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PARASITIC¡¡DISEASES

I¡¡have¡¡just¡¡adverted¡¡to¡¡the¡¡fact¡¡that¡¡Napoleon¡¡Bonaparte£»¡¡as¡¡First¡¡Consul¡¡and¡¡as¡¡Emperor£»¡¡was¡¡the¡¡victim¡¡of¡¡a¡¡malady¡¡which¡¡caused¡¡him¡¡to¡¡seek¡¡the¡¡advice¡¡of¡¡the¡¡most¡¡distinguished¡¡physicians¡¡of¡¡Paris¡£¡¡¡¡It¡¡is¡¡a¡¡little¡¡shocking¡¡to¡¡modern¡¡sensibilities¡¡to¡¡read¡¡that¡¡these¡¡physicians£»¡¡except¡¡Corvisart£»¡¡diagnosed¡¡the¡¡distinguished¡¡patient's¡¡malady¡¡as¡¡¡¨gale¡¡repercutee¡¨that¡¡is¡¡to¡¡say£»¡¡in¡¡idiomatic¡¡English£»¡¡the¡¡itch¡¡¡¨struck¡¡in¡£¡¨¡¡It¡¡is¡¡hardly¡¡necessary¡¡to¡¡say¡¡that¡¡no¡¡physician¡¡of¡¡today¡¡would¡¡make¡¡so¡¡inconsiderate¡¡a¡¡diagnosis¡¡in¡¡the¡¡case¡¡of¡¡a¡¡royal¡¡patient¡£¡¡If¡¡by¡¡any¡¡chance¡¡a¡¡distinguished¡¡patient¡¡were¡¡afflicted¡¡with¡¡the¡¡itch£»¡¡the¡¡sagacious¡¡physician¡¡would¡¡carefully¡¡hide¡¡the¡¡fact¡¡behind¡¡circumlocutions¡¡and¡¡proceed¡¡to¡¡eradicate¡¡the¡¡disease¡¡with¡¡all¡¡despatch¡£¡¡¡¡That¡¡the¡¡physicians¡¡of¡¡Napoleon¡¡did¡¡otherwise¡¡is¡¡evidence¡¡that¡¡at¡¡the¡¡beginning¡¡of¡¡the¡¡century¡¡the¡¡disease¡¡in¡¡question¡¡enjoyed¡¡a¡¡very¡¡different¡¡status¡£¡¡¡¡At¡¡that¡¡time¡¡itch£»¡¡instead¡¡of¡¡being¡¡a¡¡most¡¡plebeian¡¡malady£»¡¡was£»¡¡so¡¡to¡¡say£»¡¡a¡¡court¡¡disease¡£¡¡It¡¡enjoyed¡¡a¡¡circulation£»¡¡in¡¡high¡¡circles¡¡and¡¡in¡¡low£»¡¡that¡¡modern¡¡therapeutics¡¡has¡¡quite¡¡denied¡¡it£»¡¡and¡¡the¡¡physicians¡¡of¡¡the¡¡time¡¡gave¡¡it¡¡a¡¡fictitious¡¡added¡¡importance¡¡by¡¡ascribing¡¡to¡¡its¡¡influence¡¡the¡¡existence¡¡of¡¡almost¡¡any¡¡obscure¡¡malady¡¡that¡¡came¡¡under¡¡their¡¡observation¡£¡¡Long¡¡after¡¡Napoleon's¡¡time¡¡gale¡¡continued¡¡to¡¡hold¡¡this¡¡proud¡¡distinction¡£¡¡For¡¡example£»¡¡the¡¡imaginative¡¡Dr¡£¡¡Hahnemann¡¡did¡¡not¡¡hesitate¡¡to¡¡affirm£»¡¡as¡¡a¡¡positive¡¡maxim£»¡¡that¡¡three¡­fourths¡¡of¡¡all¡¡the¡¡ills¡¡that¡¡flesh¡¡is¡¡heir¡¡to¡¡were¡¡in¡¡reality¡¡nothing¡¡but¡¡various¡¡forms¡¡of¡¡¡¨gale¡¡repercutee¡£¡¨

All¡¡of¡¡which¡¡goes¡¡to¡¡show¡¡how¡¡easy¡¡it¡¡may¡¡be¡¡for¡¡a¡¡masked¡¡pretender¡¡to¡¡impose¡¡on¡¡credulous¡¡humanity£»¡¡for¡¡nothing¡¡is¡¡more¡¡clearly¡¡established¡¡in¡¡modern¡¡knowledge¡¡than¡¡the¡¡fact¡¡that¡¡¡¨gale¡¡repercutee¡¨¡¡was¡¡simply¡¡a¡¡name¡¡to¡¡hide¡¡a¡¡profound¡¡ignorance£»¡¡no¡¡such¡¡disease¡¡exists¡¡or¡¡ever¡¡did¡¡exist¡£¡¡¡¡Gale¡¡itself¡¡is¡¡a¡¡sufficiently¡¡tangible¡¡reality£»¡¡to¡¡be¡¡sure£»¡¡but¡¡it¡¡is¡¡a¡¡purely¡¡local¡¡disease¡¡of¡¡the¡¡skin£»¡¡due¡¡to¡¡a¡¡perfectly¡¡definite¡¡cause£»¡¡and¡¡the¡¡dire¡¡internal¡¡conditions¡¡formerly¡¡ascribed¡¡to¡¡it¡¡have¡¡really¡¡no¡¡causal¡¡connection¡¡with¡¡it¡¡whatever¡£¡¡This¡¡definite¡¡cause£»¡¡as¡¡every¡¡one¡¡nowadays¡¡knows£»¡¡is¡¡nothing¡¡more¡¡or¡¡less¡¡than¡¡a¡¡microscopic¡¡insect¡¡which¡¡has¡¡found¡¡lodgment¡¡on¡¡the¡¡skin£»¡¡and¡¡has¡¡burrowed¡¡and¡¡made¡¡itself¡¡at¡¡home¡¡there¡£¡¡Kill¡¡that¡¡insect¡¡and¡¡the¡¡disease¡¡is¡¡no¡¡more£»¡¡hence¡¡it¡¡has¡¡come¡¡to¡¡be¡¡an¡¡axiom¡¡with¡¡the¡¡modern¡¡physician¡¡that¡¡the¡¡itch¡¡is¡¡one¡¡of¡¡the¡¡three¡¡or¡¡four¡¡diseases¡¡that¡¡he¡¡positively¡¡is¡¡able¡¡to¡¡cure£»¡¡and¡¡that¡¡very¡¡speedily¡£¡¡¡¡But¡¡it¡¡was¡¡far¡¡otherwise¡¡with¡¡the¡¡physicians¡¡of¡¡the¡¡first¡¡third¡¡of¡¡our¡¡century£»¡¡because¡¡to¡¡them¡¡the¡¡cause¡¡of¡¡the¡¡disease¡¡was¡¡an¡¡absolute¡¡mystery¡£

It¡¡is¡¡true¡¡that¡¡here¡¡and¡¡there¡¡a¡¡physician¡¡had¡¡claimed¡¡to¡¡find¡¡an¡¡insect¡¡lodged¡¡in¡¡the¡¡skin¡¡of¡¡a¡¡sufferer¡¡from¡¡itch£»¡¡and¡¡two¡¡or¡¡three¡¡times¡¡the¡¡claim¡¡had¡¡been¡¡made¡¡that¡¡this¡¡was¡¡the¡¡cause¡¡of¡¡the¡¡malady£»¡¡but¡¡such¡¡views¡¡were¡¡quite¡¡ignored¡¡by¡¡the¡¡general¡¡profession£»¡¡and¡¡in¡¡1833¡¡it¡¡was¡¡stated¡¡in¡¡an¡¡authoritative¡¡medical¡¡treatise¡¡that¡¡the¡¡¡¨cause¡¡of¡¡gale¡¡is¡¡absolutely¡¡unknown¡£¡¨¡¡¡¡But¡¡even¡¡at¡¡this¡¡time£»¡¡as¡¡it¡¡curiously¡¡happened£»¡¡there¡¡were¡¡certain¡¡ignorant¡¡laymen¡¡who¡¡had¡¡attained¡¡to¡¡a¡¡bit¡¡of¡¡medical¡¡knowledge¡¡that¡¡was¡¡withheld¡¡from¡¡the¡¡inner¡¡circles¡¡of¡¡the¡¡profession¡£¡¡As¡¡the¡¡peasantry¡¡of¡¡England¡¡before¡¡Jenner¡¡had¡¡known¡¡of¡¡the¡¡curative¡¡value¡¡of¡¡cow¡­pox¡¡over¡¡small¡­pox£»¡¡so¡¡the¡¡peasant¡¡women¡¡of¡¡Poland¡¡had¡¡learned¡¡that¡¡the¡¡annoying¡¡skin¡¡disease¡¡from¡¡which¡¡they¡¡suffered¡¡was¡¡caused¡¡by¡¡an¡¡almost¡¡invisible¡¡insect£»¡¡and£»¡¡furthermore£»¡¡had¡¡acquired¡¡the¡¡trick¡¡of¡¡dislodging¡¡the¡¡pestiferous¡¡little¡¡creature¡¡with¡¡the¡¡point¡¡of¡¡a¡¡needle¡£¡¡¡¡From¡¡them¡¡a¡¡youth¡¡of¡¡the¡¡country£»¡¡F¡£¡¡Renucci¡¡by¡¡name£»¡¡learned¡¡the¡¡open¡¡secret¡£¡¡He¡¡conveyed¡¡it¡¡to¡¡Paris¡¡when¡¡he¡¡went¡¡there¡¡to¡¡study¡¡medicine£»¡¡and¡¡in¡¡1834¡¡demonstrated¡¡it¡¡to¡¡his¡¡master¡¡Alibert¡£¡¡¡¡This¡¡physician£»¡¡at¡¡first¡¡sceptical£»¡¡soon¡¡was¡¡convinced£»¡¡and¡¡gave¡¡out¡¡the¡¡discovery¡¡to¡¡the¡¡medical¡¡world¡¡with¡¡an¡¡authority¡¡that¡¡led¡¡to¡¡early¡¡acceptance¡£

Now¡¡the¡¡importance¡¡of¡¡all¡¡this£»¡¡in¡¡the¡¡present¡¡connection£»¡¡is¡¡not¡¡at¡¡all¡¡that¡¡it¡¡gave¡¡the¡¡clew¡¡to¡¡the¡¡method¡¡of¡¡cure¡¡of¡¡a¡¡single¡¡disease¡£¡¡What¡¡makes¡¡the¡¡discovery¡¡epochal¡¡is¡¡the¡¡fact¡¡that¡¡it¡¡dropped¡¡a¡¡brand¡­new¡¡idea¡¡into¡¡the¡¡medical¡¡ranksan¡¡idea¡¡destined£»¡¡in¡¡the¡¡long¡­run£»¡¡to¡¡prove¡¡itself¡¡a¡¡veritable¡¡bombthe¡¡idea£»¡¡namely£»¡¡that¡¡a¡¡minute¡¡and¡¡quite¡¡unsuspected¡¡animal¡¡parasite¡¡may¡¡be¡¡the¡¡cause¡¡of¡¡a¡¡well¡­known£»¡¡widely¡¡prevalent£»¡¡and¡¡important¡¡human¡¡disease¡£¡¡Of¡¡course¡¡the¡¡full¡¡force¡¡of¡¡this¡¡idea¡¡could¡¡only¡¡be¡¡appreciated¡¡in¡¡the¡¡light¡¡of¡¡later¡¡knowledge£»¡¡but¡¡even¡¡at¡¡the¡¡time¡¡of¡¡its¡¡coming¡¡it¡¡sufficed¡¡to¡¡give¡¡a¡¡great¡¡impetus¡¡to¡¡that¡¡new¡¡medical¡¡knowledge£»¡¡based¡¡on¡¡microscopical¡¡studies£»¡¡which¡¡had¡¡but¡¡recently¡¡been¡¡made¡¡accessible¡¡by¡¡the¡¡inventions¡¡of¡¡the¡¡lens¡­makers¡£¡¡The¡¡new¡¡knowledge¡¡clarified¡¡one¡¡very¡¡turbid¡¡medical¡¡pool¡¡and¡¡pointed¡¡the¡¡way¡¡to¡¡the¡¡clarification¡¡of¡¡many¡¡others¡£

Almost¡¡at¡¡the¡¡same¡¡time¡¡that¡¡the¡¡Polish¡¡medical¡¡student¡¡was¡¡demonstrating¡¡the¡¡itch¡¡mite¡¡in¡¡Paris£»¡¡it¡¡chanced£»¡¡curiously¡¡enough£»¡¡that¡¡another¡¡medical¡¡student£»¡¡this¡¡time¡¡an¡¡Englishman£»¡¡made¡¡an¡¡analogous¡¡discovery¡¡of¡¡perhaps¡¡even¡¡greater¡¡importance¡£¡¡¡¡Indeed£»¡¡this¡¡English¡¡discovery¡¡in¡¡its¡¡initial¡¡stages¡¡slightly¡¡antedated¡¡the¡¡other£»¡¡for¡¡it¡¡was¡¡in¡¡1833¡¡that¡¡the¡¡student¡¡in¡¡question£»¡¡James¡¡Paget£»¡¡interne¡¡in¡¡St¡£¡¡Bartholomew's¡¡Hospital£»¡¡London£»¡¡while¡¡dissecting¡¡the¡¡muscular¡¡tissues¡¡of¡¡a¡¡human¡¡subject£»¡¡found¡¡little¡¡specks¡¡of¡¡extraneous¡¡matter£»¡¡which£»¡¡when¡¡taken¡¡to¡¡the¡¡professor¡¡of¡¡comparative¡¡anatomy£»¡¡Richard¡¡Owen£»¡¡were¡¡ascertained£»¡¡with¡¡the¡¡aid¡¡of¡¡the¡¡microscope£»¡¡to¡¡be¡¡the¡¡cocoon¡¡of¡¡a¡¡minute¡¡and¡¡hitherto¡¡unknown¡¡insect¡£¡¡Owen¡¡named¡¡the¡¡insect¡¡Trichina¡¡spiralis¡£¡¡¡¡After¡¡the¡¡discovery¡¡was¡¡published¡¡it¡¡transpired¡¡that¡¡similar¡¡specks¡¡had¡¡been¡¡observed¡¡by¡¡several¡¡earlier¡¡investigators£»¡¡but¡¡no¡¡one¡¡had¡¡previously¡¡suspected¡¡or£»¡¡at¡¡any¡¡rate£»¡¡demonstrated¡¡their¡¡nature¡£¡¡¡¡Nor¡¡was¡¡the¡¡full¡¡story¡¡of¡¡the¡¡trichina¡¡made¡¡out¡¡for¡¡a¡¡long¡¡time¡¡after¡¡Owen's¡¡discovery¡£¡¡It¡¡was¡¡not¡¡till¡¡1847¡¡that¡¡the¡¡American¡¡anatomist¡¡Dr¡£¡¡Joseph¡¡Leidy¡¡found¡¡the¡¡cysts¡¡of¡¡trichina¡¡in¡¡the¡¡tissues¡¡of¡¡pork£»¡¡and¡¡another¡¡decade¡¡or¡¡so¡¡elapsed¡¡after¡¡that¡¡before¡¡German¡¡workers£»¡¡chief¡¡among¡¡whom¡¡were¡¡Leuckart£»¡¡Virchow£»¡¡and¡¡Zenker£»¡¡proved¡¡that¡¡the¡¡parasite¡¡gets¡¡into¡¡the¡¡human¡¡system¡¡through¡¡ingestion¡¡of¡¡infected¡¡pork£»¡¡and¡¡that¡¡it¡¡causes¡¡a¡¡definite¡¡set¡¡of¡¡symptoms¡¡of¡¡disease¡¡which¡¡hitherto¡¡had¡¡been¡¡mistaken¡¡for¡¡rheumatism£»¡¡typhoid¡¡fever£»¡¡and¡¡other¡¡maladies¡£¡¡Then¡¡the¡¡medical¡¡world¡¡was¡¡agog¡¡for¡¡a¡¡time¡¡over¡¡the¡¡subject¡¡of¡¡trichinosis£»¡¡government¡¡inspection¡¡of¡¡pork¡¡was¡¡established¡¡in¡¡some¡¡parts¡¡of¡¡Germany£»¡¡American¡¡pork¡¡was¡¡excluded¡¡altogether¡¡from¡¡France£»¡¡and¡¡the¡¡whole¡¡subject¡¡thus¡¡came¡¡prominently¡¡to¡¡public¡¡attention¡£¡¡But¡¡important¡¡as¡¡the¡¡trichina¡¡parasite¡¡proved¡¡on¡¡its¡¡own¡¡account¡¡in¡¡the¡¡end£»¡¡its¡¡greatest¡¡importance£»¡¡after¡¡all£»¡¡was¡¡in¡¡the¡¡share¡¡it¡¡played¡¡in¡¡directing¡¡attention¡¡at¡¡the¡¡time¡¡of¡¡its¡¡discovery¡¡in¡¡1833¡¡to¡¡the¡¡subject¡¡of¡¡microscopic¡¡parasites¡¡in¡¡general¡£

The¡¡decade¡¡that¡¡followed¡¡that¡¡discovery¡¡was¡¡a¡¡time¡¡of¡¡great¡¡activity¡¡in¡¡the¡¡study¡¡of¡¡microscopic¡¡organisms¡¡and¡¡microscopic¡¡tissues£»¡¡and¡¡such¡¡men¡¡as¡¡Ehrenberg¡¡and¡¡Henle¡¡and¡¡Bory¡¡Saint¡­Vincent¡¡and¡¡Kolliker¡¡and¡¡Rokitansky¡¡and¡¡Remak¡¡and¡¡Dujardin¡¡were¡¡widening¡¡the¡¡bounds¡¡of¡¡knowledge¡¡of¡¡this¡¡new¡¡subject¡¡with¡¡details¡¡that¡¡cannot¡¡be¡¡more¡¡than¡¡referred¡¡to¡¡here¡£¡¡But¡¡the¡¡crowning¡¡achievement¡¡of¡¡the¡¡period¡¡in¡¡this¡¡direction¡¡was¡¡the¡¡discovery¡¡made¡¡by¡¡the¡¡German£»¡¡J¡£¡¡L¡£¡¡Schoenlein£»¡¡in¡¡1839£»¡¡that¡¡a¡¡very¡¡common¡¡and¡¡most¡¡distressing¡¡disease¡¡of¡¡the¡¡scalp£»¡¡known¡¡as¡¡favus£»¡¡is¡¡really¡¡due¡¡to¡¡the¡¡presence¡¡and¡¡growth¡¡on¡¡the¡¡scalp¡¡of¡¡a¡¡vegetable¡¡organism¡¡of¡¡microscopic¡¡size¡£¡¡¡¡Thus¡¡it¡¡was¡¡made¡¡clear¡¡that¡¡not¡¡merely¡¡animal¡¡but¡¡also¡¡vegetable¡¡organisms¡¡of¡¡obscure£»¡¡microscopic¡¡species¡¡have¡¡causal¡¡relations¡¡to¡¡the¡¡diseases¡¡with¡¡which¡¡mankind¡¡is¡¡afflicted¡£¡¡This¡¡knowledge¡¡of¡¡the¡¡parasites¡¡was¡¡another¡¡long¡¡step¡¡in¡¡the¡¡direction¡¡of¡¡scientific¡¡medical¡¡knowledge£»¡¡but¡¡the¡¡heights¡¡to¡¡which¡¡this¡¡knowledge¡¡led¡¡were¡¡not¡¡to¡¡be¡¡scaled£»¡¡or¡¡even¡¡recognized£»¡¡until¡¡another¡¡generation¡¡of¡¡workers¡¡had¡¡entered¡¡the¡¡field¡£


PAINLESS¡¡SURGERY

Meantime£»¡¡in¡¡quite¡¡another¡¡field¡¡of¡¡medicine£»¡¡events¡¡were¡¡developing¡¡which¡¡led¡¡presently¡¡to¡¡a¡¡revelation¡¡of¡¡greater¡¡immediate¡¡importance¡¡to¡¡humanity¡¡than¡¡any¡¡other¡¡discovery¡¡that¡¡had¡¡come¡¡in¡¡the¡¡century£»¡¡perhaps¡¡in¡¡any¡¡field¡¡of¡¡science¡¡whatever¡£¡¡This¡¡was¡¡the¡¡discovery¡¡of¡¡the¡¡pain¡­dispelling¡¡power¡¡of¡¡the¡¡vapor¡¡of¡¡sulphuric¡¡ether¡¡inhaled¡¡by¡¡a¡¡patient¡¡undergoing¡¡a¡¡surgical¡¡operation¡£¡¡This¡¡discovery¡¡came¡¡solely¡¡out¡¡of¡¡America£»¡¡and¡¡it¡¡stands¡¡curiously¡¡isolated£»¡¡since¡¡apparently¡¡no¡¡minds¡¡in¡¡any¡¡other¡¡country¡¡were¡¡trending¡¡towards¡¡it¡¡even¡¡vaguely¡£¡¡¡¡Davy£»¡¡in¡¡England£»¡¡had¡¡indeed¡¡originated¡¡the¡¡method¡¡of¡¡medication¡¡by¡¡inhalation£»¡¡and¡¡earned¡¡out¡¡some¡¡most¡¡interesting¡¡experiments¡¡fifty¡¡years¡¡earlier£»¡¡and¡¡it¡¡was¡¡doubtless¡¡his¡¡experiments¡¡with¡¡nitrous¡¡oxide¡¡gas¡¡that¡¡gave¡¡the¡¡clew¡¡to¡¡one¡¡of¡¡the¡¡American¡¡investigators£»¡¡but¡¡this¡¡was¡¡the¡¡sole¡¡contribution¡¡of¡¡preceding¡¡generations¡¡to¡¡the¡¡subject£»¡¡and¡¡since¡¡the¡¡beginning¡¡of¡¡the¡¡century£»¡¡when¡¡Davy¡¡turned¡¡his¡¡attention¡¡to¡¡other¡¡matters£»¡¡no¡¡one¡¡had¡¡made¡¡the¡¡slightest¡¡advance¡¡along¡¡the¡¡same¡¡line¡¡until¡¡an¡¡American¡¡dentist¡¡renewed¡¡the¡¡invest

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