THE SCIENCE OF CONTROLLABLE ENVIRONMENT
A PLEA FOR BETTER LIVING CONDITIONS AS A FIRST STEP TOWARD HIGHER HUMAN EFFICIENCY
The national annual unnecessary loss of capitalized net earnings is about $1,000,000,000.
Report on National Vitality
By ELLEN H. RICHARDS Author of Cost of Living Series, Art of Right Living, etc.
WHITCOMB & BARROWS BOSTON, 1912
COPYRIGHT 1910 BY ELLEN H. RICHARDS
THOMAS TODD CO., PRINTERS 14 BEACON ST., BOSTON
Never has society been so clear as to its several special ends, never has so little effort been due to chance or compulsion.
Ralph Barton Perry, The Moral Economy.
Not through chance, but through increase of scientific knowledge; not through compulsion, but through democratic idealism consciously working through common interests, will be brought about the creation of right conditions, the control of environment.
The betterment of living conditions, through conscious endeavor, for the purpose of securing efficient human beings, is what the author means by EUTHENICS.
 Eutheneo, [Greek: Eutheneo] (eu, well; the, root of tithemi, to cause). To be in a flourishing state, to abound in, to prosper.—Demosthenes. To be strong or vigorous.—Herodotus. To be vigorous in body.—Aristotle.
Euthenia, [Greek: Euthenia]. Good state of the body: prosperity, good fortune, abundance.—Herodotus.
"Human vitality depends upon two primary conditions—heredity and hygiene—or conditions preceding birth and conditions during life."
 Report on National Vitality, p. 49.
Eugenics deals with race improvement through heredity.
Euthenics deals with race improvement through environment.
Eugenics is hygiene for the future generations.
Euthenics is hygiene for the present generation.
Eugenics must await careful investigation.
Euthenics has immediate opportunity.
Euthenics precedes eugenics, developing better men now, and thus inevitably creating a better race of men in the future. Euthenics is the term proposed for the preliminary science on which Eugenics must be based.
This new science seeks to emphasize the immediate duty of man to better his conditions by availing himself of knowledge already at hand. As far as in him lies he must make application of this knowledge to secure his greatest efficiency under conditions which he can create or under such existing conditions as he may not be able wholly to control, but such as he may modify. The knowledge of the causes of disease tends only to depress the average citizen rather than to arouse him to combat it. Hope of success will urge him forward, and it is the duty of lovers of mankind to show all possible ways of attaining the goal. The tendency to hopelessness retards reformation and regeneration, and the lack of belief in success holds back the wheels of progress.
Euthenics is to be developed:
1. Through sanitary science. 2. Through education. 3. Through relating science and education to life.
Students of sanitary science discover for us the laws which make for health and the prevention of disease. The laboratory has been studying conditions and causes, and now can show the way to many remedies.
A knowledge of these laws, of the means of conserving man's resources and vitality, which will result in the wealth of human energy, is more and more brought within the reach of all by various educational agencies.
The individual must estimate properly the value of this knowledge in its application to daily life, in order to secure efficiency and the greatest happiness for himself and for the community.
Right living conditions comprise pure food and a safe water supply, a clean and disease-free atmosphere in which to live and work, proper shelter, and the adjustment of work, rest, and amusement. The attainment of these conditions calls for hearty cooperation between individual and community—effort on the part of the individual because the individual makes personality a power; effort on the part of the community because the strength of combined endeavor is required to meet all great problems.
BETTER ENVIRONMENT FOR THE HUMAN RACE
I. The opportunity for betterment is real and practical, not merely academic 3
II. Individual effort is needed to improve individual conditions. Home and habits of living, eating, etc. Good habits pay in economy of time and force 15
III. Community effort is needed to make better conditions for all, in streets and public places, for water and milk supply, hospitals, markets, housing problems, etc. Restraint for sake of neighbors 39
IV. Interchangeableness of these two forms of progressive effort. First one, then the other ahead 59
V. The child to be "raised" as he should be. Restraint for his good. Teaching good habits the chief duty of the family 73
VI. The child to be educated in the light of sanitary science. Office of the school. Domestic science for girls. Applied science. The duty of the higher education. Research needed 91
VII. Stimulative education for adults. Books, newspapers, lectures, working models, museums, exhibits, moving pictures 117
VIII. Both child and adult to be protected from their own ignorance. Educative value of law and of fines for disobedience. Compulsory sanitation by municipal, state, and federal regulations. Instructive inspection 131
IX. There is responsibility as well as opportunity. The housewife an important factor and an economic force in improving the national health and increasing the national wealth 143
The opportunity for betterment is real and practical, not merely academic.
Men ignore Nature's laws in their personal lives. They crave a larger measure of goodness and happiness, and yet in their choice of dwelling places, in their building of houses to live in, in their selection of food and drink, in their clothing of their bodies, in their choice of occupations and amusements, in their methods and habits of work, they disregard natural laws and impose upon themselves conditions that make their ideals of goodness and happiness impossible of attainment.
Prof. George E. Dawson, The Control of Life through Environment.
And is it, I ask, an unworthy ambition for man to set before himself to understand those eternal laws upon which his happiness, his prosperity, his very life depend? Is he to be blamed and anathematized for endeavoring to fulfill the divine injunction: "Fear God and keep His commandments, for that is the whole duty of man"? Before he can keep them, surely he must first ascertain what they are.
Adam Sedgwick. Address, Imperial College of Science and Technology, December 16, 1909. Nature, December 23, 1909, p. 228.
In my judgment, the situation is hopeful. To realize that our problems are chiefly those of environment which we in increasing measure control, to realize that, no matter how bad the environment of this generation, the next is not injured provided that it be given favorable conditions, is surely to have an optimistic view.
Carl Kelsey, Influence of Heredity and Environment upon Race Improvement. Annals of American Academy of Political and Social Science, July, 1909.
It is within the power of every living man to rid himself of every parasitic disease. Pasteur.
Such facts as the following, showing the increase in health, or rather the decrease in disease, go to prove what may be done.
Since 1882, tuberculosis has decreased forty-nine per cent; typhoid, thirty-nine per cent. Statistics in regard to heart disease and other troubles under personal control, however, show increase—kidney disease, 131 per cent; heart disease, fifty-seven per cent; apoplexy, eighty-four per cent. This means that infectious and contagious diseases, of which the State has taken cognizance and to the suppression of which it has applied known laws of science, have been brought under control, and their existence today is due only to the carelessness or the ignorance of individuals.
On the other hand, such results of improper personal living as do not come under legal control—diseases of the heart, kidneys, and general degeneration, matters of personal hygiene—have so enormously increased as in themselves to show the attitude of mind of the great mass of the people, "Let us eat and drink and be merry, what if we do die tomorrow!"
Probably not more than twenty-five per cent in any community are doing a full day's work such as they would be capable of doing if they were in perfect health. This adds to the length of the school course, to the cost of production in all directions, to increased taxation, and decreases interest in daily life.
The trouble is that the public does not believe in this waste which comes from being "just poorly" or "just so as to be about." It has no conception of the difference between working with a clear brain and a steady hand, and working with a dull and nerveless tool. It must be convinced of this in some way. General warnings have been ineffective, and now the appeal is being made to the American people on the basis of money loss. Thus it has been carefully estimated that the average economic value of an inhabitant of the United States is $2,900. The vital statistics of the United States for population give 85,500,000. Eighty-five million five hundred thousand multiplied by $2,900 equals $250,000,000,000 (minimum estimate), and this exceeds the value of all other wealth. The actual economic saving possible annually in this country by preventing needless deaths, needless illness, and needless fatigue is certainly far greater than $1,500,000,000, and may be three or four times as great.
Dr. George M. Gould estimated that sickness and death in the United States cost $3,000,000,000 annually, of which at least one-third is regarded as preventable.
From all sides comes testimony to the decrease in personal efficiency of workers of all degrees. Medical science has prolonged life, hospitals and visiting nurses have made sickness less distressful, but have also in many cases prolonged the time and increased the cost. Sanitary science aims to prevent the beginnings of sickness, and so to eliminate much of the expense.
The discovery that the mosquito is the carrying agent for the yellow fever germ has saved more lives annually than were lost in the Cuban War. In the yellow fever epidemic of 1872, the loss to the country was not less than $100,000,000 in gold.
"With our present population there are always about 3,000,000 persons in the United States on the sick list.... By means of Farr's table, we may calculate that very close to a third, or 1,000,000 persons, are in the working period of life. Assuming that average earnings in the working period are $700, and that only three-fourths of the 1,000,000 potential workers would be occupied, we find over $500,000,000 as the minimum loss of earnings.
"The cost of medical attendance, medicine and nursing, etc., is conjectured by Dr. Biggs in New York to be from $1.50 each per day for the consumptive poor to a greater amount for other diseases and classes. Applying this to the 3,000,000 years of illness annually experienced, we have $1,500,000,000 as the minimum annual cost of this kind.
"The statistics of the Commissioner of Labor show that the expenditure for illness and death amounts to twenty-seven dollars per family per annum. This is for workingmen's families only. But even this figure, if applied to the 17,000,000 families of the United States, would make the total bill caring for illness and death $460,000,000. The true cost may well be more than twice this sum. Certainly the estimate is more than safe, and is only one-third of the sum obtained by using Dr. Biggs's estimate. The sum of the costs of illness, including loss of wages and cost of care, is thus $460,000,000 plus $500,000,000 equals $960,000,000.... At least three-quarters of the costs are preventable."
 Report on National Vitality, p. 119.
The cost of certain preventable diseases a year is estimated by various authorities as:
Tuberculosis $1,000,000,000 Typhoid 250,000,000 Malaria 100,000,000 Other insect diseases 100,000,000
A hopeful sign of awakening is the endeavor by life insurance companies to bring home to the people the possibilities of race betterment. One company sends out among its policy holders trained nurses, who give plain talks on health subjects and offer practical suggestions as to hygienic living. This, to be sure, is on the economic basis of money saving, but if that is the only thing that will appeal to the people is it not wise to seize upon it as a lever to lift the standard of well-being?
The possibility of saving the enormous sums that are lost by reason of premature deaths was an alluring subject to the insurance men. It gave to the world what, up to that time, it had lacked—a body of powerful men who recognized that they had a financial interest in preventing the needless death of men and women.
A table has been prepared showing that if insurance companies were to expend $200,000 a year for the purely commercial object of reducing their death losses, and should thereby decrease them only twelve one-hundredths of one per cent, they would save enough to cover the expense.
"If such a plan as this were placed on a purely scientific basis and carried out by good business methods, and all the companies pulled together for the common good, I should expect a decrease in death claims of more than one per cent; and a decrease in the death claims of one per cent would mean that the companies would save more than eight times as much as they expended, or would make a net saving of more than seven times the expense, which would be about a million and a half dollars a year."
 Hiram J. Messenger, Travelers Insurance Co., Hartford, Conn.
"While it would be impossible to state in general terms how rich a return lies ready for public or private investments in good health, these examples (life insurance) show that the rate of this return is quite beyond the dreams of avarice. Were it possible for the public to realize this fact, motives both of economy and of humanity would dictate immediate and generous expenditure of public moneys for improving the air we breathe, the water we drink, the food we eat, as well as for eliminating the dangers of life and limb which now surround us."
 Report on National Vitality, p. 123.
Undoubtedly a moral force is to be strengthened by spreading the biological lesson that man cannot live to himself alone, but that his acts or failure to act affect a large number of his fellowmen. Also, a stimulus to personal ambition is to be supplied in the suggestion of better health and consequently more money to spend as a result.
Civic pride and private gain will be brought into the endeavor to show man that to understand himself, to exercise the same control over his activities that he uses over his machines, is to double his capacity, not only for work, but for pleasure. This control is now possible through the application of recently confirmed scientific knowledge as to man's environment.
It is the aim of this book to arouse the thinking portion of the community to the opportunity of the present moment for inculcating such standards of living as shall tend to the increase of health and happiness.
To the women of America has come an opportunity to put their education, their power of detailed work, and any initiative they may possess at the service of the State.
Faith, Hope, and Courage may be taken as the three potent watchwords of the New Crusade. There is a real contagion of ideas as well as of disease germs.
Individual effort is needed to improve individual conditions. Home and habits of living. Good habits pay in economy of time and force.
The hope is springing up in some minds that the entire problem of human regeneration will be much simplified when men shall have learned more fully the nature of their own lives, the nature of the physical world that environs them, and the interaction between this physical world and the spirit of man which is set to subdue it.
Prof. George E. Dawson, The Control of Life through Environment.
We create the evil as well as the good. Nature is impersonal. To an increasing degree man determines.
The only certain remedy for any disease is man's own vital power.
Today only an exceptional man, almost a genius, learns to modify his habits and his life to his environment and to triumph over his surroundings, his appetites, and the absurd dictates of fashion.
Richard Cole Newton, M.D., How Shall the Destructive Tendencies of Modern Life Be Met and Overcome?
We have certain inherent capacities as to bodily strength, length of life, etc., but it lies largely with ourselves to adopt a mode of life which may make an actual difference in height, weight, and physical strength and intellectual capacity.
E. H. Richards, Sanitation in Daily Life.
There are two recognized ways of improving the quality of human beings: one by giving them a better heredity—starting them in life with a stronger heart, better digestion, steadier nerves; the other by so combining the factors of daily life that even a weak heart may grow strong, a poor digestion may become good, and frayed nerves gain steadiness.
E. H. Richards, The Art of Right Living.
The relation of environment to man's efficiency is a vital consideration: how far it is responsible for his character, his views, and his health; what special elements in the environment are most potent and what are the most readily controlled, provided sufficient knowledge can be gained of the forces and conditions to be used.
To this end home life—in its relations to the child, the adult, and the community—is considered in connection with the effect on the home of the influences outside it, and the reaction of each on the other. These relations and influences are partly physical and material, partly ethical and psychical.
The right of the child is protection, and it is the responsibility of the adult—parent, teacher, or state officer—to secure this protection.
The knowledge that investigators are gaining in the laboratory and are trying to give to the community must be accepted and applied by the individual. How is the individual, discouraged by sickness and hardship, to know that things are awry or that they can be set more nearly straight? How can he know that he is responsible for his limitations? Why should he suppose that he need not be eternally a slave to environment? How can he realize that "health promotes efficiency by producing more energy and leaving it all free for useful purposes?" A few enlightened souls recognize the tendency of environment to kick the man that is down; to be subservient to the man of bodily and mental vigor, of keen understanding and human insight, but the majority must be led to believe these scientific principles.
Again and again scientists and humanitarians must return to the attack, for individual carelessness becomes community menace, and "line upon line and precept upon precept" they must present their knowledge in language that shall attract and hold the attention and fancy. So the work and discoveries of Metchnikoff have gained credence because the disciple who described them had the ability to impress on his audience in a convincing fashion the one fact that made a strong appeal—the possibility of long life. If those who are zealous for any movement would study the psychology of advertising and speak as forcefully as the legitimate advertiser, they would be more persuasive and successful.
When an idea has won in a certain circle, it quickly spreads to the other members, thence to active communities. So the universal law of imitation may be the greatest help in the spread of ideas. The individual eats a certain food because his neighbor does. Boston determines to make an effort for a better city because Chicago has felt the stirrings of civic pride.
A gifted individual with a deep sense of the need of his community sees an ideal condition, which by his thought becomes a possibility. These beliefs he shares with a few choice spirits till the circle has widened. The new ideas come to the notice of the city or the town officials, new means are adopted of educating the whole community, and, if necessary, legal measures are passed. But the new means to betterment must be applied by the individual. Beginning with the exceptional individual and ending with the average individual, the perfect circle is rounded out.
The leaders must show convincingly that the laws which they have discovered may be applied to daily life, but the individual himself must adopt them. When he has been saturated with knowledge, his inertia will break down, his hopelessness give way to its very antithesis, a strong hope for a better future. Every known method must be used by the laboratory to develop this hope into a belief wide enough to reach all members of every section of the community and deep enough to become a vital working principle. Only through a belief strong enough to ride over unbelief and inertia, a belief in the value of science for personal life strong enough to make a wise choice possible, can the will to obtain a better environment be developed. The belief in better things must be thoroughly impressed on the individual mind. Each individual must understand that it does affect him, that it is his concern, that he must give heed to his environment. Then he may have the will and make the effort to combat dangers to body and mind.
Today, belief is much more difficult than ever before because the dangers are unseen and insidious, and our enemies do not generally make an appeal through the senses of sight and hearing. But the dangers to modern life are no less than in the days of the pioneers, when a stockade was built as a defense from the Indians. We have no standards for safety. Our enemies are no longer Indians and wild animals. Those were the days of big things. Today is the day of the infinitely little. To see our cruelest enemies, we must use the microscope. Of all our dangers, that of uncleanness leads—uncleanness of food and water and air—uncleanness due to unsanitary production and storage, to exposure to street dust, or to cooking and serving of food in unclean vessels. Such conditions result not only in actual disease, but in lowered vitality and lessened work power.
Lack of knowledge on the part of some, heedlessness on the part of others who should be intelligent enough to interpret such conditions, are responsible for their continuance. A few timely suggestions will accomplish more in remedying many evils than any amount of attempted legal enforcement. The very fact of a law makes many persons defy it. They feel justified in showing their wit by outwitting the law's representatives. Many of our newer citizens have come to us from the protection (?) of a personal authority that they can see and feel. In this country of ours, we have taken away that binding regard for authority, and we must as far as possible lead rather than compel.
It is, after all, what a man determines for himself and for his family that affects both his views of life and his wish to secure for himself and for them that which he believes to be best. It is not what some other man believes for him that affects his life.
Evolution from within, not a dragging from outside, even if it is in the right direction, is the method of human development. Nevertheless, if the bale of hay is skillfully hung in front of the donkey's nose it will often serve to start the wheels on an easy road.
Evidence of the value of concerted effort by individuals and of the power of suggestion was given by a woman's club in a small town. The members became aware of the dangers in exposed food, and on investigation found their own market to be very low in standards of cleanness. At a certain meeting they agreed to ask the proprietor why he did not protect this and cover that article. Certain members were told off for the duty and the days agreed upon. Mrs. A., making her usual purchases, casually asked why such an article was not covered. "I never thought about it," was the answer. Mrs. B., the next day, asked why such an article was left out for the flies. "I never thought about the flies." Mrs. C. asked the same question on the third day. The proprietor said: "You're the third woman who has asked me that. No one ever suggested it before, but it would be a good idea." Before the end of two weeks the provisions and groceries were covered. The end had been gained without resort to coercion.
We know that our capacity for mental and bodily work depends on our supply of food. Proper food is necessary as a source of power for the work of the body as well as to furnish material for growth and repair of the losses of the body. Taking food is the most interesting of the vital processes. It appeals to all the senses (except hearing).
Professor Dawson calls attention to the fact that the richest food areas in the world have provided the most powerful stocks of men of which we have any record, and it has been pointed out by many that improper food is closely connected with mental and moral defects. Strong men and women are not the product of improper food. Dr. Stanley Hall says: "The necessity of judicious, wholesome food is paramount.... You can educate a long time by externals and not accomplish as much as good feeding will accomplish by itself. Children must be supplied with plenty of nutritious food if they are to develop healthily either in mind or body."
Mr. Robert Hunter says: "All that we are, either as individuals or as a complexly constituted society of men, is made possible by the food supply.... Perhaps more than any other condition of life it lies at the door of most of the social and mental inequalities among men."
In these days of irresponsibility there is probably more harm done to the health by ignoring physical law in the matter of eating than in any other one thing.
It is in the study of food substances and their possibilities in relation to better sanitary conditions that the widest field is open to housekeepers, and the subject should be especially fascinating to women of education and ability. All the skill and knowledge of the best educated women should be enlisted in the cause of better food for the people. Certainly no subject, except that of pure air, can have a closer bearing on the health than right diet. Much sound teaching will be needed before bad habits of eating and drinking will be conquered.
A strong, well man whose work is muscular and carried on in the open air, as is that of the farmer and of the fisherman, will have the power to assimilate almost anything, and can maintain abundant health on the coarsest food poorly prepared, provided, only, that it is abundant and composed of the chemical constituents that the body requires.
Only a small proportion of our people, however, engage in work of this sort. The majority are compelled by occupation, age, or health to remain indoors. For them nutritious, readily digested food is a requisite. The farmer or the fisherman can digest, even thrive upon, food which would be deadly for a woman working in a factory.
In the fourth report of the Massachusetts State Board of Health (1873), Dr. Derby, the secretary, holds that "we have good reason to believe that the many forms of dyspepsia which are so commonly met with among all classes in Massachusetts, in country quite as much as in town, are but too often the danger signal that Nature gives us to show that the food, either in its quality, or its preparation, or its variety, is unsuited to maintain the vital processes. If this warning is rejected, the result of malnutrition is frequently chronic disease of the so-called major class."
Sanitation in relation to food deals first with wholesome and clean materials—meat from animals free from disease; fruit and vegetables free from decay; milk, butter, etc., free from harmful bacteria. The dangers are the transference to the human body of encysted organisms like trichina; of the absorption of poisonous substances as toxins or ptomaines; of the lodgment of germs of disease along with dust on berries, rough peach skins, crushed-open fruits; of dirt clinging to lettuce, celery, and such vegetables as are eaten raw.
For the next class of dangers we turn to the handling of foods with unclean hands.
In countless ways disease is spread mysteriously, all due to unclean habits. It is a safe precaution to patronize only those restaurants in which the waiters are evidently trained to handle the food and vessels with care. It will pay well to take care of one's hands and learn sanitary habits when one is young; then one will do right without effort. Whatever change of ideas may come with increase of knowledge, these habits will not need to be unlearned. Without knowing the reasons for them, they have been proclaimed in civilized lands.
It should be the part of the physicians to take pains to advise, for most of our people are accessible to ideas; yet from these can come no improvement until the people are convinced that it is needed. Just as soon as the individual fully realizes that he himself is to blame for his suffering or his poverty in human energy, he will apply his intelligence to the bettering of his condition. If he can, in a short time, make as good a showing as public effort has made in the case of water supplies, he will accomplish much for the race.
Of equal importance to food, in the proper care of the human machine, comes the air we breathe.
Many of man's present physical troubles are due to the roof over his head confining the warmed, used-up air, which would escape freely if there were an opening provided. The first law of sanitation requires the quick removal of all wastes. Once-breathed air is as much a waste as once-used water, and should be allowed to escape. Sewers are built for draining away used water. Flues are just as important to serve as sewers for used air. Air is lighter than water, and out-breathed air being warmed is lighter than that at room temperature. It rises to the ceiling, where it will escape if it is allowed to do so before it cools sufficiently to fall.
The roof also keeps out sunlight, and some late investigations indicate that glass cuts off some of the most vitally important light rays. The "glame" of the Ralstonites—"air in motion with the sunlight on it"—may have a scientific basis.
It will at once be retorted, "But we cannot heat all out-of-doors."
A partial reply is: Do not try to make your house a tropical jungle. Travelers assure us that such an atmosphere is not conducive to work or to health.
All great nations have lived in a temperate climate, where physical and mental activity was possible for many hours a day. Science is more and more clearly giving reasons for the cooler temperature in certain physiological laws. The habits of life in regard to air and food are largely under individual, or at least under family control, and should be studied as personal hygiene.
The lessons being so clearly taught in the treatment of tuberculosis should be heeded in forming the general living habits of the people.
If loss of life can be lessened and working power increased by man's effort, why does he not make the effort? Why are men and women so apathetic over the prevalence of disease? Why do they not devote their energies to stamping it out? For no other reason than their disbelief in the teachings of science, coupled with a lingering superstition that, after all, it is fate, not will power, which rules the destinies of mankind.
Perhaps it is too much to expect that a sturdy plant of belief should have grown since the days of Edwin Chadwick and Benjamin Ward Richardson (1830-50), less than a century ago, when there were perhaps not a dozen men and women who believed that man had any appreciable control over his own health.
This early school of sanitarians endeavored to "get behind fate, to the causes of sickness." The modern socionomist is, by a study of the mental conditions of communities, endeavoring to get behind the causes of poverty and consequent suffering to the reasons for fatal indifference to dirt.
It is well recognized that in severe sicknesses of many kinds the will to get well is more powerful than drugs, that something which we call nerve force acting upon the physical machine sends a vital current through the arteries, coerces the heart to renewed pumping action, and life comes again to the blanched cheek and glazing eye. This more often happens by a mental stimulus than by any medicine. In like manner the improvement of the body's shell, the home, like that of the soul's shell, the body, comes more often from an inward impulse than from outward coercion.
Appeal to the loving but listless parent will reach the heart quickest through love for the child. Therefore stress should be laid on the child, its habits, its surroundings, its ideals. By ideals is meant the very real stimulus to action coming from within. Action must come through the material things which ideals control and through which they express themselves.
Certain notions which have crept into popular currency need to be corrected before the individual can free himself from bondage sufficiently to attempt constructive advance and improvement.
Only a small percentage of adults obtain the full efficiency from the human machine—the only means they have of living, working, enjoying. They permit themselves to stand and walk badly, they breathe with only a portion of their lungs, and so fail to furnish the blood stream with oxygen. They dress unhygienically. They eat wrongly. They exercise little. In short, they subject their bodies to abusive treatment which would ruin any machine. Because retribution does not instantly follow infraction of Nature's laws, they become callous and unbelieving. Economy and efficiency in human time and strength is one of the lessons to be taught the young people, so that they may not waste their patrimony.
The youth feels as rich in his fifty years to come as he does with a legacy of $50,000 in the bank. The years, however, can yield only small variations from the established rate of interest. The human machine can manufacture only a limited amount of energy. It remains to utilize that quantity to the best advantage. This can be done only by having a purpose in life strong enough to resist alluring temptations to fritter away both time and strength.
One of the world's busy workers found that the distractions of urban life were breaking in upon his working time and making inroads upon his physical vitality. He recognized that work for the body and work for the mind must be balanced, and he evolved an acrostic to be followed as a rule of life, the fulfillment of which has meant prolonged years of efficient work and has kept the freshness of middle life with the advancing years. Taking the six days of the week as a unit, the acrostic is as follows:
The Feast of Life
F Food One-tenth the time E Exercise One-tenth the time A Amusement One-tenth the time S Sleep Three-tenths the time T Task Four-tenths the time
The first and last are nearly fixed quantities, the other three may vary within certain limits as to amount of time given and intensity of effort. Amusement and exercise may be taken together; exercise and sleep may be somewhat interchangeable.
The task, or daily work, is a necessity for mental and physical health. It should be accepted as a part of human life and the will and energy should be directed to doing it well. It may be a pure delight, the most entertaining thing that happens; it should be interesting. It is astonishing how interesting a dull piece of work may become if one sets one's self to doing it well. That which one subconsciously knows one is doing badly is drudgery. The real pleasure in life comes not from so-called amusements—things done by other people to make one laugh; to "take one's mind off"—but from seeing the work of one's own hand and brain prosper. The work of creation, of transformation to desirable result, is the purest joy the human mind can experience. Fourteen hours a day is not too much for this kind of task. The difficulty is to gain skill of hand and eye, or training of mind, to this end. A fallacy, a canker at the heart of our social fabric today, is that the daily task is something to be rid of.
The psychology of doing is clearly illustrated in the character of Fool Billy, as drawn by the author of "Priscilla of the Good Intent."
"Is there nought ye like better than idleness?" asked the blacksmith. "Think now, Billy—just ponder over it."
"Well, now," answered the other, after a silence, "there's playing—what ye might call playing at a right good game. Could ye think of some likely pastime, David?"
"Ay, could I; blowing bellows is the grandest frolic ever I came across." ...
"I doubt 'tis work, David.... I shouldn't like to be trapped into work. 'Twould scare me when I woke o' nights and thought of it."
"See ye then, Billy"—blowing the bellows gently—"is it work to make yon sparks go, blue and green and red, as fast as ever ye like to drive 'em?"
"Te-he, 'tis just a bit o' sport—I hadn't thought of it in that light." And soon he was blowing steadily.
Later, when David the smith was going to America and wished to leave his forge with the half-witted Billy, he proposed the smith's work as play.
"Te-he," laughed Billy, "am I to play wi' all your fine tools, David?"
"Ay, just that. I've taught ye the way o' them and Dan Foster's lad from Brow Farm shall come and blow the bellows for you."
"Will that be work for Dan Foster's lad, or play?"
"Hard work, Billy—grievous hard work, while you are just playing at making horseshoes, fence railings, and what not."
"And I'm to play at making horseshoes," went on Fool Billy, "while Dan Foster's lad's sweating hard at bellows-blowing."
Community effort is needed to make better conditions for all, in streets and public places, for water and milk supply, hospitals, markets, housing problems, etc. Restraint for sake of neighbors.
Quite slowly but surely, the idea is dawning on the social horizon that the persistence of conditions prejudicial to human prosperity is discreditable to a civilized community, and that economics if not ethics calls for their control.
It is the new view that disease must be understood and overcome; that hospitals, dispensaries, surgical and medical treatment, nursing and preventive measures must be developed and dovetailed into a general social scheme for the elimination of preventable diseases and a very substantial reduction in the prevalence of such diseases as cannot as yet be classed as preventable.
Edward Devine, Social Forces.
Nature endows the vast majority of mankind with a birthright of normal physical efficiency. It is the duty of those who aspire to be known as social workers each to do his share in confirming his fellow beings in this possession.
Dr. H. M. Eichholz, Inspector of Schools. Paper before Conference of Women Workers, London, 1904.
We know now that if we do the things we ought to do, we can prevent sickness. We have reached a point where it is recognized that it is the duty of the community or state to effectually protect itself against the ignorant, the selfish, the filthy, and the diseased. We believe now that we must have proper sewage disposal, pure water, decent tenements, clean streets, good-sized playgrounds, supervision of factories, protection of child labor, and pure food.
Eugene H. Porter, Report, 1909, New York State Department of Health.
Next after himself, man owes it to his neighbor to be well, and to avoid disease in order that he may impose no burden upon that neighbor.
Dr. William T. Sedgwick, The Call to Public Health.
The real significance of biological evolution has not been grasped by the people in general. It is that man is a part of organic nature, subject to laws of development and growth, laws which he cannot break with impunity. It is his business to study the forces of Nature and to conquer his environment by submitting to the inevitable. Only then will man gain control of the conditions which affect his own well-being.
Sickness, we know, is the result of breaking some law of universal nature. What that law may be, investigators in scores of laboratories are endeavoring to determine. In most diseases they have been successful. Those remaining are being attacked on all sides, and it may be confidently predicted that a few years will see success assured.
Why, then, does sickness continue to be the greatest drain upon individual and national resources? Because man, through ignorance or unbelief, will not avail himself of this knowledge, or is behind the times in his method. Where wisdom means effort and discomfort, many feel it folly to be wise.
The individual may be wise as to his own needs, but powerless by himself to secure the satisfaction of them. Certain concessions to others' needs are always made in family life. The community is only a larger family group, and social consciousness must in time take into account social welfare. Moreover, a neighbor may pollute the water supply, foul the air, and adulterate the food. This is the penalty paid for living in groups. Men band together, therefore, to protect a common water supply, to suppress smoke, dust, and foul gases which render the common air unfit to breathe. The State helps the group to protect itself from bad food as it does from destruction of property.
The development of fire protection is a good example of community effort. The isolated farmhouse may have buckets of water and blankets in an accessible place with which to put out an incipient fire. Then eight or ten families build close together. The danger of one becomes the danger of all, and a fire brigade is organized that may protect all. When hundreds of families crowd together in a small space the danger becomes so much the greater that a paid department with efficient apparatus is necessary. No one complains of the infraction of individual rights. Each one is glad to pay his share of the expense.
In securing protection from other dangers, the individual and the family unit are fast relying on community regulations. In fact, in many ways the individual, when he becomes one of a crowd, must go whither the crowd goes and at the same rate of progress.
Failure to recognize that by coming into the community he has forfeited his right to unrestrained individuality causes an irritation as unreasonable as harmful.
A certain control of sanitary conditions must be delegated to the community and its rules cheerfully followed. The legal aspects of these rules will be considered in a later chapter. Here is to be considered only the mental attitude with which the members of the community should come together to agree upon a common defense against disease and dirt. The spirit of cooperation must prevail over a tendency to antagonism when certain individual rights seem to be involved.
Numbers of families living close together are served by the same grocer or market man. These families may agree upon their requirements as to quality and cleanliness and publish their rules. If they do not take interest enough to protect themselves, the community must make rules for them. If the local officials are not vigilant enough, the State may step in and compel the observance of sanitary regulations.
The average citizen learns of the existence of a health regulation when he is warned that he has broken it, or perhaps is fined. His first attitude is rebellion at the invasion of his personal liberty. The housewife usually takes the ground that the rule is absurd or unnecessary.
When, in the interest of the community, any law is to be enforced, how are the people to be led from this rebellious state of mind? Perhaps first through authority. In America we have learned to use the phrase, "Big Stick." Authority is exactly that; it is coercion from without. It has partial result in good; the law may be fulfilled because the individual knows he must obey when within the jurisdiction of that law; but if the result is simply obedience to authority and not to the underlying principle, it will not be a force in his life or be continued if by chance he can escape it. He will be a "tramp" in his methods of obedience. This method can never be constructive; its value lies in the possibility that by continuous usage or repetition the procedure may become a habit, and from habit will come reason and intelligence.
But the more direct and efficient way to help the individual to realize his relation to communal right living is through education. The former method—blind obedience—will foster the spirit of antagonism and call the State's protection "interference," thus weakening the efficiency of the State and of the individual, for the State is the multiplication of its citizens; but through the latter method the individual will carry out the law with intelligence and interest. This will be constructive and it will be permanent, for again, if the State is the sum of its citizens, the efficiency of the State is the sum of the efficiency of the citizens.
Their interests are now identical, the man has become equal master with the State; they are co-partners. His motive for right living is greater than the letter of the law, for he is the living law, the protest against wrong and the fulfillment of the right.
* * * * *
The next generation must be born with healthy bodies, must be nurtured in healthy physical and moral environments, and must be filled with ambition to give birth to a still healthier, still nobler generation. But, as has been said, "whatever improvements may sometime be achieved, the benefits of their influence can be enjoyed only by future, perhaps distantly future generations. We of the present have to take our heredity as we find it. We cannot follow the advice of a humorous philosopher to begin life by selecting our grandparents; but through hygiene (sanitary science) we can make the most of our endowment."
 Report on National Vitality, p. 55.
There is a force in the development of public opinion somewhere between individual action and national compulsion which may be termed "semi-public" action. It is in a measure the same sort of influence that in a later chapter is termed "stimulative education." For instance, a hospital for the treatment of some special ailment is needed. Private enterprise furnishes the capital, proves the success of the treatment, and then the community comes forward and supports the institution. Such helps are accepted freely and are not considered undemocratic.
The less spectacular but more effective office of prevention of the need for charity, in the maintenance of cleanness in the markets, streets, and shops, yes, even in the homes of the people, has been neglected. Through lack of belief, and especially through inattention to causes so common as to escape notice, many details of great hygienic importance have been overlooked.
Some daring ones in commercial ventures are showing the possibilities of a standard in cleanness, and model establishments, dairies, bakeries, and restaurants should receive the hearty support of a community. If they do not receive this support, it is more than discouraging to the promoters, for it costs to be clean, a lesson the community must learn. The saving of money and the consequent loss of life through disease, or the spending of money and the saving of life through prevention, are the alternatives.
Undoubtedly the old view of charity as tenderly caring for the sick—because there must always be a certain amount of sickness in the world—has held men back from attempting to make a world without sickness. The charity worker of the past had no hope of really making things better permanently.
The new view, based upon scientific investigation, is that it is not charity that is needed to support invalids who once stricken must fade away, but preventive action to give the patient hope and fresh air. Most important of all, the experience already gained shows how far from the truth was the old fatalistic notion of the necessary continuance of disease.
While the support of many agencies—dispensaries, clinics, hospitals, sanatoria, etc.—must for a time depend upon private philanthropy, the expense is in the nature of an investment to bring in a high rate of interest in the future welfare of the race. As soon as the belief in the efficiency of these agents reaches the taxpayer he will willingly furnish the funds for public agencies.
Today the child in the school is examined; then, if need be, is given special consideration at the dispensary, then sent to school, where, with fresh air, pure food, and hygienic surroundings, he will so strengthen himself as to combat the ravages of disease.
The Association for the Improvement of the Condition of the Poor, New York City, not only sends bread to fill the hungry stomach, but now sends a wise and sympathetic worker to help women to understand food and money values, which means a permanent help. And it no longer simply says to the tired, worried woman who has had no education-stimulus along the line of cleanness, "Be clean," but sends in women to make the house an example, an exhibit of clean conditions, if you will. Example is stronger than precept.
In the rapid growth of cities, so often beyond anticipation, preparation for development or plans for extension have seldom been laid. Much suffering has been wrought to the families of men in our crowded cities, for there is no greater evil than the congestion of streets and buildings.
Many students of social conditions of today believe that the most serious menace is the situation best described as housing—the site, the crowding, the bad building, poor water supply and drainage, lack of light and air and cleanliness. All believe that it is economically a loss to the city in general, however profitable to a very few. To rent such buildings is a far greater crime than cruelty to animals or even the beating of women and children.
But groups of people the wide world over are keenly awake to this state of affairs, and though the problem is tremendous they are trying in numerous ways to solve it.
In some cities there are at present organizations urging "city planning," while in several foreign cities the municipality has already made regulations. In some cities there are municipal model tenements, but this is still a project of too small proportions to affect the community.
Perhaps no modern movement that comprehends both the city planning and the housing of the working people is more ideal than the "Garden Cities" movement in England and the other countries following it.
If there is any spot on which the hand of the law should be laid, it is the congested districts in cities and mill villages. The evil has grown to such magnitude that the first steps will mean some drastic measures.
The author has elsewhere called it the Capitalists' Opportunity. Instead of investing in an uncertain gold mine in some distant land, let the millions, for no less sum will suffice, be invested in a plot of land, whether an open field or a slum district depends on local conditions, and thereon cause to be erected habitations decently comfortable, wholly sanitary, and place over each group an inspector as both agent and teacher who shall be a friend to the tenants, and to whose office they may come freely with their needs. This plan has been in part carried out in the Model Tenements in New York, but variations and improvements are needed. There should be more light and air, more grass and trees, even if the buildings are fifteen-story towers.
The old story has been so often reiterated, "But the tenants will not use the devices," that the capitalist has become callous to this appeal. The missing link in the chain has been the instruction to go with the construction.
All department stores, all venders of new mechanical appliances, have come to recognize the value of demonstration, or instruction, in the use of articles as an aid to purchase. The advocate of better dwellings must take a leaf from the commercial book and show how. It is in this that philanthropy has been weak in the past. It has assumed a power to see, where there was only a fear of handling the strange objects.
There is a virgin field for the capitalist who wishes to use some millions for the prosperity of the country to build a short trolley line to a district of sanitary houses with gardens, playgrounds, entertainment halls, etc.; such a village to contain, not long blocks, but both separate houses and tenements from two rooms up, possibly several stories high, where the elders may have light and air without the confusion of the street. Dust and noise will be eliminated. There should be a central bakery and laundry, and, most important of all, an office where both men and women skilled in sanitary and economic practical affairs may be found ready to go to any home and advise on any subject. There has never yet been such an enterprise with all the elements worked out. Several, however, have shown the way, the Morris houses in Brooklyn, for example.
It is easier to take a city block and construct fireproof, high buildings than to solve transportation problems. We are losing our fear of the high buildings as we see the great value of light and air. There is chance for work in this direction, for in spite of rapid transit some must live in the center of things.
Let a philanthropist or two, instead of building hospitals, set some bright young architects and sanitarians to devising such suitable housing conditions for city and suburbs as will obviate the necessity for hospitals. Any lover of his kind, any one who longs for fame, could find both it and the blessing of the homeless by this means, and in the end get a fair return for his investment.
The Federal Department of Labor has studied workingmen's houses, but living in the house has not been worked up. The housewife has no station to which she may carry her trials, like the experiment stations which have been provided for the farmer. Here is another opportunity for the capitalist to hasten the time when the State will supply these. The way will very soon be laid out and the first steps taken.
 Bulletin No. 54.
For the immediate present some standard of healthful housing is needed, and now that a similar type of house and of apartment house is being built in all cities and towns from one ocean to the other, and from Texas to Maine, such a standard is compatible with conditions.
A score card for houses to rent would save much wrangling. The agent shows the card with this house's rating, and the tenant learns that some of his wishes are incompatible with the standard, and some would mean a much higher rent than he is willing to pay. Professor J. R. Commons, Department of Economics, University of Wisconsin, has devised a score card to serve the house hunter and householder as a standard of comparison. This should serve the house builder as well, indicating what the demand will be forty or fifty years hence.
At present the rating stands somewhat as follows:
Dwelling, 100 points
Location, 18 points out of 100 Congestion of buildings, 26 points Common entrance for two or more, discredit 2 points Basement, discredit 5 points Sunlight, credit 16 points of the 26 Window openings, 11 points Air and ventilation, 13 points Structural condition, 6 points House appurtenances, 26 points Well outside, discredit 3 points
The final score card may vary somewhat.
For rent collectors there is also a score card.
Occupants, 100 points
Congestion of occupancy, 61 points cubic air space 1,000 cu. ft. per person, no discredit 600 cu. ft. per person discredits 20 points Condition of air and ventilation, 18 points Cleanliness, 21 points
A score card movement might be started as a hobby, and in the end lead public opinion to judicial choice and action. No such movement, however, is possible without leaders, and leaders of the right type.
The lesson for the community to be drawn from a study of crowd psychology is that of leadership and loyal cooperation. The common man is likely to be possessed of one idea at a time. If such an one becomes a leader, there is danger that equally vital factors will be overlooked. Safety is found in a combination of leaders to make an all-round improvement.
Each individual is too busy in his own affairs to look after his own, much less his neighbor's, health and comfort, hence community life, with its advantages, brings its own dangers. Children in school in contact with other children; crowds in trains, in elevators, stores, in lecture halls, contract habits as well as diseases. The need for large quantities of supplies at one point brings long-distance transportation and cold storage difficulties. The man who caters to public need does not look far ahead to consequences, and if unrestrained may prove more of a menace than a convenience.
The safe and reasonable way is to delegate to certain persons the making and enforcement of regulations corresponding to the needs of the times, and then to obey them, even at some personal inconvenience.
Each community should put into the hands of its health officers the carrying out of the rules it has agreed to as an insurance against outbreaks of disease. Does a man let his fire insurance policy lapse because the year has passed without a fire? Even if the regulation seems superfluous to the particular individual or family, let it be remembered that there are inflammable spots in every community. Eternal vigilance is the price of safety in sanitary as well as in military affairs. As in the army, the community must delegate scout duty to certain chosen individuals and rely on their report for safety.
Interchangeableness of these two forms of progressive effort. First one, then the other ahead.
Preventive medicine is the watchword of the hour, and enlistment in the cause can come only through education....
He who understands the dangers is thrice armed, and is trained and entitled to enlist in the home guard to protect the health of his household and neighbors.
Dr. M. H. Rosenau, Harvard Medical School.
The next generation of parents is being made strong or weak in home and school today by an environment furnished by parents and teachers. These latter cannot be too well instructed in physiology, hygiene, and biology.
Prof. John Tyler, The Responsibility of the Medical Profession for Public Education in Hygiene.
The new view is a social view, which seeks in all movements, whether of research or of remedial action, for the common welfare.
Edward Devine, Social Forces.
Democracy means that the best of all life is for all, and that if there are many incapable of entering into it, then they must be helped to become capable.
Ralph Barton Perry, The Moral Economy.
If the child is not only in theory but in practice recognized as the main interest in society, the family and society will more and more assist the mother in his nurture.
W. I. Thomas, Women and Their Occupations.
Health administration cannot rise far above the hygienic standards of those who provide the means for administering sanitary law. The tax-paying public must believe in the economy, utility, and necessity of efficient health administration.
Wm. H. Allen, Civics and Health.
The connection between poverty and ill health is so direct, so immediate, and so important that the moment any individual or society turns its attention to the causes of poverty, that moment it finds itself in the thick of the public health movement.
Homer Folks, Journal Public Hygiene, November, 1909.
FAITH AND HOPE
Progress is a series of zigzags: now the individual goes ahead of the community; now the community outstrips the individual.
The community cannot rise much above the level of the individual home, and the home rises only by the pull of the community regulations, or by the initiative of a few especially farsighted individuals.
The steps need to be carefully measured, for if the family begins to rely on the State for the backbone it should have, it will not stay up, and its fall will be lower than the stage it rose from. "When man reverts, he goes not to Nature, but to death."
The example set by the city in maintaining clean streets and well-kept parks reacts upon the home yards. The insistence by the police on city regulations as to alleys and garbage educates the family as to the general attention to be paid to such things.
The city authorities, on the other hand, are prodded to their work by well-informed individuals who see the great gain to the community from certain measures.
The centers of movement, civic and quasi-religious or philanthropic, are usually the outgrowth of individual effort. The great movements for betterment—water supply, street cleaning, tenement laws, etc.—are carried out by community agreement with a common tax outlay.
The clean city means streets of clean houses. The clean house in the midst of a dirty city may be the match to start a fire of cleansing.
Probably medical inspection in the public school is as good an example as may be given of helpfulness to the community. No quicker means of influencing both home and community life may be found, for in five years it might revolutionize the whole.
School buildings should be so constructed and so managed that they cannot themselves either produce or aggravate physical defects. Departments of school hygiene should be organized, not only in every city, but for every rural school under county and state superintendents of instruction. The general question of physical welfare of children involves too many considerations to be satisfactorily treated by school physician and school nurse alone, or by busy teachers and principals.
"New York City will spend in 1910 $6,500 for making over twenty rooms in regular buildings, a first step in an entirely new plan of ventilation, which will eventually give outdoor air to all children, sick or well."
 Bureau of Municipal Research.
Speaking generally, America is one of the last of the civilized nations to deal with the subject of the medical inspection of school children upon a comprehensive and national scheme. But once aroused to the needs, it is safe to say that the nation will speedily educate parents to correct such home conditions as reduce the child's ability to profit from schooling, and to persuade governments to see that safe homes are provided. It will be easy to convince the taxpayer that it is cheaper to provide such care than to neglect the future parent and citizen, for it is easy to prove that medical inspection in our schools returns large dividends on small investments. Dr. Luther Gulick says that it seems probable, though only a guess, that the total annual expenditure for medical inspection of schools in the United States at the present time is perhaps $500,000. The money saved by enabling thousands of children to do one year's work in one year, instead of in two or three years, would greatly exceed the total expense of examining all children in all boroughs.
 Quoted in Report on National Vitality, p. 123.
The health of all our school children should be conserved by a system of competent medical inspection which should secure the correction of defects of eyes, ears, teeth, as well as defects due to infection or malnutrition.
The statistics of medical inspection in public schools tell a pitiful tale wherever it has been tried: thirty or forty per cent of the children are found with defective or diseased eyes, ten to twenty per cent with distorted spines, fifteen per cent with throat and nose troubles, all of which directly affect their intellectual proficiency.
When these deficiencies are discovered and reported to the parents, such is the apathy of disbelief that seventy-five per cent of the cases usually go unattended; therefore the school nurse, who follows the case home and explains the needs and sets forth the penalties, has become a necessity.
The parent who permits his child to go to school physically unfitted to profit from school opportunity is not only injuring his own child, but is injuring his neighbor's child, and is taxing that neighbor without the latter's consent.
It would seem as if such parents had forfeited their right to the sole care of the children, and that government would be obliged, for its own protection, to step in and do the work while it is needed. The author has termed this temporary paternalism. The providing of penny lunches during the morning recess, the service of the school nurse and the home visitor to teach those parents who are willing to learn all these schemes for the saving of the child, may be carried out in a spirit of helpfulness with a support which may be withdrawn when no longer needed.
Although all America has not become aroused to the undoubted fact of tendencies toward physical deterioration, it is on the verge of an awakening. The public school is the natural medium for the spread of better ideals, and if the teachers of cooking and of hygiene would cooperate and use all the material which sanitary science is heaping on the table before them, we should soon see a betterment of the physical status. Combined with medical inspection and sanitary construction of schoolhouses, this would raise the general health of the community thirty or forty per cent in five years and fifty to seventy per cent in ten years.
There has been in some quarters much objection to public effort towards remedying evils which would not have existed if each family had lived up to its duties. The community is a larger family, with greater resources, and can employ investigators to find the means for greater security. That individual is very foolish who does not recognize this interaction between community and individual, and who objects to taking the benefits of the larger knowledge.
To take one of the latest examples of social problems: In every thousand children in the public schools of any city, probably of the town also, there are perhaps fifty who are ill-nourished (not necessarily underfed), ill-clothed, unwashed, and deprived of good air for sleeping. What is the duty of the public? This is one of the burning questions of the moment. Send missionary teachers to the homes, some say, but that is costly; the selection of the suitable missionary is difficult, and the result may be slight. Others say, give one good luncheon at the school, for which the children pay in part or in whole, and make that an education which, by the aid of the school nurse, will in time affect a change in habit. In short, the problem is this: Shall the children suffer in childhood and become a burden on society in adult years, or shall society protect itself from future expense by community care now? "Because finding diseases and defects does not protect children unless discovery is followed by treatment, fifty-eight cities take children to dispensaries or instruct at schoolhouses; fifty-eight send nurses from house to house to instruct parents and to persuade them to have their families cared for; 101 send out cards of instruction to parents either by mail or the children; while 157 cities have arranged special cooperation with dispensaries, hospitals, and relief societies for giving the children the shoes or clothing or medical and dental care which is found necessary."
 Bulletin, Bureau of Municipal Research.
Nearly all preventive measures adopted by society and ranked as paternalism by timid philanthropists are or may be educative and temporary at the same time. They may be dropped as soon as the end is gained. The attention of parents must be called to neglected duties. Compulsory attention to such duties as affect the wards of society, the children, may be needed for a time. Just as the wise father, taking the child for a walk, allows him to run free as soon as his strength and courage permit, so the paternalism of society is relaxed as soon as its protegees show themselves both able and willing to do the right thing without its aid or command.
Compulsory school attendance places responsibility for certain care, vaccination, decent clothing, good food, decent shelter. The thousand and one ways in which society is now protecting itself are all educating the newcomers to American ideals. They are all intended to make efficient, self-sustaining citizens who do not feel the pull of the law or the bond of outside care. It is the last conflict between the ideals of individualism and those of the community need, subordinating the individual preference. Much wisdom and forbearance will be needed to secure this community ideal, but in that way evidently lies progress. It behooves the leaders of social effort to make all their work educational, and thus remove the necessity for a repetition in the future.
Just as the parent in the home establishes habits while the child's mind is plastic, so the community stands in loco parentis to the future citizen, and surrounds him with safeguards while needed. Knowledge is needed, scientific investigation is fundamental, expert wisdom is indispensable, costly though it is, being the product of long research and rare brain power. This is at the service of the nation for the good of all the people, and it is the surer the wider the range of experience. For this reason chiefly, greater actual knowledge and more complete harmonizing of conflicting interests is necessary. Certain sanitary measures are carried out by the Federal government as an education to communities, just as communities educate individuals. Federal effort may be unwisely put forth in certain cases, investigations of little consequence may be undertaken, but on the whole a democracy must learn to manage its affairs by making mistakes. The principle should not be discarded as a result of the first mistake.
The immediate concern of this chapter is with the leaders of community movements, the educated, sympathetic, farsighted sociologists, sanitarians, and economists, whose concern is for the advancement of mankind. These leaders must have courage and belief in the value of their work, for no half-hearted means will carry the community forward. Still more, they must have knowledge, a sure ground to stand upon. To acquire this means both time and opportunity. To go into betterment work without it is to set back the wheels of progress, not to advance them.
The child to be "raised" as he should be. Restraint for his good. Teaching good habits the chief duty of the family.
Our success or failure with the unending stream of babies (one every eight seconds) is the measure of our civilization: every institution stands or falls by its contribution to that result, by the improvement of the children born or by the improvement of the quality of births attained under its influence.
H. G. Wells, Mankind in the Making.
Children are the most hopeful element of our population, and we should concentrate our efforts on them.
Dr. W. F. Porter, Harvard Medical School Lectures.
We want the mothers to be the health officers of the home.
Charles W. Hewitt.
When human beings and families rationally subordinate their own interests as perfectly to the welfare of future generations as do animals under the control of instinct, the world will have a more enduring type of family life than exists at present. This can only be accomplished by the development of controlling ideals which are supported not only by reason and intelligence but by ethical impulse and religious motive.
The home should be considered the place where are to be developed and conveyed the precious qualities which are so vital to the continuity of the race and the progress of human society and civilization.
Those factors which are of a more material or physical nature, such as shelter, food, dress, and personal health, are to be estimated in their relation to mind, character, and effective conduct.
In the confusion of relative values human health as one of the essential means to many worthy ends is usually neglected. Man is the most highly developed of all species of animals. He is, to some degree at least, civilized, and yet human beings are of all animals the sickliest, and this in spite of the fact that human health is more important to man and to the world than the health of any other creature. And by health I do not mean simply existence, freedom from pain, or absence of disease, but rather organic power and efficiency, the maximum vital ability possible to the individual for the doing of all that seems most worth while in life.
Dr. Thomas D. Wood, Lake Placid Conference, 1902.
The ideal of "home" is protection from dangers from within—bad habits, bad food, bad air, dirt and abuse,—shelter, in fact, from all stunting agencies, just as the gardener protects his tender plants until they become strong enough to stand by themselves. The child's home environment is certainly a potent factor in his future efficiency.
But more than physical protection is that education in all that goes to make up profitable living, acquired by following the mother or nurse in her daily round and in having legitimate questions answered. Imitation is the first step in good habits, as in learning to walk or to read. That which is set before the child should be worthy its imitation, and be of value when fixed as a habit. Habits of health, correct position, deep breathing, clean ways, distaste for dirt in one's person or in one's vicinity, liking for fresh air, for simple food, good habits of exercise, of reading, and the thousand and one trifles that go to make up the efficient worker in adult years, all belong to the well-ordered home, where, as one author puts it, the child is the business of the day.
But the State cannot risk its property too far.
When mothers become so careless or ignorant that half their children fail to reach their first birthday, and of those that live to be three years old a majority are defrauded of their birthright of health, some agency must step in.
If the State is to have good citizens it must provide for the teaching of the essentials to a generation that will become the wiser mothers and fathers of the next. Therefore, even if we regard this as only a temporary expedient, we must begin to teach the children in our schools, and begin at once, that which we see they are no longer learning in the home. "The achievement at Huddersfield, England, is especially noteworthy. The average annual number of deaths of infants for ten years had been 310. By a systematic education of mothers the number was in 1907 reduced to 212. The cost of saving these ninety-eight lives was about $2,000."
 Dr. Charles H. Chapin.
One university has established a course in the care of children, much to the amusement of the press. The United States Commissioner of Education has, however, been a responsible mover in the idea.
But real progress by means of family education means the stable family and the permanent dwelling. Where is the family in the permanent dwelling today? Among any class, except the agricultural, where is the stable family?
Since industry has taken woman's work from her, and she has to follow it out into the world, the means of education for the child has gone from the home. Its atmosphere is artificial, if the attempt is made.
To work exclusively on the family, for the sake of the child, is a very slow process. As in all American life, the quicker method appeals most strongly. The school is today the quickest means of reaching both child and home; the present home through the child, and the future homes through the children when they grow up.
And time presses! A whole generation has been lost because the machine ran wild without guidance, and all attempt at improvement was met by futile resistance.
It is very difficult to present the socionomist's view of the child in the home so that it may appeal to the two extremes of opinion. There are those who still apply mediaeval rules to twentieth century living; those who believe, honestly, that the ideal life was found in the days when the mother was the manufacturer in her own home and the children were her helpers in all the varied processes. "There was never any artificial teaching devised so good for children as the daily helping in the household tasks." The inference is made that therefore the same restriction for the mother and the children leads to an ideal life today. Such persons fail to realize that the twentieth century is practically a new world. The old rules which related to material things hardly hold more closely than they would on the planet Mars. The fundamental moral principles of reverence, obedience, love, and unselfish sacrifice must be worked in on a new background.
To keep the eighteenth century habit, so carefully taught the girl, of courtesying as she stepped aside to allow the rider or the ox cart to pass, in these days of the swift automobile, which would be out of sight before the knee could bend, is no more ridiculous than to expect the average young mother to follow the methods of her grandmother. Her mother's ways are now pronounced all wrong, not necessarily because they were wrong then, but because conditions have changed, knowledge has been gained, and it is clearly a waste of human life, of money, of physical and mental power for people to be sick and die because the caretaker does not use the knowledge in circulation.
If the young mother can learn how better to fulfill her duties by going out of the house to lectures or classes, why not?
Tracts are not always successful as an incentive to conduct. It is obviously impossible to pass a blue law compelling parents to conform to—what ideal? The school is fast taking the place of the home, not because it wishes to do so, but because the home does not fulfill its function, and so far has not been made to, and the lack must be supplied. The personal point of view, inculcated now by modern conditions of strife for money, just as surely as it must have been by barbarian struggle in pre-civilized days, must be supplanted by the broad view of majority welfare. The extreme of the personal point of view, expressed in such phrases as "The world owes me a living;" "My child is mine to treat as I please;" "It is nobody's business how I spend my money;" "I have a right to all the pleasure I can get out of life," is well shown in Mr. H. G. Wells's analogy: "A cat's standpoint is probably strictly individualistic. She sees the whole universe as a scheme of more or less useful, pleasurable, and interesting things concentrated upon her sensitive and interesting personality. With a sinuous determination she evades disagreeables and pursues delights. Life is to her quite clearly and simply a succession of pleasures, sensations, and interests, among which interests there happen to be—kittens."
 Mankind in the Making.
This unsuspicious ignorance of the real nature of life is by no means confined to animals and savages; it would seem to be the common view of many young people today. At least they take as little care of the homes to which they bring children, and they follow the cat's example in boxing the children's ears and turning them out to fend for themselves.
The last generation seemed to become disciples of Schopenhauer in his passionate rebellion against the fate that deferred all the pleasure of the present to the needs of the future generation. Evolution has revealed the necessity for this subordination of the individual lot to the destiny of the race, if progress is to be made. The man who asserts himself as free from race trammels is snuffed out as a factor—a blighted blossom fallen to earth and trodden under foot. To the student of biological evolution, the individual is as a mere pin point on the chart of community advance, for surely society grows according to evolutionary law. "As certainly as Nature gives the poor child its chance of a good life, so certainly do the circumstances of slum environment rob it forthwith of its birthright—it is not uncommon to find more than half the children of three years of age hanging on to life with marks of disease and undergrowth firmly implanted on their tender frames. Yet, practically, none of this is inherited in the true sense; it is the victory of evil human devices in their endeavor to cheat Nature of her own. If ever there was a mission in the world worthy of the most strenuous service, it is to wrest back this victory, be it out of pity for suffering children or for the very welfare and existence of the nation.
"The schools have made their beginning; the homes have not yet started; they wait the impulse from without. It is for voluntary, intelligent opinion to get to work on the home, and never to relax until a race of parents has arisen which knows no other duty to the state than to rear with heart and brain the children which have been given to them. Then we shall hear no more about physical degeneracy."
 Dr. H. M. Eichholz, Inspector of Schools. Paper before Conference of Women Workers, London, 1904.
Hope for the future is to be found in the conclusions of the immigration commission, that in one generation certain marked changes in stature and in head measurements have taken place in the children of immigrants of various nationalities, such changes as have hitherto been considered as the result of centuries. The commissioners credit the better environment and larger opportunities with these indications of increasing intellectuality and mental force.
Most human efficiency is the result of habits rather than of innate ability. These habits of mind, as well as of body, are developed by the home life at an early age. The home is responsible for the upbringing of healthy, intelligent children. Here is the place for fostering the valuable and suppressing the harmful traits. The school can never take the place of the home in this. With the large classes of the public schools, the teacher should not be asked to undertake this individual work. Moreover, correcting a child for personal habits can hardly be effective before fifty or sixty pairs of critical eyes.
The office of the home must be to teach habits of right living and daily action, and a joy and pride in life as well as responsibility for life. It is not fair that the parents should sit back and shift to the school the whole responsibility for the future citizen.
The little modifications can best be made in the home, permanent foundations can be laid and braced with habits so good and strong that nothing can shake them. Most powers are the result of habits. Let the furrows be plowed deeply enough while the brain cells are plastic, then human energies will result in efficiency and the line of least resistance will be the right line. Everything, therefore, which influences the child must be the best known to science. The houses of the land must be regulated by the scientific laws of right living. To the woman, the home worker, we say: "You must have the will power, for the sake of your child, to bring to his service all that has been discovered for the promotion of human efficiency, so that he may have the habit, the technique."
To pay a tax today for the benefit of one's children is a principle of insurance, of benefit association. This feeling of obligation means present sacrifice of ease and inclination, and it has been increasingly shirked, so that it is not surprising that a tax to insure one against future loss by disease is an unwelcome proposition.
The whole question of the child in the home is one of ethics, as the writers on social conditions have been trying to convince the world. If the swarms of dwellers in the busy hives of industry have no sense of their humanity, if they do not use the human power of looking ahead, that power which differentiates man from animals, what better are they than animals?
No one can be sorry that there are no children in thousands of homes one knows. It is better that children should not have been born than to come into an inheritance of suffering and mental and moral dwarfing. Social uplift will not be possible while parents take the view of cats, or even of a well-to-do mother who said, "I did not have my baby to discipline her; I had her to play with."
No state can thrive while its citizens waste their resources of health, bodily energy, time, and brain power, any more than a nation may prosper which wastes its natural resources.
America today is wasting its human possibilities even more prodigally than its material wealth. The latter deficiency is being brought to a halt. Shall the human side receive less attention? A sharply divided line between home and school is no longer clearly drawn. Parents' associations are being formed and are cooperating with the school-teacher. To what end? To the better moral and intellectual atmosphere of the home. Physical education has had its vogue, but too much as an endeavor apart, not as a necessary element in the whole.
The pedagogical world is now becoming convinced that physical defects are more often than not the basis of mental incompetence, and this leads logically to the teaching of the laws of right living in a practical way, not merely as lessons from books, but as daily practice. This practice must eventually go into the home, where the most of the child's hours are spent. It is as useless to expect good health from unsanitary houses as good English from two hours' school training diluted by twelve hours of slovenly language. Hence the imperative need of such teaching and example as can be put into practice; and since immediate house to house renovation and change of view are impossible, the school must provide for teaching how to live wisely and sanely, as well as for clear thinking and aesthetic appreciation. Practical hygiene, food, cleanliness, sanitation, all must eventually be exemplified by the schoolhouse and taught as a part of a general education to all pupils, boys and girls.
If this sounds like socialism, let us not be afraid, but educate for five or ten years all children, so that homes may be better managed, and then it is to be hoped there will be no need for such school training. To live economically in the broad sense of wise use of time, money, and bodily strength is the great need of the twentieth century. This is practical economics. This is something which cannot today, except in rare instances, be learned at home, for conditions change so rapidly that grown people may not keep up with them. Mothers' ways are superseded before the children are grown.
The school, if it is maintained as a progressive institution and a defense against predatory ideas, is the people's safeguard from being crushed by the irresistible car of progress. I repeat, standards may be set by the school which will reach and influence the community in a few months. Such standards should be a means of safeguarding the people, and this leads to the most important service which a teacher of domestic economy can render to the people in giving them a sense of control over their environment, than which nothing is so conducive to stability of ideas.
To feel one's self in command of a situation robs it of its terror. A great danger in America today is the loss of this feeling of self-confidence with which the pioneer was abundantly furnished. A certain helpless dependence is creeping over the land because of the peculiar development of resources, which must be replaced by a sense of power over one's environment.
There is no noble life without a noble aim.
The watchword of the future is the welfare and security of the child.
Love of home and of what the home stands for converts the drudgery of daily routine into a high order of social service.
The economy of right uses depends largely upon the home-maker, and brings the return in health, happiness, and efficiency.
 Motto, Mary Lowell Stone Home Economics Exhibit, Jamestown Exposition, 1907.
The child to be educated in the light of sanitary science. Office of the school. Domestic science for girls. Applied science. The duty of the higher education. Research needed.
No Christian and civilized community can afford to show a happy-go-lucky lack of concern for the youth of today; for, if so, the community will have to pay a terrible penalty of financial burden and social degradation in the tomorrow.
President Roosevelt, Message to Congress, December, 1904.
The loss of faith brings us by a short cut straight to the loss of purpose in life—of any purpose, at least, beyond purely material ones. To those who need money the duty of getting it first and above anything else becomes the gospel of life. To those who feel the need of position, whether in society, business, or elsewhere, their gospel drives them to all means within the law to attain that. To those who have both money and position comes the only remaining purpose in life—that of using them for an existence of amusement and enjoyment. Is it too much to say that never before in our history have such aspirations so completely dominated and limited such large classes?
What is the poor American to do in his present fever and with his present nerves, but with fivefold greater powers placed in his hands and fivefold greater attention and capacity demanded for their control? If sixty years ago the free forces and rushing advance of the republic urgently needed the regulation of a powerful and learned conservative body, who can overestimate the necessity for such service now?
When you ask how it is to be rendered, one cannot be mistaken in turning first to those priceless qualities in any sound national life whose tendency to decay we noted at the outset. Give back to us our faith. Give back to us a serious and worthy purpose. Restore sane views of life, of our own relations to it, and of our relations to those who share it with us.
Whitelaw Reid, Phi Beta Kappa address, 1903.
THE HOME AND THE SCHOOL
One must not displace the other, for one cannot replace the other, but rather the home and the school must react on each other. The home is the place in which to gain the experience, and the school the place in which to acquire the knowledge that shall illuminate and crystallize the experience. The child should go out to the school with enthusiasm, and return to the home filled with a deeper interest and desire to realize things.
In morals and manners the school can only give tendency or direction to the child's life. The school is not the best place to teach ethics. In the family life the child himself finds his future revealed, reflected by his relations to other members of the family. The spirit of cooperation nurtured there will develop in the school through the more various opportunities of relationship to others.
The earlier conditions cannot be restored, even the home training cannot be brought back, except on the farm, and there, it is hoped, it may be revived. The city or suburban children cannot have the opportunity to pick up chips when too young to bring in wood; cannot stand by and hold skeins of yarn, or go to the barn and help feed the calves—all most interesting and provocative of endless questions. They cannot go into the garden and pick berries or vegetables for dinner, cannot learn how to avoid breaking the vines, or how to judge the ripeness of the melons.
All that is probably not feasible for many, because it is not possible to give children of this age responsibility without oversight, and today's elders are loath to give and are often incapable of giving oversight.
But while these circumstances over which, apparently, we have no control, preclude much of the valuable outdoor work, food has still to be prepared, dishes need washing, and clothes must be mended, even if towels and napkins are no longer hemmed by hand. Rooms are still swept and dusted, beds are made, and chairs and tables put straight. Has any better means of giving experience ever been devised than these small, daily tasks which differentiate men from animals? The care of the fixed habitation, the foresight needed to prepare the things for the family life in the weeks and months to come, the cooperation of all the members of the family toward one common end—all tend toward high human ideals. If the wise mother only realized the value to the child of helping in such portions as are not too heavy, of being a part of the life, she would let nothing stand in the way of using this natural means of development. But with foreign domestics whose idea is to get the various duties over as soon as possible, and whose gift is not that of teaching, how is the child to grow into the normal ways of right daily living, unconsciously and effectively?
If the parents continue to throw all the work of education on the school, then the school must take the best means of fulfilling the task.
Not only has the home put the burden of education on the school, but the school has drawn the child away from the home. The school of today demands much more from him than the school of the early New England days. It has taken the time that was formerly given to assisting in the duties of the household; it has taken from the home the interest and responsibility that were developed through the cooperation in the family life. School has taken the place of home in the child's thoughts. In the morning the thought is of reaching school in time, not of the home duties whose performance could lighten many a mother's burden.