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the evolution of modern medicine(�峇�匳勞議處延)-及47何蛍

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publications reprinted in Camac's book cited above。Ed。 

       In   1857�察  �a   young   man�察  �Louis   Pasteur�察  �sent   to   the   Lille   Scientific 

Society   a   paper   on   ;Lactic Acid   Fermentation;   and   in   December   of   the 

same   year   presented   to   the   Academy   of   Sciences   in   Paris   a   paper   on 

;Alcoholic   Fermentation; in   which   he   concluded   that   ;the   deduplication 

of sugar into alcohol and carbonic acid is correlative to a phenomenon of 

life。; A new era in medicine dates from those two publications。 The story 

of Pasteur's life should be read by every student。��*�А�It is one of the glories 

of   human   literature�察  �and�察  �as   a   record   of   achievement   and   of   nobility   of 

character�察�is almost without an equal。 

     ��*�А�Osler wrote a preface for the 1911 English edition of the Life by 

Vallery´Radot。Ed。 

       At the middle of the last century we did not know much more of the 

actual causes of the great scourges of the race�察�the plagues�察�the fevers and 

the   pestilences�察  �than   did   the   Greeks。   Here   comes   Pasteur's   great   work。 

Before him Egyptian darkness�察�with his advent a light that brightens more 

and more as the years give us ever fuller knowledge。 The facts that fevers 

were catching�察�that epidemics spread�察�that infection could remain attached 

to   articles   of   clothing�察  �etc。�察  �all   gave   support   to   the   view   that   the   actual 

cause was something alive�察�a contagium vivum。 It was really a very old 



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view�察�the germs of which may be found in the Fathers�察�but which was first 

clearly     expressedso     far   as   I  knowby      Fracastorius�察    �the   Veronese 

physician�察�in the sixteenth century�察 �who spoke of the seeds of contagion 

passing     from   one   person    to  another�撮�12�А    �and   he  first  drew    a  parallel 

between   the   processes   of   contagion   and   the   fermentation   of   wine。   This 

was more than one hundred years before Kircher�察�Leeuwenhoek and others 

began to use the microscope and to see animalcula�撮察�etc。�察�in water�察�and so 

give a basis for the ;infinitely little; view of the nature of disease germs。 

And it was a study of the processes of fermentation that led Pasteur to the 

sure ground on which we now stand。 

     ��12�А  �Varro�察  �in   De   Re   Rustica�察  �Bk。   I�察  �12   ��circa   40   B。C。���察  �speaks   of 

minute organisms which the eye cannot see and which enter the body and 

cause disease。 

       Out of these researches arose a famous battle which kept Pasteur hard 

at work for four or five yearsthe struggle over spontaneous generation。 It 

was an old warfare�察�but the microscope had revealed a new world�察�and the 

experiments on fermentation had lent great weight to the omne vivum ex 

ovo doctrine。 The famous Italians�察�Redi and Spallanzani�察�had led the way 

in their experiments�察�and the latter had reached the conclusion that there is 

no vegetable and no animal that has not its own germ。 But heterogenesis 

became      the  burning    question�察   �and   Pouchet     in  France�察   �and   Bastian   in 

England�察  �led   the   opposition   to   Pasteur。   The   many   famous   experiments 

carried   conviction   to   the   minds   of   scientific   men�察  �and   destroyed   forever 

the old belief in spontaneous generation。 All along�察�the analogy between 

disease and fermentation must have been in Pasteur's mind�察�and then came 

the suggestion�察 �What would be most desirable is to push those studies far 

enough to prepare the road for a serious research into the origin of various 

diseases。; If the changes in lactic�察�alcoholic and butyric fermentations are 

due   to   minute   living   organisms�察  �why  should   not the   same   tiny  creatures 

make the changes which occur in the body in the putrid and suppurative 

diseases�拭�With an accurate training as a chemist�察�having been diverted in 

his studies upon fermentation into the realm of biology�察�and nourishing a 

strong conviction of the identity between putrefactive changes of the body 

and   fermentation�察  �Pasteur   was   well   prepared   to   undertake   investigations 



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                         THE EVOLUTION OF MODERN MEDICINE 



which had hitherto been confined to physicians alone。 

     So impressed was he with the analogy between fermentation and the 

infectious   diseases   that�察  �in   1863�察  �he   assured   the   French   Emperor   of   his 

ambition       ;to  arrive    at  the   knowledge       of   the   causes     of  putrid    and 

contagious diseases。; After a study upon the diseases of wines�察�which has 

had     most    important      practical    bearings�察    �an   opportunity      arose    which 

changed   the   whole   course   of   his   career�察  �and   profoundly   influenced   the 

development of medical science。 A disease of the silkworm had�察�for some 

years�察�ruined one of the most important industries in France�察�and in 1865 

the Government asked Pasteur to give up his laboratory work and teaching�察�

and to devote his whole energies to the task of investigating it。 The story 

of the brilliant success which followed years of application to the problem 

will be read with deep interest by every student of science。 It was the first 

of his victories in the application of the experimental methods of a trained 

chemist   to   the   problems   of   biology�察  �and   it   placed   his   name   high   in   the 

group of the most illustrious benefactors of practical industries。 

     In   a   series   of   studies   on   the   diseases   of   beer�察  �and   on   the   mode   of 

production   of   vinegar�察  �he   became   more   and   more   convinced   that   these 

studies     on   fermentation      had   given    him    the  key    to  the   nature   of   the 

infectious diseases。 It is a remarkable fact that the distinguished English 

philosopher   of   the   seventeenth   century�察  �the   man   who   more   than   anyone 

else of his century appreciated the importance of the experimental method�察�

Robert Boyle�察�had said that he who could discover the nature of ferments 

and fermentation�察�would be more capable than anyone else of explaining 

the nature of certain diseases。 

     In   1876    there    appeared     in  Cohn's    ;Beitrage     zur   Morphologie        der 

Pflanzen;   ��II�察  �277´310���察      �a   paper   on   the   ;AEtiology   of   Anthrax;   by   a 

German district physician in Wollstein�察�Robert Koch�察�which is memorable 

in our literature as the starting point of a new method of research into the 

causation of infectious diseases。 Koch demonstrated the constant presence 

of   germs   in   the   blood   of   animals   dying   from   the   disease。   Years   before�察�

those organisms had been seen by Pollender and Davaine�察�but the epoch´ 

making advance of Koch was to grow those organisms in a pure culture 

outside   the   body�察  �and   to   produce   the   disease   artificially   by   inoculating 



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animals   with   the   cultures   Koch   is   really   our   medical   Galileo�察  �who�察  �by 

means       of   a  new     technique��pure       cultures    and    isolated    staining�察�

introduced      us   to  a   new    world。    In  1878�察   �followed     his  study    on   the 

;AEtiology   of   Wound   Infections�察─  �in   which   he   was   able   to   demonstrate 

conclusively   the   association   of   micro´organisms   with   the   disease。   Upon 

those     two   memorable       researches    made     by  a   country    doctor   rests   the 

modern science of bacteriology。 

     The next great advance was the discovery by Pasteur of the possibility 

of so attenuating�察�or weakening�察�the poison that an animal inoculated had a 

slight attack�察�recovered and was then protected against the disease。 More 

than     eighty   years    had   passed     since   on   May     14�察  �1796�察   �Jenner    had 

vaccinated   a   child   with   cowpox   and   proved   that   a   slight   attack   of   one 

disease protected the body from a disease of an allied nature。 An occasion 

equally famous in the history of medicine was a day in 1881�察�when Pasteur 

determined   that   a  flock  of  sheep   vaccinated   with the  attenuated   virus of 

anthrax remained well�察�when every one of the unvaccinated infected from 

the    same    material   had    died。  Meanwhile�察      �from   Pasteur's    researches    on 

fermentation       and    spontaneous      generation�察    �a  transformation      had    been 

initiated in the  practice of surgery�察�which�察 �it is not   too much   to say�察 �has 

proved   one   of   the   greatest   boons   ever   conferred   upon   humanity。   It   had 
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