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 Fair, are with us
in this place at this moment), ere yet these heralds had 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 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 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.
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 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 Coelius 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 convulsionary 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 names of tetanoid fever and cerebro-spinal
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.