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diff --git a/31508.txt b/31508.txt new file mode 100644 index 0000000..c07f37e --- /dev/null +++ b/31508.txt @@ -0,0 +1,4132 @@ +The Project Gutenberg EBook of Euthenics, the science of controllable +environment, by Ellen H. Richards + +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at www.gutenberg.org + + +Title: Euthenics, the science of controllable environment + a plea for better living conditions as a first step toward + higher human efficiency + +Author: Ellen H. Richards + +Release Date: March 5, 2010 [EBook #31508] + +Language: English + +Character set encoding: ASCII + +*** START OF THIS PROJECT GUTENBERG EBOOK EUTHENICS *** + + + + +Produced by Barbara Tozier, Bill Tozier, Irma Spehar and +the Online Distributed Proofreading Team at +https://www.pgdp.net + + + + + + + + EUTHENICS + + 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. + + + SECOND EDITION + + + WHITCOMB & BARROWS + BOSTON, 1912 + + + COPYRIGHT 1910 + BY ELLEN H. RICHARDS + + THOMAS TODD CO., PRINTERS + 14 BEACON ST., BOSTON + + + + +FOREWORD + + 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.[1] + + [1] 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."[2] + + [2] 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. + + + + +EUTHENICS + +BETTER ENVIRONMENT FOR THE HUMAN RACE + + + + +CONTENTS + + PAGE + +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 + + + + +CHAPTER I + + _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._ + + + + +CHAPTER I + + 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."[3] + + [3] 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."[4] + + [4] 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."[5] + + [5] 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. + + + + +CHAPTER II + + _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. + + _Carl Kelsey._ + + + 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._ + + + + +CHAPTER II + +FAITH + + +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." + + + + +CHAPTER 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._ + + + 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. + + _Alice Ravenhill._ + + + 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._ + + + + +CHAPTER III + +HOPE + + +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."[6] + + [6] 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[7] 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. + + [7] 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. + + + + +CHAPTER IV + + _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._ + + + + +CHAPTER IV + +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."[8] + + [8] 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.[9] + + [9] 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."[10] + + [10] 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. + + + + +CHAPTER V + + _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._ + + + + +CHAPTER V + +RESPONSIBILITY + + +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."[11] + + [11] 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[12]: "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." + + [12] 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."[13] + + [13] 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. + + + _Home Ideals_ + + 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.[14] + + [14] Motto, Mary Lowell Stone Home Economics Exhibit, + Jamestown Exposition, 1907. + + + + +CHAPTER 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._ + + + 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._ + + + + +CHAPTER VI + +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. + +The school, hurried with a curriculum that is wasteful of time and +energy, lacking correlation in the studies (except in a few schools +that are noted exceptions proving the rule), has little time to relate +its work to the home as the kindergarten does in its morning talk; so +there must come an intermediate step in order that the school may +emphasize the home life and industries, and that a generation may grow +up who shall have a knowledge of the daily needs of life. + +The interest awakened in the school will surely react upon the home. +It is like an expedition going out to make discoveries and to bring +back knowledge to its own land. The directive work of the school will +thus become a practical realization in the home. Then the cycle will +be complete, for while the school has separated the child from his +natural environment for many hours and weeks, it is sending him back +better equipped through knowledge and experience to fulfill his place +there. + +How shall the ends be gained artificially by devices of the school? +For gained they must be, if civilization is to be maintained. + +To quote from Isabel Bevier: + +"As the home is so inseparably connected with the house, and our +comfort and efficiency are so greatly influenced by the kind of houses +in which we live, much of interest and importance centers in the study +of the house." + +Moreover, with the house, its evolution, decoration, and care, may be +associated much that is interesting in history, art, and +architecture, as well as much that has a direct bearing on the daily +life of the individual. + +The philosophers have struggled for centuries, each contributing +according to his experience and vision to determine what is the +purpose of life. America's thought could be translated into the word +efficiency. Yes, we might almost say she worships efficiency. If, +then, efficiency is to be the goal, what are the means to develop it? +Efficiency depends chiefly upon good health, and to maintain this we +must first consider in the scheme of education the physical +aids--food, air, water, clothing and shelter, exercise and rest--and +with this goal in view must come also recreation, play or amusement, +and beauty to develop the mental and the spiritual. In relating our +scheme of work to this ideal we will consider first the shelter. + +The children of ten or twelve years of age have passed the +"make-believe" stage of play; they want the "real," but of their own +kind and age. After little children have made and played with toys and +foreshadowed the needs of the actual home, the time has come for the +youth to have his demands, which are not yet the demands of man and +manhood. + +At the Tuberculosis Congress, held in Washington in 1908, a sanatorium +in England, which won a prize, presented among many good features a +system of graded work with graded tools, almost childlike implements +for the weak and unskilled, gradually advancing toward the normal as +the strength and health of the man grew. So it should be with the +material we should give to the children. + +After the toy age a house about two-thirds the ordinary sized house +may be constructed. A room seven feet square is very livable for a +child. Three rooms is a very good working plant--the kitchen and the +bedroom, the dining and living room combined. Both boys and girls may +cooperate in planning, building, and furnishing this home. + +The plan of a modern house may be drawn, basing it on the knowledge of +house architecture through history, of the modification necessary to +site through geography, and the knowledge that science has brought of +drainage, ventilation, and construction. The house could be built by +the manual training class, or if that is not feasible it may be built +by one of the firms making portable houses. At all events, it can be +painted by the children, and this will lead to lessons on color, the +use of paint and its composition. + +While the "shelter" is being constructed the child must be considering +at the same time the principles of caring for the home, for this would +naturally influence the thought of furnishing. The simply furnished +home means less physical exertion, but not less beauty. The home +planned and executed on scientific principles of hygiene and +sanitation means a healthful home, a much cleaner home. + +The shelter of the individual has been considered; now comes the +immediate protection of the child--its clothing. It would not be quite +practical in this little home to enter into the personal activities of +bathing and dressing. A very large doll, approximating the child, may +be used, one large enough so that it can wear boots, stockings, etc., +that are usually bought for the real child. Here can be taught also +the lesson in wise spending. + +The right care of the body must be included among the necessities of +education. The teaching of the principles of hygiene should be closely +related to the lives of the children. Correct habits, not rules, are +the proper prevention for all sorts of defects. To secure and maintain +a healthy body, habits of cleanliness and enthusiasm for health must +be inculcated. Such habits can be readily impressed on the body while +it is plastic--that is, while it is young; but they are acquired only +with difficulty and by much thought in after years. Hence there is the +greatest economy of time and energy in accustoming young people to +habits of daily living which will give them the best chance in after +life--the chance to be "healthy, happy, efficient human beings." Most +of the teaching must be by indirect methods--illustrations--and so the +doll may be used again to demonstrate and relate facts about the daily +life. + +An old Scotch writer once said, "He that would be good must be happy, +and he that would be happy must be healthy." As has already been said, +the great increase of disease from causes under individual control, +such as that which is brought on by errors of diet, points to a need +for a more general education in this respect. The food problem is +fundamental to the welfare of the race. Society, to protect itself, +must take cognizance of the questions of food and nutrition. It is +necessary to give the child the right ideas on these subjects, for +only then will there be sufficient effort to get the right kind of +food and to have it clean. Right living goes further and demands the +right manner of serving and eating the food. The home table should be +the school of good manners and of good food habits of which the child +ought not to be deprived. + +If all the foregoing principles have been developed, if the child has +been led to see the joy of living through these home activities, he +will consider the home the true shelter, the place where he can have +the happiest play, the easiest rest, where he can study most +earnestly, and express himself most honestly. + +And the parents, the fathers and mothers of children of the city? How +far are we helping the city dwellers to take advantage of city life? +The principles back of housekeeping are the same, the end the +same--what are to be the means to stimulate the modern home-maker? +Show the possibilities within reach of them; send the children home +with ideas which the mother must consider. + +Education in pursuing the so-called "humanities" has been holding up +to view a hypothetical man in a hypothetical environment. + +The pursuit of gold has not been hindered thereby, and has gone on +without the restraints of education because of the complete detachment +of ideals inculcated from the actual daily life where money meant +personal pleasure and comfort for the time being. + +The power over things gained by a few students was utilized by money +power to hasten all progress. Speed was the watchword. No one could +stop to see what injury he had caused. "Get there," really seemed to +be the motto. In this scramble for power the "purpose" for which life +is lived has been lost sight of. No "worthy aim" has been impressed on +the mind of the child. + +An awakening has come and the school is the leading factor in the +upward movement. Education is coming to have a new meaning, or better, +perhaps, is going back to the older meaning with new materials. No +knowledge or power the youth may acquire will avail in real struggle +for existence of the race without a definite aim to hold steady the +eye fixed on a certain goal. This is a law of man's existence. + +The change in point of view has been growing like a root underground. +It seems to have suddenly sent up shoots in every direction. In no +line of thought has this change come more generally than in relation +to the things youth should be taught. Himself and his relation to his +environment are now to the front. Instead of extolling man as the lord +of all created things, the youth is made to see that man unaided by +scientific knowledge is at the mercy of Nature's forces; that man in +crowds is sure to succumb unless he makes a strong effort to keep +himself erect. + +Hence the boys are given manual training--power over wood and stone, +steam and electricity; and are taught the principles of production of +food and metals. The girls are being taught to distinguish values in +textiles and food stuffs; to manage finances and to keep houses in a +sanitary manner. + +It is the business of the higher education at once to apply the +knowledge of preventive measures to its own students and through them +to reach the people, but it has been very slow to take up the cause of +better environment. + +In colleges there is still more emphasis laid on external works, such +as water supply, drainage, etc., than on the more intimate hourly +needs of fresh air and clean rooms. The halls, study rooms, and dining +rooms of colleges are notoriously ill ventilated and not over clean. + +The senses are blunted at an age when they should be keenly +sensitive. It is only within ten years or so that very many of the +higher schools have made a point of indoor sanitation beyond plumbing +provisions. Outdoor sports have been relied upon to give sufficient +impetus to the health side of education. + +A new element has come into the State universities through the Home +Economics courses, which have been steadily growing in favor during +the last two decades. Within that time several buildings have been +erected and equipped to teach the principles of sanitary and economic +living both in institution, school, and family life. + +Probably no one movement has been so powerful as this in convincing +educators of the efficiency of trained women as factors in sanitary +progress. In no other direction is the outlook for social service +greater. The woman must, however, be more than a willing worker; she +must be educated in science as a foundation for sanitary work. + +Within the next few years the demand for trained women is sure far to +exceed the supply, for the fundamental sciences are not to be acquired +in one or two years. + +Young college women are even now realizing their mistake in neglecting +the sciences. They assumed that science was not of practical use. They +assumed that educational curricula were stable and would go on in the +same lines forever. + +The high school is now fully awake to these vital factors. Some of the +best buildings in the United States are the high school buildings, +those of the West excelling those of the East. By 1911 nearly every +school will have a course in Sanitary Science. It may be under the +name of Home Economics, or of Camp Cookery, or of House Building, but +the idea of better physical environment has already taken root. In the +extension of school work by the employment of the school visitor to +supplement the work of the teacher in the grade schools, in Parents' +Associations, in Mothers' Clubs, in social endeavors on every side, +there is coming the study of more special branches of sanitary +science, clean air, clean floors, clean clothes--where once cooking +lessons were the extent to which the workers could lead. + +Evolution has at last been accepted as applying to man as well as to +animals. In his inaugural address, November, 1909, President H. J. +Waters, of Kansas Agricultural College, said: "... for every dollar +that goes into the fitting of a show herd of cattle or hogs, or into +experiments in feeding domestic animals, there should be a like sum +available for fundamental research in feeding men for the greatest +efficiency.... We have millions for research in the realm of domestic +animals and nothing for the application of science to the rearing of +children." + +Evidence is not wanting that all this is to be speedily changed. Man +has awakened to the fact that he is "the sickest beast alive" and that +he has himself to blame, and, moreover, that it is within his power to +change his condition and that speedily. + +After all, human life and effort are governed largely by the conscious +or unconscious value put upon the varied elements that go to make up +the daily round. + +It seems to be a universal law that effort must precede satisfaction, +from the infant feeding to the man building up a successful business. +The satisfaction grows in a measure as the effort was a prolonged or +sustained one. + +Well-being is a product of effort and resulting satisfaction. The +child without interest in work or play does not develop; the man with +no stimulus walks through life as in a dream. + +The first steps in "civilizing" (?) a nation or tribe are to suggest +_wants_--things to strive for. Struggle, with all its attendant evils, +seems the lever that moves the world. It is therefore in line that +health, and whatever favors it, is to be gained at the expense of +struggle. The one necessary element is that men should value it enough +to struggle for it. + +Sanitary science above all others, when applied, benefits the whole +people, raises the level of productive life. + +In the rapid development of our civilization, the laboratory, the +shop, the school can be the quickest mediums of suggesting wants. + +In an earlier chapter, the indifference to clean conditions, the +ignorance of the means of obtaining pure food and clean air, were +dwelt upon, and still later the need of _will_ to choose the right +thing. + +Now we should consider the means of stimulating that choice. So far it +has been chiefly exploitation for the personal gain of the +manufacturer, who has persuaded the people to buy his product +regardless of its economic or hygienic effect. Thrift has been +undermined most subtly. + +"That's the secret of the whole situation we're talking about; it's +easier to buy a new shirt than to take care of the one you've +got."[15] + + [15] Meredith Nicholson, Lords of High Decision, p. 133. + +All sense of values has been lost, so that with no sound basis choice +is apt to be unwise, unsatisfactory, and is gradually dropped, while +the individual drifts. + +No more effective agent for the dissemination of knowledge was ever +devised than the American Public School. If only it would live up to +its opportunities, its teachers could bring to its millions of +receptive minds the best practice in daily living (never mind the +theory for the children), and through the children reach the home, +where the infants may be saved from the risks that the elders have +run. + +To be effective, however, school conditions should be satisfactory, +and teachers should be familiar with the best ways of living, or at +least in active sympathy with the medical inspector and the school +nurse. + +No more revolting revelations have ever been made than those usually +locked in the hearts of these faithful servants of the people. How +they can have courage to go on in face of parental and community +indifference is a marvel. We shall consider in the next chapter how +the average parent is to be aroused. + +But the leaders in educational and scientific thought--what of them? +The school is the pride of the community and measures the progress of +the community toward ideals. Alas, how is pride laid low in most +public school buildings in the inability of most of the teachers to +see the relations between mental stupidity and bad air. + +The awakening has begun, however, and thousands of teachers have +responded and are urging authorities to burn more coal, to employ more +help, to keep the house clean, to make it more beautiful, to make the +curriculum more helpful, to make provision for good food to be +purchased, and the hundred ways in which the school may be the most +powerful civilizing factor the nation has. _But civilization must not +spell disease and ruin._ + +The economic factor must not be lost sight of. To tell the boy and +girl that they are as good as any does not give them the right to the +most expensive food and clothing they see. How shall they choose +wisely in the multitude of new things? They wish the best, naturally, +and all America is honeycombed with the wrong idea that the best costs +the most. An Alaska Indian came into the store in Juneau one day to +buy some canned peas. The storekeeper said, "I am out of the brand you +want." "No peas?" asked the Indian. "No, only some small cans of +French peas at forty cents a can. You don't want those." "Why not? Me +want the best." + +The schools of domestic economy, the classes in all grade schools, +will have to attack and conquer these prejudices as to values, or, +rather, will need to substitute right estimates of value before our +people will choose wisely in distributing their income, for that is +what right living means. The division of the income according to the +necessities of health and efficiency, not according to whim or selfish +desire, is sometimes estimated as + + 20 to 25 per cent for rent + 25 to 30 per cent for food + 10 to 15 per cent for clothing + +This leaves only forty-five or thirty per cent for other things, and +the pennies must be carefully counted to cover fuel, light, +amusements, education, books, insurance, or investments. Something +that the family would like must be left out--no matter what, providing +only it does not injure their efficiency as wage-earners, as +comfortable human beings. + +The sensation of comfort or satisfaction is so completely a psychic +factor that the school training has a great chance to affect after +life. The child can acquire the habit of being more comfortable in +plain, washable, clean clothes, with clean hands, than in dirty, +ragged furbelows. This habit once thoroughly acquired is not likely to +be quickly lost. Provision for clean hands is a necessity in school, +and ways of making a small amount of soap and water serve may also be +taught. All the while, care is to be taken not to introduce +unnecessarily expensive materials or to inculcate over-refined +notions. + +Sound instruction as to dangers of transference of saliva, of nose +discharge, etc., can be given without also giving the despair of +impossible achievement. + +The teaching in the classes must have this practical bearing on daily +life. It is insisted on here because unclean hands are the chief +source of infectious disease. + +Instead of blaming water supplies, dusty streets, or even contagion by +the breath, sanitarians are everywhere putting emphasis upon the +actual contact of moist mucus with milk and other food, in preparation +or in serving. It is not a supercilious notion to examine tumblers +for finger marks, or to object to the habit of wetting the finger with +saliva in turning leaves of books. These little unclean acts are the +unconscious habits that cling to a person in spite of education from +reading. The greatest service to be done today in improving the health +of the community is in the application of the principles which may be +summed up in the phrases--fresh air all the twenty-four hours, clean +hands the livelong day, the free use of the handkerchief to protect +from contamination of mouth and nose. + +All these small personal habits should be taught in the earliest +months of life, _i. e._, in the home; but if the child reaches school +untaught, then in defense of the whole community the school must +insist upon teaching them. + + + + +CHAPTER VII + + _Stimulative education for adults. Books, newspapers, + lectures, working models, museums, exhibits, moving + pictures._ + + + The efficient sanitarian is not so great when he conquers a + raging epidemic as when he prevents an epidemic that might + have raged but for his preventive care, and for this result + his most continuous and effectual work is to + educate--educate--educate. + + _Wm. H. Brewer, New Haven Health Association, 1905._ + + + The essential fact in man's history to my sense is the slow + unfolding of a sense of community with his kind, of the + possibilities of cooperation leading to scarce-dreamt-of + collective powers, of a synthesis of the species, of the + development of a common general idea, a common general + purpose out of a present confusion. + + _H. G. Wells, First and Last Things._ + + + The great mass of the population is, indeed, at the present + time like clay which has hitherto been a mere deadening + influence underneath, but which this educational process, + like some drying and heating influence upon that clay, is + rendering resonant. + + _H. G. Wells, New Worlds for Old._ + + + + +CHAPTER VII + + In a store an advertisement reads: "Any kind of tea you + prefer; no charge whatever." + + She: "The women look so tired when they come in, and in ten + minutes they are so rested and refreshed." + + He: "Ready to go home?" + + She: "Why, no--ready to do some more shopping." + + _Spectator, The Outlook, December 18, 1909._ + + +Something in motion and something to eat attract the crowd. + +The social worker is just beginning to realize what the manufacturer +and the department storekeeper have long since found out. + +Why is it not legitimate to "attract a crowd," to do them a good +service in showing them how to save money as well as in impelling them +to spend it? It is wiser to _show how_ before explaining why. + +The force of example, the power of suggestion, should be used fully +before coercion is applied. Exhibits and models come before law. + +The psychology of influence is an interesting study (see +Muensterberg's article, _McClure's_, November, 1909). Its principles +have been grasped and used by those who exploit human feelings for +their own gain. The student of social conditions should make a wider +and better use of a real force. + +Publicity is perhaps first. Exhibits showing existing conditions often +shock people into attention, for it is inattention more than anything +else that prevent betterment. + +It is said that "a knowledge of danger is the surest means of guarding +against it," but this knowledge must be translated into belief and the +danger be brought home to the individual as a member of the community. + +Exhibits may often suggest for existing evils simple remedies never +thought of before. They should never suggest the one idea without the +other. Even though the remedy is not worked out, it should be called +for. America's inventive power may well be turned on its own social +affairs as well as on adaptation of European machinery. + +The man considered in these pages is the man in community environment, +and the discussion is as to what controls this community life. It will +be acknowledged by all thoughtful persons that the prime control lies +in the purpose for which the community exists. If for selfish gain, +then all is sacrificed to that end. Men and women become mere machines +and children are only in the way until they, too, may be put into the +service. + +If it exists for mutual help and general advance in civilization, then +the leaders in the community take into account the elements that +contribute to the future as well as those for the immediate present. + +In the confusion of ideas resulting from the rapid, almost cancerous +growth of the modern community, made possible by mechanical invention, +the people have lost the power of visualizing their conception of +right and wrong, a power which made the Puritan such a force in early +colonial times. Heaven and hell were very real to him and were +powerful factors in influencing his daily life. The average man today +has no such spur to good behavior. Perhaps the sword of Damocles must +be visualized by such exhibits as the going out of an electric light +every time a man dies, by the ghastly microbe in the moving picture, +by the highly colored print or by a vivid reproduction of crowded +quarters. The social worker has been doubtful of the real value of +such exhibits, but such reminders have their place in a community +accustomed to the advertising of less worthy subjects. + +A decided recognition of the value of exhibits is found in the +advertisement of a company: "We design and equip Exhibits on +Tuberculosis, Milk, Civic Betterment, Dental Hygiene, Saner Fourth of +July. Have you our catalogue?" Much of our educational work for the +dissemination of useful knowledge would gain in power and directness +from an adaptation of the methods of the man skilled in promoting +commercial interests. He knows how to apply the right stimulus at the +right time in order to arouse the desired interest. + +In many ways the adult is but the child of a larger growth, who needs +something concrete to make him understand. And so have grown up the +great industrial fairs and exhibitions. One comes away from these +wondering that so much, both good and bad, is being prepared for him, +and stimulated, usually, to work out certain suggestions and better +many of the present conditions. Both the manufacturer and the consumer +have been helped. + +Wherever it is possible, a working model illustrating the chief +features to be explained should be installed. The expense of this kind +of exhibit has in the past been prohibitive, and moreover the use of +such "claptrap" has been frowned upon; but scientific knowledge is no +longer to be held within the aristocratic circle of the university. It +is to be brought within the reach of the man in the street, and to +make up for the wasted years of seclusion experts now vie with each +other in putting cause and effect not merely into words but into +pictures, and even into motion pictures. The fly as a carrier of +disease is now shown in all its busy and disgusting activity. The +lesson of awakened attention by such means is being learned, and soon +lessons in botany, in gardening, in housewifery, will be given through +the eye, to be the better followed by the hand. + +Of all means, that product of man's ingenuity, the moving picture, is +destined to play the greatest part in quick education. It is the +quintessence of democracy. + +The extension movement in education is an evidence of a new social +ideal. It is a true expression of democracy that the university and +school can be utilized by the busy working people. Museums that at one +time were only for the educated who by previous training could +understand them now assume as a privilege the educating of all the +people. Schools of art and science, also, through lectures, bulletins, +guides, and special exhibits, extend a generous welcome to the public. + +The citizens ought to be a gladder, sadder people, stirred and +delighted and grateful for much that the city affords; sad and shocked +by some of the forbidding, existing conditions. That is the power of +an exhibit, so to visualize a condition that the mind really +conceives it, never again to recover from the shock, to be unmindful +of such possibilities of degraded existence for human beings. + +The influence of these great expositions is of a most subtle kind, not +often to be traced, but there is a noticeable change in the estimation +in which Home Economics is held dating from the time of the Mary +Lowell Stone Home Economics Exhibit held at the Exposition in St. +Louis in 1905. This illustrated the application of modern knowledge to +home life, chiefly in economic and aesthetic lines, all bearing upon +the health and efficiency of the people. The Chicago Exposition in +1893 had its Rumford Kitchen, an exhibit under the auspices of the +State of Massachusetts. This practical illustration of scientific +principles modified the ideas of the world as to the place and +importance of cookery in education. Indeed, there seemed a distinct +danger that other lines would be neglected, so that when the +Exposition at St. Louis was determined upon this legacy of fifteen +years before was drawn upon to show the wide scope of the subject as +it had been developed. + +Boards of Health might pave the way for a better understanding of +their rules and regulations if they would have temporary exhibits in +public places of some of the conditions known to them but unsuspected +by the average citizen and taxpayer. + +Traveling exhibits may show local and temporary conditions and may +call attention to needs demanding immediate remedy--with the remedy +suggested. + +Permanent exhibits in museums should, on the other hand, teach a +deeper lesson. They should always be constructive and should be +replaced when the conditions have changed. The modern idea of a museum +is a series of adjustable exhibits with distinct suggestive purpose. +Such are found in the Town Room, 3 Joy Street, Boston, the Social +Museum, Harvard College, the American Museum of Safety, and the +Sanitary Science Section, American Museum of Natural History, New +York. + +The distribution of the printed word has become so universal that it +would seem as if every family might be influenced by it; but the +scientific title, or the size of the book, or the scientific terms +seem forbidding, and so the whole question is thrust aside. + +In the past, newspaper science was largely discounted as sensational +and only one-tenth fact. Scientific workers were largely to blame for +this. They could not take the time to explain the meaning of their +work, and the few things they were ready to say were worked over out +of all semblance to truth by the writer who must have a "story" and +who had not the training in "suspension of judgment" which the +scientific investigator knows to be necessary. + +There is no concern of human life that cannot be made interesting, and +the magazine writers of today understand that art. Read the newspaper +and the world is yours. It is all things to all men. The popularizing +of knowledge is now proceeding on somewhat better lines. +Intermediaries between the laboratory and the people are springing up +to interpret the one to the other. This work is good or bad according +to the individual writer. Most of it is still too superficial. Here is +one of the most fertile fields for the educated woman, since the +evils of which we complain have to do so intimately with woman's +province, the home and the school. There is hope that the trained, +scientific woman will take her place as interpreter. Her practical +sense will give her an advantage over the young man who has never +known other home than a boarding house. + +But the expert knows that the man of "practical affairs" wants and +needs certain knowledge, and so seeks another way. Our Federal +government, through the departments of Agriculture and Education; the +State Boards of Health; the educational institutions, have with care +and accuracy formulated this knowledge and are sending to the people, +in the form of bulletins meeting their interest and requirements, +knowledge in concise and readable form, and so most valuable. More +than five hundred thousand copies of Miss Maria Parloa's bulletin on +Preserving have been distributed by the Department of Agriculture. + +These efforts by both men and women have meant independent scientific +research, which is often the only available knowledge for the +housekeeper. It is bringing to them in their "business" of life the +same help that the men on the farm and elsewhere are receiving in +theirs. + +But the written word, however clearly put, can never reach the +untrained as can the voice and personality of an earnest speaker with +a compelling vitality. Lectures by those who have been engaged in +research themselves, so that they have absorbed the spirit of the +laboratory--not by those who have merely smelled the odors of the +waste jars--are ten times more valuable than even the most +attractively illustrated articles. It is well that the personality of +the human being is an asset, and that there is a stimulus in hearing +and seeing the person who has accomplished things. There is always a +power in the spoken word. The government, with its public lectures, +recognizes this as well as the private organization, and today +ignorance is necessarily due only to indifference. + +Illustrated lectures followed by literature are of inestimable value +if rightly and not sensationally given. Even then, the seed must have +time to sprout. + +Man has reached his present stage of civilization, however we regard +it, by an incessant warfare against adverse conditions. Enemies, man +and beast, surrounded him; mountains and rivers obstructed his +passage; fire and flood swept away his dwellings; but ever onward the +inward impulse has carried him. + +It is interesting to see how the same vocabulary is transferred to the +warfare for social betterment, "campaign," "warfare," "battle," +"fight," "weapon," "corps," "army." And the fight to be won can only +come through knowledge, its dissemination and then its application. + +Publicity today means cooperation and democracy--all to help, all to +be helped. + +All the foregoing methods should be used in these campaigns for +health, with the dictum, "Man, know thyself." + + + + +CHAPTER 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._ + + + The strength of the State is the sum of all the effective + people. + + _Dr. Edward Jarvis, Massachusetts State Board of Health, 1874._ + + + When the Americans took charge of Bilibid Prison in Manila + the death rate was 238 per 1,000 per year: by improving + sanitary conditions, this death rate was reduced to about 75 + per 1,000: here it remained stationary until it was + discovered that a very high percentage of the prisoners were + infected with hookworms and other intestinal parasites: then + a systematic campaign was inaugurated to expel these worms, + and when this was done the death rate fell to 13.5 per 1,000. + + _C. W. Stiles._ + + + So the duties and responsibilities of a Health Department + are not only changed, but they are very greatly increased + and are constantly increasing. And on broad lines to cause + the citizen to do the things he can and ought to do, and + then to do for him the things that he cannot do, but which + should be done, is the duty of the State, and that, being + interpreted, means the real prevention of disease. + + _Eugene H. Porter, Report, New York State Department of + Health, 1909._ + + + The whole difference of modern scientific research from that + of the Middle Ages, the secret of its immense successes, + lies in its collective character, in the fact that every + fruitful experiment is published, every new discovery of + relationships explained. In a sense, scientific research is + a triumph over natural instinct, over that mean instinct + that makes men secretive. + + _H. G. Wells, New Worlds for Old._ + + + Public or governmental hygiene has been chiefly concerned + with pure air and pure food, and with organisms producing + epidemic diseases. Boards of health are a recent invention, + and in this country they have as yet been only imperfectly + developed. They can never become the power they should be + until, first, public opinion better realizes their + usefulness and the fact that their cost to the taxpayer is + saved many times over by the prevention of death and + disease; second, more and better health legislation is + enacted--national, state, and municipal; and, third, special + training is secured for what is really a new profession, + that of a public health officer. + + _Report on National Vitality._ + + + + +CHAPTER VIII + +LEGISLATIVE COMPULSION + + +Government is delegated to persons specially set apart for the +oversight of the people's welfare. + +Personal conduct was free from such delegated power in the Anglo-Saxon +thought. The Englishman's house was his castle inviolate. This was +especially true of the early American settlers. Laws interfering with +personal liberty, a man's right to drink tea, to punish his own +children, to beat his own wife, to keep his own muck-heap, have been +deeply resented by the American citizen. Each step in the protection +of his neighbor has been taken only by a struggle extending the common +law of nuisance to a variety of conditions. + +The protection of the man against himself, and of his wife and child +against his ignorance or greed, is one of the twentieth century tasks +yet hardly begun. + +The control of man's environment for his own good as a function of +government is a comparatively new idea in republican democracy. The +cry of paternalism is quickly raised, on the one hand, of socialism, +on the other. Each gain has been at the cost of a hard-fought battle. +But it is certain that the individual must delegate more or less of +his so-called rights for the sake of the race, and since the only +excuse for the existence of the individual is the race, he must so far +relinquish his authority. + +It is a part of the urban trend that the will of the man, of the head +of the family, should be superseded by that of the community, city, +state, nation. + +Even though all the agencies for the education of both young people +and adults that have been discussed in the preceding chapters were set +in motion at once, there would still remain many thousands in township +and city untouched by these forces, or so touched as to arouse +rebellion against such novel notions. + +Only the child can be educated to acquire habits of right living so +perfectly that the suitable action takes place unconsciously. Twenty +years hence these trained children will be the chief citizens of the +republic, the leaders of public opinion. Today, however, less gentle +means, less gradual processes, must be used in order that these +children may have a chance to grow up. + +In the social republic, the child as a future citizen is an asset of +the state, not the property of its parents. Hence its welfare is a +direct concern of the state. Preventive medicine is in this sense +truly State Medicine, and means protection of the people from their +own ignorance. + +In the laws made with this end in view lies one of the greatest +educative agencies known. We have referred in the last chapter to the +need of drawing attention to defects and dangers in order that people +may know what the results of their careless ways may be. No surer way +has been found to fix attention than to attempt to enforce a law or +collect a fine for disobedience of it. A marked illustration of this +truth is given in the case of the ordinance against spitting in street +cars. In many cities a notice was posted in each car--usually with +little effect. In some a fine of five dollars was added, with little +more result. Boston was one of the first cities to pass an ordinance, +and it accompanied the law with a fine of one hundred dollars. This +compelled attention--a sum which represented to the workman more than +his yearly savings, more than any single expenditure. To the business +man, even, it was a sum not to be lightly dropped on a filthy car +floor. This mere statement of the value of cleanness made an almost +instantaneous change in the habits of thousands. Within two days the +car floors became practically free without a single fine being +collected within that time, as far as the author is aware. + +The law imposing fines for neglect of removal of garbage or of +screening stables must be occasionally enforced in order to express +degree of disapproval. A petty fine is of little use. + +Conditions of motion, of rapid intermingling of distant populations--a +thousand miles in a day is now possible--make national control a +necessity. It is proved that quick results may be gained in saving +lives and property by that prompt and thorough action which +well-equipped Federal forces alone possess. The stamping out of yellow +fever in Cuba, the redemption of Panama, the suppression of sporadic +outbreaks at New Orleans, the quick response to a discovery, as in the +cases of pellagra and the hookworm--all these show what a thoroughly +alive government may do. + +It is no disgrace to an individual or a city to have the national +laboratory make discoveries, to have the national power put down +epidemics, as it does civil rebellion, for the good of the whole +nation. It is disgraceful, however, for the citizen to remain +indifferent or obstructive, to grumble over the cost. The indifference +of the people themselves is today almost the only stumbling block to +national prosperity. + +The time lost to the average worker by inefficient labor is a drain on +the community largely avoidable, and is the cause of that other drain +on the moral as well as physical vitality--charity. + +Preventive medicine is a science by itself, a combination of social +and scientific forces guided by research quickly applied, and it must +be accepted and upheld by those whom it benefits, namely, all the +citizens. The nation is in many cases the only power strong enough to +command confidence, and in the combination of government effort an +international science of human welfare is bound to be evolved. + +It is a waste of effort for each state to prepare a fly pamphlet. The +correctness of a Government Bulletin would give an added value as well +as the rapidity of circulation. The bulletins of the Agricultural +Department are an example. + +The Weather Service, with its quick notifications, shows what a health +service might do. A monthly or weekly _health chart_ would give the +best and worst spots. + +Precautions really workable might be furnished the Associated Press. + +In short, system and science might be put at the service of the local +health officer, of the traveler, and even of the housewife. + +The Library of Congress now furnishes cards in duplicate to a large +number of centers, thus saving time to the investigator and giving +information often not otherwise obtainable. + +The Farmers' Bulletins of the Department of Agriculture are also most +valuable to the people who are in search of help. Such agencies might +be extended without fear of trespass on any existing agencies. + +Just as the individual, if he is to do and be his best, accepts his +limitations, obeys Nature's law, and thrives in body and estate in +consequence, and as the community banding together makes and carries +out with penalties for deviation certain regulations for mutual +benefit, so must the still larger groups--the state and the +nation--use their larger wisdom and wider knowledge for the benefit of +all. The individual should recognize the value to himself of this more +complete investigation, and instead of raising the cry of paternalism +and national interference, should welcome all aids to increased +efficiency. + +State hygiene is necessary to supplement municipal hygiene. Often the +rural district has no other hygiene, and the city and the country are +interdependent, the city dependent upon the country for its water, +milk, and other supplies. + +Almost all the states are alive to the importance of milk inspection. +As early as 1869 in Massachusetts, Dr. Bowditch called the Board of +Health "The State Medicine," and quotes from Dr. Farr: "How out of the +_existing_ seed to raise races of men to divine perfection is the +final problem of public medicine." That is the function of all boards +of health. If factories are incorporated under state laws, they must +also be governed by the state regulations for health. + +Here in America we are always locking the stable door after the horse +has been stolen. Not until many "accidents" had occurred in the use of +antitoxins did Congress pass an act (1902) regulating the manufacture +and interstate sale of the viruses, serums, toxins, etc. The +supervision and control were vested in the Secretary of the Treasury +through the Public Health and Marine Hospital Service. Previous to +April 1, 1905, there was no official standard for measuring the +strength of diphtheria antitoxin. Previous to October 25, 1907, there +were as many units or standards for tetanus antitoxin as there were +producers. One was labeled "6,000,000 units per c.c." and another +"0.75 unit per c.c.," while, according to official standard, the first +had only 90 and the latter 770. + +The point to be made is that however faulty an official or Federal +standard for sanitary devices may be, it is a standard, and so is of +service in protecting the people, especially those away from active +centers of research. + + + + +CHAPTER 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._ + + + It would indeed seem that opposition to woman's + participation in the totality of life is a romantic + subterfuge, resting not so much on belief in the disability + of woman as on the disposition of man to appropriate + conspicuous and pleasurable objects for his sole use and + ornamentation. "A little thing, but all mine own," was one + of the remarks of Achilles to Agamemnon in their quarrel + over the two maidens, and it contains the secret of man's + world-old disposition to overlook the _intrinsic_ worth of + woman. + + _W. I. Thomas, Women and Their Occupations, American Magazine, + October, 1909._ + + + The president of the British Medical Association about 1892 + said, "I wish to impress it upon you that the whole future + progress of sanitary movement rests, for its permanent and + executive support, upon the women of our land." + + In a letter to Madame Bodichon, dated April 6, 1868, George + Eliot writes: "What I should like to be sure of as a result + of higher education for women--a result that will come to + pass over my grave--is their recognition of the great amount + of social _unproductive_ labor which needs to be done by + women, and which is now either not done at all or done + wretchedly." + + _Quoted by Mrs. Nixon in a paper before the Conference of Women + Workers in England, 1904._ + + + + +CHAPTER IX + +WOMAN'S RESPONSIBILITY + + +There are about 40,000,000 women and girls in the United States. About +14,000,000 live in the country and have a direct and compelling power +over the life of the community. + +In rural agricultural districts the home-keeper is the provider. She +practically requisitions from farm and garden what she deems necessary +for the family table. To an extent she makes the clothing and sews the +house linen. She also exchanges her perquisites, egg money, perhaps, +for furniture and ornaments. The itinerant peddler brings the world's +wares to her door; the mail-order houses do the rest. + +"The ideal home is a social and cooperative society in which all of +its members unite their efforts for the common good. This ideal is +realized most nearly in the country home, where even the smallest +child has opportunity to be and generally is a contributor to the +family support. It has come to be a recognized fact that boys and +girls, healthy, industrious, frugal, capable, intelligent, +self-supporting, cheerful, and patriotic, abound in country homes, and +that the prevalence there of these high qualities is largely due to +the family life, which requires each individual from his earliest +years to bear his proportionate share in providing for the maintenance +of the home. By bringing within the reach of the country people +educational advantages suited to their needs, rural life becomes more +attractive, country homes are multiplied, and the valuable qualities +which these homes develop become the possession of a correspondingly +larger number of the citizenship of the state."[16] + + [16] I. H. Hamilton, U. S. Dept. of Agriculture, Circular 85. + +The government has recognized the need and the possibilities of +meeting it in the recognition it has given to Farmers' Institutes for +women, in which, by lectures, demonstration, and short winter courses +at the colleges, the interest of the woman in her occupation is +aroused. She is not only given help in details of her daily work, but +she is shown how much the efficiency of the farm life depends upon her +capability and intelligence. She is encouraged in the using of all +mechanical and scientific appliances, is introduced to the means of +mental growth; but, best of all, she is given the stimulus of social +recognition. In the year 1908 there were held 832 such meetings in the +several states. In the year 1910 the number will be nearly or quite +doubled. + +In no other form of society is the power of the woman for good or ill +so paramount as in rural life, in no other mode of living is the +family so much at her mercy. + +In suburban and city life the family can in a measure escape from +insufficient care and uncomfortable conditions. That they do so +escape, any student of social tendencies will testify. The great +increase of restaurants, of clubs and hotels of all grades, shows one +phase of the unattractiveness of home life. The city woman is only +half a housekeeper; she has only one-eighth of a house as compared +with her rural sister. Her control is therefore curtailed until she +feels her helplessness in the hands of her landlord. She sighs and +turns to other interests. To her must be brought the knowledge of her +power as a social factor if she will but use the knowledge she can +easily gain. + +The city woman has amused herself because she has seen nothing better +to do with her time. The utilization of her ability is all that is +needed to regenerate city life. Without it all efforts will prove +fruitless. Education of all women in the principles of sanitary +science is the key to race progress in the twentieth century. + +As an economic factor, the influence of the housewife is of the +greatest moment. Production on the farm is only one phase. The city +and suburban dweller is a buyer, not a producer. In suburban and city +life the housekeeper has more temptations to buy needless articles, +food out of season, to go often to the shops, especially on bargain +days. She thinks her taste is educated, when it is only aroused to +notice what others like. She is led to strive after effects without +knowing how to attain them. It has been estimated by advertising +experts that ninety per cent of the purchases of the community are +determined by women, not always according to their judgment, but by a +suppression of it. Woman is made to think that she must buy certain +lines of goods. The power of suggestion has been referred to in a +preceding chapter. + +When civilization, as it is called, persuaded woman to give up +manufacture and to become a buyer, the first step in the +disintegration of the home as a center of information, as well as of +industry, was taken. The housewife and mother were made to look to the +dealer, and thus to feel their helplessness. This sense of ignorance, +this subconscious loss of power over things, only increased the effect +of that fatalism which the control of machinery was leading man out +from under. + +It is barely fifty years since woman began to ask questions and insist +upon knowing, to claim freedom of movement, a chance to breathe. The +time between has been a time of plowed fields, often muddy, usually +stony, but the furrows are turning green and the harvest will prove +the wisdom of the plowing. + +Woman had to struggle for right to private judgment and public action. +Some pioneers had to enter the field of research, of investigation, in +order that they might call to those below that the way was open. This +vast company, which has been nearly untouched by the scientific +spirit, was warned off the field of investigation, and society is +paying the penalty of its own blindness. + +In the very field where applied science can most serve human welfare, +scarecrows have been set up most prominently. Not until society avails +itself of those qualities of mind sorely needed in the field of +sanitary science, patient attention to detail, strong, practical sense +directed by a profound interest in the subject, will it begin to show +what height it is capable of scaling. + +The intrusting of so many great fortunes to women shows an increasing +confidence in their judgment of social needs. It shows that woman's +education has passed the selfish stage, that it has given a wider +vision of the whole horizon. + +It may be said without fear of contradiction that the future +well-being of society is largely in the hands of woman. What will she +do with it? Responsibility is always sobering. + +Let her once realize her position and woman will rise to the task. +Instances are not wanting of groups attacking scientific and +administrative problems in the true spirit, without sentimental +charity, to which in the past women have been prone. + +If civic authorities felt that women's leagues were informed bodies of +women whose suggestions they would make no error in adopting, more +legislation could be effected. Too often city councils are approached +by those who favor some whim or fad, and so ALL women's demands are +classed together. Much harm has been done to the cause by indiscreet, +pushing women with only a glimmer of knowledge. The question is not +WOMAN, but ability and women. It is better, as a rule, to work out +ideas through existing organizations. + +All the problems of environment which we have been considering would +be solved in half the time, yes, in one-quarter, if all housewives +would combine in carrying out the knowledge which some of them have +and which all may have. + +Infant mortality is controllable through the training of the mother +and nurse. Unsanitary houses are the results of careless housekeeping, +usually a product of apathetic fatalism. Landlords assume that the +woman will submit. When she has a woman sanitary inspector to appeal +to, matters will take on a different aspect. + +Unsanitary alleys exist because the abutters do not complain loudly +enough to the right authorities. Dirty markets have been so long +tolerated because women buyers carried the same fatalism to the +stalls--"what is, has to be." + +Society is only just beginning to realize that it has at its command +today for its own regeneration a great unused force in its army of +housewives, teachers, mothers, conscious of power but uncertain how to +use it. Perhaps the most progressive movement of the times is one led +by women who see clearly that cleanness is above charity, that moral +support must be given to those who know but do not dare to do right, +and that knowledge must be brought to the ignorant. Nothing can stop +this most notable progress but a relapse into apathy and fatalism of +the vast army of women now being enlisted to fight disease. + +The opportunity has come, the responsibility is woman's hereafter. No +one can take it from her; she has knowledge. The door has opened, she +has taken the weapons in hand, is learning to use them. Will she +falter on the eve of victory simply because it involves some sacrifice +of prejudice or tradition? Must she not boldly accept the twentieth +century challenge and fight her way to victory, even at some aesthetic +sacrifice? In another hundred years, then, Euthenics may give place to +Eugenics, and the better race of men become an actuality. + +The keeping of the house, the laundry work, the cleaning, the cooking, +the daily oversight, must have for its conscious end the welfare of +the family. It cannot be done without labor, but the labor in this as +in any process may be lightened by thought and by machinery. + +Knowledge of labor-saving appliances is today everywhere demanded of +the successful establishment EXCEPT of the family home. Is it not time +that it came in for its share? If the housewife would use wisely the +information at her hand today, it is safe to say that in six cases out +of ten she could cut in half the housekeeping budget and double the +comfort of living. + +As conditions are, the twentieth century sees a strange +phenomenon--the most vital of all processes, the raising of children, +carried on under adverse conditions; human labor and life being held +of as little account as in the days of building the pyramids. + +Women may be trained to become the economic leaders in the body +politic. It is doubtful if life will be anything but wasteful until +they are trained to realize their responsibility. + +The housewife was told that she must stay at home and do her work. +This was preached _at_ her, written _at_ her, but no one of them all, +save, perhaps, the Englishmen Lecky and H. G. Wells, saw the problem +in its social significance, saw that the work of home-making in this +engineering age must be worked out on engineering principles, and with +the cooperation of both trained men and trained women. The mechanical +setting of life is become an important factor, and this new impulse +which is showing itself so clearly today for the modified construction +and operation of the family home is the final crown or seal of the +conquest of the last stronghold of conservatism, the home-keeper. + +Tomorrow, if not today, the woman who is to be really mistress of her +house must be an engineer, so far as to be able to understand the use +of machines and to believe what she is told. Your ham-and-eggs woman +was of the old type, now gone by in the fight for the right to think. + +The emergence from the primitive condition was slow because the few of +us who did show our heads were beaten down and told we did not know. +It has required many college women (from some 50,000 college women +graduates) to build and run houses and families successfully, here one +and there another, until the barrel of flour has been leavened. +Society _is_ being reorganized, not in sudden, explosive ways, but +underneath all the froth and foam the yeast has been working. The +world is going to the bad only if one believes that material progress +is bad. If we can see the new heaven and the new earth in it, then we +may have faith in the future. + +The human elements of love and sacrifice, of foresight and of faith, +are going to persist, and any apparent upheaval is only because of +settling down into a more solid condition, a readjustment to +circumstances. As Caroline Hunt has said[17]: "We may disregard the +popular fear that the home will finally take upon itself the +characteristics of a public institution.... Human intelligence, which +suits means to ends, and which is ever coming to the aid of human +affection, will prevent that. So long as affection lasts it will seek +satisfactory expression in home life, and so long as intelligence +endures it will stand in the way of the extension of the borders of +the home beyond the possibilities of the mutual helpfulness to its +members." + + [17] Home Problems from a New Standpoint, p. 140. + +The persistent efforts of the farsighted to secure a place in +education for the subjects fundamental to the modern home are now +respectfully listened to. + +It is, perhaps, not strange that the first successes in modern +housekeeping were gained in public institutions, for there accounts +were kept and saving told. When one hospital saved $12,000 in one year +by an expenditure of $2,000 for a trained woman, trustees began to +take notice. When large state institutions were reorganized and made +over from unsavory scandals into reputable and life-saving +establishments, even legislators took notice. The trained woman +superintendent proved not only more competent but less affected by +perquisites. + +(I do not vouch for the universal maintenance of this high standard +when women managers have had longer experience; but so far conscience +and sterling integrity have been attributes of all my expert women, +even if they have now and then disappointed me in endurance or in +ability. Is not this a fact of great social significance?) + +It is universally conceded today, only a few willfully blind or +croaking pessimists dissenting, that home-keeping under modern +conditions requires a knowledge of conditions and a power of control +of persons and machines obtained only through education or through +bitter experience, and that education is the less costly. + +When social conditions become adjusted to the new order, it will be +seen how much gain in power the community has made, how much better +worth the people are. Have faith in the working out of the destiny of +the race; be ready to accept the unaccustomed, to use the radium of +social progress to cure the ulcers of the old friction. What if a few +mistakes are made? How else shall the truth be learned? Try all things +and hold fast that which is good. + +The Home Economics Movement is an endeavor to hold the home and the +welfare of children from slipping over the cliff by a knowledge which +will bring courage to combat the destructive tendencies. Is not one of +the distinctive features of our age a forcible overcoming of the +natural trend of things? If a river is by natural law wearing away +its bank in a place we wish to keep, do we sit down and moan and say +it is sad, but we cannot help it? No, that attitude belonged to the +Middle Ages. We say, Hold fast, we cannot have that; and we cement the +sides and confine or turn the river. + +The ancient cities whose ruins are now being explored in Asia seem to +have been abandoned because of failure of the water supply as the +earth became desiccated; so was the home of our own Zunis. Does such a +possibility stop us? No, we bring water from hundreds of miles. Will +man, who has gained such control over nature, sit down before his own +problems and say, "What am I going to do about it?" + +What if the apparent motion is toward cells to sleep in, and clubs to +play bridge in, and amusements for evenings, and a strenuous business +life, run on piratical principles, into which the women are drawn as +decoy ducks? Because this _is_, is it going to be, as soon as a good +proportion of the thinking people stand face to face with the +problem? I believe it is possible to solve the problem, but only if +the aid of scientifically trained women is brought into service to +work in harmony with the engineer who has already accomplished so +much. + +Household engineering is the great need for material welfare, and +social engineering for moral and ethical well-being. What else does +this persistent forcing of scientific training to the front mean? If +the State is to have good citizens, productive human beings, it must +provide for the teaching of the essentials to those who are to become +the parents of the next generation. 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 that wastes its +natural resources. + +The teaching of domestic economy in the elementary school and home +economics in the higher is intended to give the people a sense of +_control_ over their _environment_ and to avert a panic as to the +future. + +The economics of consumption, including as it does the ethics of +spending, must have a place in our higher education, preceded in +earlier grades by manual dexterity and scientific information, which +will lead to true economy in the use of time, energy, and money in the +home life of the land. Education is obliged to take cognizance of the +need, because the ideal American homestead, that place of busy +industry, with occupation for the dozen children, no longer exists. +Gone out of it are the industries, gone out of it are ten of the +children, gone out of it in large measure is that sense of moral and +religious responsibility which was the keystone of the whole. + +The methods of work imposed by housing conditions are wasteful of +time, energy, and money, and the people are restive, they know not +why. As was said earlier, shelter was found by early students of +social conditions to be most in need of remedy, so we see that + +"In the first place the state is beginning to offer positive aid to +secure a suitable home for each family. A communistic habitation +forces the members of a family to conform insensibly to communistic +modes of thought. Paul Goehre, in his keen observations printed in +'Three Months in a German Workshop,' interpreted this tendency in all +clearness. The architecture of a city tenement house is to blame for +the silent but certain transformation of the home into a sty. Instead +of accepting this condition as inevitable, like a law of nature, and +accepting its consequences, all experience demands of those who +believe in the monogamic family, that they make a united and +persistent fight on the evil which threatens the slowly acquired +qualities secured in the highest form of the family. It would be +unworthy of us to permit a great part of a modern population to +descend again to the animal level from which the race has ascended +only through aeons of struggle and difficulty. When we remember that +very much, perhaps most of the progress has been dearly purchased at +the cost of women, by the appeal of her weakness and need and +motherhood, we must all the more firmly resolve not to yield the field +to a temporary effect of a needless result of neglect and avarice. As +the evil conditions are merely the work of unwise and untaught +communities, the cure will come from education of the same +communities in wisdom and science and duty. What man has marred, man +can make better."[18] + + [18] C. R. Henderson, Proceedings Lake Placid Conference, 1902. + +It is not impossible to furnish a decent habitation for every +productive laborer in all our great cities. Many really humane people +are overawed by the authority, the pompous and powerful assertions of +"successful" men of affairs; and they often sleep while such men are +forming secret conspiracies against national health and morality with +the aid of legal talent hired to kill. Only when the social mind and +conscience is educated and the entire community becomes intelligent +and alert can legislation be secured which places all competitors on a +level where humanity is possible. + +Here, again, the monogamic family is the social interest at stake. It +is a conflict for altars and fires. We are told that all these results +are the effect of a natural, uniform tendency in the progress of the +business world, and that it is useless to combat it. Professor +Henderson reminds us that tendency to uniformity revealed by +statistics may be reversed when resolute men and women, possessed of +higher ideals, unite to resist it. Jacob A. Riis holds that these +evils are not by a decree of fate, but are the result of positive +wrong, and he dedicates his "Ten Years' War" as follows--"to the +faint-hearted and those of little faith." + +In like manner we call today for more faith in a way out of the slough +of despond, more resolute endeavor to improve social and economic +conditions. We beg the leaders of public opinion to pause before they +condemn the efforts making to teach those means of social control +which may build yet again a home life that will prove the nursery of +good citizens and of efficient men and women with a sense of +responsibility to God and man for the use they make of their lives. + + + + +INSTRUCTIVE INSPECTION + + Mrs. Richards intended to embody the following material in + Chapter VIII of the second edition. Because of her death it + has seemed best to add it as an appendix. + + WHITCOMB AND BARROWS. + + + + +CHAPTER X + +INSTRUCTIVE INSPECTION[19] + + [19] Read before the American Public Health Association at + Richmond, Va., October, 1909. + + +The checking of wastes of all description is much in the air, but +there is less discussion about WASTE OF EFFORT than might be expected. +Yet effort means time, and saving of time saves lives as well as +money. + +Nearly every investigation of sanitary evils leads back to the family +home (or the lack of one), and a great deal of the health authorities' +work is saving at the spigot while there is a hundred times the waste +at the bunghole. The medical inspection of the schools was found to +have little effect without the visiting school nurse, for the parents +did not know how to better conditions and in the majority of cases did +not believe in the need. + +Such experience should give the health authorities a cue. Rules and +Regulations should be enforced, but enforced with instruction as to +the means of doing. The WHY is not so easily understood as the student +of sanitary science seems to think. Germs and microbes are empty air +to the street urchins until they have been shown on a screen in a +lecture hall or until cultures have been made in the sight of the +children in a schoolroom. One whole school district of intelligent +parents was converted, many years ago, by giving the children in one +class two Petri dishes each with sterile prepared gelatine, with +directions to open one in the sitting room while it was being swept, +and two hours after the room had been thoroughly dusted to open the +other in the same place for the same time. These "dust gardens," as +the children called them, "took the place of the family album" for +callers, and spread knowledge. + +Hundreds of similar experiences should convince any intelligent, +earnest Board of Health that a teacher by nature or training should be +in their employ, to be sent WITH POWER, like any other inspector, +wherever ignorance--usually diagnosed as stubbornness--is found. + +The health officer whose mother was a good housekeeper, not afraid of +work, has no idea of the attitude of half the housewives of his +district. Having been made as a boy "to get the dustpan and brush and +sweep up his whittlings," he does not realize that these houses in the +tenement district have no dustpans, and that no one would bend his +back to sweep up litter if there were. It is all swept into the alley +or the street. Cheap, long-handled dustpans would be valuable sanitary +implements. As has been elsewhere suggested, the garbage question in +the tenement house needs study and must be solved by a practical +housewife. There are such, and Boards of Health are wasting effort and +the town's money until they avail themselves of this help in the +enforcement of their rules. + +All Health Boards use the strong arm of the law, _i. e._, a police +inspector's club, to drive the ignorant and careless householder to +keep his premises from becoming a nuisance. The newly-arrived, +prospective citizen, or more often citizeness, fails to understand +what it is all about--neither the words nor the pantomime convey an +idea, except that this country is topsy-turvy anyway, for everything +is different in this new land. + +In the process of learning what not to do, the dwellers in the alleys +flee when the health officer appears, and oppose a stubborn +indifference to his threats. When his back is turned, matters go on as +before and nothing is gained, but an opportunity is lost. Law is a +potent educator when rightly applied, but it may work more harm than +good. + +Rules of action clearly explained are soon accepted--like traffic +rules, notification of contagious diseases, disinfection, etc. + +The placing on the force of each town of at least one specially +trained "Explainer" would result in cleaner back yards and less +illness and, better than all else, a more friendly feeling between the +officials and those they honestly wish to help; for I do not think +there is often justification for such remarks as were made to me by a +shrewd California countryman when I was showing him about in the +traveling exhibit, the sanitation car: "Oh, this is all to get a job. +It's another form of graft--to get some money to spend." + +It is true that the value of many health measures does not appear on +the surface. Sometimes it is necessary to wait for vital statistics to +prove a gain. + +It is beginning to be thrown in the faces of sanitary authorities that +the laboratory wisdom does not reach the street; that there is not +enough, or rapid enough, improvement in general conditions. Newspapers +are ready, for the most part, to disseminate information and +benevolent societies write tracts, but we must remember how little +WORDS mean--especially printed words--to those unaccustomed to +acquiring information that way. + +The actual showing in an alley of the process of cleaning up; the +going into a house and opening the windows at the top and tacking on a +wire netting to keep out the flies; the actual cleaning of the garbage +pail, perhaps, or at least the standing by and seeing that it is +properly done--all such actual doing, even if it is done only in one +house on a street, will spread the information all over the +neighborhood. + +One of the most helpful offices is to tell the woman where she can +get the special article needed, and what it will cost, and to show her +the thing itself, in a friendly spirit. Such visits would soon +revolutionize the sanitary condition of any community. + +Villages need this help even more than cities, for there they have +fewer chances to know about inventions and perhaps are less +resourceful in making them. + +There may be races, as there are individuals, whom persecution drives +to progress--who do find means to execute unjust commands--but the +people a health officer has to deal with can be better led by kindness +and will learn from teachers, if the teaching is in the form of +example or demonstration. + +It is an incontrovertible fact that to hasten sanitary reform it is +only necessary to hold out the helping hand; to encourage the ignorant +citizen to ask for instruction and direction, instead of placing upon +him the task of making bricks without either clay or straw. There are +times and seasons and individuals at which and on whom the bludgeon +must be used--the greater good covering the lesser evil; but such +cases are less common than present practice would seem to indicate. + +The tenement house mother who has only one pan for all her needs and +one broken pitcher for all fluids does not readily understand why she +must keep her milk bottle for milk only. Who is to tell her so that +she will understand? + +The men may be shamed into cleaning up the back yards and alleys by +pictures of such conditions in contrast to what might result with a +little effort. [The famous Cash Register yards were started in this +way.] Neglected spots have been cleaned up all over the country by +similar influences. Why does not the health officer take a leaf from +this book of recorded good work and show conditions known to him? Is +he afraid of hard words from the owner? He will have the approval and +support of all good citizens. + +Health Board regulations may be left at a house AFTER they have been +explained, and a firm insistence on obedience may then have an +effect. + +Why should there not be a constant exhibit of the conditions found +within the boundaries of a district, with the changes for the better +indicated as soon as they occur? + +The Health Board office is now in some out-of-the-way place, where few +people ever go and where those who do go are frequently not welcomed. +Has the Board ever asked itself why it is often so misunderstood, so +hampered in its work? What Board will be the first to take an office +on a busy street and put pictures and samples with clearly printed +legends in the windows--examples of the evasion of the plumbing laws +on a T-joint pipe; photographs of a dairy barn; photographs of a +street at daybreak, showing the few open windows, and the one or two, +if any, open at the top--these would serve as texts for the +newspapers' sermons, sure to be preached, and back-alley conversations +thereon. + +Why not? Rival water companies are allowed to show filters to prove +their claims. + +The basis of all successful sanitary progress is an intelligent and +responsive public. + +The problem is to visualize cause and effect to the ordinary +individual, too absorbed in his own affairs to study out the principle +for himself. + +The success of the street cleaning brigade, tried for one season in +Boston; the improvement in the condition of parks wherever receptacles +for wastes have been placed; the tidy condition of corner lots where +civic improvement leagues have taken the matter up with the children, +all point to a means neglected by the officials, and hence to wasted +opportunity and delayed obedience to regulations. + +For the position of instructive inspector, it goes without saying that +a trained woman will be worth more than a man, since most of the +regulations affect or would be controlled by women. + +A gain in the speed of adoption of sanitary reforms would be +comparatively rapid under a thoroughly qualified woman as instructive +inspector, and that there will not be any great gain until such a +measure is adopted is the firm belief of the writer. + +Mrs. von Wagner's work in Yonkers, begun in 1897 under the Civic +League, is well known. After three years' trial the Board of Health +established her in the position of Sanitary Inspector. Her work in the +tenement districts has been most successful. Several other cities have +followed the example of Yonkers, but the practice is by no means +general. Yet there is no doubt that it would add efficiency to any +Board of Health. + +The most recent experiment was the employment, the past summer, of an +inspector provided by the Women's Municipal League of Boston, to +inspect and devise means for bettering conditions in a district of +small shops where food is sold. The district had been found by the +Market Committee of this organization to be in need of such help. A +graduate of the School for Social Workers was chosen, who carried on +her campaign with the spirit of helpfulness fostered by her training. +She was given a badge by the Board of Health, who have been most +sympathetic and cordial in their support. The experiment has been +justified by the results and especially by the reception accorded the +inspector by the people of the district. It has proved that there is a +responsive desire to fulfill the law wherever its provisions are +understood. + +Inspection cannot fulfill its purpose until it is instructive. Man and +the law will be in accord when the benefits of the law to man are +appreciated. + +It is incumbent upon the sanitary authorities to see to it that their +efforts are not wasted on an inert, partially hostile clientele. + + + + +EUTHENICS, OR THE SCIENCE OF CONTROLLABLE ENVIRONMENT + + +Human efficiency and welfare due to + + Heredity (See Eugenics) and + + Environment + 1. Natural, cosmical--climate-- + 2. Natural, modified by human effort + Wet and dry soil + Waterways and forests + Food supplies + 3. Artificial + Housing--clothing--sanitation + + EUTHENICS--Conscious acquisition and application of scientific knowledge + + I. Science in the laboratory + Discovery of laws of science + Knowledge of cause and effect + + II. Dissemination of scientific knowledge + Education + + III. Application of science + Habits of living + Technique + Stimulus to civic improvement + Constructive legislation + +I. Science acquired through laboratory and field research + + Universities + Johns Hopkins, Clark, etc. + + Research institutes + Rockefeller Institute + Carnegie Institute + Henry Phipps Institute + Sage Foundation, etc. + + Sanitary Science = Application of acquired laws to + + 1. National welfare + Hook worm, Pellagra, Yellow fever, etc., in Panama, + The Philippines, Cuba, Porto Rico, etc. + + 2. Individual health of body and mind + +The people are reached by + +II. A. Dissemination of scientific knowledge through + + 1. Schools + 2. Publicity + a. Bulletins + Boards of Health + Department of Agriculture + b. Lectures + Municipal + Endowed + c. Magazines and newspapers + d. Placards + e. Commercial advertising + Inventions of manufacturers + Food fairs, electrical exhibitions, etc. + 3. Expositions for limited purposes + Mary Lowell Stone Exhibit + "Boston 1915" + 4. Health Campaigns + Tuberculosis classes, etc. + + B. Legislation + + Restrictions + +III. Application of science to living + + A. 1. Unconsciously acquired habits of the CHILD, through imitation + in the home, the school, the street + 2. Conscious endeavor of + a. the trained parents in the home + b. the teacher in the school + c. the policemen in the street + + B. Conscious personal effort of the ADULT to better conditions + for himself and the community + + 1. Pioneer leading public opinion by + a. Personal example in right living + b. Precept and persuasion + + C. Community progress + + 1. Semi-public agencies for guarding itself and the individual + a. Remedial measures + Endowed hospitals, sanatoria, dispensaries, day camps and + hospital schools + Charity organizations--material relief + b. Preventive measures + Endowed schools (model and outdoor), extension movements, + settlements, model tenements, model factories, garden cities + + Both are developed by social organizations, civic clubs, + women's clubs, museums, libraries, lectures, exhibits, + statistical inquiries, etc. + + 2. Private agencies leading to legislation + Special hospitals and schools + Health organizations--sanitary inspection at model + dairies--private water supply + Consumer's league + + 3. Legislation. Temporary paternalism (protection). + Interpretation by individual becomes constructive. + The people work out freedom under law + + a. City + (1) Schools + Grade and trade and outdoor + (2) Police + Building laws + (3) Board of Health + (a) Shelter + Sanitary laws + { Drainage + Air--light--refuse { Garbage + { Ashes + (b) Food + Milk--water--foods { Food values + { Adulterations + (c) Sanitary laws for public places + Buildings + Streets + Sewer + Ice on sidewalk + Spitting + (4) Beauty + Height of buildings, bill boards, telegraph wires, + parks + (5) Amusements + Playgrounds, municipal music, parks, aquarium + (6) Other municipal activities + (a) Traffic regulation + (b) Medical inspection + (c) Public baths + + b. State + Education + Board of Health + Factory legislation + Water supply (advisory power) + Interstate commerce + Food (advisory) + Park reservations + Textile laws + Forest + c. Federal + Sanitation + (a) Pure food laws + (b) Quarantine + (c) Immigration restriction + (d) Future needs + Textile laws, etc. + + + + + +End of the Project Gutenberg EBook of Euthenics, the science of controllable +environment, by Ellen H. Richards + +*** END OF THIS PROJECT GUTENBERG EBOOK EUTHENICS *** + +***** This file should be named 31508.txt or 31508.zip ***** +This and all associated files of various formats will be found in: + https://www.gutenberg.org/3/1/5/0/31508/ + +Produced by Barbara Tozier, Bill Tozier, Irma Spehar and +the Online Distributed Proofreading Team at +https://www.pgdp.net + + +Updated editions will replace the previous one--the old editions +will be renamed. + +Creating the works from public domain print editions means that no +one owns a United States copyright in these works, so the Foundation +(and you!) can copy and distribute it in the United States without +permission and without paying copyright royalties. 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