a history of science-4-第35章

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　have　been　established　all　over　the　world　in　regions　as　widely　separated　as　New　York　and　Nha…Trang。


SERUM…THERAPY

In　the　production　of　the　rabies　vaccine　Pasteur　and　his　associates　developed　a　method　of　attenuation　of　a　virus　quite　different　from　that　which　had　been　employed　in　the　case　of　the　vaccines　of　chicken　cholera　and　of　anthrax。　The　rabies　virus　was　inoculated　into　the　system　of　guinea…pigs　or　rabbits　and；　in　effect；　cultivated　in　the　systems　of　these　animals。　The　spinal　cord　of　these　infected　animals　was　found　to　be　rich　in　the　virus；　which　rapidly　became　attenuated　when　the　cord　was　dried　in　the　air。　　The　preventive　virus；　of　varying　strengths；　was　made　by　maceration　of　these　cords　at　varying　stages　of　desiccation。　This　cultivation　of　a　virus　within　the　animal　organism　suggested；　no　doubt；　by　the　familiar　Jennerian　method　of　securing　small…pox　vaccine；　was　at　the　same　time　a　step　in　the　direction　of　a　new　therapeutic　procedure　which　was　destined　presently　to　become　of　all…absorbing　importancethe　method；　namely；　of　so…called　serum…therapy；　or　the　treatment　of　a　disease　with　the　blood　serum　of　an　animal　that　has　been　subjected　to　protective　inoculation　against　that　disease。

The　possibility　of　such　a　method　was　suggested　by　the　familiar　observation；　made　by　Pasteur　and　numerous　other　workers；　that　animals　of　different　species　differ　widely　in　their　susceptibility　to　various　maladies；　and　that　the　virus　of　a　given　disease　may　become　more　and　more　virulent　when　passed　through　the　systems　of　successive　individuals　of　one　species；　and；　contrariwise；　less　and　less　virulent　when　passed　through　the　systems　of　successive　individuals　of　another　species。　These　facts　suggested　the　theory　that　the　blood　of　resistant　animals　might　contain　something　directly　antagonistic　to　the　virus；　and　the　hope　that　this　something　might　be　transferred　with　curative　effect　to　the　blood　of　an　infected　susceptible　animal。　Numerous　experimenters　all　over　the　world　made　investigations　along　the　line　of　this　alluring　possibility；　the　leaders　perhaps　being　Drs。　　Behring　and　Kitasato；　closely　followed　by　Dr。　Roux　and　his　associates　of　the　Pasteur　Institute　of　Paris。　　Definite　results　were　announced　by　Behring　in　1892　regarding　two　important　diseasestetanus　and　diphtheriabut　the　method　did　not　come　into　general　notice　until　1894；　when　Dr。　Roux　read　an　epoch…making　paper　on　the　subject　at　the　Congress　of　Hygiene　at　Buda…Pesth。

In　this　paper　Dr。　Roux；　after　adverting　to　the　labors　of　Behring；　Ehrlich；　Boer；　Kossel；　and　Wasserman；　described　in　detail　the　methods　that　had　been　developed　at　the　Pasteur　Institute　for　the　development　of　the　curative　serum；　to　which　Behring　had　given　the　since…familiar　name　antitoxine。　The　method　consists；　first；　of　the　cultivation；　for　some　months；　of　the　diphtheria　bacillus　（called　the　Klebs…Loeffler　bacillus；　in　honor　of　its　discoverers）　in　an　artificial　bouillon；　for　the　development　of　a　powerful　toxine　capable　of　giving　the　disease　in　a　virulent　form。

This　toxine；　after　certain　details　of　mechanical　treatment；　is　injected　in　small　but　increasing　doses　into　the　system　of　an　animal；　care　being　taken　to　graduate　the　amount　so　that　the　animal　does　not　succumb　to　the　disease。　After　a　certain　course　of　this　treatment　it　is　found　that　a　portion　of　blood　serum　of　the　animal　so　treated　will　act　in　a　curative　way　if　injected　into　the　blood　of　another　animal；　or　a　human　patient；　suffering　with　diphtheria。　In　other　words；　according　to　theory；　an　antitoxine　has　been　developed　in　the　system　of　the　animal　subjected　to　the　progressive　inoculations　of　the　diphtheria　toxine。　　In　Dr。　Roux's　experience　the　animal　best　suited　for　the　purpose　is　the　horse；　though　almost　any　of　the　domesticated　animals　will　serve　the　purpose。

But　Dr。　Roux's　paper　did　not　stop　with　the　description　of　laboratory　methods。　It　told　also　of　the　practical　application　of　the　serum　to　the　treatment　of　numerous　cases　of　diphtheria　in　the　hospitals　of　Parisapplications　that　had　met　with　a　gratifying　measure　of　success。　　He　made　it　clear　that　a　means　had　been　found　of　coping　successfully　with　what　had　been　one　of　the　most　virulent　and　intractable　of　the　diseases　of　childhood。　Hence　it　was　not　strange　that　his　paper　made　a　sensation　in　all　circles；　medical　and　lay　alike。

Physicians　from　all　over　the　world　flocked　to　Paris　to　learn　the　details　of　the　open　secret；　and　within　a　few　months　the　new　serum…therapy　had　an　acknowledged　standing　with　the　medical　profession　everywhere。　What　it　had　accomplished　was　regarded　as　but　an　earnest　of　what　the　new　method　might　accomplish　presently　when　applied　to　the　other　infectious　diseases。

Efforts　at　such　applications　were　immediately　begun　in　numberless　directionshad；　indeed；　been　under　way　in　many　a　laboratory　for　some　years　before。　It　is　too　early　yet　to　speak　of　the　results　in　detail。　But　enough　has　been　done　to　show　that　this　method　also　is　susceptible　of　the　widest　generalization。　　It　is　not　easy　at　the　present　stage　to　sift　that　which　is　tentative　from　that　which　will　be　permanent；　but　so　great　an　authority　as　Behring　does　not　hesitate　to　affirm　that　today　we　possess；　in　addition　to　the　diphtheria　antitoxine；　equally　specific　antitoxines　of　tetanus；　cholera；　typhus　fever；　pneumonia；　and　tuberculosisa　set　of　diseases　which　in　the　aggregate　account　for　a　startling　proportion　of　the　general　death…rate。　Then　it　is　known　that　Dr。　Yersin；　with　the　collaboration　of　his　former　colleagues　of　the　Pasteur　Institute；　has　developed；　and　has　used　with　success；　an　antitoxine　from　the　microbe　of　the　plague　which　recently　ravaged　China。

Dr。　Calmette；　another　graduate　of　the　Pasteur　Institute；　has　extended　the　range　of　the　serum…therapy　to　include　the　prevention　and　treatment　of　poisoning　by　venoms；　and　has　developed　an　antitoxine　that　has　already　given　immunity　from　the　lethal　effects　of　snake　bites　to　thousands　of　persons　in　India　and　Australia。

Just　how　much　of　present　promise　is　tentative；　just　what　are　the　limits　of　the　methodsthese　are　questions　for　the　future　to　decide。　But；　in　any　event；　there　seems　little　question　that　the　serum　treatment　will　stand　as　the　culminating　achievement　in　therapeutics　of　our　century。　It　is　the　logical　outgrowth　of　those　experimental　studies　with　the　microscope　begun　by　our　predecessors　of　the　thirties；　and　it　represents　the　present　culmination　of　the　rigidly　experimental　method　which　has　brought　medicine　from　a　level　of　fanciful　empiricism　to　the　plane　of　a　rational　experimental　science。



IX。　THE　NEW　SCIENCE　OF　EXPERIMENTAL　PSYCHOLOGY

BRAIN　AND　MIND

A　little　over　a　hundred　years　ago　a　reform　movement　was　afoot　in　the　world　in　the　interests　of　the　insane。　As　was　fitting；　the　movement　showed　itself　first　in　America；　where　these　unfortunates　were　humanely　cared　for　at　a　time　when　their　treatment　elsewhere　was　worse　than　brutal；　but　England　and　France　quickly　fell　into　line。　　The　leader　on　this　side　of　the　water　was　the　famous　Philadelphian；　Dr。　Benjamin　Rush；　〃the　Sydenham　of　America〃；　in　England；　Dr。　William　Tuke　inaugurated　the　movement；　and　in　France；　Dr。　Philippe　Pinel；　single…handed；　led　the　way。　Moved　by　a　common　spirit；　though　acting　quite　independently；　these　men　raised　a　revolt　against　the　traditional　custom　which；　spurning　the　insane　as　demon…haunted　outcasts；　had　condemned　these　unfortunates　to　dungeons；　chains；　and　the　lash。　Hitherto　few　people　had　thought　it　other　than　the　natural　course　of　events　that　the　〃maniac〃　should　be　thrust　into　a　dungeon；　and　perhaps　chained　to　the　wall　with　the　aid　of　an　iron　band　riveted　permanently　about　his　neck　or　waist。　Many　an　unfortunate；　thus　manacled；　was　held　to　the　narrow　limits　of　his　chain　for　years　together　in　a　cell　to　which　full　daylight　never　penetrated；　sometimesiron　being　expensivethe　chain　was　so　short　that　the　wretched　victim　could　not　rise　to　the　upright　posture　or　even　shift　his　position　upon　his　squalid　pallet　of　straw。

In　America；　indeed；　there　being　no　Middle　Age　precedents　to　crystallize　into　established　customs；　the　treatment　accorded　the　insane　had　seldom　or　never　sunk　to　this　level。　Partly　for　this　reason；　perhaps；　the　work　of　Dr。　Rush　at　the　Philadelphia　Hospital；　in　1784；　by　means　of　which　the　insane　came　to　be　humanely　treated；　even　to　the　extent　of　banishing　the　lash；　has　been　but　little　noted；　while　the　work　of　the　European　leaders；　though　belonging　to　later　decades；　has　been　made　famous。　And　perhaps　this　is　not　as　unjust　as　it　seems；　for　the　step　which　Rush　took；　from　relatively　bad　to　good；　was　a　far　easier　one　to　take　than　the　leap　from　atrocities　to　good　treatment　which　the　European　reformers　were　obliged　to　compass。　In　Paris；　for　example；　Pinel　was　obliged　to　ask　permission　of　the　authorities　even　to　make　the　attempt　at　liberating　the　insane　from　their　chains；　and；　notwithstanding　his　recognized　position　as　a　leader　of　science；　he　gained　but　grudging　assent；　and　was　regarded　as　being　himself　little　better　than　a　lunatic　for　making　so　manifestly　unwise　and　hopeless　an　attempt。　Once　the　attempt　had　been　made；　however；　and　carried　to　a　successful　issue；　the　amelioration　wrought　in　the　condition　of　the　insane　was　so　patent　that　the　fame　of　Pinel's　work　at　the　Bicetre　and　the　Salpetriere　went　abroad　apace。　It　required；　indeed；　many　years　to　complete　it　in　Paris；　and　a　lifetime　of　effort　on　the　part　of　Pinel's　pupil　Esquirol　and　others　to　extend　the　reform　to　the　provinces；　but　the　epochal　turning…point　had　been　reached　with　Pinel's　labors　of　the　closing　years　of　the　eighteenth　century。

The　significance　of　this　wise　and　humane　reform；　in　the　present　connection；　is　the　fact　that　these　studies　of　the　insane　gave　emphasis　to　the　novel　idea；　which　by…and…by　became　accepted　as　beyond　question；　that　〃demoniacal　possession〃　is　in　reality　no　more　than　the　outward　expression　of　a　diseased　condition　of　the　brain。　This　realization　made　it　clear；　as　never　before；　how　intimately　the　mind　and　the　body　are　linked　one　to　the　other。　　And　so　it　chanced　that；　in　striking　the　shackles　from　the　insane；　Pinel　and　his　confreres　struck　a　blow　also；　unwittingly；　at　time…honored　philosophical　traditions。　The　liberation　of　the　insane　from　their　dungeons　was　an　augury　of　the　liberation　of　psychology　from　the　musty　recesses　of　metaphysics。　Hitherto　psychology；　in　so　far　as　it　existed　at　all；　was　but　the　subjective　study　of　individual　minds；　in　future　it　must　become　objective　as　well；　taking　into　account　also　the　relations　which　the　mind　bears　to　the　body；　and　in　particular　to　the　brain　and　nervous　system。

The　necessity　for　this　collocation　was　advocated　quite　as　earnestly；　and　even　more　directly；　by　another　worker　of　this　period；　whose　studies　were　allied　to　those　of　alienists；　and　who；　even　more　actively　than　they；　focalized　his　attention　upon　the　brain　and　its　functions。　This　earliest　of　specialists　in　brain　studies　was　a　German　by　birth　but　Parisian　by　adoption；　Dr。　Franz　Joseph　Gall；　originator　of　the　since…notorious　system　of　phrenology。　　The　merited　disrepute　into　which　this　system　has　fallen　through　the　exposition　of　peripatetic　charlatans　should　not　make　us　forget　that　Dr。　Gall　himself　was　apparently　a　highly　educated　physician；　a　careful　student　of　the　brain　and　mind　according　to　the　best　light　of　his　time；　and；　withal；　an　earnest　and