VII. SOME MEDICAL LABORATORIES AND MEDICAL PROBLEMS
THE PASTEUR INSTITUTE
THE national egotism that characterizes the French mind is not without its compensations. It leads, for example, to the tangible recognition of the merits of the great men of the nation and to the promulgation of their names in many public ways. Thus it would be hard to mention a truly distinguished Frenchman of the older generations whose name has not been given to a street in Paris. Of the men of science thus honored, one recalls off-hand the names of Buffon, Cuvier, Geoffroy Saint-Hilaire, Pinel, Esquirol, Lamarck, Laplace, Lavoisier, Arago, Claude Bernard, Broca—indeed, one could readily extend the list to tiresome dimensions. Moreover, it is a list that is periodically increased by the addition of new names, as occasion offers, for the Parisian authorities never hesitate to rechristen a street or a portion of a street, regardless of former associations.
One of the most recent additions to this roll of fame is the name of Pasteur. The boulevard that bears that famous name is situated in a somewhat out-of-the-way corner of the city, though to reach it one has but to traverse the relatively short course of the Avenue de Breteuil from so central a position as the tomb of Napoleon. The Boulevard Pasteur itself is a not long but very spacious thoroughfare, which will some day be very beautiful, when the character of its environing buildings has somewhat changed and its quadruple rows of trees have had time for development. At present its chief distinction, in the eyes of most observers, would probably be found in the fact that it is the location of the famous fête forain at one of the annually recurring stages of the endless itinerary of that noted function. During the period of this distinction, which falls in the month of May, the boulevard becomes transformed into a veritable Coney Island of merry-go-rounds, shooting-galleries, ginger-bread booths, and clap-trap side-shows, to the endless delight of throngs of pleasure-seekers. There is no sight in all Paris worthier inspection for the foreigner than the Boulevard Pasteur offers at this season, for one gains a deep insight into the psychology of a people through observation of the infantile delight with which the adult population here throws itself into the spirit of amusements which with other nations are for the most part reserved for school-children. Only a race either in childhood or senescence, it would seem, could thus give itself over with undisguised delight to the enchantments of wooden horses, cattle, cats, and pigs; to the catching of wooden fish with hooks; to the shooting at targets that one could almost touch with the gun-muzzle, and to the grave observation of sideshow performances that would excite the risibilities of the most unsophisticated audience that could be found in the Mississippi Valley.
As we move among this light-hearted and lightheaded throng we shall scarcely escape a feeling of good-humored contempt for what seems an inferior race. It will be wholesome, therefore, for us to turn aside from the boulevard into the Rue Dotot, which leads from it near its centre, and walk a few hundred yards away from the pleasure-seekers, where an evidence of a quite different and a no less characteristic phase of the national psychology will be before us. For here, within easy sound of the jangling discords of the organs that keep time for the march of the cheveaux de bois, rises up a building that is in a sense the monument of a man who was brother in blood and in sentiment to the revellers we have just left in the boulevard, yet whose career stamped him as one of the greatest men of genius of any race or any time. That man was Louis Pasteur. The building before us is the famous institute that bears his name.
In itself this building is a simple and unimposing structure, yet of pleasing contour. It is as well placed as the surroundings permit, on a grassed terrace, a little back from the street, where a high iron fence guards it and gives it a degree of seclusion. There are other buildings visible in the rear, which, as one learns on entering, are laboratories and the like, where the rabbits and guinea-pigs and dogs that are so essential to the work of the laboratory are kept. On the terrace in front is a bronze statue of a boy struggling with a rabid dog—a reminder of the particular labor of the master-worker which led directly to the foundation of the institution. It will be remembered that it was primarily to give Pasteur a wider opportunity to apply his newly discovered treatment for the prevention of rabies that the subscription was undertaken which led finally to the erection of the buildings before us and brought the Pasteur Institute in its present form into being. Of the other aims and objects of the institution I shall speak more at length in a moment.
I have just said that the building before us is in effect the monument of the great savant. This is true in a somewhat more literal sense than might be supposed, for the body of Pasteur rests in a crypt at its base. The personal labors of the great discoverer were practically ended at the time when the institute was opened in 1888, on which occasion, as will be remembered, the scientific representatives of all nations gathered in Paris to do honor to the greatest Frenchman of his generation. He was spared to the world, however, for seven years more, during which time he fully organized the work of the institution along the lines it has since followed, and was, of course, the animating spirit of all the labors undertaken there by his devoted students and assistants. He is the animating spirit of the institution still, and it is fitting that his body should rest in the worthy mausoleum within the walls of that building whose erection was the tangible culmination of his life labors. The sarcophagus is a shrine within this temple of science which will serve to stimulate generations of workers here to walk worthily in the footsteps of the great founder of the institution. For he must be an unimaginative person indeed who, passing beneath that arch bearing the simple inscription "Ici Repose Pasteur," could descend into the simple but impressive mausoleum and stand beside the massive granite sarcophagus without feeling the same kind of mental uplift which comes from contact with a great and noble personality. The pretentious tomb of Galileo in the nave of Santa Croce at Florence, and the crowded resting-place of Newton and Darwin in Westminster Abbey, have no such impressiveness as this solitary vault where rests the body of Pasteur, isolated in death as the mightier spirits must always be in life.
AIMS AND OBJECTS OF THE PASTEUR INSTITUTE
If one chances to come to the institute in the later hours of the morning he will perhaps be surprised to find a motley company of men, women, and children, apparently of many nationalities and from varied walks of life, gathered about one of the entrances or sauntering near by. These are the most direct beneficiaries of the institution, the unfortunate victims of the bites of rabid dogs, who have come here to take the treatment which alone can give them immunity from the terrible consequences of that mishap. Rabies, or hydrophobia as it is more commonly termed with us, is well known to be an absolutely fatal malady, there being no case on record of recovery from the disease once fully established. Even the treatment which Pasteur developed and which is here carried out cannot avail to save the victim in whom the active symptoms of the malady are actually present. But, fortunately, the disease is peculiarly slow in its onset, sometimes not manifesting itself for weeks or months after the inoculation; and this delay, which formerly was to the patient a period of fearful doubt and anxiety, now suffices, happily, for the application of the protective inoculations which enable the person otherwise doomed to resist the poison and go unscathed. Thus it is that the persons who gather here each day to the number of fifty, or even one hundred, have the appearance of and the feelings of average health, though a large proportion of them bear in their systems, on arrival, the germs of a disease that would bring them speedily to a terrible end were it not that the genius of Pasteur had found a way to give them immunity. The number of persons who have been given the anti-rabic treatment here is more than twenty-five thousand. To have given safety to such an army of unfortunates is, indeed, enough merit for any single institution; but it must not be supposed that this record is by any manner of means the full measure of the benefits which the Institut Pasteur has conferred upon humanity. In point of fact, the preparation and use of the anti-rabic serum is only one of many aims of the institution, whose full scope is as wide as the entire domain of contagious diseases. Pasteur's personal discoveries had demonstrated the relation of certain lower organisms, notably the bacteria, to the contagious diseases, and had shown the possibility of giving immunity from certain of these diseases through the use of cultures of the noxious bacteria themselves. He believed that these methods could be extended and developed until all the contagious diseases, which hitherto have accounted for so startling a proportion of all deaths, were brought within the control of medical science. His deepest thought in founding the institute was to supply a tangible seat of operations for this attempted conquest, where the brilliant assistants he had gathered about him, and their successors in turn, might take a share in this great struggle, unhampered by the material drawbacks which so often confront the would-be worker in science.
He desired also that the institution should be a centre of education along the lines of its work, adding thus an indirect influence to the score of its direct achievements. In both these regards the institution has been and continues to be worthy of its founder. The Pasteur Institute is in effect a school of bacteriology, where each of the professors is at once a teacher and a brilliant investigator. The chief courses of instruction consist of two series each year of lectures and laboratory demonstrations on topics within the field of bacteriology. These courses, at which all the regular staff of the institution assist more or less, are open to physicians and other competent students regardless of nationality, and they suffice to inculcate the principles of bacteriology to a large band of seekers each year.
But more important, perhaps, than this form of educational influence is the impetus given by the institute to the researches of a small, select band of investigators who have taken up bacteriology for a life work, and who come here to perfect themselves in the final niceties of the technique of a most difficult profession. Thus such men as Calmette, the discoverer of the serum treatment of serpent-poisoning, and Yersin, famous for his researches in the prevention and cure of cholera by inoculation, are "graduates" of the Pasteur Institute. Indeed, almost all the chief laborers in this field in the world to-day, including the directors of practically all the daughter institutes bearing the same name that are now scattered all over the world, have had at least a share of their training in the mother institute here in Paris.
Of the work of the men who form the regular staff of the Pasteur Institute only a few words need be said here. Doctors Roux, Grancher, Metchnikoff, and Chamberland all had the privilege of sharing Pasteur's labors during the later years of the master's life, and each of them is a worthy follower of the beloved leader and at the same time a brilliant original investigator.*1* Roux is known everywhere in connection with the serum treatment of diphtheria, which he was so largely instrumental in developing. Grancher directs the anti-rabic department and allied fields. Metchnikoff, a Russian by birth and Parisian by adoption, is famous as the author of the theory that the white blood-corpuscles of the blood are the efficient agents in combating bacteria. Chamberland directs the field of practical bacteriology in its applications to hygiene, including the department in which protective serums are developed for the prevention of various diseases of domesticated animals, notably swine fever and anthrax. About one million sheep and half as many cattle are annually given immunity from anthrax by the serum here produced.
Of the patient and unremitting toil demanded of the investigator in this realm of the infinitely little; of the skill in manipulation, the fertility of resource, the scrupulous exactness of experiment that are absolutely prerequisite to success; of the dangers that attend investigations which deal with noxious germs, every one who knows anything of the subject has some conception, but those alone can have full comprehension who have themselves attempted to follow the devious and delicate pathways of bacteriology. But the goals to which these pathways lead have a tangibility that give them a vital interest for all the world. The hopes and expectations of bacteriology halt at nothing short of the ultimate extirpation of contagious diseases. The way to that goal is long and hard, yet in time it will be made passable. And in our generation there is no company of men who are doing more towards that end than the staff of that most famous of bacteriological laboratories the Pasteur Institute.
THE VIRCHOW INSTITUTE OF PATHOLOGY
Even were the contagious diseases well in hand, there would still remain a sufficient coterie of maladies whose origin is not due to the influence of living germs. There are, for example, many diseases of the digestive, nutritive, and excretory systems, of the heart and arteries, of the brain and nerves, and various less clearly localized abnormal conditions, that owe their origin to inherent defects of the organism, or to various indiscretions of food or drink, to unhygienic surroundings, to material injuries, or to other forms of environmental stress quite dissociated from the action of bacteria. It is true that one would need to use extreme care nowadays in defining more exactly the diseases that thus lie without the field of the bacteriologist, as that prying individual seems prone to claim almost everything within sight, and to justify his claim with the microscope; but after that instrument has done its best or worst, there will still remain a fair contingent of maladies that cannot fairly be brought within the domain of the ever-present "germ." On the other hand, all germ diseases have of course their particular effects upon the system, bringing their results within the scope of the pathologist. Thus while the bacteriologist has no concern directly with any disease that is not of bacterial origin, the pathologist has a direct interest in every form of disease whatever; in other words, bacteriology, properly considered, is only a special department of pathology, just as pathology itself is only a special department of general medicine.
Whichever way one turns in science, subjects are always found thus dovetailing into one another and refusing to be sharply outlined. Nevertheless, here as elsewhere, there are theoretical bounds that suffice for purposes of definition, if not very rigidly lived up to in practice; and we are justified in thinking of the pathologist (perhaps I should say the pathological anatomist) as the investigator of disease who is directly concerned with effects rather than with causes, who aims directly at the diseased tissue itself and reasons only secondarily to the causes. His problem is: given a certain disease (if I may be permitted this personified form of expression), to find what tissues of the body are changed by it from the normal and in what manner changed.
It requires but a moment's reflection to make it clear that a certain crude insight into the solution of this problem, as regards all common diseases, must have been the common knowledge of medical men since the earliest times. Thus not even medical knowledge was needed to demonstrate that the tissues of an in: flamed part become red and swollen; and numerous other changes of diseased tissues are almost equally patent. But this species of knowledge, based on microscopic inspection, was very vague and untrustworthy, and it was only after the advent of the perfected microscope, some three-quarters of a century ago, that pathological anatomy began to have any proper claim to scientific rank. Indeed, it was not until about the year 1865 that the real clew was discovered which gave the same impetus to pathology that the demonstration of the germ theory of disease gave at about the same time to etiology, or the study of causes of disease. This clew consisted of the final demonstration that all organic action is in the last resort a question of cellular activities, and, specifically, that all abnormal changes in any tissues of the body, due to whatever disease, can consist of nothing more than the destruction, or the proliferation, or the alteration of the cells that compose that tissue.
That seems a simple enough proposition nowadays, but it was at once revolutionary and inspiring in the day of its original enunciation some forty years ago. The man who had made the discovery was a young German physician, professor in the University of Freiburg, by name Rudolph Virchow. The discovery made him famous, and from that day to this the name of Virchow has held somewhat the same position in the world of pathology that the name of Pasteur occupied in the realm of bacteriology. Virchow was called presently to a professorship in the University of Berlin. In connection with this chair he established his famous Institute of Pathology, which has been the Mecca of all students of pathology ever since. He did a host of other notable things as well, among others, entering the field of politics, and becoming a recognized leader there no less than in science. Indeed, it seemed during the later decades of his life as if one encountered Virchow in whatever direction one turned in Berlin, and one feels that it was not without reason that his compatriots spoke of him as "the man who knows everything." To the end he retained all the alertness of intellect and the energy of body that had made him what he was. One found him at an early hour in the morning attending to the routine of his hospital duties, his lectures, and clinical demonstrations. These finished, he rushed off, perhaps to his parliamentary duties; thence to a meeting of the Academy of Sciences, or to preside at the Academy of Medicine or at some other scientific gathering. And in intervals of these diversified pursuits he was besieged ever by a host of private callers, who sought his opinion, his advice, his influence in some matter of practical politics, of statecraft, or of science, or who, perhaps, had merely come the length of the continent that they might grasp the hand of the "father of pathology."
In whatever capacity one sought him out, provided the seeking were not too presumptuous, one was sure to find the great savant approachable, courteous, even cordial. A man of multifarious affairs, he impressed one as having abundance of time for them all, and to spare. There is a leisureliness about the seeming habit of existence on the Continent that does not pertain in America, and one felt the flavor of it quite as much in the presence of this great worker as among those people who from our stand-point seem never really to work at all. This is to a certain extent explained if one visited Virchow in his home, and found to his astonishment that the world-renowned physician, statesman, pathologist, anthropologist was domiciled in a little apartment of the most modest equipment, up two flights, in a house of most unpretentious character. Everything was entirely respectable, altogether comfortable, to be sure; but it was a grade of living which a man of corresponding position in America could not hold to without finding himself quite out of step with his confrères and the subject of endless comment. But in this city of universal apartment-house occupancy and relatively low average of display in living it is quite otherwise. Virchow lived on the same plane, generally speaking, with the other scientists of Europe; it is only from the American standpoint that there is any seeming disparity between his fame and his material station in life; nor do I claim this as a merit of the American stand-point.
Be that as it may, however, our present concern lies not with these matters, but with Virchow the pathologist and teacher. To see the great scientist at his best in this rôle, it was necessary to visit the Institute of Pathology on a Thursday morning at the hour of nine. On the morning of our visit we found the students already assembled and gathered in clusters all about the room, examining specimens of morbid anatomy, under guidance of various laboratory assistants. This was to give them a general familiarity with the appearances of the disease-products that would be described to them in the ensuing lecture. But what is most striking about the room was the very unique method of arrangement of the desk or table on which the specimens rested. It was virtually a long-drawn-out series of desks winding back and forth throughout the entire room, but all united into one, so that a specimen passed along the table from end to end will make a zigzag tour of the room, passing finally before each person in the entire audience. To facilitate such transit, there was a little iron railway all along the centre of the table, with miniature turn-tables at the corners, along which microscopes, with adjusted specimens for examination, might be conveyed without danger of maladjustment or injury. This may seem a small detail, but it is really an important auxiliary in the teaching by demonstration with specimens for which this room was peculiarly intended. The ordinary lectures of Professor Virchow were held in a neighboring amphitheatre of conventional type.
Of a sudden there was a hush in the hum of voices, as a little, thin, frail-seeming man entered and stepped briskly to the front of the room and upon the low platform before the blackboard in the corner. A moment's pause for the students to take their places, and the lecturer, who of course was Virchow himself, began, in a clear, conversational voice, to discourse on the topic of the day, which chanced to be the formation of clots in blood-vessels. There was no particular attempt at oratory; rather the lecturer proceeded as if talking man to man, with no thought but to make his meaning perfectly clear. He began at once putting specimens in circulation, as supplied on his demand by his assistants from a rather grewsome-looking collection before him. Now he paused to chaff the assistant who was making the labels, poking good-humored jokes at his awkwardness, but with no trace of sting. Again he became animated, his voice raised a little, his speech more vehement, as he advanced his own views on some contested theory or refuted the objections that some opponent had urged against him, always, however, with a smile lurking about his eyes or openly showing on his lips.
Constantly the lecturer turned to the blackboard to illustrate with colored, crayons such points of his discourse as the actual specimens in circulation might leave obscure. Everything must be made plain to every hearer or he would not be satisfied. One can but contrast such teaching as this with the lectures of the average German professor, who seems not to concern himself in the least as to whether anything is understood by any one. But Virchow had the spirit of the true teacher. He had the air of loving his task, old story as it was to him. Most of his auditors were mere students, yet he appealed to them as earnestly as if they were associates and equals. He seemed to try to put himself on their level—to make his thought near to them. Physically he was near to them as he talked, the platform on which he stood being but a few inches in height, and such physical nearness conduces to a familiarity of discourse that is best fitted for placing lecturer and hearers en rapport. All in all, appealing as it does almost equally to ear and eye, it is a type of what a lecturer should be. Not a student there but went away with an added fund of information, which is far more than can be said of most of the lectures in a German university.
Needless to say, there are other departments to the Institute of Pathology. There are collections of beautifully preserved specimens for examination; rooms for practical experimentation in all phases of the subject, the chemical side included; but these are not very different from the similar departments of similar institutions everywhere. What was unique and characteristic about this institution was the personality of the director. Now he is gone, but his influence will not soon be forgotten. The pupils of a great teacher are sure to carry forward the work somewhat in the spirit of the master for at least a generation.
THE BERLIN INSTITUTE OP HYGIENE
I purposely refrain from entering into any details as to the character of the technical work done at the Virchow Institute, because the subject of pathology, despite its directly practical bearings, is in itself necessarily somewhat removed from the knowledge of the general reader. One cannot well understand the details of changes in tissues under abnormal conditions unless one first understands the normal conditions of the tissues themselves, and such knowledge is reserved for the special students of anatomy. For the nonprofessional observer the interest of the Virchow Institute must lie in its general scope rather than in the details of the subjects there brought under investigation, which latter have, indeed, of necessity, a somewhat grewsome character despite the beneficent results that spring from them. It is quite otherwise, however, with the work of the allied institution of which I now come to speak. The Institute of Hygiene deals with topics not very remote from those studied in the Virchow Institute, part of its work, indeed, falling clearly within the scope of pathology; but it differs in being clearly comprehensible to the general public and of immediate and tangible interest from the most strictly utilitarian stand-point, hygiene being, in effect, the tangible link between the more abstract medical sciences and the affairs of every-day life.
The Institute of Hygiene has also the interest that always attaches to association with a famous name, for it was here that Professor Koch made the greater part of those investigations which made his name the best known, next to that of Pasteur, of any in the field of bacteriology. In particular, the researches on the cholera germ, and those even more widely heralded researches that led to the discovery of the bacillus of tuberculosis, and the development of the remedy tuberculin, of which so much was at first expected, were made by Professor Koch in the laboratories of the antiquated building which was then and is still the seat of the Institute of Hygiene. More recently Professor Koch has severed his connection with the institution after presiding over it for many years, having now a semi-private laboratory just across from the Virchow Institute, in connection with the Charité Hospital; but one still thinks of the Institute of Hygiene as peculiarly the "Koch Institute" without injustice, so fully does its work follow the lines laid out for it by the great leader.
But however much the stamp of any individual personality may rest upon the institute, it is officially a department of the university, just as is the Virchow Institute. Like the latter, also, its local habitation is an antiquated building, strangely at variance, according to American ideas, with its reputation, though by no means noteworthy in this regard in the case of a German institution. It is situated in a part of the city distant from any other department of the university, and there is nothing about it exteriorly to distinguish it from other houses of the solid block in which it stands. Interiorly, it reminds one rather of a converted dwelling than a laboratory proper. Its rooms are well enough adapted to their purpose, but they give one the impression of a makeshift. The smallest American college would be ill-satisfied with such an equipment for any department of its work. Yet in these dingy quarters has been accomplished some of the best work in the new science of bacteriology that our century will have to boast.
The actual equipment of the bacteriological laboratory here is not, indeed, quite as meagre as it seems at first, there being numerous rooms, scattered here and there, which in the aggregate give opportunity for work to a large number of investigators, though no single room makes an impressive appearance. There is one room, however, large enough to give audience to a considerable class, and here lectures were given by Professor Koch and continue to be given by his successors to the special students of bacteriology who come from all over the world, as well as to the university students who take the course as a part of their regular medical curriculum. In regard to this feature of its work, the Institute of Hygiene differs in no essential respect from the Pasteur Institute and other laboratories of bacteriology. The same general routine of work pertains: the patient cultivation of the minute organisms in various mediums, their careful staining by special processes, and their investigation under the microscope mark the work of the bacteriologist everywhere. Many details of the special methods of culture or treatment originated here with Professor Koch, but such matters are never kept secret in science, so one may see them practised quite as generally and as efficiently in other laboratories as in this one. Indeed, it may frankly be admitted that, aside from its historical associations with the pioneer work in bacteriology, which will always make it memorable, there is nothing about the bacteriological laboratory here to give it distinction over hundreds of similar ones elsewhere; while in point of technical equipment, as already noted, it is remarkable rather for what it lacks than for what it presents.
The department of bacteriology, however, is only one of several important features of the institute. One has but to ascend another flight of stairs to pass out of the sphere of the microbe and enter a department where attention is directed to quite another field. We have now come to what may be considered the laboratory of hygiene proper, since here the investigations have to do directly with the functionings of the human body in their relations to the every-day environment. Here again one is struck with the meagre equipment with which important results may be attained by patient and skilled investigators. In only one room does one find a really elaborate piece of apparatus. This exceptional mechanism consists essentially of a cabinet large enough to give comfortable lodgment to a human subject—a cabinet with walls of peculiar structure, partly of glass, and connected by various pipes with sundry mysterious-seeming retorts. This single apparatus, however, is susceptible of being employed for the investigation of an almost endless variety of questions pertaining to the functionings of the human body considered as a working mechanism.
Thus, for example, a human subject to be experimented upon may remain for an indefinite period within this cabinet, occupied in various ways, taking physical exercise, reading, engaged in creative mental labor, or sleeping. Meantime, air is supplied for respiration in measured quantities, and of a precisely determined composition, as regards chemical impurities, moisture, and temperature. The air after passing through the chamber being again analyzed, the exact constituents added to it as waste products of the human machine in action under varying conditions are determined. It will readily be seen that by indefinitely varying the conditions of such experiments a great variety of data may be secured as to the exact physiological accompaniments of various bodily and mental activities. Such data are of manifest importance to the physiologist and pathologist on the one hand, while at the same time having a direct bearing on such eminently practical topics as the construction of shops, auditoriums, and dwellings in reference to light, heat, and ventilation. It remains only for practical architecture to take advantage of the unequivocal data thus placed at its disposal—an opportunity of which practical architecture, in Germany as elsewhere on the Continent, has hitherto been very slow to avail itself.
THE MUSEUM OF HYGIENE
The practical lessons thus given in the laboratory are supplemented in an even more tangible manner, because in a way more accessible to the public, in another department of the institution which occupies a contiguous building, and is known as the Museum of Hygiene. This, unlike the other departments of the institute, is open to the general public on certain days of each week, and it offers a variety of exhibits of distinctly novel character and of high educational value. The general character of the exhibits may be inferred from the name, but perhaps the scope is even wider than might be expected. In a word, it may be said that scarcely anything having to do with practical hygiene has been overlooked. Thus one finds here numberless models of dwelling-houses, showing details of lighting, heating, and ventilation; models not merely of individual dwellings, but also of school-buildings, hospitals, asylums, and even prisons. Sometimes the models represent merely ideal buildings, but more generally they reproduce in miniature actual habitations. In the case of the public buildings, the model usually includes not merely the structures themselves but the surroundings—lawns, drives, trees, out-buildings—so that one can get a very good idea of the more important hospitals, asylums, and prisons of Germany by making a tour of the Museum of Hygiene. Regarding the details of structure, one can actually gain a fuller knowledge in many cases than he could obtain by actual visits to the original institutions themselves.
The same thing is true of various other features of the subjects represented. Thus there is a very elaborate model here exhibited of the famous Berlin system of sewage-disposal. As is well known, the essential features of this system consist of the drainage of sewage into local reservoirs, from which it is forced by pumps, natural drainage not sufficing, to distant fields, where it is distributed through tile pipes laid in a network about a yard beneath the surface of the soil. The fields themselves, thus rendered fertile by the waste products of the city, are cultivated, and yield a rich harvest of vegetables and grains of every variety suitable to the climate. The visitor to this field sees only rich farms and market-gardens under ordinary process of cultivation. The system of pipes by which the land is fertilized is as fully hidden from his view as are, for example, the tributary sewage-pipes beneath the city pavements. The average visitor to Berlin knows nothing, of course, about one or the other, and goes away, as he came, ignorant of the important fact that Berlin has reached a better solution of the great sewage problem than has been attained by any other large city. Such, at least, is likely to be the case unless the sight-seer chance to pay a visit to the Museum of Hygiene, in which case a few minutes' inspection of the model there will make the matter entirely clear to him. It is to be regretted that the authorities of other large cities do not make special visits to Berlin for this purpose; though it should be added that some of them have done so, and that the Berlin system of "canalization" has been adopted in various places in America. But many others might wisely follow their example, notably the Parisians, whose sewerage system, despite the boasted exhibition canal-sewer, is, like so many other things Parisian, of the most primitive character and a reproach to present-day civilization.
It may be added that there are plenty of things exhibited in this museum which the Germans themselves might study to advantage, for it must be understood that the other hygienic conditions pertaining to Berlin are by no means all on a par with the high modern standard of the sewerage system. In the matter of ventilation, for example, one may find admirable models in the museum, showing just how the dwelling and shop and school-room should make provision for a proper supply of pure air for their occupants. But if one goes out from the museum and searches in the actual dwelling or shop or school-room for the counterparts of these models, one will be sorely puzzled where to find them. The general impression which a casual inspection will leave in his mind is that the word ventilation must be as meaningless to the German mind as it is, for example, to the mind of a Frenchman or an Italian. This probably is not quite just, since the German has at least reached the stage of having museum models of ventilated houses, thus proving that the idea does exist, even though latent, in his mental equipment, whereas the other continental nationalities seem not to have reached even this incipient stage of progress. All over Europe the people fear a current of air as if veritable miasm must lurk in it. They seem quite oblivious to any systematic necessity for replenishing the oxygen supply among large assemblies, as any one can testify who has, for example, visited their theatres or schools. And as to the private dwellings, after making them as nearly air-tight as practicable, they endeavor to preserve the status quo as regards air supply seemingly from season to season. They even seem to have passed beyond a mere negative regard for the subject of fresh air, inasmuch as they will bravely assure you that to sleep in a room with an open window will surely subject you to the penalty of inflamed eyes.
In a country like France, where the open fireplace is the usual means employed to modify the temperature (I will not say warm the room), the dwellings do of necessity get a certain amount of ventilation, particularly since the windows are not usually of the best construction. But the German, with his nearly air-tight double windows and his even more nearly sealed tile stove, spends the winter in an atmosphere suggestive of the descriptions that arctic travellers give us of the air in the hut of an Eskimo. It is clear, then, that the models in the Museum of Hygiene have thus far failed of the proselyting purpose for which they were presumably intended. How it has chanced that the inhabitants of the country maintain so high an average of robust health after this open defiance is a subject which the physiological department of the Institute of Hygiene might well investigate.
Even though the implied precepts of the Museum of Hygiene are so largely disregarded, however, it must be admitted that the existence of the museum is a hopeful sign. It is a valuable educational institution, and if its salutary lessons are but slowly accepted by the people, they cannot be altogether without effect. At least the museum proves that there are leaders in science here who have got beyond the range of eighteenth-century thought in matters of practical living, and the sign is hopeful for the future, though its promise will perhaps not be fulfilled in our generation.