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which, with slight exceptions, can hardly yet be regarded as out
of date.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