THE CAUSATION OF DISEASE. 285 



needs die unless placed under proper surgical treatment. The 

 surgeon stands in the relation of a specific form of E to such 

 a sufferer, who, if he be placed amid the artificial E created 

 by surgical skill, may be, practically, always rescued from 

 otherwise certain death. Delivery by forceps and the arti- 

 ficial rearing of iufants are other modes of artificial E : upon 

 them, indeed, the lives of many children depend. 



The physician occupies a similar position to the surgeon, 

 and, although he cannot claim such rapid and startling results, 

 there can be no doubt that numbers come safely out of 

 illnesses, which, but for his skill, would necessarily destroy 

 them ; delicate children also are frequently, by a careful regu- 

 lation of the E, enabled to survive. 



In like manner, many domesticated animals are wholly 

 dependent upon the artificial E supplied to them by man ; for 

 instance, some kinds of camel cannot be brought into proper 

 sexual connection without man's aid, and bees may become so 

 vitiated in instinct by artificial treatment as to be absolutely 

 dependent upon the help of man. 



Now, what effect upon the race has the interference of the 

 doctor ? It is manifest that the process of elimination is 

 checked, and the amount of disease thereby increased ; for not 

 only are diseased individuals kept alive, but they are enabled 

 to rear offspring to inherit the like diseases. Thus, while 

 benefiting the individual, we help, as we have already seen, to 

 cause racial deterioration. 



I am careful to say, " help to cause racial deterioration," for 

 it will be presently manifest that these artificial checks to 

 natural elimination need not in all cases have such a result. 

 We must first, however, answer the question : Is there any 

 intrinsic difference between a highly artificial form of E and 

 so-called " Nature " ? We will take as an instance that most 

 highly artificial E — surgical skill. Given this E, then ovarian 

 cysts, vesical calculus, and strangulated hernia are compatible 

 with life ; wherefore it follows that the human race might 

 persist, even though these diseases became universal, provided 

 the necessary surgical skill were at hand. Hence whereas 

 S -I- natural E = death in some cases, S + artificial E would be 

 consistent with continued healthful life. If, then, all indi- 



