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 superstition. 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, Kölliker, and Virchow, for instance—who gradually and conclusively proved the identity, 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, constitute 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 passing curiosity was aroused as to their hidden import, nor was their profound significance suspected.

Thus, though half a century has passed 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 accumulating 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 associated 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 mediæval 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 morass 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 classes, 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 masses 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 classical 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 associated 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 accumulated 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 mass of superstition. 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 superstitiously regarded as discipline from the Deity, not to be averted or avoided, but rather to be accepted as a chastisement 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 noble, 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 mediæval 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 superstition 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 accumulation of a huge mass 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 mass 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 Institutions,” “then first acquired the novel virtue of an imperative mood.” “Must” was substituted 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, assumed more importance and vigour.

Since that date the reports of health committees all over the country record the substantial results of persevering work in the interests of hygiene, qualified by the fact that the experience of other nations has been abundantly confirmed by our own, namely, that it is futile to legislate in advance of public opinion. Until the populace has been impregnated with a knowledge of what is right, right action, though demanded by its legislators, will be perverted by ignorant intention or by resentful indolence. Even those who have served the cause of sanitation most loyally recognise that coercion is but a poor yeast with which to leaven measures for the public weal; the product is liable to become sour and worthless rather than wholesome and effective. One higher grade must be passed by the nation under the tutelage of a sanitary reform before its education can be called complete.

The final stage in this last long period is described by Professor de Chaumont as that of “Freedom,” of which the attainment is not possible until action is based on intelligent individual conviction. Then and then alone there will be a general recognition that “rights” are inevitably associated with responsibilities, and that true liberty is followed not by license, but by self-control and respect for the rights of others.

IV. WHY THE IDEALS OF MODERN HYGIENE ARE NOT ATTAINED

And so it has come about that, with this ideal in view, the methods of modern hygiene are directed to awaken the nation’s sanitary conscience and to stimulate the growth of true civic freedom. These methods may be fairly defined as the working of common sense aided by the results of scientific research, in their turn supported by very carefully tested applications. Necessarily it is assumed that each individual will accord to them intelligent, personal support and, where necessary, will be willing to sink unreasonable likes and dislikes in the sea of social service.

Examples of the enormous benefit inseparable from well-considered sanitary legislation could be multiplied; though, on the other hand, it is also necessary to check optimism by many illustrations of the grievous harm still being wrought by want of thought. Hindrance to possible progress is also associated with the ignorance of those whose development has not yet attained the level when freedom of action can be permitted. It is some of the results of this ignorant indolence which cause the minds of the thoughtful and far-sighted to be tense with anxiety for the welfare of their country, and arouse a wish for further and more stringent public health enactments. Nevertheless, again it must be said that to legislate in advance of public opinion is futile. Only after stupendous exertion, for instance, has the serious and continued mortality among infants excited general attention; and the curious, widespread indifference to the recommendations of recent Royal Commissions on the Poor Law and the Care of the Feeble-minded indicates that, were infant mortality controllable by legislation, such legislation would still fail of its object unless it were also realised that a child’s hold on life is practically dependent upon parental care, and is intimately associated with maternal nutrition before its birth.

Or again; the law relating to the protection of the public food supply is approaching a high pitch of excellence; the penalties on adulteration or on the sale of diseased or otherwise unwholesome foodstuffs are severe and quite frequently inflicted; but these regulations are powerless to influence the errors of nutrition constantly reflected in the features of our population at each age period, neither can they stem the tide of self-indulgence, emotionalism and luxury which enervate and deteriorate thousands of our people. Vain indeed are their endeavours to disguise by alcoholism and drugs the traces of their misfortunes. Stern Nature is relentless; her laws are as those of the Medes and Persians; the children’s teeth shall be set on edge by the fruits of the reckless folly and intemperance of their ancestors.

Is sanitary legislation therefore a failure, or by what means can light from the sun of knowledge penetrate this dense mass of ignorance and apathy? For what reason has it opposed such a resistant surface to the manipulations of the reformer or to the coercions of the official? These questions do not, unfortunately, admit of concise or conclusive replies.

Each political party in turn points the finger of reproach and derision at its opponents for the modest success by which their legislative efforts at social reforms are attended. Disease, malnutrition, alcoholism and overwork continue to hamper their efforts, and will continue so to do, until a sanitary conscience is awakened in each breast, at an age when habits and ideals are still unformed.

There is no royal road to the solution of these serious problems. They call for infinite, patient and untiring tact, while they also demand the employment of many and varied well-considered methods, based on a sound foundation of sanitary and social science. The day for reform by theory is over; the moment for practice by individual example and co-operative effort has arrived.

V. SOME CHARACTERISTICS OF MAN’S PHYSICAL NATURE

Before proceeding to suggest some means by which to increase the stability of the national health through the agency of family life, it will be advantageous to recall the advice given to students of any form of life by Professor Arthur Thomson:—that they should, before attempting to form conclusions as to its nature, submit its constitution to analysis, with the assistance of what he described as the biological prism. This, he says, will throw light on the inherited nature of the creature—the capital, so to say, with which it is endowed at birth. It will illuminate the functional nature of its parts, and will reveal what it does in the course of its ceaseless activities—nervous, muscular and organic. Further, the prismatic rays will render visible the results of some of the influences dependent upon the environment with which it is surrounded, which play upon it before and after birth. Unfortunately these rays, when directed to human nature, cannot penetrate so deeply nor divulge so clearly the secrets of this the highest and most complex form of life, as they do when directed to its simpler manifestations. All ordinary difficulties are enhanced by our human capacity for racial admixture and the creation of an artificial environment.

This much, however, is clearly revealed by a partial analysis. Human beings, in common with all life, are distinguished by the power of movement, and are sensitive to many forms of external stimulus:—heat, cold, electricity, or pressure. They pass their lives in rhythmic alternations of activity and repose; they breathe; they absorb food to supply energy and to maintain unimpaired the substance of their bodies; they excrete waste products. They share with plants and animals an intrinsic tendency to continue their growth for a certain period and up to a definite amount, while, at the close of the most pronounced period of growth, ability to transmit life absorbs the energy hitherto utilised for personal development, by which means the perpetuation of a species is secured. Research shows, also without possibility of question, that certain similar characteristics distinguish the mechanism of every type of animal life; though the machinery be in some cases of the simplest, in others highly complex. Thus have been revealed many secrets of man’s physical nature; as, for instance, the knowledge that, in the earliest stages of their existence, higher forms of life recapitulate more or less imperfectly certain far-off ancestral phases of development, of which living specimens are still to be found on the lower branches of humanity’s huge genealogical tree. By means also of the close and detailed observation of these lowlier organisms a clearer conception has been formed of the intricacies of growth and the prolonged process of development in mankind. Just how human beings have come to be what they are, mentally and morally as well as physically, is a still unsolved problem. There are, of course, many missing chapters in the long story of life, though so far no contradictions have been detected in its arguments. The sad side of this biological lore exists in the now ascertained fact that the highest intellectual and moral powers, those last to develop, are the first to suffer arrest or to die away when the organism is subjected to premature exhaustion or to precocious responsibility. Predisposing causes are found in disease, dissipation, or defective nurture.

Another of the more important lessons to be learnt from the pages of this book of life’s history is the conservative influence of the law of inherited nature; a law which makes for the preservation of racial types by suppressing wide deviations from the normal. A familiar illustration of this may be found in the fact that the children of parents of great height or of very short stature usually revert to the average of the race. The significance of this genetic relation in maintaining an efficient people was unrecognised until quite recent times, and though valuable evidence is accumulating on the descent of hereditary character in mankind, no definite conclusions have yet been reached on the intensity of the transmission of qualities. It is, of course, a subject of intense complexity, the full discussion of which is here impossible. In the interests of future generations it is, however, to be wished that more thought were given to the conclusions it is allowable to draw. “If,” for instance, says a recent writer, “instead of allowing the race to mate at random we selected both parents for some one quality, we could raise the intensity of inheritance and establish gradually, by continued selection, a strain in which the quality reached a value much higher than the average in the original mixed race....”[99] Thus could a race be strengthened for life’s calls, or, on the contrary, until and unless the people are awakened to the existence and bearing on their national security of such fundamental hygienic influences, it can be emasculated. No such selection is likely ever to dominate human marriages, but an appreciation of these and similar facts is fundamental to national progress; and in time the dissemination of such knowledge will be considered a parental duty, the more urgent since the resources of civilisation and ill-regulated sympathy have combined to brush aside the sterner laws of nature, so that the deteriorated threaten to become the chief progenitors of the next generation.

During the process of studying the abundant evidence of life’s progress from the simple to the complex, it becomes also apparent that it is affected by forces other than heredity. Recognition of the ever-present influence of these potent but often disregarded forces makes for harmonious living, whereas their neglect is associated with heavy penalties. I refer to the capacity for individual variation from the racial type; to the modification of each individual by his or her surroundings; and to the personal predisposition, technically described as diathesis, which influences the reaction made to every form of stimulus. Of these three forces, the first is the result of an inborn tendency to deviate from the ancestral type; an orderly process with a definite intention, by no means a mere chance fluctuation. This certainly makes for progress as well as for interest in life, though it enhances the difficulties of education, because it demands the adaptation of conditions to each individual’s requirements. The second, the law of modification, takes into account the influence of environment upon inherited nature; the effects of climate, and food, for example, or of forms of occupation. Predisposition is, of course, a personal quality—a factor of primary importance in our susceptibility to or power to resist disease or in our capacity to withstand adverse conditions. This property is responsible for the greater or less degree of adaptability to new conditions possessed by each of us, and is concerned with our power to live in tune or at discord with our surroundings.

Another biological law, that of periodicity,[100] or of rhythmic alternations of activity and rest, has hitherto often suffered among human beings more in the breach than in the observance of its tenets; though unquestionably conformity to its requirements makes for health and stability. Throughout nature habits of rhythmic, organic activity are too familiar to attract attention. Of these, the periodic return of the seasons, for instance, or the daily tides, the flowering of plants and the ripening of fruit, the migrations of birds and the hibernation of certain insects and animals, are obvious examples. These rhythms have been proved by experience to be advantageous in the world. They make for efficiency and economise energy, and, from their high degree of development in man’s nature, it may be fairly assumed that to him their observance is of great consequence. Many of them are beyond his control; such, for example, as the diurnal variations of his body temperature, the beating of the heart, the call of hunger, or the rhythm of growth. Others he can observe or abuse according to his pleasure; sleep, for instance, or the rhythm of work, or the daily discharge from his body of its waste products.[101] It is the work of hygiene to demonstrate how to combine obedience to all these laws with the demands of modern existence, and it is the duty of man to conform reasonably to modes of life based on these demonstrations. More especially does responsibility for the establishment of certain rhythms, such as sleep, devolve upon the organiser of a child’s early life.

VI. THE ORIGIN OF FAMILY LIFE AND ITS RELATIONSHIP TO SANITARY SCIENCE

Further researches into the records of the past, and a closer study of the underlying principles upon which humanity has formulated many generally adopted customs, indicate how unexpectedly intimate is the relation between the growth of a social organisation and the origin of primitive efforts after the preservation of life and health. The world at large is so accustomed to the widespread existence of family life that curiosity is rarely aroused as to its origin, intention and worth; consequently to ignorance of its significance must be attributed the assertion that the custom is well-nigh obsolete and the proposal of some would-be reformers to abolish the institution and to instal the State in loco parentis.

Professor McDougall[102] assures us that such is the social importance of the family that all who have given serious attention to the question are agreed that the stability of the family is the prime condition of a healthy state. This opinion is supported by other writers,[103] who have emphasised their conviction that the healthful development of the individual—even the possibilities of racial progress—depend to a large degree upon maintaining intact the integrity of family life. Their conclusions are based upon recent researches into the sciences of biology, sociology, and economics.

The origin of this relation is apparently traceable to one of the many forms of human association which have proved advantageous in the struggle for existence, when the value to a man and his wife of so protecting their offspring during childhood that there should be later on an array of lusty sons and industrious daughters thrust itself on their notice. The division of strenuous work, for instance, the pursuit and preparation of food, the effective defence of their rude shelters against the depredations of their foes, were substantial advantages to be derived in primitive times from the possession of a large group of children. Upon the youthful vigour and strength of their family the parents could rely also when overtaken by the weakness of old age or by accident or disease.

These economic and sociological advantages were so early appreciated and are so widely adopted that traces of family life are to be detected in the history and customs of every tribe or community hitherto investigated. The bond thus formed, even amongst the lowest savages, first developed, then strengthened the ties of natural affection between a mother and her children and prolonged its emotional existence. In the case of the paternal parent, it is probable that the motives which incited him to make the efforts necessary for the protection of his helpless infants might more probably be found in the desire to leave an avenger on individual enemies and a feeling that funeral rites would be duly performed after his death, as well as his tribe strengthened in war.

The gradual development of the human home has been admirably described by more than one writer, who has associated its evolution with the gregarious instinct, recognised in many of the higher forms of animal life.[104] Within reason, associated numbers represent power—power to preserve the progeny, therefore to maintain the numbers, which again in reason make for social support and independence. Power for defence, power to secure an adequate supply of food and ability to differentiate occupations, thus dividing labour, so that while the men of a family group were engaged in war or the chase, their womenkind devoted their attention to the creature comforts which promote health and efficiency—these are all factors which make for progress.

VII. WOMAN’S VOCATION IN HOME AND FAMILY LIFE

And so it came about that to some extent woman’s special and privileged vocation as a home-maker began even in prehistoric times. Upon her it devolved to rear the children she bore; to cook, to mend, to make, to spin and dye and weave; to prepare a welcome for the victor and to minister to the sick or wounded. No sense of menial limitation in their duties was apparent among the notable women of the past. They were skilled workers, capable and respected managers, under whose direction men as well as women carried out the details of daily work, to whose care in later centuries castle and garrison were entrusted in the absence of their lords, and who most evidently assumed this responsibility with confidence and success.

The changing conditions of the last three centuries, however, reacted in many ways to the detriment of women’s domestic energies and sapped their pride in the vocation of housewife. Industrial developments took much occupation out of their hands, and they were not apparently concerned to undertake others more in consonance with modern life. As concentration of the population in large centres undermined the last survival of feudal conditions, the strong conservative instinct of women made it hard for them to adapt themselves and their households to revised methods:—to substitute “new lamps for old,” so that gradually it seems women became split up into two parties, somewhat out of sympathy one with the other. Adherence to the traditions of the past and the attractions of social life distinguished the one party; a restless desire to give scope to their whole nature and to work out their own salvation on unconventional lines possessed the other. In the one case there was no desire for domestic reformation. What methods could be better than their great-grandmother’s! In the other, glimpses of what seemed a far wider and more intellectual life than that of the ordinary housewife diminished interest in the physical needs of human nature, which it was thought made no claims on mental faculties, and of which the daily care was constantly associated with irksome restrictions and a position of financial dependence.

It is not possible here even to outline the numerous social and commercial innovations which have modified every side of daily life for the last two hundred years; but, when inclined harshly to rebuke women for some of their now almost inexplicable blindness to these changes, it is well to remember that the flood of new discoveries, new inventions, new modes of transit, new forms of occupation and amusement, new means of money-making and fresh excitements imposed an enormous strain upon nervous systems, still but slowly adapting themselves to the stir and stress of the modern world. That eyes should be temporarily dazzled by the brilliance of the “wonderful century”; that the first results of freedom from a period of unnatural restraint should be intoxication with liberty, is not surprising. Full of encouragement is, however, the fact that an increasing number of women of all ranks are engaged to-day in efforts to direct the light of modern knowledge to the betterment of human life; the movement speaks for the innate soundness of their womanhood and for their realisation of their imperial responsibilities. Many of these efforts are still unsystematised, many good intentions are held to be of equal worth with organised practical knowledge; many women are alive only to the needs of the least favoured of the community and are dead to the urgent calls for intelligent reforms in their own domiciles. But if the willing mind be there, the direction of the work into desirable channels will slowly though surely follow. It is most certainly unnecessary to pour every girl into the mould of a conventional German hausfrau in order that she may perceive the inner meaning of family life. God fulfils Himself in many ways, and diversity of training and of interests is as beneficial as it is desirable. Neither can the women of a country single-handed conserve this great institution of family life. The loyalty of boys and the co-operation of men are imperative to its preservation. They as well as their mothers, wives, and sisters must realise its responsibilities and opportunities, and must maintain the dignified position of those who preside over this unit of community life; they also must respond to the crying need for its adaptation to the requirements of modern civilisation.

VIII. THE FUNCTION OF THE FAMILY IN NATIONAL LIFE

Mrs. Bosanquet[105] has told us that the most important economic function of the family to-day is its direct control of the prosperity or ruin of nations; for here alone are found in combination the forces which determine the quantity of the population with the forces which determine its quality. To control these forces offers, to say the least, a life-work for countless men and women. Both parents must safeguard the character of their children’s inherited nature; both sexes are more or less directly or remotely concerned in the provision of a suitable environment for human lives, infant or adult. Under the circumstances it may well be a matter for surprise that we have been so slow to perceive that the right performance of these duties demands a preliminary study of the art of preserving health and promoting progress, and we marvel at the placid spirit of content which has sanctioned the conversion into a stronghold of empiricism, the very place where a sound knowledge of progressive sanitary science is of primary importance.

In the book to which reference has been already made, Mrs. Bosanquet also enumerates the causes which in her opinion militate most actively against the continuance of family life at the present day. Among others she mentions evasion of responsibility, self-indulgence (with which we are very familiar), reliance upon external sources of maintenance, and the unequal distribution among the members of a family of the burden of support. Further, she refers to the unfortunate failure among parents to realise that the old Roman customs of parental possession and filial submission are out of date to-day, and calls upon the wise guardian to substitute others which lead to loyalty and love.

The new movement for a study of the characteristics of childhood and adolescence should materially contribute to the realisation that this parental attitude of dominant authority must be now associated with and modified by a more balanced understanding of the phases of youthful development and of the intricacies of individual temperament. Convenience has hitherto encouraged the customary regulation of a group of young lives as if they were one and the same individual, no allowance being made for variation in character or in age, in propensities or in health. Each nursery party or infant school serves to illustrate the point. Individual tendencies to cold or to fatigue, to nerve storms or to indolence; individual capacities in diet, occupation or exercise, must be intelligently respected if potentialities are to become actualities.

In the well-conducted home, for example, a study of individual character must in the future replace cast-iron discipline or easy-going, child-spoiling indulgence. The fact that the early cultivation of good habits makes for healthful happiness must be generally appreciated; and the duty of the home to provide opportunity for the exercise of personal tastes, the importance of training as a relief to nervous strain and as the best means to develop resource and skill, must be perceived. It will be by this constant understanding supervision in early years, and later by the cultivation of an intimate sympathetic comradeship with his children, that the modern parent will retain for his country the cementing force of family life.

IX. THE MEANING OF INFANCY

The great discovery of John Fiske as to the reasons for the long continuance of childhood in man must not be overlooked in this connection; it bears so directly on health and efficiency, and is closely associated with the importance of the family to the individual as well as to the nation. Why, it may be asked, is man’s period of helplessness so prolonged; why, when his brain development reaches so high a standard, is he for years in a position of entire dependence, whereas snakelet and chick are practically self-supporting from the hour of hatching? When the lower forms of animal life are compared with mankind, the non-existence in their case of any such stage as infancy is at once apparent. They are brought into the world able to take care of themselves and to live an independent individual existence. Young pigs run almost as soon as they are born, young swallows fly directly they are fledged.

Now, if the structure of lower animals be examined, it will be found that they have no central warehouse corresponding to the human brain for the storage of new sensations or for an elaborate and original response to them. Each such animal repeats the life of its parents; each responds in exactly the same way to the contact of air, of earth, of food, or of water. Their activities, it is true, are distinguished by accuracy and despatch, but the offspring of a hen of the twentieth century has no larger capacity for the variation of these activities than has the chick which was hatched out six thousand years ago. The guinea-pig of to-day, for example, remains mentally at the level of his thousandth ancestor. Wherein then lies the difference between the pig and the baby?

As animals rise in the scale, as their brains become more subtle, more elaborate in structure, their actions become correspondingly more numerous and complicated, more varied, more individual. The nervous systems of such animals are characterised by an increasing complexity of development, and this provides the machinery necessary to the performance of an increasing number of muscular and mental co-ordinations; they can adapt themselves to unfamiliar surroundings and possess much enhanced advantages in the struggle for existence. But, associated with these advantages, is a much longer period of immaturity, because, where the capacity for flexibility and progress is great, the antenatal period is insufficient for the establishment of the necessary nervous connections or even for the development of the brain cells between which these connections will be formed. The chick will have its full plumage in ten weeks, but mentally it is far below a dog or a monkey, whose period of immaturity is much longer. Similarly, the dog attains his maturity long before the monkey, who is infinitely his superior in fertility of resource, power to learn through imitation, and capacity for attention. The infant in its turn is far longer in a dependent condition than the highest ape.

Relatively large in bulk at birth, and reaching usually its full mass in the first fourteen years of life, the human brain possesses throughout childhood vast silent areas, big with future potentialities, areas in which the cells are slowly ripening to function. Even after full growth in size is reached, many more years must pass before capacity for the higher mental functions or for the complete control of such functions has developed. It must be borne in mind that, throughout this period of immaturity, errors of nutrition or defective stimulation may interfere with function. One of the most important duties of the home is to provide the suited environment for its child occupants during these long and anxious years. How long they are has been emphasised by Dr. Clouston,[106] who has said that, of all the periods of brain growth, the most important, as regards the development of our highest moral and mental potentialities, is that between eighteen and twenty-five years of age, when the capacity for self-control should be coming into function in its highest relations, and when failure to ripen in due course is fraught with most serious consequences for the future.

There is no such thing, therefore, as infancy or parental care in the lowest orders of animal life; of which, one result is a gigantic mortality among their offspring. Enormous numbers of eggs are laid to ensure the preservation of the species when left to fend for themselves. The turbot, for instance, must deposit millions of minute glassy ova or the species would become extinct. Even among frogs the destruction of tadpoles is so great that provision must be made to allow for this loss. The fostering care of birds for their young at once permits a great reduction in the number of the offspring; but, though birds give evidence of some capacity for parental care, infancy, as such, is really confined to mammalian young. Even here it is curtailed in a vast number of species; but wherever it exists it stands for power to progress, and represents capacity for benefiting by, indeed depending upon, education, if only in the simple form of learning by imitation—a form familiar to readers of such books as Long’s “Schools of the Woods.”

Plasticity is the hall-mark of progress; educability indicates a brain more or less competent to assimilate, to remember, to compare, to discriminate. This door of progress has been merely set ajar for even the higher apes; it is open to man only. The period of plasticity is evidently prolonged in proportion to the degree in which conscious intelligence has superseded mere brute force in promoting successful survival—that is to say, the transmission of mental ability rather than of physical strength postpones maturity. Man alone possesses in full the powers of selection and adaptation, of reason and of emotion, of memory and of mental originality, which are included in his rich heritage of life. If he is to realise his full potentialities, he must have protection for years after birth and an extended time for development. The immature infant must be fed, sheltered, and stimulated, if the inherent powers of adjustment to surroundings are to develop normally. But so great is the instability associated with human immaturity and future potentiality, that arrested development is too often the heavy penalty paid by the child for the ignorance and carelessness of his parents.[107] Faults of food and clothing, insufficient warmth, cleanliness, or exercise, premature work or precocious responsibility and independence, prolonged overstrain or insufficient stimulation of mind and body, are the prevalent causes by which a child’s normal growth is warped and prejudiced. Where this occurs he never enters into his birthright of power; it has too often been thoughtlessly bartered by his natural guardians, literally for a mere mess of pottage.

X. CAUSES WHICH MENACE HEALTHFUL INFANCY AND CHILDHOOD

Perhaps one of the greatest inconsistencies of an inconsistent nation lies in the fact that the extraordinary ignorance of the elementary needs of a tender infant is not confined to one section of society; it is found in Belgravia as well as in Bermondsey. Thus, though the chief sources of the tuberculosis which is responsible for the presence of 45 per cent. of the children in the London Invalid Schools are confined to the homes of the poorer classes,[109] inquiries into the incidence of rickets among children in Glasgow show a higher percentage of cases in the families of mechanics than of labourers[110]—a clear illustration that ignorance and not poverty is here the predisposing cause. Impure air and stuffy, ill-ventilated rooms are concerned in the susceptibility to both diseases, as is also malnutrition with its associated diminution of the innate powers of self-protection. But, in the one case, inability to provide suitable food is the general cause; while in the other, inexcusable ignorance of the right forms in which food should be supplied to young children is a certain source of the evil.

The thought is pathetic, for the causes are wholly preventable. Pitiful also, because less excusable, is the grievous injury to health associated with a mouth full of rotten teeth, permitted as it is among families possessed of sufficient means to meet the cost of cure, who prefer to spend their money upon dress and amusement, or among the members of which necessary endurance of a trifling shock has not been cultivated. Were the foulness of the discharge from a carious tooth to be externally visible, the æsthetic instinct among the refined would clamour for prompt treatment; but, unfortunately for health, the results of the disease are concealed, and consequently condoned.

Again: light, sunshine and quiet are now known to be essential to physical development and to the possession of a sound nervous system; the statement amounts to a platitude, for is not every wealthy invalid despatched to complete convalescence by the sea or in the country, and is not the custom of a general annual holiday due largely to the conscious benefits derived from an open-air life far from the bustle of towns? Yet physical morality is so poorly developed that the atmosphere of suburban as well as urban districts is permanently obscured by the preventable and wasteful results of imperfect combustion, though the detriment is incalculable to those whose lives see no change of air. The ceaseless rumble of noisy traffic, allowed to disturb the rest of thousands, or more probably of millions, of our population, is another factor responsible for the prevalence of unstable nerves and of ill-balanced brains. It assumes great gravity when it is realised that among these sleepers are numbered the children whose hours of rest are already most seriously curtailed.

Another sin against childhood bears long enduring fruits. I refer to the terrible results upon the lives of those infants who survive efforts to prevent their birth. The fact ought to be, if it is not, common knowledge; yet the sale of the infamous drugs, necessary to the crime, by pennyworths, in every drug-store, is tacitly sanctioned by the community.

Professor Sadler’s[111] determination to direct attention to the requirements of our adolescents has aroused such response, that excuse is now impossible for ignoring the detrimental effects upon young people of unskilled, exhausting “blind alley” work, or of removing prematurely the restraint of moral discipline and systematised training.[112] Statistics show not only the economic disasters which result from the unsatisfactory methods of past years; they bring home also the steady increase in the percentage of the proportion of nervous instability as well as of anæmia, which interfere with the form of brain growth so rapid in adolescence (namely, increase in complexity of association, and in power to inhibit, to reason, and to concentrate). Another result of these investigations is to draw attention to the increase in organic heart disease, which has been shown to occur in more than thirty per cent. of the London errand boys who are engaged in prolonged work on Saturdays, as well as in out-of-school hours during the week.[113]

Should not parents inform themselves diligently on these matters? for there are warnings and to spare from physician and educationalist upon this reckless wreckage of the nation’s most valuable asset. It was pointed out ten years ago that the imposition of adult duties upon the child, or even upon the young adolescent, is the most effective machinery for the manufacture of the unemployed and the unemployable. Only now, however, are bye-laws being sanctioned which impose at all adequate restrictions upon child labour. For a longer period the steady migration of the rural population from country to towns has been bemoaned, as coupled with the risk lest the deterioration of the individual decline into the degeneration of the race. Nevertheless, in spite of the sustained efforts of the Rural Housing Association and of private individuals, the housing problem still lies at the root of some at least of this exodus. Miserable and inconvenient as are hundreds of our cottages, their number is still insufficient in many places to meet the demand; so perforce the young people of marriageable age must go, or the elementary code of decency must be violated.

The curse of alcohol,[114] too, lies heavy on our land; it shortens life, incapacitates for work, impoverishes and degrades; visits in innumerable forms the sins of the parents upon their innocent yet grievously afflicted children; promotes crime and perverts judgment. Each year brings more statistical and biological evidence of its enduring and deteriorating effects upon humanity. It seems strange, therefore, that the law to insist upon the provision of an adequate water supply for every dwelling remains entirely insufficient to meet the most urgent needs of many town streets as well as country villages. Cleanliness is consequently impossible, and the public-house must be perforce frequented, for it provides a beverage more palatable and perhaps as wholesome as the cottager’s nearest supply.

XI. THE SOURCE OF THESE CAUSES TO BE FOUND IN FAULTY ADMINISTRATION OF THE HOME

May not the causes of some considerable proportion of this apathy be traced to a want of popular faith in the teachings of hygiene? Is not one source of the prevalent unbelief in its tenets to be found in the widespread ignorance of the right administration of human life in the home, which turns out therefore a product of unhealthy, inharmonious citizens, who are a source of weakness to their country and a menace to civilisation? How could it be otherwise? If the cradle of life be defective, and its occupants be debilitated, it is not the nurslings alone upon whom the penalties will fall; whereas if home administration be guided by intelligence, and the quality of the inmates be high, individual and national prosperity are assured. The burden of responsibility or the privilege of promoting progress (according to the spirit in which obligations are assumed) rests with those who propose to be or already are parents; they being influenced in their turn by the educational and social conditions of their surroundings. Parental care and intelligent home management are thus intimately concerned with the physical evolution of the race, as well as with its moral development. They must, therefore, assume an increasing rather than a diminishing importance, if the full development of potentialities is to be insured in the rising generation, and racial progress promoted. Any proclivity to depreciate the dignity or to undermine the influence of these institutions must be carefully examined and, if necessary, sternly repressed.

The fact that such tendencies show signs of sprouting is, it seems to me, a serious reflection upon the parental and domestic methods of the day. There is no smoke without fuel; faults are rarely all on one side; the young are not necessarily always in the wrong; therefore, a course of self-examination into their methods and motives may be a wholesome and fruitful discipline for those who are responsible for the nature and nurture of our children, and for the stability and efficiency of adolescent and adult. The absence of elasticity and adaptation to modern requirements among the elders of a family is often responsible for miserable homes, and for much arrested development in their inmates.

XII. HARMONIES AND DISHARMONIES IN HUMAN LIFE

Such a condition of affairs is, however, no longer to be tolerated; for the result of research carried out during the past and present centuries has opened up a hitherto unsuspected vista of progress to mankind, if and when he is intelligent enough to establish an harmonious unison between himself and his environment. Once the jarring discords of debility, disease, and deterioration have been modulated into the major chords of health—moral and physical—the latent potentialities of his higher life will be quickened into productive activity. The misconception of humanity which has denied to it the power to rise above the level of present attainments, which has dwelt insistently upon the hopeless degradation of the body, has brought about a condition of enervating and passive fatalism, based upon the conviction that all reforming efforts must be directed solely to the preparation of one part only of man’s triune nature for another and future sphere of existence. The duty and possibility of building a fit temple for man’s spiritual nature here and now is the ideal of a minority to-day—in the future it will be that of an overwhelming majority; for the proofs of human capacity for progress, of man’s power to control the forces of nature, are ever becoming more firmly authenticated, and all that they imply will soon become far better understood.

Though our knowledge of the subject is still incomplete and often tentative, much progress has been made, for instance, in a correct conception of the means by which the physiological balance of human life is adjusted, since Metchnikoff[115] drew attention to the interference brought about in man’s normal development by certain fundamental disharmonies in his constitution, of which the end is premature death, if not a pathological old age. It is quite evident that unjustifiable encroachments upon the reserve powers of the human body have been commonly permitted hitherto, and though each year brings fresh proof of the extraordinary endowment which it possesses to respond to the demands made upon it, yet each year also confirms the conviction that this reserve fund must in future be husbanded and used with economy. When these powers are constantly drawn upon the body is necessarily reduced to a lower level of health. If the metaphor be employed of the body as a building in course of erection, it becomes obvious that if one of a group of converging thrusts be much weakened or withdrawn, a skilful rearrangement of forces may meet the strain, but the total strength of the structure is reduced. In how many cases has the temple of a child’s body been permanently damaged by such withdrawals, or how many adolescents are launched into life with their capital of health seriously diminished by premature calls upon its resources.

The duty to maintain so far as possible a condition of physiological equilibrium in ourselves and in our children amounts to an obligation; for which reason health promotion during the plastic period of early life assumes a new importance. Of course, a certain capacity for vicarious activity is associated with the various organs of the body in order to maintain their functions against temporary failure. Healthy tissues are furnished with power to respond to increased call for exertion. How often are they most sorely abused and unwisely taxed? Even now, when made aware of these facts, we are slow to apply to the conduct of life the lessons thus taught us, and continue to be filled with self-commiseration for the results to our bodies of overtaxing their capacity for accurate readjustment.

It is not possible, much less desirable, that the whole population should plunge into amateur studies of recent physiological advance, nor even that it should dabble, as its units are too much disposed to do, in pseudo-scientific pathological publications. But it is both possible and desirable for all who assume the direction of their own lives or those of children to “read, mark, learn, and inwardly digest” some fruits of the labours of others in the garden of health.

Were there one fixed standard of health to which all could attain, the practice of hygiene would be attended by a charming simplicity. Unfortunately, modern science forces us to conclude that each individual can only reach his own particular standard of well-being. The grades of health are consequently infinite in number, and the task which devolves on parents and guardians to secure that the standard possible to each child under their care be attained is no light one. So general is the blindness to these truths, that the degree of health enjoyed is in most cases far below the possible standard; the results of ancestral vice, of parental ignorance, or of defective environment having sapped prematurely the springs of progressive potentiality.[116] The mental and physical balance is thus rendered relatively less stable and the powers of resistance to adverse conditions are diminished.

Happily, by virtue of its inherent power, but strictly in proportion to the vigour of this power, an organism is usually able to strike a new balance; for the capacity to regain its equilibrium is exquisitely delicate in human nature, if the change be neither too sudden nor too severe. Throughout life this process of self-adaptation to the presence of morbid influences is constantly exercising its protective power. If, however, the effort to overcome disadvantageous conditions be very great or much prolonged, the life of the individual is never quite so vigorous and symmetrical as it might and should have been. In a luminous address, delivered at the University of Leeds some few months ago,[117] Lord Justice Fletcher Moulton instituted a comparison between the human organism, which invariably tends to swing back to the normal whenever the balance of health is disturbed, and a ship which has safely weathered a stormy voyage. The ship, he writes, “is not stable, if stability means that she can defy the forces that bear on her to move her from her normal upright position, for ... the slightest roll of the sea ... will make her heel over. But she is stable, because when made to lean over, there is thereby generated a system of forces tending to return her to her place, which grows greater the greater is the displacement, and thus ultimately becomes sufficient to overpower the disturbing forces.... As the ship arrives safely, her construction must be such that disturbances tend to right themselves when stability is seriously endangered. Some corresponding righting force also tends to bring back an organism to its normal state.”

The caution may not be amiss that the amplitude of the swing of a human pendulum, as well as the accuracy of its final balance, depends not only upon inherited nature and the amount of reserve force possessed, but will be stable or feeble, durable or transient, according to the influence of environment.

In what way, it will be asked, can individual capacity for health be gauged? to what degree can the power to progress or to resist encroachments be strengthened? at what age is intelligent supervision most important?

No concise and conclusive answers can be given to these most natural inquiries, but much light has been recently thrown upon the long duration of immaturity and associated instability in mankind; upon the power of self-protection inherent in the body;[118] upon the influence thereon of its environment; upon the penetrating power of heredity; and upon the urgent importance of the adolescent period.

Further, it appears that the healthful body is equipped to withstand the attack of the bacteria of most diseases, though the mechanism of self-defence is of more kinds than one. Of the different pathological bacteria identified up to the present, for instance, some appear to be eminently sensible to one kind of action of normal blood fluids, while they are in a much less measure sensible, or are, perhaps, entirely insensible to others; a complication which enhances our respectful admiration for the marvellous and intricate system which provides for our bodily welfare. Obviously, human nature would be practically immune from disease if this protective machinery were always in good working order: unfortunately this is not invariably the case—hence disease. It is the duty of hygiene to insure constant physical equilibrium, but the intricate tactics of Nature are as yet so imperfectly understood that man is not yet an ally of great worth in her operations.

Nevertheless, the perception that the secret of individual health lies in fostering the resistant or protective elements, which should be present in normal blood, marks a great step in advance; for from it have originated measures to curtail the course of an illness and to reduce the risk of its recurrence. It is hardly Utopian to forecast, as Sir Almroth Wright has done, that the physician of the future will take upon himself a still higher rôle than he has hitherto assumed in this work of the prevention of ill-health, for he will attempt, by means of systematically strengthening individual capacity for resistance to disease, to remove the necessity for curing those who have fallen victims to its attacks. The gain in health, in happiness, in time and in money would be incalculable. For instance, had the death-rate all over England during 1908 stood at 13.8 per thousand, instead of at favoured places only, no less than 33,831 lives would have been saved. Of these deaths, one-fifth were those of infants under twelve months old, the majority of them wholly preventable. What a reckless waste of racial and national capital; what an unnecessary cause of bitter sorrow and disappointment; what a source of unprofitable expenditure! The calculation has been made that for each death there are at least six cases of more or less serious illness, involving confinement to bed for a few days or a few weeks as the case may be. A simple multiplication sum will enable the reader to estimate the amount of serious illness represented by the total arrived at: the loss in time, health, happiness and efficiency is incalculable.

The bright prospects for human health in the future, therefore, rely largely upon the use which will be made of this protective machinery, and the prospective gain to humanity lies in the hope that when family histories are kept systematically and the inherited tendencies of a child are far more accurately known, the invading forces of disease will never get a footing, because precautions to strengthen the body’s own defensive powers will be taken as a matter of routine practice. The physiological balance being thus preserved from disturbance, the great fund of energy now utilised to resist encroachments will be available for productive purposes.

So great a reformation cannot of course be brought about till shame is felt for the scandalously low standard of health now common among all classes, nor until a general determination is developed to remove the minor miseries from which we all suffer more or less impatiently.

XIII. THE IMPORTANCE OF MENTAL HYGIENE IN FAMILY LIFE

The result of a curious obtuseness to the economics of personal and domestic hygiene is also responsible for another serious dereliction of parental duty, by which health and progress have been grievously, though quite unnecessarily and constantly, hampered. I refer to the general failure to economise nervous energy or to take any interest in what is rightly called mental hygiene. Yet Press and people alike deplore the evident increase of mental abnormalities, and anticipate the future with undisguised anxiety. It has been well said that though men carry more of the wood, women carry not less of the worries of life. They may in some cases escape the physical toil which strengthens; they do not escape the mental toil which demoralises and kills spirit and energy if not body and health. Now, though the brain tissues do not create mental activities, nevertheless we all know that they are conditioned in some inexplicable way by that organ. Derangement in any part of the brain deranges or diminishes its functions; non-development in any part of the brain can and does arrest mind growth. Chronic over-fatigue and exhaustion, anæmia however produced, the circulation through the nervous tissues of impure blood, alter the character of the mental processes. The results of starvation may so distort them, that the horrors of the French Revolution are attributed by some authorities to this particular cause. That the imperfect lymph circulation associated with adenoid vegetations accounts for much so-called stupidity is one of the first fruits of the medical inspection of school children; that a severe shock may destroy intelligence is a fact familiar to every expert in mental hygiene. If it were generally known to parents that every impression received by this, the most sensitive of all organs, is stored up from early infancy, albeit subconsciously, and can at some future time rise up into the field of consciousness, influencing both thought and action for good or ill, a very different line of conduct would be taken towards the persons or the places which make up a young child’s surroundings and most indelibly impress his brain cells.

It is surely time, therefore, that some broad outline of the process of normal development of the whole nervous system should be possessed by all in charge of children. Every mother, for example, should know that the movements of a new-born baby, such as the facial contortions observed during sleep, or the stretching and bending of the limbs in very young infants, involuntary and automatic in character, constitute the simplest form of nervous activity. They are the necessary precursors of that intellectual ability, to the development of which parental ambitions aspire, and should merge into more advanced forms of nerve and muscle co-ordination, which, rightly utilised, are invaluable agents in infant education.[119] An intelligent nurse possessed of even this outline could begin quite early that training in physiological righteousness and in the strict voluntary control of the whole group of emotional expressions, of which, as a little reflection will quickly show, good manners largely consist. Presently, as the brain cells are stimulated into function by nutrition and a quicker and more extensive recognition of external sensations is acquired, a child will perform instinctive movements, such as sitting, crawling, standing, walking, jumping and throwing. Though considerable latitude must be allowed for their wide individual variation, failure to display these evidences of mental progress should call for careful investigation. Later on, skill in a hundred different forms of muscular activity should be displayed; but many years will elapse before full control of the body in all its parts will be acquired, and more years still must roll by before reasoned control of the mental and moral actions is developed. The last years of this long period of development are, perhaps, the most critical of the whole; though all depend for their favourable fruition upon an infinity of loving care and suitable provision for their appropriate activities.

There would be a marked reduction in exhausting disciplinary difficulties were every parent aware that, to the almost vegetative character of the first few post-natal months (when sleep will or should absorb at least twenty hours out of the twenty-four), will succeed a period of extraordinary activity, which lasts till about eight or nine years of age, when the mind is essentially an exploring organ; imitative, impressionable, retentive. Every legitimate opportunity for the liberal gratification of these characteristics should be provided, as well as suitable surroundings for the eager, inquiring brain. Elaborate toys are not necessary, nor is premature book-learning permissible; but freedom to investigate, to experiment, to test, to explore, is the child’s urgent need, as well as suitable arrangements for the intervening periods of profound sleep. Repressed activity is often responsible for breaches of discipline; so is insufficient sleep, following on over-excitement, accountable for “temper” and passions.

The next phase of growth is still distinguished by this continued capacity for and dependence upon muscular activity, but the mind becomes more reflective, more productive. The power to initiate should develop during this stage of development, as well as increased power to control mental and bodily functions; and, throughout each of these periods, there should be a steady, unintermittent formation of good habits. At first, the nature of these will be chiefly physical; the habitual performance of the bodily functions should be safeguarded, until their neglect is attended by discomfort and their violation becomes almost painful. Then, by degrees, the moral and mental nature develops.

Thus is the child prepared for the stress and turmoil of the long and anxious years of adolescence; when, under the influence of new emotions, of fresh temptations, of unfamiliar powers, the character built on the sands of parental indulgence is undermined, if not swept clean away; whereas when built on the firm rock of good habits it emerges unshaken from the storm.

That childhood is an honourable estate must be now evident; pregnant as it is with possibilities, pathetic in the risks associated with its plasticity and dependence. Should it therefore be necessary in the twentieth century to point out that, when the fund of nervous energy is constantly exhausted by deficient sleep and poor food; when a demand on function in advance of what nature is prepared to comply with is persistently made, as it has habitually been in our schools; when exaggerated and pernicious stimuli are allowed to fatigue and to paralyse our child population; when inadequate training in the right conduct of life is provided, and no information given on the dawning functions of potential parenthood; when premature responsibility is imposed or precocious and unwholesome independence is permitted; worst of all, when, through parental disease or alcoholism, the brain tissue is of too poor a quality to resist the strain of modern life—it is no matter for surprise that mental instability and insanity are on the increase, nor that degenerates hamper by their helplessness and crime the productive capacity of the normal.

The importance of mental hygiene calls for no more emphasis on my part; though, did space permit, further illustrations might be given of its scope. It includes the methods in our nurseries, the curriculum of our schools, the care of our adolescents, the increasing differentiation of our industrial processes, the character of our often miscalled recreations. It is concerned with the warding off of nervous breakdowns, and, with Goethe, it would call the attention of all women to the fact that the secret of rest is found not “in quitting a busy career, but rather the fitting of self to one’s sphere.” It views with anxiety the growing disregard of religious obligations and restraints, and emphasises the grave antenatal responsibilities of parents for their offspring; they who should be the most ardent advocates of a sound heredity, as well as the promoters of a good home environment for their children.

XIV. WOMAN’S RESPONSIBILITIES FOR HOME ADMINISTRATION

Thus, though the human constitution is still imperfectly understood, though its intricacies and the details of environmental influences are still mainly undefined, the women of every nation must nevertheless see to it that progress in the administration of the home keeps pace with modern demands for revised methods and less conservative practice, in order to give every chance of normal health to their occupants.

It is a serious reflection upon many housekeepers that the hall-mark of progressive civilisation, namely growth in power to organise, is generally absent from their domestic methods. The time will come when it will be to them a matter for the deepest searchings of heart that they are directly and inexcusably responsible for a mass of the disharmonies which disfigure the fugue of family life. The fact is too certain to be denied. Homes have not developed in proportion to the opportunities offered, and the chief opponents to progress have been their organisers. The economic link they form between the physical economics of the individual and the social economics of the nation has been unnoticed. Reference to the hygienic significance of due economy of time, of strength and of health, as well as of money, has hitherto been generally met with incredulous smiles; and though home has been extolled as the place for children, how scant has been the attention devoted to their legitimate requirements, and how few demands for special training have emanated from, or been attempted by, those who have undertaken the sole charge of young lives during their most important and impressionable years.

The new movement, designed to foster the science and art of right living, cannot gain strength and influence unless it receives the whole-hearted support of the millions of women whose lives and energies are absorbed in the care of man’s physical needs. It behoves them to recognise that intuition and tireless industry are insufficient qualifications for their imperial service, and they must themselves promote the substitution of systematic training for rule-of-thumb anomalies.

This training must be varied and comprehensive. No other profession is concerned with so many interests nor associated with more fateful responsibilities. For those who can afford the time, it should include a general acquaintance with the biological basis of life, and should further direct attention to the vast mental and moral endowments which give pre-eminence to our race. The products of literature and art and the records of natural and moral science afford ever present evidence of the extent of these endowments, and of the executive capacity associated with their utilisation.

Chemistry must play a prominent part in the training, were it only for the insight it gives into the inviolable law of cause and effect! besides which physiologists tell us that the chief commerce of our bodies with their environment is chemical; therefore, this subject becomes an indispensable element in any comprehensive course of domestic training. Without a working acquaintance with the physics of water, of heat, or of air, a housewife is at the mercy of her architect, if not of her plumber and her servants. In the absence of an introduction to bacteriology she lives in constant perplexity over the vagaries of her larder; and is at a loss to understand the sources of fermentation or the methods of infection by the majority of known diseases. Without an insight into economics she is helpless in the hands of the advertiser or the vendor of patent preparations, all of whose wares are warranted to perform impossible feats with an infinitesimal expenditure of trouble. At their best these preparations are expensive, and at their worst they are injurious to health.

Some personal practice of the domestic arts is also advisable even for the wealthy; it is indeed essential to a right adjustment of the daily duties in a home, though naturally the degree of skill acquired will depend on the style of living. A study of hygiene in sufficient detail is of course imperative, and while it will remove difficulties by explaining common errors in diet, habits, and dress, it will be found materially to lighten labour. Finally, hygiene will render extraordinary assistance in the right rearing of children and in the general arrangements of family life.

The objections may here be advanced that the study of these scientific subjects is uncongenial to those whose temperaments are artistic or literary; upon these people sanitary science has surely meagre claims, while life is not long enough for all to pursue such exhaustive studies. The reply to the first objection must be in the negative. There can be no health under modern conditions of existence unless those who assume responsibility in the affairs of men possess a scientific acquaintance with its right regulation. The subjects just enumerated are the very pillars which support the temple of Hygeia. But, for the encouragement of these complainants, be it added that the temple walls demand decoration; the shelves must be filled with wholesome mental provender; the gifts of both artist and author are therefore contributory to harmonious living, and an unlimited scope is offered to their utilisation. The building which shelters a healthy family, for instance, should be characterised not only by advances on existing provisions for convenience but by symmetry in its parts. The test of beauty (use, ease, and economy) can certainly not be passed by a large proportion of modern houses, neither do they provide the space which gives to each occupant “a chance to utilise his own gifts or to pursue his own hobby.” Space needs in its turn regulation, for the saving of steps must be considered and compactness is essential. Decorations and furniture should also be suitable in form and colour to their purpose, not a mere heterogeneous confusion of inappropriate colours and articles, out of tune one with the other.

The natural needs of normal children, too, must be more taken into account in the future than in the past, and the conveniences offered by scientific progress must be far more generally introduced into the most modest homes. Here is a huge field for intelligent, artistic work; for true beauty and real utility are near of kin.

It has been said that as in the world of life the localisation of function made the organ subsequently to become responsible for that function, so may the differentiation of labour develop individual talents, just as the exercise of our vital activities has led to the differentiation of parts in a house. Thus, as satisfaction of hunger is a first necessity, eating made the kitchen, where means for the gratification of this instinct were localised. By degrees the growth of men’s social and intellectual demands led to the setting apart of a chamber for conversation; that is, the parlour. Storage of bread called the pantry into existence; increased refinement necessitated a scullery for the washing of cups and platters. Centuries, however, elapsed before the enlarging personality of the individual demanded privacy for the toilet and the right to isolate himself periodically from the bustle and publicity of group life. The general provision of separate bedchambers for each unit of a household is not even yet habitual, though most desirable in the interests of health. Reparation of the omission will mark a further phase of social evolution, and will remove one disintegrating force now continually at work in home life. Here again the artist will most advantageously collaborate with landlord and with health authorities to devise means for the suitable satisfaction of this laudable demand.

Further objections to the adoption of any comprehensive schemes for training housewives of all ranks are found in the apparent want of time available for the purpose and the prohibitive cost incurred if the period of education be prolonged. The best answers to both objections are found in the movement now active all over Europe and North America to furnish more and fuller opportunities for this training, and to extend, not curtail, its duration. More than this: this movement, which generally originated in the desire to improve home life among the poorest, has recently extended itself just as generally to institutions for higher education, upon whose pupils and students its claims are now recognised. There is no suggestion, for instance, in Germany or England, Norway or the United States, of restricting the education of girls by this movement or of prematurely enforcing upon them technical instruction. The growth of public opinion is due rather to a belated realisation that the end of all education is the betterment of life, and that suggested applications to the practical concerns of daily life in the course of a girl’s general education make for the sounder assimilation of theory by the pupil, and are thus contrived a “double debt to pay.”

The progress of preventive medicine has also introduced another incentive to the diffusion of this training; for it affords convincing proofs that the foundation of the national health is laid in the home. If, however, the foundation is permitted to be imperfect the edifice must necessarily be unstable.

Among other influences prejudicial to family life, the force of which was for a long time unsuspected, mention must be made of modern industrialism, the reopening of professional life to women, with its associated financial independence and the increasing seductions of society. For a century past the tendency has been to discredit housekeeping as an unsystematised occupation, which has emphasised the common and sometimes humiliating financial dependence of its representatives. The first nation to perceive the importance of stemming this dangerous tide was the United States, where conclusive demonstrations are now offered of the fact that intelligent housekeeping calls for a high degree of capacity, and that its problems demand the resources of a university for their solution. By the recognition of housecraft as a profession, American colleges accomplished even more than at first they anticipated. A satisfactory proportion of their students return to home life convinced of its scope and importance, and satisfied to perform the duties which there present themselves, instead of seeking outside occupations and divorcing themselves from family interests. The King’s College Course for graduate students in Home Science and Household Economics bids fair to exercise an influence of as satisfactory, though naturally of a slightly variant, character.

XV. THE FUNCTIONS OF THE HOME

If the functions of the home are briefly enumerated under three heads, no hint of exaggeration will attach to the assertion that by its atmosphere children are modified in soul and body, and that upon its outlook depends the ideals and health of all its occupants.

The first function of the home may be fitly defined as Protective. If its evolution be traced it will be found that home life originated in a craving for warmth, safety, and shelter; in the desire for a place where the weary could rest and where security from ill was assured. Physical comfort, sympathy and sanctuary are, or should be, primary characteristics of every home.

The second function of the home is Educational. It is largely responsible for the systematic formation of good habits, which should here be stimulated by example and precept, and every advantage taken of the imitative instincts so powerful in early life. Within its precincts care can be exercised to afford opportunity for the development of individuality; it is also, par excellence, the place for early training in the judicious expenditure of energy and in the acquirement of self-control. Such training improves brain power, relieves nervous tension, and obviates the tendency to mental and moral confusion and disorderliness which is associated with its absence. In a good home the child’s sanitary education should be fairly complete, at least in its main principles, before the infection of bad habits from without can interfere with automatic practice or weaken faith in home standards and conduct. Regular washing of the teeth, for instance, should be early inculcated, and rigid conscientiousness in matters of personal cleanliness:—external, by bathing, rubbing, and brushing; internal, by strict daily attention to the bodily functions. Slow and thorough mastication of food should be cultivated, as well as good habits of posture, of enunciation, and of regular exercise. Last, but not least, habits of prompt and cheerful obedience, of truthfulness, and in due course of moral purity, must be wrought into the very fibre of a child’s being. The discipline of home ought to be above all things consistent; gentle, though firm and well considered. The virtues of obedience, of self-restraint, and of respect for others should become instinctive almost from infancy; for they sow the seeds of physical morality in later life.

The third function of the home is Social. Before the present era of “only” children, the exaggerated individualism was uncommon, of which many of them are now unfortunately the victims. When large families were the fashion, the give-and-take in nursery and schoolroom gave early training in the duty of participation in the interests, the pleasures, or the sorrows of others; it rubbed off the rough angles of selfishness and gave invaluable lessons in consideration for those whose circumstances varied from immediate individual experience. The wider social sphere, for which much of the rough and tumble of family life was an excellent preparation, was not familiar then to young children as it is now, when the modern child’s premature introduction to its attractions is not only a constant source of physical detriment and of mental exhaustion, but tends to disguise its real character and to stimulate precociously the capacity to respond to its demands. Occasional glimpses of this larger life are a desirable part of home education; but constant familiarity with its excitements is to be sternly deprecated in the causes of health and of mental stability.

Where and when, then, are “only” children to receive this necessary social training, occupants as they are of solitary nurseries; or where are these qualities to be developed in the millions of children reared under circumstances of such acute overcrowding and poverty that the amenities of life are obscured by its fierce and exhausting conditions? Observation shows that the function of accomplishing this training is steadily devolving upon the school. Unfortunately, though the school does offer necessary opportunities for social intercourse, this intercourse is relatively of an advanced type, which presupposes some previous training in the more elementary principles of community life, most fitly acquired at home. This tendency to force the school to supplant instead of to supplement home training must be resisted, as it involves loss to parents as well as to the children themselves.

The stress here laid upon the social function of the home may seem to some exaggerated, and its association with the subject of this paper may appear far-fetched; but to the writer its pressing importance calls for this emphasis, for its connection with habits of sanitary practice within and without the home is of the closest. The social spirit is the very essence of sympathy; it exercises the imagination, it widens the horizon, it quickens the sense of duty and of self-respect. If graduation through the school of domestic, social training be omitted in childhood, the realisation of personal responsibility is too often indefinitely postponed. Consideration for others, care for their welfare and personal sacrifice for their protection, must ever bulk largely in importance throughout life, and must always be associated with self-respect and self-control. When this sense of personal responsibility is habitual, conduct which makes for limitations of health in self, family, or neighbours will appear unjustifiable; and neglect of either domestic or civic duties will become as unpardonable as it is unpatriotic.

But antecedent to the attainment of this ideal, fundamental even to its entertainment, is the adjustment or readjustment of home influences or methods, as the case may be, to a higher standard. A better understanding of the constitution of those for whose welfare the home is established must also be insisted upon as an integral part of general education.

It may be wise to point out that no proposal to sweep away in wholesale fashion all the domestic traditions and family methods of this or any other phase of civilisation is even suggested. Apart from the impossibility of such a holocaust, treasures of great worth have been handed on to us by our forebears, of which the majority only need some slight readjustment to enrich many generations yet to come.