Being disillusioned regarding the possibility of obtaining happiness in

this world, or in a future state, humanity falls back upon a third

illusion. Firmly convinced that the aim of life is true happiness, man

concluded that it was only attainable in some future state of the cosmic

process. This hypothesis is based upon belief in a system of progressive

development. “This,” declares Hartmann, “is yet another mistake.

Humanity may progress as much as it likes,” he says, “but it will never

succeed in suppressing or even diminishing the greatest evils which

beset it: disease, old age, dependence on the wishes or the power of

others, misery and discontent. Notwithstanding the new remedies which

are discovered, the number of diseases, especially those of a chronic

nature which are so trying, continues to increase at a rate that

medicine cannot keep pace with. Joyous youth will always constitute a

small portion of humanity, while the greater part will consist of

melancholy old age.”[234]

Against this idea that the happiness of the race will be the eventual

result of progress, Hartmann employs the following arguments: “The

happiest people are those who are the rudest and most primitive, and,

among civilised races, the uneducated classes. It is well known that the

progress of education increases discontent. The progress of science

contributes little or nothing to the absolute happiness of the world.

Practically speaking, this progress is of advantage to politics, social

life, morality, and the arts; but factories, steam-boats, railways, and

telegraphs, have so far done no positive good to humanity.”[235]

Hartmann frequently recurs to the conclusion that the primitive are

happier than the civilised, and that “the lower classes, inferior and

rude, are happier than the rich who are well educated and great; that

idiots are happier than the intelligent, and that, as a general rule,

the less sensitive a man’s nervous system may be, the happier he is, as

his capacity for feeling pain is not so much in excess of his capacity

for enjoyment, and his illusion is therefore greater. With the

progressive development of humanity, however, not only is there an

increase in the extent of human needs, but in the sensitiveness of the

nervous system, and in the cultivation of the mind. In consequence, the

balance of pain over pleasure increases, and the illusion is destroyed,

that is to say, knowledge comes of the misery of life, of the vanity of

most of the pleasures. Misery itself increases as much as knowledge of

misery, as experience has shown; and the apparent increase of happiness

in the world, due to the progress of universe, is merely superficial.

Having reached this extremely pessimistic conclusion, that it is

impossible for humanity to attain happiness, Hartmann proceeds to

inquire into the real destiny of man. He would be no true philosopher if

he did not hold that the world was created according to a general plan,

and that it follows a regular course tending towards a definite end. “We

have seen,” he says, “how that in the present world all has been

arranged in the wisest, and for the most part the best way, and that it

should therefore be regarded as the best possible of worlds.

Notwithstanding this, however, it is supremely miserable, and worse than

if it did not exist at all.”

Being convinced of the illusory nature of its hopes, humanity “must

definitely renounce all pretensions to positive happiness, and aspire

only to a freedom from pain, to annihilation or Nirvâna. This, however,

must not be merely the attitude of solitary individuals, but humanity at

large must cry out for annihilation. This is the only possible outcome

of the third and last phase of illusion.”

By what means is this end to be attained? Hartmann is no advocate of

suicide as the best remedy of the evils of human existence. Upon this

point he agrees with Schopenhauer, and thinks that such a course would

have no effect upon the general progress of the cosmic process. A

renunciation of pleasure—asceticism—would present no better solution of

the problem. Even abstinence from reproduction would not serve the

purpose. “What good would it do,” says Hartmann, “if humanity were to

cease to be by means of sexual abstinence? This unfortunate universe

would continue to exist, and the Unconscious would immediately take

advantage of the opportunity to create a new man or some other similar

type.”[236] Thus it is not the disappearance of mankind that should

constitute our aim, but “the complete abandonment of the individual to

the cosmic process, in order that the latter may accomplish its end and

bring about the universal deliverance of the world.”[237] This being so,

the instinctive love of life reasserts itself, and it becomes necessary

to admit, at least as provisional truth, “the validity of the will to

live; for it is only by complete resignation to life and its troubles,

and not by cowardly renunciation and abandonment, that one may

contribute one’s share in the development of the cosmic process.”[238]

Hartmann’s proposed solution of the problem of human existence belongs

undoubtedly to the category of systems advocating resignation. He is

unable to tell us what is the cosmic process to which he bids man lend

all his forces. He advises humanity to continue to live and to multiply

in the full certainty that happiness cannot be attained. Hartmann

obviously demands a true renunciation and an absolute submission. His

solution has the appearance of being more exact, and of furnishing a

guide to human conduct more clear than that vague aspiration to Nirvâna

proposed by Schopenhauer. But on closer investigation it becomes at once

plain that the greater precision is illusory.

It is easy to see, under such circumstances, that a school of criticism

or negation of the pessimistic doctrines should have gained many

adherents. Very few, on the other hand, have embraced pessimistic

doctrines because of any power being inherent in them to resolve the

difficulties of life. A German pessimistic philosopher, Mailaender,[239]

shared fully Schopenhauer’s opinions as to the misery of human life, but

opposed the latter’s doctrine of resignation and Nirvâna as the solution

of the general problem of life. Mailaender accepted the three stages of

human illusion as expounded by Hartmann, but attacked vigorously the

view of facilitating the cosmic process by acquiescence in the will to

live. “Indeed,” he cried, “your advice is that we should sacrifice

ourselves to the cosmos, we are to choose a career, to learn a trade,

acquire money, property, fame, power, and so forth; we are to marry and

to beget offspring; by such advice you are merely undoing with your own

hands the sole merit of your work, the analysis of illusion. You

suddenly advise the very man who has got behind all these illusions to

succumb to them again, as if an illusion, although it has been

recognised, could still deceive and exercise its power.”[240]

Mailaender takes an entirely different view of the problem. Like his

predecessors, he is convinced of the futility of happiness, but he has

achieved an original view of the cosmic process. He holds that an

unaccountable and divine Being existed before the creation of the world.

Before disappearing “this divinity gave birth to the universe.” By this

means, complete annihilation was made possible. “The world,” says

Mailaender, “is but the means for bringing about a condition of

non-existence, and is the only possible means by which that end could be

attained. God knew that only by creating a real world could we pass from

existence into non-existence.” Maileander regards as certain “that the

universe tends towards universal non-existence.”[241] This tendency is

characterised by the weakening of the total amount of energy, so that

“every individual at the close of the weakening process to which his

energy is submitted, is led in the course of his development to the

point at which his desire for annihilation may be fulfilled.”[242] Life

on our planet, he says, ought to be regarded as a halting-place on the

road to death. In order to appreciate fully the happiness brought by

death, it is necessary first to taste of life, and that is why the

instinct of self-preservation is so well developed in animals. Man

passes first through a phase of development in which he is like any

other animal. “As with them, the will to live is stronger than the will

to die. Life is clung to with extreme pertinacity, and death is

proportionately execrated.” “At first, not only the fear of death

increases, but equally the love of life.” Terror of death becomes

acuter. Animals, knowing nothing of death, only fear it instinctively

through their perception of approaching danger. Man, on the contrary,

knows of the existence of death and what it means. He looks back on his

past life and wonders what the future may hold in store, and realises,

infinitely more than animals realise it, the dangers that threaten him.

During this phase, man does all in his power to keep death at bay, and

to make his life as happy as possible. This, however, is not the last

stage of his development. The thinking man soon comes to the conclusion

that a craving for life is not the true aim of the universe; it is only

the means for attaining to a knowledge of the definite aim of existence,

which is the cessation of life. Philosophy soon shows that perfect

happiness is not possible, and that only death is really desirable. In

summing up the cosmic process, the conclusion arrived at is “that

throughout the universe the desire of death exists in a form more or

less masked, but that in the organic world this assumes the form of a

will to live.”[243] In the end, however, the desire of death becomes

more and more plain, until the philosopher can see “in the whole

universe nothing but a longing for absolute extinction, and fancies that

he can hear the cry rolling from star to star, ‘Deliverance,

deliverance, death to our life!’ and the echoing cry of consolation,

‘Extinction and deliverance await you all!’”[244]

In order to explain in a clearer way the progress of this evolution,

Mailaender describes the state of mind of a man who develops the will to

die, and commits suicide. “At first he glances anxiously and from afar

at death, and shrinks from it with horror. Later, he draws nearer and

walks round it in wide circles. Day by day, however, these circles

become smaller, until finally he embraces Death with weary arms and

looks it straight in the face. Then Peace comes; gentle Peace!”[245]

It is absurd to expect anything to follow death but absolute

annihilation, and the ordinary man faces this prospect with terror. “But

it is essential,” says Mailaender, “that man should dominate the

universe by knowledge, and wise men look forward to total annihilation

with joy.”[246] “In relinquishing Schopenhauer’s will to live,”

concluded Mailaender, “I have finally arrived at the will to die. I have

raised myself upon the shoulders of Schopenhauer, until I have attained

a point of view such as others have never accomplished. At present I am

alone, but behind me all humanity is pressing on to freedom; and before

me is the clear translucent vista of the future.”[247]

I have quoted these views, not because of the solidity of Mailaender’s

arguments, but merely because this pessimistic philosopher proved

himself to be more consistent than his predecessors. While Schopenhauer

and Hartmann, both so firmly convinced of the non-existence of happiness

and the vast preponderance of suffering in all imaginable conditions of

life, lived out their lives, Mailaender, true to his principles,

committed suicide when barely thirty-five years of age.

This is probably not a solitary instance. Under the influence of

pessimism, a certain number of young persons, especially those whose

mental equilibrium is not very firmly established, follow in the tragic

footsteps of Mailaender. Some commit suicide, while others abstain from

taking part in the perpetuation of the race. Others, but these are not

many, curtail their existence by dissipation, thinking life not worth

the care of it.

A modern writer of great talent, Maeterlinck, echoes the pessimism of

the present generation. “It is plain,” he says,[248] “that from one

point of view humanity will always seem wretched, and as though being

dragged towards a fatal precipice, since it will ever be doomed to

disease, to the inconstancy of matter, to old age and to death.” “Yes,

human life as a whole is sad, and it is easier, I may almost say

pleasanter, to discuss and expose its dark side, than to enumerate its

consolations and make the best of them. The miseries of life are many,

obvious, and never failing; whereas the consolations, or rather the

reasons which cause us to fulfil with alacrity the duty of living, are

rare, hard to seek, and precarious.”

Although pessimism has been greatly developed and widely spread during

the nineteenth century, dissentient voices in opposition to this

negative attitude towards the things of this world have not been

wanting. Take the views of the German poet, Robert Hammerling,[249] who

reproaches the pessimistic philosophers with ignoring the attitude of

mind of the majority of mankind who ask but one thing,—life—life at any

price and under any conditions. Against this sentiment all dogmatic

arguments are useless, for, according to Hammerling, the question of

pleasure and pain is a matter of feeling and not of reason. Now, with

regard to the general feeling of humanity, there can be no doubt—it is

frankly optimistic.

Max Nordau, the well-known writer, supports a similar theory. According

to him, all living nature betrays its optimistic foundation. “The truth

is,” he says, “that optimism, limitless and irradicable optimism,

constitutes the fundamental attitude of man, and is the instinctive

feeling which governs him under all circumstances. All other forms of

life confirm this truth....” “All nature,” according to Max Nordau, “by

the bells of flowers and the throats of her birds, rings and proclaims

the truth of optimism.” “No animals feel the pain of the world; and our

own ancestor, the contemporary of the cave bear, was certainly free from

all anxiety relating to the destiny of the human race.”

These arguments do not take into account that, to be true, pessimism

need not necessarily be felt and agreed with by all living creatures.

Birds and other animals, happy in their lives, that is to say optimists,

know nothing of the inevitability of death. Our cave ancestors knew

nothing of it either. If the greater portion of modern humanity is

optimistic, that might be accounted for by its being still under the

influence of one of the three phases of illusion alluded to by Hartmann.

It is only when the highest stage of development is reached that man,

being convinced of the futility of his hopes, arrives at a pessimistic

conception of the universe.

Max Nordau disclaims discipleship of Doctor Pangloss, who held that the

world is the best of all possible worlds. But his arguments reveal a

pronounced optimism. He regards pain as an indispensable factor of the

maintenance of life. “Without pain,” he says, “our lives would not

endure an hour, for we should be unable to recognise dangerous symptoms

and guard against them.” Insensibility to pain is often so grave a

symptom that sick people rejoice when they are again able to feel the

prick of a needle.

This is true enough, but none the less the feeling of pain is very

erratic in both animals and human beings. Quite insignificant causes and

unimportant illnesses, such as certain forms of neuralgia, give rise to

unbearable agony. A physiological phenomenon such as childbirth is often

attended by extremely violent pain which is absolutely useless as a

danger-signal. On the other hand, some of the most dangerous diseases,

such as cancer or kidney disease, may exist for a long time without

causing any sensation of pain, with the result that the sufferer knows

nothing of the presence of the disease until it is too late. Were pain

to play the part assigned to it by Nordau, it would appear in all cases

of danger, and yet would never become almost unbearably acute.

But when men have passed through the three stages of illusion it is not

physical pain which presses most heavily on them. Max Nordau himself

admits that it is “appalling to think of the cessation of our

consciousness, and the annihilation of our ego.” None the less, he

believes “that we are so happily constituted as to be able to accept the

really inevitable with a light heart, and that there is no ill feeling

about the matter.” This admission is not in accordance with the

well-established facts discussed in chap. vi. With very rare exceptions

man does not willingly accept the prospect of death, especially if he be

still under the influence of illusion in any of its three stages. As a

rule those who desire to live feel not only a repugnance to the

contemplation of death, but death seems to them something abnormal and

irrational. It is no answer to assert that all who feel this are

psychopaths, or that it is absurd to think that the happiness of mankind

counts for something in the cosmic process. On the contrary, it is quite

natural that man should seek after happiness, and that he should try to

analyse the phenomena taking place within him and around him from the

point of view of that ideal. For this reason it is quite unjust to say

that pessimism cannot be treated seriously. It is pessimism which has

been the first to draw up a true indictment of human nature, and if pain

is to be regarded as useful in its quality of danger-signal we should

equally recognise that the pessimistic view of the universe is a step

onwards in the evolution of humanity. Without pessimism we might easily

sink into a kind of contented fatalism, and end in quietism, in the

manner of many religions.

It is only natural, however, that the thinking world should not accept

pessimism as the last word of human wisdom, and that more or less noted

philosophers should devote themselves to finding a possible solution of

the problem of life and death. These systems of philosophy, one and all,

have abandoned readily all belief in future life and personal

immortality. But they have adopted pantheistic conceptions, and have

accepted the existence of some general principle into which the

individual consciousness will eventually be absorbed. There is division

of opinion as to the properties of this principle. For some it is the

Idea, for others Will, for others Force, or Eternal Energy.[250] The

nomenclature is the less important as the views as to the nature of the

general principle are absolutely vague. Accordingly this part of the

philosophic doctrines appears in a lyrical form and has passed over into

the domain of poetry.

German poets have helped to spread pantheistic conceptions very widely.

I need hardly mention Goethe, whose ideas were purely those of Spinoza,

but Schiller’s well-known lines are precise:—

“Vor dem Tode erschrickst Du? Du wünschest, unsterblich zu leben?

Leb’ im Ganzen! Wenn du lange dahin bist, es bleibt!”

“Do you shrink from approaching Death? and crave immortality?

Live on in the All! Long after you vanish the All will remain!”

Rückert, in lines almost equally well known, expresses the same idea:—

“Vernichtung weht dich an, so lang Du Einzles bist.

O, fühl’ im Ganzen dich, das unvernichtbar ist.”

“Annihilation fills you with terror, because you are self-centred. You

must feel your unity with the All, which is indestructible.”

A volume might be filled with the attempts of thinkers of different

countries to present these poetical ideas in a form less vague and more

philosophical. I shall select only a few of the more modern instances.

Renan’s[251] ideas may be taken as typical of the compromise between

poetry and philosophy. Speaking of immortality, he said “that we shall

each live again by the traces we leave on the bosom of the

Infinite.”[252]

The views elaborated by Guyau[253] are equally poetic. Like so many

others he is unable to accept without protest the prospect of the

inevitability of death. Brought face to face with this end, he declares

that he feels “not sorrow but indignation, as against an injustice of

nature.” “It is with justice,” he cries, “that we look on nature as a

murderess if she kills what is morally best in ourselves and in

others.”[254]

It is chiefly in the name of love that Guyau protests against death:

“The death of others, the annihilation of those we love, is

insupportable to men, who are essentially thinking and loving

creatures.”[255]

This problem, so vast and so difficult to solve, is presented by him as

follows: “As regards the question of individual immortality, human

thought is dragged in opposite directions by two great forces—science,

in the name of evolution, prepared to sacrifice the individual

completely; love, in the name of an evolution, morally and socially

higher, which would preserve the individual at all hazards. There is no

more disturbing dilemma proposed to the philosopher.”[256]

Guyau hopes that in the course of evolution there will come about a

merging of individual consciousness in the consciousness of the whole.

“One may ask,” he says, “if it may not be that these conscious entities

mingling and interpenetrating, may come to live on from one to the

other, and so to acquire a new duration?” On such a hypothesis he can

foresee “an epoch not, indeed, certain to come, but far from

inconceivable, in which individual consciousnesses will have achieved a

corporate integrity and a complex intercommunion, without themselves

being lost by the union.”[257]

On this hypothesis, “the problem is to be at the same time loving enough

and loved enough to live and endure in another.[258]... Those who vanish

and those who remain must love one another so greatly that the shadows

cast by them on the universal consciousness are identical.” “We should

then feel ourselves passing and ascending from this life to an

immortality of love,” and “the point of contact between life and

immortality would be discovered.”[259]

A solution recently offered by Finot[260] is much less poetical.

According to him, it is only “when death is conceived of as annihilation

that it is repugnant. On the other hand, if we regard it merely as a

change of life, we shall cease to fear it, and even come to love

it.”[261]

But what is this “change of life” that is to prove so consoling? It is

the “immortality of the body,” that is to say, the life of the creatures

developed at the expense of the human body. “Flies begin the work of the

labourers on the dead,” giving birth to worm-like larvæ that writhe in

the decomposing flesh. The same vermin that horrified Tolstoi when he

thought of his own death (see chap. vi. p. 123) became Finot’s symbol of

consolation. He describes the whole succession of the fauna of corpses,

and concludes by saying, “and so goes on the routine of life, from birth

to the tomb, of noisy, clamorous life, ceaselessly renewed. Ever loving,

giving birth, living and dying. The peace of the tomb is as filled with

life as the dust into which we think our bodies will fall.”[262]

I have given the above quotation as an instance showing to what lengths

men have gone in their search for a solution of the problem of death and

in their desire for a gleam of hope that the end may not be final. I

need not say that this idea of the fauna of the corpse has no place in

the philosophy of death. Thinkers, no doubt, would prefer the most vague

ambiguities to certainties of such a nature. Most contemporary

philosophers regard the problem in a very different fashion.

In my opinion, Meyer-Benfey, a scholar at Göttingen, has summed up the

present condition of the problem very clearly and exactly, in essays on

Modern Religion.[263] He realises that it is impossible to accept the

immortality of the soul. Personality must utterly and inevitably perish.

But, just as no single atom of our bodies can be annihilated, so “no

parts of our souls can be lost.” Our actions during life leave traces so

much the deeper as the life has been fuller. It is this reuniting “of

the actions of individuals with the life of the whole of humanity, that

constitutes the true immortality or Nirvâna.” He says, too, “In

accustoming our minds to this thought, and in educating ourselves with a

view to the accomplishment of this end, lies the only possible means of

overcoming the fear of death and the terror of annihilation.”

Meyer-Benfey is of the pessimistic opinion that happiness cannot

possibly be regarded as the supreme end of humanity, for he thinks, if

that were so, the whole course of evolution would have been a mistake.

It would have been much better had evolution been arrested before the

creation of the human race, since animals, being unaware of the

inevitability of death, are undoubtedly happier than man. As, however,

we have passed through the animal stage and reached the human stage, and

achieved some measure of civilisation, and this not by our own desire,

or as the result of mere chance, but guided by the inner workings of our

nature, it is plain that the ultimate goal towards which we are

advancing, must be some other than mere happiness. There can be no

question but that the goal is the triumph of pure and perfect culture.

This idea, that the goal of humanity is progress in all its

manifestations, is no recent theory, and many definitions of this

progress have been advanced, but so far none have been generally

accepted as satisfactory. The term “culture,” though vague, will have to

continue in use until some better word conveying a more precise meaning

is found to replace it.

On reviewing all the systems of philosophy which have attempted so

strenuously to solve the problem of individual death, it becomes plain

that all, or nearly all, of them deny the existence of a future life and

the immortality of the soul. The greater part of them, however, admit

some general principle incomprehensible but eternal, which will

eventually incorporate within itself all individual souls. Feeling that

these vague ideas are incapable of conveying consolation to poor

humanity in its fear of annihilation through death, philosophers have

persistently taught the advantages of resignation. Even Guyau, realising

that his philosophy regarding the immortality of love fails to reassure

those who look to philosophy for some word of consolation, ends by

admitting that “as there is no help to be expected from the inexorable,

nor mercy from that which is in conformity with the universe and even

with our own judgment, resignation is best.”[264] As it is the general

opinion that to be philosophical is to take things as they are, without

undue protest, the watchword of all systems of philosophy is to bow to

the inevitable, that is to say, to be resigned to the prospect of

annihilation.

PART III

WHAT SCIENCE IS ABLE TO DO TO ALLEVIATE THE DISHARMONIES OF THE HUMAN

CONSTITUTION

CHAPTER IX

WHAT SCIENCE CAN DO AGAINST DISEASE

Formation of the experimental method—The intervention of

religion in disease—Disease as a basis of pessimistic systems of

philosophy—Advance of medical science in the war against

disease—The revolution in medicine and surgery due to the

discoveries of Pasteur—The beneficial results of Serum Therapy

in the war against infectious diseases—Failure of science to

cure tuberculosis and malignant tumours—Protests against the

advance of science—Opposition of Rousseau, Tolstoi, and

Brunetière—Proclamation of the fallibility of science—Return to

religion and mysticism

Science, the youngest daughter of knowledge, has begun to investigate

the great problems affecting humanity. The chief religions and many

systems of philosophy had been long established before the spirit of

scepticism dared to inquire whether or no these products of the human

mind were really in harmony with fact. Scepticism gained ground little

by little, and open war was declared between religious dogma and

authority on the one side, and scientific reason on the other.

The great religions and the philosophy of Aristotle had ruled a majority

of mankind for some twenty centuries before doubt was cast on the real

value of these doctrines.

Francis Bacon, Lord Verulam, asked why it was that all the systems of

his time were so vague and so powerless to explain the phenomena of the

world. The cause could not lie in nature herself, for without doubt she

followed laws that were immutable and that could be subjected to exact

observation; nor could it lie in any want of intelligence in those men

who devoted themselves to solve the problems. The true cause of the

failure lay in the falsity or insufficiency of the methods employed.

Bacon, trying to provide a remedy for this condition of affairs, advised

that makers of generalisations should proceed very slowly, passing only

by the smallest stages from particular facts to conclusions only more

general in the slightest degree, and so on, until the ultimate formula

might be reached. By such a path it was possible to attain principles

neither vague nor ambiguous, but clear and exact and that would not be

denied by nature herself.

The first steps taken by science according to this method, which indeed

had been suggested long ago, but which was first clearly laid down by

Bacon, were slow and halting. Religious and philosophical doctrines

still weighed heavily on inquiring minds, so that the new method was not

followed with any great courage. None the less progress was achieved,

until at length the great problems of humanity opened out. More than two

thousand years before the birth of exact science, Buddha had given voice

to the chief grievances of the human race. “Behold, O monks, the holy

truth as to suffering,” he had proclaimed in the Sermon at Benares,

“birth is suffering, old age is suffering, disease is suffering, and

death is suffering.” Science, in its slow progress, passing from

particular to general, reached first one of these four sorrows, the

suffering due to disease.

In the Buddhist legend that I quoted in chap. vi., the sight of a sick

man “whose senses were weakened, who drew his breath with difficulty,

whose limbs were shrivelled, whose bowels were wrung with pain, and his

body pitifully soiled with excrement,” suggested to Buddha the

reflection that “health is no more than the idle vision of a dream while

fear and disease are horrible realities. What wise man, having seen the

thing that life is, can still think of joy or of pleasure? Woe upon

health which is assailed by so many maladies.” When Buddha, who was a

young prince, asked of his father the gift “that he might always remain

full of health, and that he should be smitten by no disease,” his

father, who was the king, replied: “You ask me what is impossible; in

that my son, I can do nothing.”

From that day, every religion has busied itself with the cure and

prevention of disease. They believed that the causes of these were the

influence of evil spirits or the visitations of God; and as remedies

they prescribed sacrifice and prayer and anything that might avert the

anger of God. Even at the present day, similar medicine is used by

primitive races. In Sumatra for instance, when it is impossible to

arrest the flow of blood from a wound, the disaster is ascribed to an

evil spirit (Polasièq) who is sucking the wound and making it incurable.

In Nias, when bleeding from the nose occurs in children, it is supposed

to be due to the father having killed a cock during the pregnancy of the

mother. The indispensable remedy is to make sacrifice to the outraged

deity.

No doubt there co-exist with such practices of primitive races, certain

useful rules, based on correct observation or on experience. It is a

common practice to try all manner of remedies on the sick; although most

do harm, now and again something useful may be discovered. Such vulgar

medicine has undoubted merit, but it cannot be compared with the results

of scientific medicine, which are drawn from rigorous experiment.

Medical science has been slow in developing, but it has now reached a

condition of which humanity may be proud. It is outside my purpose to

give a long exposition of this subject; but it is necessary to my

argument to set out a few facts from which the reader may judge of the

present condition of medical science.

Without doubt the fear of disease has played a large part in the

pessimistic conceptions of the universe. Not only the words of Buddha

that I have quoted, but many of the systems of pessimistic philosophy

attest this. I have already stated in chap. vi. that Schopenhauer in

1831 was driven from Berlin to Frankfurt by fear of cholera.

In his statement of the case against this universe, and as a chief

argument for his proposition that “this is the worst of possible worlds”

Schopenhauer adduced the spreading of epidemics. “An alteration of the

atmosphere so slight that it cannot be detected by chemistry brings

about cholera, or yellow fever, or the black death, diseases which

number their victims by millions; an alteration slightly greater might

destroy all life.”[265]

Hartmann, who has been one of the chief advocates of Schopenhauer’s

pessimism, also had gloomy views on diseases and medicine. He was

convinced that howsoever great the progress of humanity might come to

be, there never would be an end or even a diminution of diseases. “It is

no matter,” he said, “how many remedies may be discovered for diseases;

new diseases, and particularly chronic affections which, although not

serious are extremely painful, will continue to appear more rapidly than

the discoveries of medicine.”[266]

Humanity will be fortunate if the pessimistic philosophers prove as

wrong about their other grievances as they have proved about disease and

medicine. To understand the vast progress made by medicine, it is

necessary only to compare the complaint of Schopenhauer with the actual

state of affairs. When he spoke of epidemics being due to slight changes

of the atmosphere, Schopenhauer obviously was repeating the medical

opinion current in his times. Experimental science has proved that he

was quite wrong. It has been shown conclusively that two of the great

affections of which he spoke, cholera and plague, are due not to

chemical changes in the air, but to definite microbes, the natural

history of which is known as well as that of any other plant. Cholera is

produced by the vibrio, discovered by Koch, a minute organism that lives

in water and that enters the human alimentary canal with food or drink.

We do not yet know a definite cure for cholera, but we do know how to

prevent infection. The most simple mode of guarding against infection is

to swallow only material that has been boiled, and to prevent

contamination of water or of vessels with fæcal matter containing the

Koch’s vibrio. Moreover, in individual cases use may be made of

anti-cholera serums. In 1831, if these discoveries had been made,

philosophy would have taken a different course. Instead of trembling at

the epidemic, and flying to Frankfurt, Schopenhauer would have remained

quietly at Berlin, and Hegel would not have ceased to develop his

idealism in the university of that town.

Schopenhauer enforced his argument by reference to the black death

“capable of destroying millions of victims.” It is certain that the

black death was no other than human plague, which made enormous ravages,

in the fourteenth century, for instance, destroying nearly a third of

the population of Europe. In those days, no one doubted but that it was

a visitation of the Divine wrath, and people gathered in churches to

make common supplication. Sacrifices were offered and flagellations took

place in the hope of averting the terrible malady. Travellers who have

been in the capital of Austria must have seen in one of the chief

streets (Graben) a large and unlovely monument, erected in the

seventeenth century to commemorate the interposition of Providence in

staying one of the great epidemics of plague. Now that science has made

known the true cause of plague, our ideas as to the causes of the

appearance and disappearance of epidemics are very different. Plague is

not the manifestation of the anger of God, but is a scourge due to

invasion by a minute organism, discovered simultaneously by Kitasato and

Yersin in 1894. The natural history of the microbe has been studied, and

we know that it may live not only in human bodies but in the bodies of

small rodents, such as rats and mice, which live in association with

man. These animals are the source of human infection, and it is

necessary to destroy them as completely as possible. There is no doubt

but that the arrest of the plague in the seventeenth century was due to

the fact that rats and mice had themselves been exterminated by the

plague.

Plague, which formerly was the most terrible of epidemic diseases, has

now become a misfortune against which it is simple to guard ourselves.

To secure that end, however, we have not to pray or to scourge

ourselves, but to take measures to destroy rats and mice. Moreover

serums may be employed; and the use of these is not only prophylactic,

but if the disease be not too advanced, is actually curative. The danger

of which Schopenhauer spoke may be regarded as definitely averted, and

this is due to the advance of medical knowledge. In such countries as

British India in which plague still causes great losses, we have to

blame the ignorance of the population. Instead of following the course

prescribed by science, these people still prefer the rules laid down by

the Brahmanistic religion. Their idea of cleanliness and purity is a

religious idea, and not that of medicine and bacteriology. It is not

surprising that plague still exists in India, but none the less no case

is a better instance of the progress of knowledge.

Hartmann’s idea as to a progressive increase in the number of diseases

rests on no exact grounds, and is in opposition to much that we know. As

a matter of fact, as knowledge of hygiene advances and becomes spread

among the peoples, diseases become less frequent and less fatal.

A great stimulus was given to medicine and surgery when there was

applied to these the knowledge gained by Pasteur in his study of

fermentation. Pasteur showed that fermentations were chemical

alterations in organic matter, excited by the presence of minute

organisms very common in the neighbourhood of man.

This discovery was applied in the first place to surgery. Lord Lister,

then a surgeon in Scotland, showed that the festering of wounds was due

to the entrance of minute organisms. Following this clue, he succeeded,

by the use of dressings, in preventing the contamination of wounds and

at once saw a vast reduction in deaths following surgical operations.

Since the discovery of anæsthetics, such as ether, chloroform, and

cocaine, and the use of germ-free dressings, surgery has been developed

in a marvellous fashion. The varied and delicate feats of abdominal

operation are known to all, and recently surgery of the heart has become

possible.

A comparison of the mortality of the wounded in the different wars of

the nineteenth century affords an excellent means of gauging the

progress of surgical treatment of gunshot wounds. The mortality of the

wounded among the English troops in the Crimean war reached 15.21 per

cent.; in the French troops in Italy in 1859–1860, it was 17.36 per

cent.; in the German army in 1870–1871, the years in which antiseptic

surgery came into use, it fell to 11.07 per cent.; while in the

Spanish-American war in 1898, in the most brilliant period of modern

surgery, the percentage mortality of wounded had fallen to 6.64.[267] In

the recent Transvaal war, the mortality was half what it had been in the

Franco-German war.[268]

New medical knowledge, founded on the discovery of the nature of

ferments and of the virus of infection, has reformed the practice of

midwifery to such an extent that puerperal fever, formerly one of the

great scourges of humanity, is now extremely rare.

Blindness acquired at birth, which formerly rendered many lives

extremely miserable, is now practically completely prevented, by means

of the precautions taken to hinder the child from being contaminated by

the mother in the process of birth. The most successful method is that

which was suggested by Credé,[269] a German physician, and consists in

placing in the pupils of the infant a minute drop of nitrate of silver,

which is an antiseptic, and prevents the occurrence of ocular

blennorrhagia.

Appendicitis, a disease so common that I referred to it in chap. iv. as

one of the most salient examples of disharmony in the human

constitution, has been resolutely attacked by medical science. In some

cases, surgical interference makes a definite end of the disease; in

other cases medical treatment has been enough to subdue the symptoms

without recourse to operation.

For a considerable period, those of a sceptical disposition asserted

that the advance of bacteriological knowledge was of service only in

surgical cases. But Pasteur showed that this was an erroneous view.

Working with Chamberland and Roux, Pasteur demonstrated that many

infectious diseases could be prevented by the use of attenuated virus;

he succeeded in saving the lives of many animals and of men, bitten by

rabid dogs and affected by hydrophobia, a disease formerly almost

invariably fatal and among the most horrible to which man is liable.

In the latter direction, medical science is developing at an

extraordinary rate, and is achieving results of a remarkable nature.

Among recent discoveries, I may mention that of the curative properties

of the blood serum of animals which have been subjected to the action

either of microbes or of the soluble products of microbes. Von Behring,

working with the Kitasato, a Japanese investigator, has shown that a

serum of this nature, prepared with the poison produced by the microbe

of diphtheria (the poison was discovered by Roux in collaboration with

Yersin), is capable not only of protecting those in good health from

diphtheria, but of curing those who have been attacked by the disease.

The serum fails to act only when it is employed in advanced cases of

diphtheria.

Anti-diphtheritic serum, introduced into medical practice about eight

years ago, has been tried in every way and has been proved to possess

both preventive and curative properties. If patients still die from

diphtheria, it is only because the treatment has been applied too late

or insufficiently.

The use of the anti-diphtheritic serum has reduced the mortality in

cases of diphtheria from 50 or even 60 per cent. to 12 or 14 per cent.

The number of infant lives that have been saved by this method must be

enormous.

The beneficent discovery of the curative value of serums has been

applied to other diseases and is giving very encouraging results. I

cannot go into details here, but it is enough to say that in the last

quarter of a century medicine has entered a new epoch, and has taken its

place among other exact sciences based on the experimental method.

Although it is not surprising that in so short a space of time science

has not yet conquered all the ills affecting humanity, this failure has

provoked the most severe criticism.

“Indeed,” one of the critics has said, “you vaunt the progress of

medical science at a time when you have to confess that it has failed to

cure tuberculosis, one of the gravest of the infectious diseases, which

alone causes the death of a sixth part of the human race.” It is true

that the infectious nature of this scourge was announced by Villemin

more than forty years ago. Twenty years have passed since Koch, the

German bacteriologist, discovered the microbe that produces not only the

ordinary form of pulmonary consumption but all other varieties of

tuberculosis. And we are still ignorant of any remedy for the disease.

In all the bacteriological institutes and laboratories search is being

made for some vaccine or serum or medicament which will arrest a disease

that in many cases nature herself cures. But the results amount

practically to nothing.

This is certainly a good example of the failure of science. None the

less a closer examination shows that even with the knowledge already

gained we could deal with tuberculosis in a manner more efficacious than

is the existing practice. When the infectious nature of the disease had

been made known, before waiting for the discovery by Koch of the actual

bacillus, we should have employed all the known modes of destroying

infectious matter. In spite of all that has been said and written on the

subject, people still spit on the floors of omnibuses and cars and on

street pavements. Tuberculosis is propagated not because of the failure

of science, but because of the ignorance and stupidity of the

population. To diminish the spread of tuberculosis, of typhoid fever, of

dysentery, and of many other diseases, it is necessary only to follow

the rules of scientific hygiene, without waiting for specific remedies.

Although the science of to-day is sufficiently armed against the

diseases commonly known as infectious, the case is very different with

some other affections, among which the chief place is taken by malignant

tumours, or cancers, in the most general sense of the word.

There are few maladies more terrible, for they practically never

disappear spontaneously, and surgery can remove them successfully only

if they have been recognised at an early stage. Every year a number of

persons, old and young, die victims of malignant tumours, and it is even

possible that cancer is more prevalent now than in former times. It has

been suggested that the increase of cancer is due to the greater

longevity among modern races, and as malignant tumours are most common

in old persons, it may well be that the prolongation of life has given

this disease a larger field. However, even allowing for this, it is

probable that there is a real increase of cancer.

Unquestionably the malignant tumours are the diseases most disappointing

to medicine and surgery, and these sciences are as much at a loss with

regard to them as in the case of infectious diseases before the

discovery of pathogenic organisms. Science is perhaps even in worse case

with regard to cancer than it formerly was with regard to infectious

diseases, for, before the discovery of microbes, something was known of

the virus which produces infection. Thus the virus of smallpox was

known, and was used, by the method of inoculation, to prevent more

serious attacks of the disease. Nearly a century before the discoveries

of Pasteur, Jenner had been able to be of the greatest service to

mankind by his discovery that the virus of cow-pox could be used as a

preventive of infection by smallpox.

In the case of malignant tumours, we do not even know their real nature;

we are ignorant as to whether or no they are infectious, and whether

they are caused by a microbe coming from without or are due to internal

changes of the tissues. Our ignorance, however, affords no ground for

despair. It is probable that the malignant tumours will soon come to be

ranged with infectious diseases due to invasions by specific microbes.

Experiments on the cancers in rats and mice have shown that these can be

inoculated in the same manner as in the case of the recognised

infectious diseases. Hanau has shown that this occurs in the case of

epithelioma of old rats; Morau[270] has succeeded in transferring the

cancers of white mice, and his results have been confirmed by

Jensen[271] and Borr[272], in the Institut Pasteur. These

investigations mark the beginning of a new stage in the knowledge of

tumours. I am unable to see, therefore that the malignant tumours

provide a satisfactory argument in favour of a pessimistic conception of

the universe.

Dr. Boas, of Berlin,[273] in a recent publication, has laid stress on

the fact that most patients affected with cancer do not seek medical aid

until the disease is far advanced. For instance, in 80 per cent. of the

cases of cancer of the rectum that he had attended, the patients

presented themselves too late for operation. Boas advised that the

attention of the public should be drawn, by means of widespread

publication, to the earliest symptoms of cancerous disease. He thought

that such a course might save many lives by making possible operation in

early stages.

The prevention and treatment of disease, which for long was in the hands

of religious authorities, is now passing into the care of those who

employ the methods of scientific medicine. It is now only in the case of

certain nervous maladies, which can be treated by suggestion, that

religion has any important part to play. I have not thought it necessary

to expound at length the work of science in the struggle against

disease, because the evidence on this point is extremely clear and

precise. Every one must accept it, and even the passionate enemies of

science have to bow before the fact.

However, the problem has been changed. Science they now admit, is

capable, no doubt, of assuaging humanity in its sufferings from this or

the other disease. But there is another question. Disease is only an

episode in human life, and the great problems remain unsolved by

science. It is not enough to cure a man of diphtheria or intermittent

fever; it is necessary to explain what the destiny of man is, and why he

must grow old and die at a time when his desire to live is strongest.

Here, plainly, all science must fail, and here must begin the beneficent

work of religion and philosophy. But as science is constantly casting

doubt on the dogmas of religion, and criticising adversely the systems

of philosophy, it is plain, that so far from being of service, science

is actually harmful to mankind.

The campaign against science was opened long ago. In the eighteenth

century Rousseau[274] opened it with brilliancy and zest worthy of his

reputation. He defended his theme with vigour and eloquence and the

following quotations may serve as an example, “Know O people,” he wrote,

“that nature has desired to preserve you from science as a mother tries

to snatch a dangerous weapon from the hands of her child; that the

secrets which she has hidden from you are evils from which she would

preserve you, and that one of her greatest gifts is the difficulty with

which knowledge is acquired. Human beings are perverse, but they would

have been worse had they had the misfortune to be born learned men.[275]

Our sciences are futile in so far as they fail to attain their objects,

but they are worse than futile in the results that they bring about.

Born of idleness, they cherish their mother—Tell me, illustrious

philosophers, you from whom we know why matter attracts matter, the

relations of the orbits traced by revolving planets, the mathematical

properties of curves, what stars may be inhabited, what insects exhibit

curious modes of reproduction; tell me, I say, you from whom we have

gained such marvellous information, if you had never learned of these

things, should we have been less numerous, less well governed, less

flourishing, or worse disposed?”[276]

Such words were capable of impressing men because of their eloquence and

sincerity, but they could not arrest the continued and triumphant

advance of science, which indeed, precisely at the end of the eighteenth

century, began its modern and lasting progress. For it was then that

Laplace described the system of the heavens and that Lavoisier laid the

foundation of modern chemistry and of our knowledge of the

indestructibility of matter.

In the nineteenth century, science has made a revolution in life by its

application of steam and by its other triumphs. None the less it has not

satisfied many distinguished persons. And to-day we find a writer of

genius, in the manner of Rousseau, raising his voice against the science

of the nineteenth century.

Tolstoi, in an essay of which the title is, “On the Aim of Science and

Art,” has attempted to show the incompetence of science with regard to

the great problems that occupy humanity. The task set himself by the

Russian writer was much harder than that of Rousseau, for with the

passing of a century science has become much more powerful.

Tolstoi is convinced that theoretical investigations into the origin of

life, the intimate structure of living matter and so forth, are of no

importance to human beings, and serve no other purpose than to flatter

the pretensions of the learned. “All that we call culture,” he affirmed,

“our sciences, our arts, improvements in the amenity of life, are no

other than attempts to deceive the moral cravings of mankind; all that

we call hygiene and medicine are no other than attempts to deceive the

physical and natural cravings of mankind.”[277]

The whole progress of science “up to the present time, has not only not

improved the lot of the majority of mankind, that is to say of the

labourers, but has made it worse.”[278]

Tolstoi thinks that the epithet “true science” could be given only to

“knowledge of the right aim and true happiness of each individual and of

mankind as a whole. Such a science would serve as a guiding thread in

determining the proper sphere of all knowledge”; “without knowledge of

the proper aim of life and of the real good of humanity, all other

knowledge and every art become merely amusements idle or even

harmful.”[279]

The chief grievance of the great Russian writer against knowledge,

culture, and progress can be resolved into the powerlessness of these to

explain the most difficult problems of humanity, that is to say the real

aim of human life, and what really constitutes true happiness.

In this connection, Tolstoi gives expression to a view which is shared

by many thinkers. Some years later, Brunetière,[280] a well-known French

writer and public man, under the influence of a recent journey to Rome

and visit to the Pope, made public a similar opinion, and proclaimed

aloud the fallibility of science.

Brunetière made his criticism as follows: “For the last two or three

centuries, science has promised to change the face of the earth, to

dispel every mystery; she has not done so. She is powerless to resolve

the sole problems that are essential, that concern the origin of man,

the rules for his conduct, and his future destiny. We know now that

natural science can teach us none of these matters. Thus, in the battle

between science and religion, science has been defeated, because she has

had to admit her powerlessness precisely where religion is most strong.

For religion gives the solutions that science has failed to supply.

Religion teaches us what we can learn neither from anatomy nor from

physiology, that is to say, what we are, whither we are going, and how

we ought to act. Religion and science supplement each other; and, as

science can do nothing for morality, it becomes the duty of religion to

take her place.”

It has been replied to Brunetière, that his recriminations are

unfounded, first, because science has never undertaken to solve the

great problems of the aim of life and the proper basis of morality;

next, because it is probable that these problems will never be solved by

the human understanding. Charles Richet, a well-known French

physiologist, made a vain effort to find any written evidence that

science had promised to solve the great problems which have absorbed the

attention of Tolstoi and Brunetière as well as of quite a large section

of humanity. “In what standard works has science made the astonishing

promises that M. Brunetière recalls with so much bitterness?” asked

Richet.[281] “I have now before me,” he proceeded, “the Manuel du

baccalauréat ès sciences (Guide to a Degree in Science). It is a summary

of contemporary scientific ideas. I have looked through it in vain for

promises—it contains no promises.”[282]

The promises referred to must be looked for in scientific treatises that

deal in generalisations. It is not to be disputed that, since the

renaissance in Europe of the rational and sceptical spirit, that is to

say, in the last two or three centuries, the view has been proclaimed

that all human life may be regulated by natural laws without the

interposition of dogmas, either metaphysical or religious. Attempts of

this kind have been numerous. Büchner, in his treatise on “Force and

Matter,” in which he tried to give a general conception of the universe

based on the scientific knowledge of the nineteenth century, made very

plain statements on this point. “We must seek the foundation of

morality,” said the German populariser, “elsewhere than in the timeworn

and fantastic belief in the supernatural. Science must replace religion;

belief in the real existence of a natural and immutable order in things

must displace belief in spirits and ghosts; natural moral law must take

the place of artificial or dogmatic morality.”[283] Büchner even tried

to indicate what natural morality is. According to him it is “the law of

mutual consideration of the equal rights of each person, both from the

general and the individual point of view, so as to assure the greatest

happiness of the greatest number. Everything that damages or destroys

the common good is ‘evil;’ everything that favours it is ‘good.’”

The other question, as to whither we are going, finds an answer in the

materialistic and scientific breviary of Büchner. He disputes the idea

of immortality, which has been supported by nearly all the religions,

and comes to the conclusion that there is nothing appalling to a man,

“imbued with the principles of philosophy, in the conception of the

annihilation of the individual life.” “Annihilation is perfect rest; it

is freedom from all pain and escape from the sensations that torture the

body and the mind—as was explained so clearly in the great religion of

Buddha; it is not to be feared, but rather to be coveted when life has

reached its normal term and when old age has come with its inevitable

assemblage of infirmities.”

I do not wish to suggest that the views I have just quoted are peculiar

to Büchner. That writer has served to a large extent as the mouthpiece

of ideas current among the materialistic and positivist men of science

of his time. In Haeckel’s book, “The Riddle of the Universe,” which

appeared nearly half a century after the first edition of “Force and

Matter,” the same ideas are to be found. He also has found answers to

the questions that absorb mankind. In his opinion also, as I have shown

in chap. v. the problem of natural morality resolves itself into the

social instincts of man, and has nothing to do with religious dogma. As

for the destiny of man, he concludes as follows: “The best end we can

desire after a courageous life, spent in doing good according to our

light, is the eternal peace of the grave.”[284]

There is a very close resemblance between the views of the two great

popularisers of the nineteenth century. Just as Büchner, to show the

stupidity of the idea of eternal life, repeated the legend of the

“Wandering Jew,” so Haeckel, with the same object, related the legend of

the unhappy “Ahasuerus” who sought death vainly, finding his eternal

life intolerable. “However gloriously we may depict this eternal life in

paradise, in the end it would be a fearful burden to the best of men.”

While there is no doubt but that such ideas are shared by many men who

rely on scientific arguments, there are others to whom the problem

presents itself differently. The German physiologist, Du Bois Reymond,

after reflecting on the general problems of knowledge and the universe,

proclaimed an “Ignorabimus” as a warning that a whole series of problems

of the highest importance to humanity were outside the range of human

knowledge and incapable of solution. These problems were precisely the

seven “riddles of the universe” that Haeckel claimed to have solved in

his book.

Many learned men think that the great problems, those, according to

Tolstoi, that constitute the only true science, can never be solved.

“Every day there comes a new conquest,” said Richet,[285] “but we are no

nearer solution of the ultimate enigma, the destiny of human life, an

enigma probably never to be solved.” Philosophers have taken the same

view. “It cannot be from science,” said Guyau, “that personality is to

require the proofs of its own durability.”[286]

The answers given by science as it exists to-day, have failed to console

the spirits that have applied to her. When Richet, in the discussion on

the “bankruptcy of science” recalled the discovery of treatment of

diphtheria by specific serums as an instance of the value of scientific

research, Brunetière replied, “Serum therapy cannot prevent us from

dying, nor tell us why we must die.” The problem of death always recurs.

What is the use of saving the life of a child smitten by diphtheria only

that it may grow up, and by learning the inevitability of death become

filled with terror?

If science be really powerless before the gravest problems that torture

mankind, if she has to excuse herself by admitting her incompetence, if

she can do no better than to extol the silent annihilation of the grave,

it is not surprising that many minds and these not the least capable,

turn from her. The desire to find some consolation in the miseries of a

purposeless existence throws them into the arms of religion or

metaphysics. Here lies the explanation of the actual return in these

days to faith. People plunge into mysticism hoping to find there

something more comforting than the annihilation offered by science.

In all ranks of modern society there are signs of this craving for the

supernatural. It is therefore extremely interesting to follow the

intimate steps of such an abandonment of science and return to faith.

The “Confessions” of Tolstoi gave one of the best examples of the

metamorphosis.

Having reached the conclusion that life is meaningless because it cannot

be harmonised with the fear of death and the prospect of absolute

annihilation, Tolstoi (see chap. vi.) asked if it were not possible to

solve the great problem of human existence by means of the facts of

science. “I searched in all the sciences,” he said, “and not only found

nothing myself, but became convinced that all who sought would find

nothing. Not only would they find nothing, but they would see clearly

precisely what had driven me to despair, the fact that the absurdity of

life is the sole indisputable bit of knowledge open to man.” “For a long

time, observing the grave and solemn tones of the exact sciences, which

indeed, hardly touched the problem of life, it seemed to me that they

must be concealing something that I did not understand.”

All the while, the question that Tolstoi put to himself seemed simple

enough: “Why am I to keep alive? Why am I to do anything?” or, in

another way: “Has life any object that is not destroyed by the

inevitable death that awaits me? To the one question, put in many ways,

I sought an answer in human knowledge.” “From my earliest youth the

speculative sciences interested me deeply. Later on, the mathematical

and physical sciences attracted me, and until my question rose up

clearly before me, day by day growing larger, and imperatively demanding

an answer, until then I was satisfied with the semblance of an answer

given by science.” “I said to myself; everything is evolving,

differentiating, moving towards complexity and amelioration, and the

progress is under the guidance of law. You, you yourself are part of

this whole.” “Although I am deeply ashamed to confess it, there was a

time when I thought myself content with these things. My muscles grew

and became stronger. My memory added to its stores. My ability for

thinking and understanding increased. I grew and developed, and feeling

the growth within me, it seemed natural to believe that the solution of

my own life was given by the law of the whole universe. But the time

came when I stopped growing. I felt that I was no longer developing and

even that I was slipping back. My muscles weakened; my teeth dropped

out; and I felt that this law not only explained nothing, not only had

never explained anything, but had not been a law at all; that in fact I

had taken for a law what I found in myself at a particular stage of my

life.”

“As I found no explanation in science,” Tolstoi went on, in his poignant

narrative, “I began to look for the answer in life, hoping to find it in

the men around me.” “My intellect was at work, but also something else,

something that I can call only the consciousness of life, like some

strong force that compelled my intellect to turn in another direction

and to rescue me from my desperate condition.”

The new direction was the feeling of faith. “However I might put to

myself the question: how must I live? the answer was—by the law of God.

Whither tends my present life? To eternal pain or to blessedness

everlasting. How is my life not destroyed by death? By eternal union

with God, by heaven. And thus I was led inevitably to see that quite

independently of human knowledge, which formerly seemed to me the only

guide, mankind had another guide, a guide that is irrational; faith

which makes life possible. Faith seemed to be as irrational as ever, but

I could not but recognise that faith alone gave mankind an answer to the

problem of life, and in consequence made life possible. Reason had led

me to the conviction that life was absurd, and so, there being no longer

a reason to live, I had wished to kill myself. Looking at mankind as a

whole, I saw that men kept alive by assuring themselves that they saw a

meaning in life. I myself came back to that point of view. I had reached

a time when there seemed to me to be no meaning in life. But as to other

men, so to me, life and the possibility of living were offered by

faith.”

Driven in the direction of faith, Tolstoi reached the following

conclusion: “The object of a man’s life is the salvation of his soul;

for that, we must live in God, and to live in God it is necessary to

give up the pleasures of life, to work, to submit, to suffer and to be

charitable.” And this conclusion led to the other that “a faith has

value in so far as it gives a meaning to life which is not destroyed by

death.”

It is plain then that all this evolution, the beginning of which was the

fear of death, ended in belief in something beyond death. And it is also

plain why Tolstoi should have been as bitter against science as I have

shown him to be. Tolstoi does not afford the only example of a case

where the failure of science to solve the problem of death has led to

the abandonment of science in favour of religion. Brunetière, if it is

possible to judge from his published writings, traversed similar paths

in his journey to the Catholic religion.

However, even an intellect so positive and so sceptical as that of Zola

has been unable to resist the lures of faith. There is a very

interesting note on this subject in the _Journal_ of de Goncourt, dated

February 20, 1883. “To-night, after dinner, at the foot of the bedstead

of carved wood, where coffee was served, Zola began to talk of death, on

which his thoughts have been fixed more than ever since the death of his

mother. After a short silence, he said that death had made an in-road on

the nihilism of his religious convictions, as he could not face the

possibility of an eternal separation.”

In strata of society less impregnated with rational and scientific

thought, it is plain that the return to religion must be more common. I

recall the case of a woman of the people, a workwoman, who declared that

she formerly had had no belief, but that, since the birth of her son,

she had begun to believe in the good God, as she was convinced that it

was only by such a belief that she could guard the life of her child

from the evils of the world.

As things are, it is not wonderful that many people decline to educate

their children in an exclusively scientific spirit, which is destructive

to faith, as they cannot substitute for faith something equally

consoling. Perhaps ideas of this kind lie behind the story of the apple

of the Garden of Eden and the invention of the words of Jahveh: “But of

the tree of the knowledge of good and evil, thou shalt not eat of it:

for in the day that thou eatest thereof thou shalt surely die” (Genesis

ii. 17). The legend of Prometheus, who stole fire from heaven, and was

chained to a rock, is in the same category.

Solomon gave voice to the same idea, in the clearest way, in his words:

“I communed with mine own heart, saying, Lo, I am come to great estate,

and have gotten more wisdom than all they that have been before me in

Jerusalem; yea, my heart had great experience of wisdom and knowledge.

“And I gave my heart to know wisdom, and to know madness and folly: I

perceived that this also is vexation of spirit.

“For in much wisdom is much grief: and he that increaseth knowledge,

increaseth sorrow” (Ecclesiastes, i. 16).

Much later, Shakespeare offered to us in _Hamlet_, the type of a man

very highly cultivated, in whom reason and reflection had arrested

action. As he could not solve by reason the problems that haunted him,

he asked if it were worth while to remain alive. Then followed the

famous lines:

“Thus conscience does make cowards of us all,

And thus the native hue of resolution

Is sicklied o’er with the pale cast of thought.”

As so many men of genius have taken the same point of view, it becomes

necessary to inquire carefully as to whether or no too much knowledge be

harmful to human happiness. If science do no more than to destroy faith

and to teach us that the whole living world is moving towards a

knowledge of inevitable old age and death, it becomes necessary to ask

if the perilous march of science should not be stayed. Is it that the

attraction of mankind to knowledge is as dangerous to the race, as the

attraction of moths to the light is fatal to these wretched insects? The

question demands an exact answer. But before giving the verdict, the

facts of the case must be examined. I shall proceed to this in the

chapters to follow.

CHAPTER X

INTRODUCTION TO THE SCIENTIFIC STUDY OF OLD AGE

General account of old age—Theory of senile degeneration amongst

unicellular organisms—Conjugation amongst infusoria—Old age in

birds and anthropoid apes—General characters of senile

degeneration—Sclerosis of the organs—Phagocyte theory of senile

degeneration—Destruction of higher elements by macrophags—Mechanism of

whitening of the hair—Serums acting on cells (cytotoxins)—Sclerosis of

the arteries and its causation—Harm done by the microbes of the

alimentary canal—Intestinal putrefaction and the modes of preventing

it—Attempts to prolong human life—Longevity in biblical times

While I cannot share the views of those who turn from science to seek

truth and consolation in religion, it would be wrong to ignore or to be

indifferent to the existence of that attitude. There are men who are

tormented by the contradiction between the desire of life and the

inevitability of death, and when these demand some solution of the

problem, it is unreasonable merely to say that they are too exacting and

should learn contentment.

If a man complains to his physician of uncontrollable hunger and thirst,

he is not told that it is wrong to be so greedy, and that that fault

could be mastered by strength of mind. The doctor carefully examines the

patient and does what he can for the distressing symptoms, which,

indeed, in this case are generally due to diabetes. Those who hunger and

thirst after eternal life, ought to be similarly treated by men of

science whose duty it is to ameliorate their sufferings as much as

possible.

Science has undoubtedly gone far in the successful treatment of disease,

both as regards prevention and cure, but it is powerless before those

other evils from which Buddha implored his father to grant him

exemption—old age and death. Science has attained to heights of

knowledge undreamed of by Buddha’s father, King Couddhôdana, and yet it

knows no more than he did with regard to the problem of old age and

death. Like the king, science can but reply to its questioners: “You ask

the impossible. I cannot help you!”

Not only is no remedy for old age known to science, but little or

nothing is known with regard to that period in the lives of men and

animals. It was no easy task to compress an account of the present

position of medicine within a few pages, the subject matter being

overwhelming in quantity. With regard to old age it is quite the

contrary, our knowledge being so limited that the subject may be dealt

with in a few lines. With the advance of years, man and the higher

animals undergo important modifications. They become weaker, the body

shrinks, the hair whitens, and the teeth decay; in fact, all the

phenomena connected with senile decay manifest themselves.

At this period of life which overtakes various species of animals at

different ages, the body becomes an easy prey to pernicious influences

and diseases. The direct cause of death cannot always be determined, and

is attributed to the general breaking up of the system which we call

natural death. The first question which presents itself to the

scientific mind is whether this degeneration or senile decay is proper

only to man and the higher animals, or is common to all forms of life.

We have all seen very old trees, the appearance of which proclaims their

age. The trunk is decayed, the bark gnarled, the branches shrivelled,

and the leaves scanty. Some kinds of trees live for hundreds—possibly

thousands—of years, while others age with comparative rapidity. Senile

decay is not unknown in the vegetable kingdom, and its presence is

suspected even among creatures of very simple organisation belonging to

the group of infusoria. These creatures may be reared with ease in

vessels containing macerations of chopped hay or leaves. They multiply

by means of division (Fig. 12), an operation which takes place at very

short intervals, some of them dividing nearly every hour. Owing to this

rapid multiplication the vessels soon become full of a mass of

infusoria. M. Maupas,[287] a very distinguished zoologist, observed that

the infusoria became smaller and smaller after a number of generations,

exhausting themselves, as it were, and perishing unless two individuals

succeed in uniting. This process of “conjugation” (Fig. 13), involves an

exchange of portions of the bodies of the two creatures and brings about

a complete rejuvenescence of the two individuals. After conjugation, a

process essentially similar to the details of sexual fertilisation, the

infusoria resume the normal appearance and again become capable of

reproduction by simple division for many generations.

[Illustration:

FIG. 12. Paramecium about to divide in two.

]

The periodical debility, which precedes conjugation is, according to

Maupas, an instance of senile degeneration among infusoria. He has

recognised its existence in the case of many species of the higher

infusoria (_Ciliata_), but while this phenomenon has been observed in

the case of many other simple organisms, it cannot be set down as

universal among microscopic beings. Among bacteria, a group that

includes the greater number of pathogenic organisms, conjugation has

been very rarely observed. Even the largest kinds, such as, for

instance, the _anthrax_ bacillus, may be propagated for a long series of

generations without the occurrence of conjugation.

[Illustration:

FIG. 13. Conjugation of two Paramecia (after Bütschli).

]

Even in the case of the infusoria which by means of the process of

conjugation can reproduce indefinitely, the preconjugal debility cannot

be identified with the senile degeneration of human beings, the higher

animals and trees. In all these debility is the antecedent, not of

conjugation and rejuvenescence, but of the end of life.

Another important difference is that in the case of infusoria the

preconjugal debility does not occur in every individual, as is the case

with the animals and plants which display real old age. In the infusoria

an indefinite number of generations occur between the individuals that

display debility and those that are ready for conjugation.

If, in spite of these differences, we were to insist on the existence of

an essential resemblance between senile degeneration in man and

preconjugal debility in infusoria, it would be enough to reflect on the

result of applying to the case of man what is an infallible remedy in

the case of the infusoria. For conjugation brings about a real

rejuvenescence of the infusoria and a similar event in the case of man

would only increase the debility. Moreover, according to recent

investigations of Calkins,[288] infusoria, weakened by degeneration, may

become young again not only by conjugating with their kind, but by the

addition of bouillon or extract of brain to the medium in which they

live.

Real old age is a phase of existence in which the natural forces abate

never to be renewed. In animals, the life cycle of which is very

definite, the signs of senile degeneration are not visible. Insects, in

the adult condition, very often live only a short time, and die without

displaying the slightest mark of age. In the case of lower vertebrates,

old age is little known, and has few signs. On the other hand, mammals

and birds display senile atrophy in a marked fashion.

Some species of birds live to a great age, longevity being more common

than among mammals. Cases in which birds such as geese, swans, ravens,

and some birds of prey, have been known to reach the age of fifty

years,[289] are not uncommon, whereas such an event is very rare in the

case of a mammal. Even small birds, such as canaries, may live as long

as twenty years. Parrots are especially long-lived birds. Cockatoos have

been known to reach the age of eighty years and more. I myself have had

opportunities of observing a South American parakeet (_Chrysotis

amazonica_) which lived more than eighty-two years, longer than is usual

even with parrakeets. Several years before it died the bird showed

unmistakable signs of old age. It became less lively, its plumage,

although it did not whiten, lost much of its brightness, and the joints

of the claws showed evidence of the presence of disease. In short, the

parrakeet was obviously worn out and debilitated.

Mammals show the signs of age even more plainly than do birds. A dog

reveals old age by its slow movements, its white hairs, and worn teeth.

The appearance of such an animal is never agreeable, while it is often

dirty and ill-tempered. Brehm describes the old age of a dog as follows:

“At twelve years of age a dog has grown old, and his gait and whole

organisation show signs of age. The coat is no longer glossy; the

forehead and muzzle are grey, the teeth are blunted or have fallen out.

The animal is lazy and apathetic. Many such dogs are dumb and blind.

Dogs may live for twenty, six and twenty, or even thirty years, but such

cases are most unusual.”

As the dog is a domesticated animal, it might be argued that its old

age, with its manifest signs of decrepitude, is the result of the

artificial conditions of its life. To decide on this point it is

necessary to examine an instance of old age in a wild animal. This

presents certain difficulties since wild animals when old and feeble

become an easy prey to carnivorous enemies. It will best serve our

present purpose to consider such information as has been collected

regarding the period of old age in anthropoid apes.

The natives of Borneo have observed “old orangs, which have not only

lost their teeth, but being too feeble to climb, live on the fallen

fruits and herbs.”[290] Gorillas, according to Savage, turn grey in

their old age, from which has arisen the erroneous view that there are

two species of the gorilla.

In their wild state, monkeys, like ourselves, are subject in their old

age to various distressing ailments. Senile degeneration, then, which is

universally looked upon as one of the greatest evils of life, is by no

means restricted to the human race. Old age, as portrayed in the

Buddhist legend, referred to in chap. vi., is perhaps somewhat

exaggerated, but this period of life is undoubtedly characterised by

changes of such a nature as considerably to affect the happiness of the

old. Buddha, being a pessimist, took too dark a view of this, but let us

hear what optimists have to say on the subject. Max Nordau, a doctor, a

writer of books and a journalist, says: “Physically speaking, an old man

presents an unpleasant picture of decrepitude to the casual observer.

Morally speaking, he is a blind and pitiless egotist, having lost all

interest in anything outside himself. Intellectually he becomes

feeble-minded and narrow in his views, being governed by antiquated

notions and prejudices, and incapable of grasping new ideas.”[291]

It may be objected that I am here supporting my argument by quoting from

a writer who, in his capacity of clever journalist, rather forces the

note. Let me therefore refer to what a learned physiologist said when

addressing a serious audience assembled for the purpose of obtaining

truth and information from his lips. After dealing in broad outline with

the physical degeneracy caused by old age, Longet[292] draws the

following mental picture: “The old feel that their task in life is

accomplished, and believe themselves to be universally grudged the space

they occupy in the world. This renders them suspicious of all around

them, and jealous of the young. Their craving for solitude and the

uncertainty of their tempers are due to the same cause. All old people

are not like this, of course. The hearts of some remain youthful and

beat strongly within their feeble frames, but, as a general rule, they

are morose and a nuisance to themselves and others, excepting when they

are surrounded by their children or grandchildren, who like to listen to

them about the past, and who make excuses for the present. Thus the

years speed onward, every round of the clock bringing the end nearer,

and every hour adding a new wrinkle to their faces, some fresh weakness

and some new regret. Their bodies ... become decrepit; their backbones,

too weak to hold them upright, curve over and bend them downwards

towards the earth.”

There can be no doubt but that the period of old age is sad, and a

thorough knowledge of it is necessary before it can be understood.

Disease can only be successfully dealt with when the cause of its

presence is known, and so it is with old age.

Is it possible, one might ask, at the present stage of the world’s

knowledge, to define, with even approximate accuracy, the characteristic

features of senile decay? The task is difficult, for although the

subject is very important, few facts have been collected.

It is common knowledge that the flesh of old animals, used as food, is

tough. An old fowl cannot be compared with a tender and juicy chicken.

Organs such as the liver and kidneys are much harder in the case of old

animals. The horny flesh of old animals is often compared with

boot-leather. Although the comparison does not pretend to be scientific,

it is far from being incorrect. Boot-leather is made from the hides of

animals; that is to say, of a very resistant material that is called

“connective tissue,” and which consists of a dense mass of fibres,

mingled with the living elements or “connective tissue” cells. This

tissue is very durable and so is employed for boots and shoes.

The infiltration of any organ with connective tissue makes it tough and

unpalatable. This hardening is called a _sclerosis_ (of the liver,

kidneys, &c.). In old age many organs exhibit this tendency to hardening

or sclerotic degeneration. The fact has been known for long, but its

significance has been perceived more recently. Demange,[293] in his

monograph on the organic changes associated with old age, states as

follows: “Besides atrophy and degeneration of the parenchymatous

elements,[294] there is to be observed a profound change in the

framework of connective tissue, which serves to support the organs. In

some cases the skeletal framework of an organ becomes more conspicuous,

simply on account of the degeneration of the cells; this is the

condition usually present in the liver of aged persons. More often,

however, the connective tissue receives some kind of stimulation, which,

although it does not amount to inflammation, brings about an active

growth and resulting sclerosis. According to the particular case, the

hardening occurs in the form of isolated patches or strands, or affects

the whole periphery or even the depths of the organ, and smothers the

higher elements in its meshes, so producing a further degeneration. The

cellular elements disappear gradually, connective tissue taking their

place, and the change may be so profound, that as in the case of the

prostate gland, the altered organ may actually transcend the normal

size, partial or general atrophy, however, being more often the result.”

Sclerosis in old people sometimes takes the form of a hardening of the

liver (cirrhosis of the liver) or of the kidneys (renal cirrhosis), but

it is the arteries which are most commonly affected by it, producing a

symptom of degeneration which is called arterial sclerosis.

Cazalis long ago originated the oft-repeated aphorism: “A man is as old

as his arteries,” these vessels, by means of which the blood is

distributed throughout the whole system, being of immense importance in

the economy of the organism. When the connective tissue is so freely

developed as to cause a hardening of the arteries, these are hampered in

the exercise of their function and become very brittle. According to

Demange, all the special modifications undergone by the body during the

period of old age may be attributed to this atrophy of the arteries, but

this theory is proved to be an exaggeration by the fact that post

mortems on the aged frequently reveal the presence of little or no

arterial sclerosis.

It might fairly be supposed that the hardening seen in many organs of

the body during the period of old age is universal, and lends greater

strength to the frame. The bones, which are separated from one another

in youth, become welded together in old age owing to the calcareous

deposits in the joints, and the ossification of the joints between the

vertebra frequently causes the backbone to assume the appearance of a

continuous bone, the greater part of the cartilage having become

ossified. In spite of this, and as though for the purpose of proving how

physically full of contradictions is the period of old age, the human

frame actually becomes lighter and the quantity of component mineral

substances becomes less. This brings about a liability to fracture of

the bones in old people. The fracture of the neck of the femur is a

constant cause of death in the aged, as occurred for instance in the

case of Virchow, one of the most distinguished medical scientists of the

nineteenth century.

Is science, it may be asked, in a position to state precisely what are

the principal modifications which occur in the tissues of old people? At

the International Congress of Medicine held at Berlin in 1890, a

well-known German anatomist, Merkel,[295] attempted to reply to this

question. Speaking of the tissues of old people, he tried to show that

certain of these, such as the skin and the mucous membrane (the

epithelial tissues), preserve their youthful characters to the end,

whereas others, such as the connective tissues, display profound

changes. This essay was the first attempt to form a picture of the

details of senile degeneration, but it did not reach any simple, general

conclusion.

Later on, I myself[296] tried to complete the work, and for the purpose

made use of the published results of all the investigators who had

studied senile degeneration. I gave a summary of my conclusions in the

following words: “In senile atrophy the same condition is always

present: _the atrophy of the higher and specific cells of a tissue and

their replacement by hypertrophied connective tissue_.” In the brain,

the nerve cells disappear; that is to say, the cells which subserve the

higher functions such as intellectuality, sensation, control of

movement, and these are replaced by elements of a lower kind, in

especial by neuroglœa, a kind of connective tissue of the brain. In the

liver, the hepatic cells, of great importance to the nutrition of the

organism, yield to connective tissue. In the kidneys, that tissue

invades and blocks the tubes by which the necessary process of

eliminating soluble waste matter is accomplished. In the ovaries, the

ova, the specific elements which serve to propagate the race, are

similarly eliminated and replaced by granular cells, a variety of

connective tissue. In other words, a conflict takes place in old age

between the higher elements and the simpler or primitive elements of the

organism, and the conflict ends in the victory of the latter. This

victory is signalised by a weakening of the intellect, by digestive

troubles, and by lack of sufficient oxygen in the blood. The word

conflict is not used metaphorically in this case. It is a veritable

battle that rages in the innermost recesses of our beings. Distributed

throughout every part of our bodies are certain cells which fulfil

special functions of their own. They are capable of independent

movement, and also of devouring all sorts of solid matter, a capacity

which has gained them their name of phagocytes or voracious cells. The

function these phagocytes fulfil is a very important one, for it is they

that congregate in vast numbers around microbes or other harmful

intruders, in order to devour them. Effusions of blood and other

elements, on penetrating to parts of the body where their presence is

disadvantageous, are absorbed by these phagocytes. In cases of apoplexy,

where blood is shed into a part of the brain, setting up paralysis, the

phagocytes cluster round the clot and devour the blood corpuscles it has

encased. This absorption is a lengthy process, but by degrees, as the

pressure of the effusion of blood is removed from the brain, and

paralysis disappears, the health of the organism may become completely

restored, recovery in such a case being due to the work of the

phagocytes. After childbirth, when the uterus presents the appearance of

a great open wound clotted with blood, it is again the phagocytes that

clean it and re-establish the normal condition. It is plain, therefore,

that the part played by these cells is beneficent.

The phagocytes may be divided into small active phagocytes, generally

known as the microphags, and larger phagocytes called macrophags, which

are sometimes active and sometimes still. The former, which are produced

in the marrow of the bones, circulate freely in the blood, and occur as

some of the white blood corpuscles, or leucocytes. They are

distinguishable by their oval shape which facilitates their easy passage

through the smaller blood-vessels, and allows of their accumulating in

great numbers in the exudations that form around microbes. These

exudations may be formed extremely rapidly, and so may arrest infection

in the case of many diseases.

The absorption of extravasations of blood and the healing of wounds are

the work of the macrophags. In a general way, the microphags may be said

to rid us of microbes, and the macrophags to heal mechanical injuries,

such as hæmorrhages, wounds, and so forth. Macrophags possess a single

unlobulated nucleus, and occur as white corpuscles in the blood, lymph,

and exudations, or as the fixed cells in connective tissues, the spleen,

and the lymphatic glands, &c.

[Illustration:

FIG. 14. Section of a Renal Tubule, invaded by Macrophags, from the

body of an old man of 90 years. _m_ = macrophag. (From a preparation

made by Dr. Weinberg.)

]

[Illustration:

FIG. 15. Cell from the brain of a woman 100 years old being devoured

by macrophags. (From a preparation made by Dr. Philippe.)

]

The phagocytes are endowed with a sensitiveness of their own, and by

means of a sense of smell or taste are able to recognise the nature of

their surroundings. According to the impression made upon this sense,

they approach the object which arouses it, exhibit indifference to it,

or withdraw from its vicinity. When, however, an infectious microbe

finds its way into the body, the microphags are attracted by its

excretions and swarm into the exudations surrounding it. The macrophags

play a very important part in bringing about senile decay. The atrophy

of the kidneys in old persons is attributable to their agency (Fig. 14).

They accumulate in large quantities in these organs, clustering round

about the renal tubes which they ultimately cause to disappear. Having

appropriated the place of the renal tubes, the macrophags proceed to

form connective tissue, which thus takes the place of the normal renal

tissue. A similar process occurs in the other organs that degenerate in

old age. In the brains of old persons and animals, for instance, it is

known that a number of nervous cells are surrounded and devoured by

macrophags (Fig. 15). Judging from the investigations mentioned above, I

think I am justified in asserting that senile decay is mainly due to the

destruction of the higher elements of the organism by macrophags. This

conclusion has been confirmed by means of direct observation, which was

the more necessary as it is contrary to the opinions of some biologists.

Marinesco,[297] an authority upon everything connected with the nervous

system, has disputed my theory, asserting that the destruction of the

specific elements in the nervous centres of old persons is not brought

about through the agency of macrophags. In support of his theory, M.

Marinesco was good enough to send me a series of preparations from the

spinal marrow of persons of very advanced years from which evidence of

destruction by means of phagocytes or phagocytosis, was completely

absent. I freely admit the absence of phagocytosis in M. Marinesco’s

preparations, but these were derived from the cells of spinal marrow,

which is much less subject to the ravages of senile decay than is the

brain. Even in the lower portions of the encephalon, senility and its

parallel, phagocytosis, are uncommon, whereas in the brains of old

persons, which are more generally affected by senile decay, the higher

elements are clearly shown to undergo destruction by macrophags (Fig.

15). The same phenomenon may be observed in the case of parrots and dogs

of advanced age, and in other animals.

So universal a symptom of old age is the invasion of the tissues by

macrophags, that it must be regarded as of immense importance. In order,

however, to determine more precisely the nature of the function

fulfilled by these phagocytes, it was necessary to select a specially

favourable subject of investigation. My choice fell upon an examination

into the causes of the hair turning white,[298] that being as a rule the

first visible sign of approaching old age.

Hair, before it has lost its colour, is full of pigment scattered

throughout the two layers of which each hair is composed. At a given

moment, the cells of the central cylinder of a hair become active, and

proceed to devour all the pigment within their reach. Once they are

filled with coloured particles, these cells, which are a variety of

macrophag (generally called pigmentophags or more properly speaking

chromophags), become migratory, and, quitting the hair, either find

their way under the skin or leave the body (Fig. 16). The

colouring-matter of the hair is removed in this way by chromophags,

leaving the hair colourless.

The process by which hair becomes white is of importance, because it

shows that the activity of macrophags is a dominant factor in bringing

about senile decay. The brittleness of old people’s bones is probably

due to a similar cause, _i.e._, to the absorption and destruction of the

framework brought about by macrophags invading the layers of bone. There

is still much that remains unknown in this subject, which is well worthy

of special research.

[Illustration:

FIG. 16. Hair about to become grey. Chromophags transporting the

pigment granules.

]

The activity acquired by macrophags during old age is closely connected

with the phenomena that are characteristic of certain chronic

complaints. Sclerosis in old persons belongs to the same category as

organic sclerosis, which may be set up by various morbid influences. The

analogy between senile decay of the kidneys and chronic nephritis,

commonly called interstitial nephritis, is incontestable. The

destruction of nervous cells through the agency of macrophags, which we

have already mentioned as occurring in old age, is equally a symptom of

several diseases of the nervous centres, such as general paralysis of

the insane. Arterial sclerosis in old persons is actually an

inflammatory disease, similar to the inflammation of the arteries set up

by other maladies.

The similarity between senility and disease has long been recognised,

and partly accounts for the repugnance we all experience at the approach

of old age. In childhood and early youth people regard themselves as

older than they really are, and long to be “grown-up,” but having once

arrived at man’s estate, they do not wish to grow old. An instinctive

feeling tells us that there is something abnormal in old age. It cannot

be regarded as a part of healthy physiological function. No doubt,

because old age is the inevitable lot of mankind, it may be termed

normal, in the same fashion as we call the pains of childbirth normal,

since few women escape them. In both cases, however, we have to deal

with pathological rather than physiological conditions. Just as every

effort is made to relieve the sufferings of a woman in labour, so it is

natural to try to suppress the evils accompanying old age, but whereas

in childbirth an anæsthetic affords relief, old age is a chronic malady,

a remedy for which is much harder to find. We have seen that in old age

a struggle takes place between the higher elements and the phagocytes,

the end being usually a weakening in vitality of the former, while the

activity of the latter is enormously increased. It would appear, arguing

from this, that one means of fighting against old age, pathologically

speaking, would be to strengthen the higher elements of the organism,

and to weaken the aggressive capacities of the phagocytes. Let me at

once warn the reader that this is not presented as a definite, but as a

possible solution of the problem, and is offered for consideration like

many other hypotheses on scientific questions. The properties of

cellular elements are easily changed when subjected to various

influences, and it is therefore not irrational to seek some means of

strengthening the blood corpuscles, nerve cells, liver cells, muscular

fibres of the heart, and so forth. The task has become easier since the

discovery of serums that have specific actions on the tissues.

In the third chapter I stated that serums were known which give

precipitates only with the blood of man and of his near relatives the

anthropoid apes. Serum of this kind has a definite specific action.

Serums may be prepared that dissolve only the red corpuscles of

particular species of animals, and that are without action on the other

organic elements. It has been found possible, even, to prepare a serum

that arrests instantaneously the movements of human spermatozoa, and

that is neutral to the similar cells of other animals.

These serums are all prepared in the same way. The cellular elements in

question, spermatozoa or red corpuscles, cells of the liver or of the

kidney, taken from one animal, are injected into an animal of another

species. After several injections have been made, the serum of the

animal operated on becomes active with respect to the cells introduced

into its body. These serums were discovered by J. Bordet of the Pasteur

Institute, but the results have been confirmed by investigators in other

countries. The serums are specifically _cytotoxic_, that is to say, they

poison particular kinds of cells.

Now it has been shown that such serums, employed in small doses, do not

kill or dissolve the specific tissue elements, but actually strengthen

them.[299] Here the case is analogous with the action of poisons, such

as digitalis, which kill in strong doses, but which in weak doses

improve or strengthen the action of certain tissues. In accordance with

this indication, experiment has shown that small doses of a serum which

is capable of dissolving the red corpuscles of human blood, actually

increase the number of those in the body of a patient treated by

injections. In the same way, in the case of a serum large doses of which

destroy the red corpuscles of a rabbit, small doses increase the number

of these elements in the blood.

Here there seems to be a rational method by which we may strive to

strengthen the higher elements of the human body, and so prevent them

from growing old. The task, at first sight indeed, seems an easy one,

only necessitating the injection of a horse (or other animal) with

finely minced atoms of human organs, such as brain, heart, liver,

kidney, &c., when serums could be drawn off in the course of a few

weeks, capable of acting upon those organs. In reality the process would

be a very difficult one to carry out, as human organs are rarely

obtainable in a condition suitable for injecting into animals. Post

mortems can only be legally made twenty-four hours after death, and

there are many other obstacles in the way of removing organs from dead

bodies. Even if all these difficulties were overcome, another difficulty

that would present itself would be the experimenting with various doses

of cytotoxic serums of various strength. It is not therefore to be

wondered at that the attempt to reinforce the higher elements of the

human organism will require much time. If it be necessary to strengthen

the higher elements (nervous, hepatic, renal, and cardiac cells), it is

plain that they undergo a progressively weakening process. It would be

of the highest importance to ascertain the cause of this, for the

knowledge would be a guide to future action.

The similarity between senile decay and the diseases entailing atrophy

in the more important human organs suggests a similitude in cause.

Scleroses of the brain, kidneys, and liver frequently originate in

intoxication by poisons such as alcohol, lead, mercury, and so forth, or

the disease may be induced by some virus, the virus of syphilis being a

common cause.

The immense importance of venereal disease as a malevolent factor in the

phenomena of old age, is especially manifested in arterial sclerosis.

According to the careful investigations of a Swedish doctor,

Edgren,[300] published in his “Monograph on Arterial Sclerosis,” one

case in every five of this disease is caused by syphilis, and he shows

that chronic alcoholism is an even more frequent cause (25 per cent.).

These two factors when united are responsible for nearly half (45 per

cent.) the cases of arterial sclerosis that occur. Syphilitic virus and

alcohol act as poisons which bring about first degeneration and

brittleness of the arterial walls, and eventually a weakening of the

higher elements of the organism. The phagocytes, being cells of an

inferior order, are less sensitive to these poisons, which accounts for

their victory over the poisoned elements.

Rheumatism, gout, and infectious diseases only play a secondary part in

setting up arterial sclerosis. Edgren asserts, as the result of very

careful calculation, that in nearly every fifth case he found it was

impossible to account for the origin of arterial sclerosis. In the

majority of cases the sufferers were elderly persons who, according to

Edgren, “were afflicted with physiological sclerosis.”[301]

I take it that this sclerosis of unknown origin was by no means

physiological but was pathological like that set up by syphilis or

alcoholism. The question then arises whence comes the poison in such

cases? In syphilis there is a virus of a definite nature to deal with,

which causes infection or poisoning, and brings about arterial

sclerosis, general paralysis, and other serious ailments. Alcoholism is

a poison arising from fermentation, excited by microscopical fungi

related to true microbes. Instances of arterial sclerosis which are due

neither to syphilis nor to alcohol poisoning nor to any other known

cause, can only be accounted for as probably arising from poisoning set

up by the mass of microbes congregated in the human intestines. Among

these microbes there may be some that are harmless, and possibly even

beneficial, but there are undoubtedly a great number the presence of

which is extremely prejudicial to health and life. It is impossible to

enter into the details of such an important question, and a brief

mention must suffice.

The human intestine contains an enormous quantity of bacteria, which,

according to the recent investigations of Strassburger,[302] increase at

the rate of 128,000,000,000,000 each day. These microbes, of which there

are few in the digestive portion of the alimentary canal, are very

numerous in the large intestines, _i.e._, in the lower part containing

the waste material. The remains of undigested foods and the mucous

secretions form a medium very favourable to the growth of microbes. This

bacterial flora constitutes a third part of the human excreta. It is

very varied, and contains an immense number of different species, among

which are bacilli, cocci, and many kinds of other bacteria, about which

little is known. The distribution of this bacterial flora shows that it

contributes nothing to the well-being of man, being scanty in the

digestive portions of the body, and abundant in other parts of the gut.

This fact alone suffices to refute the theory of those who attribute

great functional importance to the intestinal flora. This theory

originated principally from the fact that certain animals perish when

brought up under special conditions protecting them from the presence of

microbes. Schottelius[303] was the first to try the experiment of

rearing chickens in a cage specially constructed for this purpose. The

chickens hatched out, and lived for a few weeks: then, there being no

microbes within them and only sterilised food being given, instead of

increasing in weight, they became thin and showed signs of starvation.

Schottelius supplied them with food from which bacteria were no longer

excluded, upon which the chickens rallied, and soon became completely

restored to health. Madame Metchnikoff[304] tried a similar experiment

with tadpoles, which, when kept in vessels and fed upon bread containing

the usual microbes, developed normally, but which, when reared under

conditions entirely free from the presence of microbes, lived on for

some months, but in a degenerate condition, their development being

arrested.

On the other hand, Nuttall and Thierfelder[305] succeeded in keeping

alive for several days new-born guinea-pigs, the alimentary canals of

which were free from microbes, and which were fed only on absolutely

sterilised milk and vegetable matter. Notwithstanding this complete

absence of microbes the guinea-pigs developed well.

As the two sets of experiments were conducted under conditions arranged

so carefully that the chance of error was excluded, it is important to

try to reconcile the apparently contradictory results. There is one

point common to these three experiments, _i.e._, that they were all

executed upon newly born creatures. Now it is well known that at birth

the digestive juices are often very imperfectly secreted. In the case of

the guinea-pigs, these juices sufficed in quantity for the digestion of

the diet provided, whereas in the cases of the chickens and the

tadpoles, the digestive juices were incapable of fulfilling their

function satisfactorily, and the introduction of microbes endowed with

considerable digestive capacity into the intestines compensated for the

functional inefficiency of the gastric juices. In addition to the

guinea-pigs experimented upon by Nuttall and Thierfelder, there may be

mentioned a whole series of lower creatures such as the larvæ of mites

and other insects which are able to digest such indigestible material as

wax and wool in spite of the total absence of microbes within their

intestinal tubes. These experiments are corroborated by the established

physiological fact that the gastric and pancreatic juices of mammals

easily digest the most varied kinds of foods, even if treated so

antiseptically as to ensure the total exclusion of microbes from the

intestines.

I need not go further into this subject as the facts which I have cited

suffice for my present purpose. The complete atrophy of the large

intestines in the case of the woman referred to in chap. iv. proves not

only that this portion of the alimentary canal is not indispensable to

healthy life, but that life may be maintained in the absence of the

flora of the large intestines. And this really is the centre of the

problem. The useless bacterial flora may give rise to serious or fatal

maladies. Wounds of the abdomen are really serious only when they

penetrate the large intestines and so allow the entrance of bacteria

from that region to the peritoneal cavity. In such an event, the

microbes rapidly multiply in the organism and produce a grave and

frequently mortal illness. So long as the microbes remain within the

intestines very few of them get into the circulation, and with these few

the organism is able to cope. While most of the microbes are confined

within the walls of the alimentary canal, the soluble excretions

produced by them pass through into the lymph and blood. Quite a number

of different facts establish this. Thus, for instance, it has been known

for long that the urine of human beings and of animals contains a series

of substances such as derivatives of phenol, indol, creosol, skatol, and

so forth. In certain diseases the amount of these substances greatly

increases. The stagnation of the contents of the intestines increases

the amount of phenol and indol. Such facts and many others make it

probable that these substances are the products of the bacterial flora

of the intestines. They are absorbed by the intestinal wall, pass into

the general circulation, and may give rise to various symptoms of a more

or less serious nature.

Baumann, who has done much work on the subject, has brought together a

series of arguments supporting the bacterial origin of the presence in

the urine of the substances in question. Ewald, working from another

point of view has obtained strong confirmation of Baumann’s suggestions.

He had the opportunity of making observations on a female patient, in

whom, on account of a strangulated hernia, an intestinal fistula was

established. Throughout the time during which the large intestines were

inactive, the urine contained neither phenol nor indol. But as soon as

the fistula was closed and communication with the large intestine had

been re-established, phenol and indol reappeared in the excreta. Ewald

formed the opinion, therefore, that these substances were products of

the large intestine.

I need not weary the reader with more of the facts serving to show that

the bacterial flora of the large intestines is the source of many

poisons harmful to the body. It is among such substances that we must

look for the slow poisons which, in the absence of syphilis or

alcoholism, produce the arterial sclerosis of old age.

In the fourth chapter I gave reasons to support my view that the large

intestine in mammals had been developed because, by storing the products

of digestion, it allowed them to run long distances without stopping,

and so was an advantage in the struggle for existence. Moreover, the

microbes which abound in the contents of the gut make it possible to use

certain substances such as cellulose, that are difficult to digest. But

these two advantages do not count in the case of the human race. Man

does not secure his prey or escape from his enemies by the rapidity of

his locomotion. The great development of his intellectual powers has

given him advantages of another kind. Moreover, by the use of cooking

and the cultivation of plants of high nutritive value, he is able to

dispense with the digestion of cellulose.

There is another side to the picture. Ignorant of death and of old age,

mammals have acquired the advantages of a large intestine at the expense

of longevity. I have already stated that birds live longer than mammals.

Birds are practically devoid of a large intestine, and maintain a

bacterial flora very much poorer than that found in mammals. There is

one exception to this rule, an exception of great importance. Ostriches

and their allies, the largest known birds, are characterised by absence

of the power of flight and by rapidity of terrestrial locomotion by

which they escape their enemies. These are the only birds in which the

large intestine is well-developed. The duration of life is much less in

their case than in that of smaller birds, such as parrots, ravens, and

swans. According to M. Rivière, who has been engaged in ostrich farming

in Algeria, these large birds do not live more than thirty-five years.

The mode of life, and the shorter duration of life, the huge development

of the large intestines and the rich bacterial flora found therein make

the ostriches much more like mammals than birds.

It is to be noticed that many birds in which the duration of life is

long do not possess a cæcum, the portion of the alimentary canal that

contains most bacteria. Examination of the intestinal contents of

parrots shows that there exist in these birds very few microbes. A

comparative study shows plainly that the existence of an abundant

intestinal flora, useless for digestion, helps to shorten life by

producing bacterial poisons which weaken the higher elements and

strengthen the phagocytes.

The human race has inherited from its ancestors an enormous large

intestine and conditions favourable to the life of bacteria. It has to

endure the disadvantages of this heritage. On the other hand, the brain

of man is very highly developed, and with the increase of intellectual

power has come a consciousness of old age and death. Our strong will to

live is opposed to the infirmities of age and the shortness of life.

Here lies the greatest disharmony of the constitution of man.

If we desired to make the phenomena of old age physiological rather than

pathological, it would be necessary to reduce the evils arising from the

presence of a large intestine. It is impossible, I may at once say, to

wait for the operation of forces independent of the human will and that

might lead to the suppression of an organ which has become useless. Man,

guided by exact science, must strive to accelerate or anticipate such a

result. In spite of the progress of surgery, I do not expect to find in

our time that the large intestine will be removed by operation. Perhaps

in the distant future such a proceeding will become normal. For the

present it is more reasonable to attack the harmful microbes of the

large intestine. In the varied flora of that region there exist microbes

termed anærobic, because they are able to live in the absence of free

oxygen, obtaining what they require by the decomposition of organic

matter. Such decomposition is attended by fermentations and

putrefactions, and the production of poisons, such as the alkaloids

(ptomaines), fatty acids, and even true toxins.

In the human intestines under normal conditions, putrefaction occurs

only very slightly, or does not occur at all. But in intestinal diseases

of children and of adults, the microbes of putrefaction multiply

abundantly and produce copious secretions which inflame the intestinal

walls. To avoid these diseases of putrefaction in the case of infants,

it has been suggested to use as food only sterilised milk or other foods

quite free from microbes. This regimen has proved extremely successful.

In the investigation of the factors that hinder putrefaction, it has

been noticed that milk putrefies with considerable difficulty, whereas

meat, preserved under the same conditions, decomposes very readily.

Investigators have attributed the stability of milk to the presence of

casein or of milk-sugar. However, investigations recently made by

Bienstock[306] and confirmed by Tissier and Martel[307] have proved

the existence of certain microbes that hinder the putrefaction of milk.

These are in particular the microbes that sour milk, _i.e._, cause the

formation of lactic acid, and which are antagonistic to the microbes of

putrefaction. The latter multiply only in an alkaline medium. The lactic

acid microbes produce large quantities of acid and so hinder the

multiplication of the organisms of putrefaction. Putrefaction takes

place rapidly, in spite of the presence of the lactic acid microbes, if

there be added soda to macerations of meat or milk. Such facts explain

how it is that lactic acid frequently stops some cases of diarrhœa, and

why treatment with lactic acid is so useful in maladies associated with

putrefaction of the intestinal contents. It makes intelligible,

moreover, the medicinal value of fermented milk.

Rovighi,[308] an Italian physician, drank daily a litre and a half of

kephir, a preparation made by subjecting milk to lactic acid and

alcoholic fermentations. He found that in a few days the products of

intestinal putrefaction in his urine either disappeared or were greatly

reduced.

It is plain, then, that the slow intoxications that weaken the

resistance of the higher elements of the body and that strengthen the

phagocytes may be arrested by the use of kephir, or still better of

soured milk. The latter differs from kephir in that it contains no

alcohol, and alcohol in course of time diminishes the vitality of some

important cells in the body. The presence of a number of the lactic acid

bacteria is inimical to the growth of the bacteria of putrefaction, and

so is of great service to the organism.

But it is not enough merely to introduce useful microbes into the body.

We must also prevent the entrance of “wild” microbes, many of which are

harmful. Soil, especially when it has been manured, contains large

numbers of microbes, some of which are harmful. Bienstock found that the

soil of the strawberry-beds in his garden contained the bacilli of

tetanus. For three weeks he swallowed some of this soil, but found that

the bacteria were destroyed in his intestines, which he attributed to

the action of the normal bacterial inhabitants of the alimentary canal.

It is probable that if this arresting action were weakened the body

would be infected by tetanus from spores of the tetanus microbe

swallowed with earth or strawberries or green vegetables. Moreover,

besides the organisms of tetanus, there are many other dangerous

anærobic bacteria in manured garden soil.

Obviously we should eat no raw food, but confine our diet rigidly to

food that has been thoroughly cooked or sterilised. The exclusion of

“wild” microbes and the introduction of beneficial microbes, such as

those of lactic acid fermentation, must be of great service to health. I

know of individuals who have derived great benefit from such a regimen.

Science, even in its present imperfect condition, has many weapons by

which to prevent or at least diminish the slow and chronic poisoning of

the organism that leads eventually to the degeneration of the higher

elements. When these elements are being destroyed by syphilis or

alcoholism the struggle must be directed against these evils. It is long

since we have known how to do this; that success has not been greater is

due to the carelessness of the people who are concerned.

To strengthen the resistance of the higher elements and to transform the

“wild” population of the intestine into a cultured population, these are

the means by which the pathological symptoms may be removed from old

age, and by which, in all probability, the duration of the life of man

may be considerably increased.

If it be found impossible to eliminate all the harmful microbes from the

flora of the intestines, those that are refractory may be rendered

harmless by appropriate serums. We know already a serum that is specific

against the microbe of botulism, an organism capable of exciting serious

disturbance if it gain entrance to the alimentary canal.

Our inmost convictions assure us that life is too short, and since the

remotest ages attempts have been made to prolong it. I need hardly

mention the quest of the Middle Ages for an elixir of life, but many

thoughtful men have occupied themselves with the problem.