190 



NATURE 



IJnly 5, 1877 



tecting care, and, if not removed, reduced to a short 

 calendar. 



It is felt by some that the medical Sanitarian of the 

 future will have his best efforts thwarted by the forcible 

 excess of life beyond the means that can be found for the 

 support of life, as if life were a mere secondary principle 

 in the universal order. I see no such cause for fear. That 

 in the progress of life on the earth the day will ever come 

 when the earth will not supply food for its people is to 

 my mind pessimism carried into an insane vulgarity. It is 

 clear that man can always reduce to his wants the lives 

 of all animals except man. The question rests therefore 

 on the abnormal increase of man alone. Nature knows 

 that and rules accordinf.ly. Let man remain savage, and, 

 however sensual he may be, he will die fast enough by 

 war, plague, famine, or luxury. In that state he will never 

 overstock the earth, but either grope in solitary places a 

 neglected family, unprotected from all the killing vicissi- 

 tudes, or will sink into luxurious barbaric decadence. 

 Let man become exalted in life ; exalted by communion 

 with noble pursuits ; with pursuits of science, art, letters, 

 and cultivation of greatest happiness for the greatest 

 number, and his sensual life will become too subject to 

 the virtue to leave a chance for the danger which a low 

 sensuality sets up as a terror and at the same lime a 

 temptation for the vulgar. 



I think it my duty to deal plainly with a question which 

 affects so closely the future of sanitation, and to express, 

 from an experience which is confirmed, as I know, by 

 some of the brightest ornaments of my learned profession, 

 that nothing is wanted to correct the danger of over- 

 population but improvement of mental process ; nearer 

 communion with the eternal mind in His works ; purer 

 artistic education, healthier homes, more rational amuse- 

 ments, and the ennoblinginfluenceof a holier life amongst 

 those who assume to be the cynosures of the nation. 



On the whole the prospects of medical learning and ac- 

 tion will be greatly improved by sanitary advancement. It 

 is possible that fortunes or reputations resting on faith in 

 famous curers will dwindle slowly away, and that not for 

 long will the skill of the physician be valued by the fal- 

 lacious reckoning of mere results. But in exchange there 

 will be opened to the pkhysician a career in which skill 

 of labour will be e.xhibited together with results, the results 

 obvious as to their relation to the work, and both, if good, 

 successful beyond praise. 



The Social Part. 



The future of sanitary science in relation to social hfe 

 generally, its effect that is to say on all classes of the 

 community, promises steady progress. No one who has 

 been actively engaged for the past quarter of a century in 

 sanitary work can doubt this statement. Throughout all 

 sections of the community there is desire to know ; and if 

 the legislator will be content not to legislate until he sees 

 that free-will guided by knowledge is in the same train 

 with him — it doesn't matter in which class, — all will go 

 well. The workers in our Sanitary Institute though they 

 be not legislators can, nevertheless, greatly assist Par- 

 liament by bringing free-will into harmony with know- 

 ledge, and though the distinction does not at first sight 

 stand out, in separating free-will from ignorance and from 

 those automatic demonstrations of ignorance which are 

 the outward and visible signs of unhealthy habits of life. 



The social work that has to be carried out for the future 

 of sanitary science is purely educational. Educational not 

 merely by lectures and books and lessons from books, 

 but by demonstrations of sanitary works, plans, buildings, 

 mechanisms, results of all labours bestowed on the cause. 

 Without venturing on details of this kind which would 

 land me in another address, I may be content to touch on 

 two points, both of vital moment for the future. 



The first of these relates to modes of teaching so 



as to carry the sympathies of the learner and his more 

 refined tastes along with his reason ; to attract and charm 

 his senses as well as his intellect. It is said of us sani- 

 tarians, and sometimes I fear with some truth, that 

 we would make health hideous. We need not do so ; 

 and if the feat has ever been accomplished it is but the 

 work of a " 'prentice han," that ought to be forgiven. 

 Health truly is beauty in the living evidences of it, and 

 should be so in those inanimate evidences which the 

 builder and the engineer construct for us. I would there- 

 fore urge that in all coming sanitary work, theoretical or 

 practical, the sanitarian should call the artist also to his 

 side, and that no design of a sanitary kind should ever be 

 executed in which the hand of the artist does not play its 

 beautifying part. 



And if I might suggest so much to the imaginative 

 scholars who live to make life sweeter to the many, I 

 would ask them, — poets, painters, sculptors, players, 

 musicians, — to believe that to render practical even their 

 refined labour is to render that labour more acceptable, 

 more diffusible, more durable. 



The second topic relates to those who require first to 

 be taught the sanitary lessons of the future. I want 

 strongly to enforce that it is the section of the nation 

 which Dr. Farr classes as the dom.estic, the six million 

 of women of the nation, on whom full sanitary light re- 

 quires first to fall. Health in the home is health every- 

 where. Elsewhere it has no abiding place. 



I have been brought indeed by experience to the conclu- 

 sion that thewholefuture progress of the sanitary movement 

 rests for permanent and executive support on the women of 

 the country. When as a physician I enter a house where 

 there is a contagious disease, I am, of course, primarily 

 impressed by the type of the disease and the age, strength, 

 and condition of the sick person. From the observations 

 made on these points I form a judgment of the possible 

 course and termination of the disease, and at one time I 

 should have thought such obser-ations sufficient. Now 

 I know them to be but partly sufficient. A glance at the 

 appointments, and arrangements, and managements of 

 the house is now necessary to make perfect the judgment. 

 By this is shown what aid the physician may expect in 

 keeping the sick in a condition most favourable for escape 

 from death ; and by this is also shown what are the chances 

 that the affection will be confined to one sufferer or distri- 

 buted to many. As a rule to which there are the rarest excep- 

 tions, the character of the judgment is hereupon depen- 

 dent on the character of the presiding genius of the home, 

 — on the woman who rules over that small domain. The 

 men of the house come and go ; know little of the ins and 

 outs of anything domestic ; are guided by what they are 

 told, and are practically of no assistance whatever. The 

 women are conversant with every nook of the dwelling, 

 from basement to roof, and on their knowledge, wisdom, 

 patience, and skill, the physician rests his hopes. How 

 important, then, how vital that they shall learn as a part 

 of their earliest duties, the choicest sanitary code. How 

 correct the decision of the founders of the Sanitary Insti- 

 tute, that from the first they should include sanitarians of 

 both sexes as working associates. 



To women more than to men this work is new. To 

 women more than to men this work is hard to realise. Natu- 

 rally more conservative than men they are moved with less 

 haste to tasks of reformation and reconstruction. More 

 sensitive to criticism than men, they are given, at first, to 

 resent, as if it were an insult to past customs and usages 

 to which they are attached, the suggestion of innovation. 

 But these passing difficulties removed, there is in the 

 hearts of women such matchless generosity, such over- 

 powering love for every device tending to promote the 

 happiness of all things of life, that we sanitarians may 

 indeed be content for the future of sanitary science in its 

 social aspects, if we do no more than win them to our 

 cause and entrust its details to their ministering spell. 



