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a new and favourable environment to be the strongest force both to modify and to control the defects of a vicious heredity. I believe that we can alter the physical and psychical characters through the influence of the environment-and school teachers acquainted with the family history of a child may be able to guard against the bad effects of a family heredity-otherwise where does the reformer, the sociologist, and the educationalist come n? It is the logical basis of all the ethics. I know that it is urged by Weismann and others that one portion of the germ plasm lies dormant in the body of
COMPARATIVE WEIGHT AND HEIGHT TABLE.-COUNTRY versus TOWN.
general experience tends to press one particular line of thought upon him, viz., that where drinking had begun with the parents of a child prior to its birth, and where such drinking had become habitual and had been long continued, the effects, seen in many ways in the child's organism, were not necessarily permanent, and if the child is placed early enough in a healthy environment, the inherited evil tendencies and effects appear to diminish year by year. Where, however, drinking began two or three generations back with the grandparents or great grandparents, then the character of the evils was
the host, giving rise to the continuity of the germ plasm from generation to generation, and that the other portion becomes the new organism, and I am also aware that the deductions of morphology, laboratory experiments, and microscopical observations are against the transmission of acquired characteristics, but the practical man does not coincide with this view, and the experience of the philanthropists does not support it Look at the picture from Dr. Barnardo's Home of the girls of 14 years of age, who for years have been clothed, nourished, and trained mentally and physically in accordance with the laws of health, and yet who were received as deteriorated specimens from the waifs and strays of the slums of East London. Compare their height and weight with others. Dr. Barnardo himself says in regard to drink that his
much more permanent, powerful, and deteriorating.
Look also at the pictures presented by Dr. Hall's experiment at Leeds already referred to. Look again at the statistics of Claybury Asylum where physical drill is applied to the women, and farm or workshop occupation, such as carpentering, wood-carving, tailoring, ing, shoemaking, painting, &c., is provided for the men, and where both sexes are fed upon a considered and fixed dietary scale. During 1903, 45 patients who recovered were detained from one to three months, 27 were detained from three to six months, 21 from six to nine months, and 21 from nine to 12 months. Those from 15 to 20 years of age gained an average of 163 lbs., those from 20 to 25 gained 17 lbs., and those from 25 to 30 years of age 12 lbs. A gain in weight indi
cates, as a very general rule, marked improvement in mental health as well as physique. I cannot help thinking that too much is made of heredity and too little of environment. Whilst upon this aspect I venture to call special attention to the success, mentally and physically, which has attended the application of drill, or a methodical use of muscular exercise in the case of the female patients under my treatment. Besides improving the mind and strengthening the body, this exercise has a special educational value, for it connects mental and muscular processes, it quickens the senses, re-opens dormant paths in the mind, and, by engaging the attention, ensures a more precise and ready re-action to outward stimula. My colleague, Dr. Ewart, and myself, can speak in the highest praise of Swedish drill, as the system is called, as a corrective of neurotic heredity, and a valuable addition to the treatment of the insane. It places the nervous system in a more normal state of tension, the whole mind, for the time, is absorbed in one task, and there is a pleasant reaction, due to a new attainment. It has been witnessed by the Lunacy Commissioners, who recommend its extension, and some pictures of it are shown here to-night for the first time. I feel certain that physical culture is one of the greatest needs for our young people of to-day, and the matter is not too strongly urged in that invaluable report of the Commissioners appointed to investigate physical training in Scotland, a report which it is not too much to say should be in the hands of every teacher, as well as of every father of a family.
There is an urgent need to fortify the individual against any hereditary predisposition to break down under the depressing effects of town life, which acts so detrimentally upon the poor. To this stratum-which is at the mercy of every economic fluctuation, and which is most prone to insanity-town life brings lack of proper nutrition, overcrowding, with unsuitable hygienic and moral surroundings, poverty, and crime-the latter an evil worse than poverty, and one bearing a very intimate relation to insanity.
Overcrowding leads to many and various miseries, with personal discomforts which are humiliating and demoralising to the grown-up, and are a source of moral contamination to their descendants, in whom they cause mental and bodily degeneration. In spite of the great efforts made to bring the poor into touch with the church, religion plays a very small part in
their lives. The conclusions of Booth show how crowds of people have their happiness stifled by their environment in our own city, where an immense number of poor people live in small and badly ventilated apartments, with filth and squalor in their mean streets, and where their children become unhealthy, anæmic and stunted from the want of pure air and radiant light. As to the association of religion and cleanliness, we are encouraged to believe that cleanliness and godliness are characters essentially English, and that as à people we are the most godly and cleanly race upon whom the sun has the privilege of shining, but it is a rude shock to learn that the baths in the model dwellings are often used as receptacles for lumber. As to poverty there were in London, according to the census of 1891, no fewer than 174,500 tenements consisting of a single room, each giving shelter to families, varying from three to 12 persons, and there are over a million and a quarter of people whose wages for an average family of five does not exceed 21s. per week. In the first week of February, 1904, there were in London no less than 117,307 paupers, of whom 75,085 were indoor and 42,222 were out-door. This shows an increase of 1,191 upon the corresponding week of 1903, and of 6,641 over the corresponding week of 1902, and 10,367 over that of 1901, a greater proportion per 1,000 of the population than for the corresponding period of any year since 1875, showing a definite spreading of the dependence upon State assistance, and a decline in the effective strength of individual self-help and self-respect, which are the vital conditions of economic and social progress. There is one aspect of this class which is not to some without comfort, and that is their infertility. Mr. Alexander McDougall took careful records of the antecedents of paupers in Manchester for one year, and he only found 14 per cent. whose parents had also been in receipt of relief. I have further noticed this feature in regard to the insane; many, indeed I may say a fair proportion of married women in the asylum are childless, which seems to be a wise dispensation of Providence, that the unfit should not cumber the earth.
The food of the poor in cities is deficient in quality and quantity, and the cooking for this class in cities is stated, on good authority, to be worse than that of the same class in the country. It may be wondered how vegetables. fish, and milk can be fresh and digestible by the time they reach the poor of London, and
yet there is a constant stream of 80,000 persons annually migrating from the country to the towns, some of whom swell the ranks of the unemployed, and many of whom might be more healthily employed on the land. In 1876, 18 million quarters of wheat were produced at 50s. per quarter, whereas in 1901, only 63 million quarters were produced at 28s., and the number of agricultural labourers have diminished in 20 years by 211,000, whereas, according to the increase of the population, there should have been an increase of 300,000 !
The question of afforestation, reclaiming waste lands, and preventing sea encroachments at Imperial, county, or local cost, have received recent attention in another place. There is no doubt some need for simplification and a readjustment of the relationship between central and local authorities to remedy the grievous problem of the unemployed. It is estimated that there are 30,000 tramps 66 on the road," of whom one-third only are of the pauper class, and, in addition, 61,000 able-bodied paupers in England and Wales, and there is at present no uniformity in the treatment of this class. Many of these migrants from the country to the towns suffer in winter from cold, want of food and clothing, and in summer they endure a debilitating atmosphere from the reeking odours of dirt, decomposing garbage and noisome refuse. In cities where the population has to accommodate itself to the pressure of competition, the tension of mind is also more continuous, artificial desires multiply, unhealthy activities are created and ambition further forces the overworked brain, which sooner or later results in its complete breakdown. The wants of modern civilised life are many, but are rarely gratified, the eager hand reaches to grasp the prize which is plucked away by some other of the numerous competitors, and bitter disappointment is added to the nervous strain and mental overwork. There is no doubt that London, and a fortiori, other great cities, produce in the present day a tension of the nervous system as baneful as it is unnatural. One has only to look at the living maelstrom which pours into airless and sunless London offices, workshops, and factories every day from the suburbs to see the strained, eager, earnest, and inwardly pre-occupied faces of the people who are compelled to sacrifice their health and overstrung nerves in the cause of civilisation. As to mental degeneration, the earlier writers laid great stress upon a disturbance of the emotions or the habitual in
dulgence of the passions as physical causes of insanity. The over-much attention paid to personal longings and sensations by those who have too little occupation, or whose occupation is irrational and unhealthy. It has been demonstrated in the laboratory that the most exact nervous reaction takes place when the nerve circle is complete and in a state of healthy strain or tonus, and a life full of mental work and occupation is the most healthy. The tendency of many idle men and women of to-day is to gratify every passion, irrespective of the misery this may involve to those dependent upon them, and so much is this the case, that the Medico-Psychological Association, at the instigation of Dr. Mercier and others, considered, not long since, the advisability of calling for special legislation to deal with prodigals, spendthrifts, and persons guilty of gross self-indulgence. The judicial statistics (1903) show that certain kinds of lawbreaking are on the increase, and, as indicating laxity of morals, the petitions for judicial separation and dissolution of marriage were higher than in any previous year. Commercial morality has declined; the business of the County Courts was the largest in any year since the Courts were established, and the number of debtors imprisoned was the largest yet recorded. This egotism, a characteristic of insanity, is fostered in the poorer classes by the poisoned environment of town life, and London alone is responsible for the production of over 70 insane persons per week. This number, high as it is, unfortunately is destined unrelentingly to increase, and it is not too much to say that the more highly developed a race becomes, the more cases of general paralysis and other lethal forms of insanity due to similar causes will occur.
The form of insanity named "dementia precox" was unknown a hundred years ago; indeed, it did not even find a place in the Lunacy Commissioners' Report to the Lord Chancellor until after 1878. It attacks prematurely our most promising and educated youth, it is practically incurable—the majority never recover from it-and it is, of all forms. the one caused by overstrain, and the mental rather than the manual worker is subject to its ravages. A quarter of a century ago the type of insanity was different from that of to-day. There is now an increased tendency to melancholia, which is less recoverable than the form characterised by excitement and called mania, and it is probably a deeper reduction of nerve elements than occurs in mania. Melancholia
has shown a considerable rise among the educated and the private or paying class of the insane, and I am stating a fact and not an opinion when I say that recovery may be complete after a sharp attack of mania, whereas this is rarely the case after melancholiaespecially in the male sex. As to the general recovery rate, that of the last year recorded by the Lunacy Commissioners, 1902, shows an actual decrease when compared with 1877, which is twenty-five years ago.
As to the increase of physical degeneration, there is a marked increase, within the last quarter of a century, in deaths from cancer and nervous diseases. The former has increased 2319 per million persons, and the latter, 2393. As to mental degeneration, on January 1st, 1859, when the number of lunatics was first officially registered, the proportion of the insane to the general population was 1 to 536. To-day the proportion is over 1 to 293, and a rise has been noticed in "first attacks or occurring insanity. Moreover, the practice of alienist physicians to-day reports more weak-minded and backward children as being recognised among the poor. In London today these number 1 to every 182 healthy children. There is also a considerable increase in borderland insanity, and there is more of mental instability which scarcely amounts to actual insanity.
There is, further, also a larger proportion of cases which exhibit what is called "psychic trouble," cases which are not included in official records and which are outside statistics, but which with different exciting causes may at any time add to and become the registered insane, more especially at one or other of the physiological crisis, such as puberty, childbirth, or the climacteric age. There is a difficulty on the part of people to grow old physiologically. Possibly, indeed very probably, the high pressure at which we are living, and the necessary sub-division of labour have evolve 1 a very complicated mental mechanism with every possibility therefore of getting out of order in a manner unknown to a former generation. Mental evolution means greater inhibition or the power to say no" and the pent-up energies of our day are fewer and of less moment than in primitive times when they found a more ready exit through muscular exercises.
Although I do not deny that improvements have taken place during the present generation
through special legislation 'for the protection of adult and child life, as also for the better condition of the town-dweller, much yet remains to be done. We must, however, advance carefully and even slowly in regard to restrictive legislation, for such enactments should hold the balance equally between protecting the workman on the one hand and promoting the industry on the other, otherwise they work mischief.
With regard to the public health in London, insanitary areas have to some extent been removed, open spaces have been increased and extended, and model dwellings for the working class have been erected, yet these boasted improvements are merely as a drop in the ocean, and there is without doubt a deplorable amount of ill-health existing among the very poor. There are many who are battling against tubercle, rheumatism and infection, the ravages of alcohol, contagious diseases, and crime. There is among the poorer classes of London and other large towns such a marked mal-nutrition from the want of light and air, through insufficient and improper dietary, as to be a disgrace to our humanity, and among a considerable number of the children attending schools there is an amount of bodily deficiency and a latent degree of disease which saddens a medical expert, and which must render the sufferers absolutely unfit for the struggle of life. At present we have no measure of what this may be and the first requisite is to establish a standard to be a basis for further inquiry as was done in the Scotch Commission. We shall then know the measure of overpressure and the amount of departure from the normal. This is a matter which must be of moment to every class of society and is of high importance to the nation. Teachers are unable to estimate the full amount of this deterioration, and up to the present it is only known in vague general terms. Teachers in conjunction with medical experts can give us the information and the investigation should be pressed upon the Government. There must be an awakening of the public conscience in regard to the elementary laws of health in so far as they concern the proper use of air and efficient ventilation, food, as to purity and cooking, and drink, as to its moderation. Mothers should have been taught in their schools, as children, the necessity for personal cleanliness, the value of and the care for their teeth, the elements of feeding and drinking with regard to temperance, and the importance of proper warm clothing. Our first attention
should be to the children-the great national asset of the State. The upbringing and feeding of children should be made familiar to every mother, and children should be properly and adequately fed, and they should have the joys of life brought before them. They should have plenty of little open air playgrounds, exclusively for themselves, with someone interested to organise their games, as in Germany. Between school time and manhood both sexes should receive as an essential teaching the elements of physical training also in the open air, and every effort should be made to encourage, by individual philanthropy, and, if possible, by State aid, such invaluable organisations as the Cadet Corps, Boys' Brigades, gymnasia and clubs with systema. tised athletic sports. Finally, no effort should be spared to realise Mr. Ebenezer Howard's great scheme of the migration of industries into the country. To summarise my recommendations I urge (1) a scheme for a health standard; (2) the better education of girls in the choice and cooking of food, and in all domestic duties; (3) improved physical training for both sexes; (4) greater inducements for people to remain on the land; (5) when migrating into the towns, better sanitary surroundings; (6) less alcohol and self-indulgence generally.
We do not want to “muddle through" with this great question which involves the physical as well as the intellectual power of our people, for at no time in the history of our country has the stress of ever-growing competition made a greater demand upon brain power for the scientific spirit in our workshops, in all branches of the executive, whether in the army, the navy, the higher commercial enterprises, or the universities. The effect of a Royal Commission has been likened to a high class funeral. It merely draws attention to the matter. It is true, I fear, that one of the greatest dangers threatening us to-day is a "mental listlessness" which prevents men from taking more than a passing interest in questions affecting the well-being of the community. There is reason, if not for alarm, at any rate for pause and reflection, and I hope for positive action upon this question. The Society of Arts, founded just 150 years ago for the advancement of British commerce among other objects, has done well and acted wisely in endeavouring to educate a public opinion by calling attention to a subject which deals with the strength, the vigour, and the vitality of our population, and upon which our very existence as a nation must depend.
The CHAIRMAN said that as Dr. Jones had rightly stated, what was wanted was evidence such as that which medical experts had given before the Royal Commission on Physical Training as the result of their examinations of the Edinburgh schools, although such elaborate statistics as they gave would hardly be required in determining the question whether the standard had really deteriorated. It appeared to him that if they had some system by which the children in the elementary and secondary schools could be roughly measured and notes made of their appearance and general health, there would be accumulated in the course of a few years some really satisfactory data by which judgment could be formed as to how the nation was progressing in physical health. No one could doubt the very serious and lamentable condition of a large proportion of the population; but whether the country was in a proportionately worse condition than it was thirty, or forty, or fifty years ago was a question which we could not possibly decide. On this matter we were guided by our own impressions, and he would venture to say that his own impressions were not the same as those of Dr. Jones. He had had an experience of some forty years, including both London dispensary and hospital work, and he could not say that his own observations led him to think that even the urban population were worse than they were at the beginning of that period, though certainly their condition called urgently for improvement. In the valuable report to which the reader of the paper had alluded, Dr. Leslie Mackenzie showed incontestibly that the degenerated or, he would say, the impoverished and ill-nourished children were especially found among the poorest elements of the population, for instance, the majority of the children in the Canongate school came from families which lived in only one, two, or three rooms. It seemed to him that the bed-rock of the question was poverty, and the inability of the poor to live under fairly hygienic conditions. It was very hard for him to believe that the physical condition of the nation was degenerating, for unless the progress of the whole of the Victorian era was a delusion and a myth, we were in a far better condition now than we were at the commencement of that era. The people were now better housed, better fed, and better clothed, besides living under better sanitary conditions. With regard to the reference to Mr. Darwin's remark about the cartilage of the ears in certain cases, he had always been under the impression that what Darwin drew attention to, was that the projection on the concha of the ear, or the little cartilage which some people had got, was a sign of reversion to ancestral conditions, but he did not know that it was to be taken as a sign of degeneration. If it was a sign of reversion to the ancestral type, those who possessed it ought to be physically