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 223 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 224 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; 225 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.
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 226 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 227 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 228 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.
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 229 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 230 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 231 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 232 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 233 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.
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. 235 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 236 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.
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 237 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! 238 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 239 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.
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 240 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.
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 243 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 245 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 246 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. 247 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.
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, 248 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 249 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 250 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 251 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.
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 252 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 253 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.
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 254 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 255 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 256 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 257 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 258 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.