The Task of Social Hygiene

In every age the question of Individualism and Socialism takes on a different form. In our own age it has become acute under the form of a conflict between the advocates of good heredity and the advocates of good environment. On the one hand there is the desire to breed the individual to a high degree of efficiency by eugenic selection, favouring good stocks and making the procreation of bad stocks more difficult. On the other hand there is the effort so to organize the environment by collectivist methods that life for all may become easy and wholesome. As usual, those who insist on the importance of good environment are inclined to consider that the question of heredity may be left to itself, and those who insist on the importance of good heredity are indifferent to environment. As usual, also, there is a real underlying harmony of those two demands. There is, however, here more than this. In this most modern of their embodiments, Socialism and Individualism are not merely harmonious, each is the key to the other, which remains unattainable without it. However carefully we improve our breed, however anxiously we guard the entrance to life, our labour will be in vain if we neglect to adapt the environment to the fine race we are breeding. The best individuals are not the toughest, any more than the highest species are the toughest, but rather, indeed, the reverse, and no creature needs so much and so prolonged an environing care as man, to ensure his survival. On the other hand, an elaborate attention to the environment, combined with a reckless inattention to the quality of the individuals born to live in that environment can only lead to an overburdened social organization which will speedily fall by its own weight.

During the past century the Socialists of the school for bettering the environment have for the most part had the game in their own hands. They founded themselves on the very reasonable basis of sympathy, a basis which the eighteenth-century moralists had prepared, which Schopenhauer had formulated, which George Eliot had passionately preached, which had around its operations the immense prestige of the gospel of Jesus. The environmental Socialists—always quite reasonably—set themselves to improve the conditions of labour; they provided local relief for the poor; they built hospitals for the free treatment of the sick. They are proceeding to feed school children, to segregate and protect the feeble-minded, to insure the unemployed, to give State pensions to the aged, and they are even asked to guarantee work for all. Now these things, and the likes of them, are not only in accordance with natural human impulses, but for the most part they are reasonable, and in protecting the weak the strong are, in a certain sense, protecting themselves. No one nowadays wants the hungry to hunger or the suffering to suffer. Indeed, in that sense, there never has been any laissez-faire school. 258

But as the movement of environmental Socialism realizes itself, it becomes increasingly clear that it is itself multiplying the work which it sets itself to do. In enabling the weak, the incompetent, and the defective to live and to live comfortably, it makes it easier for those on the borderland of these classes to fall into them, and it furnishes the conditions which enable them to propagate their like, and to do this, moreover, without that prudent limitation which is now becoming universal in all classes above those of the weak, the incompetent, and the defective. Thus unchecked environmental Socialism, obeying natural impulses and seeking legitimate ends, would be drawn into courses at the end of which only social enfeeblement, perhaps even dissolution, could be seen.

The key to the situation, it is now beginning to be more and more widely felt, is to be found in the counterbalancing tendency of Individualism, and the eugenic guardianship of the race. Not, rightly understood, as a method of arresting environmental Socialism, nor even as a counterblast to its gospel of sympathy. Nietzsche, indeed, has made a famous assault on sympathy, as he has on conventional morality generally, but his "immoralism" in general and his "hardness" in particular are but new and finer manifestations of those faded virtues he was really seeking to revive. The superficially sympathetic man flings a coin to the beggar; the more deeply sympathetic man builds an almshouse for him so that he need no longer beg; but perhaps the most radically sympathetic of all is the man who arranges that the beggar shall not be born.

So it is that the question of breed, the production of fine individuals, the elevation of the ideal of quality in human production over that of mere quantity, begins to be seen, not merely as a noble ideal in itself, but as the only method by which Socialism can be enabled to continue on its present path. If the entry into life is conceded more freely to the weak, the incompetent, and the defective than to the strong, the efficient, and the sane, then a Sisyphean task is imposed on society; for every burden lifted two more burdens appear. But as individual responsibility becomes developed, as we approach the time to which Galton looked forward, when the eugenic care for the race may become a religion, then social control over the facts of life becomes possible. Through the slow growth of knowledge concerning hereditary conditions, by voluntary self-restraint, by the final disappearance of the lingering prejudice against the control of procreation, by sterilization in special cases, by methods of pressure which need not amount to actual compulsion, 259 it will be possible to attain an increasingly firm grip on the evil elements of heredity. Not until such measures as these, under the controlling influence of a sense of personal responsibility extending to every member of the community, have long been put into practice, can we hope to see man on the earth risen to his full stature, healthy in body, noble in spirit, beautiful in both alike, moving spaciously and harmoniously among his fellows in the great world of Nature, to which he is so subtly adapted because he has himself sprung out of it and is its most exquisite flower. At this final point social hygiene becomes one with the hygiene of the soul. 260

Poets and prophets, from Jesus and Paul to Novalis and Whitman, have seen the divine possibilities of Man. There is no temple in the world, they seem to say, so great as the human body; he comes in contact with Heaven, they declare, who touches a human person. But these human things, made to be gods, have spawned like frogs over all the earth. Everywhere they have beslimed its purity and befouled its beauty, darkening the very sunshine. Heaped upon one another in evil masses, preying upon one another as no other creature has ever preyed upon its kind, they have become a festering heap which all the oceans in vain lave with their antiseptic waters, and all the winds of heaven cannot purify. It is only in the unextinguished spark of reason within him that salvation for man may ever be found, in the realization that he is his own star, and carries in his hands his own fate. The impulses of Individualism and of Socialism alike prompt us to gain self-control and to learn the vast extent of our responsibility. The whole of humanity is working for each of us; each of us must live worthy of that great responsibility to humanity. By how fine a flash of insight Jesus declared that few could enter the Kingdom of Heaven! Not until the earth is purified of untold millions of its population will it ever become the Heaven of old dreamers, in which the elect walk spaciously and nobly, loving one another. Only in such spacious and pure air is it possible for the individual to perfect himself, as a rose becomes perfect, according to Dante's beautiful simile, 261 in order that he may spread abroad for others the fragrance that has been generated within him. If one thinks of it, that seems a truism, yet, even in this twentieth century, how few, how very few, there are who know it!

This is why we cannot have too much Individualism, we cannot have too much Socialism. They play into each other's hands. To strengthen one is to give force to the other. The greater the vigour of both, the more vitally a society is progressing. "I can no more call myself an Individualist or a Socialist," said Henry George, "than one who considers the forces by which the planets are held to their orbits could call himself a centrifugalist or a centripetalist." To attain a society in which Individualism and Socialism are each carried to its extreme point would be to attain to the society that lived in the Abbey of Thelema, in the City of the Sun, in Utopia, in the land of Zarathustra, in the Garden of Eden, in the Kingdom of Heaven. It is a kingdom, no doubt, that is, as Diderot expressed it, "diablement idéal." But to-day we hold in our hands more certainly than ever before the clues that were imperfectly foreshadowed by Plato, and what our fathers sought ignorantly we may attempt by methods according to knowledge. No Utopia was ever realized; and the ideal is a mirage that must ever elude us or it would cease to be ideal. Yet all our progress, if progress there be, can only lie in setting our faces towards that goal to which Utopias and ideals point.

THE END

1

Muralt, Lettres sur les Anglais. Lettre V.

2

In the reign of Richard II (1388) an Act was passed for "the punishment of those which cause corruption near a city or great town to corrupt the air." A century later (in Henry VII's time) an Act was passed to prevent butchers killing beasts in walled towns, the preamble to this Act declaring that no noble town in Christendom should contain slaughter-houses lest sickness be thus engendered. In Charles II's time, after the great fire of London, the law provided for the better paving and cleansing of the streets and sewers. It was, however, in Italy, as Weyl points out (Geschichte der Sozialen Hygiene im Mittelalter, at a meeting of the Gesellschaft für Soziale Medizin, May 25, 1905), that the modern movement of organized sanitation began. In the thirteenth century the great Italian cities (like Florence and Pistoja) possessed Codici Sanitarii; but they were not carried out, and when the Black Death reached Florence in 1348, it found the city altogether unprepared. It was Venice which, in the same year, first initiated vigorous State sanitation. Disinfection was first ordained by Gian Visconti, in Milan, in 1399. The first quarantine station of which we hear was established in Venice in 1403.

3

The rate of infant mortality in England and Wales has decreased from 149 per 1000 births in 1871-80 to 127 per 1000 births in 1910. In reference to this remarkable fall which has taken place pari passu with the fall in the birth-rate, Newsholme, the medical officer to the Local Government Board, writes: "There can be no reasonable doubt that much of the reduction has been caused by that 'concentration' on the mother and the child which has been a striking feature of the last few years. Had the experience of 1896-1900 held good there would have been 45,120 more deaths of infants in 1910 than actually occurred." In some parts of the country, however, where the women go out to work in factories (as in Lancashire and parts of Staffordshire) the infantile mortality remains very high.

4

Mrs. Bertrand Russell, "The Ghent School for Mothers," Nineteenth Century, December, 1906.

5

It is scarcely necessary to say that other classifications of social reform on its more hygienic side may be put forward. Thus W.H. Allen, looking more narrowly at the sanitary side of the matter, but without confining his consideration to the nineteenth century, finds that there are always seven stages: (1) that of racial tutelage, when sanitation becomes conscious and receives the sanction of law; (2) the introduction of sanitary comfort, well-paved streets, public sewers, extensive waterworks; (3) the period of commercial sanitation, when the mercantile classes insist upon such measures as quarantine and street-cleaning to check the immense ravages of epidemics; (4) the introduction of legislation against nuisances and the tendency to extend the definition of nuisance, which for Bracton, in the fourteenth century, meant an obstruction, and for Blackstone, in the eighteenth, included things otherwise obnoxious, such as offensive trades and foul watercourses; (5) the stage of precaution against the dangers incidental to the slums that are fostered by modern conditions of industry; (6) the stage of philanthropy, erecting hospitals, model tenements, schools, etc.; (7) the stage of socialistic sanitation, when the community as a whole actively seeks its own sanitary welfare, and devotes public funds to this end.

(W.H. Allen, "Sanitation and Social Progress," American Journal of Sociology, March, 1903.)

6

Dr. F. Bushee has pointed out ("Science and Social Progress," Popular Science Monthly, September, 1911) that there is a kind of related progression between science and practice in this matter: "The natural sciences developed first, because man was first interested in the conquest of nature, and the simpler physical laws could be grasped at an early period. This period brought an increase of wealth, but it was wasteful of human life. The desire to save life led the way to the study of biology. Knowledge of the physical environment and of life, however, did not prevent social disease from flourishing, and did not greatly improve the social condition of a large part of society. To overcome these defects the social sciences within recent years have been cultivated with great seriousness. Interest in the social sciences has had to wait for the enlarged sympathies and the sense of solidarity which has appeared with the growing interdependence of dense populations, and these conditions have been dependent upon the advance of the other sciences. With the cultivation of the social sciences, the chain of knowledge will be complete, at least so far as the needs which have already appeared are concerned. For each group of sciences will solve one or more of the great problems which man has encountered in the process of development. The physical sciences will solve the problems of environment, the biological sciences the problems of life, and the social sciences the problems of society."

7

This exclusive pre-occupation with the improvement of the environment has been termed Euthenics by Mrs. Ellen H. Richards, who has written a book with this title, advocating euthenics in opposition to eugenics.

8

Not one of the four stages of social reform already summarized can be neglected. On the contrary, they all need to be still further consolidated in a completely national organization of health. I may perhaps refer to the little book on The Nationalization of Health, in which, many years ago, I foreshadowed this movement, as well as to the recent work of Professor Benjamin Moore on the same subject. The gigantic efforts of Germany, and later of England, to establish National Insurance systems, bear noble witness to the ardour with which these two countries, at all events, are moving towards the desired goal.

9

In some countries, however, the decline, although traceable about 1876, only began to be pronounced somewhat later, in Austria in 1883, in the German Empire, Hungary and Italy in 1885, and in Prussia in 1886. Most of these countries, though late in following the modern movement of civilization initiated by France, are rapidly making their way in the same direction. Thus the birth-rate in Berlin is already as low as that of Paris ten years ago, although the French decline began at a very early period. In Norway, again, the decline was not marked until 1900, but the birth-rate has nevertheless already fallen as low as that of Sweden, where the fall began very much earlier.

10

"Foresight and self-control is, and always must be, the ground and medium of all Moral Socialism," says Bosanquet (The Civilization of Christendom, p. 336), using the term "Socialism" in the wide and not in the economic sense. We see the same civilized growth of foresight and self-control in the decrease of drunkenness. Thus in England the number of convictions for drunkenness, while varying greatly in different parts of the country, is decreasing for the whole country at the rapid rate of 5000 to 8000 a year, notwithstanding the constant growth of the population. It is incorrect to suppose that this decrease has any connection with decreased opportunities for drinking; thus in London County and in Cardiff the proportion of premises licensed for drinking is the same, yet while the convictions for drunkenness in 1910 were in London 83 per 10,000 inhabitants, in Cardiff they were under 6 per 10,000.

11

Thus Heron finds that in London during the past fifty years there has been 100 per cent increase in the intensity of the relation between low social birth and high birth-rate, and that the high birth-rate of the lower social classes is not fully compensated by their high death-rate (D. Heron, "On the Relation of Fertility in Man to Social Status," Drapers' Company Research Memoirs, No. I, 1906). As, however, Newsholme and Stevenson point out (Journal Royal Statistical Society, April, 1906, p. 74), the net addition to the population made by the best social classes is at so very slightly lower a rate than that made by the poorest class that, even if we consent to let the question rest on this ground, there is still no urgent need for the wailings of Cassandra.

12

Sociological Papers of the Sociological Society, 1904, p. 35.

13

There is a certain profit in studying one's own ancestry. It has been somewhat astonishing to me to find how very slight are the social oscillations traceable in a middle-class family and the families it intermarries with through several centuries. A professional family tends to form a caste marrying within that caste. An ambitious member of the family may marry a baronet's daughter, and another, less pretentious, a village tradesman's daughter; but the general level is maintained without rising or falling. Occasionally, it happens that the ambitious and energetic son of a prosperous master-craftsman becomes a professional man, marries into the professional caste, and founds a professional family; such a family seems to flourish for some three generations, and then suddenly fails and dies out in the male line, while the vigour of the female line is not impaired.

14

The new social adjustment of a family, it is probable, is always difficult, and if the change is sudden or extreme, the new environment may rapidly prove fatal to the family. Lorenz (Lehrbuch der Genealogie, p. 135) has shown that when a peasant family reaches an upper social class it dies out in a few generations.

15

See, on this point, Reibmayr, Entwicklungsgeschichte des Talentes und Genies, Vol. I, ch. vii.

16

Fahlbeck, op. cit., p. 168.

17

Regeneration implies that there has been degeneration, and it cannot be positively affirmed that such degeneration has, on the whole, occurred in such a manner as to affect the race. Reibmayr (Die Entwicklungsgeschichte des Talentes und Genies, Bd. I, p. 400) regards degeneration as a process setting in with urbanization and the tendency to diminished population; if so, it is but another name for civilization, and can only be condemned by condemning civilization, whether or not physical deterioration occurs. The Inter-departmental Commission on Physical Deterioration held in 1904, in London, concluded that there are no sufficient statistical or other data to prove that the physique of the people in the present, as compared with the past, has undergone any change; and this conclusion was confirmed by the Director-General of the Army Medical Service. There is certainly good reason to believe that urban populations (and especially industrial workers in factories) are inferior in height and weight and general development to rural populations, and less fit for military or similar service. The stunted development of factory workers in the East End of London was noted nearly a century ago, and German military experience distinctly shows the inferiority of the town-dweller to the country-dweller. (See e.g. Weyl, Handbuch der Hygiene, Supplement, Bd. IV, pp. 746 et seq.; Politisch-Anthropologische Revue, 1905, pp. 145 et seq.) The proportion of German youths fit for military service slowly decreases every year; in 1909 it was 53.6 per cent, in 1910 only 53 per cent; of those born in the country and engaged in agricultural or forest work 58.2 were found fit; of those born in the country and engaged in other industries, 55.1 per cent; of those born in towns, but engaged in agricultural or forest work, 56.2 per cent; of those born in towns and engaged in other industries 47.9 per cent. It is fairly clear that this deterioration under urban and industrial conditions cannot properly be termed a racial degeneration. It is, moreover, greatly improved even by a few months' training, and there is an immense difference between the undeveloped, feeble, half-starved recruit from the slums and the robust, broad-shouldered veteran when he leaves the army. The term "aggeneration"—not beyond criticism, though it is free from the objection to "regeneration"—was proposed by Prof. Christian von Ehrenfels ("Die Aufsteigende Entwicklung des Menschen," Politisch-Anthropologische Revue, April, 1903, p. 50).

18

It is unnecessary to touch here on the question of infant mortality, which has already been referred to, and will again come in for consideration in a later chapter. It need only be said that a high birth-rate is inextricably combined with a high death-rate. The European countries with the highest birth-rates are, in descending order: Russia, Bulgaria, Roumania, Servia, and Hungary. The European countries with the highest death-rates are, in descending order, almost the same: Russia, Hungary, Spain, Bulgaria, and Servia, It is the same outside Europe. Thus Chile, with a birth-rate which comes next after Roumania, has a death-rate that is only second to Russia.

19

Nyström (La Vie Sexuelle, 1910, p. 248) believes that "the time is coming when it will be considered the duty of municipal authorities, if they have found by experience or have reason to suspect that children will be thrown upon the parish, to instruct parents in methods of preventive conception."

20

The directly unfavourable influences on the child of too short an interval between its birth and that of the previous child has been shown, for instance, by Dr. R.J. Ewart ("The Influence of Parental Age on Offspring," Eugenics Review, October, 1911). He has found at Middlesbrough that children born at an interval of less than two years after the birth of the previous child still show at the age of six a notable deficiency in height, weight, and intelligence, when compared with children born after a longer interval, or with first-born children.

21

Tatler, Vol. II, No. 175, 1709.

22

"Write Man for Primula, and the stage of the world for that of the greenhouse," says Professor Bateson (Biological Fact and the Structure of Society, 1912, p. 9), "and I believe that with a few generations of experimental breeding we should acquire the power similarly to determine how the varieties of men should be represented in the generations that succeed." But Bateson proceeds to point out that our knowledge is still very inadequate, and he is opposed to eugenics by Act of Parliament.

23

E. Solmi, La Città del Sole di Campanella, 1904, p. xxxiv.

24

Only a year before his death Galton wrote (Preface to Essays in Eugenics): "The power by which Eugenic reform must chiefly be effected is that of Popular Opinion, which is amply strong enough for that purpose whenever it shall be roused."