That considerable attention was paid in very early times to matters relating to health, is also shewn by the elaborate directions contained in the Mosaic law as to extreme care in the choice of wholesome foods and drinks, in isolation of the sick, and attention to personal and public cleanliness. It is not surprising, therefore, to find that the Jews, throughout the whole of their history, have apparently enjoyed a high standard of health.
In this country great ignorance of the laws of Health has prior to the last fifty years prevailed, and consequently preventible diseases have been rampant, and have claimed innumerable victims. Each century has been marked by great epidemics, which have swept through the country, scattering disease and death in their course. In the fourteenth century, for instance, there was the Black Death, a disease so fatal that it left scarcely one-fourth part of the people alive; while Europe altogether is supposed to have lost about 40 millions of its inhabitants, and China alone 13 millions. A century and a half later came the Sweating Sickness (though there were a score of minor epidemics in between). This was carried by Henry the Seventh’s army throughout the country, and so great was the mortality, that “if half the population in any town escaped, it was thought great favour.” Considerable light is thrown on the rapid spread of this disease after its importation, when we remember that there were no means of ventilation in the houses; that the floors were covered with rushes which were constantly put on fresh without removing the old, thus concealing a mass of filth and exhaling a noisome vapour; while clothing was immoderately warm and seldom changed; baths were very seldom indulged in, and soap hardly used.
In the sixteenth and seventeenth centuries there were five or six epidemics of The Plague, and it was only eradicated from London, when all the houses from Temple Bar to the Tower were burned down in the Great Fire of September 2nd, 1666, which destroyed the insanitary and necessitated the building of new and larger houses.
Scurvy, jail-fever, and small-pox, are other diseases which were formerly frightfully prevalent. Jail-fever, the same disease as the modern typhus-fever, has now become practically extinct in its former habitat, owing largely to the noble work of John Howard, “whose life was finally brought to an end by the fever, against the ravages of which his life had been expended.” This disease was fostered by overcrowding, ill-ventilation, and filth.
Scurvy formerly produced a very great mortality, especially among sea-faring men. In Admiral Anson’s fleet in 1742, out of 961 men, 626 died in nine months, or nearly two out of every three, and this was no solitary case. Captain Cook, on the other hand, conducted an expedition round the world, consisting of 118 men; and although absent over three years, only lost one life. He was practically the first to demonstrate the potency of fresh vegetables in preventing scurvy.
The striking facts respecting small-pox will be found on page 293. The general death-rate has also greatly declined. Thus while the annual death-rate in London 200 years ago was 80 per 1,000, it only averaged 18.8 in the four years 1896-99; and the death-rate of England and Wales has declined from 22.4 in 1841-50 to 18.7 per 1,000 in 1891-95 and 17.6 in 1896-99.
That much still remains to be done is evident on every hand. There is little doubt that the general death-rate might be reduced to 15 per 1,000 per annum, instead of the present 18, were the laws of health applied in every household and community. It has been estimated that on the average at least 20 cases of sickness occur for every death; therefore nearly half of the population is ill at least once a year. A simple calculation will show how much loss the community annually suffers from this vast mass of preventible sickness. It amounts to many millions of pounds, leaving out of the reckoning the suffering and distress which are always associated with sickness. For details relating to special diseases, see page [297].
In the prevention of this mass of sickness, the knowledge of its causation is half the battle; when once a disease is traced to its source, as a rule, the agency which produces it can be avoided.
The reason why even more progress has not been made in the prevention of disease is not far to seek. In order to prevent a disease it is necessary to remove its causes. The causes of disease can only be ascertained by a careful investigation of its phenomena; and it is only within the last century that these have been studied to any large extent scientifically. Such knowledge of morbid processes not only results in improved measures of treatment, but in more rational and complete measures of prevention. Thus, not only is the number of diseases which are curable becoming gradually augmented, but the number preventible is even more rapidly on the increase.
Inasmuch as the preservation of health involves the prevention of disease, Hygiene, the science of health, is sometimes called Preventive Medicine.