Popular Science Monthly/Volume 39/September 1891/New Chapters in the Warfare of Science: From Fetich to Hygiene II
|NEW CHAPTERS IN THE WARFARE OF SCIENCE.|
XIII. FROM FETICH TO HYGIENE.
By ANDREW DICKSON WHITE, LL. D., L. H. D.,
EX-PRESIDENT OF CORNELL UNIVERSITY.
WE have now seen how powerful in various nations especially obedient to theology were the forces working in opposition to the evolution of hygiene. We shall find this same opposition, less effective, it is true, but still acting with great power in countries which had become somewhat emancipated from theological control. In England, during the mediæval period, persecutions of Jews were occasionally resorted to, and here and there we hear of dealings with witches; but, as torture was rarely used in England, there were few of those torture-born confessions of persons charged with producing plague which in other countries gave rise to wide-spread cruelties. Down to the sixteenth and seventeenth centuries the filthiness in the ordinary mode of life in England was such as we can now hardly conceive: fermenting organic material was allowed to accumulate and become a part of the earthen floors of rural dwellings; and this undoubtedly developed the germs of many diseases. In his noted letter to the physician of Cardinal Wolsey, Erasmus describes the filth thus incorporated into the floors of English houses, and, what is of far more importance, he had an inkling of the true cause of the wasting diseases of the period. He says, "If I entered into a chamber which had been uninhabited for months, I was immediately seized with a fever." He ascribed the fearful plague of the sweating sickness to this cause. So, too, the noted Dr. Caius advised sanitary precautions against the plague; and in after-generations, Mead, Pringle, and others urged them; but the prevailing thought was too strong, and little was done. Even the floor of the presence-chamber of Queen Elizabeth in Greenwich Palace was "covered with hay, after the English fashion," as one of the chroniclers tells us. In the seventeenth century, aid in these great scourges was mainly sought in special church services; the foremost English churchmen during that century being greatly given to study of the early fathers of the Church, the theological theory of disease, so dear to the fathers, still held sway, and this was the case when the various visitations reached their climax in the great plague of London in 1065, which swept off more than a hundred thousand people from that city. The attempts at meeting it by sanitary measures were few and poor; the medical system of the time was still largely tinctured by superstitions resulting from mediæval modes of thought; hence that plague was generally attributed to the divine wrath caused by "the prophaning of the Sabbath." Texts from Numbers, the Psalms, Zechariah, and the Apocalypse were dwelt upon in the pulpits to show that plagues are sent by the Almighty to punish sin; and perhaps the most ghastly figure among all those fearful scenes described by De Foe is that of the naked fanatic walking up and down the streets with a pan of fiery coals upon his head, and, after the manner of Jonah at Nineveh, proclaiming woe to the city and its destruction in forty days.
That sin caused this plague is certain, but it was sanitary sin; both before and after this culmination of the disease cases of plague were constantly occurring in London throughout the seventeenth century; but about the beginning of the eighteenth century it began to disappear; the great fire had done a good work by sweeping off many causes and centers of infection, and there had come wider streets, better pavements, and improved water-supply; so that with the disappearance of the plague, other diseases, especially dysenteries, which had formerly raged in the city, became much less frequent.
But while these epidemics were thus checked in London, others developed by sanitary sin raged fearfully both there and elsewhere, and of these perhaps the most fearful was the jail-fever. The prisons of that period were vile beyond belief. Men were confined in dungeons rarely if ever disinfected after the death of previous occupants, and on corridors connecting directly with the foulest sewers; there was no proper disinfection, ventilation, or drainage; hence in most of the large prisons for criminals or debtors the jail-fever was supreme, and from these centers it frequently spread through the adjacent towns. This was especially the case during the sixteenth and seventeenth centuries. In the Black Assize at Oxford in 1577 the chief baron, the sheriff, and about three hundred men died within forty hours. Lord Bacon declared the jail-fever "the most pernicious infection next to the plague." In 1730, at the Dorsetshire Assize, the chief baron and many lawyers were killed by it. The High Sheriff of Somerset also took the disease and died. A single Scotch regiment being infected from some prisoners, lost no less than two hundred. In 1750, the disease was so virulent at Newgate, in the heart of London, that two judges, the lord mayor, sundry aldermen, and many others died of it.
It is worth noting that while efforts at sanitary dealing with this state of things were few, the theological spirit developed special forms of prayer for prisoners, and especially that a new prayer was placed in the Irish Prayer-book.
These forms of prayer seem to have been the main reliance through the first half of the eighteenth century. But about 1750 began the work of John Howard: among other evidences of saintship he visited the prisons of England, made known their condition to the world, and never rested until they were greatly improved. Then he applied the same benevolent activity to prisons in other countries, in the far East and in southern Europe, and finally laid down his life, a victim to disease contracted on one of his missions of mercy; but the hygienic reforms he began were developed more and more until this fearful blot upon modern civilization was removed.
The same thing was seen in the Protestant colonies of America; but here, while plagues were steadily attributed to divine wrath or satanic malice, there was one case in which it was claimed that such a visitation was due to the divine mercy: the pestilence among the Indians, before the arrival of the Plymouth Colony, was attributed in a notable work of that period to the divine purpose of clearing New England for the heralds of the gospel; on the other hand, the plagues which destroyed the white population were attributed by the same authority to devils and witches. In Increase Mather's Wonders of the Invisible World, published at Boston in 1693, we have striking examples of this. The great Puritan divine tells us:
"Plagues are some of those woes, with which the Divil troubles us. It is said of the Israelites, in 1 Cor. 10. 10. They were destroyed of the destroyer. That is, they had the Plague among them. 'Tis the Destroyer, or the Divil, that scatters Plagues about the World: Pestilential and Contagious Diseases, 'tis the Divel, who do's oftentimes Invade us with them. 'Tis no uneasy thing, for the Divel, to impregnate the Air about us, with such Malignant Salts, as meeting with the Salt of our Microcosm, shall immediately cast us into that Fermentation and Putrefaction, which will utterly dissolve All the Vital Tyes within us; Ev'n as an Aqua Fortis, made with a conjunction of Nitre and Vitriol, Corrodes what it Siezes upon. And when the Divel has raised those Arsenical Fumes, which become Venomous Quivers full of Terrible Arrows, how easily can he shoot the deleterious Miasms into those Juices or Bowels of Mens Bodies, which will soon Enflame them with a Mortal Fire! Hence come such Plagues, as that Beesome of Destruction which within our memory swept away such a throng of people from one English City in one Visitation: and hence those Infectious Feavers, which are but so many Disguised Plagues among us, Causing Epidemical Desolations" (pp. 17 and 18).
Mather gives several instances of witches causing diseases, and speaks of "some long Bow'd down under such a Spirit of Infirmity" being "Marvelously Recovered upon the Death of the Witches," of which he gives an instance. He also gives an instance where a patient "was brought unto death's door and so remained until the witch was taken and carried away by the constable, when he began at once to recover and was soon well."
In France we see, during generation after generation, a similar history evolved; pestilence after pestilence came, and was met by various fetiches. Noteworthy is the plague at Marseilles near the beginning of the last century. The chronicles of its sway are ghastly. They speak of great heaps of the unburied dead in the public places, "forming pestilential volcanoes"; of plaguestricken men and women in delirium wandering naked through the streets; of churches and shrines thronged with great crowds shrieking for mercy; of other crowds flinging themselves into the wildest debauchery; of robber bands plundering the dead and assassinating the dying; of three thousand neglected children collected in one hospital and then left to die; and of the death-roll numbering at last fifty thousand out of a population of less than ninety thousand.
In the midst of these fearful scenes stood a body of men and women worthy to be held in eternal honor—the physicians from Paris and Montpellier; the mayor of the city, and one or two of his associates; but, above all, the Chevalier Roze and Bishop Belzunce. The history of these men may well make us glory in human nature; but in all this noble group the figure of Belzunce is the most striking. Nobly and firmly, when so many others even among the regular and secular ecclesiastics fled, he stood by his flock: day and night he was at work in the hospitals, cheering the living, comforting the dying, and doing what was possible for the decent disposal of the dead. In him were united the two great antagonistic currents of religion and of theology. As a theologian he organized processions and expiatory services, which, it must be confessed, rather increased the sway of the disease than diminished it; moreover, he accepted that wild dream of a hysterical nun—the worship of the material, physical sacred heart of Jesus—and was one of the first to consecrate his diocese to it; but, on the other hand, the religious spirit gave in him one of its most beautiful manifestations in that or any other century: justly have the people of Marseilles placed his statue in the midst of their city in an attitude of prayer and blessing.
In every part of Europe and America, down to a recent period, we find pestilences resulting from carelessness or superstition still called "inscrutable providences" As late as the end of the eighteenth century, when great epidemics made fearful havoc in Austria, the main means against them seem to have been the special "witch-doctors"—that is, monks who cast out devils. To seek the aid of physicians was, in the neighborhood of these monastic centers, very generally considered impious, and the enormous death-rate in such neighborhoods was only diminished in the present century when scientific hygiene began to make its way.
The old view of pestilence had also its full course in Calvinistic Scotland—the only difference being that, while in Roman Catholic countries relief was sought by fetiches, gifts, processions, exorcisms, and works of expiation, promoted by priests; in Scotland, after the Reformation, it was sought in fast-days established by Presbyterian elders. Accounts of the filthiness of Scotch cities and villages, as well as of ordinary dwellings, down to a period well within this century, seem monstrous. All that in these days is swept into the sewers, was in those allowed to remain around the houses or thrown into the streets. The old theological, theory that "vain is the hand of man," checked scientific thought and paralyzed sanitary endeavor. The result was natural: between the thirteenth and seventeenth centuries thirty notable epidemics swept the country, and some of them carried off multitudes; but as a rule these never suggested sanitary improvement; they were called "visitations," attributed to divine wrath against human sin, and the work of the authorities was to announce the particular sin concerned, and to declaim against it. Amazing theories were thus propounded—theories which led to spasms of severity; and, in some of these, offenses generally punished much less severely were visited with death. Every pulpit interpreted the ways of God to man in such seasons so as rather to increase than to diminish the pestilence. The effect of thus seeking supernatural causes rather than natural may be seen in such facts as the death by plague of one fourth of the whole population of the city of Perth in a single year of the fifteenth century; other towns suffering similarly both then and afterward.
Here and there, physicians more wisely inspired endeavored to push sanitary measures, and in 1585 attempts were made to clean the streets of Edinburgh, but the chroniclers tell us that "the magistrates and ministers gave no heed." One sort of calamity, indeed, came in as a mercy—the great fires which swept through the cities, clearing and cleaning them. Though the town council of Edinburgh declared the noted fire of 1700 "a fearful rebuke of God," it was observed that, after it had done its work, disease and death were greatly diminished.
But by those standing in the higher places of thought some glimpses of scientific truth had already been obtained, and attempts at compromise between theology and science in this field began to be made, not only by ecclesiastics, but first of all, as far back as the seventeenth century, by a man of science, eminent both for attainments and character—Robert Boyle. Inspired by the discoveries in other fields, which had swept away so much of theological thought, he could no longer resist the conviction that some epidemics are due, in his own words, "to a tragical concourse of natural causes"; but he argued that some of these may be the result of divine interpositions provoked by human sins. As time went on, great difficulties showed themselves in the way of this compromise—difficulties theological not less than difficulties scientific. To a Catholic it was more and more hard to explain the theological grounds why so many orthodox cities, firm in the faith, were punished, and so many heretical cities spared, and why, in regions devoted to the Church, the poorer people, whose faith in theological fetiches was unquestioning, died in times of pestilence like flies, while skeptics so frequently escaped. Difficulties of the same sort beset devoted Protestants; they, too, might well ask why it was that the devout peasantry in their humble cottages perished, while so much larger a proportion of the more skeptical upper classes were untouched. Gradually it dawned both upon Catholic and Protestant countries that, if any sin be punished by pestilence, it is the sin of filthiness; more and more it began to be seen by thinking men of both religions that Wesley's great dictum stated even less than the truth; that not only was "cleanliness akin to godliness," but that, as a means of keeping off pestilence, it was far superior to godliness as godliness was then generally understood.
The recent history of sanitation in all civilized countries shows triumphs which may well fill us with wonder, did there not rise within us a far greater wonder that they were so long delayed. Amazing is it to see how near the world has come again and again to discovering the key to the cause and cure of pestilence. It is now a matter of the simplest elementary knowledge that some of the worst epidemics are conveyed in water. But this fact seems to have been discovered many times in human history. In the Peloponnesian war the Greeks asserted that their enemies had poisoned their cisterns; in the middle ages the people generally declared that the Jews had poisoned their wells; and as late as the cholera of 1832 the Parisian mob charged the water-carriers who distributed water for drinking purposes from the Seine, polluted as it was by sewage, with poisoning the water, and in some cases murdered them for it; so far did this feeling go, that locked covers were sometimes placed upon the water buckets. Had not such men as Roger Bacon and his long line of successors been thwarted by theological authority—had not such men as Thomas Aquinas, Vincent de Beauvais, and Albert the Great been drawn or driven from the paths of science into the dark, tortuous paths of theology, leading nowhither, the world to-day, at the end of the nineteenth century, would have arrived at the solution of great problems and the enjoyment of great results which will only be reached at the end of the twentieth century, and even in generations more remote. Diseases like pulmonary consumption, scarlet fever, diphtheria, pneumonia, and la grippe, which now carry off so many most precious lives, would have long since ceased to scourge the world.
Still, there is one great cause for joy: the law governing the relation of theology to disease is now well before the world, and it is seen in the striking fact that just in proportion as the world progressed from the sway of Hippocrates to that of the ages of faith, so it progressed in the frequency and severity of great pestilences; and, on the other hand, just in proportion as the world has receded from that period when theology was all-pervading and all-controlling, plague after plague has disappeared, and those remaining have become less and less frequent and virulent.
The recent history of hygiene in all countries shows a long series of victories, and these may well be studied in Great Britain and the United States. In the former, though there had been many warnings from eminent physicians, and, above all, in the seventeenth and eighteenth centuries, from men like Caius, Mead, and Pringle, the result was far short of what might have been gained; and it was only in the year 1838 that a systematic sanitary effort was begun in England by the public authorities. The state of things at that time, though by comparison with the middle ages happy, was, by comparison with what has since been gained, fearful; the death-rate among all classes was high, but among the poor it was ghastly. Out of seventy-seven thousand paupers in London during the years 1837 and 1838, fourteen thousand were suffering from fever, and of these nearly six thousand from typhus. In many other parts of the British Islands the sanitary condition was no better. A noble body of men grappled with the problem, and in a few years one of these rose above his fellows—the late Edwin Chadwick. The opposition to his work was bitter, and, though many churchmen aided him, the support given by theologians and ecclesiastics as a whole was very far short of what it should have been. Too many of them were occupied in that most costly of all processes, "the saving of souls" by the inculcation of dogma. Yet some of the higher ecclesiastics and many of the lesser clergy did much, sometimes risking their lives, and one of them, Sidney Godolphin Osborne, deserves lasting memory for his struggle to make known the sanitary wants of the peasantry.
Chadwick began to be widely known in 1848 as a member of the Board of Health, and was driven out for a time for overzeal; but from one point or another, during forty years, he fought the opposition, developed the new work, and one of the best exhibits of its results is shown in his address before the Sanitary Conference at Brighton in 1888. From this and other perfectly trustworthy sources some idea may be gained of the triumph of the scientific over the theological method of dealing with disease, whether epidemic or sporadic.
In the latter half of the seventeenth century the mortality of London is estimated to have been not less than eighty per thousand; about the middle of this century it stood at twenty-four in a thousand; in 1889 it stood at less than eighteen in a thousand; and in many parts the most recent statistics show that it has been brought down to fourteen or fifteen in a thousand. A quarter of a century ago the death-rate from disease in the Royal Guards at London was twenty per thousand; in 1888 it had been reduced to six in a thousand. In the army generally it had been seventeen in a thousand, but it has been reduced until it now stands at eight. In the old Indian army it had been sixty-nine in a thousand; but of late it has been brought down, first to twenty, and finally to fourteen. Mr. Chadwick in his speech proved that much more might be done, for he called attention to the German army, where the death-rate from disease has been reduced to between five and six in a thousand. Between 1871 and 1880 the death-rate in England among men fell more than four in a thousand, and among women more than six in a thousand. In the decade between 1851 and 1860 there died of zymotic diseases over four thousand persons in every million throughout England; these numbers have declined until in 1888 there died less than two thousand in every million. As to the scourge which, next to plagues like the black death, was formerly the most dreaded—small-pox—there died of it in London during the year 1890 just one person. Drainage in Bristol reduced the death-rate by consumption from 4·4 to 2·3; at Cardiff, from 3·47 to 2·31; and in all England and Wales from 2·68 in 1851 to 1·55 in 1888.
What can be accomplished by better sanitation is also seen today by a comparison between the death-rate among the children outside and inside the charity schools. The death-rate among those outside in 1881 was twelve in a thousand; while inside, where the children were under sanitary regulations, maintained by competent authorities, it has been brought down, first to eight, then to four, and finally to less than three in a thousand.
In view of statistics like these, it becomes clear that Edwin Chadwick and his compeers among the sanitary authorities have in half a century done far more to reduce the rate of disease and death than has been done in fifteen hundred years by all the fetiches which theological reasoning could devise or ecclesiastical power enforce.
Not less striking has been the history of hygiene in France; thanks to the decline of theological control over the universities, to the abolition of monasteries, and to such labors in hygienic research and improvement as those of a succession of men like Tardieu, Levy, and Bouchardat, a wondrous change has been wrought in public health. Statistics carefully kept show that the mean length of human life has been remarkably increased. In the eighteenth century it was but twenty-three years; from 1825 to 1830 it was thirty-two years and eight months; and since 1864, thirty-seven years and six months. The question may come up here whether this progress has been purchased at any real sacrifice of religion in its highest sense. One piece of recent history enables us to answer this question. The Second Empire in France had its head in Napoleon III, a noted Voltairean. At the climax of his power he determined to erect an Academy of Music, which should be the noblest building of its kind in the world. It was projected on a scale never before known, at least in modern times, and carried on for years, millions being lavished upon it. But at the same time the emperor determined to rebuild the Hôtel-Dieu, the great Paris hospital; this, too, was projected on a greater scale than anything of the kind ever before known, and also required millions. In the erection of these two buildings the emperor's determination was distinctly made known, that with the highest provision for intellectual enjoyment there should be a similar provision, and moving on parallel lines with it, for the relief of human suffering. This plan was carried out to the letter; the Palace of the Opera and the Hôtel-Dieu went on with equal steps, and the former was not allowed to be finished before the latter. Among all the "most Christian kings" of the house of Bourbon who had preceded him for five hundred years, history shows no such obedience to the religious and moral sense of the nation. Catharine de' Medici and her sons, plunging the nation into the great wars of religion, never showed any such feeling; Louis XIV, revoking the edict of Nantes for the glory of God, and bringing the nation to sorrow for hundreds of years, never dreamed of making the construction of his palaces and public buildings wait upon the demands of charity; Louis XV, so subservient to the Church in all things, never betrayed the slightest consciousness that while making enormous expenditures to gratify his own and the national vanity, he ought to carry on works, pari passu, for charity. Nor did the French nation, at those periods when it was most largely under the control of theological considerations, seem to have any inkling of the idea that nation or monarch should make provision for relief from human suffering, to justify provision for the sumptuous enjoyment of art: it was reserved for the second half of the nineteenth century to develop this feeling so strongly, though quietly, that Napoleon III, notoriously an unbeliever in all orthodoxy, was obliged to recognize it and to set this great example.
Nor has the recent history of the United States been less fruitful in lessons. Yellow fever, which formerly swept not only Southern cities but even New York and Philadelphia, has now been almost entirely warded off. Such epidemics as that in Memphis a few years since, and the immunity of the city from such visitations since its sanitary condition was changed by Mr. Waring, are a most striking object-lesson to the whole country. Cholera, which again and again swept the country, has ceased to be feared by the public at large. Typhus fever, once so deadly, is now rarely beard of. Curious is it to find that some of the diseases which in the olden time swept off myriads on myriads in every country, now cause fewer deaths than some diseases thought of little account, and for the cure of which, therefore, people rely to their cost on quackery instead of medical science.
This development of sanitary science and hygiene in the United States has been coincident with a marked change in the attitude of the American pulpit as regards the theory of disease. In this country, as in others, down to a period within living memory, deaths due to want of sanitary precautions were constantly dwelt upon in funeral sermons as "results of national sin," or as "inscrutable Providences." That view has mainly passed away among the clergy of the more enlightened parts of the country, and we now find them, as a rule, active in spreading useful ideas as to the prevention of disease; the religious press has been especially faithful in this respect, carrying to every household more just ideas of sanitary precautions and hygienic living.
In summing up the whole subject, we see in this field another of those great triumphs of scientific modes of thought which are gradually doing so much to evolve in the world a religion which shall be more and more worthy of the goodness of God and of the destiny of man.
- For Erasmus, see the letter cited in Bascome, History of Epidemic Pestilences, London, 1851. For account of the condition of Queen Elizabeth's presence-chamber, see the same, p. 206. See also the same for attempts at sanitation by Caius, Mead, Pringle, and others. See Baas and various medical authorities. For the plague in London, see Green's History of the English People, chap, ix, sec. 2; and for a more detailed account, see Lingard, History of England, enlarged edition of 1849, vol. ix, p. 107 et seq. For the London 'plague as a punishment for Sabbath-breaking, see A divine Tragedie lately acted, A collection of sundrie memorable examples of God's judgements upon Sabbath Breakers and other like libertines, etc. By that worthy Divine, Mr. Henry Burton, 1641. The book gives fifty-six accounts of Sabbath-breakers sorely punished, generally struck dead, in England, with places, names, and dates. For a general account of the condition of London in the sixteenth and seventeenth centuries, and the diminution of the plague by the rebuilding of some parts of the city after the great fire, see Lecky, History of England in the Eighteenth Century, vol. i, pp. 592, 593. For the jail-fever, see Lecky, vol. i, pp. 500-503.
- For the passages cited from Increase Mather, see in his book as cited, pp. 17, 18, also 134, 145. Johnson's History of New England, published in London in 1654, declares that "By this meanes Christ. . . not only made roome for His people to plant, but also tamed the hard and cruell hearts of these barbarous Indians, insomuch that halfe a handful of His people landing not long after in Plymouth Plantation, found little resistance." See the History of New England, by Edward Johnson, London, 1654. Reprinted in Massachusetts Historical Society's Collection, second series, vol. i, p. 67.
- For the plague at Marseilles and its depopulation, see Henri Martin, Histoire de France, vol. xv, especially document cited in appendix; also Gibbon, Decline and Fall, chap, xliii; also Rambaud. For the resort to witch-doctors in Austria against pestilence, down to the end of the eighteenth century, see Biedermann, Deutschland Im Achtzehnten Jahrhundert. For the reign of filth and pestilence in Scotland, see Charles Rogers, D. D., Social Life in Scotland, Edinburgh, 1834, vol. i, pp. 305-316; see also Buckle's second volume.
- For Boyle's attempt at compromise, see Discourse on the Air, in his works, vol. iv, pp. 288, 289, cited by Buckle, vol. i, pp. 128, 129, note.
- For the charge of poisoning water and producing pestilence among the Greeks, see Grote's History of Greece, vi, 213. For a similar charge against the Jews in the middle ages, see various histories already cited; and for the great popular prejudice against water carriers at Paris in recent times, see the larger recent French histories.
- On the improvement in sanitation in London and elsewhere in the north of Europe, see the editorial and Report of the Conference on Sanitation at Brighton, given in the London Times of August 27, 1888. For the best authorities on the general subject in England, see Sir John Simon on English Sanitary Institutions, 1890; also his published Health Reports for 1887, cited in the Edinburgh Review for January, 1891. See also Parkes's Hygiene, passim. For the great increase of the mean length of life in France under better hygienic conditions, see Rambaud, La Civilisation contemporaine en France, p. 682. For the approach to depopulation at Memphis, under the cesspool system in 1878, see Parkes, Hygiene. American appendix, p. 397. For the facts brought out in the investigation of the departments of the city of New York, by the Committee of the State Senate, see New York Senate documents for 1865. For decrease of death-rate in New York city under the new Board of Health, beginning in 1866, and especially among children, see Buck, Hygiene and Popular Health, New York, 1879, vol. ii, p. 575; and for wise remarks on religious duties during pestilence, see ibid., vol. ii, p. 579. For a contrast between the old and new ideas regarding pestilences, see Charles Kingsley in Fraser's Magazine, Iviii, 134; also the sermon of Dr. Burns in 1875 at the Cathedral of Glasgow, before the Social Science Congress. For a particularly bright and valuable statement of the triumphs of modern sanitation, see Mrs. Plunkett's article in The Popular Science Monthly for June, 1891