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Title: Hygeia, a City of Health

Author: Benjamin Ward Richardson

Release Date: April 15, 2004 [EBook

#12036]

Language: English

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HYGEIA

MY DEAR MR CHADWICK,

I wrote this Address with the intention

of dedicating it to you, as a simple but hearty acknowledgment by a sanitary student, himself well ripened in the work, of your pre-eminent position as the living leader of the sanitary reformation of this century.

The favour the Address has received indicates notably two facts: the advance of public opinion on the subject of public health, and the remarkable value and influence of your services as the sanitary statesman by whom that opinion has been so wisely

formed and directed.

In this sense of my respect for you, and

of my gratitude, pray accept this trifling recognition, and believe me to be,

Ever faithfully yours,

B.W RICHARDSON

PREFATORY NOTE.

The immediate success of this Addresscaused me to lay it aside for somemonths, to see if the favour with which itwas received would remain I amsatisfied to find that the good fortunewhich originally attended the effortholds on, and that in publishing it now in

a separate form I am acting in obedience

to a generally expressed desire

Since the delivery of the Address beforethe Health Department of the SocialScience Congress, over which I had thehonour to preside, at Brighton, in

October last, every day has broughtsome new suggestion bearing on thesubjects discussed, and the temptationhas been great to add new matter, oreven to recast the essay and bring it out

as a more compendious work Onreflection I prefer to let it take its place

in literature, in the first instance, in itsoriginal and simple dress

12 HINDE STREET, W.: August 18,

1876

HYGEIA, A CITY OF

HEALTH

We meet in this Assembly, a voluntaryParliament of men and women, to studytogether and to exchange knowledge andthought on works of every-day life andusefulness Our object, to make thepresent existence better and happier; toinquire, in this particular section of ourCongress:—What are the conditionswhich lead to the pain and penalty ofdisease; what the means for the removal

of those conditions when they are

discovered? What are the most readyand convincing methods of makingknown to the uninformed the facts: thatmany of the conditions are under ourcontrol; that neither mental serenity normental development can exist with anunhealthy animal organisation; thatpoverty is the shadow of disease, andwealth the shadow of health?

These objects relate to ourselves, to ourown reliefs from suffering, to our ownhappiness, to our own riches We have, Itrust and believe, yet another object, onethat relates not to ourselves, but to thosewho have yet to be; those to whom wemay become known, but whom we cannever know, who are the ourselves,unseen to ourselves, continuing our

We are privileged more than any whohave as yet lived on this planet in beingable to foresee, and in some measureestimate, the results of our wealth oflabour as it may be possibly extendedover and through the unborn A fewscholars of the past, like him who,writing to the close of his mortal day,sang himself to his immortal rest with

the 'Gloria in excelsis,' a few scholars

might foresee, even as that Baeda did,that their living actual work was but thebeginning of their triumphant coursethrough the ages,—the momentum Butthe masses of the nations, crude andselfish, have had no such prescience, nosuch intent 'Let us eat and drink, for to-

morrow we die!' That has been the pass,

if not the password, with them andtheirs

We, scholars of modern thought, havethe broader, and therefore more solemnand obligatory knowledge, that howevermany to-morrows may come, andwhatever fate they may bring, we neverdie; that, strictly speaking, no one yetwho has lived has ever died; that forgood or for evil our every change frompotentiality into motion is carried onbeyond our own apparent transitoriness;that we are the waves of the ocean oflife, communicating motion to theexpanse before us, and leaving thehistory we have made on the shorebehind

Thus we are led to feel this greaterobject: that to whatever extent we, byour exertions, confer benefits on thosewho live, we extend the advantage tothose who have to live; that one goodthought leading to practical useful actionfrom one man or woman, may go to thevirtue of thousands of generations; thatone breath of health wafted by our breathmay, in the aggregate of life saved by it,represent in its ultimate effect all the lifethat now is or has been.

At the close of a Parliamentary session,

an uneventful leader of a section ofParliament banters his more eventfulrival, and enlivening his criticism by asneer at our Congress, challenges thecontempt of his rival, as if to draw it

forth in the same critical direction Alas!

it is too true that great congresses, likegreat men, and even like Parliaments, dolive sometimes for many years and talkmuch, and seem to miss much andadvance little; so that in what relates tothe mere present it were wrong,possibly, to challenge the sally of thestatesman who, from his own helplessheight, looked down on our weakness.But inasmuch as no man knoweth the end

of the spoken word, as that which isspoken to-day, earnestly and simply,may not reappear for years, and may thenappear with force and quality of hiddenvirtue, there is reason for our unitingtogether beyond the proof of necessitywhich is given in the fact of our

existence Perchance some day ournatural learning, gathered in our variedwalks of life, and submitted in opencouncil, may survive even Parliamentarystrife; perchance our resolutions, though

no sign-manual immediately grace them,are the informal bills which ministersand oppositions shall one day discuss,Parliaments pass, royal hands sign, andthe fixed administrators of the will of thenation duly administer

These thoughts on the future, rather than

on the passing influence of ourcongressional work, have led me to thesimple design of the address which, asPresident of this Section, I venture tosubmit to you to-day It is my object toput forward a theoretical outline of a

community so circumstanced and somaintained by the exercise of its ownfreewill, guided by scientificknowledge, that in it the perfection ofsanitary results will be approached, ifnot actually realised, in the co-existence

of the lowest possible general mortalitywith the highest possible individuallongevity I shall try to show a workingcommunity in which death,—if I mayapply so common and expressive aphrase on so solemn a subject,—is kept

as nearly as possible in its proper ornatural place in the scheme of life

to see which way they should go, butwhen they have made up their minds theyshould hesitate no longer, but proceedwith cheerfulness,' For a moment, then,

we will stand on the past

From this vantage-ground we gather the

fact, that onward with the simpleprogress of true civilisation the value oflife has increased Ere yet the words'Sanitary Science' had been written; ereyet the heralds of that science (some ofwhom, in the persons of our illustriouscolleagues, Edwin Chadwick andWilliam Fair, are with us in this place atthis moment), ere yet these heralds hadsummoned the world to answer for itsprofligacy of life, the health and strength

of mankind was undergoingimprovement One or two striking factsmust be sufficient in the brief space at

my disposal to demonstrate this truth InEngland, from 1790 to 1810, Heberdencalculated that the general mortalitydiminished one-fourth In France, during

the same period, the same favourablereturns were made The deaths inFrance, Berard calculated, were 1 in 30

in the year 1780, and during the eightyears, from 1817 to 1828, 1 in 40, or afourth less In 1780, out of 100 new-borninfants, in France, 50 died in the twofirst years; in the later period, extendingfrom the time of the census that wastaken in 1817 to 1827, only 38 of thesame age died, an augmentation of infantlife equal to 25 per cent In 1780 asmany as 55 per cent died beforereaching the age of ten years; in the laterperiod 43, or about a fifth less In 1780only 21 persons per cent attained theage of 50 years; in the later period 32, oreleven more, reached that term In 1780

but 15 persons per cent, arrived at 60years; in the later period 24 arrived atthat age.

Side by side with these facts of thestatist we detect other facts which showthat in the progress of civilisation theactual organic strength and build of theman and woman increases As in thehighest developments of the fine arts thesculptor and painter place before us thefinest imaginative types of strength,grace, and beauty, so the silent artist,civilisation, approaches nearer andnearer to perfection, and by evolution ofform and mind developes what ispractically a new order of physical andmental build Peron,—who first used, if

he did not invent, the little instrument,

the dynamometer, or muscular-strengthmeasurer,—subjected persons ofdifferent stages of civilisation to the test

of his gauge, and discovered that thestrength of the limbs of the natives ofVan Diemen's Land and New Hollandwas as 50 degrees of power, while that

of the Frenchmen was 69, and of theEnglishmen 71 The same order of factsare maintained in respect to the size ofbody The stalwart Englishman of to-daycan neither get into the armour nor beplaced in the sarcophagus of those sons

of men who were accounted the heroes

of the infantile life of the human world

We discover, moreover, from our view

of the past, that the developments oftenacity of life and of vital power have

been comparatively rapid in their coursewhen they have once commenced There

is nothing discoverable to us that wouldlead to the conception of a humancivilisation extending back over twohundred generations; and when in thesegenerations we survey the actual effect

of civilisation, so fragmentary andovershadowed by persistent barbarism,

in influencing disease and mortality, weare reduced to the observation of at mosttwelve generations, including our own,engaged, indirectly or directly, in thework of sanitary progress During thiscomparatively brief period, the labour ofwhich, until within a century, has had nosystematic direction, the changes forgood that have been effected are amongst

the most startling of historical facts.Pestilences which decimatedpopulations, and which, like the greatplague of London, destroyed 7,165people in a single week, have lost theirvirulency; gaol fever has disappeared,and our gaols, once each a plague-spot,have become, by a strange perversion ofcivilisation, the health spots of, at least,one kingdom The term, Black Death, isheard no more; and ague, from which theLondon physician once made a fortune,

is now a rare tax even on the skill of thehardworked Union Medical Officer.From the study of the past we arewarranted, then, in assuming thatcivilisation, unaided by specialscientific knowledge, reduces disease

and lessens mortality, and that the hope

of doing still more by systematicscientific art is fully justified

I might hereupon proceed to my projectstraightway I perceive, however, that itmay be urged, that as mere civilisinginfluences can of themselves effect somuch, they might safely be left tothemselves to complete, through thenecessity of their demands, the wholesanitary code If this were so, a formulafor a city of health were practicallyuseless The city would come withoutthe special call for it

I think it probable the city would come

in the manner described, but how long itwould be coming is hard to say, for

whatever great results have followedcivilisation, the most that has occurredhas been an unexpected, unexplained,and therefore uncertain arrest of thespread of the grand physical scourges ofmankind The phenomena have beensuppressed, but the root of not one ofthem has been touched Still in our midstare thousands of enfeebled humanorganisms which only are comparablewith the savage Still are left amongst usthe bases of all the diseases that, up tothe present hour, have afflicted humanity.The existing calendar of diseases,studied in connection with the classicalhistory of the diseases written for us bythe longest unbroken line of authorities

in the world of letters, shows, in

unmistakable language, that theimposition of every known malady ofman is coeval with every phase of hisrecorded life on the planet No malady,once originated, has ever actually diedout; many remain as potent as ever Thatwasting fatal scourge, pulmonaryconsumption, is the same in character aswhen Coelius Aurelianus gave itdescription The cancer of to-day is thecancer known to Paulus Eginæta TheBlack Death, though its name is gone,lingers in malignant typhus The greatplague of Athens is the modern greatplague of England, scarlet fever Thedancing mania of the Middle Ages andthe convulsionary epidemic ofMontmartre, subdued in their violence,

are still to be seen in some Americancommunities, and even at this hour in theNew Forest of England Small-pox,when the blessed protection ofvaccination is withdrawn, is the samevirulent destroyer as it was when theArabian Rhazes defined it Ague lurksyet in our own island, and, albeit thephysician is not enriched by it, is in nosymptom changed from the ague thatCelsus knew so well Cholera, in itsmodern representation is more terrible amalady than its ancient type, in so far as

we have knowledge of it from ancientlearning And that fearful scourge, thegreat plague of Constantinople, theplague of hallucination and convulsionwhich raged in the Fifth Century of our

era, has in our time, under the newnames of tetanoid fever and cerebro-spinal meningitis, been met with hereand in France, and in Massachusetts has,

in the year 1873, laid 747 victims in thedust

I must cease these illustrations, though Icould extend them fairly over the wholechapter of disease, past and present.Suffice it if I have proved the generalpropositions, that disease is now as itwas in the beginning, except that in someexamples of it it is less virulent; that thescience for extinguishing any onedisease has yet to be learned; that, as thebases of disease exist, untouched bycivilisation, so the danger of disease isever imminent, unless we specially

provide against it; that the development

of disease may occur with originalvirulence and fatality, and may at anymoment be made active under accidental

or systematic ignorance

A CITY OF

HEALTH.

I now come to the design I have in hand

Mr Chadwick has many times told usthat he could build a city that would giveany stated mortality, from fifty, or anynumber more, to five, or perhaps somenumber less, in the thousand annually Ibelieve Mr Chadwick to be correct tothe letter in this statement, and for thatreason I have projected a city that shallshow the lowest mortality I need not saythat no such city exists, and you mustpardon me for drawing upon your

imaginations as I describe it Depictingnothing whatever but what is at thispresent moment easily possible, I shallstrive to bring into ready and agreeableview a community not abundantlyfavoured by natural resources, which,under the direction of the scientificknowledge acquired in the past twogenerations, has attained a vitality notperfectly natural, but approaching to thatstandard In an artistic sense it wouldhave been better to have chosen a smalltown or large village than a city for mydescription; but as the great mortality ofStates is resident in cities, it ispractically better to take the larger andless favoured community If cities could

be transformed, the rest would follow

Our city, which may be named Hygeia,

has the advantage of being a newfoundation, but it is so built that existingcities might be largely modelled upon it.The population of the city may be placed

at 100,000, living in 20,000 houses,built on 4,000 acres of land,—anaverage of 25 persons to an acre Thismay be considered a large populationfor the space occupied, but, since theeffect of density on vitality tells onlydeterminately when it reaches a certainextreme degree, as in Liverpool andGlasgow, the estimate may be ventured.The safety of the population of the city isprovided for against density by thecharacter of the houses, which ensures

an equal distribution of the population.Tall houses overshadowing the streets,and creating necessity for one entrance

to several tenements, are nowherepermitted In streets devoted to business,where the tradespeople require a place

of mart or shop, the houses are fourstories high, and in some of the westernstreets where the houses are separate,three and four storied buildings areerected; but on the whole it is found bad

to exceed this range, and as each story islimited to 15 feet, no house is higherthan 60 feet

The substratum of the city is of twokinds At its northern and highest part,there is clay; at its southern and south-eastern, gravel Whatever disadvantages

might spring in other places from aretention of water on a clay soil, is heremet by the plan that is universallyfollowed, of building every house onarches of solid brickwork So, where inother towns there are areas, andkitchens, and servants' offices, there arehere subways through which the airflows freely, and down the inclines ofwhich all currents of water are carriedaway.

The acreage of our model city allowsroom for three wide main streets orboulevards, which run from east to west,and which are the main thoroughfares.Beneath each of these is a railway alongwhich the heavy traffic of the city iscarried on The streets from north to

south which cross the mainthoroughfares at right angles, and theminor streets which run parallel, are allwide, and, owing to the lowness of thehouses, are thoroughly ventilated, and inthe day are filled with sunlight They areplanted on each side of the pathwayswith trees, and in many places withshrubs and evergreens All theinterspaces between the backs of housesare gardens The churches, hospitals,theatres, banks, lecture-rooms, and otherpublic buildings, as well as someprivate buildings such as warehousesand stables, stand alone, forming parts ofstreets, and occupying the position ofseveral houses They are surroundedwith garden space, and add not only to

the beauty but to the healthiness of thecity The large houses of the wealthy aresituated in a similar manner.

The streets of the city are pavedthroughout with the same material Asyet wood pavement set in asphalte hasbeen found the best It is noiseless,cleanly, and durable Tramways arenowhere permitted, the system ofunderground railways being found amplysufficient for all purposes The sidepavements, which are everywhere tenfeet wide, are of white or light greystone They have a slight incline towardsthe streets, and the streets have anincline from their centres towards themargins of the pavements

From the circumstance that the houses ofour model city are based on subways,there is no difficulty whatever incleansing the streets, no more difficultythan is experienced in Paris Thatdisgrace to our modern civilisation, themud cart, is not known, and even thenecessity for Mr E.H Bayley's roadwaymoveable tanks for mud sweepings,—somuch wanted in London and other townssimilarly built,—does not exist Theaccumulation of mud and dirt in thestreets is washed away every daythrough side openings into the subways,and is conveyed, with the sewage, to adestination apart from the city Thus thestreets everywhere are dry and clean,free alike of holes and open drains.

Gutter children are an impossibility in aplace where there are no gutters for theirinnocent delectation Instead of thegutter, the poorest child has the garden;for the foul sight and smell ofunwholesome garbage, he has flowersand green sward.

It will be seen, from what has beenalready told, that in this our model citythere are no underground cellars,kitchens, or other caves, which, worsethan those ancient British caves thatNottingham still can show theantiquarian as the once fastnesses of hersavage children, are even now theloathsome residences of many millions

of our domestic and industrial classes.There is not permitted to be one room

underground The living part of everyhouse begins on the level of the street.The houses are built of a brick whichhas the following sanitary advantages:—

It is glazed, and quite impermeable towater, so that during wet seasons thewalls of the houses are not saturatedwith tons of water, as is the case with somany of our present residences Thebricks are perforated transversely, and

at the end of each there is a wedgeopening, into which no mortar isinserted, and by which all the openingsare allowed to communicate with eachother The walls are in this mannerhoneycombed, so that there is in them aconstant body of common air let in byside openings in the outer wall, which