An Ethical Problem Part 19

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[1] In demonstrating that the English law for the regulation of vivisection is not there regarded with the disapprobation alleged by certain writers in this country, I must not be taken as claiming that the law from a humane standpoint is satisfactory. Until amended as advised by Dr. Wilson, a member of the Royal Commission, it cannot adequately protect animals liable to experimentation from hte possibility of abuse.

The extent to which an untruth concerning vivisection may be worked to create prejudice against reform is afforded by a curious legend concerning the late Lord Lister, one of the most eminent men of the last century.

So far as I have been able to discover, the first appearance of the story was in an address delivered before the Women's Medical College, and reprinted in the Popular Science Monthly of May, 1885, nearly thirty years ago. It thus appears:

"Lister himself, no tyro, but the great master, is still searching for further improvements. But when, lately, he desired to make some experiments on animals, still further to perfect our practice, so many obstructions were thrown in his way in England that HE WAS DRIVEN TO TOULOUSE to pursue his humane researches."

"He was driven to Toulouse." The phrase is worth remembering. Fifteen years later the author of this statement appeared before the Senate Committee at Was.h.i.+ngton, D.C., to oppose a Bill regulating the practice of animal experimentation in the District of Columbia. In course of his address, delivered February 21, 1900, he again repeated the story:

"When Lord Lister, whose name is the most ill.u.s.trious in the history of surgery, wanted to carry out some further experiments in Great Britain, where, as Dr. Leffingwell has expressed it, the 'very moderate restriction of the law applies'--experiments for the direct benefit of humanity--HE WAS OBLIGED TO GO TO FRANCE TO CARRY ON HIS EXPERIMENTS for the benefit of the human race BECAUSE HE COULD NOT DO IT IN ENGLAND!"

Can one imagine any argument against the legal regulation of vivisection more weighty than this a.s.sertion, that the most ill.u.s.trious man in English medicine was "obliged to go to France"

because he could not make his researches on English soil? Could doubt of the story exist when it was related by the President of the American Medical a.s.sociation before a committee of the United States Senate? This story alone may have indused the rejection of the proposed legislation.

The legend again found expression nearly three years later, in a letter written by the same person to Senator Gallinger, and telegraphed to the newspaper press throughout the country. In the Philadelphia Medical Journal of December 13, 1902, it appeared as follows:

"If the laws which you and your friends advocate were in force, the conditions for scientific investigation in this country would be quite as deplorable as those in England. For example, when Lord Lister, who has revolutionized modern surgery, largely as a result of such experiments, wished to discover possibly some still better way of operating by further experiments, HE WAS OBLIGED TO GO TO TOULOUSE TO CARRY THEM OUT, as the vexatious restrictions of the law in England practically made it impossible for him to continue there these eminently humane experiments."

Nearly a quarter of a century after the first appearance of this story, we meet it again. In an article ent.i.tled "Recent Surgical Progress," appearing in Harper's Monthly for April, 1909, we are told the same tale:

"To complete his beneficent work, LORD LISTER WAS COMPELLED TO GO TO FRANCE, BY REASON OF THE STRINGENCY OF THE ENGLISH ANTIVIVISECTION LAWS."

The law of 1876 has now multiplied into "laws" which obstruct and hinder even the researches of a Lister. And yet two years before, in his testimony before the Royal Commission, the President of the Royal College of Surgeons in England--Sir Henry Morris--had stated: "I think the present Act of 1875, under which vivisectional experiments are done, was amply protective against cruelty to animals AND SUFFICIENTLY FREE AND LIBERAL FOR THE DUE PROSECUTION OF PROPER SCIENTIFIC AND PHYSIOLOGICAL INQUIRY."[1] But of the readers of Harper's Monthly probably not one in ten thousand had ever seen this evidence in the Vivisection Report.

[1] Minutes of Evidence, Question 7,805.

It will be seen that no two of these accounts are precisely the same.

They agree, however, in stating that one of the most distinguished of English scientists was compelled to leave England in order to do his work; he "was driven to Toulouse."

It seemed to me worth while to investigate the truth of this story; and accordingly I wrote to Lord Lister, asking him, among other things, if it was true that he had been obliged to go to France to carry out experiments looking to the improvement of surgical methods, because the restrictions of the English law had made it impossible for him to carry out his investigations in England? The reply to my inquiry was clear and definite. The italics are mine.

"12, Park Crescent, "Portland Place, "December 23, 1910.

"MY DEAR SIR,

"It is not strictly true that I was compelled to go out of the country to perform the experiments in question.

"I COULD, NO DOUBT, HAVE OBTAINED A LICENCE TO DO THEM HERE. But they had to be on large animals; and the Veterinary College, in which, I dare say, I might have had opportunity given me for the investigations, is a long way from my residence, and it would have been inconvenient to have worked there. Thus, my going to Toulouse was a matter of convenience rather than of necessity.

"The circ.u.mstance was of course of no interest to anyone but myself, AND I HAVE GIVEN NO ACCOUNT OF IT FOR PUBLICATION.... I have answered your question frankly, but I must beg you to understand that it is not intended for publication.

"Believe me, "Sincerely yours, "LISTER."

From every man's correspondence Death at last removes the seal; and Lister's true story surely may now confront the distorted fiction which in America for many years has been given so wide a publicity.

The facts are indeed different from the legend which for more than a quarter of a century has been repeated as a convincing argument against reform. Of the malign influence of such a tale upon public opinion in preventing legislation in America, we can form no adequate estimate. For any intentional deception we may, of course, absolve the distinguished professional man who has made himself responsible as transmitter of the myth; no man with any conception of honour would state as facts what he knew to be false. But from the charge of carelessness, of gross inaccuracy, is one as readily to be freed? For a quarter of a century the statement has been in circulation--that when Lister desired to make most important researches, "so many obstructions were thrown in his way in England, that HE WAS DRIVEN TO TOULOUSE to pursue his humane researches"; and now Lister's letter shows us that he "could, no doubt, have obtained a licence to do them here"--showing that he did not even ask permission to experiment. In 1900 the public was informed that Lister "was obliged to go to France to carry on his experiments"; the readers of Harper's are told that "Lord Lister was COMPELLED TO GO TO FRANCE by reason of the stringency of the English antivivisection laws"; and now Lister writes that going to France was a matter of convenience, and not of necessity; that at the Veterinary College "I dare say I might have had the opportunity given me for the investigation"--showing that the opportunity had never been sought! Yet the influence of the untruth will continue for many a year.

Of Lister's extreme antipathy to the antivivisectionists and to th erestriction of animal experimentation there can be no doubt. That he misapprehended the effect of the law of 1876 we know; he imagined that even the observation of the circulation of the blood in a frog's foot under the microscope by an unauthorized investigator would render the student liable to a criminal prosecution. We can be very sure that if this were true, the Act of 1876 would never have escaped the condemnation of the scientific men whose opinions have been quoted from evidence given before the Royal Commission, men who found in this Act no impediment to any reasonable investigation. But when the reports of personal experience were brought to Lister's notice, he was willing to correct their gross exaggerations; yet--to avoid controversy, perhaps--he desired that the facts should not be published, and during his lifetime, compliance was given to his wish.

The phase of untruthfulness in the defence of unrestricted experimentation deserves far more attention than can here be accorded. One is loth to regard as possible any intent to deceive; the inaccuracy and exaggeration are undoubtedly due chiefly to ignorance on the part of men who ought to be well-informed, because the world looks to them for statements of fact concerning the benefits claimed to be due to experimentation. Take, for instance, an a.s.sertion made in testimony given before the Royal Commission by Sir Victor Horsley, a Fellow of the Royal Society, and the representative of the British Medical a.s.sociation. Referring to pyaemia, or blood- poisoning, he was not content to affirm the disappearance of these formidable maladies from the hospital to which he was attached, but went on to declare their disappearance altogeher. "Anybody," said Sir Vitor Horsley, "who would now be asked to write an article on pyaemia or blood-poisoning in a dictionary of surgery, COULD NOT DO IT; THE DISEASES ARE GONE!"[1]

[1] Evidence before Royal Commission, Question 15,669.

This statement is a most remarkable one. The witness was once widely known as a ruthless experimenter upon living animals, and he was now defending the practice by an enumeration of its gains. Apparently, no member of the Commission questioned his evidence; the representative of the British Medical a.s.sociation solemnly affirmed that as a result of vivisection certain diseases had so completely disappeared that present observation or description was impossible, and the Royal Commission accepted his word. The statement that these septic diseases had disappeared crossed the Atlantic, and nearly six years afterward, in the columns of a New York journal, it again appeared.[2] Yet the statement was untrue. It is indeed difficult to believe that any educated medical man in England or America could have read it without recognition of its untruth. Let us glance at the evidence.

[2] New York Times, July 28, 1912.

If it were true that the septic diseases which relate to blood- poisoning had really been so completely abolished that description of them were now impossible--as Sir Victor Horsley declared--it is evident that as causes of any part of English mortality they would cease to appear. The report of the Registrar-General of England and Wales tells a very different story. Sir Victor Horsley gave this testimony in November, 1907. During the five years preceding, and ending December 31, 1907, NO LESS THAN 2,933 PERSONS DIED FROM BLOOD- POISONING (PYAEMIA AND SEPTICAEMIA) IN ENGLAND AND WALES. During the year 1907, the year that testimony was given, the tribute of 604 lives was exacted by these diseases which had "GONE"! Even during the year following (1908), the recorded deaths due to blood-poisoning in England and Wales were 560; and yet the disease had been solemnly declared to be non-existent by the leading defender of English vivisection!

Nor is this all. In proportion to the total population the death-rate from blood-poisoning WAS HIGHER DURING THE YEAR THAT SIR VICTOR HORSLEY GAVE THIS ASTOUNDING TESTIMONY THAN IT WAS EVEN FORTY YEARS BEFORE. In 1868, in England and Wales, to a million persons living, the death-rate from septic diseases, or blood-poisoning, was fifteen; the year following it was sixteen. In 1870 it rose to eighteen, falling, however, to sixteen for the next two years. Nearly forty years go by, and we find a leading English vivisector a.s.suring a Royal Commission that blood-poisoning had so completely disappeared that a medical writer could not describe it; and the Registrat-General charging this extinct disease with a death-rate of nineteen in 1906 and eighteen in 1907, A HIGHER RATE OF MORTALITY THAN A GENERATION BEFORE![1]

[1] For these statistics see reports of the Registrar-General of England and Wales, 54th Report, Table 16, and 73rd Report, Table 22.

These are officially stated facts. At the cost of half a crown Sir Victor Horsley might have learned that the diseases he so glibly declared had "gone" were still responsible for a part of English mortality, and a greater proportion even than during thirty-five to forty years before. It is this gross ignorance on the part of those who would teach us, this willingness in the defence of all phases of vivisection, to make a.s.sertions which are without foundation in fact, that justly tends to create distrust of every such statement, unsupported by proof. We are not questioning the value of asepsis, which is only a learned phrase to express absolute surgical cleanliness. The time may come when these septic forms of disease will entirely disappear. That day, however, has not yet arrived. Why declare that it is already here? Why proclaim that diseases had "GONE"

which still existed, or that an enemy had been utterly exterminated which still was responsible for hundreds of deaths?

Nor are English medical writers alone guilty of blunders and exaggerations concerning the effect of experiments on animals. In the number of Harper's Monthly for April, 1909, to which we have referred, an American writer blunders quite as badly as his English confre're.

He tells us that "the friends of experimental research have almost completely abolished the dangers of maternity, reducing its death-rate FROM TEN OR MORE MOTHERS OUT OF EVERY HUNDRED, to less than one in every hundred."

A more ignorant statement was never put forth by an intelligent writer. Where are statistics to be found going to prove that among any people, in any land, at a ny time, 10 PER CENT. of all mothers giving birth to offspring perished from the accidents or diseases incident to child-birth? No such statistics can be produce, for the simple reason they do not exist. In the United States we have no official statistics of mortality covering the entire country or reported from year to year. England, however, has recorded the mortality of its people for over half a century. What support does it afford to the a.s.sertion that at any time one in every ten mothers, bringing children into the world, perished either from accident or disease? During a period of sixty-two years, from 1851 down to th epresent time, there was not a single year in which mortality of Englishwomen from septic diseases connected with child-birth EVER REACHED EVEN ONE IN A HUNDRED. But this is the figure for all England. Then take the forty-four counties into which England is divided, and from the downs of Devon to the slums of Lancas.h.i.+re, one cannot find a county in all England in which the mortality of mothers from diseases pertaining to child-birth has reached even a quarter of the ratio stated by this medical writer. "From all causes together NOT FOUR DEATHS IN A THOUSAND BIRTHS and miscarriages happened in England and Wales during the first year, seventy-five years ago, that official statistics were gathered; it was a death-rate of five in one thousand the following year."[1] We are not questioning the value of surgical cleanliness; we dispute only the justice of exaggerated and misleading statements concerning any fact capable of scientific demonstration.

There can be no doubt that less than half a century ago, in the maternity wards of certain hospitals and in the experience of certain men, there was a death-rate from such ailments far above the average experience of the country; but it was solely due to the ignorance, the criminal blindness and obstinacy of certain men in the medical profession. But a little over seventy years ago, when Dr. Oliver Wendell Holmes pointed out that this saddest place of mortality was due to want of care on the part of medical men, it was two professors in two of the largest medical schools of America who opposed him; it was Professor Charles Meigs, of Jefferson Medical College in Philadelphia, who laughed to scorn his warnings, and held up to the ridicule of the medical profession the theories that are now accepted as facts. With such men as teachers of medical science, what wonder that for women about to become mothers certain hospitals of that day were little better than slaughter-houses, to enter which was to leave hope behind?[2] But the experience of such hospitals is not the basis upon which Science rests conclusions when they may be ascertained by reference to the statistics of a nation. The murder-rate of Philadelphia is not to be determined by that of one of its slum districts. If, a century ago, a slave-owner of Jamaica owning ten negroes, whipped one of them so severely that he died, should we be justified in declaring that in the West Indies the murder-rate of slaves was 10 per cent., or "ten in a hundred"? Its absurdity is manifest. When, therefore, a reputable writer for a magazine largely read by wives and mothers puts forth the statement that by reason of some experiments the death-rate of diseases incident to maternity has been reduced "from ten or more mothers out of every hundred," leaving it to be inferred that such rate of mortality was once general, what are we to infer concerning his ideals of scientific accuracy?

[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 interns.h.i.+p at Bellevue, he saw FORTY- FIVE WOMEN DIE OUT OF THE SIXTY WHO HAD BEEN DELIVERED DURING A SINGLE MONTH."--Williams; Jour. Am. Med. a.s.sociation, June 6, 1914.

Equally mistaken is the implication conveyed by the pa.s.sage 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 pract.i.tioners, 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 pract.i.tioner 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 b.u.t.t of their ridicule and scorn. It was Semmelweis, a young a.s.sistant 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 a.s.sertion? 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 ill.u.s.trates 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:

ENGLAND AND WALES: AVERAGE ANNUAL DEATH-RATE FROM PHTHISIS PER MILLION PERSONS LIVING, IN GROUPS OF YEARS.

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 a.s.sertions 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 a.s.sertions that have no basis in fact; we have covert appeals to woman's fears in her greatest emergency, and to that sentiment, the n.o.blest 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."

An Ethical Problem Part 19

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