2014년 11월 30일 일요일

Louis Pasteur 8

Louis Pasteur 8


FOWL CHOLERA._


If fowls are naturally impervious to the infection of splenic
fever, there is a disastrous malady to which they are subject, and
which is commonly called 'fowl cholera.' Pasteur thus describes the
disorder:--'The bird which is attacked by this disease is without
strength, staggering, the wings drooping. The ruffled feathers of the
body give it the shape of a ball. An overpowering somnolence takes
possession of it. If forced to open its eyes, it appears as if it were
awakened out of a deep sleep. Very soon the eyelids close again, and
generally death comes without the animal changing its place, or without
any struggle, except at times a slight movement of the wings for a few
seconds.' The examination after death reveals considerable internal
disorders.

Here, again, the disease is produced by a microscopic organism. A
veterinary surgeon of Alsace, M. Moritz by name, was the first who
suspected the presence of microbes in this disease; a veterinary
surgeon of Turin, M. Peroncito, depicted it in 1878; a professor of
the veterinary school of Toulouse, M. Toussaint, recognised it, in his
turn, in 1879, and sent to Pasteur the head of a cock which had died
of the cholera. But, however skilful they were, these observers had
not succeeded in deciding the question of parasitism. None of them had
hit upon a suitable cultivating medium for the parasite, nor had they
reared it in successive crops. This, however, is the only method of
proving that the virulence belongs exclusively to a parasite.

It is absolutely necessary, in the study of maladies caused by
microscopic organisms, to procure a liquid where the infectious
parasite can grow and multiply without possible mixture of other
organisms of different kinds. An infusion of the muscles of the fowl,
neutralised by potash, and rendered sterile by a temperature of 110 to
115 degrees, has proved to be wonderfully appropriate to the culture of
the microbe of fowl cholera. The facility of its multiplication in this
medium is almost miraculous. In some hours the clearest infusion begins
to grow turbid, and is found to be filled with a multitude of little
organisms of an extreme tenuity slightly strangulated at their centres.
These organisms have no movement of their own. In some days they change
into a multitude of isolated specks, so diminished in volume that
the liquid, which had been turbid to the extent of resembling milk,
becomes again almost as clear as at first. The microbe here described
belongs to a totally different group from that of the vibrios. It is
ranged under the genus called 'micrococci.' 'It is in this group,' said
Pasteur on one occasion, 'that the microbes of the viruses which are
yet unknown will probably be one day found.'

In the cultivation of the microbe of fowl cholera, Pasteur tried one
of the cultivating liquids which he had previously made use of with
most success--the water of yeast--that is to say, a decoction of
yeast in water rendered clear by filtration and then sterilised by a
temperature of over 100 degrees. The most diverse microscopic organisms
find in this liquid suitable nourishment, particularly if it has been
neutralised. When, for example, the bacterium of splenic fever is sown
in the liquid, it assumes in a few hours a surprising development.
Now, it is remarkable that this medium is quite unsuited to the life
of the microbe of fowl cholera. Not only does it not develop, but the
microbe perishes in this liquid in less than forty-eight hours. May
we not connect this singular fact with that which is observed when
a microscopic organism proves innocuous in an animal which has been
inoculated with it? It is innocuous because it cannot develop itself in
the body of the animal, or because, its development being arrested, it
cannot attain the vital organs.

The decoction extracted from the muscles of the fowl is the only
medium which really suits the microbe of fowl cholera. It suffices
to inoculate the fowl with the hundredth, even the thousandth, part
of a drop of this mixture, to produce the disease and cause death.
But here is a strange peculiarity. If guinea-pigs are inoculated with
this little parasite they are hardly ever killed by it. Guinea-pigs
of a certain age generally exhibit only a local lesion at the point
of inoculation, which ends in an abscess more or less prominent.
After opening spontaneously, the abscess closes again and heals,
while the animal preserves its appetite and its appearance of health.
These abscesses sometimes last several weeks. They are surrounded
by a pyogenic membrane and filled with a creamy pus, in which the
microbe swarms side by side with the pus globules. It is the life of
the microbe inoculated under the skin which causes the abscess. The
abscess, with the membrane which surrounds it, becomes for the little
organism a sort of closed vessel, which it is even easy to tap without
sacrificing the guinea-pig. The organism is mixed with the pus in a
state of great purity, and although it is localised its virulence is
extreme. When fowls are inoculated with the contents of the abscess
they die rapidly, while the guinea-pig, which has furnished the virus,
gets well without the least suffering. A curious instance this is of
the local evolution of a very virulent microscopic organism, which
produces neither internal disorders nor the death of the animal
upon which it lives and multiplies, but which can carry death to
other species inoculated with it. Fowls and rabbits living among the
guinea-pigs suffering from these abscesses might in a moment be smitten
and perish, while the health of the guinea-pigs remained unchanged. To
produce this result it would suffice that a little of the discharge
from the abscess of a guinea-pig should get smeared over the food of
the fowls and rabbits. An observer witnessing such deaths without
apparent cause, and ignorant of this strange dependency, would no doubt
be tempted to believe in the spontaneity of the disease. He would be
far from supposing that the evil had originated in the guinea-pigs,
which were all in good health. In the history of contagia what
mysteries may some day be cleared up by even more simple solutions than
this one!

When some drops of the liquid containing this microbe are placed on
the food of fowls, the disease penetrates by the intestinal canal.
There the little organism increases in such great abundance that
inoculation with the excrements of the injected fowls produces death.
It is thus easy to account for the mode of propagation of this very
serious disease, which depopulates sometimes all the poultry yards in
the country. The only means of arresting the contagion is to isolate,
for a few days only, the fowls and the chickens, to remove the dung
heaps, to wash the yard thoroughly, especially with water acidulated
with a little sulphuric acid, or carbolised water with two grammes of
acid to the litre. These liquids readily destroy the microbe, or at
least suspend its development. Thus all causes of contagion disappear,
because, during their isolation, the animals already smitten die. The
action of the disease, in fact, is very rapid.

The repeated cultivation of the infectious microbe in the fowl
infusion, passing always from one infusion to the next following,
by sowing in the latter an infinitely small quantity, so to speak,
of the virus--as much, for example, as may be retained on the point
of a needle simply plunged into the cultivation--does not sensibly
lessen the virulence of the microscopic organism. Its multiplication
inside the bodies of fowls is quite as easy with the last as with the
first culture. In short, whatever may be the number of the successive
cultures of the microbe in the fowl infusion, the last culture is
still very virulent. This proves the microbe to be the cause of the
disease--a proof the same in kind as that which had already enabled
Pasteur to show that splenic fever and septicæmia are produced by
specific microbes.

Like the bacillus of splenic fever, the microbe of the fowl cholera is
an aerobic organism. It is cultivated in contact with the air, or in
aerated liquids. At the same time, though it is entitled to be called
an aerobic organism, it differs essentially in certain respects from
the parasite of splenic fever. If splenic fever blood filled with
filaments of the parasite be enclosed in a vessel protected from the
air--say, in a tube closed at its two extremities--in a few days,
eight or ten at the most, and much fewer in summer, the parasite
disappears, or rather is reduced to fine amorphous granulations, and
the blood loses all its virulence. If the same system of shutting out
the air be employed with the blood of a fowl charged with the microbe
of fowl cholera, this microbe will be preserved with its virulence for
weeks, months, even years. Pasteur has been able to keep for three
years tubes thus sealed, a drop of blood from which when cultivated
in fowl infusion, sufficed to infect the birds in the poultry yard
with cholera. And not only is the microbe preserved thus in the blood
contained in the tube; the same occurs if fowl infusion be put into
tubes and then sealed by the flame of a lamp.

When, in course of time, such tubes lose their virulence, it is because
the vitality of the organism is extinct. The moment the contents of the
tube cease to be virulent, it is a sign that the contagium is dead. It
is useless, then, to attempt to cultivate it: the microbe cannot be
revived.

Here, then, is a third virulent disease, also produced by a microscopic
organism. The characteristics of fowl cholera are very different
from those of splenic fever and acute septicemia, and these three
microbes do not in the least resemble each other. But, glancing back
over Pasteur's work, are not the diseases of silkworms, pebrine and
flacherie, also virulent diseases? Thus, in so many things, through
so many studies, the same connection holds good. Each discovery of
Pasteur's is linked to those which precede it, and is the rigorous
verification by experimental method of a preconceived idea.

'Nothing can be done,' said he one day, 'without preconceived ideas;
only there must be the wisdom not to accept their deductions beyond
what experiments confirm. Preconceived ideas, subjected to the severe
control of experimentation, are the vivifying flame of scientific
observation, whilst fixed ideas are its danger. Do you remember the
fine saying of Bossuet? "The greatest sign of an ill-regulated mind is
to believe things because you wish them to be so." To choose a road, to
stop habitually and to ask whether you have not gone astray, that is
the true method.'

It is this method which conducted him in 1880 to that wonderful
discovery, the attenuation of contagia. What certain of these contagia
are, we have already seen. We shall now learn what they become in the
hands of Pasteur.




     _THE ATTENUATED VIRUS, OR VACCINATION OF VIRULENT DISEASES._

                     THE VACCINE OF FOWL CHOLERA.


Among the scourges which afflict humanity there are none greater
than virulent diseases. Measles, scarlatina, diphtheria, small-pox,
syphilis, splenic fever, yellow fever, camp typhus, the plague of
the East--what a terrible enumeration! I pass over some, such as
glanders, leprosy, and hydrophobia. The history of these diseases
presents extraordinary circumstances. The most strange, assuredly,
is that which has been from all time established with a great number
of these diseases, that they are non-recurrent. As a general rule,
notwithstanding some rare exceptions, man can only have measles,
scarlet fever, plague, yellow fever once. What explanation, even
hypothetically, can be given of such a fact? Still more difficult is it
to explain how vaccination, which is itself a virulent though benign
disease, preserves from a more serious malady, the small-pox? Has
there ever been a discovery more mysterious in its causes and origin,
standing, as it does, alone in the history of medicine, and for more
than a century defying all comparison?

After dwelling long on Jenner's discovery this question arose in
Pasteur's mind: If contagious maladies do not repeat themselves, why
should there not be found for each of them a disease different from
them, but having some likeness to them, which, acting upon them as
cow-pox does upon small-pox, would have the virtue of a prophylactic? A
chance occurrence, one of those chances which not unfrequently occur to
those who are steadfastly looking out for them, opened out to Pasteur
the way to a discovery which may well be called one of the greatest
discoveries of the age.

In causing the microbe of fowl cholera to pass from culture to culture,
in an artificial medium, a sufficient number of times to render it
impossible that the least trace of the virulent matter from which it
originally started should still exist in the last cultivation, Pasteur
gave in an absolute manner the proof that infectious microbes are the
sole authors of the diseases which correspond to them. This culture
may be repeated ten, twenty, a hundred, even a thousand times: in the
latest culture the virulence is not extinguished, or even sensibly
weakened. But it is a fact worthy of attention that the preservation
of the virulence in successive cultures is assured only when no great
interval has been allowed to elapse between the cultures. For example,
the second culture must be sown twenty-four hours after the first, the
third twenty-four hours after the second, the hundredth twenty-four
hours after the ninety-ninth, and so on. If a culture is not passed on
to the following one until after an interval of several days or several
weeks, and particularly if several months have elapsed, a great change
may then be observed in the virulence. This change, which generally
varies with the duration of the interval, shows itself by the weakening
of the power of the contagium.

If the successive cultures of fowl cholera, made at short intervals,
have such virulence that ten or twenty inoculated birds perish in
the space of twenty-four or forty-eight hours, a culture which has
remained, say, for three months in its flask, the mouth of which has
been protected from the introduction of all foreign germs by a stopper
of cotton wool, which allows nothing but pure air to pass through
it--this culture, if used to inoculate twenty fowls, though it may
render them more or less ill, does not cause death in any of them.
After some days of fever they recover both their appetite and spirits.
But if this phenomenon is extraordinary, here is one which is surely
in a different sense singular. If after the cure of these twenty birds
they are reinoculated with a very virulent virus--that, for instance,
which was just now mentioned as capable of killing its hundred per
cent. of those inoculated with it, in twenty-four or forty-eight
hours--these fowls would perhaps become rather ill, but they would not
die. The conclusion is simple; the disease can protect _from_ itself.
It has evidently that characteristic of all virulent diseases, that it
cannot attack a second time.

However curious it may be, this characteristic is not a thing unknown
in pathology. Formerly it was the custom to inoculate with small-pox to
preserve from small-pox. Sheep are still inoculated to preserve them
from the _rot_; to protect horned cattle from peripneumonia they are
inoculated with the virus of the disease. Fowl cholera offers the same
immunity; it is an additional scientific acquisition, but not a novelty
in principle.

The great novelty which is the outcome of the preceding facts, and
which gives them a distinct place in our knowledge of virulent
diseases, is that we have here to do with a disease of which the
virulent agent is a microscopic parasite, a living organism cultivated
outside of the animal body, and that the attenuation of the virulence
is in the power of the experimenter. He creates it, he diminishes it,
he does what he wishes with it; and all these variable virulences he
obtains from the maximum virulence by manipulation in the laboratory.
Looked at in juxtaposition with the great fact of vaccination for
small-pox, this weakened microbe, which does not cause death, behaves
like a real vaccine relatively to the microbe which kills, producing a
malady which may be called benign, since it does not cause death, but
is a protection from the same malady in its more deadly form.

But for this enfeebled microbe to be a real vaccine, comparable to that
of cow-pox, must it not be fixed, so to speak, in its own variety, so
that there should be no necessity for having recourse again to the
preparation from which it was originally derived? Jenner, when he had
demonstrated that cow-pox vaccination preserved from small-pox, feared
for some time that it would be always necessary to have recourse to the
cow to procure fresh vaccinating matter. His true discovery consisted
in establishing that the cow-pox from the cow could be dispensed with,
and that inoculation could be performed from arm to arm. Pasteur made
his enfeebled microbe pass from one cultivation to another. What would
it become? Would it resume its very active virulence, or would it
preserve its moderate virulence?

The virulence remained enfeebled and, we may say, unchanged. This
showed it to be a real vaccine. Some veterinary surgeons and farmers,
on the announcement of this discovery, applied to Pasteur for a vaccine
against the disease which was so disastrous among their poultry. Some
trials were made, and all succeeded beyond expectation. To preserve
this vaccine it must be secured from contact with the air, the cultures
being enclosed in tubes, the extremities of which are sealed by the
flame of a blowpipe.

What takes place during that interval of time intentionally placed
between two successive cultivations of the cholera microbe--that
interval which is employed in effecting the attenuation and producing
the vaccine? What is the secret of this result? The agent which
intervenes is no other than the oxygen of the air. Here is the proof.
If the cultivation of this microbe is carried on in a tube containing
very little air, and if the tube is then closed by the flame of a lamp,
the microbe, by its development and life, quickly appropriates all the
free oxygen contained in the tube, as well as the oxygen dissolved in
the liquid. Thus, completely protected from contact with oxygen, the
microbe does not become sensibly weakened for months, sometimes even
for years.

The oxygen of the air, then, appears to be the cause of modification in
the virulence of the microbe.

But how, then, is the absence of influence on the part of the
atmospheric oxygen, in the successive cultures which are practised
every twenty-four hours, to be explained? There is, in Pasteur's
opinion, but one possible explanation; it is that the oxygen of the air
in this latter case is solely employed in the life of the microbe. A
culture has a duration of some days; in twenty-four hours it is not
terminated. The air which comes in contact with it is then entirely
employed in nourishing and largely reproducing the microbe. During the
longer intervals of culture, the air acts only as a modifier, and at
last there arrives a moment when the virulence is so much weakened as
to become nil.

This very extraordinary fact is, then, established that the virulence
may be entirely gone while yet the microbe lives. The cultures offer
the spectacle of a microbe indefinitely cultivable, yet, on the other
hand, incapable of living in the bodies of fowls, and in consequence
deprived of virulence. May not this domesticated microbe, as M. Bouley
calls it, be compared to those inoffensive microbes of which there are
so many in nature? May not our common microbes be those organisms which
have lost their former virulence? But may not these harmless microbes,
become infectious in some particular circumstances? And if there are
fewer virulent maladies now than there were in times past, might not
the number of these maladies again increase?

Questions multiply as the facts relating to the attenuation of a virus
suggest inductions, awaken ideas, and throw new lights upon a problem
which, until within these last few years, has remained so obscure.
Formerly it was believed that these viruses were morbid entities.
A virus was a unity. This opinion has still its declared upholders.
According to Pasteur a virus has different degrees of virulence; it can
pass from the weakest virulence to the maximum. Modifying, at will, the
virus of fowl cholera, Pasteur inoculates some hens, for instance, with
a virus too attenuated to protect from death, but which nevertheless
is effectual in securing them against a virus stronger than itself.
The second virus will preserve them from the attacks of a third virus,
and thus passing from virus to virus they end by being guaranteed
against the most deadly virulences. The whole question of vaccination
resolves itself into knowing at what moment a certain degree of virus
attenuation is a guarantee of protection against the mortal virus.

It seems that between small-pox and cow-pox facts of a similar kind
take place. It is probable that vaccination rarely gives perfect
security against the infection of a very malignant small-pox; moreover,
during epidemics of small-pox many persons who have been previously
vaccinated are attacked, and some even die of the disease.

As regards the practice of vaccinating fowls against the cholera
peculiar to them--which, though it certainly is not of the same
importance as human vaccination, is a scientifically _capital_ fact--we
may hope that whatever the differences of receptivity in different
races, or in different individuals of the same race, there will be
found vaccines to suit them all, special care being taken to resort to
the employment of two successive vaccines of unequal power, employed
after an interval of ten or fifteen days. The first vaccine may always
be chosen of a degree of weakness which will not in any case cause
death, and yet of sufficient strength to prevent dangerous consequences
from the second vaccine, which would in some cases be fatal if employed
at once, and to enable it to act as a vaccine against the most virulent
virus.

With regard to the preparation of vaccines, and the ascertaining of
their proper strength, it is necessary to make trials upon a certain
number of fowls, even at the risk of sacrificing a few in these
preliminary experiments. Beyond such questions of manipulation there
remains still a scientific question. How are the effects of vaccination
to be conceived? What explanation can be given of the fact that a
benign disease can preserve from a more serious and deadly one? Pasteur
long sought for the solution of this problem. Without flattering
himself that he has unravelled the difficulty, he has nevertheless
amassed facts which, amid these physiological mysteries, permit us to
frame a hypothesis which can satisfy the mind. Pasteur believes, for
example, that the vaccine, when cultivated in the body of the animal,
robs the globules of the blood, for example, of certain material
principles which the vital actions take a long time to restore to the
system, and which to the most deadly contagium is a condition of life.
The impossibility of action of the progressive virus and of the deadly
virus is thus accounted for.

When Pasteur communicated to the Academy of Sciences these important
and unforeseen facts, they were at first received with hesitation.
It was not without some surprise that the word vaccination, hitherto
exclusively reserved for Jenner's discovery, was heard applied to
fowl cholera. At the International Medical Congress held in London in
August 1881, Pasteur, in the presence of 3,000 doctors of medicine
from all parts of the world, who received him with an enthusiasm which
reflected glory on France, justified the name that he had given to his
prophylactic experiments.

'I have lent,' he said, 'to the expression vaccination an extension
that I hope science will consecrate, as a homage to the merit and
immense services rendered to humanity by one of the greatest men of
England--Jenner.'

Still, while rendering homage to the sentiment which induced Pasteur
to efface himself in favour of Jenner, we may be permitted to say that
there is no likeness between the two discoveries. Great as was the
discovery of Jenner, it was but a chance observation, which had no
ulterior development; and for a whole century, medicine has not been
able to derive anything from it beyond its actual application, which
is the one result achieved. 'Vaccination is vaccination,' an opponent
of Pasteur's, who was driven hard, was obliged to say. The opponent
found no other answer, and he could not have found any other. The
cow-pox is a malady belonging exclusively to a race of animals. Man
can only observe it; he cannot produce it. Suppress cow-pox and there
will be no more vaccination. In the French discovery, on the contrary,
it is the deadly virus itself which serves as a starting point for
the vaccine. It is the hand of man which makes the vaccine, and this
vaccine may be artificially prepared in the laboratory, in sufficient
quantity to supply all needs. What a future is presented to the mind
in the thought that the virus and its vaccines are a living species,
and that in this species there are all sorts of varieties susceptible
of being fixed by artificial cultivation! The genius of Jenner made a
discovery, but Pasteur discovered a method of genius.

'This is but a beginning,' said M. Bouley on the day when Pasteur
announced these facts to the Academy of Sciences. 'A new doctrine
opens itself in medicine, and this doctrine appears to me powerful
and luminous. A great future is preparing; I wait for it with the
confidence of a believer and with the zeal of an enthusiast.'




                    _THE VACCINE OF SPLENIC FEVER._


We have seen how the facts have been established with regard to the
microbe of fowl cholera. Immunity against a virulent disease may be
obtained by the influence of a benign malady which is induced by the
same microbe, only weakened in virulence. What a future there would be
for medicine if this method could be applied to the prevention of all
virulent diseases! As splenic fever was at that time being studied in
the laboratory of the Ecole Normale, it was upon this fever that the
research was first attempted. But the success of this research, said
Pasteur, can only be hoped for if the disease is non-recurrent. It
is only in this case that inoculation with the weakened microbe can
protect from the deadly splenic fever. Unfortunately, human medicine
is dumb as regards this question of non-recurrence. The man who is
smitten with malignant pustule rarely recovers. If there are any
cases of recovery--and there are some authentic ones--he who has so
narrowly escaped death could not confidently count upon his chance of
protection from the disease in future. In order to acquire such a
sense of security he would have to expose himself to experiments of
direct inoculation, which he would hardly care to do. Animals alone
offer the possibility of solving this problem. Yet it is not to all
species of animals that we can have recourse. Every sheep inoculated
with splenic fever infection is a sheep lost; but the ox and the cow
have more power of resistance. Among them there are frequent cases of
cure. An incident occurred which enabled Pasteur to push very far this
experimental study.

In 1879 the Minister of Agriculture appointed him to give judgment upon
the value of a proposed mode of cure for cows smitten with splenic
fever, which had been devised by M. Louvrier, a veterinary surgeon
of the Jura. Choosing M. Chamberland as his assistant to watch the
application of M. Louvrier's remedy, Pasteur instituted a series of
comparative experiments. Some cows were inoculated, two and sometimes
four at a time, with the virulent splenic fever virus. Half of these
cows were treated by M. Louvrier's method; the other half were left
without treatment. A certain number of the cows under M. Louvrier's
care resisted the disease, but an equal number of those not under
treatment recovered also. The inefficacy of the remedy was demonstrated
as well as the cause of the inventor's illusions. But one precious
result remained from the trial of this remedy. Pasteur and Chamberland
had thus at their disposition several cows which had recovered from
splenic fever, and which had experienced in their attack all the worst
symptoms. At the places of inoculation enormous swellings were formed,
which extended to the limbs, or under the abdomen, and which contained
several quarts of watery fluid. The fever had been intense, and at one
time death had appeared imminent. When these cows recovered they were
reinoculated with great quantities of virulent virus. Not the least
trace of disease showed itself, even in cases where the inoculation was
performed after an interval of more than a year.

The question was solved; splenic fever, like most of the virulent
diseases which it has been possible to study, was non-recurrent. The
immunity obtained has a long duration. With that valiant ardour which
always urges him on, Pasteur next proposed to examine the vaccine of
splenic fever. In view of these new investigations, which would require
long and careful labours, and which necessitated a certain amount of
medical knowledge, Pasteur associated with himself, in addition to M.
Chamberland, a young savant, now a doctor of medicine, M. Roux.

Following the rigorous course of his deductions, Pasteur naturally
turned to the oxygen of the air in his attempts to modify the virulence
of the splenic microbe. But a difficulty presented itself at the
outset. Between this microbe and the microbe of fowl cholera there
exists an essential difference. The microbe of fowl cholera, as is the
case with a great number of microscopic organisms, reproduces itself
only by fission. The parasite of splenic fever, on the contrary, has
another mode of generation; it forms spores, nothing analogous to which
is found in the microbe of cholera.

In the blood of animals, as in the cultures at the beginning, the
splenic fever microbe appears at first in transparent filaments, more
or less divided into segments. Up to that point, the resemblance
between the microbe of splenic fever and the microbe of cholera is
complete. But this blood, or the cultures exposed to the free contact
of the air, instead of continuing this first mode of generation,
frequently exhibit, even in the course of twenty-four hours, spores
distributed more or less regularly along the length of the filaments.
All around these corpuscles the matter of the filaments is absorbed,
in the manner formerly illustrated by Pasteur in the diagrams of
his work on the diseases of silkworms, when treating of the bacilli
of putrefaction. Little by little, all cohesion between the spores
disappears, and the whole collection soon forms nothing more than
a dust of germs. But--and here lies the great difficulty which
experimenters encountered in applying to splenic fever the method
of gradual attenuation which was practised with the microbe of
cholera--these germs of splenic fever may be exposed for years to
the air without losing their virulence, always ready to reproduce
themselves without any appreciable change, and to manifest their
effects in the bodies of animals. How can it be hoped to discover a
vaccine of splenic fever by the method used with the contagium of fowl
cholera, since the splenic fever virulence, at the end of twenty-four
hours, is concentrated in a spore? Before the oxygen of the air has had
time to attenuate the contagium, the virulence of the parasite would be
encased in these spores. Yet this objection did not appear insuperable
to Pasteur. Since (said he to himself), under its filamentous form,
the microbe of splenic fever is quite analogous to the microbe of fowl
cholera, may not the problem of exposing the splenic microbe to the
air be reduced to the following one: to determine the conditions which
would prevent the production of spores? The difficulty would thus
be surmounted; for, once we have got rid of the spores, the splenic
filaments might be maintained in contact with air for any length of
time, and we might then no doubt fall back upon the conditions which
had produced the attenuation of the cholera microbe.

Pasteur and his two assistants gave themselves up to this research.
Days passed and experiments were multiplied. Pasteur became more and
more engrossed: he had, what his daughter called, 'the face of an
approaching discovery.'

'Ah! what a grand thing it would be,' he was heard from time to time
to murmur to himself with a suppressed voice, 'if one could arrive at
that--if the fact that the attenuation of the microbe of fowl cholera
proved not to be an isolated one!' But if anyone ventured to ask him a
timid question as to the phase his experiments were going through, he
would reply, 'No, I can tell you nothing. I dare not express aloud what
I hope.'

At last one day he came up from his laboratory with a triumphant face.
His joy was such that tears stood in his eyes. I have never seen a
more radiant expression of the highest and most generous emotions than
emanated from his countenance.

'I should never console myself,' he said while embracing us, 'if a
discovery such as my assistants and I have just made were not a French
discovery.'

                   *       *       *       *       *

And with the clearness which is the charm of this powerful mind, he
related to us the most recent discoveries of his laboratory.

In neutralised chicken infusion the splenic microbe can no longer be
cultivated at a temperature of 44 or 45 degrees. Its cultivation, on
the contrary, is easy at 42 or 43 degrees; and in these conditions the
microbe produces no spores. At this latter temperature, therefore,
and in contact with pure air, we can maintain a culture of filamentous
parasites of splenic fever, deprived of all germs. In some weeks the
crop dies--that is to say, when this culture is sown in fresh broth
the sterility of the broth remains complete. But during the preceding
days life exists in the cultivating liquid. If after two, four, six, or
eight days of exposure to the air and to heat, the contagium is tried
upon animals, its virulence is found to be continually changing with
the time of its exposure to the air, and, consequently, it represents
a series of attenuated contagia. From the moment when the formation
of the spores of the splenic fever bacillus is prevented, all becomes
substantially the same as in the case of the microbe of fowl cholera.
Moreover, as in the cholera microbe, each of these states of attenuated
virulence can be reproduced by cultivation. Finally, splenic fever not
being recurrent, each of these splenic fever microbes constitutes a
vaccine for the more virulent microbe.

In order to apportion the virulence of the vaccine to the species
it is desired to vaccinate, it must be tried on a certain number
of individuals of the same species. If some vaccinated animals are
inoculated with the virulent virus, and none of them perish, the
vaccine is good. Among individuals of the same species, however,
the difference of receptivity is in general great enough to make it
prudent, and even necessary, to have recourse to two vaccines, one
weak and the other stronger, with an interval of from 12 to 15 days
between the two inoculations.

                   *       *       *       *       *

It was on February 28, 1881, that Pasteur communicated to the Academy
of Sciences, in his own name, and in those of his two fellow workers,
the exposition of this great discovery. Loud applause burst forth with
patriotic joy and pride. And yet so marvellous were these results that
some colleagues could not help saying, 'There is a little romance in
all this.' All this reminds one, in fact, of what the alchemist of
Lesage did to the demons which annoyed him. He shut them up in little
bottles, well corked, and so kept them imprisoned and inoffensive.
Pasteur shut up in glass bulbs a whole world of microbes, with all
sorts of varieties which he cultivated at will. Virulences attenuated
or terrible, diseases benign or deadly, he could offer all. Hardly had
the journals published the _compte-rendu_ of this communication when
the President of the Society of Agriculture in Melun, M. le Baron de la
Rochette, came, in the name of the Society, to invite Pasteur to make a
public experiment of splenic fever vaccination.

Pasteur accepted. On April 28 a sort of convention was entered
into between him and the Society. The Society agreed to place at
the disposal of Pasteur and his two young assistants, Chamberland
and Roux, sixty sheep. Ten of these sheep were not to receive
any treatment; twenty-five were to be subjected to two vaccinal
inoculations at intervals of from twelve to fifteen days, by two
vaccines of unequal strength. Some days later these twenty-five sheep,
as well as the twenty-five remaining ones, were to be inoculated with
the virus of virulent splenic fever. A similar experiment was to be
made upon ten cows. Six were to be vaccinated, four not vaccinated; and
the ten cows were afterwards, on the same day as the fifty sheep, to
receive inoculation from a very virulent virus.

Pasteur affirmed that the twenty-five sheep which had not been
vaccinated would perish, while the twenty-five vaccinated ones would
resist the very virulent virus; that the six vaccinated cows would not
take the disease, while the four which had not been vaccinated, even if
they did not die, would at least be extremely ill.

As soon as the agricultural and scientific press had published this
programme, and recorded Pasteur's prophecies, several of his colleagues
at the Academy of Sciences, startled by such boldness in reference to a
subject which had hitherto been enveloped in such profound obscurity,
and fearing to see the illustrious company somewhat compromised by
these affirmations in relation to problems of physiology and pathology,
addressed some observations to M. Pasteur on what they called 'a
scientific imprudence.'

'Take care,' they said to him, 'you are committing yourself without
possibility of retreat. Your experiments in the laboratory hardly
authorise you to attempt experiments like those at Melun.'

'No doubt,' Pasteur answered, 'we have never had in our experimental
studies so many animals at our disposition to inoculate; but I have
full confidence. What has been already done in my laboratory is to me a
guarantee of what can be done.'

And M. Bouley, confident also in the assurances of his illustrious
friend, and arranging to meet him, to witness these audacious
experiments, said to his anxious colleagues, 'Fear nothing; he will
come back triumphant.'

The experiments began on May 5, 1881, at four kilometers' distance
from Melun, in a farm of the commune of Pouilly-le-Fort, belonging to
a veterinary doctor, M. Rossignol, secretary-general of the Society
of Melun. At the desire of the Society of Agriculture, a goat had
been substituted for one of the twenty-five sheep of the first lot.
On the 5th of May they inoculated, by means of the little syringe of
Pravaz--that which is used in all hypodermic injections--twenty-four
sheep, the goat, and six cows with five drops of an attenuated splenic
virus. Twelve days after, on May 17, they reinoculated these thirty-one
animals with an attenuated virus, which was, however, stronger than the
preceding one.

On May 31 very virulent inoculation was effected. Veterinary doctors,
inquisitive people, and agriculturists formed a crowd round this
little flock. The thirty-one vaccinated subjects awaiting the terrible
trial stood side by side with the twenty-five sheep and the four cows,
which awaited also their first turn of virulent inoculation. Upon the
proposal of a veterinary doctor, who disguised his scepticism under the
expressed desire to render the trials more comparative, they inoculated
alternately a vaccinated and a non-vaccinated animal. A meeting was
then arranged by Pasteur and all other persons present for Thursday,
June 2, thus allowing an interval of forty-eight hours after the
virulent inoculation.

More than two hundred persons met that day at Melun. The Prefect of
Seine-et-Marne, M. Patinot, senators, general counsellors, journalists,
a great number of doctors, of veterinary surgeons, and farmers; those
who believed, and those who doubted, came, impatient for the result. On
their arrival at the farm of Pouilly-le-Fort, they could not repress
a shout of admiration. Out of the twenty-five sheep which had not
been vaccinated, twenty-one were dead; the goat was also dead; two
other sheep were dying, and the last, already smitten, was certain
to die that very evening. The non-vaccinated cows had all voluminous
swellings at the point of inoculation, behind the shoulder. The fever
was intense, and they had no longer strength to eat. The vaccinated
sheep were in full health and gaiety. The vaccinated cows showed no
tumour; they had not even suffered an elevation of temperature, and
they continued to eat quietly.

There was a burst of enthusiasm at these truly marvellous results.
The veterinary surgeons especially, who had received with entire
incredulity the anticipations recorded in the programme of the
experiments, who in their conversations and in their journals
had declared very loudly that it was difficult to believe in the
possibility of preparing a vaccine capable of triumphing over such
deadly diseases as fowl cholera and splenic fever, could not recover
from their surprise. They examined the dead, they felt the living.

'Well,' said M. Bouley to one of them, 'are you convinced? There
remains nothing for you to do but to bow before the master,' he added,
pointing to Pasteur, 'and to exclaim--

             "I see, I know, I believe, I am undeceived."'

Having suddenly become fervent apostles of the new doctrine, the
veterinary surgeons went about proclaiming everywhere what they
had seen. One of those who had been the most sceptical carried his
proselytising zeal to such a point that he wished to inoculate himself.
He did so with the two first vaccines, without other accident than a
slight fever. It required all the efforts of his family to prevent him
from inoculating himself with the most virulent virus.

An extraordinary movement was everywhere produced in favour of
vaccination. A great number of agricultural societies wished to repeat
the celebrated experiment of Pouilly-le-Fort. The breeders of cattle
overwhelmed Pasteur with applications for vaccine. Pasteur was obliged
to start a small manufactory for the preparation of these vaccines in
the Rue Vauquelin, a few paces from his laboratory. At the end of the
year 1881, he had already vaccinated 33,946 animals. This number was
composed of 32,550 sheep, 1,254 oxen, 142 horses. In 1882, the number
of animals vaccinated amounted to 399,102, which included 47,000 oxen
and 2,000 horses. In 1883, 100,000 animals were added to the total of
1882.

From the commencement of the practical application of this new system,
the results were topical. Among flocks where half had been vaccinated
and the other half not vaccinated--all the animals continuing to live
together--the mortality from splenic fever in 1881 was ten times less
in the vaccinated sheep than in the non-vaccinated, being 1 in 740 as
against 1 in 78; and in cows and oxen fourteen times less, being 1
in 1,254 against 1 in 88. In 1882 also, the mortality was ten times
greater among the non-vaccinated than among the vaccinated animals.

In 1883 it was proved that the duration of the immunity generally
lasted longer than a year. It is, however, prudent to vaccinate
every year, and to select for performing the operation a period when
splenic fever has not yet become developed--in March and April. If
the vaccinating is postponed until the fever is in the sheepfolds,
there is the risk of attributing to vaccination the losses which in
reality belong to the natural disease. Just as human vaccination cannot
preserve from small-pox a patient who is already under the influence of
small-pox, so the splenic vaccinations are powerless against a fever
already in process of incubation.

It must not be assumed that the duration of immunity to animals
after splenic vaccination cannot be compared with the duration of
immunity from small-pox after Jennerian vaccination. Jenner and his
contemporaries believed that vaccination was able to preserve from
small-pox during the whole life. That illusion disappeared long ago,
and now ten years has been fixed as the average duration of that
immunity and of the interval which ought to separate successive
vaccinations. This interval, moreover, is too long for a certain
number of individuals. Besides, in order to judge of the immunity of
antisplenic vaccination, we must not lose sight of the formidable trial
which vaccinated animals have to undergo when inoculated with the most
virulent virus. What doctor would dare to subject a vaccinated child
to inoculation from virulent small-pox a year after its vaccination?
Finally, taking into consideration the commercial and economic view of
the life of a sheep--if such an expression may be used--the average
scarcely exceeds three years. The duration, then, of the immunity that
vaccination confers is about a third of the duration of the animal's
life.




                      _THE RETURN TO VIRULENCE._


After having reduced the microbes of fowl cholera and splenic fever
to all degrees of virulence, and brought them to a point where they
could no longer multiply in the bodies of animals inoculated with
them, and fixed them in media appropriate to their life, Pasteur asked
himself whether it would not be possible to restore to these attenuated
microbes--weakened to such a degree as to have lost all virulence--a
deadly virulence, and to render them again capable of living and
multiplying in the bodies of animals.

Experiment soon confirmed this mental prevision. An attenuated
splenic fever virus which could cause no danger of disease or death
to guinea-pigs of a year, or a month, or even a week old, could kill
a little guinea-pig just born, or one or two days old. The attenuated
microbe could multiply itself in the blood of so young an animal. We
can well imagine that in an animal, scarcely formed, the power of
oxygenation of the blood globules is not as yet capable of preventing
the aerobic microbe from turning to its own account the oxygen of the
blood. The disease does its work and death supervenes.

After all, there is nothing surprising in the fact that the vital
resistance of a newly-born guinea-pig should differ from that of an
adult one. But what is very remarkable is, that if an older guinea-pig
be inoculated with the blood of one a day old; if a third, still
older, be inoculated with the blood of the second; and so on; the
virulence of the microbe will be gradually reinforced--that is to
say, the usual habit of this parasite to develop itself in the body
of the animal will be restored. The process may be likened to that of
an animal or vegetable species, passing by successive stages and long
sojourns, from one region to another very distant one, subjected to
quite new conditions of climate, and gradually becoming acclimatised
to the last one. How great, then, must be the importance of the medium
of cultivation, with regard to the virulence of the microbes of
communicable diseases! Cultivating the microbe by passing it from one
guinea-pig to another, we soon arrive at a strength capable of killing
guinea-pigs of a week, a month, or several years old, until at last
the smallest drop of the blood of these guinea-pigs suffices to kill a
sheep; and from the sheep we may pass on to the ox.

The same is the case with the microbe of fowl cholera. When it has
ceased to have any effect upon fowls, its virulence can be restored by
inoculating small birds. Blackbirds, canaries, sparrows, all die, if
the virus has not been too much attenuated; and the effect is similar
on young chicks. Thus by several successive transitions from bird to
bird a virulence may be fostered capable of destroying full-grown fowls.

These facts suggested to Pasteur certain inductions which may be well
founded. Is not the attenuation of the virus by the influence of the
air one of the factors in the extinction of great epidemics? And may not the reappearance of these scourges be accounted for by the reinforcement of the virulence?

댓글 없음: