Why a Poor Man or Child Hasn't a Fair Chance

New Zealand Graphic, Volume XLII, Issue 20, 19 May 1909, Page 61

Why a Poor Man or Child Hasn't a Fair Chance

By

C. W. SALEEBY, M.D.

I BEGIN with the physique of the poor, for reasons which, as I see them, are abundantly adequate. There is no overweening human interest in fine animals an such. They are jo be seen any day' in the big cat house of the Gardens of the Zoological Society. Anyone inclined to read more than a vaguely symbolic meaning in the giant children of Mr. Wells’ “ Boomfood ” may be recommended to contemplate the exploits of Japan. Our interest in the physique of the poor depends upon the fact that the physical qualities are ths root qualities tn which all others, mental and moral, inhere, and without which all others must necessarily—even if they exist—run an abbreviated and crippled career. Even if it be possible, on occasion, to find the mens sans without the corpus sanum, the output of that mind must inevitably be adversely affected ia quantity, if not in quality. Let us, then, consider the initial fact, Which there is certainly no need to labour, that the poor of our great cities are very far from being even fine animals, and let us first observe an obvious fallacy, which may vitiate the interpretation of this, as of so many other statistical facts. Before we inquire into tha conditions which determine the faet that the poor are physically inferior, let us fullv recognise that a certain, and, probably by no means small percentage are poor because they were not fine animals in the first place. Physically inferior by reason of causes which will later be considered, they are unfit io do an adequate amount of work, or to do that inadequate amount adequately well. The point is obvious enough, but it 'must not be ignored—for the significance and utility of hospitals and dispensaries in relation to poverty are closely bound up with it. We must recognise the existence of a vicious circle. The man who is imperfect as a physical machine, whether by reason of inherited constitution or bad habits or disease, or any combination of these, is compelled, being inefficient, to live under conditions which aggravate his inefficiency. But here, very often, the hospital may intervene.

But having duly considered this point, Jve must recognise that the wretched physical state of the great majority of slum-dwellers is produced by the conditions under which they live. The poor of our great cities live under conditions which outrage every known law of common sense and of science. From the first lachrymose breath of their entry into the abominable environment which their day and generation have provided for them to that- last imperfect respiration with which they expire, many pf them never breathe a cubic inch of unpolluted air. Solid impurities in air—sterile dust—are bad enough; far worse nre. the living bacteria, every known condition for the full vitality of which is rigorously complied with in the dwellings ot the poor; far worse, also, are the gaseous impurities exhaled from the lungs and skin of all animals, human or other. Ths reader knows all this as well as 1 do.

What I ask is this: Are the elementary facts as to the significance of air hammered daily, or even annually, into the head of every ehild that attends a public School? If not, in the name of common sense, common decency, and our common humanity, why not? If there is any antidote to filthy air it is the light of day, the sunlight which is yital to nun, lethal to his most deadly foe*. The reader needs no telling that in the slums dirty air does its dirty work in darkness. But of what use is it to Ipreaek about thia in a eity where men think fogs funny ?

In naming, first, bad. and second, lack £>f punlight, I have indicated the essential causes of which overcrowding is only a proximate expression. The reader knowa, of course, that, in general, curves of death-rate and of overcrowding eotnclde. But overcrowding is not an evil

as such; man's society, indeed, is essential to man'* health; overcrowding is an evil because it entails bad air and lack of sunlight. The poor are deetroyed and maimed directly by foul air and darkness; but these also destroy and maim indirectly by the microbes which they breed. With the curves of general death-rate and of overcrowding, the curve of tuberculosis closely corresponds. The influence of the tubercle bacillus upon the physique of the poor would be hard to over-esti-mate. It ia not merely that this microscopic plant kills some one in seven of all who <fie upon the earth, nor that its ravages are far greater among the poorer than the more fortunate classes.

Type of a protean disease, tuberculosis often disables where it does not kill. In the form of lupus it disfigures a girl's face and makes it impossible for her to get work; as chronic disease of the hip or elbow or knee, it incapacitates thousands; yet these and many other forms of tuberculosis are as nothing compared with its ravages in the form of consumption, from which one person dies in London alone every three quarters of an hour, day and night, year in, year out-

each such death terminating a period of, on the average, some four years’ incapacity. Yet the public has still to learn that the chief function of sanatoria in a modern state is not the cure of consumption, but the prevention of it, by the segregation of patients in the most infectious stages of the disease. For all these evils —and be it remembered that- the possession of a very small income is not an evil in itself—there are known and adequate remedies. The tuberculosis death-rate has been steadily falling for many years past. Typhus fever, once familiar, and always to be seen in Whitechapel, has been banished therefrom by improved sanitation. A former medical officer of health for that district told me, on my last visit, that he bad not seen a case for some years, whereas a quarter of a century ago he could at any time have shown me two or three cases within five minutes’ walk of his house. Of tuberculosis, His Majesty tho King, when presiding over a meeting of the National Association for its prevention, has said: “If preventable, why not prevented?’’ Tuberculosis, one of the fruits of overcrowding, is being prevented; but with 12,000 deaths a year in London alone, can we say that His Majesty’s question as to the prevention of the disease has yet been creditably answered? No one can produce any satisfactory evidence to ah o4 ' that the national payeique is declining, save in so far as overcrowding and the other evils of cities

are increasing. But we know that 77 per cent of our population now lives in cities, whereas 51 per cent was the figure 50 years ago. The wretched physique of the poor —i.e., of the majority among city dwellers —whether due to disease or to merely devitalising conditions, is a product of the present conditions of city life. The cry, “Back to the land,’’ well meaning as it is, must be criticised in the light of sociological science. Not only is the transition from agriculture to manufacture a natural evolution, but there is a great distinction as to the demand for the two. A given population needs only a finite quantity of food; but its demand for products ef manufacture is. obviously indefinite. The city, therefore—the maker of poverty—is an inevitable fact.