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Part 25

Makers of Modern Medicine · James J. Walsh — chapter 25 of 32 · ~3,713 words · public domain

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In German Louvain is Löwen, which also means lion; that is, it is the dative case of the name of the lion. Reference is made to the fact that as Samson found honeycomb (in German, bee-cells) in the lion, so now Louvain--i.e., in German, Löwen, the lion--finds a champion in the man of the cells. As Samson's riddle was suggested by finding the bee-cells, so will the new professor at Louvain solve the riddles of science by the demonstration of cells. The youthful jesting seer prophesied better than he knew. Schwann's first completed work at Louvain was the Microscopical Researches into the Accordance in Structure and Growth of Plants and Animals. [Footnote 11] {265} The theory it advanced was to prove the most potent element thus far introduced into biological science to help in the solution of the difficult problems that constantly occur in the study of the various forms of life.

At Louvain, Schwann remained for about ten years. The period is marked by a continuance of his fruitful investigation of cell-life, of the physiological biology of ferments and fermentation, and of the allied subject of digestion in animals. His researches in Berlin on this interesting and important subject, which was practically a complete mystery at that time, had been mainly concerned with the gastric juice. He now began the study of various secretions which aid intestinal digestion. He proved that bile, which used to be considered an excretion, was really an important digestive secretion. He was not able to demonstrate the function of bile as completely as he had done for the gastric juice. The problem of intestinal digestion is much more complicated than that of stomach digestion, and involves a number of factors for which allowance has to be made if the value of any one of them is to be accurately determined. Even in our own day all of the physiological problems in the functions of biliary secretion are not solved. The greatest step was the demonstration that bile is a thing whose presence in the intestines is to be encouraged, not because, as Horace said, mental trouble was imminent unless one were purged of black bile in the springtime, but because its presence insures the proper preparation of food, and neutralizes in the intestinal tract certain poisonous substances that if absorbed would prove sources of irritation to all higher tissues.

His work on bile practically closes Schwann's career as an investigator. The seven years between twenty and {266} twenty-seven were so full of discovery that there seemed to be great promise for his mature years. Had Schwann died at thirty his biographies would have surely contained lengthy comments on the great discoveries that would undoubtedly have rewarded his efforts in the prime of his powers. Schwann's seeming inactivity has been a fruitful cause for conjecture. The fact of the matter is, however, that original work of a high order is accomplished mainly during the time when activity of the imagination is at its height. There are very few cases in which this acme of inventive effort has lasted more than ten years.

Besides this there were certain more material factors that hindered original work. Schwann was a German, yet had to give his lectures at Louvain in French. For several years most of his efforts were devoted to acquiring facility in the language of his adopted country. Then Schwann was not such a teacher as Müller, but the true pedagogue who took seriously to heart the duty of teaching all his students. To do this meant, in the rapidly advancing science of that day, unceasing toil on the part of a conscientious professor. For it was a time of great discoveries succeeding one another with almost incredible rapidity. For ten years Schwann faithfully devoted himself to his teaching duties in the anatomical course at Louvain. He then accepted the chair of comparative anatomy and physiology at Liège, where he continued to lecture for thirty years. As the result of his stay at Louvain there has always been special attention given to biological studies at that university. At the present time there is published there a very well and favorably known biological journal, La Cellule, through which many important contributions from the professors and students of the university find their way before the public.

During his stay at Liège Schwann was formally invited, {267} on three different occasions, to return to his German Father-land to become professor at some of her great universities. Professorial chairs in anatomy or physiology at Würzburg, at Giessen, and at Breslau, were offered him between 1850 and 1860. He refused them, however, to continue his work in Belgium. He found his adopted countrymen eminently sympathetic. It seems clear that he felt more at home in the midst of the profoundly Catholic sentiment that pervaded the Belgian universities, and which was in such marked contrast to the rationalistic spirit characteristic of the German universities at that time. Schwann was penetrated with a lively sense of the deepest religious feeling, which is noticeable all through his life. His attitude in this matter greatly impressed his scientific contemporaries. His sense of duty in matters spiritual was only equalled by his affectionate regard for his relatives. His vacations were invariably spent with his parents while they were alive, and later with his brothers and sisters in the neighborhood of Cologne. It was while making a Christmas visit to them that he suffered the fatal stroke which carried him away.

Toward the end of his career Schwann was invited to be a member of a commission to investigate the case of Louise Lateau. It will be remembered that the report of recurring bleedings from stigmata in this case attracted a great deal of attention, not only among Catholics, but among all classes throughout the world. After careful observation Schwann refused to concur in the report that the bleedings were manifestly miraculous. At first it was announced that he had declared them evidently beyond the domain of natural causes, but this report he took occasion to correct immediately. The circumstance led to the publication of some harsh words in the religious press, but with his usual moderation Schwann refused to enter into any discussion, and so the affair ended. {268} His thoroughly conservative attitude in the matter, and his application of the strictest scientific criteria to the case, prevented formal expression of approval on the part of those in authority. While such an opinion would have carried only personal weight with it, it might easily have been made a cause for unfortunate aspersions upon the Church.

The most marked feature of Schwann's career is the unfailing friendships that linked him to those with whom he was associated. At Louvain, and later at Liège, he was the personal friend of most of his students, while at Berlin he made friendships with some of the great men in German medicine which endured to the end of his life. When the celebration of his fortieth anniversary came around, the hearty tributes from all over Europe showed in what lofty reverence the kindly old man was held, who had sacrificed some of his chances for greater scientific fame in order to be a teacher of others, and a living exponent of the fact that the frame of mind which leads to great scientific discovery and that which bows humbly to religious truth, far from being hopelessly and essentially opposed to each other, may be peacefully united in the same person in their highest expression.

{269}

CLAUDE BERNARD, PHYSIOLOGIST

{270}

The experienced eye, the power of perceiving minute differences and fine analogies which discriminate or unite the objects of science, and the readiness of comparing new phenomena with others already treasured up in the mind--these are accomplishments which no rules can teach and no precepts put us in possession of. This is a portion of knowledge which every man must acquire for himself; nobody can leave as an inheritance to his successor. It seems, indeed, as if nature had, in this instance, admitted an exception to the will by which she has ordained the perpetual accumulation of knowledge among civilized men, and had destined a considerable portion of science continually to grow up and perish with individuals. --Dr. John Brown, Edward Forbes, Spare Hours.

{271}

CLAUDE BERNARD, THE PHYSIOLOGIST.

With the recent development of post-graduate education the Collège de France has become a favorite shrine of pilgrimage for educators who visit Paris. It represents the oldest educational institution deliberately founded with the idea of combining teaching with investigation. The professors were not bound to teach definite doctrines, literary or scientific, but to give rather the results of recent investigations and personal meditation on great scientific and philosophic problems. The college was not meant, in a word, so much for students as for specialists. It was intended not to convey a definite body of knowledge on any subject, but rather to round out the knowledge acquired in the regular course at the University of Paris, and to dwell particularly on recent lines of advance in special subjects in a manner that would encourage original investigation.

In a word, the Collège de France was the first modern post-graduate school. We have learned in recent years how important are post-graduate departments for their influence on the regular work of a university. Unless original investigation of a high order is constantly done at a university, it is inevitable that the regular course will cease to be up to date. Modern educators are coming to realize very forcibly this quality of a successful teaching institution. Hence the interest that will surely continue to grow in the Collège de France, its foundation, its history, its teachers, and its methods.

To the great majority of those who come to pay their respects at this shrine of original investigation, it will prove a {272} distinct surprise to find the centre of the court of the Collège de France occupied by a statue of Claude Bernard. Bernard is not well known, and is still less appreciated out of scientific circles. By many it is forgotten that the original free school, the Collège de trois langues, in which Hebrew, Greek, and Latin were the only chairs, has extended its scope, and that in our day the natural sciences represent the most fertile field of its achievements. The absolute freedom of opinion guaranteed to professors originally, and which constituted the principal reason for an educational institution apart from the University of Paris and its trammels, has proved a precious heritage to later generations. Science has flourished vigorously, and the memorial to its representative cultivator at the college in this century has deservedly been given the place of honor in its court.

To the initiate, however, for whom, in medicine and physiology and general biology, his work is still an inspiration, many points of interest around the college will have all their attraction from associations with Claude Bernard's career. His neglect by the popular mind is more than compensated for by the fervent admiration of all those who are occupied with investigations along the lines he followed. For in him they recognize a master mind such as is given to a branch of science not more than once in a century; the veritable possessor of a magician's wand, who knows how to disclose the hidden veins of precious ore, the exploitation of which will prove a source of riches to so many faithful followers. For these the dark little laboratory of the college in which Bernard made so many of his ground-breaking discoveries will be in the nature of a shrine to which one comes with grateful memories of the genius loci that was. The apartment across the street at No. 40 Rue des Ecoles, where Bernard lived for years, will be the term of many a pilgrimage. Scientists {273} from all over the world will wander from here out to the laboratory in the Jardin des Plantes, where Bernard's work was done in his later years, and where the fundamental problems of life--plant and animal--usurped the attention that had at first been devoted exclusively to human physiology and its allied sciences.

Claude Bernard is another and a striking illustration of the historical tradition that great men usually come from the country, and not infrequently from poor parents. He was born in 1813, at St. Julien, not far from Lyons, almost in the centre of France. His father owned a small farm in the Beaujolais wine district. The little estate came later into Bernard's hands, and when he could afford the time he spent his summers there. When the air is clear the white summits of the Alps can be seen, and they make a pleasing contrast to the plains along the Saone and the hill-sides of the immediate neighborhood, all covered with vineyards. The physiologist, who enjoyed nature very much, speaks enthusiastically of his "little verdant summer nest."

He was educated at the Jesuit school of Villefranche. It will be recalled that Theodore Schwann was also a student of the Jesuits. In these days, when Jesuit educational training is impugned, the facts are worth noting. It is claimed especially that the old-fashioned training by means of the classics is narrowing. The old method of a definitely prescribed course of study for every student is said to hamper development. Slavish devotion to old pedagogic methods, it is urged, cannot but shackle and destroy initiative. The subordinate place of the sciences in this scheme of education is said to hinder progress in the sciences later in life, to leave the powers of observation undeveloped until too late, and to distract the mind of the student too much from the practical side of life. Here are two men whose lives are {274} an open contradiction to all the allegations of the opponents of the old Jesuit system of training. Needless to say that they are but two of many.

Bernard pursued the course with the Jesuits at the Collège de Villefranche as far as it went. After this we find him at Lyons, at first pursuing studies in philosophy in preparation for his baccalaureate degree, evidently with the idea of eventually entering the university. Family reasons, mainly financial, compelled him to give up his studies, and for nearly two years he was an assistant in a pharmacy in Lyons. Here he developed a skepticism with regard to the effect of the drugs he compounded that led later in life to his important studies on the physiological action of remedies.

The science of therapeutics was at that time in a most inchoate stage. Very little was known of the exact action of drugs. Exaggerated claims were made for many, but mainly on uncertain clinical experience. The modern, patent medicine was as yet unknown, but something not unlike it had become popular among the patrons of the Lyons pharmacy. One remedy was in constant demand by city patrons and by country people, who came from long distances especially to procure it. It was known as la thériaque--"the cure"--I suppose from some fancied connection with the root of the word therapeutics.

This remedy, according to the old women of the neighborhood and the countryside, was a panacea for every ill that flesh is heir to, and a few others besides (pro morbis omnibus cognitis et quibusdam aliis). The composition of this wonder-worker was even more interesting than its universal curative efficacy. Whenever a drug spoiled from too long keeping, or an error in its manufacture made it unavailable for the purpose for which it was originally intended, or whenever an involuntary mistake in compounding occurred, the {275} assistants in the pharmacy were directed not to throw the drugs away, but to reserve them for "la thériaque." "Mettez vous cela de côté pour la thériaque" (put that aside for "la thériaque") was a standing order in the shop. From a remedy of such varied ingredients the most wonderful effects could be expected and were secured. An unexpected action of the remedy, however, was that produced on Bernard's mind. This influence was later to lead to the healing of numberless ills in the system of therapeutics, and to bring about the establishment of the sciences of experimental pharmacology and physiology.

Bernard developed literary ambitions while at work in the pharmacy. He spent many of his free evenings at the theatre, and wrote a musical comedy, "The Rose of the Rhone," which was acted with some success. He worked at a prose drama, and, thinking the possibilities of life too narrow in Lyons, he resolved to go to Paris. With his play in his pocket, and a letter of introduction to the distinguished critic, St. Marc Girardin, he reached the capital. Bernard's drama, "Arthur de Bretagne," was published after his death, and shows that its author possessed literary talent of a high order. This must have been evident to Girardin, to whom it was given to read; but he very wisely advised its author to eschew literature, at least for a time, until he was able to make his living by some other means. Girardin advised Bernard to take up the study of medicine, for which his work in pharmacy had already prepared him somewhat.

Bernard, having once made up his mind to pursue medicine, threw himself, as was his wont, enthusiastically into the study of it. The utmost frugality was necessary in order to enable him to live on the scant income that could be allowed him from home. He lived with a fellow-student in a garret in the Quartier Latin. Their one room was study and {276} sleeping room, and even, on occasion, kitchen. When a "box" came from home, utensils were borrowed from the laboratory for whatever cooking was necessary.

Bernard was especially interested in anatomy, and soon made himself known by the perfection of his dissections. Physiology attracted him not for what was known in the science, but for the many problems as yet unsolved. His was above all a mind not prone to accept scientific teaching on the ipse dixit of a professor. Except in the dissecting-room, his work attracted no attention. He was not looked upon as a brilliant student, and yet all the while he was unconsciously preparing himself thoroughly for his life-work. Later on his dissecting skill was to be a most helpful acquisition. Bernard's first promising opening came unexpectedly. The nicety with which he did certain dissecting work in preparation for one of Magendie's lessons attracted the attention of the professor, at that time the greatest living experimental physiologist. Magendie, in his bluff, characteristic way, without asking further about him, called out one day: "I say, you there, I take you as my preparateur at the Collège de France."

This position was gladly accepted by Bernard, for it provided him with an income sufficient to support himself. The work was congenial. His duty was to prepare the specimens and make ready the demonstrations for Magendie's lectures. His career as a physiologist dates from this appointment. He had to give some private lessons, and do what is called "coaching," or "tutoring," to eke out his slender income, but in the main his time after this was entirely devoted to investigation and experiment.

His first investigation concerned stomach digestion. It was important mainly because it directed his mind to digestive questions. In these he was to make his great discoveries. {277} His first independent investigation concerned the differences to be found in the digestive apparatuses and functions of the carnivora and herbivora--that is, of the meat and plant-eating animals. The differences in the natural habits of these two classes of animals had long been noted. While the meat-eaters invariably bolt their food, the plant-eaters chew theirs very carefully. Many of these latter, like the cow, are ruminants--that is, they bring up their food to chew it over again at their leisure. The instinct that makes them do this is most precious. Their food is mainly composed of starch, in the digestion of which the saliva takes a large part. The thorough mixture of the food with saliva, then, is an extremely important matter. Human beings, who are both herbivorous and carnivorous, must learn to masticate thoroughly at least the starch-containing portions of the food. Bernard's first researches concerned the nerves that supplied the salivary glands, and which consequently influence the flow of saliva. Curiously enough, the conclusions of his first experiments were erroneous. The topic led him, however, into the general subject of the influence of nerves upon glandular secretion, a problem that he was destined to illustrate in many ways.

After the salivary glands the most important structure for the digestion of starches in the animal economy is the pancreas. It was early evident, however, that the pancreatic secretion effected more than the conversion merely of starch into sugar. Its most important rôle, that of influencing the digestion and absorption of fats, was only recognized as the result of a classical observation of Bernard's upon the rabbit. He noticed that fat introduced into the digestive tract of a rabbit undergoes no change until it has advanced a considerable distance beyond the stomach. When fat is introduced into the dog's digestive apparatus a marked change {278} begins in it almost as soon as it leaves the stomach. At first this seemed very mysterious. Observations were made over and over again, always with the same result. There was evidently some important distinction between the intestines of the two animals. Careful investigation showed that the difference between the behavior of the fat in the rabbit and the dog was due to the presence or absence of the pancreatic fluid from the intestinal contents. In the dog the pancreatic duct which carries the secretion of the gland to the intestine empties into the intestine just beyond the stomach. In the rabbit the duct and its secretion empty into the intestine only some eight to ten inches below the intestinal orifice of the stomach. It is just beyond where the pancreatic duct reaches the intestine in both animals that the digestion of fat begins. This observation solved the seeming mystery of fat digestion, and at the same time made clear the importance of the pancreatic secretion in the general work of digestion.

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