[Assistant] And the Deity, if his existence were not denied, tended to become a mere “Supreme Being,” who was removed to such a distance from mankind that he could hardly be reached by their reverence, still less by their love. At the same time, the influences which, in one point of view, seemed to limit and narrow human existence, in another point of view tended to liberate and enlarge it. If they excluded the idea of the infinite from man’s life, they emancipated him from many degrading superstitions, which in an earlier age had held him “all his lifetime subject to bondage.” And as the pressure from above was lightened the individual seemed to become master of himself and of his destiny. If the king could no longer say, “_L’Etat c’est moi_,” the rights of the subject were vindicated; if the authority of the Church was weakened, the bonds of free inquiry were broken; if imagination ceased to fill men with the awe and wonder of higher powers, the way was opened up for scientific and industrial development; if God was regarded as unknowable, “the proper study of mankind was man,” and that study could now be pursued without fear or hinderance. Poetry and religion might be impoverished, the sense of the binding force of social relations might be weakened, but interest in the bettering of man’s earthly condition was awakened, and with it came a new desire for justice to all, a new intolerance of human suffering, and a new demand that the lot of the class “which is most numerous and poor” should be made less wretched and insecure, and, towards the end of the century, a new turn was given to its leading thought, for an effort was made to discover in the nature of the individual himself the equivalent of those universal powers which the enlightenment had banished from the external world and from the life of society. Rousseau carried individualism to an extreme point, at which it became its own correction, and taught men to find _within_ their own souls the infinite which they could no longer discover _without_.


[Assistant] Rousseau carried individualism to an extreme point, at which it became its own correction, and taught men to find _within_ their own souls the infinite which they could no longer discover _without_. Rejecting in the first instance all social conventions as unjust limitations of the natural man, and adopting the prevailing theory of the time, that the State is only the product of a contract between independent persons, he yet discovered in the individual thus liberated from all external pressure a “common reason,” and “a general will,” which could reorganize his life and bind him to his fellow-men and to God. This great idea, which appears in Rousseau rather as a stroke of insight, an intuition of genius—lifting him above his first thoughts and insensibly changing their meaning—was grasped by Kant as the principle of a new philosophy and worked out in a comprehensive system that dealt with all the great problems of thought and life. Kant, indeed, seemed, like Rousseau, to begin on the plane of eighteenth-century individualism, but, influenced as he was by the philosophy of Leibnitz, he from the first conceived the individual as in himself universal; or, to speak more exactly, as having a universal principle realized in him. Thus, though in one aspect of his being man is a finite object among other objects, confined within limits of space and time, and forming only a link in the chain of natural causation, in another aspect of it, as a conscious self, he is emancipated from all these limitations. For—such is Kant’s argument—a knowing subject, for whom the whole finite world, including his own finite existence, is an object of knowledge, cannot himself be comprehended in that world or limited by any of its conditions.


[Assistant] For—such is Kant’s argument—a knowing subject, for whom the whole finite world, including his own finite existence, is an object of knowledge, cannot himself be comprehended in that world or limited by any of its conditions. As there can be no world of objects except for a self, it is impossible that such a self should be merely one of these objects. Thus, as knowing, or capable of knowing, all things, man cannot be identified with any of them; or if, from one point of view, as an individual, he is so identified, yet he has within him a universal principle that carries him beyond the limits of his individuality. And this contrast shows itself also in his practical life. For if as an object he appears to be but an animal organism, moved by the impressions of pleasure and pain which he receives from other objects, yet in his inner moral life man is revealed to himself as a self-determining subject, emancipated from all sensuous motives and from the necessity of nature which they bring with them, and conscious of subordination only to the law of duty, which is the law of his own reason. And that law, in spite of every pressure of circumstance from without, and of every impulse of passion from within, he knows that he ought to obey, and therefore he knows that he _can_ obey it.


[Assistant] And that law, in spite of every pressure of circumstance from without, and of every impulse of passion from within, he knows that he ought to obey, and therefore he knows that he _can_ obey it. Thus, in Kant’s theory, the two extreme views of humanity, as natural and as spiritual, as limited to a finite individuality, hemmed in by necessities on every side, and yet as possessing a universal capacity of knowing, and an absolute power of self-determination, these two views are presented in sharp antithesis, and at the same time held together as different aspects of one life. In fact, we have here, as it were, compressed into a nutshell, the result of the whole history of eighteenth-century individualism, which began by depressing man and ended by exalting him; which, with one of its voices, seemed to reduce him to the level of an animal, a mere part of the partial world, a transitory phenomenal existence among other phenomena; and then, with its other voice, proceeded to recognize him as a member of the intelligible world, a “spectator of all time and existence,” and gifted with the absolute freedom of a will which could be determined by nothing but itself. “The solitary,” says Aristotle, “must be either a god or a beast,” and the eighteenth century, in its conception of the individual, seemed to oscillate between the one and the other till Kant, awaking to the impossibility of omitting either aspect of his being, demanded that he should be conceived as both at once. Kant thus set the problem of the future; and if he did not solve it, he at least showed the futility of any narrow or one-sided solution and the direction in which an adequate solution could alone be sought. In short, Kant asked the question to which the nineteenth century, in all its philosophical reflection, has been striving to find an answer.


[Assistant] In short, Kant asked the question to which the nineteenth century, in all its philosophical reflection, has been striving to find an answer. For in philosophy, as in other departments of knowledge, the work of the nineteenth century has been one of mediation and reconciliation. It has been an endeavor to break down the sharp antithesis of philosophical and scientific theories that was characteristic of an earlier time. In the writings of the greatest thinkers, the oppositions of materialism and spiritualism, of sensationalism and idealism, of empiricism and _a priori_ speculation, of individualism and socialism, all the great oppositions of theoretical and practical philosophy, which formerly were held to be absolute and irreconcilable, have been modified, restated, reduced to the _relative_ antagonism of the different aspects of one truth. The great controversies of the past have thus passed into a new phase, in which absolute statements _pro_ and _con_ have become, as it were, antiquated; and the question is no longer whether a particular doctrine or its opposite is true, but what are the elements of truth and error in each of them, and how we can attain to a comprehensive view of things, in which justice is done to both. And if it be asked, what are the principles or ideas that have suggested this reconciling work, and have been the guides of the greatest scientific or philosophic writers in attempting to achieve it, I think the answer must be that they are _the idea of organic unity_, and, as implied in that, _the idea of development_.


[Assistant] And if it be asked, what are the principles or ideas that have suggested this reconciling work, and have been the guides of the greatest scientific or philosophic writers in attempting to achieve it, I think the answer must be that they are _the idea of organic unity_, and, as implied in that, _the idea of development_. Goethe and Hegel, in Germany; Comte, in France; Darwin and Spencer, in England, are writers who almost span the whole range of difference in modern thought; but they, and a multitude of others in every department of study, have been inspired by the ideas of organism and development. And they have all used them somewhat in the same way to turn the edge of the old controversial weapons, or to lift thought above the “yes” and “no” of opposing dogmatisms. It is true that the definitions or interpretations of the ideas of organism and development given by these writers are very different, and often, indeed, so sharply opposed that they seem to bring back the old controversies in a new form. But this does not alter the significance of the general fact; for, in the first place, the use of an idea by any writer is by no means always limited by his own interpretation of it; and, in the second place, the true interpretation of the idea is that which contains the secret of its power and prevalence, and it must in the long run gain the victory over all other interpretations of it. We may, therefore, fairly say that these ideas have been the marked ideas of the century, the conscious or unconscious stimulus of its best thought; and that they have been working, and are working still, in the direction of a deeper and more comprehensive irenicon between the different tendencies of the human mind than has been attained in any previous stage of the history of philosophy.


[Assistant] We may, therefore, fairly say that these ideas have been the marked ideas of the century, the conscious or unconscious stimulus of its best thought; and that they have been working, and are working still, in the direction of a deeper and more comprehensive irenicon between the different tendencies of the human mind than has been attained in any previous stage of the history of philosophy. Against such a general characterization of an age, there is the same objection which Burke indicated when he said that “he could not draw up an indictment against a nation.” We are taking a distant and general view of a period, in which all its inequalities of movement, all the ebb and flow of opinion, are lost sight of, and only one main current of thought is visible. We may get a step nearer to the subject by distinguishing three periods in the century, in which there is a partial difference of tendency. The first period, which we may roughly define as lasting well on into the 30’s, is, in the main, a period of construction, of creative thought, in which the great germinating ideas that distinguished the century are more or less adequately expressed in different countries, and in which they receive a first, somewhat hasty, application to all departments of human knowledge. Idealistic philosophy, which gave the fullest expression to those ideas, seems for a time to carry all before it in Germany; and a similar movement of thought, less definitely reflective or speculative, enriches the literature of other countries. In the next period, lasting until the 70’s, the new ideas do not lose their hold upon men’s minds, but there is a certain critical recoil against them, a tendency to explain them away.


[Assistant] In the next period, lasting until the 70’s, the new ideas do not lose their hold upon men’s minds, but there is a certain critical recoil against them, a tendency to explain them away. The first premature synthesis of idealistic philosophy is attacked by a scepticism, which seems at times as if it would measure back the whole way to the individualistic materialism of an earlier age, or which only avoids that extreme to fall into a scientific agnosticism, at first sight even more hostile to the claims of philosophy. But the lesson of Kant could never be altogether forgotten, nor could the negative or sceptical tendencies of the _Critique of Pure Reason_ be permanently separated from the positive results of his later writings. And the great scientific movement of the time, which at first seemed to draw away all interest from speculative inquiry, tended in the long run, especially by the advance of biological study, to raise metaphysical questions which the methods of science were incapable of answering. Hence, in the latest decades of the century, there has come a revival of interest in philosophy, and especially in the idealistic philosophy of its first years. But if philosophy has revived, it is in a more critical and cautious form, and accompanied by a clear consciousness that the only true idealism is that which is able to absorb and assimilate all the data supplied by empirical investigation, and do justice to all the results of the special sciences.


[Assistant]
But if philosophy has revived, it is in a more critical and cautious form, and accompanied by a clear consciousness that the only true idealism is that which is able to absorb and assimilate all the data supplied by empirical investigation, and do justice to all the results of the special sciences. The general movement of thought in the nineteenth century has thus, on the whole, taken an idealistic direction; but there has come with it also a deeper consciousness of the immense difficulty of a comprehensive synthesis; of the inefficacy of any easy monism or optimism, that would pluck the fruit of knowledge before it is ripe; of the infinite labor and patience, the sympathetic appreciation of the opposing views of others, and constant and unsparing criticism of our own, which are needed for the construction of a true philosophy. II
In a short article like this, it is impossible to give more than a few indications of the way in which this three-fold _schema_ of the history of nineteenth-century philosophy should be filled up. To give any definite impression, the writer must, so to speak, put on the seven-leagued boots of Jack the Giant Killer; in other words, however conscious he may be of the truth that _dolus latet in generalibus_, he must generalize and be content to mention only a few leading names in illustration of the tendencies of thought of which he speaks. It is the instinct of each new generation to vindicate its freedom by rebelling against the authority of its predecessors; and when a new idea begins to influence human thought, it usually, on its first appearance, shows that side which is most antagonistic to the spirit of the past. Thus the peculiar nineteenth-century movement begins with a reassertion of the _universal_ as against the _individual_, which is so emphatic that it looks like a return to Spinozism.


[Assistant] Thus the peculiar nineteenth-century movement begins with a reassertion of the _universal_ as against the _individual_, which is so emphatic that it looks like a return to Spinozism. Schelling is the most prominent philosophical representative of this tendency. In the works which he wrote about the beginning of the century, he broke away even from the universalized individualism of Fichte, and gave emphatic prominence to the great philosophical commonplace—which had been almost forgotten by the previous age—that there is an identity which is below or above all distinction, and that the universe is one through all its multiplicity, and permanent through all its changes. His maxim—that there are none but _quantitative_ differences in things, and that all these, even the difference of mind and matter, disappear in the “indifference” of the Absolute—was like a declaration of war against the “enlightenment.” It meant that philosophy was no longer content to regard the whole as the sum of the parts, but could look upon the distinction of the parts only as a differentiation of the whole. With Schelling, indeed, this differentiation was in danger of being reduced to a mere appearance and the unity of the Absolute was on the point of vanishing in a bare or abstract identity. But his strong assertion of the unity beneath all difference, of the priority of the universal to all particulars, was perhaps necessary, ere the true conception of the organic unity of the world could be arrived at.


[Assistant] But his strong assertion of the unity beneath all difference, of the priority of the universal to all particulars, was perhaps necessary, ere the true conception of the organic unity of the world could be arrived at. And the correction soon came with Hegel, who maintained that the absolute is “not substance, but subject.” For this meant that the absolute is a self-differentiating principle, realizing itself in a world of difference which is no mere appearance, but its own essential manifestation; and again—what is the counterpart or complementary truth to this—that in the world there are “degrees of reality,” and that “mind is higher in degree than nature.” But these ideas could hardly have been understood until the uncompromising assertion of the absolute unity had been made, and until the subjectivity of the Kantian and Fichtean points of view had once for all been set aside. The philosophy of Hegel derives its power from the way in which it strikes what, as I have already said, was the key-note of the nineteenth-century philosophy. In the first place, it is a philosophy of reconciliation, which attempts, through a criticism of the oppositions of philosophical theory, to reach a point of view in which they are all seen to be subordinated to the unity of one principle. His attack upon the “law of contradiction,” as formulated by scholastic logicians, meant simply that absolute distinctions are unmeaning, and that the only real differences are differences within a unity. On this principle he tried to show that all the oppositions of thought and things which have found expression in philosophy are relative oppositions, which find a solution or reconciliation in the life and movement of the whole.


[Assistant] On this principle he tried to show that all the oppositions of thought and things which have found expression in philosophy are relative oppositions, which find a solution or reconciliation in the life and movement of the whole. Hence he maintained that in all the great controversies that have divided the world, in metaphysics and psychology, in ethics and theology, the combatants have really been co-operators. Both sides, to use the expression of Leibnitz, have been “right in what they affirmed and wrong only in what they denied.” And their conflict has been the means of the evolution of a fuller truth than that which was contained in the doctrine of either party. In the second place, Hegel is guided throughout by the conception of the universe—and, in a sense, of every even relatively independent existence in it—as an organism, every element in which implies the whole, every change in which is a phase of its self-evolution. For his logical doctrine of the “_notion_” (as _Begriff_ is commonly translated) means simply that we do not see anything truly until we comprehend it as a whole, in which one principle manifests itself through all the difference of the parts and—just through their distinctions and their relations—binds itself into one individual—reality. In this sense, everything just so far as it has an independent individual existence at all is an organism.


[Assistant] In this sense, everything just so far as it has an independent individual existence at all is an organism. Lastly, while thus conceiving the universe as organic, Hegel maintained that it is not a natural but a spiritual organism. For the limited scope of a natural organism and its process cannot be regarded as commensurate with a universe, which comprehends all existence, whether classed as organic or inorganic. Only the conscious and self-conscious unity of mind can overreach and overcome such extreme antagonisms, and reduce them all to elements in the realization of its own life. We must, therefore, think of the universe as an organism which includes nature, but manifests its ultimate principle only in the life of man. We may add that in all this Hegel attempted to show that he was only working out in the sphere of speculative thought what Christianity had already expressed for the ordinary consciousness, according to its half-pictorial methods of representation.


[Assistant] We may add that in all this Hegel attempted to show that he was only working out in the sphere of speculative thought what Christianity had already expressed for the ordinary consciousness, according to its half-pictorial methods of representation. While this is the general meaning of Hegelianism, it must be added that Hegel was more successful in formulating these ideas in their logical or metaphysical form than in applying them to the results of the special sciences of nature, which he only knew at second hand; or even to the different provinces of the spiritual life and history of man, which he had studied more thoroughly. In both cases his data were very incomplete, and the scientific interpretation of them had not then been carried far enough to prepare—as, according to Hegel himself, it should prepare—for the final interpretation of philosophy. There is another circumstance to be taken into account, a circumstance which deeply affected Hegel and all the writers of his time. In the slow process of human history the new wine is always at first poured into old bottles, and only when the old bottles burst is an effort made to find new ones that will contain it safely. Hence the development of the new spirit in philosophy seemed often to go hand-in-hand with a movement of restoration in politics and religion which was not easily distinguishable from reaction.


[Assistant] Hence the development of the new spirit in philosophy seemed often to go hand-in-hand with a movement of restoration in politics and religion which was not easily distinguishable from reaction. Just as the politicians of the time could find for the newly awakened spirit of nationality no other embodiment than the institutions of the ancient _régime_, and tried to revive the old system destroyed by the Revolution, with only a few repairs and additions, so the great philosophical writers sought generally to reanimate the old scheme of life and thought by means of the new ideas, rather than completely to recast it in accordance with them. Hence, although Hegel’s _principle_ of evolution was as hostile to reaction as to revolution, as hostile to an authoritative system that denied the rights of the individual as to mere individualism, his particular doctrines, both in politics and theology, took a strongly conservative tinge. When we look more closely we see that it is only as restoration is at the same time reformation, as it makes the old forms the expression of a new life, that Hegel could logically defend them. But the form which he gave to his ideas was perplexing; it tended in many minds to identify the principle of development, which means that the future can only spring _out_ of the past and the present, with the defence of the _status quo_ in Church and State; and, on the other hand, to confuse the forces of progress with those of revolution. Thus the mediating, reconciling power of the new doctrine was for a time obscured, and its effect in raising men’s minds above the old levels of controversy was delayed.


[Assistant]
Thus the mediating, reconciling power of the new doctrine was for a time obscured, and its effect in raising men’s minds above the old levels of controversy was delayed. III
In other countries during the earlier decades of the century a similar movement of thought is discernible, though it was not carried out anywhere with the same philosophical thoroughness as in Germany. In France the organic idea did not find any very powerful representative till the time of Comte, and even in his expression of it there is a certain ambiguity. In his well-known law of development, indeed, he seems to reproduce the individualistic doctrine of the eighteenth century, and to deny the reality of the _universal_, both in its theological and its philosophical form. But already in the last volume of his _Positive Philosophy_, when he begins to deal with human society, he maintains that “the individual man is an abstraction, and that there is nothing real but humanity”; and in his _Positive Politics_ he treats this unity of mankind as not only real, but divine. In that work, moreover, he makes another step.


[Assistant] In that work, moreover, he makes another step. Rejecting at once the obstructions of the individualists and those of the socialists, he rises to the conception of a social organism, which gives play to the competitive energy of individuals, and yet binds them together in its own more comprehensive life. In England, before the close of the eighteenth century, the same spirit had found a representative in Burke, who rejected entirely the idea of a social contract, and maintained that the State is based on an unconscious reason of society, which is far wiser than the conscious reason of even the wisest individuals. In general, however, the spiritualistic movement of the earlier part of the century took, among the English-speaking people, rather a poetic and literary than a philosophical form. And the imperfect attempts of Coleridge to transplant German ideas into England—attempts followed up with signal energy by Frederic Denison Maurice—hardly constitute an exception to this rule. In this connection, also, as one who partly grasped the organic idea of social life and its development, but who gave it a somewhat imperfect and even contradictory expression, I may mention a later writer, Thomas Carlyle, whose imaginative genius and moral enthusiasm did much to breathe a new life into history.


[Assistant]
In this connection, also, as one who partly grasped the organic idea of social life and its development, but who gave it a somewhat imperfect and even contradictory expression, I may mention a later writer, Thomas Carlyle, whose imaginative genius and moral enthusiasm did much to breathe a new life into history. Though not a philosopher in any technical sense, he was, like his friend Emerson, a vehicle of philosophical ideas, and he contributed greatly to scatter the seed of idealism upon British soil. His Calvinistic pessimism, indeed, makes a curious contrast with the fearless optimism of the new country which is characteristic of Emerson; but whether great men are to be regarded as “heroes to be worshipped,” according to the teaching of the one, or as “representative men,” who are to be followed because they express what all are thinking, according to the ideas of the other, we are led, in both cases, to a deeper view of the solidarity of human society and of its spiritual basis. IV
It is difficult to determine more than approximately the beginning of special movements of thought; for the different nations of the civilized world are not exactly contemporaneous in their development, and in each nation there are always individuals who lag behind the time or hasten on before it. But, speaking generally, we may say that as early as the fourth decade of the century a certain reaction had set in against the conclusions of idealistic philosophy, and especially against the organic idea of human life; and a tendency was even shown to revert, so far as possible, to the methods and ideas of the eighteenth century. The reasons for this change are various.


[Assistant] The reasons for this change are various. In Germany the succession of great philosophers had come to an end, and their followers were smaller men, who were inclined too much to repeat the formulas, but had little of the creative power, of their predecessors. More attention, therefore, began to be paid to the protests of writers like Herbart and Schopenhauer, who, even in the hour of its triumph, had criticised and attacked the prevailing philosophy. Again, the physical sciences were advancing by “leaps and bounds,” and there was a growing inclination to believe in the universal validity of the mechanical methods of explanation to which _they_ owed their success, and even in those sociological and historical studies to which the idealistic philosophy had given so great an impetus. The progress of empirical research and the increase of the materials of knowledge caused much of the work of Hegel and his followers to seem inadequate, if not entirely to set it aside. Even in Germany, where the new ideas had taken a distinctly philosophical shape, they seemed to lose their hold in the controversies that attended the breaking up of the Hegelian school; and in other countries, where they never found such a systematic expression, they were even less able to resist the attack now made upon them.


[Assistant] Even in Germany, where the new ideas had taken a distinctly philosophical shape, they seemed to lose their hold in the controversies that attended the breaking up of the Hegelian school; and in other countries, where they never found such a systematic expression, they were even less able to resist the attack now made upon them. Furthermore, as I have already indicated, writers of an idealistic tendency, in their recoil from the enlightenment, had devoted themselves so much to an appreciation of institutions derived from the past that they seemed to have no eyes for the defects of these institutions, and to confuse evolution with restoration. The general result of all these influences was, then, to discredit philosophy and exalt science, so far as might be, into its place. Either the abstract methods of the physical sciences were proclaimed as adequate for the discovery of all truth, or, if this was seen to be impossible, agnosticism was professed in regard to all subjects to which these methods could not be applied. Even the phenomena of life were supposed to be capable of explanation by the action and reaction of the parts or elements of the physical organism, and Huxley looked forward to the time when man with all his spiritual endowments should be shown to be only the “cunningest of nature’s clocks.” The new science of psychophysics, which arose in Germany and has been cultivated with so much zeal by Wundt and others in all civilized countries, seemed to carry the method of physics into the investigation of mind, and some of its students were ready to maintain that it was the only psychology that deserved the name of science. Darwin’s great work on the _Origin of Species_, in so far as it set aside the idea of special creation and referred the “purposiveness” of organic structures to a process in which the external environment, and not any inward power of self-adaptation, was the controlling factor, seemed to bring a new reinforcement to the same way of thinking.


[Assistant] Darwin’s great work on the _Origin of Species_, in so far as it set aside the idea of special creation and referred the “purposiveness” of organic structures to a process in which the external environment, and not any inward power of self-adaptation, was the controlling factor, seemed to bring a new reinforcement to the same way of thinking. And he and his followers were not slow to apply the theory of natural selection to the life of man, as well as to that of plants and animals. Finally, the historical studies, which were now cultivated with an energy to an extent hitherto unexampled, and immensely extended the knowledge of the process whereby the present has grown out of the past, were invaded by a similar spirit; and the historical method was maintained to be a solvent which could disintegrate all metaphysical conceptions of ethics or politics or even of theology. The account of the genesis of any idea was regarded as reducing its claims to the level of the elements or rudiments out of which it had sprung, and thus as enabling the scientific historian to explain, or explain away, the spiritual by the natural in all human life and experience. All things appeared again to be pointing towards a system of thought which would resolve ethics and psychology into physiology, and physiology into chemistry and physics. At the same time the victory of this tendency was always more apparent than real.


[Assistant] At the same time the victory of this tendency was always more apparent than real. In the first place, “out of the eater came forth meat”—that very advance of the special sciences, which in its earlier stages had tended to throw all speculative thought into the shade, in the long run caused the need of philosophy to be again felt. In particular, the study of development in the organic world, which had received so great a stimulus from the work of Darwin, could not be carried on without the aid of higher conceptions than were required for the guidance of the physicist. The hypothesis of natural selection might expel the idea of design in the cruder form of a special creation of every distinct species; and the emphasis which it had laid upon the outward conditions of growth might seem unfavorable to the higher conception of an immanent teleology of the organism, but it was confessed by its author to be an incomplete theory of development, and Darwin himself, when he turned his attention to the evolution of man, found it necessary to supplement it by what might be called the converse theory of sexual selection; thus adding a principle of co-operation to his first principle of competition. And Mr. Spencer, who defined growth as a process of integration and differentiation, little as he might himself intend it, was really putting into popular language the Hegelian idea of evolution—an idea which necessarily involved the conception of a self-determined end.


[Assistant] Spencer, who defined growth as a process of integration and differentiation, little as he might himself intend it, was really putting into popular language the Hegelian idea of evolution—an idea which necessarily involved the conception of a self-determined end. Evolutionists might cling, as they still cling, to the belief that, though constantly and necessarily speaking of purpose, they could eliminate it from the result of their investigations by the hypothesis of Darwin, or, subsequently, of Weissmann; but their discussions, especially when they were extended to the historical development of man, could not but reawaken the great controversy whether in the _ultimate_ explanation of things it is more reasonable to “level up,” or to “level down,” to explain the higher by the lower, or the lower by the higher. That both explanations are necessary, nay, that no teleology can be of much worth which does not presuppose a thorough inquiry into the causal connections of particular phenomena, was admitted by all modern idealists. But they began to press the question whether the unity of the whole is not prior to its distribution into parts, and does not govern their relations with each other; and, in particular, whether it is possible in the case of organic beings, and especially of organic beings possessed of consciousness and self-consciousness, to be satisfied with a mode of explanation that treats them as mere collections of material elements which act and react externally upon each other. Whatever its value as a provisional hypothesis, can such a mode of explanation be finally regarded as adequate for the explanation of the nature of the world as a whole, or, indeed, of any one existence in it, that has even a relative independence or separate being of its own? But, in the second place, a revival of the idealistic philosophy was made necessary by an obvious weakness which clung to the scientific materialism of the nineteenth century from the very beginning.


[Assistant] But, in the second place, a revival of the idealistic philosophy was made necessary by an obvious weakness which clung to the scientific materialism of the nineteenth century from the very beginning. The Kantian criticism of knowledge, which could not be entirely neglected, had convincingly proved that in our experience objects can be known only in relation to a subject, and matter only in relation to mind. But, if so, how could the latter be explained by the former? Even to those who had not fully understood this doctrine, it became evident that mind is at least co-ordinate with matter, and cannot be treated as a mere “_epiphenomenon_” of it. Mr. Spencer, therefore, had to take refuge in the strange notion that we are possessed of “two consciousnesses”: the consciousness of ideas within us, and the consciousness of motions without us; and that neither of these can be resolved into the other, though both are the phenomena of an unknowable Absolute.


[Assistant] Spencer, therefore, had to take refuge in the strange notion that we are possessed of “two consciousnesses”: the consciousness of ideas within us, and the consciousness of motions without us; and that neither of these can be resolved into the other, though both are the phenomena of an unknowable Absolute. It is in this citadel of ignorance that Huxley tries to intrench himself; but the place was taken before it could be occupied. The self-contradiction of an unknowable Absolute, and the equal though less obvious self-contradiction of a dualistic separation between two aspects of our life—which, as a matter of fact, are never, and logically can never be, divided—could not long be maintained against a criticism armed with the weapons of Kant and his idealistic successors. Already, in the 50’s, the cry “Back to Kant” was raised in Germany, and, not long after, it led in England and America to a renewed study of the German idealistic writers, in which Dr. Hutchison Sterling and the late Professor Green took a leading part. It was soon obvious to every one who had learned the lesson of critical philosophy that the agnostic dualism of Mr.


[Assistant] It was soon obvious to every one who had learned the lesson of critical philosophy that the agnostic dualism of Mr. Spencer was due to a fundamental misconception of what is meant by the subjectivity of knowledge. It was pointed out that if we have the consciousness of object and subject only in relation to each other, it is not necessary to seek for the principle of their unity in any _Tertium Quid_ which is neither the one nor the other. That which Mr. Spencer sought in an unknowable Absolute was “in our mouths and in our hearts”; it was to be found in the inseparable unity of experience, in which the inward and the outward are correlative elements. Agnosticism was a sort of spiritual refuge for the destitute constructed by those who had renounced their heritage: who, in other words, had by their abstractions separated the elements of experience from each other, and were thus forced to seek beyond experience for the unity which they had lost.


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Agnosticism was a sort of spiritual refuge for the destitute constructed by those who had renounced their heritage: who, in other words, had by their abstractions separated the elements of experience from each other, and were thus forced to seek beyond experience for the unity which they had lost. The true remedy for the evil was to give up such abstract ways of thinking and to learn to “think things together”; in other words, to recognize the organic relation of the inner and the outer life, and to explain the parts by the whole, and not the whole by the artificially severed parts. V
The great distinguishing feature of the last two decades of the century has been a movement of approximation, partly conscious and partly unconscious, between the representatives of science, and particularly of those sciences that deal with special aspects or elements of human life, on the one hand, and the representatives of idealistic philosophy on the other. The reconciling ideas of an earlier time have become better understood and have shown more effectively their power to reconcile. Not that this mediating power had previously been entirely unfelt. Even in the time when philosophy was most discredited in Germany, Lotze, in whom a cautious critical temper was combined with deep moral and religious sympathies, and a practical knowledge of the biological and medical sciences with careful studies of Kant and Hegel, sought to show how an idealistic view of the universe and of human life could be maintained consistently with the fullest recognition of scientific methods and results.


[Assistant] Even in the time when philosophy was most discredited in Germany, Lotze, in whom a cautious critical temper was combined with deep moral and religious sympathies, and a practical knowledge of the biological and medical sciences with careful studies of Kant and Hegel, sought to show how an idealistic view of the universe and of human life could be maintained consistently with the fullest recognition of scientific methods and results. And though his system was, on the whole, rather a compromise than a true reconciliation of philosophy and science, yet it has undoubtedly had very great influence in modifying the ideas of the opposing schools of thought and narrowing the ground of controversy between them. Thus the old English empirical psychology, which was represented by the Mills and by Mr. Bain, has gradually widened its scope in the hands of writers like Professor Ward and Mr. Stout, at first probably through the study of Herbart and then by contact with the revived idealistic movement. On the other hand, we may notice how idealistic writers, like Mr.


[Assistant] On the other hand, we may notice how idealistic writers, like Mr. Bradley and Mr. Bosanquet, have tried to absorb every lesson that can be learned from empiricism, and to shun with the utmost care the very suspicion of anything like dogmatism. Mr. Bradley’s denunciations of a “too easy monism” and a philosophy that turns the living world into a “ballet of bloodless categories” are too well known to be more than referred to. Nor is this the place to discuss whether his fear of such a result has not sometimes led him into compromises which are inconsistent with his own fundamental principle that the world must be conceived as an intelligible system.


[Assistant] Nor is this the place to discuss whether his fear of such a result has not sometimes led him into compromises which are inconsistent with his own fundamental principle that the world must be conceived as an intelligible system. In any case, we may fairly point to his work and to the work of other writers animated by a similar spirit, as showing the growing prevalence of that reconciling spirit which seeks at once to do justice to all the results of empirical inquiry and of the investigations of the special sciences, and yet at the same time to give them a new interpretation in the light of an idealistic philosophy. It is impossible within our limits to illustrate this view of the tendencies of the time by further reference to the recent philosophical literature of England and America, or of Germany and France. Still less can I refer to the numerous books on special departments of inquiry in ethics and theology, in sociology and in history, in which the “ideally organic view of life and the world,” as we may call it, has shown its mediating and reconciling influence. Nor can I do more than refer to the counter current of pessimism, which has found its most distinguished representatives in Hartmann and Nietzsche; the former a man of great wealth of thought and dialectical power, whose philosophy is idealistic in all but its ultimate principle, and is indeed pessimistic only by an exaggeration of the opposition between the conscious and the unconscious working of reason; the latter, hardly a philosopher at all but rather a writer of pungent and suggestive aphorisms, winged with indignant passion against prevalent opinions—aphorisms which always contradict some one, and often contradict each other. From Nietzsche at his best we may receive a useful warning against too easily satisfying ourselves with the commonplaces of idealistic optimism; from Hartmann we may derive very considerable help in estimating the difficulties that have to be met by those who would seek to work out idealistic principles into a systematic view of the world.


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From Nietzsche at his best we may receive a useful warning against too easily satisfying ourselves with the commonplaces of idealistic optimism; from Hartmann we may derive very considerable help in estimating the difficulties that have to be met by those who would seek to work out idealistic principles into a systematic view of the world. But, without attempting to enter upon any more detailed criticism of these or other important writers of recent years, I shall devote the space that remains to one general thought as to the present state of controversy, in relation to the fundamental principles of philosophy. VI
Ever since the revival of the study of Kant, the main conflict in philosophy has ceased to lie between materialism and idealism. It has rather become a conflict between those who take up some position analogous to that of Kant and those who seek to carry out the idealistic principle to all its consequences. For the essential characteristic of Kant’s position lay in his sharp division between the spheres of knowledge and of faith—between a knowledge which was confined to phenomena and their connection in experience, and a faith of practical reason, which reached beyond experience to apprehend that which is noumenally real. Even the agnosticism of Mr.


[Assistant] Even the agnosticism of Mr. Spencer might be regarded as a modification of the Kantian point of view, in so far as his denial of the possibility of knowing the absolute is based on Mansel’s version of the Kantian antinomies; while his description of the “vague consciousness” of the absolute which he bids us worship may be regarded as representing that faith which, in Kant’s view, enables us to pierce the veil of the phenomena and grasp the ultimate reality of things. And in the latter part of the century there has been a continual germination of similar theories, theories agreeing with the Kantian philosophy at least in making some kind of dualistic division between the sphere of clearly defined knowledge and the sphere of ideal or spiritual faith, and also in confining the former to phenomena while the latter is held to be capable of rising in some way from the phenomenal to the real. One of the earliest fruits of the Neo-Kantian movement in Germany was Lange’s _History of Materialism_, which insisted on the strictest interpretation of the lesson of the _Critique of Pure Reason_, that scientific knowledge is confined to the empirical and phenomenal, but which maintained also the chartered freedom of imagination to feed our hopes with the idea of a world not realized, or realizable, under the conditions of finite experience. And, with a different aim, but in a similar spirit, Ritschl, borrowing some of his weapons from Lotze, sought to take away from philosophy the right to investigate the spiritual truths of religion, and maintained that such truths were given in a kind of intuition of faith which is above criticism and which some of his followers identify, like Kant, with the demands or postulates of the moral consciousness. Other writers, following Schopenhauer, have sought to emancipate the will from the intelligence and to give it an independent power of estimating values.


[Assistant] Other writers, following Schopenhauer, have sought to emancipate the will from the intelligence and to give it an independent power of estimating values. The great effort to bring science and philosophy together—which, as we have seen, has characterized the later years of the century—has itself naturally given rise to many such dualistic compromises, of which Lotze’s philosophy was among the earliest. And it is partly to Lotze’s influence that we owe the tendency, visible in some of the most important recent contributions to philosophy, to regard our actual experience as having an intuitive completeness which is beyond all analysis, while reflective thought on the other hand is conceived as having a purely analytic and discursive operation, which can grasp only the severed fragments of the given reality and connect them externally to each other, but which can never restore the organic whole again. Here, too, we seem by another way to be landed in the same conclusion, viz., that we are perpetually poised between an ideal which we cannot verify, but which yet is held to be our only vision of reality, and a definite result of knowledge, which only gives us what is abstract and phenomenal. Yet it is difficult to understand how such an organic idea of the universe can exist except for the thinking intelligence, and how the thought that grasps it can be separated from the discursive thought by which the different elements of reality are brought into relation. How, indeed, can there be any thought which is not both discursive and intuitive at once, any thought which connects the parts without resting upon the unity of the whole to which they belong?


[Assistant] How, indeed, can there be any thought which is not both discursive and intuitive at once, any thought which connects the parts without resting upon the unity of the whole to which they belong? All these different compromises are really different forms of the Kantian dualism, but they supply convenient cities of refuge for those who are unwilling to admit that faith is but implicit reason, and that it is always possible to translate its intuitions of truth into explicit logic. There is much excuse, indeed, in many cases for such unwillingness when we consider how often reason has presented itself as purely a critical or dissolving power, and how often abstract theories which grasp only one aspect of things have been set forth as complete explanations of religion or morality or some other of the higher interests of life. It has always to be kept in view that it is in something like immediate perception that truth is given in the first instance, and that philosophy, therefore, must always be in a sense toiling after the intuitions of faith. Yet, on the other hand, to hold that there is anywhere an abstract division between the two is to hold that faith is essentially irrational; it is to exalt it above reason in a way that inevitably leads in the end to its being depressed below reason. If, however, this view can be maintained it must lead in the long run to the rejection of all dualistic compromises.


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If, however, this view can be maintained it must lead in the long run to the rejection of all dualistic compromises. And there are already many who hold that after the unstable equilibrium of the Kantian theory has been shaken there is no secure standing-ground for philosophy short of a thorough-going idealism. Yet even they have learned by experience how dangerous it is to snatch prematurely at the readiest idealistic interpretation of facts; and they are aware how easy it is to fall into a simple optimistic theory, which slurs over difficulties instead of solving them. They know that if Hegel or any one ever pretended, or could reasonably be interpreted as pretending, to construe the universe _a priori_, the pretence was futile, and that a true and valuable idealism can be reached only through the interpretation of the data of experience by the special sciences, and the reinterpretation of the results of these sciences by philosophy. They hold, in short, that if the well-known saying of Hegel is to be taken for truth, both of its clauses must be equally emphasized, and that no philosophy can safely maintain that “what is rational is actual” which has not gone through all the effort that is necessary to prove that “what is actual is rational.”
            EDWARD CAIRD. MEDICINE

INTRODUCTION
For countless generations the prophets and kings of humanity have desired to see the things which men have seen, and to hear the things which men have heard in the course of the wonderful nineteenth century.


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MEDICINE

INTRODUCTION
For countless generations the prophets and kings of humanity have desired to see the things which men have seen, and to hear the things which men have heard in the course of the wonderful nineteenth century. To the call of the watchers on the towers of progress there had been the one sad answer—the people sit in darkness and in the shadow of death. Politically, socially, and morally the race had improved, but for the unit, for the individual, there was little hope. Cold philosophy shed a glimmer of light on his path, religion in its various guises illumined his sad heart, but neither availed to lift the curse of suffering from the sin-begotten son of Adam. In the fulness of time, long expected, long delayed, at last Science emptied upon him from the horn of Amalthea blessings which cannot be enumerated, blessings which have made the century forever memorable; and which have followed each other with a rapidity so bewildering that we know not what next to expect. To us in the medical profession, who deal with this unit, and measure progress by the law of the greatest happiness to the greatest number, to us whose work is with the sick and suffering, the great boon of this wonderful century, with which no other can be compared, is the fact that the leaves of the tree of Science have been for the healing of the nations.


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To us in the medical profession, who deal with this unit, and measure progress by the law of the greatest happiness to the greatest number, to us whose work is with the sick and suffering, the great boon of this wonderful century, with which no other can be compared, is the fact that the leaves of the tree of Science have been for the healing of the nations. Measure as we may the progress of the world—materially, in the advantages of steam, electricity, and other mechanical appliances; sociologically, in the great improvement in the conditions of life; intellectually, in the diffusion of education; morally, in a possibly higher standard of ethics—there is no one measure which can compare with the decrease of physical suffering in man, woman, and child when stricken by disease or accident. This is the one fact of supreme personal import to every one of us. This is the Promethean gift of the century to man. THE GROWTH OF SCIENTIFIC MEDICINE
The century opened auspiciously, and those who were awake saw signs of the dawn. The spirit of Science was brooding on the waters.


[Assistant] The spirit of Science was brooding on the waters. In England the influence of John Hunter stimulated the younger men to the study of the problems of anatomy and pathology. On the Continent the great Boorhaave—the Batavian Hippocrates—had taught correct ways in the study of the clinical aspects of disease, and the work of Haller had given a great impetus to physiology. The researches of Morgagni had, as Virchow had remarked, introduced anatomical thinking into medicine. But theories still controlled practice. Under the teaching of Cullen, the old idea that humors were the seat of disease had given place to a neuro-pathology which recognized the paramount influence of the nervous system in disease.


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Under the teaching of Cullen, the old idea that humors were the seat of disease had given place to a neuro-pathology which recognized the paramount influence of the nervous system in disease. His colleague at Edinburgh, Brown, brought forward the attractive theory that all diseases could be divided into two groups, the one caused by excess of excitement—the sthenic—the other by a deficiency—the asthenic—each having its appropriate treatment, the one by depletion, the other by stimulation. In a certain measure Hahnemann’s theory of homœopathy was a reaction against the prevalent theories of the day, and has survived through the century, though in a much modified form. Some of his views were as follows:
“The only vocation of the physician is to heal; theoretical knowledge is of no use. In a case of sickness he should only know what is curable and the remedies. Of the diseases he cannot know anything except the symptoms.


[Assistant] Of the diseases he cannot know anything except the symptoms. There are internal changes, but it is impossible to learn what they are; symptoms alone are accessible; with their removal by remedies the disease is removed. Their effects can be studied in the healthy only. They act on the sick by causing a disease similar to that which is to be combated, and which dissolves itself into this similar affection. The full doses required to cause symptoms in the well are too large to be employed as remedies for the sick. The healing power of a drug grows in an inverse proportion to its substance.


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The healing power of a drug grows in an inverse proportion to its substance. He says, literally: ‘Only potencies are homœopathic medicines.’ ‘I recognize nobody as my follower but him who gives medicine in so small doses as to preclude the perception of anything medicinal in them by means either of the senses or of chemistry.’ ‘The pellets may be held near the young infant when asleep.’ ‘Gliding the hand over the patient will cure him, provided the manipulation is done with firm intention to render as much good with it as possible, for its power is in the benevolent will of the manipulator.’ Such is the homœopathy of Hahnemann, which is no longer recognized in what they call homœopathy to-day.”—(A. JACOBI.)
The awakening came in France. In 1801 Bichat, a young man, published a work on general anatomy, in which he placed the seat of disease, not in the organs, but in the tissues or fabrics of which they were composed, which gave an extraordinary impetus to the investigation of pathological changes. Meanwhile, the study of the appearances of organs and bodies when diseased (morbid anatomy), which had been prosecuted with vigor by Morgagni in the eighteenth century, had been carried on actively in Great Britain and on the Continent, and the work of Broussais stimulated a more accurate investigation of local disorders. The discovery by Laennec of the art of auscultation, by which, through changes in the normal sounds within the chest, various diseases of the heart and lungs could be recognized, gave an immense impetus to clinical research.


[Assistant] The discovery by Laennec of the art of auscultation, by which, through changes in the normal sounds within the chest, various diseases of the heart and lungs could be recognized, gave an immense impetus to clinical research. The art of percussion, discovered by Avenbrugger in the eighteenth century, and reintroduced by Corvisart, contributed not a little to the same. Laennec’s contributions to the study of diseases of the lungs, of the heart, and of the abdominal organs really laid the foundation of modern clinical medicine. A little later Bright published his researches on diseases of the kidneys, from which we date our knowledge of this important subject. One of the most complicated problems of the first half of the century related to the differentiation of the fevers. The eruptive fevers, measles, scarlet fever, and small-pox, were easily recognized, and the great group of malarial fevers was well known; but there remained the large class of continued fevers, which had been a source of worry and dispute for many generations.


[Assistant] The eruptive fevers, measles, scarlet fever, and small-pox, were easily recognized, and the great group of malarial fevers was well known; but there remained the large class of continued fevers, which had been a source of worry and dispute for many generations. Louis clearly differentiated typhoid fever, and by the work of his American pupils, W. W. Gerhard and Alfred Stillé, of Philadelphia, and George B. Shattuck, of Boston, typhus and typhoid fevers were defined as separate and independent affections. Relapsing fever, yellow fever, dengue, etc., were also distinguished.


[Assistant] Relapsing fever, yellow fever, dengue, etc., were also distinguished. The work of Graves and Stokes, of Dublin, of Jenner and Budd, in England, of Drake, Dickson, and Flint, in America, supplemented the labors of the French physicians, and by the year 1860 the profession had reached a sure and safe position on the question of the clinical aspects of fevers. The most distinguishing feature of the scientific medicine of the century has been the phenomenal results which have followed _experimental investigations_. While this method of research is not new, since it was introduced by Galen, perfected by Harvey, and carried on by Hunter, it was not until well into the middle of the century that, by the growth of research laboratories, the method exercised a deep influence on progress. The lines of experimental research have sought to determine the functions of the organs in health, the conditions under which perversion of these functions occur in diseases, and the possibility of exercising protective and curative influences on the processes of disease. The researches of the physiological laboratories have enlarged in every direction our knowledge of the great functions of life—digestion, assimilation, circulation, respiration, and excretion.


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The researches of the physiological laboratories have enlarged in every direction our knowledge of the great functions of life—digestion, assimilation, circulation, respiration, and excretion. Perhaps in no department have the results been more surprising than in the growth of our knowledge of the functions of the brain and nerves. Not only has experimental science given us clear and accurate data upon the localization of certain functions of the brain and of the paths of sensatory and of motor impulses, but it has opened an entirely new field in the diagnosis and treatment of the diseases of these organs, in certain directions of a most practical nature, enabling us to resort to measures of relief undreamed of even thirty years ago. The study of physiology and pathology within the past half-century has done more to emancipate medicine from routine and the thraldom of authority than all the work of all the physicians from the days of Hippocrates to Jenner, and we are as yet but on the threshold. THE GROWTH OF SPECIALISM
The restriction of the energies of trained students to narrow fields in science, while not without its faults, has been the most important single factor in the remarkable expansion of our knowledge. Against the disadvantages in a loss of breadth and harmony there is the compensatory benefit of a greater accuracy in the application of knowledge in specialism, as is well illustrated in the cultivation of special branches of practice.


[Assistant] Against the disadvantages in a loss of breadth and harmony there is the compensatory benefit of a greater accuracy in the application of knowledge in specialism, as is well illustrated in the cultivation of special branches of practice. Diseases of the skin, of the eye, of the ear, of the throat, of the teeth, diseases of women and of children, are now studied and practised by men who devote all their time to one limited field of work. While not without minor evils, this custom has yielded some of the great triumphs of the profession. Dentistry, ophthalmology, and gynæcology are branches which have been brought to a state of comparative perfection, and very largely by the labors of American physicians. In the last-named branch the blessings which have been brought to suffering women are incalculable, not only as regards the minor ailments of life, but in the graver and more critical accidents to which the sex is liable. One of the most remarkable and beneficial reforms of the century has been in the attitude of the profession and the public to the subject of insanity, and the gradual formation of a body of men in the profession who labor to find out the cause and means of relief of this most distressing of all human maladies.


[Assistant] One of the most remarkable and beneficial reforms of the century has been in the attitude of the profession and the public to the subject of insanity, and the gradual formation of a body of men in the profession who labor to find out the cause and means of relief of this most distressing of all human maladies. The reform movement inaugurated by Tuke in England, by Rush in the United States, by Pinel and Esquirol in France, and by Jacobi and Hasse in Germany, has spread to all civilized countries, and has led not only to an amelioration and improvement in the care of the insane, but to a scientific study of the subject which has already been productive of much good. In this country, while the treatment of the insane is careful and humanitarian, the unfortunate affiliation of insanity with politics is still in many States a serious hinderance to progress. It may be interesting to take a glance at the state of medicine in this country at the opening of the nineteenth century. There were only three schools of medicine, the most important of which were the University of Pennsylvania and the Harvard. There were only two general hospitals.


[Assistant] There were only two general hospitals. The medical education was chiefly in the hands of the practitioners, who took students as apprentices for a certain number of years. The well-to-do students and those wishing a better class of education went to Edinburgh or London. There were only two or three medical journals, and very few books had been published in the country, and the profession was dependent entirely upon translations from the French and upon English works. The only medical libraries were in connection with the Pennsylvania Hospital and the New York Hospital. The leading practitioners in the early years were Rush and Physick, in Philadelphia; Hossack and Mitchill, in New York; and James Jackson and John Collins Warren, in Boston.


[Assistant] The leading practitioners in the early years were Rush and Physick, in Philadelphia; Hossack and Mitchill, in New York; and James Jackson and John Collins Warren, in Boston. There were throughout the country, in smaller places, men of great capabilities and energy, such as Nathan Smith, the founder of the Medical Schools of Dartmouth and of Yale, and Daniel Drake in Cincinnati. After 1830 a remarkable change took place in the profession, owing to the leaven of French science brought back from Paris by American students. Between 1840 and 1870 there was a great increase in the number of medical schools, but the general standard of education was low—lower, indeed, than had ever before been reached in the medical profession. The private schools multiplied rapidly, diplomas were given on short two-year sessions, and nothing contributed more to the degeneration of the profession than this competition and rivalry between ill-equipped medical schools. The reformation, which started at Harvard shortly after 1870, spread over the entire country, and the rapid evolution of the medical school has been one of the most striking phenomena in the history of medicine in the century.


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The reformation, which started at Harvard shortly after 1870, spread over the entire country, and the rapid evolution of the medical school has been one of the most striking phenomena in the history of medicine in the century. University authorities began to appreciate the fact that medicine was a great department of knowledge, to be cultivated as a science and promoted as an art. Wealthy men felt that in no better way could they contribute to the progress of the race than by the establishment of laboratories for the study of disease and hospitals for the care of the sick poor. The benefactions of Johns Hopkins, of Sims, of Vanderbilt, of Pierpont Morgan, of Strathcona, of Mount-Stephen, of Payne, and of Levi C. Lane and others have placed scientific medicine on a firm basis. THE GROWTH OF PREVENTIVE MEDICINE
Sanitary science, hygiene, or preventive medicine may claim to be one of the brightest spots in the history of the nineteenth century.


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THE GROWTH OF PREVENTIVE MEDICINE
Sanitary science, hygiene, or preventive medicine may claim to be one of the brightest spots in the history of the nineteenth century. Public hygiene was cultivated among the Egyptians, and in the Mosaic law it reached a remarkable organization. The personal hygiene of the Greeks was embraced in the saying, “The fair mind in the fair body,” and the value of exercise and training was fully recognized. The Romans, too, in public and private hygiene, were our superiors in the matter of water supply and baths. But modern sanitary science has a much wider scope and is concerned with the causes of disease quite as much as with the conditions under which these diseases prevail. The foundations of the science were laid in the last century with Jenner’s discovery of vaccination.


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The foundations of the science were laid in the last century with Jenner’s discovery of vaccination. Howard, too, had grasped the association of fever with overcrowding in the jails, while the possibility of the prevention of scurvy had been shown by Captain Cook and by Sir Gilbert Blaine. Preventive medicine was a blundering, incomplete science until bacteriology opened unheard-of possibilities for the prevention of disease. Before discussing some of the victories of preventive medicine it will be well to take a brief survey of the growth of the following subject:

SCIENCE OF BACTERIOLOGY
From the brilliant overthrow by Pasteur, in 1861, and by Koch and Cohn, in 1876, of the theory of spontaneous generation, we may date its modern growth. Wrapped up in this theory of spontaneous generation, upon which speculation raged centuries before the invention of the microscope, lies the history of bacteriology. The ancient Greek and Roman philosophers wrestled with the question, and very interesting views of the relation of germ life to disease are preserved to us in their manuscripts.


[Assistant] The ancient Greek and Roman philosophers wrestled with the question, and very interesting views of the relation of germ life to disease are preserved to us in their manuscripts. With the invention of the microscope we can mark the first positive step towards the goal of to-day. A Jesuit priest, Kircher, in 1671, was the first to investigate putrefying meat, milk, and cheese with the crude microscope of his day, and left us indefinite remarks concerning “very minute living worms” found therein. Four years after Kircher a Dutch linen merchant, Antonius von Leeuwenhoek, by improving the lenses of the microscope, saw in rain-water, putrefying fluids, intestinal contents, and saliva, minute, moving, living particles, which he called “animalculæ.” In medical circles of his day these observations aroused the keenest interest, and the theory that these “animalculæ” might be the cause of all disease was eagerly discussed. Pleincz, of Vienna, after much observation of various fluids, putrefying and otherwise, wrote in 1762 that it was his firm belief that the phenomena of diseases and the decomposition of animal fluids were wholly caused by these minute living things. Notwithstanding such assertions, from his day on until Pasteur, Koch, and Cohn finally proved its misconceptions in 1876, the theory of spontaneous generation held the upper hand in all discussions upon the question.


[Assistant] Notwithstanding such assertions, from his day on until Pasteur, Koch, and Cohn finally proved its misconceptions in 1876, the theory of spontaneous generation held the upper hand in all discussions upon the question. The stimulus to research as to the causes of disease along the line of bacterial origin did not entirely cease to be felt, and the names of Pollender and Davaine are linked together in the first undoubted discovery of micro-organisms in disease, when the cause of anthrax, a disease of cattle, was solved in 1863. Following closely upon Davaine’s researches, the primary causes of wound infection were worked out, and to the efforts of the British surgeon Lister are due the great advances of modern surgery. In rapid succession the presence of bacteria was clearly demonstrated in relapsing fever, leprosy, and typhoid fever; but far eclipsing all former discoveries, on account of the magnitude of the difficulties encountered and overcome, were the brilliant demonstrations of the cause of consumption and allied diseases, and that of Asiatic cholera, by Dr. Robert Koch in 1882 and in 1884 respectively. From that time onward innumerable workers have satisfied the critical scientific world as to the causes of pneumonia, diphtheria, tetanus, influenza, and bubonic plague, besides many diseases of cattle, horses, sheep, and other animals and insects.


[Assistant] From that time onward innumerable workers have satisfied the critical scientific world as to the causes of pneumonia, diphtheria, tetanus, influenza, and bubonic plague, besides many diseases of cattle, horses, sheep, and other animals and insects. Having glanced hastily at the history of bacteriology, we may next consider some facts concerning the germs themselves. What are they? To the lay mind the words germ, microbe, bacterium, and bacillus often convey confused ideas of invisible, wriggling, worm-like creatures, enemies of mankind, ever on the watch to gain a stealthy entrance into our bodies, where they wreak harm and death. Scientifically considered, however, they are the smallest of living things yet known. They are not animals, but are members of the vegetable kingdom, and are possessed of definite yet varying shapes.


[Assistant] They are not animals, but are members of the vegetable kingdom, and are possessed of definite yet varying shapes. They consist of a jelly-like substance called protoplasm, which is covered in and held in place by a well-formed membrane of a relatively hard and dense character, exactly similar in composition to the woody fibre of trees. According to their shape the bacteria are divided into three chief groups, called respectively cocci, bacilli, and spirilla. The cocci are spherical bodies and may exist singly or in pairs, in fours, in clusters, or in chains. In this group we find the smallest bacteria known, many of them not over 1-150,000 of an inch in diameter. The bacilli are rod-like bodies, varying much in size in different species and in members of the same species.


[Assistant] The bacilli are rod-like bodies, varying much in size in different species and in members of the same species. They are larger than the cocci, measuring in length from 1-25,000 of an inch to 1-4000, and in breadth from 1-125,000 to 1-16,000 of an inch. Many varieties are possessed of organs of locomotion called flagella. The spirilla resemble the bacilli, except that they are twisted into corkscrew shapes, or have gently undulating outlines. Upon an average they are much longer than the bacilli, one species being very long, measuring about 1-600 of an inch. As seen in the natural state bacteria are found to be colorless, but it is by the application of various aniline dyes that they are usually studied.


[Assistant] As seen in the natural state bacteria are found to be colorless, but it is by the application of various aniline dyes that they are usually studied. These minute plants increase by a simple method of division into two equal parts, or by a more complex process of forming a seed—the so-called spore—which later on develops into the adult form. Under favorable conditions they are able to multiply at an enormous rate; for instance, it has been calculated that a bacillus dividing once every hour would at the end of twenty-four hours have increased to seventeen millions; and if the division continued at the same rate we should find at the end of the third day an incalculable number of billions, whose weight would be nearly seven thousand five hundred tons! But, fortunately for our welfare, nature by various means renders the possibility of such a happening entirely beyond the slightest chance of realization, her greatest barrier being the lack of an adequate food supply. The distribution in nature of bacteria is wellnigh universal, occurring as they do in the air we breathe, the water and milk we drink, upon the exposed surfaces of man and animals, and in their intestinal tracts, and in the soil to a depth of about nine feet. But it has been noted that at very high altitudes and in glacier ice none exist, while in the Arctic regions and at sea far from land their numbers are very few.


[Assistant] But it has been noted that at very high altitudes and in glacier ice none exist, while in the Arctic regions and at sea far from land their numbers are very few. The conditions governing their growth involve many complex problems, but a few of the chief factors concerned are moisture, air, food, temperature, and light. All bacteria must have moisture, else they die sooner or later, depending upon the hardness of the species, and none can multiply without it. A supply of air is by no means essential to all germs. To some it is absolutely necessary, and such germs are called aerobes. To others air is wholly detrimental, and they constitute the anaerobes, while to the majority of bacteria air supply is a matter of indifference, and in consequence they are grouped under the term facultative anaerobes.


[Assistant] To others air is wholly detrimental, and they constitute the anaerobes, while to the majority of bacteria air supply is a matter of indifference, and in consequence they are grouped under the term facultative anaerobes. The food supply of many consists of dead animal and vegetable materials, a few require living tissues, while a small number can exist wholly upon mineral salts, or even the nitrogen of the air. The lowest temperature at which some bacteria can multiply is the freezing-point of water, and the highest 170 degrees Fahrenheit. However, the average range of temperature suitable to the majority lies between 60 and 104 degrees Fahrenheit, 98 2-5 degrees Fahrenheit being the most suitable for the growth of disease-producing germs. Light, ordinarily diffused daylight, or its absence, is a matter of no moment to most germs, whereas direct sunlight is a destroyer of all bacteria. The study of the life histories of these diminutive plants excites the wonder of those who make observations upon them.


[Assistant] The study of the life histories of these diminutive plants excites the wonder of those who make observations upon them. It is truly marvellous to know that these bacteria can accomplish in their short lives of possibly a few hours or days feats which would baffle the cleverest of chemists if given years of a lifetime to work upon. They give to the farmer the good quality of his crops, to the dairyman superior butter and cheese; they assist in large measure in freeing our rivers and lakes from harmful pollutions. Here it should be strongly emphasized that those bacteria which cause disease are only of a few species, all others contributing to our welfare in countless ways. Quite as astonishing is the discovery that within the root-knobs of pease and beans live bacteria which by splitting up mineral salts containing nitrogen, and by absorbing nitrogen from the air, give it over to the plant so that it is enabled to grow luxuriantly, whereas, without their presence, the tiller of the soil might fertilize the ground in vain. It is quite possible that not alone pease and beans, but all grasses and plants and trees depend upon the presence of such germs for their very existence, which in turn supply man and animals with their means of existence.


[Assistant]
It is quite possible that not alone pease and beans, but all grasses and plants and trees depend upon the presence of such germs for their very existence, which in turn supply man and animals with their means of existence. Hence we see that these nitrifying bacteria, as they are called, if swept out of existence, would be the cause of cessation of all life upon the globe. And arguing backward, one prominent authority states it as his belief that the first of all life on this earth were those lowly forms of plants which only required the nitrogen of air or salts to enable them to multiply. Limiting observation now to the sphere of medicine, it will be readily perceived that the presence of bacterial life in a causative relation to disease is an object of paramount regard. The following paragraphs will briefly treat of the diseases associated with micro-organisms and the common modes of infection in each, the chain of events subsequent to an infection, and the possibilities of protection or cure by means of substances elaborated in the body of an individual or animal recently recovered from an infectious disease:
_Anthrax._—A disease chiefly of cattle and sheep, occasionally of man, is caused by the _Bacillus anthracis_, discovered in 1849–50 by Pollender and Davaine. It enters the body through abrasions of the skin, by inhalation of the spores, or seeds, into the lungs, or by swallowing infected material.


[Assistant] It enters the body through abrasions of the skin, by inhalation of the spores, or seeds, into the lungs, or by swallowing infected material. _Leprosy._—This disease is caused by a bacillus known as _Bacillus leprae_, which was discovered by Hansen in 1879. It is doubtful if it has been grown outside the body. It is supposed to enter by abrasions of the skin, but it is very feebly contagious, notwithstanding popular ideas as to its supposedly highly contagious nature. _Tuberculosis._—All forms of this disease, among which is ordinary consumption, are caused by a bacillus closely resembling that of leprosy. It was discovered by Koch in 1880–82, and named _Bacillus tuberculosis_.


[Assistant] It was discovered by Koch in 1880–82, and named _Bacillus tuberculosis_. The ways of infection are by inhaling the dried sputum of consumptives, drinking infected cow’s milk, or eating infected meat. _Typhoid Fever._—A disease of human beings only. Eberth in 1880 discovered the germ causing it and called it _Bacillus typhosus_. It gains entrance to our bodies chiefly in the milk and water we drink, which comes from infected sources; a rarer method is by inhalation of infected air. _Diphtheria._—A disease of human beings chiefly.


[Assistant] _Diphtheria._—A disease of human beings chiefly. It is caused by a bacillus which was described in 1883–84 by Klebs and Loeffler, and is known as _Bacillus diphtheriae_, or Klebs-Loeffler bacillus. Its mode of entry is by inhaling infected air, or by drinking or eating infected milk or food. _Cholera._—This disease is peculiar to human beings. Its native home is on the banks of the river Ganges in India, where Koch in 1884 was able to isolate its causative spirillum. Man is infected by drinking contaminated water or by contact.


[Assistant] Man is infected by drinking contaminated water or by contact. _Lockjaw, or Tetanus._—Afflicts man, horses, and dogs. The _Bacillus tetani_ is the most deadly of all known bacteria. It enters the body by wounds. It was discovered in 1884 by Nicolaier. _Influenza, or the Grip._—Caused by one of the smallest-known bacilli; discovered in 1892 by Canon and Pfeiffer.


[Assistant] _Influenza, or the Grip._—Caused by one of the smallest-known bacilli; discovered in 1892 by Canon and Pfeiffer. Infection spreads by the scattering about by air-currents of the dried nasal and bronchial secretion of those suffering from the disease, and its portal of entry is by the nose and bronchial tubes. _Pneumonia._—Caused by a coccus which grows in pairs and small chains. It enters the body by means of the respiratory tract. It is present in the saliva of twenty per cent. of healthy persons.


[Assistant] of healthy persons. Proved by Frankel in 1886 to be the cause of this disease. _Bubonic Plague._—In 1894 Kitasato and Yersin isolated a small bacillus in a large number of cases and proved it to be the cause. It enters the body by means of wounds of the skin, and through bites of fleas from infected rats, which are said to be one of the chief factors in spreading this dread malady. _Yellow Fever._—The cause of this disease is still under discussion. Such are a few of the infectious diseases which we can readily attribute to the presence of definite micro-organisms in respective cases.


[Assistant]
Such are a few of the infectious diseases which we can readily attribute to the presence of definite micro-organisms in respective cases. But strange as it may seem, the most typical of all infectious diseases, small-pox, scarlet fever, measles, and hydrophobia, have as yet not yielded up their secrets. This is possibly due to the minute size of the micro-organisms concerned, which make it beyond the power of the best microscope to demonstrate them. In this connection it has recently been shown by Roux and Nocard that in the case of the disease known as pleuro-pneumonia of cattle the causative agent is so very small as just to be barely visible. Again, it is quite possible that these diseases may be caused by living things we know nothing about, which may be quite dissimilar from the bacteria. INFECTION—ITS PROCESSES AND RESULTS
In the foregoing list of diseases associated with specific bacteria, attention has been drawn to the common modes of infection, or, as they are technically called, “portals of entry,” and it now remains to touch upon the main factors, processes, and results following upon the entry into the body of such disease-producing microbes.


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INFECTION—ITS PROCESSES AND RESULTS
In the foregoing list of diseases associated with specific bacteria, attention has been drawn to the common modes of infection, or, as they are technically called, “portals of entry,” and it now remains to touch upon the main factors, processes, and results following upon the entry into the body of such disease-producing microbes. It is a well-known fact that the normal blood has of itself to a considerable extent the power of killing germs which may wander into it through various channels. Likewise the tissue cells of the body in general show similar action depending upon the different cell groups, state of health, general robustness, and period of life. The germ-killing power varies in different individuals, though each may be quite healthy. Considered as a whole, this power possessed by the body against germs is known as “general resistance.” And when by any means this power of resistance is lost or diminished, we run grave risks of incurring disease. Granted a case of infection, let us now trace up briefly what occurs.


[Assistant] Granted a case of infection, let us now trace up briefly what occurs. Between the period when the bacteria gain a lodgment and that in which the disease assumes a noticeable form, the patient simply feels out of sorts. It is during this stage that the blood and tissues are deeply engaged in the attempt to repel the attacks of the invading microbes. With varying speed the germs multiply throughout the body generally, or may be at first localized, or even, as in lockjaw, remain localized throughout the entire disease. Multiplying in the tissues, they generate in increasing amounts their noxious poisons, which soon cause profound changes throughout the body; the patient becomes decidedly ill, and shows now the signs of an unmistakable infection. Does the body now give up the fight entirely?


[Assistant] Does the body now give up the fight entirely? No; on the contrary, the white blood-cells, the wandering cells, and the cells of the tissues most affected still carry on an unequal fight. From the lymphatic glands and spleen, armies of white cells rush to the fray and attempt to eat up and destroy the foe, but possibly in vain; the disease runs its course, to end either in death or recovery. How, then, in cases of recovery, are the microbes finally overcome? This question involves many complex processes which at present are by no means thoroughly understood, but we will concern ourselves with the simple principles. It has been previously mentioned that once the bacteria get a good foothold the body is subjected to the action of generated poisons, which are known as toxins.


[Assistant] It has been previously mentioned that once the bacteria get a good foothold the body is subjected to the action of generated poisons, which are known as toxins. They give rise to such symptoms as loss of appetite, headache, fever, pains and aches, and even a state of stupor or unconsciousness. In addition to the active warfare of the white blood-cells, groups of cells throughout the body, after recovering from the first rude shock of the toxins, begin to tolerate their presence, then effect a change in the chemical constitution of the toxins, and finally elaborate substances which antagonize the toxins and destroy their action altogether, thus lending aid to the warrior cells, which at last overcome the invading microbes. Recovery is brought about, and a more or less permanent degree of immunity against the special form of disease ensues. Now if we could use these antagonizing substances, or, as they are called, antitoxins, upon other men or animals sick with a similar disease, would their bodies be at once strengthened to resist and finally overcome the disease? Yes, in a certain majority of cases they would, and this is exactly what scientific observers have noted, worked out, and have successfully applied.


[Assistant] Yes, in a certain majority of cases they would, and this is exactly what scientific observers have noted, worked out, and have successfully applied. A new art in the healing of disease, which is spoken of broadly as serum-therapy, or medication by curative or protective serums, has thus been discovered. The first observers in this new field were Pasteur and Raynaud in France in 1877–78, and Salmon and Smith in this country in 1886. Raynaud, by injecting serum from a calf which had had an attack of cow-pox, prevented the appearance of the disease in a calf freshly inoculated with the virulent material of the disease. Pasteur, by using feebly infective germs of fowl cholera, conferred immunity upon healthy fowls against the disease, and was able to cure those which were ill. Salmon and Smith injected small and repeated amounts of the elaborated toxins or poisons of the bacillus of hog cholera into healthy swine, and were able to confer immunity upon them.


[Assistant] Salmon and Smith injected small and repeated amounts of the elaborated toxins or poisons of the bacillus of hog cholera into healthy swine, and were able to confer immunity upon them. However, it was not until Behring in 1892 announced his discovery of an antitoxin serum for diphtheria, along with an undisputed proof of its value in treatment, that the attention of the scientific world was finally aroused and stimulated to the appreciation of the great possibilities of serum-therapy. Strange as it may seem, much opposition arose to this new method of treatment, not alone from the lay portions of the community, but even from the ranks of the medical profession itself. This opposition was due in part to misconceptions of the principles involved in the new doctrine, and in part to the falsely philanthropic prejudices of the pseudo-scientific sections of both parties. But by the persevering work of the enthusiastic believers in serum-therapy, positive conviction has now replaced misconception and prejudice in the minds of the majority of its former opponents. The accumulation of statistical evidence, even where all allowance is made for doubtful methods of compilation, shows that the aggregate mortality of diphtheria has been reduced fully fifty per cent.


[Assistant] The accumulation of statistical evidence, even where all allowance is made for doubtful methods of compilation, shows that the aggregate mortality of diphtheria has been reduced fully fifty per cent. since the introduction of antitoxic treatment by Behring in 1892. Since the method of preparation of the commercial diphtheria antitoxin illustrates the general principles involved in the search for the production of curative or protective serums for infectious diseases in general, a summary of the steps in its manufacture will now be given. A race of diphtheria bacilli, which has been found to yield a poison of great virulence in alkaline beef broth, is grown for a week or ten days in this medium. The toxin is then separated and its virulence exactly determined. It is preserved in sterile receptacles for immediate or future use.


[Assistant] It is preserved in sterile receptacles for immediate or future use. The next step is the inoculation of a suitable animal with the toxin. Of all animals the horse has been found to meet nearly every requirement. Such an animal, in a state of perfect health, receives an injection of twenty cubic centimetres of toxin, along with ten or fifteen of standard antitoxin, beneath the skin of the neck or fore-quarters, upon three separate occasions at intervals of five days. After this it receives increasing doses of toxin, alone, at intervals of six to eight days, until, at the end of two months, it is able to stand with little discomfort doses of such strength that if given in the first stage these doses would have quickly caused death. At this period the horse is bled to a small extent, and its serum tested to ascertain if prospects are good for the production by the animal of a high grade of antitoxin.


[Assistant] At this period the horse is bled to a small extent, and its serum tested to ascertain if prospects are good for the production by the animal of a high grade of antitoxin. If satisfactory progress has been made, the injections are continued for another month, when, as a rule, the maximal degree of antitoxic power in the serum will have been attained. The horse is now bled to the proper extent, the blood being received in a sterile jar and placed in an ice-box. Here it coagulates, and the serum separates from it. When the separation of clot and serum is complete, the latter is drawn off, taken to the laboratory, and standardized. This being finished, an antiseptic fluid is added to preserve the serum from decomposition.


[Assistant] This being finished, an antiseptic fluid is added to preserve the serum from decomposition. It is then bottled, labelled, and sent out for use. In similar fashion tetanus antitoxin is prepared; and quite recently Calmette has produced an antitoxic serum for use in snake bite, by injecting horses with minute increasing doses of snake venom. His experiments have given some remarkable results, not only in laboratory work, but also in cases of actual snake bite occurring in man. Thus bacteriological scientists, after years of laborious work, in the face of much criticism and severe denunciation, may confidently announce that they have in their possession a magic key to one of nature’s secret doors. The lock has been turned.


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The lock has been turned. The door stands partly open, and we are permitted a glimpse of the future possibilities to be attained in the great fight against disease. PREVENTIVE MEDICINE
The following are some of the diseases which have been remarkably controlled through preventive medicine:
_Small-pox._—While not a scourge of the first rank, like the plague or cholera, at the outset of the century variola was one of the most prevalent and dreaded of all diseases. Few reached adult life without an attack. To-day, though outbreaks still occur, it is a disease thoroughly controlled by vaccination. The protective power of the inoculated cow-pox is not a fixed and constant quantity.


[Assistant] The protective power of the inoculated cow-pox is not a fixed and constant quantity. The protection may be for life, or it may last only for a year or two. The all-important fact is this: That efficiently vaccinated persons may be exposed with impunity, and among large bodies of men (_e.g._, the German army), in which revaccination is practised, small-pox is unknown. Of one hundred vaccinated persons exposed to small-pox, possibly one might take the disease in a mild form; of one hundred unvaccinated persons so exposed, one alone might escape—from twenty-five to thirty would die. To be efficient, vaccination must be carried out systematically, and if all the inhabitants of this country were revaccinated at intervals small-pox would disappear (as it has from the German army), and the necessity for vaccination would cease. The difficulty arises from the constant presence of an unvaccinated remnant, by which the disease is kept alive.


[Assistant] The difficulty arises from the constant presence of an unvaccinated remnant, by which the disease is kept alive. The Montreal experience in 1885 is an object-lesson never to be forgotten. For eight or ten years vaccination had been neglected, particularly among the French-Canadians. On February 28, 1885, a Pullman car conductor, who came from Chicago, where the disease had been slightly prevalent, was admitted into the Hôtel Dieu. Isolation was not carried out, and on the 1st of April a servant in the hospital died of small-pox. Following her death the authorities of the hospital sent to their homes all patients who presented no symptoms of the disease.


[Assistant] Following her death the authorities of the hospital sent to their homes all patients who presented no symptoms of the disease. Like fire in dry grass the contagion spread, and within nine months there died of small-pox three thousand one hundred and sixty-four persons. It ruined the trade of the city for the winter, and cost millions of dollars. There are no reasonable objections to vaccination, which is a simple process, by which a mild and harmless disease is introduced. The use of the animal vaccine does away with the possibility of introduction of other disorders, such as syphilis. _Typhus Fever._—Until the middle of the present century this disease prevailed widely in most of the large cities, particularly in Europe, and also in jails, ships, hospitals, and camps.