Popular Science Monthly/Volume 14/April 1879/Experiments with Living Human Beings II
By GEORGE M. BEARD, M. D.
IN experimenting with living human beings, deception, whether voluntary or involuntary, can only be scientifically met by deception; it must be beaten with its own weapons. No experiment of this kind in which the results depend in any way on the honesty of the subjects experimented on can be of any value in science; and those who assume that, because the subjects of these experiments are members of great churches, and move in high society, they are therefore incapable of untruth, would do well to resign the task of investigations of this sort to those who are better endowed with the scientific sense. Systematic orderly, exhaustive deception, on the part of the experimenter, as here suggested, will, in all cases, exclude both intended and unintended deception on the part of the subject or bystanders.
Sixth Source of Error: Chance and coincidences.—The subject of chance and coincidences seems never to have received the attention from men of science that its direct and practical bearings on experimental research and the principles of evidence would long ago have demanded. On the mathematical side the philosophy of chance has been investigated and discussed by various writers, and with not a little intelligence and skill; but with the effect also of misleading many amateur experimenters and reasoners, who have thereby been tempted to employ mathematical estimates in departments of science where they are sure to guide into error. No forms of error are so erroneous as those that have the appearance without the reality of mathematical precision. Of this sort are the blunders of those physiologists who, at various times and under various guises, have sought to solve physiological problems by experiments half built up on rigid mathematical calculations, the other half having no foundation at all; for the average non-expert observer is awed and overpowered by the very sight of figures, and assumes that an investigation into which addition, subtraction, and multiplication enter, must inevitably lead to precise and unerring results, forgetting that, as quantitative truth is of all forms of truth the most absolute and satisfying, so quantitative error is of all forms of error the most complete and illusory. Figures, to be of arty value in science, must go all around the subject and thoroughly embrace it, else they fail to master it, and become its possessor: for, while the truth is apparently shut in on one side, it is all the time stealthily escaping at the other. Thus it is that the most acute calculators, most logical reasoners, and most accurate observers as well, are so often cheated out of the truths to the search for which their lives are devoted; the instincts of the plow-boy often outstripping the wisdom of the philosopher.
Among this class of scientific blunders is the custom of applying the calculations of chances to experiments with living human beings. Thus in the now well-known mind-reading performances it was averred that by a mathematical calculation there would be but one chance in several hundred thousand of finding any object in a house or hall or assemblage; hence it was inferred that a new force, or manifestation of force, had been revealed to the world. The fallacies in this philosophy do not require a very long search; of the many objects in any house, or indeed in any public building, but a small minority would be accessible in any mind-reading test, and of these few only a limited number are of a sufficiently positive nature and description to be thought of by the subject of such experiments; then, in addition, are all the errors that come from intentional and unintentional assistance of audiences and bystanders.
Practically the only way to eliminate, in a scientific manner, the error of chance or coincidence in all experiments of that character, is by making comparative experiments in the same line, with all the sources of error closed except chance, and to repeat these a sufficient number of times to make an absolute. In this way it was shown that mind-reading, so called, was really muscle-reading. In these and in all studies of like character it is to be recognized that coincidences of the most extraordinary and astonishing nature are liable to occur at any instant, and that they are as likely to occur on the first trial as on the last of a long series. To determine whether any conjunction of events is simple coincidence, or the result of some new fact or law in science, is possible oftentimes only through a series of comparative experiments. In the researches which I made in muscle-reading it was shown over and over that by pure chance alone—every other element of error being excluded—the blindfold subject would, under certain conditions, find the object looked for in one case and sometimes in two cases out of twelve.
It would seem that the errors from chance and coincidence were the most patent of all the errors that complicate and confound scientific investigation, and so clear even to the unskilled and unthinking mind, that trained investigators would never be deluded by them. But in practice it vitiates the research and the philosophizing of educated men, even more perhaps than any other of the six, excepting the involuntary action of mind on body which, as we have seen, has been the stone of stumbling for physiologists ever since physiology was introduced into science.
Hay-fever, for half a century and more, has supplied an unusual richness of material for false reasoning of a similar type. An English physician, a victim of this disorder, notices that he is worse as he crosses a field of grass, and concludes that at last he has found the one source of the mystery, and so gives the affection a misleading name which it can never lose; Helmholtz, a leader both in physics and physiology, puts the nasal secretions under the microscope, discovers some unexpected infusoria that are killed by quinine, and announces to the world in one breath a theory of the disease and a specific for its cure, without apparently suspecting, what is now known, that the presence of infusoria might be a coincidence or effect and not a cause.
To all this it may be said that practically we do find out the true value of medicines and their objective action on the human body without systematically eliminating any of the six elements of error here pointed out. This is to be allowed; but the admission of the fact requires also an explanation of the way in which these errors are in practice actually eliminated, although unintentionally and unsystematically, and I may say also, most unscientifically.
It is by an immense number of experiments or trials on a large variety of cases, at different times, by different observers, and under varying conditions, that medical science has been able, after centuries of doubt and struggle, to arrive at some few real scientific facts in regard to the action of medicines. If these six elements of error had, from the first, been everywhere recognized and comprehended and systematically guarded against, the process of finding the truth in this department might have been abridged by hundreds of years. The method by which, in practice, physicians learn the action of any new remedy, is to give it to a number of cases, and then to watch and report the results; another physician repeats the experiments on a different set of cases; he also notes the results: and this process goes on perhaps for years, until in lapse of time the profession, without being able to give precise and convincing reasons for their faith, slowly and instinctively settles down to the persuasion that the effects claimed for the remedy are genuine, and act accordingly.
In many instances they are right in this conclusion; but how awkwardly and in what a roundabout way, and through what useless and wearying toil, have they, in doubt and distrust and suspicion, finally reached that goal! All the trials with the remedy, from beginning to end, have been impaired in scientific value by some one or all of the six elements of error; but through the immensity and variety of the experiments, extending through a long period, these errors have been unconsciously and unwittingly eliminated, so that only the solid fact is left. This unconscious elimination or rather leaving behind of errors, after the analogy of the formation of the universe according to the nebular hypothesis, takes place in this manner: In the first hundred cases treated there will be perhaps one of two, or more, who have no faith in and no expectation from it, good or bad; these few obtain the real objective effects of the remedy, while all the others deceive, more or less, themselves and their physician. In subsequent experiments by other observers, some of whom perhaps are less hopeful than the original investigator, the same unconscious and irregular elimination takes place, until the objective power of the remedy may for all practical needs be regarded as established. Such is the history and philosophy of medical experimentation in all ages and with all schools of medicine. I claim that by the rigid following out of the principles here taught it will be possible for even the humblest member of the profession to take any new remedy, and, if a sufficient number of cases be provided, to accurately determine some points at least of its therapeutic value, if it really possesses any that are capable of being demonstrated to the senses or reason of man. It is the unconscious or unformulated apprehension of these errors in the working up of remedies that causes so many of the profession to take at certain periods of their lives the extreme and unscientific view that all medication is a mistake—that drugs have no power outside of the mind of the one who takes them—and consequently, and logically, to trust only to the forces of nature and hygiene.
In relation to this branch of our theme, it is worthy of note that there are certain modes of treating disease which from the very nature and manner of their employment can not be experimented with in a truly scientific way; it is impossible to use them so as to deceive the patient on whom they are used; of necessity, therefore, they must be developed by the process of successive eliminations already described. Among the medical procedures of this class are hydro-therapeutics or hydropathy, electro-therapeutics, and massage, or systematized rubbing, kneading, and manipulation; none of these remedial operations can be used without the patient's knowledge; none of them can be used in a different way from what the patient supposes they are being used; they are open, in clear sight, and affect the various senses so strikingly that satisfactory deception is impossible; patients know when they are being galvanized or faradized; they know when they are washed or showered; they know when they are rubbed and kneaded; no art or device of the physician can avail to so deceive them as to absolutely eliminate the error that comes from the hope or fear or expectation of what the treatment is to accomplish. The practical value of these methods of treatment—and they are all of undoubted value—could only be ascertained, as it has been ascertained, by the immense variety of the experiments that have been made with them, wherein through the process of time the six sources of error have been little by little eliminated.
In all new remedies and systems of treatment the aim of the scientific physician should be to make the deception so thorough that whatever effects are obtained must be known positively to be the objective action of the treatment or of nature. The criticism which I make on Burq, Charcot, and others, who have recently experimented with the action of metals of different kinds on the anæsthesia of hysterical patients, is that they left the question open when, by a systematic, orderly, and thorough provision against these six sources of error, they had it in their power, with the vast material at their command, to have absolutely closed it; if they could not determine with certainty whether the temporary disappearance of the anæsthesia on the application of plates of copper or silver or gold was the result of feeble electrical currents excited, or of simple mechanical pressure, or of absorption, they could surely have answered, to the satisfaction of scientific men, the question whether it was to be explained subjectively or objectively; but this, through want of appreciation of the sources of error, or from want of a formula to guide them in their elimination, they failed to do. Even though it should be proved, as it may be, that some of these phenomena observed by Burq, and Charcot, and Westphal are objective, and independent of the expectation of the persons operated on, the validity of this criticism is thereby not at all affected. To attempt to build up a practice of metal-therapeutics on the basis of metalloscopy as that claim now stands, is like putting up a house before we are sure of our foundations. The first question to decide is whether metal-therapeutics is or is not really mental-therapeutics.
In the illustrations for this essay I have chosen, by preference, the experiments of scientific men of skill, honor, and distinction, and for the same reason that Blair, in his work on rhetoric, refers, for examples of incorrectness, inelegance, and carelessness of style, only to the writings of the greatest masters of style in the language: if these things be done in the green trees, what shall be done in those that are utterly dry? The average scientist, the every-day physician, the followers, the gleaners and popularizers of knowledge, are expected to blunder and teach but half truths, if not positive error; but if all those who should be our experts fail us, where can we look for clear ideas? It is no overplus of enthusiasm, no fancy of rhetoric, to say that if these six sources of error and the true methods of providing for them had been mastered half a century ago, the history of scientific experimenting during that time would have been radically different from what it now is.
On this subject no nation can throw stones at another; in all the great centers of modern civilization the strongest leaders of science and scientific thought have been and are constantly demonstrating their non-expertness in the art of experimenting with living human beings; the history of science, or the demonstrably true, and the history of delusions, or the demonstrably false, run in the same channels; but in the minds of the French there appears to be some psychological peculiarity that, while it urges them to undertake, at the same time unfits them to succeed in researches of this character, their very genius for science, as it relates to inanimate nature and the lower forms of life, predisposing them to all error when dealing with living human creatures; hence the paradox of history that France is at once the home of science and the home of delusions. Now, for almost a century, the ablest philosophers and experimenters of France have been wrestling with the problem how to experiment with living human beings; from the first committee of the French Academy on mesmerism, through Perkinism and Burqism, down to the very latest bulletin of Charcot on metalloscopy, it is one uniform, unbroken record of persevering non-expertness and failure: Science constantly baffled, beaten, utterly overthrown, yet as often returning-to the hopeless contest, where delusions always compel a drawn battle, if they do not positively win; experiments without number that have the form of precision without its substance; all truth, or even the suggestions of truth, submerged in vast floods of error; the faith that belongs to religion and emotion carried into the realm of science and intellect; all along the line of strong endeavor an obvious want not only of the philosophy but even of the instinct of seeking truth from living human beings—in the whole history of folly one shall not find a more instructive chapter than this; were there no other proof of the limitations of the human brain, sufficient could be found in this fruitless searching after truth on the part of the most intellectual leaders, of the most intellectual of nations, in the most intellectual era of the world. Not only during the past year, in the hospital of Salpêtrière, but, by recurring intervals, during the past century, the best science of France has been on its knees before hysterical women, and there it must remain until it has mastered the true philosophy of trance and the involuntary life, and learned by heart the sources of error.
The time must come when it shall be well understood that experiments with living human beings, in which the elements of error are unrecognized, are not only unscientific but are a satire on science; bearing the same relation to the true method of investigation in this special department of physiology that the dreams of the mediæval sages sustained to the general philosophy of induction. The philosophy of the future will be that the laws of nature are not to be put on the market, and can not be bid off at auction, and that the long-standing and unaccepted financial prize of the French Academy for the one who should prove to be endowed with clairvoyant or mind-reading power is as unscientific and as puerile as to attempt the bribery of the law of the conservation of force, or to hire the sun to rise in the west instead of the east.
During the past few years it has been my destiny to have been frequently requested to carry out or to plan for others various experimental researches with living human beings; these requests have sometimes come from professional and scientific men who, in all dealings with inanimate objects, are amply competent, both by instinct and by reflection, to guard against all illusions and deceptions. It is my hope and belief that this formal attempt—ill perfected as it may be—will so reduce this subject to a science as to bring it within the power of all physiologists to plan and to complete all such experiments for themselves, with ample confidence that the results will invariably be in harmony with the truth. The above analysis, in spite of its necessary condensation, will, it is hoped, make clear even to those who do not follow all its details, that in this, as in every other realm of knowledge and acquirement, success need not be the result of any special acuteness, or cunning, or wisdom, but can be made the possession of any sober and well-trained mind that has a sufficient endowment of the scientific sense to recognize and submit to the inevitableness of law in all mental as in all physical phenomena, and to subordinate, even in scientific research, all feeling and emotion to intellect and reason.
The relation of this subject to delusions is also of much interest, both psychological and practical; during the present century especially the prevailing follies of civilization have received an unusual and unprecedented dignity and strength from the non-expert experiments of scientific men with living human beings. It is a part of the inconsistency of ignorance, and one of the effects of long breathing the atmosphere of superstition, that the apostles of the demonstrably false, while they uniformly dread and oppose the advance of their natural enemy, organized knowledge, yet pray for and welcome all mistakes of scientific men, either in experiment or philosophy, as so much addition to their capital; the weapons with which delusionists of every name prefer to fight their battles are forged in scientific armories; trace any one of the rank and overrunning superstitions of our day to its utmost radicle, and it will surely lead to sources where we are wont to look for light and truth—to some great discovery which our chemists, our naturalists, our astronomers, of fair and noble fame, have evolved, or are believed to have evolved, out of experiments that they have made, or tried to make, with living human beings; to the laboratory of some physiologist even, who forgets that the chief fact in human life is the involuntary life; to some logician and philosopher, who has yet to learn that the habit of trusting the senses, though endorsed and inculcated in all the universities of the world, is the source of half the ignorance and not a little of the suffering of mankind.