Largely stimulated by a study of the professional career of Hahnemann, the circumstances surrounding his discovery and promulgation of the “Simili Principle in Medicine,” I became interested in the effect on science generally, and on medicine in particular, of discoveries accidentally or incidentally made.
Although chance or luck seems to play an important part in such discoveries, the fact that the observer has the mentality to comprehend their significance is the important thing. Similar observations by an untrained individual would likely pass unnoticed. Even though such occurrences are not anticipated, the comprehension of their importance removes the discovery from the category of sheer luck, coincidence or chance.
Soon I learned that my interest in such things was shared by others. The late Walter B. Cannon, former Professor of Physiology at Harvard University, produced a monograph, “The Way of an Investigator.” From this work I learned that there exists a word designating such accidental observations. The word is SERENDIPITY.
Serendipity was coined by Horace Walpole in 1754, and suggested after he had read a fairy tale entitled, “The Three Princess of Serendip.” Serendip, according to Cannon, is the ancient name of Ceylon. The story goes on to state that, “as their highnesses (the three princes) travelled, they were always making discoveries, by accident or sagacity, of things they were not in quest of.” Walpole suggested that SERENDIPITY be added to our vocabulary and Webster gives as its definition, “The gift of finding valuable or agreeable things not sought for.”.
Alton Ochsner+ The William Henderson, Professor of Surgery and Head of Department of Surgery, School of Medicine, Tulane University of Louisiana. of the Ochsner Clinic in New Orleans has been equally interested in these matters. I wish to give full credit to this author from whose works I have borrowed and quoted quite freely. In Ochsners words: The Influence of Serendipity on Medicine Jerome Cochran Lecture. “No reading is more stimulating than stories of accidental discoveries and their influence upon medical science. Often more amazing than tales of fiction and more exciting than fairy legends are these happenings in real life.”.
Let me remind you of a few examples:.
The Archimedian Principle- Tradition has bequeathed to us the intriguing account of Archimedes, Greek inventor and mathematician, who noted water overflowing as he stepped into his bath. The thought that struck him, as he ran home naked, crying, “Eureka I have found it” was the hydrostatic principle which bears his name a body immersed in a liquid sustains an upward pressure equal to the weight of the liquid displaced.
The Musical Scale and the Mathematics of Acoustics In the writings of Hippocrates, the father of medicine, we find many evidences of the strange and the unusual. Pythagoras. Greek philosopher, is said to have thought of the musical scale upon passing a blacksmiths shop and hearing the hammer strike the anvil, and later introduced the mathematics of acoustics.
The Law of Motion- There are the timeworn tales of Galileo, father of mathematics, watching the swaying lamps in the Cathedral of Pisa, envisioning the laws of motion.
There are many of these interesting stories to be told and as many Princes in the Realm of Serendip. There was the accidental discovery of America when Columbus was seeking a short route to the East; James Watt, as a youth, noting the possibility of the steam engine as he watched the tea kettle lid rise and fall; and of Sir Isaac Newton, observing the falling apple and introducing the theory of gravitation.
Galvanism In the 1780, in the city of Bologna, electrophysiology originated in the home of Aloiso Galvani. His fair wife Lucia, was not in good health and a diet of frogs legs was prescribed for her. The frogs legs were suspended by a copper wire from an iron balustrade and when, as a result of swinging in the breeze, they touched the iron, violent convulsions of the muscles were noted. Galvani set about to learn the cause of this reaction. His elaborate studies and experiments resulted in the description of galvanism. Volta, his contemporary, later analyzed this current and these were the chance beginnings of our knowledge of animal electricity.
The Father of Modern Surgery- Ambroisia Pare, who lived in the 16th century, quite by accident discovered that simple dressings were better for gunshot wounds than the timeworn cauterization with boiling oil which was the accepted method of the time.
“Following a heavy engagement in which there were many casualties, the supply of boiling oil ran out. At last my oil was used up and I was constrained to apply in its place a digestive made of yolks of eggs, oil of roses and turpentine. That night I could not sleep, fearing the effect on the poor patient.” The results were astonishing no inflammation and no swelling, obviously a superior method of wound treatment had been discovered.
Digitalis in Therapeutics There is a delightful story of a country doctors, William Withering, who knew a family of farmers in his native Shropshire who were very successful in treating dropsy with a secret concoction of herbs.
Withering was a skilled botanist. He found that the active ingredient used was the flower of the purple fox-glove, digitalis. Witherings monograph “An Account of the Fox-glove” is considered a medical masterpiece. Dropsy had been considered a primary disease until this physician showed it could be due to cardiac irregularities. Here again was an incidence of finding “valuable or agreeable things not sought for.”.
The Stethoscope (Auscultation and Percussion) Various legends are attached to the origin of the stethoscope. The shy and brilliant young French physician, Theophile Laennec, was quite disturbed that he could not properly examine the chest in the case of a robust young woman, in fact of many of his patients.
One day while walking through the Gardens of the Louvre, he noticed a youth tapping the end of a long beam while his companions at the opposite end had their ears pressed close to the beam to receive the sound travelling along this make-shift telephone.
Immediately he grasped the principle and hurried to the Necker Hospital, rolled a piece of paper into a cylinder and applied it to the chest of his patient.
Thus, in 1816, the stethoscope was born. Auscultation became practical to the crowning glory of physical diagnosis.
Fifteen years before, Leopold Auenbrugger, a young Austrian physician, had applied the “tapping system” or percussion, to the body because he had observed that innkeepers were able to determine how full beer kegs were by tapping the surface of the keg.
Puerperal Fever Ignaz Semmelweiss, a young Hungarian, died in 1865 at the age of 47, a victim of the disease he had clarified for the profession. In that day, from 10-30 per cent of mothers attended by medical students and doctors died, whereas, strangely enough, the mortality was only 3 per cent in the division of the hospital where midwives attended the patients. Semmelweiss was puzzled by this discrepancy. He studied the problem unceasingly, attended post-mortems of the dead women, but found no explanation.
A friend and co-worker died of blood poisoning which had been contracted while performing an autopsy upon a mother dead of childbed fever. Semmelweiss noted the similarity of the pathologic changes in his friends body and those dying from puerperal fever. He became convinced that puerperal sepsis was contagious and that it was carried from the autopsy room to the delivery room by the hands of the students and instructors. When he ordered scrubbing of the hands with soap, water and nail brush followed by disinfection with chloride of lime, the mortality rate showed a spectacular fall.
Semmelweiss was persecuted for preaching this doctrine. It would seem that persecution of its own is a thing which the medical profession has always been able to perform quite thoroughly, if not always judiciously.
The Etiological Factor in Scabies- In this instance it was a student, F. Rennuci, a pupil in the class of the famous dermatologist, Baron Aliberti, of Paris, who made the contribution. Rennuci persisted to argue in spite of an obstinant teacher that “all the old women in Corsica, my country, know the cause, and they know how to cure the itch.”.
He recalled to his superiors how the old women would prick the skin of their fingers and remove a little red spider or insect and following this the itch would disappear. Finally Rennuci was permitted t o demonstrate the validity of this theory and thus the etiologic factor in scabies was proved.
Vaccination against Smallpox- It was a milkmaid who, in 1768, said to the famous Edward Jenner, “I cannot take smallpox, because I have had the cowpox.” Jenner never forget this remark and later mentioned it to his teacher, John Hunter, the great English surgeon, explaining that this was an idea prevalent among the farmers and dairy maids in his native Gloucestershire. Considerable experimentation followed and in 1786, opportunity came. According to Jenners own words:.
