Historical perspectives in preventive medicine

Historical perspectives in preventive medicine

PREVENTIVE MEDICINE 15, Historical 203-205 (1986) Perspectives in Preventive The First Rabies Vaccination: Medicine Rue d’Ulm 100 Years Ago ...

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PREVENTIVE

MEDICINE

15,

Historical

203-205

(1986)

Perspectives

in Preventive

The First Rabies Vaccination:

Medicine

Rue d’Ulm 100 Years Ago

July 1985 marked the 100th anniversary of the first human vaccination against rabies. The centennial of the rabies vaccine is an important landmark in preventive medicine not only because of the prophylaxis of rabies, which is a rather rare disease, but also because it opened the way for an organized effort to prevent other contagious diseases with much greater morbidity. On Monday, July 6, 1885, Louis Pasteur was visited in his laboratory at the Sorbonne on Rue d’Ulm by a 9-year-old boy from Alsace, Joseph Meister, and his mother. Two days earlier, Joseph had been bitten 14 times by a rabid dog. The wounds were so deep and painful that the boy could hardly walk. Pasteur, a chemist and biologist, consulted two distinguished physicians, Dr. Vulpian, dean of the medical school in Paris, and Dr. Grancher, a professor at the medical school, for help with a decision. Both agreed that without treatment, Joseph’s chances for survival were nil. The first injection was administered by Dr. Grancher at 8 PM on July 6, 1885, and the race against the disease continued with 13 more inoculations. The treatment was completed on July 16, 1885. The material in the last three injections was so virulent that it killed the control rabbits in a few days. One can easily imagine the anguish and tension of waiting for the long incubation period to be over. Finally, on October 26, 1885, Pasteur reported to the Academy of Sciences that Joseph Meister was perfectly normal and should be considered immunized against “hydrophobia.” A few days before, on October 14, a teenage shepherd, Jean Baptiste-Jupille, confronted a “mad dog” in defense of six younger children who had accompanied him to the field. His hands were cruelly bitten during the fight with the animal. Because of his courage and stamina he became a public hero. Dr. Grancher repeated the treatment applied to Meister, and Jupille never developed the disease. To mark this event a statue by Truffot, “Jupille Fighting the Mad Dog,” was erected in the courtyard at the Pasteur Institute. A collateral result of the human antirabic vaccination was the founding of an institute for research into the causes and treatment of various diseases-the Pasteur Institute. Its members were supposed to be full-time researchers, independent of any medical school, hospital, state agency, or drug company. Initially, a general skepticism in academic circles accompanied Pasteur’s idea of such an independent institute, but it gained widespread popular support. The Pasteur Institute was built through a worldwide subscription inspired by the success of the antirabic vaccine. Within a few years, the Pasteur Institute was so successful in its independent work that almost every developed country built similar laboratories, e.g., the Lister Institute in London, Ehrlich Institute in Frankfurt, Rockefeller Institute in 203 0091-7435/86 $3.00 Copyright ,411 rIghI\

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New York, Imperial Institute in Petersburg, Kitasato Institute in Tokyo, as well as the chain of Pasteur Institutes in various countries. Immediate practical application and wide theoretical implications are constant characteristics of almost each of Pasteur’s discoveries. From the prevention of diseases of beer and wine making to the prevention of sepsis in operating rooms, Pasteur’s doctrine remains unshaken to this day. It was no surprise, therefore, that Pasteur received honors during his life; after all, his ideas have been translated into common everyday practices, from the pasteurization of milk to the sterilization of equipment placed in spaceships. Pasteur’s fame and accomplishments were used politically during his lifetime. Both the national media and the French people in the street needed someone or something they could be proud of after their defeat in the 1871 war. Pasteur was held up as an example of the genius of France and of its powerful influence on the general progress of mankind. Recently during the celebration of the rabies-vaccine centennial some news commentators reassessed Pasteur’s accomplishments, perhaps in order to make him seem more realistic. Their efforts were, however, in poor taste. Anne DeSaint Romain cites Gerald Geison, who claims that the experimental protocols of Pasteur were not at all conclusive and certainly not scientifically acceptable; it is also claimed that Pasteur’s success with rabies can be explained by the fact that his patients were not bitten by rabid dogs (1). Moreover, to show that “the culte of Pasteur is today questionable,” Fabien Gruhier, under the malicious title “Pasteur, a Suspect Messiah” (2), exhumes and cites some old anti-Pasteur articles, like “Pastorian Delirium” (1886) written by Henry Rockeford. He also cites a book by Andre Giordan and Daniel Raichvarg (3), who allege that “Pasteur would hide the embarrassing cases and fake the statistics by ascribing the death [of his vaccinated persons] to various causes” and that “Pasteur never understood what he was doing.” He concludes that “Raichvarg has scratched the colors of the surface only to discover underneath myth and forgery in all its components.” To appear impartial, Gruhier also mentions some of Pasteur’s good qualities: He invented the in vitro culture of microbes, had the idea of using the microscope for the study of human diseases, effectively immunized hens, and had a genius for public relations. One century after the dubious vaccination of Joseph Meister, the Pasteur Institute remains a unique research center, a fantastic concentration of competence which day after day obtains spectacular victories against disease and constitutes one of the rarest sources of Nobel prize winners existing under the European sky. Certainly, Pasteur was neither a saint nor a preacher, yet he never tried to be either. He was, however, one of the greatest reformers of his time, whose discoveries and theories opened a new era. Certainly he had precious collaborators who contributed immensely to his work. It was their duty to do so, and it was Pasteur’s merit to choose them. Certainly, many mistakes were made. Are they not an intrinsic part of research when one steps deep into the unknown? Are they not made today? Certainly, there have been exaggerations in promoting a “culte” of Pasteur after his death (mostly by groups with political interests). Yet, the

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simple truth is that our way of life has been forever changed by Pasteur’s discoveries which remain completely valid and firm. The fact that his discoveries are unshaken for more than 150 years is the best proof of their value. As for Gruhier et ul., they can be forgiven; children, after all, throw stones only at those trees loaded with fruit, The first immunization against rabies remains what it really is: a cornerstone in preventive medicine. REFERENCES I. De Saint Romain, A. Pasteur: The real reasons for glory. L’Histoire 79, 40-41 (1985). 2. Giordan, A., and Raichvarg, D. “History of Biology.” Lavoisier Publications, in press. (In French) 3. Gruhier, E Pasteur, a suspect messiah. For the Centennial of the famous vaccine, a Pamphlet Assassin. Novel Observarew, May 24, 1985.

ABRAHAMRIVENSON, M.D. Naylor Dana institute for Disease Prevention American Health Foundation One Dana Road Valhalla, New York 10595