Franciscan Medicine

Today, October 4th, is the feast day of St Francis of Assisi, and also World Animal Day, an “international day of action for animal rights and welfare”. Something was said in this blog last year about the World Day, and about the mind and personality of St Francis whom it commemorates. This time I shall speak about a notable latter-day disciple of his, the physician and writer Axel Munthe, who wrote one of the twentieth century’s best-selling books, published in 1929 and in print ever since: The Story of San Michele.

The book is a sort of memoir, which begins and ends with Munthe’s project to build a house among the ruins of the Emperor Tiberius’s villa at San Michele on the island of San Michele.JPGCapri – a project conceived by Munthe as a young man, and gradually completed during and after his career as a doctor to the rich, whence his social and financial success, and also to the poor, whence the fame and honours he won.

St Francis too is there at the book’s start and at its end. While Munthe was still a medical student, working in the public hospitals of Paris, he learned, in what were then religious institutions, of the “wonderful features” of St Francis, “the friend of all humble and forlorn creatures of sky and earth, who was to become my lifelong friend as well.” [28] Not that Munthe himself was persuaded by Catholicism or by any other faith, and his agnosticism shows in the very unorthodox fantasy with which he closes the book. He imagines himself before St Peter in the Hall of Judgement, unlikely to come off well. In his desperation he calls for the intercession of St Francis: “I have loved him my whole life and he knows me, he understands me.” [351] And happily the saint is indeed fetched to Munthe’s aid, not by the attendant sub-gods but by a sympathetic skylark who knows of Munthe’s past services to his species (more of those services later). In the last scene of the book, then, “there he came, the pale Umbrian saint, slowly descending the winding hill path . . . Swift-winged birds fluttered and sang round his head, others fed from his outstretched hands . . .” And so on.

Yes, you’ll be finding this a bit soppy. No doubt there is something of Ronald Searle’s “sissy” schoolboy Fotherington Thomas – with his “Hello clouds, hello sky!” – about St Francis himself, at least as recorded in legends. (In fact, of course, he was a very strong personality as religious leader and as administrator of the order he founded.) And like St Francis, Axel Munthe speaks of “my brothers and sisters from forests and fields, from skies and seas” [9]. In The Story of San Michele and his other writings he often converses with animals, imputing replies to them, as indeed he does in the case of that skylark. Accordingly, the entry for Axel Munthe in the Dictionary of National Biography (Munthe was a British, as well as a Swedish, citizen) calls him “a sentimental lover of animals”.

Munthe knew himself liable to the disparagement. When he denounces the shooting of larks for food, a friend says to him “You are an idealist, my dear doctor.” Munthe replies, “No, they call it sentimentality and only sneer at it.” But then he says, “mark my words! The time will come . . . when they will understand that the animal world was placed by the Creator under our protection, and not at our mercy; that animals have as much right to live as we have.” [73] If ‘sentimentality’ means pleasurable indulgence in the gentler emotions, then Munthe’s anger about the larks is a plain refutation of the charge. For as he exclaims later when speaking of his retirement on Capri, “The birds! The birds! How much happier would not my life on the beautiful island have been had I not loved them as I do!” [309]

And it’s not just that decisive ethic, “as much right to live as we have” (an ethic which must indeed bring unhappiness to all who know it to be right but see it everywhere violated) that gives his relation with animals unsentimental substance. No, he fought for those birds on Capri. Even literally he did so: he was fined for knocking down the man whose land on the side of the mountain was used for trapping the birds when they briefly rested there, thousands of them, on their way across the Mediterranean in spring and autumn. Munthe’s feud with that man – the local butcher, appropriately enough – and his eventual success (he finally bought the mountain-side and made it into the bird sanctuary which it remains today) is one of many practical animal narratives in the book. He knew very well the difference between ‘love of animals’ as a sentiment and as a motive for conduct. When he says in his book of essays titled Vagaries “I know well that England is the country for lovers of animals”, he is speaking sarcastically, his topic at that moment being fox-hunting.

Besides, the phrase “right to live” was one which Munthe couldn’t have used carelessly. For he spoke as a doctor, and one who was even more familiar than most in his profession with what he calls “the battle between life and death”. [125] He writes a lot about ‘Death’ (his own is being imagined in that last scene). Parts of San Michele constitute a sort of meditation on death, felt and addressed as a distinct personality. First seen “at work” in a relatively modest way (“a mere child’s play”) in the Paris hospitals, death later assumes giant proportions in Munthe’s career:

I saw Him at Naples killing more than a thousand people a day before my very eyes [i.e. during the cholera epidemic of 1884, the subject of Munthe’s book Letters from a Mourning City]. I saw Him at Messina burying over one hundred thousand men, women and children under the falling houses in a single minute [the earthquake of 1908]. Later on I saw Him at Verdun, His arms red with blood to the elbows, slaughtering four hundred thousand men, and mowing down the flower of a whole army on the plains of Flanders and of the Somme [Munthe was serving in the ambulance corps, as described in his book Red Cross, Iron Cross]. [125]

To all these places Munthe had gone voluntarily, leaving his comfortable practice in order to attend the sick and dying. His experiences during the two Italian disasters are described in San Michele. But this man who felt so much sympathy and took so much risk for humans in extremis was with equal willingness and earnestness a doctor to animals. In Rome he kept “a sort of infirmary and convalescent home” [291] for them alongside his human practice, and some of the most vivid images in the book are of suffering animals. There is the gorilla dying in the Paris zoo, who “sat up in his bed and put his two hands to his temples in a gesture of despair” [47] (Munthe hated zoos and menageries: “The cruel wild beast”, he said, “is not behind the bars of the cage, he stands in front of it.” [60]) Or there is the time when Munthe is asked to attend a monkey scalded by boiling water; the request comes from a fellow-doctor who “begged me to wait in his salon, and appeared a minute later with a monkey in his arms, a huge baboon all wrapped up in bandages.” The bandages once removed, “it was a pitiful sight, his whole body was one terrible wound.” [243]

No, there is nothing sentimental here, only careful observation, sympathy, and devoted Axel_Munthe00service. And what Munthe says about his skill as a “dog-doctor” seems to have been true with all these animals: as patients, they needed love and understanding, “the same as with us, with the difference that it is easier to understand a dog than a man, and easier to love him.” [49]

It’s in the monkeys in particular that we see how Munthe had, in his own thinking, revised the conventional Darwinian scheme. He knew and felt its general implication, of course, that we were all, as he says in the book Vagaries, “fellow-citizens in Creation’s great society”. But the idea that humans were evolution’s newest and best did not appeal to him. The zoologist Thomas Huxley had spoken in his justly famous Romanes Lecture, ‘Evolution and Ethics’ (1893), of rising above the heritage of “ape and tiger” in man. For Munthe, however, humanity was more of a coarsening of what had come before than an ascent from it. Near the end of San Michele he combines Genesis and Darwin in a scarifying narrative of man’s emergence on the seventh day of Creation:

a huge monkey maddened by hunger set to work with his horny hands to forge himself weapons to slay the other animals . . . he grew up, a brutish Protanthropos slaying friends and foes, a fiend to all living things, a Satan among animals . . . His raucous cry of wrath and fear grew into articulate sounds and words . . . he evolved into man . . . The ferocious war began, the war which has never ceased. [349-50]

If – so Munthe suggests – the God who made this mistake ever wakens from his “haunted slumber” sufficiently to organize a second world-cleansing deluge, the next Ark will be for animals only.

No sentimentalist, then, though it’s true that his excitability as a writer leads him into maudlin moments, as it does into all sorts of other carryings-away: whimsies, exaggerations, obvious fictions, over-coloured dreams and visions. The author himself confesses it, but with one beguiling reservation: in the prefaces which he wrote from time to time for new editions of San Michele, he admits that some of the scenes in the book are mixtures of “real and unreal . . . fact and fancy”, but then he says, “in one respect at least I can say with a clear conscience that I have not deceived my readers – in my love for animals.”

Still, Munthe was a physician; his training had therefore implicated him in the use of animals for research, and to some extent it had even reconciled him to it. He had direct experience, as a student, of Louis Pasteur’s studies in rabies. Then in his own practice he had to deal with the worst medical scourges of that time, whose aetiologies were just then being uncovered in the laboratory: cholera, diphtheria, consumption. Rabies too he was called in to treat, and it’s while writing about rabies that he suddenly faces this subject, using the rhetorical question to which he habitually resorts in passionate moments: “When will the anti-vivisectionists realize that when they are asking for total prohibition of experiments on living animals they are asking for what is impossible to grant them?” Researchers like Pasteur, Behring (on diphtheria), and Koch (cholera), he says, “must be left to pursue their researches unhampered by restrictions and undisturbed by interference by outsiders.” [59]

True, it’s only to such directly disease-related studies that Munthe concedes this freedom, and such projects are “so few that they can be counted on one’s fingers”. For the rest he agrees to “severe restrictions . . . perhaps even total prohibition.”  Moreover, he acknowledges that differences between the physiologies of animals and men often undermine the “practical value” of vivisection. He even proposes that convicted criminals be offered remission of their sentences in exchange for service in laboratories – in the laboratory, for instance, of the then fashionable ‘rejuvenation’ specialist (or fantasist) Dr Voronoff, as “substitutes for his wretched monkeys”.

That’s a desperate alternative, which was no more practicable at that period than it is now, but it suggests something of Munthe’s restlessness of mind on this subject. And of course there did not exist in his time the many non-animal “substitutes” that have become available since.

It’s notable also that the terrifying rabies-related case to which Munthe has been called, and which prompts this single brief disquisition on animal research, is not in fact a case of rabies at all. After frightful scenes of panic, bloodshed, and attempted suicide, leaving in their wake a shot dog and a blinded and mentally unhinged patient, laboratory tests indicate that neither man nor dog had any infection. This story of false alarm, therefore, so far from illustrating the case for research (I don’t think that Munthe means it to), belongs with a much larger theme in Munthe’s career as a doctor: namely hypochondria, the resort to medical explanations and therapies for what are really moral and social ailments. We would now call it the ‘medicalization’ of unhappiness. At that time it was only for the rich, naturally enough. The poor, meanwhile (as Munthe clearly shows) were living in conditions which made even ordinary good health nearly impossible. Their poverty was what above all needed curing. Certainly disease is real enough, but much of human illness is of our own creating, and can be put right (if at all) without benefit of medicine.

The Story of San Michele is not an orderly narrative of Munthe’s life, still less is it a reasoned report on his profession. He shows the horrors of disease and suffering, the vanities of invalidism, good and bad doctoring, the comedy and tragedy of these, but offers no summing-up, except what is implied in the joy of escaping them, as he finally does escape them at San Michele. But of course there is a philosophy that takes form and persists through it all. Munthe brings with him into his San Michele way of life animals new and old (including that scalded monkey, now fit and hyper-active) and also his continuing sense of the necessity to love and defend them and all their kind. In short, the philosophy of St Francis: the one thing, as he says in the preface, that is unconditionally to be trusted in all he has written. As to vivisection, the dissonant element there, we may trust what he says or not. St Francis, his model in so much, could not guide him in that matter.

 

Notes and references:

Quotations from The Story of San Michele use the edition issued by John Murray in 2004, Murray having also published the first edition in 1929. Vagaries (later titled Memories and Vagaries) is a collection of short essays, many of them about animals, and was published by John Murray in 1898: quotations are from the chapters titled ‘Blackcock-Shooting‘ and ‘Zoology’.

The idea of using convicted offenders in medical trials may have some obvious logic and appeal but is also flawed and dangerous, even sinister. There is quite an informative piece about it on the web-site of Understanding Animal Research here: http://www.understandinganimalresearch.org.uk/news/communications-media/why-testing-on-prisoners-is-a-bad-idea/  But I don’t mean to promote that web-site, which is given some critical attention in this blog here: https://voiceforethicalresearchatoxford.wordpress.com/2018/06/08/on-the-trail-of-an-untruth/

Last year’s post about World Animal Day can be read here: https://voiceforethicalresearchatoxford.wordpress.com/2018/10/02/two-anniversaries-one-lesson/

The portrait in charcoal and pastel of Axel Munthe is by his contemporary, Feodora Gleichen.

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