Sanitary and Social Lectures and Essays

The rapid increase of population during the first half of this century began at a moment when the British stock was specially exhausted; namely, about the end of the long French war.  There may have been periods of exhaustion, at least in England, before that.  There may have been one here, as there seems to have been on the Continent, after the Crusades; and another after the Wars of the Roses.  There was certainly a period of severe exhaustion at the end of Elizabeth’s reign, due both to the long Spanish and Irish wars and to the terrible endemics introduced from abroad; an exhaustion which may have caused, in part, the national weakness which hung upon us during the reign of the Stuarts.  But after none of these did the survival of the less fit suddenly become more easy; or the discovery of steam power, and the acquisition of a colonial empire, create at once a fresh demand for human beings and a fresh supply of food for them.  Britain, at the beginning of the nineteenth century, was in an altogether new social situation.

At the beginning of the great French war; and, indeed, ever since the beginning of the war with Spain in 1739—often snubbed as the “war about Jenkins’s ear”—but which was, as I hold, one of the most just, as it was one of the most popular, of all our wars; after, too, the once famous “forty fine harvests” of the eighteenth century, the British people, from the gentleman who led to the soldier or sailor who followed, were one of the mightiest and most capable races which the world has ever seen, comparable best to the old Roman, at his mightiest and most capable period.  That, at least, their works testify.  They created—as far as man can be said to create anything—the British Empire.  They won for us our colonies, our commerce, the mastery of the seas of all the world.  But at what a cost!

Their bones are scattered far and wide,By mount, and stream, and sea.

Year after year, till the final triumph of Waterloo, not battle only, but worse destroyers than shot and shell—fatigue and disease—had been carrying off our stoutest, ablest, healthiest young men, each of whom represented, alas! a maiden left unmarried at home, or married, in default, to a less able man.  The strongest went to the war; each who fell left a weaklier man to continue the race; while of those who did not fall, too many returned with tainted and weakened constitutions, to injure, it may be, generations yet unborn.  The middle classes, being mostly engaged in peaceful pursuits, suffered less of this decimation of their finest young men; and to that fact I attribute much of their increasing preponderance, social, political, and intellectual, to this very day.  One cannot walk the streets of any of our great commercial cities without seeing plenty of men, young and middle-aged, whose whole bearing and stature shows that the manly vigour of our middle class is anything but exhausted.  In Liverpool, especially, I have been much struck not only with the vigorous countenance, but with the bodily size of the mercantile men on ’Change.  But it must be remembered always, first, that these men are the very élite of their class; the cleverest men; the men capable of doing most work; and next, that they are, almost all of them, from the great merchant who has his villa out of town, and perhaps his moor in the Highlands, down to the sturdy young volunteer who serves in the haberdasher’s shop, country-bred men; and that the question is, not what they are like now, but what their children and grandchildren, especially the fine young volunteer’s, will be like?  A very serious question I hold that to be, and for this reason.

War is, without doubt, the most hideous physical curse which fallen man inflicts upon himself; and for this simple reason, that it reverses the very laws of nature, and is more cruel even than pestilence.  For instead of issuing in the survival of the fittest, it issues in the survival of the less fit: and therefore, if protracted, must deteriorate generations yet unborn.  And yet a peace such as we now enjoy, prosperous, civilised, humane, is fraught, though to a less degree, with the very same ill effect.

In the first place, tens of thousands—who knows it not?—lead sedentary and unwholesome lives, stooping, asphyxiated, employing as small a fraction of their bodies as of their minds.  And all this in dwellings, workshops, what not?—the influences, the very atmosphere of which tend not to health, but to unhealth, and to drunkenness as a solace under the feeling of unhealth and depression.  And that such a life must tell upon their offspring, and if their offspring grow up under similar circumstances, upon their offspring’s offspring, till a whole population may become permanently degraded, who does not know?  For who that walks through the by-streets of any great city does not see?  Moreover, and this is one of the most fearful problems with which modern civilisation has to deal—we interfere with natural selection by our conscientious care of life, as surely as does war itself.  If war kills the most fit to live, we save alive those who—looking at them from a merely physical point of view—are most fit to die.  Everything which makes it more easy to live; every sanitary reform, prevention of pestilence, medical discovery, amelioration of climate, drainage of soil, improvement in dwelling-houses, workhouses, gaols; every reformatory school, every hospital, every cure of drunkenness, every influence, in short, which has—so I am told—increased the average length of life in these islands, by nearly one-third, since the first establishment of life insurances, one hundred and fifty years ago; every influence of this kind, I say, saves persons alive who would otherwise have died; and the great majority of these will be, even in surgical and zymotic cases, those of least resisting power, who are thus preserved to produce in time a still less powerful progeny.

Do I say that we ought not to save these people if we can?  God forbid.  The weakly, the diseased whether infant or adult, is here on earth; a British citizen; no more responsible for his own weakness than for his own existence.  Society, that is, in plain English, we and our ancestors, are responsible for both; and we must fulfil the duty, and keep him in life; and, if we can, heal, strengthen, develop him to the utmost; and make the best of that which “fate and our own deservings” have given us to deal with.  I do not speak of higher motives still; motives which, to every minister of religion, must be paramount and awful.  I speak merely of physical and social motives, such as appeal to the conscience of every man—the instinct which bids every human-hearted man or woman to save life, alleviate pain, like Him who causes His sun to shine on the evil and on the good, and His rain to fall on the just and on the unjust.

But it is palpable that in doing so we must, year by year, preserve a large percentage of weakly persons who, marrying freely in their own class, must produce weaklier children, and they weaklier children still.  Must, did I say?  There are those who are of opinion—and I, after watching and comparing the histories of many families, indeed of every one with whom I have come in contact for now five-and-thirty years, in town and country, can only fear that their opinion is but too well founded on fact—that in the great majority of cases, in all classes whatsoever, the children are not equal to their parents, nor they, again, to their grand-parents of the beginning of the century; and that this degrading process goes on most surely and most rapidly in our large towns, and in proportion to the antiquity of those towns, and therefore in proportion to the number of generations during which the degrading influences have been at work.

This and cognate dangers have been felt more and more deeply, as the years have rolled on, by students of human society.  To ward them off, theory after theory has been put on paper, especially in France, which deserve high praise for their ingenuity, less for their morality, and, I fear, still less for their common sense.  For the theorist in his closet is certain to ignore, as inconvenient to the construction of his Utopia, certain of those broad facts of human nature which every active parish priest, medical man, or poor-law guardian has to face every day of his life.

Society and British human nature are what they have become by the indirect influences of long ages, and we can no more reconstruct the one than we can change the other.  We can no more mend men by theories than we can by coercion—to which, by-the-bye, almost all these theorists look longingly as their final hope and mainstay.  We must teach men to mend their own matters, of their own reason, and their own free-will.  We must teach them that they are the arbiters of their own destinies; and, to a fearfully large degree, of their children’s destinies after them.  We must teach them not merely that they ought to be free, but that they are free, whether they know it or not, for good and for evil.  And we must do that in this case, by teaching them sound practical science; the science of physiology as applied to health.  So, and so only, can we cheek—I do not say stop entirely—though I believe even that to be ideally possible; but at least cheek the process of degradation which I believe to be surely going on, not merely in these islands, but in every civilised country in the world, in proportion to its civilisation.

It is still a question whether science has fully discovered those laws of hereditary health, the disregard of which causes so many marriages disastrous to generations yet unborn.  But much valuable light has been thrown on this most mysterious and most important subject during the last few years.  That light—and I thank God for it—is widening and deepening rapidly.  And I doubt not that in a generation or two more, enough will be known to be thrown into the shape of practical and provable rules; and that, if not a public opinion, yet at least, what is more useful far, a widespread private opinion will grow up, especially among educated women, which will prevent many a tragedy and save many a life.

But, as to the laws of personal health: enough, and more than enough, is known already, to be applied safely and easily by any adults, however unlearned, to the preservation not only of their own health, but of that of their children.

The value of healthy habitations, of personal cleanliness, of pure air and pure water, of various kinds of food, according as each tends to make bone, fat, or muscle, provided only—provided only—that the food be unadulterated; the value of various kinds of clothing, and physical exercise, of a free and equal development of the brain power, without undue overstrain in any one direction; in one word, the method of producing, as far as possible, the mentem sanam in corpore sano, and the wonderful and blessed effects of such obedience to those laws of nature, which are nothing but the good will of God expressed in facts—their wonderful and blessed tendency, I say, to eliminate the germs of hereditary disease, and to actually regenerate the human system—all this is known; known as fully and clearly as any human knowledge need be known; it is written in dozens of popular books and pamphlets.  And why should this divine voice, which cries to man, tending to sink into effeminate barbarism through his own hasty and partial civilisation: “It is not too late.  For your bodies, as for your spirits, there is an upward, as well as a downward path.  You, or if not you, at least the children whom you have brought into the world, for whom you toil, for whom you hoard, for whom you pray, for whom you would give your lives,—they still may be healthy, strong, it may be beautiful, and have all the intellectual and social, as well as the physical advantages, which health, strength, and beauty give.”—Ah, why is this divine voice now, as of old, Wisdom crying in the streets, and no man regarding her?  I appeal to women, who are initiated, as we men can never be, into the stern mysteries of pain, and sorrow, and self-sacrifice;—they who bring forth children, weep over children, slave for children, and, if they have none of their own, then slave, with the holy instinct of the sexless bee, for the children of others—Let them say, shall this thing be?

Let my readers pardon me if I seem to write too earnestly.  That I speak neither more nor less than the truth, every medical man knows full well.  Not only as a very humble student of physiology, but as a parish priest of thirty years’ standing, I have seen so much unnecessary misery; and I have in other cases seen similar misery so simply avoided; that the sense of the vastness of the evil is intensified by my sense of the easiness of the cure.

Why, then—to come to practical suggestions—should there not be opened in every great town in these realms a public school of health?  It might connect itself with—I hold that it should form an integral part of—some existing educational institute.  But it should at least give practical lectures, for fees small enough to put them within the reach of any respectable man or woman, however poor, I cannot but hope that such schools of health, if opened in the great manufacturing towns of England and Scotland, and, indeed, in such an Irish town as Belfast, would obtain pupils in plenty, and pupils who would thoroughly profit by what they hear.  The people of these towns are, most of them, specially accustomed by their own trades to the application of scientific laws.  To them, therefore, the application of any fresh physical laws to a fresh set of facts, would have nothing strange in it.  They have already something of that inductive habit of mind which is the groundwork of all rational understanding or action.  They would not turn the deaf and contemptuous ear with which the savage and the superstitious receive the revelation of nature’s mysteries.  Why should not, with so hopeful an audience, the experiment be tried far and wide, of giving lectures on health, as supplementary to those lectures on animal physiology which are, I am happy to say, becoming more and more common?  Why should not people be taught—they are already being taught at Birmingham—something about the tissues of the body, their structure and uses, the circulation of the blood, respiration, chemical changes in the air respired, amount breathed, digestion, nature of food, absorption, secretion, structure of the nervous system—in fact, be taught something of how their own bodies are made and how they work?  Teaching of this kind ought to, and will, in some more civilised age and country, be held a necessary element in the school course of every child, just as necessary as reading, writing, and arithmetic; for it is after all the most necessary branch of that “technical education” of which we hear so much just now, namely, the technic, or art, of keeping oneself alive and well.

But we can hardly stop there.  After we have taught the condition of health, we must teach also the condition of disease; of those diseases specially which tend to lessen wholesale the health of townsfolk, exposed to an artificial mode of life.  Surely young men and women should be taught something of the causes of zymotic disease, and of scrofula, consumption, rickets, dipsomania, cerebral derangement, and such like.  They should be shown the practical value of pure air, pure water, unadulterated food, sweet and dry dwellings.  Is there one of them, man or woman, who would not be the safer and happier, and the more useful to his or her neighbours, if they had acquired some sound notions about those questions of drainage on which their own lives and the lives of their children may every day depend?  I say—women as well as men.  I should have said women rather than men.  For it is the women who have the ordering of the household, the bringing up of the children; the women who bide at home, while the men are away, it may be at the other end of the earth.

And if any say, as they have a right to say—“But these are subjects which can hardly be taught to young women in public lectures;” I rejoin—of course not, unless they are taught by women—by women, of course, duly educated and legally qualified.  Let such teach to women, what every woman ought to know, and what her parents will very properly object to her hearing from almost any man.  This is one of the main reasons why I have, for twenty years past, advocated the training of women for the medical profession; and one which countervails, in my mind, all possible objections to such a movement.  And now, thank God, we are seeing the common sense of Great Britain, and indeed of every civilised nation, gradually coming round to that which seemed to me, when I first conceived of it, a dream too chimerical to be cherished save in secret—the restoring woman to her natural share in that sacred office of healer, which she held in the Middle Ages, and from which she was thrust out during the sixteenth century.

I am most happy to see, for instance, that the National Health Society, 3 which I earnestly recommend to the attention of my readers, announces a “Course of Lectures for Ladies on Elementary Physiology and Hygiene,” by a lady, to which I am also most happy to see, governesses are admitted at half-fees.  Alas! how much misery, disease, and even death might have been prevented, had governesses been taught such matters thirty years ago, I, for one, know too well.  May the day soon come when there will be educated women enough to give such lectures throughout these realms, to rich as well as poor—for the rich, strange to say, need them often as much as the poor do—and that we may live to see, in every great town, health classes for women as well as for men, sending forth year by year more young women and young men taught, not only to take care of themselves and of their families, but to exercise moral influence over their fellow-citizens, as champions in the battle against dirt and drunkenness, disease and death.

There may be those who would answer—or rather, there would certainly have been those who would have so answered thirty years ago, before the so-called materialism of advanced science had taught us some practical wisdom about education, and reminded people that they have bodies as well as minds and souls—“You say, we are likely to grow weaklier, unhealthier.  And if it were so, what matter?  Mind makes the man, not body.  We do not want our children to be stupid giants and bravos; but clever, able, highly educated, however weakly Providence or the laws of nature may have chosen to make them.  Let them overstrain their brains a little; let them contract their chests, and injure their digestion and their eyesight, by sitting at desks, poring over books.  Intellect is what we want.  Intellect makes money.  Intellect makes the world.  We would rather see our son a genius than a mere athlete.”  Well: and so would I.  But what if intellect alone does not even make money, save as Messrs. Dodson and Fogg, Sampson Brass, and Montagu Tigg were wont to make it, unless backed by an able, enduring, healthy physique, such as I have seen, almost without exception, in those successful men of business whom I have had the honour and the pleasure of knowing?  What if intellect, or what is now called intellect, did not make the world, or the smallest wheel or cog of it?  What if, for want of obeying the laws of nature, parents bred up neither a genius nor an athlete, but only an incapable unhappy personage, with a huge upright forehead, like that of a Byzantine Greek, filled with some sort of pap instead of brains, and tempted alternately to fanaticism and strong drink?  We must, in the great majority of cases, have the corpus sanem if we want the mentem sanem; and healthy bodies are the only trustworthy organs for healthy minds.  Which is cause and which is effect, I shall not stay to debate here.  But wherever we find a population generally weakly, stunted, scrofulous, we find in them a corresponding type of brain, which cannot be trusted to do good work; which is capable more or less of madness, whether solitary or epidemic.  It may be very active; it may be very quick at catching at new and grand ideas—all the more quick, perhaps, on account of its own secret malaise and self-discontent; but it will be irritable, spasmodic, hysterical.  It will be apt to mistake capacity of talk for capacity of action, excitement for earnestness, virulence for force, and, too often; cruelty for justice.  It will lose manful independence, individuality, originality; and when men act, they will act from the consciousness of personal weakness, like sheep rushing over a hedge, leaning against each other, exhorting each other to be brave, and swaying about in mobs and masses.  These were the intellectual weaknesses which, as I read history, followed on physical degradation in Imperial Rome, in Alexandria, in Byzantium.  Have we not seen them reappear, under fearful forms, in Paris but the other day?

I do not blame; I do not judge.  My theory, which I hold, and shall hold, to be fairly founded on a wide induction, forbids me to blame and to judge; because it tells me that these defects are mainly physical; that those who exhibit them are mainly to be pitied, as victims of the sins or ignorance of their forefathers.

But it tells me too, that those who, professing to be educated men, and therefore bound to know better, treat these physical phenomena as spiritual, healthy, and praiseworthy; who even exasperate them, that they may make capital out of the weaknesses of fallen man, are the most contemptible and yet the most dangerous of public enemies, let them cloak their quackery under whatsoever patriotic, or scientific, or even sacred words.

There are those again honest, kindly, sensible, practical men, many of them; men whom I have no wish to offend; whom I had rather ask to teach me some of their own experience and common sense, which has learned to discern, like good statesmen, not only what ought to be done, but what can be done—there are those, I say, who would sooner see this whole question let alone.  Their feeling, as far as I can analyse it, seems to be that the evils of which I have been complaining, are on the whole inevitable; or, if not, that we can mend so very little of them, that it is wisest to leave them alone altogether, lest, like certain sewers, “the more you stir them, the more they smell.”  They fear lest we should unsettle the minds of the many for whom these evils will never be mended; lest we make them discontented; discontented with their houses, their occupations, their food, their whole social arrangements; and all in vain.

I should answer, in all courtesy and humility—for I sympathise deeply with such men and women, and respect them deeply likewise—but are not people discontented already, from the lowest to the highest?  And ought a man, in such a piecemeal, foolish, greedy, sinful world as this is, and always has been, to be anything but discontented?  If he thinks that things are going all right, must he not have a most beggarly conception of what going right means?  And if things are not going right, can it be anything but good for him to see that they are not going right?  Can truth and fact harm any human being?  I shall not believe so, as long as I have a Bible wherein to believe.  For my part, I should like to make every man, woman, and child whom I meet discontented with themselves, even as I am discontented with myself.  I should like to awaken in them, about their physical, their intellectual, their moral condition, that divine discontent which is the parent, first of upward aspiration and then of self-control, thought, effort to fulfil that aspiration even in part.  For to be discontented with the divine discontent, and to be ashamed with the noble shame, is the very germ and first upgrowth of all virtue.  Men begin at first, as boys begin when they grumble at their school and their schoolmasters, to lay the blame on others; to be discontented with their circumstances—the things which stand around them; and to cry, “Oh that I had this!”  “Oh that I had that!”  But by that way no deliverance lies.  That discontent only ends in revolt and rebellion, social or political; and that, again, still in the same worship of circumstances—but this time desperate—which ends, let it disguise itself under what fine names it will, in what the old Greeks called a tyranny; in which—as in the Spanish republics of America, and in France more than once—all have become the voluntary slaves of one man, because each man fancies that the one man can improve his circumstances for him.

But the wise man will learn, like Epictetus the heroic slave, the slave of Epaphroditus, Nero’s minion—and in what baser and uglier circumstances could human being find himself?—to find out the secret of being truly free; namely, to be discontented with no man and no thing save himself.  To say not—“Oh that I had this and that!” but “Oh that I were this and that!”  Then, by God’s help—and that heroic slave, heathen though he was, believed and trusted in God’s help—“I will make myself that which God has shown me that I ought to be and can be.”