Before Jenner completed the study of medicine the folklore of his county concerning cowpox was impressed upon his mind by a young country girl, who assured him that she could never take smallpox, as she had already had cowpox. This fact haunted him, and for years before his discovery he mentioned it time and again to many of his associates, including John Hunter. Having observed the immunity against smallpox enjoyed by milkers who had contracted cowpox from cattle, he determined upon a bold experiment. In November, 1789, he inoculated his two-year-old son with swinepox matter, and produced a few vaccinia pustules. Later he inoculated the child many times with smallpox pus, but the disease never developed. It must have required firm courage and faith to insert this virus into his first-born. Later, on May 14, 1796, he was able to prove that cowpox could be transmitted from one person to another, thus producing artificial immunity against smallpox. Pus from the hand of Sarah Nelmes, infected by milking cattle, was inserted into the arm of James Phipps, who later developed a typical vaccinia pustule. Jenner then introduced the pus from a smallpox pustule into the tissues of this boy, but smallpox did not develop. This classical experiment was followed by a series of inoculations by which the virus was transferred from children successfully inoculated with cowpox or vaccinia to other children who had never suffered from either cowpox or smallpox. All of these children developed successful vaccinations. They were then all inoculated with pus from smallpox cases, but not one of them developed smallpox. Thus, to continue in his own words, "they (the experiments) proved that the matter in passing from one human subject to another, through five gradations, lost none of its original properties." These, together with other observations which we cannot consider at this time, he published in June, 1798, under the title of "An Inquiry Into the Causes and Effects of the Variola-Vaccinae, a Disease Discovered in Some of the Western Counties of England, Particularly Gloucestershire, and Known by the Name of the Cowpox." The publication of an alleged preventive for smallpox caused much popular discussion. A few broadminded men at once took up the suggestion and soon confirmed Jenner's observation. The practice of vaccination spread through the civilized world, and Jenner received hundreds of commendatory letters from France, Spain, Austria, Italy, Turkey, India, Arabia, Denmark, Sweden, Russia, and America. The importance of this discovery was first recognized in America in March, 1799, when Dr. Waterhouse, professor of the theory and practice of physic in the University of Cambridge, now Harvard University, Massachusetts, introduced the practice of vaccination in the New World. President John Adams took great interest in the discovery, and later Thomas Jefferson had all of his family vaccinated. You who are now present may observe an interesting bit of local history on your way to lectures in the morning. If you will stop for a moment and look at the old house on the southwest corner of St. Paul and Pleasant streets you will see where Dr. James Smith, the father of vaccination in Maryland, began the use of vaccine obtained from England in May, 1801, soon after it reached New England. He established a vaccine institute in Baltimore, and after vaccinating all of his family, he inoculated them with smallpox pus at the bedside of a patient. None of them developed smallpox, and this striking demonstration greatly helped the cause of vaccination in this country. His tremendous correspondence and the frequent visits to London had caused Jenner to lose most of his practice, and his friends proposed a grant of money from Parliament. After some haggling they obtained a grant of £10,000. He had spent £6000 on his experiments and about £1000 on postage and incidentals, although he did not mention the latter item when called before the parliamentary committee. They did not pay this money to him for two years, and when he received it he found that £1000 had been extracted from the grant as fees. Shade of Aesculapius! Two thousand pounds for the discovery of vaccination! Jenner also received another rebuff at the hands of his fellowcountrymen. Some of his friends thought that he should become a member of the Royal College of Physicians, but the voice of pompous authority at that time decided that he must take the regular examination and apply for membership. His celebrated reply was as follows: * "In my youth I * * * obtained a tolerable proficiency in the Latin language, and got a decent smattering of the Greek. ** At my time of life to set about brushing up would be irksome to me beyond measure. I would not do it for a diadem. That, indeed, would be a bauble. I would not do it for John Hunter's museum." It is more pleasant to turn to the bright pages in his life-history and learn of the many honors showered upon him by most of the learned societies in Europe and America. Among the most important were the medical diploma from Oxford, the appointment as foreign associate of the Medical Society of Paris, and the fellowship of the American Society of Arts and Sciences. This last diploma was signed by President John Adams. He was also appointed physician extraordinary to the King, and in all he received 47 honorary degrees. An amusing incident occurred when they conferred upon him the "Freedom of the City of Dublin." The notice was accompanied by a bill for £10. This was rather expensive freedom. It is hard in these days to fully appreciate the great benefits of vaccination, but let us remember that in Jenner's day one out of every 14 human beings died of smallpox. In 1890 only 38 persons died of smallpox in the registration area of this country, mak ing a rate of about one death from smallpox to every 1,000,000 of inhabitants. Although the discovery of vaccination has practically relieved mankind of one of the most dreaded of all scourges, yet we have Jenner to thank for another great gift to humanity. His observations first taught men to think of the great principles of protective inoculation and immunity, and the wonderful discoveries of our day have proceeded from this beginning. The next great medical discovery which we shall briefly consider was made by the late Dr. Walter Reed, a surgeon in the United States army. You are all aware of his observation that yellow fever is conveyed from one person to another by a special variety of the mosquito. Walter Reed was born in Gloucester county, Virginia, in 1857, and after studying medicine at the University of Virginia and Bellevue Hospital Medical College, he entered the army as a surgeon. In 1892 he made some brilliant studies at the pathological laboratory of the Johns Hopkins Hospital. He was the first to describe the important focal necroses in the liver in typhoid fever, which observation directed the attention of other pathologists to these important lesions in other diseases. Doubtless while working here on the livers of typhoid-fever cases he first caught his inspiration for his very famous work on the means of spreading yellow fever. When the United States army occupied Cuba, Dr. Reed and his assistants, Drs. Lazear and Carroll, all of whom were known personaily by many of us here in Baltimore, were detailed to carry on experiments in Cuba for the purpose of determining the cause of yellow fever. They carried on their work at Quemados, Cuba, and in order to make a series of comparative experiments they erected two buildings. Building No. 1, called the "Infected-Clothing Building," was tightly built, and was carefully protected against mosquitoes by screens. Three large boxes of pillows, pillowslips, and blankets from yellow-fever patients were distributed through the building. Seven young Americans lived in this building for two months, and even wore the pajamas, undershirts and nightshirts, and slept on the mattresses with the blankets and sheets all from yellowfever cases. Yet not one of these men developed yellow fever, and these experiments effectually disposed of the hazy idea that yellow fever was caused by the fomites or exhalations from infected clothing. Dr. Reed and his associates now became convinced that yellow fever was conveyed by other means, and as they already suspected the mosquito, they proceeded to erect Building No. 2, or the "In- . fected-Mosquito Building." No infected clothing was allowed in this building, all clothing and bedding being disinfected by steam. Thirteen young American soldiers volunteered for these perilous experiments in this building, allowing themselves to be bitten again and again by infected mosquitoes from yellow-fever patients. Ten out of the thirteen developed yellow fever, and Dr. Lazear died from this disease. It takes a courageous man to risk his life in battle, but no soldier ever met a braver end than Jesse William Lazear, dying of yellow fever in his tent at Columbia Barracks in Cuba. The value of this important discovery can be estimated from a commercial and a humanitarian standpoint. Let us first consider its commercial aspect. Yellow fever was first observed in this country in 1693, and since that time it has invaded the United States 95 times. We have no means of discovering the total cash value of these 95 epidemics, but the great epidemic of 1878 cost this country $100,000,000. The "Yellow Jack" has also slain its millions, and from 1853 to 1900 in Havana yellow fever killed 35,952 persons. In 1901 Major Gorgas of the United States army took control of the sanitary government of Havana and made practical application of Reed's discovery, and since September, 1901, not one case of yellow fever has occurred in Havana. Although Dr. Reed returned alive from Cuba, he died of appendicitis in Washington in the fall of 1902. His many friends, through the American Medical Association, have already raised. a large sum for the purpose of commemorating his work in some appropriate way, and I hope that they will erect a suitable monument to this great American soldier, who has already saved more human lives than ever a Napoleon or an Alexander destroyed. And now in the very few minutes which remain I shall link together two other discoveries, the one English and the other American. These observations have placed surgery in the position of an approximately exact science. I refer to the discovery of antiseptics and anesthesia. Sir Joseph Lister was the first man to emphasize the importance of using clean instruments, dressings, and other appliances while performing surgical operations. In 1878 he published his article entitled "The Germ Theory of Fermentation and Its Bearing on Pathology." He emphasized the importance of keeping a wound free from all bacterial life, and thereby greatly lessened the mortality in all surgical procedures. It is difficult in these days to appreciate the havoc wrought by surgical infection in preaseptic times, but these are things of the past, and have been replaced by the brilliant surgery of the brain and peritoneal cavity, which many of you have already witnessed. Innumerable lives have therefore been saved by Lister's contribution to medicine. Our friends, Professor Latimer and Professor Keirle, could tell you another story. They might vividly describe the dreaded hospital gangrene, passing through whole wards filled with wounded,, and leaving at times a mortality of 20 to 40 per cent. They might recall long night vigils when they waited for secondary hemorrhage after amputations. The discovery of anesthesia is a matter of especial interest to the College of Physicians and Surgeons and the Baltimore College of Dental Surgery, since these affiliated institutions helped to train Dr. Morton was born in Charlton, Mass., on August 9, 1819, Various attempts were made during antiquity and the Middle ancepimus, eumque singulis inter nos et alibi gentiam purelegus et juribus ad gradas usum perte mentibus, pour popimus. CUJUS KHI QUO MAJOR SIT FIDES, Raventer. His Collegie Segelle et choregraphes nostres munitas, dare placuit 1. Honorary Degree in Medicine Granted Morton by Washington University (Loaned by Dr. Wm. Morton, of New York. Ages to find a substance which would produce insensibility to pain, When we see a patient sink peacefully to sleep and spend hours |