Euthenics, the science of controllable environment
by Ellen H. Richards
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The school, hurried with a curriculum that is wasteful of time and energy, lacking correlation in the studies (except in a few schools that are noted exceptions proving the rule), has little time to relate its work to the home as the kindergarten does in its morning talk; so there must come an intermediate step in order that the school may emphasize the home life and industries, and that a generation may grow up who shall have a knowledge of the daily needs of life.

The interest awakened in the school will surely react upon the home. It is like an expedition going out to make discoveries and to bring back knowledge to its own land. The directive work of the school will thus become a practical realization in the home. Then the cycle will be complete, for while the school has separated the child from his natural environment for many hours and weeks, it is sending him back better equipped through knowledge and experience to fulfill his place there.

How shall the ends be gained artificially by devices of the school? For gained they must be, if civilization is to be maintained.

To quote from Isabel Bevier:

"As the home is so inseparably connected with the house, and our comfort and efficiency are so greatly influenced by the kind of houses in which we live, much of interest and importance centers in the study of the house."

Moreover, with the house, its evolution, decoration, and care, may be associated much that is interesting in history, art, and architecture, as well as much that has a direct bearing on the daily life of the individual.

The philosophers have struggled for centuries, each contributing according to his experience and vision to determine what is the purpose of life. America's thought could be translated into the word efficiency. Yes, we might almost say she worships efficiency. If, then, efficiency is to be the goal, what are the means to develop it? Efficiency depends chiefly upon good health, and to maintain this we must first consider in the scheme of education the physical aids—food, air, water, clothing and shelter, exercise and rest—and with this goal in view must come also recreation, play or amusement, and beauty to develop the mental and the spiritual. In relating our scheme of work to this ideal we will consider first the shelter.

The children of ten or twelve years of age have passed the "make-believe" stage of play; they want the "real," but of their own kind and age. After little children have made and played with toys and foreshadowed the needs of the actual home, the time has come for the youth to have his demands, which are not yet the demands of man and manhood.

At the Tuberculosis Congress, held in Washington in 1908, a sanatorium in England, which won a prize, presented among many good features a system of graded work with graded tools, almost childlike implements for the weak and unskilled, gradually advancing toward the normal as the strength and health of the man grew. So it should be with the material we should give to the children.

After the toy age a house about two-thirds the ordinary sized house may be constructed. A room seven feet square is very livable for a child. Three rooms is a very good working plant—the kitchen and the bedroom, the dining and living room combined. Both boys and girls may cooperate in planning, building, and furnishing this home.

The plan of a modern house may be drawn, basing it on the knowledge of house architecture through history, of the modification necessary to site through geography, and the knowledge that science has brought of drainage, ventilation, and construction. The house could be built by the manual training class, or if that is not feasible it may be built by one of the firms making portable houses. At all events, it can be painted by the children, and this will lead to lessons on color, the use of paint and its composition.

While the "shelter" is being constructed the child must be considering at the same time the principles of caring for the home, for this would naturally influence the thought of furnishing. The simply furnished home means less physical exertion, but not less beauty. The home planned and executed on scientific principles of hygiene and sanitation means a healthful home, a much cleaner home.

The shelter of the individual has been considered; now comes the immediate protection of the child—its clothing. It would not be quite practical in this little home to enter into the personal activities of bathing and dressing. A very large doll, approximating the child, may be used, one large enough so that it can wear boots, stockings, etc., that are usually bought for the real child. Here can be taught also the lesson in wise spending.

The right care of the body must be included among the necessities of education. The teaching of the principles of hygiene should be closely related to the lives of the children. Correct habits, not rules, are the proper prevention for all sorts of defects. To secure and maintain a healthy body, habits of cleanliness and enthusiasm for health must be inculcated. Such habits can be readily impressed on the body while it is plastic—that is, while it is young; but they are acquired only with difficulty and by much thought in after years. Hence there is the greatest economy of time and energy in accustoming young people to habits of daily living which will give them the best chance in after life—the chance to be "healthy, happy, efficient human beings." Most of the teaching must be by indirect methods—illustrations—and so the doll may be used again to demonstrate and relate facts about the daily life.

An old Scotch writer once said, "He that would be good must be happy, and he that would be happy must be healthy." As has already been said, the great increase of disease from causes under individual control, such as that which is brought on by errors of diet, points to a need for a more general education in this respect. The food problem is fundamental to the welfare of the race. Society, to protect itself, must take cognizance of the questions of food and nutrition. It is necessary to give the child the right ideas on these subjects, for only then will there be sufficient effort to get the right kind of food and to have it clean. Right living goes further and demands the right manner of serving and eating the food. The home table should be the school of good manners and of good food habits of which the child ought not to be deprived.

If all the foregoing principles have been developed, if the child has been led to see the joy of living through these home activities, he will consider the home the true shelter, the place where he can have the happiest play, the easiest rest, where he can study most earnestly, and express himself most honestly.

And the parents, the fathers and mothers of children of the city? How far are we helping the city dwellers to take advantage of city life? The principles back of housekeeping are the same, the end the same—what are to be the means to stimulate the modern home-maker? Show the possibilities within reach of them; send the children home with ideas which the mother must consider.

Education in pursuing the so-called "humanities" has been holding up to view a hypothetical man in a hypothetical environment.

The pursuit of gold has not been hindered thereby, and has gone on without the restraints of education because of the complete detachment of ideals inculcated from the actual daily life where money meant personal pleasure and comfort for the time being.

The power over things gained by a few students was utilized by money power to hasten all progress. Speed was the watchword. No one could stop to see what injury he had caused. "Get there," really seemed to be the motto. In this scramble for power the "purpose" for which life is lived has been lost sight of. No "worthy aim" has been impressed on the mind of the child.

An awakening has come and the school is the leading factor in the upward movement. Education is coming to have a new meaning, or better, perhaps, is going back to the older meaning with new materials. No knowledge or power the youth may acquire will avail in real struggle for existence of the race without a definite aim to hold steady the eye fixed on a certain goal. This is a law of man's existence.

The change in point of view has been growing like a root underground. It seems to have suddenly sent up shoots in every direction. In no line of thought has this change come more generally than in relation to the things youth should be taught. Himself and his relation to his environment are now to the front. Instead of extolling man as the lord of all created things, the youth is made to see that man unaided by scientific knowledge is at the mercy of Nature's forces; that man in crowds is sure to succumb unless he makes a strong effort to keep himself erect.

Hence the boys are given manual training—power over wood and stone, steam and electricity; and are taught the principles of production of food and metals. The girls are being taught to distinguish values in textiles and food stuffs; to manage finances and to keep houses in a sanitary manner.

It is the business of the higher education at once to apply the knowledge of preventive measures to its own students and through them to reach the people, but it has been very slow to take up the cause of better environment.

In colleges there is still more emphasis laid on external works, such as water supply, drainage, etc., than on the more intimate hourly needs of fresh air and clean rooms. The halls, study rooms, and dining rooms of colleges are notoriously ill ventilated and not over clean.

The senses are blunted at an age when they should be keenly sensitive. It is only within ten years or so that very many of the higher schools have made a point of indoor sanitation beyond plumbing provisions. Outdoor sports have been relied upon to give sufficient impetus to the health side of education.

A new element has come into the State universities through the Home Economics courses, which have been steadily growing in favor during the last two decades. Within that time several buildings have been erected and equipped to teach the principles of sanitary and economic living both in institution, school, and family life.

Probably no one movement has been so powerful as this in convincing educators of the efficiency of trained women as factors in sanitary progress. In no other direction is the outlook for social service greater. The woman must, however, be more than a willing worker; she must be educated in science as a foundation for sanitary work.

Within the next few years the demand for trained women is sure far to exceed the supply, for the fundamental sciences are not to be acquired in one or two years.

Young college women are even now realizing their mistake in neglecting the sciences. They assumed that science was not of practical use. They assumed that educational curricula were stable and would go on in the same lines forever.

The high school is now fully awake to these vital factors. Some of the best buildings in the United States are the high school buildings, those of the West excelling those of the East. By 1911 nearly every school will have a course in Sanitary Science. It may be under the name of Home Economics, or of Camp Cookery, or of House Building, but the idea of better physical environment has already taken root. In the extension of school work by the employment of the school visitor to supplement the work of the teacher in the grade schools, in Parents' Associations, in Mothers' Clubs, in social endeavors on every side, there is coming the study of more special branches of sanitary science, clean air, clean floors, clean clothes—where once cooking lessons were the extent to which the workers could lead.

Evolution has at last been accepted as applying to man as well as to animals. In his inaugural address, November, 1909, President H. J. Waters, of Kansas Agricultural College, said: "... for every dollar that goes into the fitting of a show herd of cattle or hogs, or into experiments in feeding domestic animals, there should be a like sum available for fundamental research in feeding men for the greatest efficiency.... We have millions for research in the realm of domestic animals and nothing for the application of science to the rearing of children."

Evidence is not wanting that all this is to be speedily changed. Man has awakened to the fact that he is "the sickest beast alive" and that he has himself to blame, and, moreover, that it is within his power to change his condition and that speedily.

After all, human life and effort are governed largely by the conscious or unconscious value put upon the varied elements that go to make up the daily round.

It seems to be a universal law that effort must precede satisfaction, from the infant feeding to the man building up a successful business. The satisfaction grows in a measure as the effort was a prolonged or sustained one.

Well-being is a product of effort and resulting satisfaction. The child without interest in work or play does not develop; the man with no stimulus walks through life as in a dream.

The first steps in "civilizing" (?) a nation or tribe are to suggest wants—things to strive for. Struggle, with all its attendant evils, seems the lever that moves the world. It is therefore in line that health, and whatever favors it, is to be gained at the expense of struggle. The one necessary element is that men should value it enough to struggle for it.

Sanitary science above all others, when applied, benefits the whole people, raises the level of productive life.

In the rapid development of our civilization, the laboratory, the shop, the school can be the quickest mediums of suggesting wants.

In an earlier chapter, the indifference to clean conditions, the ignorance of the means of obtaining pure food and clean air, were dwelt upon, and still later the need of will to choose the right thing.

Now we should consider the means of stimulating that choice. So far it has been chiefly exploitation for the personal gain of the manufacturer, who has persuaded the people to buy his product regardless of its economic or hygienic effect. Thrift has been undermined most subtly.

"That's the secret of the whole situation we're talking about; it's easier to buy a new shirt than to take care of the one you've got."[15]

[15] Meredith Nicholson, Lords of High Decision, p. 133.

All sense of values has been lost, so that with no sound basis choice is apt to be unwise, unsatisfactory, and is gradually dropped, while the individual drifts.

No more effective agent for the dissemination of knowledge was ever devised than the American Public School. If only it would live up to its opportunities, its teachers could bring to its millions of receptive minds the best practice in daily living (never mind the theory for the children), and through the children reach the home, where the infants may be saved from the risks that the elders have run.

To be effective, however, school conditions should be satisfactory, and teachers should be familiar with the best ways of living, or at least in active sympathy with the medical inspector and the school nurse.

No more revolting revelations have ever been made than those usually locked in the hearts of these faithful servants of the people. How they can have courage to go on in face of parental and community indifference is a marvel. We shall consider in the next chapter how the average parent is to be aroused.

But the leaders in educational and scientific thought—what of them? The school is the pride of the community and measures the progress of the community toward ideals. Alas, how is pride laid low in most public school buildings in the inability of most of the teachers to see the relations between mental stupidity and bad air.

The awakening has begun, however, and thousands of teachers have responded and are urging authorities to burn more coal, to employ more help, to keep the house clean, to make it more beautiful, to make the curriculum more helpful, to make provision for good food to be purchased, and the hundred ways in which the school may be the most powerful civilizing factor the nation has. But civilization must not spell disease and ruin.

The economic factor must not be lost sight of. To tell the boy and girl that they are as good as any does not give them the right to the most expensive food and clothing they see. How shall they choose wisely in the multitude of new things? They wish the best, naturally, and all America is honeycombed with the wrong idea that the best costs the most. An Alaska Indian came into the store in Juneau one day to buy some canned peas. The storekeeper said, "I am out of the brand you want." "No peas?" asked the Indian. "No, only some small cans of French peas at forty cents a can. You don't want those." "Why not? Me want the best."

The schools of domestic economy, the classes in all grade schools, will have to attack and conquer these prejudices as to values, or, rather, will need to substitute right estimates of value before our people will choose wisely in distributing their income, for that is what right living means. The division of the income according to the necessities of health and efficiency, not according to whim or selfish desire, is sometimes estimated as

20 to 25 per cent for rent 25 to 30 per cent for food 10 to 15 per cent for clothing

This leaves only forty-five or thirty per cent for other things, and the pennies must be carefully counted to cover fuel, light, amusements, education, books, insurance, or investments. Something that the family would like must be left out—no matter what, providing only it does not injure their efficiency as wage-earners, as comfortable human beings.

The sensation of comfort or satisfaction is so completely a psychic factor that the school training has a great chance to affect after life. The child can acquire the habit of being more comfortable in plain, washable, clean clothes, with clean hands, than in dirty, ragged furbelows. This habit once thoroughly acquired is not likely to be quickly lost. Provision for clean hands is a necessity in school, and ways of making a small amount of soap and water serve may also be taught. All the while, care is to be taken not to introduce unnecessarily expensive materials or to inculcate over-refined notions.

Sound instruction as to dangers of transference of saliva, of nose discharge, etc., can be given without also giving the despair of impossible achievement.

The teaching in the classes must have this practical bearing on daily life. It is insisted on here because unclean hands are the chief source of infectious disease.

Instead of blaming water supplies, dusty streets, or even contagion by the breath, sanitarians are everywhere putting emphasis upon the actual contact of moist mucus with milk and other food, in preparation or in serving. It is not a supercilious notion to examine tumblers for finger marks, or to object to the habit of wetting the finger with saliva in turning leaves of books. These little unclean acts are the unconscious habits that cling to a person in spite of education from reading. The greatest service to be done today in improving the health of the community is in the application of the principles which may be summed up in the phrases—fresh air all the twenty-four hours, clean hands the livelong day, the free use of the handkerchief to protect from contamination of mouth and nose.

All these small personal habits should be taught in the earliest months of life, i. e., in the home; but if the child reaches school untaught, then in defense of the whole community the school must insist upon teaching them.


Stimulative education for adults. Books, newspapers, lectures, working models, museums, exhibits, moving pictures.

The efficient sanitarian is not so great when he conquers a raging epidemic as when he prevents an epidemic that might have raged but for his preventive care, and for this result his most continuous and effectual work is to educate—educate—educate.

Wm. H. Brewer, New Haven Health Association, 1905.

The essential fact in man's history to my sense is the slow unfolding of a sense of community with his kind, of the possibilities of cooperation leading to scarce-dreamt-of collective powers, of a synthesis of the species, of the development of a common general idea, a common general purpose out of a present confusion.

H. G. Wells, First and Last Things.

The great mass of the population is, indeed, at the present time like clay which has hitherto been a mere deadening influence underneath, but which this educational process, like some drying and heating influence upon that clay, is rendering resonant.

H. G. Wells, New Worlds for Old.


In a store an advertisement reads: "Any kind of tea you prefer; no charge whatever."

She: "The women look so tired when they come in, and in ten minutes they are so rested and refreshed."

He: "Ready to go home?"

She: "Why, no—ready to do some more shopping."

Spectator, The Outlook, December 18, 1909.

Something in motion and something to eat attract the crowd.

The social worker is just beginning to realize what the manufacturer and the department storekeeper have long since found out.

Why is it not legitimate to "attract a crowd," to do them a good service in showing them how to save money as well as in impelling them to spend it? It is wiser to show how before explaining why.

The force of example, the power of suggestion, should be used fully before coercion is applied. Exhibits and models come before law.

The psychology of influence is an interesting study (see Muensterberg's article, McClure's, November, 1909). Its principles have been grasped and used by those who exploit human feelings for their own gain. The student of social conditions should make a wider and better use of a real force.

Publicity is perhaps first. Exhibits showing existing conditions often shock people into attention, for it is inattention more than anything else that prevent betterment.

It is said that "a knowledge of danger is the surest means of guarding against it," but this knowledge must be translated into belief and the danger be brought home to the individual as a member of the community.

Exhibits may often suggest for existing evils simple remedies never thought of before. They should never suggest the one idea without the other. Even though the remedy is not worked out, it should be called for. America's inventive power may well be turned on its own social affairs as well as on adaptation of European machinery.

The man considered in these pages is the man in community environment, and the discussion is as to what controls this community life. It will be acknowledged by all thoughtful persons that the prime control lies in the purpose for which the community exists. If for selfish gain, then all is sacrificed to that end. Men and women become mere machines and children are only in the way until they, too, may be put into the service.

If it exists for mutual help and general advance in civilization, then the leaders in the community take into account the elements that contribute to the future as well as those for the immediate present.

In the confusion of ideas resulting from the rapid, almost cancerous growth of the modern community, made possible by mechanical invention, the people have lost the power of visualizing their conception of right and wrong, a power which made the Puritan such a force in early colonial times. Heaven and hell were very real to him and were powerful factors in influencing his daily life. The average man today has no such spur to good behavior. Perhaps the sword of Damocles must be visualized by such exhibits as the going out of an electric light every time a man dies, by the ghastly microbe in the moving picture, by the highly colored print or by a vivid reproduction of crowded quarters. The social worker has been doubtful of the real value of such exhibits, but such reminders have their place in a community accustomed to the advertising of less worthy subjects.

A decided recognition of the value of exhibits is found in the advertisement of a company: "We design and equip Exhibits on Tuberculosis, Milk, Civic Betterment, Dental Hygiene, Saner Fourth of July. Have you our catalogue?" Much of our educational work for the dissemination of useful knowledge would gain in power and directness from an adaptation of the methods of the man skilled in promoting commercial interests. He knows how to apply the right stimulus at the right time in order to arouse the desired interest.

In many ways the adult is but the child of a larger growth, who needs something concrete to make him understand. And so have grown up the great industrial fairs and exhibitions. One comes away from these wondering that so much, both good and bad, is being prepared for him, and stimulated, usually, to work out certain suggestions and better many of the present conditions. Both the manufacturer and the consumer have been helped.

Wherever it is possible, a working model illustrating the chief features to be explained should be installed. The expense of this kind of exhibit has in the past been prohibitive, and moreover the use of such "claptrap" has been frowned upon; but scientific knowledge is no longer to be held within the aristocratic circle of the university. It is to be brought within the reach of the man in the street, and to make up for the wasted years of seclusion experts now vie with each other in putting cause and effect not merely into words but into pictures, and even into motion pictures. The fly as a carrier of disease is now shown in all its busy and disgusting activity. The lesson of awakened attention by such means is being learned, and soon lessons in botany, in gardening, in housewifery, will be given through the eye, to be the better followed by the hand.

Of all means, that product of man's ingenuity, the moving picture, is destined to play the greatest part in quick education. It is the quintessence of democracy.

The extension movement in education is an evidence of a new social ideal. It is a true expression of democracy that the university and school can be utilized by the busy working people. Museums that at one time were only for the educated who by previous training could understand them now assume as a privilege the educating of all the people. Schools of art and science, also, through lectures, bulletins, guides, and special exhibits, extend a generous welcome to the public.

The citizens ought to be a gladder, sadder people, stirred and delighted and grateful for much that the city affords; sad and shocked by some of the forbidding, existing conditions. That is the power of an exhibit, so to visualize a condition that the mind really conceives it, never again to recover from the shock, to be unmindful of such possibilities of degraded existence for human beings.

The influence of these great expositions is of a most subtle kind, not often to be traced, but there is a noticeable change in the estimation in which Home Economics is held dating from the time of the Mary Lowell Stone Home Economics Exhibit held at the Exposition in St. Louis in 1905. This illustrated the application of modern knowledge to home life, chiefly in economic and aesthetic lines, all bearing upon the health and efficiency of the people. The Chicago Exposition in 1893 had its Rumford Kitchen, an exhibit under the auspices of the State of Massachusetts. This practical illustration of scientific principles modified the ideas of the world as to the place and importance of cookery in education. Indeed, there seemed a distinct danger that other lines would be neglected, so that when the Exposition at St. Louis was determined upon this legacy of fifteen years before was drawn upon to show the wide scope of the subject as it had been developed.

Boards of Health might pave the way for a better understanding of their rules and regulations if they would have temporary exhibits in public places of some of the conditions known to them but unsuspected by the average citizen and taxpayer.

Traveling exhibits may show local and temporary conditions and may call attention to needs demanding immediate remedy—with the remedy suggested.

Permanent exhibits in museums should, on the other hand, teach a deeper lesson. They should always be constructive and should be replaced when the conditions have changed. The modern idea of a museum is a series of adjustable exhibits with distinct suggestive purpose. Such are found in the Town Room, 3 Joy Street, Boston, the Social Museum, Harvard College, the American Museum of Safety, and the Sanitary Science Section, American Museum of Natural History, New York.

The distribution of the printed word has become so universal that it would seem as if every family might be influenced by it; but the scientific title, or the size of the book, or the scientific terms seem forbidding, and so the whole question is thrust aside.

In the past, newspaper science was largely discounted as sensational and only one-tenth fact. Scientific workers were largely to blame for this. They could not take the time to explain the meaning of their work, and the few things they were ready to say were worked over out of all semblance to truth by the writer who must have a "story" and who had not the training in "suspension of judgment" which the scientific investigator knows to be necessary.

There is no concern of human life that cannot be made interesting, and the magazine writers of today understand that art. Read the newspaper and the world is yours. It is all things to all men. The popularizing of knowledge is now proceeding on somewhat better lines. Intermediaries between the laboratory and the people are springing up to interpret the one to the other. This work is good or bad according to the individual writer. Most of it is still too superficial. Here is one of the most fertile fields for the educated woman, since the evils of which we complain have to do so intimately with woman's province, the home and the school. There is hope that the trained, scientific woman will take her place as interpreter. Her practical sense will give her an advantage over the young man who has never known other home than a boarding house.

But the expert knows that the man of "practical affairs" wants and needs certain knowledge, and so seeks another way. Our Federal government, through the departments of Agriculture and Education; the State Boards of Health; the educational institutions, have with care and accuracy formulated this knowledge and are sending to the people, in the form of bulletins meeting their interest and requirements, knowledge in concise and readable form, and so most valuable. More than five hundred thousand copies of Miss Maria Parloa's bulletin on Preserving have been distributed by the Department of Agriculture.

These efforts by both men and women have meant independent scientific research, which is often the only available knowledge for the housekeeper. It is bringing to them in their "business" of life the same help that the men on the farm and elsewhere are receiving in theirs.

But the written word, however clearly put, can never reach the untrained as can the voice and personality of an earnest speaker with a compelling vitality. Lectures by those who have been engaged in research themselves, so that they have absorbed the spirit of the laboratory—not by those who have merely smelled the odors of the waste jars—are ten times more valuable than even the most attractively illustrated articles. It is well that the personality of the human being is an asset, and that there is a stimulus in hearing and seeing the person who has accomplished things. There is always a power in the spoken word. The government, with its public lectures, recognizes this as well as the private organization, and today ignorance is necessarily due only to indifference.

Illustrated lectures followed by literature are of inestimable value if rightly and not sensationally given. Even then, the seed must have time to sprout.

Man has reached his present stage of civilization, however we regard it, by an incessant warfare against adverse conditions. Enemies, man and beast, surrounded him; mountains and rivers obstructed his passage; fire and flood swept away his dwellings; but ever onward the inward impulse has carried him.

It is interesting to see how the same vocabulary is transferred to the warfare for social betterment, "campaign," "warfare," "battle," "fight," "weapon," "corps," "army." And the fight to be won can only come through knowledge, its dissemination and then its application.

Publicity today means cooperation and democracy—all to help, all to be helped.

All the foregoing methods should be used in these campaigns for health, with the dictum, "Man, know thyself."


Both child and adult to be protected from their own ignorance. Educative value of law and of fines for disobedience. Compulsory sanitation by municipal, state, and federal regulations. Instructive inspection.

The strength of the State is the sum of all the effective people.

Dr. Edward Jarvis, Massachusetts State Board of Health, 1874.

When the Americans took charge of Bilibid Prison in Manila the death rate was 238 per 1,000 per year: by improving sanitary conditions, this death rate was reduced to about 75 per 1,000: here it remained stationary until it was discovered that a very high percentage of the prisoners were infected with hookworms and other intestinal parasites: then a systematic campaign was inaugurated to expel these worms, and when this was done the death rate fell to 13.5 per 1,000.

C. W. Stiles.

So the duties and responsibilities of a Health Department are not only changed, but they are very greatly increased and are constantly increasing. And on broad lines to cause the citizen to do the things he can and ought to do, and then to do for him the things that he cannot do, but which should be done, is the duty of the State, and that, being interpreted, means the real prevention of disease.

Eugene H. Porter, Report, New York State Department of Health, 1909.

The whole difference of modern scientific research from that of the Middle Ages, the secret of its immense successes, lies in its collective character, in the fact that every fruitful experiment is published, every new discovery of relationships explained. In a sense, scientific research is a triumph over natural instinct, over that mean instinct that makes men secretive.

H. G. Wells, New Worlds for Old.

Public or governmental hygiene has been chiefly concerned with pure air and pure food, and with organisms producing epidemic diseases. Boards of health are a recent invention, and in this country they have as yet been only imperfectly developed. They can never become the power they should be until, first, public opinion better realizes their usefulness and the fact that their cost to the taxpayer is saved many times over by the prevention of death and disease; second, more and better health legislation is enacted—national, state, and municipal; and, third, special training is secured for what is really a new profession, that of a public health officer.

Report on National Vitality.



Government is delegated to persons specially set apart for the oversight of the people's welfare.

Personal conduct was free from such delegated power in the Anglo-Saxon thought. The Englishman's house was his castle inviolate. This was especially true of the early American settlers. Laws interfering with personal liberty, a man's right to drink tea, to punish his own children, to beat his own wife, to keep his own muck-heap, have been deeply resented by the American citizen. Each step in the protection of his neighbor has been taken only by a struggle extending the common law of nuisance to a variety of conditions.

The protection of the man against himself, and of his wife and child against his ignorance or greed, is one of the twentieth century tasks yet hardly begun.

The control of man's environment for his own good as a function of government is a comparatively new idea in republican democracy. The cry of paternalism is quickly raised, on the one hand, of socialism, on the other. Each gain has been at the cost of a hard-fought battle. But it is certain that the individual must delegate more or less of his so-called rights for the sake of the race, and since the only excuse for the existence of the individual is the race, he must so far relinquish his authority.

It is a part of the urban trend that the will of the man, of the head of the family, should be superseded by that of the community, city, state, nation.

Even though all the agencies for the education of both young people and adults that have been discussed in the preceding chapters were set in motion at once, there would still remain many thousands in township and city untouched by these forces, or so touched as to arouse rebellion against such novel notions.

Only the child can be educated to acquire habits of right living so perfectly that the suitable action takes place unconsciously. Twenty years hence these trained children will be the chief citizens of the republic, the leaders of public opinion. Today, however, less gentle means, less gradual processes, must be used in order that these children may have a chance to grow up.

In the social republic, the child as a future citizen is an asset of the state, not the property of its parents. Hence its welfare is a direct concern of the state. Preventive medicine is in this sense truly State Medicine, and means protection of the people from their own ignorance.

In the laws made with this end in view lies one of the greatest educative agencies known. We have referred in the last chapter to the need of drawing attention to defects and dangers in order that people may know what the results of their careless ways may be. No surer way has been found to fix attention than to attempt to enforce a law or collect a fine for disobedience of it. A marked illustration of this truth is given in the case of the ordinance against spitting in street cars. In many cities a notice was posted in each car—usually with little effect. In some a fine of five dollars was added, with little more result. Boston was one of the first cities to pass an ordinance, and it accompanied the law with a fine of one hundred dollars. This compelled attention—a sum which represented to the workman more than his yearly savings, more than any single expenditure. To the business man, even, it was a sum not to be lightly dropped on a filthy car floor. This mere statement of the value of cleanness made an almost instantaneous change in the habits of thousands. Within two days the car floors became practically free without a single fine being collected within that time, as far as the author is aware.

The law imposing fines for neglect of removal of garbage or of screening stables must be occasionally enforced in order to express degree of disapproval. A petty fine is of little use.

Conditions of motion, of rapid intermingling of distant populations—a thousand miles in a day is now possible—make national control a necessity. It is proved that quick results may be gained in saving lives and property by that prompt and thorough action which well-equipped Federal forces alone possess. The stamping out of yellow fever in Cuba, the redemption of Panama, the suppression of sporadic outbreaks at New Orleans, the quick response to a discovery, as in the cases of pellagra and the hookworm—all these show what a thoroughly alive government may do.

It is no disgrace to an individual or a city to have the national laboratory make discoveries, to have the national power put down epidemics, as it does civil rebellion, for the good of the whole nation. It is disgraceful, however, for the citizen to remain indifferent or obstructive, to grumble over the cost. The indifference of the people themselves is today almost the only stumbling block to national prosperity.

The time lost to the average worker by inefficient labor is a drain on the community largely avoidable, and is the cause of that other drain on the moral as well as physical vitality—charity.

Preventive medicine is a science by itself, a combination of social and scientific forces guided by research quickly applied, and it must be accepted and upheld by those whom it benefits, namely, all the citizens. The nation is in many cases the only power strong enough to command confidence, and in the combination of government effort an international science of human welfare is bound to be evolved.

It is a waste of effort for each state to prepare a fly pamphlet. The correctness of a Government Bulletin would give an added value as well as the rapidity of circulation. The bulletins of the Agricultural Department are an example.

The Weather Service, with its quick notifications, shows what a health service might do. A monthly or weekly health chart would give the best and worst spots.

Precautions really workable might be furnished the Associated Press.

In short, system and science might be put at the service of the local health officer, of the traveler, and even of the housewife.

The Library of Congress now furnishes cards in duplicate to a large number of centers, thus saving time to the investigator and giving information often not otherwise obtainable.

The Farmers' Bulletins of the Department of Agriculture are also most valuable to the people who are in search of help. Such agencies might be extended without fear of trespass on any existing agencies.

Just as the individual, if he is to do and be his best, accepts his limitations, obeys Nature's law, and thrives in body and estate in consequence, and as the community banding together makes and carries out with penalties for deviation certain regulations for mutual benefit, so must the still larger groups—the state and the nation—use their larger wisdom and wider knowledge for the benefit of all. The individual should recognize the value to himself of this more complete investigation, and instead of raising the cry of paternalism and national interference, should welcome all aids to increased efficiency.

State hygiene is necessary to supplement municipal hygiene. Often the rural district has no other hygiene, and the city and the country are interdependent, the city dependent upon the country for its water, milk, and other supplies.

Almost all the states are alive to the importance of milk inspection. As early as 1869 in Massachusetts, Dr. Bowditch called the Board of Health "The State Medicine," and quotes from Dr. Farr: "How out of the existing seed to raise races of men to divine perfection is the final problem of public medicine." That is the function of all boards of health. If factories are incorporated under state laws, they must also be governed by the state regulations for health.

Here in America we are always locking the stable door after the horse has been stolen. Not until many "accidents" had occurred in the use of antitoxins did Congress pass an act (1902) regulating the manufacture and interstate sale of the viruses, serums, toxins, etc. The supervision and control were vested in the Secretary of the Treasury through the Public Health and Marine Hospital Service. Previous to April 1, 1905, there was no official standard for measuring the strength of diphtheria antitoxin. Previous to October 25, 1907, there were as many units or standards for tetanus antitoxin as there were producers. One was labeled "6,000,000 units per c.c." and another "0.75 unit per c.c.," while, according to official standard, the first had only 90 and the latter 770.

The point to be made is that however faulty an official or Federal standard for sanitary devices may be, it is a standard, and so is of service in protecting the people, especially those away from active centers of research.


There is responsibility as well as opportunity. The housewife an important factor and an economic force in improving the national health and increasing the national wealth.

It would indeed seem that opposition to woman's participation in the totality of life is a romantic subterfuge, resting not so much on belief in the disability of woman as on the disposition of man to appropriate conspicuous and pleasurable objects for his sole use and ornamentation. "A little thing, but all mine own," was one of the remarks of Achilles to Agamemnon in their quarrel over the two maidens, and it contains the secret of man's world-old disposition to overlook the intrinsic worth of woman.

W. I. Thomas, Women and Their Occupations, American Magazine, October, 1909.

The president of the British Medical Association about 1892 said, "I wish to impress it upon you that the whole future progress of sanitary movement rests, for its permanent and executive support, upon the women of our land."

In a letter to Madame Bodichon, dated April 6, 1868, George Eliot writes: "What I should like to be sure of as a result of higher education for women—a result that will come to pass over my grave—is their recognition of the great amount of social unproductive labor which needs to be done by women, and which is now either not done at all or done wretchedly."

Quoted by Mrs. Nixon in a paper before the Conference of Women Workers in England, 1904.



There are about 40,000,000 women and girls in the United States. About 14,000,000 live in the country and have a direct and compelling power over the life of the community.

In rural agricultural districts the home-keeper is the provider. She practically requisitions from farm and garden what she deems necessary for the family table. To an extent she makes the clothing and sews the house linen. She also exchanges her perquisites, egg money, perhaps, for furniture and ornaments. The itinerant peddler brings the world's wares to her door; the mail-order houses do the rest.

"The ideal home is a social and cooperative society in which all of its members unite their efforts for the common good. This ideal is realized most nearly in the country home, where even the smallest child has opportunity to be and generally is a contributor to the family support. It has come to be a recognized fact that boys and girls, healthy, industrious, frugal, capable, intelligent, self-supporting, cheerful, and patriotic, abound in country homes, and that the prevalence there of these high qualities is largely due to the family life, which requires each individual from his earliest years to bear his proportionate share in providing for the maintenance of the home. By bringing within the reach of the country people educational advantages suited to their needs, rural life becomes more attractive, country homes are multiplied, and the valuable qualities which these homes develop become the possession of a correspondingly larger number of the citizenship of the state."[16]

[16] I. H. Hamilton, U. S. Dept. of Agriculture, Circular 85.

The government has recognized the need and the possibilities of meeting it in the recognition it has given to Farmers' Institutes for women, in which, by lectures, demonstration, and short winter courses at the colleges, the interest of the woman in her occupation is aroused. She is not only given help in details of her daily work, but she is shown how much the efficiency of the farm life depends upon her capability and intelligence. She is encouraged in the using of all mechanical and scientific appliances, is introduced to the means of mental growth; but, best of all, she is given the stimulus of social recognition. In the year 1908 there were held 832 such meetings in the several states. In the year 1910 the number will be nearly or quite doubled.

In no other form of society is the power of the woman for good or ill so paramount as in rural life, in no other mode of living is the family so much at her mercy.

In suburban and city life the family can in a measure escape from insufficient care and uncomfortable conditions. That they do so escape, any student of social tendencies will testify. The great increase of restaurants, of clubs and hotels of all grades, shows one phase of the unattractiveness of home life. The city woman is only half a housekeeper; she has only one-eighth of a house as compared with her rural sister. Her control is therefore curtailed until she feels her helplessness in the hands of her landlord. She sighs and turns to other interests. To her must be brought the knowledge of her power as a social factor if she will but use the knowledge she can easily gain.

The city woman has amused herself because she has seen nothing better to do with her time. The utilization of her ability is all that is needed to regenerate city life. Without it all efforts will prove fruitless. Education of all women in the principles of sanitary science is the key to race progress in the twentieth century.

As an economic factor, the influence of the housewife is of the greatest moment. Production on the farm is only one phase. The city and suburban dweller is a buyer, not a producer. In suburban and city life the housekeeper has more temptations to buy needless articles, food out of season, to go often to the shops, especially on bargain days. She thinks her taste is educated, when it is only aroused to notice what others like. She is led to strive after effects without knowing how to attain them. It has been estimated by advertising experts that ninety per cent of the purchases of the community are determined by women, not always according to their judgment, but by a suppression of it. Woman is made to think that she must buy certain lines of goods. The power of suggestion has been referred to in a preceding chapter.

When civilization, as it is called, persuaded woman to give up manufacture and to become a buyer, the first step in the disintegration of the home as a center of information, as well as of industry, was taken. The housewife and mother were made to look to the dealer, and thus to feel their helplessness. This sense of ignorance, this subconscious loss of power over things, only increased the effect of that fatalism which the control of machinery was leading man out from under.

It is barely fifty years since woman began to ask questions and insist upon knowing, to claim freedom of movement, a chance to breathe. The time between has been a time of plowed fields, often muddy, usually stony, but the furrows are turning green and the harvest will prove the wisdom of the plowing.

Woman had to struggle for right to private judgment and public action. Some pioneers had to enter the field of research, of investigation, in order that they might call to those below that the way was open. This vast company, which has been nearly untouched by the scientific spirit, was warned off the field of investigation, and society is paying the penalty of its own blindness.

In the very field where applied science can most serve human welfare, scarecrows have been set up most prominently. Not until society avails itself of those qualities of mind sorely needed in the field of sanitary science, patient attention to detail, strong, practical sense directed by a profound interest in the subject, will it begin to show what height it is capable of scaling.

The intrusting of so many great fortunes to women shows an increasing confidence in their judgment of social needs. It shows that woman's education has passed the selfish stage, that it has given a wider vision of the whole horizon.

It may be said without fear of contradiction that the future well-being of society is largely in the hands of woman. What will she do with it? Responsibility is always sobering.

Let her once realize her position and woman will rise to the task. Instances are not wanting of groups attacking scientific and administrative problems in the true spirit, without sentimental charity, to which in the past women have been prone.

If civic authorities felt that women's leagues were informed bodies of women whose suggestions they would make no error in adopting, more legislation could be effected. Too often city councils are approached by those who favor some whim or fad, and so ALL women's demands are classed together. Much harm has been done to the cause by indiscreet, pushing women with only a glimmer of knowledge. The question is not WOMAN, but ability and women. It is better, as a rule, to work out ideas through existing organizations.

All the problems of environment which we have been considering would be solved in half the time, yes, in one-quarter, if all housewives would combine in carrying out the knowledge which some of them have and which all may have.

Infant mortality is controllable through the training of the mother and nurse. Unsanitary houses are the results of careless housekeeping, usually a product of apathetic fatalism. Landlords assume that the woman will submit. When she has a woman sanitary inspector to appeal to, matters will take on a different aspect.

Unsanitary alleys exist because the abutters do not complain loudly enough to the right authorities. Dirty markets have been so long tolerated because women buyers carried the same fatalism to the stalls—"what is, has to be."

Society is only just beginning to realize that it has at its command today for its own regeneration a great unused force in its army of housewives, teachers, mothers, conscious of power but uncertain how to use it. Perhaps the most progressive movement of the times is one led by women who see clearly that cleanness is above charity, that moral support must be given to those who know but do not dare to do right, and that knowledge must be brought to the ignorant. Nothing can stop this most notable progress but a relapse into apathy and fatalism of the vast army of women now being enlisted to fight disease.

The opportunity has come, the responsibility is woman's hereafter. No one can take it from her; she has knowledge. The door has opened, she has taken the weapons in hand, is learning to use them. Will she falter on the eve of victory simply because it involves some sacrifice of prejudice or tradition? Must she not boldly accept the twentieth century challenge and fight her way to victory, even at some aesthetic sacrifice? In another hundred years, then, Euthenics may give place to Eugenics, and the better race of men become an actuality.

The keeping of the house, the laundry work, the cleaning, the cooking, the daily oversight, must have for its conscious end the welfare of the family. It cannot be done without labor, but the labor in this as in any process may be lightened by thought and by machinery.

Knowledge of labor-saving appliances is today everywhere demanded of the successful establishment EXCEPT of the family home. Is it not time that it came in for its share? If the housewife would use wisely the information at her hand today, it is safe to say that in six cases out of ten she could cut in half the housekeeping budget and double the comfort of living.

As conditions are, the twentieth century sees a strange phenomenon—the most vital of all processes, the raising of children, carried on under adverse conditions; human labor and life being held of as little account as in the days of building the pyramids.

Women may be trained to become the economic leaders in the body politic. It is doubtful if life will be anything but wasteful until they are trained to realize their responsibility.

The housewife was told that she must stay at home and do her work. This was preached at her, written at her, but no one of them all, save, perhaps, the Englishmen Lecky and H. G. Wells, saw the problem in its social significance, saw that the work of home-making in this engineering age must be worked out on engineering principles, and with the cooperation of both trained men and trained women. The mechanical setting of life is become an important factor, and this new impulse which is showing itself so clearly today for the modified construction and operation of the family home is the final crown or seal of the conquest of the last stronghold of conservatism, the home-keeper.

Tomorrow, if not today, the woman who is to be really mistress of her house must be an engineer, so far as to be able to understand the use of machines and to believe what she is told. Your ham-and-eggs woman was of the old type, now gone by in the fight for the right to think.

The emergence from the primitive condition was slow because the few of us who did show our heads were beaten down and told we did not know. It has required many college women (from some 50,000 college women graduates) to build and run houses and families successfully, here one and there another, until the barrel of flour has been leavened. Society is being reorganized, not in sudden, explosive ways, but underneath all the froth and foam the yeast has been working. The world is going to the bad only if one believes that material progress is bad. If we can see the new heaven and the new earth in it, then we may have faith in the future.

The human elements of love and sacrifice, of foresight and of faith, are going to persist, and any apparent upheaval is only because of settling down into a more solid condition, a readjustment to circumstances. As Caroline Hunt has said[17]: "We may disregard the popular fear that the home will finally take upon itself the characteristics of a public institution.... Human intelligence, which suits means to ends, and which is ever coming to the aid of human affection, will prevent that. So long as affection lasts it will seek satisfactory expression in home life, and so long as intelligence endures it will stand in the way of the extension of the borders of the home beyond the possibilities of the mutual helpfulness to its members."

[17] Home Problems from a New Standpoint, p. 140.

The persistent efforts of the farsighted to secure a place in education for the subjects fundamental to the modern home are now respectfully listened to.

It is, perhaps, not strange that the first successes in modern housekeeping were gained in public institutions, for there accounts were kept and saving told. When one hospital saved $12,000 in one year by an expenditure of $2,000 for a trained woman, trustees began to take notice. When large state institutions were reorganized and made over from unsavory scandals into reputable and life-saving establishments, even legislators took notice. The trained woman superintendent proved not only more competent but less affected by perquisites.

(I do not vouch for the universal maintenance of this high standard when women managers have had longer experience; but so far conscience and sterling integrity have been attributes of all my expert women, even if they have now and then disappointed me in endurance or in ability. Is not this a fact of great social significance?)

It is universally conceded today, only a few willfully blind or croaking pessimists dissenting, that home-keeping under modern conditions requires a knowledge of conditions and a power of control of persons and machines obtained only through education or through bitter experience, and that education is the less costly.

When social conditions become adjusted to the new order, it will be seen how much gain in power the community has made, how much better worth the people are. Have faith in the working out of the destiny of the race; be ready to accept the unaccustomed, to use the radium of social progress to cure the ulcers of the old friction. What if a few mistakes are made? How else shall the truth be learned? Try all things and hold fast that which is good.

The Home Economics Movement is an endeavor to hold the home and the welfare of children from slipping over the cliff by a knowledge which will bring courage to combat the destructive tendencies. Is not one of the distinctive features of our age a forcible overcoming of the natural trend of things? If a river is by natural law wearing away its bank in a place we wish to keep, do we sit down and moan and say it is sad, but we cannot help it? No, that attitude belonged to the Middle Ages. We say, Hold fast, we cannot have that; and we cement the sides and confine or turn the river.

The ancient cities whose ruins are now being explored in Asia seem to have been abandoned because of failure of the water supply as the earth became desiccated; so was the home of our own Zunis. Does such a possibility stop us? No, we bring water from hundreds of miles. Will man, who has gained such control over nature, sit down before his own problems and say, "What am I going to do about it?"

What if the apparent motion is toward cells to sleep in, and clubs to play bridge in, and amusements for evenings, and a strenuous business life, run on piratical principles, into which the women are drawn as decoy ducks? Because this is, is it going to be, as soon as a good proportion of the thinking people stand face to face with the problem? I believe it is possible to solve the problem, but only if the aid of scientifically trained women is brought into service to work in harmony with the engineer who has already accomplished so much.

Household engineering is the great need for material welfare, and social engineering for moral and ethical well-being. What else does this persistent forcing of scientific training to the front mean? If the State is to have good citizens, productive human beings, it must provide for the teaching of the essentials to those who are to become the parents of the next generation. No state can thrive while its citizens waste their resources of health, bodily energy, time and brain power, any more than a nation may prosper that wastes its natural resources.

The teaching of domestic economy in the elementary school and home economics in the higher is intended to give the people a sense of control over their environment and to avert a panic as to the future.

The economics of consumption, including as it does the ethics of spending, must have a place in our higher education, preceded in earlier grades by manual dexterity and scientific information, which will lead to true economy in the use of time, energy, and money in the home life of the land. Education is obliged to take cognizance of the need, because the ideal American homestead, that place of busy industry, with occupation for the dozen children, no longer exists. Gone out of it are the industries, gone out of it are ten of the children, gone out of it in large measure is that sense of moral and religious responsibility which was the keystone of the whole.

The methods of work imposed by housing conditions are wasteful of time, energy, and money, and the people are restive, they know not why. As was said earlier, shelter was found by early students of social conditions to be most in need of remedy, so we see that

"In the first place the state is beginning to offer positive aid to secure a suitable home for each family. A communistic habitation forces the members of a family to conform insensibly to communistic modes of thought. Paul Goehre, in his keen observations printed in 'Three Months in a German Workshop,' interpreted this tendency in all clearness. The architecture of a city tenement house is to blame for the silent but certain transformation of the home into a sty. Instead of accepting this condition as inevitable, like a law of nature, and accepting its consequences, all experience demands of those who believe in the monogamic family, that they make a united and persistent fight on the evil which threatens the slowly acquired qualities secured in the highest form of the family. It would be unworthy of us to permit a great part of a modern population to descend again to the animal level from which the race has ascended only through aeons of struggle and difficulty. When we remember that very much, perhaps most of the progress has been dearly purchased at the cost of women, by the appeal of her weakness and need and motherhood, we must all the more firmly resolve not to yield the field to a temporary effect of a needless result of neglect and avarice. As the evil conditions are merely the work of unwise and untaught communities, the cure will come from education of the same communities in wisdom and science and duty. What man has marred, man can make better."[18]

[18] C. R. Henderson, Proceedings Lake Placid Conference, 1902.

It is not impossible to furnish a decent habitation for every productive laborer in all our great cities. Many really humane people are overawed by the authority, the pompous and powerful assertions of "successful" men of affairs; and they often sleep while such men are forming secret conspiracies against national health and morality with the aid of legal talent hired to kill. Only when the social mind and conscience is educated and the entire community becomes intelligent and alert can legislation be secured which places all competitors on a level where humanity is possible.

Here, again, the monogamic family is the social interest at stake. It is a conflict for altars and fires. We are told that all these results are the effect of a natural, uniform tendency in the progress of the business world, and that it is useless to combat it. Professor Henderson reminds us that tendency to uniformity revealed by statistics may be reversed when resolute men and women, possessed of higher ideals, unite to resist it. Jacob A. Riis holds that these evils are not by a decree of fate, but are the result of positive wrong, and he dedicates his "Ten Years' War" as follows—"to the faint-hearted and those of little faith."

In like manner we call today for more faith in a way out of the slough of despond, more resolute endeavor to improve social and economic conditions. We beg the leaders of public opinion to pause before they condemn the efforts making to teach those means of social control which may build yet again a home life that will prove the nursery of good citizens and of efficient men and women with a sense of responsibility to God and man for the use they make of their lives.


Mrs. Richards intended to embody the following material in Chapter VIII of the second edition. Because of her death it has seemed best to add it as an appendix.




[19] Read before the American Public Health Association at Richmond, Va., October, 1909.

The checking of wastes of all description is much in the air, but there is less discussion about WASTE OF EFFORT than might be expected. Yet effort means time, and saving of time saves lives as well as money.

Nearly every investigation of sanitary evils leads back to the family home (or the lack of one), and a great deal of the health authorities' work is saving at the spigot while there is a hundred times the waste at the bunghole. The medical inspection of the schools was found to have little effect without the visiting school nurse, for the parents did not know how to better conditions and in the majority of cases did not believe in the need.

Such experience should give the health authorities a cue. Rules and Regulations should be enforced, but enforced with instruction as to the means of doing. The WHY is not so easily understood as the student of sanitary science seems to think. Germs and microbes are empty air to the street urchins until they have been shown on a screen in a lecture hall or until cultures have been made in the sight of the children in a schoolroom. One whole school district of intelligent parents was converted, many years ago, by giving the children in one class two Petri dishes each with sterile prepared gelatine, with directions to open one in the sitting room while it was being swept, and two hours after the room had been thoroughly dusted to open the other in the same place for the same time. These "dust gardens," as the children called them, "took the place of the family album" for callers, and spread knowledge.

Hundreds of similar experiences should convince any intelligent, earnest Board of Health that a teacher by nature or training should be in their employ, to be sent WITH POWER, like any other inspector, wherever ignorance—usually diagnosed as stubbornness—is found.

The health officer whose mother was a good housekeeper, not afraid of work, has no idea of the attitude of half the housewives of his district. Having been made as a boy "to get the dustpan and brush and sweep up his whittlings," he does not realize that these houses in the tenement district have no dustpans, and that no one would bend his back to sweep up litter if there were. It is all swept into the alley or the street. Cheap, long-handled dustpans would be valuable sanitary implements. As has been elsewhere suggested, the garbage question in the tenement house needs study and must be solved by a practical housewife. There are such, and Boards of Health are wasting effort and the town's money until they avail themselves of this help in the enforcement of their rules.

All Health Boards use the strong arm of the law, i. e., a police inspector's club, to drive the ignorant and careless householder to keep his premises from becoming a nuisance. The newly-arrived, prospective citizen, or more often citizeness, fails to understand what it is all about—neither the words nor the pantomime convey an idea, except that this country is topsy-turvy anyway, for everything is different in this new land.

In the process of learning what not to do, the dwellers in the alleys flee when the health officer appears, and oppose a stubborn indifference to his threats. When his back is turned, matters go on as before and nothing is gained, but an opportunity is lost. Law is a potent educator when rightly applied, but it may work more harm than good.

Rules of action clearly explained are soon accepted—like traffic rules, notification of contagious diseases, disinfection, etc.

The placing on the force of each town of at least one specially trained "Explainer" would result in cleaner back yards and less illness and, better than all else, a more friendly feeling between the officials and those they honestly wish to help; for I do not think there is often justification for such remarks as were made to me by a shrewd California countryman when I was showing him about in the traveling exhibit, the sanitation car: "Oh, this is all to get a job. It's another form of graft—to get some money to spend."

It is true that the value of many health measures does not appear on the surface. Sometimes it is necessary to wait for vital statistics to prove a gain.

It is beginning to be thrown in the faces of sanitary authorities that the laboratory wisdom does not reach the street; that there is not enough, or rapid enough, improvement in general conditions. Newspapers are ready, for the most part, to disseminate information and benevolent societies write tracts, but we must remember how little WORDS mean—especially printed words—to those unaccustomed to acquiring information that way.

The actual showing in an alley of the process of cleaning up; the going into a house and opening the windows at the top and tacking on a wire netting to keep out the flies; the actual cleaning of the garbage pail, perhaps, or at least the standing by and seeing that it is properly done—all such actual doing, even if it is done only in one house on a street, will spread the information all over the neighborhood.

One of the most helpful offices is to tell the woman where she can get the special article needed, and what it will cost, and to show her the thing itself, in a friendly spirit. Such visits would soon revolutionize the sanitary condition of any community.

Villages need this help even more than cities, for there they have fewer chances to know about inventions and perhaps are less resourceful in making them.

There may be races, as there are individuals, whom persecution drives to progress—who do find means to execute unjust commands—but the people a health officer has to deal with can be better led by kindness and will learn from teachers, if the teaching is in the form of example or demonstration.

It is an incontrovertible fact that to hasten sanitary reform it is only necessary to hold out the helping hand; to encourage the ignorant citizen to ask for instruction and direction, instead of placing upon him the task of making bricks without either clay or straw. There are times and seasons and individuals at which and on whom the bludgeon must be used—the greater good covering the lesser evil; but such cases are less common than present practice would seem to indicate.

The tenement house mother who has only one pan for all her needs and one broken pitcher for all fluids does not readily understand why she must keep her milk bottle for milk only. Who is to tell her so that she will understand?

The men may be shamed into cleaning up the back yards and alleys by pictures of such conditions in contrast to what might result with a little effort. [The famous Cash Register yards were started in this way.] Neglected spots have been cleaned up all over the country by similar influences. Why does not the health officer take a leaf from this book of recorded good work and show conditions known to him? Is he afraid of hard words from the owner? He will have the approval and support of all good citizens.

Health Board regulations may be left at a house AFTER they have been explained, and a firm insistence on obedience may then have an effect.

Why should there not be a constant exhibit of the conditions found within the boundaries of a district, with the changes for the better indicated as soon as they occur?

The Health Board office is now in some out-of-the-way place, where few people ever go and where those who do go are frequently not welcomed. Has the Board ever asked itself why it is often so misunderstood, so hampered in its work? What Board will be the first to take an office on a busy street and put pictures and samples with clearly printed legends in the windows—examples of the evasion of the plumbing laws on a T-joint pipe; photographs of a dairy barn; photographs of a street at daybreak, showing the few open windows, and the one or two, if any, open at the top—these would serve as texts for the newspapers' sermons, sure to be preached, and back-alley conversations thereon.

Why not? Rival water companies are allowed to show filters to prove their claims.

The basis of all successful sanitary progress is an intelligent and responsive public.

The problem is to visualize cause and effect to the ordinary individual, too absorbed in his own affairs to study out the principle for himself.

The success of the street cleaning brigade, tried for one season in Boston; the improvement in the condition of parks wherever receptacles for wastes have been placed; the tidy condition of corner lots where civic improvement leagues have taken the matter up with the children, all point to a means neglected by the officials, and hence to wasted opportunity and delayed obedience to regulations.

For the position of instructive inspector, it goes without saying that a trained woman will be worth more than a man, since most of the regulations affect or would be controlled by women.

A gain in the speed of adoption of sanitary reforms would be comparatively rapid under a thoroughly qualified woman as instructive inspector, and that there will not be any great gain until such a measure is adopted is the firm belief of the writer.

Mrs. von Wagner's work in Yonkers, begun in 1897 under the Civic League, is well known. After three years' trial the Board of Health established her in the position of Sanitary Inspector. Her work in the tenement districts has been most successful. Several other cities have followed the example of Yonkers, but the practice is by no means general. Yet there is no doubt that it would add efficiency to any Board of Health.

The most recent experiment was the employment, the past summer, of an inspector provided by the Women's Municipal League of Boston, to inspect and devise means for bettering conditions in a district of small shops where food is sold. The district had been found by the Market Committee of this organization to be in need of such help. A graduate of the School for Social Workers was chosen, who carried on her campaign with the spirit of helpfulness fostered by her training. She was given a badge by the Board of Health, who have been most sympathetic and cordial in their support. The experiment has been justified by the results and especially by the reception accorded the inspector by the people of the district. It has proved that there is a responsive desire to fulfill the law wherever its provisions are understood.

Inspection cannot fulfill its purpose until it is instructive. Man and the law will be in accord when the benefits of the law to man are appreciated.

It is incumbent upon the sanitary authorities to see to it that their efforts are not wasted on an inert, partially hostile clientele.


Human efficiency and welfare due to

Heredity (See Eugenics) and

Environment 1. Natural, cosmical—climate— 2. Natural, modified by human effort Wet and dry soil Waterways and forests Food supplies 3. Artificial Housing—clothing—sanitation

EUTHENICS—Conscious acquisition and application of scientific knowledge

I. Science in the laboratory Discovery of laws of science Knowledge of cause and effect

II. Dissemination of scientific knowledge Education

III. Application of science Habits of living Technique Stimulus to civic improvement Constructive legislation

I. Science acquired through laboratory and field research

Universities Johns Hopkins, Clark, etc.

Research institutes Rockefeller Institute Carnegie Institute Henry Phipps Institute Sage Foundation, etc.

Sanitary Science = Application of acquired laws to

1. National welfare Hook worm, Pellagra, Yellow fever, etc., in Panama, The Philippines, Cuba, Porto Rico, etc.

2. Individual health of body and mind

The people are reached by

II. A. Dissemination of scientific knowledge through

1. Schools 2. Publicity a. Bulletins Boards of Health Department of Agriculture b. Lectures Municipal Endowed c. Magazines and newspapers d. Placards e. Commercial advertising Inventions of manufacturers Food fairs, electrical exhibitions, etc. 3. Expositions for limited purposes Mary Lowell Stone Exhibit "Boston 1915" 4. Health Campaigns Tuberculosis classes, etc.

B. Legislation


III. Application of science to living

A. 1. Unconsciously acquired habits of the CHILD, through imitation in the home, the school, the street 2. Conscious endeavor of a. the trained parents in the home b. the teacher in the school c. the policemen in the street

B. Conscious personal effort of the ADULT to better conditions for himself and the community

1. Pioneer leading public opinion by a. Personal example in right living b. Precept and persuasion

C. Community progress

1. Semi-public agencies for guarding itself and the individual a. Remedial measures Endowed hospitals, sanatoria, dispensaries, day camps and hospital schools Charity organizations—material relief b. Preventive measures Endowed schools (model and outdoor), extension movements, settlements, model tenements, model factories, garden cities

Both are developed by social organizations, civic clubs, women's clubs, museums, libraries, lectures, exhibits, statistical inquiries, etc.

2. Private agencies leading to legislation Special hospitals and schools Health organizations—sanitary inspection at model dairies—private water supply Consumer's league

3. Legislation. Temporary paternalism (protection). Interpretation by individual becomes constructive. The people work out freedom under law

a. City (1) Schools Grade and trade and outdoor (2) Police Building laws (3) Board of Health (a) Shelter Sanitary laws { Drainage Air—light—refuse { Garbage { Ashes (b) Food Milk—water—foods { Food values { Adulterations (c) Sanitary laws for public places Buildings Streets Sewer Ice on sidewalk Spitting (4) Beauty Height of buildings, bill boards, telegraph wires, parks (5) Amusements Playgrounds, municipal music, parks, aquarium (6) Other municipal activities (a) Traffic regulation (b) Medical inspection (c) Public baths

b. State Education Board of Health Factory legislation Water supply (advisory power) Interstate commerce Food (advisory) Park reservations Textile laws Forest c. Federal Sanitation (a) Pure food laws (b) Quarantine (c) Immigration restriction (d) Future needs Textile laws, etc.


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