The Remedy

by Thomas Goetz

  Simultaneously, laboratory science demanded more animal experiments. As Koch’s work with field mice and guinea pigs and Pasteur’s experiments with livestock demonstrated, new understanding of the origins and process of disease stemmed directly from animal testing—the germ theory couldn’t have existed without them. But as the use of animals for medical research increased, it generated new questions of morality and decency. These questions only grew as it became clear that there were few standards for the treatment or care of animals in these experiments, particularly when it came to vivisection—the dissection of animals while they’re still alive.

  In part, medical scientists were the victims of a larger failure to reckon with the care of animals, even as society had grown increasingly dependent upon them. Despite its industrial nature, much of the progress of the nineteenth century was borne on the backs of animals, beasts that were as poorly treated as they were indispensable. Indeed, to live in London in midcentury was to be surrounded by animals at every turn. The city’s 2.5 million humans lived cheek by jowl with some 300,000 horses and untold hundreds of thousands of pigs, chickens, dogs, cats, and sheep (among the unintended consequences being the mountains of manure they produced, a grave problem for public sanitation).

  Even under the best conditions, these animals were in for a rough life. The average life span of a streetcar horse was barely two years. (Horses can typically live twenty-five to thirty years.) In New York, which, like London, was dependent on horses as the engines of commerce and transportation, some fifteen thousand horses died on its streets annually, the victims of beatings, malnourishment, and injury. The misery of these animals was inescapable for city dwellers. In 1824 a group of reformers (led by Richard Martin, a member of Parliament known as “Humanity Dick”) formed the Society for the Prevention of Cruelty to Animals, the first charity for animal welfare in the world. Sympathizing with the group, in 1840 Queen Victoria gave it royal sanction.

  By the 1860s, animal welfare had become a formidable cross-social movement of Quakers, feminists, popular authors, and reforming politicians. They argued not just against outright cruelty, but that any treatment that jeopardized animals for the advantage of humanity was a crime against nature. This included, quite specifically, the vivisection of animals in scientific experiments. Charles Dickens captured the spirit of the argument in “Inhumane Humanity,” an essay published in 1866 in his journal All the Year Round. “No doubt it will be said that such experiments are justifiable and necessary in the interests of surgical science for the benefit of mankind. Their necessity I dispute,” he wrote. “Man may be justified—though I doubt it—in torturing the beasts that he himself may escape pain. But he certainly has no right to gratify an idle and purposeless curiosity through the practice of cruelty.”

  The antivivisectionists found their hero in Frances Power Cobbe, a rampaging suffragette and defender of animal rights. The daughter of a leading Anglo-Irish family in Dublin, Cobbe rejected traditional women’s roles and devoted herself to religious philosophy and, increasingly, social justice. One of her first attacks on vivisection was an 1863 essay titled “On the Rights of Man and the Claims of Brutes,” a vivid description of the horrors of animal experiments conducted in a col-lege of medicine in Paris. In what would become Cobbe’s trademark sarcastic tone, she assumed the voice of a mock-biblical epic:

  They took a number of tame and inoffensive animals—but principally those noblest and most sensitive animals, horses—and having bound them carefully for their own safety, proceeded to cut, hew, saw, gouge, bore, and lacerate the flesh, bones, marrow, heart, and brains of the creatures groaning helpless at their feet. And in so orderly and perfect a fashion was this accomplished, that these wise men, and learned men, and honourable men discovered that a horse could be made to suffer for ten hours, and to undergo sixty-four different modes of torture before he died. Wherefore to this uttermost limit permitted by the Creator did they regularly push their cutting and hacking, delivering each horse into the hands of eight inexperienced students to practise upon him in turn during the ten hours. This, therefore, they did in that great city, not deigning to relieve the pains they were inflicting by the beneficial fluid whereby all suffering may be alleviated, and not even heeding to put out of their agonies at the last the poor mangled remnants of creatures on which they had expended their tortures three score and four.

  In 1875, Cobbe founded London’s Society for the Protection of Animals Liable to Vivisection; that organization was soon joined by the Victoria Street Society, and that same year the antivivisection cause earned the public support of Queen Victoria. The queen endorsed a Royal Commission on Vivisection in July 1875, and in August 1876, Parliament passed the Cruelty to Animals Act, which prohibited experimentation on animals without the use of anesthetic. The act required scientists to acquire a license for animal experiments but allowed the process and the licensees to remain confidential.

  In April 1881, Cobbe turned her artillery squarely on the medical profession in an essay in the popular Modern Review titled “The Medical Profession and Its Morality.”

  Doctors are daily assuming authority which, at first, perhaps, legitimate and beneficial, has a prevailing tendency to become meddling and despotic. . . . It would seem as if our ancestors scarcely realised how painful is sickness, how precious is life—so enhanced is our dread of disease, so desperately anxious are we to postpone the hour of dissolution! As old Selden said, “To preach long, loud, and damnation is the way to be cried up. We love a man that damns us, and run after him to save us.” “To preach long, loud and sanitation” is the modern doctor’s version of this apophthegm, and we do “cry them up,” and run after them to save us from “germs” and all other imps of scientific imagination.

  The mockery of germs as “imps of scientific imagination” was a trenchant insult. If medicine was a true science, with virtues that placed it beyond the strictures of society, then where, she scoffed, were the cures for the “most terrible scourges of mortality, such as cholera, or consumption, or cancer”? This lack of demonstrable progress, Cobbe argued, was testimony that, for all their laboratories, physicians should follow the Victorian rules of decency and humility, like everyone else.

  It was a worthy point, touching on the germ theory’s greatest vulnerability: True or not, what measurable improvement had it fostered for human health? Cobbe’s larger point was valid as well. For decades, scientific research had been guilty of great cruelty in animal experiments, particularly in those years before Koch and Pasteur began to establish a clear methodology for experimentation. By 1881, Cobbe’s efforts had succeeded in bringing some decency to the research, and yet she was not satisfied.

  The stakes grew higher when Pasteur had his triumph at Pouilly-le-Fort in 1881. While a victory for science, Pasteur’s experiments had the consequence of fusing antivivisection with another controversial scientific practice: the use of vaccines. Vaccines had been controversial in the United Kingdom since 1853, when Parliament made the smallpox vaccine compulsory for all newborns. In 1867 the law was extended to all children fourteen years and younger and assigned penalties for refusal. Public antipathy to this law was widespread, fed by the perception that the state was exceeding its authority and invading citizens’ homes. Wrote one antivaccination tract, “Are we to be leeched, bled, blistered, burned, douched, frozen, pilled, potioned, lotioned, salivated . . . by Act of Parliament?” In London and other English cities, antivaccination leagues began forming, and periodicals started to appear, such as The Vaccination Inquirer, published by the London Society for the Abolition of Compulsory Vaccination. The discoveries of Koch and Pasteur didn’t dissuade people from this revolt. Rather, the antivaccination movement found evidence of conspiracy in the rising tide of microbial disease. More germs, the Inquirer noted, would inevitably create more vaccines and let the medical establishment continue to perpetrate its witchcraft. Every so-called discovery was just a way for scientists to keep experim
enting upon an unwitting and unwilling populace.

  The antivaccine movement, of course, was confused by the paradox created by all vaccines: The more effective the vaccine, the more invisible its effectiveness became. The perceived side effects, meanwhile, were readily apparent and easily linked to the trauma of inoculation. To be sure, smallpox vaccines at the time were imperfect. Most inoculations resulted in at least a fever and occasionally death. Many practicing physicians were sympathetic with the antivaccine crowd; they were themselves concerned about the high rates of illness in children following vaccination, illness that many felt was entirely unnecessary. But the vaccine opponents’ argument, by and large, wasn’t concerned with whether vaccines represented the greater good. They were opposed outright to the invasion of the sanctity of their bodies, their families, and their rights by a newly aggressive medical profession.

  In this, the antivaccination leagues found a common enemy with the antivivisection groups. Both movements were deeply distrustful of the advances in scientific medicine, insofar as these discoveries were used to justify the insult, be it animal experiments or human vaccination. Moreover, the two arguments bore on each other. Antivivisectionists such as Cobbe were deeply skeptical of the argument that vaccines helped prevent disease and, therefore, legitimized animal experiments for the development of such treatments. Cobbe herself claimed that vaccines were more dangerous than the diseases themselves. Denouncing the “vivisecting staffs of Koch and Pasteur,” she wrote in her journal, The Zoophilist, that “the experiment-intoxicated mind of the medical world cannot be brought to see if this grand prophylactic were adopted, there would soon be an end of epidemics and consumption, for the simple reason that there would be an end of the population.”

  On some level, the resistance of many British citizens to the incursion of medicine into their homes was understandable. The nineteenth century had seen a series of parliamentary acts that advanced the role of state-sanctioned medicine, at the perceived expense of individual liberty. Beginning with the 1832 Anatomy Act and continuing with the Public Health Act in 1848, the Vaccination Act in 1853, the Contagious Diseases Act in 1864, and the Infectious Diseases (Notification) Acts of 1889 and 1899 (which required the reporting of contagious diseases and confined the sick to hospitals), advances in medicine seemed to be negatively correlated with the autonomy of the common citizen. Time and again, medical science was compelling people to change the way they lived, disrupting norms, and putting notions of public health above those of personal rights. The result was an anti-science libertarianism that took umbrage at an increasingly paternalistic state. At every turn, science was being deployed to constrain the public, a public that was poorly equipped to assess the validity of the science.

  This tension, of course, is still palpable today. From the animal rights movement to the antivaccine chorus, from creationists to climate change skeptics, science remains as contentious today as it was in the late nineteenth century, on many of the same issues. As much as science offers the benefits of truth and progress, it often instead generates fear and resistance. This resistance can be readily measured by counting cases of diseases that, given available vaccines, simply shouldn’t occur at all. Start with whooping cough, or pertussis. Before a vaccine was developed in the 1940s, it was a major killer of children, with two hundred thousand US cases annually not uncommon. Once the vaccine was widely adopted, though, pertussis was nearly eliminated from the United States. But lackadaisical vaccination, along with the perception that the vaccine was more dangerous than the disease, has caused a resurgence over the past decade, with more than twenty-seven thousand cases in 2010—double the number in 2009. In Europe, where vaccination rates have been plummeting as more governments allow for voluntary immunization, measles has roared back. In 2011 there were nearly thirty thousand cases and a dozen deaths across Europe, three times the number in 2007. (Pasteur would be devastated to know that half these cases occurred in France.)

  As in the nineteenth century, the politics of this resistance to science—science that is able readily to reduce illness, eliminate suffering, and save lives—can be confounding. In the United States, for instance, vaccine refusal is frequently widespread in the most affluent, most educated communities, where a combination of presumed sophistication (“I know what’s best for my family”) along with a distrust of corporate interests (the hostility toward “Big Pharma”) can result in parents opting to avoid vaccines. As in the 1880s, a paradox is at work here: Vaccines have been so effective at eliminating the disease they would prevent that the risks of vaccination seem to outweigh the risk of getting the disease.

  A century after Koch, in 1990, Carl Sagan, the great popularizer of science, expressed this paradox precisely: “We live in a society exquisitely dependent on science and technology, in which hardly anyone knows anything about science and technology.” Science asks people to take a leap of faith. After Jenner developed his smallpox vaccine, for example, people were asked to roll up their sleeves and get vaccinated against something that nobody would thoroughly understand for another seventy-five years. Discoveries forced people to think about how they washed themselves, how they cooked their food, and how they raised their children. Science, in very ordinary terms and very measurable ways, created upheaval.

  Science had aroused social controversy before the waning years of the nineteenth century, to be sure. One need only recall Copernicus, Galileo, and Darwin. But the disputes these earlier thinkers engendered were confined to elites. However controversial they were, the disagreements were largely philosophical, not material. In other words, they infuriated the priests, but the parishioners were too busy working for a living to pay them much mind.

  This wasn’t at all the case with the scientific controversies of nineteenth-century Europe, and of Britain in particular. Now, for perhaps the first time in human history, scientific discovery was making its way into people’s homes, affecting how they conducted the daily business of their lives. To the skeptics, this was more intrusion than they were willing to bear.

  • • •

  ORDINARY DOCTORS SUCH AS CONAN DOYLE FOUND THEMSELVES conscripted into a war that Cobbe and her legions eagerly framed as a battle between science and citizens. For his part, Conan Doyle was plainly frustrated with the anti-science rhetoric and embarrassed for his country. Where scientists were championed as heroes in Berlin and Paris, in England to defend science was to invite mockery and suspicion. Though he was toiling in a tuppence-and-shilling practice in Southsea, he’d learned enough in Edinburgh to grasp the challenge of medical research and the promise it held for human health. He was keenly aware of how much medicine had changed in recent decades and how it had gone from largely palliative to genuinely preventive. His 1883 “Life and Death in the Blood” essay was clearly one gesture at reframing the issue. Out in Europe great men were doing great work. The work of Koch and Pasteur and others, Conan Doyle declared, “has opened up a romance world of living creatures so minute as to be hardly detected by our highest lenses, yet many of them endowed with such fearful properties that the savage tiger or venomous cobra have not inflicted one-fiftieth part of the damage upon the human race.” In 1883 he began delivering lectures to the Portsmouth Literary and Scientific Society and was himself elected to the council a few months in.

  He first took up arms—which is to say, his pen—in 1883, to chastise opponents of the Contagious Diseases Act. The law, which was first passed in 1864 and amended in 1866 and 1869, allowed police to arrest prostitutes and subject them to checks for venereal disease. Any woman found to be infected was subject to confinement in a hospital for up to a year. The law was clearly unfairly punitive to the women; their male customers were subject to no such treatment. But in the face of a rising campaign against the law, Conan Doyle felt obliged to speak up and point out the rampant threat to the public health that infectious disease presented. In a letter to The Medical Times and Gazette, he argued for the greater good. “For fear de
licacy should be offended where no touch of delicacy exists, dreadful evils are to result, men to suffer, children to die, and pure women to inherit unspeakable evils,” he lamented. “It becomes a matter of public calamity that these Acts should be suspended for a single day, far more for an indefinite period.”

  A few years later, it was mandatory vaccination laws that needed defending. After a Col. S. B. Wintle of Southsea objected to vaccination in the local newspaper, Conan Doyle rushed to defend the practice. “The interests at stake are so vital,” he wrote in response, “that an enormous responsibility rests with the men whose notion of progress is to revert to the condition of things which existed in the dark ages before the dawn of medical science.” After brandishing statistics that showed that the incidence and mortality rate of smallpox were decreasing, he offered a more heartfelt argument to counter Colonel Wintle. “Is it immoral to preserve a child from a deadly disease by methods that have been proven by science and experience?”

  Colonel Wintle soon argued back that epidemics of smallpox continued to break out in London and Liverpool. So much for vaccines, he implied. Conan Doyle answered with more evidence: “The death rate varies from less than one in a hundred among the well-vaccinated to the enormous mortality of 37 per cent among Colonel Wintle’s followers.” He further noted that London and Liverpool both had large transient populations that made it difficult to enforce the vaccination laws fully. Finally, he got personal. Colonel Wintle, like all those who would argue against vaccination, “undertakes a vast responsibility when, in the face of the overwhelming testimony of those who are brought most closely into contact with the disease, he incites others . . . to take their chance of infection in defiance of hospital statistics.”