In the treatise he had published in 1862, criticizing the doctrine of spontaneous generation, he had mentioned, among the organisms produced by urine in putrefaction, the existence of a torulacea in very small-grained chaplets. A physician, Dr. Traube, in 1864, had demonstrated that Pasteur was right in thinking that ammoniacal fermentation was due to this torulacea, whose properties were afterwards studied with infinite care by M. Van Tieghem, a former student of the Ecole Normale, who had inspired Pasteur with a deep affection. Pasteur, in his turn, completed his own observations and assured himself that this little organized ferment was to be found in every case of ammoniacal urine. Finally, after proving that boracic acid impeded the development of that ammoniacal ferment, he suggested to M. Guyon, the celebrated surgeon, the use of boracic acid for washing out the bladder; M. Guyon put the advice into practice with success, and attributed the credit of it to Pasteur.
In a letter written at the end of 1873, Pasteur wrote: “How I wish I had enough health and sufficient knowledge to throw myself body and soul into the experimental study of one of our infectious diseases!” He considered that his studies on fermentations would lead him in that direction; he thought that when it should be made evident that every serious alteration in beer was due to the micro-organisms which find in that liquid a medium favourable to their development, when it should be seen that—in contradiction to the old ideas by which those alterations are looked upon as spontaneous, inherent in those liquids, and depending on their nature and composition—the cause of those diseases is not interior but exterior, then would indeed be defeated the doctrine of men like Pidoux, who à propos of diseases, said: “Disease is in us, of us, by us,” and who, à propos of small-pox, even said that he was not certain that it could only proceed from inoculation and contagion.
Though the majority of physicians and surgeons considered that it was waste of time to listen to “a mere chemist,” there was a small group of young men, undergraduates, who, in their thirst for knowledge, assembled at the Académie de Médecine every Tuesday, hoping that Pasteur might bring out one of his communications concerning a scientific method “which resolves each difficulty by an easily interpreted experiment, delightful to the mind, and at the same time so decisive that it is as satisfying as a geometrical demonstration, and gives an impression of security.”
Those words were written by one of those who came to the Académie sittings, feeling that they were on the eve of some great revelations. He was a clinical assistant of Dr. Béhier’s, and, busy as he was with medical analysis, he was going over Pasteur’s experiments on fermentations for his own edification. He was delighted with the sureness of the Pastorian methods, and was impatient to continue the struggle now begun. Enthusiasm was evinced in his brilliant eyes, in the timbre of his voice, clear, incisive, slightly imperious perhaps, and in his implacable desire for logic. Of solitary habits, with no ambition for distinction or degrees, he worked unceasingly for sheer love of science. The greatest desire of that young man of twenty-one, quite unknown to Pasteur, was to be one day admitted, in the very humblest rank, to the Ecole Normale laboratory. His name was Roux.
Was not that medical student, that disciple lost in the crowd, an image of the new generation hungering for new ideas, more convinced than the preceding one had been of the necessity of proofs? Struck by the unstable basis of medical theories, those young men divined that the secret of progress in hospitals was to be found in the laboratories. Medicine and surgery in those days were such a contrast to what they are now that it seems as if centuries divided them. No doubt one day some professor, some medical historian, will give us a full account of that vast and immense progress. But, whilst awaiting a fully competent work of that kind, it is possible, even in a book such as this (which is, from many causes, but a hasty epitome of many very different things spread over a very simple biography), to give to a reader unfamiliar with such studies a certain idea of one of the most interesting chapters in the history of civilization, affecting the preservation of innumerable human lives.
“A pin-prick is a door open to Death,” said the surgeon Velpeau. That open door widened before the smallest operation; the lancing of an abscess or a whitlow sometimes had such serious consequences that surgeons hesitated before the slightest use of the bistoury. It was much worse when a great surgical intervention was necessary, though, through the irony of things, the immediate success of the most difficult operations was now guaranteed by the progress of skill and the precious discovery of anæsthesia. The patient, his will and consciousness suspended, awoke from the most terrible operation as from a dream. But at that very moment when the surgeon’s art was emboldened by being able to disregard pain, it was arrested, disconcerted, and terrified by the fatal failures which supervened after almost every operation. The words pyæmia, gangrene, erysipelas, septicæmia, purulent infection, were bywords in those days.
In the face of those terrible consequences, it had been thought better, about forty years ago, to discourage and even to prohibit a certain operation, then recently invented and practised in England and America, ovariotomy, “even,” said Velpeau, “if the reported cures be true.” In order to express the terror inspired by ovariotomy, a physician went so far as to say that it should be “classed among the attributes of the executioner.”
As it was supposed that the infected air of the hospitals might be the cause of the invariably fatal results of that operation, the Assistance Publique[31] hired an isolated house in the Avenue de Meudon, near Paris, a salubrious spot. In 1863, ten women in succession were sent to that house; the neighbouring inhabitants watched those ten patients entering the house, and a short time afterwards their ten coffins being taken away. In their terrified ignorance they called that house the House of Crime.
Surgeons were asking themselves whether they did not carry death with them, unconsciously scattering virus and subtle poisons.
Since the beginning of the nineteenth century, surgery had positively retrograded; the mortality after operations was infinitely less in the preceding centuries, because antisepsis was practised unknowingly, though cauterizations by fire, boiling liquids and disinfecting substances. In a popular handbook published in 1749, and entitled Medicine and Surgery for the Poor, we read that wounds should be kept from the contact of air; it was also recommended not to touch the wound with fingers or instruments. “It is very salutary, when uncovering the wound in order to dress it, to begin by applying over its whole surface a piece of cloth dipped into hot wine or brandy.” Good results had been obtained by the great surgeon Larrey, under the first Empire, by hot oil, hot brandy, and unfrequent dressings. But, under the influence of Broussais, the theory of inflammation caused a retrogression in surgery. Then came forth basins for making poultices, packets of charpie (usually made of old hospital sheets merely washed), and rows of pots of ointment. It is true that, during the second half of the last century, a few attempts were made to renew the use of alcoholized water for dressings. In 1868, at the time when the mortality after amputation in hospitals was over sixty per cent., Surgeon Léon Le Fort banished sponges, exacted from his students scrupulous cleanliness and constant washing of hands and instruments before every operation, and employed alcoholized water for dressings. But though he obtained such satisfactory results as to lower, in his wards at the Hôpital Cochin, the average of mortality after amputations to twenty-four per cent., his colleagues were very far from suspecting that the first secret for preventing fatal results after operations consisted in a reform of the dressings.