LIB RAHY OF THE UNIVERSITY Of 1LLI NOIS S3 THE INFLUENCE OK SOCIAL AND SANITARY CONDITIONS ON RELIGION: A PAPER READ BY DESIRE AT THE CHURCH CONGRESS AT BRIGHTON, Oct. 9, 1874, BY HENRY W. ACLAND, F.R.S. PRESIDENT OF THE MEDICAL COUNCIL, HON. PHYSICIAN TO H.K.H. THE PRINCE OF WALES, AND REGIUS PROFESSOR OF MEDICINE IN THE UNIVERSITY OF OXFORD. OXFORD and LONDON: JAMES PARKER WD CO. 1874. 9 JC „ From the A uthor. THE INFLUENCE OF SOCIAL AND SANITARY CONDITIONS ON RELIGION. "\T THEN I was favoured with a request to » * address the Church Congress on " The Influence of Social and Sanitary Conditions on Religion," coupled with the instruction that no paper can be permitted to occupy a space of more than twenty minutes, it may be readily supposed that my first impulse was to shrink from so difficult, if not so impossible, a task. Yet the benefit of free discussion on this ques- tion seemed so great, and the necessity for the discussion so urgent, that I dared not refuse an honour so graciously conferred on me. I was glad also of an opportunity of testifying that the Science of Medicine, while claiming for its votaries the utmost possible freedom of thought, docs not desire to discourage, still less to attack, the religious sentiments which have hitherto animated the human race. It seeks rather patiently to investigate, and truly to know, the relative places and connections 4 The Influence of Social and of all departments of human function and human thought. From the wide subject you have chosen, three points only will be selected for consideration : — The broad basis of sanitary science, the national application of sanitary science, and the share which ministers of religion can take therein. Whatever hypothesis social or sanitary science may advance as to the relations and conditions of man as part of the universe, science can never alter the principles, be they called hu- man or be they divine, on which Christian practice is founded, the principles of universal justice and love. These principles demand in their very nature that by every means and in every direction science should, without ceasing, seek further to alleviate the mental and physical suffering which, by inexorable law, oppresses all conscious life on the earth, and has, as far as we know, oppressed it from unmeasured, and perhaps immeasurable time. Science has this in common with religion, that it seeks more to know than to explain. It is ever learning what are the laws which constitute what we call ° Nature' 1 in this vast system of conservation, of change, and of dis- solution. It admits that almost every indi- vidual, animate or inanimate, exists by the Sanitary Conditions on Religion. 5 destruction or alteration of some other in- dividual entities ; and as regards man, science is engaged, among other tasks, in the effort to discover how to guide those vast physical forces which surround him, and how to help him to observe rules by which his physical and his moral welfare may be most fully se- cured. But, after all, man feels still, as ever, his feebleness. Who now, more than in the infancy of our race, can watch the fury of the elements as they dash on an iron-bound coast ; look abroad on the immensity of space, as men looked out of old in the days of supersti- tion and ignorance, on the starry night ; weigh the significance of the instincts and habits, the sagacity, affections, and passions of the brute creation, and then say that modern know- ledge, astounding though it be, has yet solved the mystery of our state, or has shewn man's independence of the general order of the world about him ? Will he not say now, as ever, both that the physical and sanitary conditions which surround us must, ctcma lege, whether we can read them or no, have a definite rela- tion to Qur moral nature — and also that, in some sense, understood or not understood, " not a sparrow falls to the ground but is known to our Heavenly Father," — falls in obedience to 6 The Influence of Social and laws fixed from the beginning; all form, all matter changing — law alone abiding for ever ? To consider, therefore, social and sanitary- conditions in relation to religion is practically to affirm that we believe in the unity of the laws and arrangements under which man, con- scious and responsible man, lives on earth. All who hold this belief can but wonder that men of power, contemplating the phenomena of human existence, should ever dissociate ma- terial from mental science — should seek to de- preciate the marvel, and despise the require- ments of our bodily frames, which, after all said, are the temples, foul or fair, of the spirit dwelling within them. They long for the time when teachers and taught alike shall look, though darkly, on nature all as one, and when ignorance of material laws will seem as culpable and as disastrous as ignorance of moral truth. Such, and kindred thoughts, seem to me to lie at the foundation of the thesis you have proposed for your discussion to-day. Of that thesis the "social" portion must be set aside, to give our few minutes to questions immediately bearing on the relations of health and religion. It is right, perhaps, just to notice the fact that the meaning of the word Religion is often now disputed. Yet nothing need here be said Sanitary Conditions on Religion. 7 which should jar with any interpretation men may think fit to assign to the word. It is now sufficient to insist that the close interdependence of the physical and mental constitution of man has become, as time has lengthened over the human race, more clear. Some great minds, indeed, have seemed to rise superior to most material wants, to their habitations, to heat and cold, to the kind of daily food ; but for all ordinary men, any conditions which are in- jurious to health are more or less unfavourable to culture, to the family life, to pure and refined morality, and to practical religion. Habitual intemperance, habitual uncleanli- ness, unchastity, unhealthy dwellings, inade- quate food, luxury — all that depresses, all that pampers the body, all that enfeebles the har- monious action of the mental faculties, has to be opposed equally by the physician and by the moralist. If it is become a truism to say that vicious, self-indulgent men, however they became what they are, are less capable of phy- sical and intellectual exertion, and of moral or religious excellence, than they would have been had they lived in virtuous habits of self- restraint, or in refined habits without ener- vating ease ; so also it is not less a truism that preventible material conditions lead to 8 The Influence of Social and states of the nervous system which promote intemperance and other vices, from which per- sons living in the open air and in active exer- cise, though otherwise apparently in a state of want, are nearly exempt. Without further argument, then, this may be assumed — that ministers of religion, as such, and for their special functions, are interested in the physical health of their flocks. The question, it is to be presumed, to be con- sidered by this Congress is rather how far min- isters can with prudence share directly in the measures which have to be publicly taken for the public health ; or how far the division of labour necessarily incident to "civilisation" re- quires that the clergy in general should be less rather than more occupied with the tem- poral condition of the people, leaving all mea- sures for the prevention, as well as the cure, of disease strictly to the profession of medicine. I believe that this necessary law of " divi- sion of labour" should not here be trenchantly applied. It is a question of time and place, of degree and discretion, rather than of kind. There are vast districts in Scotland and Ire- land, in India and the colonies, in which it would be simply idle to expect that the me- dical officers can wisely dispense with the in- Sanitary Conditions on Religion. 9 telligent support of any good and educated minister of religion, willing and able to help them. National health and sanitation are terms on the lips of every one. Sound na- tional health has been said to be that phy- sical condition of a nation which enables the individuals composing it to discharge rightly their respective functions in the State. The statesman, for instance, ought to be in train- ing for the intellectual and social work of his high office — the artisan, the soldier, the ab- stract thinker, each for his. Sanitation is the attempt to influence for good by all known methods the factors which bear on the na- tional health ; to promote education in its truest sense, physical, intellectual, moral ; to teach men wisely to work and wisely to phi)- ; to make noxious occupations as harmless as they can be made ; to hinder men from overtly or secretly poisoning for their own advantage their neighbours' dwellings, or air, or food, or drink ; to shew how one form of power or skill, men- tal or bodily, may be developed without detri- ment to the higher or general faculties of the man ; to endeavour to abolish, not only things hurtful, but to limit the abuse of things harm- less, or even of things beneficial when mo- derately employed. 10 The Influence of Social and Three illustrations out of many will at once occur to you — (i) Excessive hours of labour ; (2) abuse of alcoholic liquors ; (3) uncontrolled spread of diseases originating in preventible ways, and spreading by preventible infection. Each of these subjects has of late years, as you know, been the object of careful and minute legislation, and often of angry discussion. Nor can this be otherwise. They are all grave ques- tions, not only for the physiologist, but for the moralist, and for the patriot. To discover what manner of life in the se- veral classes of man and of woman, what la- bour, what recreation, what personal habit of body, what education — nay, what alliances in marriage, conduce most to that tone of the nervous system, personal or inherited, which shall put the nerve power of each citizen at the best for the discharge of his public or of his private duty, and how far the State should endeavour to regulate these, are truly prime questions for the modern statesman. Be as- sured no vicious man, nor drunkard, nor gam- bler, still more no masses of such men, can be useful or safe citizens in a free State. Vice makes men feeble. Feebleness makes them irritable. Irritability makes them selfish. Some may, I fear, consider that these obser- Sanitary Conditions on Religion. II vations are, in a grave sense, political rather than in a practical one, sanitary. But it is not so. The key to sanitary science is to be found in a full apprehension of its entire aims. The day ought now to be past for discussing the necessity of sewers, sewage-irrigation, and kin- dred topics. The mode only of executing such essential works has to be considered by honest experts. Men have perished by hecatombs because of the scant knowledge of builders, architects, and town councils. An able physician, and an ad- mirable and cultivated clergyman a , (well known to many of you,) died but the other day from such preventible causes. That no city, no private houses, when saturated with unre- moved filth, are healthy is now as freely ad- mitted as that personal filth, or drink, or vice engender disease. The clergy and public should remember that this elementary knowledge was taught in great detail three thousand years ago to the Israelites, as they passed along the wadys that wind round the foot of Mount Sinai. This teaching has been too often for- gotten by ascetic religionists, anxious to mor- tify the bodies of men, when they ought to • Dr. Anstie and Lord Cottcsloe's son, Mr. Frcmantle, Tutor and Student of Christ Church. 1 2 The Influence of Social and have held them as soldiers in discipline for the good fight, not in subjection, as enemies to be trodden down. Two main principles have to be borne in mind in practically dealing with this subject — (i) That the care of personal health depends mainly on the individual ; (2) that the care of national health depends mainly on imperial and local administration. It is clear that in both these categories a body so influential in a nation as the ministers of religion can effect much. Individuals can be taught what conduces to their physical well-being ; and a clergy skilled in doing this, through the schools, the pulpit, and by personal influence, can, in our country, largely aid the intelligent efforts of the members in both Houses of Par- liament, and especially, I venture to say, of the House of Peers. That august body con- tains the heads of the National Church. Whose practical knowledge should better disclose the wants of the denser populations than that of your Archbishops and your Bishops ? Whose voice can better cheer on their way the grave and large-hearted men whose chief pleasure is the welfare of their country, and who feel that they hold their high estate as stewards of her people's good ? Who, when natural knowledge Sanitary Conditions on Religion. 13 is part of a high education, more fitly proclaim the true relations of body and of soul ? A few words more on the special relation of these two points to ministers of religion, and my task, however imperfectly, will be fulfilled. A knowledge of how to regulate our personal health as individuals depends on a variety of considerations. Abstractedly, no doubt a knowledge of the structure of the body is desirable for all. Abstractedly, there- fore, human physiology should be a necessary subject of early education in schools. But after all said on that head, it is doubtful whether men's instincts, acting with a pure conscience, are not an adequate guide to per- sonal health. The essence of the thins lies in cleanliness, morality, and order. By in- stincts the wild animals are kept in vigour and health for their appointed time. If the instinct of boys, their self-respect, self-restraint, pure conscience, healthy homes, and good mo- thers are of no avail for good conduct, it is indeed a question whether the knowledge of the constituents of diet, or of the relations of waste to supply in the combustion of the human body, will make them temperate in satisfying their natural appetites. I must, however, here, in passing, guard 14 The Influence of Social and against any interpretation of these words which may fix on me an opinion adverse to biological studies as a means of culture and a noble ob- ject of knowledge, — I say here only, that men need not be biologists for the practical object of being strong, healthy, and wise ; an opinion with which all rational men must agree — and I need not here argue, as I could, that no man can nowadays be said to be of complete culture who is not to some extent a biologist. But the second subject, that of promotion of national health as a part of national capital, stands on wholly different grounds. With the best possible intentions, and with the highest personal morale, the masses of the population in this country cannot live healthy lives. Re- flect, for instance, on the conditions requisite for healthy habitations, and the means of pro- viding them in our great towns or our country districts. There are rural districts in these islands where the dwellings have no floors, no chimneys, no closets. There are alleys and streets in our towns where the poor are crowded into rooms without requisite space, or air, or light, or separation of sexes. In the rural districts generally, the poor cannot command capital or soil, or erect adequate dwellings any more than their brethren in the Sanitary Conditions on Religion. 15 towns ; and these last cannot unaided obtain water or drainage oftcner within reach of the peasant. How are these to be obtained ? Arc the owners of soil to be forced by the State to give sites, and the owners of house property to be compelled to give adequate space, or forfeit their property ? Who shall decide what is ade- quate ? Where draw the line of State inter- ference with private liberty ? It is certain that many necessary works can- not be well devised nor executed except under the direction of the law. This must be either permissively or compulsorily carried out by public authority. The authority may be either local or imperial. As a matter of fact, sanitary work falls under all these categories. Some sewage and water supply in towns should be compulsory under imperial acts. The mode of executing work may be decided by the locality under imperial sanction. The preven- tion of contagious disease is an imperial duty, the regulation of drinking houses a local pro- blem, and so of other numerous details. In promoting all these administrative mea- sures, the clergy are, as has been stated, im- mediately aiding the moral and religious pro- gress of their flocks ; and they may be assured, that as long as they do not profess technical 1 6 The Influence of Social and medical knowledge, they are as well qualified by general education as any other citizens, and should be more able than most men to take an enlightened part in local sanitary affairs. They might follow attentively the course of sanitary legislation, read the chief Reports which bear on the public health, and assist with their great insight the efforts of their local medical officers, when they are satisfied of their prac- tical utility, for the well-being of all who need their help. Much as the Government has yet to do, recent legislation has made possible all the sanitary machinery that is required for the country. The central authority has power to provide every officer that is needed for its complete working. Every spot in the country can, if it will, obtain competent help. The principles on which sanitary science depends can be discovered only by those whose thoughts are specially occupied in that direction. The full application of those principles demands the education of the engineer, chemist, phy- sician, lawyer, and statistician. But there is still a wide field of work, in which the district visitor, the parish nurse, the minister of re- ligion, all have functions that alone can be discharged by them, as well for the moral as the physical advantage of the people. Time Sanitary Conditions on Religion. ly has forced me merely to touch in the lightest way on your great theme. It permits me to speak of only one concluding topic. The latter part of my observations has been directed ra- ther to the local help which in this country ministers of religion may give to the cause of public health. The former had reference to those general conditions of humanity which enter into the essential idea of sanitary science. To all humanity these principles equally apply. As the messages of purity, of good-will, and of peace come alike to every portion of the human race, so do the messages of prevention of disease, of relief of bodily pangs. To whom can we look for the spread of these common principles throughout the world of races with more certainty of response than to a cultivated and skilled missionary clergy, foreign and home ? Already in Oxford (I venture to speak of that University) the question is being se- riously considered — What are the essentials of the most complete education that she can gi\e to the Missionary of the future ? No one will doubt the testimony of such ted soldiers of the Cross as Caldwell, Livingstone, or Callaway. These testily that no portion of the training of the foreign mis- sionary is more valuable than the medi 1 8 The Influence of Social and training. Is not this to say that one of the chief ways to reach the heart of man is by the care of his frail body ? To cure his diseases — still more to prevent them — is part of the disciples', as it was of their Master's, work. Sir Bartle Frere, with his wonted grace and large experience, told of the general need of widening the basis of missionary education in Oxford. Some of us have urged the ap- plication of funds to missionary Fellowships, obtained by persons trained for the work in the fullest sense — religious, moral, scientific, ethnological, literary, sanitary. There is a long vista before us of work here. May your dis- cussion of to-day, seeking to determine the influence of sanitary conditions on religion, bring forth fruit through the many races of our fellow-subjects who have immediate claim on our sympathy and fostering care. There is, no doubt, a tendency in the world to follow other counsels than these — one that would sever all secular from all sacred studies ; one that, hopeless of comprehending the in- comprehensible, professes, by closing our eyes to one part of the unity and order of things about us, to make each of us a better judge of the whole, — a tendency which would end in confining all striving for communion with Sanitary Conditions on Religion. 19 the Unseen to a professional clergy, and would keep that clergy at a distance from progressive acquaintance with positive physical science. No error would be more fatal to the growth of the spiritual life throughout the world, than any decision by which ministers of religion should be removed (when have their brightest lights been so removed ?) from an intelligent interest in those branches of knowledge on which alone sanitary and social science can be founded, unless it were the delusion that any one-sided and partial training of the fa- culties can ever impart thorough education to a people. From such misfortune, my lord, your course to-day aims at preserving the members of the National Church. May the social and sanitary condition of the people, in the widest sense of these words, be ever thought by a learned and benevolent clergy to be in- separably related to the best interests of true Religion. 20 The Influence of Social and The Bishop of Chichester, (Chairman of the Congress,) in bringing the discussion to a close, referred to the difference of opinion which had been expressed on the subject of lodging- houses, and suggested that a middle view was probably the correct one. It was best to provide the workman with a good, well- ventilated, well- drained house of his own, wherever that was practicable ; but when it was not (as was the case in London and other large towns), the next best thing was to have a large and lofty model lodging-house. The fact, however, was, that such houses were not occupied by the class for whom they were intended, but by persons of a higher grade, — clerks and others. Having lived in Lancashire, he knew something of the effect of machinery upon the working classes. The more the hours of labour were limited, the more the powers of steam were accelerated, so that a man did in fewer hours what he formerly did in more ; yet he had observed at the night- schools that the young people, after their day's work, were more lively and less given to sleep than himself: they had all their faculties un- impaired, and were ready for any kind of work that might be set before them. With regard to family arrangements, almost everything de- Sanitary Conditions on Religion. 2 1 pended upon the mother, especially as to the character and conduct of the daughters. Un- less the parents could be reached, the efforts to educate the children would be greatly im- peded. The place in which he lived was once entirely deficient in drainage, and the result was the prevalence of typhus and other ma- lignant diseases, so that the clergy were often subjected to great peril in attending upon the sick and dying. At length a board was ob- tained, which carried out a system of drainage throughout the whole district. This was not done without great resistance on the part of the owners of property, who went with them to the Court of Queen's Bench. The result was a triumph for the board, and the case then decided was a leading one. The district was now perfectly drained ; fever had almost entirely disappeared, infectious disorders were not so malignant as before, and the clergy were relieved from much of the peril to which they were formerly subjected. It was a matter of congratulation that recent legislation, and the manner in which the act was carried out, would secure an adequate inspection of all nuisances, not only in town but in country places, and also a correction of those nui- sances, the expense of such correction being 22 Tlie Influence, &c. thrown upon those who ought to bear rt,~the owners of the property of the district. The word of the inspector was law in his district, but it was not law in cases where it was es- pecially needed, — the cases of ancient bodies possessing great privileges, which, he was sorry to say, they were not always inclined to use for the benefit of their fellow - citizens. His Lordship, who had not spoken on any subject of debate throughout the sittings of Congress, except on questions of order, said he thought he was entitled to say this much after four days' patient listening. — (From the " Guardian " Oct. 21 , 1874.) VRINTED BV JAMES PARKER AND CO., CROWN-YARD, OXFORD.