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Chapter 14 - From Fetich to Hygiene
The Triumph of Sanitary Science
But by those standing in the higher places of thought some
glimpses of scientific truth had already been obtained, and
attempts at compromise between theology and science in this field
began to be made, not only by ecclesiastics, but first of all, as
far back as the seventeenth century, by a man of science eminent
both for attainments and character - Robert Boyle. Inspired by the
discoveries in other fields, which had swept away so much of
theological thought, he could no longer resist the conviction
that some epidemics are due - in his own words - "to a tragical
concourse of natural causes"; but he argued that some of these
may be the result of Divine interpositions provoked by human
sins. As time went on, great difficulties showed themselves in
the way of this compromise - difficulties theological not less
than difficulties scientific.
To a Catholic it was more and more
hard to explain the theological grounds why so many orthodox
cities, firm in the faith, were punished, and so many heretical
cities spared; and why, in regions devoted to the Church, the
poorer people, whose faith in theological fetiches was
unquestioning, died in times of pestilence like flies, while
sceptics so frequently escaped. Difficulties of the same sort
beset devoted Protestants; they, too, might well ask why it was
that the devout peasantry in their humble cottages perished,
while so much larger a proportion of the more sceptical upper
classes were untouched. Gradually it dawned both upon Catholic
and Protestant countries that, if any sin be punished by
pestilence, it is the sin of filthiness; more and more it began
to be seen by thinking men of both religions that Wesley's great
dictum stated even less than the truth; that not only was
"cleanliness akin to godliness," but that, as a means of keeping
off pestilence, it was far superior to godliness as godliness was
then generally understood.
The recent history of sanitation in all civilized countries
shows triumphs which might well fill us with wonder, did there
not rise within us a far greater wonder that they were so long
delayed. Amazing is it to see how near the world has come again
and again to discovering the key to the cause and cure of
pestilence. It is now a matter of the simplest elementary
knowledge that some of the worst epidemics are conveyed in water.
But this fact seems to have been discovered many times in human
history. In the Peloponnesian war the Athenians asserted that
their enemies had poisoned their cisterns; in the Middle Ages the
people generally declared that the Jews had poisoned their wells;
and as late as the cholera of 1832 the Parisian mob insisted that
the water-carriers who distributed water for drinking purposes
from the Seine, polluted as it was by sewage, had poisoned it,
and in some cases murdered them on this charge: so far did this
feeling go that locked covers were sometimes placed upon the
water-buckets. Had not such men as Roger Bacon and his long line
of successors been thwarted by theological authority, - had not
such men as Thomas Aquinas, Vincent of Beauvais, and Albert the
Great been drawn or driven from the paths of science into the
dark, tortuous paths of theology, leading no whither, - the world
to-day, at the end of the nineteenth century, would have arrived
at the solution of great problems and the enjoyment of great
results which will only be reached at the end of the twentieth
century, and even in generations more remote. Diseases like
typhoid fever, influenza and pulmonary consumption, scarlet
fever, diphtheria, pneumonia, and la grippe, which now carry off
so many most precious lives, would have long since ceased to
scourge the world.
Still, there is one cause for satisfaction: the law
governing the relation of theology to disease is now well before
the world, and it is seen in the fact that, just in proportion as
the world progressed from the sway of Hippocrates to that of the
ages of faith, so it progressed in the frequency and severity of
great pestilences; and that, on the other hand, just in
proportion as the world has receded from that period when
theology was all-pervading and all-controlling, plague after
plague has disappeared, and those remaining have become less and
less frequent and virulent.
The recent history of hygiene in all countries shows a long
series of victories, and these may well be studied in Great
Britain and the United States. In the former, though there had
been many warnings from eminent physicians, and above all in the
seventeenth and eighteenth centuries, from men like Caius, Mead,
and Pringle, the result was far short of what might have been
gained; and it was only in the year 1838 that a systematic
sanitary effort was begun in England by the public authorities.
The state of things at that time, though by comparison with the
Middle Ages happy, was, by comparison with what has since been
gained, fearful: the death rate among all classes was high, but
among the poor it was ghastly. Out of seventy-seven thousand
paupers in London during the years 1837 and 1838, fourteen
thousand were suffering from fever, and of these nearly six
thousand from typhus. In many other parts of the British Islands
the sanitary condition was no better. A noble body of men
grappled with the problem, and in a few years one of these rose
above his fellows - the late Edwin Chadwick. The opposition to his
work was bitter, and, though many churchmen aided him, the
support given by theologians and ecclesiastics as a whole was
very far short of what it should have been. Too many of them were
occupied in that most costly and most worthless of all
processes, "the saving of souls" by the inculcation of dogma. Yet
some of the higher ecclesiastics and many of the lesser clergy
did much, sometimes risking their lives, and one of them, Sidney
Godolphin Osborne, deserves lasting memory for his struggle to
make known the sanitary wants of the peasantry.
Chadwick began to be widely known in 1848 as a member of the
Board of Health, and was driven out for a time for overzeal; but
from one point or another, during forty years, he fought the
opposition, developed the new work, and one of the best exhibits
of its results is shown in his address before the Sanitary
Conference at Brighton in 1888. From this and other perfectly
trustworthy sources some idea may be gained of the triumph of the
scientific over the theological method of dealing with disease,
whether epidemic or sporadic.
In the latter half of the seventeenth century the annual
mortality of London is estimated at not less than eighty in a
thousand; about the middle of this century it stood at
twenty-four in a thousand; in 1889 it stood at less than eighteen
in a thousand; and in many parts the most recent statistics show
that it has been brought down to fourteen or fifteen in a
thousand. A quarter of a century ago the death rate from disease
in the Royal Guards at London was twenty in a thousand; in 1888
it had been reduced to six in a thousand. In the army generally
it had been seventeen in a thousand, but it has been reduced
until it now stands at eight. In the old Indian army it had been
sixty-nine in a thousand, but of late it has been brought down
first to twenty, and finally to fourteen. Mr. Chadwick in his
speech proved that much more might be done, for he called
attention to the German army, where the death rate from disease
has been reduced to between five and six in a thousand. The
Public Health Act having been passed in 1875, the death rate in
England among men fell, between 1871 and 1880, more than four in
a thousand, and among women more than six in a thousand. In the
decade between 1851 and 1860 there died of diseases attributable
to defective drainage and impure water over four thousand persons
in every million throughout England: these numbers have declined
until in 1888 there died less than two thousand in every million.
The most striking diminution of the deaths from such causes was
found in 1891, in the case of typhoid fever, that diminution
being fifty per cent. As to the scourge which, next to plagues
like the Black Death, was formerly the most dreaded - smallpox - there
died of it in London during the year 1890 just one person. Drainage
in Bristol reduced the death rate by consumption from 4.4 to 2.3; at
Cardiff, from 3.47 to 2.31; and in all England and Wales, from 2.68
in 1851 to 1.55 in 1888.
What can be accomplished by better sanitation is also seen
to-day by a comparison between the death rate among the children
outside and inside the charity schools. The death rate among
those outside in 1881 was twelve in a thousand; while inside,
where the children were under sanitary regulations maintained by
competent authorities, it has been brought down first to eight,
then to four, and finally to less than three in a thousand.
In view of statistics like these, it becomes clear that
Edwin Chadwick and his compeers among the sanitary authorities
have in half a century done far more to reduce the rate of
disease and death than has been done in fifteen hundred years by
all the fetiches which theological reasoning could devise or
ecclesiastical power enforce.
Not less striking has been the history of hygiene in France:
thanks to the decline of theological control over the
universities, to the abolition of monasteries, and to such
labours in hygienic research and improvement as those of Tardieu,
Levy, and Bouchardat, a wondrous change has been wrought in
public health. Statistics carefully kept show that the mean
length of human life has been remarkably increased. In the
eighteenth century it was but twenty-three years; from 1825 to
1830 it was thirty-two years and eight months; and since 1864,
thirty-seven years and six months.
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