History of medical practice in Illinois - Bushnell Historical Society

344 History of Medical Practice in Illinois"Believing erysipelas to be a specific disease, caused by an animal poison,either imbibed with the air and water from without or engendered by someimperfection of the disintegrating processes within; I cannot fully agreewith the majority of writers on practical medicine, who statein generalterms that it must be treated on the same principles as the continuedfevers."A few years later, in a thoughtful paper on the study of etiology, hewrote:"With a steadily increasing tendency in the professional mind to referto all acute diseases, whether epidemic, endemic or sporadic, to specificcauses or viruses, capable of propagation by fermentative or zymotic action,there is an equal tendency to indulge in hypotheses instead of carefullyobserved facts."In order that more needed facts might be gathered he proposed a cooperativestudy of diseases by such means of clinical observation as werethen available. But at the end of the decade a change set in. In 1879Christian Fenger (1840-1902), a Danish pathologist and surgeon who cameto Chicago in 1877, made a report to the Chicago Pathological Societywhich was recorded by the secretary, William T. Belfield, as follows:"Dr. Chris. Fenger, pathologist to the Cook County Hospital, exhibitedsome morbid specimens obtained from a recent patient. When he openedthe body, the doctor had no history of the case,except that the patientpresented typhoid symptoms. Opening the abdomen, he found infarctionsin the submucous tissue of the intestines, in the spleen and in the kidneys.The source of these emboli was found in an ulcerous endocarditis, bothsets of semilunar valves presenting an abundant deposit. Upon examiningfarther, an embolus was found in the left middle meningeal artery, whichhad caused an extensive infarct; and several small infarcts were found ineach retina(illustrating the value of the opthalmoscope in the diagnosis ofheart disease). The doctor thought from the fact that some of the infarctswere breaking down into abscesses, that the cause of endocarditis wassepticemia. There was no evidence of acute rheumatism nor of any surgicaloperation. Careful search, however, revealed a suppurating synovitis at thebottom of a large bunion. Dr. Fenger said this might have been the startingpoint of the whole disease. As a proof that this was a blood disease thedoctor exhibited under the microscope some of the exudate from the heartvalves in which were myriads of micrococci."As I have stated elsewhere, this was the first demonstration of the bacterialnature of acute endocarditis on this side of the Atlantic. It was alsoone of the first, if not the first, of the public demonstrations of pathogenicbacteria in Chicago.In 1880 H. D. Valin reviewed the work of Pasteur, Lister, Koch and