476 DISCUSSION 



whether the physiology taught has been the right kind. Perhaps it has been 

 too detailed. For general consumption only the simple elementary 

 principles should be taught, especially in their application to healthy living. 



Now let us consider the practical value of a knowledge of the body's 

 working and the part it should play in the maintenance of health and the 

 prevention of disease. There are two ways in which this will be of obvious 

 importance. Directly, it will help the individual to know how to live 

 healthily and how to adapt himself to varying conditions, and by its effect 

 on individual behaviour it will influence the health of the community. 

 Indirectly, it will provide an informed public to influence the promotion 

 and control of legislation which affects the health and well-being of the 

 community. As an instance of its value I will quote one set of figures 

 from the last Annual Report of the Chief Medical Officer of the Ministry 

 of Health. (Incidentally may I strongly recommend a study of this report 

 to those interested in the state of public health.) Dr. MacNalty maintains 

 the tradition set up by his predecessor, Sir George Newman, in writing 

 reports which go far beyond statements of figures and of statistics and give 

 interesting information as to recent discoveries and new fields of public 

 work. 



Most people are aware of the fact that during this century there has been 

 a most satisfactory fall in the rate of infant mortality. Last year it was 

 the lowest yet recorded for this country — 57 per thousand. (In South 

 Australia, to which I was invited last year for a Conference on Infant 

 Welfare, held as part of the Government's Centenary celebrations, the 

 rate is only 32 per thousand, and in New Zealand just lower — 31 per 

 thousand.) What this improvement in rate means in the saving of 

 life is shown very strikingly by a comparison of the deaths actually 

 recorded with the number they would have been had the rate re- 

 mained as it was from 1901-10, 128 per thousand. The actual 

 deaths in 1935 were 34,092, but at the earlier rate would have been 

 76,664 : that means there has been a saving of 42,549 infant lives. No 

 doubt several factors contribute to this : improved sanitation, housing 

 and feeding ; but most authorities agree that it is chiefly to be attributed 

 to education and to instruction given in the Infant Welfare and Maternity 

 Centres and Clinics. This is a fine example of what can be done by educa- 

 tion, and it is starting at the right end. But if we put the question, ' Is this 

 enough ? ' there can be but one answer. It is not enough. We have only 

 to look round to see that the after development of these babies, so many of 

 them really lovely and bonny at the start, has fallen far short of what it 

 might have been. No doubt again there are many factors all playing their 

 part in the failure to reach the optimum : lack of knowledgeable care and 

 proper environment in the pre-school years — to be remedied largely by 

 adequate provision of nursery schools. The national and racial type may 

 be changing to one of a smaller physique, though against this can be set 

 the dramatic and almost phenomenal increases in growth that are sometimes 

 produced by attention to diet. Employment at too early an age under 

 unsuitable conditions as regards hours, environment and feeding, certainly 

 plays its part in preventing development up to possibilities. These condi- 

 tions would tend to disappear with physiological thinking on the part of 

 authorities. (The smaller size of the citizens of the industrial north as 

 compared with other parts of the country is suggestive in this direction.) 

 But undoubtedly a most, perhaps the most, important factor is lack of interest 

 in physical fitness a?id lack of knowledge of the conditions necessary for proper 

 development, found in the individuals themselves and in those responsible for 

 the conditions of others. Health is something more than absence of disease — 



