MEDICAL RESEARCH AND NATURAL PHILOSOPHY BY

Niels Bohr.
Invited to contribute to this volume in honour of a great master in medical science, I have felt some difficulty since, as a physicist, I have of course no expert information to offer as regards the causes and treatment of diseases. I must therefore confine myself to some general remarks on the relationship between medical research and natural philosophy suggested by the modern development of physical science.1) From early days, medical science has been closely related to many other aspects. of knowledge and philosophy, and mankind still remembers with veneration the teaching of the great Hippocra-tes as regards the duty of doctors not only to keep abreast with practical developments in their field, but also to enlighten their minds through the study of general human problems in order to be able properly to fulfil their important mission. It is this spirit which lies behind the development of anatomy and physiology in the Renaissance, when the great pioneers, like Vesallius and Harveg, were at the same time highly honoured doctors who were given most responsible tasks in the society of those days. Fundamental progress in physics at that time, which led to the clarification of the principles of mechanics, gave a great impetus to the development of medical science. Still classical within their scope are studies of Borelli, inspired by his close contact with Galileo, of the functioning of skeleton and muscles. Through the ages, contact with the medical sciences has also been a decisive stimulus to the development of physics and chemistry. The fundamental role which electricity plays in natural phenomena might for
1)

These remarks form the substance of an address delivered at the Second International Poliomyelitis Conference in Copenhagen, September 1951.

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long have remained hidden if nature had not presented us, in the nervous system of the higher organisms, with such refined and sensitive apparatus. Indeed, Galvanis discoveries were not only basic for the development of neurophysiology, but even paved the way for the discoveries of electrochemistry and electromagnetism. We also remember how Robert Mayer was led to the idea of energy conservation, so central in physical science, by observations during his surgical operations in tropical climates. In return, physical and chemical sciences have offered more and more effective tools and fruitful viewpoints for the exploration of the structure and functioning of the organisms. At the same time, however, this exploration has revealed an ever increasing variety of possibilities for regulation and adaptation, which again and again has struck us with wonder and led to a renewal of the old debate of the attitude to take to the explanation of life, or rather of the rational description of the position of living beings among the natural phenomena. According to the weight which in such discussions has been laid on words like cause and purpose, two viewpoints, characterized as mechanicism and vitalism, have often stood sharply against each other. Mechanistic viewpoints have especially prevailed at times when the developm.ent of physics and chemistry has given new insight into organic functions, while vitalistic viewpoints have been revived when attention was focused on new discoveries regarding the surprising resources of living organisms. The problem of finding a rational and consistent way to orientate ourselves in this situation reminds in many ways of the problems with which we have been confronted in modern physics through the exploration of the world of atoms, and which have given rise to a renewed discussion regarding the principles for the description and comprehension of physical phenomena. Although is was understood already in ancient Greece that the regularities which, inspite of all variety, manifest themselves in the properties of material substances, suggest a limited divisibility of matter, it was up to our century believed that the coarseness of our senses would for ever prevent the observation of individual atoms. Still, the marvellous development of the art of experimentation, and especially of the technique of amplification, has allowed us to observe effects produced by single atoms and even to study the constitution of the atoms themselves. The information which we have thus received is in many ways of a very simple character and, as everyone knows, our picture of the atom consists of a cluster of electrons held together by the attraction from a central charged nucleus. While, in many physical and chemical phenomena, the electrons may be displaced or even removed from the nucleus, the latter will, under ordinary physical conditions, including those existing in the organisms, remain uninfluenced. Moreover, the fact that the properties of an atom are to a high degree determined only by the electric charge of the nucleus - and not by its internal constitution - has made it possible by

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application of so-called isotopic indicators to label the atoms and thereby study metabolic processes in far greater detail than was hitherto possible. Notwithstanding the simplicity in such respects of our ideas concerning atomic constitution, it is equally clear that it is not possible, on the basis of the principles which have proved so fruitful in the description and comprehension of large scale physical phenomena, to account in detail for the properties of atoms. In particular, the stability of atomic systems presents us with an entirely new feature of physical regularities bound up with the universal quantum of action, discovered by Pianck in the first years of this century. This discovery has initiated a whole new epoch in natural philosophy in revealing that the classical principles of mechanics and electrodynamics are idealizations which hold only for phenomena where we have to do with actions which are large compared with the individual quantum. In atomic phenomena, where this condition is no longer fulfilled, we meet with regularities of a quite new kind, which reject pictorial interpretation and even defy a detailed causal description. The clarification of the apparent paradoxes with which we are here confronted has demanded a revision of the principles for the comprehension of physical experience. A decisive point has been the. recognition that, in atomic physics, we can no longer uphold the idea of a behaviour of objects, independent of the circumstances under which the phenomena are observed. Jt is here not a question of a practical limitation of the accuracy of measurements, but of an aspect of the laws of nature, associated with the quantum of action, which sets a lower limit to the interaction between the objects and the measuring instruments. This Yery circumstance presents us with an entirely new situation, since any attempt to control the interaction between objects and measuring instruments will imply that the bodies so far used for fixing the experimental conditions will now themselves become objects under investigation. Additional measuring instruments with new uncontrollable interaction with the objects would therefore be demanded, and all which could be achieved will be the replachinent of the original system by a new, more complicated one, for the description of' which quite similar conditions will hold. In this situation, it is not surprising that evidence obtained under different experimental arrangements cannot be combined in the accustomed manner. In particular, specific quantum processes cannot be represented as a continuous causal chain of events, since any subdivision into welldefined steps would demand a change in the experimental arrangement, which would be incompatible with the appearance of the phenomenon we want to study. We are here presented with a peculiar feature of wholeness in atomic processes, quite foreign to classical physics, and the manifestation of which is inherently associated with the latitude involved in the definition of the behaviour of atomic objects. Apparently contrasting phenomena, appearing under different experi969

mental conditions, are termed complementary in order to emphasize that only together they exhaust the knowledge obtainable about the objects. By the ingenious formalism of quantum mechanics, which abandons pictorial representation and aims directly a t a statistical account of quantuiii processes, it has actually been possible along the lines of complementary description to bring logical order within a rich field of experiencc regarding fundamental physical and chemical properties of matter. This whole development has forcefully reminded us that even principles so well established by earlier experience as the causal description in classical physics may fail to comprehend new fields of experimental evidence. Far from implying an arbitrary renunciation on detailed scientific explanation, the concept of complementarity points to a widening of our conceptual framework demanded when dealing with experience where the interaction between the objects under investigation and the tools of observation cannot be eliminated. When, on this background, we return to the basic biological problems, we must realize that the stability of the atoms composing the tissues, and not least the fine molecular structures in the cell with which the hereditary properties of the organism are associated, bring us right into the domain of quantum physics. In this connection, the statistical laws governing the occurrence of individual quantum processes have, as is well known, found interesting and promising application in the interpretation of experience regarding artificial mutations. Also the fineness of our senses, like visual perception, has been found to go down to the atomic level, and we must assume that amplification processes analogous to those applied in the registration of atomic phenomena play a decisive role in the mechanism of nervous messages. These remarks, however, do in no way imply that, even if quantum theory is indispensable for dealing with biological phenomena, it should in itself suffice for an explanation of life. On the contrary, the point which I want to emphasize is the wider implication of the lesson atomic physics has taught us about our position as observers of natural phenomena and, in particular, about the rational use of words like cause and purpose. Although science will of course strive for ever more detailed knowledge of the physical mechanism underlying the functions of organisms, a description of life corresponding to the ideal of mechanicisni will only constitute one line of approach. In fact, we must recognize that experimental conditions demanded for an exhaustive description conforming with this ideal would involve a control of the organism to an extent which would preclude the display of life. In actual biological research, a vitalistic approach is equally indispensable, since the primary object must often be the studies of the reaction of the organism as a whole for the purpose of upholding life, a point of which we are not least reminded in medical research.
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We are here neither speaking of any crude attempt of tracing a n analogy to life in simple machinery, nor of the old idea of a mystic life force, but of two scientific approaches which only together exhaust the possibilities of increasing our knowledge. In this sense, mechanistic and vitalistic viewpoints may be considered as complementary, and in the harmonious balance between their applications we find the basis for the practical and rational use of the word life. Such an attitude implies no limit to the obtainable knowledge of the detailed structure of the organism nor to our hopes of exploiting our potentialities and combating diseases. It is true that, up to this stage, we have as always in physical science considered ourselves merely as observers, and this attitude applies equally to classical and to quantum physics. It may be stressed, however, that the concept of complementarity is also suited to characterize essential aspects of the consciousness associated with our life. I do not only think of the unity of the personality which presents a similarity to the wholeness of the organism, but also of many features of introspection which strikingly remind of the conditions for comprehension of experience in atomic physics. Corresponding to the relationship between object and measuring instrumenfs in quantum phenomena, we have, in the various psychical experiences, to do with a different placing of the line of section between the object on which attention is focused and the observing and judging subject. Any attempt to avoid this section by including subject as well as object in the consciousness would clearly imply the introduction of a new subject to keep account of the original one. If in this situation the normal balance is lost, symptoms well known in psychology and psychiatry and referred to as confusion of the egos and dissolution of personality may occur. A clear example of psychological situations of mutually exclusive character we meet in the problem of the free will, which through the ages has given rise to eager debate. The decisive point is here the recognition that a state of consciousness, in the description of which words like I will find application, is complementary to a state where we are concerned with an analysis of motives for our actions. It is on this background that we may speak in a rational manner about volition a s an indispensable element in any attempt a t an exhaustive description of consciousness. Just as no one would attempt to avoid the use of the word life, notwithstanding all difficulty in distinguishing sharply between inanimate and living, so will hardly anyone be able to deny that in speaking of freedom of will we are expressing ourselves as adequately as verbal communication allows. In this connection, we must recognize that, in all use of language, the practical application of any word is complementary to attempts at its strict definition. Rather than with sophistical argumentation we are here concerned with sober analysis of the proper use of words in the description of our position as actors as well as spectators in the drama of existence. Indeed, how shall
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we decide whether a man can d o something because he will or whether he wants to do it because he is able to. In particular, how can we, in thinking of the mastership of Erik Warburg in the art of medicine, separate his ability, based on scientific insight, to assist ailing fellow-men in restoring their strength and regaining their vitality, from the power of his versatile and vigorous personality to stimulate their will to live and with his help to recover their health.

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