11 January 1887, the day medicine changed: Joseph Grancher's defense of Pasteur's treatment for rabies

Bulletin of the History of Medicine

Volumn 76, Issue 4, 2002, Pages 698-718

  Gelfand, Toby ^a  

^a NONE

Author keywords

Clinical medicine; French National Academy of Medicine; Joseph Grancher; Louis Pasteur; Michel Peter; Nineteenth century Paris; Rabies

Indexed keywords

RABIES VACCINE;

ARTICLE; FRANCE; HISTORY; HUMAN; RABIES;

HISTORY, 19TH CENTURY; HUMANS; PARIS; RABIES; RABIES VACCINES;

EID: 0036884578     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.2002.0176     Document Type: Article

References (97)

1. Emile Roux, "L'oeuvre médicale de Pasteur," Agenda du chimiste, 1896, pp. 1-29, on p. 22. The converse also applied, at least in the apprehensions of Pastorians-namely, that a failure on rabies would discredit their medical program. Roux noted in a letter to Pasteur near the outset of the Academy of Medicine debate: "Dans l'état des esprits et de l'opinion un accident nouveau serait absolument fatal" (Roux to Pasteur, 12 January 1887, Pasteur Papers [PP], Nouvelles Acquisitions Françaises [NAF] 18106, Bibliothèque Nationale de France, Paris, France).
2. It is a moot point whether the Pasteur treatment for rabies should be considered "therapeutic," in the sense that treatment began after the virus of rabies had already entered the patient's body, or prophylactic, since the procedure sought to prevent the appearance of the fatal disease. In any case, both the Pastorians and their opponents considered the work to involve therapeutic aspects of clinical medicine, and I shall follow their precedent.
3. Standard accounts of Pasteur's work on rabies as a triumph of laboratory medicine may be found in the many biographies, from René Vallery-Radot, La vie de Pasteur, 2 vols. (Paris: Flammarion, 1900), to Patrice Debré, Louis Pasteur, trans. Elborg Foster (Baltimore: Johns Hopkins University Press, 1998). Gerald L. Geison, The Private Science of Louis Pasteur (Princeton: Princeton University Press, 1995), pp. 177-256, presents a more critical discussion of the problems encountered in the laboratory and the transition to clinical trials. Prior to the opening of the Pasteur Institute in 1888 the patients, beginning with Joseph Meister in July 1885, were inoculated in facilities on the Rue Vauquelin, not in the laboratory of Rue d'Ulm. Geison (Private Science, pp. 195-205) draws attention to two patients whom Pasteur briefly saw and treated just before Meister - but they remained in Paris hospitals rather than under his authority in the Vauquelin clinic. This justifies, in part, why Pasteur, privately as well as publicly, could consider Meister the first patient to undergo the full rabies inoculation procedure. For an active participant's elegant aperçu of the role of rabies in the genesis of the Pasteur Institute, sec Joseph Grancher to Pasteur, 28 March 1887 (PP, NAF 18103): "Cette pauvre rage, dont on ne voulait guère, et qui soutient tout l'édifice cependant."
4. Standard accounts of Pasteur's work on rabies as a triumph of laboratory medicine may be found in the many biographies, from René Vallery-Radot, La vie de Pasteur, 2 vols. (Paris: Flammarion, 1900), to Patrice Debré, Louis Pasteur, trans. Elborg Foster (Baltimore: Johns Hopkins University Press, 1998). Gerald L. Geison, The Private Science of Louis Pasteur (Princeton: Princeton University Press, 1995), pp. 177-256, presents a more critical discussion of the problems encountered in the laboratory and the transition to clinical trials. Prior to the opening of the Pasteur Institute in 1888 the patients, beginning with Joseph Meister in July 1885, were inoculated in facilities on the Rue Vauquelin, not in the laboratory of Rue d'Ulm. Geison (Private Science, pp. 195-205) draws attention to two patients whom Pasteur briefly saw and treated just before Meister - but they remained in Paris hospitals rather than under his authority in the Vauquelin clinic. This justifies, in part, why Pasteur, privately as well as publicly, could consider Meister the first patient to undergo the full rabies inoculation procedure. For an active participant's elegant aperçu of the role of rabies in the genesis of the Pasteur Institute, sec Joseph Grancher to Pasteur, 28 March 1887 (PP, NAF 18103): "Cette pauvre rage, dont on ne voulait guère, et qui soutient tout l'édifice cependant."
5. Standard accounts of Pasteur's work on rabies as a triumph of laboratory medicine may be found in the many biographies, from René Vallery-Radot, La vie de Pasteur, 2 vols. (Paris: Flammarion, 1900), to Patrice Debré, Louis Pasteur, trans. Elborg Foster (Baltimore: Johns Hopkins University Press, 1998). Gerald L. Geison, The Private Science of Louis Pasteur (Princeton: Princeton University Press, 1995), pp. 177-256, presents a more critical discussion of the problems encountered in the laboratory and the transition to clinical trials. Prior to the opening of the Pasteur Institute in 1888 the patients, beginning with Joseph Meister in July 1885, were inoculated in facilities on the Rue Vauquelin, not in the laboratory of Rue d'Ulm. Geison (Private Science, pp. 195-205) draws attention to two patients whom Pasteur briefly saw and treated just before Meister - but they remained in Paris hospitals rather than under his authority in the Vauquelin clinic. This justifies, in part, why Pasteur, privately as well as publicly, could consider Meister the first patient to undergo the full rabies inoculation procedure. For an active participant's elegant aperçu of the role of rabies in the genesis of the Pasteur Institute, sec Joseph Grancher to Pasteur, 28 March 1887 (PP, NAF 18103): "Cette pauvre rage, dont on ne voulait guère, et qui soutient tout l'édifice cependant."
6. Standard accounts of Pasteur's work on rabies as a triumph of laboratory medicine may be found in the many biographies, from René Vallery-Radot, La vie de Pasteur, 2 vols. (Paris: Flammarion, 1900), to Patrice Debré, Louis Pasteur, trans. Elborg Foster (Baltimore: Johns Hopkins University Press, 1998). Gerald L. Geison, The Private Science of Louis Pasteur (Princeton: Princeton University Press, 1995), pp. 177-256, presents a more critical discussion of the problems encountered in the laboratory and the transition to clinical trials. Prior to the opening of the Pasteur Institute in 1888 the patients, beginning with Joseph Meister in July 1885, were inoculated in facilities on the Rue Vauquelin, not in the laboratory of Rue d'Ulm. Geison (Private Science, pp. 195-205) draws attention to two patients whom Pasteur briefly saw and treated just before Meister - but they remained in Paris hospitals rather than under his authority in the Vauquelin clinic. This justifies, in part, why Pasteur, privately as well as publicly, could consider Meister the first patient to undergo the full rabies inoculation procedure. For an active participant's elegant aperçu of the role of rabies in the genesis of the Pasteur Institute, sec Joseph Grancher to Pasteur, 28 March 1887 (PP, NAF 18103): "Cette pauvre rage, dont on ne voulait guère, et qui soutient tout l'édifice cependant."
7. Despite withering criticism and scorn - amounting nearly to demonization from Pasteur - Dr. Michel Peter, the principal adversary of the Pastorians, emerged from the debate with his reputation as a respected clinician intact. Over the past century, however, he has shared the fate of most historical losers. His voice has been muffled, although his arguments remain clearly and forcefully articulated in the Academy's published proceedings and in the medical and lay press of the period of the debates. Obituaries at the time of his death in 1893 were generally complimentary; although, by then, Pasteur's triumph was definitive, some commentators praised Peter's caution in tempering enthusiasm for the risky initial human trials on rabies. See Le Siècle, 11 June 1893, p. 3. I have been able to locate very little in the way of unpublished writings and no personal correspondence by Peter, to whom I plan to return in another study. Serious scholarship has portrayed him almost as sterotypically as the Pasteur hagiography. See Geison, Private Science (n. 3), pp. 221-23. In two popular documentary-style film dramas, "Microbes and Men: Certain Death" (British Broadcasting Corporation, 1974) and "5 Années de Rage" (Les Films du Triangle, France 3, 1995), Peter is cast as a stock villain.
8. Despite withering criticism and scorn - amounting nearly to demonization from Pasteur - Dr. Michel Peter, the principal adversary of the Pastorians, emerged from the debate with his reputation as a respected clinician intact. Over the past century, however, he has shared the fate of most historical losers. His voice has been muffled, although his arguments remain clearly and forcefully articulated in the Academy's published proceedings and in the medical and lay press of the period of the debates. Obituaries at the time of his death in 1893 were generally complimentary; although, by then, Pasteur's triumph was definitive, some commentators praised Peter's caution in tempering enthusiasm for the risky initial human trials on rabies. See Le Siècle, 11 June 1893, p. 3. I have been able to locate very little in the way of unpublished writings and no personal correspondence by Peter, to whom I plan to return in another study. Serious scholarship has portrayed him almost as sterotypically as the Pasteur hagiography. See Geison, Private Science (n. 3), pp. 221-23. In two popular documentary-style film dramas, "Microbes and Men: Certain Death" (British Broadcasting Corporation, 1974) and "5 Années de Rage" (Les Films du Triangle, France 3, 1995), Peter is cast as a stock villain.
9. Volume 4 of Louis Pasteur, Correspondance, ed. Pasteur Vallery-Radot, 4 vols. (Paris: Flammarion, 1940-51), covers the period 1885-95 (hereafter cited as Correspondance). Letters addressed to Pasteur are in the Pasteur Papers in the manuscript collection of the Bibliothèque Nationale de France, NAF 18101-18107. Pasteur's own manuscript letters for the period 1884-87 are in NAF 18099. Given the numerous biographies of Pasteur, it is remarkable that this correspondence remains nearly untapped. Perhaps this is further evidence of the way in which the conception of Pasteur, the genius, has tended to overwhelm his contemporaries in the historical literature as much as during his lifetime.
10. Geison, Private Science (n. 3), p. 6.
11. Bruno Latour, in Les microbes: Guerre et paix; suivi de irréductions (Paris: Métallié, 1984), has brilliantly sketched the contours of the broad cultural and hygienist milieu that served to construct, and perhaps even determined, Pasteur's success. But the same sociologist of science has also reminded us how little is known in detail about the reception of the project: in Bruno Latour, "A propos de 'La science privé de Louis Pasteur'" [review of Geison], La Recherche, November 1995, 281: 35-36, he remarks: "Et pourtant l'histoire de Pasteur et de son milieu reste encore à faire." Several scholars have recently drawn attention to the problematic status of germ theory(ies) for clinicians in the United States and Great Britain: see Nancy J. Tomes, "American Attitudes toward the Germ Theory of Disease: Phyllis Allen Richmond Revisited," J. Hist. Med. Allied Sci., 1997, 52: 17-50; Anna Greenwood, "Lawson Tait and Opposition to Germ Theory: Defining Science in Surgical Practice," ibid., 1998, 53: 99-131. But in France, the historiography (Latour execpted) has generally not moved toward considering the Pastorian Revolution in terms of a contingent and negotiated project. See Anne-Marie Moulin, "Bacteriological Research and Medical Practice in and out of the Pastorian School," Clio Med., 1994, 25: 327-19.
12. Bruno Latour, in Les microbes: Guerre et paix; suivi de irréductions (Paris: Métallié, 1984), has brilliantly sketched the contours of the broad cultural and hygienist milieu that served to construct, and perhaps even determined, Pasteur's success. But the same sociologist of science has also reminded us how little is known in detail about the reception of the project: in Bruno Latour, "A propos de 'La science privé de Louis Pasteur'" [review of Geison], La Recherche, November 1995, 281: 35-36, he remarks: "Et pourtant l'histoire de Pasteur et de son milieu reste encore à faire." Several scholars have recently drawn attention to the problematic status of germ theory(ies) for clinicians in the United States and Great Britain: see Nancy J. Tomes, "American Attitudes toward the Germ Theory of Disease: Phyllis Allen Richmond Revisited," J. Hist. Med. Allied Sci., 1997, 52: 17-50; Anna Greenwood, "Lawson Tait and Opposition to Germ Theory: Defining Science in Surgical Practice," ibid., 1998, 53: 99-131. But in France, the historiography (Latour execpted) has generally not moved toward considering the Pastorian Revolution in terms of a contingent and negotiated project. See Anne-Marie Moulin, "Bacteriological Research and Medical Practice in and out of the Pastorian School," Clio Med., 1994, 25: 327-19.
13. Bruno Latour, in Les microbes: Guerre et paix; suivi de irréductions (Paris: Métallié, 1984), has brilliantly sketched the contours of the broad cultural and hygienist milieu that served to construct, and perhaps even determined, Pasteur's success. But the same sociologist of science has also reminded us how little is known in detail about the reception of the project: in Bruno Latour, "A propos de 'La science privé de Louis Pasteur'" [review of Geison], La Recherche, November 1995, 281: 35-36, he remarks: "Et pourtant l'histoire de Pasteur et de son milieu reste encore à faire." Several scholars have recently drawn attention to the problematic status of germ theory(ies) for clinicians in the United States and Great Britain: see Nancy J. Tomes, "American Attitudes toward the Germ Theory of Disease: Phyllis Allen Richmond Revisited," J. Hist. Med. Allied Sci., 1997, 52: 17-50; Anna Greenwood, "Lawson Tait and Opposition to Germ Theory: Defining Science in Surgical Practice," ibid., 1998, 53: 99-131. But in France, the historiography (Latour execpted) has generally not moved toward considering the Pastorian Revolution in terms of a contingent and negotiated project. See Anne-Marie Moulin, "Bacteriological Research and Medical Practice in and out of the Pastorian School," Clio Med., 1994, 25: 327-19.
14. Bruno Latour, in Les microbes: Guerre et paix; suivi de irréductions (Paris: Métallié, 1984), has brilliantly sketched the contours of the broad cultural and hygienist milieu that served to construct, and perhaps even determined, Pasteur's success. But the same sociologist of science has also reminded us how little is known in detail about the reception of the project: in Bruno Latour, "A propos de 'La science privé de Louis Pasteur'" [review of Geison], La Recherche, November 1995, 281: 35-36, he remarks: "Et pourtant l'histoire de Pasteur et de son milieu reste encore à faire." Several scholars have recently drawn attention to the problematic status of germ theory(ies) for clinicians in the United States and Great Britain: see Nancy J. Tomes, "American Attitudes toward the Germ Theory of Disease: Phyllis Allen Richmond Revisited," J. Hist. Med. Allied Sci., 1997, 52: 17-50; Anna Greenwood, "Lawson Tait and Opposition to Germ Theory: Defining Science in Surgical Practice," ibid., 1998, 53: 99-131. But in France, the historiography (Latour execpted) has generally not moved toward considering the Pastorian Revolution in terms of a contingent and negotiated project. See Anne-Marie Moulin, "Bacteriological Research and Medical Practice in and out of the Pastorian School," Clio Med., 1994, 25: 327-19.
15. Bruno Latour, in Les microbes: Guerre et paix; suivi de irréductions (Paris: Métallié, 1984), has brilliantly sketched the contours of the broad cultural and hygienist milieu that served to construct, and perhaps even determined, Pasteur's success. But the same sociologist of science has also reminded us how little is known in detail about the reception of the project: in Bruno Latour, "A propos de 'La science privé de Louis Pasteur'" [review of Geison], La Recherche, November 1995, 281: 35-36, he remarks: "Et pourtant l'histoire de Pasteur et de son milieu reste encore à faire." Several scholars have recently drawn attention to the problematic status of germ theory(ies) for clinicians in the United States and Great Britain: see Nancy J. Tomes, "American Attitudes toward the Germ Theory of Disease: Phyllis Allen Richmond Revisited," J. Hist. Med. Allied Sci., 1997, 52: 17-50; Anna Greenwood, "Lawson Tait and Opposition to Germ Theory: Defining Science in Surgical Practice," ibid., 1998, 53: 99-131. But in France, the historiography (Latour execpted) has generally not moved toward considering the Pastorian Revolution in terms of a contingent and negotiated project. See Anne-Marie Moulin, "Bacteriological Research and Medical Practice in and out of the Pastorian School," Clio Med., 1994, 25: 327-19.
16. Brouardel to Pasteur, 25 January 1887, PP, NAF 18102.
17. "Ce ne sont pas toujours les arguments scientifiques qui touchent le plus nos bons collègues" (ibid.).
18. Oeuvres de Pasteur, ed. Pasteur Vallery-Radot, vol. 6 (Paris: Masson, 1933), pp. 779-83, esp. p. 781 (séance of Academy, 11 January 1887) (hereafter cited as Oeuvres; all cites are from vol. 6). The facts in this case were revealed only some fifty years later by Pasteur's laboratory assistant and nephew, Adrien Loir, in "A l'ombre de Pasteur," Mouvement Sanitaire, 1937, 14: 344-48. Loir had been an eyewitness to the events. The Pasteur-Grancher correspondence discussed below hints that both men believed rabies, most likely attributable to treatment by the Pasteur method, to be the genuine cause of the child's death. They would thus have been aware of Brouardel's falsification. See below, at n. 58.
19. Oeuvres de Pasteur, ed. Pasteur Vallery-Radot, vol. 6 (Paris: Masson, 1933), pp. 779-83, esp. p. 781 (séance of Academy, 11 January 1887) (hereafter cited as Oeuvres; all cites are from vol. 6). The facts in this case were revealed only some fifty years later by Pasteur's laboratory assistant and nephew, Adrien Loir, in "A l'ombre de Pasteur," Mouvement Sanitaire, 1937, 14: 344-48. Loir had been an eyewitness to the events. The Pasteur-Grancher correspondence discussed below hints that both men believed rabies, most likely attributable to treatment by the Pasteur method, to be the genuine cause of the child's death. They would thus have been aware of Brouardel's falsification. See below, at n. 58.
20. Oeuvres de Pasteur, ed. Pasteur Vallery-Radot, vol. 6 (Paris: Masson, 1933), pp. 779-83, esp. p. 781 (séance of Academy, 11 January 1887) (hereafter cited as Oeuvres; all cites are from vol. 6). The facts in this case were revealed only some fifty years later by Pasteur's laboratory assistant and nephew, Adrien Loir, in "A l'ombre de Pasteur," Mouvement Sanitaire, 1937, 14: 344-48. Loir had been an eyewitness to the events. The Pasteur-Grancher correspondence discussed below hints that both men believed rabies, most likely attributable to treatment by the Pasteur method, to be the genuine cause of the child's death. They would thus have been aware of Brouardel's falsification. See below, at n. 58.
21. Peter launched his attack against the Pasteur treatment for rabies on 4 January 1887.
22. Brouardel to Pasteur, 25 January 1887 (n. 8): "Quant à Peter, je crois que sa punition est venue. Si on avait voté à l'académie il aurait rallié peut-être 4 ou 5 voix, mardi dernier. Aujourd'hui, surtout depuis son éloge dans le Figaro, personne ne levrait la main en sa faveur. Ce qui est vrai, c'est que nous n'étions pas dès le premier jour assez prêts à répondre. Aujourd'hui il faut nous préparer à un attaque imprévue et avoir toujours nos arguments en poche."
23. "Tout votre personnel a été admirable de dévouement. Grancher, Roux, Charrin, Chantemesse tous avaient l'ardeurs de bon chevaux qui ont senti la poudre" (ibid.). From a technical laboratory perspective, Emile Roux was the essential collaborator and, to a considerable extent, an innovator of the rabies project.
24. The Pasteur Papers, NAF 18103, contain ten manuscript letters from Grancher to Pasteur during January 1887; Correspondance has six letters from Pasteur to Grancher during that month. The total of forty-eight letters and telegrams from Grancher to Pasteur (eighty-nine folio pages) between 1885 and 1894 constitutes one of the richest collections of letters in the Pasteur papers. It exceeds that of Emile Duclaux and rivals that of Emile Roux, Pasteur's two closest collaborators over much longer periods. Roux wrote just one letter to Pasteur during the debates of January, in which he highly praised Grancher's performance at the Academy: Roux to Pasteur, 12 January 1887, PP, NAF 18106. The scene in the docudrama "Microbes and Men" (n. 4) in which Roux makes a stirring speech against Peter in the Academy is purely apocryphal: Roux, not an academician at the time, did not have speaking privileges.
25. Gerald Geison, "Pasteur, Roux, and Rabies: Scientific versus Clinical Mentalities," J. Hist. Med. Allied Sci., 1990, 45: 341-65.
26. Roux's correspondence with Pasteur reflects this reconciliation. He wrote nothing to Pasteur for nearly three years preceding a letter of 14 July 1886 discussing the application to a child of the intensive method of rabies inoculation. In a subsequent letter of 4 January 1887, he declared: "our data on the vaccination of dogs after being bitten . . . are of great importance and justify the application of the method to man" (PP, NAF 18106).
27. "Grancher est un diplomate admirable. Je crois que l'hostilité de l'Académie aurait éclaté sans l'habilité avec laquelle il a pris chacun en particulier: Si jamais je suis président de la République, je n'aurais pas d'autre ministre des affaires étrangères" (Roux to Pasteur, 12 January 1887, PP, NAF 18106). One might interpret the amusing analogy in the last sentence as Roux's conception of Grancher as his (and the Pastorians') diplomatic liaison with the medical elite, rather than as a leader in the scientific project.
28. Grancher to Vallery-Radot, 16 September 1884, PP, NAF 18110. The precise date of Granchcr's joining Pasteur's group is unclear, but it was obviously sometime prior to this letter. Adrien Loir's recollection that Pasteur first met Grancher at the Copenhagen Congress in August 1884 appears unreliable, although his charming anecdote of Grancher picking his brains about bacteriology over an excellent luncheon topped off by one of Grancher's custom-labeled Cuban cigars may be trustworthy: Loir, "A l'ombre de Pasteur" (n. 10), pp. 333-34. As early as the fall of 1883, Grancher was working at Pasteur's laboratory "à acquérir des connaissances pratiques nécessaires pour mener à bien les recherches sur la pathologie des maladies infectieuses" (Report by V. Cornil on Grancher's candidacy for the chair of internal medicine, Archives Nationales AJ 16 6310). Grancher himself recalled that he had entered the laboratory on the rue d'Ulm to learn bacteriology in 1883: Joseph Grancher, "Louis Pasteur," Annales d'Hygiène Publique et de Médecine Légale, 1895, 34: 385-400, on p. 391. The earlier dating is significant for establishing that Grancher was scarcely a neophyte in microbiology at the time he came to assist in the treatment of Joseph Meister.
29. Grancher to Vallery-Radot, 16 September 1884, PP, NAF 18110. The precise date of Granchcr's joining Pasteur's group is unclear, but it was obviously sometime prior to this letter. Adrien Loir's recollection that Pasteur first met Grancher at the Copenhagen Congress in August 1884 appears unreliable, although his charming anecdote of Grancher picking his brains about bacteriology over an excellent luncheon topped off by one of Grancher's custom-labeled Cuban cigars may be trustworthy: Loir, "A l'ombre de Pasteur" (n. 10), pp. 333-34. As early as the fall of 1883, Grancher was working at Pasteur's laboratory "à acquérir des connaissances pratiques nécessaires pour mener à bien les recherches sur la pathologie des maladies infectieuses" (Report by V. Cornil on Grancher's candidacy for the chair of internal medicine, Archives Nationales AJ 16 6310). Grancher himself recalled that he had entered the laboratory on the rue d'Ulm to learn bacteriology in 1883: Joseph Grancher, "Louis Pasteur," Annales d'Hygiène Publique et de Médecine Légale, 1895, 34: 385-400, on p. 391. The earlier dating is significant for establishing that Grancher was scarcely a neophyte in microbiology at the time he came to assist in the treatment of Joseph Meister.
30. Emile Lagrange, Monsieur Roux (Brussels: Goemaere, 1954), p. 13; and see below, n. 64. On Grancher, see Jacques Roussillat, Un patron des hôpitaux de Paris à la Belle Époque: La vie de Joseph Grancher (Guéret: Société des Sciences Naturelles et Archéologiques de la Creuse, 1989), and the same author's medical thesis: idem, "La vie et l'oeuvre du Professeur Jacques-Joseph Grancher (University of Paris, 1964).
31. Emile Lagrange, Monsieur Roux (Brussels: Goemaere, 1954), p. 13; and see below, n. 64. On Grancher, see Jacques Roussillat, Un patron des hôpitaux de Paris à la Belle Époque: La vie de Joseph Grancher (Guéret: Société des Sciences Naturelles et Archéologiques de la Creuse, 1989), and the same author's medical thesis: idem, "La vie et l'oeuvre du Professeur Jacques-Joseph Grancher (University of Paris, 1964).
32. This is amply reflected in their correspondence, where Pasteur soon added bon ami and "cher" to "docteur" in addressing Grancher, regularly sent his warm regards to Grancher's wife and mother, and made plans for their two families to spend holidays together.
33. "Je suis en possession d'une méthode très perfectionée de prophylaxie de ce terrible mal, méthode aussi sûre pour les personnes que pour les chiens" (Pasteur to Leon Say, 21 August 1885, Correspondance, p. 34); and see Pasteur to M. Liard, 22 August 1885: "une confiance de plus en plus grande dans ma nouvelle méthode" (ibid., p. 35). For detailed discussion of the complicated story of Pasteur's methods for treating rabies, see Geison, Private Science (n. 3).
34. "Je suis en possession d'une méthode très perfectionée de prophylaxie de ce terrible mal, méthode aussi sûre pour les personnes que pour les chiens" (Pasteur to Leon Say, 21 August 1885, Correspondance, p. 34); and see Pasteur to M. Liard, 22 August 1885: "une confiance de plus en plus grande dans ma nouvelle méthode" (ibid., p. 35). For detailed discussion of the complicated story of Pasteur's methods for treating rabies, see Geison, Private Science (n. 3).
35. "Je suis en possession d'une méthode très perfectionée de prophylaxie de ce terrible mal, méthode aussi sûre pour les personnes que pour les chiens" (Pasteur to Leon Say, 21 August 1885, Correspondance, p. 34); and see Pasteur to M. Liard, 22 August 1885: "une confiance de plus en plus grande dans ma nouvelle méthode" (ibid., p. 35). For detailed discussion of the complicated story of Pasteur's methods for treating rabies, see Geison, Private Science (n. 3).
36. Louise Pelletier had been severely bitten on the face and brought in for treatment too late in the incubation period of the disease. So hopeless was the case that Pasteur did not usually count her in his mortality statistics; nonetheless, he tested to make sure she had died from rabies and not from the antirabies treatment. See below, n. 29.
37. Oeuvres, pp. 627-35. For Pasteur's estimates of the mortality of untreated bites by rabid animals, see ibid., p. 619, and Pasteur to Victor Horsley, 31 August 1886, Correspondance, p. 95.
38. Oeuvres, pp. 627-35. For Pasteur's estimates of the mortality of untreated bites by rabid animals, see ibid., p. 619, and Pasteur to Victor Horsley, 31 August 1886, Correspondance, p. 95.
39. Oeuvres, pp. 627-35. For Pasteur's estimates of the mortality of untreated bites by rabid animals, see ibid., p. 619, and Pasteur to Victor Horsley, 31 August 1886, Correspondance, p. 95.
40. Pasteur to Dr. Chautemps, 8 October 1886, Correspondance, p. 111.
41. Ibid. Between September 1886 and the opening debate in the Academy of Medicine in January 1887, 12 deaths among 632 treated represented a threefold increase in mortality rate over the preceding record.
42. Pasteur to Grancher, 1 December 1886, Correspondance, pp. 124-25. The "R" in the published letter masks the identity of the child, Jules Rouyer, named in the original manuscript letter in the Pasteur papers; an editor's note in the published correspondence incorrectly substitutes the name of another patient who had died, the young man Réveillac. On the case of Rouyer, sec below, n. 36.
43. In a letter to Pasteur of 14 October 1886, Horsley had reported the patient, Smith, alias Gaffi, "en parfaite santé grâce aux soins que vous lui avez donnés" (PP, NAF 18104). Pasteur read of the death in Le Matin of 25 October and wrote to Horsley that day; Horsley's first reply was dated 27 October: Correspondance, pp. 113-14.
44. Notably with the Russian patients: on 26 August 1886 and again on 31 August, Pasteur wrote to Emile Roux urging him to intensify the treatment in the more serious cases: Correspondance, pp. 91, 93.
45. PP, NAF 18019, fol. 66 (emphasis added). On this case, sec Geison, Private Science (n. 3), pp. 195-98. After the death of Louise Pelletier, Pasteur inoculated autopsy material into rabbits: a longer incubation period (14 days as opposed to 7) before the appearence of rabies indicated that she had died from the bite, not the treatment. Sec Oeuvres, pp. 617-18.
46. PP, NAF 18019, fol. 66 (emphasis added). On this case, sec Geison, Private Science (n. 3), pp. 195-98. After the death of Louise Pelletier, Pasteur inoculated autopsy material into rabbits: a longer incubation period (14 days as opposed to 7) before the appearence of rabies indicated that she had died from the bite, not the treatment. Sec Oeuvres, pp. 617-18.
47. Horsley to Pasteur, 27 and 29 October 1886, PP, NAF 18104. In a third letter, on 2 November, Horsley repealed tbat the experimental rabbits inoculated with the dead man's spinal cord showed "all the signs characteristic of the death that follows your inoculations" (ibid.). Horsley's first letter, written after the autopsy of the patient but before the experiment, made the diagnosis of Landry's paralysis; at that point lie still claimed that the disease had been "causée sans dovite par le froid, car il fut trempé presqu'aux os sur le bateau en revenant de Paris et les symptômes commencèrent de cet moment."
48. Pasteur to Horsley, 4 November 1886, Correspondence, p. 118.
49. Joseph Grancher, Leçon d'ouverture. Clinique des maladies des enfants (Paris: Alcan-Lévy, 1885), pp. 10-15.
50. Grancher to Pasteur, 27 November 1886, PP, NAF 18103.
51. Ibid.
52. Pasteur to Grancher, 1 December 1886, Correspondence, p. 125.
53. "Je suis toujours sous le coup de la mort de cet enfant et votre lettre d'hier concernant son autopsie ne l'a pas aggravé, car dès le premier jour la fatale vérité m'a apparu" (Pasteur to Grancher, 4 December 1886, Correspondence, pp. 125-26). In a portion of this letter not included in the published correspondence, Pasteur reviewed the series of inoculations in Rouyer's treatment, wondered "what mistake was made [quelle faute a été commise]," and concluded that it was "faulty treatment from the outset followed by excessive [treatment] for a simple and not serious bite [mauvais traitement du début et ensuite exagération et pour morsure plus que simple et sans gravité]" (PP, NAF 18099, fol. 320). Both this letter and that of 1 December bear blue pencil marks suggesting their importance for Pasteur. Pasteur's tone suggests that he believed the child had died from the treatment. Grancher's letter of the preceding day, mentioned by Pasteur as giving an account of the autopsy, is inexplicably missing from his correspondence in the Pasteur papers.
54. "Bref nous sommes conduits par les faits à un traitement intermédiaire entre l'ancien, évidemment insuffisant, et l'intensif d'août, septembre et octobre parfois dangereux" (Pasteur to Grancher, 4 December 1886, Correspondence, p. 126). On 6 January 1887, Pasteur wrote to Victor Horsley: "Depuis le fait de Goffi, nous avons supprimé, dans nos inoculations, l'emploi des moelles très virulentes en conservant toutefois les traitements répétés" (ibid., p. 144).
55. "Bref nous sommes conduits par les faits à un traitement intermédiaire entre l'ancien, évidemment insuffisant, et l'intensif d'août, septembre et octobre parfois dangereux" (Pasteur to Grancher, 4 December 1886, Correspondence, p. 126). On 6 January 1887, Pasteur wrote to Victor Horsley: "Depuis le fait de Goffi, nous avons supprimé, dans nos inoculations, l'emploi des moelles très virulentes en conservant toutefois les traitements répétés" (ibid., p. 144).
56. Pasteur to Grancher, 1 December 1886, Correspondance, p. 125.
57. Grancher to Pasteur, 3 January 1887, PP, NAF 18103. See also Grancher to Pasteur, 9 December 1886, in which he asked Pasteur for data on patients, including "the names of all those bitten who succumbed in spite of the treatment"; he described a statistical table for Pasteur to complete that he would pass on to a friendly surgeon; and he asked Pasteur for a letter in reply to Italian critics or, "si vous le voulez, émanée du laboratoire et signée de moi" (ibid.).
58. Grancher to Pasteur, 3 January 1887 (n. 39).
59. The debates over rabies during the first half of 1887 were published at the time in the Bulletin de l'Académie de Médecine and are reproduced in Oeuvres, pp. 761-859; see pp. 761-67 for the the debate of 4 January.
60. Ibid., p. 786. In fact, a few years earlier, Peter had ridiculed a microbial expanation of infectious diseases during discussions at the Academy of Medicine concerning the etiology of typhoid fever. This marked his first direct hostile confrontation with Pasteur. See Bulletin de l'Académie de Médecine, 1883, 20 and 27 March, pp. 357-79 and 395-116.
61. Ibid., p. 786. In fact, a few years earlier, Peter had ridiculed a microbial expanation of infectious diseases during discussions at the Academy of Medicine concerning the etiology of typhoid fever. This marked his first direct hostile confrontation with Pasteur. See Bulletin de l'Académie de Médecine, 1883, 20 and 27 March, pp. 357-79 and 395-116.
62. Oeuvres, p. 784.
63. Gruncher to Pasteur, 6 January 1887, PP, NAF 18103. In a letter of 9 January to Grancher, Pasteur repeated: "Everything you want to do has my approval [Approuve lout ce que vous ferez]" (Correspondance, p. 146; emphasis in original).
64. Oeuvres, pp. 767-68.
65. Grancher to Pasteur, 7 January 1887, PP, NAF 18103.
66. "J'avais bien préparé le terrain, et les rôles avaient été ainsi distribués: ma communication; le rapport de Brouardel sur l'affaire Rouyer; discours et rapport de Beaumetz sur l'affaire Réveillac; en réserve, Vulpian et Chauveau qui m'avaient promis, de prendre la parole, et Vulpian le prendra: la prochaine séance" (Grancher to Pasteur, 12 January 1887, ibid.).
67. "Je n'ai pas pensé que le débat doit commencer par la lecture de votre lettre. Elle doit le clore. Elle est juste, mais dure votre lettre, mon cher maître et le sentiment de l'Académie étant pour vous absent et souffrant, contre Peter, il ne fallait pas changer les bonnes dispositions morales de l'Assemblée et commencer le débat par une condamnation - venue de Bordighera" (ibid.). Grancher further expressed his apprehension that offensive tactics might have backfired if Peter had had further damaging revelations of case histories: "et puis, quels documents avaient M. Peter?, si la discussion allait tourner mal? Avant de trancher dans le vif, il valait mieux attendre" (ibid.). Pasteur's note to the Academy is reproduced in Correspondance, p. 147. In the accompanying letter of 9 January 1887 to Béclard, the secretary of the Academy of Medicine (incorectly identified as addressed to Vulpian in Correspondance, p. 146 n. 2), he stated that he thought his note should be read first, before Grancher's presentation, but then he added: "Je subordonne toutefois mon jugement à celui du Dr Grancher" (ibid., p. 148).
68. "Je n'ai pas pensé que le débat doit commencer par la lecture de votre lettre. Elle doit le clore. Elle est juste, mais dure votre lettre, mon cher maître et le sentiment de l'Académie étant pour vous absent et souffrant, contre Peter, il ne fallait pas changer les bonnes dispositions morales de l'Assemblée et commencer le débat par une condamnation - venue de Bordighera" (ibid.). Grancher further expressed his apprehension that offensive tactics might have backfired if Peter had had further damaging revelations of case histories: "et puis, quels documents avaient M. Peter?, si la discussion allait tourner mal? Avant de trancher dans le vif, il valait mieux attendre" (ibid.). Pasteur's note to the Academy is reproduced in Correspondance, p. 147. In the accompanying letter of 9 January 1887 to Béclard, the secretary of the Academy of Medicine (incorectly identified as addressed to Vulpian in Correspondance, p. 146 n. 2), he stated that he thought his note should be read first, before Grancher's presentation, but then he added: "Je subordonne toutefois mon jugement à celui du Dr Grancher" (ibid., p. 148).
69. "Je n'ai pas pensé que le débat doit commencer par la lecture de votre lettre. Elle doit le clore. Elle est juste, mais dure votre lettre, mon cher maître et le sentiment de l'Académie étant pour vous absent et souffrant, contre Peter, il ne fallait pas changer les bonnes dispositions morales de l'Assemblée et commencer le débat par une condamnation - venue de Bordighera" (ibid.). Grancher further expressed his apprehension that offensive tactics might have backfired if Peter had had further damaging revelations of case histories: "et puis, quels documents avaient M. Peter?, si la discussion allait tourner mal? Avant de trancher dans le vif, il valait mieux attendre" (ibid.). Pasteur's note to the Academy is reproduced in Correspondance, p. 147. In the accompanying letter of 9 January 1887 to Béclard, the secretary of the Academy of Medicine (incorectly identified as addressed to Vulpian in Correspondance, p. 146 n. 2), he stated that he thought his note should be read first, before Grancher's presentation, but then he added: "Je subordonne toutefois mon jugement à celui du Dr Grancher" (ibid., p. 148).
70. "Une guerre de partisans ou, si vous aimez mieux, une guerre de petits papiers" (Grancher to Pasteur, 7 January 1887, PP, NAF 18103).
71. Ibid.
72. Oeuvres, p. 769.
73. Ibid.
74. Grancher to Pasteur, 6 and 7 January 1887, PP, NAF 18103.
75. Grancher to Pasteur, 11 January 1887, ibid.
76. Grancher to Pasteur, 12 January 1887, ibid. Grancher began his detailed four-page letter: "La première journée, (car il y en aura une seconde et peut-être une troisième) tourné bien; et les partisans de M. Peter, qui se rengorgaient en entrant dans la salle, ont bientôt baissé le nez, puis filé un à un" (ibid.).
77. Joseph Grancher, "M. Pasteur et la médecine contemporaine," Archives de Médecine Expérimentale et d'Anatomie Pathologique, 1894, 6: 121-50, quotation on p. 140; see especially pp. 139-41. Grancher first presented this paper in a public lecture on 18 November 1893, and it was initially published in the Revue Scientifique, 1893, 52: 673-85. Pasteur's medical adversaries, other than Michel Peter, were not named by Grancher. Examination of earlier debates in the Academy of Medicine would shed light on this poorly researched subject. 57. Grancher to Pasteur, 12 January 1887, PP, NAF 18103.
78. Joseph Grancher, "M. Pasteur et la médecine contemporaine," Archives de Médecine Expérimentale et d'Anatomie Pathologique, 1894, 6: 121-50, quotation on p. 140; see especially pp. 139-41. Grancher first presented this paper in a public lecture on 18 November 1893, and it was initially published in the Revue Scientifique, 1893, 52: 673-85. Pasteur's medical adversaries, other than Michel Peter, were not named by Grancher. Examination of earlier debates in the Academy of Medicine would shed light on this poorly researched subject. 57. Grancher to Pasteur, 12 January 1887, PP, NAF 18103.
79. Ibid, (emphasis added). Grancher's use of "naturally" in this context suggests Pasteur's complicity in the concealment orchestrated by Brouardel, a complicity not mentioned in Adrien Loir's reconstruction of the Rouycr Affair. See Loir, "A l'ombre de Pasteur" (n. 10), pp. 344-48. Peter vigorously disputed the attribution of the child's death to uremia by pointing out that this clinical state was entirely compatible with rabies.
80. Pasteur to Grancher, 14 and 16 January 1887, Correspondance, pp. 148, 151. Pasteur tacitly agreed with his entourage that his absence from Paris favored their cause. The Pasteur Papers are replete with correspondence praising Cruncher's key role in defending the rabies project: see Roux to Pasteur, 12 January 1887, NAF 18106; Loir to Vallery-Radot, 11 January 1887, NAF 18110; Béclard to Pasteur, 18 January 1887, NAF 18101; Vallery-Radot to Grancher, 15 January 1887, NAF18110; Georges Daremberg to Grancher, 21 January 1887, NAF 18110. Nearly a month before the debate in the Academy, Vallery-Radot wrote to Grancher from Bordighera: "C'est sur vous que tout repose, mais quel lourd fardeau et que de fois M. Pasteur se reproche de l'avoir mis sur vos épaules! Sa reconnaissance et la nôtre, mon bien cher ami, sont presque à la hauteur de votre dévouement" (20 December 1886, NAF 18110).
81. In a face-to-face encounter on 5 July 1887, Pasteur declared that he considered Peter incompetent as a clinician as well as an experimentalist to judge the efficacy of his method: Oeuvres, pp. 834-35. On 12 July, Peter responded to Pasteur's charge against his abilities as an experimental scientist by pointing out that 99 percent of his colleagues at the Academy of Medicine shared this disadvantage; on the other hand, he defended his clinical judgment over a career spanning thirty-five years: ibid., pp. 837-38.
82. In a face-to-face encounter on 5 July 1887, Pasteur declared that he considered Peter incompetent as a clinician as well as an experimentalist to judge the efficacy of his method: Oeuvres, pp. 834-35. On 12 July, Peter responded to Pasteur's charge against his abilities as an experimental scientist by pointing out that 99 percent of his colleagues at the Academy of Medicine shared this disadvantage; on the other hand, he defended his clinical judgment over a career spanning thirty-five years: ibid., pp. 837-38.
83. Ever cautious, Grancher wrote following the 11 January debate: "J'espère que nous sommes à l'abri, fort heureusement mais qui sait!" (Grancher to Pasteur, 14 January 1887, PP, NAF 18103). Echoing Pasteur, he also adopted a more belligerent tone, perhaps to allay suspicions among the Pastorians that he might be favorably inclined toward Peter, a senior hospital colleague with whom he had had friendly relations: "votre cause est bonne et triomphera - mais ce n'est pas assez - il faut que vos adversaires - M. Peter surtout sorte de là méprisé" (Grancher to Pasteur, 12 January 1887, ibid.). Roux wrote to Pasteur on 12 January in a similar vein: "L'alerte a été chaude. La leçon ne sera pas perdue" - and on Peter, "En restant dans les faits il était genant, en se lançant dans les interprétations il devient ridicule" (PP, NAF 18106).
84. Roux to Pasteur, 12 January 1887, PP, NAF 18106 (n. 17).
85. See above, n. 53.
86. I depart here from Gerald Geison's reification of Emile Koux's supposed "clinical mentality" to explain Roux's disagreement with Pasteur's rabies programme; see Geison, "Pasteur, Roux, and Rabies" (n. 15). Not only was Roux solidly in support of Pasteur (and Grancher) prior to and during the Academy debate but, as mentioned above, Roux was a laboratory man, not a clinician. Grancher recollected in 1893 that the defenders behind the scenes of Pasteur's rabies method during his absence from Paris had been "Roux et moi" (Grancher, "M. Pasteur" [n. 56], p. 140). Only André Chantemesse (in his mid-thirties at the time of the rabies debate), or possibly Isidore Straus (then in his mid-fifties), could have rivaled, if not matched, Grancher's dual qualifications - but neither shared his experience with or interest in rabies.
87. Grancher to Pasteur, 20 September 1892, PP, NAF 18103. For general discussion of Pasteur's lack of any trace of the cautious and conservative modes of reasoning often associated with clinical practice, see Gcison, "Pasteur, Roux, and Rabies" (n. 15).
88. Grancher to Vallcry-Radot, 27 August 1888, PP, NAF 18103. See also Grancher to Pasteur, 15 September 1888, ibid.; Joseph Grancher, "La rage et sa prophylaxie," Reuve Scientifique, 1886 (10 July), 23:33-39, esp. p. 36.
89. Pasteur to Vulpian, 22 January 1887 [marked "not sent"], PP, NAF 18099. Correspondance, p. 154 n. 2, states that this letter to Vulpian was "not found." This lone trace of correspondence between the two men suggests that Vulpian's working relationship with Pasteur was marginal, apart from the famous consultation (along with Grancher) on Joseph Meister's treatment. After Vulpian's lengthy speech on 18 January 1887 at the Academy of Medicine, glorifying Pasteur and denouncing Peter, Grancher commented: "M. Vulpian a été très passionné, trop passionné même, et ses excellents arguments ont perdu un peu de leur force noyés dans une plaidoyer sentimentale et patriotique" (Grancher to Pasteur, 19 January 1887, PP, NAF 18103). Grancher's critique is particularly telling, since he had indicated in previous letters to Pasteur (12 and 14 January) that he was preparing the "excellent arguments" for Vulpian's speech.
90. Pasteur to Vulpian (n. 67). Pasteur's misent letter consisted of precisely the kind of vituperative attack on Peter that Grancher wished to avoid in the Academy, and for which he criticized Vulpian.
91. Latour, Les microbes (n. 7), esp. pp. 130-52.
92. Grancher to Pasteur, 26 January 1887, PP, NAF 18103.
93. "Toutes les relations, telles réflexions et tontes les influences politiques et autres de ce journal seront à nous... .je suis naturellement gros actionnaire" (ibid.).
94. Grancher, "M. Pasteur" (n. 56), p. 150. For Pasteur's appreciation of this tribute, see Pasteur to Grancher, 1 March 1894, Correspondance, p. 352.
95. Grancher, "M. Pasteur" (n. 56), p. 150. For Pasteur's appreciation of this tribute, see Pasteur to Grancher, 1 March 1894, Correspondance, p. 352.
96. Grancher, "M. Pasteur" (n. 56), p. 150.
97. Grancher to Pasteur, 7 December 1886, PP, NAF 18103.