Health and Civilisation.

Before I proceed to this task, it is right I should ask of the past what hope there is of any such advancement of human progress. For, as my Lord of Verulam quaintly teaches, 'the past ever deserves that men should stand upon it for awhile to see which way they should go, but when they have made up their minds they should hesitate no longer, but proceed with cheerfulness.' For a moment, then, we will stand on the past.

From this vantage-ground we gather the fact, that onward with the simple progress of true civilisation the value of life has increased. Ere yet the words 'Sanitary Science' had been written; ere yet the heralds of that science (some of whom, in the persons of our illustrious colleagues, Edwin Chadwick and William Farr, are with us in this-place at this moment), ere yet these heralds had page 12 summoned the world to answer for its profligacy of life, the health and strength of mankind was undergoing improvement. One or two striking facts must be sufficient in the brief space at my disposal to demonstrate this truth. In England, from 1790 to 1810, Heberden calculated that the general mortality diminished one-fourth. In France, during the same period, the same favourable returns were made. The deaths in France, Berard calculated, were 1 in 30 in the year 1780, and during the eight years, from 1817 to 1828, 1 in 40, or a fourth less. In 1780, out of 100 new-born infants, in France, 50 died in the two first years; in the later period, extending from the time of the census that was taken in 1817 to 1827, only 38 of the same age died, an augmentation of infant life equal to 25 per cent. In 1780 as many as 55 per cent, died before reaching the age of ten years; in the later period 43, or about a fifth less. In 1780 only 21 persons per cent, attained the age of 50 years; in the later period 32, or eleven more, reached that term. In 1780 but 15 persons per cent, arrived at 60 years; in the later period 24 arrived at that age.

Side by side with these facts of the statist we detect other facts which show that in the progress of civilisation the actual organic strength and build page 13 of the man and woman increases. As in the highest developments of the fine arts the sculptor and painter place before us the finest imaginative types of strength, grace, and beauty, so the silent artist, civilisation, approaches nearer and nearer to perfection, and by evolution of form and mind developes what is practically a new order of physical and mental build. Peron,—who first used, if he did not invent, the little instrument, the dynamometer, or muscular-strength measurer,—subjected persons of different stages of civilisation to the test of his gauge, and discovered that the strength of the limbs of the natives of Van Diemen's Land and New Holland was as 50 degrees of power, while that of the Frenchmen was 69, and of the Englishmen 71. The same order of facts are maintained in respect to the size of body. The stalwart Englishman of to-day can neither get into the armour nor be placed in the sarcophagus of those sons of men who were accounted the heroes of the infantile life of the human world.

We discover, moreover, from our view of the past, that the developments of tenacity of life and of vital power have been comparatively rapid in their course when they have once commenced. There is nothing discoverable to us that would lead to the conception of a human civilisation page 14 extending back over two hundred generations; and when in these generations we survey the actual effect of civilisation, so fragmentary and overshadowed by persistent barbarism, in influencing disease and mortality, we are reduced to the observation of at most twelve generations, including our own, engaged, indirectly or directly, in the work of sanitary progress. During this comparatively brief period, the labour of which, until within a century, has had no systematic direction, the changes for good that have been effected are amongst the most startling of historical facts. Pestilences which decimated populations, and which, like the great plague of London, destroyed 7,165 people in a single week, have lost their virulency; gaol fever has disappeared, and our gaols, once each a plague-spot, have become, by a strange perversion of civilisation, the health spots of, at least, one kingdom. The term, Black Death, is heard no more; and ague, from which the London physician once made a fortune, is now a rare tax even on the skill of the hardworked Union Medical Officer.

From the study of the past we are warranted, then, in assuming that civilisation, unaided by special scientific knowledge, reduces disease and lessens mortality, and that the hope of doing still more by systematic scientific art is fully justified.

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I might hereupon proceed to my project straightway. I perceive, however, that it may be urged, that as mere civilising influences can of themselves effect so much, they might safely be left to themselves to complete, through the necessity of their demands, the whole sanitary code. If this were so, a formula for a city of health were practically useless. The city would come without the special call for it.

I think it probable the city would come in the manner described, but how long it would be coming is hard to say, for whatever great results have followed civilisation, the most that has occurred has been an unexpected, unexplained, and therefore uncertain arrest of the spread of the grand physical scourges of mankind. The phenomena have been suppressed, but the root of not one of them has been touched. Still in our midst are thousands of enfeebled human organisms which only are comparable with the savage. Still are left amongst us the bases of all the diseases that, up to the present hour, have afflicted humanity.

The existing calendar of diseases, studied in connection with the classical history of the diseases written for us by the longest unbroken line of authorities in the world of letters, shows, in unmistakable language, that the imposition of every known malady page 16 of man is coeval with every phase of his recorded life on the planet. No malady, once originated, has ever actually died out; many remain as potent as ever. That wasting fatal scourge, pulmonary consumption, is the same in character as when Cœlius Aurelianus gave it description. The cancer of to-day is the cancer known to Paulus Eginæta. The Black Death, though its name is gone, lingers in malignant typhus. The great plague of Athens is the modern great plague of England, scarlet fever. The dancing mania of the Middle Ages and the convnlsionary epidemic of Montmartre, subdued in their violence, are still to be seen in some American communities, and even at this hour in the New Forest of England. Small-pox, when the blessed protection of vaccination is withdrawn, is the same virulent destroyer as it was when the Arabian Rhazes defined it. Ague lurks yet in our own island, and, albeit the physician is not enriched by it, is in no symptom changed from the ague that Celsus knew so well. Cholera, in its modern representation is more terrible a malady than its ancient type, in so far as we have knowledge of it from ancient learning. And that fearful scourge, the great plague of Constantinople, the plague of hallucination and convulsion which raged in the Fifth Century of our era, has in our time, under the new page 17 names of tetanoid fever and cerebrospinal meningitis, been met with here and in France, and in Massachusetts has, in the year 1873, laid 747 victims in the dust.

I must cease these illustrations, though I could extend them fairly over the whole chapter of disease, past and present. Suffice it if I have proved the general propositions, that disease is now as it was in the beginning, except that in some examples of it it is less virulent; that the science for extinguishing any one disease has yet to be learned; that, as the bases of disease exist, untouched by civilisation, so the danger of disease is ever imminent, unless we specially provide against it; that the development of disease may occur with original virulence and fatality, and may at any moment be made active under accidental or systematic ignorance.