Hygeia, a City of Health

Part 1

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HYGEIA A CITY OF HEALTH

BENJAMIN WARD RICHARDSON M.D., F.R.S.

1876

TO EDWIN CHADWICK, C.B.

MY DEAR MR. CHADWICK,

_I wrote this Address with the intention of dedicating it to you, as a simple but hearty acknowledgment by a sanitary student, himself well ripened in the work, of your pre-eminent position as the living leader of the sanitary reformation of this century.

The favour the Address has received indicates notably two facts: the advance of public opinion on the subject of public health, and the remarkable value and influence of your services as the sanitary statesman by whom that opinion has been so wisely formed and directed.

In this sense of my respect for you, and of my gratitude, pray accept this trifling recognition, and believe me to be,

Ever faithfully yours_,

B.W. RICHARDSON.

PREFATORY NOTE.

The immediate success of this Address caused me to lay it aside for some months, to see if the favour with which it was received would remain. I am satisfied to find that the good fortune which originally attended the effort holds on, and that in publishing it now in a separate form I am acting in obedience to a generally expressed desire.

Since the delivery of the Address before the Health Department of the Social Science Congress, over which I had the honour to preside, at Brighton, in October last, every day has brought some new suggestion bearing on the subjects discussed, and the temptation has been great to add new matter, or even to recast the essay and bring it out as a more compendious work. On reflection I prefer to let it take its place in literature, in the first instance, in its original and simple dress.

12 HINDE STREET, W.: August 18, 1876.

HYGEIA, A CITY OF HEALTH

We meet in this Assembly, a voluntary Parliament of men and women, to study together and to exchange knowledge and thought on works of every-day life and usefulness. Our object, to make the present existence better and happier; to inquire, in this particular section of our Congress:--What are the conditions which lead to the pain and penalty of disease; what the means for the removal of those conditions when they are discovered? What are the most ready and convincing methods of making known to the uninformed the facts: that many of the conditions are under our control; that neither mental serenity nor mental development can exist with an unhealthy animal organisation; that poverty is the shadow of disease, and wealth the shadow of health?

These objects relate to ourselves, to our own reliefs from suffering, to our own happiness, to our own riches. We have, I trust and believe, yet another object, one that relates not to ourselves, but to those who have yet to be; those to whom we may become known, but whom we can never know, who are the ourselves, unseen to ourselves, continuing our mission.

We are privileged more than any who have as yet lived on this planet in being able to foresee, and in some measure estimate, the results of our wealth of labour as it may be possibly extended over and through the unborn. A few scholars of the past, like him who, writing to the close of his mortal day, sang himself to his immortal rest with the 'Gloria in excelsis,' a few scholars might foresee, even as that Baeda did, that their living actual work was but the beginning of their triumphant course through the ages,--the momentum. But the masses of the nations, crude and selfish, have had no such prescience, no such intent. 'Let us eat and drink, for to-morrow we die!' That has been the pass, if not the password, with them and theirs.

We, scholars of modern thought, have the broader, and therefore more solemn and obligatory knowledge, that however many to-morrows may come, and whatever fate they may bring, we never die; that, strictly speaking, no one yet who has lived has ever died; that for good or for evil our every change from potentiality into motion is carried on beyond our own apparent transitoriness; that we are the waves of the ocean of life, communicating motion to the expanse before us, and leaving the history we have made on the shore behind.

Thus we are led to feel this greater object: that to whatever extent we, by our exertions, confer benefits on those who live, we extend the advantage to those who have to live; that one good thought leading to practical useful action from one man or woman, may go to the virtue of thousands of generations; that one breath of health wafted by our breath may, in the aggregate of life saved by it, represent in its ultimate effect all the life that now is or has been.

At the close of a Parliamentary session, an uneventful leader of a section of Parliament banters his more eventful rival, and enlivening his criticism by a sneer at our Congress, challenges the contempt of his rival, as if to draw it forth in the same critical direction. Alas! it is too true that great congresses, like great men, and even like Parliaments, do live sometimes for many years and talk much, and seem to miss much and advance little; so that in what relates to the mere present it were wrong, possibly, to challenge the sally of the statesman who, from his own helpless height, looked down on our weakness. But inasmuch as no man knoweth the end of the spoken word, as that which is spoken to-day, earnestly and simply, may not reappear for years, and may then appear with force and quality of hidden virtue, there is reason for our uniting together beyond the proof of necessity which is given in the fact of our existence. Perchance some day our natural learning, gathered in our varied walks of life, and submitted in open council, may survive even Parliamentary strife; perchance our resolutions, though no sign-manual immediately grace them, are the informal bills which ministers and oppositions shall one day discuss, Parliaments pass, royal hands sign, and the fixed administrators of the will of the nation duly administer.

These thoughts on the future, rather than on the passing influence of our congressional work, have led me to the simple design of the address which, as President of this Section, I venture to submit to you to-day. It is my object to put forward a theoretical outline of a community so circumstanced and so maintained by the exercise of its own freewill, guided by scientific knowledge, that in it the perfection of sanitary results will be approached, if not actually realised, in the co-existence of the lowest possible general mortality with the highest possible individual longevity. I shall try to show a working community in which death,--if I may apply so common and expressive a phrase on so solemn a subject,--is kept as nearly as possible in its proper or natural place in the scheme of life.

HEALTH AND CIVILISATION.

Before I proceed to this task, it is right I should ask of the past what hope there is of any such advancement of human progress. For, as my Lord of Verulam quaintly teaches, 'the past ever deserves that men should stand upon it for awhile to see which way they should go, but when they have made up their minds they should hesitate no longer, but proceed with cheerfulness,' For a moment, then, we will stand on the past.

From this vantage-ground we gather the fact, that onward with the simple progress of true civilisation the value of life has increased. Ere yet the words 'Sanitary Science' had been written; ere yet the heralds of that science (some of whom, in the persons of our illustrious colleagues, Edwin Chadwick and William Fair, are with us in this place at this moment), ere yet these heralds had summoned the world to answer for its profligacy of life, the health and strength of mankind was undergoing improvement. One or two striking facts must be sufficient in the brief space at my disposal to demonstrate this truth. In England, from 1790 to 1810, Heberden calculated that the general mortality diminished one-fourth. In France, during the same period, the same favourable returns were made. The deaths in France, Berard calculated, were 1 in 30 in the year 1780, and during the eight years, from 1817 to 1828, 1 in 40, or a fourth less. In 1780, out of 100 new-born infants, in France, 50 died in the two first years; in the later period, extending from the time of the census that was taken in 1817 to 1827, only 38 of the same age died, an augmentation of infant life equal to 25 per cent. In 1780 as many as 55 per cent. died before reaching the age of ten years; in the later period 43, or about a fifth less. In 1780 only 21 persons per cent. attained the age of 50 years; in the later period 32, or eleven more, reached that term. In 1780 but 15 persons per cent, arrived at 60 years; in the later period 24 arrived at that age.

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