Being profoundly impressed by the fundamental character of these truths as necessary guides in medicine as well as in every department of human life, when I learned that extensive preparations were being made in the greatest city of the world for consideration of perhaps the most important subject that can engage our attention—viz., Health—I arranged to be present as a delegate, and steadily attended the Congress, comparing notes with other friends who were attending its various sections.
In this way we gathered an accurate knowledge of the tone of the discussions, the methods pursued, and the tendencies of modern investigation.
These facts seemed to me of sufficiently serious import to make them worth recording in the following pages.
WHY HYGIENIC CONGRESSES FAIL
The Seventh International Congress of Hygiene was held in London from August 10 to 15 of 1891. It is noteworthy for the number and representative character of its members, and also for the wide range of subjects affecting the physical welfare of the race, which were considered. Representatives from America and from Asia, as well as from the various nations of Europe, assembled in the Great Metropolis to consider the vital subject of Health. These learned men met together daily during the week in nine different sections, from ten to two o’clock. They were occupied with the subjects of Architecture, Engineering, Chemistry, the health of soldiers and sailors, the care of early childhood, the duty of the State in relation to the Health of the Nation, Health Statistics, Bacteriology, and the relations of Animal and Human Disease.
In the consideration of this wide range of subjects, valuable experience and much useful information were presented in the papers read and in the discussions that followed. But in a Congress not held together by any great guiding principle, where persons of various nationalities, moulded by different laws, methods of education, and social customs were represented, a great variety of opinion, of contradictory facts, of imperfect statistics and superficial theories, would necessarily be brought forward. Nevertheless, a remarkable concensus of opinion established one great result of experience—a result which may be considered the striking practical lesson of the Congress—viz., that it is to sanitation that we must look, not only for the prevention of disease, but largely also for its cure.
Supremacy of Hygiene.—Taking the results of sectional discussions as a whole, it was very generally shown that, by our increasing knowledge of hygienic law, its wide diffusion amongst the people, and its intelligent application to daily life, we can counteract the evil influence of heredity, get rid of epidemics, improve the stamina of the race, advance in longevity and in the natural enjoyment of our earthly span of life. Thus it is by the advance of sanitation that the Art of Healing can alone become a science of Medicine.
A few illustrations will show how this growing result of modern thought was both directly and indirectly supported by the papers and discussions of the various sections.
Thus Sir Charles Cameron, of Dublin, showed the beneficial change wrought by ten years’ sanitary effort in the Dublin slums through rebuilding, draining, cleaning, and free disinfecting. Those wretched quarters were a breeding-ground of human misery in 1871, where small-pox, typhoid fever, and all contagious diseases seemed to be endemic. The annual mortality was reduced in ten years by sanitary measures from 34·11 to 28·80 in the most crowded portions of this wretched quarter; in its less crowded part the mortality had fallen to a much lower figure, notwithstanding the intemperance and destitution which still continued to afflict the inhabitants. In this example it should be especially noted that the goodwill of the people was enlisted, for the municipality laid aside the idea of pecuniary gain on the sum expended in rebuilding, etc., and offered a better lodging at a rent that could be paid, and provided all sanitary appliances free, thus losing, in the sense of money profit, to gain in the far higher value—health.
Another remarkable illustration from very large experience was that given by Professor Smith, of Aldershot, who is at the head of the cavalry department of our army. He showed, by most interesting tables, that diseases formally rife amongst horses—glanders, farcy, canker of the foot, etc.—were now practically unknown in the army. This triumphant result was entirely due to careful hygiene, the utmost attention being paid to food, ventilation, drainage of stables, the care of the feet and shoeing, of saddles and harness, and reduction of the burden which the horses were required to carry, to fifteen stone as a fair average. As was justly remarked, there is a limit to the weight that a horse can carry or draw, beyond which is cruelty and injury.