The answer may be found by reference to the late Professor de Chaumont's
now classical outline of the stages to be identified in the hygienic
education of a race. He divided these into three periods, of which he
described the first as merely "Instinctive," for efforts after sanitary
practice were dictated solely by the personal discomfort associated with
their neglect. In those far-off prehistoric days, Professor Boyd
Dawkins tells us that primitive man, then in his nomadic stage, would
dig runnels to carry off the rain water from the near neighbourhood of
his shelters, or would move on to fresh pastures when his family and
herds had fouled the nearest stream, or change his camping ground when
the accumulated refuse of his food and his prowess as a hunter
interfered with convenient access to his dwelling; but he took no
precautions to prevent the recurrence of these discomforts, and his
efforts to remove their consequences were purely temporary.
To this there succeeded what Professor de Chaumont designated the
"Supernatural" period,[96] which extended over many thousands of years,
during the dawn of which Eastern rulers often combined in their own
person the triple callings of priest, prophet, and physician. Whether it
be in China or in Persia, in Egypt or in India, among the Greeks, the
Arabs, or the Hebrews, the practice of physical morality and of personal
cleanliness, of restrictions of diet or protection from infection, were
closely woven into the religion of the people. Reasons of health and
sanitary advantages permeate the rules of more faiths than that of the
Jews--whose Lawgiver embodied in the Pentateuch health maxims now known
to have been derived from earlier civilisations.
But, remarkable and interesting as are the ancient sanitary codes to a
generation which professes to believe in the necessity for hygienic
practice, their usage was tinctured from the first by a mass of
superstition. Tradition and fatalism hampered true consistency between
faith and works; the often sound regulations suffered from their
empirical foundations. Constant warfare, varied by alternations of
luxury with asceticism, combined to absorb men's minds and to pervert
their common sense, so that plague and famine, disease and penury, were
superstitiously regarded as discipline from the Deity, not to be averted
or avoided, but rather to be accepted as a chastisement prompted by
love. The creed that to save suffering to the vile body might risk the
salvation of the soul, cost Europe far dearer than is at all generally
recognised; for the noble, the pure, the high-minded, the intellectual,
segregated themselves for centuries in monastery and convent, in the
firm faith that by denying to themselves the joy of parenthood they
promoted the spiritual welfare of their country. Ignorant of their
racial responsibilities, they left as progenitors of the next generation
the less refined and ruder elements in the population. It is no cause
for surprise, therefore, that progress in sanitation moved slowly.
Domestic and urban conditions were permitted of a character well defined
by the facts that, in mediaeval times, a man of forty-five or fifty was
considered long lived, and that first attempts to control disease were
based upon commercial convenience rather than upon the saving of life.
To this long night of superstition succeeded the third and last period,
known as the "Rational," of which the first dawnings can be detected
even in Plantagenet days. In this period it is desirable further to
differentiate three stages of progress--(_a_) that of Development, when
uneasiness made itself felt, but from absence of knowledge efforts at
reform and control were crude, though often intelligent; (_b_) the stage
of Legislation, and (_c_) the stage of Freedom.[97]
In the first of these, for instance, Henry III. effected an improvement
on any former practice by bringing water to the city of London in pipes,
made by boring or burning a channel through the trunks of large trees.
Half a century later, in 1297-8, laws were promulgated upon the subjects
of offensive trades, food adulteration, and wandering pigs; while
Richard II. imposed penalties upon those guilty of fouling rivers and
ditches. Out of sight out of mind, however, was the sanitary creed of
this and many succeeding generations, so that too often the apparent
gain of the moment sowed the noxious seed of intensified subsequent
ills.
Sir John Simon has pointed out that it was not until the early part of
the eighteenth century that hygiene in its modern significance loomed on
the social horizon with clearer outline and more definite aims. A
gradual transformation took place in the next hundred and fifty years,
when the national records, as well as the reports of philanthropic
organisations, indicate the gradual growth of a public opinion which
presently sought its sanitary salvation in legislation. The nineteenth
century saw, as a consequence, the accumulation of a huge mass of public
health laws, designed to accomplish reforms where philanthropy or
self-interest had failed to influence habits.
The suggested designation, namely, the Legislative, is therefore
peculiarly appropriate for this, the second stage of progress in the
third period of our country's hygienic education. To legislation men
pinned their faith as the most potent weapon of reform. From the first
most inadequate and ineffective Factory Act of 1802 until the enactments
of the last parliamentary session, each year has seen substantial
additions made to the growing mass of sanitary legislation, which has
become unwieldy in bulk and intensely complicated in machinery.
Any attempt to enumerate even a few of the public health laws which
crowd our statute books would here be tedious and out of place, though
the community in general ought to be better acquainted than it is with
its powers and obligations. For, truth to tell, fifty years of public
health administration has proved that human beings are not yet consumed
with a sufficiently strong desire for health and efficiency to be
willing to change objectionable or unwholesome habits or to sacrifice
their conception of comfort at the _suggestion_ of officials. Indeed
the sterner measures of compulsory conformity were so necessary to the
education of the public in the elements of healthy living, that the year
1866 saw the commencement of a new era in Public Health Department of
the Government. "The grammar of common sanitary legislation,"[98] writes
the historian of our "English Sanitary Institutions," "then first
acquired the novel virtue of an imperative mood." "Must" was substituted
in some laws for "may," and though the permissive has not, even in fifty
years, entirely given place to the peremptory, the efforts to effect
individual reform by Act of Parliament have, since the formation of the
Local Government Board in 1872, assumed more importance and vigour.
Since that date the reports of health committees all over the country
record the substantial results of persevering work in the interests of
hygiene, qualified by the fact that the experience of other nations has
been abundantly confirmed by our own, namely, that it is futile to
legislate in advance of public opinion. Until the populace has been
impregnated with a knowledge of what is right, right action, though
demanded by its legislators, will be perverted by ignorant intention or
by resentful indolence. Even those who have served the cause of
sanitation most loyally recognise that coercion is but a poor yeast with
which to leaven measures for the public weal; the product is liable to
become sour and worthless rather than wholesome and effective. One
higher grade must be passed by the nation under the tutelage of a
sanitary reform before its education can be called complete.
The final stage in this last long period is described by Professor de
Chaumont as that of "Freedom," of which the attainment is not possible
until action is based on intelligent individual conviction. Then and
then alone there will be a general recognition that "rights" are
inevitably associated with responsibilities, and that true liberty is
followed not by license, but by self-control and respect for the rights
of others.