The Task of Social Hygiene | Page 5

began in the eighteenth
century. The era of social reform was delayed until the second quarter
of the nineteenth century. It has proceeded by four successively
progressive stages, each stage supplementing, rather than supplanting,

the stage that preceded it. In 1842 Sir Edwin Chadwick wrote an
official Report on the Sanitary Condition of the Labouring Population
of Great Britain, in which was clearly presented for the first time a
vivid, comprehensive, and authoritative picture of the incredibly filthy
conditions under which the English labouring classes lived. The times
were ripe for this Report. It attracted public attention, and exerted an
important influence. Its appearance marks the first stage of social
reform, which was mainly a sanitary effort to clear away the gross filth
from our cities, to look after the cleansing, lighting, and policing of the
streets, to create a drainage system, to improve dwellings, and in these
ways to combat disease and to lower the very high death-rate.
At an early stage, however, it began to be seen that this process of
sanitation, necessary as it had become, was far too crude and
elementary to achieve the ends sought. It was not enough to improve
the streets, or even to regulate the building of dwellings. It was clearly
necessary to regulate also the conditions of work of the people who
lived in those streets and dwellings. Thus it was that the scheme of
factory legislation was initiated. Rules were made as to the hours of
labour, more especially as regards women and children, for whom,
moreover, certain specially dangerous or unhealthy occupations were
forbidden, and an increasingly large number of avocations were
brought under Government inspection. This second stage of social
reform encountered a much more strenuous opposition than the first
stage. The regulation of the order and cleanliness of the streets was
obviously necessary, and it had indeed been more or less enforced even
in medieval times;[2] but the regulation of the conditions of work in the
interests of the worker was a more novel proceeding, and it appeared to
clash both with the interests of the employers and the ancient principles
of English freedom and independence, behind which the employers
consequently sheltered themselves. The early attempts to legislate on
these lines were thus fruitless. It was not until a distinguished
aristocratic philanthropist of great influence, the seventh Earl of
Shaftesbury, took up the question, that factory legislation began to be
accepted. It continues to develop even to-day, ever enlarging the sphere
of its action, and now meeting with no opposition. But, in England, at
all events, its acceptance marks a memorable stage in the growth of the

national spirit. It was no longer easy and natural for the Englishmen to
look on at suffering without interference. It began to be recognized that
it was perfectly legitimate, and even necessary, to put a curb on the
freedom and independence which involved suffering to others.
But as the era of factory legislation became established, a further
advance was seen to be necessary. Factory legislation had forbidden the
child to work. But the duty of the community towards the child, the
citizen of the future, was evidently by no means covered by this purely
negative step. The child must be prepared to take his future part in life,
in the first place by education. The nationalization of education in
England dates from 1870. But during the subsequent half century
"education" has come to mean much more than mere instruction; it now
covers a certain amount of provision for meals when necessary, the
enforcement of cleanliness, the care of defective conditions, inborn or
acquired, with special treatment for mentally defective children, an
ever-increasing amount of medical inspection and supervision, while it
is beginning to include arrangements for placing the child in work
suited to his capacities when he leaves school.
During the past ten years the movement of social reform has entered a
fourth stage. The care of the child during his school-days was seen to
be insufficient; it began too late, when probably the child's fate for life
was already decided. It was necessary to push the process further back,
to birth and even to the stage before birth, by directing social care to the
infant, and by taking thought of the mother. This consideration has led
to a whole series of highly important and fruitful measures which are
only beginning to develop, although they have already proved very
beneficial. The immediate notification to the authorities of a child's
birth, and the institution of Health Visitors to ascertain what is being
done for the infant's well-being, and to aid the mother with advice, have
certainly been a large factor in the recent reduction in the infantile
death-rate in England.[3]
The care of the infant has indeed now become a new applied science,