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 260 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 261 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.
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 262 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 263 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 264 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 265 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 266 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.
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 268 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 269 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 271 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 272 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 274 graduate students in Home Science and Household Economics bids fair to exercise an influence of as satisfactory, though naturally of a slightly variant, character.
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 275 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 276 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 277 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 278 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.
To take a somewhat extreme example. The mention of such homely, old-fashioned, domestic remedies as black-currant tea for a bad cough, or soap and sugar plasters for a boil—genuine relics from our grandmothers—now usually excite a smile of derision; nevertheless they have been instanced by one of our most able living pathologists[120] for their admirable adaptation to their purpose, and have been shown to rest upon a hitherto unsuspected basis of physiological therapeutics.
Another illustration may be drawn from the nursery tradition that bad temper is often effectually cured by a dose of rhubarb.[121] Carefully conducted 279 observations upon children confirm the conventional connection of peevishness with disordered digestion. It has been found that gastric indigestion produces oversensitiveness, fretfulness, and irritability, while chronic constipation results in erratic conduct, stupidity, languor, headache, and moodiness. These effects may be so far-reaching that, for no other reason than chronic constipation, children may lose a large proportion of the advantages provided in school life; they may even run the risk of being classed as “backward,” from the interference with mental progress of the food poisons reabsorbed into their circulation.
Modern methods of child training lay great emphasis upon the prevention of these or kindred conditions by early formation of good habits; or, when carelessness necessitates curative treatment, our old nurse’s panacea of drugs is the last resort; the first consists in attempts to re-establish normal functions by the more natural means of suited food and special exercise.
It is time, too, that the so-called “hardening fallacies,” responsible for the maiming of countless lives, were finally exposed and exploded. The idea, for example, dies hard that beneficial endurance is cultivated by exposure to cold; therefore, bare necks, arms and legs are lauded as means of developing a Spartan spirit in young children. Now no profound study of hygiene is required to demonstrate the close interdependence of warmth with growth and nutrition, or to show that the chilly 280 and underclothed, sedentary child is both stunted and starved; whereas the suitably clothed and freely active child is able to carry on unhampered the necessary processes of growth and development.[122] So important is warmth to the infant, that eighty per cent. of the total energy derived from its food is utilised for the maintenance of the body temperature essential to growth and for the activities of the organic and muscular systems.
Children, in accordance with the law of the relation between mass and surface in a cube, have, relatively to their mass, about thrice the body surface possessed by an adult. The greatest loss of heat occurs by radiation from the skin and by the evaporation of sweat, therefore undue loss from this extensive area should be prevented by its suitable covering; otherwise the child is placed at a far more serious disadvantage than would be suffered by an adult similarly situated; for in his case growth as well as equilibrium must be maintained. Few parents realise the further fact that the power of heat regulation is very imperfect at birth; indeed its slow development accounts for the instability of a child’s temperature for many years after. The fallacy therefore of seeking to strengthen a young life by inadequate clothing, by enforced and prolonged inactivity, or by abstinence from the source of all energy—food—must be persistently exposed. Quite recently, also, Dr. Eurich has advanced evidence 281 to show that the quality of sleep is adversely affected where the sleeper is insufficiently protected from cold, thus emphasising the injury to health associated with going to bed with cold feet.
All parents are ambitious that their offspring shall be distinguished by the energy, the stability, the endurance and the power which characterise the cream of humanity. The lives of young people are carefully planned with this object in view. The waking hours of most girls and boys are distributed in ordered sequence between what is intended to be concentrated work and vigorous more or less exciting play. But the fact has been very commonly ignored that these young people are built up of young cells, which cells are passing through almost every conceivable phase of instability in the course of development; consequently recurring periods of leisure and rest are as important to nutrition and nervous stability, more especially in the case of girls, as are the most elaborate arrangements for exercise. Thus it comes about that many youths and maidens suffer from chronic though unrecognised fatigue, while others are unable to employ pleasurably even a short space of “time to themselves,” finding no interest in occupations from which excitement is absent. The habitual limitation of the hours of sleep among the rising generation is equally serious. The loss which would be unbearable,[123] says Dr. Acland, 282 even among our most favoured children, were it not for the indulgence permitted them during their long holidays. Is it not a parental duty to insist upon the necessary provision for rest being made in every school, and ought not inviolable rules upon the subject be laid down in their home circles? Sleep, be it remembered, is the property of animals possessed of brains and endowed with consciousness; it affords mechanical rest, and is accompanied by a respite from the chemical changes which are particularly rapid during childhood and adolescence. The intense activity of the child’s waking hours must be counterbalanced by ample periods of entire rest. Habits of prolonged profound sleep are said to be the best investment against mental instability and insanity; yet parents permit a constant loss of from two to four hours’ sleep each night throughout the long period of immaturity.[124] Our newspapers and lunatic asylums bear evidence to the price paid for this now inexcusable carelessness.
Many more examples might be given of similar fallacies which apply to later periods of life. How soon will a loving daughter allow herself to learn that the consumption of large quantities of highly nutritious food will not make for the prolongation of an aged parent’s life? The fact that abstemiousness and rigid conformity to the “simple life” 283 are not coincidents of longevity, but contributory to it, should be now common knowledge. When will the day come that the fact will be accepted that alcohol does not warm and protect the consumer, but actually lowers the temperature, and by this means, in cold weather, renders him a more ready prey to the effects of exposure. When will the value of good work cease to be measured by the exhaustion it brings about or the breakdown to which it conduces? Is it not, time that the housewife should be abashed rather than self-commiserating when a bad cold runs through her household, for observation of certain elementary principles of disinfection would go far to avert such a catastrophe? When will the fallacy be destroyed which gauges the strength of a disinfectant by the pungency of its odour? The knowledge now available on these and many other points only awaits assimilation by the housekeepers of the empire, to serve as a powerful lever by which to raise the standard of health in its every part.
The urgent call for a more intimate acquaintance with these tenets of domestic sanitary science calls for no further examples, though at the risk of wearying the reader one or two more may be selected to illustrate their claims upon every member of a household.
It behoves the householder, in the first place, to choose his dwelling with care; and, in the second, to maintain the health of its inmates by his own conduct and by compliance with the requirements of public health enactments. He must be generally acquainted, therefore, with the essentials of a healthy home and with the obligations he must fulfil or the demands he may legitimately make upon local authorities and neighbours; otherwise he cannot insure that his own care is not frustrated by derelictions of duty on the part of others. The selection and purchase of the family’s food will probably devolve upon his wife, but it rests with him to insist that this food is produced, transported or distributed, with due observance of cleanliness, and that reliable protection from sophistication or adulteration is maintained. If conformity to necessary standards as well as the good quality of their products is to be safeguarded, the premises of dairy, bakehouse, slaughter-house, laundry, market, and local purveyor of goods should come under his intelligent inspection. The surroundings as well as the conveniences of a house also call for careful consideration, especially when some of its inmates are of tender years; and the reminder that to the provision for light and air in its rooms must be assigned a greater prominence than the mere prettiness of external elevation is still necessary. It is the householder who for some time to come must from his wider knowledge of economics personally safeguard his women-folk 285 from unnecessary exertion and chronic fatigue, by the provision of efficient fittings and equipment, by a judicious expenditure upon labour-saving devices, and by insistence upon adequate rest, recreation, and remuneration. To the graduate in the school of personal experience the duty of public service will next arise, in order that the advantages enjoyed in his own home may be extended to those for whom cheap housing must be provided. Civic claims must in the near future appear much more prominently than hitherto in the balance-sheet of duty.
The necessity for a study of child life and its requirements ought to be realised by both parents before the bitter results of inexperience have permanently shadowed their home. This should be pursued by the man as well as the woman before marriage is consummated, if their offspring is to be “well born” and well nurtured.
Maternal care is of course the more conspicuous during the first ten years of a child’s life; but during the next fifteen, more especially in the case of his sons, it is the father’s example, sympathy, and companionship which will steer them healthily through the stormy seas of adolescence, which will safeguard them from pernicious habits and will extend a helping hand in moments of temptation.
To enumerate the opportunities for hygienic practice by the prime organiser of domestic methods—the mother—is almost superfluous at this point. It is the foundation upon which 286 depends the welfare of each member of a household; for it is the housekeeper who plans the food and is responsible for its character and suitability to age, season, health, and occupation. It is she who superintends, if she does not carry out, the details of cleanliness, so arduous and discouraging in our great cities. It is she who selects the clothing of her family; who directs the order of their lives:—their work and play, their rest and exercise, their sleep and their habits. It is her place to shake faith in popular patent preparations, by good reasons and demonstrations of their exaggerated claims on purse and person.[125] It is her example which sets the tone in recreation, pursuit of hobby, or choice of literature. It is her infinite, understanding patience which cements breaches in family love; it is her skilful treatment which heals wounds, spiritual as well as physical. It is her privilege to devise better methods for daily doings and to appreciate the principles of sound economics. It falls on her to discourage futile expenditure of health, time, or temper; to be alive to possibilities of progress; to show by her deeds how profound is her faith in the dignity of a home-maker and her recognition of the extraordinary demands made by her profession on intelligence, moral capacity, and mental attainments.
It has been slowly dawning upon some minds for half a century at least that kitchen methods in many of their details fail to meet the requirements 287 of sanitary science. The ordinary cook does not even suspect what cleanliness means from the laboratory point of view; neither, alas! does her mistress, in the case of 90 per cent. of middle-class housekeepers. Both alike cheerfully ignore the relative value as cleansing agents of boiling as compared with “scalding” water; and refer to the broad shoulders of the weather or, quite frankly, to bad luck, the waste of food directly attributable to ignorant and uncleanly methods in market, purveyor’s cart, or scullery. Yet no valid excuse can now be offered for ignorance of the real causes of the souring of milk, the tainting of meat, or the decay of vegetables; neither is it permissible to entrust to the untrained the care of larder and refrigerator, except under intelligent supervision. It is of course a sign of progress that the modern housewife prides herself upon the delivery of the daily milk supply in bottles. But a quite superficial acquaintance with bacteriology would show the imperfect character of such a protection. The milk may still be poured by the cook from the unwashed mouth of a bottle, grasped, even if but momentarily, by the hand of a milkman, which shortly before was caressing his horse or serving him as a substitute for a pocket-handkerchief! When the numerous uses of paper in the kitchen are considered, the advantage of a scientific acquaintance with its constituents and absorbent properties should hardly need emphasis. But the laissez-faire attitude, common in many households, permits 288 newspaper or brown-paper bags of questionable antecedents to be used indiscriminately for the lining of cake tins or the draining of fried foods. Should this be tolerated any longer?
A sounder knowledge of the risks to health associated with unwholesome food would surely check the growing disposition to purchase provisions over the telephone, instead of by personal inspection and careful selection; for the risks associated with stale vegetables or with “woolly” fish would be recognised, in the light of this fuller knowledge, as too serious to be encountered by any one responsible for the health of a household. Again, cold storage is so justly credited with the numerous and unquestionable benefits which it confers upon the housewife, that she is apt to forget the coincident dangers; only through tardily acquired experience does she become aware that foods which are thawed after freezing possess a singular faculty for rapid deterioration, and undergo subtle and detrimental changes when so preserved over a long period. No excuse for continued ignorance as to the changes responsible for such deterioration is now permissible; neither can it be condoned in connection with the “flora” of the refrigerator, now known to be accountable for the unpleasant and all-pervading flavours of the food stored in such a receptacle, and itself the product of defective cleanliness. The idiosyncrasies of different groceries, as regards temperature and receptacles, have hitherto received no attention, though the art of preserving fruits, 289 fresh as well as dried, is better appreciated than was formerly the case.
It would be easy to show, too, did space permit, what ample scope there is for the application of sanitary science in the storeroom, as well as the true hygienic inwardness of frequent coats of limewash in larder and scullery, not to mention the worth of impervious coverings to their wall surfaces and shelves. This suggests the inquiry: How many women to-day are versed in the external tests, simple as some of them are, which can be applied to tins containing foodstuffs, with the object of gauging the quality of their contents; or who among our ordinary housewives understands the reasons for the employment of reliable, domestic methods of preserving the contents of the larder, such as sterilisation by the use of heat, or why fat, sugar, salt, or vinegar are preferable to the seductive yet questionable chemicals, so attractive to the producer and purveyor of provisions?
A better understanding of the relation of sanitary science to daily life would also facilitate some of the painful steps which must inevitably be taken, in order to bridge the gulf set between the feudal methods of the past and the modern problems of domestic service. That the isolation from her kind of a “general” servant predisposes to anæmia is stated as a fact on good authority, but it is certainly not generally known. That absence of opportunity for recreation or social intercourse has led and may lead again to deception, if not 290 to worse, is recognised unwillingly, if at all. That human nature is physiologically similar, however diverse its external appearance and standards, is very hard to realise or to act upon; so the fact that suitable provision for bathing and wholesome sleep by dependents is not always made, is apt to be ignored on economic grounds; and the resultant complications are assigned to any but their real cause.
The solution of another of the acute problems of the day depends upon the women also of this country. I refer to the character of the influence, an influence of the most intimate, to which young children are subjected during infancy. In addition to vulgarities of conduct or enunciation, actual moral harm may be suffered from want of care in the choice of a child’s attendant. Bad habits, impossible to eradicate, are to be traced to this source only. Their hygienic import calls for no further stress. Their prevention rests entirely with the child’s parents.
Another illustration of the need for a better acquaintance with hygiene is found in the general custom of entrusting the preparation and care of the daily diet to empirically prepared, ill-informed, young women. Ascertained facts in connection with, for instance, “typhoid carriers”[126] should have surely created almost a panic in the households of England; but it is rare to learn that even one mistress has inquired into the personal 291 habits of her cook, or that she has concerned herself personally in the cultivation of most careful attention to necessary hand-washing by her household. A mere tyro in sanitary science would take warning and be on her guard against this and other disgusting and preventable sources of domestic infection.
Finally, the protective function of the home must not be allowed to obscure the educational and social. It is the right of all children to be trained in habits of social, as well as of family, sanitary service. Very early the love of ceaseless doing, by which these little people are distinguished, can be taken hold of as an agent in this department of education. Habits of neatness and order, of kindness and ready help, of self-sacrifice and self-control, become lifelong in their persistence and develop a physical as well as moral conscience which makes for public health. But, without appropriate stimulus this interest in others, this sense of civic obligation, remains in abeyance. Therefore girls should be encouraged in the educational practice of the domestic arts about the age of thirteen or fourteen; though instruction in the care of children may be postponed for a year or two. Always it should precede marriage and be adapted to the prospective social sphere of the pupils. It would be advantageous to foster the interest of boys in social sanitation by the introduction of some equivalent training into their curriculum.
Enough has been said to show that knowledge 292 of household administration must soon become an indispensable qualification for any woman who undertakes the charge of human lives, whether it be as wife or guardian, as official or philanthropist, as physician or educator, as head of an institution (such as orphanage, asylum, hospital or prison), or as almoner of public funds. To be practical and influential this comprehensive subject must be systematically acquired and securely based; it must be accorded the support of men, and it must receive the recognition due to its imperial importance. Thus sustained and fortified, acquaintance with all that is comprehended in the domestic administration for good of human lives will lead our women to redeem their many shortcomings in the past, and will stimulate them to assume with courageous confidence their weighty responsibilities in the present and future.
Whether prepared or not for their discharge, these responsibilities cannot be evaded. Upon their capable fulfilment depend human health and happiness. “Health and good estate of body are above all gold,” said Ecclesiasticus, “and a strong body above infinite wealth.” Seen in its true light this great, beautiful, responsible work becomes the highest form of consecrated service to the Source of all Life and to the Giver of all those good things which humanity is intended richly to enjoy.