When, therefore, one tries to consider industrial disease, one must realize how complex a thing it is, how essential it is to go beyond the inspection of the factory and to study all the conditions of the lives of the people that one is concerned with.
In a big Western American town that I visited recently, where the automobile tire industry was employing some fifty thousand hands in factories, the most obvious cause for ill health was the tremendous congestion in that town, and as a result the fearful state of the available lodgings. Again most of the factory hands were foreigners; very few of them spoke English; they were wholly dislocated from normal family life, from any connection with their own countries and from their own previous interests. That is in itself a dangerous condition for hygiene as well as for morals. Factors like that must be taken account of when we want to help anybody to get free of the troubles, the fatigue or strain or debility, which we are apt to attribute to industry.
We are keen, and rightly keen, to find and to abolish poisons, such as lead, such as phosphorus, such as carbon monoxide. We ought to be keen to study poisons of that kind, and more interest has lately been concentrated upon them through war work and war industries than ever before. But there are moral poisons which we do not notice or mention. Monotony, for instance. Monotony is not altogether a horrible or hateful fact. Most of us want some monotony in our day. We want a rhythm and a certain recurrence in it, whereby our work comes to seem familiar to us and we do somewhere near the same thing each day. There is rest in that. But how much we need is individual; the dose of monotony, the amount that is good for you and for me is limited. People often get too much, and when they get too much, then it is a moral poison. One of the most appalling things, I think, is its effect upon the mind. I have often wondered whether I ever had or ever would have any mind again, when I have come to the end of such a day. Any one of us, of course, can duplicate that experience, and it certainly ought to make us think hard about the lives of manual workers whose days are quite likely to be like that right along. At the end of such a monotonous day a person may be pretty reckless, may feel that he does not care what happens to him. I have met that in a great many histories. It is not so much that monotony makes machines of them as that it makes wild animals of them.
Another moral poisoning is the sense of injustice, a sense that it is not right that somebody else, whom the Lord did not make very different, has so much more of money and opportunity and happiness than the person himself has. It is altogether a secondary question to discuss whether that is true or not. I do not myself believe that the rich are any happier than the poor. On the whole, I think the evils of money are just as great as the evils of poverty. But the sense of injustice is often just as real even though the reasoning on which it is based is wrong; and the sense of injustice is a moral poison which breaks down health and spoils happiness.
Can we do anything about it? Sometimes. By going over the details of people's lives, by telling them stories of other people's lives, by confessing a great deal about our own life, we can help people to see things differently. When I was speaking of pains in the region of the heart I said that one of the most important things that one could learn is to distinguish between the pain and what we think of it. The pain often cannot be changed, but our interpretation of it often can. The patient often suffers chiefly from what he thinks of the pain, and when he knows that the pain is not due to heart disease and that he probably will live to be a hundred, that particular form of suffering leaves him. So in this matter of the sense of injustice, the causes for suffering may be unchangeable, but if we can change the patient's point of view we may help him a great deal.
A greater evil, I think, than any I have mentioned, and one that we are almost powerless to attack, is lowered sex standards, which come from the crowding of people of all ages and both sexes into industry. As in the housing problem, it is the moral rather than the physical side of crowding that is most serious.
That is why the visiting part of social work seems to me so much the most important. The important part is what we hope goes on in home visits, when the social assistant meets people where they will talk as of course they cannot talk in the dispensary.