III. STAGES IN THE GROWTH OF SANITARY SCIENCE
The answer may be found by reference to the late Professor de Chaumont’s now classical outline of the stages to be identified in the hygienic education of a race. He divided these into three periods, of which he described the first as merely “Instinctive,” for efforts after sanitary practice were dictated solely by the personal discomfort associated with their neglect. In those far-off 220 prehistoric days, Professor Boyd Dawkins tells us that primitive man, then in his nomadic stage, would dig runnels to carry off the rain water from the near neighbourhood of his shelters, or would move on to fresh pastures when his family and herds had fouled the nearest stream, or change his camping ground when the accumulated refuse of his food and his prowess as a hunter interfered with convenient access to his dwelling; but he took no precautions to prevent the recurrence of these discomforts, and his efforts to remove their consequences were purely temporary.
To this there succeeded what Professor de Chaumont designated the “Supernatural” period,[96] which extended over many thousands of years, during the dawn of which Eastern rulers often combined in their own person the triple callings of priest, prophet, and physician. Whether it be in China or in Persia, in Egypt or in India, among the Greeks, the Arabs, or the Hebrews, the practice of physical morality and of personal cleanliness, of restrictions of diet or protection from infection, were closely woven into the religion of the people. Reasons of health and sanitary advantages permeate the rules of more faiths than that of the Jews—whose Lawgiver embodied in the Pentateuch health maxims now known to have been derived from earlier civilisations.
But, remarkable and interesting as are the ancient sanitary codes to a generation which 221 professes to believe in the necessity for hygienic practice, their usage was tinctured from the first by a mass of superstition. Tradition and fatalism hampered true consistency between faith and works; the often sound regulations suffered from their empirical foundations. Constant warfare, varied by alternations of luxury with asceticism, combined to absorb men’s minds and to pervert their common sense, so that plague and famine, disease and penury, were superstitiously regarded as discipline from the Deity, not to be averted or avoided, but rather to be accepted as a chastisement prompted by love. The creed that to save suffering to the vile body might risk the salvation of the soul, cost Europe far dearer than is at all generally recognised; for the noble, the pure, the high-minded, the intellectual, segregated themselves for centuries in monastery and convent, in the firm faith that by denying to themselves the joy of parenthood they promoted the spiritual welfare of their country. Ignorant of their racial responsibilities, they left as progenitors of the next generation the less refined and ruder elements in the population. It is no cause for surprise, therefore, that progress in sanitation moved slowly. Domestic and urban conditions were permitted of a character well defined by the facts that, in mediæval times, a man of forty-five or fifty was considered long lived, and that first attempts to control disease were based upon commercial convenience rather than upon the saving of life.
To this long night of superstition succeeded the third and last period, known as the “Rational,” of which the first dawnings can be detected even in Plantagenet days. In this period it is desirable further to differentiate three stages of progress—(a) that of Development, when uneasiness made itself felt, but from absence of knowledge efforts at reform and control were crude, though often intelligent; (b) the stage of Legislation, and (c) the stage of Freedom.[97]
In the first of these, for instance, Henry III. effected an improvement on any former practice by bringing water to the city of London in pipes, made by boring or burning a channel through the trunks of large trees. Half a century later, in 1297-8, laws were promulgated upon the subjects of offensive trades, food adulteration, and wandering pigs; while Richard II. imposed penalties upon those guilty of fouling rivers and ditches. Out of sight out of mind, however, was the sanitary creed of this and many succeeding generations, so that too often the apparent gain of the moment sowed the noxious seed of intensified subsequent ills.
Sir John Simon has pointed out that it was not until the early part of the eighteenth century that hygiene in its modern significance loomed on the social horizon with clearer outline and more definite aims. A gradual transformation took place in the next hundred and fifty years, when 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.