The Nature of Food—The Roller Mill—The Middlings Purifier—Culinary Utensils—Bread Machinery—Dairy Appliances—Centrifugal Milk Skimmer—The Canning Industry—Sterilization—Butchering and Dressing Meats—Oleomargarine—Manufacture of Sugar—The Vacuum Pan—Centrifugal Filter—Modern Dietetics and Patented Foods.
If called upon to name the most important of all factors of human existence, that which underlies and sustains all others, even to life itself, everyone must agree that it is food. A remarkable fact in this connection is that all animal life lives and thrives by eating some other thing that is or has been alive, or is the product of organic growth. The vegetarian may pride himself upon his higher ideals of living, but after all his fruit, vegetables, and cereals belong to the great category of living organisms, and are to a certain extent sentient and conscious, for even the plant will turn to the sun. The beasts of the field and fowls of the air live by preying upon other weaker animals and birds, these upon plants and grasses, and the plants and grasses upon the decaying mosses and organic mould of the soil, and the mosses upon still lower organisms. The big fish of the sea eat the little fish, the little fish the small fry, and these in turn live upon worms and animalcula, and so on all the way down to protoplasm. Omniverous man, in spite of his boasted civilization and enlightment, not only eats them all, flesh, fowl, fish, grain and plants, but lives exclusively upon them. But he can only live on that which has been produced by the mysterious agency of life, and this furnishes a significant suggestion for the philosopher, for it may be that life itself is only an accumulated active power or unitary force regenerated in some metamorphic way from vital force stored up in the bacteria of organic food, and necessarily connected therewith in an endless chain of reproductions, and if this be true, the hope of the scientist as to the synthesis of food from its elements must ever remain a philosophic dream, because the scientist cannot create a bacterium.
It has been said that when a man eats meat he thinks meat, and when he eats bread he thinks bread, and when he eats fruit he thinks fruit. It is not clear that the quality or character of man’s food is so closely correlated to his thought, but that it has its influence cannot be doubted. It would be safer to say, however, that when a man eats meat he acts meat, and when he eats bread he acts bread, for the muscular energy and aggressive potentiality appear to be much more closely related to the quality of his food than are his thoughts. May it not be that the powerful achievement of the British Empire was directly related to its roast beef? Is not the listless apathy of the Chinese due to a diet of rice? Is not the dominant and masterful power of the lion or the eagle related to a carniverous diet, and the mild and placid temper of the ox the reflex expression of his vegetable food? It is quite true that our potentialities are largely represented by what we eat, and our food therefore becomes a most interesting topic, not only by virtue of its indispensable quality, but by reason also of the possibilities of development in the betterment and elevation of the human race.
From the earliest times even down to the present day man’s food has been the same—flesh, fish, cereals, fruits and vegetables. The development of the present century has not extended this category, but it has been directed to an increase in the supply, an improvement in quality, the preservation against decay and waste, and its intelligent selection and adaptation to the special needs of the body. Progress manifests itself in the great field of agriculture, in improved processes and machines for milling; in butchering, packing and handling meats; in preserving and drying fruits; in the preparation of canned goods, in dairy appliances, in cake and cracker machines; in the manufacture of sugar; in the great advance in cookery; in the science of dietetics, and in thousands of minor industries.
In agriculture the raising of grain has extended in the Nineteenth Century to enormous proportions. More than ten thousand patents for plows, as many for reapers, and a proportionate number of planters, cultivators, threshers, and other implements and tools represent the extent to which inventive genius has been directed to the increase of the yield in the harvest field.
This yield in the United States for the year 1898 was:
| Corn | 1,924,184,660 | bushels |
| Wheat | 675,148,705 | bushels |
| Oats | 730,906,643 | bushels |
| Rye | 25,657,522 | bushels |
| Barley | 55,792,257 | bushels |
| Buckwheat | 11,721,927 | bushels |
| Potatoes | 192,306,338 | bushels |
For converting the grain into flour, the inventors of the Nineteenth Century have made revolutionary changes. Milling processes within the last twenty-five years have been completely transformed by the introduction of the roller mill and middlings purifier. Formerly two horizontal disk-shaped stones or burrs were employed, the lower one stationary and the upper one revolving in a horizontal plane and crudely crushing the grain between them. In all modern mills these have been entirely displaced by porcelain rolls revolving on horizontal axes and crushing the grain between them. The first of these roller mills is shown in pat. No. 182,250, to Wegmann, Sept. 12, 1876. (See Fig. 164). The outer rolls d e are pressed against the inner ones a c by a system of weighted levers, and scrapers below remove the crushed grain from the periphery of the rolls. Many subsequent improvements have been made, one type of which employs a succession of rolls which act in pairs on the grain one after the other and reduce it by successive gradations.
The middlings purifier, see Fig. 165, comprehends a flat bolt or shaker screen b, of bolting cloth, arranged as a horizontal partition in an enclosing case through which passes an upward draft of air produced by suction fan D at the top. This air passing up through the bolting screen lifts the bran specks and fuzz from the shaken material as it passes downward through the screen, brushes K being arranged below to keep the screen constantly clean. A representative and pioneer type of this machine is seen in Pat. No. 164,050 to George T. Smith, June 1, 1875, from which the view is taken. The useful effect of the roller mill and middlings purifier is to save the most nutritious and valuable part of the grain, which lies between the outer cuticle and the white starch within, and which breaks up in fine grains and is of a golden hue. This portion of the grain was formerly unseparated, and was mixed with the middlings and bran as an inferior product. Modern analysis has disclosed its superior food value, and the roller mill and middlings purifier have provided means by which it can be separated from the bran and incorporated with the flour, thereby greatly adding to its wholesome character and nutritive value, and imparting to the flour the rich creamy tint which characterizes all higher grades.
Minneapolis, Minn., is the great center of the milling interests of the United States. The Pillsbury Mills are located there, and the “Pillsbury A.” which is said to be the largest in the world, has a capacity of 7,000 barrels per day.
In 1877-78 disastrous flour dust explosions at Minneapolis brought about the development of the dust collector, for withdrawing from the air of the mills the suspended particles of flour dust, which not only invited explosion, but rendered the air unfit to breathe. Washburn’s Pat. No. 213,151, March 11, 1879, is an early example.
The use of crushing rolls has also developed a great variety of new foods, such as cracked wheat, oatmeal grits, etc. These crushing rolls have sometimes been made hollow, and are steam heated, and as they crush the grain they simultaneously effect the cooking or partial conversion of the starch, and the product is known as hominy flake, ceraline, coralline, etc., which furnish popular breakfast foods when served with cream.
In the field of cookery such activity has been displayed that the average kitchen to-day is a veritable museum of modern inventions. Egg beaters, waffle irons, toasters, broilers, baking pans, apple parers, cherry stoners, cheese cutters, butter workers, coffee mills, corn poppers, cream freezers, dish washers, egg boilers, flour sifters, flat irons, knife sharpeners, can openers, lemon squeezers, potato mashers, meat boilers, nutmeg graters, sausage grinders, and frying pans in endless array; all patented and clustered around the modern cooking range as a central figure, and all presenting points of excellence in the matter of economy and convenience, or the betterment of result. The most extensive application of inventive genius is to be found in the large manufacturing bakeries, which make and sell the millions of pounds of crackers and cakes that fill the bins and shelves of the grocery store. In these manufactories the dough is prepared by a mixer, see Fig. 166, which consists of a spiral working blade revolving in a trough, and capable of handling half a dozen barrels of flour at a time. It is then put through a kneading machine, called a “brake,” shown in Fig. 167, and is then ready to be converted into crackers or cakes on a great machine 25 feet long, which finishes the crackers and puts them in the pan ready for the oven. This machine, see Fig. 168, receives the dough at A, where it is coated with flour and flattened into a sheet between rolls. It is then received on a traveling apron B, has the flour brushed off by a rotary brush C, and is then cut into crackers or cakes by vertically reciprocating dies D. At E a series of fingers press the cakes down through the sheet of dough, while the surrounding scraps are raised on a belt F and delivered into a suitable receptacle. The separated cakes at B′ are then delivered into pans at G, the pans being fed on the subjacent belt at G′. Such machines, costing nearly a thousand dollars, produce from forty to sixty barrels of crackers a day, enabling them to be sold at about 5 cents a pound at retail.
Dairy Appliances have come in for a large share of attention at the hands of the Nineteenth Century inventor. There are about sixteen million milch cows in the United States, and their contribution to the food stuffs of the day in milk, butter, and cheese is no insignificant factor. There have been over 2,700 patents granted for churns alone, and besides these there are milk coolers, cheese presses, milk skimmers, and even cow milkers. The centrifugal milk skimmer is an interesting type of this class of machine. In the old way the milk was set for the cream to rise, which it did slowly from its lighter specific gravity. In the centrifugal skimmer the milk is continuously poured in through a funnel, and the cream runs out continuously through one spout, and the skimmed milk at the other. An illustrative type of this machine is shown in Fig. 169. A steam turbine wheel near the base turns a vertical shaft bearing at its upper end a pan which rotates within the outer case. The milk enters through the faucet at the top, and as the pan within rotates, the heavier milk, by its greater specific gravity, is thrown to the outer part of the pan and passes out through the larger of the two spouts, while the lighter cream is crowded to the center and passes out of the upper spout, which opens into the center of the pan. Patents to Lefeldt & Lentsch, No. 195,515, Sept. 25, 1877, and Houston and Thomson, No. 239,659, April 5, 1881, represent pioneer milk skimmers of this type.
Closely allied to the dairy appliances are the incubator and the bee hive, both of which have claimed a large share of attention, and for which many patents have been granted.
One important and characteristic feature of the present age is the conservation of waste in perishable foodstuffs. Fruits, vegetables, fish and oysters were suitable food to our forefathers only when freshly taken, and any superabundance in supply was either wasted by natural processes of decay, or was fed to the hogs. To-day thousands of patented fruit dryers, cider mills, and preserving processes save this waste and carry over for valuable use through the unproductive winter months these wholesome and valuable articles of diet. Even more important is the canning industry, by which not only fruits are maintained in a practically fresh condition for an indefinite time, but oysters, meats, fish, soups, and vegetables are also put up in enormous quantities. To-day the grocer’s shelves present an endless array of canned tomatoes, peaches, corn, peas, beans, fish, oysters, condensed milk, and potted meats, which constitute probably three-fourths of his staple goods. The tin can is in itself a very insignificant thing, not entitled to rank with any of the great inventions, but in the every-day campaign of life it is playing its part, and working its influence to an extent that is little dreamed of by the casual observer. It renders possible our military and exploring expeditions; it holds famine and starvation in abeyance; it gives wholesome variety to the diet of both rich and poor; and it transfers the glut of the full season to the want of future days. Perhaps no single factor of modern life has so great an economic value. Simple as is the tin can, quite complex machines are required to make it. Originally such machines were operated by hand or foot power, but within the last 25 years power machines have been devised which automatically convert a simple blank or plate of sheet metal into a finished can. Of the many patents granted for such machines the most representative ones are 243,287, 250,096, 267,014, 384,825, 450,624, 465,018, 480,256, 495,426, 489,484.
In the process of putting up canned goods the products are filled into the cans, and the caps, or heads, are soldered on. These caps have a minute hole in the center for the escape of air and steam in the process of cooking and sterilizing, which is conducted as follows: A large number of cans are placed on a tray swung from a crane and the cans lowered into one of a series of great cooking boilers. The cover of the boiler is then closed and fastened by lugs, and steam turned on until the goods in the can are thoroughly heated through. During this process the air and steam escape through the little vent hole from the interior of each can. The cans are then removed, the vent hole closed by a drop of solder, and the goods thus hermetically sealed in a cooked or sterilized condition will keep for a long period of time.
Sterilizing.—During the last quarter of the century, which has witnessed the growth of the wonderful science of bacteriology, a class of devices known as sterilizers has come into existence, whose primary function is to kill the germs of decay by heat. This has had in the canning industry an important commercial application. An example is found in the patent to Shriver, No. 149,256, March 31, 1874. In some of these devices the receptacles containing the food stuffs are in large numbers placed within the heating chamber, and by devices operated from the outside the cans or bottles are opened and shut while within the steam filled chamber. A late illustration is found in patent to Popp et al., 524,649, August 14, 1894.
Butchering and Dressing Meats.—Chicago is the leading city of the world in this industry, and Armour & Co. the largest packers. In the year ending April 1, 1891, they killed and dressed 1,714,000 hogs, 712,000 cattle, and 413,000 sheep. They had 7,900 employees, and 2,250 refrigerating cars were employed for the transportation of their products. The ground area covered by their buildings was fifty acres, giving a floor area of 140 acres, a chill room and cold storage area of forty acres, and a storage capacity of 130,000 tons. In addition to its meat packing business the firm has separate glue works, with buildings covering fifteen acres, where 600 hands are employed, their production in 1890 being 7,000,000 pounds of glue, and 9,500 tons of fertilizer. Since 1891 this great business has increased until to-day it is said that the army of workmen employed is greater than that of Xenophon, that the firm pays out in wages alone, half a million dollars every month, that four thousand cars are required to carry the products of their factory, and whose business amounts to the enormous sum of one hundred million dollars annually.
There are from forty to fifty million cattle raised in the United States, and an equal amount of sheep. The number of hogs raised has diminished somewhat in the past few years, but from 1889 to 1892 more than fifty million were maintained. The process of slaughtering and dressing pork, as practiced to-day, is a continuous one, and is well illustrated in Fig. 170, in 13 operations. The animals are driven into a catching pen at 1, where they are strung up by one leg, and secured to a traveling pulley on an overhead rail. At 2 the animal is instantly killed by a knife thrust that reaches the heart; at 3 he is dumped into a vat of scalding water, kept hot by steam pipes, where the hair is loosened (see detail view Fig. 171). A series of oscillating curved arms, shaped like a horse hay-rake, dips the carcass out of the scalding vat and deposits it upon the table 4 (Fig. 170), where it is attached to an endless cable that drags it through a scraping machine at 5. This takes off the hair, as shown in detail view Fig. 172. At 6 (Fig. 170) the remnants of hair are removed by hand, and at 7 the skin is washed clean. At 8 the carcass is inspected, and the throat cut across; at 9 the entrails are removed; at 10 the leaf lard is taken out; at 11 the heads are severed and tongues removed; at 12 the carcass is split into halves, and at 13 the sections are ready to be run into the cooling room.
From 10 to 15 minutes only are required to convert the living animal into dressed pork. Every part of the animal is utilized. The lungs, heart, liver and trimmings go to the sausage department. The feet are pickled or converted into glue. The intestines are stripped and cleaned for sausage casings. The soft parts of the head are made into so-called cheese, and the fat is rendered into lard. The finer quality of bristles goes to the brushmakers, and the balance is used by upholsterers for mixing with horse hair. The blood is largely used for making albumen for photographic uses, as well as in sugar refining, for meat extracts, and for fertilizers. The bones are ground for fertilizer, and even the tank waters are concentrated and used for the same purpose.
Oleomargarine.—About 1868 M. Mege, a French chemist, commissioned by his government to investigate certain questions of domestic economy, was led into the study of beef fat, and to make comparisons of the same with butter. He found that when cows were deprived of food containing fat they still continued to give milk yielding cream or fatty products. He therefore concluded that the stored-up fat in the animal was then converted into cream, and that it was practicable, therefore, to convert beef fat into butter fat. Physiology taught that in the living animal the change was wrought through the withdrawal of the larger part of the stearine by respiratory combustion, while the oleomargarine was secreted by the milk glands, and its conversion into butyric oleomargarine effected in the udder under the influence of the mammary pepsin. In the process of making butter by the ordinary method of churning the cream, the finely divided butter fat globules are united into masses, containing by mechanical admixture from 12 to 14 per cent. of water or buttermilk carrying a fractional per cent. of cheese. This buttermilk contributes somewhat to the flavor, but at the same time furnishes a ferment which ultimately spoils the butter by making it rancid. It is a purely accidental ingredient, and one not at all desirable. To some extent the same may be said of the soluble fats which give to the butter its variable though characteristic flavor. They are unstable compounds, decomposing readily, and furnish the acrid products which make “strong” butter. M. Mege sought to imitate the natural process of butter-making, which was first to separate from the oily fat of suet the cellular tissue and excess of stearine or hard fat; second, to add to the oil a sufficient proportion of butyric compounds to give the necessary flavor, and third, to consolidate the butter fat without grain, and to add at the same time the requisite proportion of water, salt, and coloring matter, to make a compound substantially the same in composition, flavor, and appearance, as butter churned from the cream, and all this without adding to the original fat anything dietetically objectionable, and without submitting it to any process capable of impairing its wholesome quality. These objects were fairly obtained in the product known as oleomargarine, the United States patent for which was granted to Mege Dec. 30, 1873, No. 146,012.
The process in brief is to take fresh beef fat, which is first chopped up and thoroughly washed. It is then placed in melting tanks at a temperature of 122° to 124° F, and the clear yellow oil is drawn off and allowed to stand until it granulates. The fat is then packed in cloths set in moulds and a slowly increasing pressure squeezes out the pure amber colored oil, leaving the stearine behind. This sweet and pure yellow oil is then churned with milk for 20 minutes until the oil is completely broken up, and a small quantity of annato, a vegetable coloring matter, is added to give a yellow color. The product is then cooled in ice, and after a second churning with milk it is salted and finished like butter. Chemical analysis shows oleomargarine to have substantially the same constituents and in almost the identical proportions of pure butter. It is equally wholesome, and while it does not have the same rich flavor, it has the advantage that it keeps better, and is not so liable to become rancid or strong. The oleomargarine industry is closely related to the beef packing industries of the United States, and its growth has been enormous. Notwithstanding the stringent laws on the subject, much of the oleomargarine made is sold for, and by the average purchaser is not distinguishable from, pure butter. In 1899 there were 80,495,628 pounds of oleomargarine made in the United States, or more than a pound for every man, woman, and child in the country. The internal revenue tax paid on it was $1,609,912.56. The exports for the year 1899 were 5,549,322 pounds of the artificial butter, and 142,390,492 pounds of the oleo oil prepared for conversion into the complete product by simply churning with milk.
Sugar.—Sugar-cane, beets, and the sap of the maple constitute the sources from which sugar is extracted, but the cane furnishes by far the largest supply. When crushed between rolls it yields 65 per cent. of its weight as juice, and 18 per cent. of this juice is sugar. It is concentrated by evaporation at a low temperature, the crystallized portion being known as “raw” or brown sugar, which is subsequently refined, while the uncrystallized portion forms molasses.
In the process of refining, 2 or 3 parts of raw sugar, with one of water containing a little lime, ground bone black, and the serum of bullocks’ blood, is heated by the passage of steam through it. The albumen of the serum coagulates and rises to the surface in a scum which entangles the impurities and bone black, leaving the syrup light in color. The latter is then filtered through bone black until it is colorless and is then evaporated in the vacuum pan, which is the important invention of the century in sugar making. Heat has the effect of converting the crystallized sugar into the uncrystallized variety, and hence the evaporation must, to prevent this, be conducted at a low temperature. Contact with the air is also objectionable. These conditions are provided for by conducting the evaporation in a vacuum, which lowers the evaporating temperature and avoids contact with the air. The vacuum pan was the invention of Howard, an Englishman. (British Pat. No. 3,754, of 1813). As constructed to-day it is an enormous vessel (see Fig. 173), capable of holding 7,000 or more gallons, and yielding 250 barrels of sugar at a strike. In this a vacuum is maintained by a condenser, the vapors passing from the pan to the condenser through the great curved pipe rising from the top, which pipe is five feet in diameter. A gentle heat is applied through internal steam-heated coils which connect with an external series of steam inlet pipes on one side, and a corresponding series of steam outlet pipes on the other. A large discharge valve for the concentrated syrup closes the bottom of the pan. After concentration the crystallized sugar is separated from the syrup by a centrifugal filter, in which the liquid is thrown from the crystallized sugar by centrifugal action. The first centrifugal filter is shown in British patent to Joshua Bates, No. 6,068, of 1831. This, however, revolved about a horizontal axis. The present form of centrifugal filter is a cylinder revolving about a vertical axis, the sides of the cylinder being formed of filtering medium, through which the liquid is thrown by centrifugal action, while the sugar is retained within. This was the invention of Joseph Hurd, of Mass., U. S. Pat. No. 3,772, Oct. 3, 1844; re-issue No. 607, Sept. 29, 1858, which patent was extended for seven years, from Oct. 3, 1858. The diffusion process, which extracts the juice by cutting the cane in slices and soaking in water; the bagasse furnace, which dries and burns the expressed cane stalks as fuel, and the manufacture of glucose and grape sugar by the reaction of sulphuric acid on starch, are interesting allied features of this industry which can only be briefly mentioned. Most of the sugar consumed in the United States is imported, much raw sugar being imported and refined here. The imports for the year 1899 were 3,980,250,569 pounds, and the per capita consumption in 1898 was 61.1 pounds a year.
Aids to Digestion.—It is only during the last part of the Nineteenth Century that the world has learned how to live. “What is one man’s food is another man’s poison” has been a trite old saying for many years, but the reason why has only in late years been fully understood. The physiology of digestion, the relative digestibility of different articles of food, and their nutritive values, have received of late years the earnest attention of physicians and students of dietetics and have contributed much to the quality and kind of food, and a knowledge of when and how to eat it. We know that the starchy foods are digested by the saliva, which is an alkaline digestion; that meat, fish, eggs, cheese and the albumenoids are digested in the stomach by the gastric juices (pepsin and hydrochloric acid) which is an acid digestion, and that the remaining portions of starch, the sugars, and fats are digested in the intestines, and that this is also an alkaline digestion, and this has helped to solve the problem for us. We also know that starch is an excellent food, provided the vital powers are sufficiently stimulated by fresh air, sunlight, and exercise to digest it, as do the horse and the ox when they eat corn, but we know furthermore that the sedentary occupations of modern life leave many stomachs in a condition unable to assimilate starch, and so bread, oatmeal, potatoes and such simple staples, instead of nourishing the body, ferment in the enfeebled stomach, produce acids and gas, and lay the foundation for serious chronic diseases. The student of chemistry and dietetics knows to-day that one part of diastase will effect the conversion of 2,000 parts of starch into grape sugar, as a preliminary step to its digestion, and so by treating starchy matter with substances containing diastase (derived from malt) a partial transformation is effected which will materially shorten and assist its digestion. This fact has been largely made use of in the preparation of easily soluble or pre-digested foods, examples of which are found in patent to Horlick (malted milk), No. 278,967, June 5, 1883; to Carnrick (milk-wheat food), Dec. 27, 1887, No. 375,601; and Boynton and Van Patten (cereals and diastase), 344,717, June 29, 1886.
Beverages.—Pure water, nature’s own gift, has ever supplied every legitimate need of the human race, but civilized life has greatly extended its list of drinks, much to its own detriment. Soda water, whiskey, beer, ginger ale, tea, coffee, and chocolate represent enormous industries, and probably all do more harm than they do good. Much inventive genius in the Nineteenth Century has been bestowed upon the soda water fountain, on stills, and processes for aging liquors and processes for brewing beer, on cider and wine presses, on bottling machines and bottle stoppers, on devices for carbonating waters, and in coffee and teapots. The trend of the times is shown in the following figures, which represent the per capita consumption of beverages in the United States for 1898: tea, .91 of a pound; coffee, 11.45 pounds; wines, .28 of a gallon; distilled spirits, 1.10 gallons; and malt liquors 15.64 gallons. The largest per capita increase since 1870 has been in malt liquors, and the next in coffee. In tea and distilled spirits there has been a decrease, while the consumption of wines is the smallest of all and has varied but little.
Discovery of Circulation of the Blood by Harvey—Vaccination by Jenner—Use of Anæsthetics the Great Step of Medical Progress of the Century—Materia Medica—Instruments—Schools of Medicine—Dentistry—Artificial Limbs—Digestion—Bacteriology, and Disease Germs—Antiseptic Surgery—House Sanitation.
In the early gropings through the uncertain light of first progress, man was accustomed to ascribe the ills of his flesh to the anger of the gods, and in his craven and abject superstition made peace offerings. Later he learned to locate the cause within himself, and constructed the theory that the fluids of the body had become disordered. The characteristic feature of progress in the Nineteenth Century, in this field, has been in the accurate tracing of the relation of cause and effect, and with the discovery of true causes has grown efficient means of treatment. The old expedients of charms, incantations, conjuration and exorcism gave place first to intelligent medication, and this in turn is rapidly giving way to the prevention of disease by improved conditions of sanitation and right living. The ounce of prevention has been found to be worth more than the pound of cure. With the improved knowledge of physiology, anatomy, chemistry and biology, which the century has brought, the intelligent physician was able to make a logical and for the most part a correct diagnosis, but supplemented with the microscope, that great revealer of the unseen world of small things, corporeal existence itself becomes an open book, and from the principles of organic evolution to the germ theory of disease the mystery of life and death is being slowly revealed.
When the Eighteenth Century gave birth to the Nineteenth, its great natal gift in medicine was vaccination. Jenner in 1798 for the first time announced his discovery of this great boon to the human race. In 1799 Dr. Benjamin Waterhouse, in Boston, obtained virus from Jenner and vaccinated four of his children, and in 1801 Dr. Valentine Seaman obtained virus from Dr. Waterhouse and performed the first vaccination in New York. During the Seventeenth and Eighteenth Centuries the annual death rate from smallpox in London ranged from 2 to 4 per 1,000 of population. In 1892 it was only 0.073 per 1,000.
It is also stated on good authority that the mortality from smallpox in England alone, was 20,000 a year less after the introduction of vaccination than it was in the preceding century, and that its benefits to the world at large have been so great that the lancet of Jenner has saved more lives than were sacrificed by the sword of Napoleon.
Each century in modern history has been marked by some important discovery in the field of medicine. The Seventeenth Century was notable for the discovery of the circulation of the blood by Harvey; the Eighteenth Century brought with it vaccination by Jenner. The Nineteenth Century’s greatest gift in this field has been anæsthesia, or insensibility to pain. Nature has wisely endowed man with nerves of sensation as danger signals for the conservation of life. Accident and disease, however, are the inseparable concomitants of human existence, and suffering and pain the ineffaceable legacies of mortality. Sometimes these nerves of sensation are no longer useful as monitors, and in the unavoidable emergency of accident, surgical operations, child birth, and certain diseases, suffering can do no good, and then pain—that Prince of Terrors—thrusting his presence upon the hapless victim, racks body and limb, calling forth groans, and shrieks and writhings, till the poor sufferer, possessed with a dominating agony which displaces all thought of life, memory of friends, and love of God, breaks down in unutterable distress, and prays for death and oblivion. To this poor sufferer insensibility is next to heaven. For the past half century all the formidable operations of the surgeon have been performed with the aid of anæsthetics and without suffering to the patient, producing happy recoveries, and greatly contributing to the success of the result by relieving the surgeon of the distraction of the patient’s pain, and the interference of his involuntary movements. Quite a number of anæsthetics are known and used to-day. Those more generally employed are—naming them in the order of their first application—nitrous oxide gas, ether, and chloroform. Nitrous oxide gas is chiefly used for the extraction of teeth. Sir Humphrey Davy, in 1800, was the first to observe the peculiar quality of nitrous oxide gas, which gave it the name of “laughing gas,” from the fact that it caused those inhaling it to act in a manner exhibiting an abnormal exhilaration. Dr. Horace Wells, a dentist of Hartford, Conn., in 1844, had the gas administered, experimentally, to himself during the operation of extracting a tooth, and was the discoverer of its useful application as an anæsthetic.
The greatest discovery, however, in anæsthetics is the application of ether for this purpose. Ether as a chemical product has been known for several centuries, and as early as 1818 Faraday pointed out the similarity between the effects of ether and nitrous oxide gas. Dr. Morton, a dentist, of Boston, first applied it as an anæsthetic Oct. 16, 1846, being guided largely in its selection and use by Dr. Jackson, an eminent chemist of the same city. On Nov. 12, 1846, U. S. Pat. No. 4,848 was issued to them for this invention. In the latter part of December of the same year Dr. Liston, an eminent English surgeon, performed the operation of amputating the thigh while the patient was under the influence of ether.
Chloroform, discovered by Guthrie in 1831, was first applied as an anæsthetic by Sir James Y. Simpson, of Edinburgh, in 1847. Of the two leading anæsthetics, ether is more generally used in the United Sates and chloroform in Europe. Ether is less dangerous, but its administration is more difficult and disagreeable. It is said on the highest authority that in the Crimean War chloroform was administered 25,000 times without a single death, and ether is even safer than chloroform. In the hands of a skillful physician practically no danger is to be apprehended from the use of either of the two agents. A little over fifty years ago any severe or prolonged surgical operation involved such irresistible pain that the patient’s writhings were required to be restrained by powerful muscular assistants, and by straps which bound the patient to the table, and when it is remembered that a false cut of a hundredth part of an inch might be fatal, the haste, the disquieting influence upon the surgeon, and the interference with the accuracy of his hand, added greatly to the percentage of unsuccessful operations, as well as to the prolonged agony of the patient. Contrast this with the present methods of using anæsthetics, and we find the patient dropping into a quiet and peaceful sleep before the operation, and awakening thereafter to find, to his astonishment, that it is all over, and that recovery is only a question of careful nursing.
Materia Medica.—Many important contributions have been made to the pharmacopœia in the century. In 1807 the remedy known as ergot was brought to the notice of the profession by Dr. Stearns, and named by him pulvis parturiens. Iodine was first used as a medicine in 1819 by Dr. Coindet, Sr., of Geneva. Quinine was discovered by Pelletier and Caventou in 1820, although Peruvian bark had long been used for the same purpose. Chloral hydrate, discovered by Liebig in 1832, was applied in medicine in 1869 by Dr. Liebreich, of Berlin. Carbolic acid was discovered in 1834 by Runge. Artificial seidlitz powders were first put up under Savory’s British Pat. No. 3,954, of 1815. Veratrum viride, lobelia, worm seed, and chloroform were all introduced in the first part of the century. The sulphates of morphia, strychnia, atropia and other alkaloids are of comparatively recent addition to the pharmacopœia, and the iodide of potash, tincture of iron, digitalis, bichloride of mercury, sub-nitrate of bismuth, boracic acid and gallic acid, chlorate of potash and Dover’s powders have become standard remedies within a hundred years. In the latter part of the century the new remedies derived from coal tar have occupied an important place. Of these may be mentioned antipyrine, by Knorr (pat. Oct. 28, 1884), phenacetin, by Hinsberg (pat. March 26, 1889), salol, by Von Nencki (pat. Sept. 28, 1886), sulfonal, by Bauman (patented Jan. 22, 1889), antikamnia (acetanilide), and many others, besides new and valuable antiseptic compounds, such as salicylic acid and formalin. A characteristic feature of the modern practice of medicine is in improved forms of its administration. Sugar-coated pills, gelatine capsules and cod liver oil emulsions make the remedy much less disagreeable to take, and very ingenious and effective machines have been devised for putting up remedies in such forms.
Instruments.—Laennec’s discovery in 1819 of auscultation, and the stethoscope, for determining internal conditions by sound, was a great step in diagnosing diseases. The binaural stethoscope was invented by Cammann in 1854, and a later improvement is the phonendoscope, by Bianchi. The opthalmoscope is an instrument for inspecting the interior of the eye, which was invented by Prof. Helmholtz, and described by him in 1851. The laryngoscope, for obtaining a view of the larynx, was said to have been constructed by Mr. John Avery, of London, as early as 1846. The opthalmometer, Fig. 174, is a comparatively recent invention. It is designed to ascertain variations in corneal curvature for the correction of corneal astigmatism. Electric lights with reflectors are arranged on each side of the patient’s head, while the operator looks into the eye with a telescope. The sphygmograph, a little instrument to be strapped on to the wrist to record the action of the pulse, was first reduced to a practically useful form by Marey in 1860. A later development of these devices, by Verdin, known as the sphygmometrograph, is shown in Fig. 175. The endoscope, for looking into the urethra, and the cystoscope, for looking into the bladder, are other useful instruments of the modern practitioner. Greater than them all, however, is the modern X-ray apparatus, for locating foreign substances in the body and making visible the bones through the flesh, for which see special chapter. The use of the thermometer in recording the progress of fevers is also a valuable modern application, and the list of instruments and small tools is beyond enumeration. There are series of obstetrical appliances, instruments relating to bone surgery, to the taking up of arteries, cupping instruments, trepanning instruments, speculums, hypodermic syringes, electric cauteries, fracture appliances, instruments for lithotrity, bandages for varicose veins, atomizers, breast pumps, inhalers, nasal douches, trusses, pessaries, catheters, abdominal supporters, and an endless variety of proprietary articles, such as electric baths and belts, plasters, chest protectors, liver pads, and so forth, all of which are practically the products of the Nineteenth Century. The surgeon of to-day can straighten the eyes of a cross-eyed man, or take the bow out of his bandy legs, can make him a new nose of his own flesh, patch his skull with a silver plate, remove the stone from his bladder, supply him with a wind-pipe, wash out his stomach, and perform many other operations even more difficult. Among such more important operations may be mentioned ovariotomy, which was first performed by Dr. Ephraim McDowell, of Danville, Kentucky, in 1809, and the tying of the great arteries. The operation of lithotrity, for removing stone from the bladder by crushing the stone, was introduced by Civiale, 1817-1824, who devised successful instruments and modes of using them. In 1836 to 1840 Richard Bright, an English physician, made important researches and discoveries in relation to the functions and diseases of the kidneys, and established the nature of the so-called “Bright’s disease.”
Schools of Medicine.—While the regular school of medicine (called by some “Allopathy”) has held the leading place in medicine, various other schools have sprung up in the Nineteenth Century, all of which represent advances in a knowledge of the laws of health, and the modes of preventing and curing diseases. Hahnemann, in his “Organon der Rationellen Heilkunde,” in 1810, gave homœopathy its name, and reduced it to a system. The doctrine of similia similibus curantur (like cures like), has gained great popularity in the latter part of the century. Hydropathy, as a school, also made its appearance in the early part of the Nineteenth Century. Priessnitz was its first disciple, and the Grafenberg cure, established in 1826, was a noted institution for many years. The useful application of water in the form of baths and cold packs, has been known for centuries, and will always be used as a valuable agency in sickness and in health. The “Thompsonian” system of treating diseases was covered by patents in 1813, 1823 and 1836, and attained considerable notoriety in the early half of the century. Sweating by hot bricks and hot tea made of “Composition Powders,” vomiting with lobelia to produce relaxation, and a fiery liquid for cramps, called “No. 6,” were the chief remedies, and very few boys who had once taken the treatment were ever willing afterwards to admit that they were sick. In the latter part of the Nineteenth Century electro-therapeutics has received a large share of attention, many forms of medical batteries have been devised, and probably no more promising field of study and research exists in the whole domain of medicine.
Dentistry.—George Washington had false teeth, and it is said that the teeth of some of the mummies of Egypt had gold fillings, but it remained for the Nineteenth Century to establish dentistry as an art, and its influence in securing better mastication and digestion of food, more sanitary mouths and shapely faces, cannot be estimated. Few people can be found to-day who have not either filled teeth, bridge work, gold caps, or artificial sets of teeth. The most important advance in the art was in the invention of the rubber plate for holding the porcelain teeth. This was the invention of J. A. Cummings, and was covered by him in his patent No. 43,009, June 7, 1864. In more recent years “bridge-work” represents the most important advance. In this practice one or more artificial teeth are firmly held in the place of missing teeth by a strong bridge-piece of metal, which at its ends is anchored to the adjacent natural teeth. This was first done by Bing (British Pat. No. 167, of 1871), and was afterwards patented in somewhat different form in the United States by J. E. Lowe, No. 238,940, March 15, 1881, No. 313,434, March 3, 1885, and Richmond, May 22, 1883, No. 277,933. Porcelain and gold crowns and dental pluggers run by electricity represent other important advances in this art. It is said that there are 20,425 dentists in the United States, and that in 1899 they employed in their practice 20,499,000 false teeth.
Artificial Limbs.—With the successful work of the surgeon came the effort to repair, as far as possible, the loss of the limb. Until about the middle of the Nineteenth Century the survivor of an operation was an unsymmetrical, unique, and pitiful object. The peg-leg of Peter Stuyvesant lives in history, and the arm-hook of Capt. Cuttle is familiar to every reader. The first United States patent for an artificial leg was granted to B. F. Palmer, Nov. 4, 1846, No. 4,834. Wooden legs with a restricted back and forward ankle motion and a spring, were constructed by A. A. Marks from 1853 to 1863. On Dec. 1, 1863, a patent, No. 40,763, was granted to Mr. Marks for the use of sponge rubber for constructing artificial feet and hands that dispensed with the articulated joints, and made a great improvement. In patent No. 366,494, July 12, 1887, to G. E. Marks, the foot and leg portion of a wooden leg are made from wood which grows with a crook, as at the root of a tree, where the strength and lightness of a continuous natural grain is obtained at the instep. About 300 patents have been granted for artificial legs and arms. Modern improvements have extended to every detail of construction, and so perfect to-day is the average wooden leg that it is hardly to be detected. Men with wooden legs ride horseback, are expert users of the bicycle, and have even performed feats on the tight rope. The inventor’s genius has not stopped at repairing limbs, however, for artificial eyes, artificial ear drums, the audiphone, foot extensions for short legs, crutches, braces, abdominal supporters, and various other applications to supplement the defects of the body have been devised.
Digestion.—The physiology of digestion had, perhaps, the first real light shed upon it by Beaumont’s observations from 1825 to 1832. A Canadian boatman, Alexis San Martin, was wounded in the abdomen from a charge of buckshot, and the wound healed, leaving a permanent opening in the stomach, through which the operation of digestion could be observed. This furnished visible evidence of the relative digestibility of different kinds of foods, and the general functions of the stomach. The peculiar and different conditions governing the digestion of the starch foods, the albumenoids (such as meat and fish), and the sugars and fats, have been clearly ascertained, and “what is one man’s food is another man’s poison” is now susceptible of intelligent diagnosis and effective adjustment. Of late years the stomach has been greatly aided in its functions by prepared or predigested foods. The action of diastase, in converting starch into grape sugar, has been taken advantage of, and cereals treated with diatase, malted milk, lactated and peptonized foods, have proven a boon to the enfeebled digestion, while the intelligent study of dietetics has done much to relieve the physician and promote the health of the individual by right living.
Bacteriology.—Although Leeuwenhoeck discovered the bacterium in 1668-1675, up to 100 years ago disease and death were largely regarded as dispensations of Providence, and with fatuous resignation were accepted as inevitable. The microscope and the study of bacteriology, however, have revealed to us the presence of minute living organisms or germs, which are everywhere around us, infesting the air, the earth, the water, our food, our bodies, and all organic matter in countless millions. These infinitely small beings multiply with a rapidity and fecundity that bewilders the imagination. Their method of multiplication is by fissiparism—that is to say, each splits into two independent beings that separate and afterwards lead independent lives. It is said that there is one species in which not more than six or seven minutes are required for the division to take place. A single individual might consequently produce more than a thousand offspring in an hour, more than a million in two hours, and in three hours more than the number of inhabitants on the globe. They are known as micro-organisms, of which the bacteria are the most important. The bacteria are further divided into species, and names are given them to distinguish the different forms. The little rod-shaped ones are called bacilli: the spheroidal ones micrococci or cocci. If they cling together in chains they are called streptococci; if of a spiral or corkscrew form they are called spirallae. The curved bacilli are called “comma” bacilli, from their resemblance to the punctuation mark of that name. The presence of peculiar forms of these bacteria in diseases has so suggested the relation of cause and effect as to have given rise to the so-called “germ theory” of disease. Now we know with reasonable certainty that cholera, diphtheria, typhoid fever, whooping cough, mumps, cerebro-spinal meningitis, pneumonia, tuberculosis, hydrophobia, and many other diseases have each its specific cause in the form of a microbe.
BACILLUS OF TUBERCULOSIS IN SPUTUM.
BACILLUS OF DIPHTHERIA (KLEBS-LOEFFLER).
FIG. 176.
BACILLUS OF TYPHOID FEVER.
(Photo-Micrographs, 1,000 diam., by William M. Gray, M. D.)
BACILLUS OF TUBERCULOSIS IN SPUTUM.
BACILLUS OF DIPHTHERIA (KLEBS-LOEFFLER).
BACILLUS OF TYPHOID FEVER.
FIG. 176.
Henle, a German physiologist, as early as 1840, maintained the doctrine of contagium vivum, or contagion by the transmission of living germs. Certain classes of diseases have also long been known as zymotic, or ferment diseases. Louis Pasteur’s work, however, marks the first definite and important results in the study of bacteriology, and he is the father of the “germ theory” of disease. He exploded the previously held theories of scientists concerning the spontaneous generation of living things, and clearly established and promulgated the knowledge of disease germs. Commencing his great work about 1865 with the investigation of the silk worm plague in France, he discovered it to be due to parasites, and checked it. He also gave great attention to the subject of fermentation, proving it to be caused by micro-organisms. Taking up the diseases of men and animals, he gave practical value to the truths of his theory in the treatment of hydrophobia, diphtheria, and other diseases, using the principle of vaccination to destroy or render innocuous the toxins or disease-producing poisons derived from living germs. Working along the same lines must be mentioned Dr. Koch, whose success in detecting the microbes which cause consumption and cholera has made him famous the world over. Of the great variety of these little microbes which have been separately identified, many are innocuous, and, in fact, subserve many important and useful purposes in nature, while others are to be as much dreaded as the deadly cobra or the rattlesnake. A few typical examples of the latter are given in Figs. 176 and 177, multiplied 1,000 diameters. The illustrations represented in Fig. 177 show the parasites that cause malaria, or fever and ague. The dark bean-shaped cells are the normal blood corpuscles, and the few speckled cells are those infested with the malarial parasites. It is now believed that the mosquito is the active factor in the dissemination of malaria, and it is, therefore, to be remembered that this pestiferous little insect not only inflicts a painful and disagreeable sensation with his puncture, but innoculates the system with poisonous malarial germs at the same time.
FIG. 177.—BLOOD OF MAN. SHOWING PARASITE OF MALARIA (LAVERAN).
(Photo-Micrographs, 1,000 diam., by William M. Gray, M. D.)
TERTIAN FORM.
AESTIVO-AUTUMNAL FORM.
FIG. 177.—BLOOD OF MAN. SHOWING PARASITE OF MALARIA (LAVERAN).
(Photo-Micrographs, 1,000 diam., by William M. Gray, M. D.)
FIG. 178.
TUBE CONTAINING CULTURE OF BACILLI OF TUBERCULOSIS.
TUBE CONTAINING CULTURE OF COMMA BACILLI OF CHOLERA.
TUBE CONTAINING CULTURE OF BACILLI OF TUBERCULOSIS.
TUBE CONTAINING CULTURE OF COMMA BACILLI OF CHOLERA.
FIG. 178.
For the study of bacteria they are propagated artificially in a test tube—i. e., a substance called a “culture” is prepared from some organic material which, like the substances of the human body, is favorable to their propagation. Such culture media are found in beef blood, gelatine, beef extracts, meat broth, milk, etc. An ordinary test-tube is supplied with some of the culture medium, and is then sterilized over the fire to destroy all interfering germs. Material infected with the microbe is then placed in the test-tube by a sterilized platinum wire and the tube closed by raw cotton. It is then placed in an incubator oven and is subjected to a gentle heat. In a little while the microbes begin to develop and increase, forming colonies, in which they swarm by the million, and present the clotted appearance seen in Fig. 178. The separation of different bacteria existing in the same material, so as to isolate each species and get what is called a “pure culture,” has been greatly promoted by Prof. Koch’s method of plate culture. In this the propagation of bacteria is effected upon a sterilized glass plate under a bell jar in such a thin layer as to facilitate the segregation of species, enabling them to be counted under the microscope and picked out and sown in another culture to get an unmixed crop of a definite species. Such a culture so multiplies the same microbe, to the exclusion of others, as to permit it to be easily identified and studied.
According to the practice in modern municipal health regulations, the test as to when a child recovering from diphtheria is incapable of disseminating the disease is by test culture. A swab of cotton is rubbed against the interior walls of the child’s throat to secure the germs (if present), and the swab is then placed in a “culture” in a test-tube and the tube put in an incubator. If, after the period of incubation, no colonies of the germs develop, it is accepted as evidence that the diphtheria germs are no longer present in the throat, and the child is released from quarantine.
It is the presence of these specific microbes in the fluids or solids of the system which constitutes the disease, and for the cure of the same the intelligent physician of to-day looks less to medication, and more for some agent that will destroy the germ, neutralize its effect, or render the body tolerant thereto. Out of the knowledge of disease germs has grown the great era of antiseptic surgery, inaugurated by Sir Joseph Lister, about 1865. Carbolic acid, the bichloride of mercury, and formalin are the most efficient weapons against the dreaded microbe. To-day every surgeon in the civilized world sterilizes his knife, and conducts the treatment of wounds and all operations by antiseptic methods, in accordance with a knowledge of the deadly influence of the ubiquitous microbe, and the result has been to so reduce the risk to life that even capital operations are no longer coupled with the apprehensions of death. Every hospital, board of health, and organized medical and sanitary body predicates its laws and modes of treatment upon the principles of bacteriology.
House Sanitation.—The permanent home of the microbe is the sewer, and sanitary plumbing, designed to exclude from the house the germ-laden and disease-breeding gases from the sewer, constitutes one of the great advances of the century. About 3,500 patents have been granted for water closets and bath appliances, and about 900 patents on sewerage alone, the most of which are directed to improved conditions of sanitation.
An illustration of the plumbing and sewer connections of a modern house is given in Figs. 179 and 179A. The sewer pipes are shown in solid black, the unshaded pipes (in outline only) are air ventilation pipes, the single black lines are cold water pipes, and the dotted lines hot water pipes. The important sanitary feature in modern plumbing is to keep all sewer gas and disease germs out of the house. For this purpose traps have long been used under the wash basins, closet hoppers, and sinks; but the back pressure of sewer gas would sometimes bubble through the trap into the house, and besides the water in passing out from a basin would sometimes, by a siphon effect, pass entirely out of the trap, leaving it unsealed. Both these results are prevented by the air ventilation pipes which connect with the discharge side of every trap in the house and lead to a stack extending out through the roof. This prevents pressure of sewer gas on the water seal of the trap, destroys the siphon action of the trap and allows a circulation of air to be taken in from the sidewalk on the house side of the running trap and through the sewer pipe of the house, and thence through the air vent pipes to the roof.
The great science of bacteriology, dealing with these smallest of living things, only came into existence with the microscope, and it was a field which was not only wholly unknown and unexplored a few years ago, but there was no suggestion visible to the eye to direct attention to it, until the lens began to reveal the secrets of microcosm. What development the future may bring no one can predict, but to the biologist and the physician no more promising field exists. Certain it is that the knowledge already gained is of incalculable benefit, and constitutes one of the greatest eras of progress the world has known, for with the noble army of patient, devoted, and self-sacrificing physicians, the discoveries of the scientist, our boards of health, our hospitals and asylums for the insane, our quarantine laws, our modern plumbing and improved sanitation in the home and public departments, there is no reason why the life of man should not be extended far beyond the three-score and ten years, and the 50 per cent. of population dying in childhood saved for useful lives and citizenship.