Popular Science Monthly/Volume 68/April 1906/A Sanitary Outlook

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A SANITARY OUTLOOK[1]
By Sir JAMES CRICHTON-BROWNE, M.D., LL.D., F.R.S.

ONE of the hopeful signs of the times is the popular interest that is manifested in health questions. No doubt, as Carlyle said, all men are born hypochondriac, and in all ages—never more so than in the present one—swindlers like Caliogstro have driven a thriving trade in well-advertised potions and specifics, but never before has health in the aggregate been the object of public concernment as it now is; never before have the scientific principles that underline its preservation and the practical methods by which these may be applied become, to the same extent as now, part of the civil polity of the nation. The whole country is valetudinarian now, in the best sense of the word, conscious of its weakness, determined to recover its strength. Topics that not long ago would have been thought suitable only for a medical society are discussed in the streets and across the dinner table, while the newspapers teem with articles on physical deterioration, infantile mortality, tuberculosis and cancer research.

And this is, I think, as it should be. The intelligent cooperation of all classes is needed in carrying on the great work of sanitary reform. There should be no squeamish affectation in ignoring subjects that are of vital and universal significance. There is no mystery in physiology and hygiene, and the better these are understood the greater will be the deference paid to expert opinion in matters in which special knowledge is involved, the clearer will be the appreciation of the boundary where prophylaxis terminates and medical diagnosis and treatment begin.

But the inevitability with which all statements bearing on public health are in these days bruited abroad and the avidity with which they are received make it incumbent more than ever on those who speak with authority on such subjects to observe caution and discretion, for doubts or speculations that would be harmless or even stimulating when addressed to a critical and well-informed audience, may become confusing or misleading when, having passed through the alembic of the journalistic mind, they appeal to the general. I had that brought home to me somewhat forcibly on a recent occasion on reading the newspaper reports, just for one day, of the meeting of the British Medical Association at Leicester. I found there an eminent medical authority reported as giving some countenance to telepathy, which I am sure ninety-nine hundredths of the medical profession regard as an unproven and in its present shape improbable hypothesis, and throwing cold water on the sanatorial treatment of consumption which, I believe the great mass of the medical profession regard as a valuable addition to our means of contending with that malady. Dr. Maudsley deplored the want of sobriety in some medical statements on the popular platform, in consequence of which the public has jumped to the conclusion that because the bacillus has been discovered phthisis is curable, the old notions of its heredity erroneous, the objection to phthisical marriages obsolete, and the right thing to do forthwith to dot the land with sanatoriums for which, he concludes, not more can be said than for sensible treatment before their invention.

Now, I have made and listened to a good many medical statements on popular platforms respecting tuberculosis, but I have never become conscious of the insobriety which has shocked Dr. Maudsley. On every occasion, three factors in the etiology of phthisis—the seed, the soil and the surroundings—have been fully recognized, and while emphasis has been properly laid upon the seed as the primary and essential cause of the disease, due weight has been given to the greater or less resistance of the living tissues in which the seed is sown, and to the more or less favorable nature of the environment during its germination and growth. Dr. Maudsley is the apostle of heredity and of temperament—matters of great moment—but I do not know of any hereditary predisposition or temperamental condition that will make a man proof against a sufficient dose of arsenic or strychnia, and we have no evidence that there is any that will make him immune to a sufficient dose of the tubercle bacillus of sufficient virulence introduced into his system. The resistance, to the implantation of the bacillus and to its spread and propagation, varies greatly. In some habits of body it will scarce take root; in others it springs up rapidly and flourishes luxuriantly, but congeniality of the soil is a very different thing from hereditary transmission, and there is no kind of inherited constitution or temperament in which in the absence of the seed tuberculosis can be developed. The bacillus has its heredity, as well as its animal or human victim, and it is possible that the occasional failure of its attacks may be due, not so much to the stoutness of the resistance offered, as to the feebleness of the assistants, the descendants of an attenuated stock.

Dr. Maudsley says, 'no one thinking clearly ever thought that actual tubercle may be inherited,' but in saying so he must, for a moment, have lost his wonted lucidity of thought, for Professor Bang has demonstrated that the tubercle bacillus has been found in the livers of the new-born calves of tubercular cows. This mode of transmission of the disease is, however, so rare that it may be ignored, and as it is certain that tuberculosis is not handed down as gout and insanity are known to be, it is right that the public should be taught that the old notion of its heredity is erroneous, and that the main thing to be held in view is the avoidance of the pestiferous bacillus. But it is right also that they should be taught—and they have been so taught from all platforms of which I know anything—that the marriage of a person actually laboring under consumption or of two persons belonging to families in which a marked liability to take on consumption has been decisively manifested are imprudent and to be condemned.

The belief for which Dr. Maudsley makes our intemperate platform orators responsible, that phthisis is curable because the tubercle bacillus has been discovered must have been promulgated, if it exists, by persons in a state of complete obfuscation; for every medical tyro knows that phthisis was curable and was cured in many cases long before Koch's enlightening revelation, and that the espial of the bane, did not at once guide us to an efficacious antidote. But surely Dr. Maudsley will not deny that the discovery of the one true cause of the disease puts us in an infinitely better position for circumscribing its ravages, for preventing it, ay, and for curing it than we were before. We know now that it is the outgrowth not of any subtle tendency passed on from generation to generation, but of a fungus which invades the body from without, by certain channels and has a definite life history; which outside the body has certain favorite haunts and may be destroyed by certain agents and inside the body may have its growth encouraged or retarded by certain conditions, which it is in our power to create or modify. Phthisis is still killing upwards of 40,000 persons in England and Wales annually. Tuberculosis in all its forms is killing upwards of 57,000, but the mortality from phthisis and tuberculosis has fallen enormously and is still falling. Twenty years ago—and during that time there can be no question as to improved diagnosis or change in nomenclature vitiating statistical returns—phthisis caused upwards of 49,000 deaths; to-day it is causing only about 40,000 per annum; tuberculosis caused upwards of 20,000 deaths; to-day it is causing not more than 17,000. Twenty years ago the annual death rate from phthisis was 1,827 per million, against 1,203 in 1903; the death rate from other forms of tuberculosis was 567 per million, living against 459 in 1903. In as short a period as twenty years the death rate from phthisis was reduced as much as 25 per cent. Surely these figures justify platform speakers in some degree of exultation if not of insobriety, and warrant them in exhorting the people to persevere in the use of the means which have secured such splendid results, and to supplement these by other means suggested by our new knowledge of the cause of the disease. The reduction in the mortality from phthisis and tuberculosis has been due, we know, to subsoil drainage, and the other great sanitary improvements that have been effected in the last half century, and has taken place in the absence of any special precautions against the dissemination of the seed of the disease. Is it too much to hope that, now that we know this seed and can intercept and destroy it at the shoots by which it is discharged from its culture beds and granaries to be scattered broadcast, we shall be able still further, and more materially to reduce the tuberculosis death rate and the prevalence of the disease? Nay, further, is it too much to hope that by removing those who have contracted the disease from the impoverished, insalubrious and ill-regulated conditions of life that have invited and fostered it and by immersing them in pure air and unpolluted sunlight in restful and hopeful circumstances, with a liberal and welladjusted diet and under constant skilled medical supervision, so that untoward symptoms are dealt with as they arise and every bodily function is ordered, as far as may be, in the interests of health—and this is what sanatorium treatment consists in—is it too much to hope that we shall thus save many lives that would otherwise be lost, and prolong the days and alleviate the sufferings of those who are beyond hope of permanent recovery? Our sanatoriums in this country have not yet been in existence for a sufficient length of time to allow of the collection of wholly trustworthy statistics, but the returns as far as they go are highly encouraging, and confirmatory of the favorable verdict on sanatorial treatment arrived at by German institutions. Dr. Maudsley, himself, admits that so far the outcome of experience seems to be that many patients who are sent to sanatoriums in the early stage of the disease, recover if they are kept long enough, that most of those in a more advanced stage improve while they are there, frequently relapsing afterwards, and that those who are badly diseased ought not to be sent at all. And this, he calls a modest result. I am disposed to describe it as a result of which we may well feel proud and as one that, if properly presented to the public, should lead to the adoption on a larger scale than hitherto of this system of treatment at that stage of the disease when it may prove so efficacious. The benefits to be derived from sanatorial treatment have perhaps been exaggerated in prospect. It can not altogether supersede other forms of treatment, at high altitudes on sunny littorals, on the veldt, prairie or desert, or by sea voyages; it can not reconstruct a disorganized lung, but to those whose means do not enable them to command the best treatment under private care, and in whom the tubercular lesions are still of limited extent, and leave enough breathing space, it opens up new hopes of restoration to health. Even to the affluent, sanatorial treatment is profitable in the medical discipline it involves. The time may come when science will give us some tuberculin, or serum, or antitoxin, or antiseptic, that will kill the tubercle bacillus in its hidden lair, act its poisonous products, or reinforce the phagocytes in their attacks on it, but meanwhile sanatorial treatment gives expectations of recovery greater than those of any other kind of treatment that is known to us, and it seems to me inexpedient to say anything which may discourage the benevolent from putting it within reach of the poor and needy, or hinder the poor and needy, stricken with tuberculosis, from taking advantage of it. Even if sanatorial treatment were not superior to home treatment in the number of cures it effected, it is still deserving of support because it withdraws, for a time, from their own homes and from places of public resort persons who are jets of deadly dust, and thus diminishes the diffusion of tuberculous disease. And surely even the arrest of the disease, which Dr. Maudsley admits is secured by sanatorial treatment in advanced cases, is worth having. Even a damaged life is sometimes sweet to its possessor and precious to those who hold it dear; and it will be a sad day for humanity when the prolongation of life under all circumstances ceases to be the chief aim of the medical profession, and when euthanasia procured or suffered, is recognized as a justifiable mode of exit from the sick room. But beyond all this, even in hopeless cases, in which no arrest is secured, sanatorial treatment is not without its merits, for all patients who have undergone it return to their homes educated in the procedure that is necessary to make them innocuous to others, and trained how to deal with their infectious expectoration, and thus again the propagation of the disease may be in some measure limited.

But Dr. Maudsley is not only sceptical about sanatorial treatment, but apparently doubtful of the wisdom of any sort of curative treatment in tuberculosis. The ordained function of the bacillus in the universe is, he suggests, to make away with weak humanity. The loss to the community by the death of consumptives is not, he hints, as real as is imagined. "Might not the ultimate cost to the commonwealth," he asks, "be greater, were those persons allowed to go on living and breeding in it." The assumptions here are that consumptives inevitably breed consumptives, and that the tubercle bacillus invariably fastens on weak humanity, and both these assumptions are erroneous. Recent inquiries have shown that the influence of heredity in consumption is not so great as was at one time believed. Dr. Claud Muirhead found, after an elaborate investigation, and with peculiar facilities for arriving at the facts, that out of five hundred and twenty-four cases of death from phthisis, only one hundred and twenty, or 22.89 per cent., presented in their family history distinct evidence of direct phthisical taint, and other 62, or an additional 11.83 per cent., exhibited a suspicious family history of phthisis. That is to say, at the very outside, only 34.72 per cent, of these five hundred and twenty-four persons who died of consumption, exhibited in their family history any evidence of family predisposition to the disease. This percentage accords fairly closely with the published statistics of Dr. Williams and Dr. Cotton, who give, as the result of their investigations into this point, 34 per cent, and 36 per cent., respectively. In an inquiry carried out by Dr. Squire he found that while about 33 per cent, of consumptives present a family history of tuberculosis, statistics give grounds for attributing the disease to occupations and surroundings in by far the greater number of these cases, and place the possible influence of heredity at about 9 per cent, instead of 33 per cent.

It is certain that persons who have recovered from consumption breed perfectly strong and vigorous children, who remain throughout life free from the disease, and it is preposterous to suggest that if we succeeded in saving the lives of the 40,000 persons who die annually of consumption we should have thereby added to the burdens of the community. We should thereby directly and indirectly have secured enormous economic advantages in the productive industry of the persons saved, and in their contributions to the maintenance of those dependent on them. Mr. Baldwin Latham estimates the saving to this country in twenty years, by sanitary work, in funerals avoided, sickness prevented, and wage-earning powers retained, at £267,141,060; and of that huge sum a big slice must go to the credit of tuberculosis.

Then again, vulnerability to consumption does not necessarily imply either bodily or mental weakness. The disease is most fatal in the prime of life, and strikes down, not merely the feeble and incapable, but the strong and vigorous, catching them at some moment of temporary debility. The intellectually gifted seems to be peculiarly susceptible to it, and it has robbed the world of incalculable benefits in the fruits of genius. It is not by any means merely an eliminator of waste material, but a ruthless destroyer of some of the finest elements of our species, and we need have no misgivings in resisting it and in doing our best to extirpate it altogether. The enormous reduction that has taken place in the mortality from consumption has been an unmixed good, and its final disappearance from amongst us, which is not a chimera, but a reasonable anticipation, will be attended by nothing but gain to mankind.

Dr. Maudsley thinks we shall never be able to keep bacilli out of the body. Well, as regards the tubercle bacilli, we mean to try! And his gloomy prognostications in this matter are considerably discounted when we find associated with them some disparagement of antiseptic surgery and of the sterilization of food because, forsooth, there are hundreds of different kinds of bacilli in the human mouth and intestines, and because the nutritive value of certain kinds of food may be reduced by sterilization. Our operating theaters, as they exist to-day, and every kitchen range, are a standing protest against Dr. Maudsley's extraordinary impeachment. Surgeons do somehow succeed in excluding from wounds bacilli of an injurious character in injurious numbers, and a recent experience in Birmingham suggests that the ice-creams there would have been none the worse for sterilization by boiling, even at the sacrifice of the whole of their nutritive and glacial virtues.

I venture to think that Dr. Maudsley has spoken too despondently about the sanatorial treatment of consumption, and I regret the wide publication of his views, because, coming as they do from one so eminent in his profession, they may tend to check a movement of great promise.

In the same newspaper that contained Dr. Maudsley's fling at sanatoriums, I read a report of a discussion on physical deterioration that must, I think, have proved somewhat bewildering to the man in the railway train. Physical deterioration was affirmed and denied; it was traced to education and to the want of education. It was declared to be decimating our infant population and to be non-existent till the age of thirteen. It was ascribed to underfeeding and overfeeding, to cheap sweets and cigarettes, to maternal neglect, paternal drunkenness, and the want of a Minister of Public Health of cabinet rank. I can not pause to reconcile these apparently divergent views, for, of course, they are reconcilable, but there was one statement made so startling that I should like to refer to it more particularly. And that was that 'environment would knock heredity into a cocked hat,' a statement leading to an article in the paper headed 'The Bubble of Heredity Pricked,' which must mean that organic creation has burst up. Now it may be well that there should be a reaction against an extreme and fatalistic belief in the power of ancestral sour grapes to set the children's teeth on edge, but we can not altogether dispense with heredity, and any one who will contemplate a sheep and a cow and a goose and a rabbit, all brought up on the same common, fed on the same grass, and exposed to the same weather, will realize that there are limits to the power of environment. Tremendous are the potentialities pent up in those little particles of protoplasm—the germ and sperm cell. The truth is that heredity lies at the core of things, while environment plays on the surface. Their reciprocal influences may be detected in every living being. Heredity modifies environment, and environment deflects heredity, always within bounds and under some higher authority that controls the two. The plan of the edifice is practically fixed, but its dimensions, stability, symmetry, soundness and adornment, are subject to modification as the building goes on, and must depend largely on the nature of the material supplied and on the character of the builders. Heredity is, in every individual, made up of two convergent hereditary streams, and becomes solid at the center, but has a fluent edge, and it is on that that environment operates. It is of great importance that we should accurately distinguish between these environmental influences that are temporary in their effects and modify the individual or existing generation, and those that are permanent, and, as it were, sink in and modify the race.

It was in connection with the former of these that the contemptuous treatment of heredity at Leicester, to which I have alluded, took place. Dr. William Hall, who has done so much to stir up an active interest in the feeding of school children, impressed by the prompt and striking results he had witnessed by beneficially influencing their food environment, threw discredit on heredity, and not only so, but argued that there is really only one important element in environment, and that is food. He went so far as to say that food altered the whole condition of the individual, and that the children in the slums of our great cities, properly fed, could be reared superior in physique to children reared in better class districts, which, from his own point of view, proved rather too much, for if the slum children when well fed are superior to the better class children, presumably equally well fed, then they must have inherited more vigorous constitutions, or the better class children must be retarded in their development by conditions other than food. Amongst the Jewish children in Leeds, examined by Dr. Hall, who were so much stronger and less rickety than the Gentile children living in the same district, careful feeding may have been, and probably was, the principal factor in their better health and vigor, but there were other factors which should not be ignored. Eacial characteristics must count for something. Dr. Hall says that the poor Jew is more self-reliant, temperate, and has a greater power of resisting infectious disease than the poor Gentile. Does he suggest that these traits must also be attributed to feeding? Then the Mosaic law bears on personal hygiene through other channels than that of diet. The Tenth Ward in New York, the population of which consists almost entirely of Russian and Polish Jews, is the most densely populated in the city, both as regards the number of inhabitants to the acre and of tenants to the house, and notwithstanding this the Tenth Ward has the extremely low death rate, for New York, of 17.14, and is surpassed in healthfulness only by two wards out of the twenty-four of the city—one a business, and the other a suburban district. Now this favorable death-rate and general salubrity of the Tenth Ward are not the result of superior economic conditions, or better feeding, for the people are of the very poorest class, but must be credited to cleanliness and that careful observance of domestic sanitation in all its branches, enjoined by Hebraic rule and custom.

No one will underrate the importance of the part played by food in physical development, or the sinister effects of a deficiency of it, especially when growth is going on, in the production of degeneration; but, as Dr. Dawson Williams pointed out, it is going far to say that the whole of the unfitness of the race is attributable to the lack of food. Many other causes contribute to that. A little later Dr. William Hall seemed himself to realize this, for he affirmed that poverty—a very comprehensive term, covering a multitude of evils—is ultimately responsible for the unsatisfactory physique of our people. Luxury has its degenerates as well as poverty, but poverty is the wholesale degenerator, and it is, therefore, I am sure, with immense satisfaction that all we who are interested in the public health have heard that it is the intention of the government to appoint a Royal Commission to inquire into the working of the poor law. It is to be hoped that the deliberations of that commission will lead not only to the adaptation of the poor law to modern social conditions, but to the discovery of efficient methods of dealing with what may be called incipient pauperism, or pauperism in the making, of distinguishing between professional paupers and the widely different classes that are from time to time in need of relief owing to fluctuating economic conditions, sickness, immaturity, or senile decay, and of ensuring that there shall no longer be death or disease due to actual starvation amongst us. If the commission can solve the problems thus indicated, and if at the same time our statesmen can in their wisdom, by free trade, or retaliation, or tariff reform, or colonial preference, or in any other way, secure steady employment to all who are willing to work, we may then feel sure that the golden age will not be long delayed.

But we can not sit with hands folded waiting for the golden age to be conferred by any government or commission. We must strenuously persevere in our endeavors to ameliorate the condition of the people, and this we can best do by improving their environment in the widest sense. It is with environment you are officially concerned, and sure I am that you have already by your up-hill labors in mending it left your stamp on the condition of the people. And, indeed, I am inclined to think if there had been no sanitary science and no sanitary inspectors, the environment in this country would by this time have been pretty nearly empty in certain localities. The right hand of the medical officers of health, and with special functions of your own, you have in a multiplicity of ways promoted that cleanliness which is not inferior to godliness in giving a man length of days in the land. You have sweetened our lives by curbing the offensive cupidity of tradesmen and manufacturers. You have protected us from secret poisoning in our food, on a scale that the Borgia never dreamt of. You have, at no small risk to yourselves, warded off from us contagious, infectious and epidemic diseases, and extinguished sparks of them, which but for you might have become ruinous conflagrations. You have even in certain cases provided us with mortuaries and superintended our burial.

Your duties as sanitary inspectors bring you into intimate contact with the people of all classes; you are better acquainted than any one else with their environmental conditions, and you will, I think, agree with me that of these the one most urgently in need of consideration at this moment is their housing. It would take many addresses to deal with the housing question in all its aspects. It is a large question. We have, on the one hand, men with half a dozen houses of palatial size, standing in broad demesnes, empty for the most part or thinly populated by a retinue of pampered domestics, and we have, on the other hand, half a dozen pinched families huddled into one mean hovel reeking with filthy effluvium. It is, of course, mainly with the hovel-dwellers that sanitary reformers are concerned, and these present difficulties which may well tax their energies for a long time to come. They are everywhere, for from all parts of the country come complaints of over-crowding in wretched dwellings. It is, of course, in the large towns where benevolent enterprise is moving that we hear most of these evils; but they are by no means confined to the great centers of population, in which, however, they are growing at a rate that can no longer be overlooked. Our town population is, as you know, swelling portentously at the expense of the country. Thirty years ago the population of England and Wales was equally divided between town and country, but now three fourths of it are town dwellers, while only one fourth remains on the land, and the cry of the town is 'still they come.' According to the last census, the persons enumerated in urban were to those in rural districts as 335 to 100, whereas ten years previously they were as 250 to 100. The increase in the proportion of the population in urban districts is due partly to the growth of these districts themselves through the absorption of areas which were previously rural, but in a far larger degree to the migration to the towns of country people, and, as the provision of housing accommodation in urban districts has by no means kept pace with their increase of population, overcrowding has thickened and slums have multiplied.

I need not describe to you the state of matters which has resulted—a state of matters in many places deplorable and repulsive. We have in London 300,000 persons living in families of two or more in one-roomed tenements in which privacy and decency are impossible, often without the smallest ray of sunshine summer or winter, with walls and floors in every stage of dirt and decay, with an atmosphere that is stifling and not seldom alive with vermin. Mr. Burns told us that not long ago in Glasgow, where the housing problem is being so vigorously grappled with, there were places where the floors of the houses were let out at a penny or twopence a place so that any one could lie down on his pennyworth, and all huddled together for warmth in a dense mass of struggling humanity till the morning came. "There were," he said, "two places where the only accommodation given was a cord stretched across the room on which, on the payment of a penny, men were entitled to rest their arms and sleep standing." I do not know that in many places things are quite as bad as that, but in all our large towns and in our small towns, too, housing conditions and overcrowding exist that are an outrage on decency and a disgrace to our civilization.

And heavy are the penalties we pay for these housing conditions and this overcrowding in combination with other insanitary influences that appertain to towns! The urban death-rate for England and Wales is 17 per 1,000 living; the rural death-rate is 12.9; the urban infantile death-rate is 165 per 1,000 births, the rural rate is 126. In every city and town with the increasing density of population on square space, there is an increasing general and special mortality at all ages, but particularly under one year, in insanitary areas. Typhoid fever causes a much greater loss of life in the town than in the country. The urban death-rate from pneumonia exceeds the rural by 87 per cent. The mortality from consumption is at the rate of 1,298 per million living in urban districts and of 1,108 in rural districts. Urban areas suffer more severely from cancer than do rural areas. And almost all these diseases, as well as others which I have not mentioned, because they figure less largely as causes of death, are most prevalent in the most densely built parts of the town, and in the most densely populated areas of these parts, and prevail in these areas in proportion to the number of inmates in the houses, of persons per room, and of insanitary dwellings such as back to back houses, stable dwellings, tenement houses, cellar dwellings and flat houses.

That the townsman is shorter lived than the countryman is incontrovertible. Dr. Tatham calculated that in the rural districts of England the average expectation of life at birth is 51.48 years for males and 54.04 for females, whereas in Manchester it is only 28.78 for males and 32.67 for females, which means that each male has to sacrifice 10.48 years or 39 per cent, of his life, and each female 9.82 years or 34 per cent, of her life for the privilege of being born in an urban area. To show the social waste involved in such heavy mortality, it is enough to point out that 100,000 males born in Manchester would be reduced to 62,326, and 100,000 females to 66,325 in five years; while in the healthy districts it would take fifty and forty-eight years respectively to bring about the same reduction. Clearly the concentration of the population produces a prodigious drain on the vitality of the people, another indication of which is supplied by Dr. ShrubshalPs observation that town life tends to extinguish the fair-haired Scandinavian and Teutonic elements in our people which are giving way before the brunette elements of southern derivation.

And the pernicious consequences of such concentration are discernable in other directions. The children reared in towns are on the average at all ages, shorter, lighter and of inferior chest-girth when compared with those brought up in the country. They suffer in a larger degree—and in some towns to a very alarming degree—from rickets, decayed teeth, defects of vision, deafness, adenoids, glandular enlargements and affections of the heart and lungs, and again it is demonstrable that all these degenerative changes are more numerous in children living in houses of one or two rooms than in those living in houses with three or more apartments.

I need not proceed with the sanitary indictment against town life as now constituted. Its misdeeds are written in characters unmistakable to any one with half an eye in the pale faces, and stunted and misshapen bodies seen in swarms in slum areas; and are recorded in family Bibles, if such pious mementoes are still in vogue, for Mr. Canthe, after prolonged and careful search, could not find a single person whose ancestors, from their grandfathers downwards, had been born and bred in London. But I should like to say a word or two about one of the countervailing advantages of town life, which is often insisted on and that is, that by the mobility and stimulus it affords, it encourages that ascent of individuals from the lower to the upper social ranks upon which the salvation of society depends. It is, we are told, the concentration of population in cities which best promotes the process of bringing capable men to the front, and recruits the real aristocracy of ability and character amongst us. And if that is so then we must be content to put up with a good deal of destruction of human vigor, in return for the work done by cities as instruments of natural selection in weeding out the incapable and inefficient and advancing the more capable members of society, and in providing us with intellectual leaders. But is city life likely to accomplish all this?

Professor Karl Pearson, a very thoughtful and cautious anthropologist, has told us that decadence of character and of intelligent leadership is to be noted alike in the British merchant, the professional man and the workman. There is a paucity, he says, not only of the better intelligence to guide, but of the moderate intelligence to be guided. And this he attributes to the fact that the intellectual classes are not reproducing their numbers as they did fifty or a hundred years ago. And in this view Professor Pearson is supported by the Prime Minister, who said at Cambridge last year, that in the case of every man who left the laboring class, and became a member of the middle or wealthier classes, his progeny were likely to be diminished, owing to the fact that marriages are later in that class. The prospect thus presented to us is, it must be admitted, a lugubrious one. The better we educate our people and the greater the facilities we give to boys and girls of ability in the lower classes to rise in life, just by so much shall we deteriorate the race intellectually, for physical characters are not manufactured by school or college, but are bred in the bone, and if our intellectual classes are physically enfeebled by their intellectual exertions, are enervated by wealth and the love of pleasure, or restrained by prudence born of a wrong standard of life, so that they fail to supply us with a due proportion of intellectuals, then progressive decadence is in store for us.

For my own part, however, I am inclined to think that intellectual decadence, if it is upon us, is not altogether due to the causes assigned by Professor Pearson and Mr. Balfour, and is not necessarily destined to deepen as time goes on. In a people like ours, there is always outside the actually intellectual class, a still larger class, potentially intellectual with abilities incompletely evolved, because never called forth, but capable under stress of circumstance of the higher development, just as an ordinary working bee is capable of conversion into a queen by appropriate feeding. This potentially intellectual class, more prolific than the actually intellectual, may make up for its deficiencies and, breeding true or with favorable variations, supply us with intellectual leaders as good as any we have hitherto had.

Then I am quite sure that the educational ladders, provided hitherto to enable children of the humbler class to climb up in the social scale, do not by any means ensure the transference of the intellectuals from the lower to the higher level. They are mounted by the nimble, the quick-witted, the precocious, whose intellectual energies are in many instances soon exhausted, and around the foot of these ladders there remain numbers of children of really finer intellectual power but slower of growth than those who have scrambled up them. We have thus in our humbler or uneducated class, as they are called, a reserve of intellectuals of undiminished fertility, capable of supplying recruits to the intellectual class of the next generation. Many of our finest intellectuals have sprung from the unintellectual class, and genius is generally more or less of a sport.

My own view is that any dearth of ability from which we may be suffering or by which we may be threatened is to be ascribed not so much to the infertility of the cultivated classes as to the artificial production of stupidity in various ways and to the incessant draining from the country, which is the fit and proper breeding place and rearing ground of intellect, of the best elements of our people to be swallowed up, and exterminated or deteriorated in our big towns. We keep nipping off the buds of promise, and if we insist on having lots of green gooseberry tart, we must be content to go with less of ripe gooseberry jam. As Dr. Ogle has said, "the combined effect of the higher mortality of the town and of the constant immigration into it of the pick of the rural population, must clearly be a gradual deterioration of the whole, inasmuch as the more energetic and vigorous members of the community are consumed more rapidly than the rest of the population." "The country community," remarks Professor Ripley, "grows from its own loins; the city community grows almost entirely by immigration." The country community, mentally as well as physically, develops from within. It is conservative, strong, steady, tenacious, and transmits its mental characteristics, little altered, to the next generation. The city community, on the other hand, accretes largely from without. It is progressive, mobile, fickle, of unstable equilibrium, and under the stress of competition, undergoes mental modifications, which (Pace Weismann) it passes on to its successors. And the consequences of the increased instability of the city community are patent enough. Insanity and suicide, both essentially characteristic of industrialism, are far more frequent in business centers than in the homes of agriculture. This does not, however, signify that the mental powers are really more active in the one than in the other. The notion, indeed, that the country laborer is duller in intellect than the man of the same class in the town is untenable. "It is a common assumption," says Professor Wright, "that the country-man is of so limited capacity that he makes use of no more than 300 words. What a libel! The number of words in dialects at the most moderate estimate is over one hundred thousand. In Yorkshire alone, I can call to mind 30,000 different words. If we take the whole of the dialects and put them together, as representing the vocabulary of the working class of this country, and exclude from the English dictionary all technical terms and obsolete words, I venture to say that the number of dialect words will far outnumber the words of the dictionary."

And not less untenable than the notion that the agricultural laborer is dull of intellect is the idea that the city urchin is cleverer and better endowed mentally than the little yokel. Some years ago, Mr. Horsfall asked the opinions of the head masters of two large pupil teacher centers on this point. In both centers there were a number of pupil teachers from the schools of a large town and others who had been taught in country schools. "Both the masters said, that though as a rule, the urban young people were at first brighter and quicker, those from the country, in the long run, showed more staying power, and that their knowledge of country things gave them a great advantage over their town comrades." The conclusion of these masters is in complete accord with that which I arrived at a number of years ago. After a comparative examination of some London Board and Scotch Parish Schools, I found the London children much sharper, more vivacious, and, it must be admitted, more attractive in demeanor than the Scotch children, but the latter, although somewhat stolid and awkward, had decidedly more grasp of intellect and more sound knowledge. The rule seems to be that the mental development of children is hastened by city life, but soon stops short. Up till thirteen or fourteen they are precocious and then come to a standstill. "At its best," says Dr. Stanley Hall, in his work on Adolescence, "metropolitan life is hard on childhood and especially so on pubescents, and children who can not pass those years in the country are robbed of a right of childhood that should be inalienable, and are exposed to many deleterious influences which jeopardize both health and morals."

City life at its best is bad for children, involving as it does early puberty, exciting distraction, superficiality of knowledge, insufficient repose, and the want of the soothing influences that the country affords, and at its worst when it means a tight squeeze in squalid dwellings, poor food, foul air, foul language, contact with vice, and manifold temptations, it is utterly demoralizing. The chief constable of Glasgow who had to report an increase of juvenile crime in that city, notwithstanding the most strenuous efforts of the police to prevent it, informed the Royal Commission on Physical Training that juvenile depravity was regulated to a large extent by the home influence on the child, the period between twelve and fourteen being that when the mind is most susceptible to influence for good or evil. "Amongst the lower class in the city," said Mr. Ross, "of course one finds the children most depraved, the parents or guardians in many cases being criminals of the lowest possible standard. Street trading is undoubtedly a curse to this class of children. It has been proved again and again that the street gamin is second to none in vice and wickedness of every conceivable kind, in fact, he reduces the commission of a crime to a fine art. If, however, he is taken from his evil surroundings and placed in an industrial school or reformatory he, in the majority of cases, turns out a success in life."

The facts and figures I have been quoting represent the city as an instrument of physical, intellectual and moral degradation. They represent it as sucking in the crude vigor and vitality of the country, sophisticating and enfeebling them by its rigorous competition, and ultimately turning them into inefficiency. It seems obvious that if the city goes on growing at the nineteenth-century rate, and under nineteenth-century conditions, it will dry up the reservoirs of strength in the population, and leave an immense proletariat of inferior quality and without commanders.

But the shield we have been examining has another side. Big cities are with us and are likely to. remain. They have sprung up in obedience to economic laws, and they contribute to wealth, for production increases with increasing concentration of population, and wealth redounds to the advantage of the whole country. They favor specialization and enable every man to make the best of any talent or skill he may possess. The markets they open up stimulate improvements in agricultural methods, and the industries and commerce they establish conduce to good government and individual liberty. They are the nurseries of the arts and sciences, and as to the evils attending them, on which I have been enlarging, they are not all inherent in their very nature, but are largely accidental concomitants of their mode of growth and the offspring of the ignorance and stupidity of their inhabitants. Many of these are in process of mitigation and I dare say it occurs to you that if you had a free hand in demolishing and reconstructing one of our great cities with, say, the cost of the South African war at your disposal, you could free it from much of the opprobrium in relation to sanitary matters that has hitherto attached to it. But such wholesale remodeling is scarcely practicable, and even were it accomplished, the city would still probably fall short of the country standard of health, even if that standard remained where it is at present and were not raised like that of the city. For as things now are, the country is in many parts guilty of sanitary offences as heinous as those of the towns, and is only saved from their consequences in an equal ratio by the wider elbow-room it affords, and the fresh air and unpolluted sunshine it enjoys by nature's bounty. The last royal commission that reported on rural housings described the conditions under which many agricultural laborers live as 'physically and morally unwholesome and offensive.' A London association that in 1897 conducted a systematic inquiry into the state of 240 country villages with 10,000 dwellings declared that in one half of these villages the cottages were bad, and that in some thirty villages there were cases of gross overcrowding. Mr. Walter Crotch has stated that the result of his own very extensive and searching investigation had been "the discovery of whole villages without a drop of water from end to end; of cottages without even the ordinary conveniences which the law of common decency demands, and of poor people having their homes let while they lay quivering in the throes of death." "Week by week," he goes on, "the most shocking cases of overcrowding are reported in the newspapers, and there can be no doubt that this huddling together of people of both sexes and of all ages in the same room is a source of frightful immorality."

Mr. Clement Edwards said in 1900 that many of the inhabited cottages in the south and west of England were in a hopelessly dilapidated condition with gaping walls and rotting roofs, and were, moreover, terribly overcrowded. Some of the facts he reported were positively revolting in themselves and much worse in their suggestions of inevitable social and moral results. As to sanitation it was non-existent. Miss Constance Cochrane, of the Sanitary Institute, quotes a case in Cambridgeshire, in which eleven members of one family were all sleeping in one room owing to the scarcity of cottages in the village. Private enterprise has failed to furnish anything like adequate accommodation for agricultural laborers, and owing to heartless indifference, indolence or official obstruction—perhaps in some degree also to their own complicated ambiguities—acts of parliament, such as the housing of the working classes act of 1890, have remained practically in abeyance. The result of all this is that lamentable abuses—which perhaps the amending act of 1900 may in some degree remedy—still abound on every hand, and that our scattered hamlets, instead of being idyllic abodes of peace, purity and health, have become hot-beds of discontent, dirt and disease.

But in spite of all this, the country, measured by every standard, remains more salubrious than the town, and, as it is certain to participate in those sanitary improvements which in the progress of medical science and of governmental activity in such matters must come, still further to lower the town death-rate and raise its vital energy, it will probably always maintain its position ahead of the town in salubrity. 'The life of the great city,' said Mr. Henry George, 'is not the natural life of man.' He has an affinity for the open fields, and just as the mortality of city adults must always exceed that of rural adults, on account of the more dangerous nature of town occupations, so must the health of a town population, as a whole, be inferior to that of a country population, because of the more unfavorable nature of its topography. The grouping and close proximity of houses interfere with ingress of sunlight and movement of air, and facilitate the spread of zymotic diseases, which often leave permanent debility and defects behind them. The close agglomeration of numbers of human beings, especially in a state of indigence, is conducive to uncleanliness, and to the generation and diffusion of poisonous exhalations of many kinds. And the larger the grouping, and the closer the proximity and the denser the agglomeration, the greater do the risks become, so that in the interests of humanity there should be some limit to town extension and stringent regulation of town organization. Industry says men must aggregate, sanitary science says they should be permitted to do so only so far as is not incompatible with the welfare of the race, and under well-understood safeguards.

We have been contrasting the merits of town and country from a health point of view, and the conclusion must be that while the country is entitled to the preference of the sanitarian, both are urgently in need of his attentions. Excellent and fruitful work has already been done in both, but much remains to be done, and, as I have already said, the most clamant want of the moment is, it appears to me, the application of remedies to relieve the pressure caused by the increase of population in urban centers.

You are acquainted with the remedies which have been proposed for that state of things, viz., regulations directed against overcrowding; the acquisition of special areas by the authorities for the obligatory rehousing in the same neighborhood of those disturbed under parliamentary powers; and the acquisition by municipalities of vacant land for the construction of suitable dwellings. These are excellent as far as they go, but seem to me to be palliatives rather than remedies. They shift the load a little but do not really lighten it, and it has been, perhaps, the perception of their futility that has been responsible for the half-hearted manner in which they have been applied. Real relief is only to be obtained by establishing an outflow from the center to the circumference, and it is by affording increased facilities of locomotion that this may be done. It is to the new motive power that is now advancing with such giant strides that we must look for the removal of some of our housing embarrassments. Railway extensions, tube railways, surface and subsurface tramways, and motor omnibuses and cycles will inevitably bring into existence a number of new suburbs around our big cities, to which, if the cost of transit be kept low and rents remain modest, many of the poorer classes who are not compelled to live near the factory or shop will resort, all the more readily if a shortening of the working day gives time for the journeys to and fro, and if associations be formed to help them to become the owners of their houses. And to these suburbs, should the cost of transit and the time occupied by it or high rents prove prohibitive to the working classes, the well-to-do will in numbers retreat, making room for their humbler neighbors in the inner circles. It is probable, too, that these new suburbs would in some degree intercept the streams of population that are perpetually flowing into the towns from the country, for statistics show that as regards London, at any rate, immigrants settle mainly in the most outlying parts.

The new suburbs of towns will, of course, always spring up on lines of communication and where facilities are offered for building speculation, and spread out around, but it is to be hoped that they will be taken in hand in time, and means devised to limit their indefinite expansion. Mr. Charles Booth has said that towns advancing, show a noticeable tendency to shoot out tongues like the sun's corona, the intervals between them being filled up later, and it is this filling up of the intervals between them that should, if possible, be prevented. Island-suburbs are well enough, but when they swell out, become continuous, and form a girdle round the parent town, they aggravate its evils, and help to strangle it. It has been proposed that air should be supplied to the center of great cities by mechanical means—by the Shone vacuum system, for example, in connection with tube railways—but infinitely preferable to any such artificial arrangement, necessarily finical and liable to break down, is a liberal scheme of natural ventilation. There should, it seems to me, be maintained, in connection with all great cities, a series of broad avenues converging towards them from all the points of the compass, free from buildings, and covered with vegetation. The parks and open spaces in our cities are called their lungs, but the lungs are not of much use without the windpipe, and the green avenues I suggest would act in that capacity, and allow an inrush of fresh air and the escape of the vitiated air which is always accumulating in cities. These avenues, I have said, should be clothed in vegetation, and to my thinking the preservation of vegetation, not only around our great cities, but throughout the country generally, is becoming a matter of grave import. Sir James Dewar once calculated that a healthy man evolves on the average about 200 pounds of carbon in the form of carbonic acid annually, and as an acre of the best cultivated land fixes annually about 2,200 pounds of carbon, it follows that one acre of land can economize as much carbon as is supplied by eleven persons. The Crystal Palace covers an area of sixteen acres. If the atmosphere had to be kept pure by interior vegetation, without external ventilation, it could not permanently contain more than 365 persons without an increasing aerial contamination. But the vegetation in the large Crystal Palace, this island of ours, is being constantly reduced in amount. Enormous tracts of land once cultivated have been appropriated by highways and railways, and works and habitations, and at the same time there has been an enormous increase in the output of carbonic acid and the demand for oxygen by combustion in the consumption of fuel by manufactures of all kinds and for domestic purposes and by the respiration of animals and human beings. The revivification of the air by home industry is gradually decreasing, and the day may come when we shall be entirely dependent on imported oxygen as well as imported food, and will have to trust to the ocean to dispose of our surplus carbonic acid. At present the air of our large towns and especially those with narrow streets and towering buildings is often a very deleterious compound.

It is to the rise of the suburb—the island suburb—set in a sea of chlorophyll easily accessible, well planned, honestly built, that we must look in the first instance for the removal of some of the afflictions that overcrowding has brought upon us. But the suburbs, while it may do much, can not do everything, and there are other sources of relief, which it is our duty to turn to and to improve. We must take measures to reduce the influx of population into our already congested towns, and to keep on the land those who have been born and brought up on it and to bring back to the land those who have inconsiderately left it. Beyond the city and its satellites, we must afford to those who are weary of the dirt, confinement, dreariness and ugliness of over-crowded quarters, room and opportunity for healthy, moral and physical life. And there are several ways in which this can be done which I can but name. We can create new cities on new sites, with all the advantages and none of the drawbacks of the old ones—garden cities of the type so eloquently and convincingly advocated by Mr. Howard, in which the needs of industry and the needs of humanity will be reconciled. Charles Kingsley in his philanthropic ardor foresaw something of the kind for he dreamt of cities—which should be "a complete interpenetration of city and country, a complete fusion of their different modes of life and a combination of the advantages of both, such as no country in the world has ever seen." And his vision has come to pass. We have Bourneville and Port Sunlight—cheering oases in the industrial desert—and better still we have Letchworth, gradually coming into being, on a broader basis and with greater amplitude of design. Letchworth is still incomplete, but two visits to it have enabled me to appreciate the judicious way in which it has been mapped out, the excellence of all its sanitary arrangements, and the rapid progress it is making. It is full of promise, and it would, it seems to me, be a national calamity should any want of financial support prevent the project in its entirety from being carried to a successful issue. It is to provide for 30,000 inhabitants, and that will not be much of a depletion for congested London, but whenever Letchworth is an accomplished fact, other garden cities will be undertaken. The transference of manufacturing industries to the country is feasible; it has indeed been going on for some time both in this country and America, in the avoidance of high rents and rates, and where suitable sites in the country can be provided with suitable accommodation for workers, with cooperating industries around, and with facilities for obtaining power, industries will congregate and garden cities arise.

Another way in which we can tap our great cities of their clogging superfluities of population, is by establishing in our dominions beyond the sea, land colonies, under some such scheme as that so ably excogitated by Mr. Eider Haggard. There are in our cities crowds of men and women brought up on the land, who have drifted into the city, and tossed about there as social flotsam, miserable failures, who with families of young children would gratefully embrace the chance of returning to conditions such as formed the surroundings of their youth, and of rectifying their own mistakes, by placing their children's feet on the path of prosperity. Such families carefully selected, settled in parties, if possible made up from the same towns at home, in well chosen localities, under skilled and sympathetic management and with necessary financial assistance to start with would undoubtedly do well as have done the indigent settlers at Port Amity, while their removal would clear the air of our towns at home.

But the best of all methods and the most promptly available for checking overcrowding in towns is by improving housing in the country. We are told that the flower of the agricultural class flock to the towns because they dislike the monotony of country life and long for excitement and variety. That is so, no doubt, to a large extent, and perhaps our present system of education is calculated to foster discontent with the peasant's lot, and engender vague ambition, restlessness, and a thirst for rousing stimulants, but I suspect that another contingent of country folk find their way into the towns, not so much attracted by their glamor as repelled by the dingy wretchedness they leave behind them. Agriculture is, after all, the most varied and least monotonous of employments, and could the cottages of the laborers be made wholesome and attractive, and the village life invested with some interest, many who now migrate to the towns would stay at home, and many who are in the towns and have tried them and failed, would be glad to be translated back to the land. I feel sure that many of the laboring class, under the goad of poverty, quit with reluctance the fields they have tilled and cast many a lingering bulging look behind at the dilapidated hut that sheltered their childhood. The Anglo-Saxon has always had a deep-rooted attachment to his 'ham' and his 'ton.' Home sickness is not, perhaps, as common as it used to be, but the homing instinct still exists amongst us and is to be diligently kept alive if our race is to avoid disintegration. Nothing has seemed to me to presage the pouring forth of the vial of the seventh angel more imminently than the proposal, seriously made, that all infants at birth should be taken away from their parents and brought up in public institutions, foundlings of the state, a system under which all virtue would forthwith go out of us leaving us mere dry husks of mankind. And nothing has seemed to me more minatory for the future of our empire than the decay—for there is some decay—of home life amongst us. The affluent classes in great numbers voluntarily resign its charms for the luxurious indulgence of the club and restaurant, and the round of pleasure, as it is called; and the poor, through no fault of their own, are in large numbers deprived of them, for it is impossible for the tender associations of the home to evolve in a temporary burrow in a town warren. They have a tenement or lodging, but no home; but a vestige of the old home sentiment is sometimes seen, as Mr. Bray assures us, in the fidelity with which the} r cling in poverty to some bit of furniture—a table, a chair or clock that has stood the wear and. tear of time. But if we are to rescue the submerged tenth and redeem the very poor, we must somehow see that decent homes are provided for them. The finest feelings, the firmest principles are nourished in the home; a genuine man's joys, hopes and ambitions should center in it. Truly did the great poet of my country—who was not only a poet but a deep-seeing social reformer—exclaim:

To make a happy fireside clime,
For weans and wife;
That's the true pathos and sublime
Of human life.

For the want of the 'happy fireside clime' the poor are doubtless themselves often to blame. Of the idleness, thriftlessness and drunkenness that keep them poor and homeless, I need say nothing; these are the theme of daily homilies, but there is a habit they have formed which I think in some degree contributes to their penury and is worth noting, and that is the habit of wandering purposely from place to place—a phase of the mania errabunda—as it has been called, which possessed the 'Ancient Mariner' and keeps the tramp and the globetrotter moving on. Without any valid reason, large numbers of them are constantly changing their abodes, and an enormous sum is spent annually on removals that might be more profitably employed in making the home habitable. Removals are, of course, largely instigated and justified by the search for work or for better surroundings, by growing family requirements and improving circumstances, but beyond all that, they go on, on the large scale, simply to gratify the love of change or in a foolish spirit of rivalry. These poor people keep shifting about in sheer restlessness; having dirtied or damaged one dwelling they pass on to another. A friend of mine in Scotland built some model cottages for his laborers, and on visiting them was surprised to find that the bedrooms upstairs were unoccupied and had been converted into stores for apples, onions and potatoes, while the families were herded together below. On inquiring the reason of this, he was told that these laborers didn't care to have more furniture than they could conveniently move in one cart. This sort of thing is very inimical to home making, for the home is a slow growth, that does not, like Jack's bean stalk, shoot up in one night, but must have time to take root and won't bear frequent transplanting. And it is inimical also to success in life. Mr. Patterson, the master mechanic of the Grand Trunk Railway, says:

"I find among the class of workmen that comes from the Old Country, there is a great tendency to run from one situation to another; in fact a number of them seem to have an aversion to permanent employment. This wandering spirit is very detrimental to a man's progress."

But apart from the improvidence and stupidity of the poor themselves, or anything like it, the home is still beyond the reach of many of them and in some districts it is a vanishing quantity. It is for the sanitary and the social reformer to work together to resuscitate the home, to augment the taste for it and make it more and more palatable in town and country.

On some future occasion you will, perhaps, allow me to say something about the town-homes of the poor and to offer a few suggestions in connection with the highly complicated problems they present for our consideration, amongst which suggestions, the not least prominent will be one for the strengthening of your hands. I feel keenly, that if the housing question in towns is to be adequately dealt with the sanitary inspector must have more power in his elbow than he has hithertd had. He must have security of tenure, and I am glad to be able to tell you that the preventive medicine section, over which I presided, at the recent Public Health Congress in London, passed a resolution desiring the council to represent to the government the urgent importance of giving security of tenure to the sanitary inspector, as well as to the medical officer of health. Then, the sanitary inspector must have more effective control over the nuisances he discovers, and the only way to give him that is to make his 'intimations' equivalent to a legal notice. These intimations are, I understand, now often treated as waste paper. There are agents and owners of property, of the baser sort, who delight in thwarting and putting obstacles in the way of sanitary inspectors, and to such gentlemen I should give short shrift, showing no particular indulgence to the slum-owner generally. Dr. Harris, medical officer of Health for Islington, reported lately, that in his district 60,296 visits were last year paid by the sanitary inspectors to 7,133 properties, on an average 8½ visits to each. That indicates, I think, much passive resistance, much waste of energy, much unnecessary maintenance of dangers to health, and I agree with Dr. Harris that in this matter 'Law ought to be brought into line with common sense' without delay.

It is to rural housing, more especially in its relation with the relief of overcrowding in towns, that I had intended to direct your attention to-day, but my excursions into the apjoroaches to that subject have left me only a few minutes in which to touch on it. The main point, however, is—and on that I have already insisted—that by improving our country cottages and adding to them cottages of an approved type, we shall in some degree check the exodus from the country and even set up a back-wash from the towns. And in order that we may do that we must have amended the building bv-laws that have been in no small measure answerable for the depopulation of rural districts and for the congested state of towns. That these by-laws require to be overhauled and remodeled, no one who has read Mr. Wilfred Blunt's article in the Nineteenth Century, or the speeches made by the members of the deputation that waited on Mr. Walter Long, then president of the Local Government Board in November last, can doubt. The unfortunate clause in the public health act of 1875, providing that poor law districts might declare themselves urban districts and so require powers similar to those exercised in towns, and frame by-laws of their own, has been the source of all the mischief. Under this clause half the rural districts of England have acquired urban powers which, being exercised by persons having for the most part an interest in urbanizing the district—jobbers in residential land ripe for development, tradesmen, contractors and local builders—have been used as an instrument to prevent the erection of dwellings suitable for agricultural laborers and to tie the hands of landowners willing to provide such dwellings. No better example of this can be adduced than Mr. Wilfred Blunt's own case. Having himself experimented with an iron bungalow which he found singularly comfortable and commodious, he directed his estate carpenter to erect on his property in the New Forest where there are no builders' by-laws, two cottages, intending should they prove successful to make them the model for cottage building in Sussex. And highly successful they proved. He found they could be erected at the cost of £130 for a building covering 700 feet area, with a verandah of 240 feet more and an outbuilding containing washhouse and closets—"as snug and sanitary a home as any poor man could wish to inhabit, for there was a fireplace in every room, roof ventilation and ample door and window space."

But when Mr. Wilfred Blunt came to Sussex, where the London building by-laws are in force, there was a lion, and a very fierce lion, in the path. The plan of a cottage was submitted to the rural council and no objection was taken to it until the building materials had been deposited on the ground. Then, however, notice was given that the plan was disapproved by the council as violating the by-law. This notice, Mr. Wilfred Blunt thought it his duty to disregard, and went on with the cottage, which cost £130, and which, with an additional quarter of an acre of land, he could let without loss at 2s. 6d. a week or Is. a week less than an old cottage it replaced. But alas for rural economy! The builder was summoned for building with other than bricks and mortar, and an action was brought against Mr. Wilfred Blunt, as a result of which a continuing penalty of two shillings a day was inflicted on him until the model cottage was pulled down.

It is clear that a check must be administered to rustic Bumbledom, and a stop put to the application to purely agricultural areas of regulations intended for towns, and which in towns have had an altogether salutary effect in preventing the construction of unsafe and insanitary houses. But I can not go as far as some who have urged that there should be no by-laws in country districts, or that such by-laws should not apply to any new building on a freehold property where such building is more than a given number of yards from other dwellings or past the property of adjacent owners. In regard to sanitary arrangements, by-laws seem to us as necessary in the country as in the town. It is not licence, but reasonable liberty that is wanted; not looseness, but elasticity, and it is to be hoped that this will be realized in the model code of by-laws for rural districts promised by Mr. Walter Long, and in which cottages in certain situations are to be permitted of wood or other material.

A powerful impulse has been given to improvement in country housing by the articles on the subject which have appeared in the Country Gentleman and Spectator, which have, as by natural magic, invoked the enchanting village at Letchworth, which is now on exhibition, and which I would recommend every sanitary inspector concerned in rural affairs to visit and study diligently. He will there, while enjoying a pleasant picnic, have an instructive lesson, and be able to satisfy himself that a serviceable and comely cottage, in all respects suitable for a laborer or working man and his family, can be built for £150, including builder's profit. He will there see cottages of many different patterns, and built of many different materials, of stone, wood, brick, iron, concrete, cement, steel and plaster in various combinations, and will obtain from the catalogue full information about the price and specifications of each. He will see a marvelous display of ingenuity and contrivance in the fitting in, of domestic requirements and of making the most of next to nothing. No doubt his critical eye will detect flaws here and there, but everywhere he will perceive an intelligent deference to the claims of modern sanitation. The cottages vary greatly; each has an individuality of its own, but sunniness, airiness and coziness characterize almost all of them. They appeal to many tastes, but to no tastes that are vulgar or debased. They are pretty, but their prettiness is subordinate to their utility; they are picturesque, but not pretentious. Simplicity and cleanliness are the dominant ideas, and they are cheap with a cheapness that is unbelievable until they have been actually seen and examined, and compared with the estimates. Think of a detached cottage, well proportioned and artistic in design, with a living room with range 15 ft. 6 in. x 11 ft. 4 in., scullery with bath, hot and cold water, 9 ft. 4 in. x 7 ft. 6 in., three bedrooms 9 ft. high. 13 ft. 4 in. x 9 ft., 13 ft. 4 in. x 9 ft. and 8 ft. 6 in.; with pantry, two cupboards, coal hole, shed for wood, water closet, water laid on, drains connected, rain water butt, floor of scullery and pantry tiled, and say whether it is dear at £150.

There are cottages at Letchworth adapted to different climates, and suitable to different districts according to the different material of which they are constructed. I saw some that I thought would scarcely survive a bias! of Boreas on a Scotch hillside, others that could withstand a hurricane; some that would be in place where timber is abundant, others where brick or iron are in the ascendant.

The village at Letchworth, unique in its diversity of cottage contours, planted on a bare common, hut in sight of stately elm trees circling a venerable church, and gaudy with many floral dyes and green embroideries, recalls, of course, Mrs. Heman's verse:

The cottage homes of England!
By thousands on her plains,
They are smiling o'er the silv'ry brooks,
And round the hamlet fanes.
Through glowing orchards forth they peep,
Each from its nook of leaves,
And fearless there the lowly sleep
As the bird beneath their eaves.

They recall that verse, but with a difference, for while Mrs. Heman's cottage homes gave delight to the eye by their rugged and peaceful external beauty, they must have brought anxiety to the soul of the sanitarian who peeped into them by their primitive squalidity. The cottage homes of Letchworth are not less gratifying in their sanitary than in their esthetical aspects, and may be slept in by their lowly inhabitants with a sense of security that the cottagers of a century ago, when typhus and smallpox patrolled the land, where scarcely entitled to feel. These cottages have dealt the death blow to foolish restrictions on country housing . That village leads the way in a new movement to which all sound sanitarians will cordially wish success.

A survey of some of these cottages at Letchworth, so quaintly pretty, so minutely commodious, so hygienically correct, so reasonable in price, suggests that they should have attractions for the well-to-do, not less than for the laboring class. Perched on some beetling cliff or breezy down, bosomed in some bosky dell, or planted in the fields neighboring some quiet hamlet, they would form a delightful week-end or holiday resort for families of moderate means. For children living in London, or other populous city, the seaside town, with the vulgar riot of the sands, is not the place in which their vacations can be most healthfully or profitably spent. They should be brought into living contact with nature, be enabled to form friendships with trees and animals, to pry into the secrets of insects and birds, and taught to take more pleasure in the hedge rows with their 'profuse wealth of unmarketable beauty,' than in the shop windows with their flaunting temptations. The cheap cottage as a holiday-home would create new family affinities, promote the unfolding of faculties that are apt to remain dormant or stunted amongst bricks and mortar, and teach self-help and independence instead of the feeble snobbery that meets every want as it arises by ringing the bell, for I saw no bells, electric or other, in these cottages. It would obviate the apprehensions of infection that are often not unjustifiably felt in taking possession of lodgings or furnished houses at seaside resorts, and elicit taste and ingenuity as no mere hired and temporary residence can do. Its decorative improvement would be a recreation, and the owner would be proud to say of it—'a cheap thing, but mine own.' It is thought sometimes that frequent changes of scene are wholesome and educational for children, and so they are shifted year after year to one watering place after another, which, in so far as they come within their observation, are all very much alike. No doubt a variety of new impressions and worldwonder are valuable, but these should come after childhood is over. The apprenticeship should precede the travels, and for young children it is far better that they should be allowed to wind their affections round some one spot of earth, and slowly to form tender associations which will be sustaining and gladdening to them to the end of their days, than that they should dissipate their interest in sight-seeing, and be pleased with a succession of images as immemorable and unemotional as the figures of the kaleidoscope. The farm house has no doubt many advantages as a holiday retreat, but the cheap cottage, as a family seat and permanent possession, is infinitely superior. I hope that some of my sanitary inspector friends in the large towns may see their way to acquire one in some suitable locality. Of well-selected plan, and with some small attractions and additions such as my sanitary inspector friends will well know how to devise, raising the price somewhat upon that of the Letchworth model, but still leaving it within the category of cheapness, such a dwelling should be a source of health and pleasure, and also a good investment.

I have taken a wide, a hurried, and, I fear, a somewhat confusing sanitary outlook, but, when I meet you, so many topics in which we are mutually interested press for attention that I am tempted to attempt too much. If at any point in the outlook I have interested you, or suggested to you some new thought, or some new aspect of an old thought, I shall be well content.

  1. A paper read before the second London conference of the Sanitary Inspectors' Association.