his own farm in this parish, in the year +1782. He was employed in applying dressings to the sore heels of +one of his master's horses, and at the same time assisted in +milking the cows. The cows became affected in consequence, but +the disease did not shew itself on their nipples till several +weeks after he had begun to dress the horse. He quitted Mr. +Bromedge's service, and went to another farm without any sores +upon him; but here his hands soon began to be affected in the +common way, and he was much indisposed with the usual symptoms. +Concealing the nature of the malady from Mr. Cole, his new +master, and being there also employed in milking, the cowpox was +communicated to the cows. + +Some years afterward Nichols was employed in a farm where the +smallpox broke out, when I inoculated him with several other +patients, with whom he continued during the whole time of their +confinement. His arm inflamed, but neither the inflammation nor +his associating with the inoculated family produced the least +effect upon his constitution. + +CASE XI.--William Stinchcomb was a fellow servant with Nichols at +Mr. Bromedge's farm at the time the cattle had the cow-pox, and +he was, unfortunately, infected by them. His left hand was very +severely affected with several corroding ulcers, and a tumour of +considerable size appeared in the axilla of that side. His right +hand had only one small tumour upon it, and no sore discovered +itself in the corresponding axilla. + +In the year 1792 Stinchcomb was inoculated with variolous matter, +but no consequences ensued beyond a little inflammation in the +arm for a few days. A large party were inoculated at the same +time, some of whom had the disease in a more violent degree than +is commonly seen from inoculation. He purposely associated with +them, but could not receive the smallpox. + +During the sickening of some of his companions their symptoms so +strongly recalled to his mind his own state when sickening with +the cow--pox that he very pertinently remarked their striking +similarity. + +CASE XII.--The paupers of the village of Tortworth, in this +county, were inoculated by Mr. Henry Jenner, Surgeon, of +Berkeley, in the year 1795. Among them, eight patients presented +themselves who had at different periods of their lives had the +cow-pox. One of them, Hester Walkley, I attended with that +disease when she lived in the service of a farmer in the same +village in the year 1782; but neither this woman, nor any other +of the patients who had gone through the cow-pox, received the +variolous infection either from the arm or from mixing in the +society of the other patients who were inoculated at the same +time. This state of security proved a fortunate circumstance, as +many of the poor women were at the same time in a state of +pregnancy. + +CASE XIII.--One instance has occurred to me of the system being +affected from the matter issuing from the heels of horses, and of +its remaining afterwards unsusceptible of the variolous +contagion; another, where the smallpox appeared obscurely; and a +third, in which its complete existence was positively +ascertained. + +First, Thomas Pearce is the son of a smith and farrier near to +this place. He never had the cow-pox; but, in consequence of +dressing horses with sore heels at his father's, when a lad, he +had sores on his fingers which suppurated, and which occasioned a +pretty severe indisposition. Six years afterwards I inserted +variolous matter into his arm repeatedly, without being able to +produce any thing more than slight inflammation, which appeared +very soon after the matter was applied, and afterwards I exposed +him to the contagion of the smallpox with as little effect. +[Footnote: It is a remarkable fact, and well known to many, that +we are frequently foiled in our endeavours to communicate the +smallpox by inoculation to blacksmiths, who in the country are +farriers. They often, as in the above instance, either resist the +contagion entirely, or have the disease anomalously. Shall we not +be able to account for this on a rational principle?] + +CASE XIV.--Secondly, Mr. James Cole, a farmer in this parish, had +a disease from the same source as related in the preceding case, +and some years after was inoculated with variolous matter. He had +a little pain in the axilla and felt a slight indisposition for +three or four hours. A few eruptions shewed themselves on the +forehead, but they very soon disappeared without advancing to +maturation. + +CASE XV.--Although in the former instances the system seemed to +be secured, or nearly so, from variolous infection, by the +absorption of matter from the sores produced by the diseased +heels of horses, yet the following case decisively proves that +this cannot be entirely relied upon until a disease has been +generated by the morbid matter from the horse on the nipple of +the cow, and passed through that medium to the human subject. + +Mr. Abraham Riddiford, a farmer at Stone in this parish, in +consequence of dressing a mare that had sore heels, was affected +with very painful sores in both his hands, tumours in each +axilla, and severe and general indisposition. A surgeon in the +neighbourhood attended him, who knowing the similarity between +the appearance of the sores upon his hands and those produced by +the cow-pox, and being acquainted also with the effects of that +disease on the human constitution, assured him that he never need +to fear the infection of the smallpox; but this assertion proved +fallacious, for, on being exposed to the infection upwards of +twenty years afterwards, he caught the disease, which took its +regular course in a very mild way. There certainly was a +difference perceptible, although it is not easy to describe it, +in the general appearance of the pustules from that which we +commonly see. Other practitioners who visited the patient at my +request agreed with me in this point, though there was no room +left for suspicion as to the reality of the disease, as I +inoculated some of his family from the pustules, who had the +smallpox, with its usual appearances, in consequence. + +CASE XVI.--Sarah Nelmes, a dairymaid at a farmer's near this +place, was infected with the cow-pox from her master's cows in +May, 1796. She received the infection on a part of her hand which +had been previously in a slight degree injured by a scratch from +a thorn. A large pustulous sore and the usual symptoms +accompanying the disease were produced in consequence. The +pustule was so expressive of the true character of the cow-pox, +as it commonly appears upon the hand, that I have given a +representation of it in the annexed plate. The two small pustules +on the wrists arose also from the application of the virus to +some minute abrasions of the cuticle, but the livid tint, if they +ever had any, was not conspicuous at the time I saw the patient. +The pustule on the forefinger shews the disease in an earlier +stage. It did not actually appear on the hand of this young +woman, but was taken from that of another, and is annexed for the +purpose of representing the malady after it has newly appeared. + +CASE XVII.--The more accurately to observe the progress of the +infection I selected a healthy boy, about eight years old, for +the purpose of inoculation for the cow-pox. The matter was taken +from a sore on the hand of a dairymaid [Footnote: From the sore +on the hand of Sarah Nelmes. See the preceding case.], who was +infected by her master's cows, and it was inserted, on the 14th +of May, 1796, into the arm of the boy by means of two superficial +incisions, barely penetrating the cutis, each about half an inch +long. + +On the seventh day he complained of uneasiness in the axilla, and +on the ninth he became a little chilly, lost his appetite, and +had a slight headache. During the whole of this day he was +perceptibly indisposed, and spent the night with some degree of +restlessness, but on the day following he was perfectly well. + +The appearance of the incisions in their progress to a state of +maturation were much the same as when produced in a similar +manner by variolous matter. The only difference which I perceived +was in the state of the limpid fluid arising from the action of +the virus, which assumed rather a darker hue, and in that of the +efflorescence spreading round the incisions, which had more of an +erysipelatous look than we commonly perceive when variolous +matter has been made use of in the same manner; but the whole +died away (leaving on the inoculated parts scabs and subsequent +eschars) without giving me or my patient the least trouble. + +In order to ascertain whether the boy, after feeling so slight an +affection of the system from the cow--pox virus, was secure from +the contagion of the smallpox, he was inoculated the 1st of July +following with variolous matter, immediately taken from a +pustule. Several slight punctures and incisions were made on both +his arms, and the matter was carefully inserted, but no disease +followed. The same appearances were observable on the arms as we +commonly see when a patient has had variolous matter applied, +after having either the cow--pox or smallpox. Several months +afterwards he was again inoculated with variolous matter, but no +sensible effect was produced on the constitution. + +Here my researches were interrupted till the spring of the year +1798, when, from the wetness of the early part of the season, +many of the farmers' horses in this neighbourhood were affected +with sore heels, in consequence of which the cow--pox broke out +among several of our dairies, which afforded me an opportunity of +making further observations upon this curious disease. + +A mare, the property of a person who keeps a dairy in a +neighbouring parish, began to have sore heels the latter end of +the month of February, 1798, which were occasionally washed by +the servant men of the farm, Thomas Virgoe, William Wherret, and +William Haynes, who in consequence became affected with sores in +their hands, followed by inflamed lymphatic glands in the arms +and axillae, shiverings succeeded by heat, lassitude, and general +pains in the limbs. A single paroxysm terminated the disease; for +within twenty--four hours they were free from general +indisposition, nothing remaining but the sores on their hands. +Haynes and Virgoe, who had gone through the smallpox from +inoculation, described their feelings as very similar to those +which affected them on sickening with that malady. Wherret never +had had the smallpox. Haynes was daily employed as one of the +milkers at the farm, and the disease began to shew itself among +the cows about ten days after he first assisted in washing the +mare's heels. Their nipples became sore in the usual way, with +bluish pustules; but as remedies were early applied, they did not +ulcerate to any extent. + +CASE XVIII.--John Baker, a child of five years old, was +inoculated March 16, 1798, with matter taken from a pustule on +the hand of Thomas Virgoe, one of the servants who had been +infected from the mare's heels. He became ill on the sixth day +with symptoms similar to those excited by cow--pox matter. On the +eighth day he was free from indisposition. + +There was some variation in the appearance of the pustule on the +arm. Although it somewhat resembled a smallpox pustule, yet its +similitude was not so conspicuous as when excited by matter from +the nipple of the cow, or when the matter has passed from thence +through the medium of the human subject. + +This experiment was made to ascertain the progress and subsequent +effects of the disease when thus propagated. We have seen that +the virus from the horge, when it proves infectious to the human +subject, is not to be relied upon as rendering the system secure +from variolous infection, but that the matter produced by it upon +the nipple of the cow is perfectly so. Whether its passing from +the horse through the human constitution, as in the present +instance, will produce a similar effect, remains to be decided. +This would mow have been effected, but the boy was rendered unit +for inoculation from having felt the effects of a contagious +fever in a workhouse soon after this experiment was made. + +CASE XIX.--William Summers, a child of five years and a half old, +was inoculated the same day with Baker, with matter taken from +the nipples of one of the infected cows, at the farm alluded to. +He became indisposed on the sixth day, vomited once, and felt the +usual slight symptoms till the eighth day, when he appeared +perfectly well. The progress of the pustule, formed by the +infection of the virus, was similar to that noticed in Case XVII, +with this exception, its being free from the livid tint observed +in that instance. + +CASE XX.-From William Summers the disease was transferred to +William Pead, a boy of eight years old, who was inoculated March +28th. On the sixth day he complained of pain in the axilla, and +on the seventh was affected with the common symptoms of a patient +sickening with the smallpox from inoculation, which did not +terminate till the third day after the seizure. So perfect was +the similarity to the variolous fever that I was induced to +examine the skin, conceiving there might have been some +eruptions, but none appeared. The efflorescent blush around the +part punctured in the boy's arm was so truly characteristic of +that which appears on variolous inoculation that I have given a +representation of it. The drawing was made when the pustule was +beginning to die away and the areola retiring from the centre. + +CASE XXI.-April 5th: Several children and adults were inoculated +from the arm of William Pead. The greater part of them sickened +on the sixth day, and were well on the seventh, but in three of +the number a secondary indisposition arose in consequence of an +extensive erysipelatous inflammation which appeared on the +inoculated arms. It seemed to arise from the state of the +pustule, which spread out, accompanied with some degree of pain, +to about half the diameter of a sixpence. One of these patients +was an infant of half a year old. By the application of mercurial +ointment to the inflamed parts (a treatment recommended under +similar circumstances in the inoculated smallpox) the complaint +subsided without giving much trouble. + +Hannah Excell, an healthy girl of seven years old, and one of the +patients above mentioned, received the infection from the +insertion of the virus under the cuticle of the arm in three +distinct points. The pustules which arose in consequence so much +resembled, on the twelfth day, those appearing from the infection +of variolous matter, that an experienced inoculator would +scarcely have discovered a shade of difference at that period. +Experience now tells me that almost the only variation which +follows consists in the pustulous fluids remaining limpid nearly +to the time of its total disappearance; and not, as in the direct +smallpox, becoming purulent. + +CASE XXII.--From the arm of this girl matter was taken and +inserted April 12th into the arms of John Macklove, one year and +a half old, Robert F. Jenner, eleven months old, Mary Pead, five +years old, and Mary James, six years old. [Footnote: Perhaps a +few touches with the lapis septicus would have proved equally +efficacious.] Among these, Robert F. Jenner did not receive the +infection. The arms of the other three inflamed properly and +began to affect the system in the usual manner; but being under +some apprehensions from the preceding cases that a troublesome +erysipelas might arise, I determined on making an experiment with +the view of cutting off its source. Accordingly, after the +patients had felt an indisposition of about twelve hours, I +applied in two of these cases out of the three, on the vesicle +formed by the virus, a little mild caustic, composed of equal +parts of quick--lime and soap, and suffered it to remain on the +part six hours. [Footnote: What effect would a similar treatment +produce in inoculation for the smallpox?] It seemed to give the +children but little uneasiness, and effectually answered my +intention in preventing the appearance of erysipelas. Indeed, it +seemed to do more, for in half an hour after its application the +indisposition of the children ceased. These precautions were +perhaps unnecessary, as the arm of the third child, Mary Pead, +which was suffered to take its common course, scabbed quickly, +without any erysipelas. + +CASE XXIII.--From this child's arm matter was taken and +transferred to that of J. Barge, a boy of seven years old. He +sickened on the eighth day, went through the disease with the +usual slight symptoms, and without any inflammation on the arm +beyond the common efflorescence surrounding the pustule, an +appearance so often seen in inoculated smallpox. + +After the many fruitless attempts to give the smallpox to those +who had had the cow-pox, it did not appear necessary, nor was it +convenient to me, to inoculate the whole of those who had been +the subjects of these late trials; yet I thought it right to see +the effects of variolous matter on some of them, particularly +William Summers, the first of these patients who had been +infected with matter taken from the cow. He was, therefore, +inoculated with variolous matter from a fresh pustule; but, as in +the preceding cases, the system did not feel the effects of it in +the smallest degree. I had an opportunity also of having this boy +and William Pead inoculated by my nephew, Mr. Henry Jenner, whose +report to me is as follows: "I have inoculated Pead and Barge, +two of the boys whom you lately infected with the cow-pox. On the +second day the incisions were inflamed and there was a pale +inflammatory stain around them. On the third day these +appearances were still increasing and their arms itched +considerably. On the fourth day the inflammation was evidently +subsiding, and on the sixth day it was scarcely perceptible. No +symptom of indisposition followed. + +"To convince myself that the variolous matter made use of was in +a perfect state I at the same time inoculated a patient with some +of it who never had gone through the cow-pox, and it produced the +smallpox in the usual regular manner." + +These experiments afforded me much satisfaction; they proved that +the matter, in passing from one human subject to another, through +five gradations, lost none of its original properties, J. Barge +being the fifth who received the infection successively from +William Summers, the boy to whom it was communicated from the +cow. + +I shall now conclude this inquiry with some general observations +on the subject, and on some others which are interwoven with it. + +Although I presume it may be unnecessary to produce further +testimony in support of my assertion "that the cow--pox protects +the human constitution from the infection of the smallpox," yet +it affords me considerable satisfaction to say that Lord +Somerville, the President of the Board of Agriculture, to whom +this paper was shewn by Sir Joseph Banks, has found upon inquiry +that the statements were confirmed by the concurring testimony of +Mr. Dolland, a surgeon, who resides in a dairy country remote +from this, in which these observations were made. With respect to +the opinion adduced "that the source of the infection is a +peculiar morbid matter arising in the horse," although I have not +been able to prove it from actual experiments conducted +immediately under my own eye, yet the evidence I have adduced +appears sufficient to establish it. + +They who are not in the habit of conducting experiments may not +be aware of the coincidence of circumstances necessary for their +being managed so as to prove perfectly decisive; nor how often +men engaged in professional pursuits are liable to interruptions +which disappoint them almost at the instant of their being +accomplished: however, I feel no room for hesitation respecting +the common origin of the disease, being well convinced that it +never appears among the cows (except it can be traced to a cow +introduced among the general herd which has been previously +infected, or to an infected servant) unless they have been milked +by some one who, at the same time, has the care of a horse +affected with diseased heels. + +The spring of the year 1797, which I intended particularly to +have devoted to the completion of this investigation, proved, +from its dryness, remarkably adverse to my wishes;-for it +frequently happens, while the farmers' horses are exposed to the +cold rains which fall at that season, that their heels become +diseased, and no cow-pox then appeared in the neighbourhood. + +The active quality of the virus from the horses' heels is greatly +increased after it has acted on the nipples of the cow, as it +rarely happens that the horse affects his dresser with sores, and +as rarely that a milkmaid escapes the infection when she milks +infected cows. It is most active at the commencement of the +disease, even before it has acquired a pus-like appearance; +indeed, I am not confident whether this property in the matter +does not entirely cease as soon as it is secreted in the form of +pus. I am induced to think it does cease [Footnote: It is very +easy to procure pus from old sores on the heels of horses. This I +have often inserted into scratches made with a lancet, on the +sound nipples of cows, and have seen no other effects from it +than simple inflamation.], and that it is the thin, darkish- +looking fluid only, oozing from the newly-formed cracks in the +heels, similar to what sometimes appears from erysipelatous +blisters, which gives the disease. Nor am I certain that the +nipples of the cows are at all times in a state to receive the +infection. The appearance of the disease in the spring and the +early part of the summer, when they are disposed to be affected +with spontaneous eruptions so much more frequently than at other +seasons, induces me to think that the virus from the horse must +be received upon them when they are in this state, in order to +produce effects: experiments, however, must determine these +points. But it is clear that when the cow-pox virus is once +generated, that the cows cannot resist the contagion, in whatever +state their nipples may chance to be, if they are milked with an +infected hand. + +Whether the matter, either from the cow or the horse, will affect +the sound skin of the human body, I cannot positively determine; +probably it will not, unless on those parts where the cuticle is +extremely thin, as on the lips, for example. I have known an +instance of a poor girl who produced an ulceration on her lip by +frequently holding her finger to her mouth to cool the raging of +a cow-pox sore by blowing upon it. The hands of the farmers' +servants here, from the nature of their employments, are +constantly exposed to those injuries which occasion abrasions of +the cuticle, to punctures from thorns, and such like accidents; +so that they are always in a state to feel the consequence of +exposure to infectious matter. + +It is singular to observe that the cow--pox virus, although it +renders the constitution unsusceptible of the variolous, should +nevertheless, leave it unchanged with respect to its own action. +I have already produced an instance [Footnote: See Case IX.] to +point out this, and shall now corroborate it with another. + +Elizabeth Wynne, who had the cow-pox in the year 1759, was +inoculated with variolous matter, without effect, in the year +1797, and again caught the cow-pox in the year 1798. When I saw +her, which was on the eighth day after she received the +infection, I found her affected with general lassitude, +shiverings, alternating with heat, coldness of the extremities, +and a quick and irregular pulse. These symptoms were preceded by +a pain in the axilla. On her hand was one large pustulous sore, +which resembled that delineated in Plate No. I. (Plate appears in +original.) + +It is curious also to observe that the virus, which with respect +to its effects is undetermined and uncertain previously to its +passing from the horse through the medium of the cow, should then +not only become more active, but should invariably and completely +possess those specific properties which induce in the human +constitution symptoms similar to those of the variolous fever, +and effect in it that peculiar change which for ever renders it +unsusceptible of the variolous contagion. + +May it not then be reasonably conjectured that the source of the +smallpox is morbid matter of a peculiar kind, generated by a +disease in the horse, and that accidental circumstances may have +again and again arisen, still working new changes upon it until +it has acquired the contagious and malignant form under which we +now commonly see it making its devastations amongst us? And, from +a consideration of the change which the infectious matter +undergoes from producing a disease on the cow, may we not +conceive that many contagious diseases, now prevalent among us, +may owe their present appearance not to a simple, but to a +compound, origin? For example, is it difficult to imagine that +the measles, the scarlet fever, and the ulcerous sore throat with +a spotted skin have all sprung from the same source, assuming +some variety in their forms according to the nature of their new +combinations? The same question will apply respecting the origin +of many other contagious diseases which bear a strong analogy to +each other. + +There are certainly more forms than one, without considering the +common variation between the confluent and distinct, in which the +smallpox appears in what is called the natural way. About seven +years ago a species of smallpox spread through many of the towns +and villages of this part of Gloucestershire: it was of so mild a +nature that a fatal instance was scarcely ever Heard of, and +consequently so little dreaded by the lower orders of the +community that they scrupled not to hold the same intercourse +with each other as if no infectious disease had been present +among them. I never saw nor heard of an instance of its being +confluent. The most accurate manner, perhaps, in which I can +convey an idea of it is by saying that had fifty individuals been +taken promiscuously and infected by exposure to this contagion, +they would have had as mild and light a disease as if they had +been inoculated with variolous matter in the usual way. The +harmless manner in which it shewed itself could not arise from +any peculiarity either in the season or the weather, for I +watched its progress upwards of a year without perceiving any +variation in its general appearance. I consider it then as a +variety of the smallpox. [Footnote: My friend, Dr. Hicks, of +Bristol, who, during the prevalence of this distemper, was +resident at Gloucester, and physician of the hospital there +(where it was soon after its first appearance in this country), +had opportunities of making numerous observations upon it, which +it is his intention to communicate to the public.]. + +In some of the preceding cases I have noticed the attention that +was paid to the state of the variolous matter previous to the +experiment of inserting it into the arms of those who had gone +through the cow-pox. This I conceived to be of great importance +in conducting these experiments, and, were it always properly +attended to by those who inoculate for the smallpox, it might +prevent much subsequent mischief and confusion. With the view of +enforcing so necessary a precaution I shall take the liberty of +digressing so far as to point out some unpleasant facts relative +to mismanagement in this particular, which have fallen under my +own observation. + +A medical gentleman (now no more), who for many years inoculated +in this neighbourhood, frequently preserved the variolous matter +intended for his use on a piece of lint or cotton, which, in its +fluid state, was put into a vial, corked, and conveyed into a +warm pocket; a situation certainly favourable for speedily +producing putrefaction in it. In this state (not unfrequently +after it had been taken several days from the pustules) it was +inserted into the arms of his patients, and brought on +inflammation of the incised parts, swellings of the axillary +glands, fever, and sometimes eruptions. But what was this +disease? Certainly not the smallpox; for the matter having from +putrefaction lost or suffered a derangement in its specific +properties, was no longer capable of producing that malady, those +who had been inoculated in this manner being as much subject to +the contagion of the smallpox as if they had never been under the +influence of this artificial disease; and many, unfortunately, +fell victims to it, who thought themselves in perfect security. +The same unfortunate circumstance of giving a disease, supposed +to be the smallpox, with inefficacious variolous matter, having +occurred under the direction of some other practitioners within +my knowledge, and probably from the same incautious method of +securing the variolous matter, I avail myself of this opportunity +of mentioning what I conceive to be of great importance; and, as +a further cautionary hint, I shall again digress so far as to add +another observation on the subject of inoculation. + +Whether it be yet ascertained by experiment that the quantity of +variolous matter inserted into the skin makes any difference with +respect to the subsequent mildness or violence of the disease, I +know not; but I have the strongest reason for supposing that if +either the punctures or incisions be made so deep as to go +through it and wound the adipose membrane, that the risk of +bringing on a violent disease is greatly increased. I have known +an inoculator whose practice was "to cut deep enough (to use his +own expression) to see a bit of fat." and there to lodge the +matter. The great number of bad cases, independent of +inflammations and abscesses on the arms, and the fatality which +attended this practice, was almost inconceivable; and I cannot +account for it on any other principle than that of the matter +being placed in this situation instead of the skin. + +It was the practice of another, whom I well remember, to pinch up +a small portion of the skin on the arms of his patients and to +pass through it a needle, with a thread attached to it previously +dipped in variolous matter. The thread was lodged in the +perforated part, and consequently left in contact with the +cellular membrane. This practice was attended with the same ill +success as the former. Although it is very improbable that any +one would now inoculate in this rude way by design, yet these +observations may tend to place a double guard over the lancet, +when infants, whose skins are comparatively so very thin, fall +under the care of the inoculator. + +A very respectable friend of mine, Dr. Hardwicke, of Sodbury, in +this county, inoculated great numbers of patients previous to the +introduction of the more modern method by Sutton, and with such +success that a fatal instance occurred as rarely as since that +method has been adopted. It was the doctor's practice to make as +slight an incision as possible upon the skin, and there to lodge +a thread saturated with the variolous matter. When his patients +became indisposed, agreeably to the custom then prevailing, they +were directed to go to bed and were kept moderately warm. Is it +not probable then that the success of the modern practice may +depend more upon the method of invariably depositing the virus in +or upon the skin, than on the subsequent treatment of the +disease? + +I do not mean to insinuate that exposure to cool air, and +suffering the patient to drink cold water when hot and thirsty, +may not moderate the eruptive symptoms and lessen the number of +pustules; yet, to repeat my former observation, I cannot account +for the uninterrupted success, or nearly so, of one practitioner, +and the wretched state of the patients under the care of another, +where, in both instances, the general treatment did not differ +essentially, without conceiving it to arise from the different +modes of inserting the matter for the purpose of producing the +disease. As it is not the identical matter inserted which is +absorbed into the constitution, but that which is, by some +peculiar process in the animal economy, generated by it, is it +not probable that different parts of the human body may prepare +or modify the virus differently? Although the skin, for example, +adipose membrane, or mucous membranes are all capable of +producing the variolous virus by the stimulus given by the +particles originally deposited upon them, yet I am induced to +conceive that each of these parts is capable of producing some +variation in the qualities of the matter previous to its +affecting the constitution. What else can constitute the +difference between the smallpox when communicated casually or in +what has been termed the natural way, or when brought on +artificially through the medium of the skin? + +After all, are the variolous particles, possessing their true +specific and contagious principles, ever taken up and conveyed by +the lymphatics unchanged into the blood vessels? I imagine not. +Were this the case, should we not find the blood sufficiently +loaded with them in some stages of the smallpox to communicate +the disease by inserting it under the cuticle, or by spreading it +on the surface of an ulcer? Yet experiments have determined the +impracticability of its being given in this way; although it has +been proved that variolous matter, when much diluted with water +and applied to the skin in the usual manner, will produce the +disease. But it would be digressing beyond a proper boundary to +go minutely into this subject here. + +At what period the cow-pox was first noticed here is not upon +record. Our oldest farmers were not unacquainted with it in their +earliest days, when it appeared among their farms without any +deviation from the phaenomena which it now exhibits. Its +connection with the smallpox seems to have been unknown to them. +Probably the general introduction of inoculation first occasioned +the discovery. + +Its rise in this country may not have been of very remote date, +as the practice of milking cows might formerly have been in the +hands of women only; which I believe is the case now in some +other dairy countries, and, consequently, that the cows might not +in former times have been exposed to the contagious matter +brought by the men servants from the heels of horses. [Footnote: +I have been informed from respectable authority that in Ireland, +although dairies abound in many parts of the island, the disease +is entirely unknown. The reason seems obvious. The business of +the dairy is conducted by women only. Were the meanest vassal +among the men employed there as a milker at a dairy, he would +feel his situation unpleasant beyond all endurance.] Indeed, a +knowledge of the source of the infection is new in the minds of +most of the farmers in this neighbourhood, but it has at length +produced good consequences; and it seems probable, from the +precautions they are now disposed to adopt, that the appearance +of the cow-pox here may either be entirely extinguished or become +extremely rare. + +Should it be asked whether this investigation is a matter of mere +curiosity, or whether it tends to any beneficial purpose, I +should answer that, notwithstanding the happy effects of +inoculation, with all the improvements which the practice has +received since its first introduction into this country, it not +very unfrequently produces deformity of the skin, and sometimes, +under the best management, proves fatal. + +These circumstances must naturally create in every instance some +degree of painful solicitude for its consequences. But as I have +never known fatal effects arise from the cow-pox, even when +impressed in the most unfavourable manner, producing extensive +inflammations and suppurations on the hands; and as it clearly +appears that this disease leaves the constitution in a state of +perfect security from the infection of the smallpox, may we not +infer that a mode of inoculation may be introduced preferable to +that at present adopted, especially among those families which, +from previous circumstances, we may judge to be predisposed to +have the disease unfavourably? It is an excess in the number of +pustules which we chiefly dread in the smallpox; but in the cow- +pox no pustules appear, nor does it seem possible for the +contagious matter to produce the disease from effluvia, or by any +other means than contact, and that probably not simply between +the virus and the cuticle; so that a single individual in a +family might at any time receive it without the risk of infecting +the rest or of spreading a distemper that fills a country with +terror. + +Several instances have come under my observation which justify +the assertion that the disease cannot be propagated by effluvia. +The first boy whom I inoculated with the matter of cow-pox slept +in a bed, while the experiment was going forward, with two +children who never had gone through either that disease or the +smallpox, without infecting either of them. + +A young woman who had the cow-pox to a great extent, several +sores which maturated having appeared on the hands and wrists, +slept in the same bed with a fellow-dairymaid who never had been +infected with either the cow-pox or the smallpox, but no +indisposition followed. + +Another instance has occurred of a young woman on whose hands +were several large suppurations from the cow-pox, who was at the +same time a daily nurse to an infant, but the complaint was not +communicated to the child. + +In some other points of view the inoculation of this disease +appears preferable to the variolous inoculation. + +In constitutions predisposed to scrophula, how frequently we see +the inoculated smallpox rouse into activity that distressful +malady! This circumstance does not seem to depend on the manner +in which the distemper has shewn itself, for it has as frequently +happened among those who have had it mildly as when it has +appeared in the contrary way. + +There are many who, from some peculiarity in the habit, resist +the common effects of variolous matter inserted into the skin, +and who are in consequence haunted through life with the +distressing idea of being insecure from subsequent infection. A +ready mode of dissipating anxiety originating from such a cause +must now appear obvious. And, as we have seen that the +constitution may at any time be made to feel the febrile attack +of cow-pox, might it not, in many chronic diseases, be introduced +into the system, with the probability of affording relief, upon +well-known physiological principles? + +Although I say the system may at any time be made to feel the +febrile attack of cow-pox, yet I have a single instance before me +where the virus acted locally only, but it is not in the least +probable that the same person would resist the action both of the +cow-pox virus and the variolous. + +Elizabeth Sarfenet lived as a dairymaid at Newpark farm, in this +parish. All the cows and the servants employed in milking had the +cow-pox; but this woman, though she had several sores upon her +fingers, felt no tumours in the axillae, nor any general +indisposition. On being afterwards casually exposed to variolous +infection, she had the smallpox in a mild way. Hannah Pick, +another of the dairymaids who was a fellow-servant with Elizabeth +Sarfenet when the distemper broke out at the farm, was, at the +same time, infected; but this young woman had not only sores upon +her hands, but felt herself also much indisposed for a day or +two. After this, I made several attempts to give her the smallpox +by inoculation, but they all proved fruitless. From the former +case then we see that the animal economy is subject to the same +laws in one disease as the other. + +The following case, which has very lately occurred, renders it +highly probable that not only the heels of the horse, but other +parts of the body of that animal, are capable of generating the +virus which produces the cow-pox. + +An extensive inflammation of the erysipelatous kind appeared +without any apparent cause upon the upper part of the thigh of a +sucking colt, the property of Mr. Millet, a farmer at +Rockhampton, a village near Berkeley. The inflammation continued +several weeks, and at length terminated in the formation of three +or four small abscesses. The inflamed parts were fomented, and +dressings were applied by some of the same persons who were +employed in milking the cows. The number of cows milked was +twenty-four, and the whole of them had the cow-pox. The milkers, +consisting of the farmer's wife, a man and a maidservant, were +infected by the cows. The man-servant had previously gone through +the smallpox, and felt but little of the cow-pox. The servant +maid had some years before been infected with the cow-pox, and +she also felt it now in a slight degree; but the farmer's wife, +who never had gone through either of the diseases, felt its +effects very severely. + +That the disease produced upon the cows by the colt and from +thence conveyed to those who milked them was the TRUE and not the +SPURIOUS cow-pox, there can be scarcely any room for suspicion; +yet it would have been more completely satisfactory had the +effects of variolous matter been ascertained on the farmer's +wife, but there was a peculiarity in her situation which +prevented my making the experiment. + +Thus far have I proceeded in an inquiry founded, as it must +appear, on the basis of experiment; in which, however, conjecture +has been occasionally admitted in order to present to persons +well situated for such discussions objects for a more minute +investigation. In the mean time I shall myself continue to +prosecute this inquiry, encouraged by the hope of its becoming +essentially beneficial to mankind. + + + + +II + +FURTHER OBSERVATIONS ON THE VARIOLA VACCINAE, OR COW-POX. 1799 + + +Although it has not been in my power to extend the inquiry into +the causes and effects of the variolae vaccinae much beyond its +original limits, yet, perceiving that it is beginning to excite a +general spirit of investigation, I think it of importance, +without delay, to communicate such facts as have since occurred, +and to point out the fallacious sources from whence a disease +imitative of the true variolae vaccinae might arise, with the +view of preventing those who may inoculate from producing a +spurious disease; and, further, to enforce the precaution +suggested in the former treatise on the subject, of subduing the +inoculated pustule as soon as it has sufficiently produced its +influence on the constitution. From a want of due discrimination +of the real existence of the disease, either in the brute or in +the human subject, and also of that stage of it in which it is +capable of producing the change in the animal economy which +renders it unsusceptible of the contagion of the smallpox, +unpleasant consequences might ensue, the source of which, +perhaps, might not be suspected by one inexperienced in +conducting such experiments. + +My late publication contains a relation of most of the facts +which had come under my own inspection at the time it was +written, interspersed with some conjectural observations. Since +then Dr. G. Pearson has established an inquiry into the validity +of my principal assertion, the result of which cannot but be +highly flattering to my feelings. It contains not a single case +which I think can be called an exception to the fact I was so +firmly impressed with--that the cow-pox protects the human body +from the smallpox. I have myself received some further +confirmations, which shall be subjoined. I have lately also been +favoured with a letter from a gentleman of great respectability +(Dr. Ingenhousz), informing me that, on making an inquiry into +the subject in the county of Wilts, he discovered that a farmer +near Calne had been infected with the smallpox after having had +the cow-pox, and that the disease in each instance was so +strongly characterized as to render the facts incontrovertible. +The cow-pox, it seems, from the doctor's information, was +communicated to the farmer from his cows at the time that they +gave out an offensive stench from their udders. + +Some other instances have likewise been represented to me of the +appearance of the disease, apparently marked with its +characteristic symptoms, and yet that the patients have +afterwards had the smallpox. On these cases I shall, for the +present, suspend any particular remarks, but hope that the +general observations I have to offer in the sequel will prove of +sufficient weight to render the idea of their ever having had +existence, but as cases of spurious cow-pox, extremely doubtful. + +Ere I proceed let me be permitted to observe that truth, in this +and every other physiological inquiry that has occupied my +attention, has ever been the object of my pursuit, and should it +appear in the present instance that I have been led into error, +fond as I may appear of the offspring of my labours, I had rather +see it perish at once than exist and do a public injury. + +I shall proceed to enumerate the sources, or what appear to me as +such, of a spurious cow-pox. + +First: That arising from pustules on the nipples or udder of the +cow; which pustules contain no specific virus. + +Secondly: From matter (although originally possessing the +specific virus) which has suffered a decomposition, either from +putrefaction or from any other cause less obvious to the senses. + +Thirdly: From matter taken from an ulcer in an advanced stage, +which ulcer arose from a true cow pock. + +Fourthly: From matter produced on the human skin from contact +with some peculiar morbid matter generated by a horse. + +On these subjects I shall offer some comments: First, to what +length pustulous diseases of the udder and nipples of the cow may +extend it is not in my power to determine; but certain it is that +these parts of the animal are subject to some variety of maladies +of this nature; and as many of these eruptions (probably all of +them) are capable of giving a disease to the human body, would it +not be discreet for those engaged in this investigation to +suspend controversy and cavil until they can ascertain with +precision what IS and what IS NOT the cow-pox? + +For example: A farmer who is not conversant with any of these +maladies, but who may have heard of the cow-pox in general terms, +may acquaint a neighbouring surgeon that the distemper appears at +his farm. The surgeon, eager to make an experiment, takes away +matter, inoculates, produces a sore, uneasiness in the axilla, +and perhaps some affection of the system. This is one way in +which a fallacious idea of security both in the mind of the +inoculater and the patient may arise; for a disease may thus have +been propagated from a simple eruption only. + +One of the first objects then of this pursuit, as I have +observed, should be, to learn how to distinguish with accuracy +between that peculiar pustule which is the true cow pock, and +that which is spurious. Until experience has determined this, we +view our object through a mist. Let us, for instance, suppose +that the smallpox and the chicken-pox were at the same time to +spread among the inhabitants of a country which had never been +visited by either of these distempers, and where they were quite +unknown before: what confusion would arise! The resemblance +between the symptoms of the eruptive fever and between the +pustules in either case would be so striking that a patient who +had gone through the chicken-pox to any extent would feel equally +easy with regard to his future security from the smallpox as the +person who had actually passed through that disease. Time and +future observation would draw the line of distinction. + +So I presume it will be with the cow-pox until it is more +generally understood. All cavilling, therefore, on the mere +report of those who TELL US they have had this distemper, and are +afterwards found susceptible of the smallpox, should be +suspended. To illustrate this I beg leave to give the following +history: + +Sarah Merlin, of the parish of Eastington in this county, when +about thirteen or fourteen years of age lived as a servant with +farmer Clarke, who kept a dairy consisting of about eighteen cows +at Stonehouse, a neighbouring village. The nipples and udders of +three of the cows were extensively affected with large white +blisters. These cows the girl milked daily, and at the time she +assisted, with two others, in milking the rest of the herd. It +soon appeared that the disease was communicated to the girl. The +rest of the cows escaped the infection, although they were milked +several days after the three above specified, had these eruptions +on the nipples and udders, and even after the girl's hand became +sore. The two others who were engaged in milking, although they +milked the cows indiscriminately, received no injury. On the +fingers of each of the girl's hands there appeared several large +white blisters--she supposes about three or four on each finger. +The hands and arms inflamed and swelled, but no constitutional +indisposition followed. The sores were anointed with some +domestic ointment and got well without ulcerating. + +As this malady was called the cow-pox, and recorded as such in +the mind of the patient, she became regardless of the smallpox; +but, on being exposed to it some years afterwards she was +infected, and had a full burthen. + +Now had any one conversant with the habits of the disease heard +this history, they would have had no hesitation in pronouncing it +a case of spurious cow-pox; considering its deviation in the +NUMEROUS blisters which appeared on the girl's hands; their +termination without ulceration; its not proving more generally +contagious at the farm, either among the cattle or those employed +in milking; and considering also that THE PATIENT FELT NO GENERAL +INDISPOSITION, ALTHOUGH THERE WAS SO GREAT A NUMBER OF VESICLES. + +This is perhaps the most deceptious form in which an eruptive +disease can be communicated from the cow, and it certainly +requires some attention in discriminating it. The most perfect +criterion by which the judgment may be guided is perhaps that +adopted by those who attend infected cattle. These white blisters +on the nipples, they say, NEVER EAT INTO THE FLESHY PARTS like +those which are commonly of a bluish cast, and which constitute +the TRUE COW-POX, but that they affect the skin only, quickly end +in scabs, and are not nearly so infectious. + +That which appeared to me as one cause of spurious eruptions, I +have already remarked in the former treatise, namely, the +transition that the cow makes in the spring from a poor to a +nutritious diet, and from the udder's becoming at this time more +vascular than usual for the supply of milk. But there is another +source of inflammation and pustules which I believe is not +uncommon in all the dairy counties in the west of England. A cow +intended to be exposed for sale, having naturally a small udder, +is previously for a day or two neither milked artificially nor is +her calf suffered to have access to her. Thus the milk is +preternaturally accumulated, and the udder and nipples become +greatly distended. The consequences frequently are inflammation +and eruptions which maturate. + +Whether a disease generated in this way has the power of +affecting the constitution in any PECULIAR manner I cannot +presume positively to determine. It has been conjectured to have +been a cause of the true cow-pox, though my inquiries have not +led me to adopt this supposition in any one instance; on the +contrary, I have known the milkers affected by it, but always +found that an affection thus induced left the system as +susceptible of the smallpox as before. + +What is advanced in my second position I consider also of very +great importance, and I could wish it to be strongly impressed on +the minds of all who may be disposed to conclude hastily on my +observations, whether engaged in their investigation by +experiments or not to place this in its clearest point of view +(as the similarity between the action of the smallpox and the +cow-pox matter is so obvious) it will be necessary to consider +what we sometimes observe to take place in inoculation for the +smallpox when imperfect variolous matter is made use of. The +concise history on this subject that was brought forward +respecting what I had observed in this neighbourhood [Footnote: +Inquiry into the Causes and Effects of the Variolae Vaccinae, +p.56 of the original article]. I perceive, by a reference since +made to the Memoirs of the Medical Society of London, may be +considered as no more than a corroboration of the facts very +clearly detailed by Mr. Kite [Footnote: See an account of some +anomalous appearances consequent to the inoculation of the +smallpox, by Charles Kite, Surgeon, of Gravesend, in the Memoirs +of the Medical Society of London, vol. iv, p. 114.]. To this +copious evidence I have to add still more in the following +communications from Mr. Earle, surgeon, of Frampton-upon-Severn, +in this county, which I deem the more valuable, as he has with +much candour permitted me to make them public: + +"SIR: + +"I have read with satisfaction your late publication on the +Variolae Vaccinae, and being, among many other curious +circumstances, particularly struck with that relating to the +inefficacy of smallpox matter in a particular state, I think it +proper to lay before you the following facts which came within my +own knowledge, and which certainly tend to strengthen the +opinions advanced in pages 56 and 57 of your treatise. + +"In March, 1784, a general inoculation took place at Arlingham in +this county. I inoculated several patients with active variolous +matter, all of whom had the disease in a favourable way; but the +matter being all used, and not being able to procure any more in +the state I wished, I was under the necessity of taking it from a +pustule which, experience has since proved, was advanced too far +to answer the purpose I intended. Of five persons inoculated with +this last matter, four took the smallpox afterwards in the +natural way, one of whom died, three recovered, and the other, +being cautioned by me to avoid as much as possible the chance of +catching it, escaped from the disease through life. He died of +another disorder about two years ago. + +"Although one of these cases ended unfortunate, yet I cannot +suppose that any medical man will think me careless or +inattentive in their management; for I conceive the appearances +were such as might have induced any one to suppose that the +persons were perfectly safe from future infection. Inflammation +in every case took place in the arm, and fever came on with a +considerable degree of pain in the axilla. In some of their arms +the inflammation and suppuration were more violent than is +commonly observed when perfect matter is made use of; in one +there was an ulcer which cast off several large sloughs. About +the ninth day eruptions appeared, which died away earlier than +common without maturation. From these circumstances I should +suppose that no medical practitioner would scarcely have +entertained a doubt but that these patients had been infected +with a true smallpox; yet I must confess that some small degree +of doubt presented itself to me at the speedy disappearance of +the eruptions; and in order, as far as I could, to ascertain +their safety, I sent one of them to a much older practitioner +than myself. This gentleman, on hearing the circumstances of the +case, pronounced the patient perfectly secure from future +infection. + +"The following facts are also a striking proof of the truth of +your observations on this subject: + +"In the year 1789 I inoculated three children of Mr. Coaley, of +Hurst farm in this county. The arms inflamed properly, fever and +pain in the axillae came on precisely the same as in the former +cases, and in ten days eruptions appeared, which disappeared in +the course of two days. I must observe that the matter here made +use of was procured for me by a friend; but no doubt it was in an +improper state; for, from the similarity of these cases to those +which happened at Arlingham five years before, I was somewhat +alarmed for their safety, and desired to inoculate them again: +which being permitted, I was particularly careful to procure +matter in its most perfect state. All the children took the +smallpox from this second inoculation, and all had a very full +burthen. These facts I conceive strikingly corroborate your +opinion relative to the different states of matter; for in both +instances that I have mentioned it was capable of producing +something strongly resembling the true smallpox, although it +afterwards proved not to be so. + +"As I think the communication of these cases is a duty I owe to +the public, you are at liberty to make what use you please of +this letter. I remain, &c., + +"John Earle. + +"FRAMPTON-UPON SEVERN, GLOUCESTERSHIRE, November 10, 1798. + +"P. S. I think it necessary to observe that I can pronounce, with +the greatest certainty, that the matter with which the Arlingham +patients were inoculated was taken from a true smallpox pustule. +I took it myself from a subject that had a very full burthen." + +Certain then it is that variolous matter may undergo such a +change from the putrefactive process, as well as from some of the +more obscure and latent processes of nature, as will render it +incapable of giving the smallpox in such a manner as to secure +the human constitution from future infection, although we see at +the same time it is capable of exciting a disease which bears so +strong a resemblance to it as to produce inflammation and matter +in the incised skin (frequently, indeed, more violent than when +it produces its effects perfectly), swelling of the axillary +glands, general indisposition, and eruptions. So strongly +persuaded was the gentleman, whose practice I have mentioned in +page 56 of the late treatise, that he could produce a mild +smallpox by his mode of managing the matter, that he spoke of it +as a useful discovery until convinced of his error by the fatal +consequence which ensued. + +After this ought we to be in the smallest degree surprised to +find, among a great number of individuals who, by living in +dairies, have been casually exposed to the cow-pox virus when in +a state analogous to that of the smallpox above described, some +who may have had the disease so imperfectly as not to render them +secure from variolous attacks? For the matter, when burst from +the pustules on the nipples of the cow, by being exposed, from +its lodgment there, to the heat of an inflamed surface, and from +being at the same time in a situation to be occasionally +moistened with milk, is often likely to be in a state conducive +to putrefaction; and thus, under some modification of +decomposition, it must, of course, sometimes find access to the +hand of the milker in such a way as to infect him. What confusion +should we have were there no other mode of inoculating the +smallpox than such as would happen from handling the diseased +skin of a person labouring under that distemper in some of its +advanced and loathsome stages! It must be observed that every +case of cow-pox in the human species, whether communicated by +design or otherwise, is to be considered as a case of +inoculation. And here I may be allowed to make an observation on +the case of the farmer communicated to me by Dr. Ingenhousz. That +he was exposed to the matter when it had undergone the +putrefactive change is highly probable from the doctor's +observing that the sick cows at the farm gave out an OFFENSIVE +STENCH FROM THEIR UDDERS. However, I must remark that it is +unusual for cattle to suffer to such an extent, when disordered +with the cowpox, as to make a bystander sensible of any ill +smell. I have often stood among a herd which had the distemper +without being conscious of its presence from any particular +effluvia. Indeed, in this neighbourhood it commonly receives an +early check from escharotic applications of the COW LEECH. It has +been conceived to be contagious without contact; but this idea +cannot be well founded because the cattle in one meadow do not +infect those in another (although there may be no other partition +than a hedge) unless they be handled or milked by those who bring +the infectious matter with them; and of course, the smallest +particle imaginable, when applied to a part susceptible of its +influence, may produce the effect. Among the human species it +appears to be very clear that the disease is produced by contact +only. All my attempts, at least, to communicate it by effluvia +have hitherto proved ineffectual. + +As well as the perfect change from that state in which variolous +matter is capable of producing full and decisive effects on the +constitution, to that wherein its specific properties are +entirely lost, it may reasonably be supposed that it is capable +of undergoing a variety of intermediate changes. The following +singular occurrences in ten cases of inoculation, obligingly +communicated to me by Mr. Trye, Senior Surgeon to the Infirmary +at Glocester, seem to indicate that the variolous matter, +previously to its being taken from the patient for the intended +purpose, was beginning to part with some of its original +properties, or, in other words, that it had suffered a partial +decomposition. Mr. Trye says: "I inoculated ten children with +matter taken at one time and from the same subject. I observed no +peculiarity in any of them previously to their inoculation, nor +did any thing remarkable appear in their arms till after the +decline of the disease. Two infants of three months old had +erysipelas about the incisions, in one of them extending from the +shoulders to the fingers' ends. Another infant had abscesses in +the cellular substance in the neighbourhood of the incisions, and +five or six of the rest had axillary abscesses. The matter was +taken from the distinct smallpox late in its progress, and when +some pustules had been dried. It was received upon glass and +slowly dried by the fire. All the children had pustules which +maturated, so that I suppose them all secure from future +infection; at least, as secure as any others whom I have ever +inoculated. My practice never afforded a sore arm before." + +In regard to my former observation on the improper and dangerous +mode of preserving variolous matter, I shall here remark that it +seems not to have been clearly understood. Finding that it has +been confounded with the more eligible modes of preservation, I +will explain myself further. When the matter is taken from a fit +pustule and properly prepared for preservation, it may certainly +be kept without losing its specific properties a great length of +time; for instance, when it is previously dried in the open air +on some compact body, as a quill or a piece of glass, and +afterwards secured in a small vial. [Footnote: Thus prepared, the +cow-pox virus was found perfectly active, and possessing all its +specific properties, at the end of three months.] But when kept +several days in a state of moisture, and during that time exposed +to a warm temperature, I do not think it can be relied upon as +capable of giving a perfect disease, although, as I have before +observed, the progress of the symptoms arising from the action of +the imperfect matter bear so strong a resemblance to the smallpox +when excited completely. + +Thirdly. That the first formed virus, or what constitutes the +true cow-pox pustule, invariably possesses the power I have +ascribed to it, namely, that of affecting the constitution with a +specific disease, is a truth that no subsequent occurrence has +yet led me to doubt. But as I am now endeavouring to guard the +public as much as possible against erroneous conclusions, I shall +observe that when this pustule has degenerated into an ulcer (to +which state it is often disposed to pass unless timely checked), +I suspect that matter possessing very different properties may +sooner or later be produced; and although it may have passed that +stage wherein the specific properties of the matter secreted are +no longer present in it, yet when applied to a sore (as in the +casual way) it might dispose that sore to ulcerate, and from its +irritation the system would probably become affected; and thus, +by assuming some of its strongest characters, it would imitate +the genuine cow-pox. + +From the preceding observations on the matter of smallpox when +decomposed it must, I conceive, be admitted that cow-pox matter +in the state now described may produce a disease, the effects of +which may be felt both locally and generally, yet that the +disease thus induced may not be effectual in obviating the future +effects of variolous contagion. In the case of Mary Miller, +related by Mr. Kite in the volume above alluded to, it appears +that the inflammation and suppuration of the inoculated arm were +more than usually severe, although the system underwent no +specific change from the action of the virus; which appears from +the patient's sickening seven weeks afterwards with the natural +smallpox, which went through its course. Some of the cases +communicated by Mr. Earle tend further to confirm this fact, as +the matter there manifestly produced ulceration on the inoculated +part to a considerable extent. + +Fourthly. Whether the cow-pox is a spontaneous disease in the +cow, or is to be attributed to matter conveyed to the animal, as +I have conceived, from the horse, is a question which, though I +shall not attempt now fully to discuss, yet I shall digress so +far as to adduce some further observations, and to give my +reasons more at large for taking up an opinion that to some had +appeared fanciful. The aggregate of these observations, though +not amounting to positive proof, forms presumptive evidence of so +forcible a kind that I imagine it might, on any other person, +have made the same impression it did on me, without fixing the +imputation of credulity. + +First: I conceived this was the source, from observing that where +the cow-pox had appeared among the dairies here (unless it could +be traced to the introduction of an infected cow or servant) it +had been preceded at the farm by a horse diseased in the manner +already described, which horse had been attended by some of the +milkers. + +Secondly: From its being a popular opinion throughout this great +dairy country, and from its being insisted on by those who here +attend sick cattle. + +Thirdly: From the total absence of the disease in Ireland and +Scotland, where the men-servants are not employed in the dairies. +[Footnote: This information was communicated to me from the first +authority.] + +Fourthly: From having observed that morbid matter generated by +the horse frequently communicates, in a casual way, a disease to +the human subject so like the cow-pox that, in many cases, it +would be difficult to make the distinction between one and the +other. [Footnote: The sound skin does not appear to be +susceptible of this virus when inserted into it, but, when +previously diseased from little accidents, its effects are often +conspicuous.] + +Fifthly: From being induced to suppose, from experiments, that +some of those who had been thus affected from the horse resisted +the smallpox. + +Sixthly: From the progress and general appearance of the pustule +on the arm of the boy whom I inoculated with matter taken from +the hand of a man infected by a horse; and from the similarity to +the cow-pox of general constitutional symptoms which followed. +[Footnote: This case (on which I laid no inconsiderable stress in +my late treatise, as presumptive evidence of the fact adduced) +seems to have been either mistaken or overlooked by those who +have commented upon it. (See Case XVIII, p. 36.) The boy, +unfortunately, died of a fever at a parish workhouse before I had +an opportunity of observing what effects would have been produced +by the matter of smallpox.] + +I fear it would be trespassing too far to adduce the general +testimony of our farmers in support of this opinion; yet I beg +leave to introduce an extract of a letter on this subject from +the Rev. Mr. Moore, of Chalford Hill, in this county: + +"In the month of November, 1797, my horse had diseased heels, +which was certainly what is termed the grease; and at a short +subsequent period my cow was also affected with what a +neighbouring farmer (who was conversant with the complaints of +cattle) pronounced to be the cow-pox, which he at the same time +observed my servant would be infected with: and this proved to be +the case; for he had eruptions on his hands, face, and many, +parts of the body, the pustules appearing large, and not much +like the smallpox, for which he had been inoculated a year and a +half before, and had then a very heavy burthen. The pustules on +the face might arise from contact with his hands, as he had a +habit of rubbing his forehead, where the sores were the largest +and the thickest. + +"The boy associated with the farmer's sons during the continuance +of the disease, neither of whom had had the smallpox, but they +felt no ill effects whatever. He was not much indisposed, as the +disease did not prevent him from following his occupations as +usual. No other person attended the horse or milked the cow but +the lad above mentioned. I am firmly of opinion that the disease +in the heels of the horse, which was a virulent grease, was the +origin of the servant's and the cow's malady." + +But to return to the more immediate object of this proposition. + +From the similarity of symptoms, both constitutional and local, +between the cow-pox and the disease received from morbid matter +generated by a horse, the common people in this neighbourhood, +when infected with this disease, through a strange perversion of +terms, frequently call it the cow-pox. Let us suppose, then, such +a malady to appear among some of the servants at a farm, and at +the same time that the cow-pox were to break out among the +cattle; and let us suppose, too, that some of the servants were +infected in this way, and that others received the infection from +the cows. It would be recorded at the farm, and among the +servants themselves wherever they might afterwards be dispersed, +that they had all had the cow-pox. But it is clear that an +individual thus infected from the horse would neither be for a +certainty secure himself, nor would he impart security to others +were they inoculated by virus thus generated. He still would be +in danger of taking the smallpox. Yet were this to happen before +the nature of the cowpox be more maturely considered by the +public my evidence on the subject might be depreciated unjustly. +For an exemplification of what is here advanced relative to the +nature of the infection when received directly from the horse see +Inquiry into the Causes and Effects of the Variolae Vaccinae, pp. +27, 28, 29, 30, and p. 35; and by way of further example, I beg +leave to subjoin the following intelligence received from Mr. +Fewster, Surgeon, of Thornbury, in this county, a gentleman +perfectly well acquainted with the appearances of the cow-pox on +the human subject: + +"William Morris, aged thirty-two, servant to Mr. Cox of +Almondsbury, in this county, applied to me the 2d of April, 1798. +He told me that, four days before, be found a stiffness and +swelling in both his hands, which were so painful it was with +difficulty he continued his work; that he had been seized with +pain in his head, small of the back, and limbs, and with frequent +chilly fits succeeded by fever. On examination I found him still +affected with these symptoms, and that there was a great +prostration of strength. Many parts of his hands on the inside +were chapped, and on the middle joint of the thumb of the right +hand there was a small phagedenic ulcer, about the size of a +large pea, discharging an ichorous fluid. On the middle finger of +the same hand there was another ulcer of a similar kind. These +sores were of a CIRCULAR form, and he described their first +appearance as being somewhat like blisters arising from a burn. +He complained of excessive pain, which extended up his arm into +the axilla. These symptoms and appearances of the sores were so +exactly like the cow-pox that I pronounced he had taken the +distemper from milking cows. He assured me he had not milked a +cow for more than half a year, and that his master's cows had +nothing the matter with them. I then asked him if his master had +a GREASY horse, which he answered in the affirmative, and further +said that he had constantly dressed him twice a day for the +[Footnote: HC--Vol.88] last three weeks or more, and remarked +that the smell of his hands was much like that of the horses's +heels. On the 5th of April I again saw him, and found him still +complaining of pain in both hands, nor were his febrile symptoms +at all relieved. The ulcers had now spread to the size of a +seven-shilling gold coin, and another ulcer, which I had not +noticed before, appeared on the first joint of the forefinger of +the left hand, equally painful with that on the right. I ordered +him to bathe his hands in warm bran and water, applied +escharotics to the ulcers, and wrapped his hands up in a soft +cataplasm. The next day he was much relieved, and in something +more than a fortnight got well. He lost his nails from the thumb +and fingers that were ulcerated." + +The sudden disappearance of the symptoms in this case after the +application of the escharotics to the sores is worthy of +observation; it seems to show that they were kept up by the +irritation of the ulcers. + +The general symptoms which I have already described of the cow- +pox, when communicated in a casual way to any great extent, will, +I am convinced, from the many cases I have seen, be found +accurate; but from the very slight indisposition which ensues in +cases of inoculation, where the pustule, after affecting the +constitution, quickly runs into a scab spontaneously, or is +artificially suppressed by some proper application, I am induced +to believe that the violence of the symptoms may be ascribed to +the inflammation and irritation of the ulcers (when ulceration +takes place to any extent, as in the casual cow-pox), and that +the constitutional symptoms which appear during the presence of +the sore, while it assumes the character of a pustule only, are +felt but in a very trifling degree. This mild affection of the +system happens when the disease makes but a slight local +impression on those who have been accidentally infected by cows; +and, as far as I have seen, it has uniformly happened among those +who have been inoculated, when a pustule only and no great degree +of inflammation or any ulceration has taken place from the +inoculation. The following cases will strengthen this opinion. + +The cow-pox appeared at a farm in the village of Stonehouse, in +this county, about Michaelmas last, and continued gradually to +pass from one cow to another till the end of November, On the +twenty-sixth of that month some ichorous matter was taken from a +cow and dried upon a quill. On the 2d of December some of it was +inserted into a scratch, made so superficial that no blood +appeared, on the arms of Susan Phipps, a child seven years old. +The common inflammatory appearances took place in consequence, +and advanced till the fifth day, when they had so much subsided +that I did not conceive any thing further would ensue. + +6th: Appearances stationary. + +7th: The inflammation began to advance. + +8th: A vesication, perceptible on the edges, forming, as in the +inoculated smallpox, an appearance not unlike a grain of wheat, +with the cleft, or indentation in the centre. + +9th: Pain in the axilla. + +10th: A little headache; pulse, 110; tongue not discoloured; +countenance in health. + +11th, 12th: No perceptible illness; pulse about 100. + +13th: The pustule was now surrounded by an efflorescence, +interspersed with very minute confluent pustules to the extent of +about an inch. Some of these pustules advanced in size and +maturated. So exact was the resemblance of the arm at this stage +to the general appearance of the inoculated smallpox that Mr. D., +a neighbouring surgeon, who took some matter from it, and who had +never seen the cow-pox before, declared he could not perceive any +difference. [Footnote: That the cow-pox was a supposed guardian +of the constitution from the action of the smallpox has been a +prevalent idea for a long time past; but the similarity in the +constitutional effects between one disease and the other could +never have been so accurately observed had not the inoculation of +the cow-pox placed it in a new and stronger point of view. This +practice, too, has shewn us, what before lay concealed, the rise +and progress of the pustule formed by the insertion of the virus, +which places in a most conspicuous light its striking resemblance +to the pustule formed from the inoculated smallpox.] The child's +arm now shewed a disposition to scab, and remained nearly +stationary for two or three days, when it began to run into an +ulcerous state, and THEN commenced a febrile indisposition +accompanied with an increase of axillary tumour. The ulcer +continued spreading near a week, during which time the child +continued ill, when it increased to a size nearly as large as a +shilling. It began now to discharge pus; granulations sprang up, +and it healed. This child had before been of a remarkably sickly +constitution, but is now in very high health. + +Mary Hearn, twelve years of age, was inoculated with matter taken +from the arm of Susan Phipps. + +6th day: A pustule beginning to appear, slight pain in the +axilla. + +7th: A distinct vesicle formed. + +8th: The vesicle increasing; edges very red; no deviation in its +appearance at this time from the inoculated smallpox. + +9th: No indisposition; pustule advancing. + +10th: The patient felt this evening a slight febrile attack. + +11th: Free from indisposition. + +12th, 13th: The same. + +14th: An efflorescence of a faint red colour extending several +inches round the arm. The pustule, beginning to shew a +disposition to spread, was dressed with an ointment composed of +hydrarg. nit. rub. and ung. cerce. The efflorescence itself was +covered with a plaster of ung. hydr. fort. In six hours it was +examined, when it was found that the efflorescence had totally +disappeared. + +The application of the ointment with the hydr. nit. rub. was made +use of for three days, when, the state of the pustule remaining +stationary, it was exchanged for the ung. hydr. nit. This +appeared to have a more active effect than the former, and in two +or three days the virus seemed to be subdued, when a simple +dressing was made use of; but the sore again shewing a +disposition to inflame, the ung. hydr. nit. was again applied, +and soon answered the intended purpose effectually. The girl, +after the tenth day, when, as has been observed, she became a +little ill, shewed not the least symptom of indisposition. She +was afterwards exposed to the action of variolous; matter, and +completely resisted it. Susan Phipps also went through a similar +trial. Conceiving these cases to be important, I have given them +in detail: first, to urge the precaution of using such means as +may stop the progress of the pustule; and, secondly, to point out +(what appears to be the fact) that the most material +indisposition, or at least that which is felt most sensibly, DOES +NOT ARISE PRIMARILY FROM THE FIRST ACTION OF THE VIRUS ON THE +CONSTITUTION, BUT THAT IT OFTEN COMES ON, IF THE PUSTULE IS LEFT +TO CHANCE, AS A SECONDARY DISEASE. This leads me to conjecture, +what experiment must finally determine, that they who have had +the smallpox are not afterwards susceptible of the primary action +of the cow-pox virus; for seeing that the simple virus itself, +when it has not passed beyond the boundary of a vesicle, excites +in the system so little commotion, is it not probable the +trifling illness, thus induced may be lost in that which so +quickly, and oftentimes so severely, follows in the casual cow- +pox from the presence of corroding ulcers? This consideration +induces me to suppose that I may have been mistaken in my former +observation on this subject. + +In this respect, as well as many others, a parallel may be drawn +between this disease and the smallpox. In the latter, the patient +first feels the effect of what is called the absorption of the +virus. The symptoms then often nearly retire, when a fresh attack +commences, different from the first, and the illness keeps pace +with the progress of the pustules through their different stages +of maturation, ulceration, etc. Although the application I have +mentioned in the case of Mary Hearn proved sufficient to check +the progress of ulceration and prevent any secondary symptoms, +yet, after the pustule has duly exerted its influence, I should +prefer the destroying it quickly and effectually to any other +mode. The term caustic to a tender ear (and I conceive none feel +more interested in this inquiry than the anxious guardians of a +nursery) may sound harsh and unpleasing, but every solicitude +that may arise on this account will no longer exist when it is +understood that the pustule, in a state fit to be acted upon, is +then quite superficial, and that it does not occupy the space of +a silver penny. [Footnote: I mention escharotics for stopping the +progress of the pustule because I am acquainted with their +efficacy; probably more simple means might answer the purpose +quite as well, such as might be found among the mineral and +vegetable astringents.] + +As a proof of the efficacy of this practice, even before the +virus has fully exerted itself on the system, I shall lay before +my reader the following history: + +By a reference to the treatise on the Variolae Vaccinae it will +be seen that, in the month of April, 1798, four children were +inoculated with the matter of cow-pox, and that in two of these +cases the virus on the arm was destroyed soon after it had +produced a perceptible sickening. Mary James, aged seven years, +one of the children alluded to, was inoculated in the month of +December following with fresh variolous matter, and at the same +time was exposed to the effluvia of a patient affected with the +smallpox. The appearance and progress of the infected arm was, in +every respect similar to that which we generally observe when +variolous matter has been inserted into the skin of a person who +has not previously undergone either the cow-pox or the smallpox. +On the eighth day, conceiving there was infection in it, she was +removed from her residence among those who had not had the +smallpox. I was now anxiously waiting the result, conceiving, +from the state of the girl's arm, she would fall sick about this +time. On visiting her on the evening of the following day (the +ninth) all I could learn from the woman who attended her was that +she felt somewhat hotter than usual during the night, but was not +restless; and that in the morning there was the faint appearance +of a rash about her wrists. This went off in a few hours, and was +not at all perceptible to me on my visit in the evening. Not a +single eruption appeared, the skin having been repeatedly and +carefully examined. The inoculated arm continued to make the +usual progress to the end, through all the stages of +inflammation, maturation, and scabbing. + +On the eighth day matter was taken from the arm of this girl +(Mary James) and inserted into the arms of her mother and brother +(neither of whom had had either the smallpox or the cow-pox), the +former about fifty years of age, the latter six. + +On the eighth day after the insertion the boy felt indisposed, +and continued unwell two days, when a measles-like rash appeared +on his hands and wrists, and was thinly scattered over his arms. +The day following his body was marbled over with an appearance +somewhat similar, but he did not complain, nor did he appear +indisposed. A few pustules now appeared, the greater part of +which went away without maturating. + +On the ninth day the mother began to complain. She was a little +chilly and had a headache for two days, but NO PUSTULE APPEARED +on the skin, nor had she any appearance of a rash. + +The family was attended by an elderly woman as a nurse, who in +her infancy had been exposed to the contagion of the smallpox, +but had resisted it. This woman was now infected, but had the +disease in the slightest manner, a very few eruptions appearing, +two or three of which only maturated. + +From a solitary instance like that adduced of Mary James, whose +constitution appears to have resisted the action of the variolous +virus, after the influence of the cow-pox virus had been so soon +arrested in its progress, no positive conclusion can be fairly +drawn; nor from the history of the three other patients who were +subsequently infected, but, nevertheless, the facts collectively +may be deemed interesting. + +That one mild variety of the smallpox has appeared I have already +plainly shewn; [Footnote: See Inquiry into the Causes and Effects +of the Variolae Vaccinae, p. 54 (of original article)], and by +the means now mentioned we probably have it in our power to +produce at will another. + +At the time when the pustule was destroyed in the arm of Mary +James I was informed she had been indisposed about twelve hours; +but I am now assured by those who were with her that the space of +time was much less. Be that as it may, in cases of cow-pox +inoculation I would not recommend any application to subdue the +action of the pustule until convincing proofs had appeared of the +patient's having felt its effects at least twelve hours. No harm, +indeed, could ensue were a longer period to elapse before the +application was made use of. In short, it should be suffered to +have as full an effect as it could, consistently with the state +of the arm. + +As the cases of inoculation multiply, I am more and more +convinced of the extreme mildness of the symptoms arising merely +from the primary action of the virus on the constitution, and +that those symptoms which, as in the accidental cow-pox, affect +the patient with severity, are entirely secondary, excited by the +irritating processes of inflammation and ulceration; and it +appears to me that this singular virus possesses an irritating +quality of a peculiar kind, but as a single cow-pox pustule is +all that is necessary to render the variolous virus ineffectual, +and as we possess the means of allaying the irritation, should +any arise, it becomes of little or no consequence. + +It appears then, as far as an inference can be drawn from the +present progress of cow-pox inoculation, that it is an accidental +circumstance only which can render this a violent disease, and a +circumstance of that nature which, fortunately, it is in the +power of almost every one to avoid. I allude to the communication +of the disease from cows. In this case, should the hands of the +milker be affected with little accidental sores to any extent, +every sore would become the nidus of infection and feel the +influence of the virus; and the degree of violence in the +constitutional symptoms would be in proportion to the number and +to the state of these local affections. Hence it follows that a +person, either by accident or design, might be so filled with +these wounds from contact with the virus that the constitution +might sink under the pressure. + +Seeing that we possess the means of rendering the action of the +sores mild, which, when left to chance, are capable of producing +violent effects; and seeing, too, that these sores bear a +resemblance to the smallpox, especially the confluent, should it +not encourage the hope that some topical application might be +used with advantage to counteract the fatal tendency of that +disease, when it appears in this terrific form? At what stage or +stages of the disease this may be done with the most promising +expectation of success I will not pretend now to determine. I +only throw out this idea as the basis of further reasoning and +experiment. + +I have often been foiled in my endeavours to communicate the cow- +pox by inoculation. An inflammation will sometimes succeed the +scratch or puncture, and in a few days disappear without +producing any further effect. Sometimes it will even produce an +ichorous fluid, and yet the system will not be affected. The same +thing we know happens with the smallpox virus. + +Four or five servants were inoculated at a farm contiguous to +this place, last summer, with matter just taken from an infected +cow. A little inflammation appeared on all their arms, but died +away without producing a pustule; yet all these servants caught +the disease within a month afterwards from milking the infected +cows, and some of them had it severely. At present no other mode +than that commonly practiced for inoculating the smallpox has +been used for giving the cow-pox; but it is probable this might +be varied with advantage. We should imitate the casual +communication more clearly were we first, by making the smallest +superficial incision or puncture on the skin, to produce a little +scab, and then, removing it, to touch the abraded part with the +virus. A small portion of a thread imbrued in the virus (as in +the old method of inoculating the smallpox) and laid upon the +slightly incised skin might probably prove a successful way of +giving the disease; or the cutis might be exposed in a minute +point by an atom of blistering plaster, and the virus brought in +contact with it. In the cases just alluded to, where I did not +succeed in giving the disease constitutionally, the experiment +was made with matter taken in a purulent state from a pustule on +the nipple of a cow. + +Is PURE PUS, though contained in a smallpox pustule, ever capable +of producing the smallpox perfectly? I suspect it is not. Let us +consider that it is always preceded by the limpid fluid, which, +in constitutions susceptible of variolous contagion, is always +infectious; and though, on opening a pustule, its contents may +appear perfectly purulent, yet a given quantity of the limpid +fluid may, at the same time, be blended with it, though it would +be imperceptible to the only test of our senses, the eye. The +presence, then, of this fluid, or its mechanical diffusion +through pus, may at all times render active what is apparently +MERE PUS, while its total absence (as in stale pustules) may be +attended with the imperfect effects we have seen. + +It would be digressing too widely to go far into the doctrine of +secretion, but as it will not be quite extraneous, I shall just +observe that I consider both the pus and the limpid fluid of the +pustule as secretions, but that the organs established by nature +to perform the office of secreting these fluids may differ +essentially in their mechanical structure. What but a difference +in the organization of glandular bodies constitutes the +difference in the qualities of the fluids secreted? From some +peculiar derangement in the structure or, in other words, some +deviation in the natural action of a gland destined to create a +mild, innoxious fluid, a poison of the most deadly nature may be +created; for example: That gland, which in its sound state +secretes pure saliva, may, from being thrown into diseased +action, produce a poison of the most destructive quality. Nature +appears to have no more difficulty in forming minute glands among +the vascular parts of the body than she has in forming blood +vessels, and millions of these can be called into existence, when +inflammation is excited, in a few hours. [Footnote: Mr. Home, in +his excellent dissertation on pus and mucus, justifies this +assertion.] + +In the present early stage of the inquiry (for early it certainly +must be deemed), before we know for an absolute certainty how +soon the virus of the cow-pox may suffer a change in its specific +properties, after it has quitted the limpid state it possesses +when farming a pustule, it would be prudent for those who have +been inoculated with it to submit to variolous inoculation. No +injury or inconvenience can accrue from this; and were the same +method practiced among those who, from inoculation, have felt the +smallpox in an unsatisfactory manner at any period of their +lives, it might appear that I had not been too officious in +offering a cautionary, hint in recommending a second inoculation +with matter in its most perfect state. + +And here let me suppose, for argument's sake (not from +conviction), that one person in an hundred after having had the +cow-pox should be found susceptible of the smallpox, would this +invalidate the utility of the practice? For, waiving all other +considerations, who will deny that the inoculated smallpox, +although abstractedly it may be considered as harmless, does not +involve in itself something that in numberless instances proves +baneful to the human frame. + +That in delicate constitutions it sometimes excites scrofula is a +fact that must generally be subscribed to, as it is so obvious to +common observation. This consideration is important. + +As the effects of the smallpox inoculation on those who have had +the cow-pox will be watched with the most scrupulous eye by those +who prosecute this inquiry, it may be proper to bring to their +recollection some facts relative to the smallpox, which I must +consider here as of consequence, but which hitherto seem not to +have made a due impression. + +It should be remembered that the constitution cannot, by previous +infection, be rendered totally unsusceptible of the variolous +poison; neither the casual nor the inoculated smallpox, whether +it produces the disease in a mild or in a violent way, can +perfectly extinguish the susceptibility. The skin, we know, is +ever ready to exhibit, though often in a very limited degree, the +effects of the poison when inserted there; and how frequently do +we see, among nurses, when much exposed to the contagion, +eruptions, and these sometimes preceded by sensible illness! yet +should any thing like an eruption appear, or the smallest degree +of indisposition, upon the insertion of the variolous matter on +those who have gone through the cow-pox, my assertions respecting +the peculiarities of the disease might be unjustly discredited. + +I know a gentleman who, many years ago, was inoculated for the +smallpox, but having no pustules, or scarcely any constitutional +affection that was perceptible, he was dissatisfied, and has +since been repeatedly inoculated. A vesicle has always been +produced in the arm in consequence, with axillary swelling and a +slight indisposition; this is by no means a rare occurrence. It +is probable that fluid thus excited upon the skin would always +produce the smallpox. + +On the arm of a person who had gone through the cow-pox many +years before I once produced a vesication by the insertion of +variolous matter, and, with a little of the fluid, inoculated a +young woman who had a mild, but very efficacious, smallpox in +consequence, although no constitutional effect was produced on +the patient from whom the matter was taken. The following +communication from Mr. Fewster affords a still clearer +elucidation of this fact. Mr. Fewster says: "On the 3d of April, +1797, I inoculated Master H--, aged fourteen months, for the +smallpox. At the usual time he sickened, had a plentiful +eruption, particularly on his face, and got well. His nursemaid, +aged twenty-four, had many years before gone through the +smallpox, in the natural way, which was evident from her being +much pitted with it. She had used the child to sleep on her left +arm, with her left cheek in contact with his face, and during his +inoculation he had mostly slept in that manner. About a week +after the child got well she (the nurse) desired me to look at +her face, which she said was very painful. There was a plentiful +eruption on the left cheek, BUT NOT ON ANY OTHER PART OF THE +BODY, which went on to maturation. + +"On enquiry I found that three days before the appearance of the +eruption she was taken with slight chilly fits, pain in her head +and limbs, and some fever. On the appearance of the eruption +these pains went off, and now, the second day of the eruption, +she complains of a little sore throat. Whether the above symptoms +are the effects of the smallpox or a recent cold I do not know. +On the fifth day of the eruption I charged a lancet from two of +the pustules, and on the next day I inoculated two children, one +two years, the other four months old, with the matter. At the +same time I inoculated the mother and eldest sister with +variolous matter taken from Master H--. On the fifth day of their +inoculation ALL their arms were inflamed alike; and on the eighth +day the eldest of those inoculated from the nurse sickened, and +the youngest on the eleventh. They had both a plentiful eruption, +from which I inoculated several others, who had the disease very +favourably. The mother and the other child sickened about the +same time, and likewise had a plentiful eruption. + +"Soon after, a man in the village sickened with the smallpox and +had a confluent kind. To be convinced that the children had had +the disease effectually I took them to his house and inoculated +them in both arms with matter taken from him, but without +effect." + +These are not brought forward as uncommon occurrences, but as +exemplifications of the human system's susceptibility of the +variolous contagion, although it has been previously sensible of +its action. + +Happy is it for mankind that the appearance of the small-pox a +second time on the same person, beyond a trivial extent, is so +extremely rare that it is looked upon as a phaenomenon! Indeed, +since the publication of Dr. Heberden's paper on the Varicellae, +or chicken-pox, the idea of such an occurrence, in deference to +authority so truly respectable, has been generally relinquished. +This I conceive has been without just reason; for after we have +seen, among many others, so strong a case as that recorded by Mr. +Edward Withers, Surgeon, of Newbury, Berks, in the fourth volume +of the Memoirs of the Medical Society of London (from which I +take the following extracts), no one, I think, will again doubt +the fact. + +"Mr. Richard Langford, a farmer of West Shefford, in this county +(Berks), about fifty years of age, when about a month old had the +smallpox at a time when three others of the family had the same +disease, one of whom, a servant man, died of it. Mr. Langford's +countenance was strongly indicative of the malignity of the +distemper, his face being so remarkably pitted and seamed as to +attract the notice of all who saw him, so that no one could +entertain a doubt of his having had that disease in a most +inveterate manner." Mr. Withers proceeds to state that Mr. +Langford was seized a second time, had a bad confluent smallpox, +and died on the twenty-first day from the seizure; and that four +of the family, as also a sister of the patient's, to whom the +disease was conveyed by her son's visiting his uncle, falling +down with the smallpox, fully satisfied the country with regard +to the nature of the disease, which nothing short of this would +have done; the sister died. + +"This case was thought so extraordinary a one as to induce the +rector of the parish to record the particulars in the parish +register." + +It is singular that in most cases of this kind the disease in the +first instance has been confluent; so that the extent of the +ulceration on the skin (as in the cow-pox) is not the process in +nature which affords security to the constitution. + +As the subject of the smallpox is so interwoven with that which +is the more immediate object of my present concern, it must plead +my excuse for so often introducing it. At present it must be +considered is a distemper not well understood. The inquiry I have +instituted into the nature of the cow-pox will probably promote +its more perfect investigation. + +The inquiry of Dr. Pearson into the history of the cow-pox having +produced so great a number of attestations in favour of my +assertion that it proves a protection to the human body from the +smallpox, I have not been assiduous in seeking for more; but as +some of my friends have been so good as to communicate the +following, I shall conclude these observations with their +insertion. + +Extract of a letter from Mr. Drake, Surgeon, at Stroud, in this +county, and late Surgeon to the North Gloucester Regiment of +Militia: + +"In the spring of the year 1796 I inoculated men, women, and +children to the amount of about seventy. Many of the men did not +receive the infection, although inoculated at least three times +and kept in the same room with those who actually underwent the +disease during the whole time occupied by them in passing through +it. Being anxious they should, in future, be secure against it, I +was very particular in my inquiries to find out whether they ever +had previously had it, or at any time been in the neighbourhood +of people labouring under it. But, after all, the only +satisfactory information I could obtain was that they had had the +cow-pox. As I was then ignorant of such a disease affecting the +human subject, I flattered myself what they imagined to be the +cow-pox was in reality the smallpox in a very slight degree. I +mentioned the circumstance in the presence of the officers, at +the time expressing my doubts if it were not smallpox, and was +not a little surprised when I was told by the Colonel that he had +frequently heard you mention the cow-pox as a disease endemial to +Gloucestershire, and that if a person were ever affected by it, +you supposed him afterwards secure from the smallpox. This +excited my curiosity, and when I visited Gloucestershire I was +very inquisitive concerning the subject, and from the information +I have since received, both from your publication and from +conversation with medical men of the greatest accuracy in their +observations, I am fully convinced that what the men supposed to +be cow-pox was actually so, and I can safely affirm that they +effectually resisted the smallpox." + +Mr. Fry, Surgeon, at Dursley in this county, favours me with the +following communication: + +"During the spring of the year 1797 I inoculated fourteen hundred +and seventy-five patients, of all ages, from a fortnight old to +seventy years; amongst whom there were many who had previously +gone through the cow-pox. The exact number I cannot state; but if +I say there were nearly thirty, I am certainly within the number. +There was not a single instance of the variolous matter producing +any constitutional effect on these people, nor any greater degree +of local inflammation than it would have done in the arm of a +person who had before gone through the smallpox, notwithstanding +it was invariably inserted four, five, and sometimes six +different times, to satisfy the minds of the patients. In the +common course of inoculation previous to the general one scarcely +a year passed without my meeting with one or two instances of +persons who had gone through the cow-pox, resisting the action of +the variolous contagion. I may fairly say that the number of +people I have seen inoculated with the smallpox who, at former +periods, had gone through the cow-pox, are not less than forty; +and in no one instance have I known a patient receive the +smallpox, notwithstanding they invariably continued to associate +with other inoculated patients during the progress of the +disease, and many of them purposely exposed themselves to the +contagion of the natural smallpox; whence I am fully convinced +that a person who had fairly had the cow-pox is no longer capable +of being acted upon by the variolous matter. + +"I also inoculated a very considerable number of those who had +had a disease which ran through the neighbourhood a few years +ago, and was called by the common people the swine-pox, not one +of whom received the smallpox. [Footnote: This was that mild +variety of the smallpox which I have noticed in the late Treatise +on the Cow-Pox (p. 233).] + +"There were about half a dozen instances of people who never had +either the cow-or swine-pox, yet did not receive the smallpox, +the system not being in the least deranged, or the arms inflamed, +although they were repeatedly inoculated, and associated with +others who were labouring under the disease; one of them was the +son of a farrier." + +Mr. Tierny, Assistant Surgeon of the South Gloucester Regiment of +Militia, has obliged me with the following information: + +"That in the summer of the year of 1798 he inoculated a great +number of the men belonging to the regiment, and that among them +he found eleven who, from having lived in dairies, had gone +through the cow-pox. That all of them resisted the smallpox +except one, but that on making the most rigid and scrupulous +enquiry at the farm in Gloucestershire, where the man said he +lived when he had the disease, and among those with whom, at the +same time, he declared he had associated, and particularly of a +person in the parish, whom he said had dressed his fingers, it +most clearly appeared that he aimed at an imposition, and that he +never had been affected with the cow-pox." [Footnote: The public +cannot be too much upon their guard respecting persons of this +description.] Mr. Tierny remarks that the arms of many who were +inoculated after having had the cow-pox inflamed very quickly, +and that in several a little ichorous fluid was formed. + +Mr. Cline, who in July last was so obliging at my request as to +try the efficacy of the cow-pox virus, was kind enough to give me +a letter on the result of it, from which the following is an +extract: + +"My DEAR SIR: + +"The cow-pox experiment has succeeded admirably. The child +sickened on the seventh day, and the fever, which was moderate, +subsided on the eleventh. The inflammation arising from the +insertion of the virus extended to about four inches in diameter, +and then gradually subsided, without having been attended with +pain or other inconvenience. There were no eruptions. + +"I have since inoculated him with smallpox matter in three +places, which were slightly inflamed on the third day, and then +subsided. + +"Dr. Lister, who was formerly physician to the Smallpox Hospital, +attended the child with me, and he is convinced that it is not +possible to give him the smallpox. I think the substituting the +cow-pox poison for the smallpox promises to be one of the +greatest improvements that has ever been made in medicine; and +the more I think on the subject, the more I am impressed with its +importance. + +"With great esteem + +"I am, etc., "HENRY CLINE. + +"Lincoln's Inn Fields, August 2, 1798." + +From communications, with which I have been favoured from Dr. +Pearson, who has occasionally reported to me the result of his +private practice with the vaccine virus in London, and from Dr. +Woodville, who also has favoured me with an account of his more +extensive inoculation with the same virus at the Smallpox +Hospital, it appears that many of their patients have been +affected with eruptions, and that these eruptions have maturated +in a manner very similar to the variolous. The matter they made +use of was taken in the first instance from a cow belonging to +one of the great milk farms in London. Having never seen +maturated pustules produced either in my own practice among those +who were casually infected by cows, or those to whom the disease +had been communicated by inoculation, I was desirous of seeing +the effect of the matter generated in London, on subjects living +in the country. A thread imbrued in some of this matter was sent +to me, and with it two children were inoculated, whose cases I +shall transcribe from my notes. + +Stephen Jenner, three years and a half old. + +3d day: The arm shewed a proper and decisive inflammation. + +6th: A vesicle arising. + +7th: The pustule of a cherry colour. + +8th: Increasing in elevation. A few spots now appear on each arm +near the insertion of the inferior tendons of the biceps muscles. +They are very small and of a vivid red colour. The pulse natural; +tongue of its natural hue; no loss of appetite or any symptom of +indisposition. + +9th: The inoculated pustule on the arm this evening began to +inflame, and gave the child uneasiness; he cried and pointed to +the seat of it, and was immediately afterwards affected with +febrile symptoms. At the expiration of two hours after the +seizure a plaster of ung. hydrarg. fort, was applied, and its +effect was very quickly perceptible, for in ten minutes he +resumed his usual looks and playfulness. On examining the arm +about three hours after the application of the plaster its +effects in subduing the inflammation were very manifest. + +10th: The spots on the arms have disappeared, but there are three +visible in the face. + +11th: Two spots on the face are gone; the other barely +perceptible. + +13th: The pustule delineated in the second plate in the Treatise +on the Variolae Vaccinae is a correct representation of that on +the child's arm as it appears at this time. + +14th: Two fresh spots appear on the face. The pustule on the arm +nearly converted into a scab. As long as any fluid remained in it +it was limpid. + +James Hill, four years old, was inoculated on the same day, and +with part of the same matter which infected Stephen Jenner. It +did not appear to have taken effect till the fifth day. + +7th: A perceptible vesicle: this evening the patient became a +little chilly; no pain or tumour discoverable in the axilla. + +8th: Perfectly well. + +9th: The same. + +10th: The vesicle more elevated than I have been accustomed to +see it, and assuming more perfectly the variolous character than +is common with the cow-pox at this stage. + +11th: Surrounded by an inflammatory redness, about the size of a +shilling, studded over with minute vesicles. The pustule +contained a limpid fluid till the fourteenth day, after which it +was incrusted over in the usual manner; but this incrustation or +scab being accidentally rubbed off, it was slow in healing. + +These children were afterwards fully exposed to the smallpox +contagion without effect. + +Having been requested by my friend, Mr. Henry Hicks, of +Eastington, in this county, to inoculate two of his children, and +at the same time some of his servants and the people employed in +his manufactory, matter was taken from the arm of this boy for +the purpose. The numbers inoculated were eighteen. They all took +the infection, and either on the fifth or sixth day a vesicle was +perceptible on the punctured part. Some of them began to feel a +little unwell on the eighth day, but the greater number on the +ninth. Their illness, as in the former cases described, was of +short duration, and not sufficient to interrupt, but at very +short intervals, the children from their amusements, or the +servants and manufacturers from following their ordinary +business. + +Three of the children whose employment in the manufactory was in +some degree laborious had an inflammation on their arms beyond +the common boundary about the eleventh or twelfth day, when the +feverish symptoms, which before were nearly gone off, again +returned, accompanied with increase of axillary tumour. In these +cases (clearly perceiving that the symptoms were governed by the +state of the arms) I applied on the inoculated pustules, and +renewed the application three or four times within an hour, a +pledget of lint, previously soaked in aqua lythargyri acetati +[Footnote: Goulard's extract of Saturn.] and covered the hot +efflorescence surrounding them with cloths dipped in cold water. + +The next day I found this simple mode of treatment had succeeded +perfectly. The inflammation was nearly gone off, and with it the +symptoms which it had produced. + +Some of these patients have since been inoculated with variolous +matter, without any effect beyond a little inflammation on the +part where it was inserted. + +Why the arms of those inoculated with the vaccine matter in the +country should be more disposed to inflame than those inoculated +in London it may be difficult to determine. From comparing my own +cases with some transmitted to me by Dr. Pearson and Dr. +Woodville, this appears to be the fact; and what strikes me as +still more extraordinary with respect to those inoculated in +London is the appearance of maturating eruptions, In the two +instances only which I have mentioned (the one from the +inoculated, the other from the casual, cow-pox) a few red spots +appeared, which quickly went off without maturating. The case of +the Rev. Mr. Moore's servant may, indeed, seem like a deviation +from the common appearances in the country, but the nature of +these eruptions was not ascertained beyond their not possessing +the property of communicating the disease by their effluvia. +Perhaps the difference we perceive may be owing to some variety +in the mode of action of the virus upon the skin of those who +breathe the air of London and those who live in the country. That +the erysipelas assumes a different form in London from what we +see it put on in this country is a fact very generally +acknowledged. In calling the inflammation that is excited by the +cow-pox virus erysipelatous, perhaps I may not be critically +exact, but it certainly approaches near to it. Now, as the +diseased action going forward in the part infected with the virus +may undergo different modifications according to the +peculiarities of the constitution on which it is to produce its +effect, may it not account for the variation which has been +observed? + +To this it may probably be objected that some of the patients +inoculated, and who had pustules in consequence, were newly come +from the country; but I conceive that the changes wrought in the +human body through the medium of the lungs may be extremely +rapid. Yet, after all, further experiments made in London with +vaccine virus generated in the country must finally throw a light +on what now certainly appears obscure and mysterious. + +The principal variation perceptible to me in the action of the +vaccine virus generated in London from that produced in the +country was its proving more certainly infectious and giving a +less disposition in the arm to inflame. There appears also a +greater elevation of the pustule above the surrounding skin. In +my former cases the pustule produced by the insertion of the +virus was more like one of those which are so thickly spread over +the body in a bad kind of confluent smallpox. This was more like +a pustule of the distinct smallpox, except that I saw no instance +of pus being formed in it, the matter remaining limpid till the +period of scabbing. + +Wishing to see the effects of the disease on an infant newly +born, my nephew, Mr. Henry Jenner, at my request, inserted the +vaccine virus into the arm of a child about twenty hours old. His +report to me is that the child went through the disease without +apparent illness, yet that it was found effectually to resist the +action of variolous matter with which it was subsequently +inoculated. + +I have had an opportunity of trying the effects of the cow-pox +matter on a boy, who, the day preceding its insertion, sickened +with the measles. The eruption of the measles, attended with +cough, a little pain in the chest; and the usual symptoms +accompanying the disease, appeared on the third day and spread +all over him. The disease went through its course without any +deviation from its usual habits; and, notwithstanding this, the +cow-pox virus excited its common appearances, both on the arm and +on the constitution, without any febrile interruption; on the +sixth day there was a vesicle. + +8th: Pain in the axilla, chilly, and affected with headache. + +9th: Nearly well. + +12th: The pustule spread to the size of a large split-pea, but +without any surrounding efflorescence. It soon afterwards +scabbed, and the boy recovered his general health rapidly. But it +should be observed that before it scabbed the efflorescence which +had suffered a temporary suspension advanced in the usual manner. + +Here we see a deflation from the ordinary habits of the smallpox, +as it has been observed that the presence of the measles suspends +the action of the variolous matter. + +The very general investigation that is now taking place, chiefly +through inoculation (and I again repeat my earnest hope that it +may be conducted with that calmness and moderation which should +ever accompany a philosophical research), must soon place the +vaccine disease in its just point of view. The result of all my +trials with the virus on the human subject has been uniform. In +every instance the patient who has felt its influence, has +completely lost the susceptibility for the variolous contagion; +and as these instances are now become numerous, I conceive that, +joined to the observations in the former part of this paper, they +sufficiently preclude me from the necessity of entering into +controversies with those who have circulated reports adverse to +my assertions, on no other evidence than what has been casually +collected. + + + + +III + +A CONTINUATION OF FACTS AND OBSERVATIONS RELATIVE TO THE VARIOUS +VACCINES, OR COW-POX. 1800 + + +Since my former publications on the vaccine inoculation I have +had the satisfaction of seeing it extend very widely. Not only in +this country is the subject pursued with ardour, but from my +correspondence with many respectable medical gentlemen on the +Continent (among whom are Dr. De Carro, of Vienna, and Dr. +Ballhorn, of Hanover) I find it is as warmly adopted abroad, +where it has afforded the greatest satisfaction. I have the +pleasure, too, of seeing that the feeble efforts of a few +individuals to depreciate the new practice are sinking fast into +contempt beneath the immense mass of evidence which has arisen up +in support of it. + +Upwards of six thousand persons have now been inoculated with the +virus of cow-pox, and the far greater part of them have since +been inoculated with that of smallpox, and exposed to its +infection in every rational way that could be devised, without +effect. + +It was very improbable that the investigation of a disease so +analogous to the smallpox should go forward without engaging the +attention of the physician of the Smallpox Hospital in London. + +Accordingly, Dr. Woodville, who fills that department with so +much respectability, took an early opportunity of instituting an +inquiry into the nature of the cow-pox. This inquiry was begun in +the early part of the present year, and in May, Dr. Woodville +published the result, which differs essentially from mine in a +point of much importance. It appears that three-fifths of the +patients inoculated were affected with eruptions, for the most +part so perfectly resembling the smallpox as not to be +distinguished from them. On this subject it is necessary that I +should make some comments. + +When I consider that out of the great number of cases of casual +inoculation immediately from cows which from time to time +presented themselves to my observation, and the many similar +instances which have been communicated to me by medical gentlemen +in this neighbourhood; when I consider, too, that the matter with +which my inoculations were conducted in the years 1797, '98, and +'99, was taken from some different cows, and that in no instance +any thing like a variolous pustule appeared, I cannot feel +disposed to imagine that eruptions, similar to those described by +Dr. Woodville, have ever been produced by the pure uncontaminated +cow-pock virus; on the contrary, I do suppose that those which +the doctor speaks of originated in the action of variolous matter +which crept into the constitution with the vaccine. And this I +presume happened from the inoculation of a great number of the +patients with variolous matter (some on the third, others on the +fifth, day) after the vaccine had been applied; and it should be +observed that the matter thus propagated became the source of +future inoculations in the hands of many medical gentlemen who +appeared to have been previously unacquainted with the nature of +the cow-pox. + +Another circumstance strongly, in my opinion, supporting this +supposition is the following: The cow-pox has been known among +our dairies time immemorial. If pustules, then, like the +variolous, were to follow the communication of it from the cow to +the milker, would not such a fact have been known and recorded at +our farms? Yet neither our farmers nor the medical people of the +neighbourhood have noticed such an occurrence. + +A few scattered pimples I have sometimes, though very rarely, +seen, the greater part of which have generally disappeared +quickly, but some have remained long enough to suppurate at their +apex. That local cuticular inflammation, whether springing up +spontaneously or arising from the application of acrid +substances, such for instance, as cantharides, pix Burgundica, +antimonium tartarizatum, etc., will often produce cutaneous +affections, not only near the seat of the inflammation, but on +some parts of the skin far beyond its boundary, is a well-known +fact. It is, doubtless, on this principle that the inoculated +cow-pock pustule and its concomitant efflorescence may, in very +irritable constitutions, produce this affection. The eruption I +allude to has commonly appeared some time in the third week after +inoculation. But this appearance is too trivial to excite the +least regard. + +The change which took place in the general appearance during the +progress of the vaccine inoculation at the Smallpox Hospital +should likewise be considered. + +Although at first it took on so much of the variolous character +as to produce pustules in three cases out of five, yet in Dr. +Woodville's last report, published in June, he says: "Since the +publication of my reports of inoculations for the cow-pox, +upwards of three hundred cases have been under my care; and out +of this number only thirty-nine had pustules that suppurated; +viz., out of the first hundred, nineteen had pustules; out of the +second, thirteen; and out of the last hundred and ten, only seven +had pustules. Thus it appears that the disease has become +considerably milder; which I am inclined to attribute to a +greater caution used in the choice of the matter, with which the +infection was communicated; for, lately, that which has been +employed for this purpose has been taken only from those patients +in whom the cow-pox proved very mild and well characterized." +[Footnote: In a few weeks after the cow-pox inoculation was +introduced at the Smallpox Hospital I was favoured with some +virus from this stock. In the first instance it produced a few +pustules, which did not maturate; but in the subsequent cases +none appeared.--E. J.] + +The inference I am induced to draw from these premises is very +different. The decline, and, finally, the total extinction +nearly, of these pustules, in my opinion, are more fairly +attributable to the cow-pox virus, assimilating the variolous, +[Footnote: In my first publication on this subject I expressed an +opinion that the smallpox and the cow-pox were the same diseases +under different modifications. In this opinion Dr. Woodville has +concurred The axiom of the immortal Hauter, that two diseased +actions cannot take place at the same time in one and the same +part, will not be injured by the admission of this theory.] +the former probably being the original, the latter the same +disease under a peculiar, and at present an inexplicable, +modification. + +One experiment tending to elucidate the point under discussion I +had myself an opportunity of instituting. On the supposition of +its being possible that the cow which ranges over the fertile +meadows in the vale of Gloucester might generate a virus +differing in some respects in its qualities from that produced by +the animal artificially pampered for the production of milk for +the metropolis, I procured, during my residence there in the +spring, some cow pock virus from a cow at one of the London milk- +farms. [Footnote: It was taken by Mr. Tanner, then a student at +the Veterinary College, from a cow at Mr. Clark's farm at Kentish +Town.] It was immediately conveyed into Gloucestershire to Dr. +Marshall, who was then extensively engaged in the inoculation of +the cow-pox, the general result of which, and of the inoculation +in particular with this matter, I shall lay before my reader in +the following communication from the doctor: + +"DEAR SIR: + +"My neighbour, Mr. Hicks, having mentioned your wish to be +informed of the progress of the inoculation here for the cow-pox, +and he also having taken the trouble to transmit to you my +minutes of the cases which have fallen under my care, I hope you +will pardon the further trouble I now give you in stating the +observations I have made upon the subject. When first informed of +it, having two children who had not had the smallpox, I +determined to inoculate them for the cow-pox whenever I should be +so fortunate as to procure matter proper for the purpose. I was, +therefore, particularly happy when I was informed that I could +procure matter from some of those whom you had inoculated. In the +first instance I had no intention of extending the disease +further than my own family, but the very extensive influence +which the conviction of its efficacy in resisting the smallpox +has had upon the minds of the people in general has rendered that +intention nugatory, as you will perceive, by the continuation of +my cases enclosed in this letter, [Footnote: Doctor Marshall has +detailed these cases with great accuracy, but their publication +would now be deemed superfluous.--E.J.] by which it will appear +that since the 22d of March I have inoculated an hundred and +seven persons; which, considering the retired situation I resided +in, is a very great number. There are also other considerations +which, besides that of its influence in resisting the smallpox, +appear to have had their weight; the peculiar mildness of the +disease, the known safety of it, and its not having in any +instance prevented the patient from following his ordinary +business. In all the cases under my care there have only occurred +two or three which required any application, owing to +erysipelatous inflammation on the arm, and they immediately +yielded to it. In the remainder the constitutional illness has +been slight but sufficiently marked, and considerably less than I +ever observed in the same number inoculated with the smallpox. In +only one or two of the cases have any other eruptions appeared +than those around the spot where the matter was inserted, and +those near the infected part. Neither does there appear in the +cow-pox to be the least exciting cause to any other disease, +which in the smallpox has been frequently observed, the +constitution remaining in as full health and vigour after the +termination of the disease as before the infection. Another +important consideration appears to be the impossibility of the +disease being communicated except by the actual contact of the +matter of the pustule, and consequently the perfect safety of the +remaining part of the family, supposing only one or two should +wish to be inoculated at the same time. + +"Upon the whole, it appears evident to me that the cow-pox is a +pleasanter, shorter, and infinitely more safe disease than the +inoculated smallpox when conducted in the most careful and +approved manner; neither is the local affection of the inoculated +part, or the constitutional illness, near so violent. I speak +with confidence on the subject, having had an opportunity of +observing its effects upon a variety of constitutions, from three +months old to sixty years; and to which I have paid particular +attention. In the cases alluded to here you will observe that the +removal from the original source of the matter had made no +alteration or change in the nature or appearance of the disease, +and that it may be continued, ad infinitum (I imagine), from one +person to another (if care be observed in taking the matter at a +proper period) without any necessity of recurring to the original +matter of the cow. + +"I should be happy if any endeavours of mine could tend further +to elucidate the subject, and shall be much gratified is sending +you any further observations I may be enabled to make. + + "I have the pleasure to subscribe myself, + "Dear sir, etc., + "JOSEPH H. MARSHALL + +"EASTINGTON, GLOUCESTERSHIRE, April 26, 1799." + +The gentleman who favoured me with the above account has +continued to prosecute his inquiries with unremitting industry, +and has communicated the result in another letter, which at his +request I lay before the public without abbreviation. + +Dr. Marshall's second letter: + +"DEAR SIR: + +"Since the date of my former letter I have continued to inoculate +with the cow-pox virus. Including the cases before enumerated, +the number now amounts to four hundred and twenty-three. It would +be tedious and useless to detail the progress of the disease in +each individual--it is sufficient to observe that I noticed no +deviation in any respect from the cases I formerly adduced. The +general appearances of the arm exactly corresponded with the +account given in your first publication. When they were disposed +to become troublesome by erysipelatous inflammation, an +application of equal parts of vinegar and water always answered +the desired intention. I must not omit to inform you that when +the disease had duly acted upon the constitution I have +frequently used the vitriolic acid. A portion of a drop applied +with the head of a probe or any convenient utensil upon the +pustule, suffered to remain about forty seconds, and afterwards +washed off with sponge and water, never failed to stop its +progress and expedite the formation of a scab. + +"I have already subjected two hundred and eleven of my patients +to the action of variolous matter, but EVERY ONE RESISTED IT. + +"The result of my experiments (which were made with every +requisite caution) has fully convinced me that the TRUE COW-POX +is a safe and infallible preventive from the smallpox; that in no +case which has fallen under my observation has it been in any +considerable degree troublesome, much less have I seen any thing +like danger; for in no instance were the patients prevented from +following their ordinary employments. + +"In Dr. Woodville's publication on the cow-pox I notice an +extraordinary fact. He says that the generality of his patients +had pustules. It certainly appears extremely extraordinary that +in all my cases there never was but one pustule, which appeared +on a patient's elbow on the inoculated arm, and maturated. It +appeared exactly like that on the incised part. + +"The whole of my observations, founded as it appears on an +extensive experience, leads me to these obvious conclusions; that +those cases which have been or may be adduced against the +preventive powers of the cow-pox could not have been those of the +true kind, since it must appear to be absolutely impossible that +I should have succeeded in such a number of cases without a +single exception if such a preventive power did not exist. I +cannot entertain a doubt that the inoculated cow-pox must quickly +supersede that of the smallpox. If the many important advantages +which must result from the new practice are duly considered, we +may reasonably infer that public benefit, the sure test of the +real merit of discoveries, will render it generally extensive. + +"To you, Sir, as the discoverer of this highly beneficial +practice, mankind are under the highest obligations. As a private +individual I participate in the general feeling; more +particularly as you have afforded me an opportunity of noticing +the effects of a singular disease, and of viewing the progress of +the most curious experiment that ever was recorded in the history +of physiology. + "I remain, dear sir, etc., + "JOSEPH H. MARSHALL." + +"P.S. I should have observed that, of the patients I inoculated +and enumerated in my letter, one hundred and twenty-seven were +infected with the matter you sent me from the London cow. I +discovered no dissimilarity of symptoms in these cases from those +which I inoculated from matter procured in this country. No +pustules have occurred, except in one or two cases, where a +single one appeared on the inoculated arm. No difference was +apparent in the local inflammation. There was no suspension of +ordinary employment among the labouring people, nor was any +medicine required. + +"I have frequently inoculated one or two in a family, and the +remaining part of it some weeks afterwards. The uninfected have +slept with the infected during the whole course of the disease +without being affected; so that I am fully convinced that the +disease cannot be taken but by actual contact with the matter. + +"A curious fact has lately fallen under my observation, on which +I leave you to comment. + +"I visited a patient with the confluent smallpox and charged a +lancet with some of the matter. Two days afterwards I was desired +to inoculate a woman and four children with the cow-pox, and I +inadvertently took the vaccine matter on the same lancet which +was before charged with that of smallpox. In three days I +discovered the mistake, and fully expected that my five patients +would be infected with smallpox; but I was agreeably surprised to +find the disease to be genuine cow-pox, which proceeded without +deviating in any particular from my former cases. I afterwards +inoculated these patients with variolous matter, but all of them +resisted its action. + +"I omitted mentioning another great advantage that now occurs to +me in the inoculated cow-pox; I mean, the safety with which +pregnant women may have the disease communicated to them. I have +inoculated a great number of females in that situation, and never +observed their cases to differ in any respect from those of my +other patients. Indeed, the disease is so mild that it seems as +if it might at all times be communicated with the most perfect +safety." + +I shall here take the opportunity of thanking Dr. Marshall and +those other gentlemen who have obligingly presented me with the +result of their inoculations; but, as they all agree in the same +point as that given in the above communication, namely, the +security of the patient from the effects of the smallpox after +the cow-pox, their perusal, I presume, would afford us no +satisfaction that has not been amply given already. Particular +occurrences I shall, of course, detail. Some of my correspondents +have mentioned the appearance of smallpox-like eruptions at the +commencement of their inoculations; but in these cases the matter +was derived from the original stock at the Smallpox Hospital. + +I have myself inoculated a very considerable number from the +matter produced by Dr. Marshall's patients, originating in the +London cow, without observing pustules of any kind, and have +dispersed it among others who have used it with a similar effect. +From this source Mr. H. Jenner informs me he has inoculated above +an hundred patients without observing eruptions. Whether the +nature of the virus will undergo any change from being farther +removed from its original source in passing successively from one +person to another time alone can determine. That which I am now +employing has been in use near eight months, and not the least +change is perceptible in its mode of action either locally or +constitutionally. There is, therefore, every reason to expect +that its effects will remain unaltered and that we shall not be +under the necessity of seeking fresh supplies from the cow. + +The following observations were obligingly sent me by Mr. Tierny, +Assistant Surgeon to the South Gloucester Regiment of Militia, to +whom I am indebted for a former report on this subject: + +"I inoculated with the cow-pox matter from the eleventh to the +latter part of April, twenty-five persons, including women and +children. Some on the eleventh were inoculated with the matter +Mr. Shrapnell (surgeon to the regiment) had from you, the others +with matter taken from these. The progress of the puncture was +accurately observed, and its appearance seemed to differ from the +smallpox in having less inflammation around its basis on the +first days--that is, from the third to the seventh; but after +this the inflammation increased, extending on the tenth or +eleventh day to a circle of an inch and a half from its centre, +and threatening very sore arms; but this I am happy to say was +not the case; for, by applying mercurial ointment to the inflamed +part, which was repeated daily until the inflammation went off, +the arm got well without any further application or trouble. The +constitutional symptoms which appeared on the eighth or ninth day +after inoculation scarcely deserved the name of disease, as they +were so slight as to be scarcely perceptible, except that I could +connect a slight headache and languor, with a stiffness and +rather painful sensation in the axilla. This latter symptom was +the most striking--it remained from twelve to forty-eight hours. +In no case did I observe the smallest pustule, or even +discolouration of the skin, like an incipient pustule, except +about the part where the virus has been applied. + +"After all these symptoms had subsided and the arms were well, I +inoculated four of this number with variolous matter, taken from +a patient in another regiment. In each of these it was inserted +several times under the cuticle, producing slight inflammation on +the second or third day, and always disappearing before the fifth +or sixth, except in one who had the cow-pox in Gloucestershire +before he joined us, and who also received it at this time by +inoculation. In this man the puncture inflamed and his arm was +much sorer than from the insertion of the cow-pox virus; but +there was no pain in the axilla, nor could any constitutional +affection be observed. + +"I have only to add that I am now fully satisfied of the efficacy +of the cow-pox in preventing the appearance of the smallpox, and +that it is a most happy and salutary substitute for it. I remain, +etc., + +"M. J. TIERNY." + +Although the susceptibility of the virus of the cow-pox is, for +the most part, lost in those who have had the smallpox, yet in +some constitutions it is only partially destroyed, and in others +it does not appear to be in the least diminished. + +By far the greater number on whom trials were made resisted it +entirely; yet I found some on whose arm the pustule from +inoculation was formed completely, but without producing the +common efflorescent blush around it, or any constitutional +illness, while others have had the disease in the most perfect +manner. A case of the latter kind having been presented to me by +Mr. Fewster, Surgeon, of Thornbury, I shall insert it: + +"Three children were inoculated with the vaccine matter you +obligingly sent me. On calling to look at their arms three days +after I was told that John Hodges, one of the three, had been +inoculated with the smallpox when a year old, and that he had a +full burthen, of which his face produced plentiful marks, a +circumstance I was not before made acquainted with. On the sixth +day the arm of the boy appeared as if inoculated with variolous +matter, but the pustule was rather more elevated. On the ninth +day he complained of violent pain in his head and back, +accompanied with vomiting and much fever. The next day he was +very well and went to work as usual. The punctured part began to +spread, and there was the areola around the inoculated part to a +considerable extent. + +"As this is contrary to an assertion made in the Medical and +Physical Journal, No. 8, I thought it right to give you this +information, and remain, + "Dear sir, etc., + "J. FEWSTER." + +It appears, then, that the animal economy with regard to the +action of this virus is under the same laws as it is with respect +to the variolous virus, after previously feeling its influence, +as far as comparisons can be made between the two diseases. + +Some striking instances of the power of the cow-pox in suspending +the progress of the smallpox after the patients had been several +days casually exposed to the infection have been laid before me +by Mr. Lyford, Surgeon, of Winchester, and my nephew, the Rev. G. +C Jenner. Mr. Lyford, after giving an account of his extensive +and successful practice in the vaccine inoculation in Hampshire, +writes as follows: + +"The following case occurred to me a short time since, and may +probably be worth your notice. I was sent for to a patient with +the smallpox, and on inquiry found that five days previous to my +seeing him the eruption began to appear. During the whole of this +time two children who had not had the smallpox, were constantly +in the room with their father, and frequently on the bed with +him. The mother consulted me on the propriety of inoculating +them, but objected to my taking the matter from their father, as +he was subject to erysipelas. I advised her by all means to have +them inoculated at that time, as I could not procure any +variolous matter elsewhere. However, they were inoculated with +vaccine matter, but I cannot say I flattered myself with its +proving successful, as they had previously been so long and still +continued to be exposed to the variolous infection. +Notwithstanding this I was agreeably surprised to find the +vaccine disease advance and go through its regular course; and, +if I may be allowed the expression, to the total extinction of +the smallpox." + +Mr. Jenner's cases were not less satisfactory. He writes as +follows: + +"A son of Thomas Stinchcomb, of Woodford, near Berkeley, was +infected with the natural smallpox at Bristol, and came home to +his father's cottage. Four days after the eruptions had appeared +upon the boy, the family (none of which had ever had the +smallpox), consisting of the father, mother, and five children, +was inoculated with vaccine virus. On the arm of the mother it +failed to produce the least effect, and she, of course, had the +smallpox, [Footnote: Under similar circumstances I think it would +be advisable to insert the matter into each arm, which would be +more likely to insure the success of the operation.--E. J.] but +the rest of the family had the cow-pox in the usual way, and were +not affected with the smallpox, although they were in the same +room, and the children slept in the same bed with their brother +who was confined to it with the natural smallpox; and +subsequently with their mother. + +"I attended this family with my brother, Mr. H. Jenner." + +The following cases are of too singular a nature to remain +unnoticed. + +Miss R--, a young lady about five years old, was seized on the +evening of the eighth day after inoculation with vaccine virus, +with such symptoms as commonly denote the accession of violent +fever. Her throat was also a little sore, and there were some +uneasy sensations about the muscles of the neck. The day +following a rash was perceptible on her face and neck, so much +resembling the efflorescence of the scarlatina anginosa that I +was induced to ask whether Miss R--had been exposed to the +contagion of that disease. An answer in the affirmative, and the +rapid spreading of the redness over the skin, at once relieved me +from much anxiety respecting the nature of the malady, which went +through its course in the ordinary way, but not without symptoms +which were alarming both to myself and Mr. Lyford, who attended +with me. There was no apparent deviation in the ordinary progress +of the pustule to a state of maturity from what we see in +general; yet there was a total suspension of the areola or florid +discolouration around it, until the scarlatina had retired from +the constitution. As soon as the patient was freed from this +disease this appearance advanced in the usual way. [Footnote: I +witnessed a similar fact in a case of measles. The pustule from +the cow-pock virus advanced to maturity, while the measles +existed in the constitution, but no EFFLORESCENCE appeared around +it until the measles had ceased to exert its influence.] + +The case of Miss H--R--is not less interesting than that of her +sister, above related. She was exposed to the contagion of the +scarlatina at the same time, and sickened almost at the same +hour. The symptoms continued severe about twelve hours, when the +scarlatina-rash shewed itself faintly upon her face, and partly +upon her neck. After remaining two or three hours it suddenly +disappeared, and she became perfectly free from every complaint. +My surprise at this sudden transition from extreme sickness to +health in great measure ceased when I observed that the +inoculated pustule had occasioned, in this case, the common +efflorescent appearance around it, and that as it approached the +centre it was nearly in an erysipelatous state. But the most +remarkable part of this history is that, on the fourth day +afterwards, so soon as the efflorescence began to die away upon +the arm and the pustule to dry up, the scarlatina again appeared, +her throat became sore, the rash spread all over her. She went +fairly through the disease with its common symptoms. + +That these were actually cases of scarlatina was rendered certain +by two servants in the family falling ill at the same time with +the distemper, who had been exposed to the infection with the +young ladies. + +Some there are who suppose the security from the smallpox +obtained through the cow-pox will be of a temporary nature only. +This supposition is refuted not only by analogy with respect to +the habits of diseases of a similar nature, but by +incontrovertible facts, which appear in great numbers against it. +To those already adduced in the former part of my first treatise +[Footnote: See pages 217, 218, 219, 221, 223, etc.] many more +might be adduced were it deemed necessary; but among the cases I +refer to, one will be found of a person who had the cow-pox +fifty-three years before the effect of the smallpox was tried +upon him. As he completely resisted it, the intervening period I +conceive must necessarily satisfy any reasonable mind. Should +further evidence be thought necessary, I shall observe that, +among the cases presented to me by Mr. Fry, Mr. Darke, Mr. +Tierny, Mr. H. Jenner, and others, there were many whom they +inoculated ineffectually with variolous matter, who had gone +through the cow-pox many years before this trial was made. + +It has been imagined that the cow-pox is capable of being +communicated from one person to another by effluvia without the +intervention of inoculation. My experiments, made with the design +of ascertaining this important point, all tend to establish my +original position, that it is not infectious except by contact, I +have never hesitated to suffer those on whose arms there were +pustules exhaling the effluvia from associating or even sleeping +with others who never had experienced either the cow-pox or the +smallpox. And, further, I have repeatedly, among children, caused +the uninfected to breathe over the inoculated vaccine 'pustules +during their whole progress, yet these experiments were tried +without the least effect. However, to submit a matter so +important to a still further scrutiny, I desired Mr. H. Jenner to +make any further experiments which might strike him as most +likely to establish or refute what had been advanced on this +subject. He has since informed me "that he inoculated children at +the breast, whose mothers had not gone through either the +smallpox or the cow-pox; that he had inoculated mothers whose +sucking infants had never undergone either of these diseases; +that the effluvia from the inoculated pustules, in either case, +had been inhaled from day to day during the whole progress of +their maturation, and that there was not the least perceptible +effect from these exposures." One woman he inoculated about a week +previous to her accouchement, that her infant might be the more +fully and conveniently exposed to the pustule; but, as in the +former instances, no infection was given, although the child +frequently slept on the arm of its mother with its nostrils and +mouth exposed to the pustule in the fullest state of maturity. In +a word, is it not impossible for the cow-pox, whose ONLY +manifestation appears to consist in the pustules CREATED BY +CONTACT, to produce ITSELF by effluvia? + +In the course of a late inoculation I observed an appearance +which it may be proper here to relate. The punctured part on a +boy's arm (who was inoculated with fresh limpid virus) on the +sixth day, instead of shewing a beginning vesicle, which is usual +in the cow-pox at that period, was encrusted over with a rugged, +amber-coloured scab. The scab continued to spread and increase in +thickness for some days, when, at its edges, a vesicated ring +appeared, and the disease went through its ordinary course, the +boy having had soreness in the axilla and some slight +indisposition. With the fluid matter taken from his arm five +persons were inoculated. In one it took no effect. In another it +produced a perfect pustule without any deviation from the common +appearance; but in the other three the progress of the +inflammation was exactly similar to the instance which afforded +the virus for their inoculation; there was a creeping scab of a +loose texture, and subsequently the formation of limpid fluid at +its edges. As these people were all employed in laborious +exercises, it is possible that these anomalous appearances might +owe their origin to the friction of the clothes on the newly +inflamed part of the arm. I have not yet had an opportunity of +exposing them to the smallpox. + +In the early part of this inquiry I felt far more anxious +respecting the inflammation of the inoculated arm than at +present; yet that this affection will go on to a greater extent +than could be wished is a circumstance sometimes to be expected. +As this can be checked, or even entirely subdued, by very simple +means, I see no reason why the patient should feel an uneasy hour +because an application may not be absolutely necessary. About the +tenth or eleventh day, if the pustule has proceeded regularly, +the appearance of the arm will almost to a certainty indicate +whether this is to be expected or not. Should it happen, nothing +more need be done than to apply a single drop of the aqua +lythargyri acetati [Footnote: Extract of Saturn.] upon the +pustule, and, having suffered it to remain two or three minutes, +to cover the efflorescence surrounding the pustule with a piece +of linen dipped in the aqua lythargyri compos. [Footnote: Goulard +water. For further information on this subject see the first +Treatise on the Var. Vac., Dr. Marshall's letters, etc.] The +former may be repeated twice or thrice during the day, the latter +as often as it may feel agreeable to the patient. + +When the scab is prematurely rubbed off (a circumstance not +unfrequent among children and working people), the application of +a little aqua lythargyri acet. to the part immediately coagulates +the surface, which supplies its place, and prevents a sore. + +In my former treatises on this subject I have remarked that the +human constitution frequently retains its susceptibility to the +smallpox contagion (both from effluvia and contact) after +previously feeling its influence. In further corroboration of +this declaration many facts have been communicated to me by +various correspondents. I shall select one of them. + +"DEAR SIR: + +"Society at large must, I think, feel much indebted to you for +your Inquiries and Observations on the Nature and Effects of the +Variolae Vaccinae, etc., etc. As I conceive what I am now about +to communicate to be of some importance, I imagine it cannot be +uninteresting to you, especially as it will serve to corroborate +your assertion of the susceptibility of the human system of the +variolous contagion, although it has previously been made +sensible of its action. In November, 1793, I was desired to +inoculate a person with the smallpox. I took the variolous matter +from a child under the disease in the natural way, who had a +large burthen of distinct pustules. The mother of the child being +desirous of seeing my method of communicating the disease by +inoculation, after having opened a pustule, I introduced the +point of my lancet in the usual way on the back part of my own +hand, and thought no more of it until I felt a sensation in the +part which reminded me of the transaction. This happened upon the +third day; on the fourth there were all the appearances common to +inoculation, at which I was not at all surprised, nor did I feel +myself uneasy upon perceiving the inflammation continue to +increase to the sixth and seventh day, accompanied with a very +small quantity of fluid, repeated experiments having taught me it +might happen so with persons who had undergone the disease, and +yet would escape any constitutional affection; but I was not so +fortunate; for on the eighth day I was seized with all the +symptoms of the eruptive fever, but in a much more violent degree +than when I was before inoculated, which was about eighteen years +previous to this, when I had a considerable number of pustules. I +must confess I was now greatly alarmed, although I had been much +engaged in the smallpox, having at different times inoculated not +less than two thousand persons. I was convinced my present +indisposition proceeded from the insertion of the variolous +matter, and, therefore, anxiously looked for an eruption. On the +tenth day I felt a very unpleasant sensation of stillness and +heat on each side of my face near my ear, and the fever began to +decline. The affection in my face soon terminated in three or +four pustules attended with inflammation, but which did not +maturate, and I was presently well. + "I remain, dear sir, etc., + "THOMAS MILES." + +This inquiry is not now so much in its infancy as to restrain me +from speaking more positively than formerly on the important +point of scrophula as connected with the smallpox. + +Every practitioner in medicine who has extensively inoculated +with the smallpox, or has attended many of those who have had the +distemper in the natural way, must acknowledge that he has +frequently seen scrophulous affections, in some form or another, +sometimes rather quickly shewing themselves after the recovery of +the patients. Conceiving this fact to be admitted, as I presume +it must be by all who have carefully attended to the subject, may +I not ask whether it does not appear probable that the general +introduction of the smallpox into Europe has not been among the +most conductive means in exciting that formidable foe to health? +Having attentively watched the effects of the cow-pox in this +respect, I am happy in being able to declare that the disease +does not appear to have the least tendency to produce this +destructive malady. + +The scepticism that appeared, even among the most enlightened of +medical men when my sentiments on the important subject of the +cow-pox were first promulgated, was highly laudable. To have +admitted the truth of a doctrine, at once so novel and so unlike +any thing that ever had appeared in the annals of medicine, +without the test of the most rigid scrutiny, would have bordered +upon temerity; but now, when that scrutiny has taken place, not +only among ourselves, but in the first professional circles in +Europe, and when it has been uniformly found in such abundant +instances that the human frame, when once it has felt the +influence of the genuine cow-pox in the way that has been +described, is never afterwards at any period of its existence +assailable by the smallpox, may I not with perfect confidence +congratulate my country and society at large on their beholding, +in the mild form of the cow-pox, an antidote that is capable of +extirpating from the earth a disease which is every hour +devouring its victims; a disease that has ever been considered as +the severest scourge of the human race! + + + + +THE CONTAGIOUSNESS OF PUERPERAL FEVER +BY +OLIVER WENDELL HOLMES + + +INTRODUCTORY NOTE + + +Oliver Wendell Holmes was born in Cambridge, Massachusetts, +August 29, 1809, and educated at Phillips Academy, Andover, and +Harvard College. After graduation, he entered the Law School, but +soon gave up law for medicine. He studied first in Boston, and +later spent two years in medical schools in Europe, mainly in +Paris. On his return he began to practise in Boston, but in two +years he was appointed professor of anatomy at Dartmouth College, +a position which he held from 1838 to 1840, when he again took up +his Boston practise. It was soon after this, in 1843, that he +published his essay on the "Contagiousness of Puerperal Fever," +his only contribution of high distinction to medical science. +From 1847 to 1882 he was Parkman professor of anatomy and +physiology in the Harvard Medical School. He died in Boston, +October 7, 1894. + +In spite of the importance of the paper here printed, Holmes's +reputation as a scientist was overshadowed by that won by him as +a wit and a man of letters. When he was only twenty-one his "Old +Ironsides" brought him into notice; and through his poetry and +fiction, and the sparkling talk of the "Breakfast Table" series, +he took a high place among the most distinguished group of +writers that America has yet produced. + + + + +THE CONTAGIOUSNESS OF PUERPERAL FEVER + +Note.--This essay appeared first in 1843, in The New England +Quarterly Journal of Medicine, and was reprinted in the "Medical +Essays" in 1855. + + +In collecting, enforcing and adding to the evidence accumulated +upon this most serious subject, I would not be understood to +imply that there exists a doubt in the mind of any well-informed +member of the medical profession as to the fact that puerperal +fever is sometimes communicated from one person to another, both +directly and indirectly. In the present state of our knowledge +upon this point I should consider such doubts merely as a proof +that the sceptic had either not examined the evidence, or, having +examined it, refused to accept its plain and unavoidable +consequences. I should be sorry to think, with Dr. Rigby, that it +was a case of "oblique vision"; I should be unwilling to force +home the argumentum ad hominem of Dr. Blundell, but I would not +consent to make a question of a momentous fact which is no longer +to be considered as a subject for trivial discussions, but to be +acted upon with silent promptitude. It signifies nothing that +wise and experienced practitioners have sometimes doubted the +reality of the danger in question; no man has the right to doubt +it any longer. No negative facts, no opposing opinions, be they +what they may, or whose they may, can form any answer to the +series of cases now within the reach of all who choose to explore +the records of medical science. + +If there are some who conceive that any important end would be +answered by recording such opinions, or by collecting the history +of all the cases they could find in which no evidence of the +influence of contagion existed, I believe they are in error. +Suppose a few writers of authority can be found to profess a +disbelief in contagion,--and they are very few compared with +those who think differently,--is it quite clear that they formed +their opinions on a view of all the facts, or is it not apparent +that they relied mostly on their own solitary experience? Still +further, of those whose names are quoted, is it not true that +scarcely a single one could, by any possibility, have known the +half or the tenth of the facts bearing on the subject which have +reached such a frightful amount within the last few years? Again, +as to the utility of negative facts, as we may briefly call +them,--instances, namely, in which exposure has not been followed +by disease,--although, like other truths, they may be worth +knowing, I do not see that they are like to shed any important +light upon the subject before us. Every such instance requires a +good deal of circumstantial explanation before it can be +accepted. It is not enough that a practitioner should have had a +single case of puerperal fever not followed by others. It must be +known whether he attended others while this case was in progress, +whether he went directly from one chamber to others, whether he +took any, and what, precautions. It is important to know that +several women were exposed to infection derived from the patient, +so that allowance may be made for want of predisposition. Now, if +of negative facts so sifted there could be accumulated a hundred +for every one plain instance of communication here recorded, I +trust it need not be said that we are bound to guard and watch +over the hundredth tenant of our fold, though the ninety and nine +may be sure of escaping the wolf at its entrance. If any one is +disposed, then, to take a hundred instances of lives, endangered +or sacrificed out of those I have mentioned, and make it +reasonably clear that within a similar time and compass TEN +THOUSAND escaped the same exposure, I shall, thank him for his +industry, but I must be permitted to hold to my own practical +conclusions, and beg him to adopt or at least to examine them +also. Children that walk in calico before open fires are not +always burned to death; the instances to the contrary may be +worth recording; but by no means if they are to be used as +arguments against woollen frocks and high fenders. + +I am not sure that this paper will escape another remark which it +might be wished were founded in justice. It may be said that the +facts are too generally known and acknowledged to require any +formal argument or exposition, that there is nothing new in the +positions advanced, and no need of laying additional statements +before the profession. But on turning to two works, one almost +universally, and the other extensively, appealed to as authority +in this country, I see ample reason to overlook this objection. +In the last edition of Dewees's Treatise on the "Diseases of +Females" it is expressly said, "In this country, under no +circumstance that puerperal fever has appeared hitherto, does it +afford the slightest ground for the belief that it is +contagious." In the "Philadelphia Practice of Midwifery" not one +word can be found in the chapter devoted to this disease which +would lead the reader to suspect that the idea of contagion had +ever been entertained. It seems proper, therefore, to remind +those who are in the habit of referring to the works for guidance +that there may possibly be some sources of danger they have +slighted or omitted, quite as important as a trifling +irregularity of diet, or a confined state of the bowels, and that +whatever confidence a physician may have in his own mode of +treatment, his services are of questionable value whenever he +carries the bane as well as the antidote about his person. + +The practical point to be illustrated is the following: THE +DISEASE KNOWN AS PUERPERAL FEVER IS SO FAR CONTAGIOUS AS TO BE +FREQUENTLY CARRIED FROM PATIENT TO PATIENT BY PHYSICIANS AND +NURSES. + +Let me begin by throwing out certain incidental questions, which, +without being absolutely essential, would render the subject more +complicated, and by making such concessions and assumptions as +may be fairly supposed to be without the pale of discussion. + +1. It is granted that all the forms of what is called puerperal +fever may not be, and probably are not, equally contagious or +infectious. I do not enter into the distinctions which have been +drawn by authors, because the facts do not appear to me +sufficient to establish any absolute line of demarcation between +such forms as may be propagated by contagion and those which are +never so propagated. This general result I shall only support by +the authority of Dr. Ramsbotham, who gives, as the result of his +experience, that the same symptoms belong to what he calls the +infectious and the sporadic forms of the disease, and the opinion +of Armstrong in his original Essay. If others can show any such +distinction, I leave it to them to do it. But there are cases +enough that show the prevalence of the disease among the patients +of a single practitioner when it was in no degree epidemic; in +the proper sense of the term. I may refer to those of Mr. +Roberton and of Dr. Peirson, hereafter to be cited, as examples. + +2. I shall not enter into any dispute about the particular MODE +of infection, whether it be by the atmosphere the physician +carries about him into the sick-chamber, or by the direct +application of the virus to the absorbing surfaces with which his +hand comes in contact. Many facts and opinions are in favour of +each of these modes of transmission. But it is obvious that, in +the majority of cases, it must be impossible to decide by which +of these channels the disease is conveyed, from the nature of the +intercourse between the physician and the patient. + +3. It is not pretended that the contagion of puerperal fever must +always be followed by the disease. It is true of all contagious +diseases that they frequently spare those who appear to be fully +submitted to their influence. Even the vaccine virus, fresh from +the subject, fails every day to produce its legitimate effect, +though every precaution is taken to insure its action. This is +still more remarkably the case with scarlet fever and some other +diseases. + +4. It is granted that the disease may be produced and variously +modified by many causes besides contagion, and more especially by +epidemic and endemic influences. But this is not peculiar to the +disease in question. There is no doubt that smallpox is +propagated to a great extent by contagion, yet it goes through +the same records of periodical increase and diminution which have +been remarked in puerperal fever. If the question is asked how we +are to reconcile the great variations in the mortality of +puerperal fever in different seasons and places with the +supposition of contagion, I will answer it by another question +from Mr. Farr's letter to the Registrar-General. He makes the +statement that "FIVE die weekly of smallpox in the metropolis +when the disease is not epidemic," and adds, "The problem for +solution is, Why do the five deaths become 10, 15, 20, 31, 58, +88, weekly, and then progressively fall through the same measured +steps?" + +5. I take it for granted that if it can be shown that great +numbers of lives have been and are sacrificed to ignorance or +blindness on this point, no other error of which physicians or +nurses may be occasionally suspected will be alleged in +palliation of this; but that whenever and wherever they can be +shown to carry disease and death instead of health and safety, +the common instincts of humanity will silence every attempt to +explain away their responsibility. + +The treatise of Dr. Gordon, of Aberdeen, was published in the +year 1795, being among the earlier special works upon the +disease. A part of his testimony has been occasionally copied +into other works, but his expressions are so clear, his +experience is given with such manly distinctness and +disinterested honesty, that it may be quoted as a model which +might have been often followed with advantage. + +"This disease seized such women only as were visited or delivered +by a practitioner, or taken care of by a nurse, who had +previously attended patients affected with the disease." + +"I had evident proofs of its infectious nature, and that the +infection was as readily communicated as that of the smallpox or +measles, and operated more speedily than any other infection with +which I am acquainted." + +"I had evident proofs that every person who had been with a +patient in the puerperal fever became charged with an atmosphere +of infection, which was communicated to every pregnant woman who +happened to come within its sphere. This is not an assertion, but +a fact, admitting of demonstration, as may be seen by a perusal +of the foregoing table"--referring to a table of seventy-seven +cases, in many of which the channel of propagation was evident. + +He adds: "It is a disagreeable declaration for me to mention, +that I myself was the means of carrying the infection to a great +number of women." He then enumerates a number of instances in +which the disease was conveyed by midwives and others to the +neighboring villages, and declares that "these facts fully prove +that the cause of the puerperal fever, of which I treat, was a +specific contagion, or infection, altogether unconnected with a +noxious constitution of the atmosphere." + +But his most terrible evidence is given in these words: "I +ARRIVED AT THAT CERTAINTY IN THE MATTER THAT I COULD VENTURE TO +FORETELL WHAT WOMEN WOULD BE AFFECTED WITH THE DISEASE, UPON +HEARING BY WHAT MIDWIFE THEY WERE TO BE DELIVERED, OR BY WHAT +NURSE THEY WERE TO BE ATTENDED, DURING THEIR LYING-IN: AND ALMOST +IN EVERY INSTANCE MY PREDICTION WAS VERIFIED." + +Even previously to Gordon, Mr. White, of Manchester, had said: "I +am acquainted with two gentlemen in another town, where the whole +business of midwifery is divided betwixt them, and it is very +remarkable that one of them loses several patients every year of +the puerperal fever, and the other never so much as meets with +the disorder"--a difference which he seems to attribute to their +various modes of treatment. [Footnote: On the Management of +Lying-in Women. p. 120.] + +Dr. Armstrong has given a number of instances in his Essay on +Puerperal Fever of the prevalence of the disease among the +patients of a single practitioner. At Sunderland, "in all, forty- +three cases occurred from the 1st of January to the 1st of +October, when the disease ceased; and of this number, forty were +witnessed by Mr. Gregson and his assistant, Mr. Gregory, the +remainder having been separately seen by three accoucheurs." +There is appended to the London edition of this Essay a letter +from Mr. Gregson, in which that gentleman says, in reference to +the great number of cases occurring in his practice, "The cause +of this I cannot pretend fully to explain, but I should be +wanting in common liberality if I were to make any hesitation in +asserting that the disease which appeared in my practice was +highly contagious, and communicable from one puerperal woman to +another." "It is customary among the lower and middle ranks of +people to make frequent personal visits to puerperal women +resident in the same neighborhood, and I have ample evidence for +affirming that the infection of the disease was often carried +about in that manner; and, however painful to my feelings, I must +in candour declare that it is very probable the contagion was +conveyed, in some instances, by myself, though I took every +possible care to prevent such a thing from happening the moment +that I ascertained that the distemper was infectious." Dr. +Armstrong goes on to mention six other instances within his +knowledge, in which the disease had at different times and places +been limited, in the same singular manner, to the practice of +individuals, while it existed scarcely, if at all, among the +patients of others around them. Two of the gentlemen became so +convinced of their conveying the contagion that they withdrew for +a time from practice. + +I find a brief notice, in an American journal, of another series +of cases, first mentioned by Mr. Davies, in the "Medical +Repository." This gentleman stated his conviction that the +disease is contagious. + +"In the autumn of 1822 he met with twelve cases, while his +medical friends in the neighbourhood did not meet with any, 'or +at least very few.' He could attribute this circumstance to no +other cause than his having been present at the examination after +death, of two cases, some time previous, and of his having +imparted the disease to his patients, notwithstanding every +precaution." [Footnote: Philad. Med. Journal for 1825, p. 408.] + +Dr. Gooch says: "It is not uncommon for the greater number of +cases to occur in the practice of one man, whilst the other +practitioners of the neighborhood, who are not more skilful or +more busy, meet with few or none. A practitioner opened the body +of a woman who had died of puerperal fever, and continued to wear +the same clothes. A lady whom he delivered a few days afterwards +was attacked with and died of a similar disease; two more of his +lying-in patients, in rapid succession, met with the same fate; +struck by the thought that he might have carried contagion in his +clothes, he instantly changed them, and met with no more cases of +the kind. [Footnote: A similar anecdote is related by Sir +Benjamin Brodie, of the late Dr. John Clark, Lancet, May 2, +1840.] A woman in the country who was employed as washerwoman and +nurse washed the linen of one who had died of puerperal fever; +the next lying-in patient she nursed died of the same disease; a +third nursed by her met the same fate, till the neighbourhood, +getting afraid of her, ceased to employ her." [Footnote: An +Account of Some of the Most Important Diseases Peculiar to Women, +p. 4]. + +In the winter of the year 1824, "several instances occurred of +its prevalence among the patients of particular practitioners, +whilst others who were equally busy met with few or none. One +instance of this kind was very remarkable. A general +practitioner, in large midwifery practice, lost so many patients +from puerperal fever that he determined to deliver no more for +some time, but that his partner should attend in his place. This +plan was pursued for one month, during which not a case of the +disease occurred in their practice. The elder practitioner, being +then sufficiently recovered, returned to his practice, but the +first patient he attended was attacked by the disease and died. A +physician who met him in consultation soon afterwards, about a +case of a different kind, and who knew nothing of his misfortune, +asked him whether puerperal fever was at all prevalent in his +neighbourhood, on which he burst into tears, and related the +above circumstances. + +"Among the cases which I saw this season in consultation, four +occurred in one month in the practice of one medical man, and all +of them terminated fatally." [Footnote: Gooch, op. cit., p. 71.] + +Dr. Ramsbotham asserted, in a lecture at the London Hospital, +that he had known the disease spread through a particular +district, or be confined to the practice of a particular person, +almost every patient being attacked with it, while others had not +a single case. It seemed capable, he thought, of conveyance, not +only by common modes, but through the dress of the attendants +upon the patient. [Footnote: Lond. Med. Gaz., May 2, 1835.] + +In a letter to be found in the "London Medical Gazette" for +January, 1840, Mr. Roberton, of Manchester, makes the statement +which I here give in a somewhat condensed form. + +A midwife delivered a woman on the 4th of December, 1830, who +died soon after with the symptoms of puerperal fever. In one +month from this date the same midwife delivered thirty women, +residing in different parts of an extensive suburb, of which +number sixteen caught the disease and all died. These were the +only cases which had occurred for a considerable time in +Manchester. The other midwives connected with the same charitable +institution as the woman already mentioned are twenty-five in +number, and deliver, on an average, ninety women a week, or about +three hundred and eighty a month. None of these women had a case +of puerperal fever. "Yet all this time this woman was crossing +the other midwives in every direction, scores of the patients of +the charity being delivered by them in the very same quarters +where her cases of fever were happening." + +Mr. Roberton remarks that little more than half the women she +delivered during this month took the fever; that on some days all +escaped, on others only one or more out of three or four; a +circumstance similar to what is seen in other infectious +maladies. + +Dr. Blundell says: "Those who have never made the experiment can +have but a faint conception how difficult it is to obtain the +exact truth respecting any occurrence in which feelings and +interests are concerned. Omitting particulars, then, I content +myself with remarking, generally, that from more than one +district I have received accounts of the prevalence of puerperal +fever in the practice of some individuals, while its occurrence +in that of others, in the same neighborhood, was not observed. +Some, as I have been told, have lost ten, twelve, or a greater +number of patients, in scarcely broken succession; like their +evil genius, the puerperal fever has seemed to stalk behind them +wherever they went. Some have deemed it prudent to retire for a +time from practice. In fine, that this fever may occur +spontaneously, I admit; that its infectious nature may be +plausibly disputed, I do not deny; but I add, considerately, that +in my own family I had rather that those I esteemed the most +should be delivered, unaided, in a stable, by the mangerside, +than that they should receive the best help, in the fairest +apartment, but exposed to the vapors of this pitiless disease. +Gossiping friends, wet-nurses, monthly nurses, the practitioner +himself, these are the channels by which, as I suspect, the +infection is principally conveyed." [Footnote: Lect. on +Midwifery, p. 395.] + +At a meeting of the Royal Medical and Chirurgical Society Dr. +King. mentioned that some years since a practitioner at Woolwich +lost sixteen patients from puerperal fever in the same year. He +was compelled to give up practice for one or two years, his +business being divided among the neighboring practitioners. No +case of puerperal fever occurred afterwards, neither had any of +the neighboring surgeons any cases of this disease. + +At the same meeting Mr. Hutchinson mentioned the occurrence of +three consecutive cases of puerperal fever, followed subsequently +by two others, all in the practice of one accoucheur. [Footnote: +Lancet, May 3, 1840.] Dr. Lee makes the following statement: "In +the last two weeks of September, 1827, five fatal cases of +uterine inflammation came under our observation. All the +individuals so attacked had been attended in labor by the same +midwife, and no example of a febrile or inflammatory disease of a +serious nature occurred during that period among the other +patients of the Westminster General Dispensary, who had been +attended by the other midwives belonging to that institution." +[Footnote: Lond. Cyc. of Pract. Med., art., "Fever, Puerperal"] + +The recurrence of long series of cases like those I have cited, +reported by those most interested to disbelieve in contagion, +scattered along through an interval of half a century, might have +been thought sufficient to satisfy the minds of all inquirers +that here was something more than a singular coincidence. But if, +on a more extended observation, it should be found that the same +ominous groups of cases clusterings about individual +practitioners were observed in a remote country, at different +times, and in widely separated regions, it would seem incredible +that any should be found too prejudiced or indolent to accept the +solemn truth knelled into their ears by the funeral bells from +both sides of the ocean--the plain conclusion that the physician +and the disease entered, hand in hand, into the chamber of the +unsuspecting patient. + +That such series of cases have been observed in this country, and +in this neighborhood, I proceed to show. + +In Dr. Francis's "Notes to Denman's Midwifery" a passage is cited +from Dr. Hosack in which he refers to certain puerperal cases +which proved fatal to several lying-in women, and in some of +which the disease was supposed to be conveyed by the accoucheurs +themselves. [Footnote: Denman's Midwifery, p. 673, third Am. ed.] + +A writer in the "New York Medical and Physical Journal" for +October, 1829, in speaking of the occurrence of puerperal fever +confined to one man's practice, remarks: "We have known cases of +this kind occur, though rarely, in New York." + +I mention these little hints about the occurrence of such cases +partly because they are the first I have met with in American +medical literature, but more especially because they serve to +remind us that behind the fearful array of published facts there +lies a dark list of similar events, unwritten in the records of +science, but long remembered by many a desolated fireside. + +Certainly nothing can be more open and explicit than the account +given by Dr. Peirson, of Salem, of the cases seen by him. In the +first nineteen days of January, 1829, he had five consecutive +cases of puerperal fever, every patient he attended being +attacked, and the three first cases proving fatal. In March of +the same year he had two moderate cases, in June, another case, +and in July, another, which proved fatal. "Up to this period," he +remarks, "I am not informed that a single case had occurred in +the practice of any other physician. Since that period I have had +no fatal case in my practice, although I have had several +dangerous cases. I have attended in all twenty cases of this +disease, of which four have been fatal. I am not aware that there +has been any other case in the town of distinct puerperal +peritonitis, although I am willing to admit my information may be +very defective on this point. I have been told of some 'mixed +cases,' and 'morbid affections after delivery.'" [Footnote: +Remarks on Puerperal Fever, pp. 12 and 13.] + +In the "Quarterly Summary of the Transactions of the College of +Physicians of Philadelphia" [Footnote: For May, June, and July, +1842.] may be found some most extraordinary developments +respecting a series of cases occurring in the practice of a +member of that body. + +Dr. Condie called the attention of the Society to the prevalence, +at the present time, of puerperal fever of a peculiarly insidious +and malignant character. "In the practice of one gentleman +extensively engaged as an obstetrician nearly every female he has +attended in confinement, during several weeks past, within the +above limits" (the southern sections and neighboring districts), +"had been attacked by the fever." + +"An important query presents itself, the doctor observed, in +reference to the particular form of fever now prevalent. Is it, +namely, capable of being propagated by contagion, and is a +physician who has been in attendance upon a case of the disease +warranted in continuing, without interruption, his practice as an +obstetrician? Dr. C., although not a believer in the contagious +character of many of those affections generally supposed to be +propagated in this manner, has, nevertheless, become convinced by +the facts that have fallen under his notice that the puerperal +fever now prevailing is capable of being communicated by +contagion. How, otherwise, can be explained the very curious +circumstance of the disease in one district being exclusively +confined to the practice of a single physician, a Fellow of this +College, extensively engaged in obstetrical practice, while no +instance of the disease has occurred in the patients under the +care of any other accoucheur practising within the same district; +scarcely a female that has been delivered for weeks past has +escaped an attack?" + +Dr. Rutter, the practitioner referred to, "observed that, after +the occurrence of a number of cases of the disease in his +practice, he had left the city and remained absent for a week, +but, on returning, no article of clothing he then wore having +been used by him before, one of the very first cases of +parturition he attended was followed by an attack of the fever +and terminated fatally; he cannot readily, therefore, believe in +the transmission of the disease from female to female in the +person or clothes of the physician." + +The meeting at which these remarks were made was held on the 3d +of May, 1842. In a letter dated December 20, 1842, addressed to +Dr. Meigs, and to be found in the "Medical Examiner," [Footnote: +For January 21, 1843.] he speaks of "those horrible cases of +puerperal fever, some of which you did me the favor to see with +me during the past summer," and talks of his experience in the +disease, "now numbering nearly seventy cases, all of which have +occurred within less than a twelve-month past." + +And Dr. Meigs asserts, on the same page, "Indeed, I believe that +his practice in that department of the profession was greater +than that of any other gentleman, which was probably the cause of +his seeing a greater number of the cases." This from a professor +of midwifery, who some time ago assured a gentleman whom he met +in consultation that the night on which they met was the +eighteenth in succession that he himself had been summoned from +his repose, [Footnote: Medical Examiner for December 10, 1842.] +seems hardly satisfactory. + +I must call the attention of the inquirer most particularly to +the Quarterly Report above referred to, and the letters of Dr. +Meigs and Dr. Rutter, to be found in the "Medical Examiner." +Whatever impression they may produce upon his mind, I trust they +will at least convince him that there is some reason for looking +into this apparently uninviting subject. + +At a meeting of the College of Physicians just mentioned Dr. +Warrington stated that a few days after assisting at an autopsy +of puerperal peritonitis, in which he laded out the contents of +the abdominal cavity with his hands, he was called upon to +deliver three women in rapid succession. All of these women were +attacked with different forms of what is commonly called +puerperal fever. Soon after these he saw two other patients, both +on the same day, with the same disease. Of these five patients, +two died. + +At the same meeting Dr. West mentioned a fact related to him by +Dr. Samuel Jackson, of Northumberland. Seven females, delivered +by Dr. Jackson in rapid succession, while practising in +Northumberland County, were all attacked with puerperal fever, +and five of them died. "Women," he said, "who had expected me to +attend upon them, now becoming alarmed, removed out of my reach, +and others sent for a physician residing several miles distant. +These women, as well as those attended by midwives, all did well; +nor did we hear of any deaths in child-bed within a radius of +fifty miles, excepting two, and these I afterwards ascertained to +have been caused by other diseases." He underwent, as he thought, +a thorough purification, and still his next patient was attacked +with the disease and died. He was led to suspect that the +contagion might have been carried in the gloves which he had worn +in attendance upon the previous cases. Two months or more after +this he had two other cases. He could find nothing to account for +these unless it were the instruments for giving enemata, which +had been used in two of the former cases and were employed by +these patients. When the first case occurred, he was attending +and dressing a limb extensively mortified from erysipelas, and +went immediately to the accouchement with his clothes and gloves +most thoroughly imbued with its effluvia. And here I may mention +that this very Dr. Samael Jackson, of Northumberland, is one of +Dr. Dewees's authorities against contagion. + +The three following statements are now for the first time given +to the public. All of the cases referred to occurred within this +State, and two of the three series in Boston and its immediate +vicinity. + +I. The first is a series of cases which took place during the +last spring in a town at some distance from this neighborhood. A +physician of that town, Dr. C, Had the following consecutive +cases: + + No. 1, delivered March 20, died March 24. + " 2, " April 9, " April 14. + " 3, " " 10, " " 14. + " 4, " " 11, " " 18. + " 5, " " 27, " May 3. + " 6, " " 28, had some symptoms, recovered. + " 7, " May 8, had some symptoms, also recovered. + +These were the only cases attended by this physician during the +period referred to, "They were all attended by him until their +termination, with the exception of the patient No. 6, who fell +into the hands of another physician on the 2d of May." (Dr. C. +left town for a few days at this time.) Dr. C. attended cases +immediately before and after the above-named periods, none of +which, however, presented any peculiar symptoms of the disease. + +About the 1st of July he attended another patient in a +neighboring village, who died two or three days after delivery. + +The first patient, it is stated, was delivered on the 20th of +March. "On the 19th Dr. C. made the autopsy of a man who had died +suddenly, sick only forty-eight hours; had oedema of the thigh +and gangrene extending from a little above the ankle into the +cavity of the abdomen." Dr. C. wounded himself very slightly in +the right hand during the autopsy. The hand was quite painful the +night following, during his attendance on the patient No. 1. He +did not see this patient after the 20th, being confined to the +house, and very sick from the wound just mentioned, from this +time until the 3d of April. + +Several cases of erysipelas occurred in the house where the +autopsy mentioned above took place, soon after the examination. +There were also many cases of erysipelas in town at the time of +the fatal puerperal cases which have been mentioned. + +The nurse who laid out the body of the patient No. 3 was taken on +the evening of the same day with sore throat and erysipelas, and +died in ten days from the first attack. + +The nurse who laid out the body of the patient No. 4 was taken on +the day following with symptoms like those of this patient, and +died in a week, without any external marks of erysipelas. + +"No other cases of similar character with those of Dr. C. +occurred in the practice of any of the physicians in the town or +vicinity at the time. Deaths following confinement have occurred +in the practice of other physicians during the past year, but +they were not cases of puerperal fever. No post-mortem +examinations were held in any of these puerperal cases." + +Some additional statements in this letter are deserving of +insertion: + +"A physician attended a woman in the immediate neighborhood of +the cases numbered 2, 3, and 4. This patient was confined the +morning of March 1st, and died on the night of Match 7th. It is +doubtful whether this should be considered a case of puerperal +fever. She had suffered from canker, indigestion, and diarrhoea +for a year previous to her delivery. Her complaints were much +aggravated for two or three months previous to delivery; she had +become greatly emaciated, and weakened to such an extent that it +had not been expected that she would long survive her +confinement, if indeed she reached that period. Her labor was +easy enough; she flowed a good deal, seemed exceedingly +prostrated, had ringing in her ears, and other symptoms of +exhaustion; the pulse was quick and small. On the second and +third day there was some tenderness and tumefaction of the +abdomen, which increased somewhat on the fourth and fifth. He had +cases in midwifery before and after this, which presented nothing +peculiar. + +It is also mentioned in the same letter that another physician +had a case during the last summer and another last fall, both of +which recovered. + +Another gentleman reports a case last December, a second case +five weeks, and another three weeks, since. All these recovered, +A case also occurred very recently in the practice of a physician +in the village where the eighth patient of Dr. C. resides, which +proved fatal "This patient had some patches of erysipelas on the +legs and arms. The same physician has delivered three cases +since, which have all done well. There have been no other cases +in this town or its vicinity recently. There have been some few +cases of erysipelas." It deserves notice that the partner of Dr. +C, who attended the autopsy of the man above mentioned and took +an active part in it, who also suffered very slightly from a +prick under the thumb-nail received during the examination, had +twelve cases of midwifery between March 26th and April 12th, all +of which did well, and presented no peculiar symptoms. It should +also be stated that during these seventeen days he was in +attendance on all the cases of erysipelas in the house where the +autopsy had been performed. I owe these facts to the prompt +kindness of a gentleman whose intelligence and character are +sufficient guaranty for their accuracy. + +The two following letters were addressed to my friend Dr. Storer +by the gentleman in whose practice the cases of puerperal fever +occurred. His name renders it unnecessary to refer more +particularly to these gentlemen, who on their part have +manifested the most perfect freedom and courtesy in affording +these accounts of their painful experience. + +"January 38, 1843. + +II ... "The time to which you allude was in 1830. The first case +was in February, during a very cold time. She was confined the +4th, and died the 12th. Between the 10th and 28th of this month I +attended six women in labor, all of whom did well except the +last, as also two who were confined March 1st and 5th. Mrs. E., +confined February 28th, sickened, and died March 8th. The next +day, 9th, I inspected the body, and the night after attended a +lady, Mrs. B., who sickened, and died 16th. The 10th, I attended +another, Mrs. G., who sickened, but recovered. March 16th I went +from Mrs. G.'s room to attend a Mrs. H., who sickened, and died +21st. The 17th, I inspected Mrs. B. On the 19th, I went directly +from Mrs. H.'s room to attend another lady, Mrs. G., who also +sickened, and died 22d. While Mrs. B. was sick, on 15th, I went +directly from her room a few rods, and attended another woman, +who was not sick. Up to 20th of this month I wore the same +clothes. I now refused to attend any labor, and did not till +April 21st, when, having thoroughly cleansed myself, I resumed my +practice, and had no more puerperal fever. + +"The cases were not confined to a narrow space. The two nearest +were half a mile from each other, and half that distance from my +residence. The others were from two to three miles apart, and +nearly that distance from my residence. There were no other cases +in their immediate vicinity which came to my knowledge. The +general health of all the women was pretty good, and all the +labors as good as common, except the first. This woman, in +consequence of my not arriving in season, and the child being +half-born at some time before I arrived, was very much exposed to +the cold at the time of confinement, and afterwards, being +confined in a very open, cold room. Of the six cases, you +perceive only one recovered. + +"In the winter of 1817 two of my patients had puerperal fever, +one very badly, the other not so badly. Both recovered. One other +had swelled leg or phlegmasia dolens, and one or two others did +not recover as well as usual. + +"In the summer of 1835 another disastrous period occurred in my +practice. July 1st I attended a lady in labor, who was afterwards +quite ill and feverish; but at the time I did not consider her +case a decided puerperal fever. On the 8th I attended one who did +well. On the 12th, one who was seriously sick. This was also an +equivocal case, apparently arising from constipation and +irritation of the rectum. These women were ten miles apart and +five from my residence. On 15th and 2Oth two who did well. On +25th I attended another. This was a severe labor, and followed by +unequivocal puerperal fever, or peritonitis. She recovered. +August 2nd and 3rd, in about twenty-four hours, I attended four +persons. Two of them did very well; one was attacked with some of +the common symptoms, which, however, subsided in a day or two, +and the other had decided puerperal fever, but recovered. This +woman resided five miles from me. Up to this time I wore the same +coat. All my other clothes had frequently been changed. On 6th, I +attended two women, one of whom was not sick at all; but the +other, Mrs. L., was afterwards taken ill. On 10th, I attended a +lady, who did very well. I had previously changed all my clothes, +and had no garment on which had been in a puerperal room. On +12th, I was called to Mrs. S., in labor. While she was ill, I +left her to visit Mrs. L., one of the ladies who was confined on +6th. Mrs. L. had been more unwell than usual, but I had not +considered her case anything more than common till this visit. I +had on a surtout at this visit, which, on my return to Mrs. S., I +left in another room. Mrs. S. was delivered on 13th with forceps. +These women both died of decided puerperal fever. + +"While I attended these women in their fevers I changed my +clothes, and washed my hands in a solution of chloride of lime +after each visit. I attended seven women in labor during this +period, all of whom recovered without sickness. + +"In my practice I have had several single cases of puerperal +fever, some of whom have died and some have recovered. Until the +year 1830 I had no suspicion that the disease could be +communicated from one patient to another by a nurse or midwife; +but I now think the foregoing facts strongly favor that idea. I +was so much convinced of this fact that I adopted the plan before +related. + +"I believe my own health was as good as usual at each of the +above periods. I have no recollection to the contrary. + +"I believe I have answered all your questions. I have been more +particular on some points perhaps than necessary; but I thought +you could form your own opinion better than to take mine. In 1830 +I wrote to Dr. Channing a more particular statement of my cases. +If I have not answered your questions sufficiently, perhaps Dr. +C. may have my letter to him, and you can find your answer +there." [Footnote: In a letter to myself this gentleman also +stated," I do not recollect that there was any erysipelas or any +other disease particularly prevalent at the time."] + +"Boston, February 3, 1843. + +III. "My Dear Sir: I received a note from you last evening +requesting me to answer certain questions therein proposed, +touching the cases of puerperal fever which came under my +observation the past summer. It gives me pleasure to comply with +your request, so far as it is in my power so to do, but, owing to +the hurry in preparing for a journey, the notes of the cases I +had then taken were lost or mislaid. The principal facts, +however, are too vivid upon my recollection to be soon forgotten. +I think, therefore, that I shall be able to give you all the +information you may require. + +"All the cases that occurred in my practice took place between +the 7th of May and the 17th of June, 1842. + +They were not confined to any particular part of the city. The +first two cases were patients residing at the South End, the next +was at the extreme North End, one living in Sea Street and the +other in Roxbury. The following is the order in which they +occurred: + +"CASE 1.--Mrs.-- was confined on the 7th of May, at 5 o'clock, P. +M., after a natural labor of six hours. At 12 o'clock at night, +on the 9th (thirty-one hours after confinement), she was taken +with severe chill, previous to which she was as comfortable as +women usually are under the circumstances. She died on the 10th. + +"CASE 2.--Mrs.-- was confined on the 10th of June (four weeks +after Mrs. C), at 11 A. M., after a natural, but somewhat severe, +labor of five hours. At 7 o'clock, on the morning of the 11th, +she had a chill. Died on the 12th. + +"CASE 3.--Mrs.--, confined on the 14th of June, was comfortable +until the 18th, when symptoms of puerperal fever were manifest. +She died on the 20th. + +"CASE 4.--Mrs.--, confined June 17th, at 5 o'clock, A. M., was +doing well until the morning of the 19th. She died on the evening +of the 21st. + +"CASE 5.--Mrs.--was confined with her FIFTH child on the 17th of +June, at 6 o'clock in the evening. This patient had been attacked +with puerperal fever, at three of her previous confinements, but +the disease yielded to depletion and other remedies without +difficulty. This time, I regret to say, I was not so fortunate. +She was not attacked, as were the other patients, with a chill, +but complained of extreme pain in the abdomen, and tenderness on +pressure, almost from the moment of her confinement. In this, as +in the other cases, the disease resisted all remedies, and she +died in great distress on the 22d of the same month. Owing to the +extreme heat of the season and my own indisposition, none of the +subjects were examined after death. Dr. Channing, who was in +attendance with me on the three last cases, proposed to have a +post-mortem examination of the subject of case No. 5, but from +some cause which I do not now recollect it was not obtained. + +"You wish to know whether I wore the same clothes when attending +the different cases. I cannot positively say, but I should think +I did not, as the weather became warmer after, the first two +cases; I therefore think it probable that I made a change of at +least a PART of my dress. I have had no other case of puerperal +fever in my own practice for three years, save those above +related, and I do not remember to have lost a patient before with +this disease. While absent, last July, I visited two patients +sick with puerperal fever, with a friend of mine in the country. +Both of them recovered. + +"The cases that I have recorded were not confined to any +particular constitution or temperament, but it seized upon the +strong and the weak, the old and the young--one being over forty +years, and the youngest under eighteen years of age... If the +disease is of an erysipelatous nature, as many suppose, +contagionists may perhaps find some ground for their belief in +the fact that, for two weeks previous to my first case of +puerperal fever, I had been attending a severe case of +erysipelas, and the infection may have been conveyed through me +to the patient; but, on the other hand, why is not this the case +with other physicians, or with the same physician at all times, +for since my return from the country I have had a more inveterate +case of erysipelas than ever before, and no difficulty whatever +has attended any of my midwifery cases?" + +I am assured, on unquestionable authority, that "about three +years since a gentleman in extensive midwifery business, in a +neighboring State, lost in the course of a few weeks eight +patients in child-bed, seven of them being undoubted cases of +puerperal fever. No other physician of the town lost a single +patient of this disease during the same period." And from what I +have heard in conversation with some of our most experienced +practitioners, I am inclined to think many cases of the kind +might be brought to light by extensive inquiry. + +This long catalogue of melancholy histories assumes a still +darker aspect when we remember how kindly nature deals with the +parturient female, when she is not immersed in the virulent +atmosphere of an impure lying-in hospital, or poisoned in her +chamber by the unsuspected breath of contagion. From all causes +together not more than four deaths in a thousand births and +miscarriages happened in England and Wales during the period +embraced by the first Report of the Registrar-General. [Footnote: +First Report, p. 105.] In the second Report the mortality was +shown to be about five in one thousand. [Footnote: Second Report, +p. 73.] In the Dublin Lying-in Hospital, during the seven years +of Dr. Collins's mastership, there was one case of puerperal +fever to 178 deliveries, or less than six to the thousand, and +one death from this disease in 278 cases, or between three and +four to the thousand. [Footnote: Collins's Treatise on Midwifery, +p. 228, etc.] Yet during this period the disease was endemic in +the hospital, and might have gone on to rival the horrors of the +pestilence of the Maternite, had not the poison been destroyed by +a thorough purification. + +In private practice, leaving out of view the cases that are to be +ascribed to the self-acting system of propagation, it would seem +that the disease must be far from common. Mr. White, of +Manchester, says: "Out of the whole number of lying-in patients +whom I have delivered (and I may safely call it a great one), I +have never lost one, nor to the best of my recollection has one +been greatly endangered, by the puerperal, miliary, low nervous, +putrid malignant, or milk fever." [Footnote: Op. cit., p. 115.] +Dr. Joseph Clarke informed Dr. Collins that in the course of +FORTY-FIVE years' most extensive practice he lost but FOUR +patients from this disease. [Footnote: Op. cit., p.228.] One of +the most eminent practitioners of Glasgow who has been engaged in +very extensive practice for upwards of a quarter of a century +testifies that he never saw more than twelve cases of real +puerperal fever. [Footnote: Lancet, May 4, 1833.] + +I have myself been told by two gentlemen practicing in this city, +and having for many years a large midwifery business, that they +had neither of them lost a patient from this disease, and by one +of them that he had only seen it in consultation with other +physicians. In five hundred cases of midwifery, of which Dr. +Storer has given an abstract in the first number of this journal, +there was only one instance of fatal puerperal peritonitis. + +In the view of these facts it does appear a singular coincidence +that one man or woman should have ten, twenty, thirty, or seventy +cases of this rare disease following his or her footsteps with +the keenness of a beagle, through the streets and lanes of a +crowded city, while the scores that cross the same paths on the +same errands know it only by name. It is a series of similar +coincidences which has led us to consider the dagger, the musket, +and certain innocent-looking white powders as having some little +claim to be regarded as dangerous. It is the practical +inattention to similar coincidences which has given rise to the +unpleasant but often necessary documents called INDICTMENTS, +which has sharpened a form of the cephalotome sometimes employed +in the case of adults, and adjusted that modification of the +fillet which delivers the world of those who happen to be too +much in the way while such striking coincidences are taking +place. + +I shall now mention a few instances in which the disease appears +to have been conveyed by the process of direct inoculation. + +Dr. Campbell, of Edinburgh, states that in October, 1821, he +assisted at the post-mortem examination of a patient who died +with puerperal fever. He carried the pelvic viscera in his pocket +to the class-room. The same evening he attended a woman in labor +without previously changing his clothes; this patient died. The +next morning he delivered a woman with the forceps; she died +also, and of many others who were seized with the disease within +a few weeks, three shared the same fate in succession. + +In June, 1823, he assisted some of his pupils at the autopsy of a +case of puerperal fever. He was unable to wash his hands with +proper care, for want of the necessary accommodations. On getting +home he found that two patients required his assistance. He went +without further ablution or changing his clothes; both these +patients died with puerperal fever. [Footnote: Lond. Med. +Gazette, December 10, 1831.] This same Dr. Campbell is one of Dr. +Churchill's authorities against contagion. + +Mr. Roberton says that in one instance within his knowledge a +practitioner passed the catheter for a patient with puerperal +fever late in the evening; the same night he attended a lady who +had the symptoms of the disease on the second day. In another +instance a surgeon was called while in the act of inspecting the +body of a woman who had died of this fever, to attend a labor; +within forty-eight hours this patient was seized with the fever +[Footnote: Ibid. for January 1832]. + +On the 16th of March, 1831, a medical practitioner examined the +body of a woman who had died a few days after delivery, from +puerperal peritonitis. On the evening of the 17th he delivered a +patient, who was seized with puerperal fever on the 19th, and +died on the 24th. Between this period and the 6th of April the +same practitioner attended two other patients, both of whom were +attacked with the same disease and died. [Footnote: London Cyc. +of Pract. Med., art., "Fever, Puerperal."] + +In the autumn of 1829 a physician was present at the examination +of a case of puerperal fever, dissected out the organs, and +assisted in sewing up the body. He had scarcely reached home when +he was summoned to attend a young lady in labor. In sixteen hours +she was attacked with the symptoms of puerperal fever, and +narrowly escaped with her life. [Footnote: Ibid.] + +In December, 1830, a midwife, who had attended two fatal cases of +puerperal fever at the British Lying-in Hospital, examined a +patient who had just been admitted, to ascertain if labor had +commenced. This patient remained two days in the expectation that +labor would come on, when she returned home and was then suddenly +taken in labor and delivered before she could set out for the +hospital. She went on favorably for two days, and was then taken +with puerperal fever and died in thirty-six hours. [Footnote: +Ibid.] + +A young practitioner, contrary to advice, examined the body of a +patient who had died from puerperal fever; there was no epidemic +at the time; the case appeared to be purely sporadic. He +delivered three other women shortly afterwards; they all died +with puerperal fever, the symptoms of which broke out very soon +after labor. The patients of his colleague did well, except one, +where he assisted to remove some coagula from the uterus; she was +attacked in the same manner as those whom he had attended, and +died also." The writer in the "British and Foreign Medical +Review," from whom I quote this statement,--and who is no other +than Dr. Rigby,--adds: "We trust that this fact alone will +forever silence such doubts, and stamp the well-merited epithet +of 'criminal,' as above quoted, upon such attempts [Footnote: +Brit. and For. Medical Review for January, 1842, p. 112.] + +From the cases given by Mr. Ingleby I select the following: Two +gentlemen, after having been engaged in conducting the post- +mortem examination of a case of puerperal fever, went in the same +dress, each respectively, to a case of midwifery. "The one +patient was seized with the rigor about thirty hours afterwards. +The other patient was seized with a rigor the third morning after +delivery. ONE RECOVERED, ONE DIED." [Footnote: Edin. Med. and +Surg. Journal, April 1838.] One of these same gentlemen attended +another woman in the same clothes two days after the autopsy +referred to. "The rigor did not take place until the evening of +the fifth day from the first visit. RESULT FATAL." These cases +belonged to a series of seven, the first of which was thought to +have originated in a case of erysipelas. "Several cases of a mild +character followed the foregoing seven, and their nature being +now most unequivocal, my friend declined visiting all midwifery +cases for a time, and there was no recurrence of the disease." +These cases occurred in 1833. Five of them proved fatal. Mr. +Ingleby gives another series of seven cases which occurred to a +practitioner in 1836, the first of which was also attributed to +his having opened several erysipelatous abscesses a short time +previously. + +I need not refer to the case lately read before this society, in +which a physician went, soon after performing an autopsy of a +case of puerperal fever, to a woman in labor, who was seized with +the same disease and perished. The forfeit of that error has been +already paid. + +At a meeting of the Medical and Chirurgical Society before +referred to, Dr. Merriman related an instance occurring in his +own practice, which excites a reasonable suspicion that two lives +were sacrificed to a still less dangerous experiment. He was at +the examination of a case of puerperal fever at two o'clock in +the afternoon. HE TOOK CARE NOT TO TOUCH THE BODY. At nine +o'clock the same evening he attended a woman in labor; she was so +nearly delivered that he had scarcely anything to do. The next +morning she had severe rigors, and in forty-eight hours she was a +corpse. Her infant had erysipelas and died in two days. +[Footnote: Lancet, May 2, 1840.] + +In connection with the facts which have been stated it seems +proper to allude to the dangerous and often fatal effects which +have followed from wounds received in the post-mortem examination +of patients who have died of puerperal fever. The fact that such +wounds are attended with peculiar risk has been long noticed. I +find that Chaussier was in the habit of cautioning his students +against the danger to which they were exposed in these +dissections. [Footnote: Stein, L'Art d'Accoucher, 1794; Dict. des +Sciences Medicales, art., "Puerperal."] The head pharmacien of +the Hotel Dieu, in his analysis of the fluid effused in puerperal +peritonitis, says that practitioners are convinced of its +deleterious qualities, and that it is very dangerous to apply it +to the denuded skin. [Footnote: Journal de Pharmacie, January +1836.] Sir Benjamin Brodie speaks of it as being well known that +the inoculation of lymph or pus from the peritoneum of a +puerperal patient is often attended with dangerous and even fatal +symptoms. Three cases in confirmation of this statement, two of +them fatal, have been reported to this society within a few +months. + +Of about fifty cases of injuries of this kind, of various degrees +of severity, which I have collected from different sources, at +least twelve were instances of infection from puerperal +peritonitis. Some of the others are so stated as to render it +probable that they may have been of the same nature. Five other +cases were of peritoneal inflammation; three in males. Three were +what was called enteritis, in one instance complicated with +erysipelas; but it is well known that this term has been often +used to signify inflammation of the peritoneum covering the +intestines. On the other hand, no case of typhus or typhoid fever +is mentioned as giving rise to dangerous consequences, with the +exception of the single instance of an undertaker mentioned by +Mr. Travers, who seems to have been poisoned by a fluid which +exuded from the body. The other accidents were produced by +dissection, or some other mode of contact with bodies of patients +who had died of various affections. They also differed much in +severity, the cases of puerperal origin being among the most +formidable and fatal. Now a moment's reflection will show that +the number of cases of serious consequences ensuing from the +dissection of the bodies of those who had perished of puerperal +fever is so vastly disproportioned to the relatively small number +of autopsies made in this complaint as compared with typhus or +pneumonia (from which last disease not one case of poisoning +happened), and still more from all diseases put together, that the +conclusion is irresistible that a most fearful morbid poison is +often generated in the course of this disease. Whether or not it +is sui generis confined to this disease, or produced in some +others, as, for instance, erysipelas, I need not stop to inquire. + +In connection with this may be taken the following statement of +Dr. Rigby: "That the discharges from a patient under puerperal +fever are in the highest degree contagious we have abundant +evidence in the history of lying-in hospitals. The puerperal +abscesses are also contagious, and may be communicated to healthy +lying-in women by washing with the same sponge; this fact has +been repeatedly proved in the Vienna Hospital; but they are +equally communicable to women not pregnant; on more than one +occasion the women engaged in washing the soiled bed-linen of the +General Lying-in Hospital have been attacked with abscesses in +the fingers or hands, attended with rapidly spreading +inflammation of the cellular tissue."[Footnote: System of +Midwifery, p. 292] + +Now add to all this the undisputed fact that within the walls of +lying-in hospitals there is often generated a miasm, palpable as +the chlorine used to destroy it, tenacious so as in some cases +almost to defy extirpation, deadly in some institutions as the +plague; which has killed women in a private hospital of London so +fast that they were buried two in one coffin to conceal its +horrors; which enabled Tonnelle to record two hundred and twenty- +two autopsies at the Maternite of Paris; which has led Dr. Lee to +express his deliberate conviction that the loss of life +occasioned by these institutions completely defeats the objects +of their founders; and out of this train of cumulative evidence, +the multiplied groups of cases clustering about individuals, the +deadly results of autopsies, the inoculation by fluids from the +living patient, the murderous poison of hospitals--does there not +result a conclusion that laughs all sophistry to scorn, and +renders all argument an insult? + +I have had occasion to mention some instances in which there was +an apparent relation between puerperal fever and erysipelas. The +length to which this paper has extended does not allow me to +enter into the consideration of this most important subject. I +will only say that the evidence appears to me altogether +satisfactory that some most fatal series of puerperal fever have +been produced by an infection originating in the matter or +effluvia of erysipelas. In evidence of some connection between +the two diseases, I need not go back to the older authors, as +Pouteau or Gordon, but will content myself with giving the +following references, with their dates; from which it will be +seen that the testimony has been constantly coming before the +profession for the last few years: + +"London Cyclopaedia of Practical Medicine," article "Puerperal +Fever," 1833. + +Mr. Ceeley's Account of the Puerperal Fever at Aylesbury, +"Lancet," 1835. + +Dr. Ramsbotham's Lecture, "London Medical Gazette," 1835. + +Mr. Yates Ackerly's Letter in the same journal, 1838. + +Mr. Ingleby on Epidemic Puerperal Fever, "Edinburgh Medical and +Surgical Journal," 1838. + +Mr. Paley's Letter, "London Medical Gazette," 1839. + +Remarks at the Medical and Chirurgical Society, "Lancet," 1840. + +Dr. Rigby's "System of Midwifery," 1841. + +"Nunneley on Erysipelas," a work which contains a large number of +references on the subject, 1841. + +"British and Foreign Quarterly Review," 1842. + +Dr. S. Jackson, of Northumberland, as already quoted from the +Summary of the College of Physicians, 1842. + +And, lastly, a startling series of cases by Mr. Storrs, of +Doncaster, to be found in the "American Journal of the Medical +Sciences" for January, 1843. + +The relation of puerperal fever with other continued fevers would +seem to be remote and rarely obvious. Hey refers to two cases of +synochus occurring in the Royal Infirmary of Edinburgh, in women +who had attended upon puerperal patients. Dr. Collins refers to +several instances in which puerperal fever has appeared to +originate from a continued proximity to patients suffering with +typhus. [Footnote: Treatise on Midwifery, p. 228.] + +Such occurrences as those just mentioned, though most important +to be remembered and guarded against, hardly attract our notice +in the midst of the gloomy facts by which they are surrounded. Of +these facts, at the risk of fatiguing repetitions, I have +summoned a sufficient number, as I believe, to convince the most +incredulous that every attempt to disguise the truth which +underlies them all is useless. + +It is true that some of the historians of the disease, especially +Hulme, Hull, and Leake, in England; Tonnelle, Duges, and +Baudelocque, in France, profess not to have found puerperal fever +contagious. At the most they give us mere negative facts, +worthless against an extent of evidence which now overlaps the +widest range of doubt, and doubles upon itself in the redundancy +of superfluous demonstration. Examined in detail, this and much +of the show of testimony brought up to stare the daylight of +conviction out of countenance, proves to be in a great measure +unmeaning and inapplicable, as might be easily shown were it +necessary. Nor do I feel the necessity of enforcing the +conclusion which arises spontaneously from the facts which have +been enumerated by formally citing the opinions of those grave +authorities who have for the last half-century been sounding the +unwelcome truth it has cost so many lives to establish. + +"It is to the British practitioner," says Dr. Rigby, "that we are +indebted for strongly insisting upon this important and dangerous +character of puerperal fever." [Footnote: British and Foreign +Med. Rev. for January, 1842.] + +The names of Gordon, John Clarke, Denman, Burns, Young, +[Footnote: Encyc. Britannica, xiii, 467, art., "Medicine."] +Hamilton,[Footnote: Outlines of Midwifery, p. 109.] Haighton, +[Footnote: Oral Lectures, etc.] Good, [Footnote: Study of +Medicine, ii, 195.] Waller, [Footnote: Medical and Physical +Journal, July, 1830.] Blundell, Gooch, Ramsbotham, Douglas, +[Footnote: Dublin Hospital Reports for 1822.] Lee, Ingleby, +Locock, [Footnote: Library of Practical Medicine, I. 373], +Abercrombie [Footnote: Researches on Diseases of the Stomach, +etc. p. 1841], Alison [Footnote: Library of Practical Medicine, +i, 95.], Travers, [Footnote: Further Researches on Constitutional +Irritation, p. 128], Rigby, and Watson [Footnote: London Medical +Gazette, February, 1842] many of whose writings I have already +referred to, may have some influence with those who prefer the +weight of authorities to the simple deductions of their own +reason from the facts aid before them. A few Continental writers +have adopted similar conclusions [Footnote: See British and +Foreign Medical Review, vol. iil, p. 525, and vol. iv, p. 517. +Also Ed. Med. and Surg. Journal for July 1824, and American +Journal of Med. Sciences for January, 1841.] It gives me pleasure +to remember that, while the doctrine has been unceremoniously +discredited in one of the leading journals [Footnote: PIsid. Med. +Journal, vol. xii, p. 364], and made very light of by teachers in +two of the principal medical schools of this country, Dr. +Channing has for many years inculcated, and enforced by examples, +the danger to be apprehended and the precautions to be taken in +the disease under consideration. + +I have no wish to express any harsh feeling with regard to the +painful subject which has come before us. If there are any so far +excited by the story of these dreadful events that they ask for +some word of indignant remonstrance to show that science does not +turn the hearts of its followers into ice or stone, let me remind +them that such words have been uttered by those who speak with an +authority I could not claim [Footnote: Dr. Blundell and Dr. Bigby +in the works already cited.] It is as a lesson rather than as a +reproach that I call up the memory of these irreparable errors +and wrongs. No tongue can tell the heart-breaking calamity they +have caused; they have closed the eyes just opened upon a new +world of love and happiness; they have bowed the strength of +manhood into the dust; they have cast the helplessness of infancy +into the stranger's arms, or bequeathed it, with less cruelty, +the death of its dying parent. There is no tone deep enough for +regret, and no voice loud enough for warning. The woman about to +become a mother. or with her new-born infant upon her bosom, +should be the object of trembling care and sympathy wherever she +bears her tender burden or stretches her aching limbs. The very +outcast of the streets has pity upon her sister in degradation +when the seal of promised maternity is impressed upon her. The +remorseless vengeance of the law, brought down upon its victim by +a machinery as sure as destiny, is arrested in its fall at a word +which reveals her transient claim for mercy. The solemn prayer of +the liturgy singles out her sorrows from the multiplied trials of +life, to plead for her in the hour of peril. God forbid that any +member of the profession to which she trusts her life, doubly +precious at that eventful period, should hazard it negligently, +unadvisedly, or selfishly! + +There may be some among those whom I address who are disposed to +ask the question, What course are we to follow in relation to +this matter? The facts are before them, and the answer must be +left to their own judgment and conscience. If any should care to +know my own conclusions, they are the following; and in taking +the liberty to state them very freely and broadly, I would ask +the inquirer to examine them as freely in the light of the +evidence which has been laid before him. + +1. A physician holding himself in readiness to attend cases of +midwifery should never take any active part in the post-mortem +examination of cases of puerperal fever. + +2. If a physician is present at such autopsies, he should use +thorough ablution, change every article of dress, and allow +twenty-four hours or more to elapse before attending to any case +of midwifery. It may be well to extend the same caution to cases +of simple peritonitis. + +3. Similar precautions should be taken after the autopsy or +surgical treatment of cases of erysipelas, if the physician is +obliged to unite such offices with his obstetrical duties, which +is in the highest degree inexpedient. + +4. On the occurrence of a single case of puerperal fever In his +practice, the physician is bound to consider the next female he +attends in labor, unless some weeks at least have elapsed, as in +danger of being infected by him, and it is his duty to take every +precaution to diminish her risk of disease and death. + +5. If within a short period two cases of puerperal fever happen +close to each other, in the practice of the same physician, the +disease not existing or prevailing in the neighborhood, he would +do wisely to relinquish his obstetrical practice for at least one +month, and endeavor to free himself by every available means from +any noxious influence he may carry about with him. + +6. The occurrence of three or more closely connected cases, in +the practice of one individual, no others existing in the +neighborhood, and no other sufficient cause being alleged for the +coincidence, is prima facie evidence that he is the vehicle of +contagion. + +7. It is the duty of the physician to take every precaution that +the disease shall not be introduced by nurses or other +assistants, by making proper inquiries concerning them, and +giving timely warning of every suspected source of danger. + +8. Whatever indulgence may be granted to those who have +heretofore been the ignorant causes of so much misery, the time +has come when the existence of a private pestilence in the sphere +of a single physician should be looked upon, not as a misfortune, +but a crime; and in the knowledge of such occurrences the duties +of the practitioner to his profession should give way to his +paramount obligations to society. + + + + +ADDITIONAL REFERENCES AND CASES. + + +Fifth Annual Report of the Registrar-General of England, 1843, +Appendix. Letter from William Fair, Esq.--Several new series of +cases are given in the letter of Mr. Storrs, contained in the +appendix to this report. Mr. Storrs suggests precautions similar +to those I have laid down, and these precautions are strongly +enforced by Mr. Farr, who is, therefore, obnoxious to the same +criticisms as myself. + +Hall and Dexter, in Am. Journal of Med. Sc. for January, 1844.-- +Cases of puerperal fever seeming to originate in erysipelas. + +Elkington, of Birmingham, in Provincial Med. Journal, cited in +Am. Journ. Med. Sc. for April, 1844.--Six cases in less than a +fortnight, seeming to originate in a case of erysipelas. + +West's Reports, in Brit. and For. Med. Review for October, 1845, +and January, 1847.--Affection of the arm, resembling malignant +pustule, after removing the placenta of a patient who died from +puerperal fever. Reference to cases at Wurzburg, as proving +contagion, and to Keiller's cases in the Monthly Journal for +February, 1846, as showing connection of puerperal fever and +erysipelas. + +Kneeland.--Contagiousness of Puerperal Fever. Am. Jour. Med. Sc., +January, 1846. Also, Connection between Puerperal Fever Epidemic +Erysipelas. Ibid., April, 1846. + +Robert Storrs.-Contagious Effects of Puerperal Fever on the Male +Subject; or on Persons not Child-bearing. (From Provincial Med. +and Surg. Journal.) Am. Jour. Med. Sc., January, 1846. Numerous +cases. See also Dr. Reid's case in same journal for April, 1846. + +Routh's paper in Proc. of Royal Med. Chir. Soc., Am. Jour. Med. +Sc., April, 1849, also in B. and F. Med. Chir. Review, April, +1850. + +Hill, of Leuchars.--A Series of Cases Illustrating the Contagious +Nature of Erysipelas and Puerperal Fever, and their Intimate +Pathological Connection. (From Monthly Journal of Med. Sc.) Am. +Jour. Med. Sc., July, 1850. + +Skoda on the Causes of Puerperal Fever. (Peritonitis in rabbits, +from inoculation with different morbid secretions.) Am. Jour. +Med. Sc., October, 1850. + +Arneth.--Paper read before the National Academy of Medicine. +Annales d'Hygiene, Tome LXV. 2e Partie. ("Means of Disinfection +proposed by M. Semmelweis." Semmelweiss.) Lotions of chloride of +lime and use of nail-brush before admission to lying-in wards, +Alleged sudden and great decrease of mortality from puerperal +fever. Cause of disease attributed to inoculation with cadaveric +matters.) See also Routh's paper, mentioned above. + +Moir.--Remarks at a meeting of the Edinburgh Medico-chirurgical +Society. Refers to cases of Dr. Kellie, of Leith. Sixteen in +succession, all fatal. Also to several instances of individual +pupils having had a succession of cases in various quarters of +the town, while others, practising as extensively in the same +localities, had none. Also to several special cases not mentioned +elsewhere. Am. Jour. Med. Sc. for October, 1851. (From New +Monthly Journal of Med. Science.) + +Simpson.--Observations at a Meeting of the Edinburgh Obstetrical +Society. (An "eminent gentleman," according to Dr. Meigs, whose +"name is as well known in America as in (his) native land," +Obstetrics, Phil., 1852, pp. 368, 375.) The student is referred +to this paper for a valuable resume of many of the facts, and the +necessary inferences, relating to this subject. Also for another +series of cases, Mr. Sidey's, five or six in rapid succession. +Dr. Simpson attended the dissection of two of Dr. Sidey's cases, +and freely handled the diseased parts. His next four child-bed +patients were affected with puerperal fever, and it was the first +time he had seen it in practice. As Dr. Simpson is a gentleman +(Dr. Meigs, as above), and as "a gentleman's hands are clean" +(Dr. Meigs' sixth letter), it follows that a gentleman with clean +hands may carry the disease. Am. Jour. Med. Sc., October, 1851. + +Peddie.--The five or six cases of Dr. Sidey, followed by the four +of Dr. Simpson, did not end the series. A practitioner in Leith +having examined in Dr. Simpson's house, a portion of the uterus +obtained from one of the patients, had immediately afterwards +three fatal cases of puerperal fever. Dr. Peddie referred to two +distinct series of consecutive cases in his own practice. He had +since taken precautions, and not met with any such cases. Am. +Jour. Med October, 1851. + +Copland.--Considers it proved that puerperal fever may be +propagated by the hands and the clothes, or either, of a third +person, the bed-clothes or body-clothes of a patient. Mentions a +new series of cases, one of which he saw, with the practitioner +who had attended them. She was THE SIXTH he had had within a few +days. ALL DIED. Dr. Copland insisted that contagion had caused +these cases; advised precautionary measures, and the practitioner +had no other cases for a considerable time. Considers it +CRIMINAL, after the evidence adduced,--which be could have +quadrupled,--and the weight of authority brought forward, for a +practitioner to be the medium of transmitting contagion and death +to his patients. Dr. Copland lays down rules similar to those +suggested by myself, and is therefore entitled to the same +epithet for so doing. Medical Dictionary, New York, 1853. +Article, Puerperal States and Diseases. + +If there is any appetite for facts so craving as to be yet +unappeased,--lassata, necdum satiata,--more can be obtained. Dr. +Hodge remarks that "the frequency and importance of this singular +circumstance that the disease is occasionally more prevalent +with one practitioner than another, has been exceedingly +overrated." More than thirty strings of cases, more than two +hundred and fifty sufferers from puerperal fever, more than one +hundred and thirty deaths, appear as the results of a sparing +estimate of such among the facts I have gleaned as could be +numerically valued. These facts constitute, we may take it for +granted, but a small fraction of those that have actually +occurred. The number of them might be greater, but "'t is enough, +'t will serve," in Mercutio's modest phrase, so far as frequency +is concerned. For a just estimate of the importance of the +singular circumstance, it might be proper to consult the languid +survivors, the widowed husbands, and the motherless children, as +well as "the unfortunate accoucheur." + + + + +ON THE ANTISEPTIC PRINCIPLE OF THE PRACTICE OF SURGERY +BY +JOSEPH LISTER + + +INTRODUCTORY NOTE + + +Joseph Lister was born at Upton, Essex, England, in 1827, and +received Aw general education at the University of London. After +graduation he studied medicine in London and Edinburgh, and +became lecturer in surgery at the University in the latter city. +Later he was professor of surgery at Glasgow, at Edinburgh, and +at King's College Hospital, London, and surgeon to Queen +Victoria. He was made a baronet in 1883; retired from teaching in +1893; and was raised to the peerage in 1897, with the title of +Baron Lister. + +Even before the work of Pasteur on fermentation and putrefaction, +Lister had been convinced of the importance of scrupulous +cleanliness and the usefulness of deodorants in the operating +room; and when, through Pasteur's researches, he realised that +the formation of PUS was due to bacteria, he proceeded to develop +his antiseptic surgical methods. The immediate success of the new +treatment led to its general adoption, with results of such +beneficence as to make it rank as one of the great discoveries of +the age. + + + + +ON THE ANTISEPTIC PRINCIPLE OF THE PRACTICE OF SURGERY (1867) + + +In the course of an extended investigation into the nature of +inflammation, and the healthy and morbid conditions of the blood +in relation to it, I arrived several years ago at the conclusion +that the essential cause of suppuration in wounds is +decomposition brought about by the influence of the atmosphere +upon blood or serum retained within them, and, in the case of +contused wounds, upon portions of tissue destroyed by the +violence of the injury. + +To prevent the occurrence of suppuration with all its attendant +risks was an object manifestly desirable, but till lately +apparently unattainable, since it seemed hopeless to attempt to +exclude the oxygen which was universally regarded as the agent by +which putrefaction was effected. But when it had been shown by +the researches of Pasteur that the septic properties of the +atmosphere depended not on the oxygen, or any gaseous +constituent, but on minute organisms suspended in it, which owed +their energy to their vitality, it occurred to me that +decomposition in the injured part might be avoided without +excluding the air, by applying as a dressing some material +capable of destroying the life of the floating particles. Upon +this principle I have based a practice of which I will now +attempt to give a short account. + +The material which I have employed is carbolic or phenic acid, a +volatile organic compound, which appears to exercise a peculiarly +destructive influence upon low forms of life, and hence is the +most powerful antiseptic with which we are at present acquainted. + +The first class of cases to which I applied it was that of +compound fractures, in which the effects of decomposition in the +injured part were especially striking and pernicious. The results +have been such as to establish conclusively the great principle +that all local inflammatory mischief and general febrile +disturbances which follow severe injuries are due to the +irritating and poisonous influence of decomposing blood or +sloughs. For these evils are entirely avoided by the antiseptic +treatment, so that limbs which would otherwise be unhesitatingly +condemned to amputation may be retained, with confidence of the +best results. + +In conducting the treatment, the first object must be the +destruction of any septic germs which may have been introduced +into the wounds, either at the moment of the accident or during +the time which has since elapsed. This is done by introducing the +acid of full strength into all accessible recesses of the wound +by means of a piece of rag held in dressing forceps and dipped +into the liquid. [Footnote: The addition of a few drops of water +to a considerable quantity of the acid, induces it to assume +permanently the liquid form.] This I did not venture to do in the +earlier cases; but experience has shown that the compound which +carbolic acid forms with the blood, and also any portions of +tissue killed by its caustic action, including even parts of the +bone, are disposed of by absorption and organisation, provided +they are afterwards kept from decomposing. We are thus enabled to +employ the antiseptic treatment efficiently at a period after the +occurrence of the injury at which it would otherwise probably +fail. Thus I have now under my care, in Glasgow Infirmary, a boy +who was admitted with compound fracture of the leg as late as +eight and one-half hours after the accident, in whom, +nevertheless, all local and constitutional disturbance was +avoided by means of carbolic acid, and the bones were soundly +united five weeks after his admission. + +The next object to be kept in view is to guard effectually +against the spreading of decomposition into the wound along the +stream of blood and serum which oozes out during the first few +days after the accident, when the acid originally applied has +been washed out or dissipated by absorption and evaporation. This +part of the treatment has been greatly improved during the past +few weeks. The method which I have hitherto published (see Lancet +for Mar. 16th, 23rd, 30th, and April 27th of the present year) +consisted in the application of a piece of lint dipped in the +acid, overlapping the sound skin to some extent and covered with +a tin cap, which was daily raised in order to touch the surface +of the lint with the antiseptic. This method certainly succeeded +well with wounds of moderate size; and indeed I may say that in +all the many cases of this kind which have been so treated by +myself or my house-surgeons, not a single failure has occurred. +When, however, the wound is very large, the flow of blood and +serum is so profuse, especially during the first twenty-four +hours, that the antiseptic application cannot prevent the spread +of decomposition into the interior unless it overlaps the sound +skin for a very considerable distance, and this was inadmissible +by the method described above, on account of the extensive +sloughing of the surface of the cutis which it would involve. +This difficulty has, however, been overcome by employing a paste +composed of common whiting (carbonate of lime), mixed with a +solution of one part of carbolic acid in four parts of boiled +linseed oil so as to form a firm putty. This application contains +the acid in too dilute a form to excoriate the skin, which it may +be made to cover to any extent that may be thought desirable, +while its substance serves as a reservoir of the antiseptic +material. So long as any discharge continues, the paste should be +changed daily, and, in order to prevent the chance of mischief +occurring during the process, a piece of rag dipped in the +solution of carbolic acid in oil is put on next the skin, and +maintained there permanently, care being taken to avoid raising +it along with the putty. This rag is always kept in an antiseptic +condition from contact with the paste above it, and destroys any +germs which may fall upon it during the short time that should +alone be allowed to pass in the changing of the dressing. The +putty should be in a layer about a quarter of an inch thick, and +may be advantageously applied rolled out between two pieces of +thin calico, which maintain it in the form of a continuous sheet, +which may be wrapped in a moment round the whole circumference of +a limb if this be thought desirable, while the putty is prevented +by the calico from sticking to the rag which is next the +skin.[Footnote: In order to prevent evaporation of the acid, +which passes readily through any organic tissue, such as oiled +silk or gutta percha, it is well to cover the paste with a sheet +of block tin. or tinfoil strengthened with adhesive plaster. The +tin sheet lead used for lining tea chests will also answer the +purpose, and may be obtained from any wholesale grocer.] When all +discharge has ceased, the use of the paste is discontinued, but +the original rag is left adhering to the skin till healing by +scabbing is supposed to be complete. I have at present in the +hospital a man with severe compound fracture of both bones of the +left leg, caused by direct violence, who, after the cessation of +the sanibus discharge under the use of the paste, without a drop +of pus appearing, has been treated for the last two weeks exactly +as if the fracture was a simple one. During this time the rag, +adhering by means of a crust of inspissated blood collected +beneath it, has continued perfectly dry, and it will be left +untouched till the usual period for removing the splints in a +simple fracture, when we may fairly expect to find a sound +cicatrix beneath it. We cannot, however, always calculate on so +perfect a result as this. More or less pus may appear after the +lapse of the first week, and the larger the wound, the more +likely this is to happen. And here I would desire earnestly to +enforce the necessity of persevering with the antiseptic +application in spite of the appearance of suppuration, so long as +other symptoms are favorable. The surgeon is extremely apt to +suppose that any suppuration is an indication that the antiseptic +treatment has failed, and that poulticing or water dressing +should be resorted to. But such a course would in many cases +sacrifice a limb or a life. I cannot, however, expect my +professional brethren to follow my advice blindly in such a +matter, and therefore I feel it necessary to place before them, +as shortly as I can, some pathological principles intimately +connected, not only with the point we are immediately +considering, but with the whole subject of this paper. If a +perfectly healthy granulating sore be well washed and covered +with a plate of clean metal, such as block tin, fitting its +surface pretty accurately, and overlapping the surrounding skin +an inch or so in every direction and retained in position by +adhesive plaster and a bandage, it will be found, on removing it +after twenty-four or forty-eight hours, that little or nothing +that can be called pus is present, merely a little transparent +fluid, while at the same time there is an entire absence of the +unpleasant odour invariably perceived when water dressing is +changed. Here the clean metallic surface presents no recesses +like those of porous lint for the septic germs to develope in, +the fluid exuding from the surface of the granulations has flowed +away undecomposed, and the result is the absence of suppuration. +This simple experiment illustrates the important fact that +granulations have no inherent tendency to form pus, but do so +only when subjected to preternatural stimulus. Further, it shows +that the mere contact of a foreign body does not of itself +stimulate granulations to suppurate; whereas the presence of +decomposing organic matter does. These truths are even more +strikingly exemplified by the fact that I have elsewhere recorded +(Lancet, March 23rd, 1867), that a piece of dead bone free from +decomposition may not only fail to induce the granulations around +it to suppurate, but may actually be absorbed by them; whereas a +bit of dead bone soaked with putrid pus infallibly induces +suppuration in its vicinity. + +Another instructive experiment is, to dress a granulating sore +with some of the putty above described, overlapping the sound +skin extensively; when we find, in the course of twenty-four +hours, that pus has been produced by the sore, although the +application has been perfectly antiseptic; and, indeed, the +larger the amount of carbolic acid in the paste, the greater is +the quantity of pus formed, provided we avoid such a proportion +as would act as a caustic. The carbolic acid, though it prevents +decomposition, induces suppuration--obviously by acting as a +chemical stimulus; and we may safely infer that putrescent +organic materials (which we know to be chemically acrid) operate +in the same way. + +In so far, then, carbolic acid and decomposing substances are +alike; viz., that they induce suppuration by chemical +stimulation, as distinguished from what may be termed simple +inflammatory suppuration, such as that in which ordinary +abscesses originate--where the pus appears to be formed in +consequence of an excited action of the nerves, independently of +any other stimulus. There is, however, this enormous difference +between the effects of carbolic acid and those of decomposition; +viz., that carbolic acid stimulates only the surface to which it +is at first applied, and every drop of discharge that forms +weakens the stimulant by diluting it; but decomposition is a +self-propagating and self-aggravating poison, and, if it occur at +the surface of a severely injured limb, it will spread into all +its recesses so far as any extravasated blood or shreds of dead +tissue may extend, and lying in those recesses, it will become +from hour to hour more acrid, till it requires the energy of a +caustic sufficient to destroy the vitality of any tissues +naturally weak from inferior vascular supply, or weakened by the +injury they sustained in the accident. + +Hence it is easy to understand how, when a wound is very large, +the crust beneath the rag may prove here and there insufficient +to protect the raw surface from the stimulating influence of the +carbolic acid in the putty; and the result will be first the +conversion of the tissues so acted on into granulations, and +subsequently the formation of more or less pus. This, however, +will be merely superficial, and will not interfere with the +absorption and organisation of extravasated blood or dead tissues +in the interior. But, on the other hand, should decomposition set +in before the internal parts have become securely consolidated, +the most disastrous results may ensue. + +I left behind me in Glasgow a boy, thirteen years of age, who, +between three and four weeks previously, met with a most severe +injury to the left arm, which he got entangled in a machine at a +fair. There was a wound six inches long and three inches broad, +and the skin was very extensively undermined beyond its limits, +while the soft parts were generally so much lacerated that a pair +of dressing forceps introduced at the wound and pushed directly +inwards appeared beneath the skin at the opposite aspect of the +limb. From this wound several tags of muscle were hanging, and +among them was One consisting of about three inches of the +triceps in almost Its entire thickness; while the lower fragment +of the bone, which was broken high up, was protruding four inches +and a half, stripped of muscle, the skin being tucked in under +it. Without the assistance of the antiseptic treatment, I should +certainly have thought of nothing else but amputation at the +shoulder-joint; but, as the radial pulse could be felt and the +fingers had sensation, I did not hesitate to try to save the limb +and adopted the plan of treatment above described, wrapping the +arm from the shoulder to below the elbow in the antiseptic +application, the whole interior of the wound, together with the +protruding bone, having previously been freely treated with +strong carbolic acid. About the tenth day, the discharge, which +up to that time had been only sanious and serous, showed a slight +admixture of slimy pus; and this increased till (a few days +before I left) it amounted to about three drachms in twenty-four +hours. But the boy continued as he had been after the second day, +free from unfavorable symptoms, with pulse, tongue, appetite, and +sleep natural and strength increasing, while the limb remained as +it had been from the first, free from swelling, redness, or pain. +I. therefore, persevered with the antiseptic dressing; and, +before I left, the discharge was already somewhat less, while the +bone was becoming firm. I think it likely that, in that boy's +case, I should have found merely a superficial sore had I taken +off all the dressings at the end of the three weeks; though, +considering the extent of the injury, I thought it prudent to let +the month expire before disturbing the rag next the skin. But I +feel sure that, if I had resorted to ordinary dressing when the +pus first appeared, the progress of the case would have been +exceedingly different. + +The next class of cases to which I have applied the antiseptic +treatment is that of abscesses. Here also the results have been +extremely satisfactory, and in beautiful harmony with the +pathological principles indicated above. The pyogenic membrane, +like the granulations of a sore, which it resembles in nature, +forms pus, not from any inherent disposition to do so, but only +because it is subjected to some preternatural stimulation. In an +ordinary abscess, whether acute or chronic, before it is opened +the stimulus which maintains the suppuration is derived from the +presence of pus pent up within the cavity. When a free opening is +made in the ordinary way, this stimulus is got rid of, but the +atmosphere gaining access to the contents, the potent stimulus of +decomposition comes into operation, and pus is generated in +greater abundance than before. But when the evacuation is +effected on the antiseptic principle, the pyogenic membrane, +freed from the influence of the former stimulus without the +substitution of a new one, ceases to suppurate (like the +granulations of a sore under metallic dressing), furnishing +merely a trifling amount of clear serum, and, whether the opening +be dependent or not, rapidly contracts and coalesces. At the same +time any constitutional symptoms previously occasioned by the +accumulation of the matter are got rid of without the slightest +risk of the irritative fever or hectic hitherto so justly dreaded +in dealing with large abscesses. + +In order that the treatment may be satisfactory, the abscess must +be seen before it is opened. Then, except in very rare and +peculiar cases [Footnote: As an instance of one of these +exceptional cases, I may mention that of an abscess in the +vicinity of the colon, and afterwords proved by post-mortem +examination to have once communicated with it. Here the pus was +extremely offensive when evacuated, and exhibited vibros under +the microscope.], there are no septic organisms in the contents, +so that it is needless to introduce carbolic acid into the +interior. Indeed, such a procedure would be objectionable, as it +would stimulate the pyogenic membrane to unnecessary suppuration. +All that is requisite is to guard against the introduction of +living atmospheric germs from without, at the same time that free +opportunity is afforded for the escape of the discharge from +within. + +I have so lately given elsewhere a detailed account of the method +by which this is effected (Lancet, July 27th, 1867), that I shall +not enter into it at present further than to say that the means +employed are the same as those described above for the +superficial dressing of compound fractures; viz., a piece of rag +dipped into the solution of carbolic add in oil to serve as an +antiseptic curtain, under cover of which the abscess is evacuated +by free incision, and the antiseptic paste to guard against +decomposition occurring in the stream of pus that flows out +beneath it; the dressing being changed daily until the sinus is +closed. + +The most remarkable results of this practice in a pathological +point of view have been afforded by cases where the formation of +pus depended on disease of bone. Here the abscesses, instead of +forming exceptions to the general class in the obstinacy of the +suppuration, have resembled the rest in yielding in a few days +only a trifling discharge, and frequently the production of pus +has ceased from the moment of the evacuation of the original +contents. Hence it appears that caries, when no longer labouring +as heretofore under the irritation of decomposing matter, ceases +to be an opprobrium of surgery, and recovers like other +inflammatory affections. In the publication before alluded to, I +have mentioned the case of a middle-aged man with a psoas abscess +depending in diseased bone, in whom the sinus finally closed +after months of patient perseverance with the antiseptic +treatment. Since that article was written I have had another +instance of abscess equally gratifying, but the differing in the +circumstance that the disease and the recovery were more rapid in +their course. The patient was a blacksmith, who had suffered four +and a half months before I saw him from symptoms of ulceration of +cartilage in the left elbow. These had latterly increased in +severity so as to deprive him entirely of his night's rest and of +appetite. I found the region of the elbow greatly swollen, and on +careful examination found a fluctuating point at the outer aspect +of the articulation. I opened it on the antiseptic principle, the +incision evidently penetrating to the joint, giving exit to a few +drachms of pus. The medical gentleman under whose care he was +(Dr. Macgregor, of Glasgow) supervised the daily dressing with +the carbolic acid paste till the patient went to spend two or +three weeks at the coast, when his wife was entrusted with it. +Just two months after I opened the abscess, he called to show me +the limb, stating that the discharge had been, for at least two +weeks, as little as it was then, a trifling moisture upon the +paste, such as might be accounted for by the little sore caused +by the incision. On applying a probe guarded with an antiseptic +rag, I found that the sinus was soundly closed, while the limb +was free from swelling or tenderness; and, although he had not +attempted to exercise it much, the joint could already be moved +through a considerable angle. Here the antiseptic principle had +effected the restoration of a joint, which, on any other known +system of treatment, must have been excised. + +Ordinary contused wounds are, of course, amenable to the same +treatment as compound fractures, which are a complicated variety +of them. I will content myself with mentioning a single instance +of this class of cases. In April last, a volunteer was +discharging a rifle when it burst, and blew back the thumb with +its metacarpal bone, so that it could be bent back as on a hinge +at the trapezial joint, which had evidently been opened, while +all the soft parts between the metacarpal bones of the thumb and +forefinger were torn through. I need not insist before my present +audience on the ugly character of such an injury. My house- +surgeon, Mr. Hector Cameron, applied carbolic acid to the whole +raw surface, and completed the dressing as if for compound +fracture. The hand remained free from pain, redness or swelling, +and with the exception of a shallow groove, all the wound +consolidated without a drop of matter, so that if it had been a +clean cut, it would have been regarded as a good example of +primary union. The small granulating surface soon healed, and at +present a linear cicatrix alone tells of the injury he has +sustained, while his thumb has all its movements and his hand a +fine grasp. + +If the severest forms of contused and lacerated wounds heal thus +kindly under the antiseptic treatment, it is obvious that its +application to simple incised wounds must be merely a matter of +detail. I have devoted a good deal of attention to this class, +but I have not as yet pleased myself altogether with any of the +methods I have employed. I am, however, prepared to go so far as +to say that a solution of carbolic acid in twenty parts of water, +while a mild and cleanly application, may be relied on for +destroying any septic germs that may fall upon the wound during +the performance of an operation; and also that, for preventing +the subsequent introduction of others, the paste above described, +applied as for compound fractures, gives excellent results. Thus +I have had a case of strangulated inguinal hernia in which it was +necessary to take away half a pound of thickened omentum, heal +without any deep-seated suppuration or any tenderness of the sac +or any fever; and amputations, including one immediately below +the knee, have remained absolutely free from constitutional +symptoms. + +Further, I have found that when the antiseptic treatment is +efficiently conducted, ligatures may be safely cut short and left +to be disposed of by absorption or otherwise. Should this +particular branch of the subject yield all that it promises, +should it turn out on further trial that when the knot is applied +on the antiseptic principle, we may calculate as securely as if +it were absent on the occurrence of healing without any deep- +seated suppuration, the deligation of main arteries in their +continuity will be deprived of the two dangers that now attend +it, viz., those of secondary haemorrhage and an unhealthy state +of the wound. Further, it seems not unlikely that the present +objection to tying an artery in the immediate vicinity of a large +branch may be done away with; and that even the innominate, which +has lately been the subject of an ingenious experiment by one of +the Dublin surgeons, on account of its well-known fatality under +the ligature for secondary haemorrhage, may cease to have this +unhappy character when the tissues in the vicinity of the thread, +instead of becoming softened through the influence of an +irritating decomposing substance, are left at liberty to +consolidate firmly near an unoffending though foreign body. + +It would carry me far beyond the limited time which, by the rules +of the Association, is alone at my disposal, were I to enter into +the various applications of the antiseptic principle in the +several special departments of surgery. + +There is, however, one point more that I cannot but advert to, +viz., the influence of this mode of treatment upon the general +healthiness of an hospital. Previously to its introduction the +two large wards in which most of my cases of accident and of +operation are treated were among the unhealthiest in the whole +surgical division of the Glasgow Royal Infirmary, in consequence +apparently of those wards being unfavorably placed with reference +to the supply of fresh air; and I have felt ashamed when +recording the results of my practice, to have so often to allude +to hospital gangrene or pyaemia. It was interesting, though +melancholy, to observe that whenever all or nearly all the beds +contained cases with open sores, these grievous complications +were pretty sure to show themselves; so that I came to welcome +simple fractures, though in themselves of little interest either +for myself or the students, because their presence diminished the +proportion of open sores among the patients. But since the +antiseptic treatment has been brought into full operation, and +wounds and abscesses no longer poison the atmosphere with putrid +exhalations, my wards, though in other respects under precisely +the same circumstances as before, have completely changed their +character; so that during the last nine months not a single +instance of pysemia, hospital gangrene, or erysipelas has +occurred in them. + +As there appears to be no doubt regarding the cause of this +change, the importance of the fact can hardly be exaggerated. + + + + + THE PHYSIOLOGICAL THEORY OF FERMENTATION + BY LOUIS PASTEUR + TRANSLATED BY + F. FAULKNER AND D. C. ROBB + AND REVISED + + + THE GERM THEORY AND ITS APPLICATIONS TO MEDICINE AND SURGERY + BY MM. PASTEUR, JOURBERT, AND CHAMBERLAND + TRANSLATED BY + H. C. ERNST, M. D. + PROFESSOR OF BACTERIOLOGY IN THE HARVARD MEDICAL SCHOOL + + +ON THE EXTENSION OF THE GERM THEORY TO THE ETIOLOGY OF CERTAIN + COMMON DISEASES + BY LOUIS PASTEUR + TRANSLATED BY H. C. ERNST, M. D. + + +INTRODUCTORY NOTE + +Louis Pasteur was born at Dole, Jura, France, December 27, 1822, +and died near Saint-Cloud, September 28, 1895. His interest in +science, and especially in chemistry, developed early, and by the +time he was twenty-six he was professor of the physical sciences +at Dijon. The most important academic positions held by him later +were those as professor of chemistry at Strasburg, 1849; dean of +the Faculty of Sciences at Lille, 1854; science director of the +Ecole Normale Superieure, Paris, 1857; professor of geology, +physics, and chemistry at the Ecole des Beaux Arts; Professor of +chemistry at the Sorbonne, 1867. After 1875 he carried on his +researches at the Pasteur Institute. He was a member of the +Institute, and received many honors from learned societies at +home and abroad. + +In respect of the number and importance, practical as well as +scientific, of his discoveries, Pasteur has hardly a rival in the +history of science. He may be regarded as the founder of modern +stereo-chemistry; and his discovery that living organisms are the +cause of fermentation is the basis of the whole modern germ- +theory of disease and of the antiseptic method of treatment. His +investigations of the diseases of beer and wine; of pebrine, a +disease affecting silk-worms; of anthrax, and of fowl cholera, +were of immense commercial importance and led to conclusions +which have revolutionised physiology, pathology, and +therapeutics. By his studies in the culture of bacteria of +attenuated virulence he extended widely the practise of +inoculation with a milder form of various diseases, with a view +to producing immunity. + +The following papers present some of the most important of his +contributions, and exemplify his extraordinary powers of lucid +exposition and argument. + + + + +TO THE MEMORY OF MY FATHER +FORMERLY A SOLDIER UNDER THE FIRST EMPIRE CHEVALIER OF THE LEGION +OF HONOR + +The longer I live, the better I understand the kindness of thy +heart and the high quality of thy mind. + +The efforts which I have devoted to these Studies, as well as +those which preceded them, are the fruit of thy counsel and +example. + +Desiring to honor these filial remembrances, I dedicate this work +to thy memory. + +L. PASTEUR. + + + + +AUTHOR'S PREFACE + +Our misfortunes inspired me with the idea of these researches. I +undertook them immediately after the war of 1870, and have since +continued them without interruption, with the determination of +perfecting them, and thereby benefiting a branch of industry +wherein we are undoubtedly surpassed by Germany. + +I am convinced that I have found a precise, practical solution of +the arduous problem which I proposed to myself--that of a process +of manufacture, independent of season and locality, which should +obviate the necessity of having recourse to the costly methods of +cooling employed in existing processes, and at the same time +secure the preservation of its products for any length of time. + +These new studies are based on the same principles which guided +me in my researches on wine, vinegar, and the silkworm disease-- +principles, the applications of which are practically unlimited. +The etiology of contagious diseases may, perhaps, receive from +them an unexpected light. + +I need not hazard any prediction concerning the advantages likely +to accrue to the brewing industry from the adoption of such a +process of brewing as my study of the subject has enabled me to +devise, and from an application of the novel facts upon which +this process is founded. Time is the best appraiser of scientific +work, and I am not unaware that an industrial discovery rarely +produces all its fruit in the hands of its first inventor. + +I began my researches at Clermont-Ferrand, in the laboratory, and +with the help, of my friend M. Duclaux, professor of chemistry at +the Faculty of Sciences of that town. I continued them in Paris, +and afterwards at the great brewery of Tourtel Brothers, of +Tantonville, which is admitted to be the first in France. I +heartily thank these gentlemen for their extreme kindness. I owe +also a public tribute of gratitude to M. Kuhn, a skillful brewer +of Chamalieres, near Clermont-Ferrand, as well as to M. Velten of +Marseilles, and to MM. de Tassigny, of Reims, who have placed at +my disposal their establishments and their products, with the +most praiseworthy eagerness. + +L. PASTEUR. + +Paris, June 1, 1879. + + + + +THE PHYSIOLOGICAL THEORY OF FERMENTATION + +I. ON THE RELATIONS EXISTING BETWEEN OXYGEN AND YEAST + + +It is characteristic of science to reduce incessantly the number +of unexplained phenomena. It is observed, for instance, that +fleshy fruits are not liable to fermentation so long as their +epidermis remains uninjured. On the other hand, they ferment very +readily when they are piled up in heaps more or less open, and +immersed in their saccharine juice. The mass becomes heated and +swells; carbonic acid gas is disengaged, and the sugar disappears +and is replaced by alcohol. Now, as to the question of the origin +of these spontaneous phenomena, so remarkable in character as +well as usefulness for man's service, modern knowledge has taught +us that fermentation is the consequence of a development of +vegetable cells the germs of which do not exist in the saccharine +juices within fruits; that many varieties of these cellular +plants exist, each giving rise to its own particular +fermentation. The principal products of these various +fermentations, although resembling each other in their nature, +differ in their relative proportions and in the accessory +substances that accompany them, a fact which alone is sufficient +to account for wide differences in the quality and commercial +value of alcoholic beverages. + +Now that the discovery of ferments and their living nature, and +our knowledge of their origin, may have solved the mystery of the +spontaneous appearance of fermentations in natural saccharine +juices, we may ask whether we must still regard the reactions +that occur in these fermentations as phenomena inexplicable by +the ordinary laws of chemistry. We can readily see that +fermentations occupy a special place in the series of chemical +and biological phenomena. What gives to fermentations certain +exceptional characters of which we are only now beginning to +suspect the causes, is the mode of life in the minute plants +designated under the generic name of ferments, a mode of life +which is essentially different from that in other vegetables, and +from which result phenomena equally exceptional throughout the +whole range of the chemistry of living beings. + +The least reflection will suffice to convince us that the +alcoholic ferments must possess the faculty of vegetating and +performing their functions out of contact with air. Let us +consider, for instance, the method of vintage practised in the +Jura. The bunches are laid at the foot of the vine in a large +tub, and the grapes there stripped from them. When the grapes, +some of which are uninjured, others bruised, and all moistened by +the juice issuing from the latter, fill the tub--where they form +what is called the vintage--they are conveyed in barrels to large +vessels fixed in cellars of a considerable depth. These vessels +are not filled to more than three-quarters of their capacity. +Fermentation soon takes place in them, and the carbonic acid gas +finds escape through the bunghole, the diameter of which, in the +case of the largest vessels, is not more than ten or twelve +centimetres (about four inches). The wine is not drawn off before +the end of two or three months. In this way it seems highly +probable that the yeast which produces the wine under such +conditions must have developed, to a great extent at least, out +of contact with oxygen. No doubt oxygen is not entirely absent +from the first; nay, its limited presence is even a necessity to +the manifestation of the phenomena which follow. The grapes are +stripped from the bunch in contact with air, and the must which +drops from the wounded fruit takes a little of this gas into +solution. This small quantity of air so introduced into the must, +at the commencement of operations, plays a most indispensable +part, it being from the presence of this that the spores of +ferments which are spread over the surface of the grapes and the +woody part of the bunches derive the power of starting their +vital phenomena [Footnote: It has been marked in practice that +fermentation is facilitated by leaving the grapes on the bunches. +The reason of this has not yet been discovered. Still we have no +doubt that it may be attributed, principally, to the fact that +the interatices between the grapes, and the spaces between the +bunch leaves throughout, considerably increase the volume of air +placed at the service of the germs of ferment.]. This air, +however, especially when the grapes have been stripped from the +bunches, is in such small proportion, and that which is in +contact with the liquid mass is so promptly expelled by the +carbonic acid gas, which is evolved as soon as a little yeast has +formed, that it will readily be admitted that most of the yeast +is produced apart from the influence of oxygen, whether free or +in solution. We shall revert to this fact, which is of great +importance. At present we are only concerned in pointing out +that, from the mere knowledge of the practices of certain +localities, we are induced to believe that the cells of yeast, +after they have developed from their spores, continue to live and +multiply without the intervention of oxygen, and that the +alcoholic ferments have a mode of life which is probably quite +exceptional, since it is not generally met with in other species, +vegetable or animal. + +Another equally exceptional characteristic of yeast and +fermentation in general consists in the small proportion which +the yeast that forms bears to the sugar that decomposes. In all +other known beings the weight of nutritive matter assimilated +corresponds with the weight of food used up, any difference that +may exist being comparatively small. The life of yeast is +entirely different. For a certain weight of yeast formed, we may +have ten times, twenty times, a hundred times as much sugar, or +even more decomposed, as we shall experimentally prove by-and- +bye; that is to say, that whilst the proportion varies in a +precise manner, according to conditions which we shall have +occasion to specify, it is also greatly out of proportion to the +weight of the yeast. We repeat, the life of no other being, under +its normal physiological conditions, can show anything similar. +The alcoholic ferments, therefore, present themselves to us as +plants which possess at least two singular properties: they can +live without air, that is without oxygen, and they can cause +decomposition to an amount which, though variable, yet, as +estimated by weight of product formed, is out of all proportion +to the weight of their own substance. These are facts of so great +importance, and so intimately connected with the theory of +fermentation, that it is indispensable to endeavour to establish +them experimentally, with all the exactness of which they will +admit. + +The question before us is whether yeast is in reality an +anaerobian [Footnote: Capable of living without free oxygen--a +term invented by Pasteur.--En.] plant, and what quantities of +sugar it may cause to ferment, under the various conditions under +which we cause it to act. + +The following experiments were undertaken to solve this double +problem:--We took a double-necked flask, of three litres (five +pints) capacity, one of the tubes being curved and forming an +escape for the gas; the other one, on the right hand side (Fig. +1), being furnished with a glass tap. We filled this flask with +pure yeast water, sweetened with 5 per cent, of sugar candy, the +flask being so full that there was not the least trace of air +remaining above the tap or in the escape tube; this artificial +wort had, however, been itself aerated. The curved tube was +plunged in a porcelain vessel full of mercury, resting on a firm +support. In the small cylindrical funnel above the tap, the +capacity of which was from 10 cc. to 15 cc. (about half a fluid +ounce) we caused to ferment, at a temperature of 20 degrees or 25 +degrees C. (about 75 degrees F.), five or six cubic centimetres +of the saccharine liquid, by means of a trace of yeast, which +multiplied rapidly, causing fermentation, and forming a slight +deposit of yeast at the bottom of the funnel above the tap. We +then opened the tap, and some of the liquid in the funnel entered +the flask, carrying with it the small deposit of yeast, which was +sufficient to impregnate the saccharine liquid contained in the +flask. In this manner it is possible to introduce as small a +quantity of yeast as we wish, a quantity the weight of which, we +may say, is hardly appreciable. The yeast sown multiplies rapidly +and produces fermentation, the carbonic gas from which is +expelled into the mercury. In less than twelve days all the sugar +had disappeared, and the fermentation had finished. There was a +sensible deposit of yeast adhering to the sides of the flask; +collected and dried it weighed 2.25 grammes (34 grains). It is +evident that in this experiment the total amount of yeast formed, +if it required oxygen to enable it to live, could not have +absorbed, at most, more than the volume which was originally held +in solution in the saccharine liquid, when that was exposed to +the air before being introduced into the flask. + +[Illustration with caption: Fig. 1] + +Some exact experiments conducted by M. Raulin in our laboratory +have established the fact that saccharine worts, like water, soon +become saturated when shaken briskly with an excess of air, and +also that they always take into solution a little less air than +saturated pure water contains under the same conditions of +temperature and pressure. At a temperature of 25 degrees C. (77 +degrees F.), therefore, if we adopt the coefficient of the +solubility of oxygen in water given in Bunsen's tables, we find +that 1 litre (1 3/4 pints) of water saturated with air contains +5.5 cc. (0.3 cubic inch) of oxygen. The three litres of yeast- +water in the flask, supposing it to have been saturated, contains +less than 16.5 cc. (1 cubic inch) of oxygen, or, in weight, less +than 23 milligrammes (0.35 grains). This was the maximum amount +of oxygen, supposing the greatest possible quantity to have been +absorbed, that was required by the yeast formed in the +fermentation of 150 grammes (4.8 Troy ounces) of sugar. We shall +better understand the significance of this result later on. Let +us repeat the foregoing experiment, but under altered conditions. +Let us fill, as before, our flask with sweetened yeast-water, but +let this first be boiled, so as to expel all the air it contains. +To effect this we arrange our apparatus as represented in the +accompanying sketch. (Fig 2.) We place our flask, A, on a tripod +above a gas flame, and in place of the vessel of mercury +substitute a porcelain dish, under which we can put a gas flame, +and Which contains some fermentable, saccharine liquid, similar +to that with which the flask is filled. We boil the liquid in the +flask and that in the basin simultaneously, and then let them +cool down together, so that as the liquid in the flask cools some +of the liquid is sucked from the basin into the flask. From a +trial experiment which we conducted, determining the quantity of +oxygen that remained in solution in the liquid after cooling, +according to M. Schutzenberger's valuable method, by means of +hydrosulphite of soda [Footnote: NaHSO2, now called sodium +hyposulphite.--D.C.R.], we found that the three litres in the +flask, treated as we have described, contained less than one +milligramme (0.015 grain) of oxygen. At the same time we +conducted another experiment, by way of comparison (Fig. 3). We +took a flask, B, of larger capacity than the former one, which we +filled about half with the same volume as before of a saccharine +liquid of identically the same composition. This liquid had been +previously freed from alterative germs by boiling. In the funnel +surmounting A, we put a few cubic centimetres of saccharine +liquid in a state of fermentation, and when this small quantity +of liquid was in full fermentation, and the yeast in it was young +and vigorous, we opened the tap, closing it again immediately, so +that a little of the liquid and yeast still remained in the +funnel. By this means we caused the liquid in A to ferment. We +also impregnated the liquid in B with some yeast taken from the +funnel of A. We then replaced the porcelain dish in which the +curved escape tube of A had been plunged, by a vessel filled with +mercury. The following is a description of two of these +comparative fermentations and the results they gave. + +[Illustration with caption: Fig 2] + +[Illustration with caption: Fig. 3] + +The fermentable liquid was composed of yeast-water sweetened with +5 per cent, of sugar--candy; the ferment employed was +sacchormyces pastorianus. + +The impregnation took place on January 20th. The flasks were +placed in an oven at 25 degrees (77 degrees F.). + +FLASK A, WITHOUT AIR. + +January 21st.--Fermentation commenced; a little frothy liquid +issued from the escape tube and covered the mercury. + +The following days, fermentation was active. Examining the yeast +mixed with the froth that was expelled into the mercury by the +evolution of carbonic acid gas, we find that it was very fine, +young, and actively budding. + +February 3rd.--Fermentation still continued, showing itself by a +number of little bubbles rising from the bottom of the liquid, +which had settled bright. The yeast was at the bottom in the form +of a deposit. + +February 7th.--Fermentation still continued, but very languidly. + +February 9th.--A very languid fermentation still went on, +discernible in little bubbles rising from the bottom of the +flask. + +FLASK B, WITH AIR. + +January 21st.--A sensible development of yeast. + +The following days, fermentation was active, and there was an +abundant froth on the surface of the liquid. + +February 1st.--All symptoms of fermentation had ceased. + +As the fermentation in A would have continued a long time, being +so very languid, and as that in B had been finished for several +days, we brought to a close our two experiments on February 9th. +To do this we poured off the liquids in A and B, collecting the +yeasts on tared filters. Filtration was an easy matter, more +especially in the case of A. Examining the yeasts under the +microscope, immediately after decantation, we found that both of +them remained very pure. The yeast in A was in little clusters, +the globules of which were collected together, and appeared by +their well-defined borders to be ready for an easy revival in +contact with air. + +As might have been expected, the liquid in flask B did not +contain the least trace of sugar; that in the flask A still +contained some, as was evident from the non-completion of +fermentation, but not more than 4.6 grammes (71 grains). Now, as +each flask originally contained three litres of liquid holding in +solution 5 per cent of sugar, it follows that 150 grammes (2,310 +grains) of sugar had fermented in the flask B, and 145.4 grammes +(2,239.2 grains) in the flask A. The weights of yeast after +drying at 100 degrees C. (212 degrees F.) were-- + +For the flask B, with air. ... ..1,970 grammes (30.4 grains). For +the flask A, without air ... 1,368 grammes [Footnote: This appears +to be a misprint for 1.638 grammes=25.3 grains.--D. C. R.]. + +The proportions were 1 of yeast to 76 of fermented sugar in the +first case, and 1 of yeast to 89 of fermented sugar in the +second. + +From these facts the following consequences may be deduced: + +1. The fermentable liquid (flask B), which since it had been in +contact with air, necessarily held air in solution, although not +to the point of saturation, inasmuch as it had been once boiled +to free it from all foreign germs, furnished a weight of yeast +sensibly greater than that yielded by the liquid which contained +no air at all (flask A) or, at least, which could only have +contained an exceedingly minute quantity. + +2. This same slightly aerated fermentable liquid fermented much +more rapidly than the other. In eight or ten days it contained no +more sugar; while the other, after twenty days, still contained +an appreciable quantity. + +Is this last fact to be explained by the greater quantity of +yeast formed in B? By no means. At first, when the air has access +to the liquid, much yeast is formed and little sugar disappears, +as we shall prove immediately; nevertheless the yeast formed in +contact with the air is more active than the other. Fermentation +is correlative first to the development of the globules, and then +to the continued life of those globules once formed. The more +oxygen these last globules have at their disposal during their +formation, the more vigorous, transparent, and turgescent, and, +as a consequence of this last quality, the more active they are +in decomposing sugar. We shall hereafter revert to these facts. + +3. In the airless flask the proportion of yeast to sugar was +1/59; it was only 1/79 in the flask which had air at first. + +The proportion that the weight of yeast bears to the weight of +the sugar is, therefore, variable, and this variation depends, to +a certain extent, upon the presence of air and the possibility of +oxygen being absorbed by the yeast. We shall presently show that +yeast possesses the power of absorbing that gas and emitting +carbonic acid, like ordinary fungi, that even oxygen may be +reckoned amongst the number of food-stuffs that may be +assimilated by this plant, and that this fixation of oxygen in +yeast, as well as the oxidations resulting from it, have the most +marked effect on the life of yeast, on the multiplication of its +cells, and on their activity as ferments acting upon sugar, +whether immediately or afterwards, apart from supplies of oxygen +or air. + +In the preceding experiment, conducted without the presence of +air, there is one circumstance particularly worthy of notice. +This experiment succeeds, that is to say, the yeast sown in the +medium deprived of oxygen develops, only when this yeast is in a +state of great vigour. We have already explained the meaning of +this last expression. But we wish now to call attention to a very +evident fact in connection with this point. We impregnate a +fermentable liquid; yeast develops and fermentation appears. This +lasts for several days and then ceases. Let us suppose that, from +the day when fermentation first appears in the production of a +minute froth, which gradually increases until it whitens the +surface of the liquid, we take, every twenty-four hours, or at +longer intervals, a trace of the yeast deposited on the bottom of +the vessel and use it for starting fresh fermentations. +Conducting these fermentations all under precisely the same +conditions of temperature, character and volume of liquid, let us +continue this for a prolonged time, even after the original +fermentation is finished. We shall have no difficulty in seeing +that the first signs of action in each of our series of second +fermentations appear always later and later in proportion to the +length of time that has elapsed from the commencement of the +original fermentation. In other words, the time necessary for the +development of the germs and the production of that amount of +yeast sufficient to cause the first appearance of fermentation +varies with the state of the impregnating cells, and is longer in +proportion as the cells are further removed from the period of +their formation. It is essential, in experiments of this kind, +that the quantities of yeast successively taken should be as +nearly as possible equal in weight or volume, since, celeris +paribus, fermentations manifest themselves more quickly the +larger the quantity of yeast employed in impregnation. + +If we compare under the microscope the appearance and character +of the successive quantities of yeast taken, we shall see plainly +that the structure of the cells undergoes a progressive change. +The first sample which we take, quite at the beginning of the +original fermentation, generally gives us cells rather larger +than those later on, and possessing a remarkable tenderness. +Their walls are exceedingly thin, the consistency and softness of +their protoplasm is akin to fluidity, and their granular contents +appear in the form of scarcely visible spots. The borders of the +cells soon become more marked, a proof that their walls undergo a +thickening; their protoplasm also becomes denser, and the +granulations more distinct. Cells of the same organ, in the +states of infancy and old age, should not differ more than the +cells of which we are speaking, taken in their extreme states. +The progressive changes in the cells, after they have acquired +their normal form and volume, clearly demonstrate the existence +of a chemical work of a remarkable intensity, during which their +weight increases, although in volume they undergo no sensible +change, a fact that we have often characterized as "the continued +life of cells already formed." We may call this work a process of +maturation on the part of the cells, almost the same that we see +going on in the case of adult beings in general, which continue +to live for a long time, even after they have become incapable of +reproduction, and long after their volume has become permanently +fixed. + +This being so, it is evident, we repeat, that, to multiply in a +fermentable medium, quite out of contact with oxygen, the cells +of yeast must be extremely young, full of life and health, and +still under the influence of the vital activity which they owe to +the free oxygen which has served to form them, and which they +have perhaps stored up for a time. When older, they reproduce +themselves with much difficulty when deprived of air, and +gradually become more languid; and if they do multiply, it is in +strange and monstrous forms. A little older still, they remain +absolutely inert in a medium deprived of free oxygen. This is not +because they are dead; for in general they may be revived in a +marvellous manner in the same liquid if it has been first aerated +before they are sown. It would not surprise us to learn that at +this point certain preconceived ideas suggest themselves to the +mind of an attentive reader on the subject of the causes that may +serve to account for such strange phenomena in the life of these +beings which our ignorance hides under the expressions of YOUTH +and AGE; this, however, is a subject which we cannot pause to +consider here. + +At this point we must observe--for it is a matter of great +importance--that in the operations of the brewer there is always +a time when the yeasts are in this state of vigorous youth of +which we have been speaking, acquired under the influence of free +oxygen, since all the worts and the yeasts of commerce are +necessarily manipulated in contact with air, and so impregnated +more or less with oxygen. The yeast immediately seizes upon this +gas and acquires a state of freshness and activity, which permits +it to live afterwards out of contact with air, and to act as a +ferment. Thus, in ordinary brewery practice, we find the yeast +already formed in abundance even before the earliest external +signs of fermentation have made their appearance. In this first +phase of its existence, yeast lives chiefly like an ordinary +fungus. + +From the same circumstances it is clear that the brewer's +fermentations may, speaking quite strictly, last for an +indefinite time, in consequence of the unceasing supply of fresh +wort, and from the fact, moreover, that the exterior air is +constantly being introduced during the work, and that the air +contained in the fresh worts keeps up the vital activity of the +yeast, as the act of breathing keeps up the vigour and life of +cells in all living beings. If the air could not renew itself in +any way, the vital activity which the cells originally received, +under its influence, would become more and more exhausted, and +the fermentation eventually come to an end. + +We may recount one of the results obtained in other experiments +similar to the last, in which, however, we employed yeast which +was still older than that used for our experiment with flask A +(Fig. 2), and moreover took still greater precautions to prevent +the presence of air. Instead of leaving the flask, as well as the +dish, to cool slowly, after having expelled all air by boiling, +we permitted the liquid in the dish to continue boiling whilst +the flask was being cooled by artificial means; the end of the +escape tube was then taken out of the still boiling dish and +plunged into the mercury trough. In impregnating the liquid, +instead of employing the contents of the small cylindrical funnel +whilst still in a state of fermentation, we waited until this was +finished. Under these conditions, fermentation was still going on +in our flask, after a lapse of three months. We stopped it and +found that 0.255 gramme (3.9 grains) of yeast had been formed, +and that 45 grammes (693 grains) of sugar had fermented, the +ratio between the weights of yeast and sugar being thus 0.255 +divided by 45 = 1 divided by 176. In this experiment the yeast +developed with much difficulty, by reason of the conditions to +which it had been subjected. In appearance the cells varied much, +some were to be found large, elongated, and of tubular aspect, +some seemed very old and were extremely granular, whilst others +were more transparent. All of them might be considered abnormal +cells. + +In such experiments we encounter another difficulty. If the yeast +sown in the non-aerated fermentable liquid is in the least degree +impure, especially if we use sweetened yeast-water, we may be +sure that alcoholic fermentation will soon cease, if, indeed, it +ever commences, and that accessory fermentations will go on. The +vibrios of butyric fermentation, for instance, will propagate +with remarkable facility under these circumstances. Clearly then, +the purity of the yeast at the moment of impregnation, and the +purity of the liquid in the funnel, are conditions indispensable +to success. + +To secure the latter of these conditions, we close the funnel, as +shown in FIG. 2, by means of a cork pierced with two holes, +through one of which a short tube passes, to which a short length +of india-rubber tubing provided with a glass stopper is attached; +through the other hole a thin curved tube is passed. Thus fitted, +the funnel can answer the same purposes as our double-necked +flasks. A few cubic centimetres of sweetened yeast-water are put +in it and boiled, so that the steam may destroy any germs +adhering to the sides; and when cold the liquid is impregnated by +means of a trace of pure yeast, introduced through the glass- +stoppered tube. If these precautions are neglected, it is +scarcely possible to secure a successful fermentation in our +flasks, because the yeast sown is immediately held in check by a +development of anaerobian vibrios. For greater security, we may +add to the fermentable liquid, at the moment when it is prepared, +a very small quantity of tartaric acid, which will prevent the +development of butyric vibrios. + +[Illustration with caption: Fig. 4.] + +The variation of the ratio between the weight of the yeast and +that of the sugar decomposed by it now claims special attention. +Side by side with the experiments which we have just described, +we conducted a third lot by means of the flask C (Fig. 4), +holding 4.7 litres (8 1/2 pints), and fitted up like the usual +two-necked flasks, with the object of freeing the fermentable +liquid from foreign germs, by boiling it to begin with, so that +we might carry on our work under conditions of purity. The volume +of yeast-water (containing 5 per cent. of sugar) was only 200 cc. +(7 fl. oz.), and consequently, taking into account the capacity +of the flask, It formed but a very thin layer at the bottom. On +the day after impregnation the deposit of yeast was already +considerable, and forty-eight hours afterwards the fermentation +was completed. On the third day we collected the yeast after +having analyzed the gas contained in the flask. This analysis was +easily accomplished by placing the flask in a hot-water bath, +whilst the end of the curved tube was plunged under a cylinder of +mercury. The gas contained 41.4 per cent. of carbonic acid, and, +after the absorption, the remaining air contained:-- + +Oxygen . ... . ... . ... . ... . ... . ... . ... ... 19.7 + +Nitrogen . ... . ... . ... . ... . ... . ... . ... . 80.3 + + 100.0 + +Taking into consideration the volume of this flask, this shows a +minimum of 50 cc. (3.05 cub. in.) of oxygen to have been absorbed +by the yeast. The liquid contained no more sugar, and the weight +of the yeast, dried at a temperature of 100 degrees C (212 +degrees F.), was 0.44 grammes. The ratio between the weights of +yeast and sugar is 0.44/10=1/22.7 [Footnote: 200 cc. of liquid +were used, which, as containing 3 per cent., had in solution 10 +grammes of sugar.--D.C.R.]. On this occasion, where we had +increased the quantity of oxygen held in solution, so as to yield +itself for assimilation at the beginning and during the earlier +developments of the yeast, we found instead of the previous ratio +of 1/76 that of 1/23. + +[Illustration with caption: Fig. 5] + +The next experiment was to increase the proportion of oxygen to a +still greater extent, by rendering the diffusion of gas a more +easy matter than in a flask, the air in which is in a state of +perfect quiescence. Such a state of matters hinders the supply of +oxygen, inasmuch as the carbonic acid, as soon as it is +liberated, at once forms an immovable layer on the surface of the +liquid, and so separates off the oxygen. To effect the purpose of +our present experiment, we used flat basins having glass bottoms +and low sides, also of glass, in which the depth of the liquid is +not more than a few millimetres (less than 1/4 inch) (Fig. 5). The +following is one of our experiments so conducted:--On April 16th, +1860, we sowed a trace of beer yeast ("high" yeast) in 200 cc. (7 +fl. oz.) of a saccharine liquid containing 1.720 grammes (26.2 +grains) of sugar-candy. From April 18th our yeast was in good +condition and well developed. We collected it, after having added +to the liquid a few drops of concentrated sulphuric acid, with +the object of checking the fermentation to a great extent, and +facilitating filtration. The sugar remaining in the filtered +liquid, determined by Fehling's solution, showed that 1.04 +grammes (16 grains) of sugar had disappeared. The weight of the +yeast, dried at 100 degrees C. (212 degrees F.), was 0.127 gramme +(2 grains), which gives us the ratio between the weight of the +yeast and that of the fermented sugar 0.123/1.04=1/8.1, which is +considerably higher than the preceding ones. + +We may still further increase this ratio by making our estimation +as soon as possible after the impregnation, or the addition of +the ferment. It will be readily understood why yeast, which is +composed of cells that bud and subsequently detach themselves +from one another, soon forms a deposit at the bottom of the +vessels. In consequence of this habit of growth, the cells +constantly covering each other prevents the lower layers from +having access to the oxygen held in solution in the liquid, which +is absorbed by the upper ones. Hence, these which are covered and +deprived of this gas act on the sugar without deriving any vital +benefit from the oxygen--a circumstance which must tend to +diminish the ratio of which we are speaking. Once more repeating +the preceding experiment, but stopping it as soon as we think +that the weight of yeast formed may be determined by the balance +(we find that this may be done twenty-four hours after +impregnation with an inappreciable quantity of yeast), in this +case the ratio between the weights of yeast and sugar is gr/024 +yeast/0 gr. 09 sugar=1/4. This is the highest ratio we have been +able to obtain. + +Under these conditions the fermentation of sugar is extremely +languid: the ratio obtained is very nearly the same that ordinary +fungoid growths would give. The carbonic acid evolved is +principally formed by the decompositions which result from the +assimilation of atmospheric oxygen. The yeast, therefore, lives +and performs its functions after the manner of ordinary fungi: so +far it is no longer a ferment, so to say; moreover, we might +expect to find it to cease to be a ferment at all if we could +only surround each cell separately with all the air that it +required. This is what the preceding phenomena teach us; we shall +have occasion to compare them later on with others which relate +to the vital action exercised on yeast by the sugar of milk. + +We may here be permitted to make a digression. + +In his work on fermentations, which M. Schutzenberger has +recently published, the author criticises the deductions that we +have drawn from the preceding experiments, and combats the +explanation which we have given of the phenomena of fermentation. +[Footnote: International Science Series, vol. xx, pp. 179-182. +London, 1876.--D. C. R.] It is an easy matter to show the weak +point of M. Schutzenberger's reasoning. We determined the power +of the ferment by the relation of the weight of sugar decomposed +to the weight of the yeast produced. M. Schutzenberger asserts +that in doing this we lay down a doubtful hypothesis, and he +thinks that this power, which he terms FERMENTATIVE ENERGY, may +be estimated more correctly by the quantity of sugar decomposed +by the unit-weight of yeast in unit-time; moreover, since our +experiments show that yeast is very vigorous when it has a +sufficient supply of oxygen, and that, in such a case, it can +decompose much sugar in a little time, M. Schutzenberger +concludes that it must then have great power as a ferment, even +greater than when it performs its functions without the aid of +air, since under this condition it decomposes sugar very slowly. +In short, he is disposed to draw from our observations the very +opposite conclusion to that which we arrived at. + +M, Schutzenberger has failed to notice that the power of a +ferment is independent of the time during which it performs its +functions. We placed a trace of yeast in one litre of saccharine +wort; it propagated, and all the sugar was decomposed. Now, +whether the chemical action involved in this decomposition of +sugar had required for its completion one day, or one month, or +one year, such a factor was of no more importance in this matter +than the mechanical labour required to raise a ton of materials +from the ground to the top of a house would be affected by the +fact that it had taken twelve hours instead of one. The notion of +time has nothing to do with the definition of work. M. +Schutzenberger has not perceived that in introducing the +consideration of time into the definition of the power of a +ferment, he must introduce at the same time, that of the vital +activity of the cells which is independent of their character as +a ferment. Apart from the consideration of the relation existing +between the weight of fermentable substance decomposed and that +of ferment produced, there is no occasion to speak of +fermentations or of ferments. The phenomena of fermentation and +of ferments have been placed apart from others, precisely +because, in certain chemical actions, that ratio has been out of +proportion; but the time that these phenomena require for their +accomplishment has nothing to do with either their existence +proper, or with their power. The cells of a ferment may, under +some circumstances, require eight days for revival and +propagation, whilst, under other conditions, only a few hours are +necessary; so that, if we introduce the notion of time into our +estimate of their power of decomposition, we may be led to +conclude that in the first case that power was entirely wanting, +and that in the second case it was considerable, although all the +time we are dealing with the same organism--the identical +ferment. + +M. Schutzenberger is astonished that fermentation can take place +in the presence of free oxygen, if, as we suppose, the +decomposition of the sugar is the consequence of the nutrition of +the yeast, at the expense of the combined oxygen, which yields +itself to the ferment. At all events, he argues, fermentation +ought to be slower in the presence of free oxygen. But why should +it be slower? We have proved that in the presence of oxygen the +vital activity of the cells increases, so that, as far as +rapidity of action is concerned, its power cannot be diminished. +It might, nevertheless, be weakened as a ferment, and this is +precisely what happens. Free oxygen imparts to the yeast a vital +activity, but at the same time impairs its power as yeast--qua +yeast, inasmuch as under this condition it approaches the state +in which it can carry on its vital processes after the manner of +an ordinary fungus; the mode of life, that is, in which the ratio +between the weight of sugar decomposed and the weight of the new +cells produced will be the same as holds generally among +organisms which are not ferments. In short, varying our form of +expression a little, we may conclude with perfect truth, from the +sum total of observed facts, that the yeast which lives in the +presence of oxygen and can assimilate as much of that gas as is +necessary to its perfect nutrition, ceases absolutely to be a +ferment at all. Nevertheless, yeast formed under these conditions +and subsequently brought into the presence of sugar, OUT OF THE +INFLUENCE OF AIR, would decompose more IN A GIVEN TIME than in +any other of its states. The reason is that yeast which has +formed in contact with air, having the maximum of free oxygen +that it can assimilate is fresher and possessed of greater vital +activity than that which has been formed without air or with an +insufficiency of air. M. Schutzenberger would associate this +activity with the notion of time in estimating the power of the +ferment; but he forgets to notice that yeast can only manifest +this maximum of energy under a radical change of its life +conditions; by having no more air at its disposal and breathing +no more free oxygen. In other words, when its respiratory power +becomes null, its fermentative power is at its greatest. M. +Schutzenberger asserts exactly the opposite (p. 151 of his work-- +Paris, 1875) [Footnote: Page 182, English edition], and so +gratuitously places himself in opposition to facts. + +In presence of abundant air supply, yeast vegetates with +extraordinary activity. We see this in the weight of new yeast, +comparatively large, that may be formed in the course of a few +hours. The microscope still more clearly shows this activity in +the rapidity of budding, and the fresh and active appearance of +all the cells. Fig. 6 represents the yeast of our last experiment +at the moment when we stopped the fermentation. Nothing has been +taken from imagination, all the groups have been faithfully +sketched as they were. [Footnote: This figure is on a scale of +300 diameters, most of the figures in this work being of 400 +diameters]. + +[Illustration with caption: Fig. 6] + +In passing it is of interest to note how promptly the preceding +results were turned to good account practically. In well-managed +distilleries, the custom of aerating the wort and the juices to +render them more adapted to fermentation, has been introduced. +The molasses mixed with water, is permitted to run in thin +threads through the air at the moment when the yeast is added. +Manufactories have been erected in which the manufacture of yeast +is almost exclusively carried on. The saccharine worts, after the +addition of yeast, are left to themselves, in contact with air, +in shallow vats of large superficial area, realizing thus on an +immense scale the conditions of the experiments which we +undertook in 1861, and which we have already described in +determining the rapid and easy multiplication of yeast in contact +with air. + +The next experiment was to determine the volume of oxygen +absorbed by a known quantity of yeast, the yeast living in +contact with air, and under such conditions that the absorption +of air was comparatively easy and abundant. + +[Illustration with caption: Fig. 7] + +With this object we repeated the experiment that we performed +with the large-bottomed flask (Fig. 4), employing a vessel shaped +like Fig. B (Fig. 7), which is, in point of fact, the flask A +with its neck drawn out and closed in a flame, after the +introduction of a thin layer of some saccharine juice impregnated +with a trace of pure yeast. The following are the data and +results of an experiment of this kind. + +We employed 60 cc. (about 2 fluid ounces) of yeast-water, +sweetened with two percent. of sugar and impregnated with a trace +of yeast. After having subjected our vessel to a temperature of +25 degrees C. (77 degrees F.) in an oven for fifteen hours, the +drawn-out point was brought under an inverted jar filled with +mercury and the point broken off. A portion of the gas escaped +and was collected in the jar. For 25 cc. of this gas we found, +after absorption by potash 20.6, and after absorption by +pyrogallic acid, 17.3. Taking into account the volume which +remained free in the flask, which held 315 cc., there was a total +absorption of 14.5 cc. (0.83 cub. in.) of oxygen. [Footnote: It +may be useful for the non-scientific reader to put it thus: that +the 25 cc. which escaped, being a fair sample of the whole gas in +the flask, and containing (1) 25-20.6=4.4 cc., absorbed by potash +and therefore due to carbonic acid, and (2) 20.6-17.3=3.3 cc., +absorbed by pyrogallate, and therefore due to oxygen, and the +remaining 17.3 cc. being nitrogen, the whole gas in the flask, +which has a capacity of 312 cc., will contain oxygen in the above +portion and therefore its amount may be determined provided we +know the total gas in the flask before opening. On the other hand +we know that air normally contains approximately, 1-5 its volume +of oxygen, the rest being nitrogen, so that, by ascertaining the +diminution of the proportion in the flask, we can find how many +cubic centimeters have been absorbed by the yeast. The author, +however, has not given all the data necessary for accurate +calculation.--D.C.R.] The weight of the yeast, in a state of +dryness, was 0.035 gramme. + +It follows that in the production of 35 milligrammes (0.524 +grain) of yeast there was an absorption of 14 or 15 cc. (about +7/8 cub. in.) of oxygen, even supposing that the yeast was formed +entirely under the influence of that gas: this is equivalent to +not less than 414 cc. for 1 gramme of yeast (or about 33 cubic +inches for every 20 grains). [Footnote: This number is probably +too small; it is scarcely possible that the increase of weight in +the yeast, even under the exceptional conditions of the +experiment described, was not to some extent at least due to +oxidation apart from free oxygen, inasmuch as some of the cells +were covered by others. The increased weight of the yeast is +always due to the action of two distant modes of vital energy-- +activity, namely, in presence and activity in absence of air. We +might endeavor to shorten the duration of the experiment still +further, in which case we would still more assimilate the life of +the yeast to that of ordinary moulds.] + +Such is the large volume of oxygen necessary for the development +of one gramme of yeast when the plant can assimilate this gas +after the manner of an ordinary fungus. + +Let us now return to the first experiment described in the +paragraph on page 292 in which a flask of three litres capacity +was filled with fermentable liquid, which, when caused to +ferment, yielded 2.25 grammes of yeast, under circumstances where +it could not obtain a greater supply of free oxygen than 16.5 cc. +(about one cubic inch). According to what we have just stated, if +this 2.25 grammes (34 grains) of yeast had not been able to live +without oxygen, in other words, if the original cells had been +unable to multiply otherwise than by absorbing free oxygen, the +amount of that gas required could not have been less than 2.25 X +4l4 cc., that is, 931.5 cc. (56.85 cubic inches). The greater +part of the 2.25 grammes, therefore, had evidently been produced +as the growth of an anaerobian plant. + +Ordinary fungi likewise require large quantities of oxygen for +their development, as we may readily prove by cultivating any +mould in a closed vessel full of air, and then taking the weight +of plant formed and measuring the volume of oxygen absorbed. To +do this, we take a flask of the shape shown in Fig. 8, capable of +holding about 300 cc. (10 1/2 fluid ounces), and containing a +liquid adapted to the life of moulds. We boil this liquid, and +seal the drawn-out point after the steam has expelled the air +wholly or in part; we then open the flask in a garden or in a +room. Should a fungus-spore enter the flask, as will invariably +be the case in a certain number of flasks out of several used in +the experiment, except under special circumstances, it will +develop there and gradually absorb all the oxygen contained in +the air of the flask. Measuring the volume of this air, and +weighing, after drying, the amount of plant formed, we find that +for a certain quantity of oxygen absorbed we have a certain +weight of mycelium, or of mycelium together with its organs of +fructification. In an experiment of this kind, in which the plant +was weighed a year after its development, we found for 0.008 +gramme (0.123 gram) of MYCELIUM, dried at 100 degrees C. (212 +degrees F.), an absorption that amounted to not less than 43 cc. +(2.5 cubic inches) of oxygen at 25 degrees. These numbers, +however, must vary sensibly with the nature of the mould +employed, and also with the greater or less activity of its +development, because the phenomena is complicated by the presence +of accessory oxidations, such as we find in the case of mycoderma +vini and aceti, to which cause the large absorption of oxygen in +our last experiment may doubtless be attributed. [Footnote: In +these experiments, in which the moulds remain for a long time in +contact with a saccharine wort out of contact with oxygen--the +oxygen being promptly absorbed by the vital action of the plant +(see our Memoire sur les Generations dites Spontanees, p. 54. +note)--there is no doubt that an appreciable quantity of alcohol +is formed because the plant does not immediately lose vital +activity after the absorption of oxygen. + +A 300 cc. (10-oz.) flask, containing 100 cc. of must, after the +air in it had been expelled by boiling, was open and immediately +re-closed on August 15th, 1873. A fungoid growth--a unique one, +of greenish-grey colour--developed from spontaneous impregnation, +and decolourized the liquid, which originally was of a yellowish- +brown. Some large crystals, sparkling like diamonds, of neutral +tartrate of lime, were precipitated, about a year afterwards, +long after the death of the plant, we examined this liquid. It +contained 0.3 gramme (4.6 grains) of alcohol, and 0.053 gramme +(0.8 grain) of vegetable matter, dried at 100 degrees C. (212 +degrees F.). We ascertained that the spores of the fungus were +dead at the moment when the flask was opened. When sown, they did +not develop in the least degree.] + +The conclusions to be drawn from the whole of the preceding facts +can scarcely admit of doubt. As for ourselves, we have no +hesitation in finding them the foundation of the true theory of +fermentation. In the experiments which we have described, +fermentation by yeast, that is to say, by the type of ferments +properly so called, is presented to us, in a word, as the direct +consequence of the processes of nutrition, assimilation and life, +when these are carried on without the agency of free oxygen. The +heat required in the accomplishment of that work must necessarily +have been borrowed from the decomposition of the fermentable +matter, that is from the saccharine substance which, like other +unstable substances, liberates heat in undergoing decomposition. +Fermentation by means of yeast appears, therefore, to be +essentially connected with the property possessed by this minute +cellular plant of performing its respiratory functions, somehow +or other, with oxygen existing combined in sugar. Its +fermentative power--which power must not be confounded with the +fermentative activity or the intensity of decomposition in a +given time--varies considerably between two limits, fixed by the +greatest and least possible access to free oxygen which the plant +has in the process of nutrition. If we supply it with a +sufficient quantity of free oxygen for the necessities of its +life, nutrition, and respiratory combustions, in other words, if +we cause it to live after the manner of a mould, properly so +called, it ceases to be a ferment, that is, the ratio between the +weight of the plant developed and that of the sugar decomposed, +which forms its principal food, is similar in amount to that in +the case of fungi. [Footnote: We find in M. Raulin's note that +"the minimum ratio between the weight of sugar and the weight of +organized matter, that is, the weight of fungoid growth which it +helps to form, may be expressed as 10/3.2=3.1." JULES RAULIN, +Etudes chimiques sur la vegetation. Recherches sur le +developpement d'une mucedinee dans un milieu artificiel, p. 192, +Paris, 1870. We have seen in the case of yeast that this ratio +may be as low as [Proofers note: unreadable symbol]] On the other +hand, if we deprive the yeast of air entirely, or cause it to +develop in a saccharine medium deprived of free oxygen, it will +multiply just as if air were present, although with less +activity, and under these circumstances its fermentative +character will be most marked; under these circumstances, +moreover, we shall find the greatest disproportion, all other +conditions being the same, between the weight of yeast formed and +the weight of sugar decomposed. Lastly, if free oxygen occurs in +varying quantities, the ferment-power of the yeast may pass +through all the degrees comprehended between the two extreme +limits of which we have just spoken. It seems to us that we could +not have a better proof of the direct relation that fermentation +bears to life, carried on in the absence of free oxygen, or with +a quantity of that gas insufficient for all the acts of nutrition +and assimilation. + +Another equally striking proof of the truth of this theory is the +fact previously demonstrated that the ordinary moulds assume the +character of a ferment when compelled to live without air, or +with quantities of air too scant to permit of their organs having +around them as much of that element as is necessary for their +life as aerobian plants. Ferments, therefore, only possess in a +higher degree a character which belongs to many common moulds, if +not to all, and which they share, probably, more or less, with +all living cells, namely the power of living either an aerobian +or anaerobian life, according to the conditions under which they +are placed. + +It may be readily understood how, in their state of aerobian +life, the alcoholic ferments have failed to attract attention. +These ferments are only cultivated out of contract with air, at +the bottom of liquids which soon become saturated with carbonic +acid gas. Air is only present in the earlier developments of +their germs, and without attracting the attention of the +operator, whilst in their state of anaerobian growth their life +and action are of prolonged duration. We must have recourse to +special experimental apparatus to enable us to demonstrate the +mode of life of alcoholic ferments under the influence of free +oxygen; it is their state of existence apart from air, in the +depths of liquids, that attracts all our attention. The results +of their action are, however, marvellous, if we regard the +products resulting from them, in the important industries of +which they are the life and soul. In the case of ordinary moulds, +the opposite holds good. What we want to use special experimental +apparatus for with them, is to enable us to demonstrate the +possibility of their continuing to live for a time out of contact +with air, and all our attention, in their case, is attracted by +the facility with which they develop under the influence of +oxygen. Thus the decomposition of saccharine liquids, which is +the consequence of the life of fungi without air, is scarcely +perceptible, and so is of no practical importance. Their aerial +life, on the other hand, in which they respire and accomplish +their process of oxidation under the influence of free oxygen is +a normal phenomenon, and one of prolonged duration which cannot +fail to strike the least thoughtful of observers. We are +convinced that a day will come when moulds will be utilised in +certain industrial operations, on account of their power in +destroying organic matter. The conversion of alcohol into vinegar +in the process of acetification and the production of gallic acid +by the action of fungi on wet gall nuts, are already connected +with this kind of phenomena. [Footnote: We shall show, some day, +that the processes of oxidation due to growth of fungi cause, in +certain decompositions, liberation of ammonia to a considerable +extent, and that by regulating their action we might cause them +to extract the nitrogen from a host of organic debris, as also, +by checking the production of such organisms, we might +considerably increase the proportion of nitrates in the +artificial nitrogenous substances. By cultivating the various +moulds on the surface of damp bread in a current of air we have +obtained an abundance of ammonia, derived from the decomposition +of the albuminoids effected by the fungoid life. The +decomposition of asparagus and several other animal or vegetable +substances has similar results.] On this last subject, the +important work of M. Van Tieghem (Annales Scientifiques de +l'Ecole Normale, Vol. vi.) may be consulted. + +The possibility of living without oxygen, in the case of ordinary +moulds, is connected with certain morphological modifications +which are more marked in proportion as this faculty is itself +more developed. These changes in the vegetative forms are +scarcely perceptible, in the case of penicillium and mycoderma +vini, but they are very evident in the case of aspergillus, +consisting of a marked tendency on the part of the submerged +mycelial filaments to increase in diameter, and to develop cross +partitions at short intervals, so that they sometimes bear a +resemblance to chains of conidia. In mucor, again, they are very +marked, the inflated filaments which, closely interwoven, present +chains of cells, which fall off and bud, gradually producing a +mass of cells. If we consider the matter carefully, we shall see +that yeast presents the same characteristics. * * * * + +It is a great presumption in favor of the truth of theoretical +ideas when the results of experiments undertaken on the strength +of those ideas are confirmed by various facts more recently added +to science, and when those ideas force themselves more and more +on our minds, in spite of a prima facie improbability. This is +exactly the character of those ideas which we have just +expounded. We pronounced them in 1861, and not only have they +remained unshaken since, but they have served to foreshadow new +facts, so that it is much easier to defend them in the present +day than it was to do so fifteen years ago. We first called +attention to them in various notes, which we read before the +Chemical Society of Paris, notably at its meetings of April 12th +and June 28th, 1861, and in papers in the Comtes rendus de +l'Academie des Sciences. It may be of some interest to quote +here, in its entirety, our communication of June 28th, 1861, +entitled, "Influences of Oxygen on the Development of Yeast and +on Alcoholic Fermentation," which we extract from the Bulletin de +la Societe Chimique de Paris:-- + +"M. Pasteur gives the result of his researches on the +fermentation of sugar and the development of yeast-cells, +according as that fermentation takes place apart from the +influence of free oxygen or in contact with that gas. His +experiments, however, have nothing in common with those of Gay- +Lussac, which were performed with the juice of grapes crushed +under conditions where they would not be affected by air, and +then brought into contact with oxygen. + +"Yeast, when perfectly developed, is able to bud and grow in a +saccharine and albuminous liquid, in the complete absence of +oxygen or air. In this case but little yeast is formed, and a +comparatively large quantity of sugar disappears--sixty or eighty +parts for one of yeast formed. Under these conditions +fermentation is very sluggish. + +"If the experiment is made in contact with the air, and with a +great surface of liquid, fermentation is rapid. For the same +quantity of sugar decomposed much more yeast is formed. The air +with which the liquid is in contact is absorbed by the yeast. The +yeast develops very actively, but its fermentative character +tends to disappear under these conditions; we find, in fact, that +for one part of yeast formed, not more than from four to ten +parts of sugar are transformed. The fermentative character of +this yeast nevertheless, continues, and produces even increased +effects, if it is made to act on sugar apart from the influence +of free oxygen. + +"It seems, therefore, natural to admit that when yeast functions +as a ferment by living apart from the influence of air, it +derives oxygen from the sugar, and that this is the origin of its +fermentative character. + +"M. Pasteur explains the fact of the immense activity at the +commencement of fermentations by the influence of the oxygen of +the air held in solution in the liquids, at the time when the +action commences. The author has found, moreover, that the yeast +of beer sown in an albuminous liquid, such as yeast-water, still +multiplies, even when there is not a trace of sugar in the +liquid, provided always that atmospheric oxygen is present in +large quantities. When deprived of air, under these conditions, +yeast does not germinate at all. The same experiments may be +repeated with albuminous liquid, mixed with a solution of non- +fermentable sugar, such as ordinary crystallized milk-sugar. The +results are precisely the same. + +"Yeast formed thus in the absence of sugar does not change its +nature; it is still capable of causing sugar to ferment, if +brought to bear upon that substance apart from air. It must be +remarked, however, that the development of yeast is effected with +great difficulty when it has not a fermentable substance for its +food. In short, the yeast of beer acts in exactly the same manner +as an ordinary plant, and the analogy would be complete if +ordinary plants had such an affinity for oxygen as permitted them +to breathe by appropriating this element from unstable compounds, +in which case, according to M. Pasteur, they would appear as +ferments for those substances. + +"M. Pasteur declares that he hopes to be able to realize this +result, that is to say, to discover the conditions under which +certain inferior plants may live apart from air in the presence +of sugar, causing that substance to ferment as the yeast of beer +would do." + +This summary and the preconceived views that it set forth have +lost nothing of their exactness; on the contrary, time has +strengthened them. The surmises of the last two paragraphs have +received valuable confirmation from recent observations made by +Messrs. Lechartier and Bellamy, as well as by ourselves, an +account of which we must put before our readers. It is necessary, +however, before touching upon this curious feature in connection +with fermentations to insist on the accuracy of a passage in the +preceding summary; the statement, namely, that yeast could +multiply in an albuminous liquid, in which it found a non- +fermentable sugar, milk-sugar, for example. The following is an +experiment on this point:--On August 15th, 1875, we sowed a trace +of yeast in 150 cc. (rather more than 5 fluid ounces) of yeast-- +water, containing 2 1/2 per cent, of milk-sugar. The solution was +prepared in one of our double-necked flasks, with the necessary +precautions to secure the absence of germs, and the yeast sown +was itself perfectly pure. Three months afterwards, November +15th, 1875, we examined the liquid for alcohol; it contained only +the smallest trace; as for the yeast (which had sensibly +developed), collected and dried on a filter paper, it weighed +0.050 gramme (0.76 grain). In this case we have the yeast +multiplying without giving rise to the least fermentation, like a +fungoid growth, absorbing oxygen, and evolving carbonic acid, and +there is no doubt that the cessation of its development in this +experiment was due to the progressive deprivation of oxygen that +occurred. As soon as the gaseous mixture in the flask consisted +entirely of carbonic acid and nitrogen, the vitality of the yeast +was dependent on, and in proportion to, the quantity of air which +entered the flask in consequence of variations of temperature. +The question now arose, was this yeast, which had developed +wholly as an ordinary fungus, still capable of manifesting the +character of a ferment? To settle this point we had taken the +precaution on August 15th, 1875, of preparing another flask, +exactly similar to the preceding one in every respect, and which +gave results identical with those described. We decanted this +November 15th, pouring some wort on the deposit of the plant, +which remained in the flask. In less than five hours from the +time we placed it in the oven, the plant started fermentation in +the wort, as we could see by the bubbles of gas rising to form +patches on the surface of the liquid. We may add that yeast in +the medium which we have been discussing will not develop at all +without air. + +The importance of these results can escape no one; they prove +clearly that the fermentative character is not an invariable +phenomenon of yeast-life, they show that yeast is a plant which +does not differ from ordinary plants, and which manifests its +fermentative power solely in consequence of particular conditions +under which it is compelled to live. It may carry on its life as +a ferment or not, and after having lived without manifesting the +slightest symptom of fermentative character, it is quite ready to +manifest that character when brought under suitable conditions. +The fermentative property, therefore, is not a power peculiar to +cells of a special nature. It is not a permanent character of a +particular structure, like, for instance, the property of acidity +or alkalinity. It is a peculiarity dependent on external +circumstances and on the nutritive conditions of the organism. + + + + +II. FERMENTATION IN SACCHARINE FRUITS IMMERSED IN CARBONIC ACID +GAS + + +The theory which we have, step by step, evolved, on the subject +of the cause of the chemical phenomena of fermentation, may claim +a character of simplicity and generality that is well worthy of +attention. Fermentation is no longer one of those isolated and +mysterious phenomena which do not admit of explanation. It is the +consequence of a peculiar vital process of nutrition which occurs +tinder certain conditions, differing from those which +characterize the life of all ordinary beings, animal or +vegetable, but by which the latter may be affected, more or less, +in a way which brings them, to some extent within the class of +ferments, properly so called. We can even conceive that the +fermentative character may belong to every organized form, to +every animal or vegetable cell, on the sole condition that the +chemico-vital acts of assimilation and excretion must be capable +of taking place in that cell for a brief period, longer or +shorter it may be, without necessity for recourse to supplies of +atmospheric oxygen; in other words, the cell must be able to +derive its needful heat from the decomposition of some body which +yields a surplus of heat in the process. + +As a consequence of these conclusions it should be an easy matter +to show, in the majority of living beings, the manifestation of +the phenomena of fermentation; for there are, probably, none in +which all chemical action entirely disappears, upon the sudden +cessation of life. One day, when we were expressing these views +in our laboratory, in the presence of M. Dumas, who seemed +inclined to admit their truth, we added: "We should like to make +a wager that if we were to plunge a bunch of grapes into carbonic +acid gas, there would be immediately produced alcohol and +carbonic acid gas, in consequence of a renewed action starting in +the interior cells of the grapes, in such a way that these cells +would assume the functions of yeast cells. We will make the +experiment, and when you come to-morrow--it was our good fortune +to have M. Dumas working in our laboratory at that time--we will +give you an account of the result." Our predictions were +realized. We then endeavoured to find, in the presence of M. +Dumas, who assisted us in our endeavour, cells of yeast in the +grapes; but it was quite impossible to discover any. [Footnote: +To determine the absence of cells of ferment in fruits that have +been immersed in carbonic acid gas, we must first of all +carefully raise the pellicle of the fruit, taking care that the +subjacent parenchyma does not touch the surface of the pellicle, +since the organized corpuscles existing on the exterior of the +fruit might introduce an error into our miscroscopical +observations. Experiments on grapes have given us an explanation +of a fact generally known, the cause of which, however, had +hitherto escaped our knowledge. We all know that the taste and +aroma of the vintage, that is, of the grapes stripped from the +bunches and thrown into tubs, where they get soaked in the juice +that issues from the wounded specimens, are very different from +the taste and aroma of an uninjured bunch. Now grapes that have +been immersed in an atmosphere of carbonic acid gas have exactly +the flavour and smell of the vintage; the reason is that, in the +vintage tub, the grapes are immediately surrounded by an +atmosphere of carbonic acid gas, and undergo, in consequence, the +fermentation peculiar to grapes that have been plunged into this +gas. These facts deserve to be studied from a practical point of +view. It would be interesting, for example, to learn what +difference there would be in the quality of two wines, the grapes +of which, in the once case, had been perfectly crushed, so as to +cause as great a separation of the cells of the parenchyma as +possible; in the other case, left, for the most part, whole, as +in the case in the ordinary vintage. The first wine would be +deprived of those fixed and fragrant principles produced by the +fermentation of which we have just spoken, when the grapes are +immersed in carbonic acid gas, by such a comparison as that which +we suggest we should be able to form a priori judgment on the +merits of the new system, which had not been carefully studied, +although already widely adopted, of milled, cylindrical crushers, +for pressing the vintage.] + +Encouraged by this result, we undertook fresh experiments on +grapes, on a melon, on oranges, on plums, and on rhubarb leaves, +gathered in the garden of the Ecole Normale, and, in every case, +our substance, when immersed in carbonic acid gas, gave rise to +the production of alcohol and carbonic acid. We obtained the +following surprising results from some prunes de +Monsieur:[Footnote: We have sometimes found small quantities of +alcohol in fruits and other vegetable organs, surrounded with +ordinary air, but always in small proportion, and in a manner +which suggested its accidental character. It is east to +understand how, in the thickness of certain fruits, certain parts +of those fruits might be deprived of air, under which +circumstances they would have been acting under conditions +similar to those under which fruits act when wholly immersed in +the carbonic acid gas. Moreover, it would be useful to determine +whether alcohol is not a normal product of vegatation.]--On July +21, 1872, we placed twenty-four of these plums under a glass +bell, which we immediately filled with carbonic acid gas. The +plums had been gathered on the previous day. By the side of the +bell we placed other twenty-four plums, which were left there +uncovered. Eight days afterwards, in the course of which time +there had been a considerable evolution of carbonic acid from the +bell, we withdrew the plums and compared them with those which +had been left exposed to the air. The difference was striking, +almost incredible. Whilst the plums which had been surrounded +with air (the experiments of Berard have long since taught us +that, under this latter condition, fruits absorb oxygen from the +air and emit carbonic acid gas in almost equal volume) had become +very soft and watery and sweet, the plums taken from under the +jar had remained very firm and hard, the flesh was by no means +watery, but they had lost much sugar. Lastly, when submitted to +distillation, after crushing, they yielded 6.5 grammes (99.7 +grains) of alcohol, more than 1 per cent, of the total weight of +the plums. What better proof than these facts could we have of +the existence of a considerable chemical action in the interior +of fruit, an action which derives the heat necessary for its +manifestation from the decomposition of the sugar present in the +cells? Moreover, and this circumstance is especially worthy of +our attention, in all these experiments we found that there was a +liberation of heat, of which the fruits and other organs were the +seat, as soon as they were plunged in the carbonic acid gas. This +heat is so considerable that it may at times be detected by the +hand, if the two sides of the bell, one of which is in contact +with the objects, are touched alternately. It also makes itself +evident in the formation of little drops on those parts of the +bell which are less directly exposed to the influence of the heat +resulting from the decomposition of the sugar of the cells. +[Footnote: In these studies of plants living immersed in carbonic +acid gas, we have come across a fact which corroborated those +which we have already given in reference to the facility with +which lactic and viscous ferments, and generally speaking, those +which we have termed the disease ferments or beer, develop when +deprived of air, and which shows, consequently, how very marked +their aerobian character is. If we immerse beet-roots or turnips +in carbonic acid gas, we produce well-defined fermentations in +those roots. Their whole surface readily permits the escape of +the highly acid liquids, and they become filled with lactic, +viscous, and other ferments, This shows us the great danger which +may result from the use of pits, in which the beet-roots are +preserved, when the air is not renewed, and that the original +oxygen is expelled by the vital processes of fungi or other +deoxidizing chemical actions. We nave directed the attention of +the manufacturers of beet-root sugar to this point.] + +In short, fermentation is a very general phenomenon. It is life +without air, or life without free oxygen, or, more generally +still, it is the result of a chemical process accomplished on a +fermentable substance capable of producing heat by its +decomposition, in which process the entire heat used up is +derived from a part of the heat that the decomposition of the +fermentable substance sets free. The class of fermentations +properly so called, is, however, restricted by the small number +of substances capable of decomposing with the production of heat, +and at the same time of serving for the nourishment of lower +forms of life, when deprived of the presence and action of air. +This, again, is a consequence of our theory, which is well worthy +of notice, + +The facts that we have just mentioned in reference to the +formation of alcohol and carbonic acid in the substance of ripe +fruits, under special conditions, and apart from the action of +ferment, are already known to science. They were discovered in +1869 by M. Lechartier, formerly a pupil in the Ecole Normale +Superieure, and his coadjutor, M. Bellamy. [Footnote: Lechartier +and Bellamy, Comptes rendus de l'Academie des Sciences, vol. +lxix., pp., 366 and 466, 1869.] In 1821, in a very remarkable +work, especially when we consider the period when it appeared, +Berard demonstrated several important propositions in connection +with the maturation of fruits: + +I. All fruits, even those that are still green, and likewise even +those that are exposed to the sun, absorb oxygen and set free an +almost equal volume of carbonic acid gas. This is a condition of +their proper ripening. + +II. Ripe fruits placed in a limited atmosphere, after having +absorbed all the oxygen and set free an almost equal volume of +carbonic acid, continue to emit that gas in notable quantity, +even when no bruise is to be seen--"as though by a kind of +fermentation," as Berard actually observes--and lose their +saccharine particles, a circumstance which causes the fruits to +appear more acid, although the actual weight of their acid may +undergo no augmentation whatever. + +In this beautiful work, and in all subsequent ones of which the +ripening of fruits has been the subject, two facts of great +theoretical value have escaped the notice of the authors; these +are the two facts which Messrs. Lechartier and Bellamy pointed +out for the first time, namely, the production of alcohol and the +absence of cells of ferments. It is worthy of remark that these +two facts, as we have shown above, were actually fore-shadowed in +the theory of fermentation that we advocated as far back as 1861, +and we are happy to add that Messrs. Lechartier and Bellamy, who +at first had prudently drawn no theoretical conclusions from +their work, now entirely agree with the theory we have advanced. +[Footnote: Those gentlemen express themselves thus: "In a note +presented to the Academy in November, 1872, we published certain +experiments which showed that carbonic acid and alcohol may be +produced in fruits kept in a closed vessel, out of contact with +atmospheric oxygen, without our being able to discover alcoholic +ferment in the interior of those fruits. + +"M. Pasteur, as a logical deduction from the principle which he +has established in connection with the theory of fermentation, +considers that THE FORMATION OF ALCOHOL MAY BE ATTRIBUTED TO THE +FACT THAT THE PHYSICAL AND CHEMICAL PRECESSES OF LIFE IN THE +CELLS OF FRUIT CONTINUE UNDER NEW CONDITIONS, IN A MANNER SIMILAR +TO THOSE OF THE CELLS OF FERMENT. Experiments, continued during +1872, 1873, and 1874, on different fruits have furnished results +all of which seem to us to harmonize with this proposition, and +to establish it on a firm basis of proof."--Comptes rendus, t. +lxxix., p. 949, 1874.] Their mode of reasoning is very different +from that of the savants with whom we discussed the subject +before the Academy, on the occasion when the communication which +we addressed to the Academy in October, 1872, attracted attention +once more to the remarkable observations of Messrs. Lechartier +and Bellamy. [Footnote: PASTEUR, Faites nouveaux pour servir a la +connaissance de la theorie des fermentations proprement dites. +(Comptes rendus de l'Academie des Sciences, t. lxxv., p. 784.) +See in the same volume the discussion that followed; also, +PASTEUR, Note sur la production de l'alcool par les fruits, same +volume, p. 1054, in which we recount the observations anterior to +our own, made by Messrs. Lechartier and Bellamy in 1869.] M. +Fremy, in particular, was desirous of finding in these +observations a confirmation of his views on the subject of hemi- +organism, and a condemnation of ours, notwithstanding the fact +that the preceding explanations, and, more particularly our Note +of 1861, quoted word for word in the preceding section, furnish +the most conclusive evidence in favor of those ideas which we +advocate. Indeed, as far back as 1861 we pointed out very clearly +that if we could find plants able to live when deprived of air, +in the presence of sugar, they would bring about a fermentation +of that substance, in the same manner that yeast does. Such is +the case with the fungi already studied; such, too, is the case +with the fruits employed in the experiments of Messrs. Lechartier +and Bellamy, and in our own experiments, the results of which not +only confirm those obtained by these gentlemen, but even extend +them, in so far as we have shown that fruits, when surrounded +with carbonic acid gas immediately produce alcohol. When +surrounded with air, they live in their aerobian state and we +have no fermentation; immersed immediately afterwards in carbonic +acid gas, they now assume their anaerobian state, and at once +begin to act upon the sugar in the manner of ferments, and emit +heat. As for seeing in these facts anything like a confirmation +of the theory of hemi-organism, imagined by M. Fremy, the idea of +such a thing is absurd. The following, for instance, is the +theory of the fermentation of the vintage, according to M. Fremy. +[Footnote: Comptes rendus, meeting of January 15th, 1872.] + + + + + + + +"To speak here of alcoholic fermentation alone," our author says, +"I hold that in the production of wine it is the juice of the +fruit itself that, in contact with air, produces grains of +ferment, by the transformation of the albuminous matter; Pasteur, +on the other hand, maintains that the fermentation is produced by +germs existing outside of the grapes." [Footnote: As a matter of +fact, M. Fremy applies his theory of hemi-organism, not only to +the alcoholic fermentation of grape juice, but to all other +fermentations. The following passage occurs in one of his notes +(Comptes rendus de l'Academie, t. lxxv., p. 979, October 28th, +1872): + +"Experiments on Germinated Barley.--The object of these was to +show that when barley, left to itself in sweetened water, +produces in succession alcoholic, lactic, butyric, and acetic +fermentations, these modifications are brought about by ferments +which are produced inside the grains themselves, and not by +atmospheric germs. More than forty different experiments were +devoted to this part of my work." + +Need we add that this assertion is based on no substantial +foundation? The cells belonging to the grains of barley, or their +albuminous contents, never do produce cells of alcoholic ferment, +or of lactic ferment, or butyric vibrios. Whenever those ferments +appear, they may be traced to germs of those organisms, diffused +throughout the interior of the grains, or adhering to the +exterior surface, or existing in the water employed, or on the +side of the vessels used. There are many ways of demonstrating +this, of which the following is one: Since the results of our +experiments have shown that sweetened water, phosphates, and +chalk very readily give rise to lactic and butyric fermentations, +what reason is there for supposing that if we substitute grains +of barley for chalk, the lactic and butyric ferments will spring +from those grains, in consequence of a transformation of their +cells and albuminous substances? Surely there is no ground for +maintaining that they are produced by hemi-organism, since a +medium composed of sugar, or chalk, or phosphates of ammonia, +potash, or magnesia contains no albuminous substances. This is an +indirect but irresistible argument against the hemi-organism +theory.] + +Now what bearing on this purely imaginary theory can the fact +have, that a whole fruit, immersed in carbonic acid gas, +immediately produces alcohol and carbonic acid? In the preceding +passage which we have borrowed from M. Fremy, an indispensable +condition of the transformation of the albuminous matter is the +contact with air and the crushing of the grapes. Here, however, +we are dealing with UNINJURED FRUITS IN CONTACT WITH CARBONIC +ACID GAS. Our theory, on the other hand, which, we may repeat, we +have advocated since 1861, maintains that all cells become +fermentative when their vital action is protracted in the absence +of air, which are precisely the conditions that hold in the +experiments on fruits immersed in carbonic acid gas. The vital +energy is not immediately suspended in their cells, and the +latter are deprived of air. Consequently, fermentation must +result. Moreover, we may add, if we destroy the fruit, or crush +it before immersing it in the gas, it no longer produces alcohol +or fermentation of any kind, a circumstance that may be +attributed to the fact of the destruction of vital action in the +crushed fruit. On the other hand, in what way ought this crushing +to affect the hypothesis of hemi-organism? The crushed fruit +ought to act quite as well, or even better than that which is +uncrushed. In short, nothing can be more directly opposed to the +theory of the mode of manifestation of that hidden force to which +the name of hemi-organism has been given, than the discovery of +the production of these phenomena of fermentation in fruits +surrounded with carbonic acid gas; whilst the theory, which sees +in fermentation a consequence of vital energy in absence of air, +finds in these facts the strictest confirmation of an express +prediction, which from the first formed an integral part of its +statement. + +We should not be justified in devoting further time to opinions +which are not supported by any serious experiment. Abroad, as +well as in France, the theory of the transformation of albuminous +substances into organized ferments had been advocated long before +it had been taken up by M. Fremy. It no longer commands the +slightest credit, nor do any observers of note any longer give it +the least attention; it might even be said that it has become a +subject of ridicule. + +An attempt has also been made to prove that we have contradicted +ourselves, inasmuch as in 1860 we published our opinion that +alcoholic fermentation can never occur without a simultaneous +occurrence of organization, development, and multiplication of +globules; or continued life, carried on from globules already +formed. [Footnote: PASTEUR, Memoire sur la fermentation +alcoolique, 1860: Annales de Chimie et de Physique. The word +globules is here used for cells. In our researches we have always +endeavoured to prevent any confusion of ideas. We stated at the +beginning of our Memoir of 1860 that: "We apply the term +alcoholic to that fermentation which sugar undergoes under the +influence of the ferment known as BEER YEAST." This is, the +fermentation which produces wine and all alcoholic beverages. +This, too, is regarded as the type for a host of similar +phenomena designated, by general usage, under the generic name of +fermentation, and qualified by the name of one of the essential +products of the special phenomenon under observation. Bearing in +mind this fact in reference to the nomenclature that we have +adopted it will be seen that the expression ALCOHOLIC +FERMENTATION cannot be applied to every phenomenon of +fermentation in which alcohol is produced, inasmuch as there may +be a number of phenomena having this character in common. If we +had not at starting defined that particular one amongst the +number of very distinct phenomena, which, to the exclusion of the +others, should bear the name of alcoholic fermentation, we should +inevitably have given rise to a confusion of language that would +soon pass from words to ideas, and tend to introduce unnecessary +complexity into researches which are already, in themselves, +sufficiently complex to necessitate the adoption of scrupulous +care to prevent their becoming still more involved. It seems to +us that any further doubt as to the meaning of the words +ALCOHOLIC FERMENTATION, and the sense in which they are employed, +is impossible, inasmuch as Lavoisier, Gay-Lussac, and Thenard +have applied this term to the fermentation of sugar by means of +beer yeast. It would be both dangerous and unprofitable to +discard the example set by these illustrious masters, to whom we +are indebted for our earliest knowledge of this subject.] +Nothing, however, can be truer than that opinion, and at the +present moment, after fifteen years of study devoted to the +subject since the publication to which we have referred, we need +no longer say, "we think," but instead, "we affirm," that it is +correct. It is, as a matter of fact, to alcoholic fermentation, +properly so called, that the charge to which we have referred +relates--to that fermentation which yields, besides alcohol, +carbonic acid, succinic acid, glycerine, volatile acids, and +other products. This fermentation undoubtedly requires the +presence of yeast--cells under the conditions that we have named. +Those who have contradicted us have fallen into the error of +supposing that the fermentation of fruits is an ordinary +alcoholic fermentation, identical with that produced by beer +yeast, and that, consequently, the cells of that yeast must, +according to own theory, be always present. There is not the +least authority for such a supposition. When we come to exact +quantitative estimations--and these are to be found in the +figures supplied by Messrs. Lechartier and Bellamy--it will be +seen that the proportions of alcohol and carbonic acid gas +produced in the fermentation of fruits differ widely from those +that we find in alcoholic fermentations properly so called, as +must necessarily be the case since in the former the +fermentaction is effected by the cells of a fruit, but in the +latter by cells of ordinary alcoholic ferment. Indeed we have a +strong conviction that each fruit would be found to give rise to +special action, the chemical equation of which would be different +from that in the case of other fruits. As for the circumstance +that the cells of these fruits cause fermentation without +multiplying, this comes under the kind of activity which we have +already distinguished by the expression CONTINUOUS LIFE IN CELLS +ALREADY FORMED. + +We will conclude this section with a few remarks on the subject +of equations of fermentations, which have been suggested to us +principally in attempts to explain the results derived from the +fermentation of fruits immersed in carbonic acid gas. + +Originally, when fermentations were put amongst the class of +decompositions by contact-action, it seemed probable, and, in +fact, was believed, that every fermentation has its own well- +defined equation which never varied. In the present day, on the +contrary, it must be borne in mind that the equation of a +fermentation varies essentially with the conditions under which +that fermentation is accomplished, and that a statement of this +equation is a problem no less complicated than that in the case +of the nutrition of a living being. To every fermentation may be +assigned an equation in a general sort of way, an equation, +however, which, in numerous points of detail, is liable to the +thousand variations connected with the phenomena of life. +Moreover, there will be as many distinct fermentations brought +about by one ferment as there are fermentable substances capable +of supplying the carbon element of the food of that same ferment, +in the same way that the equation of the nutrition of an animal +will vary with the nature of the food which it consumes. As +regards fermentation producing alcohol, which may be effected by +several different ferments, there will be as in the case of a +given sugar, as many general equations as there are ferments, +whether they be ferment-cells properly so called, or cells of the +organs of living beings functioning as ferments. In the same way +the equation of nutrition varies in the case of different animals +nourished on the same food. And it is from the same reason that +ordinary wort produces such a variety of beers when treated with +the numerous alcoholic ferments which we have described. These +remarks are applicable to all ferments alike; for instance, +butyric ferment is capable of producing a host of distinct +fermentations, in consequence of its ability to derive the +carbonaceous part of its food from very different substances, +from sugar, or lactic acid, or glycerine, or mannite, and many +others. + +When we say that every fermentation has its own peculiar ferment, +it must be understood that we are speaking of the fermentation +considered as a whole, including all the accessory products. We +do not mean to imply that the ferment in question is not capable +of acting on some other fermentable substance and giving rise to +fermentation of a very different kind. Moreover, it is quite +erroneous to suppose that the presence of a single one of the +products of a fermentation implies the co-existence of a +particular ferment. If, for example, we find alcohol among the +products of a fermentation, or even alcohol and carbonic acid gas +together, this does not prove that the ferment must be an +alcoholic ferment, belonging to alcoholic fermentations, in the +strict sense of the term. Nor, again, does the mere presence of +lactic acid necessarily imply the presence of lactic ferment. As +a matter of fact, different fermentations may give rise to one or +even several identical products. We could not say with certainty, +from a purely chemical point of view, that we were dealing, for +example, with an alcoholic fermentation properly so called, and +that the yeast of beer must be present in it, if we had not first +determined the presence of all the numerous products of that +particular fermentation under conditions similar to those under +which the fermentation in question had occurred. In works on +fermentation the reader will often find those confusions against +which we are now attempting to guard him. It is precisely in +consequence of not having had their attention drawn to such +observations that some have imagined that the fermentation in +fruits immersed in carbonic acid gas is in contradiction to the +assertion which we originally made in our Memoir on alcoholic +fermentation published in 1860, the exact words of which we may +here repeat:--"The chemical phenomena of fermentation are related +essentially to a vital activity, beginning and ending with the +latter; we believe that alcoholic fermentation never occurs"--we +were discussing the question of ordinary alcoholic fermentation +produced by the yeast of beer--"without the simultaneous +occurrence of organization, development, and multiplication of +globules, or continued life, carried on by means of the globules +already formed. The general results of the present Memoir seem to +us to be it direct opposition to the opinions of MM. Liebig and +Berzelius." These conclusions, we repeat, are as true now as they +ever were, and are as applicable to the fermentation of fruits, +of which nothing was known in 1860, as they are to the +fermentation produced by the means of yeast. Only, in the case of +fruits, it is the cells of the parenchyma that function as +ferment, by a continuation of their activity in carbonic acid gas +whilst in the other case the ferment consists of cells of yeast. + +There should be nothing very surprising in the fact that +fermentation can originate in fruits and form alcohol without the +presence of yeast, if the fermentation of fruits were not +confounded completely with alcoholic fermentation yielding the +same products and in the same proportions. It is through the +misuse of words that the fermentation of fruits has been termed +alcoholic, in a way which has misled many persons. [Footnote: +See, for example, the communications of MM. Colin and Poggiale, +and the discussion on them. In the Bulletin de l'Academie de +Medecine, March 2d, 9th, and 30th, and February 16th and 23rd, +1875.] In this fermentation, neither alcohol nor carbonic acid +gas exists in those proportions in which they are found in +fermentation produced by yeast; and, although we may determine in +it the presence of succinic acid, glycerine, and a small quantity +of volatile acids [Footnote: We have elsewhere determined the +formation of minute quantities of volatile acids in alcoholic +fermentation. M. Bechamp, who studied these, recognized several +belonging to the series of fatty acids, acetic acid, butyric acid +&c. "The presence of succinic acid is not accidental, but +constant; if we put aside volatile acids that form in quantities +which we may call infinitely small, we may say that succinic acid +is the only normal acid of alcoholic fermentation."--PASTEUR, +Comptes rendus de l' Academie, t. xlvii., P. 224, 1858] the +relative proportions of these substances will be different from +what they are in the case of alcoholic fermentation. + + + + +III. REPLY TO CERTAIN CRITICAL OBSERVATIONS OF THE GERMAN +NATURALISTS, OSCAR BREFELD AND MORITZ TRAUBE. + + +The essential point of the theory of fermentation which we have +been concerned in proving in the preceding paragraphs may be +briefly put in the statement that ferments properly so called +constitute a class of beings possessing the faculty of living out +of contact with free oxygen; or, more concisely still, we may say +that fermentation is a result of life without air. + +If our affirmation were inexact, if ferment cells did require for +their growth or for their increase in number or weight, as all +other vegetable cells do, the presence of oxygen, whether gaseous +or held in solution in liquids, this new theory would lose all +value, its very raison d'etre would be gone, at least as far as +the most important part of fermentations is concerned. This is +precisely what M. Oscar Brefeld has endeavoured to prove in a +Memoir read to the Physico-Medical Society of Wurzburg on July +26th, 1873, in which, although we have ample evidence of the +great experimental skill of its author, he has nevertheless, in +our opinion, arrived at conclusions entirely opposed to fact. + +"From the experiments which I have just described," he says, "it +follows, in the most indisputable manner, that A FERMENT CANNOT +INCREASE WITHOUT FREE OXYGEN. Pasteur's supposition that a +ferment, unlike all other living organisms, can live and increase +at the expense of oxygen held in combination, is, consequently, +altogether wanting in any solid basis of experimental proof. +Moreover, since, according to the theory of Pasteur, it is +precisely this faculty of living and increasing at the expense of +the oxygen held in combination that constitutes the phenomenon of +fermentation, it follows that the whole theory, commanding though +it does such general assent, is shown to be untenable; it is +simply inaccurate." + +The experiments to which Dr. Brefeld alludes, consisted in +keeping under continued study with the microscope, in a room +specially prepared for the purpose, one or more cells of ferment +in wort in an atmosphere of carbonic acid gas free from the least +traces of free oxygen. We have, however, recognized the fact that +the increase of a ferment out of contact with air is only +possible in the case of a very young specimen; but our author +employed brewer's yeast taken after fermentation, and to this +fact we may attribute the non-success of his growths. Dr. +Brefeld, without knowing it, operated on yeast in one of the +states in which it requires gaseous oxygen to enable it to +germinate again. A perusal of what we have previously written on +the subject of the revival of yeast according to its age will +show how widely the time required for such revival may vary in +different cases. What may be perfectly true of the state of a +yeast to-day may not be so to-morrow, since yeast is continually +undergoing modifications. We have already shown the energy and +activity with which a ferment can vegetate in the presence of +free oxygen, and we have pointed out the great extent to which a +very small quantity; of oxygen held in solution in fermenting +liquids can operate at the beginning of fermentation. It is this +oxygen that produces revival in the cells of the ferment and +enables them to resume the faculty of germinating and continuing +their life, and of multiplying when deprived of air. + +In our opinion, a simple reflection should have guarded Dr. +Brefeld against the interpretation which he has attached to his +observations. If a cell of ferment cannot bud or increase without +absorbing oxygen, either free or held in solution in the liquid, +the ratio between the weight of the ferment formed during +fermentation and that of oxygen used up must be constant. We had, +however, clearly established, as far back as 1861, the fact that +this ratio is extremely variable, a fact, moreover, which is +placed beyond doubt by the experiments described in the preceding +section. Though but small quantities of oxygen are absorbed, a +considerable weight of ferment may be generated; whilst if the +ferment has abundance of oxygen at its disposal, it will absorb +much, and the weight of yeast formed will be still greater. The +ratio between the weight of ferment formed and that of sugar +decomposed may pass through all stages within certain very wide +limits, the variations depending on the greater or less +absorption of free oxygen. And in this fact, we believe, lies one +of the most essential supports of the theory which we advocate. +In denouncing the impossibility, as he considered it, of a +ferment living without air or oxygen, and so acting in defiance +of that law which governs all living beings, animal or vegetable, +Dr. Brefeld ought also to have borne in mind the fact which we +have pointed out, that alcoholic yeast is not the only organized +ferment which lives in an anaerobian state. It is really a small +matter that one more ferment should be placed in a list of +exceptions to the generality of living beings, for whom there is +a rigid law in their vital economy which requires for continued +life a continuous respiration, a continuous supply of free +oxygen. Why, for instance, has Dr. Brefeld omitted the facts +bearing on the life of the vibrios of butyric fermentation? +Doubtless he thought we were equally mistaken in these: a few +actual experiments would have put him right. + +These remarks on the criticisms of Dr. Brefeld are also +applicable to certain observations of M. Moritz Traube's, +although, as regards the principal object of Dr. Brefeld's +attack, we are indebted to M. Traube for our defence. This +gentleman maintained the exactness of our results before the +Chemical Society of Berlin, proving by fresh experiments that +yeast is able to live and multiply without the intervention of +oxygen. "My researches," he said, "confirm in an indisputable +manner M. Pasteur's assertion that the multiplication of yeast +can take place in media which contain no trace of free oxygen. +... M. Brefeld's assertion to the contrary is erroneous." But +immediately afterwards M. Traube adds: "Have we here a +confirmation of Pasteur's theory? By no means. The results of my +experiments demonstrate on the contrary that this theory has no +true foundation." What were these results? Whilst proving that +yeast could live without air, M. Traube, as we ourselves did, +found that it had great difficulty in living under these +conditions; indeed he never succeeded in obtaining more than the +first stages of true fermentation. This was doubtless for the two +following reasons: first, in consequence of the accidental +production of secondary and diseased fermentations which +frequently prevent the propagation of alcoholic ferment; and, +secondly, in consequence of the original exhausted condition of +the yeast employed. As long ago as 1861, we pointed out the +slowness and difficulty of the vital action of yeast when +deprived of air; and a little way back, in the preceding section, +we have called attention to certain fermentations that cannot be +completed under such conditions without going into the causes of +these peculiarities. M. Traube expresses himself thus: "Pasteur's +conclusion, that yeast in the absence of air is able to derive +the oxygen necessary for its development from sugar, is +erroneous; its increase is arrested even when the greater part of +the sugar still remains undecomposed. IT IS IN A MIXTURE OF +ALBUMINOUS SUBSTANCES THAT YEAST, WHEN DEPRIVED OF AIR, FINDS THE +MATERIALS FOR ITS DEVELOPMENT." This last assertion of M. +Traube's is entirely disproved by those fermentation experiments +in which, after suppressing the presence of albuminous +substances, the action, nevertheless, went on in a purely +inorganic medium, out of contact with air, a fact, of which we +shall give irrefutable proofs. [Footnote: Traube's conceptions +are governed by a theory of fermentation entirely his own, a +hypothetical one, as he admits, of which the following is a brief +summary: "We have no reason to doubt," Traube says, "that the +protoplasm of vegetable cells is itself, or contains within it, a +chemical ferment which causes the alcoholic fermentation of +sugar; its efficacy seems closely connected with the presence of +the cell, inasmuch as, up to the present time, we have discovered +no means of isolating it from the cells with success. In the +presence of air this ferment oxidizes sugar by bringing oxygen to +bear upon it; in the absence of air it decomposes the sugar by +taking away oxygen from one group of atoms of the molecule of +sugar and bringing it to act upon other atoms; on the one hand +yielding a product of alcohol by reduction, on the other hand a +product of carbonic acid gas by oxidation." + +Traube supposes that this chemical ferment exists in yeast and in +all sweet fruits, but only when the cells are intact, for he has +proved for himself that thoroughly crushed fruits give rise to no +fermentation whatever in carbonic acid gas. In this respect this +imaginary chemical ferment would differ entirely from those which +we call SOLUBLE FERMENTS, since diastase, emulsine, &c., may be +easily isolated. + +For a full account of the views of Brefeld and Traube, and the +discussion which they carried on on the subject of the results of +our experiments, our readers may consult the Journal of the +Chemical Society of Berlin, vii., p. 872. The numbers for +September and December, 1874, in the same volume, contain the +replies of the two authors.] + + +IV. FERMENTATION OF DEXTRO-TARTRATE OF LIME. + +[Footnote: See PASTEUR, Comptes rendus de l'Academie des +Sciences, t. lvi., p. 416.] + + +Tartrate of lime, in spite of its insolubility in waters is +capable of complete fermentation in a mineral medium. + +If we put some pure tartrate of lime, in the form of a +granulated, crystalline powder, into pure water, together with +some sulphate of ammonia and phosphates of potassium and +magnesium, in very small proportions, a spontaneous fermentation +will take place in the deposit in the course of a few days, +although no germs of ferment have been added. A living, organized +ferment, of the vibrionic type, filiform, with tortuous motions, +and often of immense length, forms spontaneously by the +development of some germs derived in some way from the inevitable +particles of dust floating in the air or resting on the surface +of the vessels or material which we employ. The germs of the +vibrios concerned in putrefaction are diffused around us on every +side, and, in all probability, it is one or more of these germs +that develop in the medium in question. In this way they effect +the decomposition of the tartrate, from which they must +necessarily obtain the carbon of their food without which they +cannot exist, while the nitrogen is furnished by the ammonia of +the ammoniacal salt, the mineral principles by the phosphate of +potassium and magnesium, and the sulphur by the sulphate of +ammonia. How strange to see organization, life, and motion +originating under such conditions! Stranger still to think that +this organization, life, and motion are effected without the +participation of free oxygen. Once the germ gets a primary +impulse on its living career by access of oxygen, it goes on +reproducing indefinitely, absolutely without atmospheric air. +Here then we have a fact which it is important to establish +beyond the possibility of doubt, that we may prove that yeast is +not the only organized ferment able to live and multiply when out +of the influence of free oxygen. + +Into a flask, like that represented in FIG. 9, of 2.5 litres +(about four pints) in capacity, we put: + + Pure, crystallized, neutral tartrate of lime. .. 100 grammes + Phosphate of ammonia. ... . ... . .. ... . ... 1 grammes + Phosphate of magnesium. ... . ... . ... . ... .. 1 grammes + Phosphate of potassium. ... . ... . ... . .. 0.5 grammes + Sulphate of ammonia. ... . ... . ... . ... .. 0.5 grammes + (1 gramme = 15.43 grains) + +To this we added pure distilled water, so as entirely to fill the +flask. + +In order to expel all the air dissolved in the water and adhering +to the solid substances, we first placed our flask in a bath of +chloride of calcium in a large cylindrical white iron pot set +over a flame. The exit tube of the flask was plunged in a test +tube of Bohemian glass three-quarters full of distilled water, +and also heated by a flame. We boiled the liquids in the flask +and test-tube for a sufficient time to expel all the air +contained in them. We then withdrew the heat from under the test- +tube, and immediately afterwards covered the water which it +contained with a layer of oil and then permitted the whole +apparatus to cool down. + +[Illustration with caption: Fig. 9] + +Next day we applied a finger to the open extremity of the exit- +tube, which we then plunged in a vessel of mercury. In this +particular experiment which we are describing, we permitted the +flask to remain in this state for a fort-night. It might have +remained there for a century without ever manifesting the least +sign of fermentation, the fermentation of the tartrate being a +consequence of life, and life after boiling no longer existed in +the flask. When it was evident that the contents of the flask +were perfectly inert, we impregnated them rapidly, as follows: +all the liquid contained in the exit-tube was removed by means of +a fine caoutchouc tube, and replaced by about 1 c. (about 17 +minims) of liquid and deposit from another flask, similar to the +one we have just described, but which had been fermenting +spontaneously for twelve days; we lost no time in refilling +completely the exit tube with water which had been first boiled +and then cooled down in carbonic acid gas. This operation lasted +only a few minutes. The exit-tube was again plunged under +mercury. Subsequently the tube was not moved from under the +mercury, and as it formed part of the flask, and there was +neither cork nor india-rubber, any introduction of air was +consequently impossible. The small quantity of air introduced +during the impregnation was insignificant and it might even be +shown that it injured rather than assisted the growth of the +organisms, inasmuch as these consisted of adult individuals which +had lived without air and might be liable to be damaged or even +destroyed by it. Be this as it may, in a subsequent experiment we +shall find the possibility removed of any aeration taking place +in this way, however infinitesimal, so that no doubts may linger +on this subject. + +The following days the organisms multiplied, the deposit of +tartrate gradually disappeared, and a sensible ferment action was +manifest on the surface, and throughout the bulk of the liquid. +The deposit seemed lifted up in places, and was covered with a +layer of dark-grey colour, puffed up, and having an organic and +gelatinous appearance. For several days, in spite of this action +in the deposit, we detected no disengagement of gas, except when +the flask was slightly shaken, in which case rather large bubbles +adhering to the deposit rose, carrying with them some solid +particles, which quickly fell back again, whilst the bubbles +diminished in size as they rose, from being partially taken into +solution, in consequence of the liquid not being saturated. The +smallest bubbles had even time to dissolve completely before they +could reach the surface of the liquid. In course of time the +liquid was saturated, and the tartrate was gradually displaced by +mammillated crusts, or clear, transparent crystals of carbonate +of lime at the bottom and on the sides of the vessel. + +The impregnation took place on February 10th, and on March 15th +the liquid was nearly saturated. The bubbles then began to lodge +in the bent part of the exit-tube, at the top of the flask. A +glass measuring-tube containing mercury was now placed with its +open end over the point of the exit-tube under the mercury in the +trough, so that no bubble might escape. A steady evolution of gas +went on from the 17th to the 18th, 17.4 cc. (1.06 cubic inches) +having been collected. This was proved to be nearly absolutely +pure carbonic acid, as indeed might have been suspected from the +fact that the evolution did not begin before a distinct +saturation of the liquid was observed. [Footnote: Carbonic add +being considerably more soluble than other gases possible under +the circumstances.--ED.] + +The liquid, which was turbid on the day after its impregnation, +had, in spite of the liberation of gas, again become so +transparent that we could read our handwriting through the body +of the flask. Notwithstanding this, there was still a very active +operation going on in the deposit, but it was confined to that +spot. Indeed, the swarming vibrios were bound to remain there, +the tartrate of lime being still more insoluble in water +saturated with carbonate of lime than it is in pure water. A +supply of carbonaceous food, at all events, was absolutely +wanting in the bulk of the liquid. Every day we continued to +collect and analyze the total amount of gas disengaged. To the +very last it was composed of pure carbonic acid gas. Only during +the first few days did the absorption by the concentrated potash +leave a very minute residue. By April 26th all liberation of gas +had ceased, the last bubbles having risen in the course of April +23rd. The flask had been all the time in the oven, at a +temperature between 25 degrees C. and 28 degrees C. (77 degrees +F. and 83 degrees F.). The total volume of gas collected was +2.135 litres (130.2 cubic inches). To obtain the whole volume of +gas formed we had to add to this what was held in the liquid in +the state of acid carbonate of lime. To determine this we poured +a portion of the liquid from the flask into another flask of +similar shape, but smaller, up to the gaugemark on the neck. +[Footnote: We had to avoid filling the small flask completely, +for fear of causing some of the liquid to pass on to the surface +of the mercury in the measuring tube. The liquid condensed by +boiling forms pure water, the solvent affinity of which for +carbonic acid, at the temperature we employ, is well known. This +smaller flask had been previously filled with carbonic acid. The +carbonic acid of the fermented liquid was then expelled by means +of heat, and collected over mercury. In this way we found a +volume of 8.322 litres (508 cubic inches) of gas in solution, +which, added to the 2.135 litres, gave a total of 10.457 litres +(638.2 cubic inches) at 20 degrees and 760 mm., which, calculated +to 0 degrees, C. and 760 mm. atmospheric pressure (32 degrees F. +and 30 inches) gave a weight of 19.700 grammes (302.2 grains) of +carbonic acid. + +Exactly half of the lime in the tartrate employed got used up in +the soluble salts formed during fermentation; the other half was +partly precipitated in the form of carbonate of lime, partly +dissolved in the liquid by the carbonic acid. The soluble salts +seemed to us to be a mixture or combination of 1 equivalent of +metacetate of lime, with 2 equivalents of the acetate, for every +10 equivalents of carbonic acid produced, the whole corresponding +to the fermentation of 3 equivalents of neutral tartrate of lime. +[Footnote: The following is a curious consequence of these +numbers and of the nature of the products of this fermentation. +The carbonic acid liberated being quite pure, especially when the +liquid has been boiled to expel all air from the flask, and +capable of perfect solution, it follows that the volume of liquid +being sufficient and the weight of tartrate suitably chosen--we +may set aside tartrate of lime in an insoluble, crystalline +powder, alone with phosphates at the bottom of a closed vessel +full of water, and find soon afterwards in their place carbonate +of lime, and in the liquid soluble salts of lime, with a mass of +organic matter at the bottom, without any liberation of gas or +appearance of fermentation ever taking place, except as far as +the vital action and transformation in the tartrate are +concerned. It is easy to calculate that a vessel or flask of five +litres (rather more than a gallon) would be large enough for the +accomplishment of this remarkable and singularly quiet +transformation, in the case of 50 grammes (767 grains) of +tartrate of lime.]. This point, however, is worthy of being +studied with greater care: the present statement of the nature of +the products formed is given with all reserve. For our point, +indeed, the matter is of little importance, since the equation of +the fermentation does not concern us. + +After the completion of fermentation there was not a trace of +tartrate of lime remaining at the bottom of the vessel: it had +disappeared gradually as it got broken up into the different +products of fermentation, and its place was taken by some +crystallized carbonate of lime--the excess, namely, which had +been unable to dissolve by the action of the carbonic acid. +Associated, moreover, with this carbonate of lime there was a +quantity of some kind of animal matter, which, under the +microscope, appeared to be composed of masses of granules mixed +with very fine filaments of varying lengths, studded with minute +dots, and presenting all the characteristics of a nitrogenous +organic substance. [Footnote: We treated the whole deposit with +dilute hydrochloric acid, which dissolved the carbonate of lime +and the insoluble phosphates of calcium and magnesium; afterwards +filtering the liquid through a weighed filter paper. Dried at 100 +degrees C. (212 degrees F.), the weight of the organic matter +thus obtained was 0.54 gramme (8.3 grains), which was rather more +than 1/200 of the weight of fermentable matter.] That this was +really the ferment is evident enough from all that we have +already said. To convince ourselves more thoroughly of the fact, +and at the same time to enable us to observe the mode of activity +of the organism, we instituted the following supplementary +observation. Side by side with the experiment just described, we +conducted a similar one, which we intermitted after the +fermentation was somewhat advanced, and about half of the +tartrate dissolved. Breaking off with a file the exit-tube at the +point where the neck began to narrow off, we took some of the +deposit from the bottom by means of a long straight piece of +tubing, in order to bring it under microscopical examination. We +found it to consist of a host of long filaments of extreme +tenuity, their diameter being about 1/1000th of a millimetre +(0.000039 in.); their length varied, in some cases being as much +as 1/20th of a millimetre (0.0019 in.). A crowd of these long +vibrios were to be seen creeping slowly along, with a sinuous +movement, showing three, four, or even five flexures. The +filaments that were at rest had the same aspect as these last, +with the exception that they appeared punctuate, as though +composed of a series of granules arranged in irregular order. No +doubt these were vibrios in which vital action had ceased, +exhausted specimens which we may compare with the old granular +ferment of beer, whilst those in motion may be compared with +young and vigorous yeast. The absence of movement in the former +seems to prove that this view is correct. Both kinds showed a +tendency to form clusters, the compactness of which impeded the +movements of those which were in motion. Moreover, it was +noticeable that the masses of these latter rested on tartrate not +yet dissolved, whilst the granular clusters of the others rested +directly on the glass, at the bottom of the flask, as if, having +decomposed the tartrate, the only carbonaceous food at their +disposal, they had then died on the spot where we captured them, +from inability to escape, precisely in consequence of that state +of entanglement which they combined to form, during the period of +their active development. Besides these we observed vibrios of +the same diameter, but of much smaller length, whirling round +with great rapidity, and darting backwards and forwards; these +were probably identical with the longer ones, and possessed +greater freedom of movement, no doubt in consequence of their +shortness. Not one of these vibrios could be found throughout the +mass of the liquid. + +[Illustration with caption: Figure 10.] + +We may remark that as there was a somewhat putrid odour from the +deposit in which the vibrios swarmed, the action must have been +one of reduction, and no doubt to this fact was due the greyish +coloration of the deposit. We suppose that the substances +employed, however pure, always contain some trace of iron, which +becomes converted into the sulphide, the black colour of which +would modify the originally white deposit of insoluble tartrate +and phosphate. + +But what is the nature of these vibrios? We have already said +that we believe that they are nothing but the ordinary vibrios of +putrefaction, reduced to a state of extreme tenuity by the +special conditions of nutrition involved in the fermentable +medium used; in a word, we think that the fermentation in +question might be called putrefaction of tartrate of lime. It +would be easy enough to determine this point by growing the +vibrios of such fermentation in media adapted to the production +of the ordinary forms of vibrio; but this is an experiment which +we have not ourselves tried. + +One word more on the subject of these curious beings. In a great +many of them there appears to be something like a clear spot, a +kind of bead, at one of their extremities. This is an illusion +arising from the fact that the extremity of these vibrios is +curved, hanging downwards, thus causing a greater refraction at +that particular point, and leading us to think that the diameter +is greater at that extremity. We may easily undeceive ourselves +if we watch the movements of the vibrio, when we will readily +recognize the bend, especially as it is brought into the vertical +plane passing over the rest of the filament. In this way we will +see the bright spot, THE HEAD, disappear, and then reappear. + +The chief inference that it concerns us to draw from the +preceding facts is one which cannot admit of doubt, and which we +need not insist on any further--namely that vibrios, as met with +in the fermentation of neutral tartrate of lime, are able to live +and multiply when entirely deprived of air. + + + + +V.--ANOTHER EXAMPLE OF LIFE WITHOUT AIR--FERMENTATION OF LACTATE +OF LIME + + +As another example of life without air, accompanied by +fermentation properly so called, we may lastly cite the +fermentation of lactate of lime in a mineral medium. + +In the experiment described in the last paragraph, it will be +remembered that the ferment liquid and the germs employed in its +impregnation came in contact with air, although only for a very +brief time. Now, notwithstanding that we possess exact +observations which prove that the diffusion of oxygen and +nitrogen in a liquid absolutely deprived of air, so far from +taking place rapidly, is, on the contrary, a very slow process +indeed; yet we were anxious to guard the experiment that we are +about to describe from the slightest possible trace of oxygen at +the moment of impregnation. + +We employed a liquid prepared as follows: Into from 9 to 10 +litres (somewhat over 2 gallons) of pure water the following +salts [Footnote: Should the solution of lactate of lime be +turbid, it may be clarified by filtration, after previously +adding a small quantity of phosphate of ammonia, which throws +down phosphate of lime. It is only after this process of +clarification and filtration that the phosphates of the formula +are added. The solution soon becomes turbid if left in contact +with air, in consequence of the spontaneous formation of +bacteria.] were introduced successively, viz: + + Pure lactate of lime. ... . ... . ... . ... . .. 225 grammes + Phosphate of ammonia. ... . ... . ... . ... . .. 0.75 grammes + Phosphate of potassium. ... . ... . ... . ... .. 0.4 grammes + Sulphate of magnesium. ... . ... . ... . ... ... 0.4 grammes + Sulphate of ammonia. ... . ... . ... . ... . ... 0.2 grammes + (1 gramme = 15.43 grains.) + +[Illustration with caption: Fig. 11] + +On March 23rd, 1875, we filled a 6 litre (about 11 pints) flask, +of the shape represented in FIG. 11, and placed it over a heater. +Another flame was placed below a vessel containing the same +liquid, into which the curved tube of the flask plunged. The +liquids in the flask and in the basin were raised to boiling +together, and kept in this condition for more than half-an-hour, +so as to expel all the air held in solution. The liquid was +several times forced out of the flask by the steam, and sucked +back again; but the portion which re-entered the flask was always +boiling. On the following day when the flask had cooled, we +transferred the end of the delivery tube to a vessel full of +mercury and placed the whole apparatus in an oven at a +temperature varying between 25 degrees C. and 30 degrees C. (77 +degrees F. and 86 degrees F.) then, after having refilled the +small cylindrical tap-funnel with carbonic acid, we passed into +it with all necessary precautions 10 cc. (0.35 fl. oz) of a +liquid similar to that described, which had been already in +active fermentation for several days out of contact with air and +now swarmed with vibrios. We then turned the tap of the funnel, +until only a small quantity of liquid was left, just enough to +prevent the access of air. In this way the impregnation was +accomplished without either the ferment-liquid or the ferment- +germs having been brought in contact, even for the shortest +space, with the external air. The fermentation, the occurrence of +which at an earlier or later period depends for the most part on +the condition of the impregnating germs, and the number +introduced in the act, in this case began to manifest itself by +the appearance of minute bubbles from March 29th. But not until +April 9th did we observe bubbles of larger size rise to the +surface. From that date onward they continued to come in +increasing number, from certain points at the bottom of the +flask, where a deposit of earthy phosphates existed; and at the +same time the liquid, which for the first few days remained +perfectly clear, began to grow turbid in consequence of the +development of vibrios. It was on the same day that we first +observed a deposit on the sides of carbonate of lime in crystals. + +It is a matter of some interest to notice here that, in the mode +of procedure adopted, everything combined to prevent the +interference of air. A portion of the liquid expelled at the +beginning of the experiment, partly because of the increased +temperature in the oven and partly also by the force of the gas, +as it began to be evolved from the fermentative action, reached +the surface of the mercury, where, being the most suitable medium +we know for the growth of bacteria, it speedily swarmed with +these organisms. [Footnote: The naturalist Cohn, of Breslau, who +published an excellent work on bacteria in 1872, described, after +Mayer, the composition of a liquid peculiarly adapted to the +propagation of these organisms, which it would be well to compare +for its utility in studies of this kind with our solution of +lactate and phosphates. The following is Cohn's formula: + + Distilled water. ... . ... . ... . ..20 cc. (0.7 fl. oz.) + Phosphate of potassium. ... . ... ...0.1 gramme (1.5 grains) + Sulphate of magnesium. ... . ... . 0.1 gramme (1.5 grains) + Tribasic phosphate of lime. ... ... 0.01 gramme (0.15 +grain) + Tartrate of ammonia. ... . ... . ... 0.2 gramme (3 grains) + +This liquid, the author says, has a feeble acid reaction and +forms a perfectly clear solution.] In this way any passage of +air, if such a thing were possible, between the mercury and the +sides of the delivery-tube was altogether prevented, since the +bacteria would consume every trace of oxygen which might be +dissolved in the liquid lying on the surface of the mercury. +Hence it is impossible to imagine that the slightest trace of +oxygen could have got into the liquid in the flask. + +Before passing on we may remark that in this ready absorption of +oxygen by bacteria we have a means of depriving fermentable +liquids of every trace of that gas with a facility and success +equal or even greater than by the preliminary method of boiling. +Such a solution as we have described, if kept at summer heat, +without any previous boiling, becomes turbid in the course of +twenty-four hours from a SPONTANEOUS development of bacteria; and +it is easy to prove that they absorb all the oxygen held in +solution. [Footnote: On the rapid absorption of oxygen by +bacteria, see also our Memoire of 1872, sur les Generations dites +Spontanees, especially the note on page 78.] If we completely +fill a flask of a few litres capacity (about a gallon) (Fig. 9) +with the liquid described, taking care to have the delivery-tube +also filled, and its opening plunged under mercury, and, forty- +eight hours afterwards by means of a chloride of calcium bath, +expel from the liquid on the surface of the mercury all the gas +which it holds in solution, this gas, when analyzed, will be +found to be composed of a mixture of nitrogen and carbonic acid +gas, WITHOUT THE LEAST TRACE OF OXYGEN. Here, then, we have an +excellent means of depriving the fermentable liquid of air; we +simply have completely to fill a flask with the liquid, and place +it in the oven, merely avoiding any addition of butyric vibrios, +before the lapse of two or three days. We may wait even longer; +and then, if the liquid does become impregnated spontaneously +with vibrio germs, the liquid, which at first was turbid from the +presence of bacteria, will become bright again, since the +bacteria, when deprived of life, or, at least, of the power of +moving, after they have exhausted all the oxygen in solution, +will fall inert to the bottom of the vessel. On several occasions +we have determined this interesting fact, which tends to prove +that the butyric vibrios cannot be regarded as another form of +bacteria, inasmuch as, on the hypothesis of an original relation +between the two productions, butyric fermentation ought in every +case to follow the growth of bacteria. + +We may also call attention to another striking experiment, well +suited to show the effect of differences in the composition of +the medium upon the propagation of microscopic beings. The +fermentation which we last described commenced on March 27th and +continued until May 10th; that to which we are now to refer, +however, was completed in four days, the liquid employed being +similar in composition and quantity to that employed in the +former experiment. On April 23, 1875, we filled a flask of the +same shape as that represented in Fig. 11, and of similar +capacity, viz., 6 litres, with a liquid composed as described at +page 69. This liquid had been previously left to itself for five +days in large open flasks, in consequence of which it had +developed an abundant growth of bacteria. On the fifth day a few +bubbles, rising from the bottom of the vessels, at long +intervals, betokened the commencement of butyric fermentation, a +fact, moreover, confirmed by the microscope, in the appearance of +the vibrios of this fermentation in specimens of the liquid taken +from the bottom of the vessels, the middle of its mass, and even +in the layer on the surface that was swarming with bacteria. We +transferred the liquid so prepared to the 6 litre flask arranged +over the mercury. By evening a tolerably active fermentation had +begun to manifest itself. On the 24th this fermentation was +proceeding with astonishing rapidity, which continued during the +25th and 26th. During the evening of the 26th it slackened, and +on the 27th all signs of fermentation had ceased. This was not, +as might be supposed, a sudden stoppage due to some unknown +cause; the fermentation was actually completed, for when we +examined the fermented liquid on the 28th we could not find the +smallest quantity of lactate of lime. If the needs of industry +should ever require the production of large quantities of butyric +acid, there would, beyond doubt, be found in the preceding fact +valuable information in devising an easy method of preparing that +product in abundance. [Footnote: In what way are we to account +for so great a difference between the two fermentations that we +have just described? Probably it was owing to some modification +effected in the medium by the previous life of the bacteria, or +to the special character of the vibrios used in impregnation. Or, +again, it might have been due to the action of the air, which, +under the conditions of our second experiment, was not absolutely +eliminated, since we took no precaution against its introduction +at the moment of filling our flask, and this would tend to +facilitate the multiplication of anaerobian vibrios, just as, +under similar conditions, would have been the case if we had been +dealing with a fermentation by ordinary yeast.] + +Before we go any further, let us devote some attention to the +vibrios of the preceding fermentations. + +On May 27th, 1862, we completely filled a flask capable of +holding 2.780 litres (about five pints) with the solution of +lactate and phosphates. [Footnote: In this case the liquid was +composed as follows: A saturated solution of lactate of lime, at +a temperature of 25 degrees C. (77 degrees F.), was prepared, +containing for every 1OO cc. (3 1/2 fl. oz.) 25.65 grammes (394 +grains) of the lactate, C6 H5 O5 Ca O (NEW NOTATION, C6 H10 Ca +O6) This solution was rendered very clear by the addition of 1 +gramme of phosphate of ammonia and subsequent filtration. For a +volume of 8 litres (14 pints) of this clear saturated solution we +used (1 gramme = 15.43 grains): + + Phosphate of ammonia. ... . ... . ... . ... 2 grammes + Phosphate of potassium. ... . ... . ... . ... 1 gramme + Phosphate of magnesium. ... . ... . ... . ... 1 gramme + Sulphate of ammonia. ... . ... . ... . ... 0.5 gramme] + +We refrained from impregnating it with any germs. The liquid +became turbid from a development of bacteria and then underwent +butyric fermentation. By June 9th the fermentation had become +sufficiently active to enable us to collect in the course of +twenty-four hours, over mercury, as in all our experiments, about +100 cc. (about 6 cubic inches) of gas. By June 11th, judging from +the volume of gas liberated in the course of twenty-four hours, +the activity of the fermentation had doubled. We examined a drop +of the turbid liquid. Here are the notes accompanying the sketch +(Fig. 12) as they stand in our note-book: "A swarm of vibrios, so +active in their movements that the eye has great difficulty in +following them. They may be seen in pairs throughout the field, +apparently making efforts to separate from each other. The +connection would seem to be by some invisible, gelatinous thread, +which yields so far to their efforts that they succeed in +breaking away from actual contact, but yet are, for a while, so +far restrained that the movements of one have a visible effect on +those of the other. By and by, however, we see a complete +separation effected, and each moves on its separate way with an +activity greater than it ever had before." + +[Illustration with caption: Fig. 12] + +One of the best methods that can be employed for the + +microscopical examination of these vibrios, quite out of contact +with air, is the following. After butyric fermentation has been +going on for several days in a flask, (Fig. 13), we connect this +flask by an india-rubber tube with one of the flattened bulbs +previously described, which we then place on the stage of the +microscope (Fig. 13). When we wish to make an observation we +close, under the mercury, at the point B, the end of the drawn- +out and bent delivery-tube. The continued evolution of gas soon +exerts such a pressure within the flask, that when we open the +tap R, the liquid is driven into the bulb LL, until it becomes +quite full and the liquid flows over into the glass V. In this +manner we may bring the vibrios under observation without their +coming into contact with the least trace of air, and with as much +success as if the bulb, which takes the place of an object glass, +had been plunged into the very centre of the flask. The movements +and fissiparous multiplication of the vibrios may thus be seen in +all their beauty, and it is indeed a most interesting sight. The +movements do not immediately cease when the temperature is +suddenly lowered, even to a considerable extent, 15 degrees C. +(59 degrees F.) for example; they are only slackened. +Nevertheless, it is better to observe them at the temperatures +most favourable to fermentation, even in the oven where the +vessels employed in the experiment are kept at a temperature +between 25 degrees C. and 30 degrees C. (77 degrees F. and 86 +degrees F.). + +[Illustration: Fig. 13] + +We may now continue our account of the fermentation which we were +studying when we made this last digression. On June 17th that +fermentation produced three times as much gas as it did on June +11th, when the residue of hydrogen, after absorption by potash, +was 72.6 per cent.; whilst on the 17th it was only 49.2 per cent. +Let us again discuss the microscopic aspect of the turbid liquid +at this stage. Appended is the sketch we made (Fig. 14) and our +notes on it: "A most beautiful object: vibrios all in motion, +advancing or undulating. They have grown considerably in bulk and +length since the 11th; many of them are joined together in long +sinuous chains, very mobile at the articulations, visibly less +active and more wavering in proportion to the number that go to +form the chain, of the length of the individuals." This +description is applicable to the majority of the vibrios which +occur in cylindrical rods and are homogeneous in aspect. There +are others, of rare occurrence in chains, which have a clear +corpuscle, that is to say, a portion more refractive than other +parts of the segments, at one of their extremities. Sometimes the +foremost segment has the corpuscle at one end, sometimes the +other. The long segments of the commoner kind attain a length of +from 10 to 30 and even 45 thousandths of a millimetre. Their +diameter is from 1 1/2 to 2, very rarely 3, thousandths of a +millimetre. [Footnote: 1 millimetre = 0.039 inch: hence the +dimensions indicated will be--length, from 0.00039 to 0.00117, or +even 0.00176 in.; diameter, from 0.000058 to 0.000078, rarely +0.000117 in.--D. C. R.] + +[Illustration: Figure 14.] + +On June 28th, fermentation was quite finished; there was no +longer any trace of gas, nor any lactate in solution. All the +infusoria were lying motionless at the bottom of the flask. The +liquid clarified by degrees, and in the course of a few days +became quite bright. Here we may inquire, were these motionless +infusoria, which from complete exhaustion of the lactate, the +source of the carbonaceous part of their food, were now lying +inert at the bottom of the fermenting vessel--were they dead +beyond the power of revival? [Footnote: The carbonaceous supply, +as we remarked, had failed them, and to this failure the absence +of vital action, nutrition, and multiplication was attributable. +The liquid, however, contained butyrate of lime, a salt +possessing properties similar to those of the lactate. Why could +not this salt equally well support the life of the vibrios? The +explanation of the difficulty seems to us to lie simply in the +fact that lactic acid produces heat by its decomposition, whilst +butyric acid does not, and the vibrios seem to require heat +during the chemical process of their nutrition.] The following +experiment leads us to believe that they were not perfectly +lifeless, and that they might behave in the same manner as the +yeast of beer, which, after it has decomposed all the sugar in a +fermentable liquid, is ready to revive and multiply in a fresh +saccharine medium. On April 22nd, 1875, we left in the oven at a +temperature of 25 degrees C. (77 degrees F.) a fermentation of +lactate of lime that had been completed. The delivery tube of the +flask A, (Fig. 15), in which it had taken place, had never been +withdrawn from under the mercury. We kept the liquid under +observation daily, and saw it gradually become brighter; this +went on for fifteen days. We then filled a similar flask, B, with +the solution of lactate, which we boiled, not only to kill the +germs of vibrios which the liquid might contain, but also to +expel the air that it held in solution. When the flask, B, had +cooled, we connected the two flasks, avoiding the introduction of +air, [Footnote: To do this it is sufficient, first, to fill the +curved ends of the stop-cocked tubes of the flasks, as well as +the india-rubber tube C C which connects them, with boiling water +that contains no air.] after having slightly shaken the flask, A, +to stir up the deposit at the bottom. There was then a pressure +due to carbonic acid at the end of the delivery tube of this +latter flask, at the point A, so that on opening the taps R and +S, the deposit at the bottom of flask A was driven over into +flask B, which in consequence was impregnated with the deposit of +a fermentation that had been completed fifteen days before. Two +days after impregnation the flask B began to show signs of +fermentation. It follows that the deposit of vibrios of a +completed butyric fermentation may be kept, at least for a +certain time, without losing the power of causing fementation. It +furnishes a butyric ferment, capable of revival and action in a +suitable fresh fermentable medium. + +[Illustration: Fig. 15] + +The reader who has attentively studied the facts which we have +placed before him cannot, in our opinion, entertain the least +doubt on the subject of the possible multiplication of the +vibrios of a fermentation of lactate of lime out of contact with +atmospheric oxygen. If fresh proofs of this important proposition +were necessary, they might be found in the following +observations, from which it may be inferred that atmospheric +oxygen is capable of suddenly checking a fermentation produced by +butyric vibrios, and rendering them absolutely motionless, so +that it cannot be necessary to enable them to live. On May 7th, +1862, we placed in the oven a flask holding 2.580 litres (4 1/2 +pints), and filled with the solution of lactate of lime and +phosphates, which we had impregnated on the 9th with two drops of +a liquid in butyric fermentation. In the course of a few days +fermentation declared itself: on the 18th it was active; on the +30th it was very active. On June 1st it yielded hourly 35 cc. +(2.3 cubic inches) of gas, containing ten per cent, of hydrogen. +On the 2nd we began the study of the action of air on the vibrios +of this fermentation. To do this we cut off the delivery-tube on +a level with its point of junction to the flask, then with a 50 +cc. pipette we took out that quantity (1 3/4 fl. oz.) of liquid +which was, of course, replaced at once by air. We then reversed +the flask with the opening under the mercury, and shook it every +ten minutes for more than an hour. Wishing to make sure, to begin +with, that the oxygen had been absorbed we connected under the +mercury the beak of the flask by means of a thin india-rubber +tube filled with water, with a small flask, the neck of which had +been drawn out and was filled with water; we then raised the +large flask with the smaller kept above it. A Mohr's clip, which +closed the india-rubber tube, and which we then opened, permitted +the water contained in the small flask to pass into the large +one, whilst the gas, on the contrary, passed upwards from the +large flask into the small one. We analyzed the gas immediately, +and found that, allowing for the carbonic acid and hydrogen, it +did not contain more than 14.2 per cent. of oxygen, which +corresponds to an absorption of 6.6 cc., or of 3.3 cc. (0.2 cubic +inch) of oxygen for the 50 cc. (3.05 cubic inches) of air +employed. Lastly, we again established connection by an india- +rubber tube between the flasks, after having seen by +microscopical examination that the movements of the vibrios were +very languid. Fermentation had become less vigorous without +having actually ceased, no doubt because some portions of the +liquid had not been brought into contact with the atmospheric +oxygen, in spite of the prolonged shaking that the flask had +undergone after the introduction of the air. Whatever the cause +might have been, the significance of the phenomenon is not +doubtful. To assure ourselves further of the effect of air on the +vibrios, we half filled two test tubes with the fermenting liquid +taken from another fermentation which had also attained its +maximum of intensity, into one of which we passed a current of +air, into the other carbonic acid gas. In the course of half an +hour, all the vibrios in the aerated tube were dead, or at least +motionless, and fermentation had ceased. In the other tube, after +three hours' exposure to the effects of the carbonic acid gas, +the vibrios were still very active, and fermentation was going +on. + +There is a most simple method of observing the deadly effect of +atmospheric air upon vibrios. We have seen in the microscopical +examination made by means of the apparatus represented in FIG. +13, how remarkable were the movements of the vibrios when +absolutely deprived of air, and how easy it was to discern them. +We will repeat this observation, and at the same time make a +comparative study of the same liquid under the microscope in the +ordinary way, that is to say, by placing a drop of the liquid on +an object-glass, and covering it with a thin glass slip, a method +which must necessarily bring the drop into contact with air, if +only for a moment. It is surprising what a remarkable difference +is observed immediately between the movements of the vibrios in +the bulb and those under the glass. In the case of the latter, we +generally see all movement at once cease near the edges of the +glass, where the drop of liquid is in direct contact with the +air; the movements continue for a longer or shorter time about +the centre, in proportion as the air is more or less intercepted +by the vibrios at the circumference of the liquid. It does not +require much skill in experiments of this kind to enable one to +see plainly that immediately after the glass has been placed on +the drop, which has been affected all over by atmospheric air, +the whole of the vibrios seem to languish and to manifest +symptoms of illness--we can think of no better expression to +explain what we see taking place--and that they gradually recover +their activity about the centre, in proportion as they find +themselves in a part of the medium that is less affected by the +presence of oxygen. + +Some of the most curious facts are to be found in connection with +an observation, the correlative and inverse of the foregoing, on +the ordinary aerobian bacteria. If we examine below the +microscope a drop of liquid full of these organisms under a +coverslip, we very soon observe a cessation of motion in all the +bacteria which lie in the central portion of the liquid, where +the oxygen rapidly disappears to supply the necessities of the +bacteria existing there; whilst, on the other hand, near the +edges of the cover-glass the movements are very active, in +consequence of the constant supply of air. In spite of the speedy +death of the bacteria beneath the centre of the glass, we see +life prolonged there if by chance a bubble of air has been +enclosed. All round this bubble a vast number of bacteria collect +in a thick, moving circle, but as soon as all the oxygen of the +bubble has been absorbed they fall apparently lifeless, and are +scattered by the movement of the liquid. [Footnote: We find this +fact, which we published as long ago as 1863, confirmed in a work +of H. Hoffman's, published in 1861 under the title of Memoire sur +les bacteries, which has appeared in French (Annales des Sciences +naturelles, 5th series, vol. ix.). On this subject we may cite an +observation that has not yet been published. Aerobian bacteria +lose all power of movement when suddenly plunged into carbonic +acid gas; they recover it, however, as if they had only been +suffering from anaesthesia, as soon as they are brought into the +air again.] + +We may here be permitted to add, as a purely historical matter, +that it was these two observations just described, made +successively one day in 1861, on vibrios and bacteria, that first +suggested to us the idea of the possibility of life without air, +and caused us to think that the vibrios which we met so +frequently in our lactic fermentations must be the true butyric +ferment. + +We may pause to consider an interesting question in reference to +the two characters under which vibrios appear in butyric +fermentations. What is the reason that some vibrios exhibit +refractive corpuscles, generally of a lenticular form, such as we +see in FIG. 14. We are strongly inclined to believe that these +corpuscles have to do with a special mode of reproduction in the +vibrios, common alike to the anaerobian forms which we are +studying, and the ordinary aerobian forms in which also the +corpuscles of which we are speaking may occur. The explanation of +the phenomenon, from our point of view, would be that, after a +certain number of fisiparous generations, and under the influence +of variations in the composition of the medium, which is +constantly changing through fermentation as well as through the +active life of the vibrios themselves, cysts, which are simply +the refractive corpuscles, form along them at different points. +From these gemmules we have ultimately produced vibrios, ready to +reproduce others by the process of transverse division for a +certain time, to be themselves encysted, later on. Various +observations incline us to believe that, in their ordinary form +of minute, soft, exuberant rods, the vibrios perish when +submitted to desiccation, but when they occur in corpuscular or +encysted form they possess unusual powers of resistance and may +be brought to the state of dry dust and be wafted about by winds. +None of the matter which surrounds the corpuscle or cyst seems to +take part in the preservation of the germ, when the cyst is +formed, for it is all re-absorbed, gradually leaving the cyst +bare. The cysts appear as masses of corpuscles, in which the most +practiced eye cannot detect anything of an organic nature, or +anything to remind one of the vibrios which produced them; +nevertheless, these minute bodies are endowed with a latent vital +action, and only await favourable conditions to develop long rods +of vibrios. We are not, it is true, in a position to adduce any +very forcible proofs in support of these opinions. They have been +suggested to us by experiments, none of which, however, have been +absolutely decisive in their favour. We may cite one of our +observations on this subject. + +In a fermentation of glycerine in a mineral medium--the glycerine +was fermenting under the influence of butyric vibrios--after we +had determined the, we may say, exclusive presence of lenticular +vibrios, with refractive corpuscles, we observed the +fermentation, which for some unknown reason had been very +languid, suddenly become extremely active, but now through the +influence of the ordinary vibrios. The gemmules with brilliant +corpuscles had almost disappeared; we could see but very few, and +those now consisted of the refractive bodies alone, the bulk of +the vibrios accompanying them having undergone some process of +re-absorption. + +Another observation which still more closely accords with this +hypothesis is given in our work on silk-worm disease (vol. 1, p. +256). We there demonstrated that, when we place in water some of +the dust formed of desiccated vibrios, containing a host of these +refractive corpuscles, in the course of a very few hours large +vibrios appear, well-developed rods fully grown, in which the +brilliant points are absent; whilst in the water no process of +development from smaller vibrios is to be discerned, a fact which +seems to show that the former had issued fully grown from the +refractive corpuscles, just as we see colpoda issue with their +adult aspect from the dust of their cysts. This observation, we +may remark, furnishes one of the best proofs that can be adduced +against the spontaneous generation of vibrios or bacteria, since +it is probable that the same observation applies to bacteria. It +is true that we cannot say of mere points of dust examined under +the microscope, that one particular germ belongs to vibrio, +another to bacterium; but how is it possible to doubt that the +vibrios issue, as we see them, from an ovum of some kind, a cyst, +or germ, of determinate character, when, after having placed some +of those indeterminate motes of dust into clean water, we +suddenly see, after an interval of not more than one or two +hours, an adult vibrio crossing the field of the microscope, +without our having been able to detect any intermediate state +between its birth and adolescence? + +[Illustration: Fig. 16] + +It is a question whether differences in the aspect and nature of +vibrios, which depend upon their more or less advanced age, or +are occasioned by the influence of certain conditions on the +medium in which they propagate, do not bring about corresponding +changes in the course of the fermentation and the nature of its +products. Judging at least from the variations in the proportions +of hydrogen, and carbonic acid gas produced in butyric +fermentations, we are inclined to think that this must be the +case; nay, more, we find that hydrogen is not even a constant +product in these fermentations. We have met with butyric +fermentations of lactate of lime which did not yield the minutest +trace of hydrogen, or anything besides carbonic acid. Fig. 16 +represents the vibrios which we observed in a fermentation of +this kind. They present no special features. Butyl alcohol is, +according to our observations, an ordinary product, although it +varies and is by no means a necessary concomitant of these +fermentations. It might be supposed, since butylic alcohol may be +produced and hydrogen be in deficit, that the proportion of the +former of these products would attain its maximum when the latter +assumed a minimum. This, however, is by no means the case; even +in those few fermentations that we have met with in which +hydrogen was absent, there was no formation of butylic alcohol. + +From a consideration of all the facts detailed in this section we +can have no hesitation in concluding that, on the one hand, in +cases of butyric fermentation, the vibrios which abound in them +and constitute their ferment, live without air or free oxygen; +and that, on the other hand, the presence of gaseous oxygen +operates prejudicially against the movements and activity of +those vibrios. But how does it follow that the presence of minute +quantities of air brought into contact with a liquid undergoing +butyric fermention would prevent the continuance of that +fermentation or even exercise any check upon it? We have not made +any direct experiments upon this subject; but we should not be +surprised to find that, so far from hindering, air may, under +such circumstances, facilitate the propagation of the vibrios and +accelerate fermentation. This is exactly what happens in the case +of yeast. But how could we reconcile this, supposing it were +proved to be the case, with the fact just insisted on as to the +danger of bringing the butyric vibrios into contact with air? It +may be possible that LIFE WITHOUT AIR results from habit, whilst +DEATH THROUGH AIR may be brought about by a sudden change in the +conditions of the existence of the vibrios. The following +remarkable experiment is well-known: A bird is placed in a glass +jar of one or two litres (60 to 120 cubic inches) in capacity +which is then closed. After a time the creature shows every sign +of intense uneasiness and asphyxia long before it dies; a similar +bird of the same size is introduced into the jar; the death of +the latter takes place instanteously, whilst the life of the +former may still be prolonged under these conditions for a +considerable time, and there is no, difficulty even in restoring +the bird to perfect health by taking it out of the jar. It seems +impossible to deny that we have here a case of the adaptation of +an organism to the gradual contamination of the medium; and so it +may likewise happen that the anaerobian vibrios of a butyric +fermentation, which develop and multiply absolutely without free +oxygen, perish immediately when suddenly taken out of their +airless medium, and that the result might be different if they +had been gradually brought under the action of air in small +quantities at a time. + +We are compelled here to admit that vibrios frequently abound in +liquids exposed to the air, and that they appropriate the +atmospheric oxygen, and could not withstand a sudden removal from +its influence. Must we, then, believe that such vibrios are +absolutely different from those of butyric fermentations? It +would, perhaps, be more natural to admit that in the one case +there is an adaptation to life with air, and in the other case an +adaptation to life without air; each of the varieties perishing +when suddenly transferred from its habitual condition to that of +the other, whilst by a series of progressive changes one might be +modified into the other. [Footnote: These doubts might be easily +removed by putting the matter to the test of direct experiment.] +We know that in the case of alcoholic ferments, although these +can actually live without air, propagation is wonderfully +assisted by the presence of minute quantities of air; and certain +experiments which we have not yet published lead us to believe +that, after having lived without air, they cannot be suddenly +exposed with impunity to the influence of large quantities of +oxygen. + +We must not forget, however, that aerobian torulae and anaerobian +ferments present an example of organisms apparently identical, in +which, however, we have not yet been able to discover any ties of +a common origin. Hence we are forced to regard them as a distinct +species; and so it is possible that there may likewise be +aerobian and anaerobian vibrios without any transformation of the +one into the other. + +The question has been raised whether vibrios, especially those +which we have shown to be the ferment of butyric and many other +fermentations, are in their nature, animal or vegetable. M. Ch. +Robin attaches great importance to the solution of this question, +of which he speaks as follows: [Footnote: ROBIN, Sur la nature +des fermentations, &c. (Journal de l'Academie et de la +Physiologie, July and August, 1875, P. 386).] "The determination +of the nature, whether animal or vegetable, of organisms, either +as a whole or in respect to their anatomical parts, assimilative +or reproductive, is a problem which has been capable of solution +for a quarter of a century. The method has been brought to a +state of remarkable precision, experimentally, as well as in its +theoretical aspects, since those who devote their attention to +the organic sciences consider it indispensable in every +observation and experiment to determine accurately, before +anything else, whether the object of their study is animal or +vegetable in its nature, whether adult or otherwise. To neglect +this is as serious an omission for such students as for chemists +would be the neglecting to determine whether it is nitrogen or +hydrogen, urea or stearine, that has been extracted from a +tissue, or which it is whose combinations they are studying in +this or that chemical operation. Now, scarcely any one of those +who study fermentations, properly so-called, and putrefactions, +ever pay any attention to the preceding data. ... Among the +observers to whom I allude, even M. Pasteur is to be found, who, +even in his most recent communications, omits to state definitely +what is the nature of many of the ferments which he has studied, +with the exception, however, of those which belong to the +cryptogamic group called torulaceae. Various passages in his work +seem to show that he considers the cryptogamic organisms called +bacteria, as well as those known as vibrios, as belonging to the +animal kingdom (see Bulletin de l'Academie de Medecine, Paris, +1875, pp. 249, 251, especially 256, 266, 267, 289, and 290). +These would be very different, at least physiologically, the +former being anaerobian, that is to say, requiring no air to +enable them to live, and being killed by oxygen, should it be +dissolved in the liquid to any considerable extent." + +We are unable to see the matter in the same light as our learned +colleague does; to our thinking, we should be labouring under a +great delusion were we to suppose "that it is quite as serious an +omission not to determine the animal or vegetable nature of a +ferment as it would be to confound nitrogen with hydrogen or urea +with stearine." The importance of the solutions of disputed +questions often depends on the point of view from which these are +regarded. As far as the result of our labours is concerned, we +devoted our attention to these two questions exclusively: 1. Is +the ferment, in every fermentation properly so called, an +organized being? 2. Can this organized being live without air? +Now, what bearing can the question of the animal or vegetable +nature of the ferment, of the organized being, have upon the +investigation of these two problems? In studying butyric +fermentation, for example, we endeavoured to establish these two +fundamental points; 1. The BUTYRIC FERMENT IS A VIBRIO. 2. THIS +VIBRIO MAY DISPENSE WITH AIR IN ITS LIFE, AND, AS A MATTER OF +FACT, DOES DISPENSE WITH IT IN THE ACT OF PRODUCING BUTYRIC +FERMENTATION. We did not consider it at all necessary to +pronounce any opinion as to the animal or vegetable nature of +this organism, and, even up to the present moment, the idea that +vibrio is an animal and not a plant is in our minds, a matter of +sentiment rather than of conviction. + +M. Robin, however, would have no difficulty in determining the +limits of the two kingdoms. According to him, "every variety of +cellulose is, we may say, insoluble in ammonia, as also are the +reproductive elements of plants, whether male or female. Whatever +phase of evolution the elements which reproduce a new individual +may have reached, treatment with this reagent, either cold or +raised to boiling, leaves them absolutely intact under the eyes +of the observer, except that their contents, from being partially +dissolved, become more transparent. Every vegetable whether +microscopic or not, every mycelium and every spore, thus +preserves in its entirety its special characteristics of form, +volume and structural arrangements; whilst in the case of +microscopic animals, or the ova and microscopic embryos of +different members of the animal kingdom, the very opposite is the +case." + +We should be glad to learn that the employment of a drop of +ammonia would enable us to pronounce an opinion with this degree +of confidence on the nature of the lowest microscopic beings; but +is M. Robin absolutely correct in his assumptions? That gentleman +himself remarks that spermatozoa, which belong to animal +organisms, are insoluble in ammonia, the effect of which is +merely to make them paler. If a difference of action in certain +reagents, in ammonia, for example, were sufficient to determine +the limits of the animal and vegetable kingdoms, might we not +argue that there must be a very great and natural difference +between moulds and bacteria, inasmuch as the presence of a small +quantity of acid in the nutritive medium facilitates the growth +and propagation of the former, whilst it is able to prevent the +life of bacteria and vibrios? Although as is well known, movement +is not an exclusive characteristic of animals, yet we have always +been inclined to regard vibrios as animals, on account of the +peculiar character of their movements. How greatly they differ in +this respect from the diatomacae, for example! When the vibrio +encounters an obstacle it turns, or after assuring itself by some +visual effort or other that it cannot overcome it, it retraces +its steps. The colpoda--undoubted infusoria--behave in an exactly +similar manner. It is true one may argue that the zoospores of +certain cryptogamia exhibit similar movements; but do not these +zoospores possess as much of an animal nature as do the +spermatozoa? As far as bacteria are concerned, when, as already +remarked, we see them crowd round a bubble of air in a liquid to +prolong their life, oxygen having failed them everywhere else, +how can we avoid believing that they are animated by an instinct +for life, of the same kind that we find in animals? M. Robin +seems to us to be wrong in supposing that it is possible to draw +any absolute line of separation between the animal and vegetable +kingdoms. The settlement of this line however, we repeat again, +no matter what it may be, has no serious bearing upon the +questions that have been the subject of our researches. + +In like manner the difficulty which M. Robin has raised in +objecting to the employment of the word GERM, when we cannot +specify whether the nature of that germ is animal or vegetable, +is in many respects an unnecessary one. In all the questions +which we have discussed, whether we were speaking of fermentation +or spontaneous generation, the word GERM has been used in the +sense of ORIGIN OF LIVING ORGANISM. If Liebig, for example, said +of an albuminous substance that it gave birth to ferment, could +we contradict him more plainly than by replying "No; ferment is +an organized being, the germ of which is always present, and the +albuminous substance merely serves by its occurrence to nourish +the germ and its successive generations"? + +In our Memoir of 1862, on so-called SPONTANEOUS generations, +would it not have been an entire mistake to have attempted to +assign specific names to the microscopic organisms which we met +with in the course of our observations? Not only would we have +met with extreme difficulty in the attempt, arising from the +state of extreme confusion which even in the present day exists +in the classification and nomenclature of these microscopic +organisms, but we should have been forced to sacrifice clearness +in our work besides; at all events, we should have wandered from +our principal object, which was the determination of the presence +or absence of life in general, and had nothing to do with the +manifestation of a particular kind of life in this or that +species, animal or vegetable. Thus we have systematically +employed the vaguest nomenclature, such as mucors, torulae, +bacteria, and vibrios. There was nothing arbitrary in our doing +this, whereas there is much that is arbitrary in adopting a +definite system of nomenclature, and applying it to organisms but +imperfectly known, the differences or resemblances between which +are only recognizable through certain characteristics, the true +signification of which is obscure. Take, for example, the +extensive array of widely different systems which have been +invented during the last few years for the species of the genera +bacterium and vibrio in the works of Cohn, H. Hoffmann, Hallier, +and Billroth. The confusion which prevails here is very great, +although we do not of course by any means place these different +works on the same footing as regards their respective merits. + +M. Robin is, however, right in recognizing the impossibility of +maintaining in the present day, as he formerly did, "That +fermentation is an exterior phenomenon, going on outside +cryptogamic cells, a phenomenon of contact. It is probably," he +adds, "an interior and molecular action at work in the innermost +recesses of the substance of each cell." From the day when we +first proved that it is possible for all organized ferments, +properly so called, to spring up and multiply from their +respective germs, sown, whether consciously or by accident, in a +mineral medium free from organic and nitrogenous matters other +than ammonia, in which medium the fermentable matter alone is +adapted to provide the ferment with whatever carbon enters into +its composition, from that time forward the theories of Liebig, +as well of Berzelius, which M. Robin formerly defended, have had +to give place to others more in harmony with facts. We trust that +the day will come when M. Robin will likewise acknowledge that he +has been in error on the subject of the doctrine of spontaneous +generation, which he continues to affirm, without adducing any +direct proofs in support of it, at the end of the article to +which we have been here replying. + +We have devoted the greater part of this chapter to the +establishing with all possible exactness the extremely important +physiological fact of life without air, and its correlation to +the phenomena of fermentations properly so called--that is to +say, of those which are due to the presence of microscopic +cellular organisms. This is the chief basis of the new theory +that we propose for the explanation of these phenomena. The +details into which we have entered were indispensable on account +of the novelty of the subject no less than on account of the +necessity we were under of combating the criticisms of the two +German naturalists, Drs. Oscar Brefeld and Traube, whose works +had cast some doubts on the correctness of the facts upon which +we had based the preceding propositions. We have much pleasure in +adding that at the very moment we were revising the proofs of +this chapter, we received from M. Brefeld an essay, dated Berlin, +January, 1876, in which, after describing his later experimental +researches, he owns with praiseworthy frankness that Dr. Traube +and he were both of them mistaken. Life without air is now a +proposition which he accepts as perfectly demonstrated. He has +witnessed it in the case of Mucor racemosus and has also verified +it in the case of yeast. "If," he says, "after the results of my +previous researches, which I conducted with all possible +exactness, I was inclined to consider Pasteur's assertion as +inaccurate and to attack them, I have no hesitation now in +recognizing them as true, and in proclaiming the service which +Pasteur has rendered to science in being the first to indicate +the exact relation of things in the phenomenon of fermentation." +In his later researches, Dr. Brefeld has adopted the method which +we have long employed for demonstrating the life and +multiplication of butyric vibrios in the entire absence of air, +as well as the method of conducting growths in mineral media +associated with fermentable substance. We need not pause to +consider certain other secondary criticisms of Dr. Brefeld. A +perusal of the present work will, we trust, convince him that +they are based on no surer foundation than were his former +criticisms. + +To bring one's self to believe in a truth that has just dawned +upon one is the first step towards progress; to persuade others +is the second. There is a third step, less useful perhaps, but +highly gratifying nevertheless, which is, to convince one's +opponents. + +We therefore, have experienced great satisfaction in learning +that we have won over to our ideas an observer of singular +ability, on a subject which is of the utmost importance to the +physiology of cells. + + + + +VI. REPLY TO THE CRITICAL OBSERVATIONS OF LIEBIG, PUBLISHED IN +1870. + +[Footnote: LIEBIG, Sur la fermentation et la source de la force +musculaire (Annales de Chimie et de Physique, 4th series, t. +xxiii., p. 5, 1870).] + +In the Memoir which we published, in 1860, on alcoholic +fermentation, and in several subsequent works, we were led to a +different conclusion on the causes of this very remarkable +phenomenon from that which Liebig had adopted. The opinions of +Mitscherlich and Berzelius had ceased to be tenable in the +presence of the new facts which we had brought to light. From +that time we felt sure that the celebrated chemist of Munich had +adopted our conclusions, from the fact that he remained silent on +this question for a long time, although it had been until then +the constant subject of his study, as is shown by all his works. +Suddenly there appeared in the Annales de Chimie et de Physique a +long essay, reproduced from a lecture delivered by him before the +Academy of Bavaria in 1868 and 1869. In this Liebig again +maintained, not, however, without certain modifications, the +views which he had expressed in his former publications, and +disputed the correctness of the principal facts enunciated in our +Memoir of 1860, on which were based the arguments against his +theory. + +"I had admitted," he says, "that the resolution of fermentable +matter into compounds of a simpler kind must be traced to some +process of decomposition taking place in the ferment, and that +the action of this same ferment on the fermentable matter must +continue or cease according to the prolongation or cessation of +the alteration produced in the ferment. The molecular change in +the sugar, would, consequently, be brought about by the +destruction or modification of one or more of the component parts +of the ferment, and could only take place through the contact of +the two substances. M. Pasteur regards fermentation in the +following light: The chemical action of fermentation is +essentially a phenomenon correlative with a vital action, +beginning and ending with it. He believes that alcoholic +fermentation can never occur without the simultaneous occurrence +of organization, development, and multiplication of globules, or +continuous life, carried on from globules already formed. But the +idea that the decomposition of sugar during fermentation is due +to the development of the cellules of the ferment, is in +contradiction with the fact that the ferment is able to bring +about the fermentation of a pure solution of sugar. The greater +part of the ferment is composed of a substance that is rich in +nitrogen and contains sulphur. It contains, moreover, an +appreciable quantity of phosphates, hence it is difficult to +conceive how, in the absence of these elements in a pure solution +of sugar undergoing fermentation, the number of cells is capable +of any increase." + +Notwithstanding Liebig's belief to the contrary, the idea that +the decomposition of sugar during fermentation is intimately +connected with a development of the cellules of the ferment, or a +prolongation of the life of cellules already formed, is in no way +opposed to the fact that the ferment is capable of bringing about +the fermentation of a pure solution of sugar. It is manifest to +any one who has studied such fermentation with the microscope, +even in those cases where the sweetened water has been absolutely +pure, that ferment-cells do multiply, the reason being that the +cells carry with them all the food-supplies necessary for the +life of the ferment. They may be observed budding, at least many +of them, and there can be no doubt that those which do not bud +still continue to live; life has other ways of manifesting itself +besides development and cell-proliferation. + +If we refer to the figures on page 81 of our Memoir of 1860, +Experiments D, E, F, H, I, we shall see that the weight of yeast, +in the case of the fermentation of a pure solution of sugar, +undergoes a considerable increase, even without taking into +account the fact that the sugared water gains from the yeast +certain soluble parts, since in the experiments just mentioned, +the weights of solid yeast, washed and dried at 100 degrees C. +(212 degrees F.), are much greater than those of the raw yeast +employed, dried at the same temperature. + +In these experiments we employed the following weights of yeast, +expressed in grammes (1 gramme=15.43 grains): + +(1) 2.313 + +(2) 2.626 + +(3) 1.198 + +(4) 0.699 + +(5) 0.326 + +(6) 0.476 + +which became, after fermentation, we repeat, without taking into +account the matters which the sugared water gained from the +yeast: + + grammes. grains. +(1) 2.486 Increase 0.173 = 2.65 + +(2) 2.963 Increase 0.337 = 5.16 + +(3) 1.700 Increase 0.502 = 7.7 + +(4) 0.712 Increase 0.013 = 0.2 + +(5) 0.325 Increase 0.009 = 0.14 + +(6) 0.590 Increase 0.114 = 1.75 + +Have we not in this marked increase in weight a proof of life, +or, to adopt an expression which may be preferred, a proof of a +profound chemical work of nutrition and assimilation? + +We may cite on this subject one of our earlier experiments, which +is to be found in the Comptes rendus de l'Academie for the year +1857, and which clearly shows the great influence exerted on +fermentation by the soluble portion that the sugared water takes +up from the globules of ferment: + +"We take two equal quantities of fresh yeast that have been +washed very freely. One of these we cause to ferment in water +containing nothing but sugar, and, after removing from the other +all its soluble particles--by boiling it in an excess of water +and then filtering it to separate the globules--we add to the +filtered liquid as much sugar as was used in the first case along +with a mere trace of fresh yeast insufficient, as far as its +weight is concerned, to affect the results of our experiment. The +globules which we have sown bud, the liquid becomes turbid, a +deposit of yeast gradually forms, and, side by side with these +appearances, the decomposition of the sugar is effected, and in +the course of a few hours manifests itself clearly. These results +are such as we might have anticipated. The following fact, +however, is of importance. In effecting by these means the +organization into globules of the soluble part of the yeast that +we used in the second case, we find that a considerable quantity +of sugar is decomposed. The following are the results of our +experiment; 5 grammes of yeast caused the fermentation of 12.9 +grammes of sugar in six days, at the end of which time it was +exhausted. The soluble portion of a like quantity of 5 grammes of +the same yeast caused the fermentation of 10 grammes of sugar in +nine days, after which the yeast developed by the sowing was +likewise exhausted." + +How is it possible to maintain that, in the fermentation of water +containing nothing but sugar, the soluble portion of the yeast +does not act, either in the production of new globules or the +perfection of old ones, when we see, in the preceding experiment, +that after this nitrogenous and mineral portion has been removed +by boiling, it immediately serves for the production of new +globules, which, under the influence of the sowing of a mere +trace of globules, causes the fermentation of so much sugar? +[Footnote: It is important that we should here remark that, in +the fermentation of pure solution of sugar by means of yeast, the +oxygen originally dissolved in the water, as well as that +appropriated by the globules of yeast in their contact with air, +has a considerable effect on the activity of the fermentation. As +a matter of fact, if we pass a strong current of carbonic acid +through the sugared water and the water in which the yeast has +been treated, the fermentation will be rendered extremely +sluggish, and the few new cells of yeast which form will assume +strange and abnormal aspects. Indeed this might have been +expected, for we have seen that yeast, when somewhat old, is +incapable of development or of causing fermentation even in a +fermentable medium containing all the nutritive principles of +yeast if the liquid has been deprived of air; much more should we +expect this to be the case in pure sugared water, likewise +deprived of air.] + +In short, Liebig is not justified in saying that the solution of +pure sugar, caused to ferment by means of yeast, contains none of +the elements needed for the growth of yeast, neither nitrogen, +sulphur nor phosphorus, and that, consequently, it should not be +possible, by our theory, for the sugar to ferment. On the +contrary, the solution does contain all these elements, as a +consequence of the introduction and presence of the yeast. + +Let us proceed without examination of Liebig's criticisms: + +"To this," he goes on to say, "must be added the decomposing +action which yeast exercises on a great number of substances, and +which resembles that which sugar undergoes. I have shown that +malate of lime ferments readily enough through the action of +yeast, and that it splits up into three other calcareous salts, +namely, the acetate, the carbonate and the succinate. If the +action of yeast consists in its increase and multiplication, it +is difficult to conceive this action in the case of malate of +lime and other calcareous salts of vegetable acids." + +This statement, with all due deference to the opinion of our +illustrious critic, is by no means correct. Yeast has no action +on malate of lime, or on other calcareous salts formed by +vegetable acids. Liebig had previously, much to his own +satisfaction, brought forward urea as being capable of +transformation into carbonate of ammonia during alcoholic +fermentation in contact with yeast. This has been proved to be +erroneous. It is an error of the same kind that Liebig again +brings forward here. In the fermentation of which he speaks (that +of malate of lime), certain spontaneous ferments are produced, +the germs of which are associated with the yeast, and develop in +the mixture of yeast and malate. The yeast merely serves as a +source of food for these new ferments without taking any direct +part in the fermentations of which we are speaking. Our +researches leave no doubt on this point, as is evident from the +observations on the fermentation of tartrate of lime previously +given. + +It is true that there are circumstances under which yeast brings +about modifications in different substances. Doebereiner and, +Mitscherlich, more especially, have shown that yeast imparts to +water a soluble material, which liquefies cane-sugar and produces +inversion in it by causing it to take up the elements of water, +just as diastase behaves to starch or emulsin to amygdalin. + +M. Berthelot also has shown that this substance may be isolated +by precipitating it with alcohol, in the same way as diastase is +precipitated from its solutions. [Footnote: DOEBEREINER, Journal +de Chimie de Schweigger, vol. xii., p. 129, and Journal de +Pharmacie, vol. i., p. 342. + +MITSCHERLICH, Monatsberichte d. Kon. Preuss. Akad. d. Wissen, eu +Berlin, and Rapports annuels da Berzelius, Paris, 1843, 3rd year. +On the occasion of a communication on the inversion of cane-sugar +by H. Rose, published in 1840, M. Mitscherlich observed: "The +inversion of cane-sugar in alcoholic fermentation is not due to +the globules of yeast, but to a soluble matter in the water with +which they mix. The liquid obtained by straining off the ferment +on a filter paper possesses the property of converting cane-sugar +into uncrystallizable sugar." + +BERTHELOT, Comptes rendus de l'Academie. Meeting of May 28th, +1860, M. Berthelot confirms the preceding experiment of +Mitscherlich, and proves, moreover, that the soluble matter of +which the author speaks may be precipitated with alcohol without +losing its invertive power. + +M. Bechamp has applied Mitscherlich's observation, concerning the +soluble fermentative part of yeast, to fungoid growths, and has +made the interesting discovery that fungoid growths, like yeast, +yield to water a substance that inverts sugar. When the +production of fungoid growths is prevented by means of an +antiseptic, the inversion of sugar does not take place. + +We may here say a few words respecting M. Bechamp's claim to +priority of discovery. It is a well-known fact that we were the +first to demonstrate that living ferments might be completely +developed if their germs were placed in pure water together with +sugar, ammonia, and phosphates. Relying on this established fact, +that moulds are capable of development in sweetened water in +which, according to M. Bechamp, they invert the sugar, our author +asserts that he has proved that "living organized ferments may +originate in media which contain no albuminous substances." (See +Comptes rendus, vol. ixxv., p. 1519.) To be logical, M. Bechamp +might say that he has proved that certain moulds originate in +pure sweetened water without nitrogen or phosphates or other +mineral elements, for such a deduction might very well be drawn +from his work, in which we do not find the least expression of +astonishment at the possibility of moulds developing in pure +water containing nothing but sugar without other mineral or +organic principles. + +M. Bechamp's first note on the inversion of sugar was published +in 1855. In it we find nothing relating to the influence of +moulds. His second, in which that influence is noticed, was +published in January, 1858, that is, subsequently to our work on +lactic fermentation, which appeared in November, 1857. In that +work we established for the first time that the lactic ferment is +a living, organized being, that albuminous substances have no +share in the production of fermentation, and that they only serve +as the food of the ferment. M. Bechamp's note was even subsequent +to our first work on alcoholic fermentation, which appeared on +December 21st, 1857. It is since the appearance of these two +works of ours that the preponderating influence of the life of +microscopic organism in the phenomena of fermentation has been +better understood. Immediately after their appearance M. Bechamp, +who from 1855 had made no observation on the action of fungoid +growths on sugar, although he had remarked their presence, +modified his former conclusions. (Comptes rendus, January 4th, +1858.)] These are remarkable facts, which are, however, at +present but vaguely connected with the alcoholic fermentation of +sugar by means of yeast. The researches in which we have proved +the existence of special forms of living ferments in many +fermentations, which one might have supposed to have been +produced by simple contact action, had established beyond doubt +the existence of profound differences between those +fermentations, which we have distinguished as fermentations +proper, and the phenomena connected with soluble substances. The +more we advance, the more clearly we are able to detect these +differences. M. Dumas has insisted on the fact that the ferments +of fermentation proper multiply and reproduce themselves in the +process whilst the others are destroyed. [Footnote: "There are +two classes of ferments; the first, of which the yeast of beer +may be taken as the type, perpetuate and renew themselves if they +can find in the liquid in which they produce fermentation food +enough for their wants; the second, of which diastase is the +type, always sacrifice themselves in the exercise of their +activity." (DUMAS, Comptes rendus de l'Academie, t. lxxv., p. +277, 1872.)] Still more recently M. Muntz has shown that +chloroform prevents fermentations proper, but does not interfere +with the action of diastase (Comptes rendus, 1875). M. Bouchardat +had already established the fact that hydrocyanic acid, salts of +mercury, ether, alcohol, creosote, and the oils of turpentine, +lemon, cloves, and mustard destroy or check alcoholic +fermentations, whilst in no way interfering with the glucoside +fermentations (Annales de Chimie et de Physique. 3rd series, t. +xiv., 1845). We may add in praise of M. Bouchardat's sagacity, +that that skilful observer has always considered these results as +a proof that alcoholic fermentation is dependent on the life of +the yeast-cell, and that a distinction should be made between the +two orders of fermentation. + +M. Paul Bert, in his remarkable studies on the influence of +barometric pressure on the phenomena of life, has recognized the +fact that compressed oxygen is fatal to certain ferments, whilst +under similar conditions it does not interfere with the action of +those substances classed under the name of SOLUBLE FERMENTS, such +as diastase (the ferment which inverts cane sugar) emulsin and +others. During their stay in compressed air, ferments proper +ceased their activity, nor did they resume it, even after +exposure to air at ordinary pressures, provided the access of +germs was prevented. + +We now come to Liebig's principal objection, with which he +concludes his ingenious argument, and to which no less than eight +or nine pages of the Annales are devoted. + +Our author takes up the question of the possibility of causing +yeast to grow in sweetened water, to which a salt of ammonia and +some yeast-ash have been added--a fact which is evidently +incompatible with his theory that a ferment is always an +albuminous substance on its way to decomposition. In this case +the albuminous substance does not exist; we have only the mineral +substances which will serve to produce it. We know that Liebig +regarded yeast, and, generally speaking, any ferment whatever, as +being a nitrogenous, albuminous substance which, in the same way +as emulsin, for example, possesses the power of bringing about +certain chemical decompositions. He connected fermentation with +the easy decomposition of that albuminous substance, and imagined +that the phenomenon occurred in the following manner: "The +albuminous substance on its way to decomposition possesses the +power of communicating to certain other bodies that same state of +mobility by which its own atoms are already affected; and through +its contact with other bodies it imparts to them the power of +decomposing or of entering into other combinations." Here Liebig +failed to perceive that the ferment, in its capacity of a living +organism, had anything to do with the fermentation. + +This theory dates back as far as 1843. In 1846 Messrs. Boutron +and Fremy, in a Memoir on lactic fermentation, published in the +Annales de Chimie et de Physique, strained the conclusions +deducible from it to a most unjustifiable extent. They asserted +that one and the same nitrogenous substance might undergo various +modifications in contact with air, so as to become successively +alcoholic, lactic, butyric, and other ferments. There is nothing +more convenient than purely hypothetical theories, theories which +are not the necessary consequences of facts; when fresh facts +which cannot be reconciled with the original hypothesis are +discovered, new hypotheses can be tacked on to the old ones. This +is exactly what Liebig and Fremy have done, each in his turn, +under the pressure of our studies, commenced in 1857. In 1864 +Fremy devised the theory of hemi-organism, which meant nothing +more than that he gave up Liebig's theory of 1843, together with +the additions which Boutron and he had made to it in 1846; in +other words, he abandoned the idea of albuminous substances being +ferments, to take up another idea, that albuminous substances in +contact with air are peculiarly adapted to undergo organization +into new beings--that is, the living ferments which we had +discovered--and that the ferments of beer and of the grape have a +common origin. + +This theory of hemi-organism was word for word the antiquated +opinion of Turpin. * * * The public, especially a certain section +of the public did not go very deeply into an examination of the +subject. It was the period when the doctrine of spontaneous +generation was being discussed with much warmth. The new word +hemi-organism, which was the only novelty in M. Fremy's theory, +deceived people. It was thought that M. Fremy had really +discovered the solution of the question of the day. It is true +that it was rather difficult to understand the process by which +an albuminous substance could become all at once a living and +budding cell. This difficulty was solved by M. Fremy, who +declared that it was the result of some power that was not yet +understood, the power of "organic impulse." [Footnote: FREMY, +Comptes rendus de l'Academie, vol. lviii., p. 1065, 1864.] + +Liebig, who, as well as M. Fremy, was compelled to renounce his +original opinions concerning the nature of ferments, devised the +following obscure theory (Memoir by Liebig, 1870, already cited): + +"There seems to be no doubt as to the part which the vegetable +organism plays in the phenomenon of fermentation. It is through +it alone that an albuminous substance and sugar are enabled to +unite and form this particular combination, this unstable form +under which alone, as a component part of the mycoderm, they +manifest an action on sugar. Should the mycoderm cease to grow, +the bond which unites the constituent parts of the cellular +contents is loosened, and it is through the motion produced +therein that the cells of yeast bring about a disarrangement or +separation of the elements of the sugar into molecules." + +One might easily believe that the translator for the Annales has +made some mistake, so great is the obscurity of this passage. + +Whether we take this new form of the theory or the old one, +neither can be reconciled at all with the development of yeast +and fermentation in a saccharine mineral medium, for in the +latter experiment fermentation is correlative to the life of the +ferment and to its nutrition, a constant change going on between +the ferment and its food-matters, since all the carbon +assimilated by the ferment is derived from sugar, its nitrogen +from ammonia and phosphorus from the phosphates in solution. And +even all said, what purpose can be served by the gratuitous +hypothesis of contact-action or communicated motion? The +experiment of which we are speaking is thus a fundamental one; +indeed, it is its possibility that constitutes the most effective +point in the controversy. No doubt Liebig might say, "but it is +the motion of life and of nutrition which constitutes your +experiment, and this is the communicated motion that my theory +requires." Curiously enough, Liebig does endeavour, as a matter +of fact, to say this, but he does so timidly and incidentally: +"From a chemical point of view, which point of view I would not +willingly abandon, a VITAL ACTION is a phenomenon of motion, and, +in this double sense of LIFE M. Pasteur's theory agrees with my +own, and is not in contradiction with it (page 6)." This is true. +Elsewhere Liebig says: + +"It is possible that the only correlation between the +physiological act and the phenomenon of fermentation is the +production, in the living cell, of the substance which, by some +special property analogous to that by which emulsin exerts a +decomposing action on salicin and amygdalin, may bring about the +decomposition of sugar into other organic molecules; the +physiological act, in this view, would be necessary for the +production of this substance, but would have nothing else to do +with the fermentation (page 10)." To this, again, we have no +objection to raise. + +Liebig, however, does not dwell upon these considerations, which +he merely notices in passing, because he is well aware that, as +far as the defence of his theory is concerned, they would be mere +evasions. If he had insisted on them, or based his opposition +solely upon them, our answer would have been simply this: "If you +do not admit with us that fermentation is correlated with the +life and nutrition of the ferment, we agree upon the principal +point. So agreeing, let us examine, if you will, the actual cause +of fermentation;--this is a second question, quite distinct from +the first. Science is built up of successive solutions given to +questions of ever increasing subtlety, approaching nearer and +nearer towards the very essence of phenomena. If we proceed to +discuss together the question of how living, organized beings act +in decomposing fermentable substances, we will be found to fall +out once more on your hypothesis of communicated motion, since +according to our ideas, the actual cause of fermentation is to be +sought, in most cases, in the fact of life without air, which is +the characteristic of many ferments." + +Let us briefly see what Liebig thinks of the experiment in which +fermentation is produced by the impregnation of a saccharine +mineral medium, a result so greatly at variance with his mode of +viewing the question. [Footnote: See our Memoir of 1860 (Annales +de Chimie et de Physique, vol. lviii, p. 61, and following, +especially pp. 69 and 70, where the details of the experiment +will be found).] After deep consideration he pronounces this +experiment to be inexact, and the result ill-founded. Liebig, +however, was not one to reject a fact without grave reasons for +doing so, or with the sole object of evading a troublesome +discussion. "I have repeated this experiment," he says, "a great +number of times, with the greatest possible care, and have +obtained the same results as M. Pasteur, excepting as regards the +formation and increase of the ferment." It was, however, the +formation and increase of the ferment that constituted the point +of the experiment. Our discussion was, therefore, distinctly +limited to this: Liebig denied that the ferment was capable of +development in a saccharine mineral medium, whilst we asserted +that this development did actually take place, and was +comparatively easy to prove. In 1871 we replied to M. Liebig +before the Paris Academy of Sciences in a Note, in which we +offered to prepare in a mineral medium, in the presence of a +commission to be chosen for the purpose, as great a weight of +ferment as Liebig could reasonably demand. [Footnote: PASTEUR, +Comptes rendus de l'Academie des Sciences, vol. lxxiii., p. 1419. +1871.] We were bolder than we should, perhaps, have been in 1860; +the reason was that our knowledge of the subject had been +strengthened by ten years of renewed research. Liebig did not +accept our proposal, nor did he even reply to our Note. Up to the +time of his death, which took place on April 18th, 1873, he wrote +nothing more on the subject. [Footnote: In his Memoir of 1870, +Liebig made a remarkable admission: "My late friend Pelouze," he +says, "had communicated to me nine years ago certain results of +M. Pasteur's researches on fermentation. I told him that just +then I was not disposed to alter my opinion on the cause of +fermentation, and that if it were possible, by means of ammonia, +to produce or multiply the yeast in fermenting liquors, industry +would soon avail itself of the fact, and that I would wait to see +if it did so; up to the present time, however, there had not been +the least change in the manufacture of yeast. "We do not know +what M. Pelouze's reply was; but it is not difficult to conceive +so sagacious an observer remarking to his illustrious friend that +the possibility of deriving pecuniary advantage from the wide +application of a new scientific fact had never been regarded as +the criterion of the exactness of that fact. We could prove, +moreover, by the undoubted testimony of very distinguished +practical men, notably by that of M. Pezeyre, director of +distilleries, that upon this point also Liebig was mistaken.] + +When we published, in 1860, the details of the experiment in +question, we pointed out at some length the difficulties of +conducting it successfully, and the possible causes of failure. +We called attention particularly to the fact that saccharine +mineral media are much more suited for the nutrition of bacteria, +lactic ferment, and other lowly forms, than they are to that of +yeast, and in consequence readily become filled with various +organisms from the spontaneous growth of germs derived from the +particles of dust floating in the atmosphere. The reason why we +do not observe the growth of alcoholic ferments, especially at +the commencement of the experiments, is because of the +unsuitableness of those media for the life of yeast. The latter +may, nevertheless, form in them subsequent to this development of +other organized forms, by reason of the modification produced in +the original mineral medium by the albuminous matters that they +introduce into it. It is interesting to peruse, in our Memoir of +1860, certain facts of the same kind relating to fermentation by +means of albumens--that of the blood for example, from which, we +may mention incidentally, we were led to infer the existence of +several distinct albumens in the serum, a conclusion which, since +then, has been confirmed by various observers, notably by M. +Bechamp. Now, in his experiments on fermentation in sweetened +water, with yeast-ash and a salt of ammonia, there is no doubt +that Liebig had failed to avoid those difficulties which are +entailed by the spontaneous growth of other organisms than yeast. +Moreover, it is possible that, to have established the certainty +of this result, Liebig should have had recourse to a closer +microscopical observation than from certain passages in his +Memoir he seems to have adopted. We have little doubt that his +pupils could tell us that Liebig did not even employ that +instrument without which any exact study of fermentation is not +merely difficult but well-nigh impossible. We ourselves, for the +reasons, mentioned, did not obtain a simple alcoholic +fermentation any more than Liebig did. In that particular +experiment, the details of which we gave in our Memoir of 1860, +we obtained lactic and alcoholic fermentation together; an +appreciable quantity of lactic acid formed and arrested the +propagation of the lactic and alcoholic ferments, so that more +than half of the sugar remained in the liquid without fermenting. +This, however, in no way detracted from the correctness of the +conclusion which we deduced from the experiment, and from other +similar ones; it might even be said that, from a general and +philosophical point of view--which is the only one of interest +here--the result was doubly satisfactory, inasmuch as we +demonstrated that mineral media were adapted to the simultaneous +development of several organized ferments instead of only one. +The fortuitous association of different ferments could not +invalidate the conclusion that all the nitrogen of the cells of +the alcoholic and lactic ferments was derived from the nitrogen +in the ammoniacal salts, and that all the carbon of those +ferments was taken from the sugar, since, in the medium employed +in our experiment, the sugar was the only substance that +contained carbon. Liebig carefully abstained from noticing this +fact, which would have been fatal to the very groundwork of his +criticisms, and thought that he was keeping up the appearance of +a grave contradiction by arguing that we had never obtained a +simple alcoholic fermentation. It would be unprofitable to dwell +longer upon the subject of the difficulties which the propagation +of yeast in a saccharine mineral medium formerly presented. As a +matter of fact, the progress of our studies has imparted to the +question an aspect very different from that which it formerly +wore; it was this circumstance which emboldened us to offer, in +our reply to Liebig before the Academy of Sciences in 1871, to +prepare, in a saccharine mineral medium, in the presence of a +commission to be appointed by our opponent, any quantity of +ferment that he might require, and to effect the fermentation of +any weight of sugar whatsoever. + +Our knowledge of the facts detailed in the preceding chapter +concerning pure ferments, and their manipulation in the presence +of pure air, enables us completely to disregard those causes of +embarrassment that result from the fortuitous occurrence of the +germs of organisms different in character from the ferments +introduced by the air or from the sides of vessels, or even by +the ferment itself. + +Let us once more take one of our double-necked flasks, which we +will suppose is capable of containing three or four litres (six +to eight pints). + +Let us put into it the following: + + Pure distilled water. + Sugar candy. ... . ... . ... . ... . ... . 200 grammes + Bitartrate of potassium. ... . ... . 1.0 grammes + Bitartrate of ammonia. ... . ... ... 0.5 grammes + Sulphate of ammonia.,. ... . ... ... 1.5 grammes + Ash of yeast. ... . ... . ... . ... . ... 1.5 grammes + (1 gramme = 15.43 grains) + +Let us boil the mixture, to destroy all germs of organisms that +may exist in the air or liquid or on the sides of the flask, and +then permit it to cool, after having placed, by way of extra +precaution a small quantity of asbestos in the end of the fine +curved tube. Let us next introduce a trace of ferment into the +liquid, through the other neck, which, as we have described, is +terminated by a small piece of india-rubber tube closed with a +glass stopper. + +Here are the details of such an experiment:-- + +On December 9th, 1873, we sowed some pure ferment--saccharomyces +pastorianus. From December 11, that is, within so short a time as +forty-eight hours after impregnation, we saw a multitude of +extremely minute bubbles rising almost continuously from the +bottom, indication that at this point the fermentation had +commenced. On the following days, several patches of froth +appeared on the surface of the liquid. We left the flask +undisturbed in the oven, at a temperature of 25 degrees C. (77 +degrees F.) On April 24, 1874, we tested some of the liquid, +obtained by means of the straight tube, to see if it still +contained any sugar. We found that it contained less than two +grammes, so that 198 grammes (4.2 oz. Troy) had already +disappeared. Some time afterwards the fermentation came to an +end; we carried on the experiment, nevertheless, until April 18, +1875. + +There was no development of any organism absolutely foreign to +the ferment, which was itself abundant, a circumstance that, +added to the persistent vitality of the ferment, in spite of the +unsuitableness of the medium for its nutrition, permitted the +perfect completion of fermentation. There was not the minutest +quantity of sugar remaining. The total weight of ferment, after +washing and drying at 100 degrees C. (212 degrees F.), was 2.563 +grammes (39.5 grains). + +In experiments of this kind, in which the ferment has to be +weighed, it is better not to use any yeast-ash that cannot be +dissolved completely, so as to be capable of easy separation from +the ferment formed. Raulin's liquid [Footnote: M. Jules Raulin +has published a well-known and remarkable work on the discovery +of the mineral medium best adapted by its composition to the life +of certain fungoid growth; he has given a formula for the +composition of such a medium. It is this that we call here +"Raulin's liquid" for abbreviation. + + Water . . . . . . . . . . . . . . . . . . 1,500 + Sugar candy . . . . . . . . . . . . . . . 70 + Tartaric acid . . . . . . . . . . . . . . 4 + Nitrate of ammonia . . . . . . . . . . . 4 + Phosphate of ammonia . . . . . . . . . . 0.6 + Carbonate of potassium . . . . . . . . . 0.6 + Carbonate of magnesia . . . . . . . . . . 0.4 + Sulphate of ammonia . . . . . . . . . . . 0.25 + Sulphate of zinc . . . . . . . . . . . . 0.07 + Sulphate of iron . . . . . . . . . . . . 0.07 + Silicate of potassium . . . . . . . . . . 0.07 + --J. Raulin, Paris, Victor Masson, 1870. These pour le +doctorat.] may be used in such cases with success. + +All the alcoholic ferments are not capable to the same extent of +development by means of phosphates, ammoniacal salts, and sugar. +There are some whose development is arrested a longer or shorter +time before the transformation of all the sugar. In a series of +comparative experiments, 200 grammes of sugar-candy being used in +each case, we found that whilst saccharomyces pastorianus +effected a complete fermentation of the sugar, the caseous +ferment did not decompose more than two-thirds, and the ferment +we have designated NEW "HIGH" FERMENT not more than one-fifth: +and keeping the flasks for a longer time in the oven had no +effect in increasing the proportions of sugar fermented in these +two last cases. + +We conducted a great number of fermentations in mineral media, in +consequence of a circumstance which it may be interesting to +mention here. A person who was working in our laboratory asserted +that the success of our experiments depended upon the impurity of +the sugar-candy which we employed, and that if this sugar had +been pure--much purer than was the ordinary, white, commercial +sugar-candy, which up to that time we had always used--the +ferment could not have multiplied. The persistent objections of +our friend, and our desire to convince him, caused us to repeat +all our previous experiments on the subject, using sugar of great +purity, which had been specially prepared for us, with the utmost +care, by a skilful confectioner, Seugnot. The result only +confirmed our former conclusions. Even this did not satisfy our +obstinate friend, who went to the trouble of preparing some pure +sugar for himself, in little crystals, by repeated +crystallizations of carefully selected commercial sugar-candy; he +then repeated our experiments himself. This time his doubts were +overcome. It even happened that the fermentations with the +perfectly pure sugar instead of being slow were very active, when +compared with those which we had conducted with, the commercial +sugar-candy. + + + + +We may here add a few words on the non-transformation of yeast +into penicillium glaucum. + +If at any time during fermentation we pour off the fermenting +liquid, the deposit of yeast remaining in the vessel may continue +there, in contact with air, without our ever being able to +discover the least formation of penicillium glaucum in it. We may +keep a current of pure air constantly passing through the flask; +the experiment will give the same result. Nevertheless, this is a +medium peculiarly adapted to the development of this mould, +inasmuch as if we were to introduce merely a few spores of +penicillium an abundant vegetation of that growth will afterwards +appear on the deposit. The descriptions of Messrs. Turpin, +Hoffmann, and Trecul have, therefore, been based on one of these +illusions which we meet with so frequently in microscopical +observations. + +When we laid these facts before the Academy, [Footnote: PASTEUR, +Comptes rendus de l'Academie, vol. lxxviii., pp. 213-216.] M. +Trecul professed his inability to comprehend them: [Footnote: +TRECUL, Comptes rendus de l'Academie, vol. lxxviii., pp. 217, +218.] "According to M. Pasteur," he said, "the yeast of beer is +ANAEROBIAN, that is to say, it lives in a liquid deprived of free +oxygen; and to become mycoderma or penicillium it is above all +things necessary that it should be placed in air, since, without +this, as the name signifies, an aerobian being cannot exist. To +bring about the transformation of the yeast of beer into +mycoderma cerevisiae or into penicillium glaucum we must accept +the conditions under which these two forms are obtained. If M. +Pasteur will persist in keeping his yeast in media which are +incompatible with the desired modification, it is clear that the +results which he obtains must always be negative." + +Contrary to this perfectly gratuitous assertion of M. Trecul's we +do not keep our yeast in media which are calculated to prevent +its transformation into penicillium. As we have just seen, the +principal aim and object of our experiment was to bring this +minute plant into contact with air, and under conditions that +would allow the penicillium to develop with perfect freedom. We +conducted our experiments exactly as Turpin and Hoffmann +conducted theirs, and exactly as they stipulate that such +experiments should be conducted--with the one sole difference, +indispensable to the correctness of our observations, that we +carefully guarded ourselves against those causes of error which +they did not take the least trouble to avoid. It is possible to +produce a ready entrance and escape of pure air in the case of +the double-necked flasks which we have so often employed in the +course of this work, without having recourse to the continuous +passage of a current of air. Having made a file-mark on the thin +curved neck at a distance of two or three centimetres (an inch) +from the flask, we must cut round the neck at this point with a +glazier's diamond, and then remove it, taking care to cover the +opening immediately with a sheef of paper which has been passed +through the flame, and which we must fasten with a thread round +the part of the neck still left. In this manner we may increase +or prolong the fructification of fungoid growths, or the life of +the aerobian ferments in our flasks. + +What we have said of Penicillium glaucum will apply equally to +Mycoderma cerevisiae. Notwithstanding that Turpin and Trecul may +assert to the contrary, yeast, in contact with air as it was +under the conditions of the experiment just described, will not +yield Mycoderma vini or Mycoderma cerevisiae any more than it +will Penicillium. + +The experiments described in the preceding paragraphs on the +increase of organized ferments in mineral media of the +composition described, are of the greatest physiological +interest. Amongst other results, they show that all the proteic +matter of ferments may be produced by the vital activity of the +cells, which, apart altogether from the influence of light or +free oxygen (unless indeed, we are dealing with aerobian moulds +which require free oxygen), have the power of developing a +chemical activity between carbohydrates, ammoniacal salts, +phosphates, and sulphates of potassium and magnesium. It may be +admitted with truth that a similar effect obtains in the case of +the higher plants, so that in the existing state of science we +fail to conceive what serious reason can be urged against our +considering this effect as general. It would be perfectly logical +to extend the results of which we are speaking to all plants, and +to believe that the proteic matter of vegetables, and perhaps of +animals also, is formed exclusively by the activity of the cells +operating upon the ammoniacal and other mineral salts of the sap +or plasma of the blood, and the carbo-hydrates, the formation of +which, in the case of the higher plants, requires only the +concurrence of the chemical impulse of green light. + +Viewed in this manner, the formation of the proteic substances, +would be independent of the great act of reduction of carbonic +acid gas under the influence of light. These substances would not +be built up from the elements of water, ammonia, and carbonic +acid gas, after the decomposition of this last; they would be +formed where they are found in the cells themselves, by some +process of union between the carbo-hydrates imported by the sap, +and the phosphates of potassium and magnesium and salts of +ammonia. Lastly, in vegetable growth, by means of a carbo-hydrate +and a mineral medium, since the carbo-hydrate is capable of many +variations, and it would be difficult to understand how it could +be split up into its elements before serving to constitute the +proteic substances, and even cellulose substances, as these are +carbo-hydrates. We have commenced certain studies in this +direction. + +If solar radiation is indispensable to the decomposition of +carbonic acid and the building up of the primary substances in +the case of higher vegetable life, it is still possible that +certain inferior organisms may do without it and nevertheless +yield the most complex substances, fatty or carbo-hydrate, such +as cellulose, various organic acids, and proteic matter; not, +however, by borrowing their carbon from the carbonic acid which +is saturated with oxygen, but from other matters still capable of +acquiring oxygen, and so of yielding heat in the process, such as +alcohol and acetic acid, for example, to cite merely carbon +compounds most removed from organization. As these last +compounds, and a host of others equally adapted to serve as the +carbonaceous food of mycoderms and the mucedines, may be produced +synthetically by means of carbon and the vapour of water, after +the methods that science owes to Berthelot, it follows that, in +the case of certain inferior beings, life would be possible even +if it should be that the solar light was extinguished. [Footnote: +See on this subject the verbal observations which we addressed to +the Academy of Sciences at its meetings of April 10th and 24th, +1876]. + + + + +THE GERM THEORY AND ITS APPLICATIONS TO MEDICINE AND SURGERY + +[Footnote: Read before the French Academy of Sciences, April +29th, 1878. Published in Comptes Rendus de l' Academie des +Sciences, lxxxvi., pp. 1037-43.] + +The Sciences gain by mutual support. When, as the result of my +first communications on the fermentations in 1857-1858, it +appeared that the ferments, properly so-called, are living +beings, that the germs of microscopic organisms abound in the +surface of all objects, in the air and in water; that the theory +of spontaneous generation is chimerical; that wines, beer, +vinegar, the blood, urine and all the fluids of the body undergo +none of their usual changes in pure air, both Medicine and +Surgery received fresh stimulation. A French physician, Dr. +Davaine, was fortunate in making the first application of these +principles to Medicine, in 1863. + +Our researches of last year, left the etiology of the putrid +disease, or septicemia, in a much less advanced condition than +that of anthrax. We had demonstrated the probability that +septicemia depends upon the presence and growth of a microscopic +body, but the absolute proof of this important conclusion was not +reached. To demonstrate experimentally that a microscopic +organism actually is the cause of a disease and the agent of +contagion, I know no other way, in the present state of Science, +than to subject the microbe (the new and happy term introduced by +M. Sedillot) to the method of cultivation out of the body. It may +be noted that in twelve successive cultures, each one of only ten +cubic centimeters volume, the original drop will be diluted as if +placed in a volume of fluid equal to the total volume of the +earth. It is just this form of test to which M. Joubert and I +subjected the anthrax bacteridium. [Footnote: In making the +translation, it seems wiser to adhere to Pasteur's nomenclature. +Bacillus anthracis would be the term employed to-day.-- +Translator.] Having cultivated it a great number of times in a +sterile fluid, each culture being started with a minute drop from +the preceding, we then demonstrated that the product of the last +culture was capable of further development and of acting in the +animal tissues by producing anthrax with all its symptoms. Such +is--as we believe--the indisputable proof that ANTHRAX IS A +BACTERIAL DISEASE. + +Our researches concerning the septic vibrio had not so far been +convincing, and it was to fill up this gap that we resumed our +experiments. To this end, we attempted the cultivation of the +septic vibrio from an animal dead of septicemia. It is worth +noting that all of our first experiments failed, despite the +variety of culture media we employed--urine, beer yeast water, +meat water, etc. Our culture media were not sterile, but we +found--most commonly--a microscopic organism showing no +relationship to the septic vibrio, and presenting the form, +common enough elsewhere, of chains of extremely minute spherical +granules possessed of no virulence whatever. [Footnote: It is +quite possible that Pasteur was here dealing with certain +septicemic streptococci that are now know to lose their virulence +with extreme rapidity under artificial cultivation.--Translator.] +This was an impurity, introduced, unknown to us, at the same time +as the septic vibrio; and the germ undoubtedly passed from the +intestines--always inflamed and distended in septicemic animals-- +into the abdominal fluids from which we took our original +cultures of the septic vibrio. If this explanation of the +contamination of our cultures was correct, we ought to find a +pure culture of the septic vibrio in the heart's blood of an +animal recently dead of septicemia. This was what happened, but a +new difficulty presented itself; all our cultures remained +sterile. Furthermore this sterility was accompanied by loss in +the culture media of (the original) virulence. + +It occurred to us that the septic vibrio might be an obligatory +anaerobe and that the sterility of our inoculated culture fluids +might be due to the destruction of the septic vibrio by the +atmospheric oxygen dissolved in the fluids. The Academy may +remember that I have previously demonstrated facts of this nature +in regard to the vibrio of butyric fermentation, which not only +lives without air but is killed by the air. + +It was necessary therefore to attempt to cultivate the septic +vibrio either in a vacuum or in the presence of inert gases--such +as carbonic acid. + +Results justified our attempt; the septic vibrio grew easily in a +complete vacuum, and no less easily in the presence of pure +carbonic acid. + +These results have a necessary corollary. If a fluid containing +septic vibrios be exposed to pure air, the vibrios should be +killed and all virulence should disappear. This is actually the +case. If some drops of septic serum be spread horizontally in a +tube and in a very thin layer, the fluid will become absolutely +harmless in less than half a day, even if at first it was so +virulent as to produce death upon the inoculation of the smallest +portion of a drop. + +Furthermore all the vibrios, which crowded the liquid as motile +threads, are destroyed and disappear. After the action of the +air, only fine amorphous granules can be found, unfit for culture +as well as for the transmission of any disease whatever. It might +be said that the air burned the vibrios. + +If it is a terrifying thought that life is at the mercy of the +multiplication of these minute bodies, it is a consoling hope +that Science will not always remain powerless before such +enemies, since for example at the very beginning of the study we +find that simple exposure to air is sufficient at times to +destroy them. + +But, if oxygen destroys the vibrios, how can septicemia exist, +since atmospheric air is present everywhere? How can such facts +be brought in accord with the germ theory? How can blood, exposed +to air, become septic through the dust the air contains? + +All things are hidden, obscure and debatable if the cause of the +phenomena be unknown, but everything is clear if this cause be +known. What we have just said is true only of a septic fluid +containing adult vibrios, in active development by fission: +conditions are different when the vibrios are transformed into +their germs, [Footnote: By the terms "germ" and "germ +corpuscles," Pasteur undoubtedly means "spores," but the change +is not made, in accordance with note 3, above.--Translator.] that +is into the glistening corpuscles first described and figured in +my studies on silk-worm disease, in dealing with worms dead of +the disease called "flacherie." Only the adult vibrios disappear, +burn up, and lose their virulence in contact with air: the germ +corpuscles, under these conditions, remain always ready for new +cultures, and for new inoculations. + +All this however does not do away with the difficulty of +understanding how septic germs can exist on the surface of +objects, floating in the air and in water. + +Where can these corpuscles originate? Nothing is easier than the +production of these germs, in spite of the presence of air in +contact with septic fluids. + +If abdominal serous exudate containing septic vibrios actively +growing by fission be exposed to the air, as we suggested above, +but with the precaution of giving a substantial thickness to the +layer, even if only one centimeter be used, this curious +phenomenon will appear in a few hours. The oxygen is absorbed in +the upper layers of the fluid--as is indicated by the change of +color. Here the vibrios are dead and disappear. In the deeper +layers, on the other hand, towards the bottom of this centimeter +of septic fluid we suppose to be under observation, the vibrios +continue to multiply by fission--protected from the action of +oxygen by those that have perished above them: little by little +they pass over to the condition of germ corpuscles with the +gradual disappearance of the thread forms. So that instead of +moving threads of varying length, sometimes greater than the +field of the microscope, there is to be seen only a number of +glittering points, lying free or surrounded by a scarcely +perceptible amorphous mass. [Footnote: In our note of July 16th, +1877, it is stated that the septic vibrio is not destroyed by the +oxygen of the air nor by oxygen at high tension, but that under +these conditions it is transformed into germ-corpuscles. This is, +however, an incorrect interpretation of facts. The vibrio is +destroyed by oxygen, and it is only where it is in a thick layer +that it is transformed to germ-corpuscles in the presence of +oxygen and that its virulence is preserved.] Thus is formed, +containing the latent germ life, no longer in danger from the +destructive action of oxygen, thus, I repeat, is formed the +septic dust, and we are able to understand what has before seemed +so obscure; we can see how putrescible fluids can be inoculated +by the dust of the air, and how it is that putrid diseases are +permanent in the world. + +The Academy will permit me, before leaving these interesting +results, to refer to one of their main theoretical consequences. +At the very beginning of these researches, for they reveal an +entirely new field, what must be insistently demanded? The +absolute proof that there actually exist transmissible, +contagious, infectious diseases of which the cause lies +essentially and solely in the presence of microscopic organisms. +The proof that for at least some diseases, the conception of +spontaneous virulence must be forever abandoned--as well as the +idea of contagion and an infectious element suddenly originating +in the bodies of men or animals and able to originate diseases +which propagate themselves under identical forms: and all of +those opinions fatal to medical progress, which have given rise +to the gratuitous hypotheses of spontaneous generation, of +albuminoid ferments, of hemiorganisms, of archebiosis, and many +other conceptions without the least basis in observation. What is +to be sought for in this instance is the proof that along with +our vibrio there does not exist an independent virulence +belonging to the surrounding fluids or solids, in short that the +vibrio is not merely an epiphenomenon of the disease of which it +is the obligatory accompaniment. What then do we see, in the +results that I have just brought out? A septic fluid, taken at +the moment that the vibrios are not yet changed into germs, loses +its virulence completely upon simple exposure to the air, but +preserves this virulence, although exposed to air on the simple +condition of being in a thick layer for some hours. In the first +case, the virulence once lost by exposure to air, the liquid is +incapable of taking it on again upon cultivation: but, in the +second case, it preserves its virulence and can propagate, even +after exposure to air. It is impossible, then, to assert that +there is a separate virulent substance, either fluid or solid, +existing, apart from the adult vibrio or its germ. Nor can it be +supposed that there is a virus which loses its virulence at the +moment that the adult vibrio dies; for such a substance should +also lose its virulence when the vibrios, changed to germs, are +exposed to the air. Since the virulence persists under these +conditions it can only be due to the germ corpuscles--the only +thing present. There is only one possible hypothesis as to the +existence of a virus in solution, and that is that such a +substance, which was present in our experiment in nonfatal +amounts, should be continuously furnished by the vibrio itself, +during its growth in the body of the living animal. But it is of +little importance since the hypothesis supposes the forming and +necessary existence of the vibrio. [Footnote: The regular limits, +oblige me to omit a portion of my speech.] + +I hasten to touch upon another series of observations which are +even more deserving the attention of the surgeon than the +preceding: I desire to speak of the effects of our microbe of pus +when associated with the septic vibrio. There is nothing more +easy to superpose--as it were--two distinct diseases and to +produce what might be called a SEPTICEMIC PURULENT INFECTION, or +a PURULENT SEPTICEMIA. Whilst the microbe-producing pus, when +acting alone, gives rise to a thick pus, white, or sometimes with +a yellow or bluish tint, not putrid, diffused or enclosed by the +so-called pyogenic membrane, not dangerous, especially if +localized in cellular tissue, ready, if the expression may be +used for rapid resorption; on the other hand the smallest abscess +produced by this organism when associated with the septic vibrio +takes on a thick gangrenous appearance, putrid, greenish and +infiltrating the softened tissues. In this case the microbe of +pus carried so to speak by the septic vibrio, accompanies it +throughout the body: the highly-inflamed muscular tissues, full +of serous fluid, showing also globules of pus here and there, are +like a kneading of the two organisms. + +By a similar procedure the effects of the anthrax bacteridium and +the microbe of pus may be combined and the two diseases may be +superposed, so as to obtain a purulent anthrax or an anthracoid +purulent infection. Care must be taken not to exaggerate the +predominance of the new microbe over the bacteridum. If the +microbe be associated with the latter in sufficient amount it may +crowd it out completely--prevent it from growing in the body at +all. Anthrax does not appear, and the infection, entirely local, +becomes merely an abscess whose cure is easy. The microbe- +producing pus and the septic vibrio (not) [Footnote: There is +undoubtedly a mistake in the original. Pasteur could not have +meant to say that both bacteria are anaerobes. The word "not" is +introduced to correct the error.--Translator.] being both +anaerobes, as we have demonstrated, it is evident that the latter +will not much disturb its neighbor. Nutrient substances, fluid or +solid, can scarcely be deficient in the tissues from such minute +organisms. But the anthrax bacteridium is exclusively aerobic, +and the proportion of oxygen is far from being equally +distributed throughout the tissues: innumerable conditions can +diminish or exhaust the supply here and there, and since the +microbe-producing pus is also aerobic, it can be understood how, +by using a quantity slightly greater than that of the bacteridium +it might easily deprive the latter of the oxygen necessary for +it. But the explanation of the fact is of little importance: it +is certain that under some conditions the microbe we are speaking +of entirely prevents the development of the bacteridium. + +Summarizing--it appears from the preceding facts that it is +possible to produce at will, purulent infections with no elements +of putrescence, putrescent purulent infections, anthracoid +purulent infections, and finally combinations of these types of +lesions varying according to the proportions of the mixtures of +the specific organisms made to act on the living tissues. + +These are the principal facts I have to communicate to the +Academy in my name and in the names of my collaborators, Messrs. +Joubert and Chamberland. Some weeks ago (Session of the 11th of +March last) a member of the Section of Medicine and Surgery, M. +Sedillot, after long meditation on the lessons of a brilliant +career, did not hesitate to assert that the successes as well as +the failures of Surgery find a rational explanation in the +principles upon which the germ theory is based, and that this +theory would found a new Surgery--already begun by a celebrated +English surgeon, Dr. Lister, [Footnote: See Lord Lister's paper +in the present volume.--Ed.] who was among the first to +understand its fertility. With no professional authority, but +with the conviction of a trained experimenter, I venture here to +repeat the words of an eminent confrere. + + + + +ON THE EXTENSION OF THE GERM THEORY +TO THE ETIOLOGY OF CERTAIN COMMON DISEASES + +[Footnote: Read before the French Academy of Sciences, May 3, +1880. Published in Comptes rendus, de l'Academie des Sciences, +xc., pp. 1033-44.] + + +When I began the studies now occupying my attention, [Footnote: +In 1880. Especially engaged in the study of chicken cholera and +the attenuation of virulence--Translator.] I was attempting to +extend the germ theory to certain common diseases. I do not know +when I can return to that work. Therefore in my desire to see it +carried on by others, I take the liberty of presenting it to the +public in its present condition. + +I. Furuncles. In May, 1879, one of the workers in my laboratory +had a number of furuncles, appearing at short intervals, +sometimes on one part of the body and sometimes on another. +Constantly impressed with the thought of the immense part played +by microscopic organisms in Nature, I queried whether the pus in +the furuncles might not contain one of these organisms whose +presence, development, and chance transportation here and there +in the tissues after entrance would produce a local inflammation, +and pus formation, and might explain the recurrence of the +illness during a longer or shorter time. It was easy enough to +subject this thought to the test of experiment. + +First observation.--On June second, a puncture was made at the +base of the small cone of pus at the apex of a furuncle on the +nape of the neck. The fluid obtained was at once sowed in the +presence of pure air--of course with the precautions necessary to +exclude any foreign germs, either at the moment of puncture, at +the moment of sowing in the culture fluid, or during the stay in +the oven, which was kept at the constant temperature of about 35 +degrees C, The next day, the culture fluid had become cloudy and +contained a single organism, consisting of small spherical points +arranged in pairs, sometimes in fours, but often in irregular +masses. Two fluids were preferred in these experiments--chicken +and yeast bouillon. According as one or the other was used, +appearances varied a little. These should be described. With the +yeast water, the pairs of minute granules are distributed +throughout the liquid, which is uniformly clouded. But with the +chicken bouillon, the granules are collected in little masses +which line the walls and bottom of the flasks while the body of +the fluid remains clear, unless it be shaken: in this case it +becomes uniformly clouded by the breaking up of the small masses +from the walls of the flasks. + +Second observation.--On the tenth of June a new furuncle made its +appearance on the right thigh of the same person. Pus could not +yet be seen under the skin, but this was already thickened and +red over a surface the size of a franc. The inflamed part was +washed with alcohol, and dried with blotting paper passed through +the flame of an alcohol lamp. A puncture at the thickened portion +enabled us to secure a small amount of lymph mixed with blood, +which was sowed at the same time as some blood taken from the +finger of the hand. The following days, the blood from the finger +remained absolutely sterile: but that obtained from the center of +the forming furuncle gave an abundant growth of the same small +organism as before. + +Third observation.--The fourteenth of June, a new furuncle +appeared on the neck of the same person. The same examination, +the same result, that is to say the development of the +microscopic organism previously described and complete sterility +of the blood of the general circulation, taken this time at the +base of the furuncle outside of the inflamed area. + +At the time of making these observations I spoke of them to Dr. +Maurice Reynaud, who was good enough to send me a patient who had +had furuncles for more than three months. On June thirteenth I +made cultures of the pus from a furuncle of this man. The next +day there was a general cloudiness of the culture fluids, +consisting entirely of the preceding parasite, and of this alone. + +Fourth observation.--June fourteenth, the same individual showed +me a newly forming furuncle in the left axilla: there was wide- +spread thickening and redness of the skin, but no pus was yet +apparent. An incision at the center of the thickening showed a +small quantity of pus mixed with blood. Sowing, rapid growth for +twenty-four hours and the appearance of the same organism. Blood +from the arm at a distance from the furuncle remained completely +sterile. + +June 17, the examination of a fresh furuncle on the same +individual gave the same result, the development of a pure +culture of the same organism. + +Fifth observation.--July twenty-first, Dr. Maurice Reynaud +informed me that there was a woman at the Lariboisiere hospital +with multiple furuncles. As a matter of fact her back was covered +with them, some in active suppuration, others in the ulcerating +stage. I took pus from all of these furuncles that had not +opened. After a few hours, this pus gave an abundant growth in +cultures. The same organism, without admixture, was found. Blood +from the inflamed base of the furuncle remained sterile. + +In brief, it appears certain that every furuncle contains an +aerobic microscopic parasite, to which is due the local +inflammation and the pus formation that follows. + +Culture fluids containing the minute organism inoculated under +the skin of rabbits and guinea-pigs produce abscesses generally +small in size and that promptly heal. As long as healing is not +complete the pus of the abscesses contains the microscopic +organism which produced them. It is therefore living and +developing, but its propagation at a distance does not occur. +These cultures of which I speak, when injected in small +quantities in the jugular vein of guinea pigs show that the +minute organism does not grow in the blood. The day after the +injection they cannot be recovered even in cultures. I seem to +have observed as a general principle, that, provided the blood +corpuscles are in good physiological condition it is difficult +for aerobic parasites to develop in the blood. I have always +thought that this is to be explained by a kind of struggle +between the affinity of the blood corpuscles for oxygen and that +belonging to the parasite in cultures. Whilst the blood +corpuscles carry off, that is, take possession of all the oxygen, +the life and development of the parasite become extremely +difficult or impossible. It is therefore easily eliminated, +digested, if one may use the phrase. I have seen these facts many +times in anthrax and chicken-cholera, diseases both of which are +due to the presence of an aerobic parasite. + +Blood cultures from the general circulation being always sterile +in these experiments, it would seem that under the conditions of +the furuncular diathesis, the minute parasite does not exist in +the blood. That it cannot be cultivated for the reason given, and +that it is not abundant is evident; but, from the sterility of +the cultures reported (five only) it should not be definitely +concluded that the little parasite may not, at some time, be +taken up by the blood and transplanted from a furuncle when it is +developing to another part of the body, where it may be +accidentally lodged, may develop and produce a new furuncle. I am +convinced that if, in cases of furuncular diathesis, not merely a +few drops but several grams of blood from the general circulation +could be placed under cultivation frequent successful growths +would be obtained. [Footnote: This prediction is fully carried +out in the present day successful use of considerable amounts of +blood in cultures and the resultant frequent demonstrations of +bacteria present in the circulation in many infections.-- +Translator.] In the many experiments I have made on the blood in +chicken-cholera, I have frequently demonstrated that repeated +cultures from droplets of blood do not show an even development +even where taken from the same organ, the heart for example, and +at the moment when the parasite begins its existence in the +blood, which can easily be understood. Once even, it happened +that only three out of ten chickens died after inoculation with +infectious blood in which the parasite had just began to appear, +the remaining seven showed no symptoms whatever. In fact, the +microbe, at the moment of beginning its entrance into the blood +may exist singly or in minute numbers in one droplet and not at +all in its immediate neighbor. I believe therefore that it would +be extremely instructive in furunculosis, to find a patient +willing to submit to a number of punctures in different parts of +the body away from formed or forming furuncles, and thus secure +many cultures, simultaneous of otherwise, of the blood of the +general circulation. I am convinced that among them would be +found growths of the micro-organism of furuncles. + +II. On Osteomyelitis. Single observation. I have but one +observation relating to this severe disease, and in this Dr. +Lannelongue took the initiative. The monograph on osteomyelitis +published by this learned practitioner is well known, with his +suggestion of the possibility of a cure by trephining the bone +and the use of antiseptic washes and dressings. On the fourteenth +of February, at the request of Dr. Lannelongue I went to the +Sainte-Eugenie hospital, where this skillful surgeon was to +operate on a little girl of about twelve years of age. The right +knee was much swollen, as well as the whole leg below the calf +and a part of the thigh above the knee. There was no external +opening. Under chloroform, Dr. Lannelongue made a long incision +below the knee which let out a large amount of pus; the tibia was +found denuded for a long distance. Three places in the bone were +trephined. From each of these, quantities of pus flowed. Pus from +inside and outside the bone was collected with all possible +precautions and was carefully examined and cultivated later. The +direct microscopic study of the pus, both internal and external, +was of extreme interest. It was seen that both contained large +numbers of the organism similar to that of furuncles, arranged in +pairs, in fours and in packets, some with sharp clear contour, +others only faintly visible and with very pale outlines. The +external pus contained many pus corpuscles, the internal had none +at all. It was like a fatty paste of the furuncular organism. +Also, it may be noted, that growth of the small organism had +begun in less than six hours after the cultures were started. +Thus I saw, that it corresponded exactly with the organism of +furuncles. The diameter of the individuals was found to be one +one-thousandth of a millimeter. If I ventured to express myself +so I might say that in this case at least the osteomyelitis was +really a furuncle of the bone marrow. [Footnote: This has been +demonstrated, as is well known.--Translator.] It is undoubtedly +easy to induce osteomyelitis artificially in living animals. + +III. On puerperal fever.--First observation. On the twelfth of +March, 1878, Dr. Hervieux was good enough to admit me to his +service in the Maternity to visit a woman delivered some days +before and seriously ill with puerperal fever. The lochia were +extremely fetid. I found them full of micro-organisms of many +kinds. A small amount of blood was obtained from a puncture on +the index finger of the left hand, (the finger being first +properly washed and dried with a STERILE towel,) and then sowed +in chicken bouillon. The culture remained sterile during the +following days. + +The thirteenth, more blood was taken from a puncture in the +finger and this time growth occurred. As death took place on the +sixteenth of March at six in the morning, it seems that the blood +contained a microscopic parasite at least three days before. + +The fifteenth of March, eighteen hours before death, blood from a +needle-prick in the left foot was used. This culture also was +fertile. + +The first culture, of March thirteenth, contained only the +organism of furuncles; the next one, that of the fifteenth, +contained an organism resembling that of furunculosis, but which +always differed enough to make it easy usually to distinguish it. +In this way; whilst the parasite of furuncles is arranged in +pairs, very rarely in chains of three or four elements, the new +one, that of the culture of the fifteenth, occurs in long chains, +the number of cells in each being indefinite. The chains are +flexible and often appear as little tangled packets like tangled +strings of pearls. + +The autopsy was performed on the seventeenth at two o'clock. +There was a large amount of pus in the peritoneum. It was sowed +with all possible precautions. Blood from the basilic and femoral +veins was also sowed. So also was pus from the mucous surface of +the uterus, from the tubes, and finally that from a lymphatic in +the uterine wall. These are the results of these cultures: in all +there were the long chains of cells just spoken of above, and +nowhere any mixture of other organisms, except in the culture +from the peritoneal pus, which, in addition to the long chains, +also contained the small pyogenic vibrio which I describe under +the name ORGANISM OF PUS in the Note I published with Messrs. +Joubert and Chamberland on the thirtieth of April, 1878. +[Footnote: See preceding paper.] + +Interpretation of the disease and of the death.--After +confinement, the pus that always naturally forms in the injured +parts of the uterus instead of remaining pure becomes +contaminated with microscopic organisms from outside, notably the +organism in long chains and the pyogenic vibrio. These organisms +pass into the peritoneal cavity through the tubes or by other +channels, and some of them into the blood, probably by the +lymphatics. The resorption of the pus, always extremely easy and +prompt when it is pure, becomes impossible through the presence +of the parasites, whose entrance must be prevented by all +possible means from the moment of confinement. + +Second observation.--The fourteenth of March, a woman died of +puerperal fever at the Lariboisiere hospital; the abdomen was +distended before death. + +Pus was found in abundance by a peritoneal puncture and was +sowed; so also was blood from a vein in the arm. The culture of +pus yielded the long chains noted in the preceding observation +and also the small pyogenic vibrio. The culture from the blood +contained only the long chains. + +Third observation.--The seventeenth of May, 1879, a woman, three +days past confinement, was ill, as well as the child she was +nursing. The lochia were full of the pyogenic vibrio and of the +organism of furuncles, although there was but a small proportion +of the latter. The milk and the lochia were sowed. The milk gave +the organism in long chains of granules, and the lochia only the +pus organism. The mother died, and there was no autopsy. + +On May twenty-eighth, a rabbit was inoculated under the skin of +the abdomen with five drops of the preceding culture of the +pyogenic vibrio. The days following an enormous abscess formed +which opened spontaneously on the fourth of June. An abundantly +cheesy pus came from it. About the abscess there was extensive +induration. On the eighth of June, the opening of the abscess was +larger, the suppuration active. Near its border was another +abscess, evidently joined with the first, for upon pressing it +with the finger, pus flowed freely from the opening in the first +abscess. During the whole of the month of June, the rabbit was +sick and the abscesses suppurated, but less and less. In July +they closed; the animal was well. There could only be felt some +nodules under the skin of the abdomen. + +What disturbances might not such an organism carry into the body +of a parturient woman, after passing into the peritoneum, the +lymphatics or the blood through the maternal placenta! Its +presence is much more dangerous than that of the parasite +arranged in chains. Furthermore, its development is always +threatening, because, as said in the work already quoted (April, +1878) this organism can be easily recovered from many ordinary +waters. + +I may add that the organism in long chains, and that arranged in +pairs are also extremely widespread, and that one of their +habitats is the mucous surfaces of the genital tract. [Footnote: +When, by the procedure I elsewhere described, urine is removed in +a pure condition by the urethra from the bladder, if any chance +growth occurs through some error of technic, it is the two +organisms of which I have been speaking that are almost +exclusively present.] + +Apparently there is no puerperal parasite, properly speaking. I +have not encountered true septicemia in my experiments; but it +ought to be among the puerperal affections. + +Fourth observation.--On June fourteenth, at the Lariboisiere, a +woman was very ill following a recent confinement; she was at the +point of death; in fact she did die on the fourteenth at +midnight. Some hours before death pus was taken from an abscess +on the arm, and blood from a puncture in a finger. Both were +sowed. On the next day (the fifteenth) the flask containing the +pus from the abscess was filled with long chains of granules. The +flask containing the blood was sterile. The autopsy was at ten +o'clock on the morning of the sixteenth. Blood from a vein of the +arm, pus from the uterine walls and that from a collection in the +synovial sac of the knee were all placed in culture media. All +showed growth, even the blood, and they all contained the long +strings of granules. The peritoneum contained no pus. + +Interpretation of the disease and of the death.--The injury of +the uterus during confinement as usual furnished pus, which gave +a lodging place for the germs of the long chains of granules. +These, probably through the lymphatics, passed to the joints and +to some other places, thus being the origin of the metastic +abscesses which produced death. + +Fifth observation.--On June seventeenth, M. Doleris, a well-known +hospital interne, brought to me some blood, removed with the +necessary precautions, from a child dead immediately after birth, +whose mother, before confinement had had febrile symptoms with +chills. This blood, upon cultivation, gave an abundance of the +pyogenic vibrio. On the other hand, blood taken from the mother +on the morning of the eighteenth (she had died at one o'clock +that morning) showed no development whatever, on the nineteenth +nor on following days. The autopsy on the mother took place on +the nineteenth. It is certainly worthy of note that the uterus, +peritoneum and intestines showed nothing special, but the liver +was full of metastatic abscesses. At the exit of the hepatic vein +from the liver there was pus, and its walls were ulcerated at +this place. The pus from the liver abscesses was filled with the +pyogenic vibrio. Even the liver tissues, at a distance from the +visible abscesses, gave abundant cultures of the same organism. + +Interpretation of the disease and of the death.--The pyogenic +vibrio, found in the uterus, or which was perhaps already in the +body of the mother, since she suffered from chills before +confinement, produced metastatic abscesses in the liver and, +carried to the blood of the child, there induced one of the forms +of infection called purulent, which caused its death. + +Sixth observation.--The eighteenth of June, 1879, M. Doleris +informed me that a woman confined some days before at the Cochin +Hospital, was very ill. On the twentieth of June, blood from a +needle-prick in the finger was sowed; the culture was sterile. On +July fifteenth, that is to say twenty-five days later, the blood +was tried again. Still no growth. There was no organism +distinctly recognizable in the lochia: the woman was +nevertheless, they told me, dangerously ill and at the point of +death. As a matter of fact, she did die on the eighteenth of July +at nine in the morning: as may be seen, after a very long +illness, for the first observations were made over a month +before: the illness was also very painful, for the patient could +make no movement without intense suffering. + +An autopsy was made on the nineteenth at ten in the morning, and +was of great interest. There was purulent pleurisy with a +considerable pocket of pus, and purulent false membranes on the +walls of the pleura. The liver was bleached, fatty, but of firm +consistency, and with no apparent metastatic abscesses. The +uterus, of small size, appeared healthy; but on the external +surface whitish nodules filled with pus were found. THERE WAS +NOTHING IN THE PERITONEUM, WHICH WAS NOT INFLAMED; but there was +much pus in the shoulder joints and the symphysis pubis. + +The pus from the abscesses, upon cultivation, gave the long +chains of granules--not only that of the pleura, but that from +the shoulders and a lymphatic of the uterus as well. An +interesting thing, but easily understood, was that the blood from +a vein in the arm and taken three-quarters of an hour after death +was entirely sterile. Nothing grew from the Fallopian tubes nor +the broad ligaments. + +Interpretation of the disease and of the death.--The pus found in +the uterus after confinement became infected with germs of +microscopic organisms which grew there, then passed into the +uterine lymphatics, and from there went on to produce pus in the +pleura and in the articulations. + +Seventh observation.--On June eighteenth, M. Doleris informed me +that a woman had been confined at the Cochin Hospital five days +before and that fears were entertained as to the results of an +operation that had been performed, it having been necessary to do +an embryotomy. The lochia were sowed on the 18th; there was not +the slightest trace of growth the next day nor the day after. +Without the least knowledge of this woman since the eighteenth, +on the twentieth I ventured to assert that she would get well. I +sent to inquire about her. This is the text of the report: "THE +WOMAN IS DOING EXTREMELY WELL; SHE GOES OUT TOMORROW" + +Interpretation of the facts.--The pus naturally formed on the +surface of the injured parts did not become contaminated with +organisms brought from without. Natura medicatrix carried it off, +that is to say the vitality of the mucous surfaces prevented the +development of foreign germs. The pus was easily resorbed, and +recovery took place. + +I beg the Academy to permit me, in closing, to submit certain +definite views, which I am strongly inclined to consider as +legitimate conclusions from the facts I have had the honor to +communicate to it. + +Under the expression PUERPERAL FEVER are grouped very different +diseases, [Footnote: Interesting as the starting point of the +conception of diseases according to the etiological factor, not +by groups of symptoms.--Translator.] but all appearing to be the +result of the growth of common organisms which by their presence +infect the pus naturally formed on injured surfaces, which spread +by one means or another, by the blood or the lymphatics, to one +or another part of the body, and there induce morbid changes +varying with the condition of the parts, the nature of the +parasite, and the general constitution of the subject. + +Whatever this constitution, does it not seem that by taking +measures opposing the production of these common parasitic +organisms recovery would usually occur, except perhaps when the +body contains, before confinement, microscopic organisms, in +contaminated internal or external abscesses, as was seen in one +striking example (fifth observation). The antiseptic method I +believe likely to be sovereign in the vast majority of cases. It +seems to me that IMMEDIATELY AFTER CONFINEMENT the application of +antiseptics should be begun. Carbolic acid can render great +service, but there is another antiseptic, the use of which I am +strongly inclined to advise, this is boric acid in concentrated +solution, that is, four per cent. at the ordinary temperature. +This acid, whose singular influence on cell life has been shown +by M. Dumas, is so slightly acid that it is alkaline to certain +test papers, as was long ago shown by M. Chevreul, besides this +it has no odor like carbolic acid, which odor often disturbs the +sick. Lastly, its lack of hurtful effects on mucous membranes, +notably of the bladder, has been and is daily demonstrated in the +hospitals of Paris. The following is the occasion upon which it +was first used. The Academy may remember that I stated before it, +and the fact has never been denied, that ammoniacal urine is +always produced by a microscopic organism, entirely similar in +many respects to the organism of furuncles. Later, in a joint +investigation with M. Joubert, we found that a solution of boric +acid was easily fatal to these organisms. After that, in 1877, I +induced Dr. Guyon, in charge of the genito-urinary clinic at the +Necker hospital, to try injections of a solution of boric acid in +affections of the bladder. I am informed by this skilful +practitioner that he has done so, and daily observes good results +from it. He also tells me that he performs no operation of +lithotrity without the use of similar injections. I recall these +facts to show that a solution of boric acid is entirely harmless +to an extremely delicate mucous membrane, that of the bladder, +and that it is possible to fill the bladder with a warm solution +of boric acid without even inconvenience. + +To return to the confinement cases. Would it not be of great +service to place a warm concentrated solution of boric acid, and +compresses, at the bedside of each patient; which she could renew +frequently after saturating with the solution, and this also +after confinement. It would also be acting the part of prudence +to place the compresses, before using, in a hot air oven at 150 +degrees C., more than enough to kill the germs of the common +organisms. [Footnote: The adoption of precautions, similar to +those here suggested, has resulted in the practically complete +disappearance of puerperal fevor.--Translator.] + +Was I justified in calling this communication "ON THE EXTENSION +OF THE GERM THEORY TO THE ETIOLOGY OF CERTAIN COMMON DISEASES?" I +have detailed the facts as they have appeared to me and I have +mentioned interpretations of them: but I do not conceal from +myself that, in medical territory, it is difficult to support +one's self wholly on subjective foundations. I do not forget that +Medicine and Veterinary practice are foreign to me. I desire +judgment and criticism upon all my contributions. Little tolerant +of frivolous or prejudiced contradiction, contemptuous of that +ignorant criticism which doubts on principle, I welcome with open +arms the militant attack which has a method in doubting and whose +rule of conduct has the motto "More light." + +It is a pleasure once more to acknowledge the helpfulness of the +aid given me by Messrs. Chamberland and Roux during the studies I +have just recorded. I wish also to acknowledge the great +assistance of M. Doleris. + + + + +PREJUDICES WHICH HAVE RETARDED THE PROGRESS OF GEOLOGY +UNIFORMITY IN THE SERIES OF PAST CHANGES IN THE ANIMATE AND +INANIMATE WORLD +BY +SIR CHARLES LYELL + + +INTRODUCTORY NOTE + + +Sir Charles Lyell was born near Kirriemuir, Forfarshire, +Scotland, on November 14, 1797. He graduated from Exeter College, +Oxford, in 1819, and proceeded to the study of law. Although he +practised for a short time, he was much hampered in this +profession, as in all his work, by weak eyesight; and after the +age of thirty he devoted himself chiefly to science. + +Lyell's father was a botanist of some distinction, and the son +seems to have been interested in natural history from an early +age. While still an undergraduate he made geological journeys in +Scotland and on the Continent of Europe, and throughout his life +he upheld by precept and example the importance of travel for the +geologist. + +The first edition of his "Principles of Geology" was published in +1830; and the phrase used in the sub-title, "an attempt to +explain the former changes of the earth's surface, by reference +to causes now in action" strikes the keynote of his whole work. +All his life he continued to urge this method of explanation in +opposition to the hypotheses, formerly much in vogue, which +assumed frequent catastrophes to account for geologic changes. +The chapters here printed give his own final statement of his +views on this important issue. + +Lyell's scientific work received wide recognition: he was more +than once President of the Geological Society, in 1864 was +President of the British Association, was knighted in 1848, and +made a baronet in 1864. He possessed a broad general culture, and +his home was a noted center of the intellectual life of London. +He twice came to the United States to lecture, and created great +interest. On his death, on February 22, 1875, he was buried in +Westminster Abbey. + +Persistent as were Lyell's efforts for the establishment of his +main theory, he remained remarkably open-minded; and when the +evolutionary hypothesis was put forward he became a warm +supporter of it. Darwin in his autobiography thus sums up Lyell's +achievement: "The science of geology is enormously indebted to +Lyell--more so, as I believe, than to any other man who ewer +lived." + + + + +THE PROGRESS OF GEOLOGY + +[Footnote: The text of the two following papers is taken from the +11th edition of Lyell's Principles of Geology, the last edition +revised by the author.] + + +I + +PREPOSSESSIONS IN REGARD TO THE DURATION OF PAST TIME--PREJUDICES +ARISING FROM OUR PECULIAR POSITION AS INHABITANTS OF THE LAND-- +OTHERS OCCASIONED BY OUR NOT SEEING SUBTERRANEAN CHANGES NOW IN +PROGRESS--ALL THESE CAUSES COMBINE TO MAKE THE FORMER COURSE OF +NATURE APPEAR DIFFERENT FROM THE PRESENT--OBJECTIONS TO THE +DOCTRINE THAT CAUSES SIMILAR IN KIND AND ENERGY TO THOSE NOW +ACTING, HAVE PRODUCED THE FORMER CHANGES OF THE EARTH'S SURFACE +CONSIDERED + + +If we reflect on the history of the progress of geology we +perceive that there have been great fluctuations of opinion +respecting the nature of the causes to which all former changes +of the earth's surface are referable. The first observers +conceived the monuments which the geologist endeavours to +decipher to relate to an original state of the earth, or to a +period when there were causes in activity, distinct, in a kind +and degree, from those now constituting the economy of nature. +These views were gradually modified, and some of them entirely +abandoned, in proportion as observations were multiplied, and the +signs of former mutations were skilfully interpreted. Many +appearances, which had for a long time been regarded as +indicating mysterious and extraordinary agency, were finally +recognised as the necessary result of the laws now governing the +material world; and the discovery of this unlooked-for conformity +has at length induced some philosophers to infer, that, during +the ages contemplated in geology, there has never been any +interruption to the agency of the same uniform laws of change. +The same assemblage of general causes, they conceive, may have +been sufficient to produce, by their various combinations, the +endless diversity of effects, of which the shell of the earth has +preserved the memorials; and, consistently with these principles, +the recurrence of analogous changes is expected by them in time +to come. + +Whether we coincide or not in this doctrine we must admit that +the gradual progress of opinion concerning the succession of +phenomena in very remote eras, resembles, in a singular manner, +that which has accompanied the growing intelligence of every +people, in regard to the economy of nature in their own times. In +an early state of advancement, when a greater number of natural +appearances are unintelligible, an eclipse, an earthquake, a +flood, or the approach of a comet, with many other occurrences +afterwards found to belong to the regular course of events, are +regarded as prodigies. The same delusion prevails as to moral +phenomena, and many of these are ascribed to the intervention of +demons, ghosts, witches, and other immaterial and supernatural +agents. By degrees, many of the enigmas of the moral and physical +world are explained, and, instead of being due to extrinsic and +irregular causes, they are found to depend on fixed and +invariable laws. The philosopher at last becomes convinced of the +undeviating uniformity of secondary causes; and, guided by his +faith in this principle, he determines the probability of +accounts transmitted to him of former occurrences, and often +rejects the fabulous tales of former times, on the ground of +their being irreconcilable with the experience of more +enlightened ages. + +PREPOSSESSIONS IN REGARD TO THE DURATION OF PAST TIME.--As a +belief in the want of conformity in the cause by which the +earth's crust has been modified in ancient and modern periods +was, for a long time, universally prevalent, and that, too, +amongst men who were convinced that the order of nature had been +uniform for the last several thousand years, every circumstance +which could have influenced their minds and given an undue bias +to their opinions deserves particular attention. Now the reader +may easily satisfy himself, that, however undeviating the course +of nature may have been from the earliest epochs, it was +impossible for the first cultivators of geology to come to such a +conclusion, so long as they were under a delusion as to the age +of the world, and the date of the first creation of animate +beings. However fantastical some theories of the sixteenth +century may now appear to us,--however unworthy of men of great +talent and sound judgment,--we may rest assured that, if the same +misconception now prevailed in regard to the memorials of human +transactions, it would give rise to a similar train of +absurdities. Let us imagine, for example, that Champollion, and +the French and Tuscan literati when engaged in exploring the +antiquities of Egypt, had visited that country with a firm belief +that the banks of the Nile were never peopled by the human race +before the beginning of the nineteenth century, and that their +faith in this dogma was as difficult to shake as the opinion of +our ancestors, that the earth was never the abode of living +beings until the creation of the present continents, and of the +species now existing,--it is easy to perceive what extravagant +systems they would frame, while under the influence of this +delusion, to account for the monuments discovered in Egypt. The +sight of the pyramids, obelisks, colossal statues, and ruined +temples, would fill them with such astonishment, that for a time +they would be as men spell-bound--wholly incapable of reasoning +with sobriety. They might incline at first to refer the +construction of such stupendous works to some superhuman powers +of the primeval world. A system might be invented resembling that +so gravely advanced by, Manetho, who relates that a dynasty of +gods originally ruled in Egypt, of whom Vulcan, the first +monarch, reigned nine thousand years; after whom came Hercules +and other demigods, who were at last succeeded by human kings. + +When some fanciful speculations of this kind had amused their +imaginations for a time, some vast repository of mummies would be +discovered, and would immediately undeceive those antiquaries who +enjoyed an opportunity of personally examining them; but the +prejudices of others at a distance, who were not eye-witnesses of +the whole phenomena, would not be so easily overcome. The +concurrent report of many travellers would, indeed, render it +necessary for them to accommodate ancient theories to some of the +new facts, and much wit and ingenuity would be required to modify +and defend their old positions. Each new invention would violate +a greater number of known analogies; for if a theory be required +to embrace some false principle, it becomes more visionary in +proportion as facts are multiplied, as would be the case if +geometers were now required to form an astronomical system on the +assumption of the immobility of the earth. + +Amongst other fanciful conjectures concerning the history of +Egypt, we may suppose some of the following to be started. 'As +the banks of the Nile have been so recently colonized for the +first time, the curious substances called mummies could never in +reality have belonged to men. They may have been generated by +some PLASTIC VIRTUE residing in the interior of the earth, or +they may be abortions of Nature produced by her incipient efforts +in the work of creation. For if deformed beings are sometimes +born even now, when the scheme of the universe is fully +developed, many more may have been "sent before their time scarce +half made up," when the planet itself was in the embryo state. +But if these notions appear to derogate from the perfection of +the Divine attributes, and if these mummies be in all their parts +true representations of the human form, may we not refer them to +the future rather than the past? May we not be looking into the +womb of Nature, and not her grave? May not these images be like +the shades of the unborn in Virgil's Elysium--the archetypes of +men not yet called into existence?' + +These speculations, if advocated by eloquent writers, would not +fail to attract many zealous votaries, for they would relieve men +from the painful necessity of renouncing preconceived opinions. +Incredible as such scepticism may appear, it has been rivalled by +many systems of the sixteenth and seventeenth centuries, and +among others by that of the learned Falloppio, who, as we have +seen (p. 33), regarded the tusks of fossil elephants as earthly +concretions, and the pottery or fragments of vases in the Monte +Testaceo, near Rome, as works of nature, and not of art. But when +one generation had passed away, and another, not compromised to +the support of antiquated dogmas, had succeeded, they would +review the evidence afforded by mummies more impartially, and +would no longer controvert the preliminary question, that human +beings had lived in Egypt before the nineteenth century: so that +when a hundred years perhaps had been lost, the industry and +talents of the philosopher would be at last directed to the +elucidation of points of real historical importance. + +But the above arguments are aimed against one only of many +prejudices with which the earlier geologists had to contend. Even +when they conceded that the earth had been peopled with animate +beings at an earlier period than was at first supposed, they had +no conception that the quantity of time bore so great a +proportion to the historical era as is now generally conceded. +How fatal every error as to the quantity of time must prove to +the introduction of rational views concerning the state of things +in former ages, may be conceived by supposing the annals of the +civil and military transactions of a great nation to be perused +under the impression that they occurred in a period of one +hundred instead of two thousand years. Such a portion of history +would immediately assume the air of a romance; the events would +seem devoid of credibility, and inconsistent with the present +course of human affairs. A crowd of incidents would follow each +other in thick succession. Armies and fleets would appear to be +assembled only to be destroyed, and cities built merely to fall +in ruins. There would be the most violent transitions from +foreign or intestine war to periods of profound peace, and the +works effected during the years of disorder or tranquillity would +appear alike superhuman in magnitude. + +He who should study the monuments of the natural world under the +influence of a similar infatuation, must draw a no less +exaggerated picture of the energy and violence of causes, and +must experience the same insurmountable difficulty in reconciling +the former and present state of nature, If we could behold in one +view all the volcanic cones thrown up in Iceland, Italy, Sicily, +and other parts of Europe, during the last five thousand years, +and could see the lavas which have flowed during the same period; +the dislocations, subsidences, and elevations caused during +earthquakes; the lands added to various deltas, or devoured by +the sea, together with the effects of devastation by floods, and +imagine that all these events had happened in one year, we must +form most exalted ideas of the activity of the agents, and the +suddenness of the revolutions. If geologists, therefore, have +misinterpreted the signs of a succession of events, so as to +conclude that centuries were implied where the characters +indicated thousands of years, and thousands of years where the +language of Nature signified millions, they could not, if they +reasoned logically from such false premises, come to any other +conclusion than that the system of the natural world had +undergone a complete revolution. + +We should be warranted in ascribing the erection of the great +pyramid to superhuman power, if we were convinced that it was +raised in one day; and if we imagine, in the same manner, a +continent or mountain-chain to have been elevated during an +equally small fraction of the time which was really occupied in +upheaving it, we might then be justified in inferring, that the +subterranean movements were once far more energetic than in our +own times. We know that; during one earthquake the coast of Chili +may be raised for a hundred miles to the average height of about +three feet. A repetition of two thousand shocks, of equal +violence, might produce a mountain-chain one hundred miles long, +and six thousand feet high. Now, should one or two only of these +convulsions happen in a century, it would be consistent with the +order of events experienced by the Chilians from the earliest +times: but if the whole of them were to occur in the next hundred +years, the entire district must be depopulated, scarcely any +animals or plants could survive, and the surface would be one +confused heap of ruin and desolation. + +One consequence of undervaluing greatly the quantity of past +time, is the apparent coincidence which it occasions of events +necessarily disconnected, or which are so unusual, that it would +be inconsistent with all calculation of chances to suppose them +to happen at one and the same time. When the unlooked-for +association of such rare phenomena is witnessed in the present +course of nature, it scarcely ever fails to excite a suspicion of +the preternatural in those minds which are not firmly convinced +of the uniform agency of secondary causes;--as if the death of +some individual in whose fate they are interested happens to be +accompanied by the appearance of a luminous meteor, or a comet, +or the shock of an earthquake. It would be only necessary to +multiply such coincidences indefinitely, and the mind of every +philosopher would be disturbed. Now it would be difficult to +exaggerate the number of physical events, many of them most rare +and unconnected in their nature, which were imagined by the +Woodwardian hypothesis to have happened in the course of a few +months: and numerous other examples might be found of popular +geological theories, which require us to imagine that a long +succession of events happened in a brief and almost momentary +period. + +Another liability to error, very nearly allied to the former, +arises from the frequent contact of geological monuments +referring to very distant periods of time. We often behold, at +one glance, the effects of causes which have acted at times +incalculably remote, and yet there may be no striking +circumstances to mark the occurrence of a great chasm in the +chronological series of Nature's archives. In the vast interval +of time which may really have elapsed between the results of +operations thus compared, the physical condition of the earth +may, by slow and insensible modifications, have become entirely +altered; one or more races of organic beings may have passed +away, and yet have left behind, in the particular region under +contemplation, no trace of their existence. + +To a mind unconscious of these intermediate events, the passage +from one state of things to another must appear so violent, that +the idea of revolutions in the system inevitably suggests itself. +The imagination is as much perplexed by the deception, as it +might be if two distant points in space were suddenly brought +into immediate proximity. Let us suppose, for a moment, that a +philosopher should lie down to sleep in some arctic wilderness, +and then be transferred by a power, such as we read of in tales +of enchantment, to a valley in a tropical country, where, on +awaking, he might find himself surrounded by birds of brilliant +plumage, and all the luxuriance of animal and vegetable forms of +which Nature is so prodigal in those regions. The most reasonable +supposition, perhaps, which he could make, if by the +necromancer's art he were placed in such a situation, would be, +that he was dreaming; and if a geologist form theories under a +similar delusion, we cannot expect him to preserve more +consistency in his speculations, than in the train of ideas in an +ordinary dream. + +It may afford, perhaps, a more lively illustration of the +principle here insisted upon, if I recall to the reader's +recollection the legend of the Seven Sleepers. The scene of that +popular fable was placed in the two centuries which elapsed +between the reign of the emperor Decius and the death of +Theodosius the younger. In that interval of time (between the +years 249 and 450 of our era) the union of the Roman empire had +been dissolved, and some of its fairest provinces overrun by the +barbarians of the north. The seat of government had passed from +Rome to Constantinople, and the throne from a pagan persecutor to +a succession of Christian and orthodox princes. The genius of the +empire had been humbled in the dust, and the altars of Diana and +Hercules were on the point of being transferred to Catholic +saints and martyrs. The legend relates, 'that when Decius was +still persecuting the Christians, seven noble youths of Ephesus +concealed themselves in a spacious cavern in the side of an +adjacent mountain, where they were doomed to perish by the +tyrant, who gave orders that the entrance should be firmly +secured with a pile of huge stones. They immediately fell into a +deep slumber, which was miraculously prolonged, without injuring +the powers of life, during a period of 187 years. At the end of +that time the slaves of Adolius, to whom the inheritance of the +mountain had descended, removed the stones to supply materials +for some rustic edifice: the light of the sun darted into the +cavern, and the seven sleepers were permitted to awake. After a +slumber, as they thought, of a few hours, they were pressed by +the calls of hunger, and resolved that Jamhlichus, one of their +number, should secretly return to the city to purchase bread for +the use of his companions. The youth could no longer recognise +the once familiar aspect of his native country, and his surprise +was increased by the appearance of a large cross triumphantly +erected over the principal gate of Ephesus. His singular dress +and obsolete language confounded the baker, to whom he offered an +ancient medal of Decius as the current coin of the empire; and +Jamblichus, on the suspicion of a secret treasure, was dragged +before the judge. Their mutual enquiries produced the amazing +discovery, that two centuries were almost elapsed since +Jamblichus and his friends had escaped from the rage of a pagan +tyrant.' + +This legend was received as authentic throughout the Christian +world before the end of the sixth century, and was afterwards +introduced by Mahomet as a divine revelation into the Koran, and +from hence was adopted and adorned by all the nations from Bengal +to Africa who professed the Mahometan faith. Some vestiges even +of a similar tradition have been discovered in Scandinavia. 'This +easy and universal belief,' observes the philosophical historian +of the Decline and Fall, 'so expressive of the sense of mankind, +may be ascribed to the genuine merit of the fable itself. We +imperceptibly advance from youth to age, without observing the +gradual, but incessant, change of human affairs; and even, in our +larger experience of history, the imagination is accustomed, by a +perpetual series of causes and effects, to unite the most distant +revolutions. But if the interval between two memorable eras could +be instantly annihilated; if it were possible, after a momentary +slumber of two hundred years, to display the new world to the +eyes of a spectator who still retained a lively and recent +impression of the old, his surprise and his reflections would +furnish the pleasing subject of a philosophical romance.' +[Footnote: Gibbon, Decline and Fall. chap, xxxiii.] + +PREJUDICES ARISING FROM OUR PECULIAR POSITION AS INHABITANTS OF +THE LAND.--The sources of prejudice hitherto considered may be +deemed peculiar for the most part to the infancy of the science, +but others are common to the first cultivators of geology and to +ourselves, and are all singularly calculated to produce the same +deception, and to strengthen our belief that the course of Nature +in the earlier ages differed widely from that now established. +Although these circumstances cannot be fully explained without +assuming some things as proved, which it has been my object +elsewhere to demonstrate, [Footnote: Elements of Geology, 6th +edit., 1865; and Student's Elements, 1871.] it may be well to +allude to them briefly in this place. + +The first and greatest difficulty, then, consists in an habitual +unconsciousness that our position as observers is essentially +unfavourable, when we endeavour to estimate the nature and +magnitude of the changes now in progress. In consequence of our +inattention to this subject, we are liable to serious mistakes in +contrasting the present with former states of the globe. As +dwellers on the land, we inhabit about a fourth part of the +surface; and that portion is almost exclusively a theatre of +decay, and not of reproduction. We know, indeed, that new +deposits are annually formed in seas and lakes, and that every +year some new igneous rocks are produced in the bowels of the +earth, but we cannot watch the progress of their formation, and +as they are only present to our minds by the aid of reflection, +it requires an effort both of the reason and the imagination to +appreciate duly their importance. It is, therefore, not +surprising that we estimate very imperfectly the result of +operations thus unseen by us; and that, when analogous results of +former epochs are presented to our inspection, we cannot +immediately recognise the analogy. He who has observed the +quarrying of stone from a rock, and has seen it shipped for some +distant port, and then endeavours to conceive what kind of +edifice will be raised by the materials, is in the same +predicament as a geologist, who, while he is confined to the +land, sees the decomposition of rocks, and the transportation of +matter by rivers to the sea, and then endeavours to picture to +himself the new strata which Nature is building beneath the +waters. + +PREJUDICES ARISING FROM OUR NOT SEEING SUBTERRANEAN CHANGES.--Nor +is his position less unfavourable when, beholding a volcanic +eruption, he tries to conceive what changes the column of lava +has produced, in its passage upwards, on the intersected strata; +or what form the melted matter may assume at great depths on +cooling; or what may be the extent of the subterranean rivers and +reservoirs of liquid matter far beneath the surface. It should, +therefore, be remembered, that the task imposed on those who +study the earth's history requires no ordinary share of +discretion; for we are precluded from collating the corresponding +parts of the system of things as it exists now, and as it existed +at former periods. If we were inhabitants of another element--if +the great ocean were our domain, instead of the narrow limits of +the land, our difficulties would be considerably lessened; while, +on the other hand, there can be little doubt, although the reader +may, perhaps, smile at the bare suggestion of such an idea, that +an amphibious being, who should possess our faculties, would +still more easily arrive at sound theoretical opinions in +geology, since he might behold, on the one hand, the +decomposition of rocks in the atmosphere, or the transportation +of matter by running water; and, on the other, examine the +deposition of sediment in the sea, and the imbedding of animal +and vegetable remains in new strata. He might ascertain, by +direct observation, the action of a mountain torrent, as well as +of a marine current; might compare the products of volcanos +poured out upon the land with those ejected beneath the waters; +and might mark, on the one hand, the growth of the forest, and, +on the other, that of the coral reef. Yet, even with these +advantages, he would be liable to fall into the greatest errors, +when endeavouring to reason on rocks of subterranean origin. He +would seek in vain, within the sphere of his observation, for any +direct analogy to the process of their formation, and would +therefore be in danger of attributing them, wherever they are +upraised to view, to some 'primeval state of nature.' + +But if we may be allowed so far to indulge the imagination, as to +suppose a being entirely confined to the nether world--some +'dusky melancholy sprite,' like Umbriel, who could 'flit on sooty +pinions to the central earth,' but who was never permitted to +'sully the fair face of light,' and emerge into the regions of +water and of air; and if this being should busy himself in +investigating the structure of the globe, he might frame theories +the exact converse of those usually adopted by human +philosophers. He might infer that the stratified rocks, +containing shells and other organic remains, were the oldest of +created things, belonging to some original and nascent state of +the planet. 'Of these masses' he might say, 'whether they consist +of loose incoherent sand, soft clay, or solid stone, none have +been formed in modern times. Every year some of them are broken +and shattered by earthquakes, or melted by volcanic fire; and +when they cool down slowly from a state of fusion, they assume a +new and more crystalline form, no longer exhibiting that +stratified disposition and those curious impressions and +fantastic markings, by which they were previously characterised. +This process cannot have been carried on for an indefinite time, +for in that case all the stratified rocks would long ere this +have been fused and crystallised. It is therefore probable that +the whole planet once consisted of these mysterious and curiously +bedded formations at a time when the volcanic fire had not yet +been brought into activity. Since that period there seems to have +been a gradual development of heat; and this augmentation we may +expect to continue till the whole globe shall be in a state of +fluidity, or shall consist, in those parts which are not melted, +of volcanic and crystalline rocks.' + +Such might be the system of the Gnome at the very time that the +followers of Leibnitz, reasoning on what they saw on the outer +surface, might be teaching the opposite doctrine of gradual +refrigeration, and averring that the earth had begun its career +as a fiery comet, and might be destined hereafter to become a +frozen mass. The tenets of the schools of the nether and of the +upper world would be directly opposed to each other, for both +would partake of the prejudices inevitably resulting from the +continual contemplation of one class of phenomena to the +exclusion of another. Man observes the annual decomposition of +crystalline and igneous rocks, and may sometimes see their +conversion into stratified deposits; but he cannot witness the +reconversion of the sedimentary into the crystalline by +subterranean heat. He is in the habit of regarding all the +sedimentary rocks as more recent than the unstratified, for the +same reason that we may suppose him to fall into the opposite +error if he saw the origin of the igneous class only. + +For more than two centuries the shelly strata of the Subapennine +hills afforded matter of speculation to the early geologists of +Italy, and few of them had any suspicion that similar deposits +were then forming in the neighbouring sea. Some imagined that the +strata, so rich in organic remains, instead of being due to +secondary agents, had been so created in the beginning of things +by the fiat of the Almighty. Others, as we have seen, ascribed +the imbedded fossil bodies to some plastic power which resided in +the earth in the early ages of the world. In what manner were +these dogmas at length exploded? The fossil relics were carefully +compared with their living analogues, and all doubts as to their +organic origin were eventually dispelled. So, also, in regard to +the nature of the containing beds of mud, sand, and limestone: +those parts of the bottom of the sea were examined where shells +are now becoming annually entombed in new deposits, Donati +explored the bed of the Adriatic, and found the closest +resemblance between the strata there forming, and those which +constituted hills above a thousand feet high in various parts of +the Italian peninsula. He ascertained by dredging that living +testacea were there grouped together in precisely the same manner +as were their fossil analogues in the inland strata; and while +some of the recent shells of the Adriatic were becoming incrusted +with calcareous rock, be observed that others had been newly +buried in sand and clay, precisely as fossil shells occur in the +Subapennine hills. + +In like manner, the volcanic rocks of the Vicentin had been +studied in the beginning of the last century; but no geologist +suspected, before the time of Arduino, that these were composed +of ancient submarine lavas. During many years of controversy, the +popular opinion inclined to a belief that basalt and rocks of the +same class had been precipitated from a chaotic fluid, or an +ocean which rose at successive periods over the continents, +charged with the component elements of the rocks in question. Few +will now dispute that it would have been difficult to invent a +theory more distant from the truth; yet we must cease to wonder +that it gained so many proselytes, when we remember that its +claims to probability arose partly from the very circumstance of +its confirming the assumed want of analogy between geological +causes and those now in action. By what train of investigations +were geologists induced at length to reject these views, and to +assent to the igneous origin of the trappean formations? By an +examination of volcanos now active, and by comparing their +structure and the composition of their lavas with the ancient +trap rocks. + +The establishment, from time to time, of numerous points of +identification, drew at length from geologists a reluctant +admission, that there was more correspondence between the +condition of the globe at remote eras and now, and more +uniformity in the laws which have regulated the changes of its +surface, than they at first imagined. If, in this state of the +science, they still despaired of reconciling every class of +geological phenomena to the operations of ordinary causes, even +by straining analogy to the utmost limits of credibility, we +might have expected, at least, that the balance of probability +would now have been presumed to incline towards the close analogy +of the ancient and modern causes. But, after repeated experience +of the failure of attempts to speculate on geological monuments, +as belonging to a distinct order of things, new sects continued +to persevere in the principles adopted by their predecessors. +They still began, as each new problem presented itself, whether +relating to the animate or inanimate world, to assume an original +and dissimilar order of nature; and when at length they +approximated, or entirely came round to an opposite opinion, it +was always with the feeling, that they were conceding what they +had been justified a priori in deeming improbable. In a word, the +same men who, as natural philosophers, would have been most +incredulous respecting any extraordinary deviations from the +known course of nature, if reported to have happened IN THEIR OWN +TIME, were equally disposed, as geologists, to expect the proofs +of such deviations at every period of the past. * * * * + + + + +UNIFORMITY OF CHANGE + + +II + +SUPPOSED ALTERNATE PERIODS OF REPOSE AND DISORDER--OBSERVED FACTS +IN WHICH THIS DOCTRINE HAS ORIGINATED--THESE MAY BE EXPLAINED BY +SUPPOSING A UNIFORM AND UNINTERRUPTED SERIES OF CHANGES--THREE- +FOLD CONSIDERATION OF THIS SUBJECT: FIRST, IN REFERENCE TO THE +LAWS WHICH GOVERN THE FORMATION OF FOSSILIFEROUS STRATA, AND THE +SHIFTING OF THE AREAS OF SEDIMENTARY DEPOSITION; SECONDLY, IN +REFERENCE TO THE LIVING CREATION, EXTINCTION OF SPECIES, AND +ORIGIN OF NEW ANIMALS AND PLANTS; THIRDLY, IN REFERENCE TO THE +CHANGES PRODUCED IN THE EARTH'S CRUST BY THE CONTINUANCE OF +SUBTERRANEAN MOVEMENTS IN CERTAIN AREAS, AND THEIR TRANSFERENCE +AFTER LONG PERIODS TO NEW AREAS--ON THE COMBINED INFLUENCE OF ALL +THESE MODES AND CAUSES OF CHANGE IN PRODUCING BREAKS AND CHASMS +IN THE CHAIN OF RECORDS--CONCLUDING REMARKS ON THE IDENTITY OF +THE ANCIENT AND PRESENT SYSTEM OF TERRESTRIAL CHANGES. + + +ORIGIN OF THE DOCTRINE OF ALTERNATE PERIODS OF REPOSE AND +DISORDER.--It has been truly observed, that when we arrange the +fossiliferous formations in chronological order, they constitute +a broken and defective series of monuments: we pass without any +intermediate gradations from systems of strata which are +horizontal, to other systems which are highly inclined--from +rocks of peculiar mineral composition to others which have a +character wholly distinct--from one assemblage of organic remains +to another, in which frequently nearly all the species, and a +large part of the genera, are different. These violations of +continuity are so common as to constitute in most regions the +rule rather than the exception, and they have been considered by +many geologists as conclusive in favour of sudden revolutions in +the inanimate and animate world. We have already seen that +according to the speculations of some writers, there have been in +the past history of the planet alternate periods of tranquillity +and convulsion, the former enduring for ages, and resembling the +state of things now experienced by man, the other brief, +transient, and paroxysmal, giving rise to new mountains, seas, +and valleys, annihilating one set of organic beings, and ushering +in the creation of another. + +It will be the object of the present chapter to demonstrate that +these theoretical views are not borne out by a fair +interpretation of geological monuments. It is true that in the +solid framework of the globe we have a chronological chain of +natural records, many links of which are wanting: but a careful +consideration of all the phenomena leads to the opinion that the +series was originally defective--that it has been rendered still +more so by time--that a great part of what remains is +inaccessible to man, and even of that fraction which is +accessible nine-tenths or more are to this day unexplored. + +The readiest way, perhaps, of persuading the reader that we may +dispense with great and sudden revolutions in the geological +order of events is by showing him how a regular and uninterrupted +series of changes in the animate and inanimate world must give +rise to such breaks in the sequence, and such unconformability of +stratified rocks, as are usually thought to imply convulsions and +catastrophes. It is scarcely necessary to state that the order of +events thus assumed to occur, for the sake of illustration, +should be in harmony with all the conclusions legitimately drawn +by geologists from the structure of the earth, and must be +equally in accordance with the changes observed by man to be now +going on in the living as well as in the inorganic creation. It +may be necessary in the present state of science to supply some +part of the assumed course of nature hypothetically; but if so, +this must be done without any violation of probability, and +always consistently with the analogy of what is known both of the +past and present economy of our system. Although the discussion +of so comprehensive a subject must carry the beginner far beyond +his depth, it will also, it is hoped, stimulate his curiosity, +and prepare him to read some elementary treatises on geology with +advantage, and teach him the bearing on that science of the +changes now in progress on the earth. At the same time it may +enable him the better to understand the intimate connection +between the Second and Third Books of this work, one of which is +occupied with the changes of the inorganic, the latter with those +of the organic creation. + +In pursuance, then, of the plan above proposed, I will consider +in this chapter, first, the laws which regulate the denudation of +strata and the deposition of sediment; secondly, those which +govern the fluctuation in the animate world; and thirdly, the +mode in which subterranean movements affect the earth's crust. + +UNIFORMITY OF CHANGE CONSIDERED, FIRST, IN REFERENCE TO +DENUDATION AND SEDIMENTARY DEPOSITION.--First, in regard to the +laws governing the deposition of new strata. If we survey the +surface of the globe, we immediately perceive that it is +divisible into areas of deposition and non-deposition; or, in +other words, at any given time there are spaces which are the +recipients, others which are not the recipients, of sedimentary +matter. No new strata, for example, are thrown down on dry land, +which remains the same from year to year; whereas, in many parts +of the bottom of seas and lakes, mud, sand, and pebbles are +annually spread out by rivers and currents. There are also great +masses of limestone growing in some seas, chiefly composed of +corals and shells, or, as in the depths of the Atlantic, of +chalky mud made up of foraminifera and diatomaceae. + +As to the dry land, so far from being the receptacle of fresh +accessions of matter, it is exposed almost everywhere to waste +away. Forests may be as dense and lofty as those of Brazil, and +may swarm with quadrupeds, birds, and insects, yet at the end of +thousands of years one layer of black mould a few inches thick +may be the sole representative of those myriads of trees, leaves, +flowers, and fruits, those innumerable bones and skeletons of +birds, quadrupeds, and reptiles, which tenanted the fertik +region. Should this land be at length submerged, the waves of the +sea may wash away in a few hours the scanty covering of mould, +and it may merely impart a darker shade of colour to the next +stratum of marl, sand, or other matter newly thrown down. So also +at the bottom of the ocean where no sediment is accumulating, +seaweed, zoophytes, fish, and even shells, may multiply for ages +and decompose, leaving no vestige of their form or substance +behind. Their decay, in water, although more slow, is as certain +and eventually as complete as in the open air. Nor can they be +perpetuated for indefinite periods in a fossil state, unless +imbedded in some matrix which is impervious to water, or which at +least does not allow a free percolation of that fluid, +impregnated, as it usually is, with a slight quantity of carbonic +or other acid. Such a free percolation may be prevented either by +the mineral nature of the matrix itself, or by the superposition +of an impermeable stratum; but if unimpeded, the fossil shell or +bone will be dissolved and removed, particle after particle, and +thus entirely effaced, unless petrifaction or the substitution of +some mineral for the organic matter happen to take place. + +That there has been land as well as sea at all former geological +periods, we know from the fact that fossil trees and terrestrial +plants are imbedded in rocks of every age, except those which are +so ancient as to be very imperfectly known to us. Occasionally +lacustrine and fluviatile shells, or the bones of amphibious or +land reptiles, point to the same conclusion. The existence of dry +land at all periods of the past implies, as before mentioned, the +partial deposition of sediment, or its limitation to certain +areas; and the next point to which I shall call the reader's +attention is the shifting of these areas from one region to +another. + +First, then, variations in the site of sedimentary deposition are +brought about independently of subterranean movements. There is +always a slight change from year to year, or from century to +century. The sediment of the Rhone, for example, thrown into the +Lake of Geneva, is now conveyed to a spot a mile and a half +distant from that where it accumulated in the tenth century, and +six miles from the point where the delta began originally to +form. We may look forward to the period when this lake will be +filled up, and then the distribution of the transported matter +will be suddenly altered, for the mud and sand brought down from +the Alps will thenceforth, instead of being deposited near +Geneva, be carried nearly 200 miles southwards, where the Rhone +enters the Mediterranean. + +In the deltas of large rivers, such as those of the Ganges and +Indus, the mud is first carried down for many centuries through +one arm, and on this being stopped up it is discharged by +another, and may then enter the sea at a point 50 or 100 miles +distant from its first receptacle. The direction of marine +currents is also liable to be changed by various accidents, as by +the heaping up of new sandbanks, or the wearing away of cliffs +and promontories. + +But, secondly, all these causes of fluctuation in the sedimentary +areas are entirely subordinate to those great upward or downward +movements of land, which will presently be spoken of, as +prevailing over large tracts of the globe. By such elevation or +subsidence certain spaces are gradually submerged, or made +gradually to emerge: in the one case sedimentary deposition may +be suddenly renewed after having been suspended for one or more +geological periods, in the other as suddenly made to cease after +having continued for ages. + +If deposition be renewed after a long interval, the new strata +will usually differ greatly from the sedimentary rocks previously +formed in the same place, and especially if the older rocks have +suffered derangement, which implies a change in the physical +geography of the district since the previous conveyance of +sediment to the same spot. It may happen, however, that, even +where the two groups, the superior and the inferior, are +horizontal and conformable to each other, they may still differ +entirely in mineral character, because, since the origin of the +older formation, the geography of some distant country has been +altered. In that country rocks before concealed may have become +exposed by denudation; volcanos may have burst out and covered +the surface with scoriae and lava; or new lakes, intercepting the +sediment previously conveyed from the upper country, may have +been formed by subsidence; and other fluctuations may have +occurred, by which the materials brought down from thence by +rivers to the sea have acquired a distinct mineral character. + +It is well known that the stream of the Mississippi is charged +with sediment of a different colour from that of the Arkansas and +Red Rivers, which are tinged with red mud, derived from rocks of +porphyry and red gypseous clays in 'the far west.' The waters of +the Uruguay, says Darwin, draining a granitic country, are clear +and black, those of the Parana, red. [Footnote: Darwin's Journal, +p. 163, and edit., p. 139.] The mud with which the Indus is +loaded, says Burnes, is of a clayey hue, that of the Chenab, on +the other hand, is reddish, that of the Sutlej is more pale. +[Footnote: Journ. Roy. Geograph. Soc., vol. iii, p. 142.] The +same causes which make these several rivers, sometimes situated +at no great distance the one from the other, to differ greatly in +the character of their sediment, will make the waters draining +the same country at different epochs, especially before and after +great revolutions in physical geography, to be entirely +dissimilar. It is scarcely necessary to add that marine currents +will be affected in an analogous manner in consequence of the +formation of new shoals, the emergence of new islands, the +subsidence of others, the gradual waste of neighbouring coasts, +the growth of new deltas, the increase of coral reefs, volcanic +eruptions, and other changes. + +UNIFORMITY OF CHANGE CONSIDERED, SECONDLY, IN REGERENCE TO THE +LIVING CREATION.--Secondly, in regard to the vicissitudes of the +living creation, all are agreed that the successive groups of +sedimentary strata found in the earth's crust are not only +dissimilar in mineral composition for reasons above alluded to, +but are likewise distinguishable from each other by their organic +remains. The general inference drawn from the study and +comparison of the various groups, arranged in chronological +order, is this: that at successive periods distinct tribes of +animals and plants have inhabited the land and waters, and that +the organic types of the newer formations are more analogous to +species now existing than those of more ancient rocks. If we then +turn to the present state of the animate creation, and enquire +whether it has now become fixed and stationary, we discover that, +on the contrary, it is in a state of continual flux--that there +are many causes in action which tend to the extinction of +species, and which are conclusive against the doctrine of their +unlimited durability. + +There are also causes which give rise to new varieties and races +in plants and animals, and new forms are continually supplanting +others which had endured for ages. But natural history has been +sucessfully cultivated for so short a period, that a few examples +only of local, and perhaps but one or two of absolute, +extirpation of species can as yet be proved, and these only where +the interference of man has been conspicuous. It will +nevertheless appear evident, from the facts and arguments +detailed in the chapters which treat of the geographical +distribution of species in the next volume, that man is not the +only exterminating agent; and that, independently of his +intervention, the annihilation of species is promoted by the +multiplication and gradual diffusion of every animal or plant. It +will also appear that every alteration in the physical geography +and climate of the globe cannot fail to have the same tendency. +If we proceed still farther, and enquire whether new species are +substituted from time to time for those which die out, we find +that the successive introduction of new forms appears to have +been a constant part of the economy of the terrestrial system, +and if we have no direct proof of the fact it is because the +changes take place so slowly as not to come within the period of +exact scientific observation. To enable the reader to appreciate +the gradual manner in which a passage may have taken place from +an extinct fauna to that now living, I shall say a few words on +the fossils of successive Tertiary periods. When we trace the +series of formations from the more ancient to the more modern, it +is in these Tertiary deposits that we first meet with assemblages +of organic remains having a near analogy to the fauna of certain +parts of the globe in our own time. In the Eocene, or oldest +subdivisions, some few of the testacea belong to existing +species, although almost all of them, and apparently all the +associated vertebrata, are now extinct. These Eocene strata are +succeeded by a great number of more modern deposits, which depart +gradually in the character of their fossils from the Eocene type, +and approach more and more to that of the living creation. In the +present state of science, it is chiefly by the aid of shells that +we are enabled to arrive at these results, for of all classes the +testacea are the most generally diffused in a fossil state, and +may be called the medals principally employed by nature in +recording the chronology of past events. In the Upper Miocene +rocks (No. 5 of the table, p. 135) we begin to find a +considerable number, although still a minority, of recent +species, intermixed with some fossils common to the preceding, or +Eocene, epoch. We then arrive at the Pliocene strata, in which +species now contemporary with man begin to preponderate, and in +the newest of which nine-tenths of the fossils agree with species +still inhabiting the neighbouring sea. It is in the Post-Tertiary +strata, where all the shells agree with species now living, that +we have discovered the first or earliest known remains of man +associated with the bones of quadrupeds, some of which are of +extinct species. + +In thus passing from the older to the newer members of the +Tertiary system, we meet with many chasms, but none which +separate entirely, by a broad line of demarcation, one state of +the organic world from another. There are no signs of an abrupt +termination of one fauna and flora, and the starting into life of +new and wholly distinct forms. Although we are far from being +able to demonstrate geologically an insensible transition from +the Eocene to the Miocene, or even from the latter to the recent +fauna, yet the more we enlarge and perfect our general survey, +the more nearly do we approximate to such a continuous series, +and the more gradually are we conducted from times when many of +the genera and nearly all the species were extinct, to those in +which scarcely a single species flourished which we do not know +to exist at present. Dr. A. Philippi, indeed, after an elaborate +comparison of the fossil tertiary shells of Sicily with those now +living in the Mediterranean, announced, as the result of his +examination, that there are strata in that island which attest a +very gradual passage from a period when only thirteen in a +hundred of the shells were like the species now living in the +sea, to an era when the recent species had attained a proportion +of ninety-five in a hundred. There is, therefore, evidence, he +says, in Sicily of this revolution in the animate world having +been effected 'without the intervention of any convulsion or +abrupt changes, certain species having from time to time died out +and others having been introduced, until at length the existing +fauna was elaborated.' + +In no part of Europe is the absence of all signs of man or his +works, in strata of comparatively modern date, more striking than +in Sicily. In the central parts of that island we observe a lofty +table-land and hills, sometimes rising to the height of 3,000 +feet, capped with a limestone, in which from 70 to 85 per cent of +the fossil testacea are specifically identical with those now +inhabiting the Mediterranean. These calcareous and other +argillaceous strata of the same age are intersected by deep +valleys which appear to have been gradually formed by denudation, +but have not varied materially in width or depth since Sicily was +first colonised by the Greeks. The limestone, moreover, which is +of so late a date in geological chronology, was quarried for +building those ancient temples of Girgenti and Syracuse, of which +the ruins carry us back to a remote era in human history. If we +are lost in conjectures when speculating on the ages required to +lift up these formations to the height of several thousand feet +above the sea, and to excavate the valleys, how much more remote +must be the era when the same rocks were gradually formed beneath +the waters! + +The intense cold of the Glacial period was spoken of in the tenth +chapter. Although we have not yet succeeded in detecting proofs +of the origin of man antecedently to that epoch, we have yet +found evidence that most of the testacea, and not a few of the +quadrupeds, which preceded, were of the same species as those +which followed the extreme cold. To whatever local disturbances +this cold may have given rise in the distribution of species, it +seems to have done little in effecting their annihilation. We may +conclude therefore, from a survey of the tertiary and modern +strata, which constitute a more complete and unbroken series than +rocks of older date, that the extinction and creation of species +have been, and are, the result of a slow and gradual change in +the organic world. + + +UNIFORMITY OF CHANGE CONSIDERED, THIRDLY, IN REFERENCE TO +SUBTERRANEAN MOVEMENTS.--Thirdly, to pass on to the last of the +three topics before proposed for discussion, the reader will +find, in the account given in the Second Book, Vol. II., of the +earthquakes recorded in history, that certain countries have from +time immemorial, been rudely shaken again and again; while +others, comprising by far the largest part of the globe, have +remained to all appearance motionless. In the regions of +convulsion rocks have been rent asunder, the surface has been +forced up into ridges, chasms have opened, or the ground +throughout large spaces has been permanently lifted up above or +let down below its former level. In the regions of tranquillity +some areas have remained at rest, but others have been +ascertained, by a comparison of measurements made at different +periods, to have risen by an insensible motion, as in Sweden, or +to have subsided very slowly, as in Greenland. That these same +movements, whether ascending or descending, have continued for +ages in the same direction has been established by historical or +geological evidence. Thus we find on the opposite coasts of +Sweden that brackish water deposits, like those now forming in +the Baltic, occur on the eastern side, and upraised strata filled +with purely marine shells, now proper to the ocean, on the +western coast. Both of these have been lifted up to an elevation +of several hundred feet above high-water mark. The rise within +the historical period has not amounted to many yards, but the +greater extent of antecedent upheaval is proved by the occurrence +in inland spots, several hundred feet high, of deposits filled +with fossil shells of species now living either in the ocean or +the Baltic. + +It must in general be more difficult to detect proofs of slow and +gradual subsidence than of elevation, but the theory which +accounts for the form of circular coral reefs and lagoon islands, +and which will be explained in the concluding chapter of this +work, will satisfy the reader that there are spaces on the globe, +several thousand miles in circumference, throughout which the +downward movement has predominated for ages, and yet the land has +never, in a single instance, gone down suddenly for several +hundred feet at once. Yet geology demonstrates that the +persistency of subterranean movements in one direction has not +been perpetual throughout all past time. There have been great +oscillations of level, by which a surface of dry land has been +submerged to a depth of several thousand feet, and then at a +period long subsequent raised again and made to emerge. Nor have +the regions now motionless been always at rest; and some of those +which are at present the theatres of reiterated earthquakes have +formerly enjoyed a long continuance of tranquillity. But, +although disturbances have ceased after having long prevailed, or +have recommenced after a suspension for ages, there has been no +universal disruption of the earth's crust or desolation of the +surface since times the most remote. The non-occurrence of such a +general convulsion is proved by the perfect horizontality now +retained by some of the most ancient fossiliferous strata +throughout wide areas. + +That the subterranean forces have visited different parts of the +globe at successive periods is inferred chiefly from the +unconformability of strata belonging to groups of different ages. +Thus, for example, on the borders of Wales and Shropshire, we +find the slaty beds of the ancient Silurian system inclined and +vertical, while the beds of the overlying carboniferous shale and +sandstone are horizontal. All are agreed that in such a case the +older set of strata had suffered great disturbance before the +deposition of the newer or carboniferous beds, and that these +last have never since been violently fractured, nor have ever +been bent into folds, whether by sudden or continuous lateral +pressure. On the other hand, the more ancient or Silurian group +suffered only a local derangement, and neither in Wales nor +elsewhere are all the rocks of that age found to be curved or +vertical. + +In various parts of Europe, for example, and particularly near +Lake Wener in the south of Sweden, and in many parts of Russia, +the Silurian strata maintain the most perfect horizontality; and +a similar observation may be made respecting limestones and +shales of like antiquity in the great lake district of Canada and +the United States. These older rocks are still as flat and +horizontal as when first formed; yet, since their origin, not +only have most of the actual mountain-chains been uplifted, but +some of the very rocks of which those, mountains are composed +have been formed, some of them by igneous and others by aqueous +action. + +It would be easy to multiply instances of similar +unconformability in formations of other ages; but a few more will +suffice. The carboniferous rocks before alluded to as horizontal +on the borders of Wales are vertical in the Mendip hills in +Somersetshire, where the overlying beds of the New Red Sandstone +are horizontal. Again, in the Wolds of Yorkshire the last- +mentioned sandstone supports on its curved and inclined beds the +horizontal Chalk. The Chalk again is vertical on the flanks of +the Pyrenees, and the tertiary strata repose unconformably upon +it. + +As almost every country supplies illustrations of the same +phenomena, they who advocate the doctrine of alternate periods of +disorder and repose may appeal to the facts above described, as +proving that every district has been by turns convulsed by +earthquakes and then respited for ages from convulsions. But so +it might with equal truth be affirmed that every part of Europe +has been visited alternately by winter and summer, although it +has always been winter and always summer in some part of the +planet, and neither of these seasons has ever reigned +simultaneously over the entire globe. They have been always +shifting from place to place; but the vicissitudes which recur +thus annually in a single spot are never allowed to interfere +with the invariable uniformity of seasons throughout the whole +planet. + +So, in regard to subterranean movements, the theory of the +perpetual uniformity of the force which they exert on the earth's +crust is quite consistent with the admission of their alternate +development and suspension for long and indefinite periods within +limited geographical areas. + +If, for reasons before stated, we assume a continual extinction +of species and appearance of others on the globe, it will then +follow that the fossils of strata formed at two distant periods +on the same spot will differ even more certainly than the mineral +composition of those strata. For rocks of the same kind have +sometimes been reproduced in the same district after a long +interval of time; whereas all the evidence derived from fossil +remains is in favour of the opinion that species which have once +died out have never been reproduced. The submergence, then, of +land must be often attended by the commencement of a new class of +sedimentary deposits, characterized by a new set of fossil +animals and plants, while the reconversion of the bed of the sea +into land may arrest at once and for an indefinite time the +formation of geological monuments. Should the land again sink, +strata will again be formed; but one or many entire revolutions +in animal or vegetable life may have been completed in the +interval. + +As to the want of completeness in the fossiliferous series, which +may be said to be almost universal, we have only to reflect on +what has been already said of the laws governing sedimentary +deposition, and those which give rise to fluctuations in the +animate world, to be convinced that a very rare combination of +circumstances can alone give rise to such a superposition and +preservation of strata as will bear testimony to the gradual +passage from one state of organic life to another. To produce +such strata nothing less will be requisite than the fortunate +coincidence of the following conditions: first, a never-failing +supply of sediment in the same region throughout a period of vast +duration; secondly, the fitness of the deposit in every part for +the permanent preservation of imbedded fossils; and, thirdly, a +gradual subsidence to prevent the sea or lake from being filled +up and converted into land. + +It will appear in the chapter on coral reefs, that, in certain +parts of the Pacific and Indian Oceans, most of these conditions, +if not all, are complied with, and the constant growth of coral, +keeping pace with the sinking of the bottom of the sea, seems to +have gone on so slowly, for such indefinite periods, that the +signs of a gradual change in organic life might probably be +detected in that quarter of the globe if we could explore its +submarine geology. Instead of the growth of coralline limestone, +let us suppose, in some other place, the continuous deposition of +fluviatile mud and sand, such as the Ganges and Brahmapootra have +poured for thousands of years into the Bay of Bengal. Part of +this bay, although of considerable depth, might at length be +filled up before an appreciable amount of change was effected in +the fish, mollusca, and other inhabitants of the sea and +neighbouring land. But if the bottom be lowered by sinking at the +same rate that it is raised by fluviatile mud, the bay can never +be turned into dry land. In that case one new layer of matter may +be superimposed upon another for a thickness of many thousand +feet, and the fossils of the inferior beds may differ greatly +from those entombed in the uppermost, yet every intermediate +gradation may be indicated in the passage from an older to a +newer assemblage of species. Granting, however, that such an +unbroken sequence of monuments may thus be elaborated in certain +parts of the sea, and that the strata happen to be all of them +well adapted to preserve the included fossils from decomposition, +how many accidents must still concur before these submarine +formations will be laid open to our investigation! The whole +deposit must first be raised several thousand feet, in order to +bring into view the very foundation; and during the process of +exposure the superior beds must not be entirely swept away by +denudation. + +In the first place, the chances are nearly as three to one +against the mere emergence of the mass above the waters, because +nearly three-fourths of the globe are covered by the ocean. But +if it be upheaved and made to constitute part of the dry land, it +must also, before it can be available for our instruction, become +part of that area already surveyed by geologists. In this small +fraction of land already explored, and still very imperfectly +known, we are required to find a set of strata deposited under +peculiar conditions, and which, having been originally of limited +extent, would have been probably much lessened by subsequent +denudation. + +Yet it is precisely because we do not encounter at every step the +evidence of such gradations from one state of the organic world +to another, that so many geologists have embraced the doctrine of +great and sudden revolutions in the history of the animate world. +Not content with simply availing themselves, for the convenience +of classification, of those gaps and chasms which here and there +interrupt the continuity of the chronological series, as at +present known, they deduce, from the frequency of these breaks in +the chain of records, an irregular mode of succession in the +events themselves, both in the organic and inorganic world. But, +besides that some links of the chain which once existed are now +entirely lost and others concealed from view, we have good reason to +suspect that it was never complete originally. + +It may undoubtedly be said that strata have been always forming +somewhere, and therefore at every moment of past time Nature has +added a page to her archives; but, in reference to this subject, it +should be remembered that we can never hope to compile a consecutive +history by gathering together monuments which were originally +detached and scattered over the globe. For, as the species of organic +beings contemporaneously inhabiting remote regions are distinct, the +fossils of the first of several periods which may be preserved in any +one country, as in America for example, will have no connection with +those of a second period found in India, and will therefore no more +enable us to trace the signs of a gradual change in the living +creation, than a fragment of Chinese history will fill up a blank in +the political annals of Europe. + +The absence of any deposits of importance containing recent shells in +Chili, or anywhere on the western coast of South America, naturally +led Mr. Darwin to the conclusion that "where the bed of the sea is +either stationary or rising, circumstances are far less favourable +than where the level is sinking to the accumulation of conchiferous +strata of sufficient thickness and extension to resist the average +vast amount of denudation." [Footnote: Darwin's S. America, pp. 136, +139.] In like manner the beds of superficial sand, clay, and gravel, +with recent shells, on the coasts of Norway and Sweden, where the +land has risen in Post-tertiary times, are so thin and scanty as to +incline us to admit a similar proposition. We may in fact assume that +in all cases where the bottom of the sea has been undergoing +continuous elevation, the total thickness of sedimentary matter +accumulating at depths suited to the habitation of most of the +species of shells can never be great, nor can the deposits be thickly +covered by superincumbent matter, so as to be consolidated by +pressure. When they are upheaved, therefore, the waves on the beach +will bear down and disperse the loose materials; whereas, if the bed +of the sea subsides slowly, a mass of strata, containing abundance of +such species as live at moderate depths, may be formed and may +increase in thickness to any amount. It may also extend horizontally +over a broad area, as the water gradually encroaches on the subsiding +land. + +Hence it will follow that great violations of continuity in the +chronological series of fossiliferous rocks will always exist, and +the imperfection of the record, though lessened, will never be +removed by future discoveries. For not only will no deposits +originate on the dry land, but those formed in the sea near land, +which is undergoing constant upheaval, will usually be too slight in +thickness to endure for ages. + +In proportion as we become acquainted with larger geographical areas, +many of the gaps, by which a chronological table, like that given at +page 135, is rendered defective, will be removed. We were enabled by +aid of the labours of Prof. Sedgwick and Sir Roderick Murchison to +intercalate, in 1838, the marine strata of the Devonian period, with +their fossil shells, corals, and fish, between the Silurian and +Carboniferous rocks. Previously the marine fauna of these last- +mentioned formations wanted the connecting links which now render the +passage from the one to the other much less abrupt. In like manner +the Upper Miocene has no representative in England, but in France, +Germany, and Switzerland it constitutes a most instructive link +between the living creation and the middle of the great Tertiary +period. Still we must expect, for reasons before stated, that chasms +will for ever continue to occur, in some parts of our sedimentary +series. + +Concluding remarks on the consistency of the theory of gradual change +with the existence of great breaks in the series.--To return to the +general argument pursued in this chapter, it is assumed, for reasons +above explained, that a slow change of species is in simultaneous +operation everywhere throughout the habitable surface of sea and +land; whereas the fossilisation of plants and animals is confined to +those areas where new strata are produced. These areas, as we have +seen, are always shifting their position, so that the fossilising +process, by means of which the commemoration of the particular state +of the organic world, at any given time, is effected, may be said to +move about, visiting and revisiting different tracts in succession. + +To make still more clear the supposed working of this machinery, I +shall compare it to a somewhat analogous case that might be imagined +to occur in the history of human affairs. Let the mortality of the +population of a large country represent the successive extinction of +species, and the births of new individuals the introduction of new +species. While these fluctuations are gradually taking place +everywhere, suppose commissioners to be appointed to visit each +province of the country in succession, taking an exact account of the +number, names, and individual peculiarities of all the inhabitants, +and leaving in each district a register containing a record of this +information. If, after the completion of one census, another is +immediately made on the same plan, and then another, there will at +last be a series of statistical documents in each province. When +those belonging to any one province are arranged in chronological +order, the contents of such as stand next to each other will differ +according to the length of the intervals of time between the taking +of each census. If, for example, there are sixty provinces, and all +the registers are made in a single year and renewed annually, the +number of births and deaths will be so small, in proportion to the +whole of the inhabitants, during the interval between the compiling +of two consecutive documents, that the individuals described in such +documents will be nearly identical; whereas, if the survey of each of +the sixty provinces occupies all the commissioners for a whole year, +so that they are unable to revisit the same place until the +expiration of sixty years, there will then be an almost entire +discordance between the persons enumerated in two consecutive +registers in the same province. There are, undoubtedly, other causes, +besides the mere quantity of time, which may augment or diminish the +amount of discrepancy. Thus, at some periods a pestilential disease +may have lessened the average duration of human life; or a variety of +circumstances may have caused the births to be unusually numerous, +and the population to multiply; or a province may be suddenly +colonised by persons migrating from surrounding districts. + +These exceptions may be compared to the accelerated rate of +fluctuations in the fauna and flora of a particular region, in which +the climate and physical geography may be undergoing an extraordinary +degree of alteration. + +But I must remind the reader that the case above proposed has no +pretensions to be regarded as an exact parallel to the geological +phenomena which I desire to illustrate; for the commissioners are +supposed to visit the different provinces in rotation; whereas the +commemorating processes by which organic remains become fossilised, +although they are always shifting from one area to the other, are yet +very irregular in their movements. They may abandon and revisit many +spaces again and again, before they once approach another district; +and, besides this source of irregularity, it may often happen that, +while the depositing process is suspended, denudation may take place, +which may be compared to the occasional destruction by fire or other +causes of some of the statistical documents before mentioned. It is +evident that where such accidents occur the want of continuity in the +series may become indefinitely great, and that the monuments which +follow next in succession will by no means be equidistant from each +other in point of time. + +If this train of reasoning be admitted, the occasional distinctness +of the fossil remains, in formations immediately in contact, would be +a necessary consequence of the existing laws of sedimentary +deposition and subterranean movement, accompanied by a constant +dying-out and renovation of 'species. + +As all the conclusions above insisted on are directly opposed to +opinions still popular, I shall add another comparison, in the hope +of preventing any possible misapprehension of the argument. Suppose +we had discovered two buried cities at the foot of Vesuvius, +immediately superimposed upon each other, with a great mass of tuff +and lava intervening, just as Portici and Resina, if now covered with +ashes, would overlie Herculaneum. An antiquary might possibly be +entitled to infer, from the inscriptions on public edifices, that the +inhabitants of the inferior and older city were Greeks, and those of +the modern towns Italians. But he would reason vary hastily if he +also concluded from these data, that there had been a sudden change +from the Greek to the Italian language in Campania. But if he +afterwards found three buried cities, one above the other, the +intermediate one being Roman, while, as in the former example, the +lowest was Greek and the uppermost Italian, he would then perceive +the fallacy of his former opinion, and would begin to suspect that +the catastrophes, by which the cities were inhumed might have no +relation whatever to the fluctuations in the language of the +inhabitants; and that, as the Roman tongue had evidently intervened +between the Greek and Italian, so many other dialects may have been +spoken in succession, and the passage from the Greek to the Italian +may have been very gradual, some terms growing obsolete, while others +were introduced from time to time. + +If this antiquary could have shown that the volcanic paroxysms of +Vesuvius were so governed as that cities should be buried one above +the other, just as often as any variation occurred in the language of +the inhabitants, then, Indeed, the abrupt passage from a Greek to a +Roman, and from a Roman to an Italian city, would afford proof of +fluctuations no less sudden in the language of the people. + +So, in Geology, if we could assume that it is part of the plan of +Nature to preserve, in every region of the globe, an unbroken series +of monuments to commemorate the vicissitudes of the organic creation, +we might infer the sudden extirpation of species, and the +simultaneous introduction o! others, as often as two formations in +contact are found to include dissimilar organic fossils. But we must +shut our eyes to the whole economy of the existing causes, aqueous, +igneous, and organic, if we fail to perceive that such is not the +plan of Nature. + +I shall now conclude the discussion of a question with which we have +been occupied since the beginning of the fifth chapter--namely, +whether there has been any interruption, from the remotest periods, +of one uniform and continuous system of change in the animate and +inanimate world. We were induced to enter into that enquiry by +reflecting how much the progress of opinion in Geology had been +influenced by the assumption that the analogy was slight in kind, and +still more slight in degree, between the cases which produced the +former revolutions of the globe, and those now in every-day +operation. It appeared clear that the earlier geologists had not only +a scanty acquaintance with existing changes, but were singularly +unconscious of the amount of their ignorance. With the presumption +naturally inspired by this unconsciousness, they had no hesitation in +deciding at once that time could never enable the existing powers of +nature to work out changes of great magnitude, still less such +important revolutions as those which are brought to light by Geology. +They therefore felt themselves at liberty to indulge their +imaginations in guessing at what might be, rather than enquiring what +is; in other words, they employed themselves in conjecturing what +might have been the course of Nature at a remote period, rather than +in the investigation of what was the course of Nature in their own +times. + +It appeared to them far more philosophical to speculate on the +possibilities of the past, than patiently to explore the realities of +the present; and having invented theories under the influence of such +maxims, they were consistently unwilling to test their validity by +the criterion of their accordance with the ordinary operations of +Nature. On the contrary. the claims of each new hypothesis to +credibility appeared enhanced by the great contrast, in kind or +intensity, of the causes referred to and those now in operation. + +Never was there a dogma more calculated to foster indolence, and to +blunt the keen edge of curiosity, than this assumption of the +discordance between the ancient and existing causes of change. It +produced a state of mind unfavourable in the highest degree to the +candid reception of the evidence of those minute but incessant +alterations which every part of the earth's surface is undergoing, +and by which the condition of its living inhabitants is continually +made to vary. The student, instead of being encouraged with the hope +of interpreting the enigmas presented to him in the earth's +structure--instead of being prompted to undertake laborious enquiries +into the natural history of the organic world, and the complicated +effects of the igneous and aqueous causes now in operation--was +taught to despond from the first. Geology, it was affirmed, could +never rise to the rank of an exact science; the greater number of +phenomena must for ever remain inexplicable, or only be partially +elucidated by ingenious conjectures. Even the mystery which invested +the subject was said to constitute one of its principal charms, +affording, as it did, full scope to the fancy to indulge in a +boundless field of speculation. + +The course directly opposed to this method of philosophising consists +in an earnest and patient enquiry, how far geological appearances are +reconcilable with the effect of changes now in progress, or which may +be in progress in regions inaccessible to us, but of which the +reality is attested by volcanos and subterranean movements. It also +endeavours to estimate the aggregate result of ordinary operations +multiplied by time, and cherishes a sanguine hope that the resources +to be derived from observation and experiment, or from the study of +Nature such as she now is, are very far from being exhausted. For +this reason all theories are rejected which involve the assumption of +sudden and violent catastrophes and revolutions of the whole earth, +and its inhabitants--theories which are restrained by no reference to +existing analogies, and in which a desire is manifested to cut, +rather than patiently to untie, the Gordian knot. + +We have now, at least, the advantage of knowing, from experience, +that an opposite method has always put geologists on the road that +leads to truth--suggesting views which, although imperfect at first, +have been found capable of improvement, until at last adopted by +universal consent; while the method of speculating on a former +distinct state of things and causes has led invariably to a multitude +of contradictory systems, which have been overthrown one after the +other--have been found incapable of modification--and which have +often required to be precisely reversed. + +The remainder of this work will be devoted to an investigation of the +changes now going on in the crust of the earth and its inhabitants. +The importance which the student will attach to such researches will +mainly depend on the degree of confidence which he feels in the +principles above expounded. If he firmly believes in the resemblance +or identity of the ancient and present system of terrestrial changes, +he will regard every fact collected respecting the cause in diurnal +action as affording him a key to the interpretation of some mystery +in the past. Events which have occurred at the most distant periods +in the animate and inanimate world will be acknowledged to throw +light on each other, and the deficiency of our information respecting +some of the most obscure parts of the present creation will be +removed. For as, by studying the external configuration of the +existing land and its inhabitants, we may restore in imagination the +appearance of the ancient continents which have passed away, so may +we obtain from the deposits of ancient seas and lakes an insight into +the nature of the subaqueous processes now in operation, and of many +forms of organic life which, though now existing, are veiled from +sight. Rocks, also, produced by subterranean fire in former ages, at +great depths in the bowels of the earth, present us, when upraised by +gradual movements, and exposed to the light of heaven, with an image +of those changes which the deep-seated volcano may now occasion in +the nether regions. Thus, although we are mere sojourner's on the +surface of the planet, chained to a mere point in space, enduring but +for a moment of time, the human mind is not only enabled to number +worlds beyond the unassisted ken of mortal eye, but to trace the +events of indefinite ages before the creation of our race, and is not +even withheld from penetrating into the dark secrets of the ocean, or +the interior of the solid globe; free, like the spirit which the poet +described as animating the universe, + + ------ire per omnes + Terrasque, tractusque maris, ccelumque profisndutn. + +[Footnote: "To go through all binds, and the tracts of the ocean, and +the boundless heaven."] + + + + + + + +End of Project Gutenberg's The Harvard Classics Volume 38, by Various + +*** END OF THE PROJECT GUTENBERG EBOOK HARVARD CLASSICS V.38 *** + +This file should be named 5694.txt or 5694.zip + +Produced by David Turner, Charles Franks +and the Online Distributed Proofreading Team. + +Project Gutenberg eBooks are often created from several printed +editions, all of which are confirmed as Public Domain in the US +unless a copyright notice is included. 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