Civics and Health | Page 6

man where he can play best. Gardening is profitless when
the gardener does not know the habits of plants and the possibilities of
different kinds of soil. So in planning a health programme we must
study our materials and use each where it will fit best. The materials of
first importance to a health programme in civilized countries are men;
for men working together can control water sources, drainage, and
ventilation, or else move away to surroundings better suited to healthful
living. Therefore the first concern of the leader in a health crusade is
the human kind he has to work for and work with.
Seven kinds of man are to be found in every community, seven
different points of view with regard to health administration. Each
individual, likewise, may have seven attitudes toward health laws,
seven reasons for demanding health protection. These seven points of
view, seven stages of development, are clearly marked in the evolution
of sanitary administration throughout the civilized world. With few
exceptions, it is possible, by examining ourselves, our friends, and our
communities, to see where one motive begins and leaves off, giving
way to or mixing with one or more other motives. A friend once asked
me if I could keep this number seven from growing to eight or nine.
Perhaps not. Perhaps there are more kinds of people, more health
motives, more stages in health progress; but I am sure of these seven,
and certain that they have been of great help to me in planning health
crusades for the state of New Jersey and for New York City. The
number seven was not reached hit-or-miss fashion, nor was it chosen
for its biblical prestige. On the contrary, it came as the result of
studying health administration in twoscore British and American cities,
and of reading scores of books on sanitary evolution.
Seven catchwords make it easy to remember the characteristics and the
source of every motive, every kind of person, and every stage in the
evolution of sanitary standards. These seven catchwords are: Instinct,
Display, Commerce, Anti-nuisance, Anti-slum, Pro-slum, Rights. By
the use of these catchwords any teacher, parent, public official,

educator, or social worker should be able to size up the situation, the
needs, and the opportunity of the individuals or the communities for
whom a health crusade is planned.
Instinct was the first health officer and made the first health laws.
Instinct warns us against unusual and offensive odors, sights, and
noises, just as it causes us to seek that which is agreeable. Primitive
man in common with other animals learned by sad experience to avoid
certain herbs as poisons; to bury or to move away from the dead; to
shun discolored drinking water. During the roaming period sun and air
and water acted as scavengers. When tribes settled down in one spot for
long periods, habits that had hitherto been inoffensive and safe became
noticeably injurious and unpleasant. Heads of tribes gave orders
prohibiting such habits and restricting disagreeable acts and objects to
certain portions of the camp. Instinct places outhouses on our farms and
then gradually removes them farther and farther from dwellings. In
many school yards, more particularly in country districts and small
towns, outhouses are a crying offense against animal instinct. In
visiting slum districts in Irish and Scotch cities, and in London, Paris,
Berlin, and New York, I never found conditions so offensive to crude
animal instinct as those I knew when a boy in Minnesota school yards,
or those I have since seen in a Boy Republic. But the evil is not
corrected because it is not made anybody's business to execute instinct's
mandates. In the Boy Republic the leaders were waiting for the children
themselves to revolt, as does primitive man.
TABLE I
TYPHOID A RURAL DISEASE[1]
==========================================+========
====+============== | Average | Average | Per Cent | Typhoid
Fever | of Rural | Death Rate | Population | per 100,000
------------------------------------------+------------+-------------- Five states
in which the urban | | population was more than 60% of the total | 30 |
25 | | Six states in which the urban population | | was between 40% and
60% | 49 | 42 | | Seven states in which the urban | | population was
between 30% and 40% | 67 | 38 | | Eight states in which the urban | |

population was between 20% and 30% | 75 | 46 | | Twelve states in
which the urban | | population was between 10% and 20% | 87 | 62 | |
Twelve states in which the urban | | population was between 0 and 10%
| 95 | 67
==========================================+========
====+==============
Among large numbers of persons, in city as well as country, washing
the body is still a matter of instinct, a bath not being