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Authors: Bill Wasik,Monica Murphy

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*
Later, after a long feud with William Shippen, the army’s top medical man, Rush would sour on Washington’s leadership of the army; when he expressed these sentiments to Patrick Henry, then governor of Virginia, Rush’s name became linked with the so-called Conway Cabal, which aimed to replace Washington with another general, Horatio Gates. Rush’s reputation as a patriot has unfairly suffered as a result.


The preface does, it should be noted, read suspiciously like boilerplate. “I cannot consent to the publication of your ingenious dissertation,” it begins, “without requesting you to allow me room enough in your preface, to express the great pleasure I derived from reading it. It will be resorted to hereafter as a repository of facts and opinions upon the disease of which it treats.”

*
As it was, Emily would live to only the age of thirty, dying in December 1848 of what was probably tuberculosis. Her younger sister, Anne, died six months later of the same condition. Charlotte, the oldest, died at thirty-eight. But as Ann Dinsdale, librarian at the Brontë Parsonage Museum in Haworth, has remarked, “The surprise is not that the Brontës died so young but that they lived so long.” A health report in 1850 found the life expectancy in Haworth to be just twenty-five. All six Brontë siblings lived through a bout of scarlet fever as children, a statistically unlikely occurrence; two-fifths of Haworth children perished before their sixth birthdays.

*
“We have little desire to disturb the dream of a benevolent man,” commented the
Gazzetta Medica di Milano
on the publication of his proposal. “We cannot, however, help stating that, while reading over his plan, a slight difficulty occurred to us. Suppose the establishment [is] in operation and flourishing. All dogs have been killed by their masters, all canine importation has been prohibited, and, lastly, all the new-born in the
seraglio
have been pitilessly castrated. So far [so] well! But what dogs remain to frequent such establishments? Where are new recruits to be found?”

Louis Pasteur oversees administration of the rabies vaccine. Cover of
L’Illustration
magazine, 1885.

5
KING LOUIS

H
e was born in 1822 to a father who was a provincial tanner of animal hides—a bitterly nostalgic veteran of the Napoleonic Wars who would pin his Legion of Honor ribbon to his spotless frock coat for his regular solitary Sunday stroll through town and field—and to an imaginative, enthusiastic mother from a large family of warmhearted gardeners. Their snug little home above the tannery in Arbois was thick with the fetid smell of wool grease. Still, Louis Pasteur’s rustic boyhood was a happy one. He enjoyed fishing, sledding, and the company of his three sisters. An eager but undistinguished student, he was noticed primarily for his artistic abilities. While some of the locally distinguished acquaintances who sat for portraits with the young Pasteur supposed he might someday have a modestly bright future in painting, his father’s ambition was that Louis would eventually achieve the respectable station of secondary-school instructor.

Pasteur was not quite nine years old when his quiet village childhood was punctuated by a disturbing drama. After hearing reports of a rabid wolf marauding through the region of Arbois, furiously biting man and beast, Pasteur and his friends witnessed one victim being
brought to the blacksmith’s shop for treatment. The sight of a red-hot iron cauterizing the man’s still-frothy wounds made a lasting impression on the young Pasteur. So did the hydrophobic deaths soon afterward of eight of his fellow Arboisians, who had suffered the wolf’s bites on their hands and heads.

As a university student in Paris, Pasteur was exposed to the great scientific minds of his day, and his own gift for original research finally surfaced. Following completion of his master’s degree at the École Normale Supérieure, Pasteur chose not to return to the provinces as a schoolteacher and instead took a position in the laboratory of the famous chemist Jérôme Balard. He defended theses in physics as well as chemistry and after one year’s time made his first report to the French Académie des Sciences on the relationship between various crystalline forms of particular chemical substances and the rotational polarization of light—a paper that elegantly unified much of the contemporary research into molecular physics and chemistry.

Pasteur was appointed a professor of chemistry at the University of Strasbourg, where he underwent two important transformations. First, almost immediately upon meeting Marie Laurent, the gentle, patient daughter of the university provost, Louis Pasteur began a campaign to win her hand that would soon seal his fate as a dutiful family man. Second, while he continued to make discoveries in the laboratory concerning the physical and chemical character of crystalline substances, Pasteur increasingly concerned himself with scientific problems that had direct practical applications, such as the process for industrial production of racemic acid crystals and, later—as the dean of the faculty of science at Lille—the fermentation of beetroot alcohol. Pasteur saw himself as performing science for the people: the French people in particular. Before long he would likewise be known as the people’s scientist.

In 1857, Pasteur returned to the École Normale in Paris. Here his ongoing discoveries in the fermentation and spoilage of wine, which he
established to be microbiological processes, led to studies that exploded the stubborn myth of spontaneous generation and notably led to the development of new preservation methods for perishables. Pasteurization was born and would change forever the handling of food and drink. Pasteur immediately and doggedly began to explore the relationship between the putrefaction of foodstuffs and the necrosis of diseased tissues. As his research interests evolved from physics and chemistry to microbiology and medicine, the general populace became increasingly interested in his work. Indeed, the emperor and empress themselves began to pay keen attention, and Pasteur, for his part, quickly learned how to transform public interest in his research into material support for the glassware, incubators, laboratory bench space, animals, and capable assistants his ongoing endeavors would require.

Many scientists would train and toil by Pasteur’s side, but the flinty young physician Emile Roux contributed more than any other to Pasteur’s researches into animal and human disease processes. Roux’s medical training had been temporarily disrupted when he, in a fit of anger at the director of the Val-de-Grâce Army Medical School for slighting the serious scientific effort he was expending on his student dissertation on rabies, insulted his superior and was consequently imprisoned and then expelled. As a medical graduate, Roux monastically devoted himself to the systematic study of microbes and immunity in the Pasteur laboratory at the École Normale (and later at the Institut Pasteur). In this role, he was often a thorn in the side of his master, pitting his own methodologies against Pasteur’s, always urging the elder scientist toward greater extremes of scientific rigor. “This Roux is really a pain,” Pasteur complained. “If you listened to him, he would stop you in everything you are trying to accomplish.” Still, the collaboration between the two men, which lasted from 1878, when Pasteur began to concentrate on contagious diseases, until Pasteur’s death in 1895, was an extraordinarily productive one.

Throughout his career, Pasteur was known for his diligence and tenacity:
he would approach every research question with an exhaustive, meticulous zeal. Since he often took on problems of particular controversy in his own lifetime, his rigor was never wasted, as he was constantly under attack. The French scientists of the nineteenth century were not content to air their disagreements in sternly worded missives placed in relevant academic journals, as is standard today. Rather, they confronted one another face-to-face before their esteemed colleagues at the Académie des Sciences, the Académie Nationale de Médecine, or even the venerated Académie Française. Pasteur’s fastidious methodology was matched by his aggressive rhetorical manner, a combination that frequently allowed him to make a great show of toppling his rivals’ scientific theories in public—indeed, to terrific applause. These performances were a particular source of satisfaction for Pasteur.

Pasteur professed a belief in research and experiment as a means to end human misery. It was a goal both lofty and earnest. He advised his younger scientific colleagues, “Live in the serene peace of laboratories and libraries. Say to yourselves…, What have I done for my country? Until the time comes when you may have the immense happiness of thinking that you have contributed in some way to the progress and to the good of humanity.” Pasteur’s love for children, in particular, and passion for preserving them against the morbid threat of infectious disease were to become famous. “When I see a child,” said Pasteur, “he inspires me with two feelings: tenderness for what he is now, respect for what he may become hereafter.” Much of Pasteur’s medical research focused on diseases that were particularly associated with childhood illness. Pasteur himself had lost three children to disease: two young daughters to typhoid and another to cancer. Following the death of the third daughter, Cecile, he wrote to a colleague, “I am now wholly wrapped up in my studies, which alone take my thoughts from my deep sorrow.”

Pasteur felt his calling as a scientist was ultimately to spare life and alleviate suffering, and as the secrets of microbiology revealed
themselves to him over the course of his career, his conscience guided him toward new humane applications. Early in his career, he painstakingly tested and vigorously defended techniques to control microbial contamination—not just of food and drink but also of surgical wounds—and in doing so saved countless lives around the world. But as his restless mind turned toward other diseases, contagions first of France’s livestock and then of its countrymen, Pasteur began to think of a more fundamental means of preventing the morbidity and mortality caused by infection. Vaccines took hold of his imagination.

Vaccination is the induction of immunity to a disease in an otherwise vulnerable individual, accomplished through intentional exposure to some less virulent form of the disease. The practice began with variolation against smallpox infection, originating in Asia more than a millennium before Pasteur. The procedure consisted of taking a small amount of the pus from an active smallpox lesion and introducing it into a small surgical incision or directly into the nose of a patient with no history of the disease. The resulting infection was milder and less disfiguring than natural smallpox, leading to a case fatality rate of only 1 to 2 percent, as opposed to 30 percent with a natural infection. Variolation was popularized in western Europe during the early eighteenth century by England’s Lady Mary Wortley Montagu. After witnessing its successful practice during her husband’s term as British ambassador to the Ottoman Empire, Lady Montagu insisted that her three-year-old daughter be variolated a few years later when a smallpox outbreak threatened England. Much interest was generated in the British court, and within a year the Prince of Wales’s daughters Amelia and Caroline had been variolated as well. The practice immediately became widespread throughout Britain but had yet to overcome several decades of resistance in France. Only after the unexpected death of Louis XV from smallpox in 1774 did variolation become common among the French.

Since variolation was neither affordable nor accessible to the lower
classes, it was never taken up generally as a preventative. Instead, large-scale vaccination efforts were set up only after an epidemic was in progress, limiting the ability of variolation to make a broad impact against smallpox. The physicians who carried out these procedures had no genuine scientific knowledge of why they were effective; it would be more than a century before Pasteur would popularize the germ theory and establish microbiology and immunology as fundamental medical sciences. Many physicians of the eighteenth century believed, for example, that variolation was most survivable when combined with fasting, bleeding, and mercurial purges.

One British country physician, still stricken by the memory of the noxious variolation protocol he himself underwent as a child, was motivated to find a way to diminish danger and discomfort to the patient without compromising protection against the dreaded smallpox. And so Edward Jenner set out to test the folk belief that those who handle cattle from a young age, and thus have the opportunity to be exposed to cowpox, or vaccinia, before they encounter smallpox, are protected from smallpox infection. Once this hypothesis was confirmed, he demonstrated that vaccinia could be intentionally inoculated into a naive human, conferring similar protection. His simple experiments on his neighbors and family members sufficed to convince the world that rather than being variolated with potentially deadly active smallpox, one could be inoculated with a much less virulent disease associated with altogether different species and thereby be protected from the graver infection. This humane innovation was quickly taken up around the globe; more than 100,000 were vaccinated before ten years had passed, and Jenner became an international celebrity. Immediately upon the creation of vaccine came the birth of the antivaccine movement, scientists and laypeople who claimed (much as in our present day) that vaccine was “poison.” But its use became more and more widespread, even compulsory in many places, as the decades wore on and vaccine production became standardized and improved.
Altogether, it would take less than two centuries for Jenner’s vaccine to eradicate the scourge of smallpox from the earth.

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