THE 
BOOKLOVERS 
MAGAZINE 
AUGUST 
1903 
VOL II NO II 
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COPYRIGHT, 1903, BY THE LIBRARY PUBLISHING CO. 
2 From photograph by Pierre Petit 
LOUIS PASTEUR 
FATHER OF MODERN SCIENTIFIC MEDICINE LENGTHS®© HEIMAN LIFE 
VICTORIES OFMODERIWEDICAL SCIENCE 
In the city of New York alone there are 
150,000 people living today who would be 
dead if the mortality of fifty years ago 
still prevailed. Popular opinion has scarcely 
yet come to realize what medical science 
has been doing in late years. People sicken 
and die, think the laity, and the efforts of 
the physician are just as futile as before 
the recent discoveries about which so much 
is said. This idea is, however, erroneous. 
I will venture to say there is scarcely an 
adult living today who has not experienced 
or will not experience an actual prolonga- 
tion of life due to discoveries of the last 
fifty years. 
Regard for a moment two of the diseases 
which have been practically eradicated from 
civilization by recent discoveries in medi- 
cine, and realize the number of lives thus 
saved. Cholera was wont to visit the 
cities of the Atlantic coast in the past 
about every ten years, and it was a stand- 
ing menace to the world every summer. 
It was not uncommon for this disease to 
decimate whole towns and cities. Since 
the discovery of its cause, however, it has 
been robbed of its terrors, and the children 
of today will probably never know of it 
except by name. Yellow fever was even 
a more frequent and fatal visitor. Now an 
ever contracting circle is gradually drawing 
about it, which limits it just at present to 
a narrow zone in the tropics and promises 
its entire extinction. 
Diseases thus eradicated are forgotten 
by the laity, the decrease in mortality from 
diseases still extant is made clear only by 
statistics which are not open to the public, 
and popular prejudice finds little or nothing 
that the scientific medical man is accom- 
plishing. As a matter of fact, however, 
the latter half of the nineteenth century 
saw medical discoveries that have already 
proven of incalculable benefit, and are 
pregnant with marvels for the future. 
The most interesting and far-reaching 
of these discoveries were in the realm of 
the infinitely little, the study of which was 
inaugurated by Pasteur. 
Pasteur's work in infectious diseases fob 
lowed the lines of a forecast made three 
hundred years ago by Sir Robert Boyle, 
who is known from his kinsman's descrip- 
tion as the "Father of chemistry and the 
brother of the Earl of Cork.'' Boyle said, 
" He who succeeds in explaining ferment- 
ation will be in a position to throw great 
light on the causes of the contagious dis- 
eases." Pasteur's first work was on fer- 
mentation, which he demonstrated to be 
due to minute living organisms, vegetable 
in nature, and he went directly from this 
to the infectious diseases. The first infec- 
tious disease to be run to the ground was 
a disease of wine. The wine industry of 
Southern France was threatened with 
annihilation on account of the failure of 
the wine to ferment properly. Pasteur's 
studies in fermentation procured him the 
invitation to discover its cause. He found 
a second micro-organism contaminating the 
wine, interfering with the desired ferment- 
ation, and demonstrated a ready means for 
preventing its entrance. 
The next step in the study of infectious 
diseases was likewise along industrial lines. 118 
The Booklovers Magazine 
There was a blight of silk-worms, so severe 
that the silk industry dwindled from fifty 
millions to three or four millions in two 
years. The silk-worms were dying by the 
thousands and the country was in despair, 
when this brilliant young chemist was 
again called on. He undertook the task 
and discovered the cause of the first posi- 
tively known infectious disease. By the 
simple method of isolation of the sick from 
the well he saved the industry. 
These two industrial triumphs made 
Pasteur one of the most notable men in 
his own country, and called the attention 
of the scientific world to infectious diseases 
generally. Even before Pasteur's time cer- 
tain small rods, since then named bacilli, 
had been found in immense numbers in the 
blood of sheep dead with anthrax, buttheir 
significance had been overlooked. Now, 
with new ideas in mind, those bacilli were 
studied and found to be the cause. Anthrax 
is a severe, frequently fatal disease, reason- 
ably common among the lower animals, 
especially sheep, but communicable to man. 
Pasteur presently found that although most 
animals were very susceptible to the disease, 
certain ones, like fowl, proved resistant. 
His ready mind, ever alert for reasons, 
jumped to the conclusion that the higher 
normal temperature of birds might have 
something to do with it. The tempera- 
ture of man and ordinary animals is about 
gS/^0; the temperature of birds about 103°. 
To test his conclusions Pasteur stood 
pigeons in ice-water, and inoculated them 
with the organism. He found to his grati- 
fication they developed the disease, but 
recovered when placed in an incubator and 
restored to normal temperature. Further 
experimentation showed that the organ- 
isms which the fowl had resisted were not 
capable of inducing the disease even in 
susceptible animals, and that the animals 
so injected with the attenuated organism 
became insusceptible to virulent cultures. 
This, in short, was the discovery of how 
vaccination acts. At the time it meant 
another industrial revolution, because Pas- 
teur's discovery was at once applied prac- 
cally and found to be effective. Anthrax 
now, as a scourge, does not exist. 
Jenner's discovery of vaccination in 1796 
practically eradicated small-pox. Pasteur's 
discovery demonstrated the modus operand!, 
so that a line was given along which 
similar experiments might be made on 
other diseases. He himself later applied 
this principle to hydrophobia, depriving it 
of its terrors in countries where hydro- 
phobia is common. 
In the actual prolongation of life Pas- 
teur's personal work is demonstrated only 
in the lives saved by the eradication of the 
disease anthrax and the curing of hydro- 
phobia; but all his discoveries were funda- 
mental in character and it is the results 
accomplished since through the knowledge 
of them that must be considered. For 
instance, without Pasteur's discoveries 
Dr. Joseph Lister's work would have been 
practically impossible, though to this is attri- 
butable the success of more than half the 
serious operations undertaken in recent 
years. In the domain of surgery the dis- 
covery of anaesthesia (which, by the way, 
was made by Morton, of South Carolina) 
holds the most important place because by 
it operations became possible that other- 
wise would not have been dreamed of; but 
second only to anaesthesia, stands Lister's 
discovery of antisepsis. Before Lister, 
operations on the abdominal cavity were 
attended by a mortality of fifty per cent.; 
since then this has been reduced to about 
five per cent. Before Lister, Senn's 
brilliant work in abdominal surgery could 
not have been done, and his invention 
of the earliest successful method of in- 
testinal anastomosis would have been 
useless. Before Lister, operations involv- 
ing the opening of the skull were almost 
invariably fatal; since then operations on 
and around the brain have a mortality 
quite comparable to that of abdominal 
surgery. Thirty years ago the removal of 
a tumor from the stomach or intestine, or 
the opening of an abscess in the brain, 
would not have been thought of; the 
disease was simply allowed to run its course 
till death. Today these are common 
surgical operations, and they have preserved 
thousands of useful lives. 
I he discovery, however, that has proven 
most beneficial as a result of Pasteur's 
original work was the discovery of the 
bacillus of tuberculosis (consumption). 
A long time before the actual finding of 
the organism it was known that tuber- 
culosis was an infectious disease, communi- 
cable from person to person, but the 
actual cause was unknown. So thousands LORD LISTER 
PIONEER OF ANTISEPSIS IN SURGERY Photograph by J. C. Schaartuachter 
ROBERT KOCH 
DISCOVERER OF THE BACILLI OF TUBERCULOSIS AND CHOLERA The Booklovers Magazine 
121 
of consumptives were walking about, 
ignorant of their condition, spreading the 
contagion broadcast. The germ of tuber- 
culosis is one of the most difficult to find 
at the outset. Yet it was captured and 
made subject to distinctive tests among 
the earliest of the micro-organisms, and is 
now the one most easily and positively 
recognised. On account of the difficulties 
to be overcome, Koch's study of the 
tubercle bacillus will always rank as one 
of the most brilliant pieces of scientific work 
ever done. Moreover the investigation 
was so thorough that though twenty years 
have elapsed since it was finished, nothing 
of importance has been added to it. 
As Pasteur's work on infectious diseases 
inaugurated the studies which have proved 
so fruitful, Koch's work on tuberculosis 
started the chase which will eventually 
hound this disease to earth. This sounds 
sanguine, but even at present, though 
scarcely imagined by the laity, tuberculosis 
has a mortality of less than twenty-five per 
cent., that is, seventy-five per cent, of the 
people affected with it recover. And the 
mortality is constantly decreasing. In the 
mind of the medical man of today there is no 
doubt that our present century will see its 
positive eradication. Today one of every 
seven deaths is attributable to it; a century 
hence it will be as rare as small-pox on 
the death certificates of the health office. 
Though a specific for the cure of tuber- 
culosis was once exploited-and exploited 
by Koch, the brilliant discoverer of the 
germ-it was found to be a delusion, and 
as far as specific curative properties were 
concerned it was practically dropped within 
a year or two. Koch's work, however, 
which was by no means an entire failure, 
stimulated research along this line, and in 
1894 Behring (and a little later Roux) 
announced his specific cure of diphtheria. 
The antitoxin for diphtheria has been 
known less than ten years, yet the mortal- 
ity of that dread disease has been reduced 
from between ten and fifteen per cent, to 
less than seven per cent. 
Quite as important a feature as the act- 
ual saving of life in diphtheria is the fact 
that it has given us another scientific 
method for the specific cure of disease, 
the first being virus attenuation as demon- 
strated by Pasteur. The cure of tubercu- 
losis, apart from the prevention of the dis- 
ease, might have been accomplished to the 
extent it is today without the discovery of 
the bacterial cause; the cure of diphtheria 
by antitoxin necessitated the discovery 
of the diphtheria bacillus, since the anti- 
toxin is manufactured through its agency. 
To understand the nature of the antitox- 
in it is necessary to understand the nature 
of the disease. Diphtheria is described 
technically as a "general disease with a 
local manifestation"-that is, it affects the 
whole body, as is shown by the prostra- 
tion, fever, and increased heart-beat, though 
the only place where actual destruction of 
tissue occurs is where the micro-organism 
locates, and this is usually in the throat. 
Any one who has ever had an ordinary 
ulcer in the mouth will readily appreciate 
that the diphtheritic ulcer per se, which is 
usually about the size of a dime, is totally 
inadequate to produce the severe symptoms 
seen in diphtheria. 
The cause must then be looked for else- 
where. It is found in the poison (or tox- 
in) thrown out by the diphtheria bacillus 
in its work of destruction. This poison is 
taken up by the blood and acts on the nerve 
centres. The poison is produced even 
when the organisms are grown outside the 
body, and can readily be separated. I he 
introduction of the poison, thus separated, 
into an animal, produces the same general 
symptoms as are seen in diphtheria. If, 
however, the dose at first injected is very 
small and then is gradually increased, the 
animal may be made completely insuscepti- 
ble to any quantity. This insusceptibility to 
the poison is apparently brought about by 
the production in the animal's blood of an 
antidote. The blood serum of such an 
animal acts as our diphtheria antitoxin. 
It is usually procured from the horse. 
Just how diphtheria antitoxin or anti- 
toxins in general (since we have anti- 
toxins to tetanus and the bubonic plague) 
act is not known, because we do not know 
how the toxin acts, and, therefore, cannot 
describe the ways it may be combatted. 
Yet recent experimentation in this line has 
developed what promises to be almost a 
whole new science-namely, the science 
of immunity. Though yet in its infancy, 
being only five years old, it has added more 
than half a hundred new words to medical 
terminology, and has for the moment 
attracted the attention of scientific observ- 122 
The Booklovers Magazine 
ors from everything else. The first scien- 
tific study of immunity-in other words, 
of toxins and antitoxins-was given to 
the world several years ago by Ehrlich, 
of Berlin. We already knew that certain 
toxins had a predilection for certain tissue 
cells, as for instance, tetanus toxin for 
nerve cells, but why was a mystery. Ehr- 
lich demonstrated that these and no other 
cells possessed certain bodies capable of 
Therefore when they are present in suffi- 
ciently large numbers in the blood, the 
blood will act as an antitoxin by ren- 
dering harmless the poison. 
The formation of antitoxin, however, to 
combat the toxin is not the only method 
adopted by nature for the cure of infec- 
tious diseases. Metschnikoff, the modest 
pupil of Pasteur, practically an exile from 
his country, Russia, has been demonstrat- 
Photograph by Pierre Petit 
ELIE METSCHNIKOFF 
DISCOVERER OF THE FUNCTION OF THE WHITE BLOOD CELLS 
combining with this particular toxin. 
Further, the cells containing these bodies 
are capable of producing them in practi- 
cally unlimited quantity, and when stimu- 
lated by repeated small doses of the toxin 
are even capable of throwing them off into 
the blood. These bodies, named receptors, 
retain the faculty of combining with the 
toxin even when free in the circulation. 
ing for the last two decades how the micro- 
organisms are dealt with directly. As is 
well known, the blood is composed of two 
principal elements, red and white blood 
cells. The function of the red, namely, 
to carry oxygen to the tissues, has long 
been known, but the interesting function 
of the white, which is to act as an actual 
police-patrol within the body, was first The Booklovers Magazine 
123 
brought out by Metschnikoff. The red 
cells are carried in the blood stream pas- 
sively; the white wander through the tis- 
sues independently. In addition the white 
cells possess a power of selecting and digest- 
ing most foreign elements. When, as in 
the case of a wound, micro-organisms are 
introduced into the tissues, the white blood 
cells emigrate from the blood vessels to the 
wound in immense numbers. They pro- 
means a pitched battle between the invad- 
ers and the police-patrol, and on which is 
victorious depends the health or death of 
the individual. 
A sketch of medical progress would be 
incomplete if it excluded Ramon y Cayal, of 
Madrid, the patient student who has revo- 
lutionized the theories on brain anatomy 
and the mechanism of nerve function. 
Fhe anatomy of the nervous system, and 
Drawn by V. Floyd Campbell 
RAMON Y CAYAL 
SPECIALIST IN PHYSIOLOGY OF THE BRAIN 
reed at once to take up, digest, and so kill 
he micro-organisms. When the micro- 
>rganisms are not very virulent this com- 
petes the process; when they are virulent, 
•nstead of being digested by the white cell, 
hey may kill it. Still, no matter how 
nany are killed, thousands more flood to 
he scene. In other words, the entrance 
)f micro-organisms into the tissues always 
consequently its physiology, was regarded 
in the past as very simple. Cayal showed 
that the specific brain cell is an indepen- 
dent unit provided with multiple processes, 
by means of which it is capable of acting 
not through one nerve alone but several. 
This independent brain unit or cell is called 
a neuron, and Cayal's theory the neuron 
theory. A simple illustration of how the EMIL BEHRING 
DISCOVERER OF DIPHTHERIA ANTITOXIN PAUL EHRLICH 
ORIGINATOR OF THE SCIENTIFIC STUDY OF TOXINS AND ANTITOXINS 126 
The Booklovers Magazine 
neuron acts is furnished by our not infre- 
quent hunt for a name or idea which we 
know we possess. We feel that the name 
is there, but we cannot recall it. We get 
various names near it, beginning even with 
the same letter or the same vowel sound, 
yet only after minutes or even hours does 
it actually occur to us. What is supposed 
to happen is that the particular cell of 
the plug into various holes eventually 
struck the proper one. 
Fhe discoveries of the last ten years 
have changed completely the story of life 
in the tropics. The two diseases making 
the tropics dread regions are so manacled 
that they are no longer to be feared, and 
it is likely that most of us will be in at their 
death. I speak of malaria and yellow fever. 
WALTER REED 
YELLOW FEVER EXPERT 
intellection which we are using throws out 
its process among the cells of memory for 
names, and though this process is brought 
in connection with cells containing similar 
names, it is only after a more or less pro- 
longed search that it hits on the right one. 
It is as if the telephone operator in the 
central office felt around blindly for the 
connection wanted, and only after putting 
The micro-organismal cause of malaria 
was discovered as far back as 1881, but 
how to avoid this cause has only been 
demonstrated in the last few years. The 
record of this running to earth reads more 
like a romance than an actual problem in 
scientific medicine. The malarial organism 
was supposed to breed in swamps and be 
wafted by the winds to places near at hand. The Booklovers Magazine 
127 
The swamps supposed to breed malaria 
were long recognised to be hot-beds of 
certain varieties of mosquitoes. The idea 
of a connection between the two was first 
publicly suggested by Manson, though at 
the time Donald Ross, a military surgeon 
in India, was endeavoring to demonstrate 
it by finding the organism in the body of 
the mosquito. With indefatigable zeal, 
Ross pushed his investigations till he found 
the disease, and transmits it in a changed 
form to the larvae. These larvae are de- 
posited in a certain kind of swamp and 
develop nowhere else. These swamps, or 
rather stagnant pools, are comparatively 
easily redeemed, and when this is im- 
possible, the larvae can be readily killed by 
other means. During this advance others 
were demonstrating that malaria could be 
contracted in no other way than by the 
Drawn by V. Floyd Campbell 
From copyright photograph by Elliott and Fry 
DONALD ROSS 
DISCOVERED THAT MOSQUITOES CONVEY MALARIA 
the organism in the stomach of the mos- 
quito, traced it through the larvae and then 
into the salivary glands in connection with 
the proboscis. Others at once took up 
the subject, demonstrating each step before 
the next was taken. They showed that 
only a definite variety of mosquito carries 
the organism. The mosquito obtains it 
hy sucking the blood of a patient ill with 
bite of a mosquito, that this practically 
always occurred at night, and that the 
simple precaution of sleeping under a net 
gave almost absolute protection. Malaria, 
therefore, with its thousands of victims 
yearly, has practically passed into medical 
history and will scarcely be heard of again. 
The results of the study of malaria gave 
the cue for the study of yellow fever. The From steel engraving by Henry Taylor, Jr. 
NICHOLAS SENN 
THE MOST FAMOUS AMERICAN SURGEON The Booklovers Magazine 
129 
idea gradually gained ground that yellow 
fever was associated with the culex fasciatus, 
a particular variety of mosquito common 
in Cuba. Dr. Walter Reed, surgeon in 
the army of occupation, started an investi- 
gation four years ago, and, following the 
line laid down in the conclusive experi- 
ments on malaria, he demonstrated again 
and again, so that it is impossible to doubt 
it, that yellow fever is not directly con- 
tagious, but is transferred from individual 
to individual only through the bite of 
this particular mosquito, and then only 
after it has fed on a yellow fever patient. 
When the history of Amercian medi- 
cine is written Walter Reed's name will 
occupy one of the most prominent places, if 
it does not actually head the list. Yellow 
fever, already sheared of its strength by 
sanitation, he tracked to its lair, and would 
not even have stopped here, but he was 
called away by death through appendicitis. 
Reading history with a medical eye it is 
remarkable to note, as we come down the 
ages, the number of prominent personages 
who died of appendicitis. Yet the exact 
definition of the disease was left to our 
own day and to an American, Reginald 
Fitz, of Boston. It is curious, yet suffi- 
ciently frequent to have passed almost into 
an axiom, that it is not the man who sees 
the greatest number of a particular kind 
of cases, but usually the one who sees only 
a few, who makes the discovery. At his 
death Rokitansky of Vienna, was said to 
have done fifty-seven thousand autopsies; 
Osler while in Montreal gave us a record 
of only twenty hundred, yet for statistics 
Osier's twenty hundred are quoted more 
frequently than Rokitansky's fifty-seven 
thousand. Rokitansky must have seen 
hundreds, if not thousands, of cases of 
appendicitis, yet the post-mortem reports 
continued to speak of inflammation of the 
bowels and general peritonitis, while the 
actual cause was overlooked. The defin- 
ition of appendicitis made by the Boston 
physician on the basis of comparatively 
few cases has been the cause of saving 
thousands of precious lives in every quarter 
of the globe. 
Another example of the man working 
with a few cases is Dr. S. Weir Mitchell, 
of Philadelphia. In the continental cities 
the nervous specialist sees ten cases of every 
kind of nervous disease to our one, yet it 
was here that the system of cure was elab- 
orated. I speak of Mitchell's rest-cure. 
Scientific medicine is only in its infancy. 
Its progress will prolong more and more 
markedly the average age of life by remov- 
ing the diseases that play havoc during 
childhood and adolescence. For example, 
cholera-infantum, the terror of mothers 
during the second summer, has within the 
year delivered up its cause to a medical 
student (Duval) of the University of Penn- 
sylvania, working under the direction of 
Professor Flexner. With the examples of 
Vienna and Munich before us we realize 
the fate of typhoid fever, which proves the 
pitfail of so many an ambitious adult. With 
typhoid will disappear its most notable 
sequela, gall-stones. Thumbs were turned 
down twenty years ago on the animal par- 
asitic diseases such as trichinosis and tape- 
worms, when the late Dr. Joseph Leidy, 
of Philadelphia, entered the lists and 
demonstrated how easily they might be 
conquered. 
When the organisms themselves cannot 
be directly handled, the source of conta- 
gion will be learned, and the diseases thus 
avoided. Our now constant enemies, ton- 
sillitis, influenza, and tuberculosis, will find 
it impossible to progress when people real- 
ize the uncleanliness of handkerchiefs and 
come to the use of paper napkins. Diph- 
theria and whooping-cough (and probably 
other diseases) will have one source of con- 
tagion removed when pet dogs and cats 
are kept away from children or carefully 
held within doors. Inventions outside the 
province of medicine will be by no means 
without influence. We have every reason 
to believe from analogy that flies are a fre- 
quent medium of transferring contagious 
diseases. Flies breed, practically, only in 
stables, and the replacing the horse by the 
automobile means their extermination. 
In thus depicting the advance of medical 
science and predicting its ultimate triumph 
over disease are we imagining a millennial 
condition? No! decidedly not. It is only 
a picture of the end of our present cen- 
tury when man will accomplish his four- 
score and ten in comparative freedom 
from the disease hobgoblins of today. 
(Philadelphia) From a photograph by Nadar 
GUY DE MAUPASSANT