a history of science-4-第39章
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cepted； and in this case a very few appeared on the arms： they were very minute； of a vivid red color； and soon died away without advancing to maturation； so that I cannot determine whether they had any connection with the preceding symptoms。
〃Thus the disease makes its progress from the horse （as I conceive） to the nipple of the cow； and from the cow to the human subject。
〃Morbid matter of various kinds； when absorbed into the system； may produce effects in some degree similar； but what renders the cow…pox virus so extremely singular is that the person that has been thus affected is forever after secure from the infection of small…pox； neither exposure to the variolous effluvia nor the insertion of the matter into the skin producing this distemper。〃＇2＇
In 1796 Jenner made his first inoculation with cowpox matter； and two months later the same subject was inoculated with small…pox matter。 But； as Jenner had predicted； no attack of small…pox followed。 Although fully convinced by this experiment that the case was conclusively proven； he continued his investigations； waiting two years before publishing his discovery。 Then； fortified by indisputable proofs； he gave it to the world。 The immediate effects of his announcement have probably never been equalled in the history of scientific discovery； unless； perhaps； in the single instance of the discovery of anaesthesia。 In Geneva and Holland clergymen advocated the practice of vaccination from their pulpits； in some of the Latin countries religious processions were formed for receiving vaccination； Jenner's birthday was celebrated as a feast in Germany； and the first child vaccinated in Russia was named 〃Vaccinov〃 and educated at public expense。 In six years the discovery had penetrated to the most remote corners of civilization； it had even reached some savage nations。 And in a few years small…pox had fallen from the position of the most dreaded of all diseases to that of being practically the only disease for which a sure and easy preventive was known。
Honors were showered upon Jenner from the Old and the New World； and even Napoleon； the bitter hater of the English； was among the others who honored his name。 On one occasion Jenner applied to the Emperor for the release of certain Englishmen detained in France。 The petition was about to be rejected when the name of the petitioner was mentioned。 〃Ah；〃 said Napoleon； 〃we can refuse nothing to that name！〃
It is difficult for us of to…day clearly to conceive the greatness of Jenner's triumph； for we can only vaguely realize what a ruthless and ever…present scourge smallpox had been to all previous generations of men since history began。 Despite all efforts to check it by medication and by direct inoculation； it swept now and then over the earth as an all…devastating pestilence； and year by year it claimed one…tenth of all the beings in Christendom by death as its average quota of victims。 〃From small…pox and love but few remain free；〃 ran the old saw。 A pitted face was almost as much a matter of course a hundred years ago as a smooth one is to…day。
Little wonder； then； that the world gave eager acceptance to Jenner's discovery。 No urging was needed to induce the majority to give it trial； passengers on a burning ship do not hold aloof from the life…boats。 Rich and poor； high and low； sought succor in vaccination and blessed the name of their deliverer。 Of all the great names that were before the world in the closing days of the century； there was perhaps no other one at once so widely known and so uniformly reverenced as that of the great English physician Edward Jenner。 Surely there was no other one that should be recalled with greater gratitude by posterity。
VIII。 NINETEENTH…CENTURY MEDICINE
PHYSICAL DIAGNOSIS
Although Napoleon Bonaparte； First Consul； was not lacking in self…appreciation； he probably did not realize that in selecting a physician for his own needs he was markedly influencing the progress of medical science as a whole。 Yet so strangely are cause and effect adjusted in human affairs that this simple act of the First Consul had that very unexpected effect。 For the man chosen was the envoy of a new method in medical practice； and the fame which came to him through being physician to the First Consul； and subsequently to the Emperor； enabled him to promulgate the method in a way otherwise impracticable。 Hence the indirect but telling value to medical science of Napoleon's selection。
The physician in question was Jean Nicolas de Corvisart。 His novel method was nothing more startling than the now…familiar procedure of tapping the chest of a patient to elicit sounds indicative of diseased tissues within。 Every one has seen this done commonly enough in our day； but at the beginning of the century Corvisart； and perhaps some of his pupils； were probably the only physicians in the world who resorted to this simple and useful procedure。 Hence Napoleon's surprise when； on calling in Corvisart； after becoming somewhat dissatisfied with his other physicians Pinel and Portal； his physical condition was interrogated in this strange manner。 With characteristic shrewdness Bonaparte saw the utility of the method； and the physician who thus attempted to substitute scientific method for guess…work in the diagnosis of disease at once found favor in his eyes and was installed as his regular medical adviser。
For fifteen years before this Corvisart had practised percussion； as the chest…tapping method is called； without succeeding in convincing the profession of its value。 The method itself； it should be added； had not originated with Corvisart； nor did the French physician for a moment claim it as his own。 The true originator of the practice was the German physician Avenbrugger； who published a book about it as early as 1761。 This book had even been translated into French； then the language of international communication everywhere； by Roziere de la Chassagne； of Montpellier； in 1770； but no one other than Corvisart appears to have paid any attention to either original or translation。 It was far otherwise； however； when Corvisart translated Avenbrugger's work anew； with important additions of his own； in 1808。
〃I know very well how little reputation is allotted to translator and commentators；〃 writes Corvisart； 〃and I might easily have elevated myself to the rank of an author if I had elaborated anew the doctrine of Avenbrugger and published an independent work on percussion。 In this way； however； I should have sacrificed the name of Avenbrugger to my own vanity； a thing which I am unwilling to do。 It is he； and the beautiful invention which of right belongs to him； that I desire to recall to life。〃＇1＇
By this time a reaction had set in against the metaphysical methods in medicine that had previously been so alluring； the scientific spirit of the time was making itself felt in medical practice； and this； combined with Corvisart's fame； brought the method of percussion into immediate and well…deserved popularity。 Thus was laid the foundation for the method of so…called physical diagnosis； which is one of the corner…stones of modern medicine。
The method of physical diagnosis as practised in our day was by no means completed； however； with the work of Corvisart。 Percussion alone tells much less than half the story that may be elicited from the organs of the chest by proper interrogation。 The remainder of the story can only be learned by applying the ear itself to the chest； directly or indirectly。 Simple as this seems； no one thought of practising it for some years after Corvisart had shown the value of percussion。
Then； in 1815； another Paris physician； Rene Theophile Hyacinthe Laennec； discovered； almost by accident； that the sound of the heart…beat could be heard surprisingly through a cylinder of paper held to the ear and against the patient's chest。 Acting on the hint thus received； Laennec substituted a hollow cylinder of wood for the paper； and found himself provided with an instrument through which not merely heart sounds but murmurs of the lungs in respiration could be heard with almost startling distinctness。
The possibility of associating the varying chest sounds with diseased
