For the men who have been thus born and taught the tasks imposed by Social Hygiene are in no degree lighter. They demand all the best qualities of a selectively bred race from which the mentally and physically weak have, so far as possible, been bred out. The substitution of law for war alike in the relations of class to class, and of nation to nation, and the organization of international methods of social intercourse between peoples of different tongues and unlike traditions, are but two typical examples of the tasks, difficult but imperative, which Social Hygiene presents and the course of modern civilization renders insistent. Again, the adequate adjustment of the claims of the individual and the claims of the community, each carried to its farthest point, can but prove an exquisite test of the quality of any well-bred and well-trained race. It is exactly in that balancing of apparent opposites, the necessity of pushing to extremes both opposites, and the consequent need of cultivating that quality of temperance the Greeks estimated so highly, that the supreme difficulties of modern civilization lie. We see these difficulties again in relation to the extension of law. It is desirable and inevitable that the sphere of law should be extended, and that the disputes which are still decided by brutal and unreasoning force should be decided by humane and reasoning force, that is to say, by law. But, side by side with this extension of law, it is necessary to wage a constant war with the law-making tendency, to cherish an undying resolve to maintain unsullied those sacred and intimate impulses, all the finest activities of the moral sphere, which the generalizing hand of law can only injure and stain.
It is these fascinating and impassioning problems, every day becoming of more urgent practical importance, which it is the task of Social Hygiene to solve, having first created the men and women who are fit to solve them. It is such problems as these that we are to-day called upon to illuminate, as far as we may—it may not yet be very far—by the dry light of science.
[1] Muralt, Lettres sur les Anglais. Lettre V.
[2] In the reign of Richard II (1388) an Act was passed for "the punishment of those which cause corruption near a city or great town to corrupt the air." A century later (in Henry VII's time) an Act was passed to prevent butchers killing beasts in walled towns, the preamble to this Act declaring that no noble town in Christendom should contain slaughter-houses lest sickness be thus engendered. In Charles II's time, after the great fire of London, the law provided for the better paving and cleansing of the streets and sewers. It was, however, in Italy, as Weyl points out (Geschichte der Sozialen Hygiene im Mittelalter, at a meeting of the Gesellschaft für Soziale Medizin, May 25, 1905), that the modern movement of organized sanitation began. In the thirteenth century the great Italian cities (like Florence and Pistoja) possessed Codici Sanitarii; but they were not carried out, and when the Black Death reached Florence in 1348, it found the city altogether unprepared. It was Venice which, in the same year, first initiated vigorous State sanitation. Disinfection was first ordained by Gian Visconti, in Milan, in 1399. The first quarantine station of which we hear was established in Venice in 1403.
[3] The rate of infant mortality in England and Wales has decreased from 149 per 1000 births in 1871–80 to 127 per 1000 births in 1910. In reference to this remarkable fall which has taken place pari passu with the fall in the birth-rate, Newsholme, the medical officer to the Local Government Board, writes: "There can be no reasonable doubt that much of the reduction has been caused by that 'concentration' on the mother and the child which has been a striking feature of the last few years. Had the experience of 1896–1900 held good there would have been 45,120 more deaths of infants in 1910 than actually occurred." In some parts of the country, however, where the women go out to work in factories (as in Lancashire and parts of Staffordshire) the infantile mortality remains very high.
[4] Mrs. Bertrand Russell, "The Ghent School for Mothers," Nineteenth Century, December, 1906.
[5] It is scarcely necessary to say that other classifications of social reform on its more hygienic side may be put forward. Thus W.H. Allen, looking more narrowly at the sanitary side of the matter, but without confining his consideration to the nineteenth century, finds that there are always seven stages: (1) that of racial tutelage, when sanitation becomes conscious and receives the sanction of law; (2) the introduction of sanitary comfort, well-paved streets, public sewers, extensive waterworks; (3) the period of commercial sanitation, when the mercantile classes insist upon such measures as quarantine and street-cleaning to check the immense ravages of epidemics; (4) the introduction of legislation against nuisances and the tendency to extend the definition of nuisance, which for Bracton, in the fourteenth century, meant an obstruction, and for Blackstone, in the eighteenth, included things otherwise obnoxious, such as offensive trades and foul watercourses; (5) the stage of precaution against the dangers incidental to the slums that are fostered by modern conditions of industry; (6) the stage of philanthropy, erecting hospitals, model tenements, schools, etc.; (7) the stage of socialistic sanitation, when the community as a whole actively seeks its own sanitary welfare, and devotes public funds to this end. (W.H. Allen, "Sanitation and Social Progress," American Journal of Sociology, March, 1903.)
[6] Dr. F. Bushee has pointed out ("Science and Social Progress," Popular Science Monthly, September, 1911) that there is a kind of related progression between science and practice in this matter: "The natural sciences developed first, because man was first interested in the conquest of nature, and the simpler physical laws could be grasped at an early period. This period brought an increase of wealth, but it was wasteful of human life. The desire to save life led the way to the study of biology. Knowledge of the physical environment and of life, however, did not prevent social disease from flourishing, and did not greatly improve the social condition of a large part of society. To overcome these defects the social sciences within recent years have been cultivated with great seriousness. Interest in the social sciences has had to wait for the enlarged sympathies and the sense of solidarity which has appeared with the growing interdependence of dense populations, and these conditions have been dependent upon the advance of the other sciences. With the cultivation of the social sciences, the chain of knowledge will be complete, at least so far as the needs which have already appeared are concerned. For each group of sciences will solve one or more of the great problems which man has encountered in the process of development. The physical sciences will solve the problems of environment, the biological sciences the problems of life, and the social sciences the problems of society."
[7] This exclusive pre-occupation with the improvement of the environment has been termed Euthenics by Mrs. Ellen H. Richards, who has written a book with this title, advocating euthenics in opposition to eugenics.
[8] Not one of the four stages of social reform already summarized can be neglected. On the contrary, they all need to be still further consolidated in a completely national organization of health. I may perhaps refer to the little book on The Nationalization of Health, in which, many years ago, I foreshadowed this movement, as well as to the recent work of Professor Benjamin Moore on the same subject. The gigantic efforts of Germany, and later of England, to establish National Insurance systems, bear noble witness to the ardour with which these two countries, at all events, are moving towards the desired goal.
[9] In some countries, however, the decline, although traceable about 1876, only began to be pronounced somewhat later, in Austria in 1883, in the German Empire, Hungary and Italy in 1885, and in Prussia in 1886. Most of these countries, though late in following the modern movement of civilization initiated by France, are rapidly making their way