CHAPTER I

ESSAYS IN MEDICAL SOCIOLOGY

ESSAYS

IN

MEDICAL SOCIOLOGY

BY

ELIZABETH BLACKWELL, M.D.

_VOLUME II._

LONDON

ERNEST BELL, YORK STREET

COVENT GARDEN

1902

CONTENTS OF VOL. II.

ESSAY PAGE

I. THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE 1

II. ERRONEOUS METHOD IN MEDICAL EDUCATION 33

III. WHY HYGIENIC CONGRESSES FAIL 47

APPENDIX 85

IV. SCIENTIFIC METHOD IN BIOLOGY 87

V. CHRISTIAN SOCIALISM 151

VI. ON THE DECAY OF MUNICIPAL REPRESENTATIVE GOVERNMENT 173

VII. ADDRESS DELIVERED AT THE OPENING OF THE WOMEN’S MEDICAL

COLLEGE, NEW YORK 197

VIII. THE RELIGION OF HEALTH 211

THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE

_Address given at the Opening of the Winter Session of the London

School of Medicine for Women, October, 1889_

THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE

In the short time that we meet together to-day I will ask you to let

me dwell upon the way in which the most beneficial influence of women

in the medical profession may be exercised. I wish also to point out

certain dangers, as well as advantages, with which medical study is now

surrounded.

The avenues by which all may enter into the profession are now so much

more widely thrown open that there is little difficulty in the way of

any man or woman who may wish to acquire a legal right to practise

medicine. In Paris all the public medical institutions, both college

and hospital, are thrown open to students without distinction of sex.

Not only as ordinary students, but as internes and externes, sex is no

longer regarded there as a barrier to opportunity and position. The

democratic principle is everywhere steadily gaining ground, and the

individual allowed to try his strength in the great battle of life.

Large numbers of women are taking advantage of this wider individual

liberty to enter the medical profession. In Great Britain our

seventy-three registered lady-doctors are few compared with the 3,000

in the United States, yet the nine students who are now connected with

our London school, with, in addition, the Edinburgh classes, the Dublin

students, and the latest fact that the Glasgow Medical College has

just opened its doors to women, clearly indicate that the movement has

taken sturdy root in our country, and when our English work has been

carried on for forty years, there is every probability that our British

lady-doctors will equal numerically our kinsfolk across the ocean.

I think, therefore, that all will see the importance of considering

the future of this growing army of medical women, and I particularly

desire that our students of medicine should realize the far-reaching

character, the social effects, of this medical career which they are

entering on. It is quite certain that the wide adoption of the medical

profession by women cannot continue to be an insignificant matter; it

must exercise an appreciable effect on future society for good or evil.

If we were children entering upon a course of education, it would

be premature to take stock of the results of education, and cast a

far-seeing glance into the future.

But it is different with adult women--women of education, somewhat

impatient of restraint--entering upon a larger liberty, and

legitimately jealous of any interference with that liberty. It is

therefore imperative upon us to consider very seriously this matter of

self-guidance at the outset of medical education, to take in a large

view of future responsibility, and ask ourselves that most important

question respecting a medical training: What will be its effect?

The flippant or superficial person may at once reply: Our object is

to gain money and pursue a remunerative calling by looking after

sick people. Women find so much difficulty in honestly supporting

themselves, that it is reason enough that they can in this way do so,

and the labourer is worthy of his hire. But I say emphatically that

anyone who makes pecuniary gain the chief motive for entering upon

a medical career is an unworthy student; he is not fit to become a

doctor, and he will be a labourer not worthy of his hire. What should

be thought of a statesman who aspired to the direction of national

affairs on account of the salary of £10,000? The nobleness of motive

must enlarge with the nobleness of occupation, or the unworthy occupier

sinks to a degradation measured by the height to which his career

should have raised him.

Now, there is no career nobler than that of the physician. The

progress and welfare of society is more intimately bound up with the

prevailing tone and influence of the medical profession than with

the status of any other class of men. This exceptional influence is

not only due to the great importance of dealing with the issues of

life and death in health and disease, but it is still more owing

to the fact that the body and the mind are so inseparably blended

in the human constitution, that we cannot deal with one portion of

this compound nature without in more or less degree affecting the

other. Our ministrations to body and soul cannot be separated by a

sharply-defined line. The arbitrary distinction between the physician

of the body and the physician of the soul--doctor and priest--tends

to disappear as science advances. Every branch of medicine involves

moral considerations, both as regards the practitioner and the patient.

Even the amputation of a limb, the care of a case of fever, the birth

of a child, all contain a moral element which is evident to the clear

understanding, and which cannot be neglected without injury to the

doctor, to the individual, and to society. But probably it will be

generally agreed that the hope of gaining money must not be the primary

motive for choosing a medical career; but that interest in the line of

study and kind of life, with a perception of the wide and beneficent

influence which it can exert, should form the determining motive for

becoming a physician.

If, then, we recognise that, although just reward for honest labour is

fair, we must not enter upon medicine as a trade for getting money, but

from a higher motive, this motive, as it influences conduct, becomes on

that account a moral motive or an ideal which should guide our future

practical life as physicians. Now, this ideal necessitates a distinct

conception of what is right or wrong for us, in medicine, both as human

beings and as women. Simply sensuous life, without an ideal or without

higher principles of action than the limited needs of every day, tends

to degrade the individual and all who surround him.

What we need is a clear idea of what is really right or wrong, with the

reasons on which the judgment is based, instead of a confused notion or

a vague and ever-shifting standard.

No woman student of medicine can safely ignore this subject. It is a

vital one for us, and only a true answer to it will make our entrance

into the profession a marked advance in social progress.

I do not attempt to disguise the difficulty of laying down the law of

right and wrong in medicine; not only because medicine, as every other

part of social life, is subject to the growth of evolution, but because

in a state of society that has not yet succeeded in moulding itself on

the fundamental principles of Christianity, we are involved in faulty

social conditions which prevent us from embodying our moral perceptions

in every phase of practical life. But, remember, thought and endeavour

may live a righteous life, no matter what faulty conditions surround

us. When we have a clear view of right and wrong, we can mentally

repudiate whatever appears to violate the moral law. We can strenuously

resist the deadening force of habitual wrong-doing, and never cease the

effort to find some way of shaping our mental protest into practical

opposition to all forms of immorality.

You will see in the course of your medical studies--particularly if

you study abroad--much to shock your enlightened intellect and revolt

your moral sense. In practice also you will be subjected to strong

temptations of the most varied character. But just for the reason that

as women we ought to see more clearly the broken bridge or approaching

danger, in the onward rush of the male intellect, I now dwell on our

special responsibility, and shall endeavour to give the reasons for it.

My object is not to limit, but to enlarge our work in medicine, when

I seek to define our ideal. It is true that the great object of this

human life of ours is essentially one for every human being, man or

woman, barbarous or civilized. It is to become a nobler creature, and

to help all others to a higher human status during this brief span

of earthly life. But as variety in unity is a law of creation, so

there are infinite methods of progress, producing harmony instead of

monotony, when the individual or classes of individuals are true to the

guiding principles of their own nature.

For the ideal of every creature must be found in the relation of its

own nature to the universe around it. Right and wrong are based upon

the sound understanding of this positive foundation. It is this fact of

variety in unity, in the progress of the race, which justifies the hope

that the entrance of women into the medical profession will advance

that profession.

In order to carry out this noble aspiration, we must understand what

the special contribution is, that women may make to medicine, what the

aspect of morality which they are called upon to emphasize.

It is not blind imitation of men, nor thoughtless acceptance of

whatever may be taught by them that is required, for this would be to

endorse the widespread error that the race is men. Our duty is loyalty

to right and opposition to wrong, in accordance with the essential

principles of our own nature.

Now, the great essential fact of woman’s nature is the spiritual power

of maternity.

We should do miserable injustice to this great fact if, looking at it

with semiblind eyes, we only see the shallow material aspect of this

remarkable speciality. It is the great spiritual life underlying the

physical which gives us our true womanly ideal.

What are the spiritual principles necessarily involved in this special

creation of one-half the race--principles which lie within the material

facts of gestation and the care of infancy and childhood, which

constitute the distinctive material domain of women?

They are the subordination of self to the welfare of others; the

recognition of the claim which helplessness and ignorance make upon

the stronger and more intelligent; the joy of creation and bestowal of

life; the pity and sympathy which tend to make every woman the born

foe of cruelty and injustice; and hope--_i.e._, the realization of

the unseen--which foresees the adult in the infant, the future in the

present.

All these are great moral tendencies, and they are necessarily

involved in the mighty potentiality of maternity. They lay upon women

the weighty responsibility of becoming more and more the moral guides

in life’s journey. Women are called upon very specially to judge all

practical action as right or wrong, and to exercise influence for this

high morality in whatever direction it can be most powerfully exerted.

We see the indication of this providential inherited impulse to moral

action, in the great and increasing devotion of women to the relief of

social suffering and their sturdy opposition to wrong-doing, which form

a distinguishing characteristic of our age. These spiritual mothers of

the race are often more truly incarnations of the grand maternal life,

than those who are technically mothers in the lower physical sense.

With sound intellectual growth the range of moral influence increases.

But such sound growth can only take place under the guidance of moral

principle; for moral perception becomes reason as the intellectual

faculties grow, and reason is the true light for all. It is in this

high moral life, enlarged by intelligence, that the ideal of womanhood

lies. It is through the moral, guiding the intellectual, that the

beneficial influence of woman in any new sphere of activity will be

felt.

Thus, from their inherited tendencies, as well as from the existent

individuality of their nature, women must seek a high moral standard as

their ideal, and acknowledge the supremacy of right over every sphere

of intellectual activity. The highest type of moral excellence which we

can find in the age in which we live, the beneficence which it exerts,

the means by which it has been attained, form so many landmarks to

guide us in our search for the right.

This very important method of growth has been well stated by Huxley,

that brave fighter in the past for freedom of thought. He has laid

down this weighty principle, that ‘the past must be explained by the

present.’

This principle is of very wide application.

What produces the noblest human creature now in our nineteenth century?

What inspires hope? What sustains us most bravely to fight the battle

of life? What makes life most worth living?

When we have ascertained these facts in the present, they will explain

the past, and give the foundations of right for guidance in the future.

It is a noteworthy feature of the present day that some of our best

men, witnessing the failure of so many panaceas for the intolerable

evils that afflict society, are longing for that untried force--the

action and co-operation of good women. ‘Our only hope is in women!’ is

a cry that may sometimes be heard from the enlightened male conscience.

But still more significant is the awakening of an increasing number of

women themselves. They begin to realize that truth comes to us through

imperfect human media, and is thus rendered imperfect; that every human

teacher must be accepted for his suggestiveness only, not as absolute

authority. Women are thus rising above the errors of the past, above

blind acceptance of imperfect authority, and are earnestly striving to

learn the will of the Creator, and walk solely according to what they

themselves, diligently seeking, can learn of that Divine will.

There is no line of practical work outside domestic life, so eminently

suited to these noble aspirations as the legitimate study and practice

of medicine. The legitimate study requires the preservation in full

force of those beneficent moral qualities--tenderness, sympathy,

guardianship--which form an indispensable spiritual element of

maternity; whilst, at the same time, the progress of the race demands

that the intellectual horizon be enlarged, and the understanding

strengthened by the observation and reasoning which will give increased

efficiency to those moral qualities.

The true physician must possess the essential qualities of maternity.

The sick are as helpless in his hands as the infant. They depend

absolutely upon the insight and judgment, the honesty and hopefulness,

of the doctor.

The fact also that every human being we are called on to treat, is,

like the infant and the child, soul as well as body, must never be

forgotten. Successful treatment requires the insight which comes from

recognition of these facts and the sympathy that they demand. In the

infinite variety of human ailments the physician will find that she

must often be the confessor of her patient, and the consulting-room

should have the sacredness of the Confessional, and she must always be

the counsellor and guide.

In those two departments of medicine which seem to me peculiarly

valuable to women physicians, which I shall refer to later--viz.,

midwifery and preventive medicine--it would be hard to say whether

the moral or intellectual qualities of the physician were called most

largely into play, so inseparably are they blended. What patience

and hopefulness also are demanded in the lingering trial of chronic

illness! What discrimination and union of gentleness and firmness these

cases require! Then think of the children in our families! To the girls

and boys, the young women and men, who grow up under our ministrations,

what an inspirer of nobleness and purity, what a guardian from

temptation the true physician can be!

Again, in the treatment of the poor, an immense demand is made upon our

pity, patience, and courage. These poor victims of our social stupidity

are often extremely trying. The faulty arrangements which compel us to

see thirty, fifty even, in an hour exhaust the nervous system of the

doctor. It requires faith and courage to recognise the real human soul

under the terrible mask of squalor and disease in these crowded masses

of poverty, and to resist the temptation to regard them as ‘clinical

material.’ The attitude of the student and doctor to the sick poor is a

real test of the true physician.

Having thus realized the profound adaptation of the nature of woman

to the practice of the Art of Healing, let us consider in what way

the intellectual faculties may be strengthened, so as to give enlarged

efficiency to the maternal qualities. In other words, how shall we

become reliable doctors?

What I have hitherto dwelt on is the necessary attitude of mind or the

atmosphere and light in which women physicians must breathe and work if

they are to attain to their distinctive efficiency; let me now refer

more particularly to the method of training for our practical work.

The intellectual training required for the physician is admirably

adapted to supply deficiencies in the ordinary experience of women.

The intellectual characteristics which must be especially gained during

student life are: the faculty of patient observation, exact statement

of what is observed, and cautious deductions from these observations.

These qualities form the foundation of sound judgment and skilful

medical practice. It is not a brilliant theorizer that the sick person

requires, but the experience gained by careful observation and sound

common-sense, united to the kindly feeling and cheerfulness which make

the very sight of the doctor a cordial to the sick. If these necessary

results of intellectual training can be secured in harmony with the

moral structure of womanhood, then a step of real social progress is

made by our study of medicine.

This necessity for making the most painstaking observation of facts,

the foundation to be laid by the student in every branch of her

studies, is well illustrated in the life of Darwin, who writes thus to

a friend: ‘I have been hard at work for the last month in dissecting

a little animal about the size of a pin’s head, from the Chronos

Archipelago, and I could spend another month and daily see more

beautiful structure.’ Of the value of this method of persistent labour,

his friend gives this noteworthy testimony: ‘Your sagacious father

never did a wiser thing than devote himself to these years of patient

toil. It is a remarkable instance of his scientific insight and courage

that he saw the necessity of proper training and did not shrink from

the labour of acquiring it.’

In medicine, anatomy, physiology and chemistry are the primary studies

where that foundation of conscientious exactitude must be laid on which

the skill of the future physician so largely depends.

The first and indispensable basis of medicine is anatomy, with which

physiology is inseparably blended; for human physiology can only

be properly studied in connection with the human structure, whose

condition in health and disease forms the direct object of our

profession. No student should be satisfied until she has most carefully

followed out the structure of every region of that human body with

whose life we shall have to deal. Careful anatomical study is the sure

and indispensable preparation for that next advanced range of clinical

observation, where pathology and therapeutics bring us into the direct

study of the sick.

The more thoroughly the human organization is investigated, the more

wonderful will the unapproachable mechanism for the use of human life

be seen to be. We shall never regret any amount of time and care spent

in acquiring the most intimate knowledge of human anatomy. For even if

we never perform a surgical operation, the thorough knowledge of the

human framework with whose aberrations we have to deal, gives a firm

foundation for practice that nothing else can supply.

The thoughtless slashing of the delicate and complicated structure

of the body, of which untrained students are sometimes guilty,

is indicative of a careless, unconscientious future physician.

If carelessness similar to what is sometimes observed in the

dissecting-room were carried on in the chemical laboratory, life

or limb would soon be sacrificed. Yet a thorough grounding in the

structure of every vital organ is more indispensable to us than

chemistry, important as the study of chemistry is. Let me here note how

the moral element on which I have so strongly insisted comes into play

in this the first of our medical studies. Reverence for this physical

structure of ours should always be shown in the use and arrangements of

the anatomical rooms. Carelessness and irreverence in this department

of study exercise a really deteriorating influence on students of

medicine. Respect for the material used, care in its disposition, and a

decent covering for each work-table in the intervals of work, may seem

small observances, but they exercise a large influence over the moral

training of the student when persistently carried out.

It does not enter into my present purpose to enlarge upon the right

method of studying each branch of medicine, for that would require a

series of discourses. But I must give an emphatic warning against the

strange neglect of _human_ physiology which I observe. This seems to

proceed from the mistaken idea that necessary knowledge can be obtained

from other organisms which bear a misleading resemblance to the human.

What I would insist upon is, that we should endeavour to make ourselves

thoroughly acquainted with the nature and variations of healthy human

physiology before we are perplexed with the changes of pathology.

Auscultation and percussion; observations of the healthy variations

of the pulse, the tongue, the skin, and the various secretions, in as

many healthy individuals, both adult and infant, as can be examined,

compared, and recorded; the vital chemistry of the human tissues and

secretions in health and disease; the modifying effects of temperament,

heredity, idiosyncrasy, etc.--all this forms a department of human

physiology, strangely neglected as a practical study, yet certainly of

primary importance to the progress of medicine.

But I must pass on to what is my immediate purpose--viz., the relation

of women to medicine. Having dwelt on the moral and intellectual

advantages of medical study, I must refer to another aspect of the

subject--viz., the dangers which meet our earnest students.

Dr. Carpenter has recorded the wide-spread recognition of this

dangerous aspect of medical study when he says: ‘There seems to

be something in the process of training students for the medical

profession which encourages in them a laxity of thought and expression

that too frequently ends in a laxity of principle and of action’;

and he further condemns the tone of some works issued by the medical

press. Now, this judgment of a very cautious teacher so many years ago,

is worthy of the most serious consideration in the present day. The

freedom of entrance now accorded to women into the medical profession,

lays a very heavy responsibility upon us, to prove that this new and

increasing movement will be a future blessing to society.

We are happy in drawing into our schools a large number of capable

women--women who may not only be a gain as physicians, but who may

exert a most beneficial influence on the profession itself, if they

bring into it fresh and independent life.

It is much to be regretted that our students are now compelled to go

abroad for the completion of their medical education, for methods of

study injurious to morality are exaggerated abroad. The abuse of the

poor as subjects of experimental investigation, in whose treatment all

decent reserves of modesty are so often stripped away; the contempt

felt for the mass of women where chastity is not recognised as an

obligatory male virtue; the atrocious cruelty of their experiments

on animals--all these results of active intellect, unguided by large

morality, as seen in full force abroad, make me deplore the necessity

which drives so many of our best but inexperienced students away, in

search of more efficient training than they can obtain at home.

The two special dangers against which I would warn our students are:

_First_, the blind acceptance of what is called ‘authority’ in medicine.

_Second_, the narrow and superficial materialism which prevails so

widely amongst scientific men.

In relation to the first point--viz., distrust of authority--although I

fully recognise the respect which is always due to the position of the

teacher, and the consideration to be shown to all who are called ‘heads

of the profession,’--I would very strongly urge you to remember that

medicine is necessarily an uncertain science.

Life in its essence we cannot grasp. We understand it only through

its effects, and all human judgment is fallible. Careful and wise

observation bring us ever nearer to a knowledge of the conditions

which are necessary for human well-being; but experience compels us

to recognise the constant failure of theory or dogmatism in dealing

with any of the infinitely varied phases of life. In medicine, we

are forced to recognise the errors in diagnosis committed even by

distinguished men, and to suffer grievous disappointment from the

failure of remedies supposed to cure the sick. We cannot fail to note

the contradictory results of experiments, the same facts differing

according to the observer--one fact upsetting another, and one theory

driven out by a later one. This uncertainty resulting from experiment,

is strikingly exemplified by the battle of experts about the effects of

arsenic displayed in a late criminal trial. Or consider the frequent

errors of statistics (a branch of knowledge that enters largely into

medical science), owing to the imperfect data on which they are often

based, important deductions being drawn from them which are logically

indisputable, but entirely false, from the unsound premisses on which

they rest. Thus, the death-rate of London, though commonly stated at

23 or 24 per 1,000, is really an unknown quantity, on account of the

enormous influx of fresh life and the efflux of broken-down lives.

Our women students especially need caution as to the blind acceptance

of authority. Young women come into such a new and stimulating

intellectual atmosphere when entering upon medical study, that they

breathe it with keen delight; they are inclined to accept with

enthusiasm the brilliant theory or statement which the active intellect

of a clever teacher lays before them. They are accustomed to accept the

government and instruction of men as final, and it hardly occurs to

them to question it. It is not the custom to realize the positive fact,

that methods and conclusions formed by one-half of the race only, must

necessarily require revision as the other half of humanity rises into

conscious responsibility.

It is a difficult lesson also, fully to recognise the limitations

of the human intellect, which recognition, nevertheless, is

necessary before we can grasp this important and positive fact in

human experience--viz., that the Moral must guide the Intellectual,

or there is no halting-place in the rapid incline to error. The

brilliant professor will always exercise an undue influence over the

inexperienced student, and particularly over the woman student. I

therefore strongly urge the necessity of cherishing a mild scepticism

respecting the dicta of so-called medical science, during the period of

student life--scepticism not in relation to truth--that noble object

which we hope to approach even more nearly--but scepticism in relation

to the imperfect or erroneous statement of what is often presented as

truth.

Of this one guiding fact, as a basis of judgment, we may be quite

sure--viz., that whatever revolts our moral sense as earnest women,

is not in accordance with steady progress; it cannot be permanently

true, and no amount of clever or logical sophistry can make it true.

It will be a real service that we, as medical women, may render to the

profession if we search out--calmly, patiently, but resolutely--why

what revolts our enlightened sense of right and wrong is not true. We

shall thus bring to light the profound reason why the moral faculties

are antecedent or superior to the intellectual faculties, and why the

sense of right and wrong must govern medical research and practice, as

well as all other lines of human effort.

As experience enlarges, we observe the immense separation in lines of

conduct which gradually results from an initial divergence between

right and wrong--a divergence almost imperceptible at first. We are

thus compelled to come to the conclusion, in relation to our own

profession, that the worship of the intellect, or so-called knowledge,

as an end in itself, entirely regardless of the character of the means

by which we seek to gain it, is the most dangerous error that science

can make. This false principle, if adopted by the medical profession,

will degrade it, and inevitably produce distrust and contempt in the

popular mind.

The second danger against which the student of medicine must guard

is the materialism which seems to arise from undue absorption in the

physical aspect of nature, and which spreads like a blight in our

profession.

The basis of materialism is the assertion that only sense is real.

Our medical studies necessarily begin with minute and prolonged study

of what we term ‘dead matter.’ If this study be carried on without

reverence, it appears to blind the student to any reality except the

material under his scalpel or in his crucible--_i.e._, the facts that

the senses reveal. Proceeding logically from this false premiss, that

only sense is real, mind is looked upon as an outcome of the brain, and

life as the result of organization of matter, which is destroyed when

the organization of the material body is broken up.

Some persons, successors of the materialistic ecclesiastics who

condemned Galileo, cannot rise beyond the gross evidence of their

senses. To such persons reason, which transcends sense, is a vague

unreality, and the clear teaching of reason may to them seem doubtful,

or superstition. But the stout fight which the old Italian nobly began,

and which has been so bravely carried on for freedom of thought in

our own day, is beginning to tell and reap a rich reward. Our senses,

so far from being the boundary of real existence, are proved to be as

untrustworthy guides now, as when Galileo’s accusers insisted that the

sun moved round the earth in twenty-four hours. The relations of our

senses to our consciousness change with biological differences, as one

creature can see what is quite invisible to another. The boundary-line

which exists between our senses and our consciousness is constantly

changing, and realities are shown to exist, of which our ordinary

consciousness connected with the senses has no knowledge. Thus, life

beyond, and independent of the senses, is being proved as positive and

pregnant fact.

The great generalizations of modern science--the Conservation of

Energy, the process of Evolution--are the products of Reason. They

are metaphysical conceptions. Like the atomic theory or the law of

gravitation, they are practical formulæ necessary to the advancement

of science from the structure of our minds but they are the results of

reason, not of sense.

Love, Hope, Reverence, are realities of a different order from the

senses, but they are positive and constant facts, always active, always

working out mighty changes in human life.

A thoughtful writer has characterized Materialism as an attempt to

explain the Universe in terms of mass and motion rather than in terms

of Intelligence, Love, and Will, and it is a true criticism. Let me

recall here the serious warning which Huxley gives to the shallow

materialist who limits existence by the senses.

He says: ‘The great danger which besets the speculative faculty is the

temptation to deal with the accepted statement of facts in natural

science as if they were not only correct but exhaustive--as if they

might be dealt with exhaustively, in the same way as propositions of

Euclid may be dealt with. In reality, every such statement, however

true it may be, is true only relatively to the means of observation

and the point of view of those who have enunciated it. Whether it will

bear every speculative conclusion that may be logically deduced from

it is quite another question.’ ‘In the complexity of organic nature

there are multitudes of phenomena which are not deducible from any

generalizations that we have yet reached; this is true of every other

class of natural objects (as the moon’s motions, gravitation, etc.).

All that should be attempted is a working hypothesis, assuming only

such causes as can be proved to be actually at work.’

These are valuable warnings from our great naturalist.

The tendency of unprejudiced science in our day is to show the

unsatisfactory character of the terms ‘matter’ and ‘spirit.’ For the

exaltation of what we term ‘matter’ tends constantly to lose itself in

what we call ‘spirit.’

Reality always transcends sense. As the vibrations of ether are only

known as light and colour, and the vibrations of the atmosphere are

translated into sound, so in the careful observation of our own mental

states, in the experiences of dream-land, in the study of clairvoyants

and somnambulists and the revelations of hypnotism, we gain an insight

into states of consciousness independent of the senses--states where

the old distinctions between matter and spirit seem to become quite

inapplicable.

One third of human life is spent in sleep, a condition of which at

present we know little, except that it entirely changes the life of

conscious sense, and that it possesses a mysterious restorative power

of the most precious significance to us as physicians. A study of

all these mysterious conditions of human life itself, many of which,

although occurring abnormally, have been presented again and again

through all the ages, is surely the most important of all subjects for

scientific medical investigation. Let us always bear in mind, as has

been well said, ‘the fact of illusion is not an illusory fact.’ As an

exception to a rule is the most suggestive fact for the investigator

to grapple with, so those exceptional facts of human nature, which

are nevertheless occurring in every age and in every nation, are the

facts of all others the most worthy of investigation by the scientific

medical intellect. This new realm of research, when legitimately

pursued, promises results of the very highest importance.

I must not now dwell longer on this new and valuable department of

medical investigation--psycho-physiology. But it is an inspiring

thought that true science supports the noblest intuitions of humanity,

and its tendency is to furnish proof suited to our age of these

intuitions. I have specially dwelt on this subject now, because the

discouragement which results from the false reasoning of materialism,

injuring hope, aspiration, and our sense of justice, is especially

antagonistic to women, whose distinctive work is joyful creation.

In practical medicine the loss is immense when recognition of the

higher facts of consciousness is obscured, and the physician is unable

to perceive life more real than the narrow limits of sensation.

The physician is called to stand by the death-bed of the most

carefully-tended patient. At that solemn moment the clear glance that

sees beyond the boundary of sense, the reverential hand-clasp which

conveys hope to the mourner, is the seal of his noble art of healing

and the profoundest consolation he can offer to the bereaved. May the

time come when every physician can convey this highest gift of healing

with his ministrations!

I have now considered the fundamental reason why great advantage will

result to society through the intellectual cultivation of the woman

physician, unless the study of medicine be pursued in such a way as to

do violence to our nature by the destruction of sympathy, reverence,

and hope.

I have also dwelt on the method of training especially needful to our

students--viz., patient, persistent drill in the fundamental studies of

medical education, a training which will form the habit of close and

careful observation at the commencement of medical life.

I would now offer a few words of counsel in relation to the work

which lies before us when we enter upon the practical career of the

physician, for which our medical studies should carefully prepare us.

I believe that the department of medicine in which the great and

beneficent influence of women may be especially exerted, is that of

the family physician, and that not as specialists, but as the trusted

guides and wise counsellors in all that concerns the physical welfare

of the family, they will find their most congenial field of labour.

It is to fit ourselves for this most useful and influential

position--viz., as the medical advisers of families--that, not limiting

our education to any speciality, we have laboured, and must continue

to labour, to remove all obstacles in the way of obtaining the fullest

medical education. For this reason I have laid so much stress upon the

cultivation of habits of careful observation, and I now would give a

warning against sensationalism in medical study.

The unreflecting student (not unnaturally) rushes after novelties.

There is a certain excitement in witnessing a formidable surgical

operation, or seeing a rare case of disease that may never again be

presented to our observation. But these exceptional occurrences do

not fit us for our future medical life as does the careful study of

the commoner forms of disease, for those are the cases that most

nearly concern us. But because they are common they cease to interest

the unobservant student, who applies a routine treatment. But the

physician whose faculties of observation have been thoroughly drilled

has learned this lesson--viz., that no two cases of illness are

exactly alike, and that it is of the utmost importance to our future

success as practitioners to note these individual differences, their

results, and why some die whilst others recover. It is far more

important to our success as practical physicians to thoroughly master

measles and whooping-cough, scarlet fever and porrigo, than to study

an isolated case of hydrophobia or leprosy. Moreover, I hold it to be

a special duty of our profession to extirpate these common diseases,

not to accept them hopelessly as necessary evils. And it is only by

a profounder and more comprehensive clinical study of the ordinary

diseases of domestic life that we can hope to do this.

There are two great branches of medicine whose importance will, I hope,

more and more engage the attention of women physicians. These are

midwifery, which introduces us to the precious position of the family

physician; and sanitary or preventive medicine, which enables us to

educate a healthy generation.

These two departments of the healing art will never cease from amongst

us. I consider it a radical defect in our present system of medical

education, that these subjects are not brought more prominently

forward, and both of them raised into first-class professorial chairs.

Before closing, I must dwell for a few moments on the vital importance

of midwifery to the future success of women physicians. This is the

more necessary because I observe a singular and growing disposition on

the part of our students, whether in America, France, or England, to

despise or neglect midwifery. I do not know whether this proceeds from

indolence, as midwifery is the most fatiguing and enchaining branch of

the profession, or whether the neglect arises from failure to perceive

the reason of our refusal to be simply midwives, for our insistence

upon a complete education really means our determination to elevate,

not repudiate, midwifery.

But the curious fact remains that many women doctors appear to look

down upon this most important branch, and often state that they do not

intend to undertake it. Yet it is through the confidence felt by the

mother during our skilful attendance upon her, that we are called in to

attend other ailments of the family, and thus secure the care of the

family health. It is therefore of the utmost importance to our future

position in medicine to establish our ability as thoroughly trustworthy

obstetricians.

It is indispensable to the stability of our movement that very thorough

provision be made for the obstetrical education of all our medical

graduates. I do not think that any young woman physician is properly

equipped for her future difficult career unless she has been to a great

extent responsible for at least thirty midwifery patients, of whose

cases she has made careful and discriminating records, and has had the

opportunity of observing a great many more patients, in addition to

the drill in all operative manœuvres that can be given in college. We

need a great maternity department, thoroughly organized, which, whilst

arranged with kindest consideration for the poor, will put our students

through a severe drill, such as is considered necessary at La Maternité

in Paris. That institution, which receives annually an average of 2,500

patients, having over 10,000 applications in the year, is not only an

invaluable practical school, but it has reduced the mortality amongst

its patients to a minimum; and the searching method of instruction

there pursued could be studied by us to great advantage as we try to

secure a well-organized maternity charity for our students in London.

Such a charity, if humanely planned, would be a blessing to poor

mothers, and it would to a great extent remove the reproach of being

obliged to send our enterprising young doctors abroad because London

does not afford them sufficient necessary practical training.

But time warns me to close these remarks, although I would gladly have

enlarged upon the primary importance of preventive medicine--the

medicine of the future--for it is quite certain that the greater part

of disease, even including many surgical operations, is preventable

disease. It is now, unfortunately, the case that unavoidable absorption

in the treatment of disease makes the practical physician too often

ignore the yet larger duty of preventing it.

I have tried to show (1) That women, from their constitutional

adaptation to creation and guardianship, are thus fitted for a special

and noble part in the advancement of the healing art. (2) That the

cultivation of the intellectual faculties necessary to secure their

moral influence requires a long and patient training by methods that

do not injure morality. (3) That the noblest department of medicine to

which we can devote our energies, will be through that guardianship of

the rising generation which is the especial privilege of the family

physician.

In conclusion, my young friends and fellow-workers, I would ask you all

to join with me in the pledge which I gave more than forty years ago to

the Chancellor of the Western University, who handed to me our first

Diploma of Doctor of Medicine. I then promised ‘that it should be the

effort of my life to shed honour on that diploma.’

This is the pledge that we must all prepare for when entering the noble

profession of medicine; in receiving honour we must add lustre to it,

or we become unworthy of it.

It is a difficult life that we enter upon, in entering upon a medical

career; but if our Christianity is worth anything, it must be ‘a

battle, not a dream.’ We must be members of the church militant if we

wish to enter the church triumphant. Life is a grand preparation for

the exercise of ever larger powers, and I heartily welcome you to this

winter’s course of study, hoping that it may be a little step forward,

but a sure one, towards that grand ideal which must be ever before us.

ERRONEOUS METHOD IN MEDICAL EDUCATION

_Addressed originally[1] to the Alumnæ Association of the Woman’s

Medical College of the New York Infirmary_

ERRONEOUS METHOD IN MEDICAL EDUCATION

Although it is many years since I have been able to assist in the

management of the Infirmary and School which I helped to found in 1853,

yet I watch its growth with steady sympathy, and rejoice in its success.

The last Report of the School, which has just reached me, contains

a very important item--viz., the effort of the Alumnæ Association

to ‘Equip a Physiological Laboratory and place it under the

superintendence of Professor W. Gilman Thompson,’ a New York

Vivisector. In relation to this effort, I desire to bring before you

some grave considerations which are the result of my long experience in

Medicine.

These considerations refer, _first_, to the kind of work that should be

carried on in a Physiological Laboratory, and, _second_, to the special

influence which women are called on to exercise in medicine.

A Physiological or Pathological Laboratory arranged for the

legitimate investigation of the material composition of the tissues

and secretions of the human body, is an interesting and important

department of medical study. The laboratory, however, is now commonly

used as a place for experimenting upon living animals as if they were

dead matter, or simple machines. This method of research is proving in

several ways extremely injurious to the progress of the Healing Art.

The practice of Vivisection and unlimited experimentations upon our

humbler fellow-creatures must be considered by us both under its

intellectual and its moral aspects. From both these points of view very

careful observation has led me to the conviction that this method of

investigation is a grave error.

Let me here state distinctly that I willingly acknowledge the good

intentions of all and the ability of some of the clever physiologists

of the present day, although their method of experimentation is

erroneous and the effects of that method injurious, being founded

on a fallacy. What I now say, however, is directed chiefly to the

instruction of medical students and to the practice of our young women

doctors.

I ask you to consider, first, the intellectual fallacy which underlies

this method of research. It is a twofold fallacy, resulting from the

differences of organization in different classes of living creatures,

and from the fact that when any organ is injured, it is a process of

destruction or death--not life--that is exhibited.

There is an ineradicable difference of physical structure between

Man and every species of lower animal. Nowhere is there identity of

structure or of function. Resemblance or parallelism often exists, but

identity never. Take the dog, for instance, whose attachment to Man

furnishes us with the widest opportunities of observation. In no single

function of its body is the action of the function the same as in Man.

All the processes of digestion, including its large group of connected

organs, differ from those of the human being. Observe carefully the

processes of healthy living animals. You will find that their senses

act in a different way to ours--a way which is often quite unknown to

us, we possessing no power even comparable with many of their powers.

Their relations to nature differ in many ways from our relations. It is

true that they eat and sleep and dream; that they possess intellectual

and moral powers, and are susceptible of education. They exhibit a

rough rudimentary sketch of our higher spiritual powers, and are

related to us in many ways. But the differences are so great, their

whole attitude towards external life is so different, that they may

be truly said to live in a different world from ours. So that in no

possible instance can we draw a positive conclusion respecting the

lower animal nature, that can be transferred as reliable information to

guide us in relation to the action of the human organs and functions,

either in health or disease. This misleading difference is true not

only in relation to the spontaneous working of functions, but it is

also true in respect to the actions of poisons, of drugs, and the

artificial production of diseases. Animals can be rendered scrofulous,

diabetic, syphilitic, leprous, by forcing the poison of diseases into

their bodies. Morbid action, atrophy, slow death, can be produced by

removing portions of their organs; but no deductions drawn from these

artificial conditions can be transferred to man in order to cure human

disease or restore lost function. The scrofula, diabetes, syphilis,

or rabies, takes on a different form when the lower animal has been

artificially poisoned by these diseases. In not a single instance known

to science has the cure of any human disease resulted necessarily from

this fallacious method of research.

In 1849-50 I was a student in Paris, and, with the narrow range

of thought which marks youth, I was extremely interested in the

investigations respecting the liver and gall bladder which Claude

Bernard (Majendie’s successor) was then carrying on and lecturing upon

at the Collège de France and the Sorbonne. I called upon M. Bernard to

ask him where I could find some work on ‘Physiologie Appliquée’ which

would show me how the results of these investigations could be applied

to the benefit of man. M. Bernard received me with the utmost courtesy,

but told me there was no such book written; the time had not come

for the deductions I sought; experimenters were simply accumulating

facts. We are still, forty years later, vainly accumulating facts! This

present summer Dr. Semmola, ‘one of the most brilliant pupils of Claude

Bernard,’ lectured in Paris on Bright’s disease, which he has been

studying for forty years with unlimited experimentation on the lower

animals, for the purpose of producing in them artificial inflammation

and disease of the kidneys. What is the result to the human being

of all this prolonged and ingenious suffering inflicted on helpless

creatures? ‘Dr. Semmola insisted upon temperance in eating as well as

drinking, and said that the best way to preserve health was to eat only

what was needed for the nourishment of the body.’ No cure for the human

malady had resulted from this persistent experimentation.

Is it not intellectual imbecility to waste thought and ingenuity in

putting animals to lingering and painful deaths in order to reassert

the well-proved fact that intemperance in eating and drinking will

produce forms of digestive and excretory disease varying with the

idiosyncrasy of the individual?

In late discussions in the French Academy of Medicine relative

to chloroform, where Laborde and Franck exhibited experiments on

animals, Dr. Le Fort (the distinguished surgeon) says: ‘None of these

experiments give us any instruction whatever which is useful in

practical surgery. Whatever their scientific interest may be, their

deductions are in no way applicable to man. Experimenters relate causes

of death, but nothing of the sort is generally found in the deaths of

practical surgery. The man faints when operations are begun too soon,

or is frightened by preparations. He dies because, being a man, his

nervous system reacts in a different way from that of the dog or the

rabbit. Do not count in any way upon the teachings of physiologists in

practical matters. Don’t let your patient see any preparations, give

the chloroform slowly, wait till he is profoundly asleep. That is all

you can do.’

Again, at another discussion at the Academy, M. Verneuil says: ‘It

is incorrect to say that laboratory experiments give certainty to

medicine, and make it scientific instead of empirical. The fact is

that experimentation has put forth as many errors as truths. There is

not sufficient identity, either physiologic or pathologic, between

man and the mammifères such as the dog and the rabbit.’ The different

ways of dying under chloroform have been long ago stated by surgeons.

The experiments shown by M. Laborde on the rabbit must be absolutely

rejected, as contrary to experience (in man). Maurice Perrin showed to

Vulpian in 1882 that the nervous reactions in man differ from those in

animals, and the effects produced by chloroformization could not be

relied on as being the same as on man. Vulpian entirely accepted this.

The experiments of physiologists have taught us absolutely nothing

in the way of preventing chloroform accidents; surgeons have been

beforehand (as was natural) in practising artificial respiration and

every other method of recovery. However interesting these experiments

on animals may be considered, they do not explain satisfactorily the

cause of chloroform accidents in man, and in no way show the way of

avoiding them.

I could multiply these facts by indefinite quotations from experienced

physicians, of the intellectual uselessness of a method of research

which ignores the spiritual essence of Life and hopes to surprise

its secrets by ruthless prying into the physical structure of the

lower animals. We are learning that vivisection is examination of the

beginning of death, not of life. Loss of blood is a loss of nutriment;

the result is muscular debility and enfeeblement of the vital organs,

and the introduction of a disturbance in the vital processes which ends

in their destruction. This method of research is now being discredited

by many of the most enlightened members of our Profession.

But what I wish especially to call your attention to, is the

educational uselessness of vivisection in training students, and the

moral danger of hardening their nature and injuring their future

usefulness as good physicians.

It is not true that vivisection is necessary to the medical student in

order that she may attain the thorough knowledge of human physiology

which is needed for the intelligent exercise of the medical profession.

Class demonstrations in opening the bodies of the lower animals to

examine their organs and tissues are misleading in respect to the

action of human organs. The action of the human salivary glands, the

action of the cavities of the human heart, the secretion of the gastric

juice, etc., can be more correctly realized by careful anatomical

study in connection with clinical observation of the effects of

healthy and diseased action in the human being, than by any amount of

bloody experiment and mutilation of still living cats and dogs. Such

demonstration may gratify that instinct of curiosity which always

exists in youthful human nature, or it may pander to that craving

for excitement which makes the spectacle of a surgical operation so

much more attractive to the undeveloped mind than careful clinical

study--a tendency which is also seen in gambling, watching executions,

bull-fights, etc.--but these are tendencies to be repressed in serious

and responsible study, not encouraged. The precious mental activities

of the student need to be specially trained into observation of our

_human_ faculties in health and in disease. The establishment of a

Physiological Laboratory for experimenting on living animals, in a

medical school, is not only giving a wrong direction to intellectual

activity, but is wasting the valuable time of the student, and

diverting the attention of the young practitioner from that careful

and intelligent study of the human organism, which alone can lead

to practical beneficial results. This practice must therefore be

condemned, as giving a false direction to the intellectual faculties of

the young.

Of the moral danger involved in such methods of study there can be but

one opinion by thoughtful and observant persons within the ranks of our

Profession.

The exercise of our superior cunning in destroying an animal’s natural

means of self-defence, that we may (with convenience to ourselves)

watch changes that occur in its organs during the slow process of a

lingering death, is an exercise of curiosity which inevitably tends

to blunt the moral sense and injure that intelligent sympathy with

suffering, which is a fundamental quality in the good physician. The

practice of recklessly sacrificing animal life for the gratification,

either of curiosity, excitement, or cruelty, tends inevitably to create

a habit of mind which affects injuriously all our relations with

inferior or helpless classes of creatures. It tends to make us less

scrupulous in our treatment of the sick and helpless poor. It increases

that disposition to regard the poor as ‘clinical material,’ which

has become, alas! not without reason, a widespread reproach to many

of the young members of our most honourable and merciful profession.

The hardening effect of vivisection is distinctly recognised in the

Profession, although often excused under the abused term--‘scientific.’

Dr. Loye, who, with another physician, studied the process of

guillotining a malefactor at Troyes, thus writes: ‘Both of us believed

that our wide experience of bloody vivisection would have hardened us

sufficiently to go through the spectacle without very great emotion.’

It is our duty and privilege, as women entering into the medical

profession, to strengthen its humane aspirations--to discourage its

dangerous tendencies. We must not be misled by clever or brilliant

materialists who take the narrow view that physical life can be

profitably studied without reverencing the spiritual force on which

it depends. A physiological and pathological laboratory, legitimately

conducted for the investigation of healthy and diseased human

secretions, in connection with clinical observation, may be made a

valuable aid to medical advancement, and I would always encourage the

organization of such a laboratory. But to use it for cutting up animals

dying under anæsthetics is stupidity, and to convert it into a torture

chamber of the lower animals, is an intellectual error and a moral

crime.

The possible results of slow deterioration in the moral nature when

we violate in any degree our religious standard of justice and mercy

may be most strongly realized in living examples of diseased inherited

tendencies. Such a fearful example is before us in the life history of

the criminal, Jesse Pomeroy, now in the State Prison of Charlestown,

Mass., who has spent his life in penal servitude, expiating his

atrocious mutilations and murders of little children, committed when

he was a lad of fifteen. The deteriorating moral influence exercised

on offspring by vicious parental tendencies, is directly exhibited

in this living object lesson. The father of this lad was a butcher.

His mother, during the gestation of this child, took a persistent

and morbid delight in watching the death of the animals slaughtered

by her husband. We see in the atrocities committed by her young son,

a terrible example of the evil effect which the mind can exercise,

in deteriorating individual character and in extending its evil

influence to others. All experience proves the powerful influence

exercised by the parental, and especially the maternal, qualities upon

the offspring. Every woman is potentially a mother. The excuse or

toleration of cruelty by a woman upon any living creature is a deadly

sin against the grandest force in creation--maternal love.

I earnestly ask all women physicians to consider the special

responsibility which rests upon them, to take that large religious view

of life which alone can check any degrading tendencies in intellectual

human activity and elevate our noble Profession. Let us not be misled

by sophistical arguments, but look steadily at the actual facts of

animal torture, and work persistently for the total abolition of

vivisection from our medical schools. In this way we shall justify

our entrance into medicine, and prove ourselves strong supporters of

that noble humanity which is the especial characteristic and solid

foundation of the Medical Profession.

FOOTNOTES:

[1] In 1891.

WHY HYGIENIC CONGRESSES FAIL

_LESSONS TAUGHT BY THE INTERNATIONAL CONGRESS OF 1891_

INTRODUCTION

The noblest aim of humanity is the application of Truth to the conduct

of life. By doing we develop our faculty of knowing.

The difficulty, however, of knowing how to apply Truth in daily life is

so great, and yet the need is so urgent, that the most pressing duty of

those who have faith in the Divine is to bring forward to the light of

sympathetic conference, the facts of life in which one’s most intimate

experience lies.

Thus the merchant and manufacturer, the business man and the

legislator, the farmer, householder, literary man, and those who,

living upon interest, should know how that interest is gained, must

ever hold it to be true religious duty to seek, in conference with

others, the way of elevating every department of life.

* * * * *

Religious or Unitary truth possesses invaluable guidance for Medicine,

not only in its practical application as an art, but in the methods by

which it can alone become a science.

Truth recognises this great fundamental fact--viz., that spirit moulds

form, that the senses alone are not reliable guides in solving the

problems of even physical life.

Research and observation also show that essential elements of Truth

have always existed in Humanity; that we cripple our power of advancing

in Truth if we do not seek out these indications of the Divine in all

past experience and carefully consider the light they throw on present

life.

We recognise in these weighty facts a great Providential method of

human growth and an infinitely beneficent aid towards the attainment of

that moral Ideal wherein Goodness and Truth, Justice and Mercy, Love

and Wisdom, become one--inseparably united.

One of the great truths given in past ages, which it is necessary to

study and enforce in the present age, is the intimate connection which

exists both mentally and physically between human beings and lower

forms of animal life.

This is a truth of great moral significance. It was dimly, perhaps

grotesquely, seen in some religions of the past, but is so much lost

sight of in the present day that our responsibility for the care of

the inferior creation we were intended to train with justice and

gentleness, becomes too often a cruel and odious tyranny. Even in some

branches of knowledge (knowledge which can only justly claim the name

of science when it is the most comprehensive study of truth) injustice

and cruelty are misleading the intellect, and thus threatening danger

to the progress of the human race.

Being profoundly impressed by the fundamental character of these truths

as necessary guides in medicine as well as in every department of

human life, when I learned that extensive preparations were being made

in the greatest city of the world for consideration of perhaps the

most important subject that can engage our attention--viz., Health--I

arranged to be present as a delegate, and steadily attended the

Congress, comparing notes with other friends who were attending its

various sections.

In this way we gathered an accurate knowledge of the tone of the

discussions, the methods pursued, and the tendencies of modern

investigation.

These facts seemed to me of sufficiently serious import to make them

worth recording in the following pages.

WHY HYGIENIC CONGRESSES FAIL

The Seventh International Congress of Hygiene was held in London

from August 10 to 15 of 1891. It is noteworthy for the number and

representative character of its members, and also for the wide range

of subjects affecting the physical welfare of the race, which were

considered. Representatives from America and from Asia, as well as

from the various nations of Europe, assembled in the Great Metropolis

to consider the vital subject of Health. These learned men met

together daily during the week in nine different sections, from ten

to two o’clock. They were occupied with the subjects of Architecture,

Engineering, Chemistry, the health of soldiers and sailors, the care of

early childhood, the duty of the State in relation to the Health of the

Nation, Health Statistics, Bacteriology, and the relations of Animal

and Human Disease.

In the consideration of this wide range of subjects, valuable

experience and much useful information were presented in the papers

read and in the discussions that followed. But in a Congress not held

together by any great guiding principle, where persons of various

nationalities, moulded by different laws, methods of education, and

social customs were represented, a great variety of opinion, of

contradictory facts, of imperfect statistics and superficial theories,

would necessarily be brought forward. Nevertheless, a remarkable

concensus of opinion established one great result of experience--a

result which may be considered the striking practical lesson of the

Congress--viz., that it is to sanitation that we must look, not only

for the prevention of disease, but largely also for its cure.

_Supremacy of Hygiene._--Taking the results of sectional discussions

as a whole, it was very generally shown that, by our increasing

knowledge of hygienic law, its wide diffusion amongst the people, and

its intelligent application to daily life, we can counteract the evil

influence of heredity, get rid of epidemics, improve the stamina of the

race, advance in longevity and in the natural enjoyment of our earthly

span of life. Thus it is by the advance of sanitation that the Art of

Healing can alone become a science of Medicine.

A few illustrations will show how this growing result of modern

thought was both directly and indirectly supported by the papers and

discussions of the various sections.

Thus Sir Charles Cameron, of Dublin, showed the beneficial change

wrought by ten years’ sanitary effort in the Dublin slums through

rebuilding, draining, cleaning, and free disinfecting. Those wretched

quarters were a breeding-ground of human misery in 1871, where

small-pox, typhoid fever, and all contagious diseases seemed to be

endemic. The annual mortality was reduced in ten years by sanitary

measures from 34·11 to 28·80 in the most crowded portions of this

wretched quarter; in its less crowded part the mortality had fallen to

a much lower figure, notwithstanding the intemperance and destitution

which still continued to afflict the inhabitants. In this example

it should be especially noted that the goodwill of the people was

enlisted, for the municipality laid aside the idea of pecuniary gain on

the sum expended in rebuilding, etc., and offered a better lodging at

a rent that could be paid, and provided all sanitary appliances free,

thus losing, in the sense of money profit, to gain in the far higher

value--health.

Another remarkable illustration from very large experience was that

given by Professor Smith, of Aldershot, who is at the head of the

cavalry department of our army. He showed, by most interesting tables,

that diseases formally rife amongst horses--glanders, farcy, canker

of the foot, etc.--were now practically unknown in the army. This

triumphant result was entirely due to careful hygiene, the utmost

attention being paid to food, ventilation, drainage of stables, the

care of the feet and shoeing, of saddles and harness, and reduction of

the burden which the horses were required to carry, to fifteen stone as

a fair average. As was justly remarked, there is a limit to the weight

that a horse can carry or draw, beyond which is cruelty and injury.

Drs. Schrevens and Gibert, from France; Dr. Abbott, of Mass.; Dr.

Pagett, of Salford; in discussing diphtheria and typhoid diseases from

defective drainage, laid stress upon purity of air and cleanliness of

the soil as the chief points for consideration. The same indispensable

principle of sanitation was shown in respect to meat and milk used for

food. In France 5 per 1,000 of animals used as food are tuberculous,

such disease resulting from wrong methods of breeding, feeding, and

managing these useful animals.

Professor Ralli showed how parasites could be conveyed from animals to

men, and dwelt on clean bedding, coverings, suitable food, water, free

exercise, as the necessary prophylaxis.

Dr. Hime, of Bradford, and Chauveau, of France, dwelt upon terrible

diseases, such as the woolsorters’ disease, to which men are exposed

who handle the skin, horns, etc., of animals--diseases which are

entirely preventable if the manufacturers engaged in such trades

would place the health of men above the profit to be gained by trade;

thorough ventilation, disinfection, and other sanitary measures would

entirely prevent the present reckless destruction of health. The same

was true in the large industry of sorting rags imported from abroad, of

match-making, etc.

It is a noteworthy fact that in the section of the Congress devoted

to the relation of diseases of men and animals, which I especially

attended, sanitary prophylaxis alone was dwelt upon as the condition

of supreme importance. Inoculation was not advocated by any speaker,

except the official representative of the French Pasteur Institute.[2]

Compliments were duly paid to M. Pasteur, whose skill and zeal in a

false method of research may justly command intellectual recognition.

But no one in any case advocated the theory of diffusing mild forms of

disease for the purpose of preventing the severe type in the important

and practical discussions which took place daily in relation to

diseases common to man and the lower animals.

Thus a great principle of progress in the prevention of disease

and in the attainment of a higher standard of health was directly

or indirectly acknowledged by this varied body of men of trained

intelligence and large experience--viz., the paramount importance of

sanitary knowledge and practice.

Obedience to the conditions of healthy growth is the law of progress,

from which there is no escape. It is the only way by which disease can

be gradually eradicated. Every attempt at evasion inevitably brings its

own retribution in various ways, swiftly or slowly, but surely.

All medical by-paths leading in a different direction from the

conditions of healthy life, however tempting they may appear to

active intellectual curiosity, or however desirable it may seem to

find a short cut to health, necessarily lead to error if the supreme

importance of sanitation be ignored.

Now, notwithstanding the large amount of valuable experience brought

together in this International Congress, there was one serious omission

in the otherwise wide and interesting plan of the Congress--an omission

which had a direct practical bearing on the discussions carried on in

the various sections. This vitiating lack was the failure to recognise

the fundamental connection of mind and body in the phenomena of Life.

There was no appointment of any special section which should give

prominence to this subject, and thus strike the keynote capable of

bringing all the sections into harmony.

This omission was the more noteworthy because a section _was_ devoted

to the theories of bacteriology, which, as will be seen, are directly

opposed to the true science of Health.

Practical success in sanitation is impossible without the recognition

of mind, both in the actual working of the organs of the living body

and in the knowledge and acceptance by mankind of the conditions which

are essential to health.

If the human constitution be governed by laws in obedience to which

healthy growth is alone possible, then those laws must be carefully

sought for before we can build up a science of hygiene. To regard

living beings as simply material bodies, without the constant and

varying influences of mental action upon the working of those bodies,

is an intellectual error which disregards the essential condition of

mental harmony in relation to health.

It must also be recognised that whatever may be the discoveries of

physiological science, they will remain barren unless applied by

individuals. In all the concerns of life, whether in the application of

principles or in the unconscious formation of habits, we are compelled

to deal with the ceaseless power or effect of Will. To treat even

the most ignorant adults by arbitrary, unreasoning compulsion is a

scientific blunder.[3]

_The Two Problems of Hygiene._--The two fundamental questions for

hygiene to solve are therefore: 1st. What are the conditions of healthy

growth? 2nd. How can those conditions be secured?

In answering these two fundamental questions the problem of mental

action enters into every hygienic section of a Congress, and is the

keynote which must be struck if harmony of theory and practice is to be

attained.

But in consequence of too narrow a view of hygiene these questions

were not solved, and this remarkable assembly of learned men, brought

together with such careful preparation and hospitable welcome, produced

no practical results of the commanding value that the public had a

right to expect from it.

Sanitary legislation was shown to be largely evaded, but the reasons

for this unsatisfactory evasion were not examined; the results of

experimental research were proved to be strangely contradictory, but

the conditions which would harmonize them were not discovered; unproved

theories abounded, but the fallacies that vitiated them were not made

clear.

Disappointment as to the practical utility of the Congress was widely

felt both at home and abroad.

This disappointment with the results of the Congress has been publicly

expressed by our foreign guests. A clever abstract of the work done

at this Seventh International Hygienic Congress has been published in

Paris by the well-known editors of _The Review of Hygienic and Sanitary

Police_. Some noteworthy statements are made in the introduction to

this volume which should be seriously considered by all who reverence

righteous sanitary science as the foundation of human welfare, but who

also know that sanitary science must approve itself to the good sense

of a people, or it will be of little practical utility.

_Failure of English as well as Foreign Sanitation._--This high French

authority declares that notwithstanding the efforts for sanitary

improvement in which England has set an example for fifty years, the

relative mortality of England has not diminished. It is stated: ‘The

subject of the mortality of England, although not touched upon in

the Congress, was the subject of most private conversation. The real

figures of English mortality show a singular coincidence with the

mortality of other European countries. It is shown that in none of

these countries has the mortality diminished during the last fourteen

or fifteen years, except when the birth-rate has diminished, and only

in an exact proportion to this birth-rate.’ England has no better

record to show in this respect than her Continental neighbours,

notwithstanding the increasing demands of her specialists for extended

legislative powers. Our French critics remark that ‘English hygienists

of to-day are demanding great administrative centralization; their

sanitary laws are rigorous to a degree that other countries would

consider excessive; local self-government as well as individual

liberty is less and less respected, and, from the statements of

specialists interested in the subject, there is reason to believe that

at no distant date every branch of public hygiene will be entirely

administered by the Central Government.’

‘It is to be hoped’ (they remark) ‘that English good sense will

learn how to avoid the abuse of centralization, for it is just as

illogical to wait for the intervention of the Central Government in

the sanitation of a parish or the prevention of a local epidemic as to

refuse such intervention when public danger arises from negligence or

stupidity.’

These observations of hygienists, coming from France, a country which

we are accustomed to consider (and which in some respects really is)

much more over-ridden by officialism than England, are extremely

valuable. They serve to warn us of the grave danger of depending upon

centralized legislation or arbitrary authority withdrawn from popular

influence, and from that growth of individual enlightenment which

arises through the sense of responsibility.

Our friendly foreign critics justly ask: How is it that England, first

in the field of sanitary science, with a rigorous system of compulsory

legislation, with administration, laws, regulations, agents, and

also a gradual development of private hygiene, has still to deplore

the unhealthiness of such a large number of towns, quarters, and

habitations, and sees no diminution in her annual rate of mortality?

They advance towards the root of the matter when they observe in

this same report that laws are one thing, their application quite

another thing! ‘So true it is that public hygiene depends upon general

education as well as on the education of specialists, that no laws or

regulations will suffice when the habits of the people generally do not

promote their application.’

In other words, mind as well as matter must be considered in the

subject of sanitation.

* * * * *

The student of science who has learned the great principle of

creative Unity knows that no manifestation of existence can be

absolutely separated from the rest of creation. As we investigate

phenomena it is seen that the laws governing separate phenomena

become more comprehensive as knowledge increases, because more widely

embracing separate facts; varieties are seen to be linked together by

relationships, and apparently different phenomena can be transmuted

into one greater force.

In the plan of an International Congress, designed to gather together

the advanced knowledge of many nations on the whole science of health,

the omission of any section which should bring into prominence this

powerful fact in life--the influence of mind on body--is a very grave

defect. It is an error which affects both the investigation of facts

and the application of results, the two indispensable factors to the

progress of sanitation. Their neglect in an International Congress on

Health was the more unfortunate because mental influence is a fact

which is forcing itself upon the attention of investigators with

increasing urgency.

_Increasing Importance of the Mental Problem._--Under the modern

title of hypnotism facts of the most remarkable character are now

acknowledged and studied. The cure of disease by suggestion, carefully

and humanely applied, has been proved beyond the possibility of

rational denial. The reality and practical effects of mental epidemics

is a positive fact. The effect of fear in predisposing to cholera,

hydrophobia, and other diseases cannot be denied.[4]

The contagion of religious enthusiasm or religious fanaticism

are facts; whether the effects are seen in the devotion of the

Salvation Army, or in pilgrimages to Lourdes or Trèves with their

so-called miracles of faith-healing, they are equally facts requiring

consideration. Wild business speculations in the craze for riches

become contagious, and lure multitudes to ruin.

The history of past and present medical delusions is also most

instructive. We need not go to the Sangrados of a past generation, who

treated every disease by blood-letting, or the search for the elixir

of life in illustration; the contagion of false hopes in relation to

consumption, which upset the judgment of two hemispheres, cannot yet be

forgotten. Thoughtful physicians possess abundant warning against being

carried away by new theories which violate the moral sense or the Law

of Unity, even when such theories are supported by distinguished names.

Experience proves the potent character of mental stimuli in moulding

practical action. Fear or hope, curiosity, vanity, cupidity, when

regardless of the Law of Unity, seize upon isolated phenomena removed

from their natural connection, and distort them by creating morbid

conditions, thus viewing facts out of proportion. Statistics thus

formed become fallacious, and serve as the bases of dangerous

theories--theories which, unless checked by popular common-sense from

being put into practice, would cause the moral and physical degradation

of the race. I need only refer to the folly of injustice embodied in

certain medical acts lately abolished and to the present theory of

inoculation, as noteworthy instances of dangerous mental delusion

desiring to shape itself into action.

Materialism, which is blind to other than sensuous life, which insists

upon reducing every phenomenon to the limits of the senses, which

refuses to be enlightened by any higher reality, or sneers at the

term ‘vitality,’ neglects a great range of positive facts, and has no

right to the noble name of science. Reflection, therefore, shows that

the moulding and guiding power of mental action in shaping physical

results being a fact of the most far-reaching character and of

permanent operation in sentient creation, its omission in a Congress of

Health was a serious injury to the results of the Congress. It was a

sufficient reason for that sterility of result which has been publicly

and privately expressed.

The error of not recognising mental as well as physical forces, or the

Law of Unity, in relation to health, and the tyranny that may result

from such imperfect method in the study and application of sanitation

and medicine, may be illustrated by an interesting incident of the

Congress.

An important joint meeting of two sections took place in order to

listen to the discourse of one of our ablest investigators--a man

in high position, and one who wields a powerful influence on the

rising generation of medical students. This gentleman early in his

discourse made the following noteworthy announcement: ‘I claim the

right of science to dictate’--and as if to strengthen this claim by

the authority of our French brethren he added ‘conformément à la

logique’--‘I claim the right of science to dictate in accordance with

logic.’

The bold demand for absolute obedience thus authoritatively made

by a professor at the head of biological research demands careful

consideration. It is the announcement of a new priesthood or esoteric

sect of physical science. In the mind of the speaker it means that his

science is identical with truth. If that be admitted, it is the highest

wisdom of the human being to obey gladly and unhesitatingly, and the

teacher thus inspired with truth rightfully commands our grateful

and profound reverence. But this claim may also mean the unconscious

arrogance of a mind taking too narrow a view of science--a mind which,

whilst earnest and laborious in investigating partial phenomena, is

intoxicated by the discovery of new facts with the theories which can

be built upon them, and at once announces himself as one of the priests

of a new religion demanding absolute obedience; for the temptation of

all priesthoods is to form an esoteric sect.

In this second case it is the bounden duty of every truthful mind to

refuse obedience. For until the claim is fully examined in all its

aspects, in both its physical and mental relations, and sustained by

the deliberate and hearty assent of all intelligent minds and the

instinctive accord of the people generally, this demand for absolute

obedience to the theories of so-called science must be resolutely

withstood as a reintroduction of mischievous and degrading superstition.

The special occasion which led to this unfortunate claim for dictation,

or the compulsory regulation of disease by specialists, was the subject

of tuberculosis and the exaggerated claim of the modern bacteriologist

that the tubercle bacillus is the sole primary cause of consumption,

with the logical claim that, as only the thoroughly-trained specialist

can detect this bacillus, consumption should be scheduled as a

contagious disease, and subjected to the rigorous regulations of the

specialist and his board of advisers.

As our largest item in annual mortality is death from

tuberculosis--about 14 per cent. with us--and as food and air _may_

introduce a bacillus into the system, we can dimly imagine the extent

to which the claim for dictation may grow in ‘accordance with logic.’

Many striking instances of crude official tyranny were revealed by our

Canadian and other foreign delegates. Thus, railway passengers from

Montreal to Ontario were compulsorily revaccinated on the train before

being allowed to enter Ontario.[5] The foolish and fallacious system

of attempting to _regulate_ special vice was seen to prevail largely in

the inexperienced civilizations of Canada and Western United States.

_Scientific Inquisitors._--I will here quote a late statement of

Professor Huxley’s, which might well be emblazoned in all our medical

schools. He says: ‘We are at the beginning of our knowledge instead

of at the end of it; the limitation of our faculties is such that we

never can set bounds to the possibilities of nature. The verdict may be

always more or less wrong, the best information being never complete,

and the best reasoning liable to fallacy.

‘The greatest mistake those who are interested in free thought can make

is to overlook these limitations and deck themselves with the dogmatic

feathers which are the traditional adornments of opponents.’

This vigorous protest of our English naturalist against the dictation

of so-called science is in striking accord with the observations of our

French visitors in relation to the futility of compulsory legislation

now urged by scientific specialists.

_What is Science?_--When the investigators in any limited branch

of knowledge glibly use the term ‘science’ to compel assent or to

enforce legislation, we are forced to ask, What _is_ true science or

certain knowledge grounded on demonstration, as distinguished from

false science, which is uncertain knowledge, based upon varying and

imperfectly observed phenomena or upon theory? Knowledge is of various

kinds: Mental, Physical, Mathematical. These separate departments of

knowledge rest equally on bases of fact. Love is as much a fact as

bread-and-butter; justice is as potent in its effects as microbes; and

from their wider range of action and more permanent duration these

mental facts are far more _real_ than the physical phenomena.

In determining the claim of science to obedience the great Law of

Unity gives the guiding principle, which, however humbling to human

arrogance, or however affirmative of the limitations of our intellect,

the truly scientific mind is bound to accept.

_The Law of Unity the Foundation of Science._--The Law of Unity

teaches us that no explanation of any fact is final or ‘true’ if it

contradicts other facts. It announces that no method of examining facts

is reliable that destroys other facts equally patent, and that any

results deducible from partial phenomena, however interesting or even

apparently useful, can only be regarded from the point of view of true

science as temporary expedients. They may possibly be recommendations

for useful trial, but they can never be justified as subjects for

dictation.

* * * * *

The confusion of thought which has brought the unnatural practices of

inoculation into fashion may be usefully illustrated by dwelling on the

mingling of truth and error which exists in relation to vaccination.

Vaccination must not be confounded with inoculation, although the word

‘vaccination’ is now incorrectly used by bacteriologists to cover up

the alarming practice of injecting the diluted virus of any particular

disease, which is inoculation. Vaccination, on the other hand, is

solely the injection of matter derived from a disease in the vacca,

which disease is neither small-pox nor derived from small-pox, and

vaccinia in a healthy cow is a mild disease.

During a lifetime of medical practice I have vaccinated children

(sharing the widespread belief that it was preventive of small-pox).

The practice, however, has always seemed to be an unsatisfactory

method, which I hoped increased knowledge of sanitation would enable us

to improve.

I also recognised the powerful influence of fear in predisposing to

disease, and I regarded vaccination as a sedative for the family or

community. My faith in the innocence of this practice was, however,

rudely shaken by the lamentable death, in my own practice, of a

scrofulous infant--a death clearly caused by the phagedenic ulceration

produced by the vaccination. I also noted the accumulating evidence of

very serious diseases communicated by so-called vaccine lymph.

_Vaccination not Scientific._--But Professor Crookshank, in his

exhaustive work lately published on vaccination, has conclusively

proved the unscientific character of the evidence on which this

practice is based, our ignorance of the sources of the virus commonly

used and its mode of action, and also the uncertainty of its

prophylactic power.[6] That the generally mild disorder of vaccination,

although arbitrarily and even tyrannically enforced on every child born

in our country, does not prove the prevention of small-pox which it is

claimed to be, is shown by the recurrence of epidemics of small-pox

amongst us, by the occurrence of the disease in vaccinated persons, and

also by the demand now made by the French Academy of Medicine (which

recognises the failure of our system of vaccination) for legislative

powers to compel repeated revaccination. This demand for power of

indefinite revaccination is a logical demand. For, proceeding on the

assumed premiss that vaccination prevents small-pox, but being met by

the inexorable fact that epidemics of small-pox _do_ occur and spread

amongst vaccinated people, the cause of this contradiction is assumed

to be that the supposed preventive power of vaccination has been thrown

out of the system, and must therefore be again renewed. Logically,

therefore, not only the infant must be subjected, but the child, the

adolescent, and the adult. All must be compulsorily revaccinated, as

the human system undergoes a change at each of those periods of growth.

The history of the struggle against compulsion in vaccination is very

interesting, as a strong condemnation of that arrogance of false

science which presumes to trample on human rights whilst neglecting

hygienic conditions. As all intelligent persons should be able to form

a practical judgment on the important question at issue, I should

like to dwell a moment on the subject of immunity, a fact (though now

misapplied) on which compulsory vaccination is based.

_Immunity._--Observation has long shown us that when the human system

is gradually exposed to injurious influences, a certain tolerance of

those influences may be acquired, which often enables those exposed to

them to escape immediate death, although with impaired health, whilst

healthy persons suddenly exposed to the same injurious influences die.

This is a well-known fact, capable of abundant verification. Thus,

persons long resident in a badly-drained house, although frequently

ailing in various ways, may never be laid up with typhoid fever; a

certain immunity has been obtained by the slow adaptation of the system

to bad air, but at the sacrifice of vigorous health. But if a new and

healthy family move into the same house a deadly outbreak of typhoid or

diphtheria may at once result.

In the malarious districts of the United States a large scattered

population of what are called by the negroes ‘mean whites’ continue

to live, with clay-coloured faces, enlarged spleens, and impaired

vitality, yet for a stranger to sleep in those regions is deadly. The

strong tendency to live, which we call vitality, though it has enabled

those born and brought up under injurious influences to struggle on

through life, does not prove equal to resistance in many constitutions

suddenly exposed to the injurious influences. The medical statistics of

our army in India show that the newly-arrived is far more apt to suffer

from enteric fever than one who has been long in the country.

‘The percentage of deaths from this cause is nearly fivefold greater in

the first or second year of service than from the sixth to the tenth

year. Medical officers are unable to trace out in any given instance a

definite insanitary condition to which with certainty the outbreak can

be attributed.’

There is, therefore, fact for theory to be built on--viz., the possible

adaptation of the human constitution to injurious influences, an

adaptation which, whilst impairing general vigour, often produces

immunity from rapid death.

This fact, confirmed in the mind of the bacteriologist by the

fallacious system of diseasing animals as ‘témoins’ or ‘controls,’ has

given rise to the dangerous theory that all contagious diseases may

be forestalled in their most deadly form by the inoculation of human

beings with diluted virus produced by those diseases. This dangerous

belief has been widely fostered by the unfortunate educational

influence of the law of compulsory vaccination. But it must be observed

that vaccination, unlike inoculation, does not introduce any products

of the special disease--small-pox--into the system. The vaccine disease

in the cow is not small-pox, nor can it ever be made to produce

small-pox. The preservative power which is claimed for it, therefore,

has not the dangers which are attached to inoculation, but neither

can it claim the occasional immunity which may attend that dangerous

practice of introducing small-pox virus into the blood. Pure air,

cleanliness, and decent house-room secured to all our people, form the

true prophylaxis of small-pox.

_Exaggeration of Bacteriology._--We observe how neglect of the Law of

Unity is misleading the intellect in relation to bacteriology. This

subject, useful if pursued without cruelty and in subordination to

higher facts, has become a mischievous exaggeration[7] both as to what

it signifies and as to what it may lead to.

The majority of our active and intelligent medical investigators are

now intensely engaged in the search for a microbe as the primary

_cause_ of every disease known to humanity. Cancer, leprosy, fevers,

hydrophobia, diphtheria, tetanus, insanity, etc., are being largely

studied by this imperfect method, in hope of finding a characteristic

microbe which can be pronounced the essential cause of the disease.

The great mental energy of biological investigators is diverted from

sanitary investigation to the search for fresh bacilli. Admirable

perseverance, acute ingenuity, unwearied energy are devoted to this

search.

Advantage has been taken of the helplessness of the lower animals

to carry on a system of experimentation upon them, the extent and

ruthlessness of which has never before been attempted. Disease

is studiously propagated. Myriads of healthy living creatures

are filled with loathsome disease in order to furnish ‘material’

for experimentation. So many kilos of dog or rabbit (used for

injecting disease, or noted as more or less slowly resisting the

death thus gradually inflicted) is a common expression now used

in experimentation, and supposed to give ‘scientific accuracy’ to

experiments. It is a pitiful intellectual fallacy of short-sighted

materialism that supposes it possible to obtain ‘scientific accuracy’

by regarding so many kilos of living dog as if they could be

experimented on as so many kilos of dead matter, or as if they were

the materials of a steam-engine, which can be taken apart, examined,

cleaned, tested, and put together again in complete working order.

This diversion of intellectual ability from the true path of sanitation

by an exaggerated search for bacilli leads directly to the dangerous

practice of inoculation, which threatens the future deterioration of

the human race. As one of the most distinguished of our hygienists, the

late Dr. Benjamin Ward Richardson, has pronounced, ‘inoculation is bad

sanitation.’[8]

Sanitary law teaches us that disease is produced by many causes, not

solely by a specific microbe.

These causes are insanitary conditions, which impair or destroy the

agents required by our human constitution for its healthy growth,

and which act with varying force according to individual tendency.

These insanitary conditions, in the course of their operation upon

varying individual constitutions, produce various forms of disease,

as chill may produce rheumatism, bronchitis, or diarrhœa, according

to idiosyncrasy. These varying idiosyncrasies of individuals, both in

their physical and mental aspects, as well as the varying action of

vital force in different classes of animals, will always vitiate the

theories of materialistic investigators. Thus the same poison will not

destroy all classes of living creatures. A healthy young dog has been

known to resist for months strenuous efforts made to disease him in a

particular way. The same disease germs produce quite different forms of

disturbance in men and in rabbits.

‘We possess no clue to the immunity of certain animals from poison.

Rabbits fed on belladonna show no signs of injury, although their flesh

becomes poisonous to those who eat it. Pigeons and other herbivora may

be safe from what will cause paralysis and asphyxia in other animals.

The meat of goats may similarly become poisonous.

‘Chickens, cats, birds, rodents, are variously affected by poisons,

some thriving on what will kill other animals. The whole cat tribe is

said to be always proof against morphia.’

Drs. Hahn and von Bergmann, in attempting to justify their

cancer-grafting experiments on hospital patients, affirm that ‘it was

necessary to select human beings for experiment, inasmuch as none of

the lower animals would have been suitable for their purpose.’

Sanitary law teaches us that unhealthy conditions vitiate the living

micro-organisms with which we are surrounded, and which, naturally

beneficial, may become, through violation of natural law, morbid germs,

capable of spreading their various forms of disease amongst persons

predisposed to such disease. Thus, according to sanitary law, the

violated health conditions (vitiating naturally innocuous particles)

are the primary cause of disease; the morbid germ or bacillus is only

the secondary cause.

The new bacteriological theory directly contradicts this important

law of sanitary experience, and in opposition to it authoritatively

announces that contagious or infectious disease can never be produced

without the antecedent microbe. It was in defence of this untenable

theory that the distinguished professor claimed the ‘right of science

to dictate.’

The great mistake, therefore, made by the Hygienic Congress was the

neglect of mind as an indispensable and prominent factor in Health, and

the exaltation of bacteriology, with the theories based upon it, into

the chief point of interest and importance.

The modern exaggeration of bacteriology, with its theory of

inoculation, must be steadily opposed by all who realize the power and

growing influence of spiritual life. The injurious results of this

exaggeration may be summarized as follows:

_The Practical Dangers arising from erroneous Scientific Method._--1.

It diverts invaluable intellectual activity into methods of

comparatively futile investigation. These investigations lead very

widely to the exercise of fraud and cruelty upon the lower animals,

and tend to reckless experiment on the poor. They waste much time and

spread the contagion of intellectual error amongst the students of all

our medical schools, where the false practices of experimentation are

increasingly carried on. They also pervert the moral sense of the great

army of assistants, caretakers, porters, nurses, and others connected

with our medical institutions, who become aware of the cruel practices

which so largely accompany this method of research.

2. This perversion of medical activity misleads our Parliamentary

representatives, who are bewildered by pseudo-science authoritatively

announcing itself as Truth, and permits a rapid increase of officialism

to crush opposition and force the dicta of superficial ‘science’ upon

the protesting conscience of intelligent people. It also misleads the

community by fallacious articles in popular magazines, in which facts,

theories, statistics, and assertions, often incorrect, are given with

an imposing air of science, in relation to which the ordinary reader is

quite unable to discriminate the true from the false.

3. The diversion of medical activity from the true path of Preventive

Medicine not only hinders the progress of sanitation, but is producing

an increasing revolt of common-sense and popular feeling against what

are erroneously supposed to be the necessary methods of medicine and

the practice of dispensary and hospital. This growing feeling in the

community increases the dread with which the poor generally regard

the hospital, and it also seriously diminishes the pecuniary support

which the well-to-do would otherwise gladly extend to their sick and

suffering fellow-creatures.

* * * * *

_Conclusion._--In considering the foregoing record of facts it is seen

to be a fundamental error, not only in a Hygienic Congress, but in

_all_ medical thought and practice, to look only at the body, and not

consider those spiritual facts which precede, animate, and succeed

the flesh. It is also certain that in the application of hygiene to

daily life we may as well pour water into a sieve as hope to enforce

permanently practical hygienic measures without enlisting the goodwill

of the people in their observance.

As the solution of the two great problems of hygiene--viz., ‘What

are the laws and conditions of healthy growth?’ and ‘How can these

conditions be secured?’ rests upon principles of spiritual truth,

those principles are of fundamental importance in directing human

intelligence into right lines of investigation. Being compelled to use

the imperfect symbolism of language, we speak of mind and matter, of

spiritualism and materialism, as if they were separate or contradictory

entities. But this is a limitation in the expression of thought to be

recognised and carefully guarded against in thought itself. There can

be no real contradiction between Religion and Science; they are only

varying manifestations in human thought of Truth, which is essentially

one. Our effort must be to unite these manifestations in thought, and

thus gain the only safe guidance possible to us for practical action.

* * * * *

The great fundamental principle of our human constitution is

incarnation--_i.e._, spirit shaping form--the Universal manifesting

itself in the phenomenal. This principle is the foundation of sanitary

science. It forms the basis of the Moral Law which must be the guide of

science.

When this principle is understood and applied, it enlarges the

intellect and enlightens the conscience. It transforms the narrow,

self-centred or arrogant individual into the humble inquirer and sharer

of the larger Diviner life.

This universalization of the individual resides essentially in the

Will of man, and is the foundation of conscience--conscience which,

gradually enlarged by the growing intellect, is the great guide of the

human race in its struggle upwards.

This universalization of the primitive self-centred life leads to the

realization of Sin. When we enter that Garden of Gethsemane where the

woes of the world, the murders and seductions, the cruelties and

hypocrisies, are revealed in all their hideousness, we realize that we

are partakers in this Sin; for it is the result of that self-centred

arrogance, that selfishness with which each one has to fight, and which

is the essence of Sin. It is through this tremendous conviction that

all must enter into that life of the Universal, where alone is true

freedom, and where alone the fulness of individual life is to be found.

Only by this saturation with the Universal does that hatred of Sin

arise which makes sins henceforth impossible.

Then the recognition of Right and Wrong in human action becomes clear,

and the supremacy of the Moral Law inevitable.

It is indispensable to refer to these deeper principles of existence

in considering their varied application. They give force to those

condensed maxims of practical wisdom which, transmitted to us from the

experience of our forefathers, are guides for our present daily life.

‘Never do evil that good may come’ is a proverb so familiar to us

in various forms that we fail to see the profound wisdom which it

expresses.

It is a confession of that intellectual limitation which cannot foresee

complicated results; it is an acceptance of that inflowing light of

conscience (however dim) by which everyone must honestly walk; it is

the subjection of the narrow, self-centred Will to the Universal Life

by which the individual becomes a free co-worker with the Divine.

Physiology rightly studied in the light of this fundamental

principle--incarnation--vindicates the supremacy of the Moral Law,

which is the Law of Unity, or transfiguration of the Self. It gives the

perception of Right and Wrong. The Law of the Universal, reverently

and intelligently studied, will guide all practical action; it will

show us how to build a hospital, plan a medical school, organize an

institute of preventive medicine, legislate for a community, or guide

the individual life.

The Law of Unity relegates bacteriology to its proper place as a branch

of pathology, and proves that truth cannot be gained by searching

into the quivering organs of tortured animals. It shows us also that

individual health cannot be secured by building a Chinese wall around

one’s self. We cannot stop the revolution of the earth in an atmosphere

which may bring bacilli from inundated China, from starved Russia, from

leprous India, or from the slums of the West.

We must work gradually towards the realization of our

ideal--Health--and work in many directions and on many lines. Advancing

sanitation will place our future hospitals in country neighbourhoods,

with only temporary receiving houses and dispensaries in large towns.

‘The oldest hospitals were the temples of Esculapius, where Divine

assistance was sought.’ To these Asclepeia, always erected on healthy

sites, hard-by fresh springs and surrounded by shady groves, the sick

and maimed resorted to seek the aid of the ‘god of Health.’ To this

wisdom of the ancients we must certainly return when the present

tendency to subordinate the welfare of the sick to the convenience of

students be checked.

The most urgent need which now exists in our profession is the

establishment of an Institute of Preventive Medicine guided by the

Moral Law. Such an Institute will recognise that mind and matter meet

in the fact called Life, will reverently study all the conditions

and laws of healthy life, and not be diverted from this great aim by

curious investigations into artificially propagated disease.

The study of the biological sciences, comparative and human physiology,

morphology, histology, electro-chemical action, etc., is most important

and necessary for the advancement of medical science; but these can

be studied without any violation of the moral Law of Unity. It is

necessary to study the forms and functions of life which are manifested

in organisms lower than man. The laws which govern animal and vegetable

growth form important steps towards our increasing knowledge of

human physiology and sanitary law; but these can only yield true and

available facts when studied through the natural and healthy working of

the objects of study. The artificial production of mental or physical

disease by fear and suffering vitiates the natural order of life, and

leads to error in observation and induction from such observation.

Torture is not only unsuited to laboratory work, but is an inevitable

source of error in results. A laboratory or workroom should never be

degraded into a torture-chamber. Experiment should never degenerate

into curiosity or inhumanity.[9]

In the future a wise Institute of Preventive Medicine may possibly

be placed in the healthy country. Around such an Institute for wise

research a well-planned health colony could grow up, which would be

of enormous utility to the overworked brains of our most valuable

people. It would be a health centre where the weary brain could be

refreshed and its vigour renewed by the restorative effects of manual

labour. Guided by true science, it would teach our teachers and our

legislators. Here they might learn to reverence those laws of health

which are equally violated by overworked brains and overworked muscles.

An Institute of Preventive Medicine genuinely ‘scientific’ would be the

soul of such a health centre.

But such a colony can only be created when narrow selfhood has been

transfigured by the universal life; for, as has been finely said: ‘True

social integration will follow upon spiritual integration, and upon

nothing else.’

Whilst working towards a fuller realization of our ideal we must

respect and aid, as far as we can, those isolated efforts to deal with

special transgressions of the Moral Law which are really steps onward

in the growth of humanity. Separate efforts to advance temperance and

purity, justice to women and children, to the poor and weak, to the

humbler animals, our fellow-creatures, are all efforts to be heartily

encouraged. Each effort forms a little step out of selfishness into

large religious life. Although those who realize the Law of Unity

cannot rest in any isolated work, yet it is by the honest fighting

of sins that we grow into that hatred of Sin which will lead to its

destruction; and by the slow perception of truths we gradually approach

that ineffable Light of Truth which will melt away the chains of

selfhood, and set us free in the larger liberty of the Universal Life.

FOOTNOTES:

[2] See Appendix, p. 85.

[3] Dr. Hambleton calculates the pecuniary loss from waste of life in

the army from preventable disease, chiefly of the lungs, as at least

half a million a year--a waste of life which adds materially to the

number of recruits required. Whilst stating the hygienic measures in

relation to clothing, special exercises, air, and bathing, which have

been shown to restore the inferior physique of recruits, he places as

the crowning necessity ‘explaining to the men the effects of good and

bad habits upon their health, so as to insure their co-operation.’

[4] Sir Walter Scott, a connoisseur in dogs, writing about popular

belief in 1832, remarks: ‘The powers of this talisman have of late been

chiefly restricted to the cure of persons bitten by mad dogs, and as

the disease in such cases frequently arises from imagination, there can

be no reason to doubt that water which has been poured on the Lee penny

furnishes a congenial cure.’

[5] An English gentleman, Captain Frank Fairbanks, was detained for a

fortnight in quarantine (says a Boston telegram) because he refused

to be vaccinated. A younger brother of his had lost his life through

vaccination.

[6] See Crookshank’s _History and Pathology of Vaccination_.

[7] Dr. Adametz states that ‘one gramme of Gruyère cheese contains

90,000 microbes; after seventy days they had increased to 800,000. A

gramme of another kind of cheese contained about two million microbes,

whilst a piece of the rind contained about five million!’

[8] This is virtually accepted by one of the foremost advocates of

inoculation, who, acknowledging that preventive inoculation ought to

be strictly limited, adds: ‘Inoculation is only a palliative measure,

for the first object to be aimed at is the stamping out of infectious

disease, and I cannot help thinking that the day will come when

preventive inoculation will be a thing of the past.’

[9] The greatest injury which is now being done to medicine and the

advancement of hygiene is the abuse of the word ‘research’ and the

degradation of this noble exercise of human intellect by methods of

application not suited to the subject of investigation.

APPENDIX (Page 56)

_On the Humane Prevention of Rabies_

In the course of a discussion on the subject of rabies, a suggestion

was made that a resolution should be passed by the Section and sent to

Government, recommending measures for the prevention of hydrophobia.

As two opposite methods of dealing with rabies had been ably supported

by Professors Roux and Fleming, I called attention to the fact that

nothing had been said in the discussion of the sufferings necessarily

inflicted upon animals where the Pasteur method advocated by Professor

Roux was adopted, and I stated that in a Pasteur Institute dogs were

kept in a state of madness. I therefore recommended that Municipal and

County Regulations, with their excellent results, as shown by Professor

Fleming of London, and Professor Ostertag of Berlin, should be adopted

rather than Pasteurian methods.

In illustration of the sufferings of dogs when made mad, I referred

to my visit to the Rue Dutôt on June 2, 1889, where, after inspecting

the Hall of rabbits, guinea-pigs, and pigeons used in experiments for

rabies, anthrax, etc., I went to the cages of three dogs also used for

experiments in rabies, who were in various stages of madness, one dying

after its ten days’ agony; a second in the full fury of madness; a

third in frantic terror clinging to the bars of his cage, imploring to

be let out.

Professor Roux’s statement in opposition to my recommendation of the

humaner methods of dealing with rabies seemed to infer that dogs were

not rendered mad in a Pasteur Institute or in dealing with rabies. But

when I stated to the Professor that I had myself seen this series of

three dogs being made mad, he replied: ‘Oh, you might have seen a great

many more, but they are not to inoculate people.’

Now, it is well known from experience that it is too dangerous to

inoculate direct from the dog to the human being. But the fact that

dogs are constantly made mad for experiment in the Pasteur Institute,

or in any institute that adopts Pasteurian methods, should be honestly

acknowledged, not evaded. The fact that this frightful disease of

rabies is kept up for purposes of experiment, although the virus be

transmitted in changed form through other animals for the inoculation

of human beings, is in itself a grave fact, and it bears directly on

the point which I dwelt on at the Congress--viz., that in choosing the

method of protecting humanity from a rare but frightful disease, the

method that does not involve sufferings to animals should be adopted by

a Christian nation.

SCIENTIFIC METHOD IN BIOLOGY

CONTENTS

PAGE

INTRODUCTION 89

CHAPTER I

THE GROWTH OF CONSCIENCE 91