Such a condition of affairs is, however, no longer to be tolerated;
for the result of research carried out during the past and present
centuries has opened up a hitherto unsuspected vista of progress to
mankind, if and when he is intelligent enough to establish an
harmonious unison between himself and his environment. Once the
jarring discords of debility, disease, and deterioration have been
modulated into the major chords of health--moral and physical--the
latent potentialities of his higher life will be quickened into
productive activity. The misconception of humanity which has denied
to it the power to rise above the level of present attainments, which
has dwelt insistently upon the hopeless degradation of the body, has
brought about a condition of enervating and passive fatalism, based
upon the conviction that all reforming efforts must be directed
solely to the preparation of one part only of man's triune nature for
another and future sphere of existence. The duty and possibility of
building a fit temple for man's spiritual nature here and now is the
ideal of a minority to-day--in the future it will be that of an
overwhelming majority; for the proofs of human capacity for progress, of
man's power to control the forces of nature, are ever becoming more
firmly authenticated, and all that they imply will soon become far
better understood.
Though our knowledge of the subject is still incomplete and often
tentative, much progress has been made, for instance, in a correct
conception of the means by which the physiological balance of human life
is adjusted, since Metchnikoff[115] drew attention to the interference
brought about in man's normal development by certain fundamental
disharmonies in his constitution, of which the end is premature death,
if not a pathological old age. It is quite evident that unjustifiable
encroachments upon the reserve powers of the human body have been
commonly permitted hitherto, and though each year brings fresh proof of
the extraordinary endowment which it possesses to respond to the
demands made upon it, yet each year also confirms the conviction that
this reserve fund must in future be husbanded and used with economy.
When these powers are constantly drawn upon the body is necessarily
reduced to a lower level of health. If the metaphor be employed of the
body as a building in course of erection, it becomes obvious that if one
of a group of converging thrusts be much weakened or withdrawn, a
skilful rearrangement of forces may meet the strain, but the total
strength of the structure is reduced. In how many cases has the temple
of a child's body been permanently damaged by such withdrawals, or how
many adolescents are launched into life with their capital of health
seriously diminished by premature calls upon its resources.
The duty to maintain so far as possible a condition of physiological
equilibrium in ourselves and in our children amounts to an obligation;
for which reason health promotion during the plastic period of early
life assumes a new importance. Of course, a certain capacity for
vicarious activity is associated with the various organs of the body in
order to maintain their functions against temporary failure. Healthy
tissues are furnished with power to respond to increased call for
exertion. How often are they most sorely abused and unwisely taxed? Even
now, when made aware of these facts, we are slow to apply to the conduct
of life the lessons thus taught us, and continue to be filled with
self-commiseration for the results to our bodies of overtaxing their
capacity for accurate readjustment.
It is not possible, much less desirable, that the whole population
should plunge into amateur studies of recent physiological advance, nor
even that it should dabble, as its units are too much disposed to do, in
pseudo-scientific pathological publications. But it is both possible and
desirable for all who assume the direction of their own lives or those
of children to "read, mark, learn, and inwardly digest" some fruits of
the labours of others in the garden of health.
Were there one fixed standard of health to which all could attain, the
practice of hygiene would be attended by a charming simplicity.
Unfortunately, modern science forces us to conclude that each individual
can only reach his own particular standard of well-being. The grades of
health are consequently infinite in number, and the task which devolves
on parents and guardians to secure that the standard possible to each
child under their care be attained is no light one. So general is the
blindness to these truths, that the degree of health enjoyed is in most
cases far below the possible standard; the results of ancestral vice, of
parental ignorance, or of defective environment having sapped
prematurely the springs of progressive potentiality.[116] The mental and
physical balance is thus rendered relatively less stable and the powers
of resistance to adverse conditions are diminished.
Happily, by virtue of its inherent power, but strictly in proportion to
the vigour of this power, an organism is usually able to strike a new
balance; for the capacity to regain its equilibrium is exquisitely
delicate in human nature, _if_ the change be neither too sudden nor too
severe. Throughout life this process of self-adaptation to the presence
of morbid influences is constantly exercising its protective power. If,
however, the effort to overcome disadvantageous conditions be very great
or much prolonged, the life of the individual is never quite so vigorous
and symmetrical as it might and should have been. In a luminous address,
delivered at the University of Leeds some few months ago,[117] Lord
Justice Fletcher Moulton instituted a comparison between the human
organism, which invariably tends to swing back to the normal whenever
the balance of health is disturbed, and a ship which has safely
weathered a stormy voyage. The ship, he writes, "is not stable, if
stability means that she can defy the forces that bear on her to move
her from her normal upright position, for ... the slightest roll of the
sea ... will make her heel over. But she is stable, because when made to
lean over, there is thereby generated a system of forces tending to
return her to her place, which grows greater the greater is the
displacement, and thus ultimately becomes sufficient to overpower the
disturbing forces.... As the ship arrives safely, her construction must
be such that disturbances tend to right themselves when stability is
seriously endangered. Some corresponding righting force also tends to
bring back an organism to its normal state."
The caution may not be amiss that the amplitude of the swing of a human
pendulum, as well as the accuracy of its final balance, depends not only
upon inherited nature and the amount of reserve force possessed, but
will be stable or feeble, durable or transient, according to the
influence of environment.
In what way, it will be asked, can individual capacity for health be
gauged? to what degree can the power to progress or to resist
encroachments be strengthened? at what age is intelligent supervision
most important?
No concise and conclusive answers can be given to these most natural
inquiries, but much light has been recently thrown upon the long
duration of immaturity and associated instability in mankind; upon the
power of self-protection inherent in the body;[118] upon the influence
thereon of its environment; upon the penetrating power of heredity; and
upon the urgent importance of the adolescent period.
Further, it appears that the healthful body is equipped to withstand the
attack of the bacteria of most diseases, though the mechanism of
self-defence is of more kinds than one. Of the different pathological
bacteria identified up to the present, for instance, some appear to be
eminently sensible to one kind of action of normal blood fluids, while
they are in a much less measure sensible, or are, perhaps, entirely
insensible to others; a complication which enhances our respectful
admiration for the marvellous and intricate system which provides for
our bodily welfare. Obviously, human nature would be practically immune
from disease if this protective machinery were always in good working
order: unfortunately this is not invariably the case--hence disease. It
is the duty of hygiene to insure constant physical equilibrium, but the
intricate tactics of Nature are as yet so imperfectly understood that
man is not yet an ally of great worth in her operations.
Nevertheless, the perception that the secret of individual health lies
in fostering the resistant or protective elements, which should be
present in normal blood, marks a great step in advance; for from it have
originated measures to curtail the course of an illness and to reduce
the risk of its recurrence. It is hardly Utopian to forecast, as Sir
Almroth Wright has done, that the physician of the future will take upon
himself a still higher role than he has hitherto assumed in this work of
the prevention of ill-health, for he will attempt, by means of
systematically strengthening individual capacity for resistance to
disease, to remove the necessity for curing those who have fallen
victims to its attacks. The gain in health, in happiness, in time and in
money would be incalculable. For instance, had the death-rate _all_ over
England during 1908 stood at 13.8 per thousand, instead of at favoured
places only, no less than 33,831 lives would have been saved. Of these
deaths, one-fifth were those of infants under twelve months old, the
majority of them wholly preventable. What a reckless waste of racial and
national capital; what an unnecessary cause of bitter sorrow and
disappointment; what a source of unprofitable expenditure! The
calculation has been made that for each death there are at least six
cases of more or less serious illness, involving confinement to bed for
a few days or a few weeks as the case may be. A simple multiplication
sum will enable the reader to estimate the amount of serious illness
represented by the total arrived at: the loss in time, health, happiness
and efficiency is incalculable.
The bright prospects for human health in the future, therefore, rely
largely upon the use which will be made of this protective machinery,
and the prospective gain to humanity lies in the hope that when family
histories are kept systematically and the inherited tendencies of a
child are far more accurately known, the invading forces of disease will
never get a footing, because precautions to strengthen the body's own
defensive powers will be taken as a matter of routine practice. The
physiological balance being thus preserved from disturbance, the great
fund of energy now utilised to resist encroachments will be available
for productive purposes.
So great a reformation cannot of course be brought about till shame is
felt for the scandalously low standard of health now common among all
classes, nor until a general determination is developed to remove the
minor miseries from which we all suffer more or less impatiently.