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 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 larvae 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 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 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!_