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.
IV. WHY THE IDEALS OF MODERN HYGIENE ARE NOT ATTAINED
And so it has come about that, with this ideal in view, the methods of modern hygiene are directed to awaken the nation’s sanitary conscience and to stimulate the growth of true civic freedom. These methods may be fairly defined as the working of common sense aided by the results of scientific research, in their turn supported by very carefully tested applications. Necessarily it is assumed that each individual will accord to them intelligent, personal support and, where necessary, will be willing to sink unreasonable likes and dislikes in the sea of social service.
Examples of the enormous benefit inseparable from well-considered sanitary legislation could 226 be multiplied; though, on the other hand, it is also necessary to check optimism by many illustrations of the grievous harm still being wrought by want of thought. Hindrance to possible progress is also associated with the ignorance of those whose development has not yet attained the level when freedom of action can be permitted. It is some of the results of this ignorant indolence which cause the minds of the thoughtful and far-sighted to be tense with anxiety for the welfare of their country, and arouse a wish for further and more stringent public health enactments. Nevertheless, again it must be said that to legislate in advance of public opinion is futile. Only after stupendous exertion, for instance, has the serious and continued mortality among infants excited general attention; and the curious, widespread indifference to the recommendations of recent Royal Commissions on the Poor Law and the Care of the Feeble-minded indicates that, were infant mortality controllable by legislation, such legislation would still fail of its object unless it were also realised that a child’s hold on life is practically dependent upon parental care, and is intimately associated with maternal nutrition before its birth.
Or again; the law relating to the protection of the public food supply is approaching a high pitch of excellence; the penalties on adulteration or on the sale of diseased or otherwise unwholesome foodstuffs are severe and quite frequently inflicted; but these regulations are powerless to influence the 227 errors of nutrition constantly reflected in the features of our population at each age period, neither can they stem the tide of self-indulgence, emotionalism and luxury which enervate and deteriorate thousands of our people. Vain indeed are their endeavours to disguise by alcoholism and drugs the traces of their misfortunes. Stern Nature is relentless; her laws are as those of the Medes and Persians; the children’s teeth shall be set on edge by the fruits of the reckless folly and intemperance of their ancestors.