A History of Science — Volume 5

by Henry Smith Williams; Edward Huntington Williams

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."