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Warren； Samuel L。 Mitchill and J。 Ailken Meigs。 He gave an immense
impetus in Great Britain to the study of morbid anatomy； and his nephew；
Matthew Baillie； published the first important book on the subject in the
English language。
Before the eighteenth century closed practical medicine had made
great advance。 Smallpox； though not one of the great scourges like plague
or cholera； was a prevalent and much dreaded disease； and in civilized
countries few reached adult life without an attack。 Edward Jenner； a
practitioner in Gloucestershire； and the pupil to whom John Hunter gave
the famous advice： 〃Don't think； try！〃 had noticed that milkmaids who had
been infected with cowpox from the udder of the cow were insusceptible
to smallpox。 I show you here the hand of Sarah Nelmes with cowpox；
1796。 A vague notion had prevailed among the dairies from time
immemorial that this disease was a preventive of the smallpox。 Jenner put
the matter to the test of experiment。 Let me quote here his own words：
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〃The first experiment was made upon a lad of the name of Phipps； in
whose arm a little vaccine virus was inserted； taken from the hand of a
young woman who had been accidentally infected by a cow。
Notwithstanding the resemblance which the pustule； thus excited on the
boy's arm； bore to variolous inoculation； yet as the indisposition attending
it was barely perceptible； I could scarcely persuade myself the patient was
secure from the Small Pox。 However； on his being inoculated some
months afterwards； it proved that he was secure。〃＇8＇ The results of his
experiments were published in a famous small quarto volume in 1798。＇*＇
From this date； smallpox has been under control。 Thanks to Jenner； not a
single person in this audience is pockmarked！ A hundred and twenty…five
years ago； the faces of more than half of you would have been scarred。 We
now know the principle upon which protection is secured： an active
acquired immunity follows upon an attack of a disease of a similar nature。
Smallpox and cowpox are closely allied and the substances formed in the
blood by the one are resistant to the virus of the other。 I do not see how
any reasonable person can oppose vaccination or decry its benefits。 I show
you the mortality figures＇9＇ of the Prussian Army and of the German
Empire。 A comparison with the statistics of the armies of other European
countries in which revaccination is not so thoroughly carried out is most
convincing of its efficacy。
＇8＇ Edward Jenner： The Origin of the Vaccine Inoculation； London；
1801。
＇*＇ Reprinted by Camac： Epoch…making Contributions to Medicine；
etc。； 1909。Ed。
＇9＇ Jockmann： Pocken und Vaccinationlehre； 1913。
The early years of the century saw the rise of modern clinical
medicine in Paris。 In the art of observation men had come to a standstill。 I
doubt very much whether Corvisart in 1800 was any more skilful in
recognizing a case of pneumonia than was Aretaeus in the second century
A。 D。 But disease had come to be more systematically studied； special
clinics were organized； and teaching became much more thorough。
Anyone who wishes to have a picture of the medical schools in Europe in
the first few years of the century； should read the account of the travels of
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Joseph Frank of Vienna。＇10＇ The description of Corvisart is of a pioneer in
clinical teaching whose method remains in vogue today in Francethe
ward visit； followed by a systematic lecture in the amphitheatre。 There
were still lectures on Hippocrates three times a week； and bleeding was
the principal plan of treatment： one morning Frank saw thirty patients； out
of one hundred and twelve； bled！ Corvisart was the strong clinician of his
generation； and his accurate studies on the heart were among the first that
had concentrated attention upon a special organ。 To him； too； is due the
reintroduction of the art of percussion in internal disease discovered by
Auenbrugger in 1761。
＇10＇ Joseph Frank： Reise nach Paris ＇etc。＇； Wien； 1804…05。
The man who gave the greatest impetus to the study of scientific
medicine at this time was Bichat； who pointed out that the pathological
changes in disease were not so much in organs as in tissues。 His studies
laid the foundation of modern histology。 He separated the chief constituent
elements of the body into various tissues possessing definite physical and
vital qualities。 〃Sensibility and contractability are the fundamental
qualities of living matter and of the life of our tissues。 Thus Bichat
substituted for vital forces 'vital properties；' that is to say； a series of vital
forces inherent in the different tissues。〃＇11＇ His 〃Anatomic Generale；〃
published in 1802； gave an extraordinary stimulus to the study of the finer
processes of disease； and his famous 〃Recherches sur la Vie et sur la
Mort〃 （1800） dealt a death…blow to old iatromechanical and iatrochemical
views。 His celebrated definition may be quoted： 〃La vie est l'ensemble des
proprietes vitales qui resistent aux proprietes physiques； ou bien la vie est
l'ensemble des fonctions qui resistent a la mort。〃 （Life is the sum of the
vital properties that withstand the physical properties； or； life is the sum of
the functions that withstand death。） Bichat is another pathetic figure in
medical history。 His meteoric career ended in his thirty…first year： he died
a victim of a post…mortem wound infection。 At his death； Corvisart wrote
Napoleon： 〃Bichat has just died at the age of thirty。 That battlefield on
which he fell is one which demands courage and claims many victims。 He
has advanced the science of medicine。 No one at his age has done so much
so well。〃
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＇11＇ E。 Boinet： Les doctrines medicules； leur evolution； Paris； 1907； pp。
85…86。
It was a pupil of Corvisart； Rene Theophile Laennec； who laid the
foundation of modern clinical medicine。 The story of his life is well
known。 A Breton by birth； he had a hard； up…hill struggle as a young man
a struggle of which we have only recently been made aware by the
publication of a charming book by Professor Rouxeau of Nantes
〃Laennec avant 1806。〃 Influenced by Corvisart； he began to combine the
accurate study of cases in the wards with anatomical investigations in the
dead…house。 Before Laennec； the examination of a patient had been largely
by sense of sight； supplemented by that of touch； as in estimating the
degree of fever； or the character of the pulse。 Auenbrugger's 〃Inventum
novum〃 of percussion； recognized by Corvisart； extended the field； but the
discovery of auscultation by Laennec；