THE HEALTH OF THE PEOPLE.* WE have so frequently insisted
on the need of the public possess- ing a greater knowledge of health matters that almost any reason- able attempt to instruct it would have met with our approval, but that such an excellent collection of books as those includedin the " English Public -Health Series " should be published so soon after the creation of a Ministry of Health exceeds all expect- ations, and renders it difficult to put in words our appreciation of what we regard as a truly patriotic service.
Sir Malcolm Morris, who edits the series, contributes the first volume, The Story of English Public Health,' tracing therein the truly . wonderful development of public health administration during the past three-quarters of a century, and showing the great part which this development owes to voluntary effort. We are so accustomed to the numerous health regulations issued by the almost equally numerous Central Health Authorities existing up to the time of the passing of the Ministry of Health Bill, that we are astonished on learning there was, when Queen Victoria ascended the throne, no public health legislation except an Act " establishing an inefficient system of quarantine," and an Act forbidding the employment of children under nine years of age, Up to 1833 little children, "who had not long learned to walk," were employed in factories for twelve to thirteen laars daily, under most insanitary conditions, for a penny a day. It is still more strange to read that the Bill forbidding the employment of children under nine was opposed by Cobden and Bright on economic grounds as destroying freedom of contract. Spurred on by enthusiastic voluntary workers, the Government, " whose tendency has always been to let sleeping dogs—that is, vested interests—lie," has passed one public health measure after another, until now there would seem to be almost a danger of over-inspection. Nevertheless we are still far from that perfect sanitation which Chadwick, the founder of our sanitary service, thought would make an end of the medical profession, in- augurating that era when, as Sir William Collins says, "doctors would be unable to live, yet perhaps unable to die." Now that there Is it- Ministry of Health taking over the duties of some twenty Central Health Authorities, we may hope for more rapid progress than in the past ; but two things must be borne in mind- • (1) Ths Story of Bnglish Public Health. By Sir Malcolm Morris, K.C.V.O. —(2) infant and Young Child Welfare. By Harold Scurfleld, M.D. Bd., D.Ph. Camb.—(3) Food and Public Health. • By W. G. Savage, B.Sc., M.D. Loud- D Ph. " EuglIsh Public Health Series," edited by Sir Malcolm Morrie,
London Casselt: Ps. net per vol.]
first, that a general Board of Health intended to unify control was created in 1848 and, after a somewhat inglorious career, was abolished in 1858 ; and, second, that in spite of the diversity of control, these islands possess the most efficient sanitary service in the world. The Ministry of Health can only prove a success if it has behind it a public well informed on health matters, and has associated with it as advisers, and not as consultants only, medical and sanitary experts. No better introduction to the acquirement of the necessary knowledge could be provided than the volume before us.
The second volume of the series, written by Dr. Scurfield, deals with Infant and Young Child Welfare,' a subject the importance of which can hardly be too much emphasized at present. The Medical Officer of Health for Sheffield is obviously an enthusiast for the proper understanding and handling of the problem about which he writes, and is a sympathetic advocate of the rights of women, and more especially of the rights of mothers. At the risk of seeming old-fashioned and quite out of date, we confess to grave doubts whether the present training of girls is best for themselves or the nation. Most people—women as well as men—reserve their greatest praise for those who have succeeded in doing men's work as well, or nearly as well, as men. • For the fulfilment of the essential duties of a woman, the rearing and education of children, the nation gives little praise and no rewards. During the years of the Great War the woman munition-maker has been loudly . acclaimed ; the patient, hard-working mother, whom we have to thank for the men of our splendid Navy and Armies, has been passed over in silence. How hard the mother works, unassisted by necessary labour-saving appliances, Dr. Scurfield shows, giving many truly pathetic examples of cases which have come under his personal notice. To those people who hold that in our attempts to conserve the children of the nation we are inter. fering with Darwin's law of the " survival of the fittest," the author points out that those " fittest " to survive the evils of slums are not necessarily the " fittest " to carry onwards the torch of civilization; and he has little patience with those, some of them eminent medical men, who regard the tubercle bacillus as a beneficent means of eliminating the unfit. Dr. Seurfield has much to say about the various forms of "mother-substi- tutes," among which are included bottle-feeding, creches, day- nurseries, &c. All these should be eliminated by giving the mother her proper place in the life of the nation; but as this is a counsel of perfection, he outlines the steps that should be taken to make these substitutes of real service to both mother and child. He has no difficulty in showing that where, as among the Jews, the mother suckles her children and pays attention to their after-care, the infant mortality, even under the same appal- ling external conditions, is much below that of the Gentile popu- lation. Space is not available to discuss the many other inter_ eating points in this book, but readers will find in it an eloquent and convincing appeal on behalf of the long-suffering mother and child.
The third volume of the series which has reached us is written by that very capable Medical Officer of Health for Somerset, Dr. Savage, and deals with Food and Public Health.' The subject is of course of great interest to every one, never more than at the present time. One is forced to admit that much of the book, especially that concerned with milk, is not calculated to improve the appetite for the foods dealt with ; but even at the cost of loss of appetite, it is well that the truth about the contamination of food, much of it easily avoidable, should be plainly stated. Prevention of contamination and adulteration would be more easily attained were it not for the existence of vested interests and the extraordinary ignorance and indifference of the consumer. In the comparatively simple matter of the milk-supply, any one who has attempted to improve it is aware how these factors impede him at every step. He is apt to be regarded as a troublesome busybody with an inhuman disregard of the interests of the farmer and dairyman. Considerable improvement was nevertheless obtained before the war, unavoid- ably followed by a relapse during the years of struggle. If Dr. Savage warns us of .many terrors, he does much to lay the " bogy " of the danger of tinned foods, a " boa " which has led to much unnecessary expense in first canning the foods and then transferring them to glass receptacles.
The publishers announce that these books appeal particularly to " workers in the various fields of hygiene, but also to the general reader." We feel that the subjects dealt with arc of such importance to the community, and are discussed so clearly and simply, that the series should be widely read by all classes. Thus would the army of voluntary unofficial workers in the various fields of hygiene be recruited in sufficient numbers to attain the sanitary ideal.
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