THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 
 MRS. PRUDENCE W. KOFOID 
 
ill 
 
 OUNCE 
 
 ;ii3v 
 
THE 
 
 FUTURE OF SANITARY SCIENCE, 
 
Digitized by the Internet Archive 
 
 in 2007 with funding frorn 
 
 IVIicrosoft Corporation 
 
 http://www.archive.org/details/futureofsanitaryOOrichrich 
 
THE FUTUKE 
 
 OF 
 
 SANITARY SCIENCE. 
 
 3,n ^bbress 
 
 Delivered before the Sanitarij Institute of Great Britain at the 
 Boyal Institution^ on July 5th, 1877. 
 
 BENJAMIN WAED KICHAKDSON, M.D., LL.D. F.R.S. 
 
 FELLOW OF THE BOYAL COLLEGE OF PHYSICIANS, 
 AXD HOXOKAKY PHYSICIAN TO THE EOY.AL LITEBABY FUSD. 
 
 MACMILLAN A:ND CO. 
 
 1877. 
 
CHARLES DICKENS AND EVANB, 
 CRYSTAL PALACE PKESS. 
 

 THE FUTURE OF SANITARY SCIENCE 
 
 POLITICAL, MEDICAL, SOCIAL. 
 
 I COULD tave wished it had been in my power on 
 the present occasion to produce one of those essays 
 which appeal to the imagination while they prepare 
 the mind for the reception of sanitary principles and 
 practice. Such essays are tempting, and, in their 
 place, instructive. To-day I am bound on a voyage 
 less pleasant, yjet I hope not less useful. 
 
 There has recently been called into existence a 
 new society under whose summons we now meet. 
 The society has assumed to itseK the expressive 
 name of The Sanitary Institute of Great Britain. It 
 starts as a voluntary effort by men and women who 
 are willing and anxious to give effect to those teach- 
 ings of sanitary science which the past half-century 
 
 M3518S5 
 
6 THE FUTURE OF SANITAHY SCIENCE: 
 
 lias revealed. It invites all who are concerned to 
 utilise tlie knowledge that has been acquired in that 
 time. It wishes to encourage new research. But 
 it has for its most anxious care to render useful to 
 mankind at large the accumulated store of know- 
 ledge which at this moment lies ready for so many 
 grand purposes relating to health. It accepts as 
 its object, work for health, health of all the human 
 family. 
 
 Shall some one say the object is ambitious ? Yea, 
 we reply, it is confessedly ambitious. Shall some 
 one say the means at command for the work to be 
 attempted are limited ? Even so. Life is short, art 
 long. Yet the short yields the long, and but for 
 the short the long could not be. It is out of these 
 littlenesses of human effort that the greatnesses 
 follow. Or, as Benjamin Rush very forcibly puts it, 
 and simply as forcibly : " There are mites in science 
 as well as in charity, and the ultimate results of 
 each are often alike important and beneficial.^' 
 
 It is my fortune, good or bad, to have to preside 
 over the council of this new society. Of the ability 
 of those who form the council, and of their ex- 
 perience, I need not speak in detail, for their names 
 are familiar to the world. They represent, I may 
 say, sanitary science in all its branches, and from 
 
POLITICAL, MEDICAL, SOCIAL. 7 
 
 them, working harmoniously together, good results 
 must be expected. 
 
 It seems fitting, therefore, as we enter on our 
 work, to look forward to the future. It is a part at 
 least of our duty to look towards the future with 
 the view of seeing in what directions we may best 
 proceed ; what assistances we may have to call upon ; 
 and chiefly, what great powers we may have to con- 
 sult and propitiate. 
 
 The three great powers with which our society 
 wiU have to treat are the Political, the Medical, the 
 Social. From each of them we shall expect constant 
 assistance. To one or other of them, whatever we 
 do, our work will be transmitted or transferred. 
 They will bring it into practical form and effect, 
 or they will reduce it to nothingness. We can 
 suggest and set forth initiatives, and with that our 
 functions are complete in each particular branch to 
 which we address ourselves. 
 
 It is our special duty to keep this special fact 
 steadily in view, and to limit our labours by it. It 
 too often happens that young societies, like young 
 men, are apt to believe that they can conduct 
 national processes as easily as they can conceive 
 them, and under this belief fail most signally with 
 the best of attempts. I remember in my early 
 
8 THE FUTURE OF SANITARY SCIENCE: 
 
 career getting a lesson from one of our late well- 
 known statesmen on this very point. I was ex- 
 plaining to him the efforts I had made in 1855 and 
 the succeeding three years to establish a registra- 
 tion of the diseases of this kingdom, and I bewailed 
 the hard experience which proved that the greater 
 the scientific success of the effort the more impos- 
 sible it became to carry it out. '^ In fact/^ said I, in 
 a pitiful strain, " the success almost ruined me in 
 mind, body, and estate.^^ " Served you right,^' was 
 the immediate reply, " served you right. If indi- 
 vidual men could carry out national projects where 
 would be the nation ? " The reply was hard as it 
 was unanswerable, and from that time to this I have 
 given up all thoughts of doing more than sowing 
 seed in the field of literature, and leaving it to the 
 chance of fructification on that extensive soil ; or in 
 showing some mere model of experiment which, 
 perchance, may grow into working form. And 
 this, I think, is the whole natural scope of our 
 Institute — to sow the seed of sanitation ; to think 
 out plans of projects for working methods ; to lend 
 its many minds, as if they made up the mind of one 
 man, for devising from the past the best for the 
 present, and respectfully to declare our conclusions. 
 The directions in which we shall have to move. 
 
FOLITIGAL, MEDICAL, SOCIAL. 9 
 
 :liG lines on wMcli we sliall have to move^ are, I 
 repeat, ctiefly three — the Political, the Medical, 
 the Social. The powers on these lines must be 
 approached in every work of ours, however simple, 
 however complicate it may be. I shall try, as the 
 title of my discourse explains, to indicate certain 
 points in which we are most likely to come in 
 contact with these powers, and the changes we 
 may expect to work in and through them. 
 
 THE POLITICAL PAET. 
 
 In this country piolitical action has been varied 
 in relation to sanitary improvements. Sometimes 
 political necessity has crossed sanitary progress, 
 as, for example, in the imposition of a tax on 
 sunlight, on foods that are essential to life, and 
 in the granting of licences for the sale of pernicious 
 drinks. At other times, and by fits and starts, 
 pohtical action has been in aid of sanitary work. 
 So far back as the reign of Edward the Third, 1361, 
 a royal proclamation was made through Parliament 
 for preventing the slaughter of cattle in the streets 
 of London, because of the pollution of the streets 
 and the drains which arose from that cause. From 
 that time under great emergencies other similar 
 
10 THE FUTURE OF SANITARY SCIENCE: 
 
 acts came into force. They rarely worked very 
 long. As tlie urgent necessity for tlieir existence 
 passed away, they wereljallowed to fall into abeyance, 
 and no permanent maciiinery was kept in order for 
 insuring their continued and effective action. 
 
 Let me not, however, be understood as con- 
 veying any special charge of neglect against English 
 legislation. It is just to state, as an historical fact 
 most creditable to our national history, that our 
 legislators have by a long precedence over those 
 of other nations, taken the lead in sanitary affairs. 
 In 1802 the great sanitary Act for regulating the 
 labour of children in factories set the example from 
 which much useful legislation has followed at home 
 and abroad. In 1838 the great original sanitary 
 scheme for the registration of the births and deaths 
 of the kingdom was inaugurated, to become a 
 collection of facts relating to life, and disease, and 
 death, of which there is elsewhere no parallel. 
 And, since the era of the Crimean campaign, so 
 much legislation has been attempted bearing on 
 health, I dare not attempt even to enumerate the 
 titles of the different measures that have been 
 introduced. At this moment there can be no 
 doubt as to the sincerity of our governments, of 
 whatever party they may be composed, for deahng 
 
POLITICAL, MEDICAL, SOCIAL. 11 
 
 witli every subject relating to the public health 
 iu an efficient manner, and m as rapid a progression, 
 as the slow and sure mode of parliamentary pro- 
 cedure will permit. The subject indeed presses 
 at this moment with so much force on the govern- 
 ing mind, that if there be any danger ahead it is 
 the danger of too miraculous a draught of small 
 enactments, to the exclusion of comprehensive 
 measures which all who run may read. 
 
 In saying this it is necessary to guard myself 
 against error of expression. By comparison with 
 all the nations of the world beside, we have 
 obtained legislative measures which are splendidly 
 comprehensive. Ko other country in the world 
 can present an approach to the Public Health Act 
 of 1875. The Act, as far as it goes, is admirably 
 constructed. Its constitution of sanitary authorities 
 throughout the kingdom ; the power it vests in 
 those authorities to appoint learned medical officers 
 of health ; the pro^^sions it makes for securing 
 to each locality better sewerage, freedom from 
 nuisances, improved water supply, regulation of 
 cellar dwellings, governance over offensive trades, 
 and removal of unsound foods ; the provisions for 
 prevention of spread of infection and for the 
 erection of hospitals and mortuaries ; and the pro- 
 
12 THE FUTURE OF SANITABT SCIENCE : 
 
 visions for tlie regulation of streets and higliways^ 
 ligliting of streets, establisliment of pleasure- 
 grounds, and regulation of slaughter-liouses — these, 
 as well as tlie general provisions for tlie carrying 
 out of the Act, are most commendable as practical 
 plans by the working of wbicli the nation may be 
 tempered into sanitary mould of thought and 
 character. 
 
 In a word, the Act of 1875 is an improvement 
 of the first degree on all that has preceded it ; and 
 although much of it, by the necessities of the 
 constitution of our country, — which recognises the 
 domination of free will even in its age of ignorance, 
 — is of a permissive nature, the working of the Act 
 must in a few years remove a great amount of 
 disease from the land, and prevent the invasion of 
 diseases of an epidemic and spreading type. 
 
 Sanitation admits of being studied from two 
 distinct points of view, the legislative and the 
 scientific. The legislator may say, and perhaps 
 with justice, that the production of such a measure 
 as the Act of which, I now speak is as much as 
 can be done. The man of science may say that 
 this is childish talk, that much more requires to 
 be done; and that, after all, that which has been 
 done, though it be comparatively great, is practi- 
 
POLITICAL, MEDICAL, SOCIAL. 13 
 
 cally imperfect and very little. Science in tliis 
 respect is always in advance pf legislation, and 
 that is her true place, — the pioneer^s place. I 
 remember the time perfectly when every fragment 
 of the Public Health Act of 1875 was in the hands 
 of men of science solely, and was called a chimera, 
 over which great lawgivers shook their wise heads 
 and passed by.' 
 
 At this moment the positions of science and 
 legislation are relatively the same as they have 
 ever been, and it is fair for us men of science now, 
 as in the past time, to declare the way ahead for 
 the law-maker. I shall proceed again, therefore, 
 as I have often before, to indicate one or two 
 new starts in sanitary legislation, not from the 
 legislative but from the purely scientific point of 
 view, and uninfluenced by the many and vehement 
 individual grievances and troubles which beset 
 the path of the minister of state. In so doing I 
 shall indicate also, by inference, what I think 
 our society ought to support in the sanitary policy 
 of the future. 
 
 In the first place, then, we ought to expect in 
 the political progress of sanitation that there will 
 be established in connection with the Government 
 one central department, in which every subject, 
 
U THE FUTURE OF BANITABY SCIENCE: 
 
 directly and even indirectly connected witli tlie 
 liealtli of the people, will be considered. This 
 department, it is to be hoped, will be under the 
 control of a Cabinet Minister, and will supervise 
 the sanitary work performed at present by the 
 Local Government Board, the Registrar-General's 
 department, the sanitary regulations of jails and 
 reformatories, and all the duties now pertaining 
 to the supervision of factories, in so far as the 
 health of the employed is concerned : in fine, 
 every sanitary work that can be weeded out of 
 every other department of the State. 
 
 To such a central board or department a specific 
 name is necessary. The name should be as distinct 
 as that of the department for War, for the Navy, 
 for the Exchequer, or for the Post Office. The 
 name, it is to be hoped, will be emphatically the 
 Health Department, and the chief of it the Minister 
 of Health. 
 
 It may be urged that substantially we are 
 drifting into some such order as is here suggested. 
 It may be urged that the Local Government Board 
 is step by step assuming the duties assigned, as 
 above, for the State Department of Health. To 
 some extent this is true ; and it might be advisable, 
 for the sake of the connection which must always 
 
POLITICAL, MEDICAL, SOCIAL. 15 
 
 exist between sucii a central board and the various 
 local boards in the kingdom, to add to the name of 
 Health Department that of Local Government 
 Board. But for the sanitary object the leading 
 name must be Health, and Local Government 
 must come in merely as indicative of the con- 
 nections that exist between the State and the 
 local centres, — as the machinery. 
 
 In this question of progress there is involved an 
 immense deal in a name. It is essential to the 
 scientific sanitary teacher that every reasoning 
 mind in the kingdom should become f amihar with 
 the two significant words : Public Health, or National 
 Health. It is equally necessary to let the people 
 know fully that the Government has the health of 
 the country under its general and wise supervision. 
 But it is utterly impossible to make either of these 
 facts understood by the masses so long as any sani- 
 tary authority, central or local, has a title which 
 fails to convey the meaning of its functions. To 
 speak to the masses who are listening to a lecture 
 or discourse on health about a local government 
 board is only to confuse them. They ask you after- 
 wards what it all means, and they go away imbued 
 with the impression that it means anything except 
 what relates to the health of the people. 
 
16 THE FUTURE OF SAmTABY SCIENCE: 
 
 I am speaking very practically in suggesting 
 that in the course of political sanitary progress it is 
 an absolute necessity for success to give its proper 
 and only name to the department of State which 
 presides over the national health. I do not state 
 too much in declaring that every public measure 
 would carry more weight if it went forth as being 
 under the supervision of the health department. It 
 may appear a refinement of illustration, and yet it 
 is a sound argument that vaccination would have 
 met and would meet with far less opposition if it 
 were enforced under the general supervision of a 
 State department of health. As it is, the people 
 connect the carrying out of vaccination with some- 
 thing other than health, and even as distinct from 
 the idea of conservation of health. Vaccination is 
 looked upon as a legal tyranny, having no scientific 
 setting forth of its inteation, and springing from no 
 scientific authority. If you attempt to reason with 
 its active opponents on the subject, and refer to the 
 authority that exists, they dispute the competency 
 of the authority in name and form ; and, foolish 
 as the objection may be, it is potent for ob- 
 struction. 
 
 In making this suggestion there is no necessity 
 to offer a word against the continued action of local 
 
POLITICAL, MEDICAL, SOCIAL. 17 
 
 self-government. Tlie work of tlie local centres in 
 all parts of the kingdom, instead of being in any 
 degree curtailed and restrained, should be encour- 
 aged and maintained. In the sanitary local work 
 the word Health should, however^ again come for- 
 ward as the one prominent designating term to 
 which all others should be subject. 
 
 Our Sanitary Institute could not turn its atten- 
 tion to any more suitable labour than that of incul- 
 cating the necessity for the institution of one State 
 department exclusively devoted to the health of the 
 people. In the success attending such an effort a 
 double result would be achieved. The country 
 would have secured for it the best and most direct 
 guidance on its most vital interests, and scope would 
 be given to the industry of men of science in a new 
 direction. Men whose lives have been devoted to 
 the study of life and health, would be prepared by 
 their devotion for the accepted service of their 
 country in pubHc form, and the Houses of Parlia- 
 ment would become, at last, congenial spheres for 
 their labours. The Houses would be strengthened 
 by such adhesions ; the men would be more useful 
 and honoured. 
 
 Another work in the political line which will be 
 demanded in the future for the benefit of the sani- 
 
 B 
 
18 THE FUTURE OF SANITABY SCIENCE: 
 
 tary cause is the preparation of sucli a digest of all 
 our practical sanitary laws that every person of in- 
 telligence can read and understand what may be 
 legally enforced for the maintenance of health. 
 What may be done in this direction ought to be so 
 simple and so plain as to be brought into a school- 
 book. Not a line should be left for the subtlety of 
 the legal brain to twist into contortioned illegi- 
 bility. The laws by which the health of a man, and 
 thereby of a nation, can be preserved to the utmost, 
 are so simple in nature that nothing but the utmost 
 simplicity can truly express them ; and the whole 
 labour of the future, if it is to be of any service 
 whatever, must be directed to the discovery and 
 establishment of such simplicity of exposition and 
 direction. Up to the present time much that has 
 been done has been provoked by that most un- 
 trustworthy of all human provocatives to action — 
 fear. Some great epidemic has occurred that has 
 caused universal dismay; some great catastrophe 
 has occurred, like that of the Crimean campaign, 
 which has excited universal criticism on the failure 
 of sanitary provisions by the authorities of the 
 nation. Some such slip has been permitted in 
 sanitary rule as that which recently let scurvy 
 undermine the workers during a great enterprise 
 
POLITICAL, MEDICAL, SOCIAL. 19 
 
 of discoYery. Straightway on the heels o£ such 
 events there have been commissions of inquiry^ and 
 as a direct or indirect result, there has often come 
 forth some particular enactment. Or, and this is 
 by no means rare, some individual of the House of 
 Commons, impressed with the danger of a great 
 national evil, has pressed for a national remedy, 
 and, by steady persistence session after session, 
 and by showing that he never knows when he is 
 beaten, has forced the Government to take up his 
 measure and to carry it through. 
 
 From these modes of legislating for health we 
 have obtained many minor acts which fill and refiU 
 the national statute books. And still this process 
 promises to go on, a process of labour in a circle, 
 with much loss of time and expenditure of force 
 without ultimate progression. 
 
 It would be vain to find fault with the Statecraft 
 of the past for its doings. As vain to find fault with 
 the State for meeting State disorders by empirical 
 remedies as it would be to find fault with the physi- 
 cians of a former day for the same mode of procedure. 
 If the people demand a recipe they must have it, be 
 it from the State or the family physician. The 
 question that now comes forward is whether the time 
 has not arrived for ceasing to treat the health of 
 
 B 2 
 
20 THE FUTURE OF SANITARY SCIENCE: 
 
 tlie nation by specific or supposed specific remedies 
 for particular errors, and whetlier we may not find 
 in the future a few very simple and natural guiding 
 principles on whicli all acts of Parliament relating 
 to the health of the people may be based ? 
 
 Before this effort can be attempted, the existing 
 acts that touch on health, — public health acts, me- 
 tropolitan health acts, contagious diseases acts, 
 vaccination acts, factory acts, acts relating to the 
 importation of cattle, adulteration acts, and others 
 relating to prisons, workhouses, and the like, and 
 which, if they even lie latent, are not repealed, — 
 these, one and all, require to be considered together,, 
 with the view of determining whether an English 
 or even a British act of settlement for the vital 
 regeneration of the realm is not practicable on a 
 simple natural basis of natural requirement. 
 
 I am fully aware that this suggestion carries 
 with it the idea of a gigantic labour; but it will 
 have to be done; and, once fairly tackled, I dare 
 say the apparent difficulties will readily dissolve 
 away. It is a mere question between doubting 
 and attempting : and we all know and feel that 
 
 " Our doubts are traitors, 
 " And make us lose the good we oft might win 
 " By feariug to attempt." 
 
POLITICAL, MEDICAL, SOCIAL. 21 
 
 Supposing tlie existence of an efficient central 
 department of health acting under the direction of a 
 minister of health, a grand new duty, as it seems to 
 me, would be to determine what is the evil or what 
 are the evils that have to be removed in order that 
 the cleanest bills of health may be regularly pre- 
 sented to the nation. Without such prehminary 
 knowledge all sanitary work is unsound to the last 
 degree. It were as wise for me to write a prescrip- 
 tion for a man without inquiring into his disease, 
 his antecedents, and modes of life, as for the State 
 physician to prescribe for national sickness without 
 inquiry into the nature of the sickness, its antece- 
 dents, and the cause or causes that have led up to it. 
 The great work, therefore, and indeed the first sani- 
 tary work of the future, standing before all other 
 sanitary legislations except the formation of the 
 central authority, is the systematic enumeration, 
 week by week, of the diseases of the kingdom, 
 through the length and breadth of the kingdom. 
 It is utterly hopeless to attempt any decisive 
 measure for lessening the mortahty, which is cer- 
 tainly more than double what it ought to be, until 
 this State labour is faithfully carried out. It is 
 vain, comparatively speaking, to know what totahty 
 disease hands over to death, unless we know also 
 
22 THE FUTURE OF SANITARY SCIENCE: 
 
 ■what healtli under one or other cause of disturb- 
 ance yields over to disease. Physicians and statists 
 strain their eyes to try to get at the extent of 
 disease. Laborious geographers like Mr. Haviland 
 spend years in constructing maps from the tables of 
 mortality, in order to get a mere approximation of 
 the distribution of disease in England ; and mean- 
 while disease itself, constantly cheating the ob- 
 servers, is making its way without being under any 
 systematised recorded observation. 
 
 For the omission of a registration of disease 
 there is no conceivable excuse. The thing has 
 only to be done. The organisation of the Eegis- 
 trar-General's department has fully opened the way 
 to the collection and the utilisation of the facts 
 relating to birth and death. These elements swing 
 in the statist's balance readily, and are balanced 
 by our consummate state weigher of life and death. 
 Dr. Farr, as accurately as the Chancellor of the 
 Exchequer balances the national ledger. With 
 equal readiness. Dr. Farr, if the data were collected 
 for him, could tell from week to week the health as 
 well as the mortality of the kingdom. In a short 
 time, under such regular record, the whole nation 
 would know the reigTiing health, the reigning 
 diseases, of every centre of life. And if, as might 
 
POLITICAL, MEDICAL, SOCIAL. 23 
 
 easily be done, the diseases of the lower animals 
 and the diseases of the vegetable kingdom were 
 included in the returns,, all the facts of disease 
 would be completely rendered. 
 
 As far back as twenty-two years ago I made 
 an attempt to carry out this design of regis- 
 tering the diseases of the kingdom. I refer to 
 that effort again for a simple reason, — for the 
 purpose of indicating that there is really no greater 
 difficulty in getting the facts than there is in 
 utilising them. I attempted no more than the 
 registration of the epidemic diseases, and I could 
 afford no more than the publication of a quarterly 
 abstract of the data that were forwarded. But in 
 a short time fifty medical observers were sending 
 in returns from as many stations, extending from 
 St. Mary^s, Scilly, to Lerwick, in the Shetland 
 Islands. These stations could easily have been 
 increased to any extent, and the amount of in- 
 formation regularly communicated was indeed most 
 valuable. 
 
 Two facts connected with this attempt are, 
 perhaps, worthy of note : one as showing something 
 determined, and the other as showing something 
 suggested. In the returns sent from the district 
 of Canterbury, in the spring quarter of the year 
 
24 THE FUTURE OF SANITARY SCIENCE: 
 
 1857, was included tlie first account of tlie invasion 
 of this country, at least in any known time, by tlie 
 disease since tlien so prevailing and fatal — diph- 
 tlieria. This disease first appeared in the little 
 village of Ash, and was called the Ash fever. The 
 outbreak was observed and recognised by Mr. 
 Eeid_, of Canterbury, and was reported to my 
 register by Mr. Haffenden, who collected for me 
 the facts of prevailing diseases from eight medical 
 observers living near to him, of whom Mr. Reid 
 was one. The first facts of a new disease in this 
 country were thus recorded on the spot, which is 
 something even as matter of history. How such 
 a fact, reported at once to a central Governmental 
 authority, might be dealt with; how promptly a 
 central authority so advised might act in arresting 
 a fatal epidemic at its origin, and what national 
 service might be rendered thereby, you, quite as 
 well as I, can judge ! 
 
 The fact of a suggestive nature springing from 
 the working of the returns is not less interesting. 
 The labour led me to refer to the returns of sick- 
 ness sent every week by the medical officers of the 
 Poor-Law districts to their boards of guardians. I 
 found that these returns, which are over 3000 in 
 number, and which, when they have served their local 
 
POLITICAL, MEDICAL, SOCIAL, 25 
 
 purpose, are practically worthless, could by the 
 slightest modification be utilised as returns of the 
 sickness of all the sick parochial population under 
 official medical care, and I submitted a plan for such 
 utilization to pubHc approval and to the Govern- 
 ment, but without effect. Yet, if the plan had 
 been adopted, from those three thousand weekly 
 returns, cast away and still cast away, I calculate 
 that 156,000 tables of disease per year would 
 have been submitted to scientific analysis, and 
 since the time when the suggestion was first made, 
 would have multiplied into 3,276,000 tables, in- 
 cluding in each table a record of at least ten times 
 as many particular examples of disease. To what 
 important national uses such an array of facts 
 systematically arranged and examined could have 
 been applied, you, as well as I, can judge ! And 
 still neither of us can judge effectively, because 
 in dealing with data taken from nature there is 
 always something important to be ehcited which 
 never was looked for, and often, too, that some- 
 thing unlooked for is better than that which was 
 specially looked for. 
 
 Our Sanitary Institute will do well in continuing 
 to press this scheme for the registration of disease 
 on the Government, and it may greatly assist the 
 
26 TEE FUTURE OF SANITARY SCIENCE: 
 
 work by lendiDg its mind to the best means of 
 collecting the facts on wbich tbe weekly reports 
 of disease will have to be based. I might enlarge 
 on this part of my subject^ but I should prefer to 
 remain silent until the views of the medical officers 
 of health, now a large and influential class, have 
 been correctly ascertained. My present purpose 
 is served if I have sufficiently redirected public 
 attention to the principles of the design. 
 
 In the future of sanitary science the politician 
 must come forward more determinately than he 
 has yet done, in order to secure for those over 
 whom he governs three pure requisites — pure 
 "Water, pure Food, pure Air. 
 
 The Public Health Act of 1875 deals with the 
 water question, and makes provisions for the local 
 authorities to supply their respective districts, by 
 means of a company, or by independent action. 
 For my part I see no hope of any effective change 
 for the better by these propositions. It is utterly 
 hopeless to trust to companies in a matter of such 
 vital moment. It is equally hopeless to trust to 
 the undirected action of local authorities. If we 
 trusted to such agencies for the collection and 
 delivery of letters by post, does any one suppose 
 that the results of our present postage system would 
 
POLITICAL, MEDICAL, SOCIAL. 27 
 
 be attained ? Yet important as intercommunication 
 by letter is, it is less important than the supply in 
 clue quantity and pure quality of that vital fluid 
 which makes up three parts out of four of every 
 human organism, and which is wanted as much by 
 the millions who never receive a letter, as by the 
 millions who do. In this political part of sanitation, 
 the Government must do one of two things. It 
 must either produce a process or processes for 
 pure water - supply, and insist on every local 
 authority carrying out the proper method; or it 
 must, — and this would be far better, — take the 
 whole matter into its own hands, so that, under 
 its supreme direction, every living centre should, 
 without fail, receive the first necessity of healthy 
 life in the condition fitted for the necessities of all 
 who live. 
 
 By recent legislation we have some security for 
 obtaining fresh animal food, and foods freed of 
 foreign substances or adulterations. The penalties 
 that may be inflicted on those who sell decomposing, 
 diseased, or adulterated foods are beginning to have 
 effect, and much good is resulting. Nevertheless, 
 even here the legal rule falls short of completeness. 
 The inspection of animal food is as yet most un- 
 systematic and imperfect. With all our richness 
 
28 THE FUTURE OF SANITARY SCIENCE: 
 
 of means ready at command, we liave not ap- 
 proached that admirable system for the inspection 
 of animal foods which our J ewish brethren, through 
 ages of ignorance and oppression, have managed 
 so efficiently to carry out, and which has entirely 
 saved them from many of the great calamities o£ 
 disease that have fallen on less careful people. 
 The complete inspection of animal foods, including 
 milk, is a clear piece of sanitary law, which, from 
 day to day and hour to hour, must, ultimately, be 
 enforced. 
 
 Imperfect as legislation may be in respect to 
 supply of pure water and food, it is advanced in 
 these directions when the steps it has taken for 
 supplying pure air are brought under observation. 
 There is no practical legislation of any kind on 
 this requisite. The air of our large towns is charged 
 with smoke and impurity. The air of our great 
 factories is charged with dusts which destroy life 
 with the precision of a deadly aim. Dr. Purdon, 
 one of the certifying surgeons under the Factory 
 Acts, reports concerning the carders, that in the 
 flax-working factories under his care, if a girl 
 under eighteen years gets a card, she very rarely, 
 if constantly employed at it, lives beyond thirty 
 years. 
 
POLITICAL, MEDICAL, SOCIAL. 29 
 
 In tlie application of political science to pre- 
 servation of health, not one subject presses more 
 earnestly than the question of the supply of a pure 
 atmosphere to the millions of industrials of these 
 islands. In an inquiry I recently undertook on 
 this matter for the Society of Arts, Manufactures, 
 and Commerce, the facts that came before me were 
 as of- a new world. You will find a compact mass 
 of these facts in the lectures I had the honour to 
 deliver before that learned society. Those lectures 
 contain a tithe only of the things seen. I am quite 
 sure that our leading politicians can have no 
 adequate conception of the mental and physical 
 condition of the great industrial classes, or of the 
 need that exists for reconciling those classes to 
 their fate. The following truths he who runs may 
 read. 
 
 The catechism has failed to satisfy these classes. 
 Bad air keeps up in them a depraved mental as 
 well as physical state. Their poverty and not 
 their will consents to their condition. In short, 
 as a physician dealing with the physiological and 
 psychological phenomena belonging to a class 
 instead of an individual, — and this is all the 
 difference there is between a politician and a 
 physician, — my diagnosis is that a serious organic 
 
30 THE FUTURE OF SANITARY SCIENCE: 
 
 condition, febrile, fitful, fatal, exists in this part of 
 tlie nation, demanding the watcliful consideration 
 of all physicians, State and ordinary ; and that the 
 sooner the natural cure for it — pure air, and plenty 
 of it — is let in, the better for every class every- 
 where. 
 
 All political troubles have a physiological cause. 
 To the statesman not less than to the physician, 
 physiology is the only true source of knowledge. 
 A society such as ours, therefore, possessing as it 
 does professed physiological skill, may render most 
 important service by tracing out for the legislator 
 the simplest scientific means for removing at- 
 mospheric impurities, and by preparing for that 
 sanitary future when men universally shall breathe 
 purity even with their freedom. 
 
 If any other incentive to action in this direction 
 were required it would be the further fact that all 
 diseases, mental and physical, national and indi- 
 vidual, begotten of an impure atmosphere, are 
 transmitted on. The consumption of body, the 
 restlessness of mind, are reproduced and gain in- 
 tensity of development with each generation, until 
 practically they inaugurate a distinct racial type of 
 human imperfectness. 
 
 With this topic of legislating for pure air would 
 
POLITICAL, MEDICAL, SOCIAL. 31 
 
 come in naturally tlie question of homes for tlie 
 people, and the development of those recent acts 
 which have been passed to meet the necessity. 
 These efforts of the world political can scarcely be 
 over-estimated ; but there is one movement which 
 stands before them and which has been singularly 
 overlooked. It is essential that the home of the 
 working man should in every case be cleared of the 
 details of daily work. So long as he is compelled 
 to work in the room in which he sleeps and takes 
 his food, so long his home must be an unhealthy 
 centre; and too often it will be the centre from 
 which infected work will pass out, bearing infection 
 into the homes of the wealthy. A modification of 
 factory legislation, by which a free and properly- 
 regulated work-room should be within the easy 
 reach of every working man in every crowded 
 centre, is a necessity which all sanitary labourers 
 should strive to get supplied. Our Institute has 
 another urgent task before it in the effort to enforce 
 this necessity on public attention. 
 
 In the future of sanitary science one more 
 amongst many other reforms of a pohticaJ character 
 must needs claim important consideration. I refer 
 to the political assistance that must be given to aU 
 of us who are engaged in the labour of quenching 
 
32 THE FUTURE OF SANITARY SCIENCE: 
 
 the drunkenness of our land. Oar best sanitary 
 efforts will fall far short of their deserts until this 
 object shall be achieved. Over the future of sanitary 
 science will be suspended a pall of sorrow until this 
 object shall be achieved. Does anyone desire to 
 know how the mortality of the kingdom is modified 
 by strong drink, let him read the knowledge in the 
 State record book, which tells that those who sell 
 the destroyer die by it at the rate of one hundred 
 and thirty-eight to the hundred of the working 
 populations. Then, starting from this signal fact, let 
 him trace the influence of the destroyer through 
 all the courses of diseases which, under learnedly 
 obscure names, spring from it and kill from it in all 
 classes of society. Finally, let him reckon up the 
 hereditary evils which are engendered by the same 
 destroyer, and the influence of that on the course of 
 disease, and his lesson will be in some measure 
 complete. 
 
 I do not think the present the occasion to discuss 
 the value of the different political sanitary measures 
 that have been, or are at this time, in the public 
 mind for the repression of the national evil now 
 touched upon. It is sufficient for me to state two 
 impressions only. First, that every day^s ex- 
 perience of the question in various communities 
 
POLITICAL, MEDICAL, SOCIAL. 33 
 
 where, as a teacher of abstaining temperance, I 
 am wont to labour, indicates to me that unless 
 the State does come to the aid of the teacher the 
 Ijattle against intemperance must be indefinitely pro- 
 longed. Secondly, that if the State, itself doing 
 nothing active in the way of repression, would but 
 determine to cease to legalise the cause of the 
 evil and would cease to make revenue out of the 
 transaction, the labours of the temperance reformer 
 would soon be crowned with the most signal suc- 
 cess. Hitherto this has not been considered as 
 :i sanitary question. In the future no sanitary 
 
 tudent will venture to exclude it from his studies. 
 
 The contemplation of the political sanitary 
 future of this kingdom offers many other topics, 
 all of which I must leave, in order to devote a 
 few minutes to sanitation in its relation to medical 
 
 cience. 
 
 THE MEDICAL PART. 
 
 The influence which sanitation will exert in the 
 future over the science and art of medicine promises 
 TO be momentous. It promises nothing less than 
 the development of a new era; nor is it at all 
 wide of the mark to say that such new era has 
 
34 TEE FUTURE OF SANITARY SCIENCE: 
 
 fairly commenced. The greatest of tlie world's 
 pMlosoplierSj tlie pMlosoplier whose thoughts cover 
 the world of science as with a garment, — I mean 
 Lord Bacon, — said of the medicine of his day, that 
 it stood for judgment on quite different merits than 
 did other learned pursuits. " Other arts and 
 sciences/' he argued, '*^are judged of by the power 
 and ability exhibited in the conduct of them by 
 their professors, and not by success or by events. 
 The lawyer is judged by the skill of his pleading, 
 not by the issue of the trial ; the pilot by his skill 
 in directing the course of the ship, not by the 
 fortune of the voyage. But the physician can 
 perform no particular act by which his ability can 
 be directly demonstrated, and therefore he is 
 principally judged by the event, which is very 
 unjust. For who shall decide, if a patient die or 
 recover, whether the good or the evil is brought 
 about by art or by accident ? Whence," says he,, 
 ^'imposture is frequently extolled, and virtue 
 decried. Nay, the weakness and credulity of men 
 is such that they often prefer a mountebank or a 
 cunning woman to a learned physician. So the 
 ancients made Esculapius and Circe brother and 
 sister, and both children of Apollo. Hence/' he 
 adds, " physicians say to themselves, in the words 
 
POLITICAL, MEDICAL, SOCIAL. 35 
 
 of Solomon : ' If it befall to me as befalleth fools, 
 why should I labour to become more wise?' And 
 therefore one cannot wonder that they commonly 
 study some other art or science more than their 
 profession^ because they find that mediocrity and 
 excellency in their own art makes no difference in 
 profit or reputation; for man's impatience of 
 diseases^ the solicitude of friends, the sweetness 
 of life, and the inducements of hope, make 
 them depend upon physicians with all their 
 defects/' 
 
 Had Bacon spoken these sayings in the present 
 day, he had spoken, with one or two exceptional 
 errors, as truthfully as he spoke in his own time. 
 Had he been a physician, he might indeed have 
 gone farther than he did. He might have de- 
 clared his too frequent and utter inadequacy to 
 decide whether his own success rested, in par- 
 ticular instances, on skill or on accident. He might 
 further have told how often the cheek of the right- 
 minded physician pales or burns with doubt, as he 
 hears his own praises declared for skill which he 
 himself cannot for a moment take credit for to his 
 own heart. This has been the fate of medicine 
 until our day. On such fate all the quackeries 
 
 have flourished; on it all the "pathies" and 
 
 c 2 
 
36 THE FVTUBE OF SANITARY SCIENCE: 
 
 dogmatic systems of medicine liave flourislied ; on 
 it tlie idea of cure has found too willing acceptance 
 and belief. 
 
 At last a change has come over the science of 
 medicine. With true nobleness of purpose^ true 
 medicine has been the first to strip herself of all 
 mere pretences to cure, and has stood boldly forward 
 to declare as a higher philosophy the prevention of 
 disease. The doctrine of absolute faith in the 
 principle of prevention indicates the existence of a 
 high order of thought, of broad views on life and 
 health, on diseases and their external origins, on 
 death and its correct place in nature. The doctrine 
 of absolute faith in curative medicine, of power 
 vested in the hands of a distinct sect or class, and 
 exercised by them as by regal right and without 
 the assistance or interference of those upon whom 
 it is exercised, indicates a low standard of know- 
 ledge; a too confiding spirit in the wisdom of a 
 minority ; a departure too wide from the safe law 
 of self-preservation ; an ignorance of the avoidable 
 causes of diseases ; a blindness and therefore an 
 unnecessary exposure to danger; an overweening 
 and sudden fear of dangers of all kinds, little and 
 great; and a hasty and thoughtless pursuit after 
 that mode of rescue from dangers of disease which 
 
POLITICAL, MEDICAL, SOCIAL. 37 
 
 claims for itself tlie greatest pretensions and boasts 
 the greatest successes. 
 
 It shall remain as one of the glories of medicine 
 that she herself has first seen these truths, and, 
 willing to sacrifice her own interests to truth and 
 light, has put them forward without fear, without 
 reward. In the science of prevention medicine 
 takes, in fact, all the world with her. The science 
 becomes a political, a social, as well as a medical 
 study. It appeals to every mind. When it once 
 is so set forth it fills all men with its teachinsrs. 
 
 o 
 
 It models itself into household truths and com- 
 mingles with the moral and even religious elements 
 of life. Admitted for a season into the household, 
 it steps forth again to find its way into the legis- 
 lature. It becomes eventually a governing science, 
 a law. 
 
 This scientific course commenced, must needs 
 go on. But in its going it must needs also change 
 gi'eatly the old face of medicine, and remove in the 
 change the Baconian reproach. I do not think 
 there is much difficulty in foreseeing what in the 
 main the change will be Hke. 
 
 I need not say that the " pathies " will go. 
 The " pathies" of all kinds are as dead as door-nails, 
 and wait only to be decently interred in a common 
 
38 THE FUTURE OF SANITARY SCIENCE: 
 
 grave. In time tlie word Cure will go altogether. 
 It is clear already that there is indeed no such 
 thing. A man born to live through a given cycle 
 lives through it free of disease, unless he be 
 stricken from without. If he be stricken, and by 
 the stroke the natural functions, by the exercise 
 of which he lives, are not so disturbed but that 
 they can swing back again in due order, he may 
 recover. If he be stricken beyond this, he will die. 
 Nature will pursue her course undisturbed by either 
 event. She wHl make no special effort to kill, and 
 assuredly she will put out no special hand to save. 
 A man may intervene, and may, by knowledge, 
 put the stricken body into such a condition that it 
 may swing back into natural course, whereby he 
 will have put it into a condition in which it will 
 not die. This is the very highest development of 
 medical art resting* on science. But it is not cure, 
 in the common meaning of that term. 
 
 By the progress of sanitary science and by its 
 influence on practical medicine we shall attain these 
 perfect rules of management after the infliction of 
 the stroke of disease ; and I do not doubt that the 
 art of placing the stricken under such conditions 
 that they may not die will for ever afford scope for 
 the inventive genius of man. The more immediate 
 
POLITICAL, MEDICAL, SOCIAL, 39 
 
 triumplis will, however, come in that part of the 
 work which is purely preventive. Down from the 
 skies comes the forked lightning and lays a man 
 prostrate. It is a question for the ages who shall 
 place that man in a condition under which he shall 
 certainly swing back again into life. But the 
 preventive art that puts up a metallic rod to divert 
 the lightning from other men, that is the present 
 triumph of human skill, skill which, carried to 
 perfection, shall prevent the stroke and put out 
 the so-called curative art by removing the necessity 
 for its application. 
 
 With the progress of sanitary science we must 
 expect to see preventive medicine taking the 
 ascendency. Cure will cease, prevention will grow. 
 Humanly- made epidemics, like the great plague of 
 London, which was planted and reared in the rush- 
 covered floors of domiciles saturated with the 
 organic refuse of years, or like the modern typhoid, 
 which is fed by streams of drinking-water un- 
 cleansed from human excreta, such self-made 
 epidemics will be prevented by simple mechanical 
 skill. Diseases imposed by indulgence in harmful 
 pleasures and appetites, or by physical overwork 
 and shock, will be removed by the effect of moral 
 influences and knowledge of cause ; and gradually. 
 
40 THE FUTURE OF SANITARY SCIENCE: 
 
 I believe, those persistent evils, which, like the 
 lightning- stroke, come without human ordinance or 
 fault, will also be placed under some protecting 
 care, and, if not removed, will be reduced to a 
 short calendar. 
 
 It is felt by some that the medical sanitarian 
 of the future will have his best efforts thwarted bv 
 the forcible excess of life beyond the means that 
 can be found for the support of life, as if life were 
 a mere secondary principle in the universal order. 
 I see no such cause for fear. That in the progress 
 of life on the earth the day will ever come when 
 the earth will not supply food for its people, is, to 
 my mind, pessimism carried into an insane vulgarity. 
 It is clear that man can always reduce to his wants 
 the lives of all animals except man. The question 
 rests, therefore, on the abnormal increase of man 
 alone. Nature knows that and rules accordingly. 
 Let mankind remain savage, and, however sensual 
 it may be, it will die fast enough by war, plague, 
 famine, or luxury. In that state it will never 
 overstock the earth, but will either grope in soli- 
 tary places a neglected family, unprotected from all 
 the killing vicissitudes, or will sink into luxurious 
 barbaric decadence. Let man become exalted in 
 life, exalted by communion with noble pursuits, 
 
POLITICAL, ilEBICAL, SOCIAL. 41 
 
 T^'itli pursuits of science, art, letters, and cultivation 
 of greatest happiness for the greatest number, and 
 his sensual hfe will become too subject ' to the 
 virtues to leave a chance for the danger which a 
 low sensuaHty sets up as a terror, and, at the same 
 time, a temptation for the vulgar. 
 
 Moreover, in studying this question, we must 
 never fail to take into account the vast resources 
 for food supply which, up to the present time, in 
 the ignorance of the world, the world has ignored. 
 The study of the chemistry of food, and the appli- 
 cation of such study to practical and economical 
 uses, has but just seen its infancy; and we, there- 
 fore, have no conception as yet what resources of 
 foods are in the gifts of Nature for our use. The 
 correct modes of growing and multiplying foods 
 are still imperfectly known, and probably will be 
 till some necessity presses. Certain it is that there 
 are endless resources to be opened to us by the 
 hands of science; and when with the work of 
 science the work of prudence is combined, so that 
 the daily mass of wantonly wasted foods shall be 
 duly applied, we shall be in no fear that the demand 
 for food will exceed the supply. 
 
 I think it my duty to deal plainly with a question 
 which affects so closely the future of sanitation, and 
 
42 THE FUTURE OF SANITARY SCIENCE: 
 
 to express, from an experience wliich is confirmed, 
 as I know, by some of tlie brightest ornaments of 
 my learned profession, tbat nothing is wanted to 
 correct the danger of over-population but improve- 
 ment of mental process, nearer communion with 
 the Eternal Mind in His works, purer artistic 
 education, healthier homes, more rational amuse- 
 ments, and the ennobling influence of a holier life 
 amongst those who assume to be the cynosures of 
 the nation. 
 
 On the whole the prospects of medical learning 
 and action will be greatly improved by sanitary 
 advancement. It is possible that fortunes and re- 
 putations resting on faith in famous curers will 
 dwindle slowly away, and that not for long will 
 the skill of the physician be valued by the fallacious 
 reckoning of mere results. But in exchange there 
 will be opened to the physician a career in which 
 skill of labour will be exhibited together with 
 results, the results obvious as to their relation to 
 the work, and both, when good, successful beyond 
 praise. 
 
POLITICAL, MEDICAL, SOCIAL. 43 
 
 THE SOCIAL PAET. 
 
 The future of sanitary science in relation to 
 social life generally, its effect, that is to say, on 
 all classes of the community, promises steady 
 progress. No one who has been actively engaged 
 for the past quarter of a century in sanitary work 
 can doubt this statement. Throughout all sections 
 of the community there is desire to know ; and if 
 the legislator will be content not to legislate until 
 he sees that free-will guided by knowledge is in the 
 same train with him, — it matters Httle in which 
 class, — all will go well. The workers in our Sanitary 
 Institute, though they be not legislators, can, never- 
 theless, greatly assist Parliament by bringing free- 
 will into harmony with knowledge, and, though the 
 distinction does not at first sight stand out, in 
 separating free-will from ignorance and from those 
 automatic demonstrations of ignorance which are 
 the outward and visible signs of unhealthy habits 
 of life. 
 
 The social work that has to be carried out for 
 the future of sanitary science is purely educational, 
 educational not merely by lectures and books and 
 lessons from books, but by demonstrations of 
 
44 THE FUTURE OF SANITARY SCIENCE: 
 
 sanitary works, plans, buildings, meclianisms : re- 
 sults of all labours bestowed on tlie cause. With- 
 out venturing on details of this kind, which would 
 land me in another address, I may be content to 
 touch on two points, both of vital moment for the 
 future. 
 
 The first of these relates to modes of teaching 
 so as to carry the sympathies of the learner and 
 his more refined tastes along with his reason ; to 
 attract and charm the senses as well as the intellect. 
 It is said of us sanitarians, and sometimes, I fear, 
 with some truth, that we would make health 
 hideous. We need not do so ; and if the feat has 
 ever been accomplished, it is but the work of a 
 '^ ^prentice han^,^' that ought to be forgiven. 
 Health truly is beauty in the living evidences of it, 
 and should be so in those inanimate evidences 
 which the builder and the engineer construct for 
 us. I would therefore urge that in all coming sani- 
 tary work, theoretical or practical, the sanitarian 
 should call the artist also to his side, and that no 
 design of a sanitary kind should ever be executed 
 in which the hand of the artist does not play its 
 beautifying part. 
 
 And if I might suggest so much to the imagina- 
 tive scholars who live to make life sweeter to the 
 
POLITICAL, MEDICAL, SOCIAL. 45 
 
 many, I would ask tliem, — poets, painters, sculptors, 
 players, musicians, — to believe that to render prac- 
 tical even tlieir refined labour is to render that 
 labour more acceptable, more diffusible, more 
 durable. 
 
 The second topic relates to those who require 
 first to be taught the sanitary lessons of the future. 
 I want strongly to enforce that it is the section of 
 the nation which Dr. Farr classes as the domestic, 
 the six millions of women of the nation, on whom 
 full sanitary Hght requires first to fall. Health in 
 the home is health everywhere; elsewhere it has 
 no abiding-place. 
 
 I have been brought indeed by experience to the 
 conclusion that the whole future progress of the 
 sanitary movement rests for permanent and execu- 
 tive support on the women of the country. AVhen 
 as a physician I enter a house where there is a con- 
 tagious disease, I am, of course, primarily im- 
 pressed by the type of the disease and the age, 
 strength, and condition of the sick person. From 
 the observations made on these points I form a 
 judgment of the possible course and termination of 
 the disease, and at one time I should have thought 
 such observations sufficient. Now I know them to 
 be but partly sufficient. A glance at the appoint- 
 
46 TEE FUTURE OF SANITARY SCIENCE: 
 
 ments, and arrangements^ and managements of tlie 
 house is now necessary to make perfect the judg- 
 ment. By this glance is detected what aid the phy- 
 sician may expect in keeping the sick in a condition 
 most favourable for escape from death; and by 
 this is also detected what are the chances that the 
 affection will be confined to one sufferer or distri- 
 buted to many. As a rule "to which there are the 
 rarest exceptions, the character of the judgment is 
 hereupon dependent on the character of the presi- 
 ding genius of the home, on the woman who rules 
 over that small domain. The men of the house 
 come and go; know little of the ins and outs of 
 anything domestic ; are guided by what they are 
 told, and are practically of no assistance whatever. 
 The women are conversant with every nook of the 
 dwelling, from basement to roof; and on their 
 knowledge, wisdom, and skill the physician rests 
 his hopes. How important, then, how vital that 
 they shall learn, as a part of their earliest duties, 
 the choicest sanitary code. How correct the deci- 
 sion of the founders of the Sanitary Institute, 
 that from the first they should include sanitarians 
 of both sexes as working associates. 
 
 To women more than to men this work is new. 
 To women more than to men this work is hard to 
 
POLITICAL, MEDICAL, SOCIAL. 47 
 
 realise. Naturally more conservative than men, 
 tliey are moved witli less haste to tasks of reforma- 
 tion and reconstruction. More sensitive to criti- 
 cism than men, they are given, at first, to resent, 
 as if it were an insult to past customs and usages 
 to which they are attached, the suggestion of inno- 
 vation. But these passing difficulties removed, 
 there is in the hearts of women such matchless 
 generosity, such overpowering love for every device 
 tending to promote the happiness of all things of 
 life, that we sanitarians may indeed be content for 
 the future of sanitary science in its social aspects, 
 if we do no more than win them to our cause and 
 entrust its details to their ministering spell. 
 
 CHARLES DICKENS AND EVANS, CRYSTAL PALACE PRESS. 
 
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