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PREFACE.
PREFACE.
At the request of friends I have willingly consented to the republication of my writings of past years in a uniform edition. Truth never grows old, though re-adaptation to different phases of life may be necessary. I shall rejoice if anything I have written in the past may prove helpful to the younger generation of workers, with whom I am in hearty sympathy. ELIZABETH BLACKWELL, M.D. Hastings , May, 1902 ....
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INTRODUCTION
INTRODUCTION
This work is written from the standpoint of the Christian physiologist. The essence of all religions is the recognition of an Authority higher, more comprehensive, more permanent than the human being. The characteristic of Christian teaching is the faith that this Supreme Authority is beneficent as well as powerful. The Christian believes that the Creative Force is a moral force, of more comprehensive morality than the human being that it creates. Under the symbol of a wise and loving parent—the
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CHAPTER I The Distinctive Character of Human Sex
CHAPTER I The Distinctive Character of Human Sex
A fundamental error as to the nature of human sex too generally exists amongst us, from failure to recognise that in the human race the mind tends to rule the body, and that sex in the human being is even more a mental passion than a physical instinct. This superficial view dims our perception of the causes which produce the facts around us; it also prevents our recognising the essential difference which exists between human and brute sex, and it blinds us to the imperative necessity of giving h
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CHAPTER II Equivalent Functions in the Male and Female
CHAPTER II Equivalent Functions in the Male and Female
In examining the characteristics of sex in Man under its dual aspect, male and female, Nature’s primary or rudimentary aim in establishing sex must be clearly recognised. This aim is the reproduction of the species. Pleasure in sexual congress is an incident depending largely on mental constitution. In the varying ranks of the animal creation it may or may not exist in connection with reproduction; for it is not essential to the one all-important dominating fact in nature, viz., parentage. Repro
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CHAPTER III On the Abuses of Sex—I. Masturbation
CHAPTER III On the Abuses of Sex—I. Masturbation
Of the various forms of abuse which spring from ignorance or corruption in the exercise of the most important of our human faculties, two only will be dwelt on—viz., masturbation and fornication. These are the two radical vices from which all forms of unnatural vice spring. The first is the especial temptation of the child, the last the temptation or corruption of the adult. It will be seen how the one prepares for the other, and how both, unchecked and unguided into rightful channels by judicio
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CHAPTER IV On the Abuses of Sex—II. Fornication
CHAPTER IV On the Abuses of Sex—II. Fornication
The second abuse of sex to be dwelt on by the Christian physiologist is the practice of fornication. One broad distinction separates this form of vice from masturbation—viz., that it necessarily affects two persons instead of only one. Its effects upon the mental and physical development of both the male and female must therefore engage the attention of the physiologist. This necessity of considering the effects produced by a joint act upon two separate individualities greatly complicates the in
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CHAPTER V The Development of the Idea of Chastity
CHAPTER V The Development of the Idea of Chastity
The most fundamental work which rests upon the medical profession is the spread of physiological truth in its practical application to the education of both boys and girls. The sexual instinct, being a primitive elementary instinct, exists alike in men and women. It is the necessary impulse leading to parentage, an impulse which the great Creative Force has laid down as a law of our present human life. But chastity and continence are not primitive instincts in either sex; they are the higher gro
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CHAPTER VI Medical Guidance in Legislation
CHAPTER VI Medical Guidance in Legislation
All thoughtful members of the medical profession will appreciate the power of education exercised by law, particularly on the rising generation. As students of human physiology, knowing the inseparable connection of mind and body, they can more fully understand how the laws of a country mould social customs, and recognise the gradual but widespread deterioration of social morality resulting from unjust laws. In all legislation which endeavours to protect and improve national health the medical p
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APPENDIX I. (Page 24)
APPENDIX I. (Page 24)
Human procreation possesses a double relation—viz., first , a relation to the race; and, second , a relation to the individual. In the former character, as the inevitable method of continuing the race, it is a great providential law whose mysteries we by no means comprehend, and which is placed quite beyond the control of the human will; but in the latter, the exercise of this great power of procreation possesses the distinctive mark of self-control, and as an individual act our power and respon
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APPENDIX II. (Page 32)
APPENDIX II. (Page 32)
The following sound advice on sexual physiology from the Lancet should be widely known: ‘Young men in their conflict with temptation to sexual advice often suffer under the disadvantage of receiving but little help from those to whom they ought to look for it with confidence. Few parents have the knowledge and the wisdom to tell their sons the most important truths about the sexual passion just at the time when it is becoming developed in them, and the latter are therefore left an easy prey to t
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ADDRESS TO MEDICAL WOMEN
ADDRESS TO MEDICAL WOMEN
Having been invited to speak to you on ‘The Responsibility of Women Physicians in relation to the Contagious Diseases Act,’ I have considered it a duty to accept this invitation for several reasons. It is twenty-seven years since my attention was first imperatively called by our philanthropist, Miss Mary Carpenter, to the subject of regulating or organizing the immorality of women. Since that time I have necessarily given much thought to this subject. I have always felt that the National Repeal
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I. On the Gravity of the Evil of Venereal Disease.
I. On the Gravity of the Evil of Venereal Disease.
The Royal College of Physicians—our highest medical authority—makes the following statement: ‘The increase of venereal disease appears to us to be a matter of serious moment, and to call for the gravest consideration. The constitutional form of the disease is one of the most serious, insidious, and lasting of all the contagious diseases that afflict humanity. Other contagious complaints— e.g. , smallpox or scarlatina—are transmissible only for a limited time, and not by inheritance. With syphili
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II. The Errors of Official Bodies in dealing with this Subject.
II. The Errors of Official Bodies in dealing with this Subject.
Before I venture to criticise any procedure or suggestion of the Government, I ask your consideration of certain scientific axioms which must be laid down as necessary data before any wise course of practical action can be initiated with rational hope of success. The first refers to the causes of disease. ‘In combating serious disease it is essential to ascertain the chief cause of the disease, which must be directly attacked and steadily removed, or no cure is possible.’ We may as well expect t
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III. On the Principle which must guide all Practical Methods of dealing with Venereal Diseases in the Army.
III. On the Principle which must guide all Practical Methods of dealing with Venereal Diseases in the Army.
On this vast subject I can only refer to-day to two practical methods of gradually extirpating venereal disease from our army in India. The first is the steady discouragement by Government of promiscuous intercourse. The second is the removal of the idleness which curses our soldiery in an army of occupation. The first indispensable condition in the prevention of disease is the steady discouragement of promiscuous intercourse. Now, I assert positively that such discouragement has never been seri
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APPENDIX I. (Page 91)
APPENDIX I. (Page 91)
The following testimony is by Dr. T. Gaillard Thomas , a recognised gynæcological authority of New York. ‘Until the last twenty years specific urethritis was regarded, in the male, as an affection of the most trivial import, as rapidly passing off, leaving few serious sequelæ, and offering itself as an excellent subject for jest and good-natured badinage. About two decades ago, Dr. Emil Noeggerath published a dissertation upon this affection, which will for ever preserve his name in the list of
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APPENDIX II. (Page 101) The following important Memorandum lately issued is full of promise of a noble future in the British army.
APPENDIX II. (Page 101) The following important Memorandum lately issued is full of promise of a noble future in the British army.
Memorandum by the Commander-in-Chief. ‘It will be the duty of company officers to point out to the men under their control, and particularly to young soldiers, the disastrous effects of giving way to habits of intemperance and immorality; the excessive use of intoxicating liquors unfits the soldier for active work, blunts his intelligence, and is a fruitful source of military crime. ‘The man who leads a vicious life enfeebles his constitution, and exposes himself to the risk of contracting disea
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RESCUE WORK
RESCUE WORK
The letter inviting me to take part in your deliberations proposed many important subjects for discussion, and, amongst others, the subject of venereal disease amongst the fallen. On this point I was asked more especially to give information. I esteem it a privilege to aid in any way your very important work. I will begin by stating certain propositions which are fundamental in rescue work, and which are susceptible of ample proof. First. By prostitution is meant mercenary and promiscuous sexual
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PREFACE
PREFACE
The object of this work is to show the real meaning of those relations of the sexes, which are commonly known under the term of ‘ordinary immorality.’ Customs in the midst of which we are brought up often befog the vision. Nations, like individuals, may journey on unsuspicious of danger, if no fresh wind lift the veil which hides the fatal precipice towards which they are rapidly moving. Much has been heard of late respecting criminal immorality— i.e. , the abuse of the sexual powers, which huma
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CHAPTER I The Foundations of Trade
CHAPTER I The Foundations of Trade
The wealth of a nation is that which contributes to its real and lasting well-being, which makes it powerful in the present, and durable and progressive in the future. A happy and intelligent people, with just and far-seeing rulers or guides amongst them, is a rich nation, and one that is fulfilling its duty by carrying on the gradual growth and ever higher development of the human race. Political economy is the study of wealth, and particularly of those results of human activity, which spring f
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CHAPTER II Trade in Women
CHAPTER II Trade in Women
It is necessary to define clearly the practical form of evil which is now under consideration, and to the effects of which the consciences of men and women must be roused. Ordinary immorality is not the demoralization of the slums—that horrible result of monopoly and speculation in land, where human beings are herded together like pigs—a condition into which the bargains of trade hardly enter. Neither is it the practice of free lust—a practice where unlimited liberty is claimed by both men and w
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INTRODUCTION
INTRODUCTION
Age after age brings forward varying phases of thought, when some particular facts of life are thrown into unusual prominence, such special development of thought serving to mould the society of that generation, giving it a special stamp, and thus advancing the progress of humanity one step forward. Of all the ideas gradually worked out and gained as the permanent possession of human society, the slowest in growth is the idea of the true relations of the sexes. The instinct of sex always exists
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CHAPTER I Physiological Laws which Influence the Physical and Mental Growth of Sex
CHAPTER I Physiological Laws which Influence the Physical and Mental Growth of Sex
The very gradual growth of mankind from lower to higher forms of social life, makes the study of the relation of the sexes a very complicated one; but a sure guide may be found in the great truths of physiology, viewed in their broad relation to human progress, and it is on the solid foundation of these truths that correct principles of education must be based. The tendency of our age, in seeking truth, is to reject theories and study facts—facts, however, on the largest and most comprehensive s
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CHAPTER II Social Results of Neglecting these Physiological Laws
CHAPTER II Social Results of Neglecting these Physiological Laws
The wide bearing and importance of the truths derived from physiology will become more and more apparent, as we examine another branch of the subject, and ascertain from an observation of facts around us, how far the present relations of men and women in civilized countries, are based upon sound principles of physiology. It is necessary to know how far these principles are understood and carried out from infancy onward, whether efforts for the improvement of the race are moulded by physiological
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CHAPTER III The Hygienic Advantage of Sexual Morality
CHAPTER III The Hygienic Advantage of Sexual Morality
The present subject may be summed up in two great questions—viz., First, is Virtue desirable? Secondly, is Virtue practicable? We have shown in the preceding investigation that the control of the sexual passion and its guidance by Reason—which we name Virtue—is of fundamental importance; that it is essential to individual health, to the happiness of the family, to the purity of Society, and the growth of a strong nation. Virtue, therefore, is desirable. It remains to consider whether it be pract
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CHAPTER IV Methods by which Sexual Morality may be Promoted
CHAPTER IV Methods by which Sexual Morality may be Promoted
The important question will present itself to everyone who realizes the gravity of the dangers which we have now exposed: What practical steps can be taken to secure the truer standard of morality which will remodel the education of youth? This weighty question can only gradually receive a complete answer, as the intelligence of our age awakens to the fact that the attainment of true sexual morality is the fundamental principle of national growth. The first indispensable basis of all efforts for
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APPENDIX I. (Page 262) Christian Duty in regard to Vice
APPENDIX I. (Page 262) Christian Duty in regard to Vice
Cruelty and Lust are the twin evils that now most seriously afflict our race, and which women—the mothers of the race—are especially called on to fight. Women must act. No one not partially blind can fail to see that the onward movement of events is carrying women forward into positions of active influence in social life that they have not hitherto occupied. Whether we welcome or dread this change, it goes on irresistibly, based upon industrial activity, and extending into every other department
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APPENDIX II. (Page 265)
APPENDIX II. (Page 265)
Terrible instances of this may be seen in Trélat’s medical work, La Folie Lucide , etc. Lallemand and other French surgeons report numerous cases of fatal injury done even to nursing infants by the wicked actions of unprincipled nurses. I have myself traced the ill-health of children in wealthy families to the habits practised by confidential nurses, apparently quiet, respectable women! Abundant medical testimony confirms these observations. It is not the plan of the present essay to enter into
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THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE
THE INFLUENCE OF WOMEN IN THE PROFESSION OF MEDICINE
If we were children entering upon a course of education, it would be premature to take stock of the results of education, and cast a far-seeing glance into the future. But it is different with adult women—women of education, somewhat impatient of restraint—entering upon a larger liberty, and legitimately jealous of any interference with that liberty. It is therefore imperative upon us to consider very seriously this matter of self-guidance at the outset of medical education, to take in a large v
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INTRODUCTION
INTRODUCTION
Thus the merchant and manufacturer, the business man and the legislator, the farmer, householder, literary man, and those who, living upon interest, should know how that interest is gained, must ever hold it to be true religious duty to seek, in conference with others, the way of elevating every department of life. Religious or Unitary truth possesses invaluable guidance for Medicine, not only in its practical application as an art, but in the methods by which it can alone become a science. Trut
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APPENDIX (Page 56) On the Humane Prevention of Rabies
APPENDIX (Page 56) On the Humane Prevention of Rabies
Now, it is well known from experience that it is too dangerous to inoculate direct from the dog to the human being. But the fact that dogs are constantly made mad for experiment in the Pasteur Institute, or in any institute that adopts Pasteurian methods, should be honestly acknowledged, not evaded. The fact that this frightful disease of rabies is kept up for purposes of experiment, although the virus be transmitted in changed form through other animals for the inoculation of human beings, is i
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INTRODUCTION
INTRODUCTION
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. It is through the gradual and harmonious development
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CHAPTER I The Growth of Conscience
CHAPTER I The Growth of Conscience
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.
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CHAPTER II Conscience in Medicine
CHAPTER II Conscience in Medicine
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 cannot be beneficially developed whilst other portions are entirely ignored or injured. Our medical schools, whilst sharpening the intellectual faculties of their students, must be careful that their modes of teaching bring with t
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CHAPTER III The Moral Element in Research
CHAPTER III The Moral Element in Research
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. T
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CHAPTER IV Right and Wrong Method
CHAPTER IV Right and Wrong Method
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
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CHAPTER V The Necessity of Medical Research
CHAPTER V The Necessity of Medical Research
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, d
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CHAPTER VI Restriction of Experiment
CHAPTER VI Restriction of Experiment
Now, however, nearly 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 (althou
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CHAPTER VII Prurigo Secandi
CHAPTER VII Prurigo Secandi
The various ethical dangers resulting from conscienceless or irrational experiments on animals demand much more serious consideration by the profession than has hitherto been given to them. In the opinion of an increasing number of intelligent physicians, a vast amount of what is now presumptuously called research—experiments disguised under learned names, but which are really the irrational mutilating and diseasing of sentient living creatures—are no more scientific research than is the gratifi
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CHAPTER VIII What is Scientific Research?
CHAPTER VIII What is Scientific Research?
Kant, in speaking of the use of analysis and synthesis in logic, lays down the test of all scientific inquiry. He says: ‘Analysis is the first and chief requirement in making our knowledge distinct. For the more distinct our knowledge of a thing is, the stronger and more effective it can be; only the analysis must not go so far that at last the object itself disappears.’ Truth being a unity, the science which demonstrates it must correlate all knowledge. Science is not, therefore, an accumulatio
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CHAPTER IX The Axiom of Science
CHAPTER IX The Axiom of Science
In research the radical difference between inorganic and organic Nature cannot be too clearly insisted on. Whilst in the former we can resolve compounds into their elements and recombine them, such process is impossible in organic Nature. We can take a steam-engine or a watch to pieces, examine their parts, repair them, and put them together again, thus proving our knowledge in this realm of Nature. But a living thing cannot be treated in the same way. Not only the difference of animal type forb
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CHAPTER X Rational Experiment in Research
CHAPTER X Rational Experiment in Research
‘The comma bacilli not only prospered in my digestive tube, but had so multiplied in it that it was evident they found a congenial soil. They were found there in quantities, and in a state of pure culture. But on October 14 all the secretions were normal, only containing a few isolated microbes, which had entirely disappeared on the 18th. ‘Now, most bacteriologists assert that the cholera bacilli remaining in the intestines secrete there a poison, which, being absorbed, produces the cholera. But
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CHAPTER XI The Range of Painless Research
CHAPTER XI The Range of Painless Research
This range is practically unlimited. The collection of all useful or suggestive facts gathered by genuinely scientific methods from the enormous accumulations to be found in our Government reports, in the records of our medical periodic literature, in the observations of hospitals, societies, cliniques, and private practice, would, if properly arranged and tabulated, form a most useful branch of such a centre. If such collection and examination were extended to the records of other countries, th
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CHAPTER XII Recapitulation of Principles
CHAPTER XII Recapitulation of Principles
Such research, reconciling by right methods of investigation intellectual activity with human conscience, would increase our knowledge and advance our well-being in accordance with the higher reason of the race. Only when thus guided by intelligence and conscience can biological research deserve the noble name of science. It is by the recognition of this true method of biological research and by the generous support of physiologists who honestly seek for truth, even when opposed by temporary fas
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THE RELIGION OF HEALTH
THE RELIGION OF HEALTH
The words ‘the Religion of Health’ convey a profound meaning to the physician who has spent a lifetime in relieving physical suffering. I will try and state what those words seem to me to imply. Obedience to Divine law is the highest wisdom of the human race. Wherever God’s laws are clearly visible, stamped in immutable characters so plain that every human being who is willing to read them can do so, then the wisdom, the happiness—nay, the simple common-sense of the race—lies in obeying them. Th
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