Civilization in the United States: An inquiry by thirty Americans

by Unknown

Thus we observe with horror the gradual replacement of those Nestors of preventive medicine who had the dispassionate view of science, and who applied its methods of cold analysis, by a group of dubious Messiahs who combine the zealous fanaticism of the missionary with the Jesuitical cynicism of the politician. For most of the organizations for the promotion of health are closely dependent upon state and municipal politics, and must become contaminated with the obscenity of political practice. Finally, it is apparent that the great privately endowed foundations are animated by the spirit of proselytism common to the majority of religions, but especially to Baptists. It will be objected that such charges are vague generalizations. It is necessary, therefore, to bring forward one or two specific instances in support of these contentions.

The soldiers of the recent successful campaign for national prohibition were supported by battalions of noted hygienists who made excellent practice with a heavy artillery of so-called scientific evidence upon the confused ranks of brewers, distillers, and their customers, the American bibuli. What is the value of their “scientific evidence”? Two charges are made against the use of alcohol as a beverage. Primo, that its moderate or excessive use is the direct cause of various maladies. Secondo, that the children of alcoholic parents are often deformed, degenerates, or imbeciles, and that such lamentable stigmata are the direct results of the imbibitions of their parents.

Now it is vain to argue that alcohol, taken in great excess, is not injurious. Mania a potu (Korsakow’s disease) is without doubt its direct result, at least in some instances. On the other hand, excessive indulgence in water is also not without its harmful effects, and I, for one, would predict evil days for our Great Commoner, should he so far lose control of himself as to imbibe a gallon of grape juice per diem. Many enthusiastic hygienists advance the opinion that alcohol is filling our insane asylums! This generalization is a gorgeous example of post hoc propter hoc reasoning, and is based upon the idiotic statistical research which forms so large a part of the activity of the minions of public health. The recent careful work of Clouston and others tends more and more to indicate that chronic alcoholics do not go crazy because they drink, but become alcoholics because they already were crazy, or had the inherited tendency toward insanity. This embarrassing fact is carefully suppressed by the medico-hygienic heavy artillerists of the prohibition army. What is more, diseases with definite pathologic pictures, such as cirrhosis of the liver, have by no means been definitely proved to be caused by alcohol. Indeed, the researches of Friedenwald, who endeavoured to produce such effects by direct experiment, have led to negative results.

The second indictment, i.e., that alcoholism in parents causes degenerate offspring, rests upon still more dubious scientific foundations. The most important animal experimentation in this field is that of Stockard, who used guinea-pigs as his subjects, and of Pearl, who had recourse to chickens. Both of these researches are sound in scientific method. Unfortunately for hygienists, they lead to completely contradictory conclusions. Stockard and his collaborators found the offspring of alcoholic guinea-pigs to be fewer in number than those of his normal controls. What is more, the children of the alcoholics were frequently smaller, had a higher post-natal mortality, and were prone to suffer from epileptiform convulsions. These results brought forth banzais from the hygienists and were extensively quoted, though their application by analogy to the problems of human heredity is not to be made too hastily.

Pearl, on the other hand, discovered that while the number of offspring from his inebriated chickens was distinctly fewer, yet these were unquestionably superior to normal chickens in eight of the twelve hereditary characters amenable to quantitative measurement. Now if one can generalize Stockard’s results to human beings, then it is equally permissible to do the same with Pearl’s. Of the two, the latter generalization would be preferable, and of greater benefit to the human race, were the analogy valid. For who will not whoop for “fewer children, but better ones”? Do the votaries of preventive medicine place the results of Pearl along side of those of Stockard? Indeed, who even mentions Pearl’s results at all? If satisfactory evidence is adduced that this has been done, I hereby promise to contribute one hundred dollars in cash toward the foundation of a home for inebriated prohibition agents. Again, while much is heard of the results of Bezzola in regard to the Rauschkinder resulting from the Swiss bacchanalia, the negative findings of Ireland in similar investigations of the seasonal debauches of Scotland are carefully avoided. Once more, Elderton and Karl Pearson have failed utterly to find increase in the stigmata of degeneracy among the children of alcoholic parents as compared with those of non-alcoholics. This research, published in a monograph of the Francis Galton Laboratory of London, is the one really careful one that has been made in the case of human beings. It was directed by Pearson, admittedly a master of biometrical science. Yet, turning to Rosenau’s “Preventive Medicine and Hygiene,” the bible of this branch, I find the Elderton-Pearson report relegated to a footnote in the edition of 1913, and omitted completely from the 1920 edition.

A discussion of the fatuity to which American preventive medicine descends cannot be terminated without touching upon the current propaganda of the syphilophobes. For just as practitioners of medicine exploit human credulity, so the preventers of disease play upon the equally universal instinct of fear. There is no intention of minimizing the seriousness of syphilis. Along with cancer, pneumonia, and tuberculosis, it is one of the major afflictions of humanity. It causes thousands of deaths yearly; it leads to great misery. Paresis, one of the important psychoses, is definitely known to be one of its manifestations. It is obvious, therefore, that its eradication is one of the major tasks of social hygiene.

But by what means? Let one of the most noted of our American syphilophobes give the answer! This gentleman, a professor of pathology in one of the most important medical schools of the Middle West, yearly lectures over the length and breadth of the land on the venereal peril. He begins his expostulation with reduction of his audiences to a state of terror by a lantern-slide display of the more loathsome manifestations of the disease. He does not state that modern treatment makes these more and more rare. He insists upon the utter impossibility of its cure, a fact by no means established. He advocates early marriage to a non-syphilitic maiden as the best means of prevention, and failing that, advises that chastity is both possible and salubrious. Then follows a master stroke of advice by innuendo—the current belief that masturbation causes insanity is probably untrue. Finally he denies the value of venereal prophylaxis, which was first experimentally demonstrated by Metchnikoff and Roux, and which the medical department of the Army and Navy know to be of almost perfect efficacy when applied early and thoroughly.

Lack of space prevents the display of further examples of the new phenomenon of the entrance of religion and morals into medicine. It is not my intention for a moment to adopt a nihilistic attitude toward the achievement of preventive medicine. But it is necessary to point out that its contamination by moralism, Puritanism, proselytism, in brief, by religion, threatens to reduce it to absurdity, and to shake its authority in instances where its functions are of unmistakable value to our republic. At present the medical profession plays a minor rôle in the more important functions of this branch. These are performed in the first place by bacteriologists who need not be doctors at all, and in the second by sanitary engineers, whose splendid achievements in water supply and sewage disposal lead those of all other nations.

It has been remarked above that one of the chief causes of the unscientific nature of medicine and the anti-scientific character of doctors lies in their innate credulity and inability to think independently. This contention is supported by the report on the intelligence of physicians recently published by the National Research Council. They are found by more or less trustworthy psychologic tests to be the lowest in intelligence of all of the professional men excepting only dentists and horse doctors. Dentists and horse doctors are ten per cent. less intelligent. But since the quantitative methods employed certainly carry an experimental error of ten per cent. or even higher, it is not certain that the members of the two more humble professions have not equal or even greater intellectual ability. It is significant that engineers head the list in intelligence.

In fact, they are rated sixty per cent. higher than doctors. This wide disparity leads to a temptation to interesting psychological probings. Is not the lamentable lack of intelligence of the doctor due to lack of necessity for rigid intellectual discipline? Many conditions conspire to make him an intellectual cheat. Fortunately for us, most diseases are self-limiting. But it is natural for the physician to turn this dispensation of nature to his advantage and to intimate that he has cured John Smith, when actually nature has done the trick. On the contrary, should Smith die, the good doctor can assume a pious expression and suggest that, despite his own incredible skill and tremendous effort, it was God’s (or Nature’s) will that John should pass beyond. Now the engineer is open to no such temptation. He builds a bridge or erects a building, and disaster is sure to follow any mis-step in calculation or fault in construction. Should such a calamity occur, he is presently discredited and disappears from view. Thus he is held up to a high mark of intellectual rigour and discipline that is utterly unknown in the world the doctor inhabits.