Part 13

The most striking proof of the thorough conscientiousness with which he faced the duties of life is to be found in his conduct after the establishment of the so-called Cis-Alpine Republic in Italy. This was a government established merely by force of arms without the consent of the people and a plain usurpation of the rights of the previous government. He considered himself bound in duty to the authority under which he had lived all his previous life and to which he had sworn fealty. When the University of Bologna was reorganized under the new government the first requirement of all those who were made professors was that they should take the oath of allegiance to the new government. This he refused to do. His motives can be readily understood, and though practically all the other professors of the university had taken the oath he did not consider that this freed him from his conscientious obligations in the matter.

Accordingly, he was dropped from the roll of professors {129} and deprived of the never very large salary which he had obtained from this chair. On this sum he had practically depended for his existence and he soon began to suffer from want. While he had been a successful practitioner of medicine, especially of surgery, he had always been very liberal and had spent large sums of money in demonstrations for his lectures and personal experimentation and in materials for the museums of the university. He began to suffer from actual want and friends had to come to his assistance. He refused, however, to give up his scruples in the matter and accept the professorship which was still open for him. Finally, at the end of two years, influence was brought to bear on the new government and Galvani was allowed to accept his chair in the university without taking the oath of allegiance. This tribute came too late, however, and within a short time after his restoration to his professorship he died.

That his action in this matter was very properly appreciated by his contemporaries, and that the moral influence of his example was not lost, can be realized from the expressions used by Alibert, the Secretary-general of the Medical Society of Emulation, in the historical address on Galvani which he delivered before that society in 1801:

"Galvani constantly refused to take the civil oath demanded by the decrees of the Cis-Alpine Republic. Who can blame him for having followed the voice of his conscience, that sacred, interior voice, which alone prescribes the duties of man and which has preceded all human laws? Who could not praise him for having sacrificed with such exemplary resignation all the emoluments of his professorship rather than violate the solemn engagements made under religious sanction?"

In the same panegyric there is a very curiously interesting passage with regard to Galvani's habit of frequently closing his {130} lectures by calling attention to the complexity yet the purposefulness of natural things and the inevitable conclusion that they must have been created with a definite purpose by a Supreme Being possessed of intelligence. At the time that Alibert wrote his memoir it was the fashion to consider, at least in France, that Christianity was a thing of the past, and that while theism might remain, that would be all that could be expected to survive the crumbling effect of the emancipation of man.

He says: "We have seen already what was Galvani's zeal and his love for the religion which he professed. We may add that in his public demonstration he never finished his lectures without exhorting his pupils to a renewal of their faith by leading them always back to the idea of the eternal Providence which develops, preserves and causes life to flow among so many different kinds of things. I write now," he continues, "in the age of reason, of tolerance and of light. Must I then defend Galvani in the eyes of posterity for one of the most beautiful sentiments that can spring from the nature of man? No, and they are but little initiated in the saner mechanism of philosophy who refused to recognize the truths established on evidence so strong and so authentic. Breves haustus in philosophiâ ad atheismum ducunt, longiores autem reducunt ad deum, small draughts of philosophy lead to atheism, but longer draughts bring one back to God"--(which may perhaps be better translated by Pope's well-known lines, "A little learning (in philosophy) is a dangerous thing; drink deep or touch not the Pierian spring").

Galvani has been honored by his fellow-citizens of Bologna as one of their greatest townsmen and by the university as one of her worthiest sons. In 1804 a medal was struck in his honor, on the reverse of which, surrounding a figure of the {131} genius of science, were the two legends: "Mors mihi vita" "Death is life or me," and "Spiritus intus alit," "The spirit works within," which were favorite expressions of the great scientist while living and are lively symbols of the spirit which animated him. In 1814 a monument was erected to him in the courtyard of the University of Bologna. It is surmounted by his bust, made by the most distinguished Bolognian sculptor of the time, De Maria. On the pedestal there are two figures in bas-relief executed by the same sculptor, which represent religion and philosophy, the inspiring geniuses of Galvani's life.

Before he died, he asked, as had Dante, whose work was his favorite reading, to be buried in the humble habit of a member of the Third Order of St. Francis. He is said to have valued his fellowship with the sons of the "poor little man of Assisi" more than the many honorary fellowships of various kinds which had been conferred upon him by the scientific societies all over Europe.

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LAENNEC, MARTYR TO SCIENCE

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The knowledge which a man can use is the only real knowledge, the only knowledge which has life and growth in it and converts itself into practical power. The rest hangs like dust about the brain, or dries like rain-drops off the stones. --Froude.

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LAENNEC, MARTYR TO SCIENCE.

On August 13, 1826, there died at Quimper in Brittany at the early age of forty-five, one of the greatest physicians of all time. His name, René Theodore Laennec, was destined to be forever associated with one of the most fruitful advances in medicine that has ever been made, and one which practically introduced the modern era of scientific diagnosis. At the present time the most interesting phase of medical development is concerned with the early recognition and the prevention of tuberculosis. To Laennec more than to any other is due all the data which enable the physician of the twentieth century to make the diagnosis of tuberculosis with assurance, and to treat it with more confidence than before, and so prevent its spread as far as that is possible.

The history of pulmonary consumption in its most modern phase is centred around the names of three men, Laennec, Villemin, and Koch. To Laennec will forever belong the honor of having fixed definitely the clinical picture of the disease, and of having separated it by means of auscultation and his pathological studies from all similar affections of the lungs. Villemin showed that it was an infectious disease, absolutely specific in character, and capable of transmission by inoculation from man to the animal. To Koch the world owes the knowledge of the exact cause of the disease and consequently of the practical method for preventing its spread. The isolation of the bacillus of tuberculosis is the great triumph of the end of the nineteenth century, as the separation of the disease from all others by Laennec was the triumph of the beginning of that century. There is {136} still room for a fourth name in the list, that of the man who will discover a specific remedy for the disease. It is to be hoped that his coming will not be long delayed.

The estimation in which Laennec was held by the most distinguished among his contemporaries, may be very well appreciated from the opinions expressed with regard to him and his work by the best-known Irish and English clinical observers of the period. Dr. William Stokes, who was himself, as we shall see, one of the most important contributors to our clinical knowledge of diseases of the heart and lungs in the nineteenth century, said with regard to the great French clinician whom he considered his master:

"Time has shown that the introduction of auscultation and its subsidiary physical signs has been one of the greatest boons ever conferred by the genius of man on the world.

"A new era in medicine has been marked by a new science, depending on the immutable laws of physical phenomena, and, like the discoveries founded on such a basis, simple in its application and easily understood--a gift of science to a favored son; one by which the ear is converted into the eye, the hidden recesses of visceral disease open to view; a new guide to the treatment, and a new help to the ready detection, prevention and cure of the most widely spread diseases which affect mankind."

Dr. Addison, who is best known by the disease which since his original description has been called by his name, was no less enthusiastic in praise of Laennec's work. He said:

"Were I to affirm that Laennec contributed more toward the advancement of the medical art than any other single individual, either of ancient or of modern times, I should probably be advancing a proposition which, in the estimation of many, is neither extravagant nor unjust. His work, {137} De l'Auscultation Mediate, will ever remain a monument of genius, industry, modesty and truth. It is a work in perusing which every succeeding page only tends to increase our admiration of the man, to captivate our attention, and to command our confidence. We are led insensibly to the bedside of his patients; we are startled by the originality of his system; we can hardly persuade ourselves that any means so simple can accomplish so much, can overcome and reduce to order the chaotic confusion of thoracic pathology; and hesitate not in the end to acknowledge our unqualified wonder at the triumphant confirmation of all he professed to accomplish."

These tributes to Laennec, however, from men who were his contemporaries across the channel, have been more than equalled by distinguished physicians on both sides of the Atlantic at the end of the nineteenth and the beginning of the twentieth century. While we might hesitate to accept the opinions of those who had been so close to him at the beginning of the new era of physical diagnosis, there can be no doubt now, after the lapse of three-quarters of a century, of what Laennec's influence really was, and the tributes of the twentieth century place him among the few great geniuses to whom scientific medicine owes its most important advance.

At the annual meeting of the State Medical Society of New York held in Albany at the end of January, 1903, the president of the society, Doctor Henry L. Elsner, of Syracuse, in his annual address devoted some paragraphs to a panegyric of Laennec. He wished to call attention to what had been accomplished for scientific medicine at the beginning of the last century by a simple observant practitioner. In the course of his references to Laennec and his work he said:

"It is by no means to be considered an accident that, {138} among the greatest advances in medicine made during the century just closed, the introduction of pathological anatomy and auscultation into the practice of medicine at the bedside were both effected by the same clear mind, Laennec. He is one of the greatest physicians of all time."

He then quoted the opinion of a distinguished English clinician, Professor T. Clifford Allbutt, who is well known, especially for his knowledge of the history of medicine. Professor Allbutt is the Regius Professor of Physic (a term about equivalent to our practice of medicine) of Cambridge University, England, and was invited to this country some years ago as the representative of English medicine to deliver the Lane lectures in San Francisco. During his stay in this country he delivered a lecture at Johns Hopkins University on "Medicine in the Nineteenth Century," in which he said, "Laennec gives me the impression of being one of the greatest physicians in history; one who deserves to stand by the side of Hippocrates and Galen, Harvey and Sydenham. Without the advances of pathology Laennec's work could not have been done; it was a revelation of the anatomy of the internal organs during the life of the patient."

René Theodore Hyacinthe Laennec, who is thus conceded by twentieth century medicine a place among the world's greatest medical discoverers, was born February 17, 1781, at Quimper in Bretagne, that rocky province at the north of France which has been the sturdy nursing mother of so many pure Celtic Frenchmen who have so mightily influenced the thought not only of their own country but of all the world. The names of such Bretons as Renan and Lamennais have a universal reputation and the province was even more distinguished for its scientists.

There was published [Footnote 2] a few years ago in France a detailed {139} history of Breton physicians. This work sketches the lives of the physicians of Breton birth from the sixteenth to the twentieth century. Only those of the nineteenth century concern us, but the list even for this single century includes such distinguished names as Broussais, whose ideas in physiology dominated medicine for nearly the whole of the first half of the nineteenth century; Jobert, the famous French surgeon whose reputation was world-wide; Alphonse Guerin, another distinguished surgeon, whose work in the protection of wounds in some respects anticipated that of Lister; Chassaignac, to whose inventive genius surgery owes new means of preventing hemorrhage and purulent infection, and who introduced the great principle of surgical drainage; finally Maisonneuve, almost a contemporary, whose name is a household word to the surgeons of the present generation; without mentioning for the moment the subject of this sketch, Laennec, the greatest of them all. Six greater men never came from one province in the same limited space of time.