[1] "Medical Essays of Dr. O. W. Holmes," Boston, 1899, p. 156. [2] "Polk told us that when he graduated in medicine, delivery in a lying-in hospital was far more dangerous than an engagement in the bloodiest battle, for during his internship at Bellevue, he saw FORTY- FIVE WOMEN DIE OUT OF THE SIXTY WHO HAD BEEN DELIVERED DURING A SINGLE MONTH."—Williams; Jour. Am. Med. Association, June 6, 1914.
Equally mistaken is the implication conveyed by the passage quoted that some vast reduction of mortality has been accomplished in regard to this special form of disease. This belief is doubtless entertained by a majority of medical practitioners, accustomed to accept statements of leaders without investigation or questioning. But it is not true. We need to remember, as Dr. Oliver Wendell Holmes tells us, "how kindly Nature deals with the parturient female, when she is not immersed in the virulent atmosphere of an impure lying-in hospital." To demonstrate the exact facts, I have tabulated all the deaths in England and Wales from diseases incident to child-birth, as compared with the number of children born, for sixty years from 1851 down to 1910. It will probably surprise many a medical practitioner to know that so far from having vastly diminished, the death-rate from diseases of this character in England and Wales WAS ACTUALLY LESS HALF A CENTURY AGO THAN IT WAS DURING THE TEN YEARS ENDING 1910. But the facts are beyond question; they not only rest upon the official reports of the Registrar-General, but they show a uniformity year after year which it is impossible to regard as due to chance. In England and Wales, during twenty years (1851-1870) the total number of births reported by the Registrar-General was 13,971,746. The total deaths from puerperal fever during the same period were 21,935—a mortality-rate per 100,000 births of 157. This was the period between forty and sixty years ago. During the ten years between 1901 and 1910, the births in England and Wales numbered 9,208,209; and the deaths from puerperal sepsis were 16,341, a mortality-rate per 100,000 births of 175—GREATER THAN THAT OF HALF A CENTURY AGO! The mortality- rate may now be going downward; it was in 1910 but 142 per 100,000 births, but in 1860 the corresponding death-rate was 140, and in 1861 it was 130—considerably less than at the present day.[1]
[1] These figures have been compiled from the annual reports of the Registrar-General of Births, Deaths, and Marriages in England and Wales. Each Annual Report furnishes the number of births and the number of deaths from puerperal sepsis.
Nor is it true that recognition of the origin of this terrible disease was due to experiments upon animals. It was Dr. Oliver Wendell Holmes, in America, who indicated, in 1843, the distasteful truth that the medical attendant was chiefly responsible for the deaths from this disease; and the great lights of the profession in Philadelphia made him and his theory the butt of their ridicule and scorn. It was Semmelweis, a young assistant in the Lying-in Hospital of Vienna, who in 1847 pointed out the same truth, drawn, not from any experiments, but from rational observation in the hospital wards; and his discovery was received with contempt, he was hated and despised in his lifetime, and he died, as an American author has phrased it, "with no other reward than the scorn of his contemporaries." It was not by laboratory experiments upon living animals that the methods by which this terrible disease is transmitted became known to Science; it was common sense in the sick-chamber that discerned its clue.
The decreased and decreasing mortality of tuberculosis is not infrequently claimed as a triumph of vivisection; in the article in Harper's Magazine to which reference has been made, it is intimated that experimentation has reduced the mortality of tuberculosis "from 30 to 50 per cent.," by treatment springing from the discovery of Koch.
Do facts support this assertion? On the contrary, the decline in the mortality due to this dread destroyer of the human race BEGAN MORE THAN A QUARTER OF A CENTURY BEFORE KOCH ANNOUNCED THAT DISCOVERY OF A GERM which was the cause of the disease. In his report for 1907, the Registrar-General of England and Wales tells us that "throughout the last forty years there has been a steady decline in the fatality of tuberculous diseases"; and he illustrates the figures by a diagram, showing, for both men and women, the steady fall in the death-rate from this disease from a period long before its bacillus was recognized. Here are the exact figures for England and Wales:
For five years, 1850-1854 .. .. .. 2,811 " " 1855-1859[1].. .. .. 2,647 " " 1861-1865 .. .. .. 2,528 " " 1866-1870 .. .. .. 2,449 " " 1871-1875 .. .. .. 2,219 " " 1876-1880 .. .. .. 2,042
" " 1881-1885 .. .. .. 1,830" " 1886-1890 .. .. .. 1,635" " 1891-1895 .. .. .. 1,462" " 1896-1900 .. .. .. 1,322" " 1901-1905 .. .. .. 1,218" " 1906-1910 .. .. .. 1,106——————————————————————————————-[1] For statistics relating to period, 1850-1859, see Registrar-General's 34th Report, p. 249. For years, 1861-1880, see 48th Report,Table 27. For later period, see 73rd Report, p. 21.
This table is very significant. The death-rate of consumption in England for the year 1853 was 2,984 per 1,000,000 population. From that year, down to the five-year period, 1881-1885, there was a steady decline in the mortality of this disease, amounting to a fraction less than 39 per cent. On March 24, 1882, Koch announced his discovery. The fall of the death-rate from 1881-1885 to 1906-1910, was almost precisely the same—a fraction over 39 per cent. NOW WHAT WERE THE CAUSES WHICH INDUCED THE CONSTANTLY DECREASING MORTALITY FROM CONSUMPTION DURING THAT EARLIER PERIOD, WHEN THE NAME OF KOCH WAS UNKNOWN? Is it conceivable that they suddenly became inoperative thirty years ago? Is it not more than probable that the chief reason why the "great white plague" has steadily and almost uniformly decreased during sixty years, not only in England, but probably in all civilized lands has been the increased recognition of the value of sanitary laws and of personal hygiene? No one questions the importance of the discovery of Koch; it has given Science the knowledge that a definite enemy exists, whose insidious invasion she strives to prevent, and whose ultimate conquest may one day be accomplished—more by prevention than by cure. But when a medical writer ascribes the decrease in mortality of this disease to the discovery of Koch in 1882, and makes no reference to the steady fall in the death-rate which went on for a quarter of a century before that discovery was known, what is to be said of his fidelity to scientific truth? Is this the ideal of fairness which the laboratory of to-day inculcates and defends?
Why does it seem worth while to dwell upon these exaggerations and untruths? Was it necessary to go through the mortality records of a nation for more than half a century merely to prove the falsity of a single laboratory claim? I think so. These are not ordinary blunders or trivial mistakes. They are affirmations made in opposition to the slightest step toward reform of great abuses, by honoured and distinguished writers; by men who are regarded as absolutely reliable in all statements of fact. Their assertions of the vast benefits conferred upon the human race by experiments upon living animals are made in the journals of the day, in popular magazines—in periodicals which refuse opportunity of rejoinder, and which therefore lend their influence to securing the permanency of untruth. There are problems of science concerning which such affirmations would be of comparatively little consequence; if they concerned, for example the weight of an atom or the distance of a star, the controversy would excite but a languid interest, and the correction of inaccuracy might safely be left to time. But here, on the contrary, we touch some of the most vital problems of life and death, problems that concern every one; and in defence of practices, the cruelty of which has been challenged as abhorrent to the conscience of mankind, we have distorted and exaggerated claims of utility; we have assertions that have no basis in fact; we have covert appeals to woman's fears in her greatest emergency, and to that sentiment, the noblest almost that man himself can entertain—his solicitude for the mother of his children in her hour of peril. To the malign influence of untrue suggestion no bounds can be placed; in the creation of a public sentiment, its influence extends in ever-widening circles. It is against this unfairness and exaggeration that those who take moderate ground in this question of animal experimentation have the duty of protest and complaint. We do not ascribe the unfairness to intentional mendacity. Such motive may be discarded without hesitancy, so far as concerns any reputable writer. But surely there has been a carelessness regarding the truth which even the plea of ignorance ought not wholly to condone.
And the lesson? It is the reasonableness of doubt. Every statement put forth by the Laboratory interests in defence of the present system of unrestricted and secret vivisection should be regarded with scepticism unless accompanied by absolute proofs. In an experience of more than a third of a century, I have never read a defence of vivisection without limitations, which did not contain some exaggerated claim, some misstatement of fact. To doubt is not to dishonour; it is the highest tribute we may pay to Science; for "without doubt, there is no inquiry, and without inquiry, no knowledge."
No phase of modern science so closely touches the welfare of humanity as the studies which concern the prevention of disease. Up to a very recent period, well within the lifetime of many now living, practically the entire energy of the medical profession was given up to the treatment of human ailments, with an almost complete disregard of problems of prevention or studies of origin. To-day, in great measure, all this has been changed, and the importance of preventing disease has come well to the front. It is permissible to doubt whether the "cure" of any of the principal infectious diseases is likely to be so thoroughly accomplished as to eliminate it as a cause of mortality, and we may regard with greater promise attempts to discover the mysterious causes of our diseases, and the best methods by which their spread may be prevented. It is certainly a great gain that during the last hundred years mankind has learned that deliverance must come through human activity, and has ceased to regard typhoid or consumption as a dispensation of Providence.
For the conquest of some of the principal maladies affecting the human race at the present time I have long questioned whether the laboratory for experimentation upon animals offers the opportunity for the surest results. The average man has his attention fixed upon mysterious researches which are being carried on in this or that "Institute"; rumours of impending discoveries and almost certain cures are published far and wide; and gradually one gets the impression that notwithstanding abundant disappointments, it is only by yet more vivisection that the mystery will be solved. Is this a valid conclusion? In many cases, might not scientific research have a better chance to discover the secret of origin were it directed into other channels? I propose to suggest one method of scientific research with which vivisection is in no way concerned—an investigation into the cause of one of the most terrible and most threatening of human maladies—cancer, or malignant disease.
The subject is a vast one. Within the limits of a few pages it cannot be treated with any approach to the completeness which its importance demands. The utmost that can now be attempted is the suggestion of certain lines of research independent of animal experimentation, which, if carried out with completeness, might lead to results of incalculable benefit to humankind.
Outside the medical profession there are few who have the faintest realization of the facts pertaining to malignant disease. One reason for such ignorance is the lack of any organized system, in the United States, for recording the annual mortality. Except among barbarous or semi-civilized people, no such condition exists. When, during the autumn of 1912, Dr. Bashford, the Director of the Imperial Cancer Research Fund of England, was invited to lecture in New York, he confessed that he had tried in vain to obtain American statistics concerning cancer which might be compared to those of other nations; they simply did not exist. There are a few states and a few cities for which mortality records exist, but in some of the principle states of America there is no official record showing even the total number of deaths from murder, from accident, or disease. Once in ten years the Federal Government resents us the mortality report of the census year, but even here the information is not available until a considerable period after it is collated. There is, however, one nation whose official registers for many years have recorded the mortality from each cause of disease, for either sex, and for each ten-year period of life. These records have no equal elsewhere, and are only approached by the mortality records of the Empire of Japan. The figures concerning cancer upon which we may chiefly depend are those which pertain to the English people. There can be no doubts but that the mortality from cancer in America exhibits the same phenomena, though the rate may be higher.
The first thing to impress the student is the immensity of the tribute of mortality exacted by this disease, from those in the maturity of life, and in large measure at the period of greatest usefulness. During thirty years, from 1881 to 1910 inclusive, there perished in England and Wales from cancer no less than 703,239 lives. Figures like these, for the average intelligence, are practically incomprehensible; for this thirty-year tribute to malignant disease in a signle country represents more human being than all estimated to have perished on the battlefields of Europe for two hundred years. And if we were able to add the mortality from this one disease on the Continent of Europe, it might represent a total of several millions.
Another significant circumstance is the uniformity of the tribute exacted by cancer, year after year. We can see that best by taking the actual number of deaths from this cause, in a single country, and observing with what slow, implacable, and ever-increasing steps the great destroyer advances.
———————————————————————- | Year. | Males | Females | |—————————————|————|————-| | 1905 .. .. .. | 12,470 | 17,761 | | 1906 .. .. .. | 13,257 | 18,411 | | 1907 .. .. .. | 13,199 | 18,546 | | 1908 .. .. .. | 13,901 | 18,816 | | 1909 .. .. .. | 14,263 | 19,790 | | 1910 .. .. .. | 14,843 | 19,764 | | 1911 .. .. .. | 15,589 | 20,313 | | 1912 .. .. .. | 16,188 | 21,135 | | | | | ———————————————————————-
The terrible thing about these figures is their uniformity from year to year. With as great a degree of certainty as the farmer foretells the produce of his fields and the results of his seed-sowing, so the statistician can calculate the tribute that cancer will exact from the human race in future years. How many persons in England and Wales will die from some from of cancer during the year 1917? Unless some great catastrophe shall vastly lessen the total population, the number of victims destined to perish from malignant disease during that one year will hardly be less than 38,500, and in all probability will be more. And we have no reason to doubt that in the United States the mortality from cancer would be found equally uniform were it possible to know the facts.
Nor does uniformity pertain to numbers of either sex only. Each period of life has to furnish its special toll. If we look at the mortality among men or women for a period of years, we shall see this phenomenon very clearly. In the following table we see the deaths of men from cancer, in England, at each ten-year age-period.
——————————————————————————————— |YEAR|Under|25-35.|35-45.|45-55.|55-65.|65-75.| Above |Total.| | | 25. | | | | | | 75. | | |——|——-|———|———|———|———|———|———-|———| |1906| 250 | 322 | 927 | 2,454| 4,087| 3,651| 1,566 |13,257| |1907| 305 | 277 | 921 | 2,392| 4,041| 3,675| 1,588 |13,199| |1908| 274 | 317 | 925 | 2,594| 4,147| 3,957| 1,687 |13,901| |1909| 262 | 296 | 921 | 2,581| 4,319| 4,174| 1,710 |14,263| |1910| 283 | 337 |1,001 | 2,778| 4,377| 4,315| 1,752 |14,843| |1911| 309 | 317 | 978 | 2,901| 4,627| 4,602| 1,855 |15,589| ———————————————————————————————
Precisely the same phenomenon is to be found in the cancer-mortality of women. Each ten-year period of life exacts its own proportion, with an increasing death-rate out of proportion to the increase of population.
Another fact, attainable only by the study of English statistics, is the singular regularity with which malignant disease selects different parts of the body year after year. If proclivity to this mysterious ailment were a matter of chance, or dependent upon the irregular action of certain forces, we should certainly fail to find such uniformity, or such approach to uniformity, as exists. One year, for instance, there would be, let us say, a preponderance of attacks upon the skin; another year the digestive organs would be the principal sufferers; a third year the joints and muscles would be chiefly involved. The actual experience proves that we are subject here to forces of incalculable stress, which nevertheless press steadily and uniformly upon humanity, where the habits and environment are the same. In the year 1901, for example, of the total number of fatal cases among men, the seat of the disease was the stomach in a little over 21 per cent. of the total number of cases. In 1910 the proportion was also 21 per cent. During the ten years 1901-1910, of the total mortality, the stomach was the organ involved in but a fraction over 21 PER CENT. OF THE TOTAL CASES.
Is cancer increasing? This is a question of vast importance to the human race. That in proportion to total population more die from the disease to-day than twenty or thrity years ago, is a fact about which there can be no doubt. Dr. Stevenson, in the Report of the Registrar- General for the year 1910, tells us that in "all countries from which returns have been received the mortality has shown a general tendency to increase in recent years." Speaking on the "Menace of Cancer," the statistician of the Prudential Insurance Company of America affirmed that "the cancer death-rate in the United States is increasing at the rate of 2.5 per cent. per annum, and a corresponding increase is taking place practically throughout the civilized world." The cancer- rate among men in the United States has increased, according to the same authority, 29 per cent. during the last decade. The steady increase of cancer year after year is strikingly shown by a curve diagram, based upon the English mortality for several years.
A significant illustration of the steady increase in the mortality from cancer is shown by its fatality among women in England between the ages of forty-five and sixty-five. In the year 1875, of all deaths of women at this period of life, one in ten (in round numbers) was due to some form of malignant disease. In 1890 the tribute exacted by the disease had become one in eight. Ten years later—in 1900—of all women dying in England during this period of middle life, the toll of cancer was one in seven; and in 1910 the corresponding proportion was one in five! At this rate of increase it will not be many years before a full third of all the deaths of women at this time of life will be due to malignant disease. There can be little doubt that the same phenomenon would be found to pertain to American experience, were it possible to disentangle the facts from the obscurity in which they are now permitted to lie. It is a curious fact that in England until the year 1900—and, so far as we know, for thousands of years—the death-rate from consumption among women was considerably higher than that of malignant disease; that in 1903, for the first time, the cancer-mortality of women exceeded that of phthisis; and that in 1910 it had so far surpassed it that they are not likely ever again to be equal, unless we shall discover the cause of the more fatal plague.
The theory has been put forth by certain writers that the increased death-rate from cancer is due, not to any increased frequency of the dissease, but rather to improved methods of detection. It is quite certain that fifty years ago, for instance, surgeons were less able and less willing to pronounce judgment regarding obscure cases of internal tumours. But if the better diagnosis of to-day accounts for some part of this increase since 1860, it does not seem probable that it can explain the rising death-rate of the last ten or fifteen years. The medical practitioner of 1900 was certainly as well qualified to pronounce upon the character of the disease as the surgeon or physician of to-day. Nevertheless, the cancer death-rate of England in 1910 had increased 16 per cent. above that of ten years before, and during the fifteen years 1895-1900 it had increased fully 28 per cent. Certainly in these last few years there has been no such increased ability to detect the disease as would account for all this. Yet another fact suggests doubt of this optimistic hypothesis. If the increased cancer death-rate were due merely to the increased ability of the physician or surgeon to recognize the ailment, we should certainly find that the increase of cancer would be seen only in those parts of the system, such as internal organs, where some degree of doubt might perhaps be entertained; while, on the other hand, there would be little or no increase discernible in the mortality of cancers affecting parts of the body where its nature could not be mistaken by any intelligent physician or surgeon. Now, for a number of years, perhaps with this hypothesis in view, the Registrar-General in England has tabulated all deaths from cancer of either sex, not only by different age-periods, but also by the part of the body affected by the fatal disease. A study of the facts thus made known is extremely suggestive. It is true that a marked increase in the death-rate has occurred in cancer affecting internal organs, as we should naturally suppose; but it is also true that malignant disease affecting parts of the body where little or no doubt of the character of the ailment could be entertained by the physician, exhibit in some instances as marked an increase in the death-rate as in some other cases, where doubt of malignancy might be justifiable. For example, cancer of the tongue among men showed a death-rate of 32 per million population in 1897; it went up to 47 per million in 1910— an increase of nearly 50 per cent. Cancer of the female breast showed a death-rate of about 142 per million population in 1897; it had arisen to a rate of 190 per million only thirteen years later; and here, assuredly, the nature of the disease in fatal cases cannot be mistaken.[1] Cancer of the stomach in its final stages does not present insuperable difficulties in way of diagnosis, but the death-rate increased for men about 40 per cent. in fifteen years; and although some of this increase may be due to more careful discrimination between cases of malignant disease affecting the liver, yet this explanation cannot account for the increase when both organs are considered together. The subject is worthy of careful and extended investigation, but even a cursory examination of the facts now available indicate a real increase in the death-rate from cancer in England, and probably in every other civilized country in the world.
[1] "During fourteen years … the mortality from mammary cancer has increased by about 29 per cent., NOTWITHSTANDING LIVES SAVED BY IMPROVED METHODS OF OPERATION."—Registrar-General's Report for 1910, p. 69.
But all these phenomena are of secondary importance compared with the great problem of medical science—the yet undiscovered cause of malignant disease. During recent years the study of cancer has been conducted with scientific enthusiasm in many laboratories. Vast sums of money have been given, in the hope that these studies may one day lead to the discovery of a cure. One whom I knew in his youth became the heir of great wealth; lived to see one whom he loved perish from the disease; was struck down himself, and dying, left a fortune for the purpose of promoting research concerning cancer. And yet to-day the problem, as attacked in the various laboratories of Europe and America, is apparently as far from solution as it was forty years ago. Sir Henry Butlin, ex-President of the Royal College of Surgeons, England, is said to have operated on as many cases of cancer as any surgeon of his day. Yet, speaking in October, 1911, he said:
"I have been associated with the Imperial Cancer Research and in touch with its staff from the foundation of the Research, and have been a member of the publication committee of all its scientific reports. IT HAS DONE NOTHING ON THE LINES IN WHICH OBSERVATION HAS BEEN SO USEFUL. It has not unfolded the life-history of a single variety of cancer, so that we can base our operations on the information. It has not even discovered whether spontaneous cancer of a particular part of the body in the rat or mouse runs a similar course to spontaneous cancer of the same part of the body in the human subject. These problems are not suited for experimental investigation; they are determined by observation."[1]
[1] Lancet, London, October 7, 1911.
No "serum," no drug, no curative agency of any kind, has thus far been discovered upon which the slightest dependence may be placed. The only measure of relieve which medical science can now suggest is early and complete extirpation. Of what proportion of cases even this insures immunity we cannot tell.
Without decrying what has been done in the laboratory, may it not be that we have gone in that direction as far as there is any hope for success, and that all effort should now be directed TO THE DISCOVERY OF THE CAUSE OF MALIGNANT DISEASE IN HUMAN BEINGS? That great secret still eludes us, but until we can penetrate that mystery, it is difficult to perceive how we may hope to prevent the increasing prevalence of the great destroyer . Yet there is one method of investigation which (speaking from a study of cancer statistics for more than twenty-five years) seems to me to offer, more than all others, a reasonable hope of ultimate success. It is independent of all sacrifice of animal life. It involves, however, an expenditure far greater than is possible for any private investigator, and probably only by the co-operation of the Government can it be undertaken with any chance of success. Yet, if Society can once be aroused to a recognition of the need for the completest possible investigation concerning malignant disease, and particularly the reasons for its differing prevalence among people of different nationalities, habits, and general environment, that inquiry will take place, even though it cost the price of a battleship.
The subject is so vast and involved that it cannot be discussed with any approach to completeness in a single essay. Suppose, however, that we glance at the theory which regards cancer as due to a microbe which in some mysterious ways gains admission into the human body, lying for a time dormant, but liable under appropriate stimulation to be awakened into malignant activity. We know at the outset that if any such germ of disease exists, it has thus far escaped visual recognition. No human eye can be said with certainty to have seen it, even when aided by the most powerful microscope; but this may be due to the fact that, like the germ of certain other diseases, it is so minute that it lies beyond the range of human vision. There are, however, certain facts pertaining to the disease which have significance. We have already seen that in a given country there is a kind of uniformity in the number of those dying from the disease from year to year; but another phenomenon relates to the unequal pressure in difference countries of the causes of the disease.
———————————————————————————————- | Five-Year Periods. | Switzerland. | England. | Italy. | |—————————————|———————|—————|————| | 1886-1890 .. .. | 114 | 63 | 43 | | 1891-1895 .. .. | 122 | 71 | 44 | | 1896-1900 .. .. | 127 | 80 | 51 | | 1901-1905 .. .. | 128 | 87 | 55 | ———————————————————————————————-
Here is the record of a period of twenty years. These differences of proclivity to cancer are exceedingly curious. Can the reader perceive why they exist?
The rate in England is quite 50 per cent. higher than that of Italy. If we explain this by the hypothesis of greater skill in detecting the disease, what are we to say of the cancer-rate in Switzerland, which is 50 per cent. higher than that of England?
But here is another curious fact. The United States census of 1900 permits a contrast of the mortality of cancer according to the birthplaces of mothers of those attacked. Here, for instance, is the death-rate from cancer and tumour of persons of different nationality, calculated in three sections of the country—the rural districts of the registration area, the cities of the same section, and the cities outside the registration area.
———————————————————————————————- | | | | | | Registration Area. | Other | | COUNTRIES. |———————————| Cities. | | | Rural | Cities. | | | | Districts. | | | |—————————————|——————|————-|—————-| | Italy .. .. .. | 20 | 24 | 39 | | Russia and Poland .. | 26 | 30 | 26 | | England and Wales .. | 79 | 77 | 80 | | Ireland .. .. | 90 | 82 | 86 | ———————————————————————————————-
How are these facts to be explained? What is there about the habits, the environment, the dietetic peculiarities of the Italians in America, which tends to confer upon them a greater immunity from cancer than is possessed by those whose maternal ancestry goes to England or Ireland? Assuredly this immunity is not due to chance. It is governed by some law, even though that law be unrecognized to-day. If the low cancer mortality of Italy made itself manifest only in that country, we might suspect it indicated a lack of skilled diagnosis; but here we find it just as prominent in three different section of the United States. Not only that, but the difference is seen in comparison of parts affected by cancer. For persons whose mothers were born in Ireland the death-rate in cancer of the stomach per million population was 184; the corresponding rate for Italians was 56.
Does the poverty of the people have anything to do with proclivity to cancer? In one way this is a probability. If we could compare the general prosperity of men and women whose parents were born in the United States with the entire population of which the parents were born in other countries, it seems to me that we should find the second class, taken as a whole, to be financially less prosperous than the first. Now, in 1900, the census reveals that in the United States the class to suffer chiefly from malignant diseasewas that which included THE FOREIGN-BORN POPULATION, alike in cities, in rural districts, within or without the registration area. This is certainly a fact of tremendous import. In America the population is a blend of every European nationality. Why, taken as a whole, should the native American suffer from one mysterious disease less than some of those who have come more recently to the United States?
In another work I have ventured to suggest that if we are to discover the cause of cancer, we must study the habits and customs of those still living who have become the victims of some form of this mysterious disease. A theory held by some is that cancer is due to the consumption of meat. If one means that the flesh of perfectly healthy animals is liable to cause cancer, the hypothesis is one for which it seems to me that the evidence is far from being sufficient to justify belief. But if, on the other hand, it is suggested that malignant disease may be due to germs derived from animals which were suffering from som form of cancer when they were killed for the food of human beings, then much that is otherwise obscure becomes plain. We should expect in such cases to find cancer more prevalent among the poor than among the rich, and especially prevalent among those who, from carelessness, or ignorance, or seeming necessity, consume the cheaper kinds of meat. And since, both in their native land and in America, the Italian population consumes less meat than peoples of other nationalities, we should expect them to be less liable to be infected by the germs of malignant disease.
A few years ago a medical writer who has given much attention to this disease published some of his investigations into the cancer death-rate of Chicago. Taking the figures for a single year, he discovered that the "cancer death-rate among the Irish and German residents of Chicago is the highest in the world, being nearly 300 per cent. higher than in their native countries."[1] Of each 10,000 population of each nationality living at the age of forty years and over, he found that the deaths from cancer among the Germans was 76, among the Irish 70, among the Scandinavians 52, and among the natives of Italy 24. It was found that, while the staple diet of Italians in Chicago was macaroni and spaghetti, the people of other nationalities among whom the cancer-rate was exceedingly high, "consume large quantities of canned and preserved meats and sausages, OFTEN EATEN UNCOOKED." He discovered that a large part of the fresh meat prepared at the establishment of a certain slaughtering establishment in Chicago was derived from animals which had been condemned on the ante- mortem inspection, but the flesh of which was perimitted TO BE SOLD AS PURE FOOD AFTER THE DISEASED PARTS HAD BEEN REMOVED. Sold thus at a cheaper price, such meat was chiefly consumed by the poorer classes of the foreign population. And while Dr. Adams does not adopt the hypothesis of the cancer-germ, he does not think there can be "the slightest question but that the increase in cancer among the foreign- born over the prevalence of that disease in their native countries is due to the increased consumption of animal foods, PARTICULARLY THOSE DERIVED FROM DISEASED ANIMALS."
[1] See article by Dr. G. Cooke Adams in Chicago Clinic of August, 1907, pp. 248-251.
A statement like this is calculated to induce serious reflections. The average reader finds it difficult to believe that, according to the present interpretation of the law, the flesh of animals found to be suffering from cancer at the time of their slaughter would be permitted to pass into the world's food-supply. We are int the presence of a great mystery. We do not know how the gret plague originates. But no reflecting man or woman can be insensible to the significance of possibilities when he learns that cancer affects animals which are killed for food; that in the majority of cases the disease affects some part of the digestive tract; that it chiefly prevails among the very poorest classes of the population, excepting only those like Italians, who use but little meat; and that, according to the official regulations of the United States Government in force to-day, THE FLESH DERIVED FROM CANCEROUS ANIMALS NEED NOT ALWAYS BE DESTROYED AS UNFIT FOR HUMAN CONSUMPTION. The cancerous tumour, the affected parts, must indeed be cut away, and carefully condemned. The disposition of the remainder of the meat is left to the decision of the inspector!
The regulation so far as it applies to meat of this kind, is as follows:
"ANY ORGAN OR PART of a carcass, which is badly bruised, or which is affected by tumours, MALIGNANT or benign, … shall be condemned; but when the lesions are so extensive as to affect the whole carcass, the whole carcass shall be condemned."[1]
[1] Regulations governing Meat Inspection, U.S.A. Regulation No. 13, section 23. See also Appendix VIII., p. 362.
The meaning of this regulation would seem to be perfectly clear. There is no demand by the Government that the entire carcass of an animal affected by malignant disease shall be utterly destroyed for food purposes, unless the disease has involved the entire body,—a condition as rarely found among domesetic animals, as among human beings. Otherwise than this, what is there in the official regulations of the bureau governing meat inspection to prevent such use of the flesh of diseased animals as the inspector may authorize?
It seems to me that if science is ever to discover the cause of malignant disease, there should be a careful study of all the conditions under which the disease now manifests itself. The mortality from cancer in the state of New York, in 1912, amounted to 8,234; in England, the number of those who perished from the disease in 1911 was nearly 36,000. By what figure must we multiply this mortality in order to ascertain the number of persons living who have been affected, or who now are suffering from cancer? Nobody knows. What has been the success of surgery in securing immunity from a recurrence of the disease? So far as the entire country is concerned, we are entirely ignorant. Is it true that among the class of people in such cities as Chicago, where cancerous animals are used for food, cancer is especially prevalent year after year? If true, it should be fully known. Such facts must be ascertained, if ever we are to penetrate the secret of the dissease. Even the number of victims of each sex is not given in the mortality reports of the state of New York at the present day.
Let us suppose that the time comes, when with a realization of peril pertaining to ignorance, public sentiment shall urge the attainment of knowledge concerning cancer as it now affects the general population. In what way is information of this character to be secured? Assuredly not by any of the ordinary census methods, implying publicity. The only practicable enumeration would be one conducted privately, by members of the medical profession. Nor can it be done parsimoniously. In the state of New York, there may be, to-day, 50,000 cases of malignant disease. To have every case, completely reported, might cost the state half a million dollars. Perhaps even the patient should be compensated. Certainly some method could be adopted whereby the reports should be absolutely confidential, the patient being known only by a number. But all this is of minor consequence. When the necessity of the inquiry is everywhere recognized, the details pertaining to accomplishment will be easily arranged.
Assuming the willingness of patients and friends to assist in making a State-wide inquiry concerning the prevalence of malignant disease, let us see in what directions the investigation will be conducted.
FIRST. After securing the name, age, and place of birth of each individual sufferer, and the particulars which would suggest themselves to every physician or surgeon, inquiry should be made concerning the parents; the names, nationality, religious faith, place and date and cause of death. Especially should inquiry be made whether there have been other cases of cancer in the family, and their termination or present state.
SECOND. What is the location of the suspected ailment? When were the first symptoms manifested? To what cause, if any, were they ascribed? Has any surgical operation been performed, and if so, what are the details of time and place? Has recurrence followed operation? For what period was there freedom from symptoms?
Whatis the social position of the patient? Does he belong to that class which is enabled always to select the best food, the most sanitary dwellings, and all the conveniences of well-ordered and comfortable existence; or, on the other hand, to the extremely poor class, which disregards cleanliness, indulges to excess in the use of stimulants, and consumes the poorest and cheapest kinds of meat? I deem it of great importance that the completest possible information be secured concerning the usual diet of every sufferer from this disease. Is he a vegetarian? Are viands invariably well-cooked, or eaten sometimes rare or raw? Is there a liking for the canned products of the packing-house, or for sausage that comes from the same source?[1] What is the water-supply? Within the knowledge of the patient or friends, has there been any other case of malignant disease in the same house? Is residence near any fresh-water lake or stream?
[1] The relation between diseased meat and human ailments is treated at length in my work on "American Meat," New York, 1909.
These are suggestions only. They constitute merely an outline of the information that is necessary, concerning the living sufferers, in whom the disease has made its appearance. Doubtless the average reader will discern no reason for all these inquiiries. Yet each one has some pertinency to the possible discovery of the great secret. Does inquiry concerning family history seem useless? It should have a decided bearing on any theory of heredity. Does the occurrence of near-by cases have no significance? We are not yet in a position to state this as a fact. Does inquiry concerning religion seem especially impertinent? What if some future investigation should prove that cancer everywhere, is more prevalent among the Christians than the Jews? Does the social condition of the sufferer seem to have no relation to cause? What if we discover, that everywhere,—and not among the foreign population of Chicago only,—cancer finds an undue proportion of its victims among the poorest and most poverty-stricken element of every nationality? Does suggestion of inquiry concerning diet induce a smile? It should not, as long as meat derived from cancerous animals is permitted by Government authority, to pass inspection, and to be distributed throughout the world. And no inquiry concerning cancer can be deemed complete which has not fully investigated the extent to which this atrocious practice has been carried on for the past quarter of a century.
But this State-wide inquiry is only a part of the work. Every year, for a period of at least ten years, the record must be revised, the result of surgical operations recorded, the deaths enumerated, the new cases added. The expense of each annual revision would be far less than that of the original inquiry; but the inquiry will be costly, and should be costly, if it is to be accurate and complete. Here, indeed, would be the opportunity for the co-operation of organizations devoted to "cancer research," and particularly of that new foundation, the income of which for a single year is far more than the original investigation would cost.
And when the inquiry is completed; when all attainable information concerning the occurrence of malignant disease shall have been secured not for a single year, but for a period of successive years, not for one community, but for an entire state, and for each of its constitutuent parts, what then? Then I believe a knowledge of the cause of cancer will soon be attained. When we know the cause, then there will be hope for prevention, which is far better than cure. All the various experiments upon mice, for example, whatever they may teach concerning the disease in the lower animals, have not enlightened us concerning the cause of the malady in mankind. The greatest and most promising fields for scientific research, now almost untrodden, awaits the explorers of the future. In a world where now there is comparative unconcern, there may soon be fearful apprehensions of the increasing prevalence of an almost irremediable disease. Within the coming century, the investigation I have here outlined, will sometime be made; and, as a result, the cause of cancer may be as well known to medical science, as the causes of typhoid fever or malaria,—mysteries that seemed insoluble less than a century ago. And I venture with assurance to predict, that some time within the next fifty years, the Governments of England and of the United States, alarmed, it may be, by a continually increasing mortality from cancer, will condemn under severest penalties, the sale for human food of meat deriveed from animals affected by malignant disease,—no matter how great may be the pecuniary loss to every slaughtering establishment and packing-house in either land. The public awakening to danger that must precede legislation cannot yet be discerned; and before the national apprehension is aroused and apathy ceases, probably more than a million lives will be sacrificed to cancer, in England and America alone. ——————————————— Note.—"The deaths ascribed to cancer or malignant disease in England and Wales during 1912, numbered 37,323. The mortality of males was 913 per million living, as compared with 891 in 1911, and that of females, 1,117, as compared with 1,098. IN THE CASE OF EACH SEX, THESE RATES ARE THE HIGHEST ON RECORD."—From 75th Report of Registrar-General, 1914, p. lxxxiii.
[1] Address delivered at Washington, D.C., before the International Humane Congress, December 10, 1913.
Attempts to forecast the future development of Humanity in any direction have always possessed for some minds a peculiar fascination. Plato and Bacon had their visions of a State superior to that in which they lived; Burton foresaw improvements in the administration of justice, and the condition of the poorer classes, which waited for two centuries for some measure of realization; even Defoe had his list of "projects," some of which, laughed at in their day, are the realities of our time. No great reform in any direction was ever effected which had not been the unrealized vision of a dreamer.
And such dreams are the romance of history. For any one to have imagined two centuries ago, that the African slave-trade and negro slavery would some day be condemned by every civilized nation, not because they were pecuniarily unprofitable, but because they contravened the conscience of Society and its sense of righteousness, requierd a faith in the ultimate triumph of justice over greed, that not one man in ten thousand possessed. For Calvin or Torquemada to have imagined the coming of a time when the burning of an unbeliever would not be regarded as pleasing to the Deity, demanded a sublimer vision than either of them possessed. Custom and universal acceptance would sometimes seem to create impregnable barriers against change. But with the slow lapse of years, the venerated custom is attacked by doubt; the superstition is undermined, and the great evil gradually passes from the sight. No great wrong is so securely entrenched, as to be absolutely safe from the ultimate condemnation of mankind.
What is to be the future of vivisection, as conducted in America to- day? Is it to continue, without other limitations against cruelty than those which are self-imposed, without legal restriction or restraint, so long as civilization endures, ever widening its scope, ever increasing the hecatombs of its victims, until uncounted milions shall have been sacrificed? Is protest against excess to grow weaker, until the ideal of humaneness in the laboratory shall become a scoff and a byword? Is approval of any research in the name of Science to become stronger until it shall cover the vivisection of human beings as well as the exploitation of animals? Or are we to expect, as the result of agitation, the legal suppression of all scientific research requiring animal life, within the limits of the next half-century? It is easier to ask questions than to answer them. Yet, as one who for over thirty years, has taken some part in the agitation for reform, you may be willing to permit a forecast of probabilities, vague, it may be, as the vision of a sailor peering through the darkness that environs the ship,—but the best he can do.
No estimate of the future of vivisection in America can be of value which does not recognize the power of the laboratory at the present day. Half a century ago, the vivisection of animals was rarely practised; to-day, in the older states, there are few institutions of higher learning which do not possess ample facilities for animal experimentation. Millionaires, many times over, have been induced to devote some part of their great wealth to the foundation and support of institutions for exsperimentation upon living things. Farms have been established where animals destined to sacrifice, are born and bred. It may safely be estimated that in America, to-day, there are not less than five hundred times as many experiments every year, as took place half a century ago.
One must recognize, too, the change which has taken place in the attitude of a majority of the medical profession towards this reform. During the past thirty years, thousands of young men have entered the profession, who have been carefully educated to regard all criticism of animal experimentation as due to a sentimentalism worthy only of contempt. I greatly doubt whether even one per cent. of the physicians in America, under fifty years of age, have ever heard that half a century ago, the feeling of the medical profession, in the English-speaking world was almost unanimous in disapproval and condemnation of methods and of experiments which now pass without notice, and uncondemned. When men, educated to come into the closest of relations with their fellow-beings, are thus prejudiced and uninformed, should we wonder that their views are so widely accepted? The wonder to me is rather that so large a minority are not to be convinced that everything in a laboratory must be right.
Another element of the forces that to-day are marshalled against reform, is the Press. Political journals, which even twenty-five years ago endeavoured to hold an attitude of impartiality, now present editorials almost every week in ridicule of any legal regulation of vivisection, or of any opposition to laboratory freedom. The intimate knowledge of medical matters sometimes exhibited by the writers, would seem to indicate a closer relation between the physiological laboratory of to-day, and the editorial sanctum, than existed forty years ago. There are journals, so closely related, apparently, to laboratory interests, that they do not permit correction of editorial misstatements or mistake to appear in their columns, even when such blunders are pointed out. The old impartial attitude of the Press seems—except here and there—to have completely disappeared. Any forecast of the future must take into account this vast and ever- increasing influence.
Yet another impediment to the legal repression of any cruelty pertaining to animal experimentation is one which we all deplore, even though no remedy appears in sight. It is not the opposition of enemies, but division among friends that constitutes, in my opinion, the greatest present obstacle to any reform. It is as though against some strong fortress, different armies were engaging in an attack, each with its separate purpose, its own plan of campaign, its own ultimate aim, and now and then crossing and recrossing in each other's way, to the infinite delight of the enemy. Some of us make the demand that ALL such inquiry on the part of Science shall be made a crime; and some of us take the position of the English-speaking medical profession of forty years ago, that ABUSES AND CRUELTY ALONE should be the object of attack. If opposition from the first, had been solely directed against ABUSES of vivisection, could any reform have been achieved? It is not certain. When Mr. Rockefeller opened his purse on the vivisection table, he added immeasurably to the strength of the forces that resist reform. And yet it is difficult to over-estimate the loss to any cause of such men as Sir Benjamin Ward Richardson, as Professor William James and Professor Henry J. Bigelow of Harvard University, or of Dr. Theophilus Parvin of Jefferson Medical College,—to refer only to the dead. Their criticisms of cruelty were outspoken, but they could not join in universal condemnation of all such inquiry into the phenomena of life. Might it not have been better—even at the cost of a lessened demand—to have kept on the side of reform that large element in the medical profession which willingly condemned abuse, but declined to denounce the simplest demonstration, or the most painless investigation? Of course such an inquiry will receive different replies. It is ever the easier task to make condemnation absolute. The thing has been done; the past is beyond recall. But in looking at the future, we cannot but recognize the changed attitude of a majority of the medical profession from that of half a century ago.
The strongest position of the modern physiological laboratory, is its SECRECY. It occupies in the popular mind almost precisely the place which was held for centuries by the Inquisition in Spain. There were men who doubtless objected, then, to the secrecy of the dungeon. "Trust us absolutely," cried the inquisitor. "Ours is the responsibility of preventing errors that lead to eternal death. Can you not leave it to us to decide what shall be done in the torture- chamber, being assured that NO MORE PAIN WILL BE INFLICTED THAN IS ABSOLUTELY NECESSARY FOR THE END IN VIEW?" "Trust us absolutely," demands the vivisector of to-day. "Can you dare to question the purity of our motives, the unselfishness of our aims, the mild and humane methods of our experimentation? Why should any one wish to disturb the silence and secrecy in which we carry on our work? Cannot the public leave it solely to us to determine what pain may be inflicted upon animals, being certain that no more suffering will be caused than we deem to be necessary for success?"
The parallelism is complete. It is a call for implicit confidence. And that confidence has been given by a too credulous public. Three hundred years ago, when the victims were marched in long procession from dungeon to burning-place, they were accompanied by an approving mob, eager to inflict every indignity and to applaud every pang. The men about the burning-place were not intentionally cruel. They had simply given the control of their judgment to the inquisitor. Is it so very different, to-day, in the matter of vivisection? Why should we hesitate to recognize that at the present time, a large section of the general public have made the same act of surrender, justifying whatever the laboratory demands, and defending whatever it defends?
It seems to me probable, therefore, that for many years to come, the laboratory for vivisection, IF ONLY IT CAN MAINTAIN ITS SECRECY, will continue as serenely indifferent to criticsm, as completely master of the confidence of modern society, as supreme in power and position as was the Spanish Inquisition of three centuries ago. New laboratories will be founded upon ill-gotten wealth; new inquisitors, with salaries greater than those of Washington or Lincoln will take the places of those that retire; new theories, now unimagined, will demand their tribute of victims to help prove or disprove some useless hypothesis; even new methods of torment may be invented, and new excuses for their necessity put forth. Nor is this all. If the laboratory of the present day shall continue to maintain its hold upon the intelligence of modern society; if it can keep unimpaired that confidence in its benevolent purpose, that belief in accomplishment, that faith in utility which now so largely obtains; and if, moreover, it can secure for the charity hospital that absolute power and secrecy which it has gained for itself in animal experimentation, then, within the lifetime of men now living, human beings will take their place as "material" for investigation of human ailments. Upon the living bodies of Amerian soldiers, upon lunatics in asylums and babes in institutions and patients in charity hospitals, experiments of this character have already taken place. Is utility to Science to be considered the standard by which human actions are to be judged? Then, even within the present century, experimentation upon human beings may be openly acknowledged as a defensible method of investigation.
Now all this is not a cry of despair, a confession of defeat. It is meant only to be rational recognition of existing conditions, and especially of the forces that now prevent reform. Perhaps if the armies were united, a different forecast could be made; but that union is beyond hope. The enthusiasm that would expect to eliminate a great evil on other terms, and within the space of time occupied by a single generation does not seem to me to be justified by the records of history. Of the ultimate triumph of the reform of vivisection, there can be no more question than of the result of the agitation against human slavery, against the torment of criminals, against the burning of the heretic or the witch. In what way may we anticipate its coming?
We may be certain that a period will yet arrive, when among the more intelligent classes of society, doubts concerning the practical utility of all that is done in the name of Science will take the place of present-day credulity. It is too soon to expect a general spirit of inquiry to arise; the closed laboratory has not been so long in existence but that a request for more time to demonstrate possibility of accomplishment may seem not unreasonable. But some time in the future, long after we have all passed away, the intellectual world may be moved by the spirit of doubt and unrest; it will ask from the laboratory a statement of account; it will demand that the books be balanced; and that against the cost of agony and death, there be made known whatever gains in way of discoveries of clearly demonstrated value to humanity, can be proven to exist.
Like the servant in the parable, the modern laboratory has been given its ten talents. It enjoys a secrecy which is profound, all that wealth can procure, and unrestricted opportunity for ever phase of research. There is no limitation to the torments which it may inflict, without impediment or fear of public criticism, if present secrecy can be maintained. The conscience of modern society—so far as vivisection is concerned,—would seem to have "journeyed into a far country." But some day it may return to its own, and ask for an accounting of its trust.
And fifty years hence, if pressed for the proof of great achievement, of grand discoveries, what evidence will then be produced by the vivisection laboratory? How much of wealth will have been devoted to fruitless explorations in desert regions? What vast fortunes will have been paid out to professional explorers, whose work will have been in vain? What proofs will the laboratory then be able to adduce of "priceless discoveries" made within its walls, proofs resting not upon the heated enthusiasm of the experimenter, but demonstrated by statistical evidence of a decreased mortaility from the scourges of disease? THAT is the test of utility, which may one day be applied not merely to Mr. Rockefeller's creation, but to every laboratory in England and America. Then, perhaps, it may not suffice to set forth discoveries, as useless to mankind, as would be the demosntration of gold and silver in the moon. Before the tribunal of an intelligent public opinion,—not of our day, but of some distant epoch, the justification of secret vivisection will assuredly be demanded. Will it be given? Against the vast cost in money, cost in depravation of the instinct of compassion, cost in the lessened sensitiveness of young men and young women to the infliction of torment, cost in the seeming necessity of defending and justifying cruelty, cost in the temptation to exaggerate facts, cost in the countless hecatombs of victims, non-existent to-day, yet doomed to perish in pain of which no record and no use can be found,—against all this, what profit will be adduced? Something? Undoubtedly. BUT SUFFICIENT TO BALANCE THE COST? When that accounting is made, will the enlightened conscience of humanity then grant condonation, because of great achievement, of all that will have been done in the name of research, and of demonstration of well-known facts? I cannot imagine it.
What can we venture to forecast regarding the future of medical school vivisections, made for the one purpose of fixing facts in memory? No one qualified by any experience in teaching can doubt the value of certain demonstrations. So far as they are performed upon animals made absolutely unconscious to any senstation of pain, it is difficult to suggest a condemnation that does not equally apply to the killing of animals for food or raiment. But the medical school laboratory seems to shrink from the public scrutiny. If there were no need for secrecy, is it likely that every attempt to penetrate the seclusion of the laboratory would be so strenuously opposed? OF WHAT IS THE LABORATORY AFRAID? If the present methods of demonstration or teaching of physiology are such as would meet general approval so far as their painlessness is concerned, why fear to make them known? On the other hand, if animals are subjected to prolonged and extreme torment for the illustration of well-known and accepted facts; if students not only witness, but are sometimes required to perform for themselves experiments as agonizing and as useless as any that ever disgraced the torture-chambers of Magendie, we can well understand why immunity from criticism can only be secured by concealment and secrecy. Opposition to publicity or to investigation by the Government is quite conceivable, if there be something which must be hidden out of sight.
In the long-run, the policy of concealment must fail, and the whole truth be known. Then, indeed, we may hope for the beginning of reform. That fifty or a hundred years hence, all utilization of animals, whether for food or raiment or scientific ends will have absolutely ceased in England and America I am not able to believe. But I am very sure that before this century closes, the subjection of animals to pain for the demonstration of well-known facts will have come to an end; that agonizing experiments will have ceased; that every laboratory wherein animals are ever used for experimental purposes will be open to inspection "from cellar to garret," as Professor Bigelow of Harvard Medical School said they should be; and that except as a shield for crime, the secrecy which now enshrouds the practice will for ever have disappeared.
We are living to-day in a period of unrest and change, such as the world has never known before. A new social consciousness has awakened throughout the civilized world, a feeling that for those who are to come after us, life should be happier and better than it is. Humanity is advancing toward its ideals by leaps and bounds, where once it slowly crept. Every social problem, from the prevention of cruelty, the suppression of vice, the rescue of the submerged, to the abolition of poverty itself, is to-day more in the thought of humanity than ever before in the history of the world. We are but just beginning to learn our duties to human beings of other races; may we not be assured that the more sensitive conscience of the future will define with authority, our duties to the humbler sharers of this mysterious gift of life? Already, Science has told us, that far in the past, we had the same origin; and surely, when some higher ideal than utility to ourselves, shall dominate human conduct, there will be a new conception of JUSTICE toward every sentient being. It may mean extinction of species; but it will notmean their torment. You and I cannot hope for life long enough to see the realization of that dream. And yet, sometimes I have wondered whether it be so far distant as I have feared. But a little while ago, who of us could have imagined that in our day, the Government of the United States would listen to the cries of little birds, starving on their nests in the swamps of Florida, and prohibit the importation of the egret plumes? How much of hopefulness for the final triumph of th eprinciples of humaneness lies in the passage of such a law!
I fancy that one day, all noxious animals, and especially those which prery upon other creatures, will largely, if not entirely, disappear. It is calculated that ever grown lion in South Africa kills for food, every year, between 200 and 300 harmless animals, and each one of which is as much entitled as the lion to the happiness of existence. In great museums to-day, we see the remains of creatures, like the sabre-toothed tiger, that lived probably, over a million years ago. In a century or two, hence, the skeletons of the panther, the tiger, the leopard and the lion, will be found in the same halls of science, with those of other extinct species, that could exist only at the expense of others' lives.
Some day the question of vivisection will be merged in the larger problem, the adjustment of man's relations to animals on the basis of JUSTICE. We who are assembled here to-day, certainly are not forgetful of other cruelties than those which pertain to animal experimentation. In the awful torment endured for days by animals caught in steel traps in order that their death may contribute to the adornment of women and the luxury of men; in the killing of seals, accompanied by the starvation of their young; in the great variety of blood-sports; in the slaughter of animals, destined for human food, in all these, as well as in the cruelties that have pertained to physiological inquiries, we see exemplified man's present indifference to the highest ethical ideals. We do not oppose one phase of cruelty; WE OPPOSE THEM ALL. And we may be assured, that when the day dawns in which humanity shall seek to govern conduct by the ideal of universal justice, then in some more blessed age than ours, the evils of vivisection not only, but all phases of cruelty and injustice will for ever cease.
There is one phase of scientific research which cannot be passed in silence. It is experimentation upon human beings. That "no experiments on animals are absolutely satisfactory unless confirmed upon man himself," a well-known vivisector has asserted; and no one acquainted with the trend of events, could doubt the coming of a time when opportunity for such "confirmation" would be given, and when a more precious and a less costly "material" than domestic animals would be used for investigations of this kind. Writing many years ago, a distinguished jurist declared that "to whomsoever in the cause of Science, the agony of a dying rabbit is of no consequence, it is likely that the old or worthless man will soon be a thing which in the cause of learning, may well be sacrificed."
It is necessary at the outset, however, to draw a careful distinction between those phases of experimentation upon man which seem to be legitimate and right, and those other pases of inquiry which are clearly immoral. It is, of course, to be expected that certain experimenters upon human being will endeavour to confound both phases of inquiry in the public estimation; and yet there is no difficulty in drawing clear distinctions between them. Let us see what differences may be perceived between the experimentation upon human beings which is laudable and right, and the other phase of inquiry which Society should condemn.
I. Any intelligently devised experiment upon an adult human being, conscientiously performed by a responsible physician or surgeon solely for the personal benefit of the individual upon whom it is made, and, if practicable, with his consent, would seem to be legitimate and right. In the practice of medicine, there must always be a "first time" when a new method of medical treatment is tested, a new operation performed, a new remedy employed. Whether the procedure pertain to medicine or surgery, so long as the amelioration of the patient is the one purpose kept in view, IT IS LEGITIMATE TREATMENT. The motive determines the morality of the act.
II. Now human vivisection is something quite different. It has been defined as "the practice of subjecting to experimentation human beings—men, women, or children, usually inmates of public institutions—by methods liable to involve pain, distress, injury to health, or even danger to life, without any full, intelligent, personal consent, FOR NO OBJECT RELATING TO THEIR INDIVIDUAL BENEFIT, BUT FOR THE PROSECUTION OF SOME SCIENTIFIC INQUIRY."
The distinction is a perfectly clear one. Under the term "human vivisection" only those experiments are included which have some of these characteristics:
2. The experiment is liable to cause some degree of pain, discomfort, distress, or injury to the health, or danger to the life of the person upon whom it is performed. The defence often made that no real injury resulted from the experiment, cannot palliate the offence against personal rights.
3. The experiment is performed without the intelligent, and full consent of the individual experimented upon. Such legal consent of course is impossible to obtain from children, from the feeble-minded, or from lunatics in public institutions.
It is the purpose of this chapter to demonstratte that such experiments upon human beings have been performed. Naturally, it will be impossible to quote the cases in full. Enough, however, will be given to prove that the charge of human experimentation is not the exaggeration of ignorance or sentimentality; that such methods of research have been practised upon the sick, the friendless, the poor in public institutions, without their knowledge or intelligent consent; that they are in vogue even in our own time; and that hospitals and institutions, founded in many cases, for charitable purposes, have lent their influence and aid in furnishing either victims or experimenters.
Commenting upon certain human vivisections in Germany, the BritishMedical Journal declared in its editorial columns:
"Gross abuses in any profession should not be hushed up, but should rather bemade public as freely as possible, so as to rouse public opinion against them and thus render their repetition or spread impossible. And therefore we have reason to thank the newspaper Vorw"arts for dragging into light the experiments made by Dr. Strubell on patients…. The whole medical profession must reprobate cruelties such as these perpetrated in the name of Science."[1]
[1] British Medical Journal, July 7, 1900, p. 60.
It is this sentiment which justifies present publicity. The cases to which attention will be directed are not many; but they suffice to illustrate the practice, and to enable the reader to decide whether such experiments should meet approval or condemnation.
I. The Case of Mary Rafferty
An instance of human vivisection which ended by the death of the victim, occurred some years ago in the Good Samaritan Hospital in Cincinnati. It would be difficult to suggest a name for a hospital more suggestive of kindly consideration for the sick and unfortunate: and to this charitable institution, there came one day a poor Irish servant girl by the name of Mary Rafferty.
She was not strong, either mentally or physically. Some years before, when a child, she had fallen into an open fire, and in some way had severely burned her scalp. In the scar tissue an eroding ulcer— possibly of the nature of cancer,—had appeared; and it had progressed so far that the covering of the brain substance had been laid bare. No cure could be expected; but with care and attention she might possibly have lived for several months. We are told that she made no complain of headache or dizziness; that she seemed "cheerful in manner," and that "she smiled easily and frequently,"—doubtless with the confidence of a child who without apprehension of evil, feels it is among friends. The accident, however, had made her good "material"; she offered opportunity for experimentation of a kind hitherto made only upon animals. "It is obvious," says the vivisector, "that it is exceedingly desirable to ascertain how far the results of experiments on the brain of animals may be employed to elucidate the functions of the human brain."[1]