The Nature of Man: Studies in Optimistic Philosophy

Meyer-Benfey is of the pessimistic opinion that happiness cannot possibly be regarded as the supreme end of humanity, for he thinks, if that were so, the whole course of evolution would have been a mistake. It would have been much better had evolution been arrested before the creation of the human race, since animals, being unaware of the inevitability of death, are undoubtedly happier than man. As, however, we have passed through the animal stage and reached the human .stage, and achieved some measure of civilisation, and this not by our own desire, or as the result of mere chance, but guided by the inner workings of our nature, it is plain that the ultimate goal towards which we are advanc- ing, must be some other than mere happiness. There can be no question but that the goal is the triumph of pure and perfect culture.

manifestations, is no recent theory, and many definitions of this progress have been advanced, but so far none have been generally accepted as satisfactory. The term " culture,'' though vague, will have to continue in use until some better word conveying a more precise meaning is found to replace it. On reviewing all the systems of philosophy which have attempted so strenuously to solve the problem of individual death, it becomes plain that all, or nearly all, of them deny the existence of a future life and the immortality of the soul. The greater part of them, however, admit some general principle incomprehensible but eternal, which will eventually incorporate within itself all individual souls. Feeling that these vague ideas are incapable of conveying consolation to poor humanity in its fear of annihilation through death, philosophers have persistently taught the advantages of resignation. Even Guyau, realising that his philosophy regarding the immortality of love fails to reas- sure those who look to philosophy for some word of conso- lation, ends by admitting that " as there is no help to be expected from the inexorable, nor mercy from that which is in conformity with the universe and even with our own judgment, resignation is best." * As it is the general opinion that to be philosophical is to take things as they are, without undue protest, the watchword of all systems of philosophy is to bow to the inevitable, that is to say, to be resigned to the prospect of annihilation.

Formation of the experimental method — The intervention of religion in disease — Disease as a basis of pessimistic systems of philosophy — Advance of medical science in the war against disease — The revolution in medicine and surgery due to the discoveries of Pasteur — The beneficial results of Serum Therapy in the war against infectious diseases — Failure of science to cure tuberculosis and malignant tumours — Protests against the advance of science — Opposition of Rousseau, Tolstoi, and Brunetiere — Proclamation of the fallibility of science — Return to religion and mysticism

SCIENCE, the youngest daughter of knowledge, has begun to investigate the great problems affecting humanity The chief religions and many systems of philosophy had been long established before the spirit of scepticism dared to inquire whether or no these products of the human mind were really in harmony with fact. Scepticism gained ground little by little, and open war was declared between religious dogma and authority on the one side, and scientific reason on the other.

The great religions and the philosophy of Aristotle had ruled a majority of mankind for some twenty centuries before doubt was cast on the real value of these doctrines. Francis Bacon, Lord Verulam, asked why it was that all the systems of his time were so vague and so powerless to explain the phenomena of the world. The cause could not lie in nature herself, for without doubt she followed laws that were immutable and that could be subjected to exact observation ; nor could it lie in any want of intelligence in those men who devoted themselves to solve the problems. The true cause of the failure lay in the falsity or insufficiency of the methods employed. Bacon, trying to provide a remedy for this condition of affairs, advised that makers of generalisations should proceed very slowly, passing only by the smallest stages from particular facts to conclusions only more general in the slightest degree, and so on, until the ultimate formula might be reached. By such a path it was possible to attain principles neither vague nor am- biguous, but clear and exact and that would not be denied by nature herself.

The first steps taken by science according to this method, which indeed had been suggested long ago, but which was first clearly laid down by Bacon, were slow and halting. Religious and philosophical doctrines still weighed heavily on inquiring minds, so that the new method was not followed with any great courage. None the less progress was achieved, until at length the great problems of humanity opened out. More than two thousand years before the birth of exact science, Buddha had given voice to the chief grievances of the human race. " Behold, O monks, the holy truth as to suffering," he had proclaimed in the Sermon at Benares, " birth is suffering, old age is suffering, disease is suffering, and death is suffering." Science, in its slow progress, passing from particular to general, reached first one of these four sorrows, the suffering due to disease.

In the Buddhist legend that I quoted in chap, vi., the sight of a sick man " whose senses were weakened, who drew his breath with difficulty, whose limbs were shrivelled, whose bowels were wrung with pain, and his body pitifully soiled with excrement," suggested to Buddha the reflection that " health is no more than the idle vision of a dream while fear and disease are horrible realities. What wise man, having seen the thing that life is, can still think of joy or of pleasure ? Woe upon health which is assailed by so many maladies." When Buddha, who was a young prince, asked of his father the gift " that he might always remain full of health, and that he should be smitten by no disease," his father, who was the king, replied: "You ask me what is impossible ; in that my son, I can do nothing."

From that day, every religion has busied itself with the cure and prevention of disease. They believed that the causes of these were the influence of evil spirits or the visitations of God ; and as remedies they prescribed sacri- fice and prayer and anything that might avert the anger of God. Even at the present day, similar medicine is used by primitive races. In Sumatra for instance, when it is impossible to arrest the flow of blood from a wound, the disaster is ascribed to an evil spirit (Polasieq) who is suck- ing the wound and making it incurable. In Nias, when bleeding from the nose occurs in children, it is supposed to be due to the father having killed a cock during the preg- nancy of the mother. The indispensable remedy is to make sacrifice to the outraged deity.

No doubt there co-exist with such practices of primitive races, certain useful rules, based on correct observation or on experience. It is a common practice to try all manner of remedies on the sick ; although most do harm, now and again something useful may be discovered. Such vulgar medicine has undoubted merit, but it cannot be compared with the results of scientific medicine, which are drawn from rigorous experiment. Medical science has been slow in developing, but it has now reached a condition of which humanity may be proud. It is outside my purpose to give a long exposition of this subject ; but it is necessary to my argument to set out a few facts from which the reader may judge of the present condition of medical science.

Without doubt the fear of disease has played a large part in the pess mistic conceptions of the universe. Not only the words of Buddha that I have quoted, but many of the systems of pessimistic philosophy attest this I have already stated in chap. vi. that Schopenhauer in 1831 was driven from Berlin to Frankfurt by fear of cholera. In his statement of the case against this universe, and as a chief argument for his proposition that " this is the worst of possible worlds " Schopenhauer adduced the spreading of epidemics. " An alteration of the atmosphere so slight that it cannot be detected by chemistry brings about cholera, or yellow fever, or the black death, diseases which number their victims by millions ; an alteration slightly greater might destroy all life."*

Hartmann, who has been one of the chief advocates of Schopenhauer's pessimism, also had gloomy views on diseases and medicine. He was convinced that howsoever great the progress of humanity might come to be, there never would be an end or even a diminution of diseases. " It is no matter," he said, " how many remedies may be discovered for diseases ; new diseases, and particularly chronic affections which, although not serious are extremely painful, will continue to appear more rapidly than the discoveries of medicine, "f

prove as wrong about their other grievances as they have proved about disease and medicine. To understand the vast progress made by medicine, it is necessary only to compare the complaint of Schopenhauer with the actual state of affairs. When he spoke of epidemics being due to slight changes of the atmosphere, Schopenhauer obviously was repeating the medical opinion current in his times. Experimental science has proved that he was quite wrong. It has been shown conclusively that two of the great affec- tions of which he spoke, cholera and plague, are due not to chemical changes in the air, but to definite microbes, the natural history of which is known as well as that of any other plant. Cholera is produced by the vibrio, dis- covered by Koch, a minute organism that lives in water and that enters the human alimentary canal with food or drink. We do not yet know a definite cure for cholera, but we do know how to prevent infection. The most simple mode of guarding against infection is to swallow only material that has been boiled, and to prevent con- tamination of water or of vessels with faecal matter con- taining the Koch's vibrio. Moreover, in individual cases use may be made of anti-cholera serums. In 1831, if these discoveries had been made, philosophy would have taken a different course. Instead of trembling at the epidemic, and flying to Frankfurt, Schopenhauer would have remained quietly at Berlin, and Hegel would not have ceased to develop his idealism in the university of that town.

Schopenhauer enforced his argument by reference to the black death " capable of destroying millions of victims." It is certain that the black death was no other than human plague, which made enormous ravages, in the fourteenth century, for instance, destroying nearly a third of the popu- lation of Europe. In those days, no one doubted but that it was a visitation of the Divine wrath, and people gathered in churches to make common supplication. Sacrifices were offered and flagellations took place in the hope of averting the terrible malady. Travellers who have been in the capital of Austria must have seen in one of the chief streets (Graben) a large and unlovely monument, erected in the seventeenth century to commemorate the inter- position of Providence in staying one of the great epidemics of plague. Now that science has made known the true cause of plague, our ideas as to the causes of the appearance and disappearance of epidemics are very different. Plague is not the manifestation of the anger of God, but is a scourge due to invasion by a minute organism, discovered simul- taneously by Kitasato and Yersin in 1894. The natural history of the microbe has been studied, and we know that it may live not only in human bodies but in the bodies of small rodents, such as rats and mice, which live in associa- tion with man. These animals are the source of human infection, and it is necessary to destroy them as completely as possible. There is no doubt but that the arrest of the plague in the seventeeth century was due to the fact that rats and mice had themselves been exterminated by the plague.

Plague, which formerly was the most terrible of epidemic diseases, has now become a misfortune against which it is simple to guard ourselves. To secure that end, however, we have not to pray or to scourge ourselves, but to take measures to destroy rats and mice. Moreover serums may be employed ; and the use of these is not only prophylactic, but if the disease be not too advanced, is actually curative. The danger of which Schopenhauer spoke may be regarded as definitely averted, and this is due to the advance of medical knowledge. In such countries as British India in

which plague still causes great losses, we have to blame the ignorance of the population. Instead of following the course prescribed by science, these people still prefer the rules laid down by the Brahmanistic religion. Their idea of cleanliness and purity is a religious idea, and not that of medicine and bacteriology. It is not surprising that plague still exists in India, but none the less no case is a better instance of the progress of knowledge.

Hartmann's idea as to a progressive increase in the number of diseases rests on no exact grounds, and is in opposition to much that we know. As a matter of fact, as knowledge of hygiene advances and becomes spread among the peoples, diseases become less frequent and less fatal. A great stimulus was given to medicine and surgery when there was applied to these the knowledge gained by Pasteur in his study of fermentation. Pasteur showed that fermen- tations were chemical alterations in organic matter, excited by the presence of minute organisms very common in the neighbourhood of man.

This discovery was applied in the first place to surgery. Lord Lister, then a surgeon in Scotland, showed that the festering of wounds was due to the entrance of minute organisms. Following this clue, he succeeded, by the use of dressings, in preventing the contamination of wounds and at once saw a vast reduction in deaths following surgical operations. Since the discovery of anaesthetics, such as ether, chloroform, and cocaine, and the use of germ-free dressings, surgery has been developed in a marvellous fashion. The varied and delicate feats of abdominal operation are known to all, and recently surgery of the heart has become possible.

A comparison of the mortality of the wounded in the different wars of the nineteenth century affords an excellent means of gauging the progress of surgical treatment of gun- shot wounds. The mortality of the wounded among the English troops in the Crimean war reached 15.21 per cent. ; in the French troops in Italy in 1859-1860, it was 17.36 per cent. ; in the German army in 1870-1871, the years in which antiseptic surgery came into use, it fell to 11.07 per cent. ; while in the Spanish-American war in 1898, in the most brilliant period of modern surgery, the percent- age mortality of wounded had fallen to 6.64.* In the recent Transvaal war, the mortality was half what it had been in the Franco-German war.f

New medical knowledge, founded on the discovery of the nature of ferments and of the virus of infection, has reformed the practice of midwifery to such an extent that puerperal fever, formerly one of the great scourges of humanity, is now extremely rare. Blindness acquired at birth, which formerly rendered many lives extremely miserable, is now practically com- pletely prevented, by means of the precautions taken to hinder the child from being contaminated by the mother in the process of birth. The most successful method is that which was suggested by Crede,| a German physician, and consists in placing in the pupils of the infant a minute drop of nitrate of silver, which is an antiseptic, and prevents the occurrence of ocular blennorrhagia.

J The efficacy of Crede's treatment may be inferred from the figures recorded at Stockholm, in which city the adoption of the treatment caused the percentage of cases of this nature to fall from 0.56 in 1891 to 0.045 in 1899. See Widmark, " Mittheilungen a d. Auejenklinik d. Carol. Med. Chir. Instit. zu Stockholm," p. 126. ;o02. Appendicitis, a disease so common that I referred to it in chap. iv. as one of the most salient examples of 'dis- harmony in the human constitution, has been resolutely attacked by medical science. In some cases, surgical in- terference makes a definite end of the disease ; in other cases medical treatment has been enough to subdue the symptoms without recourse to operation.

For a considerable period, those of a sceptical disposition asserted that the advance of bacteriological knowledge was of service only in surgical cases. But Pasteur showed that this was an erroneous view. Working with Chamber- land and Roux, Pasteur demonstrated that many infectious diseases could be prevented by the use of attenuated virus ; he succeeded in saving the lives of many animals and of men, bitten by rabid dogs and affected by hydrophobia, a disease formerly almost invariably fatal and among the most horrible to which man is liable.

In the latter direction, medical science is developing at an extraordinary rate, and is achieving results of a re- markable nature. Among recent discoveries, I may mention that of the curative properties of the blood-serum of animals which have been subjected to the action either of microbes or of the soluble products of microbes. Von Behring, working with the Kitasato, a Japanese investigator, has shown that a serum of this nature, prepared with the poison produced by the microbe of diphtheria (the poison was discovered by Roux in collaboration with Yersin), is capable not only of protecting those in good health from diphtheria, but of curing those who have been attacked by the disease. The serum fails to act only when it is employed in advanced cases of diphtheria.

Anti-diphtheritic serum, introduced into medical practice about eight years ago, has been tried in every way and has been proved to possess both preventive and curative proper- ties. If patients still die from diphtheria, it is only because the treatment has been applied too late or insufficiently. The use of the anti-diphtheritic serum has reduced the mortality in cases of diphtheria from 50 or even 60 per cent, to 12 or 14 per cent. The number of infant lives that have been saved by this method must be enormous.

The beneficent discovery of the curative value of serums has been applied to other diseases and is giving very en- couraging results. I cannot go into details here, but it is enough to say that in the last quarter of a century medicine has entered a new epoch, and has taken its place among other exact sciences based on the experimental method. Although it is not surprising that in so short a space of time science has not yet conquered all the ills affecting humanity, this failure has provoked the most severe criticism.

" Indeed," one of the critics has said, " you vaunt the progress of medical science at a time when you have to confess that it has failed to cure tuberculosis, one of the gravest of the infectious diseases, which alone causes the death of a sixth part of the human race." It is true that the infectious nature of this scourge was announced by Villemin more than forty years ago. Twenty years have passed since Koch, the German bacteriologist, discovered the microbe that produces not only the ordinary form of pul- monary consumption but all other varieties of tuberculosis. And we are still ignorant of any remedy for the disease. In all the bacteriological institutes and laboratories search is being made for some vaccine or serum or medicament which will arrest a disease that in many cases nature herself cures. But the results amount practically to nothing.

This is certainly a good example of the failure of science. None the less a closer examination shows that even with the knowledge already gained we could deal with tubercu- losis in a manner more efficacious than is the existing prac- tice. When the infectious nature of the disease had been made known, before waiting for the discovery by Koch of the actual bacillus, we should have employed all the known modes of destroying infectious matter. In spite of all that has been said and written on the subject, people still spit on the floors of omnibuses and cars and on street pavements. Tuberculosis is propagated not because of the failure of science, but because of the ignorance and stupidity of the population. To diminish the spread of tuberculosis, of typhoid fever, of dysentery, and of many other diseases, it is necessary only to follow the rules of scientific hygiene, without waiting for specific remedies.

Although the science of to-day is sufficiently armed against the diseases commonly known as infectious, the case is very different with some other affections, among which the chief place is taken by malignant tumours, or cancers, in the most general sense of the word. There are few maladies more terrible, for they practi- cally never disappear spontaneously, and surgery can remove them successfully only if they have been recognised at an early stage. Every year a number of persons, old and young, die victims of malignant tumours, and it is even possible that cancer is more prevalent now than in former times. It has been suggested that the increase of cancer is due to the greater longevity among modern races, and as malignant tumours are most common in old persons, it may well be that the prolongation of life has given this disease a larger field. However, even allowing for this, it is probable that there is a real increase of cancer.

Unquestionably the malignant tumours are the diseases most disappointing to medicine and surgery, and these sciences are as much at a loss with regard to them as in the case of infectious diseases before the discovery of pathogenic organisms. Science is perhaps even in worse case with regard to cancer than it formerly was with regard to infec- tious diseases, for, before the discovery of microbes, some- thing was known of the vi us which produces infection. Thus the virus of smallpox was known, and was used, by the method of inoculation, to prevent more serious attacks of the disease. Nearly a century before the discoveries of Pasteur, Jenner had been able to be of the greatest service to mankind by his discovery that the virus of cow-pox could be used as a preventive of infection by smallpox.

In the case of malignant tumours, we do not even know their real nature ; we are ignorant as to whether or no they are infectious, and whether they are caused by a microbe coming from without or are due to internal changes of the tissues. Our ignorance, however, affords no ground for despair. It is probable that the malignant tumours will soon come to be ranged with infectious diseases due to invasions by specific microbes. Experiments on the cancers in rats and mice have shown that these can be inoculated in the same manner as in the case of the recognised infectious diseases. Hanau has shown that this occurs in the case of epithelioma of old rats ; Morau* has succeeded in trans- ferring the cancers of white mice, and his results have been confirmed by Jensenf and BorrelJ, in the Institut Pasteur. These investigations mark the beginning of a new stage in the knowledge of tumours. I am unable to see, therefore that the malignant tumours provide a satisfactory argument in favour of a pessimistic conception of the universe.

Dr. Boas, of Berlin,* in a recent publication, has laid stress on the fact that most patients affected with cancer do not seek medical aid until the disease is far advanced. For instance, in 80 per cent, of the cases of cancer of the rectum that he had attended, the patients presented them- selves too late for operation. Boas advised that the atten- tion of the public should be drawn, by means of widespread publication, to the earliest symptoms of cancerous disease. He thought that such a course might save many lives by making possible operation in early stages.