[80] "There are unfortunately no reliable statistics as to the average wages earned by women workers, but, speaking from a large experience, I estimate that the average wage of the manual woman worker, taking into account slackness, sickness, &c., is certainly not more than 7s. 6d. all the year round."--"Trade Unions," by Mary Macarthur, in "Women in Industry from Seven Points of View," p. 66.

[81] Stephen Reynolds in "A Poor Man's House" paints this situation with great psychological insight.

[82] Compare Salmon, "Domestic Service," pp. 145-6.

[83] Compare "Englishwomen's Year-book for 1910," p. 69.

[84] _e.g._ Rowntree, "Poverty: a Study of Town Life"; Liverpool Economic and Statistical Society, "How the Casual Labourer Lives"; "Study of the Diet of the Labouring Cla.s.ses in Edinburgh" (published by Otto Schulze & Co., now out of print); Recent Blue-books on the Cost of Living, &c.

[85] Rowntree, "Poverty: a Study of Town Life," pp. 117, 298 _ff._, as to inadequacy of diet of labourer, pp. 235 and 303. Mr.

Rowntree's conclusions have been impugned by several critics, and it may be that his dietary standard is too high. But even if it turns out that only a quarter and not a third of the population are in receipt of incomes insufficient for the expenditure necessary to secure bodily efficiency, the fact is serious enough.

[86] Calculated by Messrs. Rowntree and Sherwell to amount to 6s. 10d.

per family of the working-cla.s.s population. "Temperance Problem and Social Reform" (7th ed.), p. 20.

[87] "Principles" (4th ed.), p. 194.

[88] A special charge was made for guests in this household, and the amount received was deducted from the weekly food bill.

[89] "The Camel and the Needle's Eye."

[90] "The Camel and the Needle's Eye," p. 153.

SOME RELATIONS OF SANITARY SCIENCE TO FAMILY LIFE AND INDIVIDUAL EFFICIENCY

BY ALICE RAVENHILL

Among the many notable characteristics by which the last half century has been distinguished, there are two which bid fair permanently to colour its records and materially to influence the future of our country. I refer in the first place to the scientific study of man, his nature, his needs, and his potentialities; and in the second to the growing appreciation of the fact that the centre of ethical gravity must be shifted from absorption in the sole concerns of self to an intelligent interest in the affairs of others--that is to say, that selfishness must yield to well organised and discriminating social service.

I. MAN'S PLACE IN NATURE

It is of course no new thing for questions upon the real nature of that complex creature, man, to force themselves upon the attention of the observant, and from time immemorial the philosophical have spent themselves in efforts to solve this problem by theories designed to detect, even if not to account for, the agencies active in the formation of the human mind and body. The records of older civilisations bear testimony to their labours, and are familiar to most students of ancient literatures. But it was not till the resources of modern science forged new tools for the inquirer that it became possible to chisel out from the bedrock of fact the main features of man's physical and social history.

With admirable patience and infinite skill, the scientific craftsmen of recent times have laboriously pieced together the scattered chips of biological research, of human tradition, of tribal customs and of world-wide folklore, until the dignity and power, the beauty and the possibilities of human nature have emerged from the dust of ignorance and the veil of superst.i.tion. The result is that it is no longer permissible to deplore in pessimistic tones the inevitable degradation of the race, nor to accept with supineness the threatened deterioration of a population. The forces by which humanity is moulded are no longer unknown; the principles which underlie social stability have been identified; the means by which the arts may be developed, which make life not only tolerable but healthful, are ready to our hands.

The far-reaching significance of these facts in connection with human health and progress become apparent when considered in more detail.

Observers throughout the ages have gradually noted, and subsequently turned to practical account in garden, meadow, and farmyard, certain characteristics common to all known forms of vegetable and animal life.

By due consideration of these it was found possible to improve breeds, to strengthen and lengthen life, to avert disease, and generally to enhance economic value. It may now appear simple enough, to extend and apply these observations to the betterment of human life; but many generations of human beings slipped away before the facts, dimly discerned by Aristotle and Lucretius, by Buffon and Lamarck, were clearly focussed by Darwin,[91] Wallace, Spencer, and Huxley, through whose skill and labours the continuity of the web of life was first displayed to the world at large. The design may here be almost elementary in its delicate simplicity; there its subtle intricacies well-nigh baffle description. The variety of pattern is marvellous indeed, as Nature weaves with ceaseless industry the woof of progressive development. But the warp of this wondrous web is nevertheless continuous throughout its length, uniting the whole into one vast fabric.

This basic unity of all manifestations of life has been further substantiated by another group of scientists--Schleiden, Schwann, Kolliker, and Virchow, for instance--who gradually and conclusively proved the ident.i.ty, in their simplest form, of those living bricks (_i.e._ microscopic particles of protoplasm) from which the whole vast edifice of life is constructed. The capacity they possess for differentiation in their functions and in modes of combination long masked recognition of the fact that each commonwealth of cells, whether plant or animal, is developed in the first instance in orderly progression from a similar minute speck of protoplasm, acceptation of which has sufficed to bring about a complete revolution in the scientific world. To these discoveries were shortly added Pasteur's conception of the nature and causation of infective diseases; a knowledge which brought with it a great accession of power over hitherto mysterious and uncontrollable conditions. And finally, man's eyes have been opened to the comprehension of Nature's means of self-defence against the micro-organisms of disease. Thus, while humanity is by these means armed with most potent weapons against the inroads of infection, decay, and death, the light thrown upon the mystery of the origin of each individual life has shown man his true place in the kingdom of nature. The application of these great discoveries, together with increased opportunity for and accuracy in their utilisation, const.i.tute the basis of the modern methods of hygiene.

It must be borne in mind that until less than a century ago it was man's custom to dissociate himself wholly from the less highly developed animals and plants which he employed so freely for his support and convenience. He set himself on the highest pinnacle, as it were, of the edifice of life, believing himself to be independent of the influences by which the rest of the building was dominated. And thus through countless ages he suffered, languished, and died, unconscious that the forces he had learned more or less to control in husbandry and farmyard were in their turn controlling him in the conduct of his life. Ignorant alike of the influences of his own inherited nature or of those of his environment, he paid no heed to the responsibilities of transmitting the torch of life undimmed to succeeding generations, and gave no thought to utilising to his own personal perfecting the resources of Nature, which he habitually employed to increase his wealth or to improve his crops and stock.

It was indeed to the control of his _surroundings_ that man first gave more or less careless heed. The fact that environment can either stimulate or stunt both physical and mental powers, thrust itself too persistently on his attention to be ignored; but the influence of a good parentage or of sound ancestry was less obvious, and for generations received little or no attention. Vague talk on "family temper," "family habits," "family voices" was common enough, but no more than a pa.s.sing curiosity was aroused as to their hidden import, nor was their profound significance suspected.

Thus, though half a century has pa.s.sed since Darwin placed man[92] "in his proper position in the sequence of biological forms," during which interim enormous strides have been made in applying to the betterment of human existence the principles found to hold good in the case of lowlier type of life, public sentiment has so far only supported sanitary reforms directed to the promotion of improved environment. And this in spite of Sir Francis Galton's[93] first appeal in the cause of eugenics more than forty years ago. The distinguishing characteristics of progressive races and the right of every unborn child to be the offspring of healthy, self-respecting, virtuous parents have been repeatedly pointed out; while attention is drawn to the acc.u.mulating evidence in favour of the fact that of all influences upon the individual his inherited nature is the most powerful. Yet the public ear remains deaf to the cry that the present generation is largely responsible for the weal or woe of their children's children.

This is not the place in which to discuss Darwin's theory of heredity nor its subsequent elaboration and amplification by his contemporaries or successors.[94] But the time is come when emphasis _must_ be laid upon the duty of gaining some general acquaintance with the subject and its applications in the case of an Imperial people.

It may be also well to point out that pessimism is not necessarily a.s.sociated with the fruits of the studies carried on by our students of inherited qualities, such as Sir Francis Galton or Professors Thomson, Bateson, Karl Pearson, and others; only their results give us reason to pause, for they cannot lightly be disregarded. They tell us that we hold in our hands to-day the mental vigour and bodily powers of an untold number of descendants, therefore it behoves us to consider our ways and be wise while there is yet time. For our encouragement also be it known, that while the lamp of modern hygiene illuminates the errors of the past, it sheds its bright rays over the paths of the present, and penetrates to some extent the dim twilight of the future.

II. FACTORS ADVERSE TO HUMAN PROGRESS

It is a matter for regret that the sympathetic consideration for the sufferings of others, which found such grand exponents in John Howard, in Elizabeth Fry, and in thousands more since modern methods of philanthropy were initiated in the eighteenth century,[95] has tended latterly to lose its virility. It is giving place to a maudlin sentimentality, which seeks not only to preserve life at all costs, but to permit, nay to encourage, the production of a quality of human life, so defective, so devitalised, that it threatens to minimise the multiplication of the fit, by taxing them to their detriment with the care and support of the unfit. So to smooth the path of the weakly and unsound as to put a premium on their fertility is false philanthropy and faulty hygiene; for it is well to remember that reasonable exertion is beneficial to health; that to overcome obstacles is stimulating to the energetic; that some struggle for the means of livelihood calls forth resourcefulness and adaptability in the intelligent. Success in the battle of life comes to those made of stuff equal to the wear and tear of daily existence, and possessed of the qualities which conduce to progress. These are they who are competent to perpetuate the best qualities of a good stock; these should be the chosen bulwarks of a nation's progress; nor must their numbers be swamped by the ailing, the crippled, the defective, and the insane.

A proportion probably of some of the deeply seated, complicated, social problems which have presented themselves, unperceived and almost unconsciously, are the outcome of a one-sided study of hygiene: these, combined with the slow growth of social science, and a sickly, easy-going susceptibility, have been allowed to obscure the real issues of many well-intentioned but unwise and ill-considered philanthropic measures. The necessity, the _urgent_ necessity, has now, however, arisen for the bold and scientific solution of these social problems.

The work of biologists, sociologists, and students of history during the last ten years has illuminated the whole question of race progress and public health with a light so powerful and clear that even he who runs can read the signs of the times by its clear rays; while to the millions of parents and guardians whose lives are spent in the care of children and home, its brilliance throws into high relief the dignified responsibility of their work, its far-reaching worth and enduring influence, as well as the fact that for its adequate performance something more is necessary than a bowing acquaintance with modern sanitary science.

For what is the message of scientific hygiene to the parent and householder of the twentieth century? Dr. W. H. Burnham, of Clarke University, U.S.A., a world-wide authority on the subject, has formulated this message for us into three terse, but telling and suggestive, commands.

The first gives solemn warning to beware of fads and of the many popular doctrines which are mediaeval in their crudities and damaging by their unconsidered acceptance.

The second preaches the gospel of _work_ and self-control, which must be practised in this as in every other connection where progress and good results are desired.

The third enforces the doctrine of cleanliness to a degree as comprehensive as it is unusual--cleanliness in person, dwelling, and food; in air, water, and decoration; in occupation, environment and morals; the work of home hygiene being to secure for each family conditions which will permit normal and unhampered functioning for all the organs of each one of its members; elasticity and pliancy in the functions being a primary characteristic of health.

If once it be accepted that health, capacity, endurance, and energy are more powerful weapons for a progressive people than are sword or gun, obedience to these commands will be general and their results enduring.

The pages of history teach us that each nation in turn has exhibited these qualities at its zenith of success, whether it were the relatively highly civilised inhabitants of Greece and Rome, or the barbarian hordes under Attila. They characterise equally each group of successful pioneers, whether they be the Pilgrim Fathers of the sixteenth, the Huguenots of the seventeenth, or the successful colonist of the nineteenth century. When however their cultivation is neglected the force of the life current of a people or community is lost; the mighty river of a nation's prosperity dwindles to an insignificant streamlet of mere existence, soon to be lost to view in the mora.s.s of oblivion.

To what general causes may such deterioration be attributed? Among the more prominent must be mentioned ignorance of man's physical nature and of the nurture essential to his welfare; subtle forms of self-indulgence; lowered standards of morality; enervating luxury, or, in some cases, so severe a struggle for existence among the salt of the population (the upper, middle, and professional cla.s.ses, superior mechanics and artisans), that even patriotism does not justify a quiverful of children. But the persistence of these causes is a national calamity. It is the science and art of hygiene which is emphasising their disastrous consequences. No longer in its infancy, no longer a mere collection of fads, questionable statistics, and empirical doctrines, hygiene is prepared to inform us how to promote human efficiency in every relation of life--domestic, occupational, social, and imperial. Its tenets are firmly based upon a goodly group of sciences, and their utilisation call into play a whole range of arts. Its theories find confirmation in the social problems of the day, and the experience gained from their tentative and partial application affords sound evidence of their worth to the world. The "expectation" of life, for instance, has been extended ten years in half a century; in twenty years the death-rate has decreased thirty per cent. Disease has been found in most instances to be controllable, and has been controlled; unhealthy occupations have had their dangers curbed if not entirely banished, and the lot of many has been immeasurably brightened. _Yet_ the weak joints in the nation's harness are gaping, and the vigour and virility of the ma.s.ses appear to be diminishing. Again we ask, Why?

III. STAGES IN THE GROWTH OF SANITARY SCIENCE

The answer may be found by reference to the late Professor de Chaumont's now cla.s.sical outline of the stages to be identified in the hygienic education of a race. He divided these into three periods, of which he described the first as merely "Instinctive," for efforts after sanitary practice were dictated solely by the personal discomfort a.s.sociated with their neglect. In those far-off prehistoric days, Professor Boyd Dawkins tells us that primitive man, then in his nomadic stage, would dig runnels to carry off the rain water from the near neighbourhood of his shelters, or would move on to fresh pastures when his family and herds had fouled the nearest stream, or change his camping ground when the acc.u.mulated refuse of his food and his prowess as a hunter interfered with convenient access to his dwelling; but he took no precautions to prevent the recurrence of these discomforts, and his efforts to remove their consequences were purely temporary.

To this there succeeded what Professor de Chaumont designated the "Supernatural" period,[96] which extended over many thousands of years, during the dawn of which Eastern rulers often combined in their own person the triple callings of priest, prophet, and physician. Whether it be in China or in Persia, in Egypt or in India, among the Greeks, the Arabs, or the Hebrews, the practice of physical morality and of personal cleanliness, of restrictions of diet or protection from infection, were closely woven into the religion of the people. Reasons of health and sanitary advantages permeate the rules of more faiths than that of the Jews--whose Lawgiver embodied in the Pentateuch health maxims now known to have been derived from earlier civilisations.

But, remarkable and interesting as are the ancient sanitary codes to a generation which professes to believe in the necessity for hygienic practice, their usage was tinctured from the first by a ma.s.s of superst.i.tion. Tradition and fatalism hampered true consistency between faith and works; the often sound regulations suffered from their empirical foundations. Constant warfare, varied by alternations of luxury with asceticism, combined to absorb men's minds and to pervert their common sense, so that plague and famine, disease and penury, were superst.i.tiously regarded as discipline from the Deity, not to be averted or avoided, but rather to be accepted as a chastis.e.m.e.nt prompted by love. The creed that to save suffering to the vile body might risk the salvation of the soul, cost Europe far dearer than is at all generally recognised; for the n.o.ble, the pure, the high-minded, the intellectual, segregated themselves for centuries in monastery and convent, in the firm faith that by denying to themselves the joy of parenthood they promoted the spiritual welfare of their country. Ignorant of their racial responsibilities, they left as progenitors of the next generation the less refined and ruder elements in the population. It is no cause for surprise, therefore, that progress in sanitation moved slowly.

Domestic and urban conditions were permitted of a character well defined by the facts that, in mediaeval times, a man of forty-five or fifty was considered long lived, and that first attempts to control disease were based upon commercial convenience rather than upon the saving of life.

To this long night of superst.i.tion succeeded the third and last period, known as the "Rational," of which the first dawnings can be detected even in Plantagenet days. In this period it is desirable further to differentiate three stages of progress--(_a_) that of Development, when uneasiness made itself felt, but from absence of knowledge efforts at reform and control were crude, though often intelligent; (_b_) the stage of Legislation, and (_c_) the stage of Freedom.[97]

In the first of these, for instance, Henry III. effected an improvement on any former practice by bringing water to the city of London in pipes, made by boring or burning a channel through the trunks of large trees.

Half a century later, in 1297-8, laws were promulgated upon the subjects of offensive trades, food adulteration, and wandering pigs; while Richard II. imposed penalties upon those guilty of fouling rivers and ditches. Out of sight out of mind, however, was the sanitary creed of this and many succeeding generations, so that too often the apparent gain of the moment sowed the noxious seed of intensified subsequent ills.

Sir John Simon has pointed out that it was not until the early part of the eighteenth century that hygiene in its modern significance loomed on the social horizon with clearer outline and more definite aims. A gradual transformation took place in the next hundred and fifty years, when the national records, as well as the reports of philanthropic organisations, indicate the gradual growth of a public opinion which presently sought its sanitary salvation in legislation. The nineteenth century saw, as a consequence, the acc.u.mulation of a huge ma.s.s of public health laws, designed to accomplish reforms where philanthropy or self-interest had failed to influence habits.

The suggested designation, namely, the Legislative, is therefore peculiarly appropriate for this, the second stage of progress in the third period of our country's hygienic education. To legislation men pinned their faith as the most potent weapon of reform. From the first most inadequate and ineffective Factory Act of 1802 until the enactments of the last parliamentary session, each year has seen substantial additions made to the growing ma.s.s of sanitary legislation, which has become unwieldy in bulk and intensely complicated in machinery.

Any attempt to enumerate even a few of the public health laws which crowd our statute books would here be tedious and out of place, though the community in general ought to be better acquainted than it is with its powers and obligations. For, truth to tell, fifty years of public health administration has proved that human beings are not yet consumed with a sufficiently strong desire for health and efficiency to be willing to change objectionable or unwholesome habits or to sacrifice their conception of comfort at the _suggestion_ of officials. Indeed the sterner measures of compulsory conformity were so necessary to the education of the public in the elements of healthy living, that the year 1866 saw the commencement of a new era in Public Health Department of the Government. "The grammar of common sanitary legislation,"[98] writes the historian of our "English Sanitary Inst.i.tutions," "then first acquired the novel virtue of an imperative mood." "Must" was subst.i.tuted in some laws for "may," and though the permissive has not, even in fifty years, entirely given place to the peremptory, the efforts to effect individual reform by Act of Parliament have, since the formation of the Local Government Board in 1872, a.s.sumed more importance and vigour.