I. HEALTH AND ITS GENERAL CONDITIONS.
A broad and scientific view of life is that which regards it as being composed, in its physical aspects at least, of a series of actions or functions more or less defined in their nature. These functions, as the physiologist terms them, are discharged, each, by a special organ or series of organs; and health may therefore be viewed as the result of the harmonious working of all the organs of which the body is composed.
Disturbances of health arise whenever the natural equilibrium maintained between the functions of the body is disturbed. For example, a broken bone being an infringement of the functions of a limb, is a disturbance of health equally with the fever which runs riot through the blood, and produces a general disturbance of the whole system. An aching tooth equally with brain disorder constitutes a disturbance of health. We may therefore define health as the perfect pleasurable or painless discharge of all the functions through which life is maintained.
Doubtless this bodily equilibrium of which we have spoken is subject to many and varied causes of disturbance. Life is after all a highly complex series of actions, involving equally complicated conditions for their due performance. Like all other living beings, man is dependent upon his surroundings for the necessities of life. These surroundings, whilst ministering to his wants, may under certain circumstances become sources of disease. Thus we are dependent, like all other animal forms, upon a supply of pure air, and this condition of our lives may through impurities prove a source of serious disease. The water we drink, equally a necessity of life with air, is likewise liable to cause disease, when either as regards quantity or quality it is not supplied in the requisite conditions. Man is likewise in the matter of foods dependent upon his surroundings, and numerous diseases are traceable both to a lack of necessary foods and to over-indulgence in special kinds of nourishment. The diseases known to physicians as those of over-nutrition belong to the latter class; and there are likewise many ailments due to under-nutrition which also receive the attention of medical science.
In addition to these outward sources of health-disturbance, which constitute the disease of mankind, there are other and more subtle and internal causes which complicate the problems of human happiness. Thus, for example, each individual inherits from his parents, and through them from his more remote ancestors, a certain physical constitution. This constitution, whilst no doubt liable to modifications, yet determines wholly or in greater part the physical life of the being possessing it. We frequently speak of persons as suffering from inherited weakness, and this inherited weakness becomes the ‘transmitted disease’ of the physician. Each individual, therefore, may be viewed as deriving his chances of health, or the reverse, from a double source—namely, from the constitution he has inherited and from the surroundings which make up the life he lives and pursues. It is the aim and object of sanitary science to deal as clearly and definitely as possible with both sources of health and disease. In the first instance, Hygiene, or the science of health, devotes attention to the surroundings amid which our lives are passed. It seeks to provide us with the necessary conditions of life in a pure condition. It would have us breathe pure air, consume pure food, avoid excess of work, strike the golden mean in recreation, and harbour and conserve the powers of old age, so as to prolong the period of life and secure a painless death. In the second aspect of its teachings, this important branch of human knowledge would teach us that with an inherited constitution of healthy kind we should take every means of preserving its well-being; and when on the other hand an enfeebled and physically weak frame has fallen to our lot, the teachings of health-science are cheering in the extreme.
Even when an individual has been born into the world, handicapped, so to speak, in the struggle for existence by physical infirmity and inherited disease, health-science is found to convey the cheering assurance that it is possible, even under such circumstances, to prolong life, and secure a measure of that full happiness which the possession of health can alone bestow. In illustration of this latter remark, we might cite the case of a person born into the world with a consumptive taint, or suffering from inherited tendencies to such diseases as gout, rheumatism, insanity, &c. Vital statistics prove beyond doubt, in the case of the consumptive individual, that if his life be passed under the guidance of health laws, if he is warmly clad, provided with sufficient nourishment, made to live in a pure atmosphere, and excess of work avoided, he may attain the age of thirty-six years without developing the disease under which he labours, and once past that period, may reasonably hope to attain old age.
In the case of the subject who inherits gout, a similar attention to the special conditions of healthy living suited to his case may insure great or complete freedom from the malady of his parent. Strict attention to dietary, the avoidance of all stimulants, and the participation in active, well-regulated exercise, form conditions which in a marked degree, if pursued conscientiously during youth, will ward off the tendency to develop the disease in question. In the case of an inherited tendency to mental disorders, mysterious and subtle as such tendency appears to be, it has been shown that strict attention to the education and upbringing of the child, a judicious system of education, the curbing of the passions, and the control of emotions, added to ordinary care in the selection of food and the physical necessities of life, may again insure the prolongation of life, and its freedom from one of the most terrible afflictions which can beset the human race.
These considerations in reality constitute veritable triumphs of health-science; they show us that in his war against disease and death, man finds literally a saving knowledge in observance of the laws which science has deduced for the wise regulation of his life. It is ignorance or neglect of this great teaching which sends thousands of our fellow-mortals to an early grave, and which destroys hopes, ambitions, and opportunities that may contain in themselves the promise of high excellence in every department of human effort.
The one great truth which health-reformers are never weary of proclaiming, because they know it is so true, consists in the declaration that the vast majority of the diseases which affect and afflict humanity are really of preventable nature. Until this truth has been thoroughly driven home, and accepted alike by individuals and nations, no real progress in sanitary science can be expected or attained. To realise fully the immense power which the practical application of this thought places in our hands, we may briefly consider the causes of certain diseases, which in themselves though powerful and widespread, are nevertheless of preventable kind. Amongst these diseases, those, popularly known as infectious fevers, and scientifically as zymotic diseases, stand out most prominently.
We shall hereafter discuss the nature and origin, as far as these have been traced, of those ailments. Suffice it for the present to say, that science has demonstrated in a very clear fashion the possibilities of our escape from those physical terrors by attention to the conditions to which they owe their spread.
Typhoid fever, also known as enteric and gastric fever, is thus known to be produced, and its germs to breed, amongst the insanitary conditions represented by foul drains and collections of filth wherever found. Experience amply proves that by attention to those labours which have for their object the secure trapping of drains, flushing of sewers, and abolition of all filth-heaps, the chances of this fever being produced are greatly decreased. It has also been shown that even where this fever has obtained a hold, attention to drains and like conditions has resulted in the decrease of the epidemic. Again, typhus fever is notoriously a disease affecting the over-crowded, squalid, and miserable slums of our great cities. Unlike typhoid fever, which equally affects the palace of the prince and the cottage of the peasant, typhus fever is rarely found except in the courts and alleys of our great cities. We know that the germs of this fever, which in past days constituted the ‘Plague’ and the ‘Jail Fever’ of John Howard’s time, breed and propagate amongst the foul air which accumulates in the ill-ventilated dwellings of the poor. Attention to ventilation, personal cleanliness, and the removal of all conditions which militate against the ordinary health of crowded populations, remove the liability to epidemics of this fever. Again, the disease known as ague has almost altogether disappeared from this and other countries through the improved drainage of the land; though it still occasionally lingers in the neighbourhood of swamps and in other situations which are wet and damp, and which favour the decay of vegetable matter.
Man holds in his own hands the power both of largely increasing and decreasing his chances of early death, and nowhere is this fact better exemplified than in the lessened mortality which follows even moderate attention to the laws of health; the words of Dr Farre deserve to be emblazoned in every household in respect of their pungent utterance concerning the good which mankind is able to effect by even slight attention to sanitary requirements. ‘The hygienic problem,’ says Dr Farre, ‘is how to free the English people from hereditary disease ... and to develop in the mass the athletical, intellectual, æsthetical, moral, and religious qualities which have already distinguished some of the breed. There is a divine image in the future, to which the nation must aspire. The first step towards it is to improve the health of the present age; and improvement, if as persistently pursued as it is in the cultivation of inferior species, will be felt by their children and their children’s children. A slight development for the better in each generation, implies progress in the geometrical progression which yields results in an indefinite time, that if suddenly manifested would appear miraculous.’
In 1872, Mr Simon told us that the deaths occurring in Great Britain were more numerous by a third than they would have been, had the existing knowledge of disease and its causes been perfectly applied. He added that the number of deaths in England and Wales which might reasonably be ascribed to causes of a truly preventable nature, number about one hundred and twenty thousand. Each of those deaths represents in addition a number of other cases in which the effects of preventable disease were more or less distinctly found. Such an account of a mortality, the greater part of which is unquestionably preventable, may well startle the most phlegmatic amongst us into activity in the direction of health-reform. In order that the nation at large may participate in this all-important work, it is necessary that education in health-science should find a place in the future training of the young as well as in the practice of the old. And if there is one consideration which more than another should be prominently kept in view, it is that which urges that the duty of acquiring information in the art of living healthily and well is an individual duty. It is only through individual effort that anything like national interest in health-science can be fostered. There is no royal road to the art which places length of days within the right hand of a nation, any more than there exists an easy pathway to full and perfect knowledge in any other branch of inquiry. It is the duty of each individual, as a matter of self-interest, if on no higher grounds, to conserve health; and the knowledge which places within the grasp of each man and woman the power of avoiding disease and prolonging life, is one after all which must in time repay a thousandfold the labour expended in its study. It is with a desire of assisting in some measure the advance of this all-important work, that the present series of articles has been undertaken; and we shall endeavour throughout these papers to present to our readers plain, practical, and readily understood details connected with the great principles that regulate the prevention of disease both in the person and in the home.