The Harvard Classics Part 30

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, pa.s.sed 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-p.r.i.c.k 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 pa.s.sed 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 a.s.sert 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 const.i.tution of the subject.

Whatever this const.i.tution, 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 pract.i.tioner 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 a.s.sistance of M. Doleris.

PREJUDICES WHICH HAVE r.e.t.a.r.dED 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, Forfars.h.i.+re, 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-t.i.tle, "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 a.s.sumed 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 a.s.sociation, 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 const.i.tuting 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 a.s.semblage of general causes, they conceive, may have been sufficient to produce, by their various combinations, the endless diversity of effects, of which the sh.e.l.l of the earth has preserved the memorials; and, consistently with these principles, the recurrence of a.n.a.logous 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 circ.u.mstance 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 a.s.sured 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 G.o.ds originally ruled in Egypt, of whom Vulcan, the first monarch, reigned nine thousand years; after whom came Hercules and other demiG.o.ds, 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 a.n.a.logies; 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 a.s.sumption 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 pa.s.sed 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 quant.i.ty of time bore so great a proportion to the historical era as is now generally conceded.

How fatal every error as to the quant.i.ty 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 a.s.sume 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 a.s.sembled 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 repet.i.tion 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 quant.i.ty 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 a.s.sociation 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 circ.u.mstances 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 pa.s.sed 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 pa.s.sage 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 s.p.a.ce 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 ill.u.s.tration 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 pa.s.sed 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 n.o.ble youths of Ephesus concealed themselves in a s.p.a.cious 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 princ.i.p.al 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.'