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The Pamphlet Collection of Sir Robert Stout: Volume 17



Omitting, necessarily, many minor but yet important details, I close the description of the imaginary health city. I have yet to indicate what are the results that might be fairly predicted in respect to the disease and mortality presented under the conditions specified.

Two kinds of observation guide me in this essay: one derived from statistical and sanitary work; the other from experience, extended now over thirty years, of disease, its phenomena, its origins, its causes, its terminations.

I infer, then, that in our model city certain forms page 45 of disease would find no possible home, or, at the worst, a home so transient as not to affect the mortality in any serious degree. The infantile diseases, infantile and remittent fevers, convulsions, diarrhoea, croup, marasmus, dysentery, would, I calculate, be almost unknown. Typhus and typhoid fevers and cholera could not, I believe, exist in the city except temporarily, and by pure accident; small-pox would be kept under entire control; puerperal fever and hospital fever would, probably, cease altogether; rheumatic fever, induced by residence in damp houses, and the heart disease subsequent upon it, would be removed. Death from privation and from purpura and scurvy would certainly cease. Delirium tremens, liver disease, alcoholic phthisis, alcoholic degeneration of kidney and all the varied forms of paralysis, insanity, and other affections due to alcohol, would be completely effaced. The parasitic diseases arising from the introduction into the body, through food, of the larvæ of the entozoa, would cease. That large class of deaths from pulmonary consumption, induced in less favoured cities by exposure to impure air and badly ventilated rooms, would, I believe, be reduced so as to bring down the mortality of this signally fatal malady one third at least.

Some diseases, pre-eminently those which arise page 46 from uncontrollable causes, from sudden fluctuations of temperature, electrical storms, and similar great' variations of nature, would remain as active as ever; and pneumonia, bronchitis, congestion of the lungs, and summer cholera, would still hold their sway. Cancer, also, and allied constitutional diseases of strong hereditary character, would yet, as far as I can see, prevail. I fear, moreover, it must be admitted that two or three of the epidemic diseases, notably scarlet fever, measles, and whooping cough, would assert themselves, and, though limited in their diffusion by the sanitary provisions for arresting their progress, would claim a considerable number of victims.

With these last facts clearly in view, I must be careful not to claim for my model city more than it deserves; but calculating the mortality which would be saved, and comparing the result with the mortality which now prevails in the most favoured of our large English towns, I conclude that an average mortality of eight per thousand would be the maximum in the first generation living under this salutary régime. That in a succeeding generation Mr. Chadwick's estimate of a possible mortality of five per thousand would be realised, I have no reasonable doubt, since the almost unrecognised, though potent, influence of heredity in disease page 47 would immediately lessen in intensity, and the healthier parents would bring forth the healthier offspring.

As my voice ceases to dwell on this theme of a yet unknown city of health, do not, I pray you, wake as from a mere dream. The details of the city exist. They have been worked out by those pioneers of sanitary science, so many of whom surround me to-day, and specially by him whose hopeful thought has suggested my design. I am, therefore, but as a draughtsman, who, knowing somewhat your desires and aspirations, have drawn a plan, which you in your wisdom can modify, improve, perfect. In this I know we are of one mind, that though the ideal we all of us hold be never reached during our lives, we shall continue to work successfully for its realisation. Utopia itself is but another word for time; and some day the masses, who now heed us not, or smile incredulously at our proceedings, will awake to our conceptions. Then our knowledge, like light rapidly conveyed from one torch to another, will bury us in its brightness.

By swift degrees the love of Nature works
And warms the bosom: till at last, sublimed
To rapture and enthusiastic heat,
We feel the present Deity, and taste
The joy of God to see a happy world!

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London: Printed by Spottiswoode and Co., New-Street Square and Parliament Street