Scientific Method in Biology

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SCIENTIFIC METHOD IN BIOLOGY.

BY DR. ELIZABETH BLACKWELL.

LONDON: ELLIOT STOCK, 62, PATERNOSTER ROW, E.C. 1898.

front matter

WORKS BY THE SAME AUTHOR.

THE MORAL EDUCATION OF THE YOUNG. Longmans, Green and Co. Price 2s.

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Introduction

INTRODUCTION.

A CONTROVERSY is persistently carried on between an increasing body of the non-professional laity and an important section of the medical profession, in relation to the methods pursued in investigating biological phenomena.

The criticism of medical research by non-medical people is naturally resented by some who are engaged in experimentation; and it is stated seriously that non-scientific persons will impede progress if they interfere with, or succeed in restricting, the efforts of those who specially devote themselves to this branch of research.

This controversy is still going on in ever-widening circles; and it is bound to do so, until the present confusion of thought which exists on this subject is removed, and the broad distinction between right and wrong experimentation is more fully acknowledged and more clearly defined. Our relation to the lower animals has never yet been brought fully into the clear light of reason and conscience. Yet in the order of Providential development it must so come forward.

As advancing humanity has gradually recognised natural rights as existing in the various races of mankind—is carrying on a persistent warfare against human slavery—is slowly awakening to the moral crime of introducing disease and vice amongst native races; and the rights, as well as duties, of women and of children are being gradually recognised; so the time has come when the natural rights of inferior living creatures must be seriously studied.

This study has become obligatory, not only in regard to the welfare of the brute creation, but for the sake of our own human growth as rational and moral beings.

The common-sense of mankind recognises our right to use the lower animals for human benefit, whilst our superior intelligence gives us the power to so use them. But 'can' and 'ought' are different aspects of our mental constitution, which require to he harmonized. What we can do is not the true measure of what we ought to do, in any department of life.

We can starve a child, or lash a horse to death, but we have no right to do so.

The laws of our human constitution compel us to recognise that intellect and conscience, although essential parts, are not identical parts of our nature. Long experience shows us that social progress can only become permanent when conscience guides intelligence.

How far the guidance of conscience can extend, with the practical results to medical research involved in the recognition of such guidance, forms the subject of present consideration.

Chapter 1. The Growth of Conscience

I. THE GROWTH OF CONSCIENCE.

IT is through the gradual and harmonious development of intelligence with that element in our nature that we name conscience that the human race passes from lower to higher states of civilization. In pursuing our ideals, conscience is our instinctive monitor of right and wrong.

Our great naturalist, Darwin, laid down as a law of evolution that 'the moral sense, or conscience, is by far the most important of the differences between man and the lower animals. Duty—“ought”—is the most noble of all the attributes of man.'

Victor Hugo, with the prophetic insight of genius, calls conscience ‘that modicum of innate science with which each one is born.’

The growth of human conscience, in its per of justice and in its sympathetic relation to creation, is the surest measure of individual and national progress. Various intellectual theories may be formed as to the origin and growth of conscience. It may be held to be intuitive—springing up as inevitably as the instinctive feelings born with the natural relations of life; or it may be looked upon as gradually evolved—the ‘result of countless experiences of fear, love, utility, transmitted through generations.’

But however originating, conscience is a positive and potent fact. It is, indeed, the mightiest factor in social life. It is the great controller of selfhood. It enlarges human character and guides human conduct. The deepening of this principle through the growth of justice and sympathy marks an advancement in the type of humanity. Increasing respect for life is one of the clearest signs of growing conscience. Our reverence for the principle of life grows with our enlarging intellectual perception of its universality and its unlimited power of development.

As life is marked by activity, and cannot remain stationary, so conscience shares this law of life. It must inevitably advance or retrograde.

The degradation as well as the development of conscience may be seen amongst us in the midst of our present civilization. It is contrary to the most rudimentary element of conscience to feed upon one's kind, and cannibal tribes who devour their captives represent the lowest type of humanity; even the dogs of the Arctic voyager will endure the slow agony of starvation for days before their human taskmasters can compel them to eat the flesh of their companions. The well-known naturalist, Mr. W. H. Hudson, states that wolves, when pressed with hunger, will sometimes devour a fellow-wolf; as a rule, however, rapacious animals will starve to death rather than prey upon one of their own kind.

Yet shipwrecked sailors, even of our own English race, have been known to drink the blood and eat the flesh of their comrades when confronted by starvation.

We find that intelligence may exist without conscience, but the human type changes to a destructive force when this separation takes place. A lamentable example of the social danger created by the destruction or absence of rudimentary conscience amongst us is shown by the betrayal and murder of the little boy Eccles, in Liverpool, for the sake of his clothes, by his two companions of eight and nine years old. There was the deliberate plot to entice him to a pond; the throwing him three times into the water as he scrambled out; the final holding him under water until all struggle had ceased. These facts make a striking, but not unique, object-lesson, showing how intelligence may exist without conscience amongst all our appliances of civilization, and the danger of such separation.

Examples of the social devastation produced by official corruption and business dishonesty are too numerous to be detailed; they are seen in what are called civilized countries—in London, Paris, Rome, and across the ocean. The lack of conscience in public and private transactions creates social misery proportioned to its extent.

Recognising, therefore, that this distinctive principle of conscience is a fact of gradual development, that it grows by the union of the moral with the intellectual elements in our nature, and that the far-reaching consequences for good or evil of vivid or dulled conscience in the individual and the nation are far beyond our power of foresight, a grave responsibility rests upon us in this matter. We are bound to realize that any custom, or method of education, or proposed course of action, that seems to violate the natural instincts of humanity, or is contrary to the present enlightened conscience of any section of our Anglo-American race, demands imperatively the most careful consideration on our part.

Chapter 2. Conscience in Medicine

II. CONSCIENCE IN MEDICINE.

EVERY intelligent member of the medical profession will certainly recognise the special value of human conscience in the profession.

The problems which are involved in the practice of the beneficent art, the absolute reliance which the anxious patient is compelled to place in his physician, the helplessness of the poor, who form so large a majority of those who need medical aid, and who are without the defences of wealth and station, show the need of keen moral sense, as well as intelligence, in those who practise the art of medicine.

The very discoveries of medical science enforce this necessity; for the possibility of abuse in the employment of such beneficent agents as anæs and hypnotism, by incompetent or conscienceless operators, is a very serious fact.

The suicides that have taken place after so-called 'successful' operations (as, for example, the production of artificial anus), the pathetic exclamation of poor Montagu Williams, that his brilliant operation had ruined his constitution, and the reckless castrations proved by Dr. Chanu in France, are facts, to be seriously weighed by medical conscience, showing the necessity of restraining too eager experiment.

This special responsibility of the medical profession to society is greatly increased by the fact that the training of a very large section of our intelligent youth during the important years of early manhood rests upon them. The moral as well as intellectual influence exerted by those who guide the college, the hospital, the dispensary, and post-graduate classes, will mould the future action of one of the most influential portions of the community, those, viz., on whom the health of the nation chiefly rests.

Now, whilst all recognise the need of the trained and skilful care of a nation's health, and perceive also that rightly organized medical schools and hospitals are of great value in educating our health guardians, how is it that a profound distrust of these institutions has grown up in our midst; that the support of hospitals becomes increasingly difficult, whilst at the same time the sentiment of benevolence and desire to help the poor is constantly extended?

How is it that the beneficent and necessary art of medicine no longer commands that respect and confidence which its essential character as part of our social institutions would seem to demand?

The answer to these serious questions involves both moral and intellectual considerations. These problems have arisen from failure to perceive that in education moral and intellectual activity cannot be advantageously divorced, or that one portion of our complex nature can be beneficially developed whilst other portions are entirely ignored or injured.

Our medical schools, whilst sharpening the intellectual faculties of their students, are not careful that their modes of teaching bring with them no deterioration of that important faculty of their students, the moral sense. As conscience or the moral sense is unequally developed in human beings, but is indispensable to the physician in his relations with patients, any apathy or negligence in this respect by the trainers of youth may become a national danger.

Chapter 3. The Moral Element in Research

III. THE MORAL ELEMENT IN RESEARCH.

MORALITY, as a guide in biological science, is based upon the practical distinction between organic and inorganic Nature.

If medical progress simply involved the investigation of inorganic Nature, the general public would be only learners, gladly receiving such information in geology, chemistry, astronomy, or physics, as specialists in those branches of physical science were good enough to impart to the unlearned.

But directly scientific research passes beyond the distinctive realm of matter, moulded and transformed by general energy, but not affected by individual will, it has to deal with a very different principle, viz., life. This vital distinction has been well laid down by one of our eminent medical authorities as follows: 'During the slow growth of medical knowledge it has become more and more plain that physics, chemistry, and biology are distinct sciences, with methods of their own and inductions of their own; each of the latter terms in the series using the results of its predecessors, and adding new results of its own. Although life is a structure built up of physical and chemical facts, yet to the building, to the arrangement, to the ordering of those facts, there goes something that neither physics nor chemistry can explain, any more than algebra can explain the behaviour of a magnet. To strive to interpret the series of events which make up the life of an animal in terms of chemical change (metabolism), or of conservation or expenditure of energy, is an endeavour which will fail.'

As the brute creation, as well as human beings, share in a physical organization which expresses each variety of life, there is not the same sharply-dividing line between the various categories of animal life as there is between organic and inorganic Nature. Biogenesis, or life generated by life, is the distinctive feature of organic Nature. We are linked to living creatures of higher or lower nature by the power of educating or subduing them, and by all those varying relations involved in the mystery of life.

The distinctive position of man, as an animal placed at the head of the animal world, necessarily creates serious responsibility on the part of the higher towards the lower creature.

This basis of moral responsibility extends in kind, it not in degree, to all life. It necessitates a directing conscience, which shall guide all our intellectual and practical relations with every category of life.

This moral element enters unavoidably into our treatment of animal life from its lowest to its highest form. Our treatment of a monkey or a prince contains an element of moral attitude which does not exist in our relation to inorganic Nature.

It is a difference of kind as well as of degree, which it is blindness to ignore.

The divergence which now exists between some biological investigators and their critics rests upon the failure to recognise that moral error may engender intellectual error.

The special subject which has produced this controversy is the present method of using the lower animals in biological research, which has so enormously extended of late years. The essence of the controversy is the ethical question, viz.: Have we a right to torture?

It must be distinctly understood that there is here no question of our right under certain circumstances to put to death. Neither is there a doubt of the utility of rational experiment and of research. But the right to put to death in the most humane manner known to us, and the right to torture to death, are two widely different questions.

We have no right, for any purpose whatever, to torture a living creature to death, either by the mutilation of the organs, the slow deprivation of the necessary conditions of life, or the still slower process of destroying by the inoculation of disease.

Chapter 4. Right and Wrong Methods

IV. RIGHT AND WRONG METHOD.

IT must be carefully noted that the wrong involved in inflicting torture upon a living creature is the violation of a rational principle. The employment of torture or of painful experiment in biological research is not a question of the right to gain knowledge. It is a question of how we seek to gain knowledge. It applies directly to method.

Thus, the fact observed by Paget, that in a patient who vomited all fat, the pancreas alone was found on post-mortem examination to be diseased, is worth more than a series of experiments on lower animals of different constitution from our own.

In the slow approach towards truth—which is the great object of science—no single method is indispensable. The human mind is so full of activities; Nature presents such an infinite variety of resources, that progress in research can never be hindered by the choice of right instead of wrong method.

This is well stated by one of our most experienced investigators when he says:

'Methods run with the manners and customs of the ages. In science there is no one method that can be considered indispensable. Attributes are indispensable; observation, industry, accuracy are indispensable; methods are not. They may be convenient, they may be useful, they may be expedient, but nothing more.'

This admirable statement throws a flood of light upon the confusion and perplexity of the present controversy. It shows the error of both the so-called unscientific and scientific parties. It shows the error (not unnatural) in the former of confounding together experiment, research, laboratory, and scientific investigation, and classing them under one indiscriminate ban of cruelty; it also shows the narrow vision and false reasoning of those who claim that right and wrong have no meaning when applied to the investigation of phenomena supposed to be revealed by the senses. or state that the collecting of so-called facts, named knowledge, is an end in itself, to be unrestrained and justified in itself.

That interesting book, 'The Naturalist in La Plata,' in narrating the author's observation of the natural fearlessness of all wild animals towards man, the careful research into life-habits that can be carried on where this fearlessness is not betrayed, and the susceptibility to kindness which exists amongst all the lower animals to their sovereign, man, furnishes a striking and delightful suggestion as to the method which future research should take.

It is the distinctive moral relation existing in the plane of animal life that makes our connection with the organic world a different and more comprehensive relation than that which exists with inorganic Nature. It places research in the biological sciences on a different plane from study of the physical sciences.

Therefore, whilst it would be folly for ordinary people to criticise the methods of experts in physical science, it would be dastardly dereliction of duty not to consider the methods employed in biological science.

The subject of experimentation upon the lower animals having two aspects—an ethical and an intellectual one—the medical profession will be wise to welcome all honest and kindly criticism and suggestion in the most difficult of all studies, viz., the study of life. It must be recognised that the people are absolutely in their right in refusing to submit to dictation in what concerns their relation to animal life, of which they are the responsible head.

Chapter 5. The Necessity of Medical Research

V. THE NECESSITY OF MEDICAL RESEARCH.

WHILST fully recognising the right of the laity to criticise scientific method when it deals with sentient animals, fashioned on the same general plan as ourselves, and capable of fear, pain, affection, and gratitude, there is another aspect of the subject which we are bound to consider.

The present condition of medicine is that of an art, not of a science. It is erroneous to speak of the science of medicine. There exists uncertainty in diagnosis, uncertainty in the action of remedies, ignorance of individual idiosyncrasy, and terrible inability to meet such devastating diseases as cancer, consumption, leprosy, etc.

No one outside the profession can fully realize the grave responsibility, even desperate anxiety, felt by the conscientious physician when life or death seems to depend upon his action, and he knows that medical resources are not equal to the occasion. It is a noble desire for the advancement of the beneficent art of medicine which makes the great body of busy doctors eagerly listen to those who are supposed to speak with authority, and hail with hope every announcement or supposed discovery which seems to promise improved practical results.

This is really a sound humane attitude of mind in that vast body of the profession who are unable, from the pressure of practical life, to devote themselves to investigation—a profession which has always had its heroes and martyrs, who have not shrunk from risking their lives in the service and for the advancement of their noble art.

Those also who are in the profession can most fully estimate the real and beneficial results, both in surgery and medicine, derived from careful and persistent research, notwithstanding the severe disappointment often caused by the theoretical error and unjustifiable practice resulting from rivalry in erroneous methods of investigation. The conquest of pain and diminution of nervous shock in necessary surgical operations; the disappearance of blood-poisoning, hospital gangrene, and erysipelas, which were the scourges of our public institutions in a former generation, are immense gains, due to the discovery of anæsthetics, antiseptics, and advancing sanitation. These blessings are the direct outcome of persevering and skilful clinical observation, of careful work in the laboratory, of humane experiment, and of happy accident; they are not derived from cruel experimentation.

The successful control of that terrible disease—puerperal fever—which formerly destroyed such a multitude of women, is a striking conquest of humane method in modern medicine. When I was a student in La Maternité of Paris in 1849, this destructive malady of lying-in women produced a mortality varying from 10 to 15 per cent. But when I visited La Maternité in 1889 the mortality was reduced to a little over 1 per cent. This was due to rigorous cleanliness, sanitation, and the use of antiseptics, directed by the skilful sage femme en chef Madame Henri, in spite of the old and unsuitable buildings and the depressing status of many of the patients.

A still more satisfactory result is shown in Dr. Annie McCall's Clapham Maternity, where not a single death occurred amongst the 760 cases first received into the institution.

This excellent result still continues under the same administration. In the 2,100 lying-in cases received to date in the hospital, there has been no death from puerperal fever. This excellent record has been attained by scrupulous cleanliness, absolute isolation on the occurrence of suspicious symptoms, by excellent nursing, and constant oversight by the doctors in charge. Even in the out-patient department, where the conditions of living are not under such strict medical control, the deaths from this frightful malady have only amounted to 4 in 7,000 cases under the same enlightened direction.

This great and beneficent reform in the first and world-wide branch of medicine, by means of which the lives of innumerable women in all our large centres of civilization have been saved, is the result of scientific research. It was initiated and successfully carried out by Semmelweis, of Vienna, and is a striking instance of the value of research carried on by the use of the comparative method, with absolutely no resort to experiment. The history of this reform, the methods by which it was accomplished, the opposition it encountered in the profession itself, and its triumphant vindication, are well worth serious study. An account of this valuable investigation, as also of Pettenkofer's research in cholera (referred to later), and other important discoveries by justifiable methods of inquiry, are given to English readers by the admirable translation published by the New Sydenham Society.

Medical research, therefore, is not only justifiable, but obligatory in a profession that is specially charged with the care and advancement of individual and national health; and, as will be seen later, observation, induction, and rational experiment form the essential methods of scientific inquiry.

These two facts, viz., the necessity of advance in medical knowledge, and the methods of investigation necessary for such advance, must be distinctly recognised by sincere reformers, and should shield the profession from that indiscriminate reproach which is often made against it as a whole; for such hostility tends to strengthen that undue esprit de corps which often hinders sound medical progress in the profession.

Chapter 6. Restriction of Experiment

VI. RESTRICTION OF EXPERIMENT.

WHEN we investigate the popular or ethical aspect of so-called scientific research, made upon living animals, we are at once met by facts which imperatively demand both serious thought and determined action, if we would not be participators in the degradation of human conscience. We are confronted with the enormous increase in such experiments which has taken place within the last thirty years, as well as in the severity of the sufferings inflicted. This increase is going on in England as well as in foreign countries. It is growing in many cases, not only without any benefit to the human race, but also without reference to any supposed beneficial result, as its attempted justification.

The volume of facts and evidence collected by Mr. Colam (the able Secretary of the Royal Society for the Protection of Animals), and published by that society in 1876, is a permanent record of great value. It enables us to measure the growth of experimentation in England, not only from 1862 to 1876, when the present Cruelty to Animals Bill was enacted, but it also forms a point of comparison for testing the increase of vivisectional methods since 1876 to the present day, when these easy but often fallacious methods of research have become universal in medical investigation and medical instruction.

In 1869 there were very few places where experimentation on animals could be carried on, such investigations being made by men of rare ability, and for a definite object. There were no class demonstrations, and no students encouraged to experiment. But in 1892 there were 180 persons licensed in this country, and over 3,960 experiments performed, numbers which increase with each year, the amount of unlicensed experi being of course an unknown quantity, depending on individual conscience.

The Effect on Students and Subordinates.

A point for serious consideration is the effect produced upon the unformed minds of students of medicine, by the introduction of experimentation upon living animals into our medical schools and hospitals.

The employment of destructive experimentation on living creatures is now introduced as a part of the ordinary instruction of medical students in the fundamental study—physiology. This is a novelty of the present generation. During the whole course of my medical studies, forty years ago, I never saw a living creature vivisected for the instruction of students. The same is true of the experience of most of the able physicians of an older generation.

Now, however, every medical school has its store of imprisoned living creatures awaiting their fate—from the large frogs imported from Germany, the mice, rabbits, cats, and dogs of home production, to the cargoes of monkeys brought to our foggy climate from tropical Africa. They form an enormous mass of living creatures, kept for the attempted demonstration of vital action in the lecture-room, or for the study of diseased processes in the physiological laboratory.

It is a fallacy (although proclaimed in high places) that the ordinary student of medicine must be prepared for his practical work as a physician for men by watching the opening of chest, abdomen, brain, or cutting into the delicate vital organs of living lower animals. Such demonstration is a thrilling spectacle to inexperienced students. It appeals to that love of excitement which makes them rush to a surgical operation, or to an extraordinary medical case which may have no bearing whatever on their future practice, whilst the commonplace but all-important bedside observation seems dull in comparison. Yet patient work in the anatomical and microscopic rooms, and in the chemical laboratory for general and animal chemistry, and close clinical study, all of which involve no form of suffering, are of primary importance. The genius of a Professor, as an instructor, is shown by his ability to make his pupils realize this.

Destructive experimentation on helpless animals —not for their own benefit—is a demoralizing practice. The student becomes familiar with the use of gags, straps, screws, and all the paraphernalia of ingenious instruments invented for overpowering the resistance of the living creature, or for guarding the operator from injury in case the anaesthetic, when used, should give out too soon. He learns also how easy it is to experiment in secret.

By advanced instruction and post-graduate classes the student is led on to take active part under licensed authority in this fascinating, but morally dangerous, method of study. Moreover, the large body of subordinates, who are necessary to take charge of and prepare the animals, are trained in indifference to suffering, without any excuse of intellectual gain; and the same injurious influence extends in ever-widening circles—to the traders who invent and sell instruments of torture, and to those who supply the living material.

Now, the natural instinct to be cherished in human beings is protection and kindliness to infancy and all helpless creatures, not indifference to suffering or wilful infliction of it. As human conscience is a thing of growth or degradation, the natural shrinking from needless pain can soon be hardened into callousness. Conversing with medical students, in relation to the effect made upon them by witnessing vivisections, even under chloroform, I have found that their experience is always the same, viz.: first, the shock of repulsion, then tolerance, and then, if often repeated, indifference.

The moral deterioration necessarily induced in those to whom suffering becomes a frequent spectacle is noted by the 'Englishman in Paris,' from personal experience. After speaking of the inhumanity produced by the daily sight of blood, in the originally honest bourgeois, who became the 'Conventionnels' of the French Revolution in 1793, he writes as follows: 'I have witnessed three executions. After Pommeraye's execution, I was ill for a week; after Troppmann's, the effect soon wore off in three days; after Campa's, I ceased to think about it in twenty-four hours. Then I made a vow that no power on earth should draw me to the Place de la Roquette again. But men generally regard their growing imperviousness as a sign of mental force, and pride themselves upon it.'

In Marie Bashkertseff’s 'Journal' is a striking passage which describes the effect of a Spanish bull-fight. She says: 'I was able to maintain a tranquil air in full view of the butchery, carried on with the utmost refinement of cruelty. One leaves the scene slightly intoxicated with blood, and feeling desirous to thrust a lance into the neck of every person one meets. I stuck my knife into the melon I was cutting at table, as if it were a banderilla I were planting in the hide of a bull, and the pulp seemed like the palpitating flesh of the wounded animal. The sight is one that makes the knees tremble and the head throb. It is a lesson in murder.'

The moral distinction between heroism shown when suffering is witnessed, for the purpose of aiding the sufferer, and that evinced for the selfish desire of individual gain or excitement, was strikingly exhibited by a German nurse, whom we sent on to the army during the Civil War in America. This frail-looking woman drifted on to the front, and after the Battle of Gettysburg, donning a pair of man’s boots, wading in pools of blood and mud, spent two days and nights on the field of slaughter, drawing out still-breathing bodies from the heaps of slain, binding up wounds, giving a draught of water, placing a rough pillow under the head, in an unselfish enthusiasm that knew neither hunger nor fatigue. The ghastly wounds, the blood, the shrieks and groans of that horrid scene, served but as fuel to the fire of humanity that consumed her.