In the course of gathering opinions from various authoritative sources on the subject dealt with in this book, I received communications from Sir Clifford Allbutt, the Hon. Sydney Holland, and a well-known surgeon, which, though they do not constitute separate treatises, are so important, not only in view of the distinction of the authors, but of the broad survey of the subject that they afford, that I venture to print them as part of the general introduction.
In the case of Sir Clifford Allbutt’s paper I have supplemented it by an important extract from one of his recent writings.
The Relationship between Medicine and Religion
The response you are good enough to desire can be but brief, crude, and, I fear, too blunt; but I have not time for careful consideration. I can only indicate a few points which occur to me offhand, and taking much for granted. For instance, I must avoid any discussion of those antinomies which meet us at every side of human conceptions, and be content to accept the common uses. The chief of these (for the moment) is that of the material and spiritual; without forgetting that they melt at their borders the one into the other, and that we meet with corresponding ambiguities, yet I must take them as distinct fields of human life. In our interesting personal conversation you may remember that I expressed the opinion that, on the whole, our prayers must not be for material but for spiritual things. And, speaking on the whole, sickness is a material thing. In the stories of our Lord’s miracles it has always struck me that He regarded His miracles—I must use the word for brevity—apologetically. The disciples were not to tell any man of them; or again, a miracle was performed under a compelling sense of the overwhelming faith of the pleader, which was the main thing. Faith, prayer, were to be for the needs of the soul, not of the body. For instance, the father seeing his child in diphtheria would please God better—so the experience of His world tells us—by spending his first hour in seeking the physician with his antidote rather than in prayer for a divine intervention. And when time came for prayer he would pray not for a suspension of natural law but for unity of his own will with that of the Father, and for the child’s spiritual welfare. Into the origin of evil do not fear that I shall enter; it is one of the antinomies which I have said that we must avoid, at any rate at present: I can only now say that disease is a material effect to be combated by material means, and not by religious processions or intercessions.
This being my view, I would try to eliminate notions of the priest as medicine man; they are essentially pagan, though to this day they more or less unconsciously influence our thoughts on the present subject.
But, it may be said, strange healings do take place under religious influences; and this is true. And at no time in history were such miraculous cures more frequent and wonderful than in the temples of Aesculapius or of Serapis. Modern cures, whether of the Eddyites or at Lourdes, or the like elsewhere, when compared with those of the Roman Empire fall into insignificance. Now a careful study of all reported cures of this miraculous or miraculoid kind, a study illustrated for us many years ago by Charcot, proved to him, and proves to the expert observers of to-day, that they all—palsies, convulsions and the rest, often inveterate cases—are and have been cures of one disease, and of one only, namely hysteria; a malady which in its protean manifestations mocks all and any particular diseases. I say this of the genuine cases; but the majority of such wonders recorded turn out on inquiry (like the ‘Grimsby’ case) to be grossly exaggerated or wholly false. The ‘miraculous cures’ then, so far as they are genuine, are cures by suggestion: they take their place with cures of the same kind of disorder by panic, such as an alarm of fire; by ‘hypnotism,’ or by any other over-mastering impression which startles or transports the balance of the bodily functions from one centre of equilibrium to another higher and more stable one.
So much for the ‘miracles’; which owe nothing to any sacerdotal magic, and to the physician are part of a familiar experience, and of a familiar interpretation. But giving up the hysterical cases—which, by the way, is to give up a good deal—and admitting that disease is in the body a material thing, and one not properly matter for the pleading of prayer, except in the spiritual sense of submission to the Divine order, between these positions is there a sphere in which spiritual influences—whether by a clergyman or a Biblewoman or a gentle friend—may so infuse peace and confidence into a sick man as to promote even in the body a renewal, a conversion, or an economy of energy which should make for recovery? Certainly; and here, I think, is the restricted, if still important, sphere of religion as medical.
To consider this aspect of the matter we must go back for a moment to certain principles. From the letters of Teresa—that noble saint—we may learn much of the greatest value to us in the present inquiry. We may learn from her to distrust the ‘ecstasies and melancholies’ which—as she said—were ‘the perils of conventual life’; she roundly denounced all that ‘letting one’s self go, outside the control of reason,’ which has its origin in ‘sick brains.’
‘If I were with you,’ she wrote to a certain Prioress, ‘you would not have so many extraordinary experiences.’ Now Teresa not only apprehended, but thoroughly understood, that the highest spiritual life depends upon the best bodily health. She tells us that she supported her own vigils with plenty of meat (viande) and sleep. High and holy thought demands the greatest effort of the healthiest body, of the brain most finely balanced and best nourished. The piety of the sick-bed is at best a passive piety, which on recovery is pushed aside again by the custom of the world; but herein it is that in sickness the soul flags and droops upon itself, and that the support of other sympathy is more precious. The sympathy we all depend on in health we need most when enfeebled by ailment. There is no delusion more terrible than that which lets a man run up a score of sins and negligences to be repented of under the discouragement of a sick-bed. In this melancholy, this debility, this disappointment, perhaps this remorse, energy is wasted which is sorely required for the conflict with disease. And even the man of religious life likewise—if in less degree, as one who has accumulated more inward light—is also disheartened to perceive that the fountains of spiritual contemplation are then less copious, and aspiration a wearier effort. He too needs help, if not to make, yet to reinforce, the happier conversations of his fuller life. In health the mind in solitude droops and wastes, and the sick-bed is a kind of solitude; the thousand and one stimulating impressions of common life cease, the impressions wane which should keep the mind and soul awake, and fill the wells of energy. On the sick-bed, therefore, short times of encouragement and sympathy, periods not long enough to exhaust the scanty stores of energy, are precious; and if the physician be jealous—as it has been said—of the priest, it is lest he should expend these stores more in priestly functions than in ‘angels’ visits’ of love and hope which would unite and reinforce the vacillating and fading forces. Thus also prayer at the bedside and the short communions should be of love and hope, not particular requests for material relief or cure. The kindly physician himself may be a vehicle of much of this encouragement; but—as I said to you before—he should avoid even the semblance of attending to anything beside his own business of material aid and general human sympathy. The most pious patient, openly or inwardly, resents the divided mind. The instinct of self-preservation is not lost even in those nearest to God.
So when all is said and done on this subject I fear that matters for me remain much where they were before; but they may lead to a more intimate understanding of the several parts of the spiritual and the medical visitors, and to a completer sympathy between them. If still it be urged that an imposing ceremony may, by a measure of the ‘suggestion’ so effective in the many-coloured hysteria, come to our aid in more noxious maladies, if no more than on the fringe of them, I should repeat that the advantage would be so indefinite, so relatively small, and so well to be attained by ordinary spiritual visitation, as not to be worth the peril of the moral perversion which hangs only too closely around these good intentions, the peril of imposing upon, even of bamboozling, the patient. We must remember the saying of Lavoisier, ‘Medicine came into the world with a twin brother, called charlatanism.’