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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. Anyone seeking to utilize +this eBook outside of the United States should confirm copyright +status under the laws that apply to them. diff --git a/README.md b/README.md new file mode 100644 index 0000000..b940a1b --- /dev/null +++ b/README.md @@ -0,0 +1,2 @@ +Project Gutenberg (https://www.gutenberg.org) public repository for +eBook #69998 (https://www.gutenberg.org/ebooks/69998) diff --git a/old/69998-0.txt b/old/69998-0.txt deleted file mode 100644 index 059c4fe..0000000 --- a/old/69998-0.txt +++ /dev/null @@ -1,6357 +0,0 @@ -The Project Gutenberg eBook of Essays in medical sociology, Volume 2 -(of 2), by Elizabeth Blackwell - -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you -will have to check the laws of the country where you are located before -using this eBook. - -Title: Essays in medical sociology, Volume 2 (of 2) - -Author: Elizabeth Blackwell - -Release Date: February 10, 2023 [eBook #69998] - -Language: English - -Produced by: MWS and the Online Distributed Proofreading Team at - https://www.pgdp.net (This file was produced from images - generously made available by The Internet Archive/Canadian - Libraries) - -*** START OF THE PROJECT GUTENBERG EBOOK ESSAYS IN MEDICAL SOCIOLOGY, -VOLUME 2 (OF 2) *** - - - - - - ESSAYS IN MEDICAL SOCIOLOGY - - - - - ESSAYS - IN - MEDICAL SOCIOLOGY - - BY - - ELIZABETH BLACKWELL, M.D. - - - _VOLUME II._ - - - LONDON - ERNEST BELL, YORK STREET - COVENT GARDEN - 1902 - - - - - CONTENTS OF VOL. II. - - - ESSAY PAGE - - I. THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE 1 - - II. ERRONEOUS METHOD IN MEDICAL EDUCATION 33 - - III. WHY HYGIENIC CONGRESSES FAIL 47 - - APPENDIX 85 - - IV. SCIENTIFIC METHOD IN BIOLOGY 87 - - V. CHRISTIAN SOCIALISM 151 - - VI. ON THE DECAY OF MUNICIPAL REPRESENTATIVE GOVERNMENT 173 - - VII. ADDRESS DELIVERED AT THE OPENING OF THE WOMEN’S MEDICAL - COLLEGE, NEW YORK 197 - - VIII. THE RELIGION OF HEALTH 211 - - - - - THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE - - - _Address given at the Opening of the Winter Session of the London - School of Medicine for Women, October, 1889_ - - - - - THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE - - -In the short time that we meet together to-day I will ask you to let -me dwell upon the way in which the most beneficial influence of women -in the medical profession may be exercised. I wish also to point out -certain dangers, as well as advantages, with which medical study is now -surrounded. - -The avenues by which all may enter into the profession are now so much -more widely thrown open that there is little difficulty in the way of -any man or woman who may wish to acquire a legal right to practise -medicine. In Paris all the public medical institutions, both college -and hospital, are thrown open to students without distinction of sex. -Not only as ordinary students, but as internes and externes, sex is no -longer regarded there as a barrier to opportunity and position. The -democratic principle is everywhere steadily gaining ground, and the -individual allowed to try his strength in the great battle of life. -Large numbers of women are taking advantage of this wider individual -liberty to enter the medical profession. In Great Britain our -seventy-three registered lady-doctors are few compared with the 3,000 -in the United States, yet the nine students who are now connected with -our London school, with, in addition, the Edinburgh classes, the Dublin -students, and the latest fact that the Glasgow Medical College has -just opened its doors to women, clearly indicate that the movement has -taken sturdy root in our country, and when our English work has been -carried on for forty years, there is every probability that our British -lady-doctors will equal numerically our kinsfolk across the ocean. - -I think, therefore, that all will see the importance of considering -the future of this growing army of medical women, and I particularly -desire that our students of medicine should realize the far-reaching -character, the social effects, of this medical career which they are -entering on. It is quite certain that the wide adoption of the medical -profession by women cannot continue to be an insignificant matter; it -must exercise an appreciable effect on future society for good or evil. - -If we were children entering upon a course of education, it would -be premature to take stock of the results of education, and cast a -far-seeing glance into the future. - -But it is different with adult women--women of education, somewhat -impatient of restraint--entering upon a larger liberty, and -legitimately jealous of any interference with that liberty. It is -therefore imperative upon us to consider very seriously this matter of -self-guidance at the outset of medical education, to take in a large -view of future responsibility, and ask ourselves that most important -question respecting a medical training: What will be its effect? - -The flippant or superficial person may at once reply: Our object is -to gain money and pursue a remunerative calling by looking after -sick people. Women find so much difficulty in honestly supporting -themselves, that it is reason enough that they can in this way do so, -and the labourer is worthy of his hire. But I say emphatically that -anyone who makes pecuniary gain the chief motive for entering upon -a medical career is an unworthy student; he is not fit to become a -doctor, and he will be a labourer not worthy of his hire. What should -be thought of a statesman who aspired to the direction of national -affairs on account of the salary of £10,000? The nobleness of motive -must enlarge with the nobleness of occupation, or the unworthy occupier -sinks to a degradation measured by the height to which his career -should have raised him. - -Now, there is no career nobler than that of the physician. The -progress and welfare of society is more intimately bound up with the -prevailing tone and influence of the medical profession than with -the status of any other class of men. This exceptional influence is -not only due to the great importance of dealing with the issues of -life and death in health and disease, but it is still more owing -to the fact that the body and the mind are so inseparably blended -in the human constitution, that we cannot deal with one portion of -this compound nature without in more or less degree affecting the -other. Our ministrations to body and soul cannot be separated by a -sharply-defined line. The arbitrary distinction between the physician -of the body and the physician of the soul--doctor and priest--tends -to disappear as science advances. Every branch of medicine involves -moral considerations, both as regards the practitioner and the patient. -Even the amputation of a limb, the care of a case of fever, the birth -of a child, all contain a moral element which is evident to the clear -understanding, and which cannot be neglected without injury to the -doctor, to the individual, and to society. But probably it will be -generally agreed that the hope of gaining money must not be the primary -motive for choosing a medical career; but that interest in the line of -study and kind of life, with a perception of the wide and beneficent -influence which it can exert, should form the determining motive for -becoming a physician. - -If, then, we recognise that, although just reward for honest labour is -fair, we must not enter upon medicine as a trade for getting money, but -from a higher motive, this motive, as it influences conduct, becomes on -that account a moral motive or an ideal which should guide our future -practical life as physicians. Now, this ideal necessitates a distinct -conception of what is right or wrong for us, in medicine, both as human -beings and as women. Simply sensuous life, without an ideal or without -higher principles of action than the limited needs of every day, tends -to degrade the individual and all who surround him. - -What we need is a clear idea of what is really right or wrong, with the -reasons on which the judgment is based, instead of a confused notion or -a vague and ever-shifting standard. - -No woman student of medicine can safely ignore this subject. It is a -vital one for us, and only a true answer to it will make our entrance -into the profession a marked advance in social progress. - -I do not attempt to disguise the difficulty of laying down the law of -right and wrong in medicine; not only because medicine, as every other -part of social life, is subject to the growth of evolution, but because -in a state of society that has not yet succeeded in moulding itself on -the fundamental principles of Christianity, we are involved in faulty -social conditions which prevent us from embodying our moral perceptions -in every phase of practical life. But, remember, thought and endeavour -may live a righteous life, no matter what faulty conditions surround -us. When we have a clear view of right and wrong, we can mentally -repudiate whatever appears to violate the moral law. We can strenuously -resist the deadening force of habitual wrong-doing, and never cease the -effort to find some way of shaping our mental protest into practical -opposition to all forms of immorality. - -You will see in the course of your medical studies--particularly if -you study abroad--much to shock your enlightened intellect and revolt -your moral sense. In practice also you will be subjected to strong -temptations of the most varied character. But just for the reason that -as women we ought to see more clearly the broken bridge or approaching -danger, in the onward rush of the male intellect, I now dwell on our -special responsibility, and shall endeavour to give the reasons for it. - -My object is not to limit, but to enlarge our work in medicine, when -I seek to define our ideal. It is true that the great object of this -human life of ours is essentially one for every human being, man or -woman, barbarous or civilized. It is to become a nobler creature, and -to help all others to a higher human status during this brief span -of earthly life. But as variety in unity is a law of creation, so -there are infinite methods of progress, producing harmony instead of -monotony, when the individual or classes of individuals are true to the -guiding principles of their own nature. - -For the ideal of every creature must be found in the relation of its -own nature to the universe around it. Right and wrong are based upon -the sound understanding of this positive foundation. It is this fact of -variety in unity, in the progress of the race, which justifies the hope -that the entrance of women into the medical profession will advance -that profession. - -In order to carry out this noble aspiration, we must understand what -the special contribution is, that women may make to medicine, what the -aspect of morality which they are called upon to emphasize. - -It is not blind imitation of men, nor thoughtless acceptance of -whatever may be taught by them that is required, for this would be to -endorse the widespread error that the race is men. Our duty is loyalty -to right and opposition to wrong, in accordance with the essential -principles of our own nature. - -Now, the great essential fact of woman’s nature is the spiritual power -of maternity. - -We should do miserable injustice to this great fact if, looking at it -with semiblind eyes, we only see the shallow material aspect of this -remarkable speciality. It is the great spiritual life underlying the -physical which gives us our true womanly ideal. - -What are the spiritual principles necessarily involved in this special -creation of one-half the race--principles which lie within the material -facts of gestation and the care of infancy and childhood, which -constitute the distinctive material domain of women? - -They are the subordination of self to the welfare of others; the -recognition of the claim which helplessness and ignorance make upon -the stronger and more intelligent; the joy of creation and bestowal of -life; the pity and sympathy which tend to make every woman the born -foe of cruelty and injustice; and hope--_i.e._, the realization of -the unseen--which foresees the adult in the infant, the future in the -present. - -All these are great moral tendencies, and they are necessarily -involved in the mighty potentiality of maternity. They lay upon women -the weighty responsibility of becoming more and more the moral guides -in life’s journey. Women are called upon very specially to judge all -practical action as right or wrong, and to exercise influence for this -high morality in whatever direction it can be most powerfully exerted. - -We see the indication of this providential inherited impulse to moral -action, in the great and increasing devotion of women to the relief of -social suffering and their sturdy opposition to wrong-doing, which form -a distinguishing characteristic of our age. These spiritual mothers of -the race are often more truly incarnations of the grand maternal life, -than those who are technically mothers in the lower physical sense. - -With sound intellectual growth the range of moral influence increases. -But such sound growth can only take place under the guidance of moral -principle; for moral perception becomes reason as the intellectual -faculties grow, and reason is the true light for all. It is in this -high moral life, enlarged by intelligence, that the ideal of womanhood -lies. It is through the moral, guiding the intellectual, that the -beneficial influence of woman in any new sphere of activity will be -felt. - -Thus, from their inherited tendencies, as well as from the existent -individuality of their nature, women must seek a high moral standard as -their ideal, and acknowledge the supremacy of right over every sphere -of intellectual activity. The highest type of moral excellence which we -can find in the age in which we live, the beneficence which it exerts, -the means by which it has been attained, form so many landmarks to -guide us in our search for the right. - -This very important method of growth has been well stated by Huxley, -that brave fighter in the past for freedom of thought. He has laid -down this weighty principle, that ‘the past must be explained by the -present.’ - -This principle is of very wide application. - -What produces the noblest human creature now in our nineteenth century? -What inspires hope? What sustains us most bravely to fight the battle -of life? What makes life most worth living? - -When we have ascertained these facts in the present, they will explain -the past, and give the foundations of right for guidance in the future. - -It is a noteworthy feature of the present day that some of our best -men, witnessing the failure of so many panaceas for the intolerable -evils that afflict society, are longing for that untried force--the -action and co-operation of good women. ‘Our only hope is in women!’ is -a cry that may sometimes be heard from the enlightened male conscience. -But still more significant is the awakening of an increasing number of -women themselves. They begin to realize that truth comes to us through -imperfect human media, and is thus rendered imperfect; that every human -teacher must be accepted for his suggestiveness only, not as absolute -authority. Women are thus rising above the errors of the past, above -blind acceptance of imperfect authority, and are earnestly striving to -learn the will of the Creator, and walk solely according to what they -themselves, diligently seeking, can learn of that Divine will. - -There is no line of practical work outside domestic life, so eminently -suited to these noble aspirations as the legitimate study and practice -of medicine. The legitimate study requires the preservation in full -force of those beneficent moral qualities--tenderness, sympathy, -guardianship--which form an indispensable spiritual element of -maternity; whilst, at the same time, the progress of the race demands -that the intellectual horizon be enlarged, and the understanding -strengthened by the observation and reasoning which will give increased -efficiency to those moral qualities. - -The true physician must possess the essential qualities of maternity. -The sick are as helpless in his hands as the infant. They depend -absolutely upon the insight and judgment, the honesty and hopefulness, -of the doctor. - -The fact also that every human being we are called on to treat, is, -like the infant and the child, soul as well as body, must never be -forgotten. Successful treatment requires the insight which comes from -recognition of these facts and the sympathy that they demand. In the -infinite variety of human ailments the physician will find that she -must often be the confessor of her patient, and the consulting-room -should have the sacredness of the Confessional, and she must always be -the counsellor and guide. - -In those two departments of medicine which seem to me peculiarly -valuable to women physicians, which I shall refer to later--viz., -midwifery and preventive medicine--it would be hard to say whether -the moral or intellectual qualities of the physician were called most -largely into play, so inseparably are they blended. What patience -and hopefulness also are demanded in the lingering trial of chronic -illness! What discrimination and union of gentleness and firmness these -cases require! Then think of the children in our families! To the girls -and boys, the young women and men, who grow up under our ministrations, -what an inspirer of nobleness and purity, what a guardian from -temptation the true physician can be! - -Again, in the treatment of the poor, an immense demand is made upon our -pity, patience, and courage. These poor victims of our social stupidity -are often extremely trying. The faulty arrangements which compel us to -see thirty, fifty even, in an hour exhaust the nervous system of the -doctor. It requires faith and courage to recognise the real human soul -under the terrible mask of squalor and disease in these crowded masses -of poverty, and to resist the temptation to regard them as ‘clinical -material.’ The attitude of the student and doctor to the sick poor is a -real test of the true physician. - -Having thus realized the profound adaptation of the nature of woman -to the practice of the Art of Healing, let us consider in what way -the intellectual faculties may be strengthened, so as to give enlarged -efficiency to the maternal qualities. In other words, how shall we -become reliable doctors? - -What I have hitherto dwelt on is the necessary attitude of mind or the -atmosphere and light in which women physicians must breathe and work if -they are to attain to their distinctive efficiency; let me now refer -more particularly to the method of training for our practical work. - -The intellectual training required for the physician is admirably -adapted to supply deficiencies in the ordinary experience of women. - -The intellectual characteristics which must be especially gained during -student life are: the faculty of patient observation, exact statement -of what is observed, and cautious deductions from these observations. - -These qualities form the foundation of sound judgment and skilful -medical practice. It is not a brilliant theorizer that the sick person -requires, but the experience gained by careful observation and sound -common-sense, united to the kindly feeling and cheerfulness which make -the very sight of the doctor a cordial to the sick. If these necessary -results of intellectual training can be secured in harmony with the -moral structure of womanhood, then a step of real social progress is -made by our study of medicine. - -This necessity for making the most painstaking observation of facts, -the foundation to be laid by the student in every branch of her -studies, is well illustrated in the life of Darwin, who writes thus to -a friend: ‘I have been hard at work for the last month in dissecting -a little animal about the size of a pin’s head, from the Chronos -Archipelago, and I could spend another month and daily see more -beautiful structure.’ Of the value of this method of persistent labour, -his friend gives this noteworthy testimony: ‘Your sagacious father -never did a wiser thing than devote himself to these years of patient -toil. It is a remarkable instance of his scientific insight and courage -that he saw the necessity of proper training and did not shrink from -the labour of acquiring it.’ - -In medicine, anatomy, physiology and chemistry are the primary studies -where that foundation of conscientious exactitude must be laid on which -the skill of the future physician so largely depends. - -The first and indispensable basis of medicine is anatomy, with which -physiology is inseparably blended; for human physiology can only -be properly studied in connection with the human structure, whose -condition in health and disease forms the direct object of our -profession. No student should be satisfied until she has most carefully -followed out the structure of every region of that human body with -whose life we shall have to deal. Careful anatomical study is the sure -and indispensable preparation for that next advanced range of clinical -observation, where pathology and therapeutics bring us into the direct -study of the sick. - -The more thoroughly the human organization is investigated, the more -wonderful will the unapproachable mechanism for the use of human life -be seen to be. We shall never regret any amount of time and care spent -in acquiring the most intimate knowledge of human anatomy. For even if -we never perform a surgical operation, the thorough knowledge of the -human framework with whose aberrations we have to deal, gives a firm -foundation for practice that nothing else can supply. - -The thoughtless slashing of the delicate and complicated structure -of the body, of which untrained students are sometimes guilty, -is indicative of a careless, unconscientious future physician. -If carelessness similar to what is sometimes observed in the -dissecting-room were carried on in the chemical laboratory, life -or limb would soon be sacrificed. Yet a thorough grounding in the -structure of every vital organ is more indispensable to us than -chemistry, important as the study of chemistry is. Let me here note how -the moral element on which I have so strongly insisted comes into play -in this the first of our medical studies. Reverence for this physical -structure of ours should always be shown in the use and arrangements of -the anatomical rooms. Carelessness and irreverence in this department -of study exercise a really deteriorating influence on students of -medicine. Respect for the material used, care in its disposition, and a -decent covering for each work-table in the intervals of work, may seem -small observances, but they exercise a large influence over the moral -training of the student when persistently carried out. - -It does not enter into my present purpose to enlarge upon the right -method of studying each branch of medicine, for that would require a -series of discourses. But I must give an emphatic warning against the -strange neglect of _human_ physiology which I observe. This seems to -proceed from the mistaken idea that necessary knowledge can be obtained -from other organisms which bear a misleading resemblance to the human. - -What I would insist upon is, that we should endeavour to make ourselves -thoroughly acquainted with the nature and variations of healthy human -physiology before we are perplexed with the changes of pathology. - -Auscultation and percussion; observations of the healthy variations -of the pulse, the tongue, the skin, and the various secretions, in as -many healthy individuals, both adult and infant, as can be examined, -compared, and recorded; the vital chemistry of the human tissues and -secretions in health and disease; the modifying effects of temperament, -heredity, idiosyncrasy, etc.--all this forms a department of human -physiology, strangely neglected as a practical study, yet certainly of -primary importance to the progress of medicine. - -But I must pass on to what is my immediate purpose--viz., the relation -of women to medicine. Having dwelt on the moral and intellectual -advantages of medical study, I must refer to another aspect of the -subject--viz., the dangers which meet our earnest students. - -Dr. Carpenter has recorded the wide-spread recognition of this -dangerous aspect of medical study when he says: ‘There seems to -be something in the process of training students for the medical -profession which encourages in them a laxity of thought and expression -that too frequently ends in a laxity of principle and of action’; -and he further condemns the tone of some works issued by the medical -press. Now, this judgment of a very cautious teacher so many years ago, -is worthy of the most serious consideration in the present day. The -freedom of entrance now accorded to women into the medical profession, -lays a very heavy responsibility upon us, to prove that this new and -increasing movement will be a future blessing to society. - -We are happy in drawing into our schools a large number of capable -women--women who may not only be a gain as physicians, but who may -exert a most beneficial influence on the profession itself, if they -bring into it fresh and independent life. - -It is much to be regretted that our students are now compelled to go -abroad for the completion of their medical education, for methods of -study injurious to morality are exaggerated abroad. The abuse of the -poor as subjects of experimental investigation, in whose treatment all -decent reserves of modesty are so often stripped away; the contempt -felt for the mass of women where chastity is not recognised as an -obligatory male virtue; the atrocious cruelty of their experiments -on animals--all these results of active intellect, unguided by large -morality, as seen in full force abroad, make me deplore the necessity -which drives so many of our best but inexperienced students away, in -search of more efficient training than they can obtain at home. - -The two special dangers against which I would warn our students are: - -_First_, the blind acceptance of what is called ‘authority’ in medicine. - -_Second_, the narrow and superficial materialism which prevails so -widely amongst scientific men. - -In relation to the first point--viz., distrust of authority--although I -fully recognise the respect which is always due to the position of the -teacher, and the consideration to be shown to all who are called ‘heads -of the profession,’--I would very strongly urge you to remember that -medicine is necessarily an uncertain science. - -Life in its essence we cannot grasp. We understand it only through -its effects, and all human judgment is fallible. Careful and wise -observation bring us ever nearer to a knowledge of the conditions -which are necessary for human well-being; but experience compels us -to recognise the constant failure of theory or dogmatism in dealing -with any of the infinitely varied phases of life. In medicine, we -are forced to recognise the errors in diagnosis committed even by -distinguished men, and to suffer grievous disappointment from the -failure of remedies supposed to cure the sick. We cannot fail to note -the contradictory results of experiments, the same facts differing -according to the observer--one fact upsetting another, and one theory -driven out by a later one. This uncertainty resulting from experiment, -is strikingly exemplified by the battle of experts about the effects of -arsenic displayed in a late criminal trial. Or consider the frequent -errors of statistics (a branch of knowledge that enters largely into -medical science), owing to the imperfect data on which they are often -based, important deductions being drawn from them which are logically -indisputable, but entirely false, from the unsound premisses on which -they rest. Thus, the death-rate of London, though commonly stated at -23 or 24 per 1,000, is really an unknown quantity, on account of the -enormous influx of fresh life and the efflux of broken-down lives. - -Our women students especially need caution as to the blind acceptance -of authority. Young women come into such a new and stimulating -intellectual atmosphere when entering upon medical study, that they -breathe it with keen delight; they are inclined to accept with -enthusiasm the brilliant theory or statement which the active intellect -of a clever teacher lays before them. They are accustomed to accept the -government and instruction of men as final, and it hardly occurs to -them to question it. It is not the custom to realize the positive fact, -that methods and conclusions formed by one-half of the race only, must -necessarily require revision as the other half of humanity rises into -conscious responsibility. - -It is a difficult lesson also, fully to recognise the limitations -of the human intellect, which recognition, nevertheless, is -necessary before we can grasp this important and positive fact in -human experience--viz., that the Moral must guide the Intellectual, -or there is no halting-place in the rapid incline to error. The -brilliant professor will always exercise an undue influence over the -inexperienced student, and particularly over the woman student. I -therefore strongly urge the necessity of cherishing a mild scepticism -respecting the dicta of so-called medical science, during the period of -student life--scepticism not in relation to truth--that noble object -which we hope to approach even more nearly--but scepticism in relation -to the imperfect or erroneous statement of what is often presented as -truth. - -Of this one guiding fact, as a basis of judgment, we may be quite -sure--viz., that whatever revolts our moral sense as earnest women, -is not in accordance with steady progress; it cannot be permanently -true, and no amount of clever or logical sophistry can make it true. -It will be a real service that we, as medical women, may render to the -profession if we search out--calmly, patiently, but resolutely--why -what revolts our enlightened sense of right and wrong is not true. We -shall thus bring to light the profound reason why the moral faculties -are antecedent or superior to the intellectual faculties, and why the -sense of right and wrong must govern medical research and practice, as -well as all other lines of human effort. - -As experience enlarges, we observe the immense separation in lines of -conduct which gradually results from an initial divergence between -right and wrong--a divergence almost imperceptible at first. We are -thus compelled to come to the conclusion, in relation to our own -profession, that the worship of the intellect, or so-called knowledge, -as an end in itself, entirely regardless of the character of the means -by which we seek to gain it, is the most dangerous error that science -can make. This false principle, if adopted by the medical profession, -will degrade it, and inevitably produce distrust and contempt in the -popular mind. - -The second danger against which the student of medicine must guard -is the materialism which seems to arise from undue absorption in the -physical aspect of nature, and which spreads like a blight in our -profession. - -The basis of materialism is the assertion that only sense is real. - -Our medical studies necessarily begin with minute and prolonged study -of what we term ‘dead matter.’ If this study be carried on without -reverence, it appears to blind the student to any reality except the -material under his scalpel or in his crucible--_i.e._, the facts that -the senses reveal. Proceeding logically from this false premiss, that -only sense is real, mind is looked upon as an outcome of the brain, and -life as the result of organization of matter, which is destroyed when -the organization of the material body is broken up. - -Some persons, successors of the materialistic ecclesiastics who -condemned Galileo, cannot rise beyond the gross evidence of their -senses. To such persons reason, which transcends sense, is a vague -unreality, and the clear teaching of reason may to them seem doubtful, -or superstition. But the stout fight which the old Italian nobly began, -and which has been so bravely carried on for freedom of thought in -our own day, is beginning to tell and reap a rich reward. Our senses, -so far from being the boundary of real existence, are proved to be as -untrustworthy guides now, as when Galileo’s accusers insisted that the -sun moved round the earth in twenty-four hours. The relations of our -senses to our consciousness change with biological differences, as one -creature can see what is quite invisible to another. The boundary-line -which exists between our senses and our consciousness is constantly -changing, and realities are shown to exist, of which our ordinary -consciousness connected with the senses has no knowledge. Thus, life -beyond, and independent of the senses, is being proved as positive and -pregnant fact. - -The great generalizations of modern science--the Conservation of -Energy, the process of Evolution--are the products of Reason. They -are metaphysical conceptions. Like the atomic theory or the law of -gravitation, they are practical formulæ necessary to the advancement -of science from the structure of our minds but they are the results of -reason, not of sense. - -Love, Hope, Reverence, are realities of a different order from the -senses, but they are positive and constant facts, always active, always -working out mighty changes in human life. - -A thoughtful writer has characterized Materialism as an attempt to -explain the Universe in terms of mass and motion rather than in terms -of Intelligence, Love, and Will, and it is a true criticism. Let me -recall here the serious warning which Huxley gives to the shallow -materialist who limits existence by the senses. - -He says: ‘The great danger which besets the speculative faculty is the -temptation to deal with the accepted statement of facts in natural -science as if they were not only correct but exhaustive--as if they -might be dealt with exhaustively, in the same way as propositions of -Euclid may be dealt with. In reality, every such statement, however -true it may be, is true only relatively to the means of observation -and the point of view of those who have enunciated it. Whether it will -bear every speculative conclusion that may be logically deduced from -it is quite another question.’ ‘In the complexity of organic nature -there are multitudes of phenomena which are not deducible from any -generalizations that we have yet reached; this is true of every other -class of natural objects (as the moon’s motions, gravitation, etc.). -All that should be attempted is a working hypothesis, assuming only -such causes as can be proved to be actually at work.’ - -These are valuable warnings from our great naturalist. - -The tendency of unprejudiced science in our day is to show the -unsatisfactory character of the terms ‘matter’ and ‘spirit.’ For the -exaltation of what we term ‘matter’ tends constantly to lose itself in -what we call ‘spirit.’ - -Reality always transcends sense. As the vibrations of ether are only -known as light and colour, and the vibrations of the atmosphere are -translated into sound, so in the careful observation of our own mental -states, in the experiences of dream-land, in the study of clairvoyants -and somnambulists and the revelations of hypnotism, we gain an insight -into states of consciousness independent of the senses--states where -the old distinctions between matter and spirit seem to become quite -inapplicable. - -One third of human life is spent in sleep, a condition of which at -present we know little, except that it entirely changes the life of -conscious sense, and that it possesses a mysterious restorative power -of the most precious significance to us as physicians. A study of -all these mysterious conditions of human life itself, many of which, -although occurring abnormally, have been presented again and again -through all the ages, is surely the most important of all subjects for -scientific medical investigation. Let us always bear in mind, as has -been well said, ‘the fact of illusion is not an illusory fact.’ As an -exception to a rule is the most suggestive fact for the investigator -to grapple with, so those exceptional facts of human nature, which -are nevertheless occurring in every age and in every nation, are the -facts of all others the most worthy of investigation by the scientific -medical intellect. This new realm of research, when legitimately -pursued, promises results of the very highest importance. - -I must not now dwell longer on this new and valuable department of -medical investigation--psycho-physiology. But it is an inspiring -thought that true science supports the noblest intuitions of humanity, -and its tendency is to furnish proof suited to our age of these -intuitions. I have specially dwelt on this subject now, because the -discouragement which results from the false reasoning of materialism, -injuring hope, aspiration, and our sense of justice, is especially -antagonistic to women, whose distinctive work is joyful creation. - -In practical medicine the loss is immense when recognition of the -higher facts of consciousness is obscured, and the physician is unable -to perceive life more real than the narrow limits of sensation. - -The physician is called to stand by the death-bed of the most -carefully-tended patient. At that solemn moment the clear glance that -sees beyond the boundary of sense, the reverential hand-clasp which -conveys hope to the mourner, is the seal of his noble art of healing -and the profoundest consolation he can offer to the bereaved. May the -time come when every physician can convey this highest gift of healing -with his ministrations! - -I have now considered the fundamental reason why great advantage will -result to society through the intellectual cultivation of the woman -physician, unless the study of medicine be pursued in such a way as to -do violence to our nature by the destruction of sympathy, reverence, -and hope. - -I have also dwelt on the method of training especially needful to our -students--viz., patient, persistent drill in the fundamental studies of -medical education, a training which will form the habit of close and -careful observation at the commencement of medical life. - -I would now offer a few words of counsel in relation to the work -which lies before us when we enter upon the practical career of the -physician, for which our medical studies should carefully prepare us. - -I believe that the department of medicine in which the great and -beneficent influence of women may be especially exerted, is that of -the family physician, and that not as specialists, but as the trusted -guides and wise counsellors in all that concerns the physical welfare -of the family, they will find their most congenial field of labour. - -It is to fit ourselves for this most useful and influential -position--viz., as the medical advisers of families--that, not limiting -our education to any speciality, we have laboured, and must continue -to labour, to remove all obstacles in the way of obtaining the fullest -medical education. For this reason I have laid so much stress upon the -cultivation of habits of careful observation, and I now would give a -warning against sensationalism in medical study. - -The unreflecting student (not unnaturally) rushes after novelties. -There is a certain excitement in witnessing a formidable surgical -operation, or seeing a rare case of disease that may never again be -presented to our observation. But these exceptional occurrences do -not fit us for our future medical life as does the careful study of -the commoner forms of disease, for those are the cases that most -nearly concern us. But because they are common they cease to interest -the unobservant student, who applies a routine treatment. But the -physician whose faculties of observation have been thoroughly drilled -has learned this lesson--viz., that no two cases of illness are -exactly alike, and that it is of the utmost importance to our future -success as practitioners to note these individual differences, their -results, and why some die whilst others recover. It is far more -important to our success as practical physicians to thoroughly master -measles and whooping-cough, scarlet fever and porrigo, than to study -an isolated case of hydrophobia or leprosy. Moreover, I hold it to be -a special duty of our profession to extirpate these common diseases, -not to accept them hopelessly as necessary evils. And it is only by -a profounder and more comprehensive clinical study of the ordinary -diseases of domestic life that we can hope to do this. - -There are two great branches of medicine whose importance will, I hope, -more and more engage the attention of women physicians. These are -midwifery, which introduces us to the precious position of the family -physician; and sanitary or preventive medicine, which enables us to -educate a healthy generation. - -These two departments of the healing art will never cease from amongst -us. I consider it a radical defect in our present system of medical -education, that these subjects are not brought more prominently -forward, and both of them raised into first-class professorial chairs. - -Before closing, I must dwell for a few moments on the vital importance -of midwifery to the future success of women physicians. This is the -more necessary because I observe a singular and growing disposition on -the part of our students, whether in America, France, or England, to -despise or neglect midwifery. I do not know whether this proceeds from -indolence, as midwifery is the most fatiguing and enchaining branch of -the profession, or whether the neglect arises from failure to perceive -the reason of our refusal to be simply midwives, for our insistence -upon a complete education really means our determination to elevate, -not repudiate, midwifery. - -But the curious fact remains that many women doctors appear to look -down upon this most important branch, and often state that they do not -intend to undertake it. Yet it is through the confidence felt by the -mother during our skilful attendance upon her, that we are called in to -attend other ailments of the family, and thus secure the care of the -family health. It is therefore of the utmost importance to our future -position in medicine to establish our ability as thoroughly trustworthy -obstetricians. - -It is indispensable to the stability of our movement that very thorough -provision be made for the obstetrical education of all our medical -graduates. I do not think that any young woman physician is properly -equipped for her future difficult career unless she has been to a great -extent responsible for at least thirty midwifery patients, of whose -cases she has made careful and discriminating records, and has had the -opportunity of observing a great many more patients, in addition to -the drill in all operative manœuvres that can be given in college. We -need a great maternity department, thoroughly organized, which, whilst -arranged with kindest consideration for the poor, will put our students -through a severe drill, such as is considered necessary at La Maternité -in Paris. That institution, which receives annually an average of 2,500 -patients, having over 10,000 applications in the year, is not only an -invaluable practical school, but it has reduced the mortality amongst -its patients to a minimum; and the searching method of instruction -there pursued could be studied by us to great advantage as we try to -secure a well-organized maternity charity for our students in London. -Such a charity, if humanely planned, would be a blessing to poor -mothers, and it would to a great extent remove the reproach of being -obliged to send our enterprising young doctors abroad because London -does not afford them sufficient necessary practical training. - -But time warns me to close these remarks, although I would gladly have -enlarged upon the primary importance of preventive medicine--the -medicine of the future--for it is quite certain that the greater part -of disease, even including many surgical operations, is preventable -disease. It is now, unfortunately, the case that unavoidable absorption -in the treatment of disease makes the practical physician too often -ignore the yet larger duty of preventing it. - -I have tried to show (1) That women, from their constitutional -adaptation to creation and guardianship, are thus fitted for a special -and noble part in the advancement of the healing art. (2) That the -cultivation of the intellectual faculties necessary to secure their -moral influence requires a long and patient training by methods that -do not injure morality. (3) That the noblest department of medicine to -which we can devote our energies, will be through that guardianship of -the rising generation which is the especial privilege of the family -physician. - -In conclusion, my young friends and fellow-workers, I would ask you all -to join with me in the pledge which I gave more than forty years ago to -the Chancellor of the Western University, who handed to me our first -Diploma of Doctor of Medicine. I then promised ‘that it should be the -effort of my life to shed honour on that diploma.’ - -This is the pledge that we must all prepare for when entering the noble -profession of medicine; in receiving honour we must add lustre to it, -or we become unworthy of it. - -It is a difficult life that we enter upon, in entering upon a medical -career; but if our Christianity is worth anything, it must be ‘a -battle, not a dream.’ We must be members of the church militant if we -wish to enter the church triumphant. Life is a grand preparation for -the exercise of ever larger powers, and I heartily welcome you to this -winter’s course of study, hoping that it may be a little step forward, -but a sure one, towards that grand ideal which must be ever before us. - - - - - ERRONEOUS METHOD IN MEDICAL EDUCATION - - _Addressed originally[1] to the Alumnæ Association of the Woman’s - Medical College of the New York Infirmary_ - - - - - ERRONEOUS METHOD IN MEDICAL EDUCATION - - -Although it is many years since I have been able to assist in the -management of the Infirmary and School which I helped to found in 1853, -yet I watch its growth with steady sympathy, and rejoice in its success. - -The last Report of the School, which has just reached me, contains -a very important item--viz., the effort of the Alumnæ Association -to ‘Equip a Physiological Laboratory and place it under the -superintendence of Professor W. Gilman Thompson,’ a New York -Vivisector. In relation to this effort, I desire to bring before you -some grave considerations which are the result of my long experience in -Medicine. - -These considerations refer, _first_, to the kind of work that should be -carried on in a Physiological Laboratory, and, _second_, to the special -influence which women are called on to exercise in medicine. - -A Physiological or Pathological Laboratory arranged for the -legitimate investigation of the material composition of the tissues -and secretions of the human body, is an interesting and important -department of medical study. The laboratory, however, is now commonly -used as a place for experimenting upon living animals as if they were -dead matter, or simple machines. This method of research is proving in -several ways extremely injurious to the progress of the Healing Art. - -The practice of Vivisection and unlimited experimentations upon our -humbler fellow-creatures must be considered by us both under its -intellectual and its moral aspects. From both these points of view very -careful observation has led me to the conviction that this method of -investigation is a grave error. - -Let me here state distinctly that I willingly acknowledge the good -intentions of all and the ability of some of the clever physiologists -of the present day, although their method of experimentation is -erroneous and the effects of that method injurious, being founded -on a fallacy. What I now say, however, is directed chiefly to the -instruction of medical students and to the practice of our young women -doctors. - -I ask you to consider, first, the intellectual fallacy which underlies -this method of research. It is a twofold fallacy, resulting from the -differences of organization in different classes of living creatures, -and from the fact that when any organ is injured, it is a process of -destruction or death--not life--that is exhibited. - -There is an ineradicable difference of physical structure between -Man and every species of lower animal. Nowhere is there identity of -structure or of function. Resemblance or parallelism often exists, but -identity never. Take the dog, for instance, whose attachment to Man -furnishes us with the widest opportunities of observation. In no single -function of its body is the action of the function the same as in Man. -All the processes of digestion, including its large group of connected -organs, differ from those of the human being. Observe carefully the -processes of healthy living animals. You will find that their senses -act in a different way to ours--a way which is often quite unknown to -us, we possessing no power even comparable with many of their powers. -Their relations to nature differ in many ways from our relations. It is -true that they eat and sleep and dream; that they possess intellectual -and moral powers, and are susceptible of education. They exhibit a -rough rudimentary sketch of our higher spiritual powers, and are -related to us in many ways. But the differences are so great, their -whole attitude towards external life is so different, that they may -be truly said to live in a different world from ours. So that in no -possible instance can we draw a positive conclusion respecting the -lower animal nature, that can be transferred as reliable information to -guide us in relation to the action of the human organs and functions, -either in health or disease. This misleading difference is true not -only in relation to the spontaneous working of functions, but it is -also true in respect to the actions of poisons, of drugs, and the -artificial production of diseases. Animals can be rendered scrofulous, -diabetic, syphilitic, leprous, by forcing the poison of diseases into -their bodies. Morbid action, atrophy, slow death, can be produced by -removing portions of their organs; but no deductions drawn from these -artificial conditions can be transferred to man in order to cure human -disease or restore lost function. The scrofula, diabetes, syphilis, -or rabies, takes on a different form when the lower animal has been -artificially poisoned by these diseases. In not a single instance known -to science has the cure of any human disease resulted necessarily from -this fallacious method of research. - -In 1849-50 I was a student in Paris, and, with the narrow range -of thought which marks youth, I was extremely interested in the -investigations respecting the liver and gall bladder which Claude -Bernard (Majendie’s successor) was then carrying on and lecturing upon -at the Collège de France and the Sorbonne. I called upon M. Bernard to -ask him where I could find some work on ‘Physiologie Appliquée’ which -would show me how the results of these investigations could be applied -to the benefit of man. M. Bernard received me with the utmost courtesy, -but told me there was no such book written; the time had not come -for the deductions I sought; experimenters were simply accumulating -facts. We are still, forty years later, vainly accumulating facts! This -present summer Dr. Semmola, ‘one of the most brilliant pupils of Claude -Bernard,’ lectured in Paris on Bright’s disease, which he has been -studying for forty years with unlimited experimentation on the lower -animals, for the purpose of producing in them artificial inflammation -and disease of the kidneys. What is the result to the human being -of all this prolonged and ingenious suffering inflicted on helpless -creatures? ‘Dr. Semmola insisted upon temperance in eating as well as -drinking, and said that the best way to preserve health was to eat only -what was needed for the nourishment of the body.’ No cure for the human -malady had resulted from this persistent experimentation. - -Is it not intellectual imbecility to waste thought and ingenuity in -putting animals to lingering and painful deaths in order to reassert -the well-proved fact that intemperance in eating and drinking will -produce forms of digestive and excretory disease varying with the -idiosyncrasy of the individual? - -In late discussions in the French Academy of Medicine relative -to chloroform, where Laborde and Franck exhibited experiments on -animals, Dr. Le Fort (the distinguished surgeon) says: ‘None of these -experiments give us any instruction whatever which is useful in -practical surgery. Whatever their scientific interest may be, their -deductions are in no way applicable to man. Experimenters relate causes -of death, but nothing of the sort is generally found in the deaths of -practical surgery. The man faints when operations are begun too soon, -or is frightened by preparations. He dies because, being a man, his -nervous system reacts in a different way from that of the dog or the -rabbit. Do not count in any way upon the teachings of physiologists in -practical matters. Don’t let your patient see any preparations, give -the chloroform slowly, wait till he is profoundly asleep. That is all -you can do.’ - -Again, at another discussion at the Academy, M. Verneuil says: ‘It -is incorrect to say that laboratory experiments give certainty to -medicine, and make it scientific instead of empirical. The fact is -that experimentation has put forth as many errors as truths. There is -not sufficient identity, either physiologic or pathologic, between -man and the mammifères such as the dog and the rabbit.’ The different -ways of dying under chloroform have been long ago stated by surgeons. -The experiments shown by M. Laborde on the rabbit must be absolutely -rejected, as contrary to experience (in man). Maurice Perrin showed to -Vulpian in 1882 that the nervous reactions in man differ from those in -animals, and the effects produced by chloroformization could not be -relied on as being the same as on man. Vulpian entirely accepted this. -The experiments of physiologists have taught us absolutely nothing -in the way of preventing chloroform accidents; surgeons have been -beforehand (as was natural) in practising artificial respiration and -every other method of recovery. However interesting these experiments -on animals may be considered, they do not explain satisfactorily the -cause of chloroform accidents in man, and in no way show the way of -avoiding them. - -I could multiply these facts by indefinite quotations from experienced -physicians, of the intellectual uselessness of a method of research -which ignores the spiritual essence of Life and hopes to surprise -its secrets by ruthless prying into the physical structure of the -lower animals. We are learning that vivisection is examination of the -beginning of death, not of life. Loss of blood is a loss of nutriment; -the result is muscular debility and enfeeblement of the vital organs, -and the introduction of a disturbance in the vital processes which ends -in their destruction. This method of research is now being discredited -by many of the most enlightened members of our Profession. - -But what I wish especially to call your attention to, is the -educational uselessness of vivisection in training students, and the -moral danger of hardening their nature and injuring their future -usefulness as good physicians. - -It is not true that vivisection is necessary to the medical student in -order that she may attain the thorough knowledge of human physiology -which is needed for the intelligent exercise of the medical profession. -Class demonstrations in opening the bodies of the lower animals to -examine their organs and tissues are misleading in respect to the -action of human organs. The action of the human salivary glands, the -action of the cavities of the human heart, the secretion of the gastric -juice, etc., can be more correctly realized by careful anatomical -study in connection with clinical observation of the effects of -healthy and diseased action in the human being, than by any amount of -bloody experiment and mutilation of still living cats and dogs. Such -demonstration may gratify that instinct of curiosity which always -exists in youthful human nature, or it may pander to that craving -for excitement which makes the spectacle of a surgical operation so -much more attractive to the undeveloped mind than careful clinical -study--a tendency which is also seen in gambling, watching executions, -bull-fights, etc.--but these are tendencies to be repressed in serious -and responsible study, not encouraged. The precious mental activities -of the student need to be specially trained into observation of our -_human_ faculties in health and in disease. The establishment of a -Physiological Laboratory for experimenting on living animals, in a -medical school, is not only giving a wrong direction to intellectual -activity, but is wasting the valuable time of the student, and -diverting the attention of the young practitioner from that careful -and intelligent study of the human organism, which alone can lead -to practical beneficial results. This practice must therefore be -condemned, as giving a false direction to the intellectual faculties of -the young. - -Of the moral danger involved in such methods of study there can be but -one opinion by thoughtful and observant persons within the ranks of our -Profession. - -The exercise of our superior cunning in destroying an animal’s natural -means of self-defence, that we may (with convenience to ourselves) -watch changes that occur in its organs during the slow process of a -lingering death, is an exercise of curiosity which inevitably tends -to blunt the moral sense and injure that intelligent sympathy with -suffering, which is a fundamental quality in the good physician. The -practice of recklessly sacrificing animal life for the gratification, -either of curiosity, excitement, or cruelty, tends inevitably to create -a habit of mind which affects injuriously all our relations with -inferior or helpless classes of creatures. It tends to make us less -scrupulous in our treatment of the sick and helpless poor. It increases -that disposition to regard the poor as ‘clinical material,’ which -has become, alas! not without reason, a widespread reproach to many -of the young members of our most honourable and merciful profession. -The hardening effect of vivisection is distinctly recognised in the -Profession, although often excused under the abused term--‘scientific.’ -Dr. Loye, who, with another physician, studied the process of -guillotining a malefactor at Troyes, thus writes: ‘Both of us believed -that our wide experience of bloody vivisection would have hardened us -sufficiently to go through the spectacle without very great emotion.’ - -It is our duty and privilege, as women entering into the medical -profession, to strengthen its humane aspirations--to discourage its -dangerous tendencies. We must not be misled by clever or brilliant -materialists who take the narrow view that physical life can be -profitably studied without reverencing the spiritual force on which -it depends. A physiological and pathological laboratory, legitimately -conducted for the investigation of healthy and diseased human -secretions, in connection with clinical observation, may be made a -valuable aid to medical advancement, and I would always encourage the -organization of such a laboratory. But to use it for cutting up animals -dying under anæsthetics is stupidity, and to convert it into a torture -chamber of the lower animals, is an intellectual error and a moral -crime. - -The possible results of slow deterioration in the moral nature when -we violate in any degree our religious standard of justice and mercy -may be most strongly realized in living examples of diseased inherited -tendencies. Such a fearful example is before us in the life history of -the criminal, Jesse Pomeroy, now in the State Prison of Charlestown, -Mass., who has spent his life in penal servitude, expiating his -atrocious mutilations and murders of little children, committed when -he was a lad of fifteen. The deteriorating moral influence exercised -on offspring by vicious parental tendencies, is directly exhibited -in this living object lesson. The father of this lad was a butcher. -His mother, during the gestation of this child, took a persistent -and morbid delight in watching the death of the animals slaughtered -by her husband. We see in the atrocities committed by her young son, -a terrible example of the evil effect which the mind can exercise, -in deteriorating individual character and in extending its evil -influence to others. All experience proves the powerful influence -exercised by the parental, and especially the maternal, qualities upon -the offspring. Every woman is potentially a mother. The excuse or -toleration of cruelty by a woman upon any living creature is a deadly -sin against the grandest force in creation--maternal love. - -I earnestly ask all women physicians to consider the special -responsibility which rests upon them, to take that large religious view -of life which alone can check any degrading tendencies in intellectual -human activity and elevate our noble Profession. Let us not be misled -by sophistical arguments, but look steadily at the actual facts of -animal torture, and work persistently for the total abolition of -vivisection from our medical schools. In this way we shall justify -our entrance into medicine, and prove ourselves strong supporters of -that noble humanity which is the especial characteristic and solid -foundation of the Medical Profession. - - -FOOTNOTES: - -[1] In 1891. - - - - - WHY HYGIENIC CONGRESSES FAIL - - _LESSONS TAUGHT BY THE INTERNATIONAL CONGRESS OF 1891_ - - - INTRODUCTION - -The noblest aim of humanity is the application of Truth to the conduct -of life. By doing we develop our faculty of knowing. - -The difficulty, however, of knowing how to apply Truth in daily life is -so great, and yet the need is so urgent, that the most pressing duty of -those who have faith in the Divine is to bring forward to the light of -sympathetic conference, the facts of life in which one’s most intimate -experience lies. - -Thus the merchant and manufacturer, the business man and the -legislator, the farmer, householder, literary man, and those who, -living upon interest, should know how that interest is gained, must -ever hold it to be true religious duty to seek, in conference with -others, the way of elevating every department of life. - - * * * * * - -Religious or Unitary truth possesses invaluable guidance for Medicine, -not only in its practical application as an art, but in the methods by -which it can alone become a science. - -Truth recognises this great fundamental fact--viz., that spirit moulds -form, that the senses alone are not reliable guides in solving the -problems of even physical life. - -Research and observation also show that essential elements of Truth -have always existed in Humanity; that we cripple our power of advancing -in Truth if we do not seek out these indications of the Divine in all -past experience and carefully consider the light they throw on present -life. - -We recognise in these weighty facts a great Providential method of -human growth and an infinitely beneficent aid towards the attainment of -that moral Ideal wherein Goodness and Truth, Justice and Mercy, Love -and Wisdom, become one--inseparably united. - -One of the great truths given in past ages, which it is necessary to -study and enforce in the present age, is the intimate connection which -exists both mentally and physically between human beings and lower -forms of animal life. - -This is a truth of great moral significance. It was dimly, perhaps -grotesquely, seen in some religions of the past, but is so much lost -sight of in the present day that our responsibility for the care of -the inferior creation we were intended to train with justice and -gentleness, becomes too often a cruel and odious tyranny. Even in some -branches of knowledge (knowledge which can only justly claim the name -of science when it is the most comprehensive study of truth) injustice -and cruelty are misleading the intellect, and thus threatening danger -to the progress of the human race. - -Being profoundly impressed by the fundamental character of these truths -as necessary guides in medicine as well as in every department of -human life, when I learned that extensive preparations were being made -in the greatest city of the world for consideration of perhaps the -most important subject that can engage our attention--viz., Health--I -arranged to be present as a delegate, and steadily attended the -Congress, comparing notes with other friends who were attending its -various sections. - -In this way we gathered an accurate knowledge of the tone of the -discussions, the methods pursued, and the tendencies of modern -investigation. - -These facts seemed to me of sufficiently serious import to make them -worth recording in the following pages. - - - - - WHY HYGIENIC CONGRESSES FAIL - - -The Seventh International Congress of Hygiene was held in London -from August 10 to 15 of 1891. It is noteworthy for the number and -representative character of its members, and also for the wide range -of subjects affecting the physical welfare of the race, which were -considered. Representatives from America and from Asia, as well as -from the various nations of Europe, assembled in the Great Metropolis -to consider the vital subject of Health. These learned men met -together daily during the week in nine different sections, from ten -to two o’clock. They were occupied with the subjects of Architecture, -Engineering, Chemistry, the health of soldiers and sailors, the care of -early childhood, the duty of the State in relation to the Health of the -Nation, Health Statistics, Bacteriology, and the relations of Animal -and Human Disease. - -In the consideration of this wide range of subjects, valuable -experience and much useful information were presented in the papers -read and in the discussions that followed. But in a Congress not held -together by any great guiding principle, where persons of various -nationalities, moulded by different laws, methods of education, and -social customs were represented, a great variety of opinion, of -contradictory facts, of imperfect statistics and superficial theories, -would necessarily be brought forward. Nevertheless, a remarkable -concensus of opinion established one great result of experience--a -result which may be considered the striking practical lesson of the -Congress--viz., that it is to sanitation that we must look, not only -for the prevention of disease, but largely also for its cure. - -_Supremacy of Hygiene._--Taking the results of sectional discussions -as a whole, it was very generally shown that, by our increasing -knowledge of hygienic law, its wide diffusion amongst the people, and -its intelligent application to daily life, we can counteract the evil -influence of heredity, get rid of epidemics, improve the stamina of the -race, advance in longevity and in the natural enjoyment of our earthly -span of life. Thus it is by the advance of sanitation that the Art of -Healing can alone become a science of Medicine. - -A few illustrations will show how this growing result of modern -thought was both directly and indirectly supported by the papers and -discussions of the various sections. - -Thus Sir Charles Cameron, of Dublin, showed the beneficial change -wrought by ten years’ sanitary effort in the Dublin slums through -rebuilding, draining, cleaning, and free disinfecting. Those wretched -quarters were a breeding-ground of human misery in 1871, where -small-pox, typhoid fever, and all contagious diseases seemed to be -endemic. The annual mortality was reduced in ten years by sanitary -measures from 34·11 to 28·80 in the most crowded portions of this -wretched quarter; in its less crowded part the mortality had fallen to -a much lower figure, notwithstanding the intemperance and destitution -which still continued to afflict the inhabitants. In this example -it should be especially noted that the goodwill of the people was -enlisted, for the municipality laid aside the idea of pecuniary gain on -the sum expended in rebuilding, etc., and offered a better lodging at -a rent that could be paid, and provided all sanitary appliances free, -thus losing, in the sense of money profit, to gain in the far higher -value--health. - -Another remarkable illustration from very large experience was that -given by Professor Smith, of Aldershot, who is at the head of the -cavalry department of our army. He showed, by most interesting tables, -that diseases formally rife amongst horses--glanders, farcy, canker -of the foot, etc.--were now practically unknown in the army. This -triumphant result was entirely due to careful hygiene, the utmost -attention being paid to food, ventilation, drainage of stables, the -care of the feet and shoeing, of saddles and harness, and reduction of -the burden which the horses were required to carry, to fifteen stone as -a fair average. As was justly remarked, there is a limit to the weight -that a horse can carry or draw, beyond which is cruelty and injury. - -Drs. Schrevens and Gibert, from France; Dr. Abbott, of Mass.; Dr. -Pagett, of Salford; in discussing diphtheria and typhoid diseases from -defective drainage, laid stress upon purity of air and cleanliness of -the soil as the chief points for consideration. The same indispensable -principle of sanitation was shown in respect to meat and milk used for -food. In France 5 per 1,000 of animals used as food are tuberculous, -such disease resulting from wrong methods of breeding, feeding, and -managing these useful animals. - -Professor Ralli showed how parasites could be conveyed from animals to -men, and dwelt on clean bedding, coverings, suitable food, water, free -exercise, as the necessary prophylaxis. - -Dr. Hime, of Bradford, and Chauveau, of France, dwelt upon terrible -diseases, such as the woolsorters’ disease, to which men are exposed -who handle the skin, horns, etc., of animals--diseases which are -entirely preventable if the manufacturers engaged in such trades -would place the health of men above the profit to be gained by trade; -thorough ventilation, disinfection, and other sanitary measures would -entirely prevent the present reckless destruction of health. The same -was true in the large industry of sorting rags imported from abroad, of -match-making, etc. - -It is a noteworthy fact that in the section of the Congress devoted -to the relation of diseases of men and animals, which I especially -attended, sanitary prophylaxis alone was dwelt upon as the condition -of supreme importance. Inoculation was not advocated by any speaker, -except the official representative of the French Pasteur Institute.[2] - -Compliments were duly paid to M. Pasteur, whose skill and zeal in a -false method of research may justly command intellectual recognition. -But no one in any case advocated the theory of diffusing mild forms of -disease for the purpose of preventing the severe type in the important -and practical discussions which took place daily in relation to -diseases common to man and the lower animals. - -Thus a great principle of progress in the prevention of disease -and in the attainment of a higher standard of health was directly -or indirectly acknowledged by this varied body of men of trained -intelligence and large experience--viz., the paramount importance of -sanitary knowledge and practice. - -Obedience to the conditions of healthy growth is the law of progress, -from which there is no escape. It is the only way by which disease can -be gradually eradicated. Every attempt at evasion inevitably brings its -own retribution in various ways, swiftly or slowly, but surely. - -All medical by-paths leading in a different direction from the -conditions of healthy life, however tempting they may appear to -active intellectual curiosity, or however desirable it may seem to -find a short cut to health, necessarily lead to error if the supreme -importance of sanitation be ignored. - -Now, notwithstanding the large amount of valuable experience brought -together in this International Congress, there was one serious omission -in the otherwise wide and interesting plan of the Congress--an omission -which had a direct practical bearing on the discussions carried on in -the various sections. This vitiating lack was the failure to recognise -the fundamental connection of mind and body in the phenomena of Life. -There was no appointment of any special section which should give -prominence to this subject, and thus strike the keynote capable of -bringing all the sections into harmony. - -This omission was the more noteworthy because a section _was_ devoted -to the theories of bacteriology, which, as will be seen, are directly -opposed to the true science of Health. - -Practical success in sanitation is impossible without the recognition -of mind, both in the actual working of the organs of the living body -and in the knowledge and acceptance by mankind of the conditions which -are essential to health. - -If the human constitution be governed by laws in obedience to which -healthy growth is alone possible, then those laws must be carefully -sought for before we can build up a science of hygiene. To regard -living beings as simply material bodies, without the constant and -varying influences of mental action upon the working of those bodies, -is an intellectual error which disregards the essential condition of -mental harmony in relation to health. - -It must also be recognised that whatever may be the discoveries of -physiological science, they will remain barren unless applied by -individuals. In all the concerns of life, whether in the application of -principles or in the unconscious formation of habits, we are compelled -to deal with the ceaseless power or effect of Will. To treat even -the most ignorant adults by arbitrary, unreasoning compulsion is a -scientific blunder.[3] - -_The Two Problems of Hygiene._--The two fundamental questions for -hygiene to solve are therefore: 1st. What are the conditions of healthy -growth? 2nd. How can those conditions be secured? - -In answering these two fundamental questions the problem of mental -action enters into every hygienic section of a Congress, and is the -keynote which must be struck if harmony of theory and practice is to be -attained. - -But in consequence of too narrow a view of hygiene these questions -were not solved, and this remarkable assembly of learned men, brought -together with such careful preparation and hospitable welcome, produced -no practical results of the commanding value that the public had a -right to expect from it. - -Sanitary legislation was shown to be largely evaded, but the reasons -for this unsatisfactory evasion were not examined; the results of -experimental research were proved to be strangely contradictory, but -the conditions which would harmonize them were not discovered; unproved -theories abounded, but the fallacies that vitiated them were not made -clear. - -Disappointment as to the practical utility of the Congress was widely -felt both at home and abroad. - -This disappointment with the results of the Congress has been publicly -expressed by our foreign guests. A clever abstract of the work done -at this Seventh International Hygienic Congress has been published in -Paris by the well-known editors of _The Review of Hygienic and Sanitary -Police_. Some noteworthy statements are made in the introduction to -this volume which should be seriously considered by all who reverence -righteous sanitary science as the foundation of human welfare, but who -also know that sanitary science must approve itself to the good sense -of a people, or it will be of little practical utility. - -_Failure of English as well as Foreign Sanitation._--This high French -authority declares that notwithstanding the efforts for sanitary -improvement in which England has set an example for fifty years, the -relative mortality of England has not diminished. It is stated: ‘The -subject of the mortality of England, although not touched upon in -the Congress, was the subject of most private conversation. The real -figures of English mortality show a singular coincidence with the -mortality of other European countries. It is shown that in none of -these countries has the mortality diminished during the last fourteen -or fifteen years, except when the birth-rate has diminished, and only -in an exact proportion to this birth-rate.’ England has no better -record to show in this respect than her Continental neighbours, -notwithstanding the increasing demands of her specialists for extended -legislative powers. Our French critics remark that ‘English hygienists -of to-day are demanding great administrative centralization; their -sanitary laws are rigorous to a degree that other countries would -consider excessive; local self-government as well as individual -liberty is less and less respected, and, from the statements of -specialists interested in the subject, there is reason to believe that -at no distant date every branch of public hygiene will be entirely -administered by the Central Government.’ - -‘It is to be hoped’ (they remark) ‘that English good sense will -learn how to avoid the abuse of centralization, for it is just as -illogical to wait for the intervention of the Central Government in -the sanitation of a parish or the prevention of a local epidemic as to -refuse such intervention when public danger arises from negligence or -stupidity.’ - -These observations of hygienists, coming from France, a country which -we are accustomed to consider (and which in some respects really is) -much more over-ridden by officialism than England, are extremely -valuable. They serve to warn us of the grave danger of depending upon -centralized legislation or arbitrary authority withdrawn from popular -influence, and from that growth of individual enlightenment which -arises through the sense of responsibility. - -Our friendly foreign critics justly ask: How is it that England, first -in the field of sanitary science, with a rigorous system of compulsory -legislation, with administration, laws, regulations, agents, and -also a gradual development of private hygiene, has still to deplore -the unhealthiness of such a large number of towns, quarters, and -habitations, and sees no diminution in her annual rate of mortality? - -They advance towards the root of the matter when they observe in -this same report that laws are one thing, their application quite -another thing! ‘So true it is that public hygiene depends upon general -education as well as on the education of specialists, that no laws or -regulations will suffice when the habits of the people generally do not -promote their application.’ - -In other words, mind as well as matter must be considered in the -subject of sanitation. - - * * * * * - -The student of science who has learned the great principle of -creative Unity knows that no manifestation of existence can be -absolutely separated from the rest of creation. As we investigate -phenomena it is seen that the laws governing separate phenomena -become more comprehensive as knowledge increases, because more widely -embracing separate facts; varieties are seen to be linked together by -relationships, and apparently different phenomena can be transmuted -into one greater force. - -In the plan of an International Congress, designed to gather together -the advanced knowledge of many nations on the whole science of health, -the omission of any section which should bring into prominence this -powerful fact in life--the influence of mind on body--is a very grave -defect. It is an error which affects both the investigation of facts -and the application of results, the two indispensable factors to the -progress of sanitation. Their neglect in an International Congress on -Health was the more unfortunate because mental influence is a fact -which is forcing itself upon the attention of investigators with -increasing urgency. - -_Increasing Importance of the Mental Problem._--Under the modern -title of hypnotism facts of the most remarkable character are now -acknowledged and studied. The cure of disease by suggestion, carefully -and humanely applied, has been proved beyond the possibility of -rational denial. The reality and practical effects of mental epidemics -is a positive fact. The effect of fear in predisposing to cholera, -hydrophobia, and other diseases cannot be denied.[4] - -The contagion of religious enthusiasm or religious fanaticism -are facts; whether the effects are seen in the devotion of the -Salvation Army, or in pilgrimages to Lourdes or Trèves with their -so-called miracles of faith-healing, they are equally facts requiring -consideration. Wild business speculations in the craze for riches -become contagious, and lure multitudes to ruin. - -The history of past and present medical delusions is also most -instructive. We need not go to the Sangrados of a past generation, who -treated every disease by blood-letting, or the search for the elixir -of life in illustration; the contagion of false hopes in relation to -consumption, which upset the judgment of two hemispheres, cannot yet be -forgotten. Thoughtful physicians possess abundant warning against being -carried away by new theories which violate the moral sense or the Law -of Unity, even when such theories are supported by distinguished names. - -Experience proves the potent character of mental stimuli in moulding -practical action. Fear or hope, curiosity, vanity, cupidity, when -regardless of the Law of Unity, seize upon isolated phenomena removed -from their natural connection, and distort them by creating morbid -conditions, thus viewing facts out of proportion. Statistics thus -formed become fallacious, and serve as the bases of dangerous -theories--theories which, unless checked by popular common-sense from -being put into practice, would cause the moral and physical degradation -of the race. I need only refer to the folly of injustice embodied in -certain medical acts lately abolished and to the present theory of -inoculation, as noteworthy instances of dangerous mental delusion -desiring to shape itself into action. - -Materialism, which is blind to other than sensuous life, which insists -upon reducing every phenomenon to the limits of the senses, which -refuses to be enlightened by any higher reality, or sneers at the -term ‘vitality,’ neglects a great range of positive facts, and has no -right to the noble name of science. Reflection, therefore, shows that -the moulding and guiding power of mental action in shaping physical -results being a fact of the most far-reaching character and of -permanent operation in sentient creation, its omission in a Congress of -Health was a serious injury to the results of the Congress. It was a -sufficient reason for that sterility of result which has been publicly -and privately expressed. - -The error of not recognising mental as well as physical forces, or the -Law of Unity, in relation to health, and the tyranny that may result -from such imperfect method in the study and application of sanitation -and medicine, may be illustrated by an interesting incident of the -Congress. - -An important joint meeting of two sections took place in order to -listen to the discourse of one of our ablest investigators--a man -in high position, and one who wields a powerful influence on the -rising generation of medical students. This gentleman early in his -discourse made the following noteworthy announcement: ‘I claim the -right of science to dictate’--and as if to strengthen this claim by -the authority of our French brethren he added ‘conformément à la -logique’--‘I claim the right of science to dictate in accordance with -logic.’ - -The bold demand for absolute obedience thus authoritatively made -by a professor at the head of biological research demands careful -consideration. It is the announcement of a new priesthood or esoteric -sect of physical science. In the mind of the speaker it means that his -science is identical with truth. If that be admitted, it is the highest -wisdom of the human being to obey gladly and unhesitatingly, and the -teacher thus inspired with truth rightfully commands our grateful -and profound reverence. But this claim may also mean the unconscious -arrogance of a mind taking too narrow a view of science--a mind which, -whilst earnest and laborious in investigating partial phenomena, is -intoxicated by the discovery of new facts with the theories which can -be built upon them, and at once announces himself as one of the priests -of a new religion demanding absolute obedience; for the temptation of -all priesthoods is to form an esoteric sect. - -In this second case it is the bounden duty of every truthful mind to -refuse obedience. For until the claim is fully examined in all its -aspects, in both its physical and mental relations, and sustained by -the deliberate and hearty assent of all intelligent minds and the -instinctive accord of the people generally, this demand for absolute -obedience to the theories of so-called science must be resolutely -withstood as a reintroduction of mischievous and degrading superstition. - -The special occasion which led to this unfortunate claim for dictation, -or the compulsory regulation of disease by specialists, was the subject -of tuberculosis and the exaggerated claim of the modern bacteriologist -that the tubercle bacillus is the sole primary cause of consumption, -with the logical claim that, as only the thoroughly-trained specialist -can detect this bacillus, consumption should be scheduled as a -contagious disease, and subjected to the rigorous regulations of the -specialist and his board of advisers. - -As our largest item in annual mortality is death from -tuberculosis--about 14 per cent. with us--and as food and air _may_ -introduce a bacillus into the system, we can dimly imagine the extent -to which the claim for dictation may grow in ‘accordance with logic.’ - -Many striking instances of crude official tyranny were revealed by our -Canadian and other foreign delegates. Thus, railway passengers from -Montreal to Ontario were compulsorily revaccinated on the train before -being allowed to enter Ontario.[5] The foolish and fallacious system -of attempting to _regulate_ special vice was seen to prevail largely in -the inexperienced civilizations of Canada and Western United States. - -_Scientific Inquisitors._--I will here quote a late statement of -Professor Huxley’s, which might well be emblazoned in all our medical -schools. He says: ‘We are at the beginning of our knowledge instead -of at the end of it; the limitation of our faculties is such that we -never can set bounds to the possibilities of nature. The verdict may be -always more or less wrong, the best information being never complete, -and the best reasoning liable to fallacy. - -‘The greatest mistake those who are interested in free thought can make -is to overlook these limitations and deck themselves with the dogmatic -feathers which are the traditional adornments of opponents.’ - -This vigorous protest of our English naturalist against the dictation -of so-called science is in striking accord with the observations of our -French visitors in relation to the futility of compulsory legislation -now urged by scientific specialists. - -_What is Science?_--When the investigators in any limited branch -of knowledge glibly use the term ‘science’ to compel assent or to -enforce legislation, we are forced to ask, What _is_ true science or -certain knowledge grounded on demonstration, as distinguished from -false science, which is uncertain knowledge, based upon varying and -imperfectly observed phenomena or upon theory? Knowledge is of various -kinds: Mental, Physical, Mathematical. These separate departments of -knowledge rest equally on bases of fact. Love is as much a fact as -bread-and-butter; justice is as potent in its effects as microbes; and -from their wider range of action and more permanent duration these -mental facts are far more _real_ than the physical phenomena. - -In determining the claim of science to obedience the great Law of -Unity gives the guiding principle, which, however humbling to human -arrogance, or however affirmative of the limitations of our intellect, -the truly scientific mind is bound to accept. - -_The Law of Unity the Foundation of Science._--The Law of Unity -teaches us that no explanation of any fact is final or ‘true’ if it -contradicts other facts. It announces that no method of examining facts -is reliable that destroys other facts equally patent, and that any -results deducible from partial phenomena, however interesting or even -apparently useful, can only be regarded from the point of view of true -science as temporary expedients. They may possibly be recommendations -for useful trial, but they can never be justified as subjects for -dictation. - - * * * * * - -The confusion of thought which has brought the unnatural practices of -inoculation into fashion may be usefully illustrated by dwelling on the -mingling of truth and error which exists in relation to vaccination. -Vaccination must not be confounded with inoculation, although the word -‘vaccination’ is now incorrectly used by bacteriologists to cover up -the alarming practice of injecting the diluted virus of any particular -disease, which is inoculation. Vaccination, on the other hand, is -solely the injection of matter derived from a disease in the vacca, -which disease is neither small-pox nor derived from small-pox, and -vaccinia in a healthy cow is a mild disease. - -During a lifetime of medical practice I have vaccinated children -(sharing the widespread belief that it was preventive of small-pox). -The practice, however, has always seemed to be an unsatisfactory -method, which I hoped increased knowledge of sanitation would enable us -to improve. - -I also recognised the powerful influence of fear in predisposing to -disease, and I regarded vaccination as a sedative for the family or -community. My faith in the innocence of this practice was, however, -rudely shaken by the lamentable death, in my own practice, of a -scrofulous infant--a death clearly caused by the phagedenic ulceration -produced by the vaccination. I also noted the accumulating evidence of -very serious diseases communicated by so-called vaccine lymph. - -_Vaccination not Scientific._--But Professor Crookshank, in his -exhaustive work lately published on vaccination, has conclusively -proved the unscientific character of the evidence on which this -practice is based, our ignorance of the sources of the virus commonly -used and its mode of action, and also the uncertainty of its -prophylactic power.[6] That the generally mild disorder of vaccination, -although arbitrarily and even tyrannically enforced on every child born -in our country, does not prove the prevention of small-pox which it is -claimed to be, is shown by the recurrence of epidemics of small-pox -amongst us, by the occurrence of the disease in vaccinated persons, and -also by the demand now made by the French Academy of Medicine (which -recognises the failure of our system of vaccination) for legislative -powers to compel repeated revaccination. This demand for power of -indefinite revaccination is a logical demand. For, proceeding on the -assumed premiss that vaccination prevents small-pox, but being met by -the inexorable fact that epidemics of small-pox _do_ occur and spread -amongst vaccinated people, the cause of this contradiction is assumed -to be that the supposed preventive power of vaccination has been thrown -out of the system, and must therefore be again renewed. Logically, -therefore, not only the infant must be subjected, but the child, the -adolescent, and the adult. All must be compulsorily revaccinated, as -the human system undergoes a change at each of those periods of growth. - -The history of the struggle against compulsion in vaccination is very -interesting, as a strong condemnation of that arrogance of false -science which presumes to trample on human rights whilst neglecting -hygienic conditions. As all intelligent persons should be able to form -a practical judgment on the important question at issue, I should -like to dwell a moment on the subject of immunity, a fact (though now -misapplied) on which compulsory vaccination is based. - -_Immunity._--Observation has long shown us that when the human system -is gradually exposed to injurious influences, a certain tolerance of -those influences may be acquired, which often enables those exposed to -them to escape immediate death, although with impaired health, whilst -healthy persons suddenly exposed to the same injurious influences die. -This is a well-known fact, capable of abundant verification. Thus, -persons long resident in a badly-drained house, although frequently -ailing in various ways, may never be laid up with typhoid fever; a -certain immunity has been obtained by the slow adaptation of the system -to bad air, but at the sacrifice of vigorous health. But if a new and -healthy family move into the same house a deadly outbreak of typhoid or -diphtheria may at once result. - -In the malarious districts of the United States a large scattered -population of what are called by the negroes ‘mean whites’ continue -to live, with clay-coloured faces, enlarged spleens, and impaired -vitality, yet for a stranger to sleep in those regions is deadly. The -strong tendency to live, which we call vitality, though it has enabled -those born and brought up under injurious influences to struggle on -through life, does not prove equal to resistance in many constitutions -suddenly exposed to the injurious influences. The medical statistics of -our army in India show that the newly-arrived is far more apt to suffer -from enteric fever than one who has been long in the country. - -‘The percentage of deaths from this cause is nearly fivefold greater in -the first or second year of service than from the sixth to the tenth -year. Medical officers are unable to trace out in any given instance a -definite insanitary condition to which with certainty the outbreak can -be attributed.’ - -There is, therefore, fact for theory to be built on--viz., the possible -adaptation of the human constitution to injurious influences, an -adaptation which, whilst impairing general vigour, often produces -immunity from rapid death. - -This fact, confirmed in the mind of the bacteriologist by the -fallacious system of diseasing animals as ‘témoins’ or ‘controls,’ has -given rise to the dangerous theory that all contagious diseases may -be forestalled in their most deadly form by the inoculation of human -beings with diluted virus produced by those diseases. This dangerous -belief has been widely fostered by the unfortunate educational -influence of the law of compulsory vaccination. But it must be observed -that vaccination, unlike inoculation, does not introduce any products -of the special disease--small-pox--into the system. The vaccine disease -in the cow is not small-pox, nor can it ever be made to produce -small-pox. The preservative power which is claimed for it, therefore, -has not the dangers which are attached to inoculation, but neither -can it claim the occasional immunity which may attend that dangerous -practice of introducing small-pox virus into the blood. Pure air, -cleanliness, and decent house-room secured to all our people, form the -true prophylaxis of small-pox. - -_Exaggeration of Bacteriology._--We observe how neglect of the Law of -Unity is misleading the intellect in relation to bacteriology. This -subject, useful if pursued without cruelty and in subordination to -higher facts, has become a mischievous exaggeration[7] both as to what -it signifies and as to what it may lead to. - -The majority of our active and intelligent medical investigators are -now intensely engaged in the search for a microbe as the primary -_cause_ of every disease known to humanity. Cancer, leprosy, fevers, -hydrophobia, diphtheria, tetanus, insanity, etc., are being largely -studied by this imperfect method, in hope of finding a characteristic -microbe which can be pronounced the essential cause of the disease. -The great mental energy of biological investigators is diverted from -sanitary investigation to the search for fresh bacilli. Admirable -perseverance, acute ingenuity, unwearied energy are devoted to this -search. - -Advantage has been taken of the helplessness of the lower animals -to carry on a system of experimentation upon them, the extent and -ruthlessness of which has never before been attempted. Disease -is studiously propagated. Myriads of healthy living creatures -are filled with loathsome disease in order to furnish ‘material’ -for experimentation. So many kilos of dog or rabbit (used for -injecting disease, or noted as more or less slowly resisting the -death thus gradually inflicted) is a common expression now used -in experimentation, and supposed to give ‘scientific accuracy’ to -experiments. It is a pitiful intellectual fallacy of short-sighted -materialism that supposes it possible to obtain ‘scientific accuracy’ -by regarding so many kilos of living dog as if they could be -experimented on as so many kilos of dead matter, or as if they were -the materials of a steam-engine, which can be taken apart, examined, -cleaned, tested, and put together again in complete working order. - -This diversion of intellectual ability from the true path of sanitation -by an exaggerated search for bacilli leads directly to the dangerous -practice of inoculation, which threatens the future deterioration of -the human race. As one of the most distinguished of our hygienists, the -late Dr. Benjamin Ward Richardson, has pronounced, ‘inoculation is bad -sanitation.’[8] - -Sanitary law teaches us that disease is produced by many causes, not -solely by a specific microbe. - -These causes are insanitary conditions, which impair or destroy the -agents required by our human constitution for its healthy growth, -and which act with varying force according to individual tendency. -These insanitary conditions, in the course of their operation upon -varying individual constitutions, produce various forms of disease, -as chill may produce rheumatism, bronchitis, or diarrhœa, according -to idiosyncrasy. These varying idiosyncrasies of individuals, both in -their physical and mental aspects, as well as the varying action of -vital force in different classes of animals, will always vitiate the -theories of materialistic investigators. Thus the same poison will not -destroy all classes of living creatures. A healthy young dog has been -known to resist for months strenuous efforts made to disease him in a -particular way. The same disease germs produce quite different forms of -disturbance in men and in rabbits. - -‘We possess no clue to the immunity of certain animals from poison. -Rabbits fed on belladonna show no signs of injury, although their flesh -becomes poisonous to those who eat it. Pigeons and other herbivora may -be safe from what will cause paralysis and asphyxia in other animals. -The meat of goats may similarly become poisonous. - -‘Chickens, cats, birds, rodents, are variously affected by poisons, -some thriving on what will kill other animals. The whole cat tribe is -said to be always proof against morphia.’ - -Drs. Hahn and von Bergmann, in attempting to justify their -cancer-grafting experiments on hospital patients, affirm that ‘it was -necessary to select human beings for experiment, inasmuch as none of -the lower animals would have been suitable for their purpose.’ - -Sanitary law teaches us that unhealthy conditions vitiate the living -micro-organisms with which we are surrounded, and which, naturally -beneficial, may become, through violation of natural law, morbid germs, -capable of spreading their various forms of disease amongst persons -predisposed to such disease. Thus, according to sanitary law, the -violated health conditions (vitiating naturally innocuous particles) -are the primary cause of disease; the morbid germ or bacillus is only -the secondary cause. - -The new bacteriological theory directly contradicts this important -law of sanitary experience, and in opposition to it authoritatively -announces that contagious or infectious disease can never be produced -without the antecedent microbe. It was in defence of this untenable -theory that the distinguished professor claimed the ‘right of science -to dictate.’ - -The great mistake, therefore, made by the Hygienic Congress was the -neglect of mind as an indispensable and prominent factor in Health, and -the exaltation of bacteriology, with the theories based upon it, into -the chief point of interest and importance. - -The modern exaggeration of bacteriology, with its theory of -inoculation, must be steadily opposed by all who realize the power and -growing influence of spiritual life. The injurious results of this -exaggeration may be summarized as follows: - -_The Practical Dangers arising from erroneous Scientific Method._--1. -It diverts invaluable intellectual activity into methods of -comparatively futile investigation. These investigations lead very -widely to the exercise of fraud and cruelty upon the lower animals, -and tend to reckless experiment on the poor. They waste much time and -spread the contagion of intellectual error amongst the students of all -our medical schools, where the false practices of experimentation are -increasingly carried on. They also pervert the moral sense of the great -army of assistants, caretakers, porters, nurses, and others connected -with our medical institutions, who become aware of the cruel practices -which so largely accompany this method of research. - -2. This perversion of medical activity misleads our Parliamentary -representatives, who are bewildered by pseudo-science authoritatively -announcing itself as Truth, and permits a rapid increase of officialism -to crush opposition and force the dicta of superficial ‘science’ upon -the protesting conscience of intelligent people. It also misleads the -community by fallacious articles in popular magazines, in which facts, -theories, statistics, and assertions, often incorrect, are given with -an imposing air of science, in relation to which the ordinary reader is -quite unable to discriminate the true from the false. - -3. The diversion of medical activity from the true path of Preventive -Medicine not only hinders the progress of sanitation, but is producing -an increasing revolt of common-sense and popular feeling against what -are erroneously supposed to be the necessary methods of medicine and -the practice of dispensary and hospital. This growing feeling in the -community increases the dread with which the poor generally regard -the hospital, and it also seriously diminishes the pecuniary support -which the well-to-do would otherwise gladly extend to their sick and -suffering fellow-creatures. - - * * * * * - -_Conclusion._--In considering the foregoing record of facts it is seen -to be a fundamental error, not only in a Hygienic Congress, but in -_all_ medical thought and practice, to look only at the body, and not -consider those spiritual facts which precede, animate, and succeed -the flesh. It is also certain that in the application of hygiene to -daily life we may as well pour water into a sieve as hope to enforce -permanently practical hygienic measures without enlisting the goodwill -of the people in their observance. - -As the solution of the two great problems of hygiene--viz., ‘What -are the laws and conditions of healthy growth?’ and ‘How can these -conditions be secured?’ rests upon principles of spiritual truth, -those principles are of fundamental importance in directing human -intelligence into right lines of investigation. Being compelled to use -the imperfect symbolism of language, we speak of mind and matter, of -spiritualism and materialism, as if they were separate or contradictory -entities. But this is a limitation in the expression of thought to be -recognised and carefully guarded against in thought itself. There can -be no real contradiction between Religion and Science; they are only -varying manifestations in human thought of Truth, which is essentially -one. Our effort must be to unite these manifestations in thought, and -thus gain the only safe guidance possible to us for practical action. - - * * * * * - -The great fundamental principle of our human constitution is -incarnation--_i.e._, spirit shaping form--the Universal manifesting -itself in the phenomenal. This principle is the foundation of sanitary -science. It forms the basis of the Moral Law which must be the guide of -science. - -When this principle is understood and applied, it enlarges the -intellect and enlightens the conscience. It transforms the narrow, -self-centred or arrogant individual into the humble inquirer and sharer -of the larger Diviner life. - -This universalization of the individual resides essentially in the -Will of man, and is the foundation of conscience--conscience which, -gradually enlarged by the growing intellect, is the great guide of the -human race in its struggle upwards. - -This universalization of the primitive self-centred life leads to the -realization of Sin. When we enter that Garden of Gethsemane where the -woes of the world, the murders and seductions, the cruelties and -hypocrisies, are revealed in all their hideousness, we realize that we -are partakers in this Sin; for it is the result of that self-centred -arrogance, that selfishness with which each one has to fight, and which -is the essence of Sin. It is through this tremendous conviction that -all must enter into that life of the Universal, where alone is true -freedom, and where alone the fulness of individual life is to be found. -Only by this saturation with the Universal does that hatred of Sin -arise which makes sins henceforth impossible. - -Then the recognition of Right and Wrong in human action becomes clear, -and the supremacy of the Moral Law inevitable. - -It is indispensable to refer to these deeper principles of existence -in considering their varied application. They give force to those -condensed maxims of practical wisdom which, transmitted to us from the -experience of our forefathers, are guides for our present daily life. - -‘Never do evil that good may come’ is a proverb so familiar to us -in various forms that we fail to see the profound wisdom which it -expresses. - -It is a confession of that intellectual limitation which cannot foresee -complicated results; it is an acceptance of that inflowing light of -conscience (however dim) by which everyone must honestly walk; it is -the subjection of the narrow, self-centred Will to the Universal Life -by which the individual becomes a free co-worker with the Divine. - -Physiology rightly studied in the light of this fundamental -principle--incarnation--vindicates the supremacy of the Moral Law, -which is the Law of Unity, or transfiguration of the Self. It gives the -perception of Right and Wrong. The Law of the Universal, reverently -and intelligently studied, will guide all practical action; it will -show us how to build a hospital, plan a medical school, organize an -institute of preventive medicine, legislate for a community, or guide -the individual life. - -The Law of Unity relegates bacteriology to its proper place as a branch -of pathology, and proves that truth cannot be gained by searching -into the quivering organs of tortured animals. It shows us also that -individual health cannot be secured by building a Chinese wall around -one’s self. We cannot stop the revolution of the earth in an atmosphere -which may bring bacilli from inundated China, from starved Russia, from -leprous India, or from the slums of the West. - -We must work gradually towards the realization of our -ideal--Health--and work in many directions and on many lines. Advancing -sanitation will place our future hospitals in country neighbourhoods, -with only temporary receiving houses and dispensaries in large towns. - -‘The oldest hospitals were the temples of Esculapius, where Divine -assistance was sought.’ To these Asclepeia, always erected on healthy -sites, hard-by fresh springs and surrounded by shady groves, the sick -and maimed resorted to seek the aid of the ‘god of Health.’ To this -wisdom of the ancients we must certainly return when the present -tendency to subordinate the welfare of the sick to the convenience of -students be checked. - -The most urgent need which now exists in our profession is the -establishment of an Institute of Preventive Medicine guided by the -Moral Law. Such an Institute will recognise that mind and matter meet -in the fact called Life, will reverently study all the conditions -and laws of healthy life, and not be diverted from this great aim by -curious investigations into artificially propagated disease. - -The study of the biological sciences, comparative and human physiology, -morphology, histology, electro-chemical action, etc., is most important -and necessary for the advancement of medical science; but these can -be studied without any violation of the moral Law of Unity. It is -necessary to study the forms and functions of life which are manifested -in organisms lower than man. The laws which govern animal and vegetable -growth form important steps towards our increasing knowledge of -human physiology and sanitary law; but these can only yield true and -available facts when studied through the natural and healthy working of -the objects of study. The artificial production of mental or physical -disease by fear and suffering vitiates the natural order of life, and -leads to error in observation and induction from such observation. -Torture is not only unsuited to laboratory work, but is an inevitable -source of error in results. A laboratory or workroom should never be -degraded into a torture-chamber. Experiment should never degenerate -into curiosity or inhumanity.[9] - -In the future a wise Institute of Preventive Medicine may possibly -be placed in the healthy country. Around such an Institute for wise -research a well-planned health colony could grow up, which would be -of enormous utility to the overworked brains of our most valuable -people. It would be a health centre where the weary brain could be -refreshed and its vigour renewed by the restorative effects of manual -labour. Guided by true science, it would teach our teachers and our -legislators. Here they might learn to reverence those laws of health -which are equally violated by overworked brains and overworked muscles. -An Institute of Preventive Medicine genuinely ‘scientific’ would be the -soul of such a health centre. - -But such a colony can only be created when narrow selfhood has been -transfigured by the universal life; for, as has been finely said: ‘True -social integration will follow upon spiritual integration, and upon -nothing else.’ - -Whilst working towards a fuller realization of our ideal we must -respect and aid, as far as we can, those isolated efforts to deal with -special transgressions of the Moral Law which are really steps onward -in the growth of humanity. Separate efforts to advance temperance and -purity, justice to women and children, to the poor and weak, to the -humbler animals, our fellow-creatures, are all efforts to be heartily -encouraged. Each effort forms a little step out of selfishness into -large religious life. Although those who realize the Law of Unity -cannot rest in any isolated work, yet it is by the honest fighting -of sins that we grow into that hatred of Sin which will lead to its -destruction; and by the slow perception of truths we gradually approach -that ineffable Light of Truth which will melt away the chains of -selfhood, and set us free in the larger liberty of the Universal Life. - - -FOOTNOTES: - -[2] See Appendix, p. 85. - -[3] Dr. Hambleton calculates the pecuniary loss from waste of life in -the army from preventable disease, chiefly of the lungs, as at least -half a million a year--a waste of life which adds materially to the -number of recruits required. Whilst stating the hygienic measures in -relation to clothing, special exercises, air, and bathing, which have -been shown to restore the inferior physique of recruits, he places as -the crowning necessity ‘explaining to the men the effects of good and -bad habits upon their health, so as to insure their co-operation.’ - -[4] Sir Walter Scott, a connoisseur in dogs, writing about popular -belief in 1832, remarks: ‘The powers of this talisman have of late been -chiefly restricted to the cure of persons bitten by mad dogs, and as -the disease in such cases frequently arises from imagination, there can -be no reason to doubt that water which has been poured on the Lee penny -furnishes a congenial cure.’ - -[5] An English gentleman, Captain Frank Fairbanks, was detained for a -fortnight in quarantine (says a Boston telegram) because he refused -to be vaccinated. A younger brother of his had lost his life through -vaccination. - -[6] See Crookshank’s _History and Pathology of Vaccination_. - -[7] Dr. Adametz states that ‘one gramme of Gruyère cheese contains -90,000 microbes; after seventy days they had increased to 800,000. A -gramme of another kind of cheese contained about two million microbes, -whilst a piece of the rind contained about five million!’ - -[8] This is virtually accepted by one of the foremost advocates of -inoculation, who, acknowledging that preventive inoculation ought to -be strictly limited, adds: ‘Inoculation is only a palliative measure, -for the first object to be aimed at is the stamping out of infectious -disease, and I cannot help thinking that the day will come when -preventive inoculation will be a thing of the past.’ - -[9] The greatest injury which is now being done to medicine and the -advancement of hygiene is the abuse of the word ‘research’ and the -degradation of this noble exercise of human intellect by methods of -application not suited to the subject of investigation. - - - - - APPENDIX (Page 56) - - _On the Humane Prevention of Rabies_ - - -In the course of a discussion on the subject of rabies, a suggestion -was made that a resolution should be passed by the Section and sent to -Government, recommending measures for the prevention of hydrophobia. - -As two opposite methods of dealing with rabies had been ably supported -by Professors Roux and Fleming, I called attention to the fact that -nothing had been said in the discussion of the sufferings necessarily -inflicted upon animals where the Pasteur method advocated by Professor -Roux was adopted, and I stated that in a Pasteur Institute dogs were -kept in a state of madness. I therefore recommended that Municipal and -County Regulations, with their excellent results, as shown by Professor -Fleming of London, and Professor Ostertag of Berlin, should be adopted -rather than Pasteurian methods. - -In illustration of the sufferings of dogs when made mad, I referred -to my visit to the Rue Dutôt on June 2, 1889, where, after inspecting -the Hall of rabbits, guinea-pigs, and pigeons used in experiments for -rabies, anthrax, etc., I went to the cages of three dogs also used for -experiments in rabies, who were in various stages of madness, one dying -after its ten days’ agony; a second in the full fury of madness; a -third in frantic terror clinging to the bars of his cage, imploring to -be let out. - -Professor Roux’s statement in opposition to my recommendation of the -humaner methods of dealing with rabies seemed to infer that dogs were -not rendered mad in a Pasteur Institute or in dealing with rabies. But -when I stated to the Professor that I had myself seen this series of -three dogs being made mad, he replied: ‘Oh, you might have seen a great -many more, but they are not to inoculate people.’ - -Now, it is well known from experience that it is too dangerous to -inoculate direct from the dog to the human being. But the fact that -dogs are constantly made mad for experiment in the Pasteur Institute, -or in any institute that adopts Pasteurian methods, should be honestly -acknowledged, not evaded. The fact that this frightful disease of -rabies is kept up for purposes of experiment, although the virus be -transmitted in changed form through other animals for the inoculation -of human beings, is in itself a grave fact, and it bears directly on -the point which I dwelt on at the Congress--viz., that in choosing the -method of protecting humanity from a rare but frightful disease, the -method that does not involve sufferings to animals should be adopted by -a Christian nation. - - - - - SCIENTIFIC METHOD IN BIOLOGY - - - CONTENTS - - PAGE - - INTRODUCTION 89 - - CHAPTER I - - THE GROWTH OF CONSCIENCE 91 - - CHAPTER II - - CONSCIENCE IN MEDICINE 95 - - CHAPTER III - - THE MORAL ELEMENT IN RESEARCH 98 - - CHAPTER IV - - RIGHT AND WRONG METHOD 101 - - CHAPTER V - - THE NECESSITY OF MEDICAL RESEARCH 104 - - CHAPTER VI - - RESTRICTION OF EXPERIMENT 109 - - CHAPTER VII - - PRURIGO SECANDI 119 - - CHAPTER VIII - - WHAT IS SCIENTIFIC RESEARCH? 124 - - CHAPTER IX - - THE AXIOM OF SCIENCE 134 - - CHAPTER X - - RATIONAL EXPERIMENT IN RESEARCH 137 - - CHAPTER XI - - THE RANGE OF PAINLESS RESEARCH 144 - - CHAPTER XII - - RECAPITULATION OF PRINCIPLES 148 - - - - - INTRODUCTION - -A controversy is persistently carried on between an increasing body -of the non-professional laity and an important section of the medical -profession, in relation to the methods pursued in investigating -biological phenomena. - -The criticism of medical research by non-medical people is naturally -resented by some who are engaged in experimentation, and it is stated -seriously that non-scientific persons will impede progress if they -interfere with or succeed in restricting the efforts of those who -specially devote themselves to this branch of research. - -This controversy is still going on in ever-widening circles, and it -is bound to do so until the present confusion of thought which exists -on this subject is removed, and the broad distinction between right -and wrong experimentation is more fully acknowledged and more clearly -defined. Our relation to the lower animals has never yet been brought -fully into the clear light of reason and conscience. Yet in the order -of Providential development it must so come forward. - -As advancing humanity has gradually recognised natural rights as -existing in the various races of mankind, and is carrying on a -persistent warfare against human slavery, and slowly awakening to the -moral crime of introducing disease and vice amongst native races, -and the rights as well as duties of women and of children are being -gradually recognised, so the time has come when the natural rights of -inferior living creatures must be seriously studied. - -This study has become obligatory, not only in regard to the welfare -of the brute creation, but for the sake of our own human growth as -rational and moral beings. - - * * * * * - -The common-sense of mankind recognises our right to use the lower -animals for human benefit, whilst our superior intelligence gives us -the power to so use them. But ‘can’ and ‘ought’ are different aspects -of our mental constitution, which require to be harmonized. What we can -do is not the true measure of what we ought to do in any department of -life. - -We can starve a child or lash a horse to death, but we have no right to -do so. - -The laws of our human constitution compel us to recognise that -intellect and conscience, although essential parts, are not identical -parts of our nature. Long experience shows us that social progress can -only become permanent when conscience guides intelligence. - -How far the guidance of conscience can extend, with the practical -results to medical research involved in the recognition of such -guidance, forms the subject of present consideration. - - - - - CHAPTER I - - _The Growth of Conscience_ - -It is through the gradual and harmonious development of intelligence -with that element in our nature that we name conscience that the human -race passes from lower to higher states of civilization. In pursuing -our ideals, conscience is our instinctive monitor of right and wrong. - -Our great naturalist, Darwin, laid down as a law of evolution that -‘the moral sense, or conscience, is by far the most important of the -differences between man and the lower animals. Duty--“ought”--is the -most noble of all the attributes of man.’ - -Victor Hugo, with the prophetic insight of genius, calls conscience -‘that modicum of innate science with which each one is born.’ - -The growth of human conscience in its perception of justice and in its -sympathetic relation to creation is the surest measure of individual -and national progress. Various intellectual theories may be formed as -to the origin and growth of conscience. It may be held to be intuitive, -springing up as inevitably as the instinctive feelings born with the -natural relations of life; or it may be looked upon as gradually -evolved, the ‘result of countless experiences of fear, love, utility, -transmitted through generations.’ - -But however originating, conscience is a positive and potent fact. -It is, indeed, the mightiest factor in social life. It is the great -controller of selfhood. It enlarges human character and guides human -conduct. The deepening of this principle through the growth of justice -and sympathy marks an advancement in the type of humanity. Increasing -respect for life is one of the clearest signs of growing conscience. -Our reverence for the principle of life grows with our enlarging -intellectual perception of its universality and its unlimited power of -development. - -As life is marked by activity, and cannot remain stationary, so -conscience shares this law of life. It must inevitably advance or -retrograde. - -The degradation as well as the development of conscience may be seen -amongst us in the midst of our present civilization. It is contrary to -the most rudimentary element of conscience to feed upon one’s kind, and -cannibal tribes who devour their captives represent the lowest type -of humanity; even the dogs of the Arctic voyager will endure the slow -agony of starvation for days before their human taskmasters can compel -them to eat the flesh of their companions. The well-known naturalist, -Mr. W. H. Hudson, states that wolves, when pressed with hunger, will -sometimes devour a fellow-wolf; as a rule, however, rapacious animals -will starve to death rather than prey upon one of their own kind. - -Yet shipwrecked sailors, even of our own English race, have been -known to drink the blood and eat the flesh of their own comrades when -confronted by starvation. - -We find that intelligence may exist without conscience, but the human -type changes to a destructive force when this separation takes place. A -lamentable example of the social danger created by the destruction or -absence of rudimentary conscience amongst us is shown by the betrayal -and murder of the little boy Eccles in Liverpool, for the sake of his -clothes, by his two companions of eight and nine years old. There was -the deliberate plot to entice him to a pond; the throwing him three -times into the water as he scrambled out; the final holding him under -water until all struggle had ceased. These facts make a striking, but -not unique, object-lesson, showing how intelligence may exist without -conscience amongst all our appliances of civilization, and the danger -of such separation. - -Examples of the social devastation produced by official corruption and -business dishonesty are too numerous to be detailed; they are seen in -what are called civilized countries--in London, Paris, Rome, and across -the ocean. The lack of conscience in public and private transactions -creates social misery proportioned to its extent. - -Recognising, therefore, that this distinctive principle of conscience -is a fact of gradual development, that it grows by the union of -the moral with the intellectual elements in our nature, and that -the far-reaching consequences for good or evil of vivid or dulled -conscience in the individual and the nation are far beyond our power -of foresight, a grave responsibility rests upon us in this matter. -We are bound to realize that any custom, or method of education, or -proposed course of action, that seems to violate the natural instincts -of humanity, or is contrary to the present enlightened conscience of -any section of our Anglo-American race, demands imperatively the most -careful consideration on our part. - - - - - CHAPTER II - - _Conscience in Medicine_ - -Every intelligent member of the medical profession will certainly -recognise the special value of human conscience in the profession. - -The problems which are involved in the practice of the beneficent art, -the absolute reliance which the anxious patient is compelled to place -in his physician, the helplessness of the poor, who form so large -a majority of those who need medical aid, and who are without the -defences of wealth and station, show the need of keen moral sense, as -well as intelligence, in those who practise the art of medicine. - -The very discoveries of medical science enforce this necessity; for the -possibility of abuse in the employment of such beneficent agents as -anæsthetics and hypnotism, by incompetent or conscienceless operators, -is a very serious fact. - -This special responsibility of the medical profession to society is -greatly increased by the fact that the training of a very large section -of our intelligent youth during the important years of early manhood -rests upon them. The moral as well as intellectual influence exerted -by those who guide the college, the hospital, the dispensary, and -post-graduate classes, will mould the future action of one of the most -influential portions of the community--those, viz., on whom the health -of the nation chiefly rests. - -Now, whilst all recognise the need of the trained and skilful care -of a nation’s health, and perceive also that rightly organized -medical schools and hospitals are of great value in educating our -health-guardians, how is it that a profound distrust of these -institutions has grown up in our midst, that the support of hospitals -becomes increasingly difficult, whilst at the same time the sentiment -of benevolence and desire to help the poor is constantly extended? - -How is it that the beneficent and necessary art of medicine no longer -commands that respect and confidence which its essential character as -part of our social institutions would seem to demand? - -The answer to these serious questions involves both moral and -intellectual considerations. These problems have arisen from failure -to perceive that in education moral and intellectual activity cannot -be advantageously divorced, or that one portion of our complex nature -cannot be beneficially developed whilst other portions are entirely -ignored or injured. - -Our medical schools, whilst sharpening the intellectual faculties of -their students, must be careful that their modes of teaching bring with -them no deterioration of that important faculty of their students--the -moral sense. As conscience or the moral sense is unequally developed -in human beings, but is indispensable to the physician in his relations -with patients, any apathy or negligence in this respect by the trainers -of youth may become a national danger. - - - - - CHAPTER III - - _The Moral Element in Research_ - -Morality as a guide in biological science is based upon the practical -distinction between organic and inorganic Nature. - -If medical progress simply involved the investigation of inorganic -Nature, the general public would be only learners, gladly receiving -such information in geology, chemistry, astronomy, or physics, as -specialists in those branches of physical science were good enough to -impart to the unlearned. - -But directly scientific research passes beyond the distinctive realm of -matter, moulded and transformed by general energy, but not affected by -individual will, it has to deal with a very different principle--viz., -life. This vital distinction has been well laid down by one of our -eminent medical authorities as follows: ‘During the slow growth of -medical knowledge it has become more and more plain that physics, -chemistry, and biology are distinct sciences, with methods of their own -and inductions of their own, each of the latter terms in the series -using the results of its predecessors, and adding new results of its -own. Although life is a structure built up of physical and chemical -facts, yet to the building, to the arrangement, to the ordering of -those facts, there goes something that neither physics nor chemistry -can explain, any more than algebra can explain the behaviour of a -magnet. To strive to interpret the series of events which make up the -life of an animal in terms of chemical change (metabolism), or of -conservation or expenditure of energy, is an endeavour which will fail.’ - -As the brute creation as well as human beings share in a physical -organization which expresses each variety of life, there is not the -same sharply-dividing line between the various categories of animal -life as there is between organic and inorganic Nature. Biogenesis, or -life generated by life, is the distinctive feature of organic Nature. -We are linked to living creatures of higher or lower nature by the -power of educating or subduing them, and by all those varying relations -involved in the mystery of life. - -The distinctive position of man, as an animal placed at the head of the -animal world, necessarily creates serious responsibility on the part of -the higher towards the lower creature. - -This basis of moral responsibility extends in kind, if not in degree, -to all life. It necessitates a directing conscience which shall guide -all our intellectual and practical relations with every category of -life. - -This moral element enters unavoidably into our treatment of animal -life from its lowest to its highest form. Our treatment of a monkey or -a prince contains an element of moral attitude which does not exist in -our relation to inorganic Nature. - -It is a difference of kind as well as of degree, which it is blindness -to ignore. - -The divergence which now exists between some biological investigators -and their critics rests upon the failure to recognise that moral error -may engender intellectual error. - -The special subject which has produced this controversy is the present -method of using the lower animals in biological research, which has so -enormously extended of late years. The essence of the controversy is -the ethical question--viz., Have we a right to torture? - -It must be distinctly understood that there is here no question of our -right under certain circumstances to put to death. Neither is there a -doubt of the utility of rational experiment and of research. But the -right to put to death in the most humane manner known to us, and the -right to torture to death, are two widely different questions. - -We have no right, for any purpose whatever, to torture a living -creature to death, either by the mutilation of the organs, the slow -deprivation of the necessary conditions of life, or the still slower -process of destroying by the inoculation of disease. - - - - - CHAPTER IV - - _Right and Wrong Method_ - -It must be carefully noted that the wrong involved in inflicting -torture upon a living creature is the violation of a rational -principle. The employment of torture or of painful experiment in -biological research is not a question of the right to gain knowledge; -it is a question of how we seek to gain knowledge. It applies directly -to method. - -Thus, the fact observed by Paget, that in a patient who vomited all -fat, the pancreas alone was found on post-mortem examination to be -diseased, is worth more than a series of experiments on lower animals -of different constitution from our own. - -In the slow approach towards truth, which is the great object of -science, no single method is indispensable. The human mind is so full -of activities, Nature presents such an infinite variety of resources, -that progress in research can never be hindered by the choice of right -instead of wrong method. - -This is well stated by one of our most experienced investigators when -he says: ‘Methods run with the manners and customs of the ages. In -science there is no one method that can be considered indispensable. -Attributes are indispensable; observation, industry, accuracy, are -indispensable; methods are not. They may be convenient, they may be -useful, they may be expedient, but nothing more.’[10] - -This admirable statement throws a flood of light upon the confusion -and perplexity of the present controversy. It shows the error of both -the so-called unscientific and scientific parties. It shows the error -(not unnatural), in the former, of confounding together experiment, -research, laboratory, and scientific investigation, and classing them -under one indiscriminate ban of cruelty; it also shows the narrow -vision and false reasoning of those who claim that right and wrong have -no meaning when applied to the investigation of phenomena supposed to -be revealed by the senses, or state that the collecting of so-called -facts, named knowledge, is an end in itself, to be unrestrained and -justified in itself. - -That interesting book, _The Naturalist in La Plata_, in narrating the -author’s observation of the natural fearlessness of all wild animals -towards man, the careful research into life-habits that can be carried -on where this fearlessness is not betrayed, and the susceptibility -to kindness which exists amongst all the lower animals to their -sovereign, man, furnishes a striking and delightful suggestion as to -the _method_ which future research should take.[11] - -It is the distinctive moral relation existing in the plane of animal -life that makes our connection with the organic world a different and -more comprehensive relation than that which exists with inorganic -Nature. It places research in the biological sciences on a different -plane from study of the physical sciences. - -Therefore, whilst it would be folly for ordinary people to criticise -the methods of experts in physical science, it would be dastardly -dereliction of duty not to consider the methods employed in biological -science. - -The subject of experimentation upon the lower animals having two -aspects--an ethical and an intellectual one--the medical profession -will be wise to welcome all honest and kindly criticism and suggestion -in the most difficult of all studies--viz., the study of life. It must -be recognised that the people are absolutely in their right in refusing -to submit to dictation in what concerns their relation to animal life, -of which they are the responsible head. - - - - - CHAPTER V - - _The Necessity of Medical Research_ - -Whilst fully recognising the right of the laity to criticise scientific -method when it deals with sentient animals, fashioned on the same -general plan as ourselves, and capable of fear, pain, affection and -gratitude, there is another aspect of the subject which we are bound to -consider. - -The present condition of medicine is that of an art, not of a science. -It is erroneous to speak of the science of medicine. There exists -uncertainty in diagnosis, uncertainty in the action of remedies, -ignorance of individual idiosyncrasy, and terrible inability to meet -such devastating diseases as cancer, consumption, leprosy, etc. - -No one outside the profession can fully realize the grave -responsibility, even desperate anxiety, felt by the conscientious -physician when life or death seems to depend upon his action and he -knows that medical resources are not equal to the occasion. It is a -noble desire for the advancement of the beneficent art of medicine -which makes the great body of busy doctors eagerly listen to those -who are supposed to speak with authority, and hail with hope every -announcement of supposed discovery which seems to promise improved -practical results. - -This is really a sound humane attitude of mind in that vast body of -the profession who are unable, from the pressure of practical life, to -devote themselves to investigation--a profession which has always had -its heroes and martyrs, who have not shrunk from risking their lives in -the service and for the advancement of their noble art. - -Those also who are in the profession can most fully estimate the -real and beneficial results, both in surgery and medicine, derived -from careful and persistent research, notwithstanding the severe -disappointment often caused by the theoretical error and unjustifiable -practice resulting from rivalry in erroneous methods of investigation. -The conquest of pain and diminution of nervous shock in necessary -surgical operations,[12] the disappearance of blood-poisoning, hospital -gangrene, and erysipelas, which were the scourges of our public -institutions in a former generation, are immense gains, due to the -discovery of anæsthetics, antiseptics, and to advancing sanitation. -These blessings are the direct outcome of persevering and skilful -clinical observation, of careful work in the laboratory, of humane -experiment, and of happy accident; they are not derived from cruel -experimentation. - -The successful control of that terrible disease--puerperal fever--which -formerly destroyed such a multitude of women, is a striking conquest of -humane method in modern medicine. When I was a student in La Maternité -of Paris in 1849, this destructive malady of lying-in women produced -a mortality varying from 10 to 15 per cent. But when I visited La -Maternité in 1889 the mortality was reduced to a little over 1 per -cent. This was due to rigorous cleanliness, sanitation, and the use -of antiseptics, directed by the skilful _sage femme en chef_, Madame -Henri, in spite of the old and unsuitable buildings and the depressing -status of many of the patients. - -A still more satisfactory result is shown in the Clapham Maternity -Hospital, in London, where not a single death occurred amongst the 760 -cases first received into the institution. - -This excellent result still continues under the same administration. Of -the 4,000 lying-in cases received in the hospital during the thirteen -years it has existed, there has been no death from puerperal fever. -This excellent record has been attained by scrupulous cleanliness, -absolute isolation on the occurrence of suspicious symptoms, by -excellent nursing, and constant oversight by the doctors in charge. -Even in the out-patient department, where the conditions of living are -not under such strict medical control, the deaths from this frightful -malady have only amounted to 5 in 12,500 cases under the same -enlightened direction. - -This great and beneficent reform in the first and world-wide branch -of medicine, by means of which the lives of innumerable women in all -our large centres of civilization have been saved, is the result of -scientific research. It was initiated and successfully carried out -by Semmelweis, of Vienna, and is a striking instance of the value -of research carried on by the use of the comparative method, with -absolutely no resort to experiment. The history of this reform, the -methods by which it was accomplished, the opposition it encountered in -the profession itself, and its triumphant vindication, are well worth -serious study. An account of this valuable investigation and other -important discoveries by justifiable methods of inquiry are given to -English readers by the admirable translation published by the New -Sydenham Society.[13] - -Medical research, therefore, is not only justifiable, but obligatory in -a profession that is specially charged with the care and advancement -of individual and national health, and, as will be seen later, -observation, induction, and rational experiment form the essential -methods of scientific inquiry. - -These two facts--viz., the necessity of advance in medical knowledge -and the methods of investigation necessary for such advance--must -be distinctly recognised by sincere reformers, and should shield the -profession from that indiscriminate reproach which is often made -against it as a whole; for such hostility tends to strengthen that -undue _esprit de corps_ which often hinders sound medical progress in -the profession. - - - - - CHAPTER VI - - _Restriction of Experiment_ - -When we investigate the popular or ethical aspect of so-called -scientific research made upon living animals, we are at once met by -facts which imperatively demand both serious thought and determined -action if we would not be participators in the degradation of human -conscience. We are confronted with the enormous increase in such -experiments which has taken place within the last thirty years, as well -as in the severity of the sufferings inflicted. This increase is going -on in England as well as in foreign countries.[14] It is growing in -many cases, not only without any benefit to the human race, but also -without reference to any supposed beneficial result as its attempted -justification. - -The volume of facts and evidence collected by Mr. Colam (the able -Secretary of the Royal Society for the Protection of Animals), and -published by that society in 1876, is a permanent record of great -value. It enables us to measure the growth of experimentation in -England, not only from 1862 to 1876, when the present Cruelty to -Animals Bill was enacted, but it also forms a point of comparison for -testing the increase of vivisectional methods since 1876 to the present -day, when these easy but often fallacious methods of research have -become universal in medical investigation and medical instruction. - -In 1869 there were very few places where the experimentation on animals -could be carried on, such investigations being made by men of rare -ability, and for a definite object. There were no class demonstrations -and no students encouraged to experiment. But in 1892 there were 180 -persons licensed in this country, and over 3,960 experiments performed, -numbers which increase with each year. - -_The Effect on Students and Subordinates._--A point for serious -consideration is the effect produced upon the unformed minds of -students of medicine by the introduction of experimentation upon living -animals into our medical schools and hospitals. - -The employment of destructive experimentation on living creatures -is now introduced as a part of the ordinary instruction of medical -students in the fundamental study--physiology. This is a novelty of -the present generation. During the whole course of my medical studies, -fifty years ago, I never saw a living creature vivisected for the -instruction of students. The same is true of the experience of most of -the able physicians of an older generation. - -Now, however, nearly every medical school has its store of imprisoned -living creatures awaiting their fate, from the large frogs imported -from Germany, the mice, rabbits, cats, and dogs of home production, -to the cargoes of monkeys brought to our foggy climate from tropical -Africa. They form an enormous mass of living creatures, kept for the -attempted demonstration of vital action in the lecture-room, or for the -study of diseased processes in the physiological laboratory. - -It is a fallacy (although proclaimed in high places) that the ordinary -student of medicine must be prepared for his practical work as a -physician for men by watching the opening of chest, abdomen, brain, -or cutting into the delicate vital organs of lower animals. Such -demonstration is a thrilling spectacle to inexperienced students. It -appeals to that love of excitement which makes them rush to a surgical -operation, or to an extraordinary medical case, whilst the commonplace -but all-important bedside observation seems dull in comparison. Yet -patient work in the anatomical and microscopic rooms, and in the -chemical laboratory for general and animal chemistry and close clinical -study, all of which involve no form of suffering, are of primary -importance. The genius of a Professor as an instructor is shown by his -ability to make his pupils realize this. - -Destructive experimentation on helpless animals, not for their own -benefit, is a demoralizing practice. The student becomes familiar -with the use of gags, straps, screws, and all the paraphernalia of -ingenious instruments invented for overpowering the resistance of the -living creature, or for guarding the operator from injury in case the -anæsthetic, when used, should give out too soon. He learns also how -easy it is to experiment in secret. - -By advanced instruction and post-graduate classes the student is led -on to take active part under licensed authority in this fascinating, -but morally dangerous, method of study. Moreover, the large body of -subordinates who are necessary to take charge of and prepare the -animals, are trained in indifference to suffering, without any excuse -of intellectual gain, and the same injurious influence extends in -ever-widening circles--to the traders who invent and sell instruments -of torture, and to those who supply the living material. - -Now, the natural instinct to be cherished in human beings is protection -and kindliness to infancy and all helpless creatures, not indifference -to suffering or wilful infliction of it. As human conscience is a thing -of growth or degradation, the natural shrinking from needless pain can -soon be hardened into callousness. Conversing with medical students in -relation to the effect made upon them by witnessing vivisections even -under chloroform, I have found that their experience is always the -same--viz., first, the shock of repulsion, then tolerance, and then, if -often repeated, indifference. - -The moral deterioration necessarily induced in those to whom suffering -becomes a frequent spectacle is noted by the _Englishman in Paris_, -from personal experience. After speaking of the inhumanity produced -by the daily sight of blood in the originally honest bourgeois, who -became the ‘Conventionnels’ of the French Revolution in 1793, he writes -as follows: ‘I have witnessed three executions. After Pommeraye’s -execution I was ill for a week; after Troppmann’s the effect soon -wore off in three days; after Campa’s I ceased to think about it in -twenty-four hours. Then I made a vow that no power on earth should draw -me to the Place de la Roquette again. But men generally regard their -growing imperviousness as a sign of mental force, and pride themselves -upon it.’ - -In Marie Bashkertseff’s _Journal_ is a striking passage which describes -the effect of a Spanish bull-fight. She says: ‘I was able to maintain a -tranquil air in full view of the butchery, carried on with the utmost -refinement of cruelty. One leaves the scene slightly intoxicated with -blood, and feeling desirous to thrust a lance into the neck of every -person one meets. I stuck my knife into the melon I was cutting at -table as if it were a banderilla I were planting in the hide of a bull, -and the pulp seemed like the palpitating flesh of the wounded animal. -The sight is one that makes the knees tremble and the head throb. It is -a lesson in murder.’ - -The moral distinction between heroism shown when suffering is -witnessed for the purpose of aiding the sufferer and that evinced for -the selfish desire of individual gain or excitement, was strikingly -exhibited by a German nurse whom we sent on to the army during the -Civil War in America. This frail-looking woman drifted on to the front, -and, after the Battle of Gettysburg, donning a pair of man’s boots, -wading in pools of blood and mud, spent two days and nights on the -field of slaughter, drawing out still breathing bodies from the heaps -of slain, binding up wounds, giving a draught of water, placing a rough -pillow under the head, in an unselfish enthusiasm that knew neither -hunger nor fatigue. The ghastly wounds, the blood, the shrieks and -groans of that horrid scene served but as fuel to the fire of humanity -that consumed her. - -_The Effect on Teachers or Practitioners of Medicine._--In considering -the subject of experimentation, reason requires that we realize the -necessary distinction between the methods employed in training students -for a practical profession and the exceptional position of the few -geniuses who possess the rare combination of qualities essential to -scientific investigation. In calling attention to this distinction we -do not condone torture, for this can be proved to be unscientific. But -it emphasizes a growing and mischievous evil of the present day when -numbers of ordinary teachers of physiology, whose gifts are limited and -whose especial business is to instruct students in the knowledge which -has been attained, consider themselves capable of original scientific -research, or attempt to repeat before either students or popular -audiences so-called demonstrations on living creatures. - -The showy plan of experimenting on animals is undoubtedly a great -temptation to teachers. Such practice readily gains the gratifying -applause of inexperienced learners, who are misled by an appearance of -conclusiveness in the lectures, which they are quite incompetent to -gauge. But the influence thus exercised is a harmful one, diverting the -mind from right methods of study. - -The temptation to make a display before imperfectly informed persons is -too great. If the profession is to advance in popular esteem, it will -recognise that the unfeeling destruction of living creatures, even the -pithing of a frog or the dissection of the salivary glands of a living -mouse, is a false method of forming the minds of students, which should -be entirely abandoned. - -We must here note the demand lately made by some leading members of the -profession for increased facilities for experimentation on animals. -Now, anyone who studies the Cruelty to Animals Bill (30 and 40 Vict.), -which in 1876 licensed vivisection in Great Britain,[15] will see how -easy it now is to obtain a license, and how carefully the provisions -of the Bill are arranged to give freedom to experimentation--in fact, -to protect experimenters rather than their helpless victims. Thus, -whilst in Section 2 a penalty of £100 or three months’ imprisonment is -imposed for acts of cruelty, the Bill proceeds in Section 3 to give -absolute freedom to every licensed person to torture, to mutilate, -to disease to any extent if he considers it advisable to do so. In -Section 11 it gives exceedingly wide scope for procuring licenses. By -Sections 7 to 10 it makes the efficient oversight of licensed persons -almost impossible, and by the provisions of Sections 13 to 15 it -virtually excludes the influence of growing humanitary conscience in -the community from being exerted on the persons and places licensed. -In short, the Bill would rather seem to be skilfully devised to give -a free hand to persons who may call themselves ‘scientific’ than to -protect living creatures who cannot protect themselves. - -The plea put forward by the gentlemen referred to--viz., that medical -progress is now hindered in England by restrictions--is practically a -justification by them of the inhuman practices which prevail in France, -Germany, Russia, and the United States, and in all countries where -the conscience of the people has not been aroused to the moral and -intellectual dangers involved in the torture of animals.[16] - -Surely these English physicians who demand entire freedom for -vivisection do not realize what the result of foreign methods is. They -cannot have noted the innumerable examples of atrocious cruelty which -are occurring in the records of medical research as practised on the -Continent and in America. - -They cannot have taken note of such typical examples as the utterly -useless barbarity of Senn of Philadelphia, setting fire to a dog -that he had pumped full of hydrogen gas, before the Medical Congress -of Berlin in 1890. Nor the experiments in massage on a series of -large disjointed dogs performed in Professor Charles Richet’s Paris -laboratory, not only with the permission, but with the consultative -advice of that gentleman. A set of more unjustifiable experiments were -never devised. - -Certainly, no body of honourable English physicians who are in the -habit of reading _Les Archives Générales de Médecine_ would fail to -condemn such fallacious experiments, where the pretence of anæsthesia -served to diminish the resistance of the victims--not to annihilate -pain. - -_Factors in Human Nature._--It must never be forgotten that gambling -excitement or the spirit of undue emulation exists in all classes -of men--in biological investigators as well as others--and it needs -guidance or restraint. - -The German officer Reizenstein felt keen remorse for the murder of -his beautiful Irish mare Lippespringe, yet he and his companions -tortured thirty horses to death under the temporary insanity of intense -rivalry. But it was possible to bring public conscience to bear on -this barbarity, and thus check the recurrence of any similar future -aberration. - -So in biological research we see the disastrous effects of individual -and national rivalry. They are shown in the contradictory results of -false methods of observation, in the endless repetition of similar -painful experiments, in the strife of conflicting theories, and in -the practical failure of results obtained from the lower animals when -applied to the human race. - -The moral sense of a noble profession may well be appealed to to create -a conscience which shall check the present grave abuses of so-called -research. - - - - - CHAPTER VII - - _Prurigo Secandi_ - -Another serious ethical danger connected with unrestrained experiment -on the lower animals is the enormous increase of audacious human -surgery, which tends to overpower the slower but more natural methods -of medical art and to divert attention from hygiene. - -This modern increase of surgery, entailing permanent mutilation, has -received a special name, prurigo secandi, or cacoethes secandi. It -prevails in France and in every country where no restraint is placed on -animal experimentation,[17] or where the importance of not injuring -the moral sense of students has not been recognised. - -The great increase in ovariotomy, and its extension to the insane is a -notable result of this prurigo secandi. - -Dr. Chanu, in his carefully-prepared thesis of 1896, in exposing -the grave abuse of this branch of surgery, estimates that there -were 500,000 castrated women in France, and one in every 250 women -throughout Europe. He finds the decrease of the birth-rate to coincide -with the abuse of ovariotomy. ‘Dr. Chanu affirmed, before a jury unable -to refute his assertion, that the abuse of ovariotomy has done more -harm to France in ten years than the Prussian bullets did in 1870, and -that the causes of the depopulation of France are closely allied to the -practice of the castration of women.’ - -The prevention of disease in the organs of generation must be sought -for persistently in improved education of the young--the male as well -as the female--and in _just_ relations of the sexes. - -Of the same nature as the prurigo secandi of medical practice is the -motive or source of much of the laboratory experimentation. - -The various ethical dangers resulting from conscienceless or irrational -experiments on animals demand much more serious consideration by the -profession than has hitherto been given to them. In the opinion of an -increasing number of intelligent physicians, a vast amount of what is -now presumptuously called research--experiments disguised under learned -names, but which are really the irrational mutilating and diseasing of -sentient living creatures--are no more _scientific_ research than is -the gratification of a child’s curiosity when it sticks a pin with a -thread through a cockchafer, to see how long it will fly and how loud -it will buzz. The child, when punished for its thoughtless cruelty, -might remonstrate in learned terms that it should not be restrained, -for it was investigating the vital endurance of the _Melolontha -vulgaris_ and the acoustic properties of its wing-covers, under -interesting and abnormal conditions. - -A large proportion of what is simply conscienceless curiosity, often -starting from more or less frivolous tentative diversions of the -laboratory, though now by courtesy named research, is no more valuable -than the child’s spinning of the cockchafer, and should be as sharply -checked. - -The genesis of discovery in biology, with its necessary relations to -therapeutics, has yet to be written. Extending experience is more and -more clearly showing us, as a practical fact, that whilst observation -and rational--_i.e._, humanely limited--experiment are legitimate -and noble efforts for the attainment of improved medicine, cruel -and merely curious experiment, condemned by our moral faculties, are -misleading and mischievous. - -Men like Professor Henschel, of Upsala, and Professor Pettenkofer, of -Munich, warn our eager young investigators against drawing conclusions -as to human beings from experiments made on animals. - -We find, as a matter of fact, that all the _permanent_ advances of -medicine have been gained whilst pursuing rational and righteous -methods, whilst all the fiascoes of supposed discovery have resulted -through departing from them. - -Anæsthetics, antiseptics, and sanitation are not the result of cruel -experimentation. - -_Danger of Inoculation._--The most serious fallacy arising from -erroneous methods of biological research is the practice of vitiating -human blood by the introduction of the diseased products of animals. -This dangerous method, which threatens to undermine national health, -is the necessary outcome of diseasing animals on the plea of seeking -remedies for human disease. - -The intellectual fallacy involved in this practice will be considered -later; but its ethical character as affecting conscience must here be -noted, as it is this line of research which is productive of the most -extended form of cruelty to the lower animals--viz., _slow_ torture. - -The following extract from records of the Belgian Academy of Medicine -illustrates this subject: ‘Researches on the inoculability of cancer -ought to be encouraged. The numerous experiments made on animals are -still contradictory in results. Drs. Francotte and De Rector have in -the years 1891-92 inoculated mice under the skin of the shoulder. The -inoculations were carried on from June, 1891, to May, 1892, when the -following appearances were presented: The whole region of the shoulder -was inflamed; there was necrosis of the corresponding upper extremity, -which dropped off from dry gangrene; the stump left was indurated, -hard, and painful, whilst the lymphatic glands in connection with the -part were enlarged. The examination of the tumour disclosed nothing -very particular. The bones were the seat of osteoporosis, and the -arteries showed arteritis. The investigators believe the tumours were -cancerous, but this statement must be received with caution.’ - -Such long-continued torture, even of a mouse, is morally degrading, -and, as if in retribution, is doomed to be useless. - -A Chinese medical author, Tuan Mei, writing in the last century, 1716 -to 1797, lays down a true medical axiom when he marks the difference -between death and torture as follows: ‘Living creatures are for our -use, and we may put them to death. But we may not make death a boon, -and then withhold it from them.’ - - - - - CHAPTER VIII - - _What is Scientific Research?_ - -The apparent opposition between popular and medical judgment in -relation to certain methods of biological research which claim to be -scientific, necessitates a clearer knowledge of what science is, and -a recognition of the methods of research which can alone be called -scientific. - -It is certain that knowledge of truth must reconcile varying but honest -opinions, and furnish plans of investigation that neither shock the -humane development of our nature nor hinder our intellectual progress -towards truth. - -The terms ‘science’ and ‘scientific’ are constantly used and abused. -They are often applied to the accumulating of facts or of phenomena; -but such accumulation is not necessarily science, and may even hinder -science. For although the collecting of facts may bring together -valuable materials essential for future use, it may also bring together -rotten or sham materials, which will interfere with sound work. A -faulty method of endeavouring to obtain facts may seriously destroy -the value of the phenomena thus observed. - -The gratification simply of intellectual activity or curiosity must -not be confounded with genuine research. Curiosity is the outcome -of ignorance. Now, our ignorance of much in Nature is no reproach -to anyone, but the way in which curiosity is gratified marks the -difference between the simple child and the rational adult. In the -childish development curiosity, though useful, is superficial and -short-sighted; it is necessarily a shallow impulse, which cannot -realize the wide relations of existence, and its satisfaction has no -necessary connection with the acquisition of valuable knowledge. But -the adult rises into a higher plane of thought. Curiosity is no longer -unduly exercised, but has grown into a love of truth. It has become -that reverential use of reason which is the basis of truth, and which -forms the true guide to the attainment of scientific knowledge; for -rational method does not isolate a fact from all its connections, but -sees it in its relations and in due proportion. Thus only can valuable -knowledge be acquired. - -Neither is analysis science. It is only when the observations of -analysis are corrected and proved by synthesis that the truth of -science can be obtained. - -A clear recognition of the different use of analysis and of synthesis -is essential in any claim of research to be called scientific. -‘Although by analysis we separate and by synthesis we combine, yet in -the synthesis there is more than in all the parts taken analytically. -The mere synthesis introduces something entirely new.’ - -Kant, in speaking of the use of analysis and synthesis in logic, lays -down the test of all scientific inquiry. He says: ‘Analysis is the -first and chief requirement in making our knowledge distinct. For -the more distinct our knowledge of a thing is, the stronger and more -effective it can be; only the analysis must not go so far that at last -the object itself disappears.’ - -Truth being a unity, the science which demonstrates it must correlate -all knowledge. - -Science is not, therefore, an accumulation of isolated facts, or of -facts torn from their natural relations. To know a thing scientifically -is to know it in just relation to all other things. For science unites -and demands the exercise of our various faculties as well as of our -senses. - -Science is proved knowledge. It is the study of causes and their -relations applied to facts; but such proof can only be obtained by -search which is in accordance with the laws of Nature--laws which are -gradually discovered by our race. - -Natural law is deduced from all the facts of human experience, in -searching for and collecting which we must recognise the conditions -under which we are placed, the limitations of the present phase of our -intellectual powers, the gradual growth of conscience. - -Science being proved truth, scientific method requires that all the -factors which concern the subject of research shall be duly considered, -in order to arrive at correct thought respecting the special subject of -inquiry. - -The application of scientific method necessarily varies, therefore, -according to the subject under investigation. - -Thus, the construction of a bridge and the calculation of an eclipse -equally involve the bases of scientific method--viz., observation, -deduction, and experiment; but each subject requires a special -application of scientific method, suited to the varying nature of the -subject of study. - -Consequently, biological research, in order to be scientific, requires -a special modification of method, because the new factors of sensation -and consciousness come into play in biology--factors which do not exist -in astronomy, or geology, in mechanics, physics, or chemistry. - -In order to attain truth respecting biology, therefore, the facts -concerning sensation and consciousness and their relation with, or -the way in which these new factors modify the facts of, physics and -chemistry must be carefully considered in this higher state which -we call life, or the investigation is not scientific, no matter how -interesting as an intellectual exercise. - -When first endeavouring to find a recognised definition of the term -‘science,’ I consulted the latest _Encyclopædia Britannica_ of our -public library, thinking that from such an acknowledged authority a -correct statement could there be obtained. To my surprise, I found that -the word ‘science’ was not included in the list of subjects. Searching -further in this record of nineteenth-century thought, under the head -of ‘Biology’--that department which is ordinarily supposed to be the -science of life as distinguished from the consideration of non-living -things--the following principle was found to be laid down--viz., that -there was no essential difference between organized and unorganized -Nature, for life was simply a property of matter. - -It is well to weigh the argument for this doctrine, which necessarily -destroys the essential idea of right and wrong, and removes the -foundation of good and evil. It is set forth in the following manner: - -‘The abstract-concrete sciences are mechanics, physics, chemistry.... -Whilst their subject-matter is found in a consideration of varied -concrete phenomena, they do not aim at a determination of certain -“abstract” quantitative relations and sequences known as “laws,” -which never are manifested in a pure form, but always are inferred -by observation and experiment upon complex phenomena, in which the -abstract laws are disguised by their simultaneous interaction.... These -sciences of mechanics, physics, and chemistry have for their object to -explain concrete phenomena by reference to the properties of matter set -forth in their generalizations.’ - -The following important dictum in regard to biology is thus laid down: - -‘It is the business of those occupied with that branch to assign living -things in all their variety to the one set of forces recognised by the -physicist and chemist ... and its evolution’ (that is, the evolution of -life) ‘as the necessary outcome of those forces--the automatic product -of those same forces.... The discovery of the mechanical principle of -evolution completed the doctrine’ (of the material origin of life). -‘... It may be said to comprise the history of man, sociology, and -psychology--viz., the survival of the fittest in the struggle for -existence.’ - -This ignoring by the _Encyclopædia Britannica_ of any definition of -the word ‘science,’ and also the attempted reduction of life to a -property of matter, is, however, too limited a view of Nature to be -accepted by many thoughtful students of the present day. Turning, -therefore, to _Chambers’ Cyclopædia_, which is the latest expression -of the views of the able thinkers of North Britain, an explanation of -the term ‘science’ was found, which is far truer to advancing thought. -The comprehensive definition is there given that science ‘is the -correlation of all knowledge.’ - -As science searches for causes with their relations, and is proved -knowledge, so no branch of knowledge or method of acquiring knowledge -can be considered scientific which contradicts any facts of Nature, or -which bases its methods on the destruction of those facts. - -Truth can only be arrived at by considering various or apparently -opposite aspects of human problems; so biological facts, or the -problems of organized or living creatures must be considered, not -simply from the side of ‘mechanics, physics, and chemistry, or the -automatic action of the forces of matter,’ but also from the equally -positive facts of life, and the forces which careful observation is -gradually showing to be enfolded in the fact of mind as developed -through protoplasm onward. The facts of affection, companionship, -sympathy, justice, are positive forces. They exercise a powerful -influence over the physical organization of all living creatures. - -These mental forces can change the action of the bodily functions in -the most surprising manner, arresting the heart’s action, interfering -with secretion, or changing natural secretion into poison, and -destroying the normal and beneficial controlling action of the nervous -system. They are proved by experience to be so striking that they -cannot be overlooked in any unprejudiced investigation of natural -forces. - -A fit of passion in a nursing mother has destroyed her infant; -the industrious cultivator seeing his field of strawberries, the -products of his toil, carried off by thieves, has fallen dead in his -vain efforts to stop the cruel depredation. But such instances are -world-wide, and corroborated by everyone’s experience. They prove that, -although the forces of mechanics, physics, and chemistry are employed -in the animal economy, there are also powers far beyond these limited -forces, which must be studied also in biological research, if we are to -learn how these physical may be overridden by mental forces. Without -such correlation of knowledge we fail to realize the unity of Nature, -and cannot attain to true science or proved knowledge. - -It is thus seen that, as already stated, in useful scientific -investigation the object to be attained, the method to be employed, and -the application to be made of the knowledge searched for, must all be -considered in determining the distinction between genuine science and -simple unguided intellectual activity or curiosity. - -It is necessary to emphasize the fact, because this vital distinction -is often overlooked in the claim now made for the grand term ‘science.’ - -In defining the meaning and scope of science as pursued by rational -beings, it must be recognised as a fundamental principle, which cannot -be too often dwelt upon, that what we can do, is not a measure of what -we ought to do. Thus, when Stanley attempted to excuse the infamous -action of his naturalist, Jameson,[18] by saying that he was a real -good fellow, but ‘his science misled him,’ he degraded the term -‘science’ by applying it to an act of morbid curiosity. - -Again, when the Russian nobleman purchased a child and condemned it -to be brought up with a deaf and dumb nurse, under the unnatural -condition of deprivation of all social relations, his action was not -scientific, but a gratification of inhuman curiosity. - -It is within our power apparently to drown an animal, human or brute, -and recover it to life again and again, but we gain no scientific -knowledge by so doing. We torture the creature and violate our natural -instincts, but we acquire no practical benefit to human welfare; on the -contrary, we endanger the mental integrity of the experimenter. - -It is a short-sighted and hopeless attempt to do violence to Nature in -a search for scientific truth. Distinction must be made between the -possible and impossible in the conditions under which we are placed -in life. Thus, we cannot destroy the family relation, but we can make -it happy and conducive to the welfare of the race. We cannot change -the method of human generation, but we can spiritualize its exercise. -We cannot destroy the instinct of private property, but we can guide -and limit it. We cannot change structure, but we can educate it; -nor abolish curiosity, but we can restrain and direct it; nor check -invention, but it need not be applied to evil purposes. Neither can -we make races equal, but we can establish justice and mercy in the -relations of the stronger to the weaker. - -This study of the natural laws which necessarily limit rational human -action applies with especial force to biological research, and explains -the reason for limiting scientific method. - -Thus, the study of living creatures under unnatural or destructive -conditions, although it may be a well-meaning attempt to acquire -knowledge, is, nevertheless, a dangerous one. It is intellectually a -false method which may lead to practical error, and produce a labyrinth -of confusion and contradictory experience which hinders the attainment -of exact knowledge. It is morally a false method, because it injures -those elementary instincts of justice and mercy by whose evolution -civilization advances. Thus the progress of the race is retarded. - -The present astounding multiplication of drugs, of inoculations, of -mutilations in the practice of medicine, with the eager attempt to -prove each new invention by a formidable array of imperfect statistics, -is a striking object lesson in the present day of the error into which -false methods of research have led many members of a noble and humane -profession. It is a fallacy necessarily proceeding from a wrong view of -what science really is. - -Although this erroneousness is by no means solely connected with -vivisectional methods, yet if the high claim which the noble art of -medicine makes to advance our social well-being be justly founded, a -stringent obligation rests upon it not to injure the moral sense of its -members by the methods employed in education or in practice. - - - - - CHAPTER IX - - _The Axiom of Science_ - -The fundamental law, without whose observance reliable biological -investigation is impossible, is stated as follows: - -‘In studying the laws alike of organic and of inorganic Nature, the -experimenter must be careful not to destroy the phenomenon that is -being investigated.’ - -Intellectual error, as well as practical danger, arises from the -attempt to transfer to man results supposed to be gained by fallacious -experimentation on the lower animals. The fallacy consists in noting -general resemblance of structure, but not the far more remarkable -differences of function. If, for instance, the life habits of two dogs -of good breed are closely studied, it will be seen that, although -certain individual differences are observed between the dogs, yet they -are as nothing when compared with the enormous variation of function -between the dog and the human being. The bones and garbage swallowed -without injury, and the licking of its body, show the different type of -digestion and assimilation, the action of the kidneys, of the various -senses, and the possession of senses which we are unable to appreciate; -in short, its distinctive type of existence proves the impossibility -of drawing safe inferences for man from the digestive or other canine -functions. Again, observation and rational experiment, solely for the -benefit of one species of animal, may incidentally lead to the benefit -of other races of animals, but direct experiment on one type for the -supposed benefit of another kind is unscientific. - -It is this error that vitiates the famous postulates of Professor Koch, -through the system of ‘controls,’ the latest exemplification of this -fallacy being the attempt to prove the existence of cholera in man by -cultivating the bacilli in animals. The same error also produces the -failure of M. Pasteur to prevent hydrophobia in man. - -It is well known how the influence of what we term ‘mind’ governs the -action of the bodily functions, either promoting or disturbing their -normal condition. This is a fact of growing importance in practical -medicine. Similar influence is exerted in varying degrees on all living -creatures. Destructive or non-natural experimentation on living animals -is always subject to the fallacy of morbid condition. - -The established law of research stated above exposes the error of -pursuing biological investigation (or the study of vital action) by the -process of mutilating or diseasing living animals. - -In research the radical difference between inorganic and organic Nature -cannot be too clearly insisted on. Whilst in the former we can resolve -compounds into their elements and recombine them, such process is -impossible in organic Nature. We can take a steam-engine or a watch to -pieces, examine their parts, repair them, and put them together again, -thus proving our knowledge in this realm of Nature. But a living thing -cannot be treated in the same way. Not only the difference of animal -type forbids destructive method of investigation, but as the type rises -in the scale of creation the growing fact of individual idiosyncrasy -increases the uncertainty of erroneous method. - -Therefore the law of scientific research, which forbids the destruction -of phenomena to be studied, is profoundly true. - -If this law be not observed, intellectual activity may be gratified, -self-conceit or love of novelty and excitement may be pandered to, the -panic of fear in human beings may be worked upon, but the attainment of -scientific truth in biology will be impossible. - -It is thus seen that methods of biological research which involve cruel -or destructive experimentation are both ethically unjustifiable and -intellectually fallacious. They are unscientific methods which will -inevitably be abandoned as we attain to clearer views of that unity of -truth in which the reconciliation of human conscience with intellectual -activity becomes alone recognised as science. - - - - - CHAPTER X - - _Rational Experiment in Research_ - -As an illustration of legitimate and even heroic experiment, the trial -made with cholera bacilli by Dr. Von Pettenkofer of Munich on himself -during the cholera epidemic of 1891 deserves permanent record.[19] It -is of importance as showing the fallacy that may be involved in the -exaggerated search for bacilli, as the chief cause of disease, which is -the favourite theory and practice of the present day. - -Dr. Von Pettenkofer (in opposition to the common medical belief) -asserts that the diffusion of the cholera germ or cholera bacillus is -not the chief cause of cholera. He states that there are two other -absolutely necessary conditions, without which no outbreak of cholera -is possible, and if these conditions are not present, the cholera germ -may be breathed with no production of cholera. - -The first condition is the unhealthy state of the soil or locality. But -even this does not produce an outbreak if the second condition does -not exist--viz., individual predisposition; and he shows that neither -the cholera germ nor the insanitary locality, nor both combined, will -produce cholera if this individual predisposition does not exist. He -further states that no experiments upon the lower animals can be relied -on; the only _proof_ in relation to cholera must be from the experience -of human beings. - -Dr. Von Pettenkofer proceeded to experiment on himself, choosing -Munich, in daily communion with Hamburg (where the epidemic was -raging), as the place of operations, and sent to Hamburg for the -cholera germs. On October 7 he swallowed a centimetre of fresh cholera -culture, in the presence of witnesses--_i.e._, infinitely more than -could be taken in by touching the lips with contaminated fingers, a -cubic centimetre of culture being calculated as containing a thousand -million microbes. He in no way changed his manner of living, eating -accustomed food, including fruit, cucumbers, and other forbidden -articles of diet. During the following week his physiological -condition, pulse, temperature, etc., were carefully noted. Nothing -unusual occurred but a little internal rumbling and slight diarrhœa, -which passed away of itself. Two skilled bacteriologists, MM. Peiffer -and Emerich, carefully examined the secretions during this experiment. - -M. Von Pettenkofer himself thus states the results: - -‘The comma bacilli not only prospered in my digestive tube, but had so -multiplied in it that it was evident they found a congenial soil. They -were found there in quantities, and in a state of pure culture. But -on October 14 all the secretions were normal, only containing a few -isolated microbes, which had entirely disappeared on the 18th. - -‘Now, most bacteriologists assert that the cholera bacilli remaining in -the intestines secrete there a poison, which, being absorbed, produces -the cholera. But what a quantity of poison must have been secreted -by these milliards of bacilli during the eight days’ sojourn in my -intestines! Yet I felt perfectly well, had an excellent appetite, felt -neither indigestion nor fever, etc., and I attended every day to my -usual occupations. Whence I conclude that the comma bacillus, though -it may cause a little diarrhœa, produces neither European nor Asiatic -cholera. - -‘Now, it must not be imagined that I am the adversary of the cholera -bacillus; but it is erroneous to suppose that when a specific microbe -has been discovered in the secretions of an infectious disease that the -means of fighting it has also been discovered. The discovery of the -bacillus of consumption was just as interesting as the discovery of -the cholera bacillus, but since its discovery phthisis has destroyed -neither one man less nor one man more. - -‘These (bacteriological) methods for protection against cholera rest -purely upon theory, and it seems to be thought that henceforth cholera, -etc., ought to behave according to the prevalent theory, instead of -theory being modified according to the cholera. Instead of trying to -catch the comma bacillus and draw a cordon around it, the essential -thing is to make all the dwelling-places of man healthy.’ - -Such is the vigorous and genuinely scientific experiment of a -distinguished medical investigator. - -Other experimenters have confirmed Dr. Von Pettenkofer’s observations. -On October 17 Dr. Emerich made a similar experiment on himself, with -like results. - -Since then, experiments have been made in the Vienna Pathological -Institute, with the following results: Six persons partook of the comma -bacillus in no mean quantity, and not one of them has had the disease. -The six are two doctors, the servant of the Institute, two medical -students, and a private gentleman. Professor Stricker treated them -all. Two did not feel their health impaired at all; one had headache, -was slightly feverish, and could not sleep; two had slight attacks of -diarrhœa; and only one was really ill, but recovered at the end of a -week. These experiments inspire medical men with serious misgivings as -to the theory which considers the comma bacillus as the cause of all -cholera. - -The supremacy of sanitation is the lesson which is being gradually -taught by such humane scientific experiments. Dirt in its largest -sense, as matter in the wrong place, whether in air, water, food, -clothing, habitation, soil, or contact, is undoubtedly a main physical -cause of disease. - -But in all epidemic disease the emotion of fear must be recognised as a -most potent predisposing cause. The great fact of mind or emotion is a -powerful influence in producing, in preventing, or in curing disease. - -This psychological side of medicine is only beginning to receive due -attention. As the fallacies which arise in animal experimentation -from the production of fear, pain, and coma have not yet been fully -recognised, so the inevitable influence of mind in modifying physical -conditions has never yet been studied scientifically in human medicine. -Yet facts exist in unsuspected abundance which need to be collected, -verified, tabulated, and their laws of action diligently studied. - -It is known that even that strong muscle the heart may be ruptured by -the agony of intense emotion. At Blackburn the daughter of a woman -charged with theft became dumb with horror at her mother’s sudden -arrest. Hydrophobia, cholera, and even small-pox, appear to have been -caused by fear. - -The extent to which even the so-called microbes of infectious -diseases may be produced by fear acting on idiosyncrasy demands very -serious investigation; for as it is now generally conceded that morbid -micro-organisms do not exist _ab æterno_, it is essential to know by -what unhealthy conditions the micro-organisms, or living particles that -always surround us, become disease germs. - -One of our most distinguished London physicians has full records of -the following noteworthy case, which is given, not as scientifically -proved, but as indicating a line of research which it is folly to -ignore or refuse to investigate. - -This gentleman attended a patient some years ago in an attack of -confluent small-pox under these remarkable circumstances: This -patient had always exhibited a morbid horror of the disease, refusing -to hear anything about it or to allow it to be referred to in his -presence. A friend on one occasion brought a very fine collection of -anatomical plates to show him, sent over from France. Amongst them -was a representation of confluent small-pox in a woman. No sooner had -this gentleman beheld it than he cried, ‘Take it away! I cannot look -at it; it makes me ill!’ The next day his son sent for the doctor to -see his father, who had felt unwell ever since the shock of seeing the -pathological plate. He was found suffering from the first symptoms of -an illness which proved to be an attack of confluent small-pox. The -most searching inquiry failed to discover any traces of the disease, -either in the neighbourhood or in any connection whatever with the -patient. The cause of this illness, one of the most severe cases the -doctor had ever met with, remained a mystery. - -It has become of vital importance to investigate ‘how far the mental -attitude determines or permits the onset of infectious disease.’ - - - - - CHAPTER XI - - _The Range of Painless Research_ - -‘I am content to let Nature do all the torturing and man all the -relieving ... the grandest physiology and physiological discovery could -exist outside every shade of painful experiment.’[20] - -These are the words of one of our wisest physicians, deliberately -written in the full maturity of a life devoted to original research and -its practical application to medicine. His experience led him to the -recognition of this great truth: that the supreme aim of the medical -profession must become more and more the advancement of sanitation. In -any comprehensive view of medical art as a science the cure of disease -is rationally secondary to its prevention. - -This, notwithstanding the trade exigencies of competitive living, -is recognised by the established rule of the profession--that the -physician’s first duty is not to injure his patient. - -Sanitation necessarily takes into consideration all the elements, both -mental and physical, of our complex nature. - -It is by the investigation of the laws of healthy created life and -their practical application that progress in medicine must be looked -for. By observing ‘scientifically’ the method and variations of these -laws we shall approach nearer to the understanding of ‘vital force.’ - -An immense range of biological inquiry urgently invites the genius of -those who are gifted with the rare power of original research. - -This range is practically unlimited. The collection of all useful -or suggestive facts gathered by genuinely scientific methods from -the enormous accumulations to be found in our Government reports, in -the records of our medical periodic literature, in the observations -of hospitals, societies, cliniques, and private practice, would, if -properly arranged and tabulated, form a most useful branch of such a -centre. If such collection and examination were extended to the records -of other countries, the value as well as labour of the work would be -greatly increased. - -The observation of the dietetic and hygienic as well as medical -treatment of disease, including climate, soil, atmospheric conditions, -the distribution of disease, the effect of occupations, prenatal -influences, and later training, are essential. - -The action of mineral waters, of compressed and medicated air, the -hydration of tissues, the conversion of vegetable into animal tissue, -the action of the various constituents of the human body as curative -of disease, present necessary subjects of investigation. - -A careful judicial inquiry into the claims of specific cures, where -a sufficient case for investigation is presented (as _Echinacea -angustifolia_ in snake-bite, also the Russian bath as preventive of -hydrophobia), would form another valuable department. - -In fact, it is impossible to specify the full range of important -subjects which demand the devotion of able and painstaking research, -working upon the careful study of each type of life for the benefit and -improvement of that type. - -In no branch of this wide range of inquiry is painful experiment -necessary. - -Our homes, our industrial occupations, our legislative enactments, -should all be guided by hygienic knowledge, and its diffusion should be -actively encouraged by the community. Our hospitals and dispensaries -need to promote practical hygiene. Our medical schools should turn the -force of their learning, ability, and great influence to the conversion -of their students into a vast body of sanitary missionaries. If our -thousands of medical graduates turned out every year into practice -could go forth inspired with enthusiasm for health, convinced that the -preservation of health was their especial work, and that all disease -must be regarded as a violation of the laws of health, a violation -which it was their special duty to fight against, a mighty step in the -advancement of medicine would be taken. The impulse to such progress -should come from improved instruction in our medical schools, and in -the management of our hospitals. - -We much need also an unprejudiced and exhaustive history of the -progress of biological inquiry since the Middle Ages, with its present -result in therapeutics. Such a history may be expected to confirm the -not unfounded opinion that the most important advances in practical -medicine have been made by methods which are not in any way at variance -with our natural instincts of justice and mercy. - - - - - CHAPTER XII - - _Recapitulation of Principles_ - -I. The attainment of truth, not the gratification of curiosity or of -personal ends, is the sole and distinctive aim of genuine scientific -research. - -II. It is a radical intellectual error to apply the same methods of -investigation, suitable to inorganic facts, to the study of organic -facts. Natural law being mind ruling matter, every method employed -in research into organic Nature must respect and take into account -the inseparable mental factor in each type of sentient life, or it -becomes unscientific, and may promote fallacy, not truth. Destructive -experiment on living creatures, even under the partial suspension -of consciousness produced by anæsthetics, is an erroneous method, -producing confused or contradictory results. - -III. Scientific research in biology must be based upon close and -extensive observation of the varying forms of animal life, under -natural conditions, with post-mortem examination of the records left by -health and disease. Experiments, whether for the repair of lesions or -the cure of disease, can only become scientific when made upon the type -of life to be benefited by the experiment. - -IV. Any experimentation which creates involuntary suffering in living -creatures vitiates the necessary conditions of scientific research, -and tends to degrade human conscience by producing indifference to -suffering. - -V. In training our future practitioners of the healing art, the -cultivation of respect for life and the strengthening of enlightened -sympathetic conscience in dealing with all poor or helpless creatures -are of paramount importance. The present system of medical education -requires revision in order to make health, not disease, the central -subject of study. - -Finally, full and generous encouragement to those who are engaged in -important painless research is urgently needed. Such research should be -carried on, if possible, in connection with the great body of serious -scientific investigations, by persons of proved ability and clear moral -sense, and the work should be cordially open to the observation of all -earnest friends. - -Such research, reconciling by right methods of investigation -intellectual activity with human conscience, would increase our -knowledge and advance our well-being in accordance with the higher -reason of the race. Only when thus guided by intelligence and -conscience can biological research deserve the noble name of science. - -It is by the recognition of this true method of biological research -and by the generous support of physiologists who honestly seek for -truth, even when opposed by temporary fashions of medical opinion, that -medicine will become a science. - - -FOOTNOTES: - -[10] Sir B. W. Richardson, _Biological Experimentation: its Functions -and Limits_, p. 15. - -[11] This sound method is well exemplified in the writings of the -French naturalist, Le Roy. - -[12] The former horrors of the hospital operating-room are graphically -described from personal observation in Sir B. W. Richardson’s treatise, -_The Mastery of Pain_. - -[13] See the standard work of Hirsch, _Handbook of Geographical and -Historical Pathology_ (New Sydenham Society), vol. ii., pp. 416-466. -The value of this translation is greatly increased by its excellent -index. - -[14] Thus, the authorities of Paris ordered twenty friendless dogs to -be tied to the branches of trees in a wood, and a shell made in the -municipal laboratory exploded amongst them, riddling and mangling them -fearfully. - -[15] The humane and carefully-guarded Bill drawn up by the Royal -Society for the Protection of Animals, and introduced by the Earl of -Harrowby and Lord Carnarvon, was rejected. - -[16] The judicious remarks of Lord Farrer in relation to municipal -affairs apply equally to the subject under consideration. He says: ‘My -immediate object, however, is not to preach upon the general question, -but to make a practical suggestion. What we want to know is, Which of -the two ways of doing any particular work is the cheaper and better? -Much experience of public departments leads me to doubt their own -reports upon their own doings; not, of course, from any dishonesty on -the part of the officials, but from a natural tendency in every man to -make the best of what he does. It is for this reason, as well as from -want of sufficient experience, that I cannot feel absolute confidence -in the reports made to the London County Council on the results of -their own experiments.’ - -[17] ‘Professor Leon le Fort, Professor Verneuil, Professor Duplay, -and Professor Tillaux, have been asked by a public journal for their -opinions on the operative mania (_furie opératoire_) said to be -prevalent at present. Professor le Fort says it is much more widespread -in France than in other countries, and in a long letter he protests -against the custom amongst the young French surgeons, in order to -bring their names before the public, “to seek out some operation -unknown in France, then seek out a victim on whom they can perform -it, in order to report it before a medical society, and perhaps also -show the patient.” Then, says M. le Fort, they take up the operation -as a speciality, perform it on 100 or 200 patients, and thus gain a -reputation. Professor Verneuil protests against the abuse of operations -in general, and especially of gynæcological operations. He deplores the -prurigo secandi with which so many of the French surgeons are attacked. -Professor Duplay and Professor Tillaux express the same opinions.’ See -_Medical Reprints_, May, 1893. - -[18] This naturalist, when amongst cannibals in the Emin Pasha -Expedition, bribed the cannibal tribe to eat a young negro girl. - -[19] The entirely negative results of all experiments made upon the -lower animals to determine if cholera is communicable, or where the -poison resides, is demonstrated by an endless series of experiments on -the lower animals made in many countries. The extent and severity of -these experiments, as well as their inconclusiveness, is impartially -detailed in the classic work of Hirsch, _Handbook of Geographical and -Historical Pathology_, vol. i., pp. 476-480. - -[20] Sir B. W. Richardson, _Biological Experimentation: its Function -and Limits_, pp. 92, 93. - - - - - CHRISTIAN SOCIALISM - - _THOUGHTS SUGGESTED BY THE EASTER SEASON, 1882_ - - - - - CHRISTIAN SOCIALISM - - -About thirty years ago a little band of ardent and earnest men joined -themselves together as Christian Socialists, under the guidance of -the Rev. F. Maurice, Rev. Chas. Kingsley, and other able and hopeful -leaders. They shared in a high degree that ardent desire after -‘Practical Christianity’--that embodiment in every act of daily life of -the spirit of our Master’s teachings--which has always existed in the -Christian Church, and which can only cease with the disappearance of -the Christian faith. - -The grand idea of human brotherhood is a vital principle of our Lord’s -teaching. It is the foundation on which He builds His Church. But -practical Christianity cannot exist unless political and social economy -are founded upon this principle of brotherhood. Trade and manufactures, -agriculture and education, national government and the individual -home, are not Christian unless they are inspired by this central -principle, laid down by our Divine Master, and reiterated in every page -of His wonderful life--viz., that we must live as brethren under the -inspiration of a wise and loving Father. - -Attempts to realize more fully this fundamental portion of the -Christian faith, by special associated efforts, have always been -observed in every age. From those early times when the disciples laid -their offerings at the Apostles’ feet, and strove to ‘have all things -in common,’ to the present day, the attempt to secure higher ends by -the power of combination--a combination inspired by the highest idea of -right--is always going on. - -Christian Socialism, therefore, is no new idea. It is as old as -our faith. It is the shaping of actual daily life on the principle -of Christian brotherhood. It enters in some degree into every -association--church, chapel, or society of any kind whatsoever--which -seeks to embody an unselfish or a higher spiritual idea; but the -Christian Socialist believes that the structure of society in every -part should be moulded by the idea of united interests. - -The very gradual acquisition of wisdom by our race, however (a slowness -which seems to be the necessary condition for securing both freedom and -strength), leads to the frequent exercise of zeal without knowledge. -Direct attempts to join people together under better conditions -than the haphazard methods by which villages swell into towns have -frequently ended in failure. - -But each successive generation enters upon active life with increased -intellectual development and with increased command over material -forces. If equal enlargement of the moral nature accompanies the growth -of intelligence, then the generation has made a solid advance in -wisdom, and the practical Christianity of true brotherhood is nearer at -hand. The Christian Socialist believes that many principles on which a -better society must be founded have come into clearer light during the -past thirty years, and have been, and are being, tested by varied and -valuable experiment. - -The term Christian is here used in a legitimate practical sense. -Reverently and heartily a Christian must accept the rule and guide of -life so emphatically laid down by our Master--viz., that in eating and -drinking, in buying and selling, at home and abroad, we are to act for -our brethren, not for ourselves alone. We are to seek, first of all, -righteousness. - -The problem we have to face is the ever-increasing amount and -variety of evils which we see around us, and to ascertain how far -this is caused by the present selfish structure of society, by the -false individualism which hypocritically asks, ‘Am I my brother’s -keeper?’ Evils now increase upon us more rapidly than we can remove -them. Pauperism and vice, drunkenness and crime, mammon worship and -frivolity, dishonesty and corruption, are all bred by ourselves. They -are largely produced by the conditions of the society into which -children are born, and by which they are moulded. Ten years of squalor -or degrading conditions may deteriorate or ruin the nature of the -child. My attention was once called to a bright and charming little -girl, brought to a public institution by a poor mother fallen into -sickness and poverty. One year was given to the mother to reclaim her -child. On a subsequent visit, after eighteen months’ interval, I failed -to recognise that child; her brightness was gone, her movements had -grown listless and awkward, her intelligence was dulled, her expression -vacant, she was sinking with frightful rapidity into the hopeless -pauper. - -How pitiful are the results of our penitentiaries and reformatories, -of our workhouses, orphan asylums, and industrial schools, of all -the various charities by which we painfully and vainly try to mop up -evil and misery, or to sweep it out of our sight. The recipients of -punishment or care, when released, in the large majority of cases, fall -back again into the crime, temptation, and evil from which they had -been taken, and the flood of ruffianism and vice rises ever higher. - -In the hard and crushing strife for decent living in which the great -mass of our population are entangled, health is injured, hope dies out, -and the gas-lighted gin-shop is the solace, as the dreary workhouse -is the refuge of those who have ceased to hope. Yet the great mass of -these persons have tried to do honest work. They have once hoped to -support wife and children as an honest man should do. How is it that -capital and labour have failed to come together in such a way that -every willing worker can secure a comfortable livelihood, that every -honest man can bring up his family in health and virtue? The relation -of capital to labour is a vital question of practical Christianity. - -Consider also the great agrarian fight always going on to some extent -and periodically breaking out in revolution and outrage. Why is it that -the great bulk of English men and women are divorced from the soil? -Why are they always crowding into towns, whilst the precious natural -heritage of land is so often wasted and going out of cultivation? -Health and happiness should be found in country life. Such a life -should not be one of dreariness and ennui, or of hopeless drudgery. -There is no life so suitable for the healthy development of childhood -as a country life, with natural home influences. The care of animals, -the cultivation and observation of natural objects, the pure air and -abundant exercise which can be enjoyed, mark the country as the natural -home of childhood. Again, the production in perfection and abundance of -all the articles which naturally belong to various soils is a primary -need of healthy national growth. The conditions under which such -cultivation can be best carried on, with the kind and proportion of -manufactures which might advantageously spring up in connection with -it, affect the very structure of society. They provide the necessary -material and social conditions which furnish the possibility and -favouring of a religious life, or which create serious obstacles to -such a life. - -The relation of the people to the soil of their native land is a very -serious question of practical Christianity. - -Again, in what manner is the education of the various classes of our -children carried on? Consider the education given to the boys of the -aristocracy and upper classes. What chance have these lads of growing -into a sense of Christian brotherhood? They are fawned upon from -babyhood; initiated at school into the most heathen vices; corrupted -by luxury, taught that money can do everything, that rank will be -servilely worshipped. How can these poor lads become the large-hearted -leaders of a society founded on the Great Master’s teaching of -brotherhood? The character of education does not depend only on the -more or less wise oversight and arrangements of the schoolmaster, but -still more on the constant influences of the life in which the child -grows up. Trace the various stages of education downwards, through -all classes of the community, to the enormous mass of little boys and -girls trained from babyhood into vice and ruffianism, and we see that -education is a vital subject of practical Christianity. - -Consider next the relations of the sexes. This subject is the -fundamental question of society, for the element of society is the -man, woman, and child, not the individual. How do our laws and customs -inculcate manly honour, womanly dignity--in short, Christian life? -Carefully studying this subject in its widespread ramifications, it -is seen to be the deepest question of human brotherhood--_i.e._, of -practical Christianity. - -When, proceeding from more private to public affairs, we examine the -modifications or arrangements of municipal institutions which have -arisen in our towns, the examination is not encouraging. It is the -heathen, not the Christian, principle which is chiefly exemplified. -It is self intensified. The new power created throws off a sense -of responsibility to those who create it. No enlarged sense of -duty springs from the trust that is thus given to individuals; but -petty cabals and bickerings arise, narrow party views are fostered, -selfish interests advanced, or a foolish air of authority is assumed. -The more high-minded inhabitants shrink from entering into corrupt -political contest; centralization increases as municipal control is -degraded. Local and general government is too often only a parody of -representative institutions. The important question arises, In what way -can we who believe that public as well as private life should be guided -by a religious spirit attain the end? How can we form associations and -delegate necessary authority in such a way as to advance Christian, -not heathen, life? In observing the effect of Law upon the education -of a nation, we find that its embodiment in government forms a very -important branch of practical Christianity. - -When we ponder all these vital questions, and earnestly strive to -put into practice the principles of action which we believe to be -profoundly true, we find our Christian sense of right shocked at every -turn by fixed conditions, which are the result of selfishness, not of -brotherhood. The spirit of self-interest, only useful as a servant, -has usurped the false position of master. Like all our faculties, -self-interest needs a higher guidance, or it degenerates into the -narrowest selfishness. We have not yet learned the one grand lesson of -Christianity--viz., that the largest view of self-interest can only be -found in brotherhood. - -The inquiry now to be made is whether any new principles of -association, co-operation, combination--or by whatever name we choose -to express united interests--have so grown and been proved within the -last generation, that we may make successful advance on the path dimly -seen by the noble men I have referred to. - -There have been many failures in attempts at the realization of -associated or organized life; but there are also many and striking -examples of successful, though imperfect, organization, founded either -upon a religious idea or on business enterprise, or on the enthusiasm -of some clever and benevolent individual. Roman Catholic, Moravian, -and Shaker communities will illustrate the first series of successful -organization; joint-stock enterprises and co-operative stores the -second; Leclaire’s house decorators’ guild and the Familistère of Guise -the third. It is through union of the forces exemplified in these three -classes of association that we may attain to a nineteenth-century -realization of practical Christianity in the future growth of towns or -colonies. - -The following are some of the chief applications of the principle of -Christian brotherhood, which we believe will remould the structure of -future society: - -1. The repurchase of land by Christian joint-stock companies, in order -that its control and management may henceforth belong to those who live -upon it and use it. - -The absolute irresponsible individual possession of land becomes, as -society advances, contrary to the best interests of a nation. The soil, -which is limited in quantity, but indispensable to the maintenance and -welfare of the people, should not be treated as an individual selfish -speculation, regardless of its most advantageous use, and of the needs -of those who may live upon it. - -It is the slow but sure result of the irresponsible monopoly of the -soil by individuals which is at the root of a great evil--viz., the -unnatural and diseased growth of great unorganized or selfishly -organized towns. Our towns, formerly the haphazard growth of accident, -are becoming more and more the growth of selfish speculation--_i.e._, -the false organization of self-aggrandizement. The hereditary or -other holder of land leases it to speculators, whose one object is -to make as much pecuniary profit as possible out of the lease. This -is the one point held steadily in view, often through a series of -underletting, in which each fresh speculator seeks to make a new -profit. Health, convenience, human welfare in its necessities and -interlinkings, are never thought of, or are entirely secondary to -gain. A showy neighbourhood for the rich, yielding the highest rents -that can be screwed out, and a crowded neighbourhood for the poor, -with still higher proportionate rents, are created. Gardens disappear -in the dreary mass of showy, badly-constructed brick-and-mortar -quarters in which the young generation grows up--dreary quarters, but -where rents and rates are constantly rising. This is the result of -irresponsible individual ownership and perverted organization in all -our rapidly-growing towns. It is a potent cause of growing immorality. - -The control of land by a society or colony living upon it and using it, -does not forbid the leasing of land, under wise conditions, to persons -who are members of the society. It is the irresponsible individual -possession of land, with the speculation which such a method of holding -gives rise to, which is the principle always ultimately injurious to -society.[21] - -2. Economy in distribution and management. A rational economy in the -retail distribution of products, in the domestic arrangements of our -homes, in the official management of local and general government, will -set free an immense number of persons whose time is now needlessly -occupied. The talent and energy of this wasted multitude should be -turned to increase of production and other necessary and valuable -employment, under the wise freedom of united interests. - -3. A fair share of profits to all workers. This is a most important -principle, which can only be solved under the guidance of Christian -brotherhood. In the increased production which will result from wise -economy in distribution, management, and government, an equitable -division of profits between capital, ability, and labour must be -arranged. Interests must be united, industry stimulated, and hope held -out to the humblest worker in a Christian colony. When a young man -commences life in the honourable estate of Christian marriage, it is -the first duty of Christian society to support his hope and energy. The -future of this family is a matter of national concern. Steady industry -deserves a fair and increasing share in the profits it helps to -create. Counsel, if needed, encouragement to the mother in the healthy -and virtuous education of her children, and opportunity for hopeful -occupation, are all positive duties owed to every member of a Christian -society. The fulfilment of this duty depends in a great measure upon -the righteous relation of capital to labour. - -4. The formation of insurance funds which will secure aid to every -worker in sickness or old age. Thrift, self-control, and an honourable -sense of independence are the results of such provision, which would be -the greatest possible aid to the noble temperance movement. - -5. An arrangement of dwellings which will facilitate communication, -domestic service and supply, sanitary arrangement, the education of -children, and municipal government. These objects must be secured if -the rapid degradation of our poorer English homes is to be checked. -Parental influence and responsibility are equally disappearing in the -homes from which all sanctity has departed. - -6. The entire abolition of all trade in the human body. - -The waste of virile force and the degradation of womanly character -which result from the barbarous remnant of slavery existing in our -midst under the form of prostitution is incalculable. No community -which aspires to Christian life can permit this hideous trade to -exist. The buying and selling the human body is a natural wrong. The -fearful evils, moral and physical, which result from such trade prove -its inherent iniquity. Love, with the duties and responsibilities -which accompany its expression, is the only Christian warrant for the -intimate union of the sexes, and the growth and welfare of society -absolutely depends upon the wise guidance of these relations by -Christian principle. The wonderful advance of intelligence and moral -perception on this vital subject during the present generation is -the most hopeful sign of the nearer approach of organized Christian -society. As a striking contrast to growing immorality, the possibility -and incalculable benefit of equal purity for boys and girls, for men -and women, is the great truth which is springing into vigorous life -in this Nineteenth Century. A new world of hope and freedom opens to -women, a new realm of energy to men, from the consecration of this -mighty power of sex, which is descending upon our age as a great guide -for the future. This God-created force has hitherto been squandered -in these earlier centuries of our world’s life. Ignorance of woman’s -true dignity and providential position has been the greatest obstacle -hitherto in the Christian organization of society. This ignorance now -slowly but surely vanishing, opens to us a great and glorious promise -of unlimited future progress. - -The principles thus expressed in very condensed form appear, from -their present maturer development, to be the especial gain of this -age. They are the legitimate results of Christian thought, growing in -comprehensiveness, and conscientiously applying itself to a solution of -the problems of social life. - -Every proposition now set forth requires, however, long and careful -consideration. Some persons may not realize the dangerous and growing -evils which the prevalence of opposite methods of action is inflicting -on society. Young countries possessing abundance of unoccupied land may -not appreciate evils from which older countries suffer from individual -monopoly of land. Other persons may fail to see the full bearing -of these principles of Christian Socialism on our daily relations. -Others, again, may be entirely unable to foresee the methods by which a -Christian organization of society can ever become a practical fact. For -these reasons union in preparation is indispensable. The wisest ways -of realizing these principles in all their practical details require -the varied knowledge of different classes of persons. They require the -careful consideration of many minds, possessing both varied experience -and a profound sense of the necessity of Christian organization. If, -however, the principles laid down are true, then their realization must -be only a question of time. In our towns much may be done to place both -business relations and domestic life on a sounder basis. The gradual -introduction of methods leading in the right direction is possible, -by both men and women, in the two spheres of business and home life, -when the end to be obtained is thoroughly understood. A still more -rapid advance may be made by those who wish to establish country life -on a more Christian plan by uniting religious principle, joint-stock -enterprise, and wise guidance in the organization of an industrial -colony--a colony which would be the most potent Christian Missionary -Society. - -Religious principle must be recognised as the essential basis of -permanent future growth. Only a large comprehension of the Christian -teaching of human brotherhood creates the highest conscientiousness, -with a sense of responsibility to an unseen but parental Creator. No -accumulation of material wealth, no appeal to the lower faculties of -our nature alone or chiefly, will ever hold human beings together in -permanent and harmonious organization of daily life. - -Christian conscientiousness is the only power we know of, capable -of controlling and guiding selfhood. This controlling force is -indispensable in any wise effort to unite human beings together in -the varied interests of everyday life. Without religious principle -we possess no efficient check either upon the selfish scramble for -wealth, or on the soulless pursuit of science, or on the enthralment of -physical pleasure. - -Consider some of our popular social maxims--‘Charity begins at home,’ -‘Take care of No. 1,’ ‘Competition is the life of trade,’ ‘Demand -must govern supply,’ ‘Buy cheap and sell dear,’ etc. No one will deny -that there is an element of truth in all these maxims; but their -direct logical results, pushed to an extreme under the sole guidance -of selfish interest, become diabolical. This is clearly illustrated -by a remark once made to my own father by a Southern sugar-planter. -He stated that he could raise slaves so cheaply that it was the most -profitable plan to use them up in five or six years, and supply their -place with fresh ones! - -The same necessity for the guiding influence of Christian -conscientiousness is seen in the pursuit of science. The modern -dicta, ‘Medicine has nothing to do with morality,’ ‘Knowledge is its -own end and justification,’ are the maxims of heathen, not Christian -philosophers. Indeed, many of those who now pursue scientific -investigation willingly assent to this statement, having lost all -knowledge of the value of true Christianity as the highest spiritual -guide of our race. - -Accepting, then, the principle of Christian brotherhood as the -necessary religious foundation and constant guide of any true -organization, it is evident that all these weighty problems, now -briefly indicated must be considered and solved by the ‘Church.’ - -A Church, in the true sense of the word, is a society of men and women -who, accepting the Divine Mission of Christ, strive honestly to embody -His teaching in daily life. As each age grows out of the life of the -preceding age, so the practical incarnation of our Lord’s teaching -varies in form from age to age. In 1882 the form which Christian life -takes must necessarily vary from its form in 1800. Three generations -of men have gained immensely in intellectual, scientific, and moral -development. All the conditions under which human beings grow up -have changed. What we now especially and urgently need from the -‘Church’ is aid in adapting the never-changing principle of Christian -brotherhood to the ever-changing conditions of Nineteenth-Century -life. We need sermons and conferences and earnest life in the Church; -but the sermons must take up the Christian view of the relation of -capital to labour, the Christian view of the relation of the sexes, -the Christian protection and sound education of the young--in short, -the whole conduct of life, from the cradle to the grave, in private -and public. A certain inevitable hypocrisy is engendered by listening -week after week to lofty theories which are never put into practice, -or to impracticable suggestions. The soul grows callous when teaching -demands one course of action and daily life enforces a quite opposite -course. We need to learn in what way our actual life, public and -private, can be guided by our Lord’s injunction of brotherhood instead -of selfhood. Our Church Conferences should be the honest and eager -effort of every man and woman to consider together how these true -principles can be carried out by them. A Christian Church Conference -must ponder the life of that army of little drudges in our underground -kitchens, of the blasphemous boys and girls who gather at night in our -public places, of the vicious roués who crowd on us from London, of the -struggles of the poor householder who knows not how to pay the heavy -rent, of the tendencies of the trader oppressed by taxes, who sinks all -scruples in the desire to get money, and of the speculator whose one -desire is to make ‘wealth accumulate, though men decay.’ These are the -problems for Church Conferences which the practical Christianity of the -Nineteenth Century urgently requires should be solved. - -It is only on these humble but indispensable foundations that a Church -which meets the needs of the age can be founded. It is only in a Church -so founded that prayer and praise and the worship of the Great Father -can become a glorious reality, and never sink into formalism. - -A true Church, then, suited to the needs of this age, must be a -self-governing, industrial community, guided by Christian principle, -holding and managing its own lands, varied industries, and colleges. -It should send off out-shoots from time to time, new self-governing -colonies at home and abroad. These colonies necessarily possessing -varied individual colouring, according to occupation and composition, -should all agree in the one great uniting principle--organization on -the principles of Christian brotherhood. The Christian idea of united -interest, instead of the narrow antagonism of individual selfishness, -will be the distinguishing mark of true Church colonies--the practical -Christianity of the future. - -There are large numbers of sincere followers of our Spiritual Guide -who clearly perceive the radical evils above referred to: persons who -long to devote thought, time, and means to the labour of forming a -Christian society; persons who would rejoice to leave their possessions -to the noblest Missionary work of the age. But these earnest seers are -scattered far and wide; they require the indispensable strength of -union. A grand work is before all the Churches to join their members -together under the noble banner of Christian Socialism. By careful -study of the various practical examples which now exist of successful -although imperfect organization, preparation can be made for union -together in the formation of a true Church Colony. A band of Christian -Socialists thus uniting in earnest preparation (whilst neglecting no -immediate duty) will be strengthened and guided in the course of a few -years to initiate the most important and urgent work that our age now -calls for. - -The meaning of the Easter season is the arising of Christianity from -the grave--that grave where it lies bound in darkness, corrupting in -worldliness, dying through selfishness; but, thank God! not yet dead. -May our religious people awake from their fatal lethargy and roll away -the stone from the sepulchre, by the establishment of a true Christian -Society! - - -FOOTNOTES: - -[21] The works referring to the economic principles laid down in this -paper, with the statistics and experiments which support and illustrate -them, are too numerous to mention here; but they are of the utmost -value to the Christian Socialist. - - - - - ON THE DECAY - - OF - - MUNICIPAL REPRESENTATIVE GOVERNMENT - - _A CHAPTER OF PERSONAL EXPERIENCE, 1885_ - - - - - ON THE DECAY OF MUNICIPAL REPRESENTATIVE GOVERNMENT - - -It is only in the belief that a simple narrative of facts, exactly as -they occurred, will show more vividly than an abstract statement can -do, the dangers which threaten our free institutions, that I venture to -offer this personal narrative to municipal voters, and particularly to -women householders. - -When, in 1879, I became a householder in Hastings I did not at all -realize that I thereby acquired the right to vote in municipal -affairs, and that this right necessarily involved a corresponding -duty and responsibility--the duty, viz., of voting intelligently, -and necessarily a certain responsibility for the way in which the -government of the town was carried on. - -I soon observed, however, that in the autumn, although I was neither -a Conservative nor a Liberal, I was called on by the Conservative and -the Liberal candidates for election to the Town Council to ask for my -vote, and although these visits often led to interesting conversation, -and my opinions were assented to with the most flattering courtesy -before the elections took place, I soon perceived that all influence -ceased with the election; the matters went on in the same way without -me as with me, and my supposed privilege of voting seemed really to -be very much of a mockery. Being, moreover, a peaceable person, and -much occupied with subjects of interest, it appeared to be rather a -waste of time to concern myself with an election which was managed by -cliques on strictly party issues, with no regard to questions of social -well-being, nor necessarily to the selection of the wisest and best -man, but only of the person who could in any way secure the largest -party vote. - -Being compelled, also, as far as my limited powers of observation -admitted, to criticise the two great parties of the State, as both -committing much injustice, and as rather guided by class selfishness -than by high morality, I could not feel any enthusiasm for elections -carried on by party strife. - -I thus began to fall into that easy state of indifference which -seems rapidly becoming the general condition of the mass of people -who are supposed by their votes to control municipal affairs; I -retained, however, an uneasy consciousness that in some way I was -failing to meet a duty that was laid upon me. I was roused from this -fatal moral lethargy by witnessing what seemed to me an act of gross -injustice--viz., a robbery of the poor of their inheritance. This -was the diversion of the funds of the Magdalen Charity (a bequest -from the piety and beneficence of past ages, now grown to an income -of some thousands annually) to the foundation of a middle-class -grammar school. The injustice was committed under the sanction of the -Charity Commissioners, notwithstanding a brave fight by some of our -conscientious inhabitants, carried on for more than two years. But -class interests and short-sighted officialism proved stronger than -justice in this case. - -So painful an experience effectually opened my eyes to the irreligion -of not attending to the duties which lie nearest to us, and I saw that -the condition of the poor is very near to us. I fully realized, also, -for the first time, the constant duty which rests upon all those to -whom special municipal rights are given, to concern themselves with -the management of the town in which they live, this responsibility -especially resting upon every one on whom is laid the duty of voting. -Beginning, then, to attend my parish meetings, my sympathy was soon -aroused by seeing the bitter struggle of the industrious poor going -on all around me, to avoid sinking into pauperism. Cases of inability -to pay the rates were constantly coming before us[22] from weary -struggling men and women, who, if they sometimes ‘drink and forget -their poverty,’ demand pity more than blame. - -Every year the pinch of poverty grew sharper. My own respectable young -servant could not marry her decent lover because rent was so dear. As -roomy lodging-houses and hotels spread along the sea-front, speculation -grew, and the mass of the people were huddled together in smoky cram -or squeezed out into dreary suburbs, far away from their work or from -opportunities for honest industry. I soon also learned the horror -with which the poor regard the workhouse; how they would willingly -die in peace in the forlornest home rather than be forced into what -they regard as a hopeless, cruel prison. My indignation deepened as I -thought of the deed still in our archives, in which, ‘I, Petronilla de -Cham, of Hastings, in the pure and lawful power of my widowhood,’ grant -a tract of land for maintaining the poor old men and women of Hastings -in decent maintenance and godly service; the brothers and sisters -of the Magdalen Hospital. ‘And I, Lady Petronilla and my heirs will -warrant and defend the aforesaid five acres of land with precincts, -to be held by the brothers and sisters freely, quietly, well, and -peacefully for ever,’ they praying for the souls of their benefactors. - -As descendants of humane and pious ancestors, it seems to be as clearly -a religious duty to consider the condition of the poor in 1885 as it -was in 1292, when Lady Petronilla de Cham made her foundation gift to -the Magdalen Charity. - -The more I considered this important problem of how to aid the -struggling poor in their heroic efforts to live decently, the more -important to my mind became the subject of taxation; how the rates -of a town are raised, and how they are expended. Unhappily, we see -all over the country that, in the same way, ancient endowments for -doles, retreats, pensions, and portions are swept away because the -workhouse system is said to provide for the poor; ancient endowments -for training, clothing, and apprenticing poor children are also swept -away, because the ‘Board of Education provides for the poor.’ Thus -the various necessities of social life, education, benevolence, etc., -are being committed to the hands of officials--_i.e._, everything is -rapidly being thrown upon the rates, until the rates crush the poor -into pauperism. - -Now, the question of rates is not at first sight an attractive -one, particularly to a person who has unusually little talent for -arithmetic. But in the present day they take the place of ancient -beneficence, and are administered by Town Councils instead of Church -organizations. I therefore determined to attend a meeting which was -being called to meet the Local Government official, in order to obtain -sanction for a new loan. This was my first appearance at a ‘Statutory’ -meeting. To my surprise, when I took a seat at the Council Board, I -found that I was the only non-official ratepayer present, although -the sum to be borrowed was a large one. It was stated that this -proposal had received the unanimous assent of the ratepayers. To this -statement I was compelled to make a short protest, as I had learned -from inquiries that many ratepayers knew nothing about the proposed -loan. I was informed that the time for objections had not arrived; and -the London official proceeded to inquire into various details of the -way in which the loan of six thousand guineas was to be spent, extent -of grading, kind of concrete, etc. When all was completely settled I -was then requested to state any objection I had to make. I spoke of -the burdens of taxation on the poor, and I begged to know what was -the present debt of the town. I found that with this new loan our -municipal debt would be nearly a quarter of a million. This seemed a -very large debt for a small town, where the people found a difficulty -in paying their rates, and as a prudent housekeeper I objected to go -into debt for our municipal housekeeping. I was informed by the Local -Government Board Inspector that ‘that was a question to be settled at -the polls.’ So, of course, my single protest was of no practical use. -This occurred in August. I then thought that, as the November elections -were approaching, it might be useful to try and get municipal questions -discussed with the candidates who were to be elected for three years to -the Town Council. - -The proposed councillor in my parish cordially assented to the proposal -I ventured to make to him--viz., that he should meet the ratepayers -before the time of the elections, and discuss with them various -important questions which would come before the decision of the Town -Council. This gentleman willingly promised to attend such a meeting if -it were called. - -Unfortunately, I could not find any householder willing to aid in -such an effort. The following is a type of the responses received from -householders: - -‘I do not think my presence at a conference would be of any service. I -have so little knowledge of municipal affairs, never having attended -a meeting since I resided in Hastings.’ The same sort of answer came -from busy tradesmen and leisured gentry. It therefore seemed that a -more decided educational effort was needed, an effort to show our -voters how a Town Council really represented in modern days much of the -practical action of the Church in past ages, and that it ought really -to present the Theocratic idea--_i.e._, government by the Highest Good. -But here, too, unhappily, I could find no one who did not seem to think -that the function of a Town Council was to save them all trouble and -responsibility, and that it must be elected on party grounds. - -Thus, more and more I recognised the profound character of the disease -of indifference, which has become endemic in our municipalities, -and the urgent need of remedial measures. I therefore entered into -correspondence with the Social and Political Education League, which -has borne in succession the honoured names of Professor Seeley and -Mr. Froude as Presidents. I received a cordial letter from the -honorary secretary, who forwarded a list of 107 names of lecturers, -with numerous addresses that they would be willing to deliver. -Unfortunately, in this printed list of several hundred lectures I -could find nothing that met our special need--viz., short, simple, -progressive instruction, inviting questions, ‘on the use of a Town -Council and the meaning of a vote.’ I was meditating on what to do when -I became most unexpectedly involved in municipal work, where I was -compelled to take a prominent part, for which I was not fitted either -by knowledge or experience. - -At the town meeting in August already referred to, when the addition -to the public debt was made, a Corporation Bill was spoken of, which -appeared to be of very great importance, and which was to come before -the town later. I therefore watched the notices by the church doors, -and marked down the date of the Statutory Meeting, which must be -called in order to sanction this Bill. I was much surprised not to -see attention strongly called to this important measure by the local -press and others; but the local politicians were all in such a state -of excitement because Hastings was to lose one of its Parliamentary -representatives that the way in which municipal affairs were carried -on seemed to excite no interest. I called at the Town Clerk’s Office a -few days before the meeting to sanction the Bill was to take place, and -asked for a copy of the Bill, but was told that there were ‘no copies’ -for ratepayers; neither could the Bill be seen. I spoke to about ten -persons in the course of the day, but no one knew anything about the -Bill. I then wrote to several ratepayers to beg them to attend the -Statutory Meeting. One replied that there must be a mistake as to date, -naming a meeting three days later, which, being a ‘Party’ meeting on -Redistribution, entirely drew attention from the municipal meeting. -Another householder consulted a gentleman friend, who told her that -the proposed Bill was one to lessen taxation, so there was no need of -attending the meeting. I was unable to find a single ratepayer who knew -anything about the Bill, or had even heard of it. The time came, a -very stormy evening; about seventy persons attended out of over 8,000 -ratepayers. No one had seen the Bill, which, from the short abstract -given by a Councillor, was evidently of the utmost importance to every -class of the inhabitants, and particularly to the industrious classes. -It was urged by the Town Council Committee in charge of the Bill that -no opposition to it should be made, for two reasons. In the first -place, the next day was the last chance of registering the Bill for the -present Session of Parliament, and a year would be lost if the Bill -were not accepted that night; in the next place, it was stated that -any opposition would be very expensive to the town, for, as they had -already paid £500 for the expenses of the Bill, and would pay about as -much more to complete it, if any opposition were raised it would cost -the town some thousands of pounds. - -As no other ratepayer seemed to discover any flaw in these statements, -I ventured to suggest that, as no one amongst us had seen the Bill, -we ought not to sanction it without any opportunity of examination, -and that it would be better to lose a Session than do so. I therefore -begged to move an adjournment; this was seconded by a ratepayer, but -not put to the meeting. The Bill was accepted in the name of the -ratepayers by a vote of 47, the Parliamentary agent who directed the -proceedings most courteously assuring me that ‘there would be ample -time to object to the Bill in London.’ Of course, I knew, and many -of the poorer ratepayers present knew, that it would be too late to -consider the Bill after it was accepted in our names; but I was struck -with the inability of those present to formulate their objections, -although much dissatisfaction manifested itself in the meeting. Entire -ignorance (in which I fully shared) also existed as to what steps to -take in such a case. Had I insisted, as I ought to have done, upon the -motion for adjournment being put, it would probably have been rejected -by a small majority. But I was utterly ignorant of what was right to -do in such a strange position, and it seemed almost unladylike for me -alone to oppose the Mayor and Town Council, with their Parliamentary -Committee and legal advisers, particularly as it was insisted that -opposition meant distrust of the Council, whereas I thought simply -of my duty as a ratepayer. I did not know then, and no one present -seemed to know, that any ratepayer has a right to demand a poll; -and, if insisted on, it must have been allowed. In this case the few -pounds it would have cost the town would have been well expended, in -delaying what proved to be an exceedingly bad and retrograde Bill. But -nothing has struck me more in this singular experience than the utter -ignorance of all our otherwise intelligent burgesses as to the steps by -which their municipal rights may be guarded, either in the borough or -in London. This ignorance seems to arise from the inattention and habit -of indifference to municipal duties produced, not only by the pressure -of private affairs, but by exclusive absorption in party politics. - -As soon as the Corporation Bill was thus nominally accepted by the -burgesses, copies of the Bill were allowed to circulate. I saw at once, -on scanning this enormous Bill of 243 folio pages, thus sprung upon the -town, that it was a very retrograde Bill, and would prove especially -tyrannical to the poor. Being fully convinced that a fundamental duty -of any community is to guard the industrious poor from being crushed -into paupers, I looked at the Bill from that point of view, and was -shocked by it. It was drawn up to favour the growth of that modern -mistake, a fashionable lodging-house town, by endeavouring to attract -rich temporary visitors, instead of promoting permanent productive -industry. By its provisions it largely increased the debt of the town; -it withdrew expenditure from control of the ratepayers; it provided for -a largely-increasing bureaucracy, by placing all the new institutions -under officials of the Town Council; it confirmed and established a -virtual octroi on coal and the necessaries of life; it introduced the -most minute and arbitrary regulations in relation to building, sanitary -inspection, police arrests; it re-enacted the obsolete regulation -which regards vice as female; and in many other ways it sought to -convert the Town Council into masters instead of servants of the people. - -I immediately commenced asking individual ratepayers if they had seen -this Bill, which interfered with every class of inhabitant. No one had -seen it, and later inquiry seemed to prove that not one member even of -the Town Council itself had read the Bill carefully through, outside -the little Parliamentary Committee who followed the guidance of the -London official agent. - -I am glad to say that the first note of serious public alarm was -sounded by the Medical Profession, who, finding they were to be -turned into family spies by this Bill, refused to submit, and, having -an organized medical society unanimous in opinion, they commenced -an opposition to those objectionable clauses which affected their -position. But weeks of precious time were lost before attention was -aroused to the generally tyrannical character of the Bill. At last the -growing discontent found a voice in an active, enlightened burgess. -A crowded public meeting was held, attended largely by the poorer -ratepayers, and a committee was formed to see what amendments could -be introduced. But there was then not time to examine thoroughly this -enormous Bill before it was read in Parliament. Here, again, two -circumstances were noteworthy. First of all, the complete indifference -of the richer inhabitants to the Bill and to all that involved -trouble on their part, with the dread of the poorer inhabitants of the -frightful law expenses which opposition would entail. - -The second noteworthy point was the utter ignorance of all parties -as to the best and exact method of procedure in the various steps -necessary to be taken in seeking to amend or oppose the Bill--as, for -instance, the times allowed for the various stages, the parties to -address, the ways of addressing them, the rights of the burgesses to -appear, etc. No one, either layman or lawyer, possessed exact detailed -knowledge. - -For my part, I sought information at headquarters in London. Here, -once for all, I beg to state that nothing can exceed the courtesy and -often kindness with which my crude inquiries have always been met by -those highest in authority. Indeed, all my life long, though painfully -compelled to work against rather than with social conditions, I have -always found men eager to help an honest, unselfish worker. - -In London I learned some rather surprising facts. These facts may be -thus briefly summarized: First, that it is the effect of the action of -the Central Government to weaken the Municipalities by encouraging them -to run heavily into debt; secondly, that, taking advantage of their -weakness, they apparently intend to assume themselves the authority -that has hitherto resided in the Municipalities as self-governing -communities. - -These are very serious facts, not at all due, I think, to any -influence exerted by the enlightened heads of Departments, who change -with every administration, but to the enormous growing system of -permanent officialism, which acts like a tremendous machine, crushing -individual freedom, because it naturally seeks to work without -friction. The term ‘vortex,’ familiarly applied to the system when -any individual interest is drawn into its current, well expresses the -terrible power of these official forces. - -My first amazement was awakened by the reply to my objection concerning -the increased power of borrowing given by our Hastings Bill to a little -town of 40,000 inhabitants, that already had a debt of nearly a quarter -of a million. ‘What is the rateable value of your town?’ was asked. -‘£300,000.’ ‘And do you consider a quarter of a million a large debt? -Why, let me tell you, your town is most fortunate in having such a -small debt! Do you not know that Government allows you to borrow to the -extent of two years’ annual rating?’ - -Such was the astounding view taken by a political economist of the duty -of Government. I thought of our hundreds of poor ratepayers unable to -pay their taxes. I thought of the statistical report that ‘In Great -Britain the municipal and other local debts rose in the period of -ten years from 84 to 140 millions,’ and I was simply dumb with fear -for the future. For I have already seen that power to borrow means -encouragement to borrow, and that the municipal purse is not regarded -as a Trust, to be more scrupulously guarded than the private purse. - -My next discovery related to sanitary and police clauses, and -particularly to those which pressed especially upon women. I maintained -that there were no such things as good brothels; that they were -illegal institutions, to be gradually and steadily suppressed by the -growing morality of the people, who should be encouraged by increased -facilities to set the law in motion; and that any legal distinction -as to bad houses that were ‘a nuisance to the neighbourhood’ was a -mischievous distinction. I also pointed out that the term ‘prostitute’ -should be entirely struck out of all legislative enactments as an -obsolete injustice, and that any necessary checks to growing vice -should apply to ‘all persons habitually or persistently’ offending. - -These honest suggestions were considered quite impracticable in -official circles; but I learned that the Central Government would be -quite ready to strike out any unusual local provision in order to take -all sanitary and police measures into its own hands. - -This appeared to me a most alarming intention. Surely a deadly blow -would be struck at individual liberty if all sanitary and police -regulations were to be drawn into the ‘vortex.’ The mistakes of -municipalities rouse individual conscience, and may be turned to the -education of the community; but take away this natural power of growth, -and we become a feeble, self-seeking mass, swayed by demagogues, and -the slaves of official Bastilles. - -I began to understand the wide bearing of a fact that had excited my -surprise a short time previously. Scandals occurring in one of our new -parks, permission had been obtained from the Local Government Board -to place an additional policeman there. Noticing this fact, I asked -our Councilman: ‘Why on earth did you consult the Local Government -Board about our own policemen? Does not our Watch Committee attend to -our police matters?’ He replied: ‘Oh, don’t you know that the Local -Government Board pay part of our police expenses?’ Looking over the -Borough Accounts for 1884, there, sure enough, I find this police item: -Treasury contribution, £1,881 16s. 1d. - -Our poor tax-payers cannot pay their rent, so we rob Peter to pay Paul; -we get money from the General Government, which all have to contribute -to supply, with the idea of lessening local rates, and in return allow -the central authorities to interfere with our police. Surely this is -selling our birthright for a very deceptive mess of pottage! - -As our Town Council became aware of the legitimate discontent which -existed respecting the Bill they had sent up to London, with really -imperfect knowledge of its contents, they endeavoured with willing -courtesy to meet the Ratepayers’ Committee, and at the last moment for -legal opposition, certain important amendments were accepted by the -Council, which removed the power of arbitrary arrest by the police, and -softened some of the other harsh interference with individual rights. - -The People’s Committee were compelled to accept these imperfect -concessions. The limit of time for opposing the Bill had arrived. -No rich or leisured resident showed the slightest concern in this -measure. The remark had been made to me by a high London authority: -‘If your townspeople really consider this such a bad Bill, then -they have nothing to do but to put their hands in their pockets -and raise the money to oppose it.’ This remark shows how little -rich people, high in authority, know of the conditions of life in a -fashionable lodging-house town. The work of revising this Bill--work -necessarily incomplete--had been done by burgesses of moderate means -and overwhelmed by private cares, and the time needed for this public -work had been stolen from sleep. There was neither possibility of -withdrawing a Bill on which much public money had been already -expended, nor of raising the heavy sums of money necessary to carry on -legal opposition to it. - -Thus, a new Corporation Bill of most retrograde character has been -forced upon the town--a Bill which greatly strengthens the official or -bureaucratic organization, removes much of the control of ratepayers -over expenditure, plays into the hands of a centralizing Government, -establishes protective duties on the necessaries of life, and -vexatiously interferes in various ways with the legitimate personal -liberty of the inhabitants. - -The latest ‘Battle of Hastings,’ in 1885, has ended in defeat. - -This familiar narrative of late experience in one of our little towns -is now given for a practical purpose. - -A similar course of things appears to be taking place in all our towns, -large and small. Unchecked, this neglect of social duty and thoughtless -submission to official formalism must steadily deteriorate our national -character. It can only be checked by the voluntary organization of -individuals who will resolutely battle for the Theocratic principle -of human rights against the selfish demagogueism of party strife. The -plainest fact in history is the Divine Moral Government of the world. -A nation given up to selfishness and lust always degenerates and -perishes, and is replaced by new races. This is the great lesson of -the ages. We only fail to read it because the method of action of the -Creative Power is so much grander and surer than the methods of our -individual action. But all that is strongest and noblest in our human -nature can be but a faint reflection of what is immeasurably stronger -and nobler in the Almighty Creative force. The careful study of our -own human needs measured and limited by the needs of all other human -beings is the foundation of all growth. This mutual limitation and -government of human rights by human duties is Theocracy. It alone can -be a permanent form of Government, for a righteous democratic rule must -inevitably be Theocratic rule. - -If the Churches cannot yet see that the education of the people in -their municipal life is the urgent need of the age, if political -parties are too corrupt or self-seeking to learn the same lesson, then -help must come from other sources. Perhaps women ratepayers not yet -entangled in party politics, and men who have risen above them may hear -the Divine voice which speaks to them, and may kindle a little sacred -fire which will grow into a beacon-light to the nation. - -It is now urgently necessary to consider the way in which organizations -of householders may be gradually formed in all our municipalities, for -the purpose of mutual education and legitimate criticism. - -An unofficial organization, sufficiently suited to respond promptly to -any sudden municipal call, has really become of vital importance. The -animating centre of such organizations must be three or four earnest, -unselfish persons (a true Theocratic brotherhood) who will carefully -study municipal or social questions, and plan and initiate a work of -gradual education, particularly addressed to women voters and our -poorer ratepayers. I especially mention women because nothing has been -done for their enlightenment as to the new duties laid upon them in -1867. It is a noteworthy fact that when 2,000,000 more men were lately -placed on the register, the most active efforts of the Cobden Club and -others were at once given to instruct these new voters after party -fashion, but no effort whatever has been made directly to instruct -the hundreds of thousands of women to whom the municipal vote, the -corner-stone of our political system, was given in 1867. - -There are questions of policy having a large and important national -bearing which need to be studied by united householders. Few persons -know clearly what should be the direct action and indirect influence -of a Town Council--its duty to resist encroachment by the central -government; its duty to encourage the interest and action of burgesses -in their own institutions, and to diminish the number of irresponsible -officials; its duty to consider the public purse as a solemn trust, and -to invite careful study of municipal accounts. - -The abolition of obsolete practices, the consideration of changes or -adaptation to modern needs of municipal regulations, need consideration -by householders. - -Few burgesses seem to know that ten ratepayers in a parish possess the -right to nominate any one of their fellow ratepayers to represent them -for three years on the Town Council. The nominations are now made in -secret by party cliques, a practice never intended by our Constitution. -This mischievous practice can be directly checked by the liberty of -independent action thus provided for. I have already referred to -the right to demand a poll at any statutory meeting where serious -objection is taken to any proposed measure, a most important guarantee -of municipal liberty, quite unknown, apparently, to the majority of -ratepayers. - -I need not enter upon the important questions of the selection of -Poor-law guardians, of members of School Boards, and other officers -supposed to be elected by ratepayers, because the same criticism -applies to all. At present, indifference to all these important -elections prevails unless a sharp contest springs up on party politics. -Yet questions really vital to our national welfare are involved in -these apparently minor points in our municipal housekeeping, and I -believe that the indifference now felt towards our borough elections, -when not stimulated by party strife, proceeds from ignorance of these -larger relations. - -It is in the hope of seeing this great municipal education begun on a -large plan, quite above party strife, that I have ventured to refer to -this episode of personal experience. - -Those who profoundly believe in the moral government of this world, -and who would help in establishing a true Theocracy, must seek truth -from all sources. Our modern prophets, Herbert Spencer, John Ruskin, -and many another seeker for truth, must be earnestly listened to; not -as gods, but as men who with human limitations, nevertheless through -evil and good report, never swerve from the steadfast unselfish -search for truth--men who are enabled to see clearly great aspects of -Divine truth, and who can refresh and guide us in our humbler, but -providential task. Such men are often the truest followers of our Lord -in this nineteenth century. - -To all women voters, to all our poorer ratepayers, I earnestly -recommend the formation of a union for the study of municipal -rights and duties, and I hope that my humble but earnest effort in -this direction will enlist the sympathy and guidance of all those -truth-seers most able to help us. - - -FOOTNOTES: - -[22] Between four and five hundred summonses for rates this quarter in -our little town. - - - - - ADDRESS - - DELIVERED AT THE OPENING - - OF THE - - WOMEN’S MEDICAL COLLEGE - - OF THE - - NEW YORK INFIRMARY, 126, SECOND AVENUE - - _November 2, 1868_ - - - ADDRESS - -Our Faculty has kindly insisted upon my saying the first words which -our new College addresses to its friends, and I am bound to comply -with their desire, although I could have wished that some abler person -might have shown the broad significance of those principles which are -involved in our work. - -True growth is slow (as we measure time) and silent. The tiny sapling -shoots up with invisible and noiseless force; so have we worked -on--silently. Yet the truest growth has its striking phases of -development. We watch with glad anticipation the first tender green of -budding foliage; later still we luxuriate in the delicious flowering of -the apple-blossoms in May. - -It was in 1853, in a parlour in University Place (as some two or three -of those now present will remember), that the little slip of a Medical -Institution for Women was planted, which slowly grew till it budded -into a small hospital in 1857. Many who are here to-night will recall -the opening of the hospital wards in Bleecker Street and the cordial -words of encouragement then given. They will remember that noble young -minister, cut down in his promising youth, who hurried in from his -pressing duties in a distant city, carpet-bag in hand, resolved to give -us a hearty God-speed, because the good cause was unpopular. - -Now the tree has blossomed into a college, and once more the friends -gather round to rejoice in its promise of larger usefulness. - -It has required fifteen years of patient work--work by faith, for the -way has been very dark--to lay the foundation of a college. This has -seemed strange to most persons, for many women’s colleges have sprung -up meanwhile; hundreds of women have received the physician’s diploma; -some have become highly-respected practitioners, and some have gained -large sums of money. Of the early friends of the Infirmary, many have -died, and some have been discouraged by its slow growth. - -It is an easy thing to found a poor college. Our liberal Legislature -grants a charter to anyone who asks for it, and an audience can always -be gathered together by speeches and music to witness the presentation -of learned-looking parchment rolls to a class of well-dressed students; -but charter and diploma do not necessarily guarantee the fitting -education of a physician. To found a really good college is a work -of great difficulty, and up to the present time has been impossible -for want of professional assistance--of skilful teachers, and ample -clinical provision. To this difficulty has been added another--the want -of funds. - -We have been facing these two perpendicular cliffs--money and -skill--for fifteen years, and striving in every possible way to climb -them. Everyone will sympathize with us in relation to the first -difficulty, but, at the same time, the promoters of ordinary benevolent -enterprises can hardly realize the added difficulty of begging for a -principle. People will give to a charity or popular enthusiasm, but -very seldom to a principle, more seldom still to such an unpopular idea -as the education of women in medicine. - -Little by little, however, we have laid one stone upon another, until -we have gained a foundation sufficient to stand on. It is small, -certainly, but solid, and we all feel great hope of surmounting the -first grand difficulty. - -In relation to the second obstacle--the want of professional support--I -need only refer to the prospectus of our College to show how happily -we have at last been able to surmount this second difficulty. How this -has been accomplished I really do not know. We are so accustomed to -be ‘despised and rejected’ that encouragement, welcome, success, seem -unaccountable. It is like breathing a new and delightful atmosphere, -which is, nevertheless, strange and dream-like; and one almost fears to -wake up with a shock and find again the cold, the gloom, and struggle -all around. - -But, from whatever cause proceeding, the support now given to the -formation of the College is warm and cordial. Should we fulfil -the expectations of the wise and experienced physicians who have -sanctioned and counselled the formation of this school, professional -assistance will be increased to the utmost extent the student may -require. - -We enter, then, upon this work under the most favourable auspices, and -we are encouraged to undertake it by the earnest request of medical -women from every part of the country. From the east and the west, -from California to Maine, have come the same heartfelt expressions -of interest in the establishment of a sound plan of education, the -same hope that other women may not enter upon their work under the -disadvantages of imperfect preparation that they have had to contend -with. The list of excellent women physicians who have enrolled -themselves as fellows of the College shows the trust which is felt in -this undertaking by our respected co-workers. - -We have endeavoured to follow out the suggestions of our most -experienced medical teachers, and incorporate the following features -into our plan of instruction: - -1. A three years’ college course. - -2. A larger proportion of time devoted to teaching and practical -instruction than to lecturing. - -3. A progressive succession of studies. - -I shall only refer at this time to one of these--viz., the three years’ -college course. I would remark, for the information of those who are -not familiar with medical tuition, that the Legislature, in granting -to a school the right to confer the degree of Doctor in Medicine, -requires that such degree shall only be given to those who have been -studying medicine for three years. Three years, then, is the obligatory -time of study, and no degree is legal which is granted on a less term -of study. But in the ordinary course of instruction the greater part -of that time is spent in private reading, the College being only -responsible for the instruction of two winter sessions of five months -each; in other words, for ten months out of the thirty-six required by -law. The remaining twenty-six months may or may not be well spent; it -depends upon the intelligence, resolution, and opportunities possessed -by each individual student. It is the great wish of the profession to -increase the collegiate part of instruction, and require attendance -at college during a portion of each of the three years of study. Many -colleges have added spring and autumn courses, but the attendance of -students is not obligatory, and it seems impossible to lengthen the -college course without united action. - -For women there exist so very few opportunities for profitable study -that these precious twenty-six months are, to a great extent, wasted. -At the same time a weighty responsibility rests upon all those who -introduce women into medicine to see that they are fitted to fulfil -the trust worthily. Medicine is a learned and confidential profession, -and should draw into its ranks the most highly educated, the most -irreproachable in character. This most noble profession, like all high -things, is susceptible of the worst abuse. The good which women may -accomplish in medical practice is also the measure of the evil that -they may do. Education, long and careful, should be the safeguard -of society in this matter. From many causes women are peculiarly -exposed to a great temptation--that of practising ignorantly and -superficially. The College should foresee this danger, and provide -the long and careful training which can alone discriminate between -the worthy and unworthy candidate. This education, while it sifts out -the incompetent, will give to the earnest student those advantages of -drill, of substantial knowledge, of professional support, without which -women enter upon the practical work of medicine under the most cruel -disadvantages. - -We propose, therefore, to adopt the most advanced plan of instruction, -and have arranged a progressive course of study which will require -for its completion attendance at college during three winter sessions -of five months each, which we hope eventually to be able to extend to -eight months. We shall thus be able not only to give to each student an -additional term of systematic instruction, with all those advantages -of hospital practice which belong only to a large city, but we shall -be able to keep her under college influence during the remainder -of each year, directing the intermediate studies, and forming much -more accurate acquaintance than were otherwise possible, with the -qualifications of each candidate for graduation. - -We are compelled to face many difficulties by this plan. We must -anticipate a smaller class at first in consequence of the additional -expense laid upon the student, for however low the price of tuition -may be made, the added expense of boarding has to be met. The student -also, at the outset of her career, is unable to appreciate the great -advantages of this enlarged instruction, and is naturally tempted to go -where a diploma may most easily be gained. We are quite sure, however, -that in a few years the thorough education given by our College, and -the distinction conferred by its diploma, will draw to it the best -students from every part of our country. - -There is one other feature of our College that I must allude to, as I -feel in it a profound and special interest: it is the introduction of -hygiene into our course as a prominent and obligatory study. - -It seems strange that the prevention of disease should not always -have engaged the thought and instruction of the guardians of the -public health at least as fully as the cure of disease, and yet I -believe that this is the first college in America to found a chair of -hygiene. Consider the subjects involved in the development of a healthy -human organization--a healthy race. Physical and moral training; -the inheritance and transmission of qualities; the peculiarities -of individual constitution; the nature and influences of climate, -soil, food and customs; the prevention of epidemics; the municipal -regulations of our cities, etc.--all these subjects come directly and -unavoidably into the department of hygiene. Surely every student who -receives the degree of Doctor should be thoroughly acquainted with -all that Science at present knows on these subjects. How else can he -fulfil his noblest trust--the guardianship of individual and public -health? For a specialist with a narrowed range of duties such knowledge -may, perhaps, be of less importance; but for the family physician, the -trusted friend and counsellor year after year--for the public-spirited -physician who would give to his wisdom and experience the largest -usefulness, these studies are indispensable, and his initiation, his -first impulse and interest in this knowledge, should surely be given by -his college. - -There is one branch of this subject which I think must weigh heavily -on the hearts of women physicians, and which will, I hope, through -them, engage the attention of every thoughtful woman in our land--I -refer to the frightful mortality of young children. Children are born -to live, not die. There is a wonderful force of tenacious vitality in -all growing organizations--far more proportionate vitality than in the -old or even the adult; yet, notwithstanding this beneficent provision -of nature, we destroy our young children nearly five times as fast as -the other members of our social body. If every woman in our city could -hear the daily moan of these dying infants, could feel that every day -multitudes of bereaved mothers were weeping over untimely graves, -and that her own skirts were not clear of this shedding of innocent -blood, we should see an army of earnest co-workers eager to save this -multitude of helpless children. - -Infancy and early childhood are the especial charge of women, and -how do they fulfil this trust? It does not do to look around upon a -well-furnished home, bright with the smiling faces of happy children, -and say, ‘Am I my brother’s keeper?’ Each one is his brother’s keeper -to the direct extent that knowing an evil can be cured, he refrains -from doing his part to cure it. Did the women of our city resolve to -save these children they might be saved. Year by year the mortality -might be lessened by the sanitary knowledge diffused by women, and -the sanitary regulations their influence might establish, until from -their own little circle they could look with joy to a bright cloud of -witnesses beyond--thousands of useful lives saved to their homes and -their country through their aid! - -This suggestion of important practical usefulness will give force to -the great principle involved in our College--scientific training for -women. - -Interest in natural objects, careful, comprehensive observation of -them, enthusiasm for unselfish and impersonal ends, are the main -principles of scientific study--principles that would enter with -invigorating force into the mental development of every girl, that -would regenerate the life of women. - -Science is no hard dry thing as some imagine; it is the earnest study -of this wonderful world around us. It will take the form of each -individual mind. In a narrow unimaginative nature it will seem hard -and dry; in a warm and loving nature it will flow into every form of -benevolent action. It might work a most beneficent change in the -relation that we all consider most sacred--the relation of a mother to -her children. - -The immense force of habit, second only to the original type of -constitution, and often overpowering even the original tendencies, is, -nevertheless, formed by the silent working of influences, hour by hour -and day by day, that are invisible and cannot be measured; that seem -absolutely valueless, taken item by item, in the long account, and yet -in the aggregate they will save or ruin the body and soul. A mother may -instil the love of reading or the love of dress; she may form the habit -of out-door exercise or the habit of gossip not by the set precept or -even formal regulations, but by her own tastes unavoidably moulding the -tastes of her children, and flowing out naturally into these external -arrangements that inevitably reflect the ruling spirit or affections of -the individual. Did the mother possess a hearty interest in the wonders -of field and forest, of sea and sky, what a treasury of delightful -intercourse might be found in the varied environs of our city! A -mother’s love joined to the broad tastes and knowledge would never -weary of the ceaseless questioning of childhood; the older the child, -the closer and more influential would be the companionship. The holiday -by the sea-side or amongst the mountains, so wasted now in idleness and -frivolity, might be a rich harvest-time of delightful knowledge drawn -from the treasures of land and water. - -It is, then, because of the great value that enthusiasm for natural -science would be to woman, value to the individual life, to the home -life, and to society, that I think this College will owe its greatest -interest. From the fact that it is a Medical College it will derive its -practical efficiency in cultivating a taste for science. - -A lady, now world-famous, once said to me before she began her noble -career: ‘We Englishwomen can study anything under the sun that we -desire to acquire. Not the slightest obstacle is placed in the way -of our becoming learned to any extent; but any attempt to turn the -knowledge to account, to work with it, is met with the bitterest -opposition, is ridiculed, sneered at, frowned down. Yet the greatest -impetus to study, the natural issues of study, lie in some noble -career.’ - -It is from this tendency of human mind to pour its knowledge into some -definite form that our Medical College, with its broad practical uses, -may prove so valuable as a centre for scientific study. As it becomes -older and stronger it will spread into those collateral branches as -botany, zoology, comparative anatomy, which will form so many points -of union for the professional and non-professional. Classes would -naturally form in connection with it for nursing, sanitary visiting, -for botanical and other excursions. There is no limit to its practical -usefulness if the spirit that animates it be earnest, truthful, and -intelligent. - -We enter, then, upon our college work with a bright hope that stretches -beyond the college walls into the homes and cities around; into the -higher civilization of the future as well as the present. - -Our excellent Faculty, in entire accordance with these views, commence -their patient and laborious work with a sustained enthusiasm which -recognises the difficulties in our way, but is resolved to conquer -them. They share the large and liberal views of modern medicine. They -belong to no ‘pathy,’ to no narrow and bigoted sect. They are members -of that great catholic community of science which, from the ‘Father of -Medicine’ onwards, in every age and country, under the most diverse -practical forms, has sought for truth through observation, experiment -and calm deduction; has proved all things, and held fast to that which -is good. - -We invite the co-operation of all in this noble work. Especially do -we invite the co-operation of women. United action is of immense -importance in so arduous an undertaking as this. We will do everything -in our power to conciliate diverse interests. Principle only must -not be sacrificed. The College must be an honest and earnest attempt -to give to women the very highest education that modern science will -afford. It is on this ground that union must take place. This school -is the only one that the profession has confidence in, the only one -it has sanctioned. It has laid its broad foundation by fifteen years -of patient work, and it will quickly rise into an edifice of noble -proportions if all friendly helpers will unite in its construction. - - - - - THE RELIGION OF HEALTH - - _A Lecture delivered in 1871_ - - - THE RELIGION OF HEALTH - -The words ‘the Religion of Health’ convey a profound meaning to the -physician who has spent a lifetime in relieving physical suffering. I -will try and state what those words seem to me to imply. - -Obedience to Divine law is the highest wisdom of the human race. - -Wherever God’s laws are clearly visible, stamped in immutable -characters so plain that every human being who is willing to read -them can do so, then the wisdom, the happiness--nay, the simple -common-sense of the race--lies in obeying them. The first lesson every -one of us has to learn profoundly is his subjection to law. There is -no escaping this inexorable destiny. Although each one is born with -free-will, his type--the plan and pattern of his being--is born with -him also. This type is a limitation to the nature, but it is also a -guide; it is the finger of Providence showing him the road to follow -in the great wilderness of creation; it is the Divine order, according -to which each one can freely grow and expand in body and soul to the -finest proportions. True freedom consists in the voluntary choice -of this type, in the full acceptance of all its conditions, and in -the endeavour to unfold its capacities. The will may refuse this -type, may deny the laws that govern it, may seek for license in a -lawless rejection of Divine order, but it is soon arrested by endless -obstacles, and persistence in the unequal struggle will only end in -degradation and self-destruction. - -We recognise a Divine law when we see it existing age after age -unchangeably, carrying order and beauty in its fulfilment; penalties, -discord, desolation, with infringement. These laws are grand in design, -beneficient in their effects--equally so, whether we observe the -marvel of parental love, or explore the wonders of the skies; whether -we clothe them in warm, human garments, indispensable to the simple, -loving heart, or frame them in the clear precision of scientific -formulæ, indispensable to the truthful mind. - -If there be one law that all can clearly recognise in the existence -of the material world around us, it is the unvarying method of human -development from infancy to old age. A certain plan exists, according -to which the infant expands through childhood and youth into manhood, -and thence changes through elderly life into old age. - -This plan never varies in any epoch, or race, or country. It is the -same for the lowest savage tribe as for the most cultivated race. No -effort of ours can change this unvarying sequence in human life. - -This is a wonderful fact. It is so common that we hardly notice it. -Yet it is wonderful, because it is so common--so common as to be -universal. It rises, as we regard it, into the dignity of Law. - -Reverence for this unity of life increases the more carefully this -strange fact, called the human body, is studied, the more fully we -understand what it is that thus remains unchanged age after age. We -speak of the body as if it were a single, simple thing, to be used as -a tool and then laid aside; but its complicated structure is a little -world in itself. As a machine, it is such a model of compactness and -ingenuity that no human skill can approach its perfection. It possesses -a twofold life--a life for itself as well as a life for our use. In its -own proper life it carries on a thousand curious operations necessary -for its growth and maintenance, quite independent of our volition or -consciousness. It contains extensive manufactories full of complicated -and delicate machinery for the production of sugar, milk, acids, -alkalies, salts; it has storehouses of iron, lime, and other chemical -substances; there are magazines where it lays up supplies against -a time of scarcity; it has its refiners and scavengers; apparatus -for warming and ventilating; it has pumps and propellers constantly -at work, and a more perfect electrical apparatus than has ever been -invented. All these remarkable operations are directed by intelligence, -working according to a plan, and combining these manifold energies -for one purpose--viz., the maintenance, during a certain period, of a -healthy human body. Besides this independent existence of its own, the -body possesses a life of relation, by means of which it is fitted to -the uses of individual and social existence. Its powers of locomotion, -its active senses, its faculty of feeling, its wonderful human hand, -and its still more wonderful human brain, all belong to this other use -of the body as an instrument for the expression of intelligence and -emotion. - -Equally remarkable is the system of general unvarying laws by which -this living structure is governed. The first law we notice in -human growth is the precedence of physical over mental growth. We -observe that physical development, though never separate from mental -development, is always in advance of it. This is shown by the wonder -and delight with which the parent receives the first sign of awakening -intelligence in the young infant, the first smile, the first indication -of observation. It is the awakening mind. But every physical function -essential to life has been perfectly performed from the first moment -of birth as perfectly, according to its wants, as it will ever be -performed throughout life. This precedence of physical life continues -throughout the whole period of growth, though it strikes us less as -the years roll on, and the mind gradually assumes that mastery over -the body which should be the condition of adult life. The brain is the -last part of the body to cease growth. Every other organ is perfectly -formed, every bone consolidated, the physical organization complete, -while the mind, with its necessary organ of expression, is still -growing. I place this important fact first amongst the rules which -govern the human economy because it strikes the key-note of education; -and it is only through a thorough appreciation of this principle that -we shall beneficially change our present systems of education. - -Each age has its own special method of existence; thus there are -laws for growth, for maturity, for decay. There are the great facts -of growth by exercise or use; the necessity of maintaining a just -distribution of force amongst the various parts, lest one grow at -the expense of another; the alternations of action and rest required -in every part of the economy; the varied life of different functions -which give to each its individuality and special rule; the varieties of -race, of temperament, of individual peculiarities--these will slightly -indicate the extent and variety of these unchanging laws by which our -human nature is moulded. Their importance may be realized more fully by -dwelling for a moment on one or two of them. - -What may be termed the balance of power or just distribution of force -in the various parts of our physical and mental nature--according -to each individual type--is essential to the perfection of the -organization--it is, indeed, the measure of health. It is attained and -preserved by the due exercise of all the functions of our nature. In -ascertaining what is this due exercise, we observe that the different -functions of the human being are subject to varying laws of constant -or occasional action. The higher the object of a function, the wider -is its scope, the longer are the intervals of rest required, and -the more direct is its subjection to reason; it is taken from under -the control of the automatic vegetative life of the body and placed -under the direction of the central authority--Reason--Conscience. -Thus, we see the lungs, whose sole object is the physical life of the -individual, breathing day and night unceasingly, with alternate rest -and action every moment. The digestive apparatus, with longer intervals -of rest and a wider range of objects, connected with the preparation -and enjoyment of food. The senses, with their great use both to the -individual and to society, locked in slumber every night. Thus, step by -step, the plan rises to the highest functions of human nature--those -which concern the race--which, above all others, are under the dominion -of reason, and not subject to that law of constant action which -controls the lower functions. - -Equally interesting is that law of our nature which determines growth -by exercise. It is a fact clearly demonstrated by modern science that -the governing organ of the human body, the brain, has distinct portions -of its structure devoted to the service of distinct faculties of the -mind. Thus the intellectual, the emotional, and the locomotive powers -work through corresponding portions of the highly organized brain. -Each faculty grows by exercise. Not only does the mental faculty -become stronger by use, but its physical organ of expression in the -brain, with its dependencies in the rest of the body, become larger -and stronger with a richer supply of blood and greater aptitude for -instantaneous action. This condition of the physical organ reacts upon -the mind, which takes greater pleasure in acting in a certain direction -when it finds the brain so keenly responsive to its impulses. If the -proper distribution of force is disturbed in any individual by the -neglect to exercise important portions of our nature, an antagonism of -faculties springs up, one part growing at the expense of another part. -Thus the emotional may destroy the intellectual life in an individual -who is subjected to undue excitement of the passions, particularly if -the type of the nature is not largely emotional. The other faculties -will rapidly lose their power. The intellect suffers, judgment is -lost, and mental confusion produced, which is really a species of -insanity. Those organs of the body, also, which are most intimately -connected with the excited portion of the brain become involved, and -their functions may be entirely deranged. The automatic power of the -human body may also assume undue control in those who yield to fancies -and caprice, and lead an unnatural and sedentary life. There is an -antagonism between this automatic force and the life of relation or -brain-life of the individual. The more the balance of powers is lost -in the human brain--reason being no longer the controlling force--the -greater becomes the power of this instinctive life of the body, the -greater its capability of answering every fanciful suggestion, and -even of exciting those suggestions. The individual may thus become the -sport of his own unbalanced faculties, and a prey to every species of -morbid hallucination. - -An organization so complicated (as this human body), designed for -such manifold uses, and at the same time drawing the elements of its -existence from the external world, must be powerfully influenced -by all the circumstances which surround it. Certain physical and -mental conditions are essential to human growth, to health. Hence the -question of food and clothing, of drainage and ventilation, of human -habitations, of exercise and occupations, attain equal importance and -dignity, as essential to the fulfilment of the great changeless plan of -life. - -Thus we are brought face to face with a great fixed fact, a fact which -concerns every human being during every moment of life--viz., God’s -unchanging law of human growth. This law we are called on to study, to -obey, and obedience to it is placed first in the order of human duties. -Obedience can only be rendered by study of the objects of physical -life, of its structure, its conditions, its rules. Its learning, thus -regarded, becomes sacred learning, and ignorance is criminal. - -The folly and wickedness of our practical contempt for the great -laws of human growth may be measured by the penalties of suffering, -illness, and premature death attached to this neglect. This is -rendered more striking by observing, first of all, the great force of -the principle of vitality, the strong tendency to live and resist -injurious influences, which we all possess. Nothing is more remarkable -in the history of the human race than its great power of adaptability. -Scattered all over the surface of the globe, under the most varying -conditions, men still live and thrive. The cities of Cuença and Quito, -at a height of 9,600 feet above the level of the sea, possess large -and flourishing populations; so also do the cities of Holland and New -Orleans, which lie below its level. Multitudes of workmen live in the -galleries of the deepest mines, many hundred feet below the surface -of the earth, deprived of light, breathing air much more condensed, -living under a much stronger pressure than that of the ordinary -atmosphere. And, on the other hand, scientific observers have taken -up their residence for a long period on the crest of Pichincha, at an -elevation of 14,826 feet. Agassiz spent some weeks in investigations on -the Jung-Frau. Gay Lussac attained the highest elevation ever reached -by man in his balloon, 28,000 feet. All can recall the thrilling -narratives of Arctic voyagers, where the thermometer has been known to -measure 91° below zero. Contrast this with the burning sun of India, -where 120° Fahrenheit is observed; where glass is cracked by the heat. -A wide range of more than 200° of temperature, and yet the heat of the -human body maintains its steady and necessary amount, never materially -varying under the two extremes. Similiar illustrations of the power of -human nature to adapt itself to unnatural conditions might be drawn -from all the other elements necessary to life. - -Notwithstanding this remarkable power of vitality, which can brave -such extreme variations in physical conditions and endure enormous -privations, careful observation all over our country presents a fearful -record of death, sickness, and physical degeneration produced by our -own social arrangements--arrangements and habits so destructive to the -human organization that they overpower even this great capability of -adaptation. - -This is seen in the statistics of our towns, in the condition of our -peasant population, in our social and domestic experience. - -The statistics of all our large towns demonstrate the great and -unnatural destruction of life that takes place in these centres of -civilization, where the highest medical skill is found, and placed -freely at the call of poor as well as rich. The natural death-rate at -present is 17 per thousand--_i.e._, that under the most favourable -conditions as amongst the upper classes in our healthiest cities, in -the healthiest country districts, 17 out of every thousand persons die -each year all the world over, a lower mortality being exceptional; but -the following was the death-rate of our chief cities (1868) instead -of the natural rate of 17 per thousand: Bristol, 23; London and -Birmingham, 24; Dublin, 25; Edinburgh, 27; Liverpool, 29; Glasgow, -30; Manchester, 32. That means that in London alone, in a year of no -special sickness, more than 21,000 were killed who ought to have -lived. In the British Islands an army of over 176,516 lives were -swept off unnecessarily. This is not all: a much larger proportion of -the population is always ill at one time; about 78,000 in London is -reckoned, of whom one-third are suffering from preventable diseases. -This calculation does not take into account those feeble, ailing -persons who are never more than half well, who lack strength and energy -for the daily fulfilment of duty. It is shown that in the whole of -England the people have only a mean life-time of forty-one years--not -half the term of life that seems to belong naturally to our race. Of -those who died within the year, over 134,000 were in ripe manhood; but -yet more noteworthy are the deaths under the age of twenty-five: over -242,000 perished in childhood and youth. The wholesale slaughter of -children in our civilized country is truly appalling. Out of 233,515 -deaths at all ages, 94,804, or 40·60 per cent., were those of children -under five years of age. - -To understand fully the grave import of these records three facts -must be noted: first, that the death-rate of a country is always -under-stated; second, that town populations increase at a much more -rapid ratio than country populations; third, that the death-rate -increases in direct proportion to the density of the population. - -In proof of these three propositions let me quote from recent testimony -of our most eminent statisticians: - -‘Wherever the population is increasing the amount of mortality is -under-rated in consequence of there being an excess of young people in -those numbers, which make the mortality appear lower than it really -is. The mortality of London appears much less by statistics than -it actually is; it is reduced in two ways by having a large influx -of persons at the period of age when mortality is low, and by the -departure and return of patients to the country to die, as consumptives -for instance. The causes of disease in London are excessively active, -as is seen, for instance, in the mortality of male children under -five years of age, which is about 8 per cent. (_i.e._, 80 per 1,000), -while in some of the more healthy districts it is not more than 4 per -cent.’ Again: ‘Of the 20,066,224 persons enumerated in England in -1861, nearly 11,000,000 were in the towns and 9,000,000 in villages -and country around the towns. The total population in London and 71 of -the largest towns in England was over 7,667,622, and the population in -the country and in smaller towns was over 12,398,602, so that there -are nearly eight-twentieths of the population in those 72 towns. The -total increase from 1801 to 1861 in the population of England was over -11,173,688, and one-half of that increase was in those 72 towns. It -will thus be apparent that the town population is increasing at a much -more rapid rate than the country population.’ ‘The country population -now is very nearly the same as it was in 1801. By a law, which at -present is quite constant, the mortality increases rapidly with the -density of the population. In our thinnest districts the mortality -is about 15 per 1,000; in our densest districts it ranges from 28 to -33. This relation is a constant law: where there are 179 persons to a -square mile, there the mortality is from 17 to 19; where the density -of population varies from 3,000 upwards, the mortality ranges from -26 to 33; so that under our present arrangements there is a constant -connection between the density of population and its mortality. That -connection is not necessary; our towns might be made nearly as healthy -as these country districts, having a mortality of 17 to 20.’ Of the -circumstances under which large masses of our population grow up, -another distinguished physician writes: ‘They create special diseases, -demoralize the population, and in course of generations completely -overthrow the physique of the people. It is impossible to walk through -the central streets (of this large town) without observing that you are -in contact with a population awfully degraded, both in its physical -and moral attributes; a population whose mere external characteristics -impress you at once with the idea of a depth of degradation of bad -habits growing for generations, in consequence of these arrangements.’ -‘Thousands and hundreds of thousands are thus brought up.’ - -Turning from the towns to the agricultural population, where we have -the right to expect the fullest measure of health, we find a condition -of things which strikes an observer with dismay. The cultivators -of the soil constitute the backbone of a nation. I have carefully -observed them in America, and have learned to consider them the ruling -force of the nation; independent, thoughtful, exercising judgment and -common-sense. Again and again I have seen the corrupt or mischievous -vote of the large towns reversed or overwhelmed by the country -majorities. The condition of the peasants who cultivate the soil all -over our country presents a terrible contrast to this picture. Fever, -produced by extreme misery, seems to be endemic amongst them, sapping -their strength and stupefying their minds, when it does not kill; they -are crippled by rheumatism and destroyed by scrofula; their miserable -cottages are damp, dark, close, and overcrowded; their pitiful wages -will not supply them with decent dwelling, sustaining food, and other -necessaries of life. - -Let me quote testimony from high authority given within the year: ‘As -many as ten persons are often crowded into a sleeping-room not 12 feet -square;’ ‘the external walls are too thin, the rooms too small, no -ventilation, brick or tile floors;’ ‘cottages are frequently built in -marshy situations, and by stagnant water, or at the foot of hills where -there is no free circulation of air; the spot is chosen on account -of the small value of the land and its uselessness for agricultural -purposes;’ ‘they are not able to pay what would be a fair interest on a -decent cottage.’ ‘If a new colliery is opened in an upland valley, 200, -300, or 400 cottages are built very rapidly, and they are inhabited -long before they are dry. The foundations as a rule are simply upon -the sod, which is merely turned over, and a flag is put on that sod. -There is no drainage of any kind; 40,000 to 50,000 persons will live -in houses of this kind, in one valley.’ ‘There are numbers of villages -throughout England where the people are drinking polluted water.’ ‘I -have seen no place in England in a worse condition than this village. -I have seen many native villages in South Africa, but none so bad -as this!’ Volumes might be filled with similar testimony as to the -physical state of our country population--a population whose condition -is the truest measure of a nation’s substantial strength. - -There is no error so dangerous in national life as the discouragement -of honest labour. If the conditions of labour are injurious and -repulsive, whether from exhausting hours of toil, unhealthy workplaces, -squalid homes, or dreary monotony of toil, the workers of either sex -will inevitably seek relief from hopeless drudgery in the excitement of -vicious indulgences. - -Our social experience joins its testimony with these statistics of -town and country, to show how widespread is this destruction of -health. Every housekeeper knows the extreme difficulty of obtaining a -healthy servant; nine-tenths of those who apply for a situation are -suffering from some chronic form of disease, which, if they belonged -to a different class of society, would place them in the list of -permanent invalids. There is no more frequent cause of the ill-health -of domestic servants than the damp and sunless rooms in which they pass -so much of their time, owing to the injurious practice of building -dwelling-houses, both in town and country, without a cellar under the -whole house, drained, and ventilated from side to side. No room is fit -for human habitation which has not a six-foot cellar, dry, with ample -through ventilation underneath it. It seems surprising that, in a damp -climate like ours, with rheumatism and scrofula prevailing everywhere, -this necessity has not been perceived. - -It is often thought that sanitary knowledge means chiefly ventilation, -food, and drainage; that it applies only to the lower classes, and -that we must await the action of Government to build better houses -and otherwise deal with the gigantic question of pauperism. This is a -profound mistake. Health depends upon the observance of all the laws -of our complex nature; it applies to the mind as well as the body. -A deteriorating influence which proceeds from within is more to be -dreaded than one that comes from without. The nervous system (from -mental or physical causes) may be completely shattered, leaving the -individual a wreck. The senses (from mental or physical causes) may -be rendered so craving and irritable that the noble proportion of the -nature is lost. An hysterical, feeble person is an unhealthy one; -equally unhealthy is a coarse, brutal one. In either case, health, in -the true meaning of the word, is thoroughly impaired. Those classes of -society who are able to command every physical appliance that wealth -will purchase are often, from their kind of suffering, more dangerously -diseased than the labouring classes. I need only mention the spread of -luxury, the delay of marriage, the frail progeny of unsuitable unions, -to show how inextricably the mind and body are blended in all that -concerns health. - -The highest authority on this subject thus condenses the lessons of his -great work on health: ‘Hygiene is based upon the physical and moral -perfectibility of man, of which it furnishes the proof.’ ‘Health may be -described in two words--morality, competence.’ - -The general deterioration of health prevailing in all classes and -both sexes is most strikingly seen amongst women. It is proved by the -increase of nervous and special diseases, the prevalence of scrofula -by general fragility of constitution, and inability to bear the -unavoidable burdens of life. - -The health of the mass of educated women is a matter of serious -national concern. These women form the heart of the nation, they mould -its family life, they create society, they exercise an unbounded -influence on the lower classes. If the health of the mother breaks down -family happiness is destroyed; so if the health of this class of a -people is deteriorated the welfare of the nation is imperilled both in -the present and the future. - -Young parents enter upon the heavy responsibilities of family life -in deplorable ignorance of their duties to one another and to their -children. As parents, it is their first duty to secure right conditions -of health for the infant, for the child, and for youth, until they -leave the parental roof. Each age demands a varying set of conditions, -which become continually more complicated as the necessities of the -mind increase in proportion to the physical wants. The conditions that -will keep an infant in perfect health will not suffice to secure the -health of the boy or girl of fifteen. As a weak stomach will impair the -temper, so a vacant or corrupt mind will injure the body. Comprehensive -knowledge is needed to embrace the wants of every age, and such -knowledge all parents should possess. - -In seeking the cause of this destruction and deterioration of -life, thus briefly stated, we find it in the universal ignorance -or neglect of the Divine laws of human growth. We find this -neglect and disobedience equally among rich and poor, learned and -unlearned, religious and worldly, in individual life, in business -enterprise. The fevers of the poor, the hysteria of the luxurious, the -indigestion of the learned, the devastation of our mining districts, -equally show contempt for the wonderful organization which God has -made--indifference to the conditions which He has clearly laid down as -essential to its welfare. - -One of the most important problems of the present time is how to embody -the sanitary knowledge which we possess in the life of the nation so -that a higher standard of health may be gained by the present and -succeeding generations. - -The solution of this great problem must be attempted in many -directions. It must be sought in the power of legislative action, in -the wide-spreading influence of education, and in the strength of -social combination. - -The part which legislation should take in promoting national health -demands serious consideration. Legislation is the human imitation, or -visible representation, of the greatest facts in the universe--law, -and it derives from this representative character its immense power in -moulding the mind and habits of a people; for, as the Divine laws of -the human organization limit its powers and direct its modes of action, -so the human laws which rule a people determine their modes of thought -and their relations to one another. Legislation, therefore, not only -represents the life of the present generation, but is the most powerful -educator of the rising generation. Every law contains this latent -power hidden within it, and so often overlooked. In every subject -of legislation, whether it be the most trifling village regulation -or the gravest international question, there are principles hidden -behind the facts which induced legislation, and it is the attitude -that legislation assumes towards those hidden principles, which stamps -its character as good or evil, which makes the human law obedient or -disobedient to Divine law. - -The health of a nation is a most important concern of a wise -government. No other agency can act with such extensive and combined -power. But much wise caution is needed in dealing with such a subject -as national health. Human agencies are very imperfect, and much has -to be learned as to the right way of dealing with most important -subjects of health legislation. If the authorities introduce a supply -of pure water into a village suffering from typhoid fever they do a -righteous thing. They deal with causes. By careful investigation they -have collected a body of facts which prove that impure water will -produce typhoid fever. In this act of introducing a supply of good -water there are many principles enfolded. Thus they destroy the cause -of a great evil; they express approbation of that good thing--pure -water; they educate the people into liking it; they show them, through -experience, the blessings that flow from it. They thus render obedience -to Divine law by their legislation. But it is very different if they -attempt to regulate a village gin-shop. Gin, as a drink, is always bad, -whether adulterated or not, and, in dealing with the greatest evil -that afflicts our country--the curse of drink--legislation must adopt -the same course that it did for typhoid fever: it must patiently and -persistently accumulate the facts which will show what produces this -dangerous disease of drinking. - -Divine law rewards the good (_i.e._, the obedient), punishes the bad -(_i.e._, the disobedient), swiftly, surely, inexorably, no matter at -what cost or pain; and human law must never temporize with evil, -neither directly nor indirectly sanction it, or it loses its character -of law and becomes simply blind or blundering expediency. In dealing -with evils legislation is bound to investigate the causes of evil and -attack them. Herein lies the superiority of legislative over individual -effort--that it is able to accumulate that body of varied facts -through which causes can be clearly ascertained and the attention of -the community directed to them. It is only on this sound basis that -wise legislative measures can be framed; only in this way that great -questions of national health can be judiciously dealt with. - -Our English Government--in advance of every other nation--is learning -to recognise this great function of legislation, and is gradually -accumulating such a storehouse of facts as will render comprehensible -measures of wise statesmanship possible. The mass of the people, -however, must become sufficiently intelligent to support such measures. -The difficulties which now stand in the way of health improvements -from want of this intelligence, are inconceivable to those who have -not considered the subject. No matter whether the health improvement -suggested be great or small--whether it be the redemption of a lovely -mountain river, whose sparkling waters have been turned into a black -source of pollution, or a swamp that ought to be drained, or a poor -cottage that needs the introduction of fresh air--there is always -the same opposition and misconception. Thus a short-sighted view -of expense will excite furious opposition from small ratepayers and -ignorant farmers, even to the most necessary measures--measures which -would rapidly diminish the poor-rates and increase the prosperity of -a place. Incompetent men or poorly paid men are appointed to carry -out Health Acts, or timid men, afraid to excite ill-will in the -neighbourhood. The Acts thus become a dead-letter, or lawsuits are -instituted against improvements, harassing and even destroying local -health boards. Large proprietors enclose the commons, farm out their -estates to agents, and thus neglect the duties which are inseparable -from rights. The same ignorance which opposes such endless obstacles to -the establishment of sanitary improvements often defeats the best laid -plans when they are carried out, and proves, if proof were necessary, -that a people must be educated to appreciate laws before the objects -which those laws were intended to effect can be accomplished. - -Much confusion also at present arises from patch-work legislation that -has not been based on sound principles. This is shown by the present -Acts regulating towns: ‘A recent edition of the laws affecting health -and sanitary affairs gives the text of fifteen Acts relating to health, -diseases prevention, nuisances, local government, sewage, and kindred -subjects; twelve Acts consolidating provisions as to towns, lands, -markets, police, loans, bakehouses, etc. The public health and local -government supplemental Acts are twenty-nine in number, while the laws -treated by the work are affected by not less than 296 public general -statutes, which the author tabulates in the index as being referred -to in the text. No lawyer can grasp these enactments save by great -research, much less can a man who has his own business affairs to look -after.’ - -The sanitary investigations carried on by the Privy Council and other -government bodies, the labours of the Royal Commission appointed to -inquire into the condition of the poor, etc., cannot be overestimated; -but none feel more strongly than the very men who are carrying on -these measures the necessity of effort in other directions--directions -where the co-operation of every member of society is needed--viz., in -education and in domestic and social life. - -We now possess enough sanitary knowledge to reform the physical and -moral condition of the human race if it were generally diffused and -its rules systematically applied. Scientific investigations and the -knowledge of hygienic laws are far in advance of the practices of -daily life. The knowledge is within our reach, which, if employed, -would save the lives of tens of thousands of human beings around us, -keep this army of sick in vigorous health, and make our homes the -precious centres of ennobling influence that they are intended to be. -We fail, however, in the means of diffusing and putting into practice -the substantial knowledge which scientific observation has laid before -us. The first duty, therefore, which rests upon us all is an endeavour -to secure the universal diffusion of sanitary knowledge. As every -human being in the British Isles should know how to read and write, so -every human being should be taught that health is a duty, and shown -how to secure it. Sanitary teaching (varying, of course, in its style) -should be introduced into every school and college in the kingdom--in -the common school, in Oxford and Cambridge equally, into every series -of lectures, whether at the Royal Institution or the South Kensington -Museum, into every Working Man’s Institute, and into every medical and -every theological seminary. - -Above all other classes of men, it is certainly important that -physicians and medical men generally should be thoroughly educated -in sanitary knowledge. The authority which they possess, and their -opportunities for instilling this knowledge when families are keenly -alive to the dangers of illness, would give them greater success as -health missionaries than any other class of society. But medical men -are not taught that it is equally their duty to prevent disease as to -cure it; and their attention is not, therefore, sharpened to observe -and to deprecate the numerous habits in family life which tend to -produce disease. There are but two chairs of hygiene established in -connection with our medical schools, and attendance upon those lectures -is not obligatory--_i.e._, is not essential to the attainment of a -degree. Every practical instructor knows that the press of studies is -so great that the student always neglects whatever is not absolutely -necessary to his success. One of the most beneficial changes that -could be introduced into medical education would be the establishment -of hygiene as a first-class chair, of equal importance with anatomy, -a searching examination in its teachings being indispensable to the -attainment of any degree which gives authority to attend the sick. -Almost equally important is the introduction of sanitary instruction -into theological seminaries. The clergy generally seem to be sadly -ignorant of the laws of health. The powerful and legitimate influence -which they exercise would be more valuable if it were not so one-sided. -If the clergy all over the land, who command a mighty army of parish -visitors, could show those visitors the direct and positive connection -between pure blood (made out of food, light, and air) and pure thought, -what a revolution would be wrought in every country village! But the -clergy themselves must be educated in such knowledge, for it is not -simply intellectual assent, but a thorough realization of it that is -necessary. The same knowledge is as necessary to our schoolmasters. No -one is fit to direct the education of youth who does not perceive the -difference between the young and the old, and suit education to the -child’s nature and not to his own. The kind of studies, their variety, -frequent movement, and change, the arrangement of schoolrooms, the -unlimited supply of fresh air, the playground, etc., must all be based -upon an acquaintance with sanitary knowledge, which would be a proper -subject for examinations and certificates. - -The education of children and youth in Health is a subject in which -women are especially concerned. It is a large subject; it demands -not only the introduction of sound sanitary instruction suitable for -different ages into all our schoolrooms and colleges, but the creation -of a love of such knowledge and the habit of its practical application. -But this is not all: our great need--education in Health--implies the -confirming and improving the health by means of education. It is not -sufficient that the course of studies laid down for children and youth -should not injure them--it is also necessary that it should do them -positive physical good; they should be stronger, better, and brighter -for the hours spent in technical education, or there is something wrong -in the plan of education. If lessons produce headache, lassitude, -inactivity of functions, if they make children pale, quiet, spiritless, -then the lessons are bad; they have done the children an injury, no -matter how slight the evil effect appears to be each day; and the -injury cannot be remedied by sending them out to play and repeating the -same process day after day. A wrong cannot be made right by constantly -committing it and then endeavouring to repair it. It cannot be too -strongly urged that, unless the plan of education adopted with children -does them a positive physical good in all its details, it does them a -positive physical harm; it cannot be neutral. This is also true of the -youth in college or boarding-school. The same principle is applicable: -if the course of study is not positively beneficial to the bodily -organization, it is positively injurious. The over-taxed brain cannot -be righted by boating and cricketing. The rules which apply to the -fully-formed adult organization do not apply to the growing youth, and -it could be clearly shown how much moral, as well as physical, harm -arises from our failure to recognise the radical difference between the -youthful and adult natures. - -Education in Health, therefore--not simply theoretic instruction--is -what we need to make our children stronger; and it requires such a -reverence for health on the part of educators that there shall be a -constant endeavour to make every part of instruction strengthen the -physical as well as mental nature. - -In seeking the best means of imparting sanitary instruction to youth -we find that a certain preparation is necessary before anything like -a full and direct hygienic education can be given. This preparation -must be laid in childhood. A knowledge of the structure and functions -of the human body is indispensable; yet young women generally shrink -with repugnance from physiological instruction for which they have not -been prepared. All reference to bodily functions is unpleasant to them. -They have never learned to respect the laws of their organization, and -they turn from the subject of physical structure as very repugnant, or -a great bore. The tastes of children, however, are of a very different -character; the intellect, as shown in untiring curiosity and incessant -questioning, is predominant in childhood, and taste for any study -may then be formed. Children will receive the elements of comparative -and human anatomy and physiology, learn to handle bones and examine -structure, not only without disgust, but with extreme interest; and -they may thus be prepared for the fuller instruction which they should -receive as youths. Everything should be done to cultivate the taste -for natural history and science that is latent in almost every child. -Their fondness for animals indicates this taste, and the care of -animals should be encouraged and directed. The manual of physiology in -every schoolroom should be pleasantly written, well printed, and with -abundant illustrations. Bright, well-drawn pictures, clean and fresh -specimens, shelves and little boxes for collections, should be provided. - -To the intellectual training which results in the formation of tastes -the formation of healthy habits of life must be added. These habits -should be formed without, in general, giving any reason for them. -Children should not be taught to reason on matters of Health. They -utterly lack the power of proportion which is essential to reason, and -they run the risk of becoming morbidly conscientious or hypochondriacal -if compelled to reason on these practical matters. It is very important -that they should go to sleep early, eat simple food, live in fresh air, -and take a great deal of out-door exercise, but it is not desirable -that they should know too early why they do these things. The proper -time for reasoning on these habits has not arrived, but the healthy -habits early formed will gradually become a part of their nature. -Habits of self-control and obedience to rules are also an essential -part of the moral hygiene of childhood; they prepare the nature for the -intelligent obedience to law which should come in later years. Children -should not be worried with unimportant observances. The precepts which -it is necessary to give them will make more impressions if they are -not too numerous; the rules laid down must be wise rules; children -are trustful, and their trust must never be abused. If, as they grow -older, they learn to recognise the wisdom of the obedience that has -been exacted, they will escape that dangerous scepticism which so often -comes to youth, who find that their intellectual and moral guides have -cheated their youthful trust. Intellectual tastes, healthy habits, and -obedience to law being thus formed in childhood, the youth is prepared -for that full instruction in health which is adapted to the period -where reason is developed. - -For the education of youth in health--_i.e._, in physical strength--and -in sanitary knowledge and habits a training college seems to be -urgently needed. The acquisition of knowledge, enthusiasm for the -study, and a practical realization of it must go hand in hand. -Modifications may doubtless be gradually introduced into the ordinary -plan of family and school instruction. But if, under the present system -of schoolroom discipline, we attempt to instruct young ladies in -the laws of health, we are called on to contend with insurmountable -obstacles, not only with an utter indifference to all subjects of -health and repugnance to many topics connected with it, but with -enfeebled powers from a neglected or misdirected childhood, and with -vitiated tastes from the substitution of artificial excitements for -natural healthy enjoyments; it is also impossible to find the necessary -number of teachers inspired with that respect for Divine laws which -would give them insight into matters of health and the true order of -education. This combination of difficulties makes the task of education -in health almost a hopeless one, unless the individual be placed in a -fresh educational atmosphere where the objects and methods of education -are entirely changed. Health education should train the body--of which -the brain forms part--into well-balanced strength, giving full command -of the various faculties and power to meet the demands of future life. -To accomplish this work the hearty co-operation of the individual -is essential; such education cannot be forced from without: it must -be accepted by the will. All the mixed motives which act upon human -nature are needed to vanquish indifference and excite enthusiasm: large -and beautiful arrangements in building and grounds; the sympathy of -numbers; the stimulus of honours and rewards; the increased prospect -of establishment in life. All the motives which act upon young men, -stimulating their zeal in college life, are also needed by young women. -The natures, if not identical, are strictly parallel. The broad rules -applicable in one case are applicable in the other, and success in -education can only be attained when it is adapted to the one common -human nature. - -Education in health would be best attained by giving prominence to the -following subjects: First, the practical study of natural science, -including sketching from nature. Second, the practical study of -hygiene, which would include the structure and management of houses -and households. Third, the direct training of the bodily powers in -precision, agility, and strength. - -1. The importance of the practical study of natural science in the -education of youth can hardly be too strongly urged. The love of -nature when strengthened by a knowledge of nature gives occupation, -amusement, mental and physical development of the best kind; it is -an antidote to the morbid influences of fashion and dissipation; it -hinders the premature development of function; it furnishes a basis -of intellectual companionship between the sexes, and would prove -invaluable to a mother in the education of her children. The power -of habits formed in children by their parents are second only to the -original type of constitution, and often overpower even the original -tendencies; these habits are nevertheless formed by the silent working -of influences, hour by hour and day by day, that are invisible and -cannot be measured, that seem valueless, taking item by item in the -long account, and yet in the aggregate they mould body and soul. A -mother may instil the love of reading or the love of dress, she may -form the habit of outdoor exercise or the habit of gossip, not by set -precept or even formal regulations, but by her own tastes unavoidably -moulding the tastes of her children, and flowing out naturally -into those external arrangements that reflect the ruling spirit or -affections of the individual. Did the mother possess a hearty interest -in the wonders of field and forest, of sea and sky, what a treasury -of delightful intercourse might be found in every country ramble! A -mother’s love, joined to broad tastes and knowledge, would never weary -of the ceaseless questioning of childhood; the older the child, the -closer and more influential would be the companionship. The holiday by -the sea-side or amongst the mountains, so often wasted in idleness or -frivolity, might be a rich harvest-time of delightful knowledge drawn -from the treasures of land and water. - -It is the outdoor study of science and art that must be insisted on -with the young--the cultivation of the powers of observation rather -than memory--which powers compel the exercise of the muscles and -senses. The guiding principle of health education is to follow the -order of nature, and place the strengthening of the physical powers -not independently of, but in advance of, the mental powers. If the -order is reversed, and the immature mind be allowed to tyrannize over -the immature body, and disturb the proportion of Nature’s work by -withdrawing too much creative force to the exclusive stimulus of the -mind, the true relations of mind and body can never be restored, the -adult will never receive that ready and capable service that the body -should render to the mind. In thus urging the paramount importance -of some branches of study, particularly in a girl’s education, it -is not intended to exclude all others. Many accomplishments, as -well as various branches of knowledge, may be taught in such a way -as to conduce to physical and mental health, and all studies may -be so arranged and subordinated as to be innocuous. The principle -here insisted on is that those studies must predominate and lead in -the education of youth which most fully require the exercise of the -physical as well as mental nature in their pursuit. - -2. The direct study of hygiene involves so large a range of -profoundly interesting subjects that it is difficult to display its -full importance in a condensed sketch. The creation of a healthy -happy home (which all will allow is the legitimate work of a woman) -requires comprehensive knowledge. The structure and arrangements of a -house adapted to the climate, soil, and wants of a family, including -drainage, ventilation, warming, economy of labour; the management -of a household in relation to individual wants and to society, -including the subjects of food and waste, domestic service, petty -trading, the care of the sick and prevention of disease, occupations -and amusements--these and many other topics belong directly to the -formation of a noble Christian home. These are subjects that men -and women have a direct personal interest in. They may be taught in -graduation with abundant illustration. The examination of economic -museums, exercise in the inspection of houses and neighbourhoods, etc., -should be added for advanced students. Every method should be used to -impress facts on the memory and excite personal interest. To this end -a system of rewards would be useful, whether of prizes or honours. -There seems to be no reason why honorary degrees, scholarships, and -fellowships should not be bestowed for proficiency in knowledge that -relates to the health of mankind, as well as for distinction in -classical and mathematical study. - -3. The third subject of education in Health is the direct cultivation -of the various bodily powers in strength, agility, and grace. This -culture presupposes close attention to the weak points in the health -of each individual student--those tendencies to disease which exist -at present in every person. All will have remarked that the same -morbid cause, applied to half a dozen people, will produce varying -effects, according to individual peculiarities; thus, a current of cold -air applied when the body is over-heated may cause either catarrh, -bronchitis, neuralgia, rheumatism, intestinal derangement, according -to the individual susceptibility. Youthful vitality masks, but does -not cure, weak tendencies, unless those tendencies are known, and the -exuberant vitality be especially directed to their cure. This season -of life is, however, particularly favourable to such cure. Nature will -never again present so valuable an opportunity of remodelling the -constitution. A doctor of health or preventive medicine, who shall -become acquainted with the constitution of each student and determine -how far exercise must be modified to meet individual peculiarities, is -an indispensable member of the faculty of any college that undertakes -to educate in Health. With this observation and caution modern -gymnastics and exercise in various forms will become an invaluable part -of education. The muscles of the body are capable of the same careful -training as the senses. As the eye and hand in painting, or the ear -and hand in music, require long and careful practice to acquire skill, -so the great variety of delicate or powerful muscles in the human body -require careful exercise to draw forth the varied powers that belong -to them. The ordinary movements of life do not call forth half these -powers. As the large majority of people go through life with only an -imperfect use of their lungs, from the constraint of clothing and -sedentary habits, which weaken the thoracic muscles, so it is with -other organs, and imperfect muscular action and weakened health is the -result. - -The principles of education which are thus laid down are the following, -viz.: a constant observance of the order of human growth, the selection -of studies that will carry out this order, habits and arrangements of -college life that will enforce it, direct instruction in the necessary -conditions of health, and careful training of the body. It is giving -to education the grandest of all objects--use, which, if properly -understood, includes the highest and most permanent culture of which -the individual is capable. Were our beautiful sea-coasts studded with -such colleges, with their wonderful playgrounds washed twice a day -by the Atlantic waves, furnishing endless treasures for the eager -gatherers, enthusiasm for health-giving studies would grow up in the -youthful mind, and a stronger generation mould a nobler society. - -The establishment of sanitary improvements by Government, and the -remodelling of education, are not the only means by which we must -seek to obey those Divine laws which are implanted in our nature. -Every class of society, every institution--in short, our whole social -life--needs to be re-born into the idea of health. The customs to which -we all conform, whether rich or poor, the standards by which we measure -success in life, and the means by which we seek to reach it, are all -opposed to the idea of health. The hours we keep, our dress, our food, -the excitements and strain of life, are injurious alike to mind and -body. The deeper we look into the structure and state of society, the -more serious are the effects of the general neglect of the laws of -human growth. Practical life now is a cruel foe to pure enthusiastic -youth; purity and enthusiasm are alike destroyed by the corrupt and -faithless society into which they enter. We preach one standard of -right; we practise another. We exact a superhuman effort from our -children when, surrounded by temptations, we tell them not to fall -into evil habits; we require an impossible thing when we expect them, -as social beings, to do what is right when society does what is wrong. -The diffusion, therefore, of sanitary knowledge through all classes of -adult society is as necessary as the remodelling of education. It is -through the gradual diffusion of this knowledge that combinations of -individuals may be formed who will be strong enough to put down some of -the senseless and injurious customs that now pervade society. - -This principle of combination may wield a great and increasing power -for good. Departure from any established custom by a single individual -is an eccentricity, but the union of fifty for the same purpose will -exercise a decided influence, and a hundred resolute men and women form -a social power in the State. It is encouraging to recognise the power -that might be exerted by such a band resolved to carry out the ‘Laws of -Health’ in their daily lives! - -There is only one form of combination, however, that I shall venture to -suggest, and whose utility I think will be at once apparent. - -I refer to the formation of a National Health Society.[23] Such -a society seems to be much needed--needed to give combination, -direction, and impulse to the efforts of individuals; to form a -storehouse of information to which all could apply; to assist health -legislation by looking at this great subject from a family point of -view, and educating the community into an intelligent appreciation of -wise legislative measures; to attack such a great and growing evil as -that of unconsumed smoke; to suggest improvements in education, and -draw every charitable institution into health missionary work. Every -other subject of human interest is represented by some society, more or -less active, which takes up the social side of each particular work and -urges its claims. It seems characteristic of the general neglect with -which Health is treated that no national society of men and women has -yet been formed to promote this vital subject--Health. - -Such a society should extend its branches into every town and village -of the land, and form a body of corresponding members, not only -throughout the kingdom, but abroad. It might, with great advantage, -promote the wide application of that excellent system of instruction -initiated by Mr. Twining, of Twickenham. This gentleman has devoted -his life to the diffusion of sanitary knowledge. Having established -a museum of domestic arts in his grounds, open to the public, he has -written a series of lectures, which are read by the curator of his -museum and illustrated by his librarian, the illustrations for each -lecture being ingeniously packed in a small box; he generously sends -this little establishment to any place which will make arrangements -for the delivery of the lectures. Such a system, varying the lectures -and illustrations, might be applied to every little village in England, -for two young ladies or gentlemen might certainly be found in every -place to read discourses so prepared. If a Health Society did no other -work than keep in constant activity such a simple plan of instruction -as this, it would do a work of immense utility. There is, however, no -limit to the practical suggestions that might thus be brought before -the public to the influence that might be exercised upon family life, -or to the sanitary institutions that might be formed by an energetic -Health Society. - -I have thus endeavoured to show: - - 1. That there are laws governing human growth according to an - unvarying plan. - - 2. That neglect to study and obey these laws produces individual - suffering in all classes of society and national degeneration. - - 3. That obedience must be rendered through legislation, education, and - social life. - -It is only when we have learned to recognise that God’s law for the -human body is as sacred as--nay, is one with--God’s law for the human -soul, that we shall begin to understand the Religion of Health. - - -FOOTNOTES: - -[23] The same year (1871) at a drawing-room meeting held in Dr. -Blackwell’s house the National Health Society was formed, which has its -offices at 53, Berners Street, London, W.--EDITOR. - - - BILLING AND SONS, LTD., PRINTERS, GUILDFORD. - - - - - Transcriber’s Notes - -Page 57: “theories of bateriology” changed to “theories of bacteriology” - -Page 127: “an acknowleged authority” changed to “an acknowledged -authority” - -Page 178: “herioc efforts” changed to “heroic efforts” - -Page 208: “thay will save” changed to “they will save” - -*** END OF THE PROJECT GUTENBERG EBOOK ESSAYS IN MEDICAL SOCIOLOGY, -VOLUME 2 (OF 2) *** - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the -United States without permission and without paying copyright -royalties. 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You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online -at <a href="https://www.gutenberg.org">www.gutenberg.org</a>. If you -are not located in the United States, you will have to check the laws of the -country where you are located before using this eBook. -</div> - -<p style='display:block; margin-top:1em; margin-bottom:1em; margin-left:2em; text-indent:-2em'>Title: Essays in medical sociology, Volume 2 (of 2)</p> -<p style='display:block; margin-top:1em; margin-bottom:0; margin-left:2em; text-indent:-2em'>Author: Elizabeth Blackwell</p> -<p style='display:block; text-indent:0; margin:1em 0'>Release Date: February 10, 2023 [eBook #69998]</p> -<p style='display:block; text-indent:0; margin:1em 0'>Language: English</p> - <p style='display:block; margin-top:1em; margin-bottom:0; margin-left:2em; text-indent:-2em; text-align:left'>Produced by: MWS and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive/Canadian Libraries)</p> -<div style='margin-top:2em; margin-bottom:4em'>*** START OF THE PROJECT GUTENBERG EBOOK ESSAYS IN MEDICAL SOCIOLOGY, VOLUME 2 (OF 2) ***</div> - - - - -<h1>ESSAYS IN MEDICAL SOCIOLOGY</h1> - - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<p class="center"> -<span class="big">ESSAYS</span><br> -<span class="small">IN</span><br> -<span class="xbig">MEDICAL SOCIOLOGY</span><br> -</p> -<p class="center p4"> -BY<br> -<br> -<span class="big">ELIZABETH BLACKWELL, M.D.</span><br> -</p> -<p class="center p4"> -<i>VOLUME II.</i><br> -</p> -<p class="center p4"> -<span class="big">LONDON<br> -ERNEST BELL, YORK STREET<br> -COVENT GARDEN</span><br> -1902<br> -</p> - - -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<h2 class="nobreak" id="CONTENTS_OF_VOL_II">CONTENTS OF VOL. II.</h2> -</div> - - -<table class="autotable"> -<tr><th class="tdr">ESSAY</th><th></th><th class="tdr">PAGE</th></tr> -<tr><td class="tdr"><a href="#THE_INFLUENCE_OF_WOMEN_IN_THE_PROFESSION_OF_MEDICINE">I.</a></td> -<td><a href="#THE_INFLUENCE_OF_WOMEN_IN_THE_PROFESSION_OF_MEDICINE"><span class="smcap">The Influence of Women in the Profession of Medicine</span></a></td> -<td class="tdr page"><a href="#Page_1">1</a></td></tr> -<tr><td class="tdr"> -<a href="#ERRONEOUS_METHOD_IN_MEDICAL_EDUCATION">II.</a></td> -<td><a href="#ERRONEOUS_METHOD_IN_MEDICAL_EDUCATION"><span class="smcap">Erroneous Method in Medical Education</span></a></td> -<td class="tdr page"><a href="#Page_33">33</a></td></tr> -<tr><td class="tdr"> -<a href="#WHY_HYGIENIC_CONGRESSES_FAIL">III.</a></td> -<td><a href="#WHY_HYGIENIC_CONGRESSES_FAIL"><span class="smcap">Why Hygienic Congresses Fail</span></a></td> -<td class="tdr page"><a href="#Page_47">47</a></td></tr> -<tr><td></td><td class="tdl"> -<a href="#APPENDIX_Page_56"><span class="smcap">Appendix</span></a></td> -<td class="tdr page"><a href="#Page_85">85</a></td></tr> -<tr><td class="tdr"> -<a href="#SCIENTIFIC_METHOD_IN_BIOLOGY">IV.</a></td> -<td><a href="#SCIENTIFIC_METHOD_IN_BIOLOGY"><span class="smcap">Scientific Method in Biology</span></a></td> -<td class="tdr page"><a href="#Page_87">87</a></td></tr> -<tr><td class="tdr"> -<a href="#CHRISTIAN_SOCIALISM">V.</a></td> -<td><a href="#CHRISTIAN_SOCIALISM"><span class="smcap">Christian Socialism</span></a></td> -<td class="tdr page"><a href="#Page_151">151</a></td></tr> -<tr><td class="tdr"> -<a href="#ON_THE_DECAY">VI.</a></td> -<td><a href="#ON_THE_DECAY"><span class="smcap">On the Decay of Municipal Representative Government</span></a></td> -<td class="tdr page"><a href="#Page_173">173</a></td></tr> -<tr><td class="tdr"> -<a href="#ADDRESS">VII.</a></td> -<td><a href="#ADDRESS"><span class="smcap">Address Delivered at the Opening of the Women’s Medical College, New York</span></a></td> -<td class="tdr page"><a href="#Page_197">197</a></td></tr> -<tr><td class="tdr"> -<a href="#THE_RELIGION_OF_HEALTH">VIII.</a></td> -<td><a href="#THE_RELIGION_OF_HEALTH"><span class="smcap">The Religion of Health</span></a></td> -<td class="tdr page"><a href="#Page_211">211</a></td></tr> -</table> -<p><span class="pagenum" id="Page_1">[Pg 1]</span></p> - - -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p class="xbig center">THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE</p> - - - -<p class="center"><i>Address given at the Opening of the Winter Session of the London -School of Medicine for Women, October, 1889</i></p> -<hr class="r5"> -<p><span class="pagenum" id="Page_3">[Pg 3]</span></p> - -<h2 class="nobreak" id="THE_INFLUENCE_OF_WOMEN_IN_THE_PROFESSION_OF_MEDICINE">THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE</h2> -</div> - - -<p>In the short time that we meet together to-day I will ask you to let -me dwell upon the way in which the most beneficial influence of women -in the medical profession may be exercised. I wish also to point out -certain dangers, as well as advantages, with which medical study is now -surrounded.</p> - -<p>The avenues by which all may enter into the profession are now so much -more widely thrown open that there is little difficulty in the way of -any man or woman who may wish to acquire a legal right to practise -medicine. In Paris all the public medical institutions, both college -and hospital, are thrown open to students without distinction of sex. -Not only as ordinary students, but as internes and externes, sex is no -longer regarded there as a barrier to opportunity and position. The -democratic principle is everywhere steadily gaining ground, and the -individual allowed to try his strength in the great battle of life. -Large numbers of women are taking advantage of this wider individual -liberty to enter the medical profession. In Great Britain our<span class="pagenum" id="Page_4">[Pg 4]</span> -seventy-three registered lady-doctors are few compared with the 3,000 -in the United States, yet the nine students who are now connected with -our London school, with, in addition, the Edinburgh classes, the Dublin -students, and the latest fact that the Glasgow Medical College has -just opened its doors to women, clearly indicate that the movement has -taken sturdy root in our country, and when our English work has been -carried on for forty years, there is every probability that our British -lady-doctors will equal numerically our kinsfolk across the ocean.</p> - -<p>I think, therefore, that all will see the importance of considering -the future of this growing army of medical women, and I particularly -desire that our students of medicine should realize the far-reaching -character, the social effects, of this medical career which they are -entering on. It is quite certain that the wide adoption of the medical -profession by women cannot continue to be an insignificant matter; it -must exercise an appreciable effect on future society for good or evil.</p> - -<p>If we were children entering upon a course of education, it would -be premature to take stock of the results of education, and cast a -far-seeing glance into the future.</p> - -<p>But it is different with adult women—women of education, somewhat -impatient of restraint—entering upon a larger liberty, and -legitimately jealous of any interference with that liberty. It is -therefore imperative upon us to consider very seriously this<span class="pagenum" id="Page_5">[Pg 5]</span> matter of -self-guidance at the outset of medical education, to take in a large -view of future responsibility, and ask ourselves that most important -question respecting a medical training: What will be its effect?</p> - -<p>The flippant or superficial person may at once reply: Our object is -to gain money and pursue a remunerative calling by looking after -sick people. Women find so much difficulty in honestly supporting -themselves, that it is reason enough that they can in this way do so, -and the labourer is worthy of his hire. But I say emphatically that -anyone who makes pecuniary gain the chief motive for entering upon -a medical career is an unworthy student; he is not fit to become a -doctor, and he will be a labourer not worthy of his hire. What should -be thought of a statesman who aspired to the direction of national -affairs on account of the salary of £10,000? The nobleness of motive -must enlarge with the nobleness of occupation, or the unworthy occupier -sinks to a degradation measured by the height to which his career -should have raised him.</p> - -<p>Now, there is no career nobler than that of the physician. The -progress and welfare of society is more intimately bound up with the -prevailing tone and influence of the medical profession than with -the status of any other class of men. This exceptional influence is -not only due to the great importance of dealing with the issues of -life and death in health and disease, but it is still more owing -to the fact that the body and the mind are<span class="pagenum" id="Page_6">[Pg 6]</span> so inseparably blended -in the human constitution, that we cannot deal with one portion of -this compound nature without in more or less degree affecting the -other. Our ministrations to body and soul cannot be separated by a -sharply-defined line. The arbitrary distinction between the physician -of the body and the physician of the soul—doctor and priest—tends -to disappear as science advances. Every branch of medicine involves -moral considerations, both as regards the practitioner and the patient. -Even the amputation of a limb, the care of a case of fever, the birth -of a child, all contain a moral element which is evident to the clear -understanding, and which cannot be neglected without injury to the -doctor, to the individual, and to society. But probably it will be -generally agreed that the hope of gaining money must not be the primary -motive for choosing a medical career; but that interest in the line of -study and kind of life, with a perception of the wide and beneficent -influence which it can exert, should form the determining motive for -becoming a physician.</p> - -<p>If, then, we recognise that, although just reward for honest labour is -fair, we must not enter upon medicine as a trade for getting money, but -from a higher motive, this motive, as it influences conduct, becomes on -that account a moral motive or an ideal which should guide our future -practical life as physicians. Now, this ideal necessitates a distinct -conception of what is right or wrong for us, in medicine, both as human -beings and as women.<span class="pagenum" id="Page_7">[Pg 7]</span> Simply sensuous life, without an ideal or without -higher principles of action than the limited needs of every day, tends -to degrade the individual and all who surround him.</p> - -<p>What we need is a clear idea of what is really right or wrong, with the -reasons on which the judgment is based, instead of a confused notion or -a vague and ever-shifting standard.</p> - -<p>No woman student of medicine can safely ignore this subject. It is a -vital one for us, and only a true answer to it will make our entrance -into the profession a marked advance in social progress.</p> - -<p>I do not attempt to disguise the difficulty of laying down the law of -right and wrong in medicine; not only because medicine, as every other -part of social life, is subject to the growth of evolution, but because -in a state of society that has not yet succeeded in moulding itself on -the fundamental principles of Christianity, we are involved in faulty -social conditions which prevent us from embodying our moral perceptions -in every phase of practical life. But, remember, thought and endeavour -may live a righteous life, no matter what faulty conditions surround -us. When we have a clear view of right and wrong, we can mentally -repudiate whatever appears to violate the moral law. We can strenuously -resist the deadening force of habitual wrong-doing, and never cease the -effort to find some way of shaping our mental protest into practical -opposition to all forms of immorality.</p> - -<p>You will see in the course of your medical studies—particularly<span class="pagenum" id="Page_8">[Pg 8]</span> if -you study abroad—much to shock your enlightened intellect and revolt -your moral sense. In practice also you will be subjected to strong -temptations of the most varied character. But just for the reason that -as women we ought to see more clearly the broken bridge or approaching -danger, in the onward rush of the male intellect, I now dwell on our -special responsibility, and shall endeavour to give the reasons for it.</p> - -<p>My object is not to limit, but to enlarge our work in medicine, when -I seek to define our ideal. It is true that the great object of this -human life of ours is essentially one for every human being, man or -woman, barbarous or civilized. It is to become a nobler creature, and -to help all others to a higher human status during this brief span -of earthly life. But as variety in unity is a law of creation, so -there are infinite methods of progress, producing harmony instead of -monotony, when the individual or classes of individuals are true to the -guiding principles of their own nature.</p> - -<p>For the ideal of every creature must be found in the relation of its -own nature to the universe around it. Right and wrong are based upon -the sound understanding of this positive foundation. It is this fact of -variety in unity, in the progress of the race, which justifies the hope -that the entrance of women into the medical profession will advance -that profession.</p> - -<p>In order to carry out this noble aspiration, we must understand what -the special contribution is,<span class="pagenum" id="Page_9">[Pg 9]</span> that women may make to medicine, what the -aspect of morality which they are called upon to emphasize.</p> - -<p>It is not blind imitation of men, nor thoughtless acceptance of -whatever may be taught by them that is required, for this would be to -endorse the widespread error that the race is men. Our duty is loyalty -to right and opposition to wrong, in accordance with the essential -principles of our own nature.</p> - -<p>Now, the great essential fact of woman’s nature is the spiritual power -of maternity.</p> - -<p>We should do miserable injustice to this great fact if, looking at it -with semiblind eyes, we only see the shallow material aspect of this -remarkable speciality. It is the great spiritual life underlying the -physical which gives us our true womanly ideal.</p> - -<p>What are the spiritual principles necessarily involved in this special -creation of one-half the race—principles which lie within the material -facts of gestation and the care of infancy and childhood, which -constitute the distinctive material domain of women?</p> - -<p>They are the subordination of self to the welfare of others; the -recognition of the claim which helplessness and ignorance make upon -the stronger and more intelligent; the joy of creation and bestowal of -life; the pity and sympathy which tend to make every woman the born foe -of cruelty and injustice; and hope—<i>i.e.</i>, the realization of -the unseen—which foresees the adult in the infant, the future in the -present.</p> - -<p>All these are great moral tendencies, and they are<span class="pagenum" id="Page_10">[Pg 10]</span> necessarily -involved in the mighty potentiality of maternity. They lay upon women -the weighty responsibility of becoming more and more the moral guides -in life’s journey. Women are called upon very specially to judge all -practical action as right or wrong, and to exercise influence for this -high morality in whatever direction it can be most powerfully exerted.</p> - -<p>We see the indication of this providential inherited impulse to moral -action, in the great and increasing devotion of women to the relief of -social suffering and their sturdy opposition to wrong-doing, which form -a distinguishing characteristic of our age. These spiritual mothers of -the race are often more truly incarnations of the grand maternal life, -than those who are technically mothers in the lower physical sense.</p> - -<p>With sound intellectual growth the range of moral influence increases. -But such sound growth can only take place under the guidance of moral -principle; for moral perception becomes reason as the intellectual -faculties grow, and reason is the true light for all. It is in this -high moral life, enlarged by intelligence, that the ideal of womanhood -lies. It is through the moral, guiding the intellectual, that the -beneficial influence of woman in any new sphere of activity will be -felt.</p> - -<p>Thus, from their inherited tendencies, as well as from the existent -individuality of their nature, women must seek a high moral standard as -their ideal, and acknowledge the supremacy of right over every<span class="pagenum" id="Page_11">[Pg 11]</span> sphere -of intellectual activity. The highest type of moral excellence which we -can find in the age in which we live, the beneficence which it exerts, -the means by which it has been attained, form so many landmarks to -guide us in our search for the right.</p> - -<p>This very important method of growth has been well stated by Huxley, -that brave fighter in the past for freedom of thought. He has laid -down this weighty principle, that ‘the past must be explained by the -present.’</p> - -<p>This principle is of very wide application.</p> - -<p>What produces the noblest human creature now in our nineteenth century? -What inspires hope? What sustains us most bravely to fight the battle -of life? What makes life most worth living?</p> - -<p>When we have ascertained these facts in the present, they will explain -the past, and give the foundations of right for guidance in the future.</p> - -<p>It is a noteworthy feature of the present day that some of our best -men, witnessing the failure of so many panaceas for the intolerable -evils that afflict society, are longing for that untried force—the -action and co-operation of good women. ‘Our only hope is in women!’ is -a cry that may sometimes be heard from the enlightened male conscience. -But still more significant is the awakening of an increasing number of -women themselves. They begin to realize that truth comes to us through -imperfect human media, and is thus rendered imperfect; that every human -teacher must be accepted for his suggestiveness only, not as absolute -authority. Women are<span class="pagenum" id="Page_12">[Pg 12]</span> thus rising above the errors of the past, above -blind acceptance of imperfect authority, and are earnestly striving to -learn the will of the Creator, and walk solely according to what they -themselves, diligently seeking, can learn of that Divine will.</p> - -<p>There is no line of practical work outside domestic life, so eminently -suited to these noble aspirations as the legitimate study and practice -of medicine. The legitimate study requires the preservation in full -force of those beneficent moral qualities—tenderness, sympathy, -guardianship—which form an indispensable spiritual element of -maternity; whilst, at the same time, the progress of the race demands -that the intellectual horizon be enlarged, and the understanding -strengthened by the observation and reasoning which will give increased -efficiency to those moral qualities.</p> - -<p>The true physician must possess the essential qualities of maternity. -The sick are as helpless in his hands as the infant. They depend -absolutely upon the insight and judgment, the honesty and hopefulness, -of the doctor.</p> - -<p>The fact also that every human being we are called on to treat, is, -like the infant and the child, soul as well as body, must never be -forgotten. Successful treatment requires the insight which comes from -recognition of these facts and the sympathy that they demand. In the -infinite variety of human ailments the physician will find that she -must often be the confessor of her patient, and the consulting-room -should have the sacredness of the<span class="pagenum" id="Page_13">[Pg 13]</span> Confessional, and she must always be -the counsellor and guide.</p> - -<p>In those two departments of medicine which seem to me peculiarly -valuable to women physicians, which I shall refer to later—viz., -midwifery and preventive medicine—it would be hard to say whether -the moral or intellectual qualities of the physician were called most -largely into play, so inseparably are they blended. What patience -and hopefulness also are demanded in the lingering trial of chronic -illness! What discrimination and union of gentleness and firmness these -cases require! Then think of the children in our families! To the girls -and boys, the young women and men, who grow up under our ministrations, -what an inspirer of nobleness and purity, what a guardian from -temptation the true physician can be!</p> - -<p>Again, in the treatment of the poor, an immense demand is made upon our -pity, patience, and courage. These poor victims of our social stupidity -are often extremely trying. The faulty arrangements which compel us to -see thirty, fifty even, in an hour exhaust the nervous system of the -doctor. It requires faith and courage to recognise the real human soul -under the terrible mask of squalor and disease in these crowded masses -of poverty, and to resist the temptation to regard them as ‘clinical -material.’ The attitude of the student and doctor to the sick poor is a -real test of the true physician.</p> - -<p>Having thus realized the profound adaptation of the nature of woman -to the practice of the Art of<span class="pagenum" id="Page_14">[Pg 14]</span> Healing, let us consider in what way -the intellectual faculties may be strengthened, so as to give enlarged -efficiency to the maternal qualities. In other words, how shall we -become reliable doctors?</p> - -<p>What I have hitherto dwelt on is the necessary attitude of mind or the -atmosphere and light in which women physicians must breathe and work if -they are to attain to their distinctive efficiency; let me now refer -more particularly to the method of training for our practical work.</p> - -<p>The intellectual training required for the physician is admirably -adapted to supply deficiencies in the ordinary experience of women.</p> - -<p>The intellectual characteristics which must be especially gained during -student life are: the faculty of patient observation, exact statement -of what is observed, and cautious deductions from these observations.</p> - -<p>These qualities form the foundation of sound judgment and skilful -medical practice. It is not a brilliant theorizer that the sick person -requires, but the experience gained by careful observation and sound -common-sense, united to the kindly feeling and cheerfulness which make -the very sight of the doctor a cordial to the sick. If these necessary -results of intellectual training can be secured in harmony with the -moral structure of womanhood, then a step of real social progress is -made by our study of medicine.</p> - -<p>This necessity for making the most painstaking observation of facts, -the foundation to be laid by the<span class="pagenum" id="Page_15">[Pg 15]</span> student in every branch of her -studies, is well illustrated in the life of Darwin, who writes thus to -a friend: ‘I have been hard at work for the last month in dissecting -a little animal about the size of a pin’s head, from the Chronos -Archipelago, and I could spend another month and daily see more -beautiful structure.’ Of the value of this method of persistent labour, -his friend gives this noteworthy testimony: ‘Your sagacious father -never did a wiser thing than devote himself to these years of patient -toil. It is a remarkable instance of his scientific insight and courage -that he saw the necessity of proper training and did not shrink from -the labour of acquiring it.’</p> - -<p>In medicine, anatomy, physiology and chemistry are the primary studies -where that foundation of conscientious exactitude must be laid on which -the skill of the future physician so largely depends.</p> - -<p>The first and indispensable basis of medicine is anatomy, with which -physiology is inseparably blended; for human physiology can only -be properly studied in connection with the human structure, whose -condition in health and disease forms the direct object of our -profession. No student should be satisfied until she has most carefully -followed out the structure of every region of that human body with -whose life we shall have to deal. Careful anatomical study is the sure -and indispensable preparation for that next advanced range of clinical -observation, where pathology and therapeutics bring us into the direct -study of the sick.</p> - -<p><span class="pagenum" id="Page_16">[Pg 16]</span></p> - -<p>The more thoroughly the human organization is investigated, the more -wonderful will the unapproachable mechanism for the use of human life -be seen to be. We shall never regret any amount of time and care spent -in acquiring the most intimate knowledge of human anatomy. For even if -we never perform a surgical operation, the thorough knowledge of the -human framework with whose aberrations we have to deal, gives a firm -foundation for practice that nothing else can supply.</p> - -<p>The thoughtless slashing of the delicate and complicated structure -of the body, of which untrained students are sometimes guilty, -is indicative of a careless, unconscientious future physician. -If carelessness similar to what is sometimes observed in the -dissecting-room were carried on in the chemical laboratory, life -or limb would soon be sacrificed. Yet a thorough grounding in the -structure of every vital organ is more indispensable to us than -chemistry, important as the study of chemistry is. Let me here note how -the moral element on which I have so strongly insisted comes into play -in this the first of our medical studies. Reverence for this physical -structure of ours should always be shown in the use and arrangements of -the anatomical rooms. Carelessness and irreverence in this department -of study exercise a really deteriorating influence on students of -medicine. Respect for the material used, care in its disposition, and a -decent covering for each work-table in the intervals of work, may seem -small observances, but they exercise a large influence<span class="pagenum" id="Page_17">[Pg 17]</span> over the moral -training of the student when persistently carried out.</p> - -<p>It does not enter into my present purpose to enlarge upon the right -method of studying each branch of medicine, for that would require a -series of discourses. But I must give an emphatic warning against the -strange neglect of <i>human</i> physiology which I observe. This seems -to proceed from the mistaken idea that necessary knowledge can be -obtained from other organisms which bear a misleading resemblance to -the human.</p> - -<p>What I would insist upon is, that we should endeavour to make ourselves -thoroughly acquainted with the nature and variations of healthy human -physiology before we are perplexed with the changes of pathology.</p> - -<p>Auscultation and percussion; observations of the healthy variations -of the pulse, the tongue, the skin, and the various secretions, in as -many healthy individuals, both adult and infant, as can be examined, -compared, and recorded; the vital chemistry of the human tissues and -secretions in health and disease; the modifying effects of temperament, -heredity, idiosyncrasy, etc.—all this forms a department of human -physiology, strangely neglected as a practical study, yet certainly of -primary importance to the progress of medicine.</p> - -<p>But I must pass on to what is my immediate purpose—viz., the relation -of women to medicine. Having dwelt on the moral and intellectual -advantages of medical study, I must refer to another<span class="pagenum" id="Page_18">[Pg 18]</span> aspect of the -subject—viz., the dangers which meet our earnest students.</p> - -<p>Dr. Carpenter has recorded the wide-spread recognition of this -dangerous aspect of medical study when he says: ‘There seems to -be something in the process of training students for the medical -profession which encourages in them a laxity of thought and expression -that too frequently ends in a laxity of principle and of action’; -and he further condemns the tone of some works issued by the medical -press. Now, this judgment of a very cautious teacher so many years ago, -is worthy of the most serious consideration in the present day. The -freedom of entrance now accorded to women into the medical profession, -lays a very heavy responsibility upon us, to prove that this new and -increasing movement will be a future blessing to society.</p> - -<p>We are happy in drawing into our schools a large number of capable -women—women who may not only be a gain as physicians, but who may -exert a most beneficial influence on the profession itself, if they -bring into it fresh and independent life.</p> - -<p>It is much to be regretted that our students are now compelled to go -abroad for the completion of their medical education, for methods of -study injurious to morality are exaggerated abroad. The abuse of the -poor as subjects of experimental investigation, in whose treatment all -decent reserves of modesty are so often stripped away; the contempt -felt for the mass of women where chastity is not recognised as an -obligatory male virtue; the<span class="pagenum" id="Page_19">[Pg 19]</span> atrocious cruelty of their experiments -on animals—all these results of active intellect, unguided by large -morality, as seen in full force abroad, make me deplore the necessity -which drives so many of our best but inexperienced students away, in -search of more efficient training than they can obtain at home.</p> - -<p>The two special dangers against which I would warn our students are:</p> - -<p><i>First</i>, the blind acceptance of what is called ‘authority’ in -medicine.</p> - -<p><i>Second</i>, the narrow and superficial materialism which prevails so -widely amongst scientific men.</p> - -<p>In relation to the first point—viz., distrust of authority—although I -fully recognise the respect which is always due to the position of the -teacher, and the consideration to be shown to all who are called ‘heads -of the profession,’—I would very strongly urge you to remember that -medicine is necessarily an uncertain science.</p> - -<p>Life in its essence we cannot grasp. We understand it only through -its effects, and all human judgment is fallible. Careful and wise -observation bring us ever nearer to a knowledge of the conditions -which are necessary for human well-being; but experience compels us -to recognise the constant failure of theory or dogmatism in dealing -with any of the infinitely varied phases of life. In medicine, we -are forced to recognise the errors in diagnosis committed even by -distinguished men, and to suffer grievous disappointment from the -failure of remedies supposed to cure the sick. We cannot fail to note<span class="pagenum" id="Page_20">[Pg 20]</span> -the contradictory results of experiments, the same facts differing -according to the observer—one fact upsetting another, and one theory -driven out by a later one. This uncertainty resulting from experiment, -is strikingly exemplified by the battle of experts about the effects of -arsenic displayed in a late criminal trial. Or consider the frequent -errors of statistics (a branch of knowledge that enters largely into -medical science), owing to the imperfect data on which they are often -based, important deductions being drawn from them which are logically -indisputable, but entirely false, from the unsound premisses on which -they rest. Thus, the death-rate of London, though commonly stated at -23 or 24 per 1,000, is really an unknown quantity, on account of the -enormous influx of fresh life and the efflux of broken-down lives.</p> - -<p>Our women students especially need caution as to the blind acceptance -of authority. Young women come into such a new and stimulating -intellectual atmosphere when entering upon medical study, that they -breathe it with keen delight; they are inclined to accept with -enthusiasm the brilliant theory or statement which the active intellect -of a clever teacher lays before them. They are accustomed to accept the -government and instruction of men as final, and it hardly occurs to -them to question it. It is not the custom to realize the positive fact, -that methods and conclusions formed by one-half of the race only, must -necessarily require revision as the other half of humanity rises into -conscious responsibility.</p> - -<p><span class="pagenum" id="Page_21">[Pg 21]</span></p> - -<p>It is a difficult lesson also, fully to recognise the limitations -of the human intellect, which recognition, nevertheless, is -necessary before we can grasp this important and positive fact in -human experience—viz., that the Moral must guide the Intellectual, -or there is no halting-place in the rapid incline to error. The -brilliant professor will always exercise an undue influence over the -inexperienced student, and particularly over the woman student. I -therefore strongly urge the necessity of cherishing a mild scepticism -respecting the dicta of so-called medical science, during the period of -student life—scepticism not in relation to truth—that noble object -which we hope to approach even more nearly—but scepticism in relation -to the imperfect or erroneous statement of what is often presented as -truth.</p> - -<p>Of this one guiding fact, as a basis of judgment, we may be quite -sure—viz., that whatever revolts our moral sense as earnest women, -is not in accordance with steady progress; it cannot be permanently -true, and no amount of clever or logical sophistry can make it true. -It will be a real service that we, as medical women, may render to the -profession if we search out—calmly, patiently, but resolutely—why -what revolts our enlightened sense of right and wrong is not true. We -shall thus bring to light the profound reason why the moral faculties -are antecedent or superior to the intellectual faculties, and why the -sense of right and wrong must govern medical research and practice, as -well as all other lines of human effort.</p> - -<p><span class="pagenum" id="Page_22">[Pg 22]</span></p> - -<p>As experience enlarges, we observe the immense separation in lines of -conduct which gradually results from an initial divergence between -right and wrong—a divergence almost imperceptible at first. We are -thus compelled to come to the conclusion, in relation to our own -profession, that the worship of the intellect, or so-called knowledge, -as an end in itself, entirely regardless of the character of the means -by which we seek to gain it, is the most dangerous error that science -can make. This false principle, if adopted by the medical profession, -will degrade it, and inevitably produce distrust and contempt in the -popular mind.</p> - -<p>The second danger against which the student of medicine must guard -is the materialism which seems to arise from undue absorption in the -physical aspect of nature, and which spreads like a blight in our -profession.</p> - -<p>The basis of materialism is the assertion that only sense is real.</p> - -<p>Our medical studies necessarily begin with minute and prolonged study -of what we term ‘dead matter.’ If this study be carried on without -reverence, it appears to blind the student to any reality except the -material under his scalpel or in his crucible—<i>i.e.</i>, the facts -that the senses reveal. Proceeding logically from this false premiss, -that only sense is real, mind is looked upon as an outcome of the -brain, and life as the result of organization of matter, which is -destroyed when the organization of the material body is broken up.</p> - -<p><span class="pagenum" id="Page_23">[Pg 23]</span></p> - -<p>Some persons, successors of the materialistic ecclesiastics who -condemned Galileo, cannot rise beyond the gross evidence of their -senses. To such persons reason, which transcends sense, is a vague -unreality, and the clear teaching of reason may to them seem doubtful, -or superstition. But the stout fight which the old Italian nobly began, -and which has been so bravely carried on for freedom of thought in -our own day, is beginning to tell and reap a rich reward. Our senses, -so far from being the boundary of real existence, are proved to be as -untrustworthy guides now, as when Galileo’s accusers insisted that the -sun moved round the earth in twenty-four hours. The relations of our -senses to our consciousness change with biological differences, as one -creature can see what is quite invisible to another. The boundary-line -which exists between our senses and our consciousness is constantly -changing, and realities are shown to exist, of which our ordinary -consciousness connected with the senses has no knowledge. Thus, life -beyond, and independent of the senses, is being proved as positive and -pregnant fact.</p> - -<p>The great generalizations of modern science—the Conservation of -Energy, the process of Evolution—are the products of Reason. They -are metaphysical conceptions. Like the atomic theory or the law of -gravitation, they are practical formulæ necessary to the advancement -of science from the structure of our minds but they are the results of -reason, not of sense.</p> - -<p>Love, Hope, Reverence, are realities of a different<span class="pagenum" id="Page_24">[Pg 24]</span> order from the -senses, but they are positive and constant facts, always active, always -working out mighty changes in human life.</p> - -<p>A thoughtful writer has characterized Materialism as an attempt to -explain the Universe in terms of mass and motion rather than in terms -of Intelligence, Love, and Will, and it is a true criticism. Let me -recall here the serious warning which Huxley gives to the shallow -materialist who limits existence by the senses.</p> - -<p>He says: ‘The great danger which besets the speculative faculty is the -temptation to deal with the accepted statement of facts in natural -science as if they were not only correct but exhaustive—as if they -might be dealt with exhaustively, in the same way as propositions of -Euclid may be dealt with. In reality, every such statement, however -true it may be, is true only relatively to the means of observation -and the point of view of those who have enunciated it. Whether it will -bear every speculative conclusion that may be logically deduced from -it is quite another question.’ ‘In the complexity of organic nature -there are multitudes of phenomena which are not deducible from any -generalizations that we have yet reached; this is true of every other -class of natural objects (as the moon’s motions, gravitation, etc.). -All that should be attempted is a working hypothesis, assuming only -such causes as can be proved to be actually at work.’</p> - -<p>These are valuable warnings from our great naturalist.</p> - -<p><span class="pagenum" id="Page_25">[Pg 25]</span></p> - -<p>The tendency of unprejudiced science in our day is to show the -unsatisfactory character of the terms ‘matter’ and ‘spirit.’ For the -exaltation of what we term ‘matter’ tends constantly to lose itself in -what we call ‘spirit.’</p> - -<p>Reality always transcends sense. As the vibrations of ether are only -known as light and colour, and the vibrations of the atmosphere are -translated into sound, so in the careful observation of our own mental -states, in the experiences of dream-land, in the study of clairvoyants -and somnambulists and the revelations of hypnotism, we gain an insight -into states of consciousness independent of the senses—states where -the old distinctions between matter and spirit seem to become quite -inapplicable.</p> - -<p>One third of human life is spent in sleep, a condition of which at -present we know little, except that it entirely changes the life of -conscious sense, and that it possesses a mysterious restorative power -of the most precious significance to us as physicians. A study of -all these mysterious conditions of human life itself, many of which, -although occurring abnormally, have been presented again and again -through all the ages, is surely the most important of all subjects for -scientific medical investigation. Let us always bear in mind, as has -been well said, ‘the fact of illusion is not an illusory fact.’ As an -exception to a rule is the most suggestive fact for the investigator -to grapple with, so those exceptional facts of human nature, which -are nevertheless occurring in every age and in every nation, are the -facts of all<span class="pagenum" id="Page_26">[Pg 26]</span> others the most worthy of investigation by the scientific -medical intellect. This new realm of research, when legitimately -pursued, promises results of the very highest importance.</p> - -<p>I must not now dwell longer on this new and valuable department of -medical investigation—psycho-physiology. But it is an inspiring -thought that true science supports the noblest intuitions of humanity, -and its tendency is to furnish proof suited to our age of these -intuitions. I have specially dwelt on this subject now, because the -discouragement which results from the false reasoning of materialism, -injuring hope, aspiration, and our sense of justice, is especially -antagonistic to women, whose distinctive work is joyful creation.</p> - -<p>In practical medicine the loss is immense when recognition of the -higher facts of consciousness is obscured, and the physician is unable -to perceive life more real than the narrow limits of sensation.</p> - -<p>The physician is called to stand by the death-bed of the most -carefully-tended patient. At that solemn moment the clear glance that -sees beyond the boundary of sense, the reverential hand-clasp which -conveys hope to the mourner, is the seal of his noble art of healing -and the profoundest consolation he can offer to the bereaved. May the -time come when every physician can convey this highest gift of healing -with his ministrations!</p> - -<p>I have now considered the fundamental reason why great advantage will -result to society through the intellectual cultivation of the woman -physician, unless<span class="pagenum" id="Page_27">[Pg 27]</span> the study of medicine be pursued in such a way as to -do violence to our nature by the destruction of sympathy, reverence, -and hope.</p> - -<p>I have also dwelt on the method of training especially needful to our -students—viz., patient, persistent drill in the fundamental studies of -medical education, a training which will form the habit of close and -careful observation at the commencement of medical life.</p> - -<p>I would now offer a few words of counsel in relation to the work -which lies before us when we enter upon the practical career of the -physician, for which our medical studies should carefully prepare us.</p> - -<p>I believe that the department of medicine in which the great and -beneficent influence of women may be especially exerted, is that of -the family physician, and that not as specialists, but as the trusted -guides and wise counsellors in all that concerns the physical welfare -of the family, they will find their most congenial field of labour.</p> - -<p>It is to fit ourselves for this most useful and influential -position—viz., as the medical advisers of families—that, not limiting -our education to any speciality, we have laboured, and must continue -to labour, to remove all obstacles in the way of obtaining the fullest -medical education. For this reason I have laid so much stress upon the -cultivation of habits of careful observation, and I now would give a -warning against sensationalism in medical study.</p> - -<p>The unreflecting student (not unnaturally) rushes<span class="pagenum" id="Page_28">[Pg 28]</span> after novelties. -There is a certain excitement in witnessing a formidable surgical -operation, or seeing a rare case of disease that may never again be -presented to our observation. But these exceptional occurrences do -not fit us for our future medical life as does the careful study of -the commoner forms of disease, for those are the cases that most -nearly concern us. But because they are common they cease to interest -the unobservant student, who applies a routine treatment. But the -physician whose faculties of observation have been thoroughly drilled -has learned this lesson—viz., that no two cases of illness are -exactly alike, and that it is of the utmost importance to our future -success as practitioners to note these individual differences, their -results, and why some die whilst others recover. It is far more -important to our success as practical physicians to thoroughly master -measles and whooping-cough, scarlet fever and porrigo, than to study -an isolated case of hydrophobia or leprosy. Moreover, I hold it to be -a special duty of our profession to extirpate these common diseases, -not to accept them hopelessly as necessary evils. And it is only by -a profounder and more comprehensive clinical study of the ordinary -diseases of domestic life that we can hope to do this.</p> - -<p>There are two great branches of medicine whose importance will, I hope, -more and more engage the attention of women physicians. These are -midwifery, which introduces us to the precious position of the family -physician; and sanitary or preventive<span class="pagenum" id="Page_29">[Pg 29]</span> medicine, which enables us to -educate a healthy generation.</p> - -<p>These two departments of the healing art will never cease from amongst -us. I consider it a radical defect in our present system of medical -education, that these subjects are not brought more prominently -forward, and both of them raised into first-class professorial chairs.</p> - -<p>Before closing, I must dwell for a few moments on the vital importance -of midwifery to the future success of women physicians. This is the -more necessary because I observe a singular and growing disposition on -the part of our students, whether in America, France, or England, to -despise or neglect midwifery. I do not know whether this proceeds from -indolence, as midwifery is the most fatiguing and enchaining branch of -the profession, or whether the neglect arises from failure to perceive -the reason of our refusal to be simply midwives, for our insistence -upon a complete education really means our determination to elevate, -not repudiate, midwifery.</p> - -<p>But the curious fact remains that many women doctors appear to look -down upon this most important branch, and often state that they do not -intend to undertake it. Yet it is through the confidence felt by the -mother during our skilful attendance upon her, that we are called in to -attend other ailments of the family, and thus secure the care of the -family health. It is therefore of the utmost importance to our future -position in medicine to establish our ability as thoroughly trustworthy -obstetricians.</p> - -<p><span class="pagenum" id="Page_30">[Pg 30]</span></p> - -<p>It is indispensable to the stability of our movement that very thorough -provision be made for the obstetrical education of all our medical -graduates. I do not think that any young woman physician is properly -equipped for her future difficult career unless she has been to a great -extent responsible for at least thirty midwifery patients, of whose -cases she has made careful and discriminating records, and has had the -opportunity of observing a great many more patients, in addition to -the drill in all operative manœuvres that can be given in college. We -need a great maternity department, thoroughly organized, which, whilst -arranged with kindest consideration for the poor, will put our students -through a severe drill, such as is considered necessary at La Maternité -in Paris. That institution, which receives annually an average of 2,500 -patients, having over 10,000 applications in the year, is not only an -invaluable practical school, but it has reduced the mortality amongst -its patients to a minimum; and the searching method of instruction -there pursued could be studied by us to great advantage as we try to -secure a well-organized maternity charity for our students in London. -Such a charity, if humanely planned, would be a blessing to poor -mothers, and it would to a great extent remove the reproach of being -obliged to send our enterprising young doctors abroad because London -does not afford them sufficient necessary practical training.</p> - -<p>But time warns me to close these remarks, although I would gladly have -enlarged upon the<span class="pagenum" id="Page_31">[Pg 31]</span> primary importance of preventive medicine—the -medicine of the future—for it is quite certain that the greater part -of disease, even including many surgical operations, is preventable -disease. It is now, unfortunately, the case that unavoidable absorption -in the treatment of disease makes the practical physician too often -ignore the yet larger duty of preventing it.</p> - -<p>I have tried to show (1) That women, from their constitutional -adaptation to creation and guardianship, are thus fitted for a special -and noble part in the advancement of the healing art. (2) That the -cultivation of the intellectual faculties necessary to secure their -moral influence requires a long and patient training by methods that -do not injure morality. (3) That the noblest department of medicine to -which we can devote our energies, will be through that guardianship of -the rising generation which is the especial privilege of the family -physician.</p> - -<p>In conclusion, my young friends and fellow-workers, I would ask you all -to join with me in the pledge which I gave more than forty years ago to -the Chancellor of the Western University, who handed to me our first -Diploma of Doctor of Medicine. I then promised ‘that it should be the -effort of my life to shed honour on that diploma.’</p> - -<p>This is the pledge that we must all prepare for when entering the noble -profession of medicine; in receiving honour we must add lustre to it, -or we become unworthy of it.</p> - -<p><span class="pagenum" id="Page_32">[Pg 32]</span></p> - -<p>It is a difficult life that we enter upon, in entering upon a medical -career; but if our Christianity is worth anything, it must be ‘a -battle, not a dream.’ We must be members of the church militant if we -wish to enter the church triumphant. Life is a grand preparation for -the exercise of ever larger powers, and I heartily welcome you to this -winter’s course of study, hoping that it may be a little step forward, -but a sure one, towards that grand ideal which must be ever before us.</p> - -<p><span class="pagenum" id="Page_33">[Pg 33]</span></p> - - -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p class="center xbig">ERRONEOUS METHOD IN MEDICAL EDUCATION</p> - - -<p class="center"><i>Addressed originally<a id="FNanchor_1a" href="#Footnote_1a" class="fnanchor">[1]</a> to the Alumnæ Association of the Woman’s -Medical College of the New York Infirmary</i></p> -<hr class="r5"> -<p><span class="pagenum" id="Page_35">[Pg 35]</span></p> - -<h2 class="nobreak" id="ERRONEOUS_METHOD_IN_MEDICAL_EDUCATION">ERRONEOUS METHOD IN MEDICAL EDUCATION</h2> -</div> - - -<p>Although it is many years since I have been able to assist in the -management of the Infirmary and School which I helped to found in 1853, -yet I watch its growth with steady sympathy, and rejoice in its success.</p> - -<p>The last Report of the School, which has just reached me, contains -a very important item—viz., the effort of the Alumnæ Association -to ‘Equip a Physiological Laboratory and place it under the -superintendence of Professor W. Gilman Thompson,’ a New York -Vivisector. In relation to this effort, I desire to bring before you -some grave considerations which are the result of my long experience in -Medicine.</p> - -<p>These considerations refer, <i>first</i>, to the kind of work that -should be carried on in a Physiological Laboratory, and, <i>second</i>, -to the special influence which women are called on to exercise in -medicine.</p> - -<p>A Physiological or Pathological Laboratory arranged for the -legitimate investigation of the material composition of the tissues -and secretions<span class="pagenum" id="Page_36">[Pg 36]</span> of the human body, is an interesting and important -department of medical study. The laboratory, however, is now commonly -used as a place for experimenting upon living animals as if they were -dead matter, or simple machines. This method of research is proving in -several ways extremely injurious to the progress of the Healing Art.</p> - -<p>The practice of Vivisection and unlimited experimentations upon our -humbler fellow-creatures must be considered by us both under its -intellectual and its moral aspects. From both these points of view very -careful observation has led me to the conviction that this method of -investigation is a grave error.</p> - -<p>Let me here state distinctly that I willingly acknowledge the good -intentions of all and the ability of some of the clever physiologists -of the present day, although their method of experimentation is -erroneous and the effects of that method injurious, being founded -on a fallacy. What I now say, however, is directed chiefly to the -instruction of medical students and to the practice of our young women -doctors.</p> - -<p>I ask you to consider, first, the intellectual fallacy which underlies -this method of research. It is a twofold fallacy, resulting from the -differences of organization in different classes of living creatures, -and from the fact that when any organ is injured, it is a process of -destruction or death—not life—that is exhibited.</p> - -<p>There is an ineradicable difference of physical<span class="pagenum" id="Page_37">[Pg 37]</span> structure between -Man and every species of lower animal. Nowhere is there identity of -structure or of function. Resemblance or parallelism often exists, but -identity never. Take the dog, for instance, whose attachment to Man -furnishes us with the widest opportunities of observation. In no single -function of its body is the action of the function the same as in Man. -All the processes of digestion, including its large group of connected -organs, differ from those of the human being. Observe carefully the -processes of healthy living animals. You will find that their senses -act in a different way to ours—a way which is often quite unknown to -us, we possessing no power even comparable with many of their powers. -Their relations to nature differ in many ways from our relations. It is -true that they eat and sleep and dream; that they possess intellectual -and moral powers, and are susceptible of education. They exhibit a -rough rudimentary sketch of our higher spiritual powers, and are -related to us in many ways. But the differences are so great, their -whole attitude towards external life is so different, that they may -be truly said to live in a different world from ours. So that in no -possible instance can we draw a positive conclusion respecting the -lower animal nature, that can be transferred as reliable information to -guide us in relation to the action of the human organs and functions, -either in health or disease. This misleading difference is true not -only in relation to the spontaneous working of functions, but it is -also true in respect to the actions<span class="pagenum" id="Page_38">[Pg 38]</span> of poisons, of drugs, and the -artificial production of diseases. Animals can be rendered scrofulous, -diabetic, syphilitic, leprous, by forcing the poison of diseases into -their bodies. Morbid action, atrophy, slow death, can be produced by -removing portions of their organs; but no deductions drawn from these -artificial conditions can be transferred to man in order to cure human -disease or restore lost function. The scrofula, diabetes, syphilis, -or rabies, takes on a different form when the lower animal has been -artificially poisoned by these diseases. In not a single instance known -to science has the cure of any human disease resulted necessarily from -this fallacious method of research.</p> - -<p>In 1849-50 I was a student in Paris, and, with the narrow range -of thought which marks youth, I was extremely interested in the -investigations respecting the liver and gall bladder which Claude -Bernard (Majendie’s successor) was then carrying on and lecturing upon -at the Collège de France and the Sorbonne. I called upon M. Bernard to -ask him where I could find some work on ‘Physiologie Appliquée’ which -would show me how the results of these investigations could be applied -to the benefit of man. M. Bernard received me with the utmost courtesy, -but told me there was no such book written; the time had not come -for the deductions I sought; experimenters were simply accumulating -facts. We are still, forty years later, vainly accumulating facts! This -present summer Dr. Semmola, ‘one of the most brilliant pupils of Claude -Bernard,’<span class="pagenum" id="Page_39">[Pg 39]</span> lectured in Paris on Bright’s disease, which he has been -studying for forty years with unlimited experimentation on the lower -animals, for the purpose of producing in them artificial inflammation -and disease of the kidneys. What is the result to the human being -of all this prolonged and ingenious suffering inflicted on helpless -creatures? ‘Dr. Semmola insisted upon temperance in eating as well as -drinking, and said that the best way to preserve health was to eat only -what was needed for the nourishment of the body.’ No cure for the human -malady had resulted from this persistent experimentation.</p> - -<p>Is it not intellectual imbecility to waste thought and ingenuity in -putting animals to lingering and painful deaths in order to reassert -the well-proved fact that intemperance in eating and drinking will -produce forms of digestive and excretory disease varying with the -idiosyncrasy of the individual?</p> - -<p>In late discussions in the French Academy of Medicine relative -to chloroform, where Laborde and Franck exhibited experiments on -animals, Dr. Le Fort (the distinguished surgeon) says: ‘None of these -experiments give us any instruction whatever which is useful in -practical surgery. Whatever their scientific interest may be, their -deductions are in no way applicable to man. Experimenters relate causes -of death, but nothing of the sort is generally found in the deaths of -practical surgery. The man faints when operations are begun too soon, -or is frightened by preparations. He dies because, being a man, his<span class="pagenum" id="Page_40">[Pg 40]</span> -nervous system reacts in a different way from that of the dog or the -rabbit. Do not count in any way upon the teachings of physiologists in -practical matters. Don’t let your patient see any preparations, give -the chloroform slowly, wait till he is profoundly asleep. That is all -you can do.’</p> - -<p>Again, at another discussion at the Academy, M. Verneuil says: ‘It -is incorrect to say that laboratory experiments give certainty to -medicine, and make it scientific instead of empirical. The fact is -that experimentation has put forth as many errors as truths. There is -not sufficient identity, either physiologic or pathologic, between -man and the mammifères such as the dog and the rabbit.’ The different -ways of dying under chloroform have been long ago stated by surgeons. -The experiments shown by M. Laborde on the rabbit must be absolutely -rejected, as contrary to experience (in man). Maurice Perrin showed to -Vulpian in 1882 that the nervous reactions in man differ from those in -animals, and the effects produced by chloroformization could not be -relied on as being the same as on man. Vulpian entirely accepted this. -The experiments of physiologists have taught us absolutely nothing -in the way of preventing chloroform accidents; surgeons have been -beforehand (as was natural) in practising artificial respiration and -every other method of recovery. However interesting these experiments -on animals may be considered, they do not explain satisfactorily the -cause of chloroform accidents in man, and in no way show the way of -avoiding them.</p> - -<p><span class="pagenum" id="Page_41">[Pg 41]</span></p> - -<p>I could multiply these facts by indefinite quotations from experienced -physicians, of the intellectual uselessness of a method of research -which ignores the spiritual essence of Life and hopes to surprise -its secrets by ruthless prying into the physical structure of the -lower animals. We are learning that vivisection is examination of the -beginning of death, not of life. Loss of blood is a loss of nutriment; -the result is muscular debility and enfeeblement of the vital organs, -and the introduction of a disturbance in the vital processes which ends -in their destruction. This method of research is now being discredited -by many of the most enlightened members of our Profession.</p> - -<p>But what I wish especially to call your attention to, is the -educational uselessness of vivisection in training students, and the -moral danger of hardening their nature and injuring their future -usefulness as good physicians.</p> - -<p>It is not true that vivisection is necessary to the medical student in -order that she may attain the thorough knowledge of human physiology -which is needed for the intelligent exercise of the medical profession. -Class demonstrations in opening the bodies of the lower animals to -examine their organs and tissues are misleading in respect to the -action of human organs. The action of the human salivary glands, the -action of the cavities of the human heart, the secretion of the gastric -juice, etc., can be more correctly realized by careful anatomical -study in connection with clinical observation of the effects of<span class="pagenum" id="Page_42">[Pg 42]</span> -healthy and diseased action in the human being, than by any amount of -bloody experiment and mutilation of still living cats and dogs. Such -demonstration may gratify that instinct of curiosity which always -exists in youthful human nature, or it may pander to that craving -for excitement which makes the spectacle of a surgical operation so -much more attractive to the undeveloped mind than careful clinical -study—a tendency which is also seen in gambling, watching executions, -bull-fights, etc.—but these are tendencies to be repressed in serious -and responsible study, not encouraged. The precious mental activities -of the student need to be specially trained into observation of our -<i>human</i> faculties in health and in disease. The establishment of -a Physiological Laboratory for experimenting on living animals, in a -medical school, is not only giving a wrong direction to intellectual -activity, but is wasting the valuable time of the student, and -diverting the attention of the young practitioner from that careful -and intelligent study of the human organism, which alone can lead -to practical beneficial results. This practice must therefore be -condemned, as giving a false direction to the intellectual faculties of -the young.</p> - -<p>Of the moral danger involved in such methods of study there can be but -one opinion by thoughtful and observant persons within the ranks of our -Profession.</p> - -<p>The exercise of our superior cunning in destroying an animal’s natural -means of self-defence, that we<span class="pagenum" id="Page_43">[Pg 43]</span> may (with convenience to ourselves) -watch changes that occur in its organs during the slow process of a -lingering death, is an exercise of curiosity which inevitably tends -to blunt the moral sense and injure that intelligent sympathy with -suffering, which is a fundamental quality in the good physician. The -practice of recklessly sacrificing animal life for the gratification, -either of curiosity, excitement, or cruelty, tends inevitably to create -a habit of mind which affects injuriously all our relations with -inferior or helpless classes of creatures. It tends to make us less -scrupulous in our treatment of the sick and helpless poor. It increases -that disposition to regard the poor as ‘clinical material,’ which -has become, alas! not without reason, a widespread reproach to many -of the young members of our most honourable and merciful profession. -The hardening effect of vivisection is distinctly recognised in the -Profession, although often excused under the abused term—‘scientific.’ -Dr. Loye, who, with another physician, studied the process of -guillotining a malefactor at Troyes, thus writes: ‘Both of us believed -that our wide experience of bloody vivisection would have hardened us -sufficiently to go through the spectacle without very great emotion.’</p> - -<p>It is our duty and privilege, as women entering into the medical -profession, to strengthen its humane aspirations—to discourage its -dangerous tendencies. We must not be misled by clever or brilliant -materialists who take the narrow view that physical life can be -profitably studied without reverencing the spiritual<span class="pagenum" id="Page_44">[Pg 44]</span> force on which -it depends. A physiological and pathological laboratory, legitimately -conducted for the investigation of healthy and diseased human -secretions, in connection with clinical observation, may be made a -valuable aid to medical advancement, and I would always encourage the -organization of such a laboratory. But to use it for cutting up animals -dying under anæsthetics is stupidity, and to convert it into a torture -chamber of the lower animals, is an intellectual error and a moral -crime.</p> - -<p>The possible results of slow deterioration in the moral nature when -we violate in any degree our religious standard of justice and mercy -may be most strongly realized in living examples of diseased inherited -tendencies. Such a fearful example is before us in the life history of -the criminal, Jesse Pomeroy, now in the State Prison of Charlestown, -Mass., who has spent his life in penal servitude, expiating his -atrocious mutilations and murders of little children, committed when -he was a lad of fifteen. The deteriorating moral influence exercised -on offspring by vicious parental tendencies, is directly exhibited -in this living object lesson. The father of this lad was a butcher. -His mother, during the gestation of this child, took a persistent -and morbid delight in watching the death of the animals slaughtered -by her husband. We see in the atrocities committed by her young son, -a terrible example of the evil effect which the mind can exercise, -in deteriorating individual character and in extending its evil -influence to others. All experience proves<span class="pagenum" id="Page_45">[Pg 45]</span> the powerful influence -exercised by the parental, and especially the maternal, qualities upon -the offspring. Every woman is potentially a mother. The excuse or -toleration of cruelty by a woman upon any living creature is a deadly -sin against the grandest force in creation—maternal love.</p> - -<p>I earnestly ask all women physicians to consider the special -responsibility which rests upon them, to take that large religious view -of life which alone can check any degrading tendencies in intellectual -human activity and elevate our noble Profession. Let us not be misled -by sophistical arguments, but look steadily at the actual facts of -animal torture, and work persistently for the total abolition of -vivisection from our medical schools. In this way we shall justify -our entrance into medicine, and prove ourselves strong supporters of -that noble humanity which is the especial characteristic and solid -foundation of the Medical Profession.</p> - - - -<div class="footnotes"><h3>FOOTNOTES:</h3><div class="footnote"> - -<p><a id="Footnote_1a" href="#FNanchor_1a" class="label">[1]</a> In 1891.</p> - -</div> -</div> -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_47">[Pg 47]</span></p> - -<h2 class="nobreak" id="WHY_HYGIENIC_CONGRESSES_FAIL">WHY HYGIENIC CONGRESSES FAIL<br><span class="small"><i>LESSONS TAUGHT BY THE INTERNATIONAL CONGRESS OF 1891</i></span></h2> -</div> - -<p><span class="pagenum" id="Page_49">[Pg 49]</span></p> - - -<h3>INTRODUCTION</h3> - -<p>The noblest aim of humanity is the application of Truth to the conduct -of life. By doing we develop our faculty of knowing.</p> - -<p>The difficulty, however, of knowing how to apply Truth in daily life is -so great, and yet the need is so urgent, that the most pressing duty of -those who have faith in the Divine is to bring forward to the light of -sympathetic conference, the facts of life in which one’s most intimate -experience lies.</p> - -<p>Thus the merchant and manufacturer, the business man and the -legislator, the farmer, householder, literary man, and those who, -living upon interest, should know how that interest is gained, must -ever hold it to be true religious duty to seek, in conference with -others, the way of elevating every department of life.</p> - -<hr class="tb"> - -<p>Religious or Unitary truth possesses invaluable guidance for Medicine, -not only in its practical application as an art, but in the methods by -which it can alone become a science.</p> - -<p><span class="pagenum" id="Page_50">[Pg 50]</span></p> - -<p>Truth recognises this great fundamental fact—viz., that spirit moulds -form, that the senses alone are not reliable guides in solving the -problems of even physical life.</p> - -<p>Research and observation also show that essential elements of Truth -have always existed in Humanity; that we cripple our power of advancing -in Truth if we do not seek out these indications of the Divine in all -past experience and carefully consider the light they throw on present -life.</p> - -<p>We recognise in these weighty facts a great Providential method of -human growth and an infinitely beneficent aid towards the attainment of -that moral Ideal wherein Goodness and Truth, Justice and Mercy, Love -and Wisdom, become one—inseparably united.</p> - -<p>One of the great truths given in past ages, which it is necessary to -study and enforce in the present age, is the intimate connection which -exists both mentally and physically between human beings and lower -forms of animal life.</p> - -<p>This is a truth of great moral significance. It was dimly, perhaps -grotesquely, seen in some religions of the past, but is so much lost -sight of in the present day that our responsibility for the care of -the inferior creation we were intended to train with justice and -gentleness, becomes too often a cruel and odious tyranny. Even in some -branches of knowledge (knowledge which can only justly claim the name -of science when it is the most comprehensive study of truth) injustice -and cruelty are misleading<span class="pagenum" id="Page_51">[Pg 51]</span> the intellect, and thus threatening danger -to the progress of the human race.</p> - -<p>Being profoundly impressed by the fundamental character of these truths -as necessary guides in medicine as well as in every department of -human life, when I learned that extensive preparations were being made -in the greatest city of the world for consideration of perhaps the -most important subject that can engage our attention—viz., Health—I -arranged to be present as a delegate, and steadily attended the -Congress, comparing notes with other friends who were attending its -various sections.</p> - -<p>In this way we gathered an accurate knowledge of the tone of the -discussions, the methods pursued, and the tendencies of modern -investigation.</p> - -<p>These facts seemed to me of sufficiently serious import to make them -worth recording in the following pages.</p> -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_52">[Pg 52]</span></p> - -<h2 class="nobreak" id="WHY_HYGIENIC_CONGRESSES_FAIL2">WHY HYGIENIC CONGRESSES FAIL</h2> -</div> - - -<p>The Seventh International Congress of Hygiene was held in London -from August 10 to 15 of 1891. It is noteworthy for the number and -representative character of its members, and also for the wide range -of subjects affecting the physical welfare of the race, which were -considered. Representatives from America and from Asia, as well as -from the various nations of Europe, assembled in the Great Metropolis -to consider the vital subject of Health. These learned men met -together daily during the week in nine different sections, from ten -to two o’clock. They were occupied with the subjects of Architecture, -Engineering, Chemistry, the health of soldiers and sailors, the care of -early childhood, the duty of the State in relation to the Health of the -Nation, Health Statistics, Bacteriology, and the relations of Animal -and Human Disease.</p> - -<p>In the consideration of this wide range of subjects, valuable -experience and much useful information were presented in the papers -read and in the discussions that followed. But in a Congress not held -together by any great guiding principle, where<span class="pagenum" id="Page_53">[Pg 53]</span> persons of various -nationalities, moulded by different laws, methods of education, and -social customs were represented, a great variety of opinion, of -contradictory facts, of imperfect statistics and superficial theories, -would necessarily be brought forward. Nevertheless, a remarkable -concensus of opinion established one great result of experience—a -result which may be considered the striking practical lesson of the -Congress—viz., that it is to sanitation that we must look, not only -for the prevention of disease, but largely also for its cure.</p> - -<p><i>Supremacy of Hygiene.</i>—Taking the results of sectional -discussions as a whole, it was very generally shown that, by our -increasing knowledge of hygienic law, its wide diffusion amongst -the people, and its intelligent application to daily life, we can -counteract the evil influence of heredity, get rid of epidemics, -improve the stamina of the race, advance in longevity and in the -natural enjoyment of our earthly span of life. Thus it is by the -advance of sanitation that the Art of Healing can alone become a -science of Medicine.</p> - -<p>A few illustrations will show how this growing result of modern -thought was both directly and indirectly supported by the papers and -discussions of the various sections.</p> - -<p>Thus Sir Charles Cameron, of Dublin, showed the beneficial change -wrought by ten years’ sanitary effort in the Dublin slums through -rebuilding, draining, cleaning, and free disinfecting. Those wretched -quarters were a breeding-ground of human misery<span class="pagenum" id="Page_54">[Pg 54]</span> in 1871, where -small-pox, typhoid fever, and all contagious diseases seemed to be -endemic. The annual mortality was reduced in ten years by sanitary -measures from 34·11 to 28·80 in the most crowded portions of this -wretched quarter; in its less crowded part the mortality had fallen to -a much lower figure, notwithstanding the intemperance and destitution -which still continued to afflict the inhabitants. In this example -it should be especially noted that the goodwill of the people was -enlisted, for the municipality laid aside the idea of pecuniary gain on -the sum expended in rebuilding, etc., and offered a better lodging at -a rent that could be paid, and provided all sanitary appliances free, -thus losing, in the sense of money profit, to gain in the far higher -value—health.</p> - -<p>Another remarkable illustration from very large experience was that -given by Professor Smith, of Aldershot, who is at the head of the -cavalry department of our army. He showed, by most interesting tables, -that diseases formally rife amongst horses—glanders, farcy, canker -of the foot, etc.—were now practically unknown in the army. This -triumphant result was entirely due to careful hygiene, the utmost -attention being paid to food, ventilation, drainage of stables, the -care of the feet and shoeing, of saddles and harness, and reduction of -the burden which the horses were required to carry, to fifteen stone as -a fair average. As was justly remarked, there is a limit to the weight -that a horse can carry or draw, beyond which is cruelty and injury.</p> - -<p><span class="pagenum" id="Page_55">[Pg 55]</span></p> - -<p>Drs. Schrevens and Gibert, from France; Dr. Abbott, of Mass.; Dr. -Pagett, of Salford; in discussing diphtheria and typhoid diseases from -defective drainage, laid stress upon purity of air and cleanliness of -the soil as the chief points for consideration. The same indispensable -principle of sanitation was shown in respect to meat and milk used for -food. In France 5 per 1,000 of animals used as food are tuberculous, -such disease resulting from wrong methods of breeding, feeding, and -managing these useful animals.</p> - -<p>Professor Ralli showed how parasites could be conveyed from animals to -men, and dwelt on clean bedding, coverings, suitable food, water, free -exercise, as the necessary prophylaxis.</p> - -<p>Dr. Hime, of Bradford, and Chauveau, of France, dwelt upon terrible -diseases, such as the woolsorters’ disease, to which men are exposed -who handle the skin, horns, etc., of animals—diseases which are -entirely preventable if the manufacturers engaged in such trades -would place the health of men above the profit to be gained by trade; -thorough ventilation, disinfection, and other sanitary measures would -entirely prevent the present reckless destruction of health. The same -was true in the large industry of sorting rags imported from abroad, of -match-making, etc.</p> - -<p>It is a noteworthy fact that in the section of the Congress devoted -to the relation of diseases of men and animals, which I especially -attended, sanitary prophylaxis alone was dwelt upon as the condition<span class="pagenum" id="Page_56">[Pg 56]</span> -of supreme importance. Inoculation was not advocated by any speaker, -except the official representative of the French Pasteur Institute.<a id="FNanchor_2" href="#Footnote_2" class="fnanchor">[2]</a></p> - -<p>Compliments were duly paid to M. Pasteur, whose skill and zeal in a -false method of research may justly command intellectual recognition. -But no one in any case advocated the theory of diffusing mild forms of -disease for the purpose of preventing the severe type in the important -and practical discussions which took place daily in relation to -diseases common to man and the lower animals.</p> - -<p>Thus a great principle of progress in the prevention of disease -and in the attainment of a higher standard of health was directly -or indirectly acknowledged by this varied body of men of trained -intelligence and large experience—viz., the paramount importance of -sanitary knowledge and practice.</p> - -<p>Obedience to the conditions of healthy growth is the law of progress, -from which there is no escape. It is the only way by which disease can -be gradually eradicated. Every attempt at evasion inevitably brings its -own retribution in various ways, swiftly or slowly, but surely.</p> - -<p>All medical by-paths leading in a different direction from the -conditions of healthy life, however tempting they may appear to -active intellectual curiosity, or however desirable it may seem to -find a short cut to health, necessarily lead to error if the supreme -importance of sanitation be ignored.</p> - -<p><span class="pagenum" id="Page_57">[Pg 57]</span></p> - -<p>Now, notwithstanding the large amount of valuable experience brought -together in this International Congress, there was one serious omission -in the otherwise wide and interesting plan of the Congress—an omission -which had a direct practical bearing on the discussions carried on in -the various sections. This vitiating lack was the failure to recognise -the fundamental connection of mind and body in the phenomena of Life. -There was no appointment of any special section which should give -prominence to this subject, and thus strike the keynote capable of -bringing all the sections into harmony.</p> - -<p>This omission was the more noteworthy because a section <i>was</i> -devoted to the theories of bacteriology, which, as will be seen, are -directly opposed to the true science of Health.</p> - -<p>Practical success in sanitation is impossible without the recognition -of mind, both in the actual working of the organs of the living body -and in the knowledge and acceptance by mankind of the conditions which -are essential to health.</p> - -<p>If the human constitution be governed by laws in obedience to which -healthy growth is alone possible, then those laws must be carefully -sought for before we can build up a science of hygiene. To regard -living beings as simply material bodies, without the constant and -varying influences of mental action upon the working of those bodies, -is an intellectual error which disregards the essential condition of -mental harmony in relation to health.</p> - -<p><span class="pagenum" id="Page_58">[Pg 58]</span></p> - -<p>It must also be recognised that whatever may be the discoveries of -physiological science, they will remain barren unless applied by -individuals. In all the concerns of life, whether in the application of -principles or in the unconscious formation of habits, we are compelled -to deal with the ceaseless power or effect of Will. To treat even -the most ignorant adults by arbitrary, unreasoning compulsion is a -scientific blunder.<a id="FNanchor_3" href="#Footnote_3" class="fnanchor">[3]</a></p> - -<p><i>The Two Problems of Hygiene.</i>—The two fundamental questions for -hygiene to solve are therefore: 1st. What are the conditions of healthy -growth? 2nd. How can those conditions be secured?</p> - -<p>In answering these two fundamental questions the problem of mental -action enters into every hygienic section of a Congress, and is the -keynote which must be struck if harmony of theory and practice is to be -attained.</p> - -<p>But in consequence of too narrow a view of hygiene these questions -were not solved, and this remarkable assembly of learned men, brought -together with such careful preparation and hospitable welcome, produced -no practical results of the commanding<span class="pagenum" id="Page_59">[Pg 59]</span> value that the public had a -right to expect from it.</p> - -<p>Sanitary legislation was shown to be largely evaded, but the reasons -for this unsatisfactory evasion were not examined; the results of -experimental research were proved to be strangely contradictory, but -the conditions which would harmonize them were not discovered; unproved -theories abounded, but the fallacies that vitiated them were not made -clear.</p> - -<p>Disappointment as to the practical utility of the Congress was widely -felt both at home and abroad.</p> - -<p>This disappointment with the results of the Congress has been publicly -expressed by our foreign guests. A clever abstract of the work done -at this Seventh International Hygienic Congress has been published -in Paris by the well-known editors of <i>The Review of Hygienic and -Sanitary Police</i>. Some noteworthy statements are made in the -introduction to this volume which should be seriously considered by all -who reverence righteous sanitary science as the foundation of human -welfare, but who also know that sanitary science must approve itself to -the good sense of a people, or it will be of little practical utility.</p> - -<p><i>Failure of English as well as Foreign Sanitation.</i>—This high -French authority declares that notwithstanding the efforts for sanitary -improvement in which England has set an example for fifty years, the -relative mortality of England has not diminished. It is stated: ‘The -subject of the mortality of England,<span class="pagenum" id="Page_60">[Pg 60]</span> although not touched upon in -the Congress, was the subject of most private conversation. The real -figures of English mortality show a singular coincidence with the -mortality of other European countries. It is shown that in none of -these countries has the mortality diminished during the last fourteen -or fifteen years, except when the birth-rate has diminished, and only -in an exact proportion to this birth-rate.’ England has no better -record to show in this respect than her Continental neighbours, -notwithstanding the increasing demands of her specialists for extended -legislative powers. Our French critics remark that ‘English hygienists -of to-day are demanding great administrative centralization; their -sanitary laws are rigorous to a degree that other countries would -consider excessive; local self-government as well as individual -liberty is less and less respected, and, from the statements of -specialists interested in the subject, there is reason to believe that -at no distant date every branch of public hygiene will be entirely -administered by the Central Government.’</p> - -<p>‘It is to be hoped’ (they remark) ‘that English good sense will -learn how to avoid the abuse of centralization, for it is just as -illogical to wait for the intervention of the Central Government in -the sanitation of a parish or the prevention of a local epidemic as to -refuse such intervention when public danger arises from negligence or -stupidity.’</p> - -<p>These observations of hygienists, coming from France, a country which -we are accustomed to consider (and which in some respects really is) -much<span class="pagenum" id="Page_61">[Pg 61]</span> more over-ridden by officialism than England, are extremely -valuable. They serve to warn us of the grave danger of depending upon -centralized legislation or arbitrary authority withdrawn from popular -influence, and from that growth of individual enlightenment which -arises through the sense of responsibility.</p> - -<p>Our friendly foreign critics justly ask: How is it that England, first -in the field of sanitary science, with a rigorous system of compulsory -legislation, with administration, laws, regulations, agents, and -also a gradual development of private hygiene, has still to deplore -the unhealthiness of such a large number of towns, quarters, and -habitations, and sees no diminution in her annual rate of mortality?</p> - -<p>They advance towards the root of the matter when they observe in -this same report that laws are one thing, their application quite -another thing! ‘So true it is that public hygiene depends upon general -education as well as on the education of specialists, that no laws or -regulations will suffice when the habits of the people generally do not -promote their application.’</p> - -<p>In other words, mind as well as matter must be considered in the -subject of sanitation.</p> - -<hr class="tb"> - -<p>The student of science who has learned the great principle of -creative Unity knows that no manifestation of existence can be -absolutely separated from the rest of creation. As we investigate -phenomena it is seen that the laws governing separate phenomena<span class="pagenum" id="Page_62">[Pg 62]</span> -become more comprehensive as knowledge increases, because more widely -embracing separate facts; varieties are seen to be linked together by -relationships, and apparently different phenomena can be transmuted -into one greater force.</p> - -<p>In the plan of an International Congress, designed to gather together -the advanced knowledge of many nations on the whole science of health, -the omission of any section which should bring into prominence this -powerful fact in life—the influence of mind on body—is a very grave -defect. It is an error which affects both the investigation of facts -and the application of results, the two indispensable factors to the -progress of sanitation. Their neglect in an International Congress on -Health was the more unfortunate because mental influence is a fact -which is forcing itself upon the attention of investigators with -increasing urgency.</p> - -<p><i>Increasing Importance of the Mental Problem.</i>—Under the modern -title of hypnotism facts of the most remarkable character are now -acknowledged and studied. The cure of disease by suggestion, carefully -and humanely applied, has been proved beyond the possibility of -rational denial. The reality and practical effects of mental epidemics -is a positive fact. The effect of fear in predisposing to cholera, -hydrophobia, and other diseases cannot be denied.<a id="FNanchor_4" href="#Footnote_4" class="fnanchor">[4]</a></p> - -<p><span class="pagenum" id="Page_63">[Pg 63]</span></p> - -<p>The contagion of religious enthusiasm or religious fanaticism -are facts; whether the effects are seen in the devotion of the -Salvation Army, or in pilgrimages to Lourdes or Trèves with their -so-called miracles of faith-healing, they are equally facts requiring -consideration. Wild business speculations in the craze for riches -become contagious, and lure multitudes to ruin.</p> - -<p>The history of past and present medical delusions is also most -instructive. We need not go to the Sangrados of a past generation, who -treated every disease by blood-letting, or the search for the elixir -of life in illustration; the contagion of false hopes in relation to -consumption, which upset the judgment of two hemispheres, cannot yet be -forgotten. Thoughtful physicians possess abundant warning against being -carried away by new theories which violate the moral sense or the Law -of Unity, even when such theories are supported by distinguished names.</p> - -<p>Experience proves the potent character of mental stimuli in moulding -practical action. Fear or hope, curiosity, vanity, cupidity, when -regardless of the Law of Unity, seize upon isolated phenomena removed -from their natural connection, and distort them by creating morbid -conditions, thus viewing facts out of proportion. Statistics thus -formed<span class="pagenum" id="Page_64">[Pg 64]</span> become fallacious, and serve as the bases of dangerous -theories—theories which, unless checked by popular common-sense from -being put into practice, would cause the moral and physical degradation -of the race. I need only refer to the folly of injustice embodied in -certain medical acts lately abolished and to the present theory of -inoculation, as noteworthy instances of dangerous mental delusion -desiring to shape itself into action.</p> - -<p>Materialism, which is blind to other than sensuous life, which insists -upon reducing every phenomenon to the limits of the senses, which -refuses to be enlightened by any higher reality, or sneers at the -term ‘vitality,’ neglects a great range of positive facts, and has no -right to the noble name of science. Reflection, therefore, shows that -the moulding and guiding power of mental action in shaping physical -results being a fact of the most far-reaching character and of -permanent operation in sentient creation, its omission in a Congress of -Health was a serious injury to the results of the Congress. It was a -sufficient reason for that sterility of result which has been publicly -and privately expressed.</p> - -<p>The error of not recognising mental as well as physical forces, or the -Law of Unity, in relation to health, and the tyranny that may result -from such imperfect method in the study and application of sanitation -and medicine, may be illustrated by an interesting incident of the -Congress.</p> - -<p>An important joint meeting of two sections took place in order to -listen to the discourse of one of our<span class="pagenum" id="Page_65">[Pg 65]</span> ablest investigators—a man -in high position, and one who wields a powerful influence on the -rising generation of medical students. This gentleman early in his -discourse made the following noteworthy announcement: ‘I claim the -right of science to dictate’—and as if to strengthen this claim by -the authority of our French brethren he added ‘conformément à la -logique’—‘I claim the right of science to dictate in accordance with -logic.’</p> - -<p>The bold demand for absolute obedience thus authoritatively made -by a professor at the head of biological research demands careful -consideration. It is the announcement of a new priesthood or esoteric -sect of physical science. In the mind of the speaker it means that his -science is identical with truth. If that be admitted, it is the highest -wisdom of the human being to obey gladly and unhesitatingly, and the -teacher thus inspired with truth rightfully commands our grateful -and profound reverence. But this claim may also mean the unconscious -arrogance of a mind taking too narrow a view of science—a mind which, -whilst earnest and laborious in investigating partial phenomena, is -intoxicated by the discovery of new facts with the theories which can -be built upon them, and at once announces himself as one of the priests -of a new religion demanding absolute obedience; for the temptation of -all priesthoods is to form an esoteric sect.</p> - -<p>In this second case it is the bounden duty of every truthful mind to -refuse obedience. For until<span class="pagenum" id="Page_66">[Pg 66]</span> the claim is fully examined in all its -aspects, in both its physical and mental relations, and sustained by -the deliberate and hearty assent of all intelligent minds and the -instinctive accord of the people generally, this demand for absolute -obedience to the theories of so-called science must be resolutely -withstood as a reintroduction of mischievous and degrading superstition.</p> - -<p>The special occasion which led to this unfortunate claim for dictation, -or the compulsory regulation of disease by specialists, was the subject -of tuberculosis and the exaggerated claim of the modern bacteriologist -that the tubercle bacillus is the sole primary cause of consumption, -with the logical claim that, as only the thoroughly-trained specialist -can detect this bacillus, consumption should be scheduled as a -contagious disease, and subjected to the rigorous regulations of the -specialist and his board of advisers.</p> - -<p>As our largest item in annual mortality is death from -tuberculosis—about 14 per cent. with us—and as food and air -<i>may</i> introduce a bacillus into the system, we can dimly imagine -the extent to which the claim for dictation may grow in ‘accordance -with logic.’</p> - -<p>Many striking instances of crude official tyranny were revealed by our -Canadian and other foreign delegates. Thus, railway passengers from -Montreal to Ontario were compulsorily revaccinated on the train before -being allowed to enter Ontario.<a id="FNanchor_5" href="#Footnote_5" class="fnanchor">[5]</a> The<span class="pagenum" id="Page_67">[Pg 67]</span> foolish and fallacious system -of attempting to <i>regulate</i> special vice was seen to prevail -largely in the inexperienced civilizations of Canada and Western United -States.</p> - -<p><i>Scientific Inquisitors.</i>—I will here quote a late statement of -Professor Huxley’s, which might well be emblazoned in all our medical -schools. He says: ‘We are at the beginning of our knowledge instead -of at the end of it; the limitation of our faculties is such that we -never can set bounds to the possibilities of nature. The verdict may be -always more or less wrong, the best information being never complete, -and the best reasoning liable to fallacy.</p> - -<p>‘The greatest mistake those who are interested in free thought can make -is to overlook these limitations and deck themselves with the dogmatic -feathers which are the traditional adornments of opponents.’</p> - -<p>This vigorous protest of our English naturalist against the dictation -of so-called science is in striking accord with the observations of our -French visitors in relation to the futility of compulsory legislation -now urged by scientific specialists.</p> - -<p><i>What is Science?</i>—When the investigators in any limited branch -of knowledge glibly use the term ‘science’ to compel assent or to -enforce legislation, we are forced to ask, What <i>is</i> true science -or certain knowledge grounded on demonstration, as distinguished from -false science, which is uncertain<span class="pagenum" id="Page_68">[Pg 68]</span> knowledge, based upon varying and -imperfectly observed phenomena or upon theory? Knowledge is of various -kinds: Mental, Physical, Mathematical. These separate departments of -knowledge rest equally on bases of fact. Love is as much a fact as -bread-and-butter; justice is as potent in its effects as microbes; and -from their wider range of action and more permanent duration these -mental facts are far more <i>real</i> than the physical phenomena.</p> - -<p>In determining the claim of science to obedience the great Law of -Unity gives the guiding principle, which, however humbling to human -arrogance, or however affirmative of the limitations of our intellect, -the truly scientific mind is bound to accept.</p> - -<p><i>The Law of Unity the Foundation of Science.</i>—The Law of Unity -teaches us that no explanation of any fact is final or ‘true’ if it -contradicts other facts. It announces that no method of examining facts -is reliable that destroys other facts equally patent, and that any -results deducible from partial phenomena, however interesting or even -apparently useful, can only be regarded from the point of view of true -science as temporary expedients. They may possibly be recommendations -for useful trial, but they can never be justified as subjects for -dictation.</p> - -<hr class="tb"> - -<p>The confusion of thought which has brought the unnatural practices of -inoculation into fashion may be usefully illustrated by dwelling on the -mingling of truth and error which exists in relation to vaccination. -Vaccination must not be confounded with<span class="pagenum" id="Page_69">[Pg 69]</span> inoculation, although the word -‘vaccination’ is now incorrectly used by bacteriologists to cover up -the alarming practice of injecting the diluted virus of any particular -disease, which is inoculation. Vaccination, on the other hand, is -solely the injection of matter derived from a disease in the vacca, -which disease is neither small-pox nor derived from small-pox, and -vaccinia in a healthy cow is a mild disease.</p> - -<p>During a lifetime of medical practice I have vaccinated children -(sharing the widespread belief that it was preventive of small-pox). -The practice, however, has always seemed to be an unsatisfactory -method, which I hoped increased knowledge of sanitation would enable us -to improve.</p> - -<p>I also recognised the powerful influence of fear in predisposing to -disease, and I regarded vaccination as a sedative for the family or -community. My faith in the innocence of this practice was, however, -rudely shaken by the lamentable death, in my own practice, of a -scrofulous infant—a death clearly caused by the phagedenic ulceration -produced by the vaccination. I also noted the accumulating evidence of -very serious diseases communicated by so-called vaccine lymph.</p> - -<p><i>Vaccination not Scientific.</i>—But Professor Crookshank, in his -exhaustive work lately published on vaccination, has conclusively -proved the unscientific character of the evidence on which this -practice is based, our ignorance of the sources of the virus commonly -used and its mode of action, and also the<span class="pagenum" id="Page_70">[Pg 70]</span> uncertainty of its -prophylactic power.<a id="FNanchor_6" href="#Footnote_6" class="fnanchor">[6]</a> That the generally mild disorder of vaccination, -although arbitrarily and even tyrannically enforced on every child born -in our country, does not prove the prevention of small-pox which it is -claimed to be, is shown by the recurrence of epidemics of small-pox -amongst us, by the occurrence of the disease in vaccinated persons, and -also by the demand now made by the French Academy of Medicine (which -recognises the failure of our system of vaccination) for legislative -powers to compel repeated revaccination. This demand for power of -indefinite revaccination is a logical demand. For, proceeding on the -assumed premiss that vaccination prevents small-pox, but being met by -the inexorable fact that epidemics of small-pox <i>do</i> occur and -spread amongst vaccinated people, the cause of this contradiction is -assumed to be that the supposed preventive power of vaccination has -been thrown out of the system, and must therefore be again renewed. -Logically, therefore, not only the infant must be subjected, but -the child, the adolescent, and the adult. All must be compulsorily -revaccinated, as the human system undergoes a change at each of those -periods of growth.</p> - -<p>The history of the struggle against compulsion in vaccination is very -interesting, as a strong condemnation of that arrogance of false -science which presumes to trample on human rights whilst<span class="pagenum" id="Page_71">[Pg 71]</span> neglecting -hygienic conditions. As all intelligent persons should be able to form -a practical judgment on the important question at issue, I should -like to dwell a moment on the subject of immunity, a fact (though now -misapplied) on which compulsory vaccination is based.</p> - -<p><i>Immunity.</i>—Observation has long shown us that when the human -system is gradually exposed to injurious influences, a certain -tolerance of those influences may be acquired, which often enables -those exposed to them to escape immediate death, although with impaired -health, whilst healthy persons suddenly exposed to the same injurious -influences die. This is a well-known fact, capable of abundant -verification. Thus, persons long resident in a badly-drained house, -although frequently ailing in various ways, may never be laid up -with typhoid fever; a certain immunity has been obtained by the slow -adaptation of the system to bad air, but at the sacrifice of vigorous -health. But if a new and healthy family move into the same house a -deadly outbreak of typhoid or diphtheria may at once result.</p> - -<p>In the malarious districts of the United States a large scattered -population of what are called by the negroes ‘mean whites’ continue -to live, with clay-coloured faces, enlarged spleens, and impaired -vitality, yet for a stranger to sleep in those regions is deadly. The -strong tendency to live, which we call vitality, though it has enabled -those born and brought up under injurious influences to struggle on -through life, does not prove equal to resistance in many constitutions<span class="pagenum" id="Page_72">[Pg 72]</span> -suddenly exposed to the injurious influences. The medical statistics of -our army in India show that the newly-arrived is far more apt to suffer -from enteric fever than one who has been long in the country.</p> - -<p>‘The percentage of deaths from this cause is nearly fivefold greater in -the first or second year of service than from the sixth to the tenth -year. Medical officers are unable to trace out in any given instance a -definite insanitary condition to which with certainty the outbreak can -be attributed.’</p> - -<p>There is, therefore, fact for theory to be built on—viz., the possible -adaptation of the human constitution to injurious influences, an -adaptation which, whilst impairing general vigour, often produces -immunity from rapid death.</p> - -<p>This fact, confirmed in the mind of the bacteriologist by the -fallacious system of diseasing animals as ‘témoins’ or ‘controls,’ has -given rise to the dangerous theory that all contagious diseases may -be forestalled in their most deadly form by the inoculation of human -beings with diluted virus produced by those diseases. This dangerous -belief has been widely fostered by the unfortunate educational -influence of the law of compulsory vaccination. But it must be observed -that vaccination, unlike inoculation, does not introduce any products -of the special disease—small-pox—into the system. The vaccine disease -in the cow is not small-pox, nor can it ever be made to produce -small-pox. The preservative power which is claimed for it, therefore, -has not the dangers which are attached to inoculation, but<span class="pagenum" id="Page_73">[Pg 73]</span> neither -can it claim the occasional immunity which may attend that dangerous -practice of introducing small-pox virus into the blood. Pure air, -cleanliness, and decent house-room secured to all our people, form the -true prophylaxis of small-pox.</p> - -<p><i>Exaggeration of Bacteriology.</i>—We observe how neglect of the -Law of Unity is misleading the intellect in relation to bacteriology. -This subject, useful if pursued without cruelty and in subordination to -higher facts, has become a mischievous exaggeration<a id="FNanchor_7" href="#Footnote_7" class="fnanchor">[7]</a> both as to what -it signifies and as to what it may lead to.</p> - -<p>The majority of our active and intelligent medical investigators are -now intensely engaged in the search for a microbe as the primary -<i>cause</i> of every disease known to humanity. Cancer, leprosy, -fevers, hydrophobia, diphtheria, tetanus, insanity, etc., are being -largely studied by this imperfect method, in hope of finding a -characteristic microbe which can be pronounced the essential cause of -the disease. The great mental energy of biological investigators is -diverted from sanitary investigation to the search for fresh bacilli. -Admirable perseverance, acute ingenuity, unwearied energy are devoted -to this search.</p> - -<p>Advantage has been taken of the helplessness of<span class="pagenum" id="Page_74">[Pg 74]</span> the lower animals -to carry on a system of experimentation upon them, the extent and -ruthlessness of which has never before been attempted. Disease -is studiously propagated. Myriads of healthy living creatures -are filled with loathsome disease in order to furnish ‘material’ -for experimentation. So many kilos of dog or rabbit (used for -injecting disease, or noted as more or less slowly resisting the -death thus gradually inflicted) is a common expression now used -in experimentation, and supposed to give ‘scientific accuracy’ to -experiments. It is a pitiful intellectual fallacy of short-sighted -materialism that supposes it possible to obtain ‘scientific accuracy’ -by regarding so many kilos of living dog as if they could be -experimented on as so many kilos of dead matter, or as if they were -the materials of a steam-engine, which can be taken apart, examined, -cleaned, tested, and put together again in complete working order.</p> - -<p>This diversion of intellectual ability from the true path of sanitation -by an exaggerated search for bacilli leads directly to the dangerous -practice of inoculation, which threatens the future deterioration of -the human race. As one of the most distinguished of our hygienists, the -late Dr. Benjamin Ward Richardson, has pronounced, ‘inoculation is bad -sanitation.’<a id="FNanchor_8" href="#Footnote_8" class="fnanchor">[8]</a></p> - -<p><span class="pagenum" id="Page_75">[Pg 75]</span></p> - -<p>Sanitary law teaches us that disease is produced by many causes, not -solely by a specific microbe.</p> - -<p>These causes are insanitary conditions, which impair or destroy the -agents required by our human constitution for its healthy growth, -and which act with varying force according to individual tendency. -These insanitary conditions, in the course of their operation upon -varying individual constitutions, produce various forms of disease, -as chill may produce rheumatism, bronchitis, or diarrhœa, according -to idiosyncrasy. These varying idiosyncrasies of individuals, both in -their physical and mental aspects, as well as the varying action of -vital force in different classes of animals, will always vitiate the -theories of materialistic investigators. Thus the same poison will not -destroy all classes of living creatures. A healthy young dog has been -known to resist for months strenuous efforts made to disease him in a -particular way. The same disease germs produce quite different forms of -disturbance in men and in rabbits.</p> - -<p>‘We possess no clue to the immunity of certain animals from poison. -Rabbits fed on belladonna show no signs of injury, although their flesh -becomes poisonous to those who eat it. Pigeons and other herbivora may -be safe from what will cause paralysis and asphyxia in other animals. -The meat of goats may similarly become poisonous.</p> - -<p>‘Chickens, cats, birds, rodents, are variously affected by poisons, -some thriving on what will kill other animals. The whole cat tribe is -said to be always proof against morphia.’</p> - -<p><span class="pagenum" id="Page_76">[Pg 76]</span></p> - -<p>Drs. Hahn and von Bergmann, in attempting to justify their -cancer-grafting experiments on hospital patients, affirm that ‘it was -necessary to select human beings for experiment, inasmuch as none of -the lower animals would have been suitable for their purpose.’</p> - -<p>Sanitary law teaches us that unhealthy conditions vitiate the living -micro-organisms with which we are surrounded, and which, naturally -beneficial, may become, through violation of natural law, morbid germs, -capable of spreading their various forms of disease amongst persons -predisposed to such disease. Thus, according to sanitary law, the -violated health conditions (vitiating naturally innocuous particles) -are the primary cause of disease; the morbid germ or bacillus is only -the secondary cause.</p> - -<p>The new bacteriological theory directly contradicts this important -law of sanitary experience, and in opposition to it authoritatively -announces that contagious or infectious disease can never be produced -without the antecedent microbe. It was in defence of this untenable -theory that the distinguished professor claimed the ‘right of science -to dictate.’</p> - -<p>The great mistake, therefore, made by the Hygienic Congress was the -neglect of mind as an indispensable and prominent factor in Health, and -the exaltation of bacteriology, with the theories based upon it, into -the chief point of interest and importance.</p> - -<p>The modern exaggeration of bacteriology, with its theory of -inoculation, must be steadily opposed by all who realize the power and -growing influence of<span class="pagenum" id="Page_77">[Pg 77]</span> spiritual life. The injurious results of this -exaggeration may be summarized as follows:</p> - -<p><i>The Practical Dangers arising from erroneous Scientific -Method.</i>—1. It diverts invaluable intellectual activity into -methods of comparatively futile investigation. These investigations -lead very widely to the exercise of fraud and cruelty upon the lower -animals, and tend to reckless experiment on the poor. They waste -much time and spread the contagion of intellectual error amongst the -students of all our medical schools, where the false practices of -experimentation are increasingly carried on. They also pervert the -moral sense of the great army of assistants, caretakers, porters, -nurses, and others connected with our medical institutions, who become -aware of the cruel practices which so largely accompany this method of -research.</p> - -<p>2. This perversion of medical activity misleads our Parliamentary -representatives, who are bewildered by pseudo-science authoritatively -announcing itself as Truth, and permits a rapid increase of officialism -to crush opposition and force the dicta of superficial ‘science’ upon -the protesting conscience of intelligent people. It also misleads the -community by fallacious articles in popular magazines, in which facts, -theories, statistics, and assertions, often incorrect, are given with -an imposing air of science, in relation to which the ordinary reader is -quite unable to discriminate the true from the false.</p> - -<p>3. The diversion of medical activity from the<span class="pagenum" id="Page_78">[Pg 78]</span> true path of Preventive -Medicine not only hinders the progress of sanitation, but is producing -an increasing revolt of common-sense and popular feeling against what -are erroneously supposed to be the necessary methods of medicine and -the practice of dispensary and hospital. This growing feeling in the -community increases the dread with which the poor generally regard -the hospital, and it also seriously diminishes the pecuniary support -which the well-to-do would otherwise gladly extend to their sick and -suffering fellow-creatures.</p> - -<hr class="tb"> - -<p><i>Conclusion.</i>—In considering the foregoing record of facts it is -seen to be a fundamental error, not only in a Hygienic Congress, but in -<i>all</i> medical thought and practice, to look only at the body, and -not consider those spiritual facts which precede, animate, and succeed -the flesh. It is also certain that in the application of hygiene to -daily life we may as well pour water into a sieve as hope to enforce -permanently practical hygienic measures without enlisting the goodwill -of the people in their observance.</p> - -<p>As the solution of the two great problems of hygiene—viz., ‘What -are the laws and conditions of healthy growth?’ and ‘How can these -conditions be secured?’ rests upon principles of spiritual truth, -those principles are of fundamental importance in directing human -intelligence into right lines of investigation. Being compelled to use -the imperfect symbolism of language, we speak of mind and matter,<span class="pagenum" id="Page_79">[Pg 79]</span> of -spiritualism and materialism, as if they were separate or contradictory -entities. But this is a limitation in the expression of thought to be -recognised and carefully guarded against in thought itself. There can -be no real contradiction between Religion and Science; they are only -varying manifestations in human thought of Truth, which is essentially -one. Our effort must be to unite these manifestations in thought, and -thus gain the only safe guidance possible to us for practical action.</p> - -<hr class="tb"> - -<p>The great fundamental principle of our human constitution is -incarnation—<i>i.e.</i>, spirit shaping form—the Universal -manifesting itself in the phenomenal. This principle is the foundation -of sanitary science. It forms the basis of the Moral Law which must be -the guide of science.</p> - -<p>When this principle is understood and applied, it enlarges the -intellect and enlightens the conscience. It transforms the narrow, -self-centred or arrogant individual into the humble inquirer and sharer -of the larger Diviner life.</p> - -<p>This universalization of the individual resides essentially in the -Will of man, and is the foundation of conscience—conscience which, -gradually enlarged by the growing intellect, is the great guide of the -human race in its struggle upwards.</p> - -<p>This universalization of the primitive self-centred life leads to the -realization of Sin. When we enter that Garden of Gethsemane where the -woes of the world, the murders and seductions, the cruelties and<span class="pagenum" id="Page_80">[Pg 80]</span> -hypocrisies, are revealed in all their hideousness, we realize that we -are partakers in this Sin; for it is the result of that self-centred -arrogance, that selfishness with which each one has to fight, and which -is the essence of Sin. It is through this tremendous conviction that -all must enter into that life of the Universal, where alone is true -freedom, and where alone the fulness of individual life is to be found. -Only by this saturation with the Universal does that hatred of Sin -arise which makes sins henceforth impossible.</p> - -<p>Then the recognition of Right and Wrong in human action becomes clear, -and the supremacy of the Moral Law inevitable.</p> - -<p>It is indispensable to refer to these deeper principles of existence -in considering their varied application. They give force to those -condensed maxims of practical wisdom which, transmitted to us from the -experience of our forefathers, are guides for our present daily life.</p> - -<p>‘Never do evil that good may come’ is a proverb so familiar to us -in various forms that we fail to see the profound wisdom which it -expresses.</p> - -<p>It is a confession of that intellectual limitation which cannot foresee -complicated results; it is an acceptance of that inflowing light of -conscience (however dim) by which everyone must honestly walk; it is -the subjection of the narrow, self-centred Will to the Universal Life -by which the individual becomes a free co-worker with the Divine.</p> - -<p>Physiology rightly studied in the light of this<span class="pagenum" id="Page_81">[Pg 81]</span> fundamental -principle—incarnation—vindicates the supremacy of the Moral Law, -which is the Law of Unity, or transfiguration of the Self. It gives the -perception of Right and Wrong. The Law of the Universal, reverently -and intelligently studied, will guide all practical action; it will -show us how to build a hospital, plan a medical school, organize an -institute of preventive medicine, legislate for a community, or guide -the individual life.</p> - -<p>The Law of Unity relegates bacteriology to its proper place as a branch -of pathology, and proves that truth cannot be gained by searching -into the quivering organs of tortured animals. It shows us also that -individual health cannot be secured by building a Chinese wall around -one’s self. We cannot stop the revolution of the earth in an atmosphere -which may bring bacilli from inundated China, from starved Russia, from -leprous India, or from the slums of the West.</p> - -<p>We must work gradually towards the realization of our -ideal—Health—and work in many directions and on many lines. Advancing -sanitation will place our future hospitals in country neighbourhoods, -with only temporary receiving houses and dispensaries in large towns.</p> - -<p>‘The oldest hospitals were the temples of Esculapius, where Divine -assistance was sought.’ To these Asclepeia, always erected on healthy -sites, hard-by fresh springs and surrounded by shady groves, the sick -and maimed resorted to seek the aid of the ‘god of Health.’ To this -wisdom of the ancients we must<span class="pagenum" id="Page_82">[Pg 82]</span> certainly return when the present -tendency to subordinate the welfare of the sick to the convenience of -students be checked.</p> - -<p>The most urgent need which now exists in our profession is the -establishment of an Institute of Preventive Medicine guided by the -Moral Law. Such an Institute will recognise that mind and matter meet -in the fact called Life, will reverently study all the conditions -and laws of healthy life, and not be diverted from this great aim by -curious investigations into artificially propagated disease.</p> - -<p>The study of the biological sciences, comparative and human physiology, -morphology, histology, electro-chemical action, etc., is most important -and necessary for the advancement of medical science; but these can -be studied without any violation of the moral Law of Unity. It is -necessary to study the forms and functions of life which are manifested -in organisms lower than man. The laws which govern animal and vegetable -growth form important steps towards our increasing knowledge of -human physiology and sanitary law; but these can only yield true and -available facts when studied through the natural and healthy working of -the objects of study. The artificial production of mental or physical -disease by fear and suffering vitiates the natural order of life, and -leads to error in observation and induction from such observation. -Torture is not only unsuited to laboratory work, but is an inevitable -source of error in results. A laboratory or workroom should never be -degraded into a torture-chamber.<span class="pagenum" id="Page_83">[Pg 83]</span> Experiment should never degenerate -into curiosity or inhumanity.<a id="FNanchor_9" href="#Footnote_9" class="fnanchor">[9]</a></p> - -<p>In the future a wise Institute of Preventive Medicine may possibly -be placed in the healthy country. Around such an Institute for wise -research a well-planned health colony could grow up, which would be -of enormous utility to the overworked brains of our most valuable -people. It would be a health centre where the weary brain could be -refreshed and its vigour renewed by the restorative effects of manual -labour. Guided by true science, it would teach our teachers and our -legislators. Here they might learn to reverence those laws of health -which are equally violated by overworked brains and overworked muscles. -An Institute of Preventive Medicine genuinely ‘scientific’ would be the -soul of such a health centre.</p> - -<p>But such a colony can only be created when narrow selfhood has been -transfigured by the universal life; for, as has been finely said: ‘True -social integration will follow upon spiritual integration, and upon -nothing else.’</p> - -<p>Whilst working towards a fuller realization of our ideal we must -respect and aid, as far as we can, those isolated efforts to deal with -special transgressions of the Moral Law which are really steps onward -in the<span class="pagenum" id="Page_84">[Pg 84]</span> growth of humanity. Separate efforts to advance temperance and -purity, justice to women and children, to the poor and weak, to the -humbler animals, our fellow-creatures, are all efforts to be heartily -encouraged. Each effort forms a little step out of selfishness into -large religious life. Although those who realize the Law of Unity -cannot rest in any isolated work, yet it is by the honest fighting -of sins that we grow into that hatred of Sin which will lead to its -destruction; and by the slow perception of truths we gradually approach -that ineffable Light of Truth which will melt away the chains of -selfhood, and set us free in the larger liberty of the Universal Life.</p> - - -<div class="footnotes"><h3>FOOTNOTES:</h3> - -<div class="footnote"> - -<p><a id="Footnote_2" href="#FNanchor_2" class="label">[2]</a> See Appendix, <a href="#Page_85">p. 85</a>.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_3" href="#FNanchor_3" class="label">[3]</a> Dr. Hambleton calculates the pecuniary loss from waste of -life in the army from preventable disease, chiefly of the lungs, as at -least half a million a year—a waste of life which adds materially to -the number of recruits required. Whilst stating the hygienic measures -in relation to clothing, special exercises, air, and bathing, which -have been shown to restore the inferior physique of recruits, he places -as the crowning necessity ‘explaining to the men the effects of good -and bad habits upon their health, so as to insure their co-operation.’</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_4" href="#FNanchor_4" class="label">[4]</a> Sir Walter Scott, a connoisseur in dogs, writing about -popular belief in 1832, remarks: ‘The powers of this talisman have of -late been chiefly restricted to the cure of persons bitten by mad dogs, -and as the disease in such cases frequently arises from imagination, -there can be no reason to doubt that water which has been poured on the -Lee penny furnishes a congenial cure.’</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_5" href="#FNanchor_5" class="label">[5]</a> An English gentleman, Captain Frank Fairbanks, was -detained for a fortnight in quarantine (says a Boston telegram) because -he refused to be vaccinated. A younger brother of his had lost his life -through vaccination.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_6" href="#FNanchor_6" class="label">[6]</a> See Crookshank’s <i>History and Pathology of -Vaccination</i>.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_7" href="#FNanchor_7" class="label">[7]</a> Dr. Adametz states that ‘one gramme of Gruyère cheese -contains 90,000 microbes; after seventy days they had increased to -800,000. A gramme of another kind of cheese contained about two million -microbes, whilst a piece of the rind contained about five million!’</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_8" href="#FNanchor_8" class="label">[8]</a> This is virtually accepted by one of the foremost -advocates of inoculation, who, acknowledging that preventive -inoculation ought to be strictly limited, adds: ‘Inoculation is only a -palliative measure, for the first object to be aimed at is the stamping -out of infectious disease, and I cannot help thinking that the day will -come when preventive inoculation will be a thing of the past.’</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_9" href="#FNanchor_9" class="label">[9]</a> The greatest injury which is now being done to medicine -and the advancement of hygiene is the abuse of the word ‘research’ and -the degradation of this noble exercise of human intellect by methods of -application not suited to the subject of investigation.</p> - -</div> -</div> -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_85">[Pg 85]</span></p> - -<h3 class="nobreak" id="APPENDIX_Page_56">APPENDIX (Page 56)<br><span class="small"><i>On the Humane Prevention of Rabies</i></span></h3> -</div> - - -<p>In the course of a discussion on the subject of rabies, a suggestion -was made that a resolution should be passed by the Section and sent to -Government, recommending measures for the prevention of hydrophobia.</p> - -<p>As two opposite methods of dealing with rabies had been ably supported -by Professors Roux and Fleming, I called attention to the fact that -nothing had been said in the discussion of the sufferings necessarily -inflicted upon animals where the Pasteur method advocated by Professor -Roux was adopted, and I stated that in a Pasteur Institute dogs were -kept in a state of madness. I therefore recommended that Municipal and -County Regulations, with their excellent results, as shown by Professor -Fleming of London, and Professor Ostertag of Berlin, should be adopted -rather than Pasteurian methods.</p> - -<p>In illustration of the sufferings of dogs when made mad, I referred -to my visit to the Rue Dutôt on June 2, 1889, where, after inspecting -the Hall of rabbits, guinea-pigs, and pigeons used in experiments<span class="pagenum" id="Page_86">[Pg 86]</span> for -rabies, anthrax, etc., I went to the cages of three dogs also used for -experiments in rabies, who were in various stages of madness, one dying -after its ten days’ agony; a second in the full fury of madness; a -third in frantic terror clinging to the bars of his cage, imploring to -be let out.</p> - -<p>Professor Roux’s statement in opposition to my recommendation of the -humaner methods of dealing with rabies seemed to infer that dogs were -not rendered mad in a Pasteur Institute or in dealing with rabies. But -when I stated to the Professor that I had myself seen this series of -three dogs being made mad, he replied: ‘Oh, you might have seen a great -many more, but they are not to inoculate people.’</p> - -<p>Now, it is well known from experience that it is too dangerous to -inoculate direct from the dog to the human being. But the fact that -dogs are constantly made mad for experiment in the Pasteur Institute, -or in any institute that adopts Pasteurian methods, should be honestly -acknowledged, not evaded. The fact that this frightful disease of -rabies is kept up for purposes of experiment, although the virus be -transmitted in changed form through other animals for the inoculation -of human beings, is in itself a grave fact, and it bears directly on -the point which I dwelt on at the Congress—viz., that in choosing the -method of protecting humanity from a rare but frightful disease, the -method that does not involve sufferings to animals should be adopted by -a Christian nation.</p> - -<p><span class="pagenum" id="Page_87">[Pg 87]</span></p> - -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_88">[Pg 88]</span></p> -<h2 class="nobreak" id="SCIENTIFIC_METHOD_IN_BIOLOGY">SCIENTIFIC METHOD IN BIOLOGY</h2> -</div> - - -<h3>CONTENTS</h3> - -<table class="autotable"> -<tr><th></th><th class="tdr">PAGE</th></tr> -<tr><td><a href="#Page_89"><span class="smcap">Introduction</span></a></td> -<td class="tdr page"><a href="#Page_89">89</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER I</td></tr> -<tr><td><a href="#Page_91"><span class="smcap">The Growth of Conscience</span></a></td> -<td class="tdr page"><a href="#Page_91">91</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER II</td></tr> -<tr><td><a href="#Page_95"><span class="smcap">Conscience in Medicine</span></a></td> -<td class="tdr page"><a href="#Page_95">95</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER III</td></tr> -<tr><td><a href="#Page_98"><span class="smcap">The Moral Element in Research</span></a></td> -<td class="tdr page"><a href="#Page_98">98</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER IV</td></tr> -<tr><td><a href="#Page_101"><span class="smcap">Right and Wrong Method</span></a></td> -<td class="tdr page"><a href="#Page_101">101</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER V</td></tr> -<tr><td><a href="#Page_104"><span class="smcap">The Necessity of Medical Research</span></a></td> -<td class="tdr page"><a href="#Page_104">104</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER VI</td></tr> -<tr><td><a href="#Page_109"><span class="smcap">Restriction of Experiment</span></a></td> -<td class="tdr page"><a href="#Page_109">109</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER VII</td></tr> -<tr><td><a href="#Page_119"><span class="smcap">Prurigo Secandi</span></a></td> -<td class="tdr page"><a href="#Page_119">119</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER VIII</td></tr> -<tr><td><a href="#Page_124"><span class="smcap">What is Scientific Research?</span></a></td> -<td class="tdr page"><a href="#Page_124">124</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER IX</td></tr> -<tr><td><a href="#Page_134"><span class="smcap">The Axiom of Science</span></a></td> -<td class="tdr page"><a href="#Page_134">134</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER X</td></tr> -<tr><td><a href="#Page_137"><span class="smcap">Rational Experiment in Research</span></a></td> -<td class="tdr page"><a href="#Page_137">137</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER XI</td></tr> -<tr><td><a href="#Page_144"><span class="smcap">The Range of Painless Research</span></a></td> -<td class="tdr page"><a href="#Page_144">144</a></td></tr> -<tr><td class="tdc" colspan="2"> - CHAPTER XII</td></tr> -<tr><td><a href="#Page_148"><span class="smcap">Recapitulation of Principles</span></a></td> -<td class="tdr page"><a href="#Page_148">148</a></td></tr> -</table><p> -<span class="pagenum" id="Page_89">[Pg 89]</span></p> - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<h3>INTRODUCTION</h3> -</div> -<p>A controversy is persistently carried on between an increasing body -of the non-professional laity and an important section of the medical -profession, in relation to the methods pursued in investigating -biological phenomena.</p> - -<p>The criticism of medical research by non-medical people is naturally -resented by some who are engaged in experimentation, and it is stated -seriously that non-scientific persons will impede progress if they -interfere with or succeed in restricting the efforts of those who -specially devote themselves to this branch of research.</p> - -<p>This controversy is still going on in ever-widening circles, and it -is bound to do so until the present confusion of thought which exists -on this subject is removed, and the broad distinction between right -and wrong experimentation is more fully acknowledged and more clearly -defined. Our relation to the lower animals has never yet been brought -fully into the clear light of reason and conscience. Yet in the order -of Providential development it must so come forward.</p> - -<p>As advancing humanity has gradually recognised natural rights as -existing in the various races of<span class="pagenum" id="Page_90">[Pg 90]</span> mankind, and is carrying on a -persistent warfare against human slavery, and slowly awakening to the -moral crime of introducing disease and vice amongst native races, -and the rights as well as duties of women and of children are being -gradually recognised, so the time has come when the natural rights of -inferior living creatures must be seriously studied.</p> - -<p>This study has become obligatory, not only in regard to the welfare -of the brute creation, but for the sake of our own human growth as -rational and moral beings.</p> - -<hr class="tb"> - -<p>The common-sense of mankind recognises our right to use the lower -animals for human benefit, whilst our superior intelligence gives us -the power to so use them. But ‘can’ and ‘ought’ are different aspects -of our mental constitution, which require to be harmonized. What we can -do is not the true measure of what we ought to do in any department of -life.</p> - -<p>We can starve a child or lash a horse to death, but we have no right to -do so.</p> - -<p>The laws of our human constitution compel us to recognise that -intellect and conscience, although essential parts, are not identical -parts of our nature. Long experience shows us that social progress can -only become permanent when conscience guides intelligence.</p> - -<p>How far the guidance of conscience can extend, with the practical -results to medical research involved in the recognition of such -guidance, forms the subject of present consideration.</p> - -<p><span class="pagenum" id="Page_91">[Pg 91]</span></p> - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<h3>CHAPTER I<br><span class="small"><i>The Growth of Conscience</i></span></h3> -</div> -<p>It is through the gradual and harmonious development of intelligence -with that element in our nature that we name conscience that the human -race passes from lower to higher states of civilization. In pursuing -our ideals, conscience is our instinctive monitor of right and wrong.</p> - -<p>Our great naturalist, Darwin, laid down as a law of evolution that -‘the moral sense, or conscience, is by far the most important of the -differences between man and the lower animals. Duty—“ought”—is the -most noble of all the attributes of man.’</p> - -<p>Victor Hugo, with the prophetic insight of genius, calls conscience -‘that modicum of innate science with which each one is born.’</p> - -<p>The growth of human conscience in its perception of justice and in its -sympathetic relation to creation is the surest measure of individual -and national progress. Various intellectual theories may be formed as -to the origin and growth of conscience. It may be held to be intuitive, -springing up as inevitably as the instinctive feelings born with the<span class="pagenum" id="Page_92">[Pg 92]</span> -natural relations of life; or it may be looked upon as gradually -evolved, the ‘result of countless experiences of fear, love, utility, -transmitted through generations.’</p> - -<p>But however originating, conscience is a positive and potent fact. -It is, indeed, the mightiest factor in social life. It is the great -controller of selfhood. It enlarges human character and guides human -conduct. The deepening of this principle through the growth of justice -and sympathy marks an advancement in the type of humanity. Increasing -respect for life is one of the clearest signs of growing conscience. -Our reverence for the principle of life grows with our enlarging -intellectual perception of its universality and its unlimited power of -development.</p> - -<p>As life is marked by activity, and cannot remain stationary, so -conscience shares this law of life. It must inevitably advance or -retrograde.</p> - -<p>The degradation as well as the development of conscience may be seen -amongst us in the midst of our present civilization. It is contrary to -the most rudimentary element of conscience to feed upon one’s kind, and -cannibal tribes who devour their captives represent the lowest type -of humanity; even the dogs of the Arctic voyager will endure the slow -agony of starvation for days before their human taskmasters can compel -them to eat the flesh of their companions. The well-known naturalist, -Mr. W. H. Hudson, states that wolves, when pressed with hunger, will -sometimes devour a fellow-wolf;<span class="pagenum" id="Page_93">[Pg 93]</span> as a rule, however, rapacious animals -will starve to death rather than prey upon one of their own kind.</p> - -<p>Yet shipwrecked sailors, even of our own English race, have been -known to drink the blood and eat the flesh of their own comrades when -confronted by starvation.</p> - -<p>We find that intelligence may exist without conscience, but the human -type changes to a destructive force when this separation takes place. A -lamentable example of the social danger created by the destruction or -absence of rudimentary conscience amongst us is shown by the betrayal -and murder of the little boy Eccles in Liverpool, for the sake of his -clothes, by his two companions of eight and nine years old. There was -the deliberate plot to entice him to a pond; the throwing him three -times into the water as he scrambled out; the final holding him under -water until all struggle had ceased. These facts make a striking, but -not unique, object-lesson, showing how intelligence may exist without -conscience amongst all our appliances of civilization, and the danger -of such separation.</p> - -<p>Examples of the social devastation produced by official corruption and -business dishonesty are too numerous to be detailed; they are seen in -what are called civilized countries—in London, Paris, Rome, and across -the ocean. The lack of conscience in public and private transactions -creates social misery proportioned to its extent.</p> - -<p>Recognising, therefore, that this distinctive principle of conscience -is a fact of gradual development,<span class="pagenum" id="Page_94">[Pg 94]</span> that it grows by the union of -the moral with the intellectual elements in our nature, and that -the far-reaching consequences for good or evil of vivid or dulled -conscience in the individual and the nation are far beyond our power -of foresight, a grave responsibility rests upon us in this matter. -We are bound to realize that any custom, or method of education, or -proposed course of action, that seems to violate the natural instincts -of humanity, or is contrary to the present enlightened conscience of -any section of our Anglo-American race, demands imperatively the most -careful consideration on our part.</p> - -<p><span class="pagenum" id="Page_95">[Pg 95]</span></p> -<hr class="x-ebookmaker-drop"> -<div class="chapter"> - -<h3>CHAPTER II<br><span class="small"><i>Conscience in Medicine</i></span></h3> -</div> -<p>Every intelligent member of the medical profession will certainly -recognise the special value of human conscience in the profession.</p> - -<p>The problems which are involved in the practice of the beneficent art, -the absolute reliance which the anxious patient is compelled to place -in his physician, the helplessness of the poor, who form so large -a majority of those who need medical aid, and who are without the -defences of wealth and station, show the need of keen moral sense, as -well as intelligence, in those who practise the art of medicine.</p> - -<p>The very discoveries of medical science enforce this necessity; for the -possibility of abuse in the employment of such beneficent agents as -anæsthetics and hypnotism, by incompetent or conscienceless operators, -is a very serious fact.</p> - -<p>This special responsibility of the medical profession to society is -greatly increased by the fact that the training of a very large section -of our intelligent youth during the important years of early manhood -rests upon them. The moral as well as intellectual<span class="pagenum" id="Page_96">[Pg 96]</span> influence exerted -by those who guide the college, the hospital, the dispensary, and -post-graduate classes, will mould the future action of one of the most -influential portions of the community—those, viz., on whom the health -of the nation chiefly rests.</p> - -<p>Now, whilst all recognise the need of the trained and skilful care -of a nation’s health, and perceive also that rightly organized -medical schools and hospitals are of great value in educating our -health-guardians, how is it that a profound distrust of these -institutions has grown up in our midst, that the support of hospitals -becomes increasingly difficult, whilst at the same time the sentiment -of benevolence and desire to help the poor is constantly extended?</p> - -<p>How is it that the beneficent and necessary art of medicine no longer -commands that respect and confidence which its essential character as -part of our social institutions would seem to demand?</p> - -<p>The answer to these serious questions involves both moral and -intellectual considerations. These problems have arisen from failure -to perceive that in education moral and intellectual activity cannot -be advantageously divorced, or that one portion of our complex nature -cannot be beneficially developed whilst other portions are entirely -ignored or injured.</p> - -<p>Our medical schools, whilst sharpening the intellectual faculties of -their students, must be careful that their modes of teaching bring with -them no deterioration of that important faculty of their students—the -moral sense. As conscience or the<span class="pagenum" id="Page_97">[Pg 97]</span> moral sense is unequally developed -in human beings, but is indispensable to the physician in his relations -with patients, any apathy or negligence in this respect by the trainers -of youth may become a national danger.</p> - -<p><span class="pagenum" id="Page_98">[Pg 98]</span></p> - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<h3>CHAPTER III<br><span class="small"><i>The Moral Element in Research</i></span></h3> -</div> -<p>Morality as a guide in biological science is based upon the practical -distinction between organic and inorganic Nature.</p> - -<p>If medical progress simply involved the investigation of inorganic -Nature, the general public would be only learners, gladly receiving -such information in geology, chemistry, astronomy, or physics, as -specialists in those branches of physical science were good enough to -impart to the unlearned.</p> - -<p>But directly scientific research passes beyond the distinctive realm of -matter, moulded and transformed by general energy, but not affected by -individual will, it has to deal with a very different principle—viz., -life. This vital distinction has been well laid down by one of our -eminent medical authorities as follows: ‘During the slow growth of -medical knowledge it has become more and more plain that physics, -chemistry, and biology are distinct sciences, with methods of their own -and inductions of their own, each of the latter terms in the series -using the results of its predecessors, and adding new results of<span class="pagenum" id="Page_99">[Pg 99]</span> its -own. Although life is a structure built up of physical and chemical -facts, yet to the building, to the arrangement, to the ordering of -those facts, there goes something that neither physics nor chemistry -can explain, any more than algebra can explain the behaviour of a -magnet. To strive to interpret the series of events which make up the -life of an animal in terms of chemical change (metabolism), or of -conservation or expenditure of energy, is an endeavour which will fail.’</p> - -<p>As the brute creation as well as human beings share in a physical -organization which expresses each variety of life, there is not the -same sharply-dividing line between the various categories of animal -life as there is between organic and inorganic Nature. Biogenesis, or -life generated by life, is the distinctive feature of organic Nature. -We are linked to living creatures of higher or lower nature by the -power of educating or subduing them, and by all those varying relations -involved in the mystery of life.</p> - -<p>The distinctive position of man, as an animal placed at the head of the -animal world, necessarily creates serious responsibility on the part of -the higher towards the lower creature.</p> - -<p>This basis of moral responsibility extends in kind, if not in degree, -to all life. It necessitates a directing conscience which shall guide -all our intellectual and practical relations with every category of -life.</p> - -<p>This moral element enters unavoidably into our<span class="pagenum" id="Page_100">[Pg 100]</span> treatment of animal -life from its lowest to its highest form. Our treatment of a monkey or -a prince contains an element of moral attitude which does not exist in -our relation to inorganic Nature.</p> - -<p>It is a difference of kind as well as of degree, which it is blindness -to ignore.</p> - -<p>The divergence which now exists between some biological investigators -and their critics rests upon the failure to recognise that moral error -may engender intellectual error.</p> - -<p>The special subject which has produced this controversy is the present -method of using the lower animals in biological research, which has so -enormously extended of late years. The essence of the controversy is -the ethical question—viz., Have we a right to torture?</p> - -<p>It must be distinctly understood that there is here no question of our -right under certain circumstances to put to death. Neither is there a -doubt of the utility of rational experiment and of research. But the -right to put to death in the most humane manner known to us, and the -right to torture to death, are two widely different questions.</p> - -<p>We have no right, for any purpose whatever, to torture a living -creature to death, either by the mutilation of the organs, the slow -deprivation of the necessary conditions of life, or the still slower -process of destroying by the inoculation of disease.</p> - -<p><span class="pagenum" id="Page_101">[Pg 101]</span></p> -<hr class="x-ebookmaker-drop"> -<div class="chapter"> - -<h3>CHAPTER IV<br><span class="small"><i>Right and Wrong Method</i></span></h3> -</div> -<p>It must be carefully noted that the wrong involved in inflicting -torture upon a living creature is the violation of a rational -principle. The employment of torture or of painful experiment in -biological research is not a question of the right to gain knowledge; -it is a question of how we seek to gain knowledge. It applies directly -to method.</p> - -<p>Thus, the fact observed by Paget, that in a patient who vomited all -fat, the pancreas alone was found on post-mortem examination to be -diseased, is worth more than a series of experiments on lower animals -of different constitution from our own.</p> - -<p>In the slow approach towards truth, which is the great object of -science, no single method is indispensable. The human mind is so full -of activities, Nature presents such an infinite variety of resources, -that progress in research can never be hindered by the choice of right -instead of wrong method.</p> - -<p>This is well stated by one of our most experienced investigators when -he says: ‘Methods run with<span class="pagenum" id="Page_102">[Pg 102]</span> the manners and customs of the ages. In -science there is no one method that can be considered indispensable. -Attributes are indispensable; observation, industry, accuracy, are -indispensable; methods are not. They may be convenient, they may be -useful, they may be expedient, but nothing more.’<a id="FNanchor_10" href="#Footnote_10" class="fnanchor">[10]</a></p> - -<p>This admirable statement throws a flood of light upon the confusion -and perplexity of the present controversy. It shows the error of both -the so-called unscientific and scientific parties. It shows the error -(not unnatural), in the former, of confounding together experiment, -research, laboratory, and scientific investigation, and classing them -under one indiscriminate ban of cruelty; it also shows the narrow -vision and false reasoning of those who claim that right and wrong have -no meaning when applied to the investigation of phenomena supposed to -be revealed by the senses, or state that the collecting of so-called -facts, named knowledge, is an end in itself, to be unrestrained and -justified in itself.</p> - -<p>That interesting book, <i>The Naturalist in La Plata</i>, in -narrating the author’s observation of the natural fearlessness of -all wild animals towards man, the careful research into life-habits -that can be carried on where this fearlessness is not betrayed, and -the susceptibility to kindness which exists amongst all the lower -animals to their sovereign,<span class="pagenum" id="Page_103">[Pg 103]</span> man, furnishes a striking and delightful -suggestion as to the <i>method</i> which future research should -take.<a id="FNanchor_11" href="#Footnote_11" class="fnanchor">[11]</a></p> - -<p>It is the distinctive moral relation existing in the plane of animal -life that makes our connection with the organic world a different and -more comprehensive relation than that which exists with inorganic -Nature. It places research in the biological sciences on a different -plane from study of the physical sciences.</p> - -<p>Therefore, whilst it would be folly for ordinary people to criticise -the methods of experts in physical science, it would be dastardly -dereliction of duty not to consider the methods employed in biological -science.</p> - -<p>The subject of experimentation upon the lower animals having two -aspects—an ethical and an intellectual one—the medical profession -will be wise to welcome all honest and kindly criticism and suggestion -in the most difficult of all studies—viz., the study of life. It must -be recognised that the people are absolutely in their right in refusing -to submit to dictation in what concerns their relation to animal life, -of which they are the responsible head.</p> - -<p><span class="pagenum" id="Page_104">[Pg 104]</span></p> - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<h3>CHAPTER V<br><span class="small"><i>The Necessity of Medical Research</i></span></h3> -</div> -<p>Whilst fully recognising the right of the laity to criticise scientific -method when it deals with sentient animals, fashioned on the same -general plan as ourselves, and capable of fear, pain, affection and -gratitude, there is another aspect of the subject which we are bound to -consider.</p> - -<p>The present condition of medicine is that of an art, not of a science. -It is erroneous to speak of the science of medicine. There exists -uncertainty in diagnosis, uncertainty in the action of remedies, -ignorance of individual idiosyncrasy, and terrible inability to meet -such devastating diseases as cancer, consumption, leprosy, etc.</p> - -<p>No one outside the profession can fully realize the grave -responsibility, even desperate anxiety, felt by the conscientious -physician when life or death seems to depend upon his action and he -knows that medical resources are not equal to the occasion. It is a -noble desire for the advancement of the beneficent art of medicine -which makes the great body of busy doctors eagerly listen to those -who<span class="pagenum" id="Page_105">[Pg 105]</span> are supposed to speak with authority, and hail with hope every -announcement of supposed discovery which seems to promise improved -practical results.</p> - -<p>This is really a sound humane attitude of mind in that vast body of -the profession who are unable, from the pressure of practical life, to -devote themselves to investigation—a profession which has always had -its heroes and martyrs, who have not shrunk from risking their lives in -the service and for the advancement of their noble art.</p> - -<p>Those also who are in the profession can most fully estimate the -real and beneficial results, both in surgery and medicine, derived -from careful and persistent research, notwithstanding the severe -disappointment often caused by the theoretical error and unjustifiable -practice resulting from rivalry in erroneous methods of investigation. -The conquest of pain and diminution of nervous shock in necessary -surgical operations,<a id="FNanchor_12" href="#Footnote_12" class="fnanchor">[12]</a> the disappearance of blood-poisoning, hospital -gangrene, and erysipelas, which were the scourges of our public -institutions in a former generation, are immense gains, due to the -discovery of anæsthetics, antiseptics, and to advancing sanitation. -These blessings are the direct outcome of persevering and skilful -clinical observation, of careful work in the laboratory, of<span class="pagenum" id="Page_106">[Pg 106]</span> humane -experiment, and of happy accident; they are not derived from cruel -experimentation.</p> - -<p>The successful control of that terrible disease—puerperal fever—which -formerly destroyed such a multitude of women, is a striking conquest of -humane method in modern medicine. When I was a student in La Maternité -of Paris in 1849, this destructive malady of lying-in women produced -a mortality varying from 10 to 15 per cent. But when I visited La -Maternité in 1889 the mortality was reduced to a little over 1 per -cent. This was due to rigorous cleanliness, sanitation, and the use of -antiseptics, directed by the skilful <i>sage femme en chef</i>, Madame -Henri, in spite of the old and unsuitable buildings and the depressing -status of many of the patients.</p> - -<p>A still more satisfactory result is shown in the Clapham Maternity -Hospital, in London, where not a single death occurred amongst the 760 -cases first received into the institution.</p> - -<p>This excellent result still continues under the same administration. Of -the 4,000 lying-in cases received in the hospital during the thirteen -years it has existed, there has been no death from puerperal fever. -This excellent record has been attained by scrupulous cleanliness, -absolute isolation on the occurrence of suspicious symptoms, by -excellent nursing, and constant oversight by the doctors in charge. -Even in the out-patient department, where the conditions of living are -not under such strict medical control, the deaths from this frightful -malady<span class="pagenum" id="Page_107">[Pg 107]</span> have only amounted to 5 in 12,500 cases under the same -enlightened direction.</p> - -<p>This great and beneficent reform in the first and world-wide branch -of medicine, by means of which the lives of innumerable women in all -our large centres of civilization have been saved, is the result of -scientific research. It was initiated and successfully carried out -by Semmelweis, of Vienna, and is a striking instance of the value -of research carried on by the use of the comparative method, with -absolutely no resort to experiment. The history of this reform, the -methods by which it was accomplished, the opposition it encountered in -the profession itself, and its triumphant vindication, are well worth -serious study. An account of this valuable investigation and other -important discoveries by justifiable methods of inquiry are given to -English readers by the admirable translation published by the New -Sydenham Society.<a id="FNanchor_13" href="#Footnote_13" class="fnanchor">[13]</a></p> - -<p>Medical research, therefore, is not only justifiable, but obligatory in -a profession that is specially charged with the care and advancement -of individual and national health, and, as will be seen later, -observation, induction, and rational experiment form the essential -methods of scientific inquiry.</p> - -<p>These two facts—viz., the necessity of advance in medical knowledge -and the methods of investigation<span class="pagenum" id="Page_108">[Pg 108]</span> necessary for such advance—must -be distinctly recognised by sincere reformers, and should shield the -profession from that indiscriminate reproach which is often made -against it as a whole; for such hostility tends to strengthen that -undue <i>esprit de corps</i> which often hinders sound medical progress -in the profession.</p> - -<p><span class="pagenum" id="Page_109">[Pg 109]</span></p> -<hr class="x-ebookmaker-drop"> -<div class="chapter"> - -<h3>CHAPTER VI<br><span class="small"><i>Restriction of Experiment</i></span></h3> -</div> -<p>When we investigate the popular or ethical aspect of so-called -scientific research made upon living animals, we are at once met by -facts which imperatively demand both serious thought and determined -action if we would not be participators in the degradation of human -conscience. We are confronted with the enormous increase in such -experiments which has taken place within the last thirty years, as well -as in the severity of the sufferings inflicted. This increase is going -on in England as well as in foreign countries.<a id="FNanchor_14" href="#Footnote_14" class="fnanchor">[14]</a> It is growing in -many cases, not only without any benefit to the human race, but also -without reference to any supposed beneficial result as its attempted -justification.</p> - -<p>The volume of facts and evidence collected by Mr. Colam (the able -Secretary of the Royal Society<span class="pagenum" id="Page_110">[Pg 110]</span> for the Protection of Animals), and -published by that society in 1876, is a permanent record of great -value. It enables us to measure the growth of experimentation in -England, not only from 1862 to 1876, when the present Cruelty to -Animals Bill was enacted, but it also forms a point of comparison for -testing the increase of vivisectional methods since 1876 to the present -day, when these easy but often fallacious methods of research have -become universal in medical investigation and medical instruction.</p> - -<p>In 1869 there were very few places where the experimentation on animals -could be carried on, such investigations being made by men of rare -ability, and for a definite object. There were no class demonstrations -and no students encouraged to experiment. But in 1892 there were 180 -persons licensed in this country, and over 3,960 experiments performed, -numbers which increase with each year.</p> - -<p><i>The Effect on Students and Subordinates.</i>—A point for serious -consideration is the effect produced upon the unformed minds of -students of medicine by the introduction of experimentation upon living -animals into our medical schools and hospitals.</p> - -<p>The employment of destructive experimentation on living creatures -is now introduced as a part of the ordinary instruction of medical -students in the fundamental study—physiology. This is a novelty of -the present generation. During the whole course of my medical studies, -fifty years ago, I never saw a living creature vivisected for the -instruction of<span class="pagenum" id="Page_111">[Pg 111]</span> students. The same is true of the experience of most of -the able physicians of an older generation.</p> - -<p>Now, however, nearly every medical school has its store of imprisoned -living creatures awaiting their fate, from the large frogs imported -from Germany, the mice, rabbits, cats, and dogs of home production, -to the cargoes of monkeys brought to our foggy climate from tropical -Africa. They form an enormous mass of living creatures, kept for the -attempted demonstration of vital action in the lecture-room, or for the -study of diseased processes in the physiological laboratory.</p> - -<p>It is a fallacy (although proclaimed in high places) that the ordinary -student of medicine must be prepared for his practical work as a -physician for men by watching the opening of chest, abdomen, brain, -or cutting into the delicate vital organs of lower animals. Such -demonstration is a thrilling spectacle to inexperienced students. It -appeals to that love of excitement which makes them rush to a surgical -operation, or to an extraordinary medical case, whilst the commonplace -but all-important bedside observation seems dull in comparison. Yet -patient work in the anatomical and microscopic rooms, and in the -chemical laboratory for general and animal chemistry and close clinical -study, all of which involve no form of suffering, are of primary -importance. The genius of a Professor as an instructor is shown by his -ability to make his pupils realize this.</p> - -<p>Destructive experimentation on helpless animals,<span class="pagenum" id="Page_112">[Pg 112]</span> not for their own -benefit, is a demoralizing practice. The student becomes familiar -with the use of gags, straps, screws, and all the paraphernalia of -ingenious instruments invented for overpowering the resistance of the -living creature, or for guarding the operator from injury in case the -anæsthetic, when used, should give out too soon. He learns also how -easy it is to experiment in secret.</p> - -<p>By advanced instruction and post-graduate classes the student is led -on to take active part under licensed authority in this fascinating, -but morally dangerous, method of study. Moreover, the large body of -subordinates who are necessary to take charge of and prepare the -animals, are trained in indifference to suffering, without any excuse -of intellectual gain, and the same injurious influence extends in -ever-widening circles—to the traders who invent and sell instruments -of torture, and to those who supply the living material.</p> - -<p>Now, the natural instinct to be cherished in human beings is protection -and kindliness to infancy and all helpless creatures, not indifference -to suffering or wilful infliction of it. As human conscience is a thing -of growth or degradation, the natural shrinking from needless pain can -soon be hardened into callousness. Conversing with medical students in -relation to the effect made upon them by witnessing vivisections even -under chloroform, I have found that their experience is always the -same—viz., first, the shock of repulsion, then tolerance, and then, if -often repeated, indifference.</p> - -<p><span class="pagenum" id="Page_113">[Pg 113]</span></p> - -<p>The moral deterioration necessarily induced in those to whom suffering -becomes a frequent spectacle is noted by the <i>Englishman in -Paris</i>, from personal experience. After speaking of the inhumanity -produced by the daily sight of blood in the originally honest -bourgeois, who became the ‘Conventionnels’ of the French Revolution in -1793, he writes as follows: ‘I have witnessed three executions. After -Pommeraye’s execution I was ill for a week; after Troppmann’s the -effect soon wore off in three days; after Campa’s I ceased to think -about it in twenty-four hours. Then I made a vow that no power on earth -should draw me to the Place de la Roquette again. But men generally -regard their growing imperviousness as a sign of mental force, and -pride themselves upon it.’</p> - -<p>In Marie Bashkertseff’s <i>Journal</i> is a striking passage which -describes the effect of a Spanish bull-fight. She says: ‘I was able -to maintain a tranquil air in full view of the butchery, carried on -with the utmost refinement of cruelty. One leaves the scene slightly -intoxicated with blood, and feeling desirous to thrust a lance into -the neck of every person one meets. I stuck my knife into the melon I -was cutting at table as if it were a banderilla I were planting in the -hide of a bull, and the pulp seemed like the palpitating flesh of the -wounded animal. The sight is one that makes the knees tremble and the -head throb. It is a lesson in murder.’</p> - -<p>The moral distinction between heroism shown<span class="pagenum" id="Page_114">[Pg 114]</span> when suffering is -witnessed for the purpose of aiding the sufferer and that evinced for -the selfish desire of individual gain or excitement, was strikingly -exhibited by a German nurse whom we sent on to the army during the -Civil War in America. This frail-looking woman drifted on to the front, -and, after the Battle of Gettysburg, donning a pair of man’s boots, -wading in pools of blood and mud, spent two days and nights on the -field of slaughter, drawing out still breathing bodies from the heaps -of slain, binding up wounds, giving a draught of water, placing a rough -pillow under the head, in an unselfish enthusiasm that knew neither -hunger nor fatigue. The ghastly wounds, the blood, the shrieks and -groans of that horrid scene served but as fuel to the fire of humanity -that consumed her.</p> - -<p><i>The Effect on Teachers or Practitioners of Medicine.</i>—In -considering the subject of experimentation, reason requires that we -realize the necessary distinction between the methods employed in -training students for a practical profession and the exceptional -position of the few geniuses who possess the rare combination of -qualities essential to scientific investigation. In calling attention -to this distinction we do not condone torture, for this can be proved -to be unscientific. But it emphasizes a growing and mischievous evil -of the present day when numbers of ordinary teachers of physiology, -whose gifts are limited and whose especial business is to instruct -students in the knowledge which has been attained, consider themselves -capable of original<span class="pagenum" id="Page_115">[Pg 115]</span> scientific research, or attempt to repeat before -either students or popular audiences so-called demonstrations on living -creatures.</p> - -<p>The showy plan of experimenting on animals is undoubtedly a great -temptation to teachers. Such practice readily gains the gratifying -applause of inexperienced learners, who are misled by an appearance of -conclusiveness in the lectures, which they are quite incompetent to -gauge. But the influence thus exercised is a harmful one, diverting the -mind from right methods of study.</p> - -<p>The temptation to make a display before imperfectly informed persons is -too great. If the profession is to advance in popular esteem, it will -recognise that the unfeeling destruction of living creatures, even the -pithing of a frog or the dissection of the salivary glands of a living -mouse, is a false method of forming the minds of students, which should -be entirely abandoned.</p> - -<p>We must here note the demand lately made by some leading members of the -profession for increased facilities for experimentation on animals. -Now, anyone who studies the Cruelty to Animals Bill (30 and 40 Vict.), -which in 1876 licensed vivisection in Great Britain,<a id="FNanchor_15" href="#Footnote_15" class="fnanchor">[15]</a> will see how -easy it now is to obtain a license, and how carefully the provisions -of the Bill are arranged to give freedom to experimentation—in fact, -to protect experimenters rather than<span class="pagenum" id="Page_116">[Pg 116]</span> their helpless victims. Thus, -whilst in Section 2 a penalty of £100 or three months’ imprisonment is -imposed for acts of cruelty, the Bill proceeds in Section 3 to give -absolute freedom to every licensed person to torture, to mutilate, -to disease to any extent if he considers it advisable to do so. In -Section 11 it gives exceedingly wide scope for procuring licenses. By -Sections 7 to 10 it makes the efficient oversight of licensed persons -almost impossible, and by the provisions of Sections 13 to 15 it -virtually excludes the influence of growing humanitary conscience in -the community from being exerted on the persons and places licensed. -In short, the Bill would rather seem to be skilfully devised to give -a free hand to persons who may call themselves ‘scientific’ than to -protect living creatures who cannot protect themselves.</p> - -<p>The plea put forward by the gentlemen referred to—viz., that medical -progress is now hindered in England by restrictions—is practically a -justification by them of the inhuman practices which prevail in France, -Germany, Russia, and the United States, and in all countries where -the conscience of the people has not been aroused to the moral and -intellectual dangers involved in the torture of animals.<a id="FNanchor_16" href="#Footnote_16" class="fnanchor">[16]</a></p> - -<p><span class="pagenum" id="Page_117">[Pg 117]</span></p> - -<p>Surely these English physicians who demand entire freedom for -vivisection do not realize what the result of foreign methods is. They -cannot have noted the innumerable examples of atrocious cruelty which -are occurring in the records of medical research as practised on the -Continent and in America.</p> - -<p>They cannot have taken note of such typical examples as the utterly -useless barbarity of Senn of Philadelphia, setting fire to a dog -that he had pumped full of hydrogen gas, before the Medical Congress -of Berlin in 1890. Nor the experiments in massage on a series of -large disjointed dogs performed in Professor Charles Richet’s Paris -laboratory, not only with the permission, but with the consultative -advice of that gentleman. A set of more unjustifiable experiments were -never devised.</p> - -<p>Certainly, no body of honourable English physicians who are in the -habit of reading <i>Les Archives Générales de Médecine</i> would -fail to condemn such fallacious experiments, where the pretence of -anæsthesia served to diminish the resistance of the victims—not to -annihilate pain.</p> - -<p><i>Factors in Human Nature.</i>—It must never be<span class="pagenum" id="Page_118">[Pg 118]</span> forgotten that -gambling excitement or the spirit of undue emulation exists in all -classes of men—in biological investigators as well as others—and it -needs guidance or restraint.</p> - -<p>The German officer Reizenstein felt keen remorse for the murder of -his beautiful Irish mare Lippespringe, yet he and his companions -tortured thirty horses to death under the temporary insanity of intense -rivalry. But it was possible to bring public conscience to bear on -this barbarity, and thus check the recurrence of any similar future -aberration.</p> - -<p>So in biological research we see the disastrous effects of individual -and national rivalry. They are shown in the contradictory results of -false methods of observation, in the endless repetition of similar -painful experiments, in the strife of conflicting theories, and in -the practical failure of results obtained from the lower animals when -applied to the human race.</p> - -<p>The moral sense of a noble profession may well be appealed to to create -a conscience which shall check the present grave abuses of so-called -research.</p> - -<p><span class="pagenum" id="Page_119">[Pg 119]</span></p> -<hr class="x-ebookmaker-drop"> -<div class="chapter"> - -<h3>CHAPTER VII<br><span class="small"><i>Prurigo Secandi</i></span></h3> -</div> -<p>Another serious ethical danger connected with unrestrained experiment -on the lower animals is the enormous increase of audacious human -surgery, which tends to overpower the slower but more natural methods -of medical art and to divert attention from hygiene.</p> - -<p>This modern increase of surgery, entailing permanent mutilation, has -received a special name, prurigo secandi, or cacoethes secandi. It -prevails in France and in every country where no restraint is placed on -animal experimentation,<a id="FNanchor_17" href="#Footnote_17" class="fnanchor">[17]</a> or where the<span class="pagenum" id="Page_120">[Pg 120]</span> importance of not injuring -the moral sense of students has not been recognised.</p> - -<p>The great increase in ovariotomy, and its extension to the insane is a -notable result of this prurigo secandi.</p> - -<p>Dr. Chanu, in his carefully-prepared thesis of 1896, in exposing -the grave abuse of this branch of surgery, estimates that there -were 500,000 castrated women in France, and one in every 250 women -throughout Europe. He finds the decrease of the birth-rate to coincide -with the abuse of ovariotomy. ‘Dr. Chanu affirmed, before a jury unable -to refute his assertion, that the abuse of ovariotomy has done more -harm to France in ten years than the Prussian bullets did in 1870, and -that the causes of the depopulation of France are closely allied to the -practice of the castration of women.’</p> - -<p>The prevention of disease in the organs of generation must be sought -for persistently in improved education of the young—the male as well -as the female—and in <i>just</i> relations of the sexes.</p> - -<p>Of the same nature as the prurigo secandi of medical practice is the -motive or source of much of the laboratory experimentation.</p> - -<p><span class="pagenum" id="Page_121">[Pg 121]</span></p> - -<p>The various ethical dangers resulting from conscienceless or irrational -experiments on animals demand much more serious consideration by the -profession than has hitherto been given to them. In the opinion of an -increasing number of intelligent physicians, a vast amount of what is -now presumptuously called research—experiments disguised under learned -names, but which are really the irrational mutilating and diseasing of -sentient living creatures—are no more <i>scientific</i> research than -is the gratification of a child’s curiosity when it sticks a pin with a -thread through a cockchafer, to see how long it will fly and how loud -it will buzz. The child, when punished for its thoughtless cruelty, -might remonstrate in learned terms that it should not be restrained, -for it was investigating the vital endurance of the <i>Melolontha -vulgaris</i> and the acoustic properties of its wing-covers, under -interesting and abnormal conditions.</p> - -<p>A large proportion of what is simply conscienceless curiosity, often -starting from more or less frivolous tentative diversions of the -laboratory, though now by courtesy named research, is no more valuable -than the child’s spinning of the cockchafer, and should be as sharply -checked.</p> - -<p>The genesis of discovery in biology, with its necessary relations to -therapeutics, has yet to be written. Extending experience is more and -more clearly showing us, as a practical fact, that whilst observation -and rational—<i>i.e.</i>, humanely limited—experiment are legitimate -and noble efforts for the<span class="pagenum" id="Page_122">[Pg 122]</span> attainment of improved medicine, cruel -and merely curious experiment, condemned by our moral faculties, are -misleading and mischievous.</p> - -<p>Men like Professor Henschel, of Upsala, and Professor Pettenkofer, of -Munich, warn our eager young investigators against drawing conclusions -as to human beings from experiments made on animals.</p> - -<p>We find, as a matter of fact, that all the <i>permanent</i> advances -of medicine have been gained whilst pursuing rational and righteous -methods, whilst all the fiascoes of supposed discovery have resulted -through departing from them.</p> - -<p>Anæsthetics, antiseptics, and sanitation are not the result of cruel -experimentation.</p> - -<p><i>Danger of Inoculation.</i>—The most serious fallacy arising from -erroneous methods of biological research is the practice of vitiating -human blood by the introduction of the diseased products of animals. -This dangerous method, which threatens to undermine national health, -is the necessary outcome of diseasing animals on the plea of seeking -remedies for human disease.</p> - -<p>The intellectual fallacy involved in this practice will be considered -later; but its ethical character as affecting conscience must here -be noted, as it is this line of research which is productive of the -most extended form of cruelty to the lower animals—viz., <i>slow</i> -torture.</p> - -<p>The following extract from records of the Belgian Academy of Medicine -illustrates this subject:<span class="pagenum" id="Page_123">[Pg 123]</span> ‘Researches on the inoculability of cancer -ought to be encouraged. The numerous experiments made on animals are -still contradictory in results. Drs. Francotte and De Rector have in -the years 1891-92 inoculated mice under the skin of the shoulder. The -inoculations were carried on from June, 1891, to May, 1892, when the -following appearances were presented: The whole region of the shoulder -was inflamed; there was necrosis of the corresponding upper extremity, -which dropped off from dry gangrene; the stump left was indurated, -hard, and painful, whilst the lymphatic glands in connection with the -part were enlarged. The examination of the tumour disclosed nothing -very particular. The bones were the seat of osteoporosis, and the -arteries showed arteritis. The investigators believe the tumours were -cancerous, but this statement must be received with caution.’</p> - -<p>Such long-continued torture, even of a mouse, is morally degrading, -and, as if in retribution, is doomed to be useless.</p> - -<p>A Chinese medical author, Tuan Mei, writing in the last century, 1716 -to 1797, lays down a true medical axiom when he marks the difference -between death and torture as follows: ‘Living creatures are for our -use, and we may put them to death. But we may not make death a boon, -and then withhold it from them.’</p> - -<p><span class="pagenum" id="Page_124">[Pg 124]</span></p> - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<h3>CHAPTER VIII<br><span class="small"><i>What is Scientific Research?</i></span></h3> -</div> -<p>The apparent opposition between popular and medical judgment in -relation to certain methods of biological research which claim to be -scientific, necessitates a clearer knowledge of what science is, and -a recognition of the methods of research which can alone be called -scientific.</p> - -<p>It is certain that knowledge of truth must reconcile varying but honest -opinions, and furnish plans of investigation that neither shock the -humane development of our nature nor hinder our intellectual progress -towards truth.</p> - -<p>The terms ‘science’ and ‘scientific’ are constantly used and abused. -They are often applied to the accumulating of facts or of phenomena; -but such accumulation is not necessarily science, and may even hinder -science. For although the collecting of facts may bring together -valuable materials essential for future use, it may also bring together -rotten or sham materials, which will interfere with sound work. A -faulty method of endeavouring to<span class="pagenum" id="Page_125">[Pg 125]</span> obtain facts may seriously destroy -the value of the phenomena thus observed.</p> - -<p>The gratification simply of intellectual activity or curiosity must -not be confounded with genuine research. Curiosity is the outcome -of ignorance. Now, our ignorance of much in Nature is no reproach -to anyone, but the way in which curiosity is gratified marks the -difference between the simple child and the rational adult. In the -childish development curiosity, though useful, is superficial and -short-sighted; it is necessarily a shallow impulse, which cannot -realize the wide relations of existence, and its satisfaction has no -necessary connection with the acquisition of valuable knowledge. But -the adult rises into a higher plane of thought. Curiosity is no longer -unduly exercised, but has grown into a love of truth. It has become -that reverential use of reason which is the basis of truth, and which -forms the true guide to the attainment of scientific knowledge; for -rational method does not isolate a fact from all its connections, but -sees it in its relations and in due proportion. Thus only can valuable -knowledge be acquired.</p> - -<p>Neither is analysis science. It is only when the observations of -analysis are corrected and proved by synthesis that the truth of -science can be obtained.</p> - -<p>A clear recognition of the different use of analysis and of synthesis -is essential in any claim of research to be called scientific. -‘Although by analysis we separate and by synthesis we combine, yet in -the<span class="pagenum" id="Page_126">[Pg 126]</span> synthesis there is more than in all the parts taken analytically. -The mere synthesis introduces something entirely new.’</p> - -<p>Kant, in speaking of the use of analysis and synthesis in logic, lays -down the test of all scientific inquiry. He says: ‘Analysis is the -first and chief requirement in making our knowledge distinct. For -the more distinct our knowledge of a thing is, the stronger and more -effective it can be; only the analysis must not go so far that at last -the object itself disappears.’</p> - -<p>Truth being a unity, the science which demonstrates it must correlate -all knowledge.</p> - -<p>Science is not, therefore, an accumulation of isolated facts, or of -facts torn from their natural relations. To know a thing scientifically -is to know it in just relation to all other things. For science unites -and demands the exercise of our various faculties as well as of our -senses.</p> - -<p>Science is proved knowledge. It is the study of causes and their -relations applied to facts; but such proof can only be obtained by -search which is in accordance with the laws of Nature—laws which are -gradually discovered by our race.</p> - -<p>Natural law is deduced from all the facts of human experience, in -searching for and collecting which we must recognise the conditions -under which we are placed, the limitations of the present phase of our -intellectual powers, the gradual growth of conscience.</p> - -<p>Science being proved truth, scientific method<span class="pagenum" id="Page_127">[Pg 127]</span> requires that all the -factors which concern the subject of research shall be duly considered, -in order to arrive at correct thought respecting the special subject of -inquiry.</p> - -<p>The application of scientific method necessarily varies, therefore, -according to the subject under investigation.</p> - -<p>Thus, the construction of a bridge and the calculation of an eclipse -equally involve the bases of scientific method—viz., observation, -deduction, and experiment; but each subject requires a special -application of scientific method, suited to the varying nature of the -subject of study.</p> - -<p>Consequently, biological research, in order to be scientific, requires -a special modification of method, because the new factors of sensation -and consciousness come into play in biology—factors which do not exist -in astronomy, or geology, in mechanics, physics, or chemistry.</p> - -<p>In order to attain truth respecting biology, therefore, the facts -concerning sensation and consciousness and their relation with, or -the way in which these new factors modify the facts of, physics and -chemistry must be carefully considered in this higher state which -we call life, or the investigation is not scientific, no matter how -interesting as an intellectual exercise.</p> - -<p>When first endeavouring to find a recognised definition of the term -‘science,’ I consulted the latest <i>Encyclopædia Britannica</i> of our -public library, thinking that from such an acknowledged authority a<span class="pagenum" id="Page_128">[Pg 128]</span> -correct statement could there be obtained. To my surprise, I found that -the word ‘science’ was not included in the list of subjects. Searching -further in this record of nineteenth-century thought, under the head -of ‘Biology’—that department which is ordinarily supposed to be the -science of life as distinguished from the consideration of non-living -things—the following principle was found to be laid down—viz., that -there was no essential difference between organized and unorganized -Nature, for life was simply a property of matter.</p> - -<p>It is well to weigh the argument for this doctrine, which necessarily -destroys the essential idea of right and wrong, and removes the -foundation of good and evil. It is set forth in the following manner:</p> - -<p>‘The abstract-concrete sciences are mechanics, physics, chemistry.... -Whilst their subject-matter is found in a consideration of varied -concrete phenomena, they do not aim at a determination of certain -“abstract” quantitative relations and sequences known as “laws,” -which never are manifested in a pure form, but always are inferred -by observation and experiment upon complex phenomena, in which the -abstract laws are disguised by their simultaneous interaction.... These -sciences of mechanics, physics, and chemistry have for their object to -explain concrete phenomena by reference to the properties of matter set -forth in their generalizations.’</p> - -<p>The following important dictum in regard to biology is thus laid down:</p> - -<p><span class="pagenum" id="Page_129">[Pg 129]</span></p> - -<p>‘It is the business of those occupied with that branch to assign living -things in all their variety to the one set of forces recognised by the -physicist and chemist ... and its evolution’ (that is, the evolution of -life) ‘as the necessary outcome of those forces—the automatic product -of those same forces.... The discovery of the mechanical principle of -evolution completed the doctrine’ (of the material origin of life). -‘... It may be said to comprise the history of man, sociology, and -psychology—viz., the survival of the fittest in the struggle for -existence.’</p> - -<p>This ignoring by the <i>Encyclopædia Britannica</i> of any definition -of the word ‘science,’ and also the attempted reduction of life to -a property of matter, is, however, too limited a view of Nature to -be accepted by many thoughtful students of the present day. Turning, -therefore, to <i>Chambers’ Cyclopædia</i>, which is the latest -expression of the views of the able thinkers of North Britain, an -explanation of the term ‘science’ was found, which is far truer to -advancing thought. The comprehensive definition is there given that -science ‘is the correlation of all knowledge.’</p> - -<p>As science searches for causes with their relations, and is proved -knowledge, so no branch of knowledge or method of acquiring knowledge -can be considered scientific which contradicts any facts of Nature, or -which bases its methods on the destruction of those facts.</p> - -<p>Truth can only be arrived at by considering<span class="pagenum" id="Page_130">[Pg 130]</span> various or apparently -opposite aspects of human problems; so biological facts, or the -problems of organized or living creatures must be considered, not -simply from the side of ‘mechanics, physics, and chemistry, or the -automatic action of the forces of matter,’ but also from the equally -positive facts of life, and the forces which careful observation is -gradually showing to be enfolded in the fact of mind as developed -through protoplasm onward. The facts of affection, companionship, -sympathy, justice, are positive forces. They exercise a powerful -influence over the physical organization of all living creatures.</p> - -<p>These mental forces can change the action of the bodily functions in -the most surprising manner, arresting the heart’s action, interfering -with secretion, or changing natural secretion into poison, and -destroying the normal and beneficial controlling action of the nervous -system. They are proved by experience to be so striking that they -cannot be overlooked in any unprejudiced investigation of natural -forces.</p> - -<p>A fit of passion in a nursing mother has destroyed her infant; -the industrious cultivator seeing his field of strawberries, the -products of his toil, carried off by thieves, has fallen dead in his -vain efforts to stop the cruel depredation. But such instances are -world-wide, and corroborated by everyone’s experience. They prove that, -although the forces of mechanics, physics, and chemistry are employed -in the animal economy, there are also powers far<span class="pagenum" id="Page_131">[Pg 131]</span> beyond these limited -forces, which must be studied also in biological research, if we are to -learn how these physical may be overridden by mental forces. Without -such correlation of knowledge we fail to realize the unity of Nature, -and cannot attain to true science or proved knowledge.</p> - -<p>It is thus seen that, as already stated, in useful scientific -investigation the object to be attained, the method to be employed, and -the application to be made of the knowledge searched for, must all be -considered in determining the distinction between genuine science and -simple unguided intellectual activity or curiosity.</p> - -<p>It is necessary to emphasize the fact, because this vital distinction -is often overlooked in the claim now made for the grand term ‘science.’</p> - -<p>In defining the meaning and scope of science as pursued by rational -beings, it must be recognised as a fundamental principle, which cannot -be too often dwelt upon, that what we can do, is not a measure of what -we ought to do. Thus, when Stanley attempted to excuse the infamous -action of his naturalist, Jameson,<a id="FNanchor_18" href="#Footnote_18" class="fnanchor">[18]</a> by saying that he was a real -good fellow, but ‘his science misled him,’ he degraded the term -‘science’ by applying it to an act of morbid curiosity.</p> - -<p>Again, when the Russian nobleman purchased a child and condemned it -to be brought up with a<span class="pagenum" id="Page_132">[Pg 132]</span> deaf and dumb nurse, under the unnatural -condition of deprivation of all social relations, his action was not -scientific, but a gratification of inhuman curiosity.</p> - -<p>It is within our power apparently to drown an animal, human or brute, -and recover it to life again and again, but we gain no scientific -knowledge by so doing. We torture the creature and violate our natural -instincts, but we acquire no practical benefit to human welfare; on the -contrary, we endanger the mental integrity of the experimenter.</p> - -<p>It is a short-sighted and hopeless attempt to do violence to Nature in -a search for scientific truth. Distinction must be made between the -possible and impossible in the conditions under which we are placed -in life. Thus, we cannot destroy the family relation, but we can make -it happy and conducive to the welfare of the race. We cannot change -the method of human generation, but we can spiritualize its exercise. -We cannot destroy the instinct of private property, but we can guide -and limit it. We cannot change structure, but we can educate it; -nor abolish curiosity, but we can restrain and direct it; nor check -invention, but it need not be applied to evil purposes. Neither can -we make races equal, but we can establish justice and mercy in the -relations of the stronger to the weaker.</p> - -<p>This study of the natural laws which necessarily limit rational human -action applies with especial force to biological research, and explains -the reason for limiting scientific method.</p> - -<p><span class="pagenum" id="Page_133">[Pg 133]</span></p> - -<p>Thus, the study of living creatures under unnatural or destructive -conditions, although it may be a well-meaning attempt to acquire -knowledge, is, nevertheless, a dangerous one. It is intellectually a -false method which may lead to practical error, and produce a labyrinth -of confusion and contradictory experience which hinders the attainment -of exact knowledge. It is morally a false method, because it injures -those elementary instincts of justice and mercy by whose evolution -civilization advances. Thus the progress of the race is retarded.</p> - -<p>The present astounding multiplication of drugs, of inoculations, of -mutilations in the practice of medicine, with the eager attempt to -prove each new invention by a formidable array of imperfect statistics, -is a striking object lesson in the present day of the error into which -false methods of research have led many members of a noble and humane -profession. It is a fallacy necessarily proceeding from a wrong view of -what science really is.</p> - -<p>Although this erroneousness is by no means solely connected with -vivisectional methods, yet if the high claim which the noble art of -medicine makes to advance our social well-being be justly founded, a -stringent obligation rests upon it not to injure the moral sense of its -members by the methods employed in education or in practice.</p> - -<p><span class="pagenum" id="Page_134">[Pg 134]</span></p> - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<h3>CHAPTER IX<br><span class="small"><i>The Axiom of Science</i></span></h3> -</div> -<p>The fundamental law, without whose observance reliable biological -investigation is impossible, is stated as follows:</p> - -<p>‘In studying the laws alike of organic and of inorganic Nature, the -experimenter must be careful not to destroy the phenomenon that is -being investigated.’</p> - -<p>Intellectual error, as well as practical danger, arises from the -attempt to transfer to man results supposed to be gained by fallacious -experimentation on the lower animals. The fallacy consists in noting -general resemblance of structure, but not the far more remarkable -differences of function. If, for instance, the life habits of two dogs -of good breed are closely studied, it will be seen that, although -certain individual differences are observed between the dogs, yet they -are as nothing when compared with the enormous variation of function -between the dog and the human being. The bones and garbage swallowed -without injury, and the licking of its body, show the different type of -digestion and<span class="pagenum" id="Page_135">[Pg 135]</span> assimilation, the action of the kidneys, of the various -senses, and the possession of senses which we are unable to appreciate; -in short, its distinctive type of existence proves the impossibility -of drawing safe inferences for man from the digestive or other canine -functions. Again, observation and rational experiment, solely for the -benefit of one species of animal, may incidentally lead to the benefit -of other races of animals, but direct experiment on one type for the -supposed benefit of another kind is unscientific.</p> - -<p>It is this error that vitiates the famous postulates of Professor Koch, -through the system of ‘controls,’ the latest exemplification of this -fallacy being the attempt to prove the existence of cholera in man by -cultivating the bacilli in animals. The same error also produces the -failure of M. Pasteur to prevent hydrophobia in man.</p> - -<p>It is well known how the influence of what we term ‘mind’ governs the -action of the bodily functions, either promoting or disturbing their -normal condition. This is a fact of growing importance in practical -medicine. Similar influence is exerted in varying degrees on all living -creatures. Destructive or non-natural experimentation on living animals -is always subject to the fallacy of morbid condition.</p> - -<p>The established law of research stated above exposes the error of -pursuing biological investigation (or the study of vital action) by the -process of mutilating or diseasing living animals.</p> - -<p><span class="pagenum" id="Page_136">[Pg 136]</span></p> - -<p>In research the radical difference between inorganic and organic Nature -cannot be too clearly insisted on. Whilst in the former we can resolve -compounds into their elements and recombine them, such process is -impossible in organic Nature. We can take a steam-engine or a watch to -pieces, examine their parts, repair them, and put them together again, -thus proving our knowledge in this realm of Nature. But a living thing -cannot be treated in the same way. Not only the difference of animal -type forbids destructive method of investigation, but as the type rises -in the scale of creation the growing fact of individual idiosyncrasy -increases the uncertainty of erroneous method.</p> - -<p>Therefore the law of scientific research, which forbids the destruction -of phenomena to be studied, is profoundly true.</p> - -<p>If this law be not observed, intellectual activity may be gratified, -self-conceit or love of novelty and excitement may be pandered to, the -panic of fear in human beings may be worked upon, but the attainment of -scientific truth in biology will be impossible.</p> - -<p>It is thus seen that methods of biological research which involve cruel -or destructive experimentation are both ethically unjustifiable and -intellectually fallacious. They are unscientific methods which will -inevitably be abandoned as we attain to clearer views of that unity of -truth in which the reconciliation of human conscience with intellectual -activity becomes alone recognised as science.</p> - -<p><span class="pagenum" id="Page_137">[Pg 137]</span></p> -<hr class="x-ebookmaker-drop"> -<div class="chapter"> - -<h3>CHAPTER X<br><span class="small"><i>Rational Experiment in Research</i></span></h3> -</div> -<p>As an illustration of legitimate and even heroic experiment, the trial -made with cholera bacilli by Dr. Von Pettenkofer of Munich on himself -during the cholera epidemic of 1891 deserves permanent record.<a id="FNanchor_19" href="#Footnote_19" class="fnanchor">[19]</a> It -is of importance as showing the fallacy that may be involved in the -exaggerated search for bacilli, as the chief cause of disease, which is -the favourite theory and practice of the present day.</p> - -<p>Dr. Von Pettenkofer (in opposition to the common medical belief) -asserts that the diffusion of the cholera germ or cholera bacillus is -not the chief cause of cholera. He states that there are two<span class="pagenum" id="Page_138">[Pg 138]</span> other -absolutely necessary conditions, without which no outbreak of cholera -is possible, and if these conditions are not present, the cholera germ -may be breathed with no production of cholera.</p> - -<p>The first condition is the unhealthy state of the soil or locality. But -even this does not produce an outbreak if the second condition does -not exist—viz., individual predisposition; and he shows that neither -the cholera germ nor the insanitary locality, nor both combined, will -produce cholera if this individual predisposition does not exist. He -further states that no experiments upon the lower animals can be relied -on; the only <i>proof</i> in relation to cholera must be from the -experience of human beings.</p> - -<p>Dr. Von Pettenkofer proceeded to experiment on himself, choosing -Munich, in daily communion with Hamburg (where the epidemic was -raging), as the place of operations, and sent to Hamburg for the -cholera germs. On October 7 he swallowed a centimetre of fresh cholera -culture, in the presence of witnesses—<i>i.e.</i>, infinitely -more than could be taken in by touching the lips with contaminated -fingers, a cubic centimetre of culture being calculated as containing -a thousand million microbes. He in no way changed his manner of -living, eating accustomed food, including fruit, cucumbers, and other -forbidden articles of diet. During the following week his physiological -condition, pulse, temperature, etc., were carefully noted. Nothing -unusual occurred but a little internal rumbling and slight diarrhœa,<span class="pagenum" id="Page_139">[Pg 139]</span> -which passed away of itself. Two skilled bacteriologists, MM. Peiffer -and Emerich, carefully examined the secretions during this experiment.</p> - -<p>M. Von Pettenkofer himself thus states the results:</p> - -<p>‘The comma bacilli not only prospered in my digestive tube, but had so -multiplied in it that it was evident they found a congenial soil. They -were found there in quantities, and in a state of pure culture. But -on October 14 all the secretions were normal, only containing a few -isolated microbes, which had entirely disappeared on the 18th.</p> - -<p>‘Now, most bacteriologists assert that the cholera bacilli remaining in -the intestines secrete there a poison, which, being absorbed, produces -the cholera. But what a quantity of poison must have been secreted -by these milliards of bacilli during the eight days’ sojourn in my -intestines! Yet I felt perfectly well, had an excellent appetite, felt -neither indigestion nor fever, etc., and I attended every day to my -usual occupations. Whence I conclude that the comma bacillus, though -it may cause a little diarrhœa, produces neither European nor Asiatic -cholera.</p> - -<p>‘Now, it must not be imagined that I am the adversary of the cholera -bacillus; but it is erroneous to suppose that when a specific microbe -has been discovered in the secretions of an infectious disease that the -means of fighting it has also been discovered. The discovery of the -bacillus of consumption was just as interesting as the discovery of -the<span class="pagenum" id="Page_140">[Pg 140]</span> cholera bacillus, but since its discovery phthisis has destroyed -neither one man less nor one man more.</p> - -<p>‘These (bacteriological) methods for protection against cholera rest -purely upon theory, and it seems to be thought that henceforth cholera, -etc., ought to behave according to the prevalent theory, instead of -theory being modified according to the cholera. Instead of trying to -catch the comma bacillus and draw a cordon around it, the essential -thing is to make all the dwelling-places of man healthy.’</p> - -<p>Such is the vigorous and genuinely scientific experiment of a -distinguished medical investigator.</p> - -<p>Other experimenters have confirmed Dr. Von Pettenkofer’s observations. -On October 17 Dr. Emerich made a similar experiment on himself, with -like results.</p> - -<p>Since then, experiments have been made in the Vienna Pathological -Institute, with the following results: Six persons partook of the comma -bacillus in no mean quantity, and not one of them has had the disease. -The six are two doctors, the servant of the Institute, two medical -students, and a private gentleman. Professor Stricker treated them -all. Two did not feel their health impaired at all; one had headache, -was slightly feverish, and could not sleep; two had slight attacks of -diarrhœa; and only one was really ill, but recovered at the end of a -week. These experiments inspire medical men with serious misgivings as -to the theory which<span class="pagenum" id="Page_141">[Pg 141]</span> considers the comma bacillus as the cause of all -cholera.</p> - -<p>The supremacy of sanitation is the lesson which is being gradually -taught by such humane scientific experiments. Dirt in its largest -sense, as matter in the wrong place, whether in air, water, food, -clothing, habitation, soil, or contact, is undoubtedly a main physical -cause of disease.</p> - -<p>But in all epidemic disease the emotion of fear must be recognised as a -most potent predisposing cause. The great fact of mind or emotion is a -powerful influence in producing, in preventing, or in curing disease.</p> - -<p>This psychological side of medicine is only beginning to receive due -attention. As the fallacies which arise in animal experimentation -from the production of fear, pain, and coma have not yet been fully -recognised, so the inevitable influence of mind in modifying physical -conditions has never yet been studied scientifically in human medicine. -Yet facts exist in unsuspected abundance which need to be collected, -verified, tabulated, and their laws of action diligently studied.</p> - -<p>It is known that even that strong muscle the heart may be ruptured by -the agony of intense emotion. At Blackburn the daughter of a woman -charged with theft became dumb with horror at her mother’s sudden -arrest. Hydrophobia, cholera, and even small-pox, appear to have been -caused by fear.</p> - -<p>The extent to which even the so-called microbes<span class="pagenum" id="Page_142">[Pg 142]</span> of infectious -diseases may be produced by fear acting on idiosyncrasy demands very -serious investigation; for as it is now generally conceded that morbid -micro-organisms do not exist <i>ab æterno</i>, it is essential to know -by what unhealthy conditions the micro-organisms, or living particles -that always surround us, become disease germs.</p> - -<p>One of our most distinguished London physicians has full records of -the following noteworthy case, which is given, not as scientifically -proved, but as indicating a line of research which it is folly to -ignore or refuse to investigate.</p> - -<p>This gentleman attended a patient some years ago in an attack of -confluent small-pox under these remarkable circumstances: This -patient had always exhibited a morbid horror of the disease, refusing -to hear anything about it or to allow it to be referred to in his -presence. A friend on one occasion brought a very fine collection of -anatomical plates to show him, sent over from France. Amongst them -was a representation of confluent small-pox in a woman. No sooner had -this gentleman beheld it than he cried, ‘Take it away! I cannot look -at it; it makes me ill!’ The next day his son sent for the doctor to -see his father, who had felt unwell ever since the shock of seeing the -pathological plate. He was found suffering from the first symptoms of -an illness which proved to be an attack of confluent small-pox. The -most searching inquiry failed to discover any traces of the disease, -either in the neighbourhood or in any connection whatever with<span class="pagenum" id="Page_143">[Pg 143]</span> the -patient. The cause of this illness, one of the most severe cases the -doctor had ever met with, remained a mystery.</p> - -<p>It has become of vital importance to investigate ‘how far the mental -attitude determines or permits the onset of infectious disease.’</p> - -<p><span class="pagenum" id="Page_144">[Pg 144]</span></p> - -<hr class="x-ebookmaker-drop"> -<div class="chapter"> -<h3>CHAPTER XI<br><span class="small"><i>The Range of Painless Research</i></span></h3> -</div> -<p>‘I am content to let Nature do all the torturing and man all the -relieving ... the grandest physiology and physiological discovery could -exist outside every shade of painful experiment.’<a id="FNanchor_20" href="#Footnote_20" class="fnanchor">[20]</a></p> - -<p>These are the words of one of our wisest physicians, deliberately -written in the full maturity of a life devoted to original research and -its practical application to medicine. His experience led him to the -recognition of this great truth: that the supreme aim of the medical -profession must become more and more the advancement of sanitation. In -any comprehensive view of medical art as a science the cure of disease -is rationally secondary to its prevention.</p> - -<p>This, notwithstanding the trade exigencies of competitive living, -is recognised by the established rule of the profession—that the -physician’s first duty is not to injure his patient.</p> - -<p>Sanitation necessarily takes into consideration all<span class="pagenum" id="Page_145">[Pg 145]</span> the elements, both -mental and physical, of our complex nature.</p> - -<p>It is by the investigation of the laws of healthy created life and -their practical application that progress in medicine must be looked -for. By observing ‘scientifically’ the method and variations of these -laws we shall approach nearer to the understanding of ‘vital force.’</p> - -<p>An immense range of biological inquiry urgently invites the genius of -those who are gifted with the rare power of original research.</p> - -<p>This range is practically unlimited. The collection of all useful -or suggestive facts gathered by genuinely scientific methods from -the enormous accumulations to be found in our Government reports, in -the records of our medical periodic literature, in the observations -of hospitals, societies, cliniques, and private practice, would, if -properly arranged and tabulated, form a most useful branch of such a -centre. If such collection and examination were extended to the records -of other countries, the value as well as labour of the work would be -greatly increased.</p> - -<p>The observation of the dietetic and hygienic as well as medical -treatment of disease, including climate, soil, atmospheric conditions, -the distribution of disease, the effect of occupations, prenatal -influences, and later training, are essential.</p> - -<p>The action of mineral waters, of compressed and medicated air, the -hydration of tissues, the conversion of vegetable into animal tissue, -the action of<span class="pagenum" id="Page_146">[Pg 146]</span> the various constituents of the human body as curative -of disease, present necessary subjects of investigation.</p> - -<p>A careful judicial inquiry into the claims of specific cures, where -a sufficient case for investigation is presented (as <i>Echinacea -angustifolia</i> in snake-bite, also the Russian bath as preventive of -hydrophobia), would form another valuable department.</p> - -<p>In fact, it is impossible to specify the full range of important -subjects which demand the devotion of able and painstaking research, -working upon the careful study of each type of life for the benefit and -improvement of that type.</p> - -<p>In no branch of this wide range of inquiry is painful experiment -necessary.</p> - -<p>Our homes, our industrial occupations, our legislative enactments, -should all be guided by hygienic knowledge, and its diffusion should be -actively encouraged by the community. Our hospitals and dispensaries -need to promote practical hygiene. Our medical schools should turn the -force of their learning, ability, and great influence to the conversion -of their students into a vast body of sanitary missionaries. If our -thousands of medical graduates turned out every year into practice -could go forth inspired with enthusiasm for health, convinced that the -preservation of health was their especial work, and that all disease -must be regarded as a violation of the laws of health, a violation -which it was their special duty to fight against, a mighty step in the -advancement of medicine would be taken. The<span class="pagenum" id="Page_147">[Pg 147]</span> impulse to such progress -should come from improved instruction in our medical schools, and in -the management of our hospitals.</p> - -<p>We much need also an unprejudiced and exhaustive history of the -progress of biological inquiry since the Middle Ages, with its present -result in therapeutics. Such a history may be expected to confirm the -not unfounded opinion that the most important advances in practical -medicine have been made by methods which are not in any way at variance -with our natural instincts of justice and mercy.</p> - -<p><span class="pagenum" id="Page_148">[Pg 148]</span></p> -<hr class="x-ebookmaker-drop"> -<div class="chapter"> - -<h3>CHAPTER XII<br><span class="small"><i>Recapitulation of Principles</i></span></h3> -</div> -<p>I. The attainment of truth, not the gratification of curiosity or of -personal ends, is the sole and distinctive aim of genuine scientific -research.</p> - -<p>II. It is a radical intellectual error to apply the same methods of -investigation, suitable to inorganic facts, to the study of organic -facts. Natural law being mind ruling matter, every method employed -in research into organic Nature must respect and take into account -the inseparable mental factor in each type of sentient life, or it -becomes unscientific, and may promote fallacy, not truth. Destructive -experiment on living creatures, even under the partial suspension -of consciousness produced by anæsthetics, is an erroneous method, -producing confused or contradictory results.</p> - -<p>III. Scientific research in biology must be based upon close and -extensive observation of the varying forms of animal life, under -natural conditions, with post-mortem examination of the records left by -health and disease. Experiments, whether for the<span class="pagenum" id="Page_149">[Pg 149]</span> repair of lesions or -the cure of disease, can only become scientific when made upon the type -of life to be benefited by the experiment.</p> - -<p>IV. Any experimentation which creates involuntary suffering in living -creatures vitiates the necessary conditions of scientific research, -and tends to degrade human conscience by producing indifference to -suffering.</p> - -<p>V. In training our future practitioners of the healing art, the -cultivation of respect for life and the strengthening of enlightened -sympathetic conscience in dealing with all poor or helpless creatures -are of paramount importance. The present system of medical education -requires revision in order to make health, not disease, the central -subject of study.</p> - -<p>Finally, full and generous encouragement to those who are engaged in -important painless research is urgently needed. Such research should be -carried on, if possible, in connection with the great body of serious -scientific investigations, by persons of proved ability and clear moral -sense, and the work should be cordially open to the observation of all -earnest friends.</p> - -<p>Such research, reconciling by right methods of investigation -intellectual activity with human conscience, would increase our -knowledge and advance our well-being in accordance with the higher -reason of the race. Only when thus guided by intelligence and -conscience can biological research deserve the noble name of science.</p> - -<p><span class="pagenum" id="Page_150">[Pg 150]</span></p> - -<p>It is by the recognition of this true method of biological research -and by the generous support of physiologists who honestly seek for -truth, even when opposed by temporary fashions of medical opinion, that -medicine will become a science.</p> - - -<div class="footnotes"><h3>FOOTNOTES:</h3> - -<div class="footnote"> - -<p><a id="Footnote_10" href="#FNanchor_10" class="label">[10]</a> Sir B. W. Richardson, <i>Biological Experimentation: its -Functions and Limits</i>, p. 15.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_11" href="#FNanchor_11" class="label">[11]</a> This sound method is well exemplified in the writings of -the French naturalist, Le Roy.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_12" href="#FNanchor_12" class="label">[12]</a> The former horrors of the hospital operating-room -are graphically described from personal observation in Sir B. W. -Richardson’s treatise, <i>The Mastery of Pain</i>.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_13" href="#FNanchor_13" class="label">[13]</a> See the standard work of Hirsch, <i>Handbook of -Geographical and Historical Pathology</i> (New Sydenham Society), vol. -ii., pp. 416-466. The value of this translation is greatly increased by -its excellent index.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_14" href="#FNanchor_14" class="label">[14]</a> Thus, the authorities of Paris ordered twenty friendless -dogs to be tied to the branches of trees in a wood, and a shell made in -the municipal laboratory exploded amongst them, riddling and mangling -them fearfully.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_15" href="#FNanchor_15" class="label">[15]</a> The humane and carefully-guarded Bill drawn up by the -Royal Society for the Protection of Animals, and introduced by the Earl -of Harrowby and Lord Carnarvon, was rejected.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_16" href="#FNanchor_16" class="label">[16]</a> The judicious remarks of Lord Farrer in relation to -municipal affairs apply equally to the subject under consideration. He -says: ‘My immediate object, however, is not to preach upon the general -question, but to make a practical suggestion. What we want to know is, -Which of the two ways of doing any particular work is the cheaper and -better? Much experience of public departments leads me to doubt their -own reports upon their own doings; not, of course, from any dishonesty -on the part of the officials, but from a natural tendency in every -man to make the best of what he does. It is for this reason, as well -as from want of sufficient experience, that I cannot feel absolute -confidence in the reports made to the London County Council on the -results of their own experiments.’</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_17" href="#FNanchor_17" class="label">[17]</a> ‘Professor Leon le Fort, Professor Verneuil, Professor -Duplay, and Professor Tillaux, have been asked by a public journal for -their opinions on the operative mania (<i>furie opératoire</i>) said -to be prevalent at present. Professor le Fort says it is much more -widespread in France than in other countries, and in a long letter he -protests against the custom amongst the young French surgeons, in order -to bring their names before the public, “to seek out some operation -unknown in France, then seek out a victim on whom they can perform -it, in order to report it before a medical society, and perhaps also -show the patient.” Then, says M. le Fort, they take up the operation -as a speciality, perform it on 100 or 200 patients, and thus gain a -reputation. Professor Verneuil protests against the abuse of operations -in general, and especially of gynæcological operations. He deplores the -prurigo secandi with which so many of the French surgeons are attacked. -Professor Duplay and Professor Tillaux express the same opinions.’ See -<i>Medical Reprints</i>, May, 1893.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_18" href="#FNanchor_18" class="label">[18]</a> This naturalist, when amongst cannibals in the Emin Pasha -Expedition, bribed the cannibal tribe to eat a young negro girl.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_19" href="#FNanchor_19" class="label">[19]</a> The entirely negative results of all experiments made -upon the lower animals to determine if cholera is communicable, or -where the poison resides, is demonstrated by an endless series of -experiments on the lower animals made in many countries. The extent -and severity of these experiments, as well as their inconclusiveness, -is impartially detailed in the classic work of Hirsch, <i>Handbook of -Geographical and Historical Pathology</i>, vol. i., pp. 476-480.</p> - -</div> - -<div class="footnote"> - -<p><a id="Footnote_20" href="#FNanchor_20" class="label">[20]</a> Sir B. W. Richardson, <i>Biological Experimentation: its -Function and Limits</i>, pp. 92, 93.</p> - -</div> -</div> -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_151">[Pg 151]</span></p> - -<p class="center xbig">CHRISTIAN SOCIALISM</p> - - -<p class="center"><i>THOUGHTS SUGGESTED BY THE EASTER SEASON, 1882</i></p> -<hr class="r5"> -<p><span class="pagenum" id="Page_153">[Pg 153]</span></p> - -<h2 class="nobreak" id="CHRISTIAN_SOCIALISM">CHRISTIAN SOCIALISM</h2> -</div> - - -<p>About thirty years ago a little band of ardent and earnest men joined -themselves together as Christian Socialists, under the guidance of -the Rev. F. Maurice, Rev. Chas. Kingsley, and other able and hopeful -leaders. They shared in a high degree that ardent desire after -‘Practical Christianity’—that embodiment in every act of daily life of -the spirit of our Master’s teachings—which has always existed in the -Christian Church, and which can only cease with the disappearance of -the Christian faith.</p> - -<p>The grand idea of human brotherhood is a vital principle of our Lord’s -teaching. It is the foundation on which He builds His Church. But -practical Christianity cannot exist unless political and social economy -are founded upon this principle of brotherhood. Trade and manufactures, -agriculture and education, national government and the individual -home, are not Christian unless they are inspired by this central -principle, laid down by our Divine Master, and reiterated in every page -of His wonderful life—viz., that we must live as brethren under the -inspiration of a wise and loving Father.</p> - -<p><span class="pagenum" id="Page_154">[Pg 154]</span></p> - -<p>Attempts to realize more fully this fundamental portion of the -Christian faith, by special associated efforts, have always been -observed in every age. From those early times when the disciples laid -their offerings at the Apostles’ feet, and strove to ‘have all things -in common,’ to the present day, the attempt to secure higher ends by -the power of combination—a combination inspired by the highest idea of -right—is always going on.</p> - -<p>Christian Socialism, therefore, is no new idea. It is as old as -our faith. It is the shaping of actual daily life on the principle -of Christian brotherhood. It enters in some degree into every -association—church, chapel, or society of any kind whatsoever—which -seeks to embody an unselfish or a higher spiritual idea; but the -Christian Socialist believes that the structure of society in every -part should be moulded by the idea of united interests.</p> - -<p>The very gradual acquisition of wisdom by our race, however (a slowness -which seems to be the necessary condition for securing both freedom and -strength), leads to the frequent exercise of zeal without knowledge. -Direct attempts to join people together under better conditions -than the haphazard methods by which villages swell into towns have -frequently ended in failure.</p> - -<p>But each successive generation enters upon active life with increased -intellectual development and with increased command over material -forces. If equal enlargement of the moral nature accompanies the growth -of intelligence, then the generation has<span class="pagenum" id="Page_155">[Pg 155]</span> made a solid advance in -wisdom, and the practical Christianity of true brotherhood is nearer at -hand. The Christian Socialist believes that many principles on which a -better society must be founded have come into clearer light during the -past thirty years, and have been, and are being, tested by varied and -valuable experiment.</p> - -<p>The term Christian is here used in a legitimate practical sense. -Reverently and heartily a Christian must accept the rule and guide of -life so emphatically laid down by our Master—viz., that in eating and -drinking, in buying and selling, at home and abroad, we are to act for -our brethren, not for ourselves alone. We are to seek, first of all, -righteousness.</p> - -<p>The problem we have to face is the ever-increasing amount and -variety of evils which we see around us, and to ascertain how far -this is caused by the present selfish structure of society, by the -false individualism which hypocritically asks, ‘Am I my brother’s -keeper?’ Evils now increase upon us more rapidly than we can remove -them. Pauperism and vice, drunkenness and crime, mammon worship and -frivolity, dishonesty and corruption, are all bred by ourselves. They -are largely produced by the conditions of the society into which -children are born, and by which they are moulded. Ten years of squalor -or degrading conditions may deteriorate or ruin the nature of the -child. My attention was once called to a bright and charming little -girl, brought to a public institution by a poor mother fallen into -sickness and poverty. One year was<span class="pagenum" id="Page_156">[Pg 156]</span> given to the mother to reclaim her -child. On a subsequent visit, after eighteen months’ interval, I failed -to recognise that child; her brightness was gone, her movements had -grown listless and awkward, her intelligence was dulled, her expression -vacant, she was sinking with frightful rapidity into the hopeless -pauper.</p> - -<p>How pitiful are the results of our penitentiaries and reformatories, -of our workhouses, orphan asylums, and industrial schools, of all -the various charities by which we painfully and vainly try to mop up -evil and misery, or to sweep it out of our sight. The recipients of -punishment or care, when released, in the large majority of cases, fall -back again into the crime, temptation, and evil from which they had -been taken, and the flood of ruffianism and vice rises ever higher.</p> - -<p>In the hard and crushing strife for decent living in which the great -mass of our population are entangled, health is injured, hope dies out, -and the gas-lighted gin-shop is the solace, as the dreary workhouse -is the refuge of those who have ceased to hope. Yet the great mass of -these persons have tried to do honest work. They have once hoped to -support wife and children as an honest man should do. How is it that -capital and labour have failed to come together in such a way that -every willing worker can secure a comfortable livelihood, that every -honest man can bring up his family in health and virtue? The relation -of capital to labour is a vital question of practical Christianity.</p> - -<p><span class="pagenum" id="Page_157">[Pg 157]</span></p> - -<p>Consider also the great agrarian fight always going on to some extent -and periodically breaking out in revolution and outrage. Why is it that -the great bulk of English men and women are divorced from the soil? -Why are they always crowding into towns, whilst the precious natural -heritage of land is so often wasted and going out of cultivation? -Health and happiness should be found in country life. Such a life -should not be one of dreariness and ennui, or of hopeless drudgery. -There is no life so suitable for the healthy development of childhood -as a country life, with natural home influences. The care of animals, -the cultivation and observation of natural objects, the pure air and -abundant exercise which can be enjoyed, mark the country as the natural -home of childhood. Again, the production in perfection and abundance of -all the articles which naturally belong to various soils is a primary -need of healthy national growth. The conditions under which such -cultivation can be best carried on, with the kind and proportion of -manufactures which might advantageously spring up in connection with -it, affect the very structure of society. They provide the necessary -material and social conditions which furnish the possibility and -favouring of a religious life, or which create serious obstacles to -such a life.</p> - -<p>The relation of the people to the soil of their native land is a very -serious question of practical Christianity.</p> - -<p>Again, in what manner is the education of the<span class="pagenum" id="Page_158">[Pg 158]</span> various classes of our -children carried on? Consider the education given to the boys of the -aristocracy and upper classes. What chance have these lads of growing -into a sense of Christian brotherhood? They are fawned upon from -babyhood; initiated at school into the most heathen vices; corrupted -by luxury, taught that money can do everything, that rank will be -servilely worshipped. How can these poor lads become the large-hearted -leaders of a society founded on the Great Master’s teaching of -brotherhood? The character of education does not depend only on the -more or less wise oversight and arrangements of the schoolmaster, but -still more on the constant influences of the life in which the child -grows up. Trace the various stages of education downwards, through -all classes of the community, to the enormous mass of little boys and -girls trained from babyhood into vice and ruffianism, and we see that -education is a vital subject of practical Christianity.</p> - -<p>Consider next the relations of the sexes. This subject is the -fundamental question of society, for the element of society is the -man, woman, and child, not the individual. How do our laws and customs -inculcate manly honour, womanly dignity—in short, Christian life? -Carefully studying this subject in its widespread ramifications, it is -seen to be the deepest question of human brotherhood—<i>i.e.</i>, of -practical Christianity.</p> - -<p>When, proceeding from more private to public affairs, we examine the -modifications or arrangements<span class="pagenum" id="Page_159">[Pg 159]</span> of municipal institutions which have -arisen in our towns, the examination is not encouraging. It is the -heathen, not the Christian, principle which is chiefly exemplified. -It is self intensified. The new power created throws off a sense -of responsibility to those who create it. No enlarged sense of -duty springs from the trust that is thus given to individuals; but -petty cabals and bickerings arise, narrow party views are fostered, -selfish interests advanced, or a foolish air of authority is assumed. -The more high-minded inhabitants shrink from entering into corrupt -political contest; centralization increases as municipal control is -degraded. Local and general government is too often only a parody of -representative institutions. The important question arises, In what way -can we who believe that public as well as private life should be guided -by a religious spirit attain the end? How can we form associations and -delegate necessary authority in such a way as to advance Christian, -not heathen, life? In observing the effect of Law upon the education -of a nation, we find that its embodiment in government forms a very -important branch of practical Christianity.</p> - -<p>When we ponder all these vital questions, and earnestly strive to -put into practice the principles of action which we believe to be -profoundly true, we find our Christian sense of right shocked at every -turn by fixed conditions, which are the result of selfishness, not of -brotherhood. The spirit of self-interest, only useful as a servant, -has<span class="pagenum" id="Page_160">[Pg 160]</span> usurped the false position of master. Like all our faculties, -self-interest needs a higher guidance, or it degenerates into the -narrowest selfishness. We have not yet learned the one grand lesson of -Christianity—viz., that the largest view of self-interest can only be -found in brotherhood.</p> - -<p>The inquiry now to be made is whether any new principles of -association, co-operation, combination—or by whatever name we choose -to express united interests—have so grown and been proved within the -last generation, that we may make successful advance on the path dimly -seen by the noble men I have referred to.</p> - -<p>There have been many failures in attempts at the realization of -associated or organized life; but there are also many and striking -examples of successful, though imperfect, organization, founded either -upon a religious idea or on business enterprise, or on the enthusiasm -of some clever and benevolent individual. Roman Catholic, Moravian, -and Shaker communities will illustrate the first series of successful -organization; joint-stock enterprises and co-operative stores the -second; Leclaire’s house decorators’ guild and the Familistère of Guise -the third. It is through union of the forces exemplified in these three -classes of association that we may attain to a nineteenth-century -realization of practical Christianity in the future growth of towns or -colonies.</p> - -<p>The following are some of the chief applications of the principle of -Christian brotherhood, which<span class="pagenum" id="Page_161">[Pg 161]</span> we believe will remould the structure of -future society:</p> - -<p>1. The repurchase of land by Christian joint-stock companies, in order -that its control and management may henceforth belong to those who live -upon it and use it.</p> - -<p>The absolute irresponsible individual possession of land becomes, as -society advances, contrary to the best interests of a nation. The soil, -which is limited in quantity, but indispensable to the maintenance and -welfare of the people, should not be treated as an individual selfish -speculation, regardless of its most advantageous use, and of the needs -of those who may live upon it.</p> - -<p>It is the slow but sure result of the irresponsible monopoly -of the soil by individuals which is at the root of a great -evil—viz., the unnatural and diseased growth of great unorganized -or selfishly organized towns. Our towns, formerly the haphazard -growth of accident, are becoming more and more the growth of -selfish speculation—<i>i.e.</i>, the false organization of -self-aggrandizement. The hereditary or other holder of land leases it -to speculators, whose one object is to make as much pecuniary profit as -possible out of the lease. This is the one point held steadily in view, -often through a series of underletting, in which each fresh speculator -seeks to make a new profit. Health, convenience, human welfare in its -necessities and interlinkings, are never thought of, or are entirely -secondary to gain. A showy neighbourhood for the rich, yielding the -highest rents that<span class="pagenum" id="Page_162">[Pg 162]</span> can be screwed out, and a crowded neighbourhood -for the poor, with still higher proportionate rents, are created. -Gardens disappear in the dreary mass of showy, badly-constructed -brick-and-mortar quarters in which the young generation grows -up—dreary quarters, but where rents and rates are constantly rising. -This is the result of irresponsible individual ownership and perverted -organization in all our rapidly-growing towns. It is a potent cause of -growing immorality.</p> - -<p>The control of land by a society or colony living upon it and using it, -does not forbid the leasing of land, under wise conditions, to persons -who are members of the society. It is the irresponsible individual -possession of land, with the speculation which such a method of holding -gives rise to, which is the principle always ultimately injurious to -society.<a id="FNanchor_21" href="#Footnote_21" class="fnanchor">[21]</a></p> - -<p>2. Economy in distribution and management. A rational economy in the -retail distribution of products, in the domestic arrangements of our -homes, in the official management of local and general government, will -set free an immense number of persons whose time is now needlessly -occupied. The talent and energy of this wasted multitude should be -turned to increase of production and other necessary and valuable -employment, under the wise freedom of united interests.</p> - -<p><span class="pagenum" id="Page_163">[Pg 163]</span></p> - -<p>3. A fair share of profits to all workers. This is a most important -principle, which can only be solved under the guidance of Christian -brotherhood. In the increased production which will result from wise -economy in distribution, management, and government, an equitable -division of profits between capital, ability, and labour must be -arranged. Interests must be united, industry stimulated, and hope held -out to the humblest worker in a Christian colony. When a young man -commences life in the honourable estate of Christian marriage, it is -the first duty of Christian society to support his hope and energy. The -future of this family is a matter of national concern. Steady industry -deserves a fair and increasing share in the profits it helps to -create. Counsel, if needed, encouragement to the mother in the healthy -and virtuous education of her children, and opportunity for hopeful -occupation, are all positive duties owed to every member of a Christian -society. The fulfilment of this duty depends in a great measure upon -the righteous relation of capital to labour.</p> - -<p>4. The formation of insurance funds which will secure aid to every -worker in sickness or old age. Thrift, self-control, and an honourable -sense of independence are the results of such provision, which would be -the greatest possible aid to the noble temperance movement.</p> - -<p>5. An arrangement of dwellings which will facilitate communication, -domestic service and supply, sanitary arrangement, the education of -children,<span class="pagenum" id="Page_164">[Pg 164]</span> and municipal government. These objects must be secured if -the rapid degradation of our poorer English homes is to be checked. -Parental influence and responsibility are equally disappearing in the -homes from which all sanctity has departed.</p> - -<p>6. The entire abolition of all trade in the human body.</p> - -<p>The waste of virile force and the degradation of womanly character -which result from the barbarous remnant of slavery existing in our -midst under the form of prostitution is incalculable. No community -which aspires to Christian life can permit this hideous trade to -exist. The buying and selling the human body is a natural wrong. The -fearful evils, moral and physical, which result from such trade prove -its inherent iniquity. Love, with the duties and responsibilities -which accompany its expression, is the only Christian warrant for the -intimate union of the sexes, and the growth and welfare of society -absolutely depends upon the wise guidance of these relations by -Christian principle. The wonderful advance of intelligence and moral -perception on this vital subject during the present generation is -the most hopeful sign of the nearer approach of organized Christian -society. As a striking contrast to growing immorality, the possibility -and incalculable benefit of equal purity for boys and girls, for men -and women, is the great truth which is springing into vigorous life -in this Nineteenth Century. A new world of hope and freedom opens to -women, a new realm of energy to men, from the consecration<span class="pagenum" id="Page_165">[Pg 165]</span> of this -mighty power of sex, which is descending upon our age as a great guide -for the future. This God-created force has hitherto been squandered -in these earlier centuries of our world’s life. Ignorance of woman’s -true dignity and providential position has been the greatest obstacle -hitherto in the Christian organization of society. This ignorance now -slowly but surely vanishing, opens to us a great and glorious promise -of unlimited future progress.</p> - -<p>The principles thus expressed in very condensed form appear, from -their present maturer development, to be the especial gain of this -age. They are the legitimate results of Christian thought, growing in -comprehensiveness, and conscientiously applying itself to a solution of -the problems of social life.</p> - -<p>Every proposition now set forth requires, however, long and careful -consideration. Some persons may not realize the dangerous and growing -evils which the prevalence of opposite methods of action is inflicting -on society. Young countries possessing abundance of unoccupied land may -not appreciate evils from which older countries suffer from individual -monopoly of land. Other persons may fail to see the full bearing -of these principles of Christian Socialism on our daily relations. -Others, again, may be entirely unable to foresee the methods by which a -Christian organization of society can ever become a practical fact. For -these reasons union in preparation is indispensable. The wisest ways -of realizing these principles in all their<span class="pagenum" id="Page_166">[Pg 166]</span> practical details require -the varied knowledge of different classes of persons. They require the -careful consideration of many minds, possessing both varied experience -and a profound sense of the necessity of Christian organization. If, -however, the principles laid down are true, then their realization must -be only a question of time. In our towns much may be done to place both -business relations and domestic life on a sounder basis. The gradual -introduction of methods leading in the right direction is possible, -by both men and women, in the two spheres of business and home life, -when the end to be obtained is thoroughly understood. A still more -rapid advance may be made by those who wish to establish country life -on a more Christian plan by uniting religious principle, joint-stock -enterprise, and wise guidance in the organization of an industrial -colony—a colony which would be the most potent Christian Missionary -Society.</p> - -<p>Religious principle must be recognised as the essential basis of -permanent future growth. Only a large comprehension of the Christian -teaching of human brotherhood creates the highest conscientiousness, -with a sense of responsibility to an unseen but parental Creator. No -accumulation of material wealth, no appeal to the lower faculties of -our nature alone or chiefly, will ever hold human beings together in -permanent and harmonious organization of daily life.</p> - -<p>Christian conscientiousness is the only power we know of, capable -of controlling and guiding selfhood.<span class="pagenum" id="Page_167">[Pg 167]</span> This controlling force is -indispensable in any wise effort to unite human beings together in -the varied interests of everyday life. Without religious principle -we possess no efficient check either upon the selfish scramble for -wealth, or on the soulless pursuit of science, or on the enthralment of -physical pleasure.</p> - -<p>Consider some of our popular social maxims—‘Charity begins at home,’ -‘Take care of No. 1,’ ‘Competition is the life of trade,’ ‘Demand -must govern supply,’ ‘Buy cheap and sell dear,’ etc. No one will deny -that there is an element of truth in all these maxims; but their -direct logical results, pushed to an extreme under the sole guidance -of selfish interest, become diabolical. This is clearly illustrated -by a remark once made to my own father by a Southern sugar-planter. -He stated that he could raise slaves so cheaply that it was the most -profitable plan to use them up in five or six years, and supply their -place with fresh ones!</p> - -<p>The same necessity for the guiding influence of Christian -conscientiousness is seen in the pursuit of science. The modern -dicta, ‘Medicine has nothing to do with morality,’ ‘Knowledge is its -own end and justification,’ are the maxims of heathen, not Christian -philosophers. Indeed, many of those who now pursue scientific -investigation willingly assent to this statement, having lost all -knowledge of the value of true Christianity as the highest spiritual -guide of our race.</p> - -<p>Accepting, then, the principle of Christian<span class="pagenum" id="Page_168">[Pg 168]</span> brotherhood as the -necessary religious foundation and constant guide of any true -organization, it is evident that all these weighty problems, now -briefly indicated must be considered and solved by the ‘Church.’</p> - -<p>A Church, in the true sense of the word, is a society of men and women -who, accepting the Divine Mission of Christ, strive honestly to embody -His teaching in daily life. As each age grows out of the life of the -preceding age, so the practical incarnation of our Lord’s teaching -varies in form from age to age. In 1882 the form which Christian life -takes must necessarily vary from its form in 1800. Three generations -of men have gained immensely in intellectual, scientific, and moral -development. All the conditions under which human beings grow up -have changed. What we now especially and urgently need from the -‘Church’ is aid in adapting the never-changing principle of Christian -brotherhood to the ever-changing conditions of Nineteenth-Century -life. We need sermons and conferences and earnest life in the Church; -but the sermons must take up the Christian view of the relation of -capital to labour, the Christian view of the relation of the sexes, -the Christian protection and sound education of the young—in short, -the whole conduct of life, from the cradle to the grave, in private -and public. A certain inevitable hypocrisy is engendered by listening -week after week to lofty theories which are never put into practice, -or to impracticable suggestions. The soul<span class="pagenum" id="Page_169">[Pg 169]</span> grows callous when teaching -demands one course of action and daily life enforces a quite opposite -course. We need to learn in what way our actual life, public and -private, can be guided by our Lord’s injunction of brotherhood instead -of selfhood. Our Church Conferences should be the honest and eager -effort of every man and woman to consider together how these true -principles can be carried out by them. A Christian Church Conference -must ponder the life of that army of little drudges in our underground -kitchens, of the blasphemous boys and girls who gather at night in our -public places, of the vicious roués who crowd on us from London, of the -struggles of the poor householder who knows not how to pay the heavy -rent, of the tendencies of the trader oppressed by taxes, who sinks all -scruples in the desire to get money, and of the speculator whose one -desire is to make ‘wealth accumulate, though men decay.’ These are the -problems for Church Conferences which the practical Christianity of the -Nineteenth Century urgently requires should be solved.</p> - -<p>It is only on these humble but indispensable foundations that a Church -which meets the needs of the age can be founded. It is only in a Church -so founded that prayer and praise and the worship of the Great Father -can become a glorious reality, and never sink into formalism.</p> - -<p>A true Church, then, suited to the needs of this age, must be a -self-governing, industrial community, guided by Christian principle, -holding and managing<span class="pagenum" id="Page_170">[Pg 170]</span> its own lands, varied industries, and colleges. -It should send off out-shoots from time to time, new self-governing -colonies at home and abroad. These colonies necessarily possessing -varied individual colouring, according to occupation and composition, -should all agree in the one great uniting principle—organization on -the principles of Christian brotherhood. The Christian idea of united -interest, instead of the narrow antagonism of individual selfishness, -will be the distinguishing mark of true Church colonies—the practical -Christianity of the future.</p> - -<p>There are large numbers of sincere followers of our Spiritual Guide -who clearly perceive the radical evils above referred to: persons who -long to devote thought, time, and means to the labour of forming a -Christian society; persons who would rejoice to leave their possessions -to the noblest Missionary work of the age. But these earnest seers are -scattered far and wide; they require the indispensable strength of -union. A grand work is before all the Churches to join their members -together under the noble banner of Christian Socialism. By careful -study of the various practical examples which now exist of successful -although imperfect organization, preparation can be made for union -together in the formation of a true Church Colony. A band of Christian -Socialists thus uniting in earnest preparation (whilst neglecting no -immediate duty) will be strengthened and guided in the course of a few -years to initiate the most important and urgent work that our age now -calls for.</p> - -<p><span class="pagenum" id="Page_171">[Pg 171]</span></p> - -<p>The meaning of the Easter season is the arising of Christianity from -the grave—that grave where it lies bound in darkness, corrupting in -worldliness, dying through selfishness; but, thank God! not yet dead. -May our religious people awake from their fatal lethargy and roll away -the stone from the sepulchre, by the establishment of a true Christian -Society!</p> - -<p><span class="pagenum" id="Page_172">[Pg 172]</span></p> - - -<div class="footnotes"><h3>FOOTNOTES:</h3> - -<div class="footnote"> - -<p><a id="Footnote_21" href="#FNanchor_21" class="label">[21]</a> The works referring to the economic principles laid down -in this paper, with the statistics and experiments which support and -illustrate them, are too numerous to mention here; but they are of the -utmost value to the Christian Socialist.</p> - -</div> -</div> -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_173">[Pg 173]</span></p> - -<p class="center xbig">ON THE DECAY<br>OF<br>MUNICIPAL REPRESENTATIVE GOVERNMENT</p> -</div> - -<p class="center"><i>A CHAPTER OF PERSONAL EXPERIENCE, 1885</i></p> -<hr class="r5"> -<p><span class="pagenum" id="Page_175">[Pg 175]</span></p> - -<h2 class="nobreak" id="ON_THE_DECAY">ON THE DECAY OF MUNICIPAL REPRESENTATIVE GOVERNMENT</h2> -</div> - - -<p>It is only in the belief that a simple narrative of facts, exactly as -they occurred, will show more vividly than an abstract statement can -do, the dangers which threaten our free institutions, that I venture to -offer this personal narrative to municipal voters, and particularly to -women householders.</p> - -<p>When, in 1879, I became a householder in Hastings I did not at all -realize that I thereby acquired the right to vote in municipal -affairs, and that this right necessarily involved a corresponding -duty and responsibility—the duty, viz., of voting intelligently, -and necessarily a certain responsibility for the way in which the -government of the town was carried on.</p> - -<p>I soon observed, however, that in the autumn, although I was neither -a Conservative nor a Liberal, I was called on by the Conservative and -the Liberal candidates for election to the Town Council to ask for my -vote, and although these visits often led to interesting conversation, -and my opinions<span class="pagenum" id="Page_176">[Pg 176]</span> were assented to with the most flattering courtesy -before the elections took place, I soon perceived that all influence -ceased with the election; the matters went on in the same way without -me as with me, and my supposed privilege of voting seemed really to -be very much of a mockery. Being, moreover, a peaceable person, and -much occupied with subjects of interest, it appeared to be rather a -waste of time to concern myself with an election which was managed by -cliques on strictly party issues, with no regard to questions of social -well-being, nor necessarily to the selection of the wisest and best -man, but only of the person who could in any way secure the largest -party vote.</p> - -<p>Being compelled, also, as far as my limited powers of observation -admitted, to criticise the two great parties of the State, as both -committing much injustice, and as rather guided by class selfishness -than by high morality, I could not feel any enthusiasm for elections -carried on by party strife.</p> - -<p>I thus began to fall into that easy state of indifference which -seems rapidly becoming the general condition of the mass of people -who are supposed by their votes to control municipal affairs; I -retained, however, an uneasy consciousness that in some way I was -failing to meet a duty that was laid upon me. I was roused from this -fatal moral lethargy by witnessing what seemed to me an act of gross -injustice—viz., a robbery of the poor of their inheritance. This -was the diversion of the funds of the Magdalen Charity (a bequest -from the piety and<span class="pagenum" id="Page_177">[Pg 177]</span> beneficence of past ages, now grown to an income -of some thousands annually) to the foundation of a middle-class -grammar school. The injustice was committed under the sanction of the -Charity Commissioners, notwithstanding a brave fight by some of our -conscientious inhabitants, carried on for more than two years. But -class interests and short-sighted officialism proved stronger than -justice in this case.</p> - -<p>So painful an experience effectually opened my eyes to the irreligion -of not attending to the duties which lie nearest to us, and I saw that -the condition of the poor is very near to us. I fully realized, also, -for the first time, the constant duty which rests upon all those to -whom special municipal rights are given, to concern themselves with -the management of the town in which they live, this responsibility -especially resting upon every one on whom is laid the duty of voting. -Beginning, then, to attend my parish meetings, my sympathy was soon -aroused by seeing the bitter struggle of the industrious poor going -on all around me, to avoid sinking into pauperism. Cases of inability -to pay the rates were constantly coming before us<a id="FNanchor_22" href="#Footnote_22" class="fnanchor">[22]</a> from weary -struggling men and women, who, if they sometimes ‘drink and forget -their poverty,’ demand pity more than blame.</p> - -<p>Every year the pinch of poverty grew sharper. My own respectable young -servant could not marry<span class="pagenum" id="Page_178">[Pg 178]</span> her decent lover because rent was so dear. As -roomy lodging-houses and hotels spread along the sea-front, speculation -grew, and the mass of the people were huddled together in smoky cram -or squeezed out into dreary suburbs, far away from their work or from -opportunities for honest industry. I soon also learned the horror -with which the poor regard the workhouse; how they would willingly -die in peace in the forlornest home rather than be forced into what -they regard as a hopeless, cruel prison. My indignation deepened as I -thought of the deed still in our archives, in which, ‘I, Petronilla de -Cham, of Hastings, in the pure and lawful power of my widowhood,’ grant -a tract of land for maintaining the poor old men and women of Hastings -in decent maintenance and godly service; the brothers and sisters -of the Magdalen Hospital. ‘And I, Lady Petronilla and my heirs will -warrant and defend the aforesaid five acres of land with precincts, -to be held by the brothers and sisters freely, quietly, well, and -peacefully for ever,’ they praying for the souls of their benefactors.</p> - -<p>As descendants of humane and pious ancestors, it seems to be as clearly -a religious duty to consider the condition of the poor in 1885 as it -was in 1292, when Lady Petronilla de Cham made her foundation gift to -the Magdalen Charity.</p> - -<p>The more I considered this important problem of how to aid the -struggling poor in their heroic efforts to live decently, the more -important to my mind became the subject of taxation; how the rates -of<span class="pagenum" id="Page_179">[Pg 179]</span> a town are raised, and how they are expended. Unhappily, we see -all over the country that, in the same way, ancient endowments for -doles, retreats, pensions, and portions are swept away because the -workhouse system is said to provide for the poor; ancient endowments -for training, clothing, and apprenticing poor children are also swept -away, because the ‘Board of Education provides for the poor.’ Thus the -various necessities of social life, education, benevolence, etc., are -being committed to the hands of officials—<i>i.e.</i>, everything is -rapidly being thrown upon the rates, until the rates crush the poor -into pauperism.</p> - -<p>Now, the question of rates is not at first sight an attractive -one, particularly to a person who has unusually little talent for -arithmetic. But in the present day they take the place of ancient -beneficence, and are administered by Town Councils instead of Church -organizations. I therefore determined to attend a meeting which was -being called to meet the Local Government official, in order to obtain -sanction for a new loan. This was my first appearance at a ‘Statutory’ -meeting. To my surprise, when I took a seat at the Council Board, I -found that I was the only non-official ratepayer present, although -the sum to be borrowed was a large one. It was stated that this -proposal had received the unanimous assent of the ratepayers. To this -statement I was compelled to make a short protest, as I had learned -from inquiries that many ratepayers knew nothing about the proposed -loan.<span class="pagenum" id="Page_180">[Pg 180]</span> I was informed that the time for objections had not arrived; and -the London official proceeded to inquire into various details of the -way in which the loan of six thousand guineas was to be spent, extent -of grading, kind of concrete, etc. When all was completely settled I -was then requested to state any objection I had to make. I spoke of -the burdens of taxation on the poor, and I begged to know what was -the present debt of the town. I found that with this new loan our -municipal debt would be nearly a quarter of a million. This seemed a -very large debt for a small town, where the people found a difficulty -in paying their rates, and as a prudent housekeeper I objected to go -into debt for our municipal housekeeping. I was informed by the Local -Government Board Inspector that ‘that was a question to be settled at -the polls.’ So, of course, my single protest was of no practical use. -This occurred in August. I then thought that, as the November elections -were approaching, it might be useful to try and get municipal questions -discussed with the candidates who were to be elected for three years to -the Town Council.</p> - -<p>The proposed councillor in my parish cordially assented to the proposal -I ventured to make to him—viz., that he should meet the ratepayers -before the time of the elections, and discuss with them various -important questions which would come before the decision of the Town -Council. This gentleman willingly promised to attend such a meeting if -it were called.</p> - -<p>Unfortunately, I could not find any householder<span class="pagenum" id="Page_181">[Pg 181]</span> willing to aid in -such an effort. The following is a type of the responses received from -householders:</p> - -<p>‘I do not think my presence at a conference would be of any service. I -have so little knowledge of municipal affairs, never having attended a -meeting since I resided in Hastings.’ The same sort of answer came from -busy tradesmen and leisured gentry. It therefore seemed that a more -decided educational effort was needed, an effort to show our voters how -a Town Council really represented in modern days much of the practical -action of the Church in past ages, and that it ought really to present -the Theocratic idea—<i>i.e.</i>, government by the Highest Good. But -here, too, unhappily, I could find no one who did not seem to think -that the function of a Town Council was to save them all trouble and -responsibility, and that it must be elected on party grounds.</p> - -<p>Thus, more and more I recognised the profound character of the disease -of indifference, which has become endemic in our municipalities, -and the urgent need of remedial measures. I therefore entered into -correspondence with the Social and Political Education League, which -has borne in succession the honoured names of Professor Seeley and -Mr. Froude as Presidents. I received a cordial letter from the -honorary secretary, who forwarded a list of 107 names of lecturers, -with numerous addresses that they would be willing to deliver. -Unfortunately, in this printed list of several hundred lectures I -could find nothing that met our special<span class="pagenum" id="Page_182">[Pg 182]</span> need—viz., short, simple, -progressive instruction, inviting questions, ‘on the use of a Town -Council and the meaning of a vote.’ I was meditating on what to do when -I became most unexpectedly involved in municipal work, where I was -compelled to take a prominent part, for which I was not fitted either -by knowledge or experience.</p> - -<p>At the town meeting in August already referred to, when the addition -to the public debt was made, a Corporation Bill was spoken of, which -appeared to be of very great importance, and which was to come before -the town later. I therefore watched the notices by the church doors, -and marked down the date of the Statutory Meeting, which must be -called in order to sanction this Bill. I was much surprised not to -see attention strongly called to this important measure by the local -press and others; but the local politicians were all in such a state -of excitement because Hastings was to lose one of its Parliamentary -representatives that the way in which municipal affairs were carried -on seemed to excite no interest. I called at the Town Clerk’s Office a -few days before the meeting to sanction the Bill was to take place, and -asked for a copy of the Bill, but was told that there were ‘no copies’ -for ratepayers; neither could the Bill be seen. I spoke to about ten -persons in the course of the day, but no one knew anything about the -Bill. I then wrote to several ratepayers to beg them to attend the -Statutory Meeting. One replied that there must be a mistake as to date, -naming a meeting three days<span class="pagenum" id="Page_183">[Pg 183]</span> later, which, being a ‘Party’ meeting on -Redistribution, entirely drew attention from the municipal meeting. -Another householder consulted a gentleman friend, who told her that -the proposed Bill was one to lessen taxation, so there was no need of -attending the meeting. I was unable to find a single ratepayer who knew -anything about the Bill, or had even heard of it. The time came, a -very stormy evening; about seventy persons attended out of over 8,000 -ratepayers. No one had seen the Bill, which, from the short abstract -given by a Councillor, was evidently of the utmost importance to every -class of the inhabitants, and particularly to the industrious classes. -It was urged by the Town Council Committee in charge of the Bill that -no opposition to it should be made, for two reasons. In the first -place, the next day was the last chance of registering the Bill for the -present Session of Parliament, and a year would be lost if the Bill -were not accepted that night; in the next place, it was stated that -any opposition would be very expensive to the town, for, as they had -already paid £500 for the expenses of the Bill, and would pay about as -much more to complete it, if any opposition were raised it would cost -the town some thousands of pounds.</p> - -<p>As no other ratepayer seemed to discover any flaw in these statements, -I ventured to suggest that, as no one amongst us had seen the Bill, -we ought not to sanction it without any opportunity of examination, -and that it would be better to lose a Session<span class="pagenum" id="Page_184">[Pg 184]</span> than do so. I therefore -begged to move an adjournment; this was seconded by a ratepayer, but -not put to the meeting. The Bill was accepted in the name of the -ratepayers by a vote of 47, the Parliamentary agent who directed the -proceedings most courteously assuring me that ‘there would be ample -time to object to the Bill in London.’ Of course, I knew, and many -of the poorer ratepayers present knew, that it would be too late to -consider the Bill after it was accepted in our names; but I was struck -with the inability of those present to formulate their objections, -although much dissatisfaction manifested itself in the meeting. Entire -ignorance (in which I fully shared) also existed as to what steps to -take in such a case. Had I insisted, as I ought to have done, upon the -motion for adjournment being put, it would probably have been rejected -by a small majority. But I was utterly ignorant of what was right to -do in such a strange position, and it seemed almost unladylike for me -alone to oppose the Mayor and Town Council, with their Parliamentary -Committee and legal advisers, particularly as it was insisted that -opposition meant distrust of the Council, whereas I thought simply -of my duty as a ratepayer. I did not know then, and no one present -seemed to know, that any ratepayer has a right to demand a poll; -and, if insisted on, it must have been allowed. In this case the few -pounds it would have cost the town would have been well expended, in -delaying what proved to be an exceedingly bad and retrograde Bill. But -nothing has struck me<span class="pagenum" id="Page_185">[Pg 185]</span> more in this singular experience than the utter -ignorance of all our otherwise intelligent burgesses as to the steps by -which their municipal rights may be guarded, either in the borough or -in London. This ignorance seems to arise from the inattention and habit -of indifference to municipal duties produced, not only by the pressure -of private affairs, but by exclusive absorption in party politics.</p> - -<p>As soon as the Corporation Bill was thus nominally accepted by the -burgesses, copies of the Bill were allowed to circulate. I saw at once, -on scanning this enormous Bill of 243 folio pages, thus sprung upon the -town, that it was a very retrograde Bill, and would prove especially -tyrannical to the poor. Being fully convinced that a fundamental duty -of any community is to guard the industrious poor from being crushed -into paupers, I looked at the Bill from that point of view, and was -shocked by it. It was drawn up to favour the growth of that modern -mistake, a fashionable lodging-house town, by endeavouring to attract -rich temporary visitors, instead of promoting permanent productive -industry. By its provisions it largely increased the debt of the town; -it withdrew expenditure from control of the ratepayers; it provided for -a largely-increasing bureaucracy, by placing all the new institutions -under officials of the Town Council; it confirmed and established a -virtual octroi on coal and the necessaries of life; it introduced the -most minute and arbitrary regulations in relation to building, sanitary -inspection, police arrests; it re-enacted the<span class="pagenum" id="Page_186">[Pg 186]</span> obsolete regulation -which regards vice as female; and in many other ways it sought to -convert the Town Council into masters instead of servants of the people.</p> - -<p>I immediately commenced asking individual ratepayers if they had seen -this Bill, which interfered with every class of inhabitant. No one had -seen it, and later inquiry seemed to prove that not one member even of -the Town Council itself had read the Bill carefully through, outside -the little Parliamentary Committee who followed the guidance of the -London official agent.</p> - -<p>I am glad to say that the first note of serious public alarm was -sounded by the Medical Profession, who, finding they were to be -turned into family spies by this Bill, refused to submit, and, having -an organized medical society unanimous in opinion, they commenced -an opposition to those objectionable clauses which affected their -position. But weeks of precious time were lost before attention was -aroused to the generally tyrannical character of the Bill. At last the -growing discontent found a voice in an active, enlightened burgess. -A crowded public meeting was held, attended largely by the poorer -ratepayers, and a committee was formed to see what amendments could -be introduced. But there was then not time to examine thoroughly this -enormous Bill before it was read in Parliament. Here, again, two -circumstances were noteworthy. First of all, the complete indifference -of the richer inhabitants to the Bill and to all that involved<span class="pagenum" id="Page_187">[Pg 187]</span> -trouble on their part, with the dread of the poorer inhabitants of the -frightful law expenses which opposition would entail.</p> - -<p>The second noteworthy point was the utter ignorance of all parties -as to the best and exact method of procedure in the various steps -necessary to be taken in seeking to amend or oppose the Bill—as, for -instance, the times allowed for the various stages, the parties to -address, the ways of addressing them, the rights of the burgesses to -appear, etc. No one, either layman or lawyer, possessed exact detailed -knowledge.</p> - -<p>For my part, I sought information at headquarters in London. Here, -once for all, I beg to state that nothing can exceed the courtesy and -often kindness with which my crude inquiries have always been met by -those highest in authority. Indeed, all my life long, though painfully -compelled to work against rather than with social conditions, I have -always found men eager to help an honest, unselfish worker.</p> - -<p>In London I learned some rather surprising facts. These facts may be -thus briefly summarized: First, that it is the effect of the action of -the Central Government to weaken the Municipalities by encouraging them -to run heavily into debt; secondly, that, taking advantage of their -weakness, they apparently intend to assume themselves the authority -that has hitherto resided in the Municipalities as self-governing -communities.</p> - -<p>These are very serious facts, not at all due, I<span class="pagenum" id="Page_188">[Pg 188]</span> think, to any -influence exerted by the enlightened heads of Departments, who change -with every administration, but to the enormous growing system of -permanent officialism, which acts like a tremendous machine, crushing -individual freedom, because it naturally seeks to work without -friction. The term ‘vortex,’ familiarly applied to the system when -any individual interest is drawn into its current, well expresses the -terrible power of these official forces.</p> - -<p>My first amazement was awakened by the reply to my objection concerning -the increased power of borrowing given by our Hastings Bill to a little -town of 40,000 inhabitants, that already had a debt of nearly a quarter -of a million. ‘What is the rateable value of your town?’ was asked. -‘£300,000.’ ‘And do you consider a quarter of a million a large debt? -Why, let me tell you, your town is most fortunate in having such a -small debt! Do you not know that Government allows you to borrow to the -extent of two years’ annual rating?’</p> - -<p>Such was the astounding view taken by a political economist of the duty -of Government. I thought of our hundreds of poor ratepayers unable to -pay their taxes. I thought of the statistical report that ‘In Great -Britain the municipal and other local debts rose in the period of -ten years from 84 to 140 millions,’ and I was simply dumb with fear -for the future. For I have already seen that power to borrow means -encouragement to borrow, and that the municipal purse is not regarded -as a Trust, to<span class="pagenum" id="Page_189">[Pg 189]</span> be more scrupulously guarded than the private purse.</p> - -<p>My next discovery related to sanitary and police clauses, and -particularly to those which pressed especially upon women. I maintained -that there were no such things as good brothels; that they were -illegal institutions, to be gradually and steadily suppressed by the -growing morality of the people, who should be encouraged by increased -facilities to set the law in motion; and that any legal distinction -as to bad houses that were ‘a nuisance to the neighbourhood’ was a -mischievous distinction. I also pointed out that the term ‘prostitute’ -should be entirely struck out of all legislative enactments as an -obsolete injustice, and that any necessary checks to growing vice -should apply to ‘all persons habitually or persistently’ offending.</p> - -<p>These honest suggestions were considered quite impracticable in -official circles; but I learned that the Central Government would be -quite ready to strike out any unusual local provision in order to take -all sanitary and police measures into its own hands.</p> - -<p>This appeared to me a most alarming intention. Surely a deadly blow -would be struck at individual liberty if all sanitary and police -regulations were to be drawn into the ‘vortex.’ The mistakes of -municipalities rouse individual conscience, and may be turned to the -education of the community; but take away this natural power of growth, -and we become a feeble, self-seeking mass, swayed by demagogues, and -the slaves of official Bastilles.</p> - -<p><span class="pagenum" id="Page_190">[Pg 190]</span></p> - -<p>I began to understand the wide bearing of a fact that had excited my -surprise a short time previously. Scandals occurring in one of our new -parks, permission had been obtained from the Local Government Board -to place an additional policeman there. Noticing this fact, I asked -our Councilman: ‘Why on earth did you consult the Local Government -Board about our own policemen? Does not our Watch Committee attend to -our police matters?’ He replied: ‘Oh, don’t you know that the Local -Government Board pay part of our police expenses?’ Looking over the -Borough Accounts for 1884, there, sure enough, I find this police item: -Treasury contribution, £1,881 16s. 1d.</p> - -<p>Our poor tax-payers cannot pay their rent, so we rob Peter to pay Paul; -we get money from the General Government, which all have to contribute -to supply, with the idea of lessening local rates, and in return allow -the central authorities to interfere with our police. Surely this is -selling our birthright for a very deceptive mess of pottage!</p> - -<p>As our Town Council became aware of the legitimate discontent which -existed respecting the Bill they had sent up to London, with really -imperfect knowledge of its contents, they endeavoured with willing -courtesy to meet the Ratepayers’ Committee, and at the last moment for -legal opposition, certain important amendments were accepted by the -Council, which removed the power of arbitrary arrest by the police, and -softened some of the other harsh interference with individual rights.</p> - -<p><span class="pagenum" id="Page_191">[Pg 191]</span></p> - -<p>The People’s Committee were compelled to accept these imperfect -concessions. The limit of time for opposing the Bill had arrived. -No rich or leisured resident showed the slightest concern in this -measure. The remark had been made to me by a high London authority: -‘If your townspeople really consider this such a bad Bill, then -they have nothing to do but to put their hands in their pockets -and raise the money to oppose it.’ This remark shows how little -rich people, high in authority, know of the conditions of life in a -fashionable lodging-house town. The work of revising this Bill—work -necessarily incomplete—had been done by burgesses of moderate means -and overwhelmed by private cares, and the time needed for this public -work had been stolen from sleep. There was neither possibility of -withdrawing a Bill on which much public money had been already -expended, nor of raising the heavy sums of money necessary to carry on -legal opposition to it.</p> - -<p>Thus, a new Corporation Bill of most retrograde character has been -forced upon the town—a Bill which greatly strengthens the official or -bureaucratic organization, removes much of the control of ratepayers -over expenditure, plays into the hands of a centralizing Government, -establishes protective duties on the necessaries of life, and -vexatiously interferes in various ways with the legitimate personal -liberty of the inhabitants.</p> - -<p>The latest ‘Battle of Hastings,’ in 1885, has ended in defeat.</p> - -<p><span class="pagenum" id="Page_192">[Pg 192]</span></p> - -<p>This familiar narrative of late experience in one of our little towns -is now given for a practical purpose.</p> - -<p>A similar course of things appears to be taking place in all our towns, -large and small. Unchecked, this neglect of social duty and thoughtless -submission to official formalism must steadily deteriorate our national -character. It can only be checked by the voluntary organization of -individuals who will resolutely battle for the Theocratic principle -of human rights against the selfish demagogueism of party strife. The -plainest fact in history is the Divine Moral Government of the world. -A nation given up to selfishness and lust always degenerates and -perishes, and is replaced by new races. This is the great lesson of -the ages. We only fail to read it because the method of action of the -Creative Power is so much grander and surer than the methods of our -individual action. But all that is strongest and noblest in our human -nature can be but a faint reflection of what is immeasurably stronger -and nobler in the Almighty Creative force. The careful study of our -own human needs measured and limited by the needs of all other human -beings is the foundation of all growth. This mutual limitation and -government of human rights by human duties is Theocracy. It alone can -be a permanent form of Government, for a righteous democratic rule must -inevitably be Theocratic rule.</p> - -<p>If the Churches cannot yet see that the education<span class="pagenum" id="Page_193">[Pg 193]</span> of the people in -their municipal life is the urgent need of the age, if political -parties are too corrupt or self-seeking to learn the same lesson, then -help must come from other sources. Perhaps women ratepayers not yet -entangled in party politics, and men who have risen above them may hear -the Divine voice which speaks to them, and may kindle a little sacred -fire which will grow into a beacon-light to the nation.</p> - -<p>It is now urgently necessary to consider the way in which organizations -of householders may be gradually formed in all our municipalities, for -the purpose of mutual education and legitimate criticism.</p> - -<p>An unofficial organization, sufficiently suited to respond promptly to -any sudden municipal call, has really become of vital importance. The -animating centre of such organizations must be three or four earnest, -unselfish persons (a true Theocratic brotherhood) who will carefully -study municipal or social questions, and plan and initiate a work of -gradual education, particularly addressed to women voters and our -poorer ratepayers. I especially mention women because nothing has been -done for their enlightenment as to the new duties laid upon them in -1867. It is a noteworthy fact that when 2,000,000 more men were lately -placed on the register, the most active efforts of the Cobden Club and -others were at once given to instruct these new voters after party -fashion, but no effort whatever has been made directly to instruct -the hundreds<span class="pagenum" id="Page_194">[Pg 194]</span> of thousands of women to whom the municipal vote, the -corner-stone of our political system, was given in 1867.</p> - -<p>There are questions of policy having a large and important national -bearing which need to be studied by united householders. Few persons -know clearly what should be the direct action and indirect influence -of a Town Council—its duty to resist encroachment by the central -government; its duty to encourage the interest and action of burgesses -in their own institutions, and to diminish the number of irresponsible -officials; its duty to consider the public purse as a solemn trust, and -to invite careful study of municipal accounts.</p> - -<p>The abolition of obsolete practices, the consideration of changes or -adaptation to modern needs of municipal regulations, need consideration -by householders.</p> - -<p>Few burgesses seem to know that ten ratepayers in a parish possess the -right to nominate any one of their fellow ratepayers to represent them -for three years on the Town Council. The nominations are now made in -secret by party cliques, a practice never intended by our Constitution. -This mischievous practice can be directly checked by the liberty of -independent action thus provided for. I have already referred to -the right to demand a poll at any statutory meeting where serious -objection is taken to any proposed measure, a most important guarantee -of municipal liberty, quite unknown, apparently, to the majority of -ratepayers.</p> - -<p><span class="pagenum" id="Page_195">[Pg 195]</span></p> - -<p>I need not enter upon the important questions of the selection of -Poor-law guardians, of members of School Boards, and other officers -supposed to be elected by ratepayers, because the same criticism -applies to all. At present, indifference to all these important -elections prevails unless a sharp contest springs up on party politics. -Yet questions really vital to our national welfare are involved in -these apparently minor points in our municipal housekeeping, and I -believe that the indifference now felt towards our borough elections, -when not stimulated by party strife, proceeds from ignorance of these -larger relations.</p> - -<p>It is in the hope of seeing this great municipal education begun on a -large plan, quite above party strife, that I have ventured to refer to -this episode of personal experience.</p> - -<p>Those who profoundly believe in the moral government of this world, -and who would help in establishing a true Theocracy, must seek truth -from all sources. Our modern prophets, Herbert Spencer, John Ruskin, -and many another seeker for truth, must be earnestly listened to; not -as gods, but as men who with human limitations, nevertheless through -evil and good report, never swerve from the steadfast unselfish -search for truth—men who are enabled to see clearly great aspects of -Divine truth, and who can refresh and guide us in our humbler, but -providential task. Such men are often the truest followers of our Lord -in this nineteenth century.</p> - -<p><span class="pagenum" id="Page_196">[Pg 196]</span></p> - -<p>To all women voters, to all our poorer ratepayers, I earnestly -recommend the formation of a union for the study of municipal -rights and duties, and I hope that my humble but earnest effort in -this direction will enlist the sympathy and guidance of all those -truth-seers most able to help us.</p> - - -<div class="footnotes"><h3>FOOTNOTES:</h3> - -<div class="footnote"> - -<p><a id="Footnote_22" href="#FNanchor_22" class="label">[22]</a> Between four and five hundred summonses for rates this -quarter in our little town.</p> - -</div> -</div> -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_197">[Pg 197]</span></p> - -<p class="xbig center" id="ADDRESS">ADDRESS<br>DELIVERED AT THE OPENING<br><span class="small">OF THE</span> -<br>WOMEN’S MEDICAL COLLEGE<br><span class="small">OF THE</span></p> - - -<p class="center"><span class="smcap">New York Infirmary, 126, Second Avenue</span></p> - -<p class="center"><i>November 2, 1868</i></p> - -<p><span class="pagenum" id="Page_199">[Pg 199]</span></p> -<hr class="r5"> - -<h2>ADDRESS</h2> -</div> -<p>Our Faculty has kindly insisted upon my saying the first words which -our new College addresses to its friends, and I am bound to comply -with their desire, although I could have wished that some abler person -might have shown the broad significance of those principles which are -involved in our work.</p> - -<p>True growth is slow (as we measure time) and silent. The tiny sapling -shoots up with invisible and noiseless force; so have we worked -on—silently. Yet the truest growth has its striking phases of -development. We watch with glad anticipation the first tender green of -budding foliage; later still we luxuriate in the delicious flowering of -the apple-blossoms in May.</p> - -<p>It was in 1853, in a parlour in University Place (as some two or three -of those now present will remember), that the little slip of a Medical -Institution for Women was planted, which slowly grew till it budded -into a small hospital in 1857. Many who are here to-night will recall -the opening of the hospital wards in Bleecker Street and the cordial -words of encouragement then given. They will remember<span class="pagenum" id="Page_200">[Pg 200]</span> that noble young -minister, cut down in his promising youth, who hurried in from his -pressing duties in a distant city, carpet-bag in hand, resolved to give -us a hearty God-speed, because the good cause was unpopular.</p> - -<p>Now the tree has blossomed into a college, and once more the friends -gather round to rejoice in its promise of larger usefulness.</p> - -<p>It has required fifteen years of patient work—work by faith, for the -way has been very dark—to lay the foundation of a college. This has -seemed strange to most persons, for many women’s colleges have sprung -up meanwhile; hundreds of women have received the physician’s diploma; -some have become highly-respected practitioners, and some have gained -large sums of money. Of the early friends of the Infirmary, many have -died, and some have been discouraged by its slow growth.</p> - -<p>It is an easy thing to found a poor college. Our liberal Legislature -grants a charter to anyone who asks for it, and an audience can always -be gathered together by speeches and music to witness the presentation -of learned-looking parchment rolls to a class of well-dressed students; -but charter and diploma do not necessarily guarantee the fitting -education of a physician. To found a really good college is a work -of great difficulty, and up to the present time has been impossible -for want of professional assistance—of skilful teachers, and ample -clinical provision. To this difficulty has been added another—the want -of funds.</p> - -<p><span class="pagenum" id="Page_201">[Pg 201]</span></p> - -<p>We have been facing these two perpendicular cliffs—money and -skill—for fifteen years, and striving in every possible way to climb -them. Everyone will sympathize with us in relation to the first -difficulty, but, at the same time, the promoters of ordinary benevolent -enterprises can hardly realize the added difficulty of begging for a -principle. People will give to a charity or popular enthusiasm, but -very seldom to a principle, more seldom still to such an unpopular idea -as the education of women in medicine.</p> - -<p>Little by little, however, we have laid one stone upon another, until -we have gained a foundation sufficient to stand on. It is small, -certainly, but solid, and we all feel great hope of surmounting the -first grand difficulty.</p> - -<p>In relation to the second obstacle—the want of professional support—I -need only refer to the prospectus of our College to show how happily -we have at last been able to surmount this second difficulty. How this -has been accomplished I really do not know. We are so accustomed to -be ‘despised and rejected’ that encouragement, welcome, success, seem -unaccountable. It is like breathing a new and delightful atmosphere, -which is, nevertheless, strange and dream-like; and one almost fears to -wake up with a shock and find again the cold, the gloom, and struggle -all around.</p> - -<p>But, from whatever cause proceeding, the support now given to the -formation of the College is warm and cordial. Should we fulfil -the expectations of<span class="pagenum" id="Page_202">[Pg 202]</span> the wise and experienced physicians who have -sanctioned and counselled the formation of this school, professional -assistance will be increased to the utmost extent the student may -require.</p> - -<p>We enter, then, upon this work under the most favourable auspices, and -we are encouraged to undertake it by the earnest request of medical -women from every part of the country. From the east and the west, -from California to Maine, have come the same heartfelt expressions -of interest in the establishment of a sound plan of education, the -same hope that other women may not enter upon their work under the -disadvantages of imperfect preparation that they have had to contend -with. The list of excellent women physicians who have enrolled -themselves as fellows of the College shows the trust which is felt in -this undertaking by our respected co-workers.</p> - -<p>We have endeavoured to follow out the suggestions of our most -experienced medical teachers, and incorporate the following features -into our plan of instruction:</p> - -<p>1. A three years’ college course.</p> - -<p>2. A larger proportion of time devoted to teaching and practical -instruction than to lecturing.</p> - -<p>3. A progressive succession of studies.</p> - -<p>I shall only refer at this time to one of these—viz., the three years’ -college course. I would remark, for the information of those who are -not familiar with medical tuition, that the Legislature, in granting -to a school the right to confer the degree of Doctor in<span class="pagenum" id="Page_203">[Pg 203]</span> Medicine, -requires that such degree shall only be given to those who have been -studying medicine for three years. Three years, then, is the obligatory -time of study, and no degree is legal which is granted on a less term -of study. But in the ordinary course of instruction the greater part -of that time is spent in private reading, the College being only -responsible for the instruction of two winter sessions of five months -each; in other words, for ten months out of the thirty-six required by -law. The remaining twenty-six months may or may not be well spent; it -depends upon the intelligence, resolution, and opportunities possessed -by each individual student. It is the great wish of the profession to -increase the collegiate part of instruction, and require attendance -at college during a portion of each of the three years of study. Many -colleges have added spring and autumn courses, but the attendance of -students is not obligatory, and it seems impossible to lengthen the -college course without united action.</p> - -<p>For women there exist so very few opportunities for profitable study -that these precious twenty-six months are, to a great extent, wasted. -At the same time a weighty responsibility rests upon all those who -introduce women into medicine to see that they are fitted to fulfil -the trust worthily. Medicine is a learned and confidential profession, -and should draw into its ranks the most highly educated, the most -irreproachable in character. This most noble profession, like all high -things, is susceptible of the<span class="pagenum" id="Page_204">[Pg 204]</span> worst abuse. The good which women may -accomplish in medical practice is also the measure of the evil that -they may do. Education, long and careful, should be the safeguard -of society in this matter. From many causes women are peculiarly -exposed to a great temptation—that of practising ignorantly and -superficially. The College should foresee this danger, and provide -the long and careful training which can alone discriminate between -the worthy and unworthy candidate. This education, while it sifts out -the incompetent, will give to the earnest student those advantages of -drill, of substantial knowledge, of professional support, without which -women enter upon the practical work of medicine under the most cruel -disadvantages.</p> - -<p>We propose, therefore, to adopt the most advanced plan of instruction, -and have arranged a progressive course of study which will require -for its completion attendance at college during three winter sessions -of five months each, which we hope eventually to be able to extend to -eight months. We shall thus be able not only to give to each student an -additional term of systematic instruction, with all those advantages -of hospital practice which belong only to a large city, but we shall -be able to keep her under college influence during the remainder -of each year, directing the intermediate studies, and forming much -more accurate acquaintance than were otherwise possible, with the -qualifications of each candidate for graduation.</p> - -<p>We are compelled to face many difficulties by<span class="pagenum" id="Page_205">[Pg 205]</span> this plan. We must -anticipate a smaller class at first in consequence of the additional -expense laid upon the student, for however low the price of tuition -may be made, the added expense of boarding has to be met. The student -also, at the outset of her career, is unable to appreciate the great -advantages of this enlarged instruction, and is naturally tempted to go -where a diploma may most easily be gained. We are quite sure, however, -that in a few years the thorough education given by our College, and -the distinction conferred by its diploma, will draw to it the best -students from every part of our country.</p> - -<p>There is one other feature of our College that I must allude to, as I -feel in it a profound and special interest: it is the introduction of -hygiene into our course as a prominent and obligatory study.</p> - -<p>It seems strange that the prevention of disease should not always -have engaged the thought and instruction of the guardians of the -public health at least as fully as the cure of disease, and yet I -believe that this is the first college in America to found a chair of -hygiene. Consider the subjects involved in the development of a healthy -human organization—a healthy race. Physical and moral training; -the inheritance and transmission of qualities; the peculiarities -of individual constitution; the nature and influences of climate, -soil, food and customs; the prevention of epidemics; the municipal -regulations of our cities, etc.—all these subjects come directly and -unavoidably into the department of hygiene. Surely every student who -receives the degree of<span class="pagenum" id="Page_206">[Pg 206]</span> Doctor should be thoroughly acquainted with -all that Science at present knows on these subjects. How else can he -fulfil his noblest trust—the guardianship of individual and public -health? For a specialist with a narrowed range of duties such knowledge -may, perhaps, be of less importance; but for the family physician, the -trusted friend and counsellor year after year—for the public-spirited -physician who would give to his wisdom and experience the largest -usefulness, these studies are indispensable, and his initiation, his -first impulse and interest in this knowledge, should surely be given by -his college.</p> - -<p>There is one branch of this subject which I think must weigh heavily -on the hearts of women physicians, and which will, I hope, through -them, engage the attention of every thoughtful woman in our land—I -refer to the frightful mortality of young children. Children are born -to live, not die. There is a wonderful force of tenacious vitality in -all growing organizations—far more proportionate vitality than in the -old or even the adult; yet, notwithstanding this beneficent provision -of nature, we destroy our young children nearly five times as fast as -the other members of our social body. If every woman in our city could -hear the daily moan of these dying infants, could feel that every day -multitudes of bereaved mothers were weeping over untimely graves, -and that her own skirts were not clear of this shedding of innocent -blood, we should see an army of earnest co-workers eager to save this -multitude of helpless children.</p> - -<p><span class="pagenum" id="Page_207">[Pg 207]</span></p> - -<p>Infancy and early childhood are the especial charge of women, and -how do they fulfil this trust? It does not do to look around upon a -well-furnished home, bright with the smiling faces of happy children, -and say, ‘Am I my brother’s keeper?’ Each one is his brother’s keeper -to the direct extent that knowing an evil can be cured, he refrains -from doing his part to cure it. Did the women of our city resolve to -save these children they might be saved. Year by year the mortality -might be lessened by the sanitary knowledge diffused by women, and -the sanitary regulations their influence might establish, until from -their own little circle they could look with joy to a bright cloud of -witnesses beyond—thousands of useful lives saved to their homes and -their country through their aid!</p> - -<p>This suggestion of important practical usefulness will give force to -the great principle involved in our College—scientific training for -women.</p> - -<p>Interest in natural objects, careful, comprehensive observation of -them, enthusiasm for unselfish and impersonal ends, are the main -principles of scientific study—principles that would enter with -invigorating force into the mental development of every girl, that -would regenerate the life of women.</p> - -<p>Science is no hard dry thing as some imagine; it is the earnest study -of this wonderful world around us. It will take the form of each -individual mind. In a narrow unimaginative nature it will seem hard -and dry; in a warm and loving nature it will flow into every form of -benevolent action.<span class="pagenum" id="Page_208">[Pg 208]</span> It might work a most beneficent change in the -relation that we all consider most sacred—the relation of a mother to -her children.</p> - -<p>The immense force of habit, second only to the original type of -constitution, and often overpowering even the original tendencies, is, -nevertheless, formed by the silent working of influences, hour by hour -and day by day, that are invisible and cannot be measured; that seem -absolutely valueless, taken item by item, in the long account, and yet -in the aggregate they will save or ruin the body and soul. A mother may -instil the love of reading or the love of dress; she may form the habit -of out-door exercise or the habit of gossip not by the set precept or -even formal regulations, but by her own tastes unavoidably moulding the -tastes of her children, and flowing out naturally into these external -arrangements that inevitably reflect the ruling spirit or affections of -the individual. Did the mother possess a hearty interest in the wonders -of field and forest, of sea and sky, what a treasury of delightful -intercourse might be found in the varied environs of our city! A -mother’s love joined to the broad tastes and knowledge would never -weary of the ceaseless questioning of childhood; the older the child, -the closer and more influential would be the companionship. The holiday -by the sea-side or amongst the mountains, so wasted now in idleness and -frivolity, might be a rich harvest-time of delightful knowledge drawn -from the treasures of land and water.</p> - -<p>It is, then, because of the great value that<span class="pagenum" id="Page_209">[Pg 209]</span> enthusiasm for natural -science would be to woman, value to the individual life, to the home -life, and to society, that I think this College will owe its greatest -interest. From the fact that it is a Medical College it will derive its -practical efficiency in cultivating a taste for science.</p> - -<p>A lady, now world-famous, once said to me before she began her noble -career: ‘We Englishwomen can study anything under the sun that we -desire to acquire. Not the slightest obstacle is placed in the way -of our becoming learned to any extent; but any attempt to turn the -knowledge to account, to work with it, is met with the bitterest -opposition, is ridiculed, sneered at, frowned down. Yet the greatest -impetus to study, the natural issues of study, lie in some noble -career.’</p> - -<p>It is from this tendency of human mind to pour its knowledge into some -definite form that our Medical College, with its broad practical uses, -may prove so valuable as a centre for scientific study. As it becomes -older and stronger it will spread into those collateral branches as -botany, zoology, comparative anatomy, which will form so many points -of union for the professional and non-professional. Classes would -naturally form in connection with it for nursing, sanitary visiting, -for botanical and other excursions. There is no limit to its practical -usefulness if the spirit that animates it be earnest, truthful, and -intelligent.</p> - -<p>We enter, then, upon our college work with a bright hope that stretches -beyond the college walls<span class="pagenum" id="Page_210">[Pg 210]</span> into the homes and cities around; into the -higher civilization of the future as well as the present.</p> - -<p>Our excellent Faculty, in entire accordance with these views, commence -their patient and laborious work with a sustained enthusiasm which -recognises the difficulties in our way, but is resolved to conquer -them. They share the large and liberal views of modern medicine. They -belong to no ‘pathy,’ to no narrow and bigoted sect. They are members -of that great catholic community of science which, from the ‘Father of -Medicine’ onwards, in every age and country, under the most diverse -practical forms, has sought for truth through observation, experiment -and calm deduction; has proved all things, and held fast to that which -is good.</p> - -<p>We invite the co-operation of all in this noble work. Especially do -we invite the co-operation of women. United action is of immense -importance in so arduous an undertaking as this. We will do everything -in our power to conciliate diverse interests. Principle only must -not be sacrificed. The College must be an honest and earnest attempt -to give to women the very highest education that modern science will -afford. It is on this ground that union must take place. This school -is the only one that the profession has confidence in, the only one -it has sanctioned. It has laid its broad foundation by fifteen years -of patient work, and it will quickly rise into an edifice of noble -proportions if all friendly helpers will unite in its construction.</p> -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter"> -<p><span class="pagenum" id="Page_211">[Pg 211]</span></p> - -<p class="center xbig" id="THE_RELIGION_OF_HEALTH">THE RELIGION OF HEALTH</p> - - -<p class="center"><i>A Lecture delivered in 1871</i></p> - -<p><span class="pagenum" id="Page_213">[Pg 213]</span></p> -<hr class="r5"> - -<h3>THE RELIGION OF HEALTH</h3> -</div> -<p>The words ‘the Religion of Health’ convey a profound meaning to the -physician who has spent a lifetime in relieving physical suffering. I -will try and state what those words seem to me to imply.</p> - -<p>Obedience to Divine law is the highest wisdom of the human race.</p> - -<p>Wherever God’s laws are clearly visible, stamped in immutable -characters so plain that every human being who is willing to read -them can do so, then the wisdom, the happiness—nay, the simple -common-sense of the race—lies in obeying them. The first lesson every -one of us has to learn profoundly is his subjection to law. There is -no escaping this inexorable destiny. Although each one is born with -free-will, his type—the plan and pattern of his being—is born with -him also. This type is a limitation to the nature, but it is also a -guide; it is the finger of Providence showing him the road to follow -in the great wilderness of creation; it is the Divine order, according -to which each one can freely grow and expand in body and soul to the -finest proportions. True freedom consists in the voluntary choice -of<span class="pagenum" id="Page_214">[Pg 214]</span> this type, in the full acceptance of all its conditions, and in -the endeavour to unfold its capacities. The will may refuse this -type, may deny the laws that govern it, may seek for license in a -lawless rejection of Divine order, but it is soon arrested by endless -obstacles, and persistence in the unequal struggle will only end in -degradation and self-destruction.</p> - -<p>We recognise a Divine law when we see it existing age after age -unchangeably, carrying order and beauty in its fulfilment; penalties, -discord, desolation, with infringement. These laws are grand in design, -beneficient in their effects—equally so, whether we observe the -marvel of parental love, or explore the wonders of the skies; whether -we clothe them in warm, human garments, indispensable to the simple, -loving heart, or frame them in the clear precision of scientific -formulæ, indispensable to the truthful mind.</p> - -<p>If there be one law that all can clearly recognise in the existence -of the material world around us, it is the unvarying method of human -development from infancy to old age. A certain plan exists, according -to which the infant expands through childhood and youth into manhood, -and thence changes through elderly life into old age.</p> - -<p>This plan never varies in any epoch, or race, or country. It is the -same for the lowest savage tribe as for the most cultivated race. No -effort of ours can change this unvarying sequence in human life.</p> - -<p>This is a wonderful fact. It is so common that we hardly notice it. -Yet it is wonderful, because it<span class="pagenum" id="Page_215">[Pg 215]</span> is so common—so common as to be -universal. It rises, as we regard it, into the dignity of Law.</p> - -<p>Reverence for this unity of life increases the more carefully this -strange fact, called the human body, is studied, the more fully we -understand what it is that thus remains unchanged age after age. We -speak of the body as if it were a single, simple thing, to be used as -a tool and then laid aside; but its complicated structure is a little -world in itself. As a machine, it is such a model of compactness and -ingenuity that no human skill can approach its perfection. It possesses -a twofold life—a life for itself as well as a life for our use. In its -own proper life it carries on a thousand curious operations necessary -for its growth and maintenance, quite independent of our volition or -consciousness. It contains extensive manufactories full of complicated -and delicate machinery for the production of sugar, milk, acids, -alkalies, salts; it has storehouses of iron, lime, and other chemical -substances; there are magazines where it lays up supplies against -a time of scarcity; it has its refiners and scavengers; apparatus -for warming and ventilating; it has pumps and propellers constantly -at work, and a more perfect electrical apparatus than has ever been -invented. All these remarkable operations are directed by intelligence, -working according to a plan, and combining these manifold energies -for one purpose—viz., the maintenance, during a certain period, of a -healthy human body. Besides this independent existence of its own, the -body possesses<span class="pagenum" id="Page_216">[Pg 216]</span> a life of relation, by means of which it is fitted to -the uses of individual and social existence. Its powers of locomotion, -its active senses, its faculty of feeling, its wonderful human hand, -and its still more wonderful human brain, all belong to this other use -of the body as an instrument for the expression of intelligence and -emotion.</p> - -<p>Equally remarkable is the system of general unvarying laws by which -this living structure is governed. The first law we notice in -human growth is the precedence of physical over mental growth. We -observe that physical development, though never separate from mental -development, is always in advance of it. This is shown by the wonder -and delight with which the parent receives the first sign of awakening -intelligence in the young infant, the first smile, the first indication -of observation. It is the awakening mind. But every physical function -essential to life has been perfectly performed from the first moment -of birth as perfectly, according to its wants, as it will ever be -performed throughout life. This precedence of physical life continues -throughout the whole period of growth, though it strikes us less as -the years roll on, and the mind gradually assumes that mastery over -the body which should be the condition of adult life. The brain is the -last part of the body to cease growth. Every other organ is perfectly -formed, every bone consolidated, the physical organization complete, -while the mind, with its necessary organ of expression, is still -growing. I<span class="pagenum" id="Page_217">[Pg 217]</span> place this important fact first amongst the rules which -govern the human economy because it strikes the key-note of education; -and it is only through a thorough appreciation of this principle that -we shall beneficially change our present systems of education.</p> - -<p>Each age has its own special method of existence; thus there are -laws for growth, for maturity, for decay. There are the great facts -of growth by exercise or use; the necessity of maintaining a just -distribution of force amongst the various parts, lest one grow at -the expense of another; the alternations of action and rest required -in every part of the economy; the varied life of different functions -which give to each its individuality and special rule; the varieties of -race, of temperament, of individual peculiarities—these will slightly -indicate the extent and variety of these unchanging laws by which our -human nature is moulded. Their importance may be realized more fully by -dwelling for a moment on one or two of them.</p> - -<p>What may be termed the balance of power or just distribution of force -in the various parts of our physical and mental nature—according -to each individual type—is essential to the perfection of the -organization—it is, indeed, the measure of health. It is attained and -preserved by the due exercise of all the functions of our nature. In -ascertaining what is this due exercise, we observe that the different -functions of the human being are subject to varying laws of constant -or occasional<span class="pagenum" id="Page_218">[Pg 218]</span> action. The higher the object of a function, the wider -is its scope, the longer are the intervals of rest required, and -the more direct is its subjection to reason; it is taken from under -the control of the automatic vegetative life of the body and placed -under the direction of the central authority—Reason—Conscience. -Thus, we see the lungs, whose sole object is the physical life of the -individual, breathing day and night unceasingly, with alternate rest -and action every moment. The digestive apparatus, with longer intervals -of rest and a wider range of objects, connected with the preparation -and enjoyment of food. The senses, with their great use both to the -individual and to society, locked in slumber every night. Thus, step by -step, the plan rises to the highest functions of human nature—those -which concern the race—which, above all others, are under the dominion -of reason, and not subject to that law of constant action which -controls the lower functions.</p> - -<p>Equally interesting is that law of our nature which determines growth -by exercise. It is a fact clearly demonstrated by modern science that -the governing organ of the human body, the brain, has distinct portions -of its structure devoted to the service of distinct faculties of the -mind. Thus the intellectual, the emotional, and the locomotive powers -work through corresponding portions of the highly organized brain. -Each faculty grows by exercise. Not only does the mental faculty -become stronger by use, but its physical organ of expression<span class="pagenum" id="Page_219">[Pg 219]</span> in the -brain, with its dependencies in the rest of the body, become larger -and stronger with a richer supply of blood and greater aptitude for -instantaneous action. This condition of the physical organ reacts upon -the mind, which takes greater pleasure in acting in a certain direction -when it finds the brain so keenly responsive to its impulses. If the -proper distribution of force is disturbed in any individual by the -neglect to exercise important portions of our nature, an antagonism of -faculties springs up, one part growing at the expense of another part. -Thus the emotional may destroy the intellectual life in an individual -who is subjected to undue excitement of the passions, particularly if -the type of the nature is not largely emotional. The other faculties -will rapidly lose their power. The intellect suffers, judgment is -lost, and mental confusion produced, which is really a species of -insanity. Those organs of the body, also, which are most intimately -connected with the excited portion of the brain become involved, and -their functions may be entirely deranged. The automatic power of the -human body may also assume undue control in those who yield to fancies -and caprice, and lead an unnatural and sedentary life. There is an -antagonism between this automatic force and the life of relation or -brain-life of the individual. The more the balance of powers is lost -in the human brain—reason being no longer the controlling force—the -greater becomes the power of this instinctive life of the body, the -greater its capability of answering<span class="pagenum" id="Page_220">[Pg 220]</span> every fanciful suggestion, and -even of exciting those suggestions. The individual may thus become the -sport of his own unbalanced faculties, and a prey to every species of -morbid hallucination.</p> - -<p>An organization so complicated (as this human body), designed for -such manifold uses, and at the same time drawing the elements of its -existence from the external world, must be powerfully influenced -by all the circumstances which surround it. Certain physical and -mental conditions are essential to human growth, to health. Hence the -question of food and clothing, of drainage and ventilation, of human -habitations, of exercise and occupations, attain equal importance and -dignity, as essential to the fulfilment of the great changeless plan of -life.</p> - -<p>Thus we are brought face to face with a great fixed fact, a fact which -concerns every human being during every moment of life—viz., God’s -unchanging law of human growth. This law we are called on to study, to -obey, and obedience to it is placed first in the order of human duties. -Obedience can only be rendered by study of the objects of physical -life, of its structure, its conditions, its rules. Its learning, thus -regarded, becomes sacred learning, and ignorance is criminal.</p> - -<p>The folly and wickedness of our practical contempt for the great -laws of human growth may be measured by the penalties of suffering, -illness, and premature death attached to this neglect. This is -rendered more striking by observing, first of all, the great force of -the principle of vitality,<span class="pagenum" id="Page_221">[Pg 221]</span> the strong tendency to live and resist -injurious influences, which we all possess. Nothing is more remarkable -in the history of the human race than its great power of adaptability. -Scattered all over the surface of the globe, under the most varying -conditions, men still live and thrive. The cities of Cuença and Quito, -at a height of 9,600 feet above the level of the sea, possess large -and flourishing populations; so also do the cities of Holland and New -Orleans, which lie below its level. Multitudes of workmen live in the -galleries of the deepest mines, many hundred feet below the surface -of the earth, deprived of light, breathing air much more condensed, -living under a much stronger pressure than that of the ordinary -atmosphere. And, on the other hand, scientific observers have taken -up their residence for a long period on the crest of Pichincha, at an -elevation of 14,826 feet. Agassiz spent some weeks in investigations on -the Jung-Frau. Gay Lussac attained the highest elevation ever reached -by man in his balloon, 28,000 feet. All can recall the thrilling -narratives of Arctic voyagers, where the thermometer has been known to -measure 91° below zero. Contrast this with the burning sun of India, -where 120° Fahrenheit is observed; where glass is cracked by the heat. -A wide range of more than 200° of temperature, and yet the heat of the -human body maintains its steady and necessary amount, never materially -varying under the two extremes. Similiar illustrations of the power of -human nature to adapt itself to unnatural conditions might be<span class="pagenum" id="Page_222">[Pg 222]</span> drawn -from all the other elements necessary to life.</p> - -<p>Notwithstanding this remarkable power of vitality, which can brave -such extreme variations in physical conditions and endure enormous -privations, careful observation all over our country presents a fearful -record of death, sickness, and physical degeneration produced by our -own social arrangements—arrangements and habits so destructive to the -human organization that they overpower even this great capability of -adaptation.</p> - -<p>This is seen in the statistics of our towns, in the condition of our -peasant population, in our social and domestic experience.</p> - -<p>The statistics of all our large towns demonstrate the great and -unnatural destruction of life that takes place in these centres of -civilization, where the highest medical skill is found, and placed -freely at the call of poor as well as rich. The natural death-rate -at present is 17 per thousand—<i>i.e.</i>, that under the most -favourable conditions as amongst the upper classes in our healthiest -cities, in the healthiest country districts, 17 out of every thousand -persons die each year all the world over, a lower mortality being -exceptional; but the following was the death-rate of our chief cities -(1868) instead of the natural rate of 17 per thousand: Bristol, 23; -London and Birmingham, 24; Dublin, 25; Edinburgh, 27; Liverpool, 29; -Glasgow, 30; Manchester, 32. That means that in London alone, in a year -of no special sickness,<span class="pagenum" id="Page_223">[Pg 223]</span> more than 21,000 were killed who ought to -have lived. In the British Islands an army of over 176,516 lives were -swept off unnecessarily. This is not all: a much larger proportion of -the population is always ill at one time; about 78,000 in London is -reckoned, of whom one-third are suffering from preventable diseases. -This calculation does not take into account those feeble, ailing -persons who are never more than half well, who lack strength and energy -for the daily fulfilment of duty. It is shown that in the whole of -England the people have only a mean life-time of forty-one years—not -half the term of life that seems to belong naturally to our race. Of -those who died within the year, over 134,000 were in ripe manhood; but -yet more noteworthy are the deaths under the age of twenty-five: over -242,000 perished in childhood and youth. The wholesale slaughter of -children in our civilized country is truly appalling. Out of 233,515 -deaths at all ages, 94,804, or 40·60 per cent., were those of children -under five years of age.</p> - -<p>To understand fully the grave import of these records three facts -must be noted: first, that the death-rate of a country is always -under-stated; second, that town populations increase at a much more -rapid ratio than country populations; third, that the death-rate -increases in direct proportion to the density of the population.</p> - -<p>In proof of these three propositions let me quote from recent testimony -of our most eminent statisticians:</p> - -<p><span class="pagenum" id="Page_224">[Pg 224]</span></p> - -<p>‘Wherever the population is increasing the amount of mortality is -under-rated in consequence of there being an excess of young people in -those numbers, which make the mortality appear lower than it really -is. The mortality of London appears much less by statistics than -it actually is; it is reduced in two ways by having a large influx -of persons at the period of age when mortality is low, and by the -departure and return of patients to the country to die, as consumptives -for instance. The causes of disease in London are excessively active, -as is seen, for instance, in the mortality of male children under five -years of age, which is about 8 per cent. (<i>i.e.</i>, 80 per 1,000), -while in some of the more healthy districts it is not more than 4 per -cent.’ Again: ‘Of the 20,066,224 persons enumerated in England in -1861, nearly 11,000,000 were in the towns and 9,000,000 in villages -and country around the towns. The total population in London and 71 of -the largest towns in England was over 7,667,622, and the population in -the country and in smaller towns was over 12,398,602, so that there -are nearly eight-twentieths of the population in those 72 towns. The -total increase from 1801 to 1861 in the population of England was over -11,173,688, and one-half of that increase was in those 72 towns. It -will thus be apparent that the town population is increasing at a much -more rapid rate than the country population.’ ‘The country population -now is very nearly the same as it was in 1801. By a law, which at -present is quite constant, the mortality<span class="pagenum" id="Page_225">[Pg 225]</span> increases rapidly with the -density of the population. In our thinnest districts the mortality -is about 15 per 1,000; in our densest districts it ranges from 28 to -33. This relation is a constant law: where there are 179 persons to a -square mile, there the mortality is from 17 to 19; where the density -of population varies from 3,000 upwards, the mortality ranges from -26 to 33; so that under our present arrangements there is a constant -connection between the density of population and its mortality. That -connection is not necessary; our towns might be made nearly as healthy -as these country districts, having a mortality of 17 to 20.’ Of the -circumstances under which large masses of our population grow up, -another distinguished physician writes: ‘They create special diseases, -demoralize the population, and in course of generations completely -overthrow the physique of the people. It is impossible to walk through -the central streets (of this large town) without observing that you are -in contact with a population awfully degraded, both in its physical -and moral attributes; a population whose mere external characteristics -impress you at once with the idea of a depth of degradation of bad -habits growing for generations, in consequence of these arrangements.’ -‘Thousands and hundreds of thousands are thus brought up.’</p> - -<p>Turning from the towns to the agricultural population, where we have -the right to expect the fullest measure of health, we find a condition -of things which strikes an observer with dismay. The cultivators<span class="pagenum" id="Page_226">[Pg 226]</span> -of the soil constitute the backbone of a nation. I have carefully -observed them in America, and have learned to consider them the ruling -force of the nation; independent, thoughtful, exercising judgment and -common-sense. Again and again I have seen the corrupt or mischievous -vote of the large towns reversed or overwhelmed by the country -majorities. The condition of the peasants who cultivate the soil all -over our country presents a terrible contrast to this picture. Fever, -produced by extreme misery, seems to be endemic amongst them, sapping -their strength and stupefying their minds, when it does not kill; they -are crippled by rheumatism and destroyed by scrofula; their miserable -cottages are damp, dark, close, and overcrowded; their pitiful wages -will not supply them with decent dwelling, sustaining food, and other -necessaries of life.</p> - -<p>Let me quote testimony from high authority given within the year: ‘As -many as ten persons are often crowded into a sleeping-room not 12 feet -square;’ ‘the external walls are too thin, the rooms too small, no -ventilation, brick or tile floors;’ ‘cottages are frequently built in -marshy situations, and by stagnant water, or at the foot of hills where -there is no free circulation of air; the spot is chosen on account -of the small value of the land and its uselessness for agricultural -purposes;’ ‘they are not able to pay what would be a fair interest on a -decent cottage.’ ‘If a new colliery is opened in an upland valley, 200, -300, or 400 cottages are built<span class="pagenum" id="Page_227">[Pg 227]</span> very rapidly, and they are inhabited -long before they are dry. The foundations as a rule are simply upon -the sod, which is merely turned over, and a flag is put on that sod. -There is no drainage of any kind; 40,000 to 50,000 persons will live -in houses of this kind, in one valley.’ ‘There are numbers of villages -throughout England where the people are drinking polluted water.’ ‘I -have seen no place in England in a worse condition than this village. -I have seen many native villages in South Africa, but none so bad -as this!’ Volumes might be filled with similar testimony as to the -physical state of our country population—a population whose condition -is the truest measure of a nation’s substantial strength.</p> - -<p>There is no error so dangerous in national life as the discouragement -of honest labour. If the conditions of labour are injurious and -repulsive, whether from exhausting hours of toil, unhealthy workplaces, -squalid homes, or dreary monotony of toil, the workers of either sex -will inevitably seek relief from hopeless drudgery in the excitement of -vicious indulgences.</p> - -<p>Our social experience joins its testimony with these statistics of -town and country, to show how widespread is this destruction of -health. Every housekeeper knows the extreme difficulty of obtaining a -healthy servant; nine-tenths of those who apply for a situation are -suffering from some chronic form of disease, which, if they belonged -to a different class of society, would place them in the list of<span class="pagenum" id="Page_228">[Pg 228]</span> -permanent invalids. There is no more frequent cause of the ill-health -of domestic servants than the damp and sunless rooms in which they pass -so much of their time, owing to the injurious practice of building -dwelling-houses, both in town and country, without a cellar under the -whole house, drained, and ventilated from side to side. No room is fit -for human habitation which has not a six-foot cellar, dry, with ample -through ventilation underneath it. It seems surprising that, in a damp -climate like ours, with rheumatism and scrofula prevailing everywhere, -this necessity has not been perceived.</p> - -<p>It is often thought that sanitary knowledge means chiefly ventilation, -food, and drainage; that it applies only to the lower classes, and -that we must await the action of Government to build better houses -and otherwise deal with the gigantic question of pauperism. This is a -profound mistake. Health depends upon the observance of all the laws -of our complex nature; it applies to the mind as well as the body. -A deteriorating influence which proceeds from within is more to be -dreaded than one that comes from without. The nervous system (from -mental or physical causes) may be completely shattered, leaving the -individual a wreck. The senses (from mental or physical causes) may -be rendered so craving and irritable that the noble proportion of the -nature is lost. An hysterical, feeble person is an unhealthy one; -equally unhealthy is a coarse, brutal one. In either case, health, in<span class="pagenum" id="Page_229">[Pg 229]</span> -the true meaning of the word, is thoroughly impaired. Those classes of -society who are able to command every physical appliance that wealth -will purchase are often, from their kind of suffering, more dangerously -diseased than the labouring classes. I need only mention the spread of -luxury, the delay of marriage, the frail progeny of unsuitable unions, -to show how inextricably the mind and body are blended in all that -concerns health.</p> - -<p>The highest authority on this subject thus condenses the lessons of his -great work on health: ‘Hygiene is based upon the physical and moral -perfectibility of man, of which it furnishes the proof.’ ‘Health may be -described in two words—morality, competence.’</p> - -<p>The general deterioration of health prevailing in all classes and -both sexes is most strikingly seen amongst women. It is proved by the -increase of nervous and special diseases, the prevalence of scrofula -by general fragility of constitution, and inability to bear the -unavoidable burdens of life.</p> - -<p>The health of the mass of educated women is a matter of serious -national concern. These women form the heart of the nation, they mould -its family life, they create society, they exercise an unbounded -influence on the lower classes. If the health of the mother breaks down -family happiness is destroyed; so if the health of this class of a -people is deteriorated the welfare of the nation is imperilled both in -the present and the future.</p> - -<p>Young parents enter upon the heavy responsibilities<span class="pagenum" id="Page_230">[Pg 230]</span> of family life -in deplorable ignorance of their duties to one another and to their -children. As parents, it is their first duty to secure right conditions -of health for the infant, for the child, and for youth, until they -leave the parental roof. Each age demands a varying set of conditions, -which become continually more complicated as the necessities of the -mind increase in proportion to the physical wants. The conditions that -will keep an infant in perfect health will not suffice to secure the -health of the boy or girl of fifteen. As a weak stomach will impair the -temper, so a vacant or corrupt mind will injure the body. Comprehensive -knowledge is needed to embrace the wants of every age, and such -knowledge all parents should possess.</p> - -<p>In seeking the cause of this destruction and deterioration of -life, thus briefly stated, we find it in the universal ignorance -or neglect of the Divine laws of human growth. We find this -neglect and disobedience equally among rich and poor, learned and -unlearned, religious and worldly, in individual life, in business -enterprise. The fevers of the poor, the hysteria of the luxurious, the -indigestion of the learned, the devastation of our mining districts, -equally show contempt for the wonderful organization which God has -made—indifference to the conditions which He has clearly laid down as -essential to its welfare.</p> - -<p>One of the most important problems of the present time is how to embody -the sanitary knowledge which we possess in the life of the nation so -that<span class="pagenum" id="Page_231">[Pg 231]</span> a higher standard of health may be gained by the present and -succeeding generations.</p> - -<p>The solution of this great problem must be attempted in many -directions. It must be sought in the power of legislative action, in -the wide-spreading influence of education, and in the strength of -social combination.</p> - -<p>The part which legislation should take in promoting national health -demands serious consideration. Legislation is the human imitation, or -visible representation, of the greatest facts in the universe—law, -and it derives from this representative character its immense power in -moulding the mind and habits of a people; for, as the Divine laws of -the human organization limit its powers and direct its modes of action, -so the human laws which rule a people determine their modes of thought -and their relations to one another. Legislation, therefore, not only -represents the life of the present generation, but is the most powerful -educator of the rising generation. Every law contains this latent -power hidden within it, and so often overlooked. In every subject -of legislation, whether it be the most trifling village regulation -or the gravest international question, there are principles hidden -behind the facts which induced legislation, and it is the attitude -that legislation assumes towards those hidden principles, which stamps -its character as good or evil, which makes the human law obedient or -disobedient to Divine law.</p> - -<p>The health of a nation is a most important<span class="pagenum" id="Page_232">[Pg 232]</span> concern of a wise -government. No other agency can act with such extensive and combined -power. But much wise caution is needed in dealing with such a subject -as national health. Human agencies are very imperfect, and much has -to be learned as to the right way of dealing with most important -subjects of health legislation. If the authorities introduce a supply -of pure water into a village suffering from typhoid fever they do a -righteous thing. They deal with causes. By careful investigation they -have collected a body of facts which prove that impure water will -produce typhoid fever. In this act of introducing a supply of good -water there are many principles enfolded. Thus they destroy the cause -of a great evil; they express approbation of that good thing—pure -water; they educate the people into liking it; they show them, through -experience, the blessings that flow from it. They thus render obedience -to Divine law by their legislation. But it is very different if they -attempt to regulate a village gin-shop. Gin, as a drink, is always bad, -whether adulterated or not, and, in dealing with the greatest evil -that afflicts our country—the curse of drink—legislation must adopt -the same course that it did for typhoid fever: it must patiently and -persistently accumulate the facts which will show what produces this -dangerous disease of drinking.</p> - -<p>Divine law rewards the good (<i>i.e.</i>, the obedient), punishes the -bad (<i>i.e.</i>, the disobedient), swiftly, surely, inexorably, no -matter at what cost or pain;<span class="pagenum" id="Page_233">[Pg 233]</span> and human law must never temporize with -evil, neither directly nor indirectly sanction it, or it loses its -character of law and becomes simply blind or blundering expediency. In -dealing with evils legislation is bound to investigate the causes of -evil and attack them. Herein lies the superiority of legislative over -individual effort—that it is able to accumulate that body of varied -facts through which causes can be clearly ascertained and the attention -of the community directed to them. It is only on this sound basis that -wise legislative measures can be framed; only in this way that great -questions of national health can be judiciously dealt with.</p> - -<p>Our English Government—in advance of every other nation—is learning -to recognise this great function of legislation, and is gradually -accumulating such a storehouse of facts as will render comprehensible -measures of wise statesmanship possible. The mass of the people, -however, must become sufficiently intelligent to support such measures. -The difficulties which now stand in the way of health improvements -from want of this intelligence, are inconceivable to those who have -not considered the subject. No matter whether the health improvement -suggested be great or small—whether it be the redemption of a lovely -mountain river, whose sparkling waters have been turned into a black -source of pollution, or a swamp that ought to be drained, or a poor -cottage that needs the introduction of fresh air—there is always -the same opposition and misconception. Thus a short-sighted<span class="pagenum" id="Page_234">[Pg 234]</span> view -of expense will excite furious opposition from small ratepayers and -ignorant farmers, even to the most necessary measures—measures which -would rapidly diminish the poor-rates and increase the prosperity of -a place. Incompetent men or poorly paid men are appointed to carry -out Health Acts, or timid men, afraid to excite ill-will in the -neighbourhood. The Acts thus become a dead-letter, or lawsuits are -instituted against improvements, harassing and even destroying local -health boards. Large proprietors enclose the commons, farm out their -estates to agents, and thus neglect the duties which are inseparable -from rights. The same ignorance which opposes such endless obstacles to -the establishment of sanitary improvements often defeats the best laid -plans when they are carried out, and proves, if proof were necessary, -that a people must be educated to appreciate laws before the objects -which those laws were intended to effect can be accomplished.</p> - -<p>Much confusion also at present arises from patch-work legislation that -has not been based on sound principles. This is shown by the present -Acts regulating towns: ‘A recent edition of the laws affecting health -and sanitary affairs gives the text of fifteen Acts relating to health, -diseases prevention, nuisances, local government, sewage, and kindred -subjects; twelve Acts consolidating provisions as to towns, lands, -markets, police, loans, bakehouses, etc. The public health and local -government supplemental Acts are twenty-nine in number, while the<span class="pagenum" id="Page_235">[Pg 235]</span> laws -treated by the work are affected by not less than 296 public general -statutes, which the author tabulates in the index as being referred -to in the text. No lawyer can grasp these enactments save by great -research, much less can a man who has his own business affairs to look -after.’</p> - -<p>The sanitary investigations carried on by the Privy Council and other -government bodies, the labours of the Royal Commission appointed to -inquire into the condition of the poor, etc., cannot be overestimated; -but none feel more strongly than the very men who are carrying on -these measures the necessity of effort in other directions—directions -where the co-operation of every member of society is needed—viz., in -education and in domestic and social life.</p> - -<p>We now possess enough sanitary knowledge to reform the physical and -moral condition of the human race if it were generally diffused and -its rules systematically applied. Scientific investigations and the -knowledge of hygienic laws are far in advance of the practices of -daily life. The knowledge is within our reach, which, if employed, -would save the lives of tens of thousands of human beings around us, -keep this army of sick in vigorous health, and make our homes the -precious centres of ennobling influence that they are intended to be. -We fail, however, in the means of diffusing and putting into practice -the substantial knowledge which scientific observation has laid before -us. The first duty, therefore, which rests upon us all is an endeavour -to<span class="pagenum" id="Page_236">[Pg 236]</span> secure the universal diffusion of sanitary knowledge. As every -human being in the British Isles should know how to read and write, so -every human being should be taught that health is a duty, and shown -how to secure it. Sanitary teaching (varying, of course, in its style) -should be introduced into every school and college in the kingdom—in -the common school, in Oxford and Cambridge equally, into every series -of lectures, whether at the Royal Institution or the South Kensington -Museum, into every Working Man’s Institute, and into every medical and -every theological seminary.</p> - -<p>Above all other classes of men, it is certainly important that -physicians and medical men generally should be thoroughly educated -in sanitary knowledge. The authority which they possess, and their -opportunities for instilling this knowledge when families are keenly -alive to the dangers of illness, would give them greater success as -health missionaries than any other class of society. But medical men -are not taught that it is equally their duty to prevent disease as to -cure it; and their attention is not, therefore, sharpened to observe -and to deprecate the numerous habits in family life which tend to -produce disease. There are but two chairs of hygiene established in -connection with our medical schools, and attendance upon those lectures -is not obligatory—<i>i.e.</i>, is not essential to the attainment of a -degree. Every practical instructor knows that the press of studies is -so great that the student always neglects whatever is not absolutely -necessary<span class="pagenum" id="Page_237">[Pg 237]</span> to his success. One of the most beneficial changes that -could be introduced into medical education would be the establishment -of hygiene as a first-class chair, of equal importance with anatomy, -a searching examination in its teachings being indispensable to the -attainment of any degree which gives authority to attend the sick. -Almost equally important is the introduction of sanitary instruction -into theological seminaries. The clergy generally seem to be sadly -ignorant of the laws of health. The powerful and legitimate influence -which they exercise would be more valuable if it were not so one-sided. -If the clergy all over the land, who command a mighty army of parish -visitors, could show those visitors the direct and positive connection -between pure blood (made out of food, light, and air) and pure thought, -what a revolution would be wrought in every country village! But the -clergy themselves must be educated in such knowledge, for it is not -simply intellectual assent, but a thorough realization of it that is -necessary. The same knowledge is as necessary to our schoolmasters. No -one is fit to direct the education of youth who does not perceive the -difference between the young and the old, and suit education to the -child’s nature and not to his own. The kind of studies, their variety, -frequent movement, and change, the arrangement of schoolrooms, the -unlimited supply of fresh air, the playground, etc., must all be based -upon an acquaintance with sanitary knowledge, which would be a proper -subject for examinations and certificates.</p> - -<p><span class="pagenum" id="Page_238">[Pg 238]</span></p> - -<p>The education of children and youth in Health is a subject in which -women are especially concerned. It is a large subject; it demands -not only the introduction of sound sanitary instruction suitable for -different ages into all our schoolrooms and colleges, but the creation -of a love of such knowledge and the habit of its practical application. -But this is not all: our great need—education in Health—implies the -confirming and improving the health by means of education. It is not -sufficient that the course of studies laid down for children and youth -should not injure them—it is also necessary that it should do them -positive physical good; they should be stronger, better, and brighter -for the hours spent in technical education, or there is something wrong -in the plan of education. If lessons produce headache, lassitude, -inactivity of functions, if they make children pale, quiet, spiritless, -then the lessons are bad; they have done the children an injury, no -matter how slight the evil effect appears to be each day; and the -injury cannot be remedied by sending them out to play and repeating the -same process day after day. A wrong cannot be made right by constantly -committing it and then endeavouring to repair it. It cannot be too -strongly urged that, unless the plan of education adopted with children -does them a positive physical good in all its details, it does them a -positive physical harm; it cannot be neutral. This is also true of the -youth in college or boarding-school. The same principle is applicable: -if the course of study is not positively beneficial to<span class="pagenum" id="Page_239">[Pg 239]</span> the bodily -organization, it is positively injurious. The over-taxed brain cannot -be righted by boating and cricketing. The rules which apply to the -fully-formed adult organization do not apply to the growing youth, and -it could be clearly shown how much moral, as well as physical, harm -arises from our failure to recognise the radical difference between the -youthful and adult natures.</p> - -<p>Education in Health, therefore—not simply theoretic instruction—is -what we need to make our children stronger; and it requires such a -reverence for health on the part of educators that there shall be a -constant endeavour to make every part of instruction strengthen the -physical as well as mental nature.</p> - -<p>In seeking the best means of imparting sanitary instruction to youth -we find that a certain preparation is necessary before anything like -a full and direct hygienic education can be given. This preparation -must be laid in childhood. A knowledge of the structure and functions -of the human body is indispensable; yet young women generally shrink -with repugnance from physiological instruction for which they have not -been prepared. All reference to bodily functions is unpleasant to them. -They have never learned to respect the laws of their organization, and -they turn from the subject of physical structure as very repugnant, or -a great bore. The tastes of children, however, are of a very different -character; the intellect, as shown in untiring curiosity and incessant -questioning, is predominant<span class="pagenum" id="Page_240">[Pg 240]</span> in childhood, and taste for any study -may then be formed. Children will receive the elements of comparative -and human anatomy and physiology, learn to handle bones and examine -structure, not only without disgust, but with extreme interest; and -they may thus be prepared for the fuller instruction which they should -receive as youths. Everything should be done to cultivate the taste -for natural history and science that is latent in almost every child. -Their fondness for animals indicates this taste, and the care of -animals should be encouraged and directed. The manual of physiology in -every schoolroom should be pleasantly written, well printed, and with -abundant illustrations. Bright, well-drawn pictures, clean and fresh -specimens, shelves and little boxes for collections, should be provided.</p> - -<p>To the intellectual training which results in the formation of tastes -the formation of healthy habits of life must be added. These habits -should be formed without, in general, giving any reason for them. -Children should not be taught to reason on matters of Health. They -utterly lack the power of proportion which is essential to reason, and -they run the risk of becoming morbidly conscientious or hypochondriacal -if compelled to reason on these practical matters. It is very important -that they should go to sleep early, eat simple food, live in fresh air, -and take a great deal of out-door exercise, but it is not desirable -that they should know too early why they do these things. The proper -time<span class="pagenum" id="Page_241">[Pg 241]</span> for reasoning on these habits has not arrived, but the healthy -habits early formed will gradually become a part of their nature. -Habits of self-control and obedience to rules are also an essential -part of the moral hygiene of childhood; they prepare the nature for the -intelligent obedience to law which should come in later years. Children -should not be worried with unimportant observances. The precepts which -it is necessary to give them will make more impressions if they are -not too numerous; the rules laid down must be wise rules; children -are trustful, and their trust must never be abused. If, as they grow -older, they learn to recognise the wisdom of the obedience that has -been exacted, they will escape that dangerous scepticism which so often -comes to youth, who find that their intellectual and moral guides have -cheated their youthful trust. Intellectual tastes, healthy habits, and -obedience to law being thus formed in childhood, the youth is prepared -for that full instruction in health which is adapted to the period -where reason is developed.</p> - -<p>For the education of youth in health—<i>i.e.</i>, in physical -strength—and in sanitary knowledge and habits a training college seems -to be urgently needed. The acquisition of knowledge, enthusiasm for -the study, and a practical realization of it must go hand in hand. -Modifications may doubtless be gradually introduced into the ordinary -plan of family and school instruction. But if, under the present system -of schoolroom discipline, we attempt to<span class="pagenum" id="Page_242">[Pg 242]</span> instruct young ladies in -the laws of health, we are called on to contend with insurmountable -obstacles, not only with an utter indifference to all subjects of -health and repugnance to many topics connected with it, but with -enfeebled powers from a neglected or misdirected childhood, and with -vitiated tastes from the substitution of artificial excitements for -natural healthy enjoyments; it is also impossible to find the necessary -number of teachers inspired with that respect for Divine laws which -would give them insight into matters of health and the true order of -education. This combination of difficulties makes the task of education -in health almost a hopeless one, unless the individual be placed in a -fresh educational atmosphere where the objects and methods of education -are entirely changed. Health education should train the body—of which -the brain forms part—into well-balanced strength, giving full command -of the various faculties and power to meet the demands of future life. -To accomplish this work the hearty co-operation of the individual -is essential; such education cannot be forced from without: it must -be accepted by the will. All the mixed motives which act upon human -nature are needed to vanquish indifference and excite enthusiasm: large -and beautiful arrangements in building and grounds; the sympathy of -numbers; the stimulus of honours and rewards; the increased prospect -of establishment in life. All the motives which act upon young men, -stimulating their zeal in college life, are also needed by young women. -The<span class="pagenum" id="Page_243">[Pg 243]</span> natures, if not identical, are strictly parallel. The broad rules -applicable in one case are applicable in the other, and success in -education can only be attained when it is adapted to the one common -human nature.</p> - -<p>Education in health would be best attained by giving prominence to the -following subjects: First, the practical study of natural science, -including sketching from nature. Second, the practical study of -hygiene, which would include the structure and management of houses -and households. Third, the direct training of the bodily powers in -precision, agility, and strength.</p> - -<p>1. The importance of the practical study of natural science in the -education of youth can hardly be too strongly urged. The love of -nature when strengthened by a knowledge of nature gives occupation, -amusement, mental and physical development of the best kind; it is -an antidote to the morbid influences of fashion and dissipation; it -hinders the premature development of function; it furnishes a basis -of intellectual companionship between the sexes, and would prove -invaluable to a mother in the education of her children. The power -of habits formed in children by their parents are second only to the -original type of constitution, and often overpower even the original -tendencies; these habits are nevertheless formed by the silent working -of influences, hour by hour and day by day, that are invisible and -cannot be measured, that seem valueless, taking item by item in the -long<span class="pagenum" id="Page_244">[Pg 244]</span> account, and yet in the aggregate they mould body and soul. A -mother may instil the love of reading or the love of dress, she may -form the habit of outdoor exercise or the habit of gossip, not by set -precept or even formal regulations, but by her own tastes unavoidably -moulding the tastes of her children, and flowing out naturally -into those external arrangements that reflect the ruling spirit or -affections of the individual. Did the mother possess a hearty interest -in the wonders of field and forest, of sea and sky, what a treasury -of delightful intercourse might be found in every country ramble! A -mother’s love, joined to broad tastes and knowledge, would never weary -of the ceaseless questioning of childhood; the older the child, the -closer and more influential would be the companionship. The holiday by -the sea-side or amongst the mountains, so often wasted in idleness or -frivolity, might be a rich harvest-time of delightful knowledge drawn -from the treasures of land and water.</p> - -<p>It is the outdoor study of science and art that must be insisted on -with the young—the cultivation of the powers of observation rather -than memory—which powers compel the exercise of the muscles and -senses. The guiding principle of health education is to follow the -order of nature, and place the strengthening of the physical powers -not independently of, but in advance of, the mental powers. If the -order is reversed, and the immature mind be allowed to tyrannize over -the immature body, and disturb the proportion of Nature’s work by -withdrawing<span class="pagenum" id="Page_245">[Pg 245]</span> too much creative force to the exclusive stimulus of the -mind, the true relations of mind and body can never be restored, the -adult will never receive that ready and capable service that the body -should render to the mind. In thus urging the paramount importance -of some branches of study, particularly in a girl’s education, it -is not intended to exclude all others. Many accomplishments, as -well as various branches of knowledge, may be taught in such a way -as to conduce to physical and mental health, and all studies may -be so arranged and subordinated as to be innocuous. The principle -here insisted on is that those studies must predominate and lead in -the education of youth which most fully require the exercise of the -physical as well as mental nature in their pursuit.</p> - -<p>2. The direct study of hygiene involves so large a range of -profoundly interesting subjects that it is difficult to display its -full importance in a condensed sketch. The creation of a healthy -happy home (which all will allow is the legitimate work of a woman) -requires comprehensive knowledge. The structure and arrangements of a -house adapted to the climate, soil, and wants of a family, including -drainage, ventilation, warming, economy of labour; the management -of a household in relation to individual wants and to society, -including the subjects of food and waste, domestic service, petty -trading, the care of the sick and prevention of disease, occupations -and amusements—these and many other topics belong directly to the -formation of a<span class="pagenum" id="Page_246">[Pg 246]</span> noble Christian home. These are subjects that men -and women have a direct personal interest in. They may be taught in -graduation with abundant illustration. The examination of economic -museums, exercise in the inspection of houses and neighbourhoods, etc., -should be added for advanced students. Every method should be used to -impress facts on the memory and excite personal interest. To this end -a system of rewards would be useful, whether of prizes or honours. -There seems to be no reason why honorary degrees, scholarships, and -fellowships should not be bestowed for proficiency in knowledge that -relates to the health of mankind, as well as for distinction in -classical and mathematical study.</p> - -<p>3. The third subject of education in Health is the direct cultivation -of the various bodily powers in strength, agility, and grace. This -culture presupposes close attention to the weak points in the health -of each individual student—those tendencies to disease which exist -at present in every person. All will have remarked that the same -morbid cause, applied to half a dozen people, will produce varying -effects, according to individual peculiarities; thus, a current of cold -air applied when the body is over-heated may cause either catarrh, -bronchitis, neuralgia, rheumatism, intestinal derangement, according -to the individual susceptibility. Youthful vitality masks, but does -not cure, weak tendencies, unless those tendencies are known, and the -exuberant vitality be especially directed to their cure. This<span class="pagenum" id="Page_247">[Pg 247]</span> season -of life is, however, particularly favourable to such cure. Nature will -never again present so valuable an opportunity of remodelling the -constitution. A doctor of health or preventive medicine, who shall -become acquainted with the constitution of each student and determine -how far exercise must be modified to meet individual peculiarities, is -an indispensable member of the faculty of any college that undertakes -to educate in Health. With this observation and caution modern -gymnastics and exercise in various forms will become an invaluable part -of education. The muscles of the body are capable of the same careful -training as the senses. As the eye and hand in painting, or the ear -and hand in music, require long and careful practice to acquire skill, -so the great variety of delicate or powerful muscles in the human body -require careful exercise to draw forth the varied powers that belong -to them. The ordinary movements of life do not call forth half these -powers. As the large majority of people go through life with only an -imperfect use of their lungs, from the constraint of clothing and -sedentary habits, which weaken the thoracic muscles, so it is with -other organs, and imperfect muscular action and weakened health is the -result.</p> - -<p>The principles of education which are thus laid down are the following, -viz.: a constant observance of the order of human growth, the selection -of studies that will carry out this order, habits and arrangements of -college life that will enforce it,<span class="pagenum" id="Page_248">[Pg 248]</span> direct instruction in the necessary -conditions of health, and careful training of the body. It is giving -to education the grandest of all objects—use, which, if properly -understood, includes the highest and most permanent culture of which -the individual is capable. Were our beautiful sea-coasts studded with -such colleges, with their wonderful playgrounds washed twice a day -by the Atlantic waves, furnishing endless treasures for the eager -gatherers, enthusiasm for health-giving studies would grow up in the -youthful mind, and a stronger generation mould a nobler society.</p> - -<p>The establishment of sanitary improvements by Government, and the -remodelling of education, are not the only means by which we must -seek to obey those Divine laws which are implanted in our nature. -Every class of society, every institution—in short, our whole social -life—needs to be re-born into the idea of health. The customs to which -we all conform, whether rich or poor, the standards by which we measure -success in life, and the means by which we seek to reach it, are all -opposed to the idea of health. The hours we keep, our dress, our food, -the excitements and strain of life, are injurious alike to mind and -body. The deeper we look into the structure and state of society, the -more serious are the effects of the general neglect of the laws of -human growth. Practical life now is a cruel foe to pure enthusiastic -youth; purity and enthusiasm are alike destroyed by the corrupt and -faithless society into which they enter. We preach one standard of<span class="pagenum" id="Page_249">[Pg 249]</span> -right; we practise another. We exact a superhuman effort from our -children when, surrounded by temptations, we tell them not to fall -into evil habits; we require an impossible thing when we expect them, -as social beings, to do what is right when society does what is wrong. -The diffusion, therefore, of sanitary knowledge through all classes of -adult society is as necessary as the remodelling of education. It is -through the gradual diffusion of this knowledge that combinations of -individuals may be formed who will be strong enough to put down some of -the senseless and injurious customs that now pervade society.</p> - -<p>This principle of combination may wield a great and increasing power -for good. Departure from any established custom by a single individual -is an eccentricity, but the union of fifty for the same purpose will -exercise a decided influence, and a hundred resolute men and women form -a social power in the State. It is encouraging to recognise the power -that might be exerted by such a band resolved to carry out the ‘Laws of -Health’ in their daily lives!</p> - -<p>There is only one form of combination, however, that I shall venture to -suggest, and whose utility I think will be at once apparent.</p> - -<p>I refer to the formation of a National Health Society.<a id="FNanchor_23" href="#Footnote_23" class="fnanchor">[23]</a> Such -a society seems to be much needed—needed<span class="pagenum" id="Page_250">[Pg 250]</span> to give combination, -direction, and impulse to the efforts of individuals; to form a -storehouse of information to which all could apply; to assist health -legislation by looking at this great subject from a family point of -view, and educating the community into an intelligent appreciation of -wise legislative measures; to attack such a great and growing evil as -that of unconsumed smoke; to suggest improvements in education, and -draw every charitable institution into health missionary work. Every -other subject of human interest is represented by some society, more or -less active, which takes up the social side of each particular work and -urges its claims. It seems characteristic of the general neglect with -which Health is treated that no national society of men and women has -yet been formed to promote this vital subject—Health.</p> - -<p>Such a society should extend its branches into every town and village -of the land, and form a body of corresponding members, not only -throughout the kingdom, but abroad. It might, with great advantage, -promote the wide application of that excellent system of instruction -initiated by Mr. Twining, of Twickenham. This gentleman has devoted -his life to the diffusion of sanitary knowledge. Having established -a museum of domestic arts in his grounds, open to the public, he has -written a series of lectures, which are read by the curator of his -museum and illustrated by his librarian, the illustrations for each -lecture being ingeniously packed in a small box; he generously sends -this little<span class="pagenum" id="Page_251">[Pg 251]</span> establishment to any place which will make arrangements -for the delivery of the lectures. Such a system, varying the lectures -and illustrations, might be applied to every little village in England, -for two young ladies or gentlemen might certainly be found in every -place to read discourses so prepared. If a Health Society did no other -work than keep in constant activity such a simple plan of instruction -as this, it would do a work of immense utility. There is, however, no -limit to the practical suggestions that might thus be brought before -the public to the influence that might be exercised upon family life, -or to the sanitary institutions that might be formed by an energetic -Health Society.</p> - -<p>I have thus endeavoured to show:</p> - -<div class="blockquot"> - -<p>1. That there are laws governing human growth according to an -unvarying plan.</p> - -<p>2. That neglect to study and obey these laws produces individual -suffering in all classes of society and national degeneration.</p> - -<p>3. That obedience must be rendered through legislation, education, and -social life.</p> -</div> - -<p>It is only when we have learned to recognise that God’s law for the -human body is as sacred as—nay, is one with—God’s law for the human -soul, that we shall begin to understand the Religion of Health.</p> - - -<div class="footnotes"><h3>FOOTNOTES:</h3> - -<div class="footnote"> - -<p><a id="Footnote_23" href="#FNanchor_23" class="label">[23]</a> The same year (1871) at a drawing-room meeting held in -Dr. Blackwell’s house the National Health Society was formed, which has -its offices at 53, Berners Street, London, W.—<span class="smcap">Editor.</span></p> - -</div> -</div> - -<hr class="r5"> -<p class="center p2">BILLING AND SONS, LTD., PRINTERS, GUILDFORD.</p> - - -<hr class="chap x-ebookmaker-drop"> - -<div class="chapter transnote"> -<h2 class="nobreak" id="Transcribers_Notes">Transcriber’s Notes</h2> - - -<p><a href="#Page_57">Page 57</a>: “theories of bateriology” changed to “theories of bacteriology”</p> - -<p><a href="#Page_127">Page 127</a>: “an acknowleged authority” changed to “an acknowledged -authority”</p> - -<p><a href="#Page_178">Page 178</a>: “herioc efforts” changed to “heroic efforts”</p> - -<p><a href="#Page_208">Page 208</a>: “thay will save” changed to “they will save”</p> -</div> - -<div style='display:block; margin-top:4em'>*** END OF THE PROJECT GUTENBERG EBOOK ESSAYS IN MEDICAL SOCIOLOGY, VOLUME 2 (OF 2) ***</div> -<div style='text-align:left'> - -<div style='display:block; margin:1em 0'> -Updated editions will replace the previous one—the old editions will -be renamed. -</div> - -<div style='display:block; margin:1em 0'> -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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