Show TENDENCY OF THE MODERN SCHOOL OF DR F r A mnacham no I 1 7 0 chapter in ili ahn history ol of medicine 0 1 1 I 1 in int interest ct c t allitt or r importance in p A r n 2 a the scientific deac teachings aings which step to by step atop have led to the evolution of 0 our present knowledge of physic A gr great ea work la in being accomplished for ill the advancement d van cement of scientific medicine through investigation and researches we are arc living in an age w nilen hen we should be glad to 10 live when all are interested in medical matters it la IS the pet penalty 1 ally ot of greatness that its ita form oi m should outlive its substance but not so with the medi medical cill proter protea stan alon its Is re replete p tote with triumphs and scientific discoveries d yet tor for broader fields ing ina KB its channels by deeper thoughts whence as from a fountain all its streams ot of knowledge have sprung sprang medical science and pro crees have raised their banners throughout the land where tho th easle eagle ot of war has never flown down and with nith the spread of 0 c civilization its colleges tin its institutions mark its lt progress from the ganges to the pacific slope 1 standing na as divine monuments keeping from alloy its purest principles and giving as FL a sign t that ila t no man nd walk blindly in so BO glorious glorius us a profession the years past seem to have lave closed one great page in ili its science and pausing on the thresta threshold uld we 0 tura lure fit alic next may have to untold Is it to be that man of 0 scientific principles Is 14 to conquer disease and morbid accidents and as it 11 were it keep I 1 ep I 1 in to abe abeyance yance tile the grim messenger till I 1 nature hall bring that euth anesla no one who has looked back through the last tew few decades can fall t to 0 notice how complete Us its pro progress giess in theory and practice to what extent thiv medical profession sion has haa kept pace with tile the requirements ot of society and how far wo iva are able to meet emergencies as they present themselves such as tile the outbreak of epidemic di diseases in alil li the anc ancients lents were tin unequal equal in ill s spite of at their learning the thinking public has a right to know and does expect it from every phy physician who pretends to its confidence and aspires to its guidance for many long years amill amid amusing fallacies tin and unconnected facts did medicine seel seek to verify tile tho symptoms V of L disease and gradually acquired much empirical knowledge was ivas strengthened by tin tile study of pathological histology and physiology and by important ills cov ciles in the allied sciences in the reformation of medicine no person appears to have assisted more than petrarca Petr arch tho the poet the speculative hypotheses of the me inc era were made more ra rational by tile the labors ot of the anatomists whose zeal tor for anatomical knowledge was at its full in the litter latter rail pall of 0 tile the sixteenth century when the interdiction against touching the dead was ful ully y removed it was nt not until this thin period that mod leal joel knowledge begin began to surpass that of the an lents when we ave reflect on the sufferings induced by disease and the desolation it often spreads when bestil pestilence rice ival keth abroad at noonday can any ally a allotment of human labor present stronger claims or hold out great benefit to suffering humanity than the diligent cultivation of scientific medicine tile the modern spirit of independent research has stimulated every lawful 11 use 1110 10 of 0 mans nalls ir powers and faculties to find out such facts as would build up lip a pure and exact science rather that than framing hypotheses to account for the various phenomena of 0 disease to the student of medical history there Is rauch much ot of interest and instruction tion in t the he EVOLUTION it OF OUR KNOWLEDGE KNOWLEDG 13 from the old medicine to tile the modern tudy study of the origin of disease from which we as hope tor ter so much li it Is said eald to have had its origin in ili till the observations of anthony van in the year 1675 who with his primitive linse lense discovered in water in the mouth and the alvane discharges of 0 animals and human beings the bodies we ive now recognize as bac tot ecila ia the discoveries ot of this old dutch observer were beli believed cod by many ot of the prominent physicians in the latter part of the seventeenth and eighteenth centuries to be the origin ot of many obscure diseases to such a frenzy did this new idea work them that the germ theory reached almost the height it has today to day but nothing of value was done until the last quarter of 0 the present century in its life of a little more than two centuries its develop developmental mental stages have simply been the foundation on dation on which we today to day ire are working working the doctrine ot of generation enslaved tho the minds ot of medical men tor for more than two hundred years in 2662 ferdinand conn cohn of breslau proved conclusively that many ot of the bacteria P passed a ased into a spore stage during the c course 0 urse of their life where they remal remained ned dormant for a longer or shelter period to lie ile brought to we life under favoring circumstances putrefaction and fermentation were now proved to be the jesuits of 0 bac oprial life aud not the cause ot of it and hat fiat those bacteria were tile offspring ot of preexisting pre existing bacteria Oln dinne llo ex vivo was shown to apply to these unicellular or as well wal as to the higher animal anima ma I 1 and vegetable kingdoms thus the doctrine ot at spontaneous spon lincous generation received its final blow with this doctrine overthrown with nith the investigation of pasteur with the discovery by and davagne ot of the presence of bacilli in ili the blood of animals dead of fever as well as the progress a of f our kno knowledge uledge in ili certain parasitic diseases of 0 plants is it any wonder that the pathogenic process the con vivern should receive the attention it has the coincidence and fruition of these discoveries and the establishment of the relation of 0 these micro orga n iams isms to infectious diseases was loft left to the latter halt half ot of the lie present century of necessity we pass over many important investigations and observations the fundamental and scientific ineth methods of 0 analysis ot of roell essl ISSI upon or the pathogenic bacteria and their rotation relation to infection established the firm basis on which bacteriology ot of today rests it Is easily demonstrated that in the body of 0 an individual attacks by a t contagious disease there exists the arpe effic ma capable of multiplying that it Is possible to isolate them in ili pure cultures to cultivate them for any period of 0 time outside the body and at any ally time to reproduce the oil ginni disease by inoculation into a susceptible animal and thus continue ohp disease ad libl tuni bacteriology holds the most important relation to hygiene and preventive nie m dicine the hie medicine of the autu future re it must be understood that an only ly a small fraction of 0 these w widely idely distributed gerins are pathogenic most of 0 them are arc harmless and many ire are useful those organisms capable of producing pr doduc disease are called pathogenic or infective and the disease they produce Is called an infectious disease and the process infection infection to la a chemical process and not due to tile the presence ot of bacteria per a ee in the tissues but rather to poisonous substances or toxins produced by the hie casual microorganisms micro organisms scattered throughout the body but often localized at the tito of 0 invasion only these textiles etc disseminated throughout tile the body by tho the fluids so sc the cultured germ irm fionin the cultured inedia and I 1 inoch n 0 e 1 I 1 latane u susceptible au animal with t the h a I 1 culture tile santa onal will he be produced a as 8 when tile organisms are arc introduced into t tho tissues acet certain lain individuals and animals are arc more or less leer susceptible to infectious full influence bences i abile others escape the ia laller are said to possess natural immunity on oil tile the other hand tile those tie who have ree recovered from any ot of the infectious infection influences seem to be protected protect cd against a subsequent attack of 0 like character and are cold cald to acquired am munley T this his acquired acquin ia immunity can be jile lot y brought brought about by in 1 a s u 1 e 0 animal with the P poison 0 theae r he q 0 are arc important points to boar bear in mind by cluda I it was wag found th that t it if a specific poison he be mixed out tlde tide the th body in proper proportions with the blood serum scrum milk or other fluids fram nn an immunized animal this can ile b injected into a susceptible cep tible animal without It hout producing any poisonous symptoms symptom thus the fluids ot of an all immunized animal are ACTUALLY ANTIDOTAL to the poison polain of the bacteria although it Is not an yn yet known whether they destroy or simply ly neutralize the the blood ceru serum I 1 con contains taina tho the sub lance that so acas Ls as the antidote to the polson poison anti and hus been called anti its chemical nature la Is not known but Is commonly believed to be LL a of some form the greatest part 0 if our know 0 cledge ledge ot of this antitoxic immunity relates to diphtheria and tetanus tanus tc and to the vegetable abrin r I 1 c I 1 n and robin the ahe establishment ot of the primary immunity la Is thought to be e explained I 1 by a reaction change in the Inte integral grat cells of 0 the body which pro produce d ilea an antidotal substance whereby the tin sues ue ire are enabled to lo protect themselves against further invasion and subsequent infection of virulent organ organisms lems or their products after the inoculation the animal responds with very marked constitutional reaction and during this period at 0 reaction and even tor for a considerable length ot of time afterwards tile the animal Is protected against further inroads ot at I 1 the he same virulent bacteria or their products it Is further shown that protection Is afforded against certain specific infections by the inoculation i of entirely different bacterial poisons which produce those reactive changes in the integral cells ill eliat 1 t ina manufacture nu facture the anti doxine thus thua the process of 0 immunity Is also chemical the th production of 0 the primary immunity requires some same length of it time flint as this antl anti tovine material has to bo be manufactured by the tissues but when oner once prepared and the blood serum inoculated into another animal the protection Is immediate this blood serum not only renders immunity but possesses curative powers when tile disease Is already in rr ogress the use ot at this blood scrum in the treatment of toxic conditions Is called blood serum therapy by behring who lies lias been especially prominent in ing out its principles the primary or acquired immunity can be brought about in many ways by tile the bacilli or their products the horse la is the animal chosen as he not only possesses posses mes the required sus but greater amount of 0 blood can lie be withdrawn front from which to obtain the curative serum from an exceeding virulent case of diphtheria ill ahr bacteria are gathered gather ci and cultivated in bouillon the greater tho the amount of 0 oxygen present the more virulent will be ill the toxic products with which the animal Is to be inoculated the glass vessel contains con containing taint ng the growing germs ganns Is so con constructed strutted ted that currents of moist air continually pass through it and Is k kept at a temperature p ra of 37 den deg C after several weeks a Is developed which possesses intense potency the bouillon culture Is now put through a pasteur cham filter the bacteria separated and the toxic strength of 0 the clear nl ill portion Is then ascertained by inoculation into a susceptible animal usually a guinea pig pie the degree ot of toxicity Is found out by knowing how much ot of the culture will kill an animal at ot of given weight in a given time it has been determined that one tenth ot of a cubic centimeter or of boullion bouillon cultured famine will kill EL a guinea pig weighing wel shing grammes in ia forty eight hours the having been obtained the next step Is the manu manufacture factura OF 0 the antl anti for this purpose a strong and healthy horse not less than five nor more than ten years old Is chosen having been carefully exam examined ined tor for tuberculosis and glanders jie ile Is inoculated with the beginning with one half cubic centimeter and repeated in 41 constantly increasing doses at intervals ot of several days according to the reaction changes at the site of 0 injection there Is considerable swelling with more inore or I las isa sa widely tp threading reading oedema doedema of the subcutaneous tissues he becomes a very sick horse refuses food and has a very high temperature the tha reaction reactionary try symptoms are less atter after each injection too much at any one time would mould kill tile the horse hors but by gradually the tha doses the acquired immunity front roni the CAN A BB AUGMENTED to an astonishing degree five or six AX hundred cubic centimeters can bo be injected at one time with no untoward symptoms to what extent this high immunization can bo be carried we cannot at present tell considerable time Is required to obtain tb this Is high power from six to twelve months every fresh injection uses up a certain amount of already manufactured but this reduction Is followed each time by an increase in the antitoxic power so that the difference between tilt rise and tall fall in tho the antitoxic calve becomes lots lets and less as a the animal approaches immunization when a P permanent level 13 reached lie ile Is then ready to yield his blood for the serum it contains the jugular 1 aln ten is exposed and as much blood la Is withdrawn as Is deemed a sate afe the serum Is carefully separated and its cn clency as an antidote Is recurs accurately tely doter determined ter mined so many centimeters to so eo many pounds of diphtheria patient it lias has been found that the cur curative alive properties of the serum are in direct proportion to tile the it 1 quantity injected 2 to the degree of immunity possessed by the animal yielding the serum and 3 to tile the stage and intensity of 0 the disease different colonies ot of organisms produce a textile of oc wide variation in virulence there has been found a direct relation between tho the of 0 the organisms and the intensity of 0 the poison which they are capable of yielding one must remember that sero aero ther spy apy is going through Us its experimental stages where many difficulties meet us in forming a cstreet estimate of its therapeutic value there Is a strongly rooted l belief in its clency ncy as a remedy employed early in pure therla therl ji certain it 11 Is that hat the rate of mortality in this dread disease dibease has been greatly reduced prior to the use fit elf antitoxins in diphtheria the mortality was something I 1 over 50 per cent As a general result of nil the published ishM cases in cases of diphtheria which have been treated with the antitoxic serum the genral gen ral mortal mortality ltv has been con 20 1 per cent the 1 1 treat treatment moi it appears to check the spread or of the tha m membrane into the air ras passages sages and has a I 1 effect 0 on the c course aa acer d ot of the temperature the of fever so often observed under ordinary treatment are arc eel seldom lout observed under I 1 lie serum treatment the antitoxins though antidotal to the poison of 0 diphtheria exerts no power over the poisons poison of other |