Nottingham Hospitals Archives 2011
“The Trent and I go wandering by”
Robert George Hogarth
Robert George Hogarth, 1926
The Importance of Health
I might perhaps be allowed to finish this book by writing a chapter on the above, seeing that I have spent the whole of my working life trying to cure people of their ailments and teaching them how to keep from getting them.
The value of health cannot be rated too high. Bodily health, mental health, moral health, spiritual health, national health – in each and every aspect health is a state of being well worth striving after an worth all the effort of which one is capable, to maintain.
You may suppose that this has always been so and that mankind has always thought much the same as today about the blessings of health. In this sense, of course, that is true. In another sense it is not true. The science of health, as the experts now understand it, has only lately been discovered. Indeed, I would rather say it is only now in process of being discovered.
And for the best of all reasons, in other words, the only within the last 100 years has the medical profession begun to be master of its own science and practice. But you must remember that ~certain discoveries were made, medical science not merely did not advance, but could not advance. You must not be too hard on doctors and surgeons for not making at an earlier date the supreme discoveries of the nineteenth and twentieth centuries. It would be just as unreasonable to blame the engineers for not discovering centuries ago the steam engine, the motorcar and the flying machine.
Probably almost the youngest of my readers is old enough to remember the general introduction of wireless which we now take for granted as a commonplace of civilisation. A schoolboy can now make his own wireless set. In 10 years this modern miracle will excite no more wonder than an electric tram car or a motor bus, and people will find it impossible to realise the old boredom of winter evenings when one could not switch on the wireless and listen to the news of the day, the BBC Orchestra or Dance Music till midnight from the Blackpool Winter Gardens or the Piccadilly Hotel.
When our fathers and grandfathers lived in great isolation in respect of health, they will cut off effectively. They had their physicians, surgeons and apothecaries, who looked just as wise – or problem even far wiser – than their descendants of today. Certainly they trust the part better and were much more solemn and impressive in manner. However, they took their calling seriously and lived God-fearing and self-sacrificing lives. But much of what they thought they knew best was wrong, and most of the discoveries which have wrought a beneficent revolution in medicine were wholly unguessed.
No real progress in knowledge is possible to view have firmly discovered cause and effect. To you discover its cause, any disease is your master, and even then you may grope for 50 years to find its cure. There was no science of health as we know it, till medical science had started forth on its new career. For any given person, health and life were almost a matter of luck or accident. The great killing epidemics re-occurred at intervals and mowed the people down in broad and ghastly swathes. Other diseases were permanently encamped in our midst, as they still are, but they then took an enormously high toll, because most conditions were then favourable which are now adverse to their spread.
Do you think that it was mere perversity or callousness on the part of the ruling classes that a Ministry of Health was not established in this country till the Great War. Not at all. It is fair criticism to say that it might well have been established say 20 or 30 years earlier, but much earlier than that it would have been impossible. If you ask why, the answer is that before then the grand inspiring conception of a Nation in Health had not arisen, and indeed how could it arise when the prevailing and ruling idea about disease and academics was that they were inevitable, that they were not merely allowed by Providence but were actually sent for our punishment and for our good, and that it was a matter of luck or Providence – according to the point of view – whether you escaped all you was stricken down.
I wonder how many have any conception of the opposition which the sanitary reformers more than a century ago encountered before they won the battle for decent sanitation.
You should read the violent letters attacking and denouncing such men as Chadwick and Charles Kingsley when they dared to attack the common pumps standing in the fetid courts of London and the great cities as the prime source of infection in a cholera pandemic. This is the one supplied the people with water from sources contaminated by foul and murderous cesspools, but the explanation given was that this scourge was sent by God, like other pestilences, and that the miasma of fever and malaria was as inescapable as the great clean winds blowing on the health. There was no glimpse of the real truth in the public or even in the educated mind. There was in fact a strong obsession of the public mind by the most fatal errors, especially fatal because honest, well-meant endeavours to persuade the victims to an attitude of pious resignation became perverted into an appalling defence of some of the worst social and sanitary evils arising from human selfishness.
There was a public body founded in 1848 through the agency of one eager reformer, Edwin Chadwick, called the General Board of Health, and it was an independent body, which was not even subject to any departmental or Government control. But it had no power of come portion over the vestries and municipalities which it sought to goad into action and after seven years of hectic controversial live, it was actually abolished by a Parliamentary vote in the name of individual liberty.
It was sarcastically said at the time that "the English people would prefer to take their chance of cholera rather than be bullied into health." And so the cause of sanitary reform received a painful check. That meant, of course, that public opinion was not ready for it, and candour requires the admission that general medical opinion was not very much more advanced. Moreover, Chadwick himself was too far ahead of his time to gain popular support for schemes which were the product not of practical experiment, but merely of hard reasoning and logic. The doctors disliked a man who was not even a doctor, telling them what ought to be done towards the prevention of epidemics and the organisation of a pure water supply. Survey is derided his projects for the wood-pavings of streets. Great industrialists suspected one who decided to make employers liable for accidents to their workmen. And the whole company of vestrymen, as you can well imagine, were up in arms against a reformer who was resolute in exposing their efficiency and corruption. Edwin Chadwick, however, had the vision on a great system of preventative medicine as part of a National Health Scheme as we have seen come into being within the recent century. Like Moses, he saw but did not enter the promised land.
Why have I dealt on this bygone Victorian reformer and the bitter opposition which she encountered? I will tell you. It is because I would not have the present generation repeat the mistakes of its predecessors. The battle of sanitation has, indeed, been won, and we are all sanitarians now, at any rate in theory.
But you need not look far to find gross offences against sanitation, and it is not also true that you encounter the closed mind at every end and side? You know what I mean by the closed mind. It is the lazy mind that does not want to think. It is the selfish mind which resents being convinced. It is the bigoted unprejudiced mind that will not admit new evidence. It is this shattered mind that will not open to the light.
It will not have you to be light reads shaken by the wind all to be always running about after you doctrines, or at the mercy of the latest advertisement which promises you a quick and certain cure. But I advise you to keep your mind open and receptive and when those who are qualified to give you counsel in matters of Health pass their well considered judgements, I would have you sympathetically disposed to accept and act upon them.
I would ask you, in a word, to cultivate an active Health Sense. The development of such a Sense in the general body of the nation would soon produce magnificent results. You may tell me that it exists today. I beg you to be under no such illusion. One of the most distinguished of British Scientists said not long ago that millions of people in the United Kingdom are, in a medical sense, every whit as superstitious as the natives of Darkest Africa.
Ask yourself whether it is any less superstitious to part with your good money for quack medicines which you see advertised in the newspaper or on some flaming poster on the walls than it is to call in the help of a native witchdoctor? You laugh at the fetish of the untutored savage in the jungle; but you have your own fetish in the shape of a medicine bottle.
I have seen it estimated that the 12 million insured persons under the National Health Scheme consume every year more than 10,000 tons of medicine bottles! They could almost make a railway embankment. What proportion of that enormous mass, even if harmless, is valueless to the patients who consume it? I would not attempt to estimate, that it certainly would be very large.
You may say, "Then why do doctors prescribe the stuff?" The cancer is that if they did not prescribe it, their patients would lose faith in them and would go home and say, "Oh, that fellow is no good. He did not give me a bottle of medicine."
Something of that sort was probably in the scientists mind when he said that millions of our own people are as such the victims of superstition in a medical sense as the tribes of Central Africa. They cling to the old notions. They believe that heart that a doctor who knows what is wrong with them yet cannot cure them, is an incompetent full, though too often they keep away from the doctor till they are almost passed cure. They believe that there must be an effective remedy for every ailment – which is by no means certain – and the panel Dr ought to know it and be able to apply it in their case, though they may be suffering from a complex of maladies or some disorder whose cause and cure still baffles the expert knowledge of the profession.
Again, I ask you whether it can be said that a real Health Sense exists in our midst when you see the great mass of the people flagrantly breaking the most elementary rules of health. Do the majority of our people scrupulously obey the laws of personal cleanliness? Do they behave as they understood that dirt is the deadliest enemy of health and the most fertile breeding ground of disease? Do they serve the laws of health in diet? Do they make wise and healthy use of their most precious leisure?
I could extend my list of questions ad infinitum, but these are enough. My point is this. It is little use knowing the rules of health unless you obey them. Knowledge, of course, is good, for knowledge is the basis of all improvement. But a very wise man once said: "Knowledge grows but wisdom lingers." That is where more people fail in respect of health, and that is why I say that the real and living Health Sense has still to be created in this country.
Mere knowledge is not enough. We all know the Ten Commandments and yet it is obvious that they are not frequently broke. The religion of health also has its Ten Commandments, and, speaking as a health enthusiasts, I say that I heartily admire the practical wisdom of the old Hebrew lawgiver who included the sanitary regulations of the Book of Leviticus as an essential part of the religious ritual of the Jews.
It was a sheer disaster for the sanitary health of Christendom that a critical moment in its history scrupulous cleanliness of the body came to be regarded as carnal indulgence and the loathsome hair shirt – unchanged for ten, twenty or thirty years – was looked upon as a proof of holiness. I know the historical explanations, of course. All say is that the consequences were fatal to the health of the centuries that followed. Consider how different the whole sanitary history of Europe might have been if the churches had always preached the doctrine that Cleanliness is next to Godliness, which they did not for centuries. Next to Godliness, observe – next to it, and indeed so close to that today the maxim which would have been regarded at one time as an impiety is now accepted as an obvious truth. I do not think anyone will challenge the statement that any religion is gravely incomplete if it does not recognise, sanction, approval and proclaimed the laws of bodily as well as spiritual health.
I hope that I make full allowance for the indifferent and too often unwholesome surroundings which handicap so many who try to live according to the rules of health. Many gallant souls are broken out right in the struggle. But even now in the worst places there is usually to be found a dauntless minority who make a brave show for decency and cleanliness. These are days they who have the sense of health which, if it were widely diffused, would lighten to an incredible extent the work of the Sanitary Inspector, the doctors and the hospitals.
A greater discipline is needed, a more disciplined life and conduct. Perhaps I'm a make it more palatable in this democratic age if I say self-disciplined? Democracy shies that the word Discipline like a timid colt, as though it implied infringement of his personal freedom. Yet democracy makes a rare mess of things without discipline. Just consider the painful ill success of the campaign against litter in the streets the parks and the countryside. This is a sheer loutish refusal of discipline in one of its simplest forms, and it is utterly perverse and senseless because litter is displeasing to the eye and no man can seriously suppose that he is exercising the right of a freeborn democrat when he stews the pavement or the green with cigarette boxes or orange peel.
And the same British public has dropped within little more than a generation the disgusting habit of promiscuous spitting. This is a remarkable case of the triumph of self-discipline, for which no praise can be too great. To what is due? Partly, I believe, no doubt to the deep impression made on the public mind by the discovery of the dreaded bacillus of tubercle and the proof that the habit of spitting conduced to its widespread diffusion. The white scourge of tuberculosis or consumption was known and dreaded in too many homes in England for such a hope for discovery to pass unheeded and the campaign against spitting had a marvellous success. I suppose that today you would have a difficulty in being able to purchase that once familiar and hideous article of domestic furniture, the spittoon, which the most dignified name of Cuspidor was given on the other side of the Atlantic. The younger generation can hardly conceive the change that has been wrought in the cleanliness of railway carriage floors or the street pavements.
Here then is encouraging proof that self-discipline can be acquired in the interests of health, though it is only right to remember that simultaneously there has been a great change in the smoking habits of the people and that the virtual disappearance of the short clay pipe and twist tobacco and the universal spread of the cigarette habit, have powerfully contributed to the same happy results. It is not indeed a crowning mercy that the cigarette can be smoked almost continuously without creating the desire to spit?
An eminent Professor remarked the other day that "in order to secure the submission of the Anglo-Saxon to discipline you must call it by some name which disguises the fact that discipline is what he is submitting to." He added that the most popular name with the public is education. That shrewd saying bears out my argument that a real health sense has still to be called into being among the general mass of our people and that self-control must begin in and with the body. We are suffering from undisciplined minds and from undisciplined bodies and while we do our best and the most for the improvement of both, it is with the discipline of our bodies that we should primarily be concerned. Let me put it in a homely way that all will understand – we have to learn how to digester our pudding and what pudding we can best digest.
Remember too, that never before in human experience has the health of the individual being so largely in his own hands to make or mar. He can now, if he chooses, the captain of his body as well as of his soul. Not, of course, absolutely. Men being mortal, will always be subject to the rule of morality by natural decay. But it is now within a man's power curiously to hold these processes of decay in check, to oppose retarding forces and retain a maximum maturity over a much longer space of time. We cannot indeed escape the accidents of morality; we remain subject to the caprice of chance which still, as in the Bible story, finds two working in a field and one is taken and the other left. We remain the target of the slings and arrows of outrageous fortune which with the complete unconcern makes strike you down and pass me by. We are still liable to be the innocent victims of the recklessness and folly of others. Your neighbour may be a fool or a madman and his escapades may cost you your life. You may be immune from 100 diseases and for like a child to the hundred and first. Nevertheless, it is true, as I have said, that your health is in your own hands, with laws and bylaws and the whole battalions of inspectors to protect and shield you from harm. The child born today has an expectation of 20 years more life than his grandfather. We have lengthened our days by taking thought and those who are born fifty years hence will certainly be the heirs of yet another span. But if it is not also healthier in a much fuller sense than is implied by mere survival, I am inclined to think that the extra years will only be a burden and a drag.
You will remember the Biblical phrase of having life more abundantly. That is what I have in mind. It is not life itself that is the boon, but the content of life, how you are able to use it, and with what pleasure and satisfaction, with what activity of mind and body. That is what I call health. Merely to vegetate in one's declining years, to die by slow and apathetic inches, to fight a stubborn rearguard action against death, when the real purpose of life is lost and one is a useless cucumber of the ground. That is worth nothing. The ambition of all should be life to be the last enjoyed, life active to the end, and even when activity wanes, through weakness, then serene and calm. This, I say, is a perfectly realisable ideal by those who guard their health, not as Valetudinarians who are, as you know, a garrulous, peevish and selfish race, but as men and women who love life for the joy and happiness that it has given to them, and are ready for this summons, whether to stay or go. Live, said the Roman poet, as though each day has dawned for you the last. That is the Christian ideal as well. In fact, it is the ideal of the best minds of all time.
If the viewer a brief extract from the delightful essay old age which Cicero composed more than nineteen centuries ago. It is so modern in tone that it might have been written for your morning newspaper by an apostle of a New Health Society. The words are put by Cicero into the mouth of the veteran, Marcus Cato, who is discussing old age with two young friends who have come to visit him, and the passage runs as follows: –
"It is our duty" he says, "to resist old-age, to compensate for its defects by watchful care; to fight against it as we could fight against disease, to adopt a regime of health, to take moderate exercise, to eat and drink no more than is sufficient to restore our strength and two over task it. Nor indeed must we can find our attentions to the body, even greater attention should be given to the soul and to the mind. For these become extinguished by old age like lamps, unless you replenish them with oil."
There, expressed with singular charm, as are the very latest principles of the health experts of the present age. I would gladly quote their passages from the same treatise, but will content myself with the anecdote told of Gorgias of Leontine, who lived to be 107 years old and remained an eager student of philosophy all his days. The friend asked him why he chose to go on living so long, and is and so was "I have no cause to reproach old-age."
A notable answer and worthy of a sage! Without regret for vanished youth and manhood, this Grand Old Man of the ancient world was still content to enjoy with unclouded mind the vision of the glory of the world. I do not know any story which better illustrates the ideal of the healthy old age when the machine is slowly running down. The Psalmist was not at his best when he said that after seventy man's years become heaviness and sorrow, and the sound of a grasshopper a burden. At any rate, let us who believe in the Gospel of Health welcome – even when we are past ninety – the chirp of the Cicala and the cheerful chatter of the sparrow on the house top.
Long life, I repeat, is not a boon but a curse unless it can be enjoyed. To live on and to lose the causes and purposes of life is a useless bore. It gives me no satisfaction to read of the octogenarian's and non-octogenarian's who survive bedridden for ten years or more in the wards of the infirmaries. I still see less reason for congratulation when I read of new institutions rising on all sides for the mentally deficient. This is not life. Nor do I call life the dull existence of the C3 population who are never well, who have lost the power to make a sustained effort, who cannot maintain themselves even in their general incapacity and inefficiency, and who are a burden to themselves and to those to whom they are dependent. This is not life. For how long should you reckon what it is to live? I will tell you in the words of a poet who once lived in this city of Nottingham to which I belong.
"We live in deeds not years, in thoughts not breadths,
In feelings, not in figures on a dial;
We should count time by heartthrobs. He who lives
Who thinks most, feels the noblest, acts the best."
It is possible, of course, for exceptional strength of will to overcome physical disability and for man's unconquerable mind to triumph over extreme weakness of the body. Let me recall one or two examples for your encouragement. Fifty years ago there was a famous Oxford Don who lived for years and received his pupils reclining on a sofa which he never left except to be carried to his bed. An athlete in his youthful days and an Alpine climber, a single night’s exposure on a Swiss mountain had deprived him of the use of his lower limbs. Yet his brain remained as clear as ever and he bore his terrible misfortune with perfect self-control and cheerful courage.
Arnold Hills, the shipbuilder, was another similar case. He, too, was paralysed in his lower limbs yet never allowed his disability to affect his rules of conduct and life. His fortune is the most striking because in business he was committed to a forlorn hope. His shipyard had been established in the days of sailing ships, and for his purpose was badly placed because so far distant from the sources of iron and coal. But Hills would not give up the old tradition of a flourishing shipbuilding industry in England's largest waterway, and fought on until he could fight no more.
Yet another great industrialist who would not strike his flight to the remorseless advance of disease in its most crippling form was the late Lord Trent, properly better known by the name to most of you as Sir Jesse Boot, the founder of the firm of manufacturing chemists with retail shops in every town of the country. For the last years of his life, he was so terribly stricken that he could not move a limb and was as helpless as a battered hulk on the seashore. Yet his brain never ceased to plan a more perfect organisation for the great business which he had founded in health, and a wider range and scope for the philanthropic institutions on which he had lavished his wealth.
And I would like to mention the same connection the case of the late Lord Curzon. He was one of the most ambitious public men of his times, and a tireless worker. But I wonder how many of you who remember him chiefly for what seemed to be a supercilious air of pride and superiority are aware that he suffered throughout his life from painful weakness of the spine which would have killed ambition stone dead in most men and reduce them to querulousness, and that is most splendid and polish orations were often composed and delivered in circumstances of acute physical pain.
Occasionally, too, we see in the newspapers brief obituary notices of men and women who have been the lie to their homes and the joy and inspiration to their friends, through the threads which bound them to life will born to the latest degree of tenuity and pain and weakness were their constant companions. Such a rare and choice spirits by their triumph over suffering should teach us how to endure when all the blandishments of life seem to be gone, and we should be grateful for their shining example.
Then still the hard fact remains that these are the expectations which proves a general rule that when health is broken a man's life is finished, and his usefulness done. Almost automatically drops out of the active list. In the industrial system if the wheel did not turn freely because of the damage cog, the cog is at once displaced. The machine cannot be sacrificed to the individual.
For many years the industrial system has been required to contribute to the cost of carrying out its own invalids, just as any army must carry its own sick and wounded and those who are temporary hors de combat. That is just and proper. But is it any less just and proper that these industrial invalids, actual and potential, should recognise their personal obligation to the industrial system. What, you may ask, is that? It is to keep themselves in health to the utmost of their power, for the good of the machine as well as for themselves.
In these days we think too little about our own obligations to the State in respect of health, though we require no reminder of what is called the States duty to us. If we are ill, we say that the State, in his own interest, should providers with medical attention and with a hospital bed if our case is serious. We almost expect it is our right that the larger share of the costs shall be provided out of other pockets than our own. Indeed, there are those who demand that the State should meet the entire charge.
As to that, my view is that while it is too duty of the State to see that no one in his hour of need lacks medical attention, and that institutional treatment is available for those in extremity, though ought to release the individual from his personal duty to keep himself in health and contribute what he can to the cost of his medical treatment during illness.
What is health? it may be asked. Well, there are some things which you cannot well define but which are unmistakable when seen or felt. "They are best recognised when they are lost. Health is one of them. Not until things go wrong and do we appreciate what precious thing it is.
It is difficult not to feel a pang of envy mingled with regret when we watched trained athletes or young people in perfect physical development, playing games or taking exercises which demand complete fitness of body and muscles, and suddenly realise our own utter inability to imitate even their simplest and apparently most effortless movements. When you find yourself panting if you have run 20 yards or have mounted 20 steps on the staircase; when you have put forth an exertion to rise from a chair; when you cannot get down to stop the slowest moving ball, or when you begin to develop a liver or rheumatic pains, it is then that you realise what health and fitness mean.
Man is said to be fearfully and wonderfully made. Man is also constructed that it is fairly easy for the organs of his body to function imperfectly if they are not subject to faulty or imperfect usage. As a rule, though not always, they give you unmistakable notice when you are not dealing fairly with them. I say, therefore, take heed of those first warnings if you value your health, and ask yourselves what they portend.
A famous Dean of St Paul's in the reign of James I Dr Donne, wrote versus full of odd conceits and paradoxes. I remember for lines in which he says: –
"There is no health. Physicians say that we at best are only a neutrality
And what can be worse sickness than to know
We are not well, and never can be so?"
If that were true, no sickness could indeed be worse. But, of course, it is not true, in a practical sense. Can we be well; the majority of us are well until we begin to sin against the laws of health, and we can and ought to be better than we usually are from the cradle right onto the grave. It all depends first on knowing how to be well, and second, on putting that knowledge into practice. Most of us, I suppose, fail chiefly in respect of the second. We see and approve the better course, but we pursue the worst.
Health is a just balance, a timely coordination, a nice equipoise of functional activities. And since we have been given not only bodies but minds, there can be no complete health unless we have a sane healthy mind in a healthy and sanitary body.
I should be inclined to put it this way, that a sound body is of little avail without a sound mind, which, in its turn, is equally dependent upon the maintenance of a just balance and harmony, in the body, to achieve a quiet mind – however active mind – free from the distraction of anxiety, and mind truly at peace with itself – that is essential to full health and to full bodily well-being.
We must not expect the impossible. No one in these anxious days can expect to be wholly carefree. But there is a world of difference between a mind which can face commonly and everyday difficulties of life and confront its major crisis with fortitude, and a mind which is in a perpetual worry and fret, which is scared that the prospects of having to make a critical decision, or which is obsessed by real or fancied terrors.
Probably most of you know that a depressing and deadening influence can be cast upon the spirits of the domestic household by the mere entry of a single confirmed and incorrigible pessimist. It darkens the sun at noon day; it chills the midsummer air; it wraps you in a fog and mist. A cheerful equable temper, equanimity in the largest sense of the word, is a priceless boon.
Cheerfulness, I think, is more precious for domestic health and happiness even than wisdom. It is one of the essential ingredients of health. Again, an equitable and cheerful mind is devoid of fear. Fear is the arch enemy of mankind. No man is free until his rid himself of fear. If he is in the thrall of fear, the deposit is a slave.
Fear, too, that is one of the more potent contributors to disease. Cast fear out of your minds and you gain a surprising immunity. If you face the issues of life unafraid, you will have a strong defence against most of the ills to which mankind is subject.
And as I have ventured upon a little moralising, let me also beg of you, in the interests of your bodily health, not to envy and not to hate. These are not only ugly vices of the soul; they are deadly enemies of health. They spoil digestion. Just listen to the poet and forgive me if I quote amiss for alas I have lost the reference: –
"Oh do not hate! For it rumples sleep.
It settles on the dishes of the feast.
It specks the fruit. It dips into the wine.
I rather have my enemy hate me
Then I hate him."
There is something more than good morality. It is first-class medical advice.
You may ask me for a simple rule of health by which to regulate your daily life, I think I could do better than recommend the maxim of the old Greek philosopher, who crowded to some of all practical wisdom into two short words –Meden Agan – Nothing too much. Moderation in all things, nothing in excess. They show self-control in the use and enjoyment of the good things and pleasures of life under reasonable attitude of mind towards all things, for "Health consists with Temperance alone." Can modern philosophy improve upon a precept which embodies the calm assurance of reasoned judgement and consorts perfectly with the latest discoveries of Science? I know that some good people believe that no commandment is complete without its "Thou shalt not" and detect some special virtue in rigid abstinence from the things which the generality judge to be pleasant.
With all respect, I do not agree. Of course, if it is a choice between an injurious self-indulgence and an enforced abstinence, then I stand with them strong on the side of abstinence. All injurious self-indulgence is opposed to the rule of "Nothing too much." It is also an excellent discipline to test one's power of resistance by occasional abstinence and it is useful to remember that the philosopher, who advocated pleasure as the paramount object in life, was careful to add that the supreme pleasure of all was to be able to do without. Nevertheless, I have observed as a general rule that austerity of life as opposed to Temperance of life does not make for cheerfulness or for the happiness of one's family.
But if you want health, avoid excess. That is nature's law. Break it and sooner or later you suffer, and in many cases it is fortunate if the penalty comes soon, for nature commonly reserves her severest strokes for the old offender.
Observers, too, that ignorance is no excuse. Nature is concerned more for the species than for the individual. Her care is for the race, not for Mr Jones or for Mr Smith. It is useless to plead ignorance at her bar. Indeed, whatever you plead, nature does not hear, or if she hears, she gives no sign.
Moreover, there is little or no excuse for ignorance in these days. What excuse, for example can there be for ignorance in the matter of dirt? Judging by the popular press, diet is a topic almost as absorbing as crosswords, or racing, or sunbathing. You cannot get far away for long from patient foods and vitamins, the perfect diet for hot and cold weather, the best way of dishing up a sardine, or the powerful virtues of orange juice and nuts. Health societies exist for no other purpose than to give you advice on how to dress, and how to take exercise, how to cook, how to clean your teeth, and brush your hair. The human race, with such tuition, ought to be making visible strides towards greater physical perfection.
And so, in fact, it is, for unquestionably the general standards of health and fitness are much higher today than they were a generation ago. It is not only that people live longer that they live better, then it would be a disgrace if it were not so, when we consider how many millions are spent on popular education and how freely the results of all scientific discoveries are canvassed in the newspapers, magazines and books. All who can read with discrimination and not confused and distracted, as last numbers are, by the multiplicity of the exhortation's address to them in every variety of tone from entreaty to menace, have the gospel of health preached to them daily.
Yet it is almost incredible how human folly persists; how careless the majority still are in the diet and what complete lack of judgement is displayed by a multitude of women in the choice and preparation of food. No doubt, certain excuses can be urged, such as in different cooking, accommodation, lack of training, the pressure of other duties, etc., etc., but I am not at all satisfied that these excuses are not in large measure brought forward in order to mask the growing distaste of the actual work of the kitchen. The food of the British people, as it comes to the table, does not, I fear, compare favourably with that of the many other nations. Yet food used to be cheaper in this country and it is to be had in greater variety here than anywhere else. The British people, therefore, ought to be the best nourished in the world. Yet I doubt whether that distinction is theirs.
One of the most valuable contributions that the women of Great Britain could make to the health, and wealth and happiness of their homes lies here – in the choice and preparation of the most nourishing and appetising foods. When you know how, it is just as easy to buy right as to buy wrong; to cook well as to cook badly. And may I, somewhat selfishly perhaps, add this you – that the male appreciation of good food never fails from meal to meal.
If you would like to hear what are the principal defects of the ordinary English diet, I would quote to you the considered opinion of one of the best living authorities on the subject, and one who has perhaps done more for the prevention of rickets in children than any living man. He says that proper feeding in infancy and in adolescence is the royal road to the prevention of many of the commonest causes of ill health and he finds that two main defects in the English diet.
The first is that it contains too little of such foods as milk, eggs and vegetables, cheese and fruit. The second is that it contains too much bread, rice, oatmeal and other cereals.
I beg of you, as you value the health of your children, to pay attention to those two defects – too much bread, rice and other cereals and too little milk, eggs, vegetables, fruit and cheese, of course I know they can't be obtained now.
I sometimes hear people saying confidence that they have not lived to be 40 or 50 years old without learning what is good for them and what is not. That wise man, Francis Bacon, said very much the same three centuries ago. "A man's own observation," he wrote, "what he finds good of, and what he finds hurt of, is the best physic to preserve health." Yes, but how many people can you trust to draw the right conclusions? They are often most wrong when they when they are surest that they are right. You should, also includes them among your rules of life unhesitatingly the role of the open window and the healing influence of light.
Don't become faddists in diet, making mealtimes and misery to others as food-faddists often do. They cultivate a suitable diet in the lines suggested and you will find that it is also a protective diet. It is immensely important to children and to no less important to women in pregnancy, for defects of diet frequently results in structural malformation and later liability to disease. And this also no longer admits a doubt that while certain diseases are directly due to the deficiency of certain vitamins in the food, these same deficiencies will render you less able to resist the onslaught of a whole range of infective diseases and will weaken the hour to hour defence which you have two maintain against the persistent attack of these parasitic enemies within the body which produce, unless successfully combated, a grisly troop of horrid disorders.
Science, therefore, does not demand that you should perform hard, impossible feats, if you are to guard and maintain your health. It does not tell you that you need a generous diet, expensive food and costly drinks, which you cannot afford, or get day-to-day, unless you have the purse of Fortunatus. There is no one in receipt of a living wage who cannot afford the articles of diet which I have mentioned. If you were prepared to take a little trouble, you could, before the war, insist on getting nothing but good wholemeal bread instead of white bread, from which most of the natural goodness has already been extracted. Nearly all of us like fruit, and thanks to science, almost all of the fruits of the earth, I hope, will soon be at your service throughout the year.
I remember an old rhyme originally derived from a mediaeval jingle which came from a once famous medical school of Southern Italy. It sang the praises of three celebrated doctors. One was Dr Diet; the second was Dr Merriman, and the third was Dr Quite. They formed a perfect partnership. There was much good sense in the old popular sayings:
"This surest road to health, say what they will,
Is never to suppose we shall be ill,
Most of those evils we poor mortals know
From doctors and imagination flow."
You see that they poked fun at the doctors and at the folk who brooded over their imaginary ailments until the actually brought on the illness which they feared – a perfectly common occurrence. They recognised too, the value of exercise. Listen to Glorious John.
Better to hunt in fields for health unbought
Than the fee the doctor for a nauseous draught
The wise for cure on exercise depend,
God never made his work for man to mend.
I do not recommend a last line without a caution. Dryden manifestly had not grasped the distinction between preventative and curative medicine.
I have tried to explain to you the supreme importance of preventative medicine, to which more and more the attention of the Ministry of Health, and that of the medical profession generally, will, I am sure, be directed. Prevention is better than cure, and if medical science had always gone, principal, the present health of our people would be infinitely better. But the era of preventative medicine has really begun. The scientists in their laboratories are the men to whom you should pay homage – and the men of whom you never hear except on rare occasions – those who discover the nature and causes of things and penetrate even more deeply into the secrets of life.
Don't grudge money and expenditure on health. But don't make the ridiculous mistake of supposing that an effective Health Service depends principally on the number of its officials and inspectors. It doesn't. Advance will depend primarily on the development of preventative medicine. And after that it will depend for its practical success upon yourselves.
If you will carry out the simplest rules, you can work a revolution in your own health, and in that of your families. If you don't, you have not sufficient self-discipline to school yourselves and order anew your manner of life, then you will have to pay for your follies. You will find your health decay, and you will slip back into the role of the older generation and find yourself pinning your hopes on the old fetish – the bottled medicine – to restore to you the boon which you have thrown away.
I read the other day of a fine soldier who gave this counsel to his sons – "Fear God, but take your own part." Those wise words are readily adaptable to rules of Health. Those who keep the Ten Commandments are reckoned better lives by an insurance company than those who break them.
Keep your affections at home.
Keep yourself and establish a strong self-control.
Remember that health is a rhythm, not a jazz.
You have a motherly – sometimes a grandmotherly – State. You have an efficient and watchful Ministry of Health and Medical Officers of Health. You are guaranteed against the perils of an impure water supply and bad drains. You are protected against infection and contagion.
But do not rely too much on others. Be vigilant guardian of your own health. Take your own part and let it be an active one, and even if you cannot be sure of grasping Glory with your left hand, you will have done all you can to grasp length of happy and healthy days with your right.