LIBRARY OF THE University of California. Class m Digitized by the Internet Archive in 2007 with funding from Microsoft Corporation http://www.archive.org/details/childrenofnationOOgorsrich THE CHILDREN OF THE NATION THE CHILDREN OF THE NATION HOW THEIR HEALTH AND VIGOUR SHOULD BE PROMOTED BY THE STATE BY THE RIGHT HON. SIR JOHN E. GORST NEW YORK E. P. DUTTON AND COMPANY 31 West Twenty-third Street 1907 C- I DEDICATE THIS BOOK TO THE LABOUR MEMBERS OF THE HOUSE OF COMMONS, IN TOKEN OF MY BELIEF THAT THEY ARE ANIMATED BY A GENUINE DESIRE TO AMELIORATE THE CONDITION OF THE PEOPLE CONTENTS CHAPTER I PAGE Introductory ....... i Reasons for interference — Public safety — Public economy — National interest — Intervention of charity CHAPTER II Infant Mortality . . . . . . .15 Decrease of birth-rate— Condition at birth — Death-rate — Em- ployment of mothers — Plans for reducing the death-rate — Artificial feeding — How people should be taught — Survival of the fittest — Pure milk — Municipal supply CHAPTER III Children under School-age . . . . .33 Parental care — Fresh air — Food — Medical supervision — Origin of infectious disease — Double government — Nurseries — Parental responsibility — Infant insurance CHAPTER IV Medical Inspection of School-children . . .50 A golden opportunity lost — Passing the doctor — Glimpses of deterioration — Powers of the Board of Education — Remedial measures — Official visitors of school-children's homes — Man- chester Ladies' Health Society — Visiting Committees of the London School Board vii viii CONTENTS CHAPTER V PAGE Underfed Children . . . . . .67 Revelation apprehended from medical inspection — Number of ill-nourished children — Children's rights — Parent reforma- tion — Free Feeding — Home influence — Proper diet — Delay dangerous — School meals — The official circulars CHAPTER VI Overworked Children . . . . . .91 Labour out of school-hours — Mrs. Hoare's deputation — Educa- tion Department return — Reception of the return — Joint Com- mittee — Theatrical children — How the Act is administered — By-laws — Child labour in Berlin — Incompetence CHAPTER VII Children's Ailments . . . . . .108 Heredity — Diseased glands — Adenoids — Tubercle — Heart disease — Rickets— Eyes— Ears— Teeth— I nf ectious disease CHAPTER VIII Medical Aid . . . . . . .125 Existing provision — Workhouse infirmaries — Charitable hospitals — Friendly societies — Municipal hospitals — Free medical aid — State insurance against sickness — Testimony of Birmingham brass-workers CHAPTER IX The Forest School at Charlottenburg . . .153 Origin of the idea — Establishment of the school — The buildings — Lessons — School life of the children — The teachers — Visitors to the school — Medical treatment — Health results — Education results — Cost CHAPTER X Infant Schools . . . . . . .172 Mothers must work — Premature schooling — Practical com- pulsion — Injury to mind and body — Corporal punishment — Baby-rooms — School offices — Infant nurseries CONTENTS ix CHAPTER XI PACE School Hygiene . . . . . . .189 Ventilation— Warming— Water— Lighting— Desks— Playgrounds CHAPTER XII Physical Training ...... 202 Its conditions — Military drill — Swedish drill — Jiu-jitsu — General requirements — Neglect of physical training— Evening classes — Hooligans CHAPTER XIII Factories and Mines . . . . . .216 Child workers — Factory legislation — The Berlin Conference — British faith — Mines — Hours of labour in mines CHAPTER XIV State Children ....... 227 Derelict children — Evading responsibility — Out-door relief — State children in workhouses — District schools — Village com- munities^ — Scattered homes — Boarding out — Dr. Barnardo's Homes CHAPTER XV Hereditary Disease ...... 247 Causes of hereditary disease — Alcoholism — Sj r philis — Ravages amongst children — Preventive measures — Hospitals — Detention CHAPTER XVI The Home ........ 262 Its antiquity — Overcrowding— Municipal activity — Apathy of the people — Stimulants to reform — New slums — Rural life for workers — The first Garden City — Garden suburbs — Housing in country villages x CONTENTS CHAPTER XVII PAGE Finance ........ 280 Cost of reforms — Direct and indirect taxation — Local rates — Popular delusion about rates — Local revenue — German system — Social reform Index . ..... 293 THE CHILDREN OF THE NATION CHAPTER I INTRODUCTORY THE object of this book is to bring home to the people of Great Britain a sense of the danger of neglecting the physical condition of the nation's children. These will form the future British people ; and upon their condition and capacity will depend not only the happiness of our own country but also the influence of our Empire in the world. No proper development of either their character or intelligence is possible unless their bodies are cared for first ; until this is done education, religious, moral, or intellectual, is an impossibility. It is true, as continually asserted by those who desire to renounce public responsibility, that the duty of bringing up children rests in the first instance with their parents ; but it does not stop there ; the State has duties also : it is under obligations, first, to see that the rights of children are not ignored 2 THE CHILDREN OF THE NATION or violated by their parents ; secondly, to give all possible help, by advice and otherwise, to parents in fulfilling their obligations ; and, thirdly, to perform the parental duties itself where, from death or incapacity, the natural parents fail. It is between birth and the age of sixteen or seventeen that the physical character is fixed for life, and it is mainly during this period that this book will discuss the condition of the rising generation of the nation's children, and will inquire what has been, what can be, and what ought to be done, to promote their growth into healthy and intelligent men and women. Reasons for Interference It is not necessary to trouble the reader with a preliminary discussion of the philosophic grounds which justify, and limit, interference with individual liberty. The right of the community to regulate health is in practice conceded. The doctrine of leaving matters to take their course is still occa- sionally invoked in opposition to some distasteful proposal of a particular reform ; but such an argu- ment has nowadays little practical weight. Our laws have already in so many instances prescribed the conduct to be pursued by men, women, and children for the preservation of physical health, that any reform now proposed can claim consideration on its own merits, and cannot be dismissed summarily by an appeal to general principles of individual liberty and independence. It will, how- INTRODUCTORY 3 ever, be useful to consider shortly in this preliminary chapter some of the principal grounds upon which the action of the community in regard to public health has proceeded in actual practice, and the motives which have impelled the State to recognise rights and create obligations between itself and in- dividual citizens. Public Safety Public safety was the first ground on which authority intervened to protect public health. When the plague and the small-pox spared neither noblemen nor kings, when the jail-fever, bred among the misery of the prisoners, took the lives of judges and counsel, it was time for the adminis- trators of government, who throughout the whole course of English history have belonged to the well-to-do classes, to bestir themselves and grapple with the danger at its source. A series of laws having this object in view has been gradually adopted ; and nobody will now dispute the general proposition, that society has the right to curtail the liberty of the individual to deal with his own body as he likes, so far as may be necessary to prevent him becoming a source of disease or physical danger to the community. About the moral expediency of suppressing a disease, or the efficacy of the means prescribed by law for that end, controversy may still rage in certain cases. The effort made by Government some forty years ago to mitigate the widespread mischief caused to the health of the 4 THE CHILDREN OF THE NATION people by a certain class of contagious diseases proved entirely abortive, and has been for many years discontinued. But the opponents of the Contagious Diseases Acts did not deny the general right of interference by public authority; their objection was based on two grounds : first, that for moral reasons the disease ought not to be sup- pressed by inspection and compulsory hospital treatment ; and, secondly, that the measures adopted were not proved to be efficacious. In quite recent legislation a novel principle of a somewhat similar kind has been introduced ; the individual himself is to be the judge of the expediency of remedies prescribed by law, and can exempt, not himself, but his child, from their operation, by declaring that he " conscientiously " objects to them. This principle has so far been confined to vaccination and small-pox. Indeed, it is only in regard to that particular disease and that particular remedy that consciences seem liable to be perturbed. The most ardent anti-vaccinator does not object to an injection of antitoxin if his child is suffering from diphtheria. But if the principle that conscience is to sit in judgment on the remedies of the physician were logically extended, it would render all attempts on the part of public authority to suppress disease abortive. Public Economy The second reason for the care of public health to which I shall refer is economy — economy, not for INTRODUCTORY 5 the individual, but for the State itself. Epidemics in particular are not only dangerous, they are also very expensive, and inflict a serious pecuniary loss on the whole people. But although the economy of suppressing infectious disease is not controverted, there is much difference as to the details of ad- ministration and the regulations under which public expenditure should be incurred for that purpose. The duty of caring for the public health is divided among many departments of the Central Govern- ment ; and the local administration is confided to two separate bodies, the Board of Guardians and the Sanitary Authority, which in towns is the Municipal Council. It is not surprising that the views of these two local bodies upon what is economy are sometimes in conflict. The Sanitary Authority, which has to provide out of the rates the cost of stamping out epidemics, is keenly alive to the economic advantage of dealing promptly with their first beginning. Their officers urge the poorer classes, amongst whom infectious disease is generally in the first instance propagated, to send for the doctor on the first appearance of symptoms which lead them to suspect infectious disease in their children. But the relieving officers, upon whom it is impressed by most Boards of Guardians that application for medical aid is an ugly symptom of pauperism to be at once sternly repressed, invoke all the deterrents at their command, to frighten the parents from following the advice of the sanitary officers. Medical relief is given on loan ; the debt 6 THE CHILDREN OF THE NATION so incurred hangs as a load on the struggling family ; the debtor is harassed by applications to pay instal- ments. If this involved a mere curtailment of beer and tobacco, it might not be so objectionable, but the money is often of necessity wrung from the scanty nourishment of a half-starved wife and children. The exigence of the relieving officer is by many Boards of Guardians stimulated by an allowance of 20 per cent, or so out of the sums he recovers. In other cases the parent who asks for medical aid for his child is required to appear before the Board of Guardians, missing thereby a portion of his day's work, and risking the loss of his "job " ; he incurs besides that social ignominy which attaches to parents who demand for their children that medical relief to which the latter are legally entitled. It is a mistaken sentiment, which many of the richer classes, to the detriment of their own true economic interest, sedulously foster. By means of this kind, a Board of Guardians in a rich part of London reduced the applications for medical relief from 4,246 in 1899 to 2,280 in 1901, and took great credit for the performance. National Interest There is a third and much broader ground than mere local economy that warrants public concern about public health ; it is the interest of the nation at large. This, however, cannot be invoked as an argument for attention to national health, without INTRODUCTORY 7 bringing upon its author the vague accusation of " Socialism," which to a public man is a calumny as terrible as it is unanswerable. It is without any doubt the interest of the community as a whole that every man and woman who contributes to the production of wealth should, when sick, be made whole and efficient as quickly as possible, and that every child should be so brought up as to grow into a healthy man or woman fit to be a strength, and not a burden, to the nation. The sick are of necessity during their sickness a pecuniary loss to society. They have to be fed, clothed, lodged, and cared for by the labour of others, to which, during the duration of sickness, they themselves can contribute little or nothing. It is therefore the common interest that this period of dependence should be shortened as much as possible. But a proposal for free medical aid in sick- ness, however consistent with true economy, would be dismissed by most people as flat " Socialism," and as likely, moreover, to injure the vested interests of the secretaries and officials of existing Benefit Societies. These objections are in many cases insin- cere, the real motive being to get rid without further examination of an obnoxious idea involving un- known trouble and expense. Otherwise the objector would be more ready to consider how thrift with a view to the exigencies of sickness could be pro- moted or even imposed by law as an obligation on all, and how the existing Benefit Societies could be made to fit into a universal scheme of insurance. This has been actually effected for many years in 8 THE CHILDREN OF THE NATION Germany, where upwards of ten million workers are insured, and have a right in consideration of their insurance payments to medical aid in sickness for themselves and their families, including hospital treatment, where required, surgical appliances, and any medicines or special diet ordered by the doctor. Amongst the children of parents who are too poor to perform their parental duty, or who wickedly neglect it, the cruel havoc which is wrought by starvation, by unsuitable food, by the conditions in which they live, not only in their homes, but in many of the public elementary schools, by accident, and by preventible disease, is now thoroughly well known. Many are killed ; this in the eyes of those who believe Great Britain to be overpopulated may be no economic loss. But many more survive and grow up into damaged men and women, who fill our hospitals, our prisons, our workhouses and in- firmaries, who remain a lifelong burden on society, and whose cost in care and maintenance to the community in mature age vastly exceeds the sum which, judiciously expended on them in their youth, would have turned them into useful members of society. "There are some folks," said a working man at a discussion of this subject, %i whom society has got to pay for either at the beginning or end of their lives ; and it is much cheaper to pay at the beginning." But the moment any proposal is made to deal with this diseased and neglected portion of our growing population, the cry of " Socialism " is raised by a class of philosophical philanthropists INTRODUCTORY 9 among the rich, and any attempt to treat this festering sore is denounced as " undermining parental respon- sibility. " That the objection is in many cases only an excuse for doing nothing and leaving the children to perish is shown by the fact that few of those who are loudest in raising this objection make any effort to enforce in the children's interest that parental responsibility the sense of which they regard as more important than bread to the hungry. It is now established beyond controversy that under our laws children have a legal right to be maintained by others till they are of age to maintain themselves. Maintenance includes food, clothes, lodging, and care in sickness. The obligation to fulfil this right rests in the first instance upon the parents ; but it does not stop with them ; it is one of the elementary duties of civilised society to protect the rights of every citizen, big and little, and to secure the per- formance of the corresponding duty. But in case of default by the parents, whether from poverty or neglect, the child has a further right of recourse to the State, and a legal claim to be maintained at the public expense. This is not " Socialism " : it is a description of the law of the land. The fact that notwithstanding this law children go about hungry and destitute under the eyes of public officials in the public schools was attributed by the late Presi- dent of the Local Government Board to " defective administration." Some clumsy attempts have been made since this dictum was pronounced to improve this defective administration and to amend a state 10 THE CHILDREN OF THE NATION of things not only cruel to the children and dis- creditable to our system of government, but also injurious to national interest. The method by which parental responsibility should be enforced will be discussed hereafter ; but it may be observed here that their duty to their children is already well performed by some of the poorest workers of this country, by the Jews settled in our great cities, whose poverty has caused them to be regarded by many as "undesirable aliens," and to a great extent by the poor Irish. Of the British parents who fail in their duty, a great number fail from mere ignorance, and if instructed and helped by public authority, by the visits of properly authorised visitors, would maintain their children in a satisfactory condition. Others are incapable of taking proper care of their children from destitution, and are entitled to public relief for themselves and their children. The residue, who are vicious, drunken, cruel, or negligent, are, as far as our imperfect information goes, only a small minority, not too numerous to be effectively dealt with. Intervention of Charity These, then, are the principal grounds on one or other of which collective interference with the duties and responsibilities of individuals in the interest of public health has been, or can be, justified — public safety, public economy, and national interest in having a strong and healthy people. But besides INTRODUCTORY 11 governments, central and local, there are other powerful agencies, coming under the general name of "Charity," which busy themselves in matters which concern the health of the people — Voluntary Societies, which care for women in child-birth, maintain and bring up infants, provide medical aid for the sick in hospitals and dispensaries, feed and clothe hungry and naked school children, and pro- vide better dwellings and healthier surroundings for all. As the operations of " Charity " and of Public Authority meet, conflict with, and overlap each other at every point of the field which is covered by the care of public health, some observations on the relation between the two are necessary in an introductory chapter. The motives which induce private persons to organise themselves, and contribute the necessary funds for the performance of work beneficial to the community at large, are deserving of the highest praise, and redeem the well-to-do classes from the charge of social selfishness. They feel constrained to do something to relieve their own consciences and to benefit their less fortunate brethren, and they respond to appeals for money with a benevolence which newspapers and public orators cannot too highly extol. Voluntary labour and voluntary sub- scriptions given to public purposes, our lifeboats, our voluntary schools, and our hospitals, constitute one of the best traits of our national character Miserable as is the condition of the poor in our prosperous and wealthy country, it would, in the 12 THE CHILDREN OF THE NATION absence of more energetic Government action, be more miserable still but for these philanthropic efforts. The Salvation Army and the Church Army have redeemed thousands of derelict lives ; Dr. Barnardo and the "Waifs and Strays" have rescued thousands of destitute children. But " Charity" is subject to serious drawbacks. Its efficiency is continually hampered for lack of means. A great part of the energy of chari- table people has to be expended in the collec- tion of funds. Bazaars, theatricals, concerts, and drawing-room meetings use up much of the time and money intended for the service of the poor. 1 'Charity" can seldom cover the whole ground; there are regions — and those the very places in which need and misery is greatest — where there are no rich and charitable residents, and where, therefore, "Charity" does not operate at all, or operates under great disadvantage. "Charity " has a tendency to sap self-dependence and to under- mine parental responsibility, which may in the long run produce bad effects on the character of the people. If a starving child be fed by public authority, the negligent parent can be made liable ; he cannot if the child be fed by a charitable society. Finally, when the time arrives at which the collec- tive nation awakens to its responsibilities and begins to fulfil those duties it has previously abandoned to private enterprise the existence of voluntary agencies, which can neither be ignored nor abolished, and the vested interests of their secretaries and INTRODUCTORY 13 officials, constitute an obstacle to reform and an excuse for doing nothing, which it is not always easy for the social reformer to overcome. Generous recognition by the Government of past services and an arrangement by which the zeal and experience of those who have previously been volunteers is still made use of in the public system is the proper course, but it is not always adopted. First jealousy, and then suppression of the voluntary system, is the common proceeding. Of this the recent history of education in England is an instructive example. Up to the year 1870 voluntary agencies managed the whole education of the people, first entirely at their own cost and afterwards with grants in aid from the Exchequer. In 1870 the nation awoke to its duty, and established School Boards to occupy the ground which voluntary agency failed to cover. Jealousy and rivalry between the two systems went on for thirty years. In 1902 an unskilful attempt, likely from the first to prove abortive, was made to fit voluntary schools into a national system and thus utilise the zeal which so long carried on national education by itself. Now it is proposed that the nation shall assume the sole responsibility for national education and the entire management of the public schools so long entrusted to others, and that voluntary agency shall altogether disappear. The same thing will probably happen to the voluntary agencies for promoting public health. So soon as the nation realises its duties in regard to this matter, charitable contributions will be 14 THE CHILDREN OF THE NATION gradually replaced by rates and taxes, the voluntary management by a committee of the local authority ; and if the zeal of private persons is still, as it ought to be, made use of, it will be as visitors to see that medical orders are carried out and as apostles of hygiene in the homes of the people, acting under public sanction. To such a consummation a large proportion of the richer classes would be sure to offer a determined resistance. It is one thing to dispense charity of your own accord to needy people who make no claim of right and who put forward no title but poverty and misery ; it is another thing to have your money compulsorily taken from you in the shape of rates or taxes to make good a claim of right which the poor allege to have been too long ignored and the justice of which is for the first time recognised by the collec- tive nation. A large number of the most vehement opponents of the right of starving school children to be fed at the public expense are themselves the most benevolent and praiseworthy supporters of free-dinner societies. They would think it better to let a child starve than undermine parental responsibility by giving it a penny dinner at the cost of the rates, but they lavishly support with perfect equanimity the complete destruction of the parental responsibility by charity. CHAPTER II INFANT MORTALITY Decrease of Birth-rate THE birth-rate in Great Britain, as in most civilised countries, is on the decline. The last rate published by the Registrar-General was the lowest on record ; and the birth-rate is much lower in country districts, where the death-rate of infants is lowest, than in the great towns, where it is highest. In this country no public inquiry has been made into the causes of this diminishing birth- rate, but in New South Wales, where, as in all the other Australasian colonies, a similar phenomenon has occurred, the matter was regarded as so serious that a Royal Commission was appointed, which extended its research into all the other Australian colonies and asked for and obtained a report from the Registrar of the Colony of New Zealand. From the evidence taken and the report made by this Commission it is apparent that this diminishing birth-rate is at the Antipodes due to a growing reluctance on the part of those classes of society 15 16 THE CHILDREN OF THE NATION which live in ease and comfort to incur the pains and troubles of parenthood. In the absence of any direct inquiry at home, it may not unreasonably be assumed that similar causes are in operation here. If that be so, it is in the richer, and not in the poorer, classes of society that the great diminution of births is taking place ; it is the former, not the latter, who are failing in the primitive duty of keep- ing up the British race. If those by whom our future citizens are now being bred are not the unfittest part of our people, they are at least those whose poverty makes them the least competent to provide the food, the home, and the other conditions of life which are necessary for children if they are to grow into strong and healthy men and women. This furnishes one of the strongest arguments of those who claim that the State should relieve the poor of part of the cost of feeding their children, just as it has relieved them of the cost of educa- tion. The poor, they say, bear in the interest of the nation more than their fair share of the burden of motherhood ; it is only right that the rich, who will not bring children of their own into the world, should contribute something towards the nourish- ment of the future citizens. Condition at Birth As the birth-rate dwindles it becomes more desir- able that the community should make the most of such children as are brought into the world. If it is true, as stated by public orators, that children are INFANT MORTALITY 17 a valuable national asset, it is one that we waste with the most reckless prodigality. Medical testi- mony assures us that 90 per cent, of the children born are at their birth fairly healthy and well nourished. When they come into the world the children of the rich are in their bodies little better than those of the poor. Hereditary disease, chiefly syphilis and alcoholism, are equally spread over all classes. Poverty and privation during gestation seems to affect the mother more than the child. By a curious law of physiology if nutrition is insufficient for both mother and child it is the former that is starved ; the latter gets the lion's share : the child thrives at its mothers expense. But from the moment of birth deterioration sets in ; and it is only in recent times that the public has begun to care about this or to do much to prevent it. How many infants perish by accident or lack of skilled assist- ance at the moment of birth we have no statistics to show. Commissions and committees have re- commended the registration of still births, but no Government has ever had leisure to attend to so trivial a matter. Besides the children that perish in child-birth, many are maimed for want of skilled help ; they come into the world alive, indeed, but so damaged as to be incapable of growing into healthy men and women, and remain a burden on society for the whole of their lives. The visit of a parish doctor or midwife, at the cost of a few shillings, might save the "valuable national asset," but it is not considered worth it. In Ireland women 18 THE CHILDREN OF THE NATION have a legal right to aid in child-birth, and obtain their right. In England they have the same right, but are deterred by the Boards of Guardians from availing themselves of it. Death-rate But besides the unknown losses by still births, amongst those children who do come alive into the world the mortality during the first year of life is appalling. In spite of the great reduction in the general death-rate, which in recent years has been brought about by greater attention to public health, the infant death-rate has not shared in this reduction, but has, on the contrary, shown a tendency to increase. Great Britain is in respect of infant mortality by no means the worst of the civilised nations. Percentages give a very in- adequate conception of this frightful mortality ; but as compared with the average annual mortality in Great Britain of 16 in the thousand, the death- rate per thousand of infants under a year old is given by Dr. George Newman, in his book on Infant Mortality, as follows : In Russia, 272 ; in Austria, 227; in Germany, 195; in France, 158. In Scandinavia the rate is much lower; the average for the years 1 893-1 902 was for Sweden 99 and for Norway 94. In New Zealand, during the same period, it was 82. In England and Wales it was for the same period 152 ; in Scotland, 127 ; and in Ireland only 104. In different parts of the INFANT MORTALITY 19 United Kingdom the rate varies greatly : for the five years 190 1-5 it was 91 in Wiltshire and 163 in Lancashire. It is exceptionally high in all manu- facturing towns, especially those where textile industries flourish. In Burnley in 1904 it was 233, and the Medical Officer of Health for Birmingham reported in 1905 that in the parish of St. Mary's, in the centre of that city, it was 331. These are average figures which include the whole infant population, rich and poor. But I am assured by doctors who are in actual practice in our cities that such figures give no idea of the infant mortality amongst the poor, and that they know of streets in which more than half the children born alive perish under a year old. Royal Commissions and Parliamentary Committees to inquire into the causes of this frightful infant mortality have been talked of, but in our country at least there is no mystery to explore. Employment of Mothers The main cause, before which all others sink into insignificance, is that the arrangements of modern society require mothers to labour for the sustenance of their families in factories, work- shops, and other places away from their children and homes, and thus neglect their duties to their new-born babes and rob them of their proper food. It is not their fault. The wages they earn are necessary to the support of their families, and if they were to cease work, forego 20 THE CHILDREN OF THE NATION their wages, stay at home, and suckle their children, their families would sink into poverty and destitution. But the new-born infant has to begin life by being sacrificed to the rest of the family. It is robbed of its mother's milk, it is deprived of its natural protector, and it has to be handed over to the care of others who are often ignorant and indifferent. Any one, however unfit, may in this country under- take the daily charge of little children ; abroad, they must generally be licensed. We hear nothing of undermining parental responsibility when the renunciation of maternal duty is useful to the industries of the country, and serves the interest of employers. So long as the workers themselves permit such a state of things to continue, whereby a working woman has to attempt the impossible task of combining the function of nursing-mother and bread-winner, so long will excessive infant mortality prevail in all the great centres of industry throughout the world. Many attempts have been made to deal with this evil by legislation, chiefly in the interest of mothers, but to some small extent in vindication of the infant's right to its mother's care. The subject was much discussed in the Labour Conference at Berlin in 1890, and a restriction by law of women's labour at the time of child-birth was unanimously declared to be desirable. In the United Kingdom, and in most countries of Europe, laws were afterwards passed to make the employment of women for one month after delivery illegal. In Switzerland a two months' INFANT MORTALITY 21 cessation of labour was prescribed, of which six weeks must be after child-birth. The law in our country has proved a dead letter. It was six years before the first prosecution was instituted by the lady inspectors of the Home Office in a Yorkshire town. The employer was convicted and fined, and the unfortunate woman, though she made some attempt in the witness-box to screen her employer, was promptly dismissed from her employment. Up to the time when the Committee on Physical Deterioration sat, thirteen years after the law was enacted, it had only been possible to institute proceedings in two other cases, though the general disregard of the law is notorious. But, even if the cessation from labour, recommended by the Berlin Conference, could be effectively enforced, it would be useful to the woman only as protecting her against the ill-effects of premature activity ; it is too short to ensure to the child the mother's milk and mother's care to which it has a right. Laws of this kind can never be enforced until the senti- ments and habits of the workers themselves are altered, and these laws become unnecessary. Better views as to the duty of a mother to her new-born child, which still linger in our population amongst the Jews and the Irish, may hereafter become generally prevalent. Neglect of babies, however, is not con- fined to necessitous workers ; it prevails amongst other classes of society ; and mothers are to be found, even in the highest ranks, who deny to their infants their natural food because nursing them 22 THE CHILDREN OP THE NATION interferes with the claims of " society" and with the pursuit of pleasure. Plans for Reducing Death-rate The city of Cologne is provided, as are most German cities, with a body of official visitors of the poor, men and women of education and position, who are under a legal obligation to render service in this way to the municipality, and every poor woman on giving birth to a child is visited by one of these, almost invariably a woman. If the cir- cumstances of the mother are such that she is obliged to go out to work to earn her living, a report is made to the municipality, and a daily grant is sent in to her out of municipal funds, on condition that she stays at home and suckles her infant : the official visitor sees that the condition is fulfilled. Such a plan, common in Prussian cities, is worthy of notice on two grounds. First, it is a recognition by the State of the infant's right to its mother's milk, and of the State's own obligation to see that the right is fulfilled. In Western civi- lisation the admission in practice that it is the duty of public authority to help those who cannot help themselves is rare. In Oriental countries the proudest title of the greatest potentate is 44 Protector of the poor " ; and the Hebrew poet, when extolling the majesty of Jehovah, proclaims as his highest praise : " He is a father of the fatherless, and defendeth the cause of the widow, INFANT MORTALITY 23 even God in His holy habitation." The second point to note in the Prussian system is, that it brings home to the mother her U parental responsi- bility," and teaches her that her babe has the first claim upon her, even more than the rest of her family or her employer. Some of the Socialist Municipalities in France have adopted a similar system, and in the case of widows and others with children absolutely dependent on their earnings pay the mothers a pension to stay at home and mind their children. An interesting experiment was tried in Huddersfield in 1904-5. Mr. Broadbent, on being elected mayor on the 9th of November 1904, announced that he would give a prize of £1 to the mother of every child born during his mayoralty, in the district of Huddersfield with which he was connected, who produced it alive and well at the Town Hall on November 9, 1905. A committee of ladies was, at the same time, formed to visit and advise the mothers. Upwards of a hundred infants were produced at the end of Mr. Broadbent's year of office, and the death-rate of infants in the district sank from 134 to 54 in the thousand. So easily can the co-operation of rich and poor reduce infant mortality! So small a bribe will make the difference between life and death to these " valuable national assets " ! The Huddersfield example is being imitated elsewhere. It is a well-established fact that in our country the death-rate of illegitimate infants is double that of ordinary infants, enormous 24 THE CHILDREN OF THE NATION as the latter is. In Leipsic, every illegitimate child becomes on birth a ward of the municipality. Its condition is inspected by public officers from time to time. It may only be put out to nurse with persons publicly authorised. It is produced monthly at the municipal offices, and is there medically examined. The result is that the death-rate of illegitimate infants in Leipsic is half that of ordinary infants. Artificial Feeding In rearing infants there is no absolutely satis- factory substitute for mothers milk. The most scientific system of artificial feeding is but a poor, though in some cases unavoidable, makeshift. Statistics show that in the epidemics of children the percentage of deaths among the bottle-fed is far greater than among the breast-fed. It appears from some statistics published in 1905 by the Medical Officer of Health in Birmingham that out of 178 infants who died under six months old 16 were fed at the breast, 28 were partially fed at the breast, and 134 were artificially fed ; and the medical officer gives it as his general experience that in the diseases of infants the mortality is at least 30 times as great amongst those who are brought up by hand as amongst those who have been reared on their natural food. But as in practice a large number of infants have, in the arrangements of modern social life, to be brought up by hand, it is desirable in the interest of public INFANT MORTALITY 25 health that the knowledge of how infants should be artificially fed should be widely diffused among the people. The ignorance prevalent on this subject, not by any means confined to the poorest classes, is deplorable. " A little bit of whatever we have ourselves " is a common idea of an appro- priate diet for infants who should be receiving nothing but human milk. How People should be Taught New " syllabuses of hygiene " and fresh special courses in the elementary schools are a very in- effective method of spreading the information required. The fact that the scholars in the elementary schools are only little children, and the listlessness and stupidity to which the drill of the school system reduces them, are insurmount- able obstacles to the acquisition there of knowledge that will stick in their memories, and that they will have the capacity to apply, after they have left school, to the common affairs of life. The greater part of the teaching of cookery, sewing, domestic economy, &c, is practically thrown away, chiefly owing to the tender age of the children to whom it is taught. These special subjects of instruction used to furnish needy managers with the means of "earning" extra Government grants, and any limitation of the number of children who might be taught was vigorously opposed. In selecting subjects, those were often chosen in which there 26 THE CHILDREN OF THE NATION was the prospect of earning most, quite irrespective of their being suitable to the children's surroundings. " Navigation " was at one time a favourite special subject in Midland towns. There was once a school in Greenwich which selected " Animal Physiology" and ", English Grammar " as the subjects which offered the best prospect of a large subsidy from the Consolidated Fund. This was one of the results : A girl asked in the examination to describe the human body replied, in a written answer I have myself seen — "The human body consists of three parts, the head, the chest, and the ' stummick.' The head contains the eyes and the brain (if any). The chest contains the heart, lungs, and a bit of the liver, and the 'stummick' contains the vowels, which are 'a,' 1 e,' ' i,' ' o ' and ' u,' and sometimes ! w ' and ' y.' " The management of infants and other branches of domestic economy cannot be taught effectively to girls under the age of fifteen to seventeen, who can be tempted or compelled to attend evening classes or day nurseries. Perhaps the spread of enlightenment may hereafter induce young men to give a preference as wives to girls who have acquired the domestic knowledge which adds so much to the comfort of a home. Such a practice would give a great stimulus to evening classes on domestic economy, and compulsion would probably become superfluous. Knowledge can only be effectively spread by the supervision of young children in their homes, and practical teaching of INFANT MORTALITY 27 the young mothers there, after the manner of Huddersfield and Cologne. Such a system would save thousands of lives, if it could be established with due regard to the susceptibilities of mothers and to the sanctity of private life. But it is essential that the visitors should not be mere ignorant amateurs, but properly qualified to give advice and instruction, and should be acting under public authority. Its effect on the infant death- rate would be astonishing, as the Huddersfield experiment shows. w Survival of the Fittest An argument is frequently advanced by persons who desire to prove that, however praiseworthy it may be from a humanitarian point of view to save the lives of infants, it is bad economy, and does not promote the improvement of the race. It is an interference, they say, with the law of natural selection, which is the survival of the fittest : it is the weaklings that die off, the stronger infants survive. By keeping the * feeble alive, you cause the degeneration of the race. There is no informa- tion as to the comparative condition of the infants who live and die which enables us to bring this theory to the test of actual fact. But so far as our information does go, the argument is wholly erroneous. Medical testimony does not support the assertion that it is the weaklings who die off. Children at birth are generally healthy and well 28 THE CHILDREN OF THE NATION nourished, equally fit, equally likely to survive. It is the treatment they receive after birth, above all the insufficient or improper nourishment, that decides whether they are to live or die. Many of the fatal diseases of infancy attack weak and strong alike, and the power to overcome the disease depends in most cases on post-natal, not on pre-natal, conditions. Of all the causes of infants' deaths, diarrhoea is the most frequent, and is the one which is most on the increase. So far as it is epidemic it attacks all alike, and can level the distinction between strong and weak in a few hours. Its predisposing and exciting cause is improper food, and unless improper feeding is promptly stopped death is almost certain to ensue. But there is another serious objection to the comfortable doctrine of the survival of the fittest. It is that malnutrition and disease do not always kill. They cause thousands of infants not to die, but to grow up so damaged as to be a lifelong burden on society. Rickets is the direct product of insufficient and improper food ; the necessary nourishment is not provided for the growing bones. It is not an hereditary taint ; it is not the mischief of a microbe. Proper food will prevent it ; proper food will cure it, if taken in time. It is not fatal, yet thousands of children grow up more or less crippled by this disease, and so cause the greatest economic loss to society. They cannot, in many cases, earn their living at all ; in others, not the whole of it. But rickets does not necessarily kill ; its victims may live to a good old age. INFANT MORTALITY 29 Pure Milk It is of little use to spread amongst the people a knowledge of how infants should be fed if the right food cannot be obtained. The milk of animals, pure and properly prepared, is practically the only possible substitute for human milk : nothing else should be taken during the first six months of life. Whatever else is put into the infant's inside passes through undigested. It cannot nourish, but it may injure the delicate organs. In many places pure milk cannot be procured. What is to be got is dirty and polluted, rather poison than food to the infant. The Public Health Acts have given exten- sive powers to local authorities and to the Local Government Board, which can act independently of local authorities, in order to secure a supply of pure milk to the dwellers in cities, under the Contagious Diseases (Animals) Act, 1878. The Local Government Board has power to make orders for — (i.) The registration of cow-keepers, dairymen, &c. (ii.) Inspection of cattle in dairies, and for pre- scribing and regulating the lighting, ventilation, cleansing, drainage, and water supply of dairies and cow-sheds. (iii.) Securing the cleanliness of milk-stores, milk- shops, and vessels. (iv.) Prescribing precautions to be taken for pro- tecting milk against infection or contamination. 30 THE CHILDREN OF THE NATION (v.) Authorising a local authority to make such orders. They can, in short, protect milk, so far as protec- tion is physically possible, between the cow's udder and the baby's mouth. Under these powers many of the leading City Councils have secured in their towns a supply of pure milk, and have traced con- tamination to country places far remote from the city, and brought about the immediate removal of its causes. But in the smaller and less enlightened local authorities, where keeping down the rates is the one object of public administration, the powers are not put in force, and will not be until the people who elect these local bodies are awakened to a sense of what is for their own and their children's interest, and elect an authority which will attend to it. Meanwhile in these dark places infants must either be fed on other kinds of food unfit, to the knowledge in many cases of the mother herself, or be given milk which may be the vehicle of all sorts of diseases. No food is more chemically unstable, and more certain to deteriorate by exposure to the air, than milk. In nature it passes direct from the body of the dam to that of the suckling without a moment's contact with the atmosphere. Exposed in a shop and in a shallow vessel, it absorbs microbes at a rapid rate, as scientific analysis has proved. In London, medical testimony shows that milk contains great bacterial contamination. " Four unpreserved samples of milk, selected from two good-class and two poor-class milk-shops, gave an INFANT MORTALITY 31 average of 2,370,000 bacteria per cubic centimetre, which is about 2,000,000 in excess of what should be present in good, fresh milk." So testified Dr. Vincent before the Committee on Physical Deterio- ration, and, as a proof of the extreme ignorance that prevails even among the better class of dealers as to the precautions that should be taken to pre- serve the purity of milk, he instanced the practice of a prominent dairy company in keeping a wide bowl of milk standing on the counter of a shop in the West End within a few yards of a continuous and dense traffic. This they labelled " Pure Milk," whereas from the wide surface exposed to con- tamination it was imbibing the maximum of bacterial poison and " should be pitched down the drain." And mothers wonder where their children can have caught the diphtheria or scarlet fever of which they die ! Country districts are in the matter of milk supply even worse off than towns. In most of them milk — even skim-milk — is a luxury quite un- attainable by the poor. The great advantage which country children enjoy over town children in purer air and better surroundings is Jessened by the impossibility of obtaining suitable food. Municipal Supply Some of the most advanced municipalities have already established Municipal Milk Depots, in which pure milk mixed with the proper quantity of pure water can be procured in sealed bottles, each contain- 32 THE CHILDREN OF THE NATION ing a meal for an infant of given age. The price is as low as is consistent with the depot being self- supporting. From the point of view of public health such a system cannot be too highly com- mended. It removes the risks which the purest milk runs after it reaches the home of the consumer — the dirt of the house, the pollution from surrounding articles, the peril of the long flexible feeding tube, which cannot be kept clean, the possibility of mixing with contaminated water, or the keeping of milk till it turns sour. The supply of municipal meals for infants is at present experimental and exceptional. It is in the power of the people of any place to elect a local authority with a mandate to carry such a system into practice. CHAPTER III CHILDHOOD UNDER SCHOOL-AGE Parental Care BETWEEN infancy and the tender age at which we pretend to begin the " education" of children there is a gap. School is compulsory at five years of age ; it is permitted at three ; and it often begins some months earlier. But there is a space of about two years after the child has begun to talk and run about before the State concerns itself at all about its education. During this period, the child is left to the uncontrolled and unwatched responsibility of its parents. The public shuts its eyes, and hopes that all is going on well. In most cases this close-time of exemption from interference with natural growth and development is good for the child. If it gets wholesome food, however coarse, even though scanty in quantity, it thrives, provided that the first necessity of life is not stinted — abundance of fresh air. Fresh Air I have seen magnificent children living in hovels condemned as unfit for human habitation, in the D 33 34 THE CHILDREN OF THE NATION west of Ireland, models of health and vigour. The explanation was that they lived almost entirely in the open air. The children of gipsies and vagrants who live in tents on commons, though filthy and untaught, are far healthier in their free, open-air surroundings than the corresponding class in the slums of the city. It would be a cruel reform to drive these children and their parents into settled habitations until the houses of the poor are made compatible with healthy and decent life, or to coop up the wild children in our elementary schools until these are first reformed, and more attention is paid by the school authority to the health and vigour of the children whom it undertakes to 1 'educate." But these healthy conditions prevail only in country districts. The population is migrating to the towns. The country itself is in many places being converted into slums by the building for private profit of streets of mean and squalid habitations, without gardens and with no more privacy than the tenement barrack. The result is that the years which follow babyhood are years in which much mischief is done, always preventable but sometimes irremediable. The death-rate, though not so terrible as in the first year of life, remains abnormally high up to five years of age. In the second year of life it is fifty- five in the thousand for boys and fifty-two for girls. In the slums of great cities children are crammed into single-room tenements, without fresh air to breathe. Poverty forbids any source of warmth, CHILDHOOD UNDER SCHOOL-AGE 35 except that derived from the human body, and therefore when the temperature is low, every chink by which the cold fresh air can penetrate is stuffed up with filthy rags, and the child lives and sleeps in an atmosphere loaded with germs and carbonic acid and deficient in oxygen. Out of doors, in the impure air of the street, playing in dirt and dust swarming with bacteria, its sanitary condition is little better. Food Food, during this critical time upon which its future health and vigour so largely depend, is frequently most improper in quality as well as deficient in quantity. It is not only that a large portion of the growing child population has to share the poverty of parents, and scarcely ever rises from a meal with appetite really satisfied ; but even among parents fairly well off ignorance of how children should be nourished is so profound that their children suffer as much from improper food as the children of the poorer from hunger. Peri- winkles, red-herrings, and cheese are considered as good for babies of two years old in Lancashire as milk and rice-puddings ; and "a bit of everything we have ourselves," including beer and gin, is regarded as the most generous method of catering for the little children of many a prosperous worker's family. 36 THE CHILDREN OF THE NATION Medical Supervision During this most important period of growth and development poor children are practically entirely deprived, unless seized with infectious illness, of all medical supervision, and of all medical aid except in the last extremity when the necessity of a death certi- ficate is imminent. It is true that they have a legal right to be visited and prescribed for in sickness by a public doctor. The law casts specifically upon parents the duty of applying for this assistance when they are unable to pay for a doctor themselves, and upon Boards of Guardians the obligation to supply it. The latter are liable to be indicted for misdemeanour if they neglect to pay proper attention to a sick and destitute child. But the administration of the law is so cunningly devised as to ensure that the parent will not perform his natural and statutory duty, and that the Board of Guardians will so elude its statu- tory obligation. Superior persons who administer the Poor Law on scientific principles regard an application for medical relief, even for a sick child, as a first step in pauperism to be sternly and resolutely repressed. They therefore apply to the parent who makes such a demand deterrents which will effectually discourage him from ever making it again. It is in vain that the law declares that medical relief shall not pauperise or deprive the parent of his vote. For such a loss the parent in general cares little. Loss of a day's work or the harassing demands of the relieving CHILDHOOD UNDER SCHOOL-AGE 37 officer for repayment of the doctor's charges are much more real evils. In Ireland, where the same right to medical aid exists, the children in practice obtain it. Every Union in Ireland is divided into dispensary districts, to each of which is attached a medical officer and a qualified midwife. The poor are entitled to free medical relief. In each Dispensary District wardens are appointed, who issue black tickets entitling to free medical relief at the dispensaries, and red tickets entitling to a free visit from the medical officer. There is a district hospital in each Union to which cases can be sent for treatment by the district medical officer. It may be said that Irish- men have less sturdy independence than English- men, so that Poor Law Guardians fail to frighten him into the abandonment of his child's rights ; but, on the other hand, Irish parents set an example to the rest of the United Kingdom in their love for their children, and parental responsibility is with them a reality. Origin of Infectious Disease If society were far-seeing and wise, it would adopt towards the poor parents of poor children a diametrically opposite plan. So far from keeping doctors out of the houses of the poor, every opportunity would be seized for obtaining a footing in them. From the point of view of public health these poor little children, between 38 THE CHILDREN OF THE NATION babyhood and school age, form a very important section of the population. They are the nursery in which deadly microbes and the germs of infectious diseases grow and multiply. The most elementary principles of health demand the prompt destruction of germs of disease at their source. Our system allows the deadly army to assemble in secret behind the closed doors of the poor man's dwell- ing, and to burst forth in full strength to sweep with destruction the nurseries of the rich. A poor mans child has a sore throat, the mother would if she could consult a doctor, but the father dreads the deterrent measures of the Poor Law — he is too poor to pay ; there are no distressing symptoms, so he chances it. The incipient small-pox, or measles, or diphtheria, or scarlatina, which the doctor could have immediately diagnosed and stamped out, runs its course, infection is carried into the streets and the schools ; it becomes an epidemic, which costs hundreds of lives, not only of the poor but of the rich as well, all of which a doctor's visit and simple precautions costing a few shillings might have prevented. The disease of tuberculosis is now recognised to be not, as was long supposed, a hereditary disease. There may be a hereditary condition of the body predisposing to it, but the actual disease is introduced from without by a microbe. It is a terribly fatal disease in this country, causing one-eighth of all the deaths and carrying off one-half of all those who die in the prime of life between 25 and 35. CHILDHOOD UNDER SCHOOL-AGE 39 " The well-to-do," says Sir William Broadbent, u never need have consumption unless infected by the poor." The favourite breeding-ground of the tuberculosis microbe is the bodies of ill-nourished young children. By these they are carried into the streets and into the schools, without recognition or check, and thus affect the bodies of other children and of the whole population. Some supervision over the young, at the earliest period of life possible, is essential to any steps to stamp out this terrible disease. Double Government The division of sanitary responsibility between two local authorities is mischievous. The munici- pality, which has to defray the expense of epidemics, takes in general a much broader view of public health, and is much more ready to spend public money on prevention, which is both cheaper and better than cure, than is the Board of Guardians ; their narrower energies are directed to keeping down the rates and repressing the importunities of the poor. Double government is always in- effective and expensive. Local administration will never be efficiently conducted till the final financial control is concentrated in one body, responsible to the ratepayers for all expenditure and having complete and undivided command over local revenues and local finance. Education has been already vested in the municipal body : administration of the Poor Law will follow. In 40 THE CHILDREN OF THE NATION the meanwhile a step in the right direction might be taken, by vesting in the municipality every function which relates to public health. Parliament has long ago enacted that medical relief is not to pauperise. But Boards of Guardians have made the law of none effect by their regulations. Medical and other relief are blended as much as possible in their proceedings. If the administration of medical aid to the poor was entrusted to an entirely separate body, free from the pauper taint of Boards of Guardians, the intentions of Parliament would be carried into effect, and the health of the people would be greatly improved. But in the case of children at least it is essential that no obstacle should be interposed if there is any suspicion of incipient infectious disease. In this contingency the visit of the doctor should be free ; it is made as much in the interest of society, as in that of the child or its parents, and it is just that society should pay. Nurseries Efforts to establish public nurseries for the care of young children while their mothers go out to work have hitherto in this country met with little success. In France institutions of this kind have taken root and flourish. The first creche was established by M. Marbeau in Paris, in the Rue de Chaillot, in 1844. Its de- sign was to help working women to bring up their new-born children without giving up their CHILDHOOD UNDER SCHOOL-AGE 41 employment, in order to encourage matrimony and the procreation of children. Creches, on the plan of that in the Rue de Chaillot, soon spread throughout the towns of France, and extended to Brussels, Milan, and Vienna. At M. Marbeau's death, in 1875, there were 35 creches in Paris, and nearly 100 in other towns of France. At present the number is stated to be upwards of 500. All creches in France are now under the control and supervision of the Prefet. The number of children who may be admitted is fixed by him ; the creche is under Government inspection, and must be under the control of a doctor. Factory owners have in many places established creches for their work- people ; and some of the Town Councils have set up municipal creches supported by grants from the central government, by fetes, and by contri- butions from the public revenue of the town. English and Scotch mothers " appear to have," according to the evidence of Miss Anderson, the factory inspector, "an instinctive prejudice in favour of individual care by nurses. Generally the nurse is a relation of the mother who, on account of increasing years, has given up work at the mill." Such " nurses " rarely take more than one baby at a time, but they will take two or three children of one family. During a depression of trade, the master of a workhouse "had had a large increase in the number of old and widowed women, no longer wanted to mind the home and children while the mother went to the mill." In 42 THE CHILDREN OF THE NATION the great cotton strike, which took place in Preston in 1853, it is recorded by the Rev. John Clay, chaplain of the prison at Preston, that there was a great diminution in the mortality in the town of children under 5 years of age. It went down from 594 in the six months before the strike to 497 in the six months that the strike lasted, and he observes : " From reliable data obtained from a trustworthy source it may be estimated that 1,100 female operatives in Preston had children under five years of age. When these mothers were occupied at their work in the factories their infants were committed to hired nurses, children, or other protectors whose care would be very inferior to that of a mother. But while the strike lasted mother and child were in their proper places, the former gratifying maternal feelings and instincts from which, under the ordinary circumstances of her position, she is debarred, and the latter profiting by the care and affection which none but a mother can supply. It is not assuming too much to say, therefore, that in this bringing together of mother and child the diminished infant mortality is accounted for; and grave consideration ought to be given to the subject." In many cases no provision of any kind is made for taking care of the little children. They are just left to take their chance. Miss Anderson had received particulars of 144 cases, where the health visitors recently found two, three, or more, very young children left alone in the house (in some CHILDHOOD UNDER SCHOOL-AGE 43 cases locked in) while the mother was at the mill, with only such food as the mother could prepare overnight or in the early morning before leaving. The care of infants by individual nurses would be much more consistent with public health if a system of registration and licence were established ; and the business might gradually be restricted to persons who possess some qualification for taking care of infants. It would be, of course, impossible to pre- vent mothers entrusting their children to relatives, or to prevent the latter from receiving some recom- pense for their services ; but the regular business of nursing young children for payment might be restricted, as other callings which require special knowledge and skill, to those who are certified by public authority to be competent to perform the duties which they have undertaken. Mean- while a certain number of nurseries for infants already exist in this country, and more are being continually added by the benevolence of the public. The city of Glasgow has for many years kept a lodging-house for working women who are widows, and arranges for the care of their children while they are absent at work as part of the accommo- dation which the city provides for these tenants. There are at present no public regulations to which infant nurseries — except those called " Infant Schools," to which a subsequent chapter will be devoted — are liable. It is clear that they ought to be under competent medical supervision. The bringing together of a number of little children 44 THE CHILDREN OF THE NATION is in itself a source of public danger, as the epidemics, which have followed children's * 'parties," public and private, have repeatedly shown, and the number allowed in any one establishment should be from the first rigidly kept down. Chil- dren, like any other material on which operations have to be performed, can be dealt with wholesale in large numbers at a much less first cost than retail in smaller numbers ; and this has already led persons who do not look very far ahead to erect enormous schools. But the practice turns out costly in the end, by reason of the easy spread amongst these children, unnaturally crowded to- gether, of disease and mischief of various kinds : it should be strictly prohibited in the case of infant nurseries. The establishment of infant nurseries might serve one most useful purpose, to which attention was called by the Committee on Physical Deterioration. They could be made useful for teaching older girls the rudiments of infant management and feeding. Miss Eves, who keeps a creche at a Settlement in the East of London, thinks that as an instrument of educating women in the care of children the creche is greatly superior to a County Council lecture : " These are very good as far as they go, but you cannot teach people about a baby unless you have the baby there. I am an old science student, and I worked for years in a laboratory, and I do not believe in teaching these things unless you have the things there to show. I have found the CHILDHOOD UNDER SCHOOL-AGE 45 mothers anxious to learn, the small number that I have had to deal with, and the girls are very fond of children and very interested in anything practical. I think if you had an attractive course of lessons, and had the babies there to show them how to wash, dress, and feed them, the girls would come and be interested in it." Many other witnesses gave evidence to the same effect. The committee recommended in their report that wherever municipal creches were established, girls over 14 might be made to attend occasionally, and the teaching of infant management to such girls should be eligible for aid from the grant for public education. There is no doubt that under Public Health Acts municipal and urban councils have power without any further legislation to establish infant nurseries. Parental Responsibility An objection is made to the establishment of nurseries on the ground that it weakens parental responsibility, and encourages mothers to go to work to earn money instead of staying at home to mind their babies. A similar objection is made to every proposal for the intervention of public authority to improve the physical condition of children, notably to the suggestion that they should be fed before they are taught in the public elementary schools. There are two answers to all objections of this kind : first, that withholding aid 46 THE CHILDREN OF THE NATION from the child does not produce, and is never likely to produce, the proposed effect upon the parent ; and secondly, that a child is worth a great deal too much to be used for the purpose of improving the moral character of its parent. That infants have the first claim on their mother's time and attention is undoubted : but the practice of leaving the little ones to shift for themselves, or handing them over to the care of incompetent nurses while the mother goes abroad to earn wages, has unfortunately established itself in the social condition of our people. Laws will not put a stop to it, as the ineffrcacy of the law against the employment of women immediately after childbirth has proved ; still less would the practice be put down by the closing of all the creches. Moreover, under our present social system, a great number of women have to go out to work, or see their children starve : widows and the wives of broken-down bread- winners are expected to work to maintain their families, and for their children some provision ought to be made. But even if the withholding of aid to infants whose mothers go out to work would ultimately bring about the suppression of the practice, what a length of time the process would occupy, and how many children would have to be sacrificed to bring about this social reform ! The cost would be too great. In an ideal state of society no mother of young children would have to work except in the care of her family ; but to abandon these children to their fate would risk CHILDHOOD UNDER SCHOOL-AGE 47 their destruction without bringing about the desired result. Infant Insurance Observations were made by several witnesses who gave evidence before the Committee on Physical Deterioration on the prejudicial effect upon the lives of infants and young children, caused by insurance, not so much in large public insurance companies as in certain burial societies or clubs. Public attention was called to this matter more than fifty years ago by the Rev. John Clay, Chaplain of the Preston Prison, before mentioned. During his researches into the causes of infant mortality in Preston, he became convinced "that in hundreds and thousands of instances the prospect of ' burial money ' created direct and powerful in- ducements to parental neglect and cruelty." From that time he sought to stir up public opinion on the subject by letters and pamphlets, and, aided by the panic created by the bringing to justice of the murderers of several children for the purpose of obtaining burial money, he succeeded so far that a Committee of the House of Commons was appointed in 1853, before which he gave evidence. But, like other social reformers, he failed to awaken the conscience of the governing classes. " They'll do nothing," he said. " The pot-houses back the clubs, and I have long ceased to hope for anything from M.P.'s, when the pot-house interest has to be meddled with : they dare not offend the publicans, 48 THE CHILDREN OF THE NATION and so risk the loss of their seats." Are the influences which affect M.P.'s much changed since fifty years ago ? What is required is that no money should be received from a burial club but only a gratuitous funeral. When several insured children die at the same time, as often happens in the case of epidemics, the sums received from the club are generally far greater than the cost of the joint funeral, and the surplus is frequently spent in revelry and drunkenness. " I do not propose," wrote Mr. Clay in 1854 to the late Lord Derby (then Lord Stanley), " to suppress burial clubs entirely, but to limit their operation to the purpose for which I imagine they were originally intended, viz., the defraying of the actual funeral expenses of a deceased member. By 13 and 14 Vic. : c. 115, ' No sum is to be paid on the death of a child under ten years of age, except for the actual funeral expenses, not exceeding ^3, which shall be paid to the undertaker, &c.' But * this Act is to be in force ' only for one year after ' the time of passing, and thence to the end of the next session of Parliament,' so that the restraint intended is no longer, even nominally, the law ; and in point of fact never took effect at all. If the clubs were actually limited to the funeral expenses there would be no objection to the providing such expenses for young children. ... I think an ailing child would not be neglected for the sake of a gratuitous funeral ; though there can be no doubt that hundreds of children have been allowed to die CHILDHOOD UNDER SCHOOL-AGE 49 for the sake of the money payable on their death — the amount of which money depends on the number of clubs in which the child may have been enrolled." In 1902 a sub-committee was appointed by the Corporation of Preston to con- sider the causes of the high infant mortality in that town, and they reported that " among the causes may be mentioned ' insurance,' by which the death of a child brings a monetary gain to the parents." Dr. Malins, Professor of Midwifery in the University of Birmingham, said before the Committee on Physical Deterioration, " the tempta- tion to infant insurance is very great, particularly in times of poverty or in times of distress, and it overcomes parental instinct. The fact of a large family existing and the greater number of them starving or having insufficient food, makes them less careful about the latest offspring." Asked whether he would limit the sum recovered to the actual expense of burial, he replied, "Yes, that would be a wise precaution. I think- that would have a very great influence in diminishing the number of infant insurances." The expired Act of 13 and 14 Vic: c. 115 might be re-enacted, and made permanent with great advantage to child life. CHAPTER IV MEDICAL INSPECTION OF SCHOOL CHILDREN A Golden Opportunity Lost SCHOOL-TIME is the period at which the peoples health can be most easily and most effectively dealt with by public authority. There is then an opportunity of ascertaining and watch- ing the condition of children from day to day, and of bringing influences to bear to improve their health which is impossible at any other time of life. But this golden opportunity is at present almost entirely neglected. It is the settled principle of the Board of Education that they, and the local Education authorities which act under them, have no responsibility for the bodily health of the children, whom they force to attend for instruction in their schools. The President of the Board of Education under the late Government is reported to have said that it was no part of the duty of the Board to see that the children came to school properly fed or properly clothed. When the head of a public department makes such a statement 50 MEDICAL INSPECTION 51 it is understood that he is giving utterance to the settled policy of his department, which is, in the long run, controlled by the permanent Civil servants in the office. Like Miss Susan Nipper, they are "permanencies," while the Parliamentary head is only a " temporary." The latter must at first necessarily be guided by their advice ; otherwise they quickly land him in a quagmire. After he has gained some experience, he may, if able and energetic, impose upon his nominal subordinates some ideas of his own ; but the influence so exercised is very transient in its effects. When after a few years he is superseded by political changes, the officials abolish, as far as possible, everything he has done, and revert to the old practice and policy. Some slight inroads, which may prove of a more permanent character, have in recent years been made into the conservatism of the official view, but it still remains the basis of educa- tional policy that it is with the minds and not with the bodies of the scholars that education authorities have to deal. The law of the land appears to require that parents should send their children to school in a fit state to receive the instruction provided at the public cost, but the language of the Educa- tion Act is obscure, and if the law is that which I have stated no attempt is ever made to put it in force. It is not even suggested to the education authorities that it is any part of their functions to see that this law is carried out. The child may come dirty, ragged, hungry, diseased, or wearied 52 THE CHILDREN OF THE NATION out with labour ; the whole duty of the school authority appears to be to pass it through the education mill, regardless of the consequences or the effect. To do otherwise, and to interfere in the matter of the child's clothing, or food, or bodily condition, would be to undermine parental responsi- bility, and it is better to leave the child to perish rather than to interfere with the moral dignity and independence of the parent. This attitude of the Board of Education is repugnant to the most elementary principles of public duty and interest. It is inconsistent with public safety. The aggre- gation of thousands of young children in closed buildings is in itself a public danger, unless proper precautions are taken to prevent the intro- duction and spread of infectious disease. It is contrary to public economy, because the neglect of the medical care of destitute and ailing children in their youth entails the much greater cost of maintaining a good many of them in after-life, when they have grown up unfit to earn their own living. It offends against the principles of humanity, because it is cruel to work a hungry and ailing child, either in body or mind. " To subject a half-starved child," says Dr. Mackenzie, * to the routine of school would be the height of cruelty." It is cruelty perpetrated on thousands every day. Lastly, it is unpatriotic, for it flings away an opportunity of securing that the coming race of Englishmen shall be strong and vigorous. The advanced municipalities do not act on such a principle ; but their action is MEDICAL INSPECTION 53 spontaneous, not stimulated by any pressure from the central authority at Whitehall. The real objection to the discharge by public authority of its duty is the unwise opposition to immediate expense, which mostly prevails when the interests of the poor are at stake : it is fear of the cost that prompts the desire to leave everything to parents, even when it is known that they will not or cannot perform their duty. Millions are spent in providing ships and rifles, and guns for wars that will never take place : the smallest outlay is grudged towards pro- viding the men to man those ships and fire those guns, should the occasion ever arise for the people to defend their country. Passing the Doctor When the children of the nation are assembled in the public schools, the first thing that would suggest itself to a prudent public authority would be to take stock of them and see what they are like. It is the raw material on which the education machinery is to work : it is but business-like to ascertain its quality, and see if it is fit to stand the operations to which it is to be subjected. This simple and obvious measure of having the con- dition of school children ascertained by means of an examination by competent medical authority, has been recommended for years by Royal Com- missions, by public committees, by scientific bodies, and by public meetings without number; it has 54 THE CHILDREN OF THE NATION never yet been prescribed by the Board of Educa- tion, though many of the advanced municipalities have spontaneously taken it up. In Prussia, where the Government is wise enough to take care of its growing children, every boy and girl on entering school is examined medically like recruits for the army. Height, weight, and other particulars are recorded ; any ailment or malformation is in- vestigated and prescribed for. Children who require attention are marked down to appear before the doctor at his monthly visit, along with any others about whose health the teacher is not satisfied. At each year of school life the medical inspection of all the children is repeated. There is thus a record of each child's condition and progress from the time it enters till the time it leaves school. Similar arrangements are made in many other civilised States. In our country we have nothing so universal and systematic as this. The medical inspection which is beginning to be spontaneously carried out by some municipalities varies too much from place to place to furnish the ground for accurate information, although, however unsystematic it may be, it is most valuable for the health of the children themselves. Controversies rage as to the physical condition of our children, how many are starving, how many are diseased, how many are feeble-minded, how many are crippled, blind, or deaf, which proper medical inspection would at once set at rest. MEDICAL INSPECTION 55 Glimpses of Deterioration That such an inquiry into the condition of our school children would startle us may be gathered from the glimpses we have had by partial inquiries in various parts of the country. A sample exami- nation of the Edinburgh school children, good and bad, was made by Dr. Mackenzie for the Royal Commission on Physical Training in Scotland. He found 75 per cent, of the children examined ailing in one way or another, principally from disease of the nose, throat, or ears. Dr. Eichholz, in the evidence which he gave, as the official witness of the Board of Education, before the Committee on Physical Deterioration, declared that at the Johanna Street School in Lambeth, which he had examined for the purpose of the inquiry, 92 per cent, of the elder children, and 94 per cent, of the infants, were below normal physical condition, and that in some schools in the North of England, more than 60 per cent, of the scholars were in a similar condition. A committee afterwards appointed by the Board of Education to endeavour to shake the testimony of their witness, entirely failed to do so. In Dundee a medical examination of the elementary scholars was carried out by the Dundee Social Union. It disclosed a most unsatisfactory condition of general health, as appears from a de- tailed Report which has been published. In a school called Blackness, for example, which is described as a large modern Board School with a good class of 56 THE CHILDREN OF THE NATION children, and as the one in which, on the whole, the best results were obtained, 154 boys were examined ; of these 47 were found to be suffering from diseases of the glands, 5 from diseases of the bones, 9 from dis- eases of the heart, and 1 7 from diseases of the lungs. Of the same number 92 were normal as regards eyes ; 62, as regards ears; and 84, as regards other parts of their bodies. At least one-third of all the children examined suffered from such defects of vision as to interfere with their power of receiving instruction under ordinary school methods. The Medical Officer of Health for Dundee justly observes : " When it is borne in mind that in a large number of school children such defects are often unsuspected by the most careful parent, and that many of them are easily remedied in youth, which, if neglected, may seriously handicap the child throughout the whole of his future life, I think the result of the examination of the Dundee school children materially adds to the mass of evidence already accumulated, showing the urgent necessity for the compulsory medical inspection of school children." Powers of the Board of Education The Board of Education possesses power with- out further legislation to establish a complete system of medical inspection of schools, and it could carry this object out by proper administration gradually and tentatively. Its most important financial func- tion is to distribute to schools the millions voted MEDICAL INSPECTION 57 annually by Parliament for grants to support elementary education. These grants are distributed upon conditions which are from time to time framed by the Board of Education, and laid before the two Houses of Parliament. It would be a most reason- able condition to attach to the reception of a grant that measures satisfactory to the Board of Education should be taken by the local Education authority to secure that children attending the schools should be in a fit state to receive the instruction provided. As entrusted by Parliament with the expenditure of this great sum, the Board of Education would be doing no more than its duty in seeing that it is not wasted as it is now by being applied to the instruction of children, who not only cannot profit by it but to whom teaching adds an additional torture to their condition of bodily distress. The measures re- quired to be taken should be at first prescribed in general and elastic terms, and due notice should be given before the new regulation was put in force. But the promulgation of it would at once constrain every local authority to take the question of medical inspection into consideration, and frame schemes suitable to local circumstances. The facts to be ascertained and recorded should, for statistical pur- poses, be the same for all. But the same complete- ness of organisation need not, at all events in the first instance, be exacted from all alike. Cities like Liverpool, Manchester, Leeds, and Birmingham, who vie with each other in keeping in the van of educational progress, would at once establish a 58 THE CHILDREN OF THE NATION complete system of medical inspection, as good as their own municipal experience and the lessons to be learnt from other countries could create. Smaller boroughs and rural counties might at first lag behind. Nurses might be substituted for doctors ; inspection might extend over fewer children and be less frequent. But all would make progress of some kind, and information, much more reliable than any accessible now, would be obtained as to how many ailing children were to be found in our schools, and what was the matter with them. Remedial Measures Things could not long stop short, as in most places they do now, at the mere ascertaining of the truth. As soon as facts were known, the demand for remedies would become irresistible. It is a lurking dread of the inevitable consequence of a medical inquiry that makes so many good people object to its being undertaken. They can, with an untroubled conscience, shut their eyes and see nothing ; but if they once have to open them and see, the memory of the miserable condition of these poor children will haunt them until some remedy is found, even it may be at the expense of the rate- payer. When the medical examination of a school was concluded, a certain portion of the children would be passed as sound and healthy and requiring no further attention, unless before the next annual inspection came round the teacher, who should be MEDICAL INSPECTION 59 required to exercise a vigilant supervision over the health of the class, should suspect something to be amiss : the rest would be reported to be in need of aid of some kind or other. What the ratio of the former to the latter would be we do not know. It would vary from district to district and from school to school ; the infirm would probably be most numerous in the poorest neighbourhoods, though even in the best schools, as the example of Black- ness in Dundee shows, much unsuspected mischief might be discovered. The doctor's report would state what was amiss with the child and what remedies he prescribed ; it would remain on record in the school. The nature of the child's ailment and the remedial measures to be taken should be at once communicated to the parent, who would in most cases gladly co-operate in promoting the child's welfare. The primary duty is his to obtain and apply the remedies recommended so as to send the child to school in a fit state to receive instruc- tion. The report should not be merely sent by letter, or handed in at the door as a printed notice ; it should be personally delivered to the parent by some one representing the managers of the school and acting with the sanction and authority of the local Education committee. To many schools there are now attached boards of visitors, mostly women, volunteers acting under the managers, who visit the homes of the children, and come into direct relations with the parents. This plan has, wherever it has been tried, proved effective 60 THE CHILDREN OF THE NATION in improving the physical condition of the children, and in really enforcing parental responsibility ; such boards ought to be established universally in con- nection with every public elementary school. But it is essential for the success of such a plan that the visitor should be competent to give advice, should be clothed with public authority, and should not be a mere prying intruder into a poor man's home. The bearer of a doctors certificate that the child is ailing and requires certain remedial treatment is no intruder : he enters the house of right. If anybody sends his child to school unfit to receive instruction, he is breaking the spirit if not the letter of the law, and the Education authority has a right to send its agent to remonstrate, to submit to the parent the doctor's report and to press for the application of the remedies which he has prescribed. If no other visitor was available, the attendance officer might be employed. In a great number of cases of dirt, of insufficient clothing, of improper food, and of less important maladies, the visit alone would be sufficient to procure the amelioration desired. The progress of the child would be watched by the school teacher, and reported to the doctor on his next visit. But in other cases — we may hope only a small percentage — further proceedings would be necessary. Ignorance would by these means be eliminated from the causes of the deteriorated condition of the child : the prescription of the doctor and the explanation of the visitor would have removed that excuse. The cause would now MEDICAL INSPECTION 61 be either wilful neglect or incapacity from poverty to provide the treatment required. If the doctor had ordered spectacles, or quinine, or cod liver oil, the parent might be too poor to provide such medical luxuries. What in such a case is to be done ? The child, it must be remembered, has a legal right to have all things necessary to its health, in default of their being provided for it by its parent, furnished at the public expense ; and even if it had no such legal right, it would be generally good economy for the State to provide such neces- saries now, in order to save greater expenditure hereafter. Under the existing law the Education authority has no power given to it in the Education Acts to provide either medicine or surgical appli- ances for poor children, who stand in need of them. It is doubtful whether such expenditure would come within the functions of the municipal council as the Health authority. The power is now vested in the Poor Law Guardians. The latter are elected by the same constituency as the municipality ; but personally they generally belong to a somewhat different class, and are influenced by different maxims and principles. Until the power of the Education authority is so extended as to comprehend all that is necessary for the healthy education of a child in the true sense of the word, its capacity for bringing up children will remain seriously crippled, and will continue to be dependent on Poor Law Guardians. The Education authority will have to make application to them for much that is necessary. 62 THE CHILDREN OF THE NATION The deterrents and obstacles which they throw in the way of any such application would have to be faced. The parent, whose primary duty it is to demand what is necessary for his child, might succeed in overcoming obstacles when backed up by the support of the official visitor. If the Guardians ignore the children's rights, or are oppressive to the parents who claim them, the latter have the remedy in their own hands. Guardians are elected by the suffrages of all the householders of the district, male and female, and if these choose to return a body which oppresses the poor and denies the rights of the helpless, they have only themselves to blame. Official Visitors of School Children s Homes The medical inspection of schools, so far as it was designed not merely for statistical purposes but to effect a real improvement in the health of the scholars, would depend greatly on the efficiency of the visitors of the children's homes. There is no legal provision for constraining any one to undertake and perform the duty of visiting the houses of the poor, as guardians and protectors of the little ones. In Prussia it is otherwise. Every citizen can be called upon by his municipality to perform service of this kind, and is liable to a fine if he refuses or neglects to do so, just as in this country a citizen is liable to a fine if he refuses the office of mayor. The effect of this is that a great deal more unpaid MEDICAL INSPECTION 63 municipal work of this kind is performed in Prussia than in Great Britain ; but it is done almost entirely by men. Our own voluntary system has the great advantage of enlisting in the work the services of women, which in everything relating to the bringing up of little children is naturally vastly superior to that of men. Had the counsels of women been more sought after and attended to, many of the lamentable blunders that men have made in the treatment of children would have been avoided. But the experience of parish work, of charitable societies, and of the administration of the Poor Law itself, shows that an abundance of volunteer workers, both men and women, are to be had for the service of the poor. There is no reason to imagine that they would be less disposed to undertake such work, if they had to act under public control and were clothed with public authority. Any local authority could now, without any legal compulsion, organise a body of volunteer visitors quite as competent to perform the duties above described as any body constituted under the laws of Prussia. Manchester Ladies Health Society In Manchester there has existed for many years a society called "The Ladies' Public Health Society." It operates in the belt of poor dwellings, where the poorest of the working people live, which intervenes between the business centre of Manchester and the suburbs. This girdle of poverty 64 THE CHILDREN OF THE NATION which surrounds the wealth of Central Manchester is roughly divided into districts, to each of which there is a lady superintendent and a health visitor ; the latter lives in the district, receives a salary, and devotes her whole time to the work. The City Council pay half the salary of the visitors, on con- dition that they receive assistance from all of them. The ladies and the visitors under them work in conjunction with the City Council and under the direction of the Medical Officer of Health. The houses in which there are babies receive special attention, with the view of informing mothers as to the best methods of bringing up young children. These health visitors report to the City Council all sanitary defects, cases of overcrowding, stopped drains, and structural defects. When the society began its operation there were in Ancoats 300 back- to-back houses, the majority of which had no ordinary sanitary conveniences ; many had no tap or anything of the kind. At the time of the sitting of the Committee on Physical Deterioration there were not more than twenty of such back-to-back houses left. The lady superintendent makes house- to-house visitations in her district. Mother's meet- ings are organised, and the women who attend them become apostles of health among their neighbours and popularise notions of a higher standard of domesticity. The advice given is said to be accepted with gladness by the mothers, especially by the younger ones. MEDICAL INSPECTION 65 Visiting Committees of the London School Board The London School Board endeavoured to es- tablish visiting committees in connection with the London Board Schools, chiefly for the purpose of visiting the homes of underfed children, but also for the purpose of generally improving the physical condition of school children. The success of these committees was not indeed universal, but wherever the system was efficiently carried out the results were so admirable as to encourage a more complete and effective organisation of the plan. At the Tower Street School, Seven Dials, for example, a school relief committee has been in existence since January, 1899, consisting of the three head teachers and two lady managers. The names of all children who ask for food tickets, also of all children who seem sick or sorry are given to the visiting managers by the head teachers ; the homes are visited and the mothers interviewed. The visits and the interest taken in the children appear to produce no injurious effect on the careless mothers ; they even induce them to keep the children clean. The visitor sees under what conditions the children are living, whether the windows open, whether the children are being washed, whether they are suffering from want of air and want of sleep. In some cases the mothers are found to be widows or deserted wives in receipt of the pittance of outdoor relief given by Poor Law Guardians, just enough to prevent her from going into the workhouse and making the 66 THE CHILDREN OF THE NATION children chargeable to the Union. The visitor may in such cases help the widow to appeal for justice ; there would be a much better chance if the appeal could be made to an Education rather than a Poor Law authority. The local Sanitary authority can be called in, verminous rooms can be cleansed, drains and dustbins can be attended to. A joint committee, appointed by the London County Council, reported, in 1905, that the duty of managers in respect of visiting the homes of the children and procuring information regarding their home conditions, has been in the majority of cases imperfectly fulfilled. The Council, however, seems to have in view relief rather than health committees as in Manchester ; they advise that a local organisation is required only in schools likely to contain necessitous children ; and its function is to be the distribution of food tickets and boots, rather than the establishment of healthy conditions in the homes of the children. CHAPTER V UNDERFED CHILDREN Revelation apprehended from Medical Inspection BEFORE any general and systematic inspection of school children takes place there is one thing for which we must prepare ourselves in advance — that such an examination would disclose an appalling number of children who chronically suffer from lack of nourishment to an extent that unfits them for school work. What the exact percentage of such children may be as compared with the whole child population we have at present no means of knowing : we can only guess. It is the dread of having conjecture turned into certainty that induces many persons to resist medical inquiry. Whether it is more due to improper than to insuffi- cient food we cannot tell. Some persons take great pains to prove that it is with improper rather than insufficient food that we have to deal. To the child who thrives, not on what it eats but on what it digests, it makes no difference. This chronic malnutrition of great masses of children, is by far 6 7 68 THE CHILDREN OF THE NATION the most serious and most urgent matter in con- nection with public health with which the community at the present moment has to deal. Dr. Eichholz says : " I hold a very firm opinion, which is shared by medical men, members of education committees, managers, teachers, and others con- versant with the condition of school children, that food is at the base of all the evils of child degeneracy ; that is to say, if we can take steps to ensure the proper adequate feeding of the children, the evil will rapidly cease. Other circumstances noted in connection with degeneracy are bad clothing, bad boots, exposure, want of fresh air, overcrowding, filth, late hours, overstrain at work, and, to a less extent, the smoking by boys. But all these causes pale beside the stress laid on food." Number of ill-nourished Children There would be no advantage in discussing here the exact percentage of underfed children. It corresponds probably with the proportion of families who are below what is called the "poverty line," that is to say, whose earnings devoted to the support of their families are insufficient to maintain those families in a position of reasonable health and comfort. But this poverty line is not a fixed standard which can be scientifically ascertained. It is dependent on opinion as well as fact. Sir Charles Booth for London, and Mr. Rowntree for York, estimate a third of the population as below what UNDERFED CHILDREN 69 they regard as the poverty line. Dr. Mackenzie in Edinburgh reported more than one-third of the children examined, to be what he considered ill- nourished. But the correspondence between under- feeding and poverty is not exact. In many of our great English cities the poorest classes of the population consist of Jews, many of them recent immigrants from Russia and Poland, and Irish, refugees from the poverty of their own country. Yet these do not send their children to school underfed. Dr. Hall, of Leeds, where there is a large Jewish population engaged in the ready-made clothing trade, has made a study of this matter, and has published statistics showing the superior height and weight of Jewish boys and girls as compared with Gentiles. He took me, in 1904, to pay surprise visits to two Board Schools in the poorest quarters of Leeds, one frequented by Jews, the other by Gentiles. The two schools presented the most marked contrast in healthy appearance, cleanliness, neatness of clothes, and general brightness, though Dr. Hall declared that the parents of the two sets of children were equally poor and their homes equally dirty and overcrowded. On the steps of the Gentile school was a little girl of ten partaking of a cup of cocoa, administered to her by a poor ragged woman. It turned out on inquiry to be a Jewish child, who had been out of sorts at break- fast, and eaten nothing ; its mother had brought up the cup of cocoa to the school, fearing her child might be faint and hungry, and unfit to do her 70 THE CHILDREN OF THE NATION lessons. Dr. Eichholz says that both Jews and Irish " make a great point of caring for their young children " — it is, in fact, a matter of religious obliga- tion with both — " with the result that these two types very usually stand apart in the poorer neigh- bourhoods from the general degeneracy." Children s Rights Whether the default of parents arises from negligence, ignorance, or poverty, the children have in this country an indefeasible right to be fed, and if the parent fails, from any cause whatever, the State is under a legal obligation to step in. If the laws were properly administered, there ought to be no such thing as a starving child in the land, much less under the eyes of public officials in the public schools. The only excuse for the existence of such a reproach to our performance of public duty would be that the child had escaped notice, and in the case of children who come under the daily observation of public officers, in the form of school teachers, such an excuse would be inadmissible. In the case of the Attorney-General v. the Guardians of the Poor of Merthyr Tydfil, the question was discussed and the law distinctly laid down by the Court of Appeal. In that case the Guardians had given outdoor relief to miners on strike, their wives and children, and the ques- tion was whether they were legally entitled to this relief. It was shown that the miners could, if they UNDERFED CHILDREN 71 would, obtain work and wages ; and it was held that this fact disentitled them to receive relief, however laudable their object might be in refusing the work and wages offered : but with the women and children the case was different ; they were, it destitute, entitled to immediate relief, from whatever cause and whatever default their destitution had arisen. The President of the Local Government Board of the late Government declared that " the obligation has always rested on the Guardians to relieve children who were destitute for want of food, even though that destitution might arise solely from the neglect of the parent. But it was true that in consequence of administrative diffi- culties that was rarely and perhaps never done." In plain words, children are systematically robbed of their rights, because our administration of government is badly organised. Parent Reformation There is a strange idea rooted in the minds of a great number of people, otherwise of a just and generous disposition, that the rights of children may be ignored, and that they may properly be used as an instrument for compelling parents to fufil their moral obligation ; children should be left to starve in order to coerce their parents into feed- ing them. Nothing could be more foolish and unwise than such a proceeding. In the first place, it is ineffective. Parents who spend in drink the 72 THE CHILDREN OF THE NATION money that should buy their children's food are past being recalled to a sense of their duty by the sight of their children's sufferings. On this point Dr. Airy, H.M. Inspector in Birmingham, says : " I have looked into the matter very carefully, of a drunken parent who neglects his children, and he will not drink a pint less or more for anything that we do for his child : it will not make the slightest difference." It is besides quite certain that public charity will step in in some form or other, to relieve the wants of the child. The drunken parent knows this, and reckons upon it as an excuse for his inhumanity. In the next place, a child is too valuable a " national asset " to be turned into an instrument for improving the general morality of the community ; its welfare and healthy develop- ment is of far more importance to the State than the moral reformation of a worthless parent. To. risk the damage of the child for the remote possi- bility of mending the parent is the height of bad economy : if you must choose between the two, save the child and let the parent go. The duty and interest of the community is to feed the child first, and afterwards to take such measures as it can to ensure for the future the due performance by the parent of his obligations. For this purpose the existing administration is at present so defective that, as the President of the Local Government Board declares, it does not act at all, and it is difficult to amend it without an alteration of the law. To pass amending Acts of Parliament, even UNDERFED CHILDREN 73 with the help of a sympathetic Government, is a long process, and many generations of school children may perish of hunger before the reform which is to bring about the feeding of the hungry child is accomplished. Free Feeding Perplexed by these difficulties, some Associations which have taken a keen interest in the condition of starving school children, such as the Social Democratic Federation, have proposed to cut the Gordian knot by feeding all school children at the public expense. They propose to do this not out of the rates, which are paid in the long run by owners of property, but out of the taxes, of which more than a fair share is paid by the poor. The effect of such a plan would be to relieve the parents of children from legal obligations to which they are now subject, and impose these upon the general body of the people. The cost of giving one good meal, sufficient to allay hunger, to a child for the five days in the week on which it attends school, would be 5d. ; and would amount in the year to about 16s. 8d. Dr. Airy, who was for twenty years chairman of a committee in Birming- ham for providing meals for necessitous school children, testifies that a dinner consisting of a bowl of lentil soup, and a large slab of bread and jam, can be given for a halfpenny. Unlike Oliver Twist, they may ask for more and get it. The amount of a halfpenny each provides all the O c THF UNIVERSITY OF 74 THE CHILDREN OF THE NATION expense, one-third of which consists of salaries to managers. In other places, where a more generous diet is given, the cost has proved to be a penny or a little less. Evidence was given before a com- mittee of the Board of Education, of an enterprising old lady, who earned her living in Liverpool by giving penny dinners to all children who came, fifty or sixty a day. It was not a charity, but a commercial undertaking. The child brought its penny, ate its dinner, and went away again. No questions were asked. She gave a very good meal of meat and vegetables, and made a profit on which she lived. The average number of children attending the public elementary schools in England and Wales is in round numbers 6,000,000, so that the cost to the Exchequer of providing one meal of the Liverpool lady's menu, or two of Dr. Airy's, on each day that the school was open, would come to ,£5,000,000 per annum. This would not, however, solve the problem of underfed children. The one meal a day for five days only in the week is not sufficient to build up a child's constitution : it is at best a stop-gap, and prevents further degeneracy. To turn the ill- nourished slum child into a strong, healthy boy or girl a much more generous diet, with plenty of oil and fat, is requisite. Dr. Hall, of Leeds, who has had a large experience in the feeding of destitute children, thinks the cost would be twopence a day. He has during this year fed children at this price for the Leeds City Council, and says that nourish- UNDERFED CHILDREN 75 ment is ample and the cost more than covered. Dr. Hall's estimate is borne out by the experience of municipal bodies who feed school children in the cities of Europe. At the rate of twopence a day the cost of feeding 6,000,000 children on all week- days, leaving their parents to find the food on Sundays, would amount to ,£15,650,000. It is probable that if a public gratuitous meal was offered not more than half the school children would at first partake of it. If this were so, the cost would be as follows : — For a id. meal on all school-days ,£1,250,000 For a id. meal on all school-days ,£2,500,000 For a generous and sufficient diet on all school-days ... ... ,£5,000,000 For a generous and sufficient diet all the year round except Sundays £7,825,000 Of course the time would come when all children attending the public elementary schools would par- take of the gratuitous public meal, and then these sums would be doubled. Home Influence The cost ought not to stand in the way of the adoption of a plan of this kind. But there are other and graver objections. It would certainly undermine parental responsibility, and would take the children still more than now out of the hands of their parents, and make them still more than now children of the State. So far as the parents 76 THE CHILDREN OF THE NATION were relieved of the cost of feeding their children, it would be a boon to those now on the edge of the poverty line ; it would lift some now under the line above it. But it would tend, as free education has tended, to lessen parental interest and parental co-operation in the bringing up of children. If attention is paid only to the third of the child population which is now destitute and neglected, this might be no great loss ; but it is probable that nearly all parents who are not stupefied by the grinding influence of poverty, do still love and care for their little ones, and, even with the few who do not, neglect is rather the result of ignorance than of wickedness. The mother who loves her child is by far the best instrument the State can employ in providing for its real education ; better than teachers, or school managers, or medical inspectors, or attendance officers ; and it is sound economy to educate and improve the mothers, to draw forth the natural love of offspring implanted in them, and so to make their influence effective in the bringing up of children to be healthy and useful citizens. It is reckless extravagance to cast away all this natural force which costs the State nothing, and gives work and interest and pleasure in life to the mothers themselves, and trust the whole of educa- tion to the incompetent hands of State officials. Hitherto, so far as experience teaches us, the State has proved itself a bad stepmother. It has already in its workhouses, its district schools, its cottage homes, and its industrial and reformatory schools, UNDERFED CHILDREN 77 an army of children whose condition and treatment will be considered in a subsequent chapter. It is enough to observe here that, as compared with the work of a private person like Dr. Barnado, its education of the children in its charge has proved a lamentable failure, and that the chief cause of this failure is the absence, perhaps unavoidable, from State institutions of that special individual love for each child which Nature implants in a mother. This is the most powerful and essential influence that can be brought to bear upon a child, and free education and free feeding tend to diminish, if not to obliterate it. Proper Diet Another objection to free feeding is that it must of necessity be somewhat stinted and parsimonious and cannot readily be varied to suit the needs of each child. Medical testimony is agreed in assert- ing that most of the mischief which results from starvation and neglect in the first years of life is curable during school age. Proper nourishment and proper conditions of life will at that age retrieve almost any lapse from normal health. No sadder or more pregnant testimony was given to the Com- mittee on Physical Deterioration than that of Dr. Collie, Medical Inspector of the London School Board, about feeble-minded children. " Mental disability is not only preventable, but in many cases curable. In a large number of instances, after the careful individual attention and midday dinner of 78 THE CHILDREN OF THE NATION the special schools, they are returned after from sixteen to eighteen months to the elementary schools with a new lease of mental vigour. These children are functionally mentally defective. Their brains are starved and naturally fail to react to the ordinary methods of elementary teaching. In the absence of proper provision for feeding ill-nourished children, these special schools in London are fulfill- ing a very useful function. . . . Many of these children are apparently only dull and backward, but they are really functionally defective. And in a certain proportion of the cases it is the result of semi-starvation." Asked whether under better conditions of feeding the brain recovered, he replied, " Yes ; after sixteen or eighteen months they get a fresh start with feeding." But medical testimony also asserts that to call forth the healing force of nature a generous diet suitable to the special case of each neglected child is requisite. A bowl of lentil soup and a slab of bread and jam will not in all cases produce the result desired. "The present method of feeding in London," says Dr. Eichholz, "is entirely of the nature of a temporary stop-gap. There is but little concentrated effort at building up enfeebled consti- tutions, school-feeding doing little beyond arresting further degeneracy." " It is probable that free meals at present do little beyond arresting further degeneracy, without doing much in the way of building up." UNDERFED CHILDREN 79 Delay Dangerous A further objection to relying on free feeding by the State as the best mode of meeting the emer- gency of the present moment is the long delay that must occur. It is an immediate remedy that is required ; delay is dangerous. Free feeding involves a very fundamental change in the law and the shifting of a considerable financial burden, if the cost is to be defrayed out of rates, from the shoulders of the poor to those of the rich. Every- body with any experience of British domestic politics knows how long a controversy of this sort is likely to last, how many vicissitudes, how many battles won and lost there will be before the desired consummation is reached. In the meantime even those who advocate free feeding will agree that the rights of children under the existing law should be enforced, that the unjust administration of the law, admitted by the President of the Local Government Board, should be put an end to, and that adequate measures should be at once taken to secure (i) that school children shall be properly fed by those parents who have the means of feeding them ; (2) that the public authority should perform its duty in making provision for the feeding of those children whose parents do not or cannot perform their legal obliga- tion. School Meals The efforts of public authority should, therefore, at first be limited to making provision for feeding 80 THE CHILDREN OF THE NATION those children who are now attending school half- starved, and to taking measures for the reduction of their number, whatever it may prove to be, by visitation of the children's homes and prosecution of some of the worst offenders as an example to the rest. The best method of attaining such a result would be the institution, wherever the local educa- tion authority found it necessary, of school meals, such as are now provided in a great many of the cities of Europe. In many schools, both in town and country, there is no necessity for anything of the kind. The children are well fed ; the parents wish to give them their breakfasts and dinners at home ; the starving child is a rare exception, and can easily be dealt with by exceptional treatment. While medical inspection is urgently demanded in all schools because mischief may exist unsuspected by the most careful parent, school feeding is only wanted in a certain section — how large or small there is no way of at present judging — situated mostly in the poorer parts of our cities. There may be places in which the establishment of school meals would be a great boon to workers who are comparatively well off, and they would gladly pay the cost. It depends upon the conditions of work in the district. In Birmingham and other places the establishment of self-supporting meals for children has been tried with a conspicuous lack of success. One reason for this appears to be that children for whom it is known that the parents have paid and those for whom it is known that the UNDERFED CHILDREN 81 parents have not paid are mixed up together, and the former are very soon withdrawn, either because parents do not wish their children to be confounded with the indigent class or because they feel it to be a sort of injustice that they should be made to pay for that which others get for nothing. In the "cantines scolaires," in Paris, poor children who pay and who do not pay dine side by side. But the distribution of tickets is so conducted as to preclude the possibility of knowing which of the children receive them gratuitously. Canteens are established in every one of the Arrondissements except the VIII th, in which there is no indigent population. Free meals are given to children known to be in want, whether their parents are on the books of the Bureau de Bienfaisance or not. No meal is served except on presentation of a ticket ; the ticket which is given is of exactly the same pattern as that which is bought. The children receive a wholesome hot dinner at a cost usually less than fifteen centimes. The working of the canteens is left entirely to the Mayor and School Fund Committees. About two-thirds of the expenses are provided by the Municipality of Paris and one-third by the sale of tickets and contributions, generally derived from endowments by the School Fund Committees. In 1904 10,660,000 meals were given at a cost of 1,461,000 francs. About one-fourth of the cost — 359»ooo francs — was defrayed by the sale of tickets. In the case of dinners provided in secondary schools, where all pay, no such difficulty arises. 82 THE CHILDREN OF THE NATION In the Manchester Municipal Secondary School efforts have been made with complete success to provide a wholesome dinner for the higher class of children who attend it. Different kinds of dinner can be obtained at the school at prices varying from a penny to sixpence. For the latter sum meat, two vegetables, and bread, with a clean cloth and a glass of water, is served. Formerly the children were often sent with money for their dinners, which they spent at the pastrycook's on cakes and sweets. The dining-room is well fre- quented and more than self-supporting. This last condition is essential, as no money can be taken from the rates for such a purpose. Similar dinners are organised by the Education authority in many other towns. The children who attend the public elementary schools have in many places, especially in those where mothers go to work in factories, the same necessity for a cheap and wholesome meal, for which their parents are able and willing to pay. But this requires organisation, and the parents have neither the knowledge nor the leisure to organise for themselves. Mr. Priestman, the chairman of a committee at Bradford for feeding children and a member of the City Council, says : " The ideal thing would, in our opinion, be to have half-a-dozen dining-rooms with kitchens attached in half-a-dozen centres in the city, where the children could be fed and where we could give a good substantial meal of soup and bread, or rice pudding, or both, and charge the parents a penny for providing it. We UNDERFED CHILDREN 83 think we could make a fairly satisfactory meal for a penny. That would be a boon in this way. We have a large number of homes at Bradford where the mother is working at the mill, and from that and other causes a proper meal cannot be cooked for the children. The children come home to a very unsatisfactory dinner, perhaps of bread and jam and tea. We hold that we have done the children great physical good by providing them with more nutritious diet and a diet more fit for children, and that it would be a great boon to the children and to the parents if we could do that on a large scale and get the money from the parents." He was of opinion that if such a cheap meal were available it would be largely taken advantage of by parents. Whether it is possible to combine the organisation of self-supporting meals for children whose parents pay with provision for feeding the hungry and destitute is a question on which much difference of opinion exists. It depends upon the extent to which the number of those who have to be fed free can be reduced by visitation of homes. This is the key to most of the difficulties raised in regard to the feeding of school children. Public authority has made no provision for a certain and rigid inquiry at its home into the case of every child who presents itself at school unfit to receive instruction ; and in this neglect of public duty the Education authority is backed up by the Board of Education. Voluntary associations, who are eager to take up many of the public duties which society neglects, 84 THE CHILDREN OF THE NATION have only assumed this most vital duty in a few cases. If Miss Frere's experience in Seven Dials is to be relied on, a systematic visitation of underfed children's homes would marvellously reduce the number of underfed children. Public authority should at once undertake the organisation and direction of such a system of visiting, using all that volunteer help which in most places would be abundantly forthcoming. Instead of that, it has hitherto been content to sit by and watch the feed- ing of children by " charity," with very perfunctory investigation of cases and with little or no attempt to compel the performance by parents of their legal duty. In a few cases the charitable givers of dinners have referred cases to the Society for the Prevention of Cruelty to Children, another association which takes up the public duty of protecting children which is neglected by the established authorities ; but a large section of the poorer classes have come to regard the provision of free dinners for their children, at least during the winter months, as a permanent social institution, and to rely upon this precarious source for the nourishment which they would otherwise have to provide themselves. Many of them would be able to do it. So long as the law imposes on parents the obligation to maintain their children — the action of ''charity" in re- lieving them of this liability tends to lower wages, to enable higher house-rents to be screwed out of the poor, and to increase rather than diminish poverty. But it must be clearly apprehended UNDERFED CHILDREN 85 that it is not feeding the children that occasions the mischief; it is the omission to make those parents who can repay the cost of so doing. To feed the hungry child at once, without any inquiry except into the fact of its hunger, is an imperative duty. Miss Frere gives a starving child a ticket immediately, before inquiry, then she visits ; then, if the case is one of distress which wants a lot of inquiry, the child is put on for a fortnight. Should the result of a system of visitation be to reduce the children who have to be fed free to anything like the small proportion that obtains in Tower Street, Seven Dials, there is no reason why these should not be provided for in dining- rooms like those suggested for Bradford, where the rest pay : so small a number, if the same precautions were taken as in Paris, would not frighten away the paying children. There should be no distinction in the dining-room between the paying and the free ; the latter should be furnished with tickets like the rest, paid for out of charitable or Poor Law funds. If, however, the number of free meals is to remain at anything like its present number the combination in the same dining-hall of free and paying diners would become in many cases difficult or impossible, and it would be necessary either to give up any system of self-supporting dinners or entirely to separate the two classes of children and provide for them in different establish- ments — a thing in itself undesirable and likely to be productive of much social mischief. 86 THE CHILDREN OF THE NATION The Official Circulars. A revolution was made in the question of feeding school children in 1905, which is still in progress, and of which it is yet possible to foresee the final result. In March of that year a descent was made by Lady Warwick, Dr. Macnamara, M.P., Dr. Robert Hutchison, M.D., Physician to the Hospital for Sick Children, Great Ormond Street, and myself upon the Johanna Street School of the London Council, situated in a very poor part of Lambeth. The classes were carefully inspected, and about twenty boys were picked out by Dr. Hutchison, of whom he was prepared to certify that they were actually suffering from hunger, that they were unfit to do any school work, and that they were in urgent need of immediate relief in the shape of food. The party then proceeded to the offices of the Lambeth Board of Guardians, which was sitting at the time, and requested an interview which was most courteously granted. They then made application to the Board, on behalf of the boys whose names had been taken down, for food and relief, and demanded that the relieving officers should be directed to proceed to the school and furnish food immediately to the boys, of whom a list was furnished to the Guardians. This application was granted. The further pro- ceedings of the Board and their relieving officer are of no consequence, because the matter was immediately after brought to the notice of the UNDERFED CHILDREN 87 House of Commons, and it was admitted by the President of the Local Government Board that children in the state of those in the Johanna Street School were entitled to immediate relief from the Poor Law authorities, irrespective of the condition and conduct of their parents, and he promised that circulars should be issued by his department and the Board of Education call- ing attention to the rights of hungry children, and directing school teachers and managers to take steps for enforcing them. The object which prompted the action of Lady Warwick and her party was thus fully attained. The promised circulars were issued in April, 1905, and confer- ences took place between the county, municipal, and urban councils and the various Boards of Guardians in their districts as to the best method of carrying them into effect. Various plans were adopted, and, until reports have been made upon the feeding of school children in the several places during the winter of 1905-6, it is premature to judge of the efficacy of the circulars, or to discuss how far the friendly co-operation of Education authorities and Boards of Guardians can get over the inconvenience of having a public duty of this kind entrusted to two bodies, instead of one. It was the best makeshift without legislation : and the Government at the time were incompetent to carry any legislation through. It is doubtless quite possible for the two authorities and the two departments of Government, if they could agree, 88 THE CHILDREN OF THE NATION to establish a system by which every hungry child would be fed, every ignorant parent instructed, and every negligent parent coerced into doing his duty. But no such agreement is likely. Boards of Guardians and municipal councils act, as we have before seen, on very different principles, and the issue of the circulars was not regarded with much favour by the permanent officials of the depart- ments concerned. Until a better and more effective plan is established by some strong minister either at the Local Government Board or Board of Education, the circulars will do little more than stand on record as an acknowledgment of the public obligation, and will in few places be of any practical use to the children, as the following example shows. In a large city in Yorkshire the Education authority sent, at the beginning of the year 1906, a list of upwards of 3,000 children, whom they alleged to be underfed to the Board of Guardians. After two months' inquiry 1,347 of these cases had been dealt with in the following manner. In 399 the parents assured the relieving officer that the children were sent to school properly fed ; the assurance was accepted as satisfactory, and no further steps were taken. There was no medical examination. In 291 cases the Guardians accepted a written undertaking, signed by the parent undertaking to feed the child properly, as a sufficient guarantee for the child's future nourishment. The requiring of such an undertaking seems to establish UNDERFED CHILDREN 89 the fact that, in the opinion of the Guardians, the child had been previously underfed. In 229 cases the relieving officer found that the family required more help than the mere feeding of the school children. These also had therefore, in the opinion of the Guardians, been previously underfed. Sixty- six children did not come within the terms of the order, because they did not live with their fathers, or from some such cause, though why these children should be left to starvation does not appear; 331 children were fed under the Order by persons reimbursed by the Guardians ; and 3 1 were cases of neglect in which the food was given on loan to be repaid by the parent. Some 150 more cases were afterwards disposed of, and further proceedings then deferred to await the fate of a Bill for feeding school children which was at that time before Parliament. This probably gives a fair sample of the operation and effect of the circulars. More than two-thirds of those whose cases were examined proved to be, even in the opinion of the Board of Guardians, underfed : how far the relief was proper and adequate may be left to the judgment of the reader. If the pro- portion in the cases uninvestigated is the same as in the investigated cases, more than 1,000 children had been starving in this city since the commencement of the year 1906, about whom no inquiry had been made, and nothing had been done. Let us hope the procedure of Parliament will be more rapid than that of this Board of 90 THE CHILDREN OF THE NATION Guardians if the hungry children are to wait for food until this Bill has been disposed of. There is one advantage in having a public meal for school children, carried on under public superin- tendence, that must not be overlooked. It would enable the school medical officer, as soon as there was one, to prescribe a diet for an ailing child, with the assurance that his prescription would be carried out. Children generally, and poorly nourished children especially, require food much more than physic. Parents should, of course, have the right to feed their children according to the doctor's order at home ; but if it was found that the orders were not properly carried out, it should be in the power of the Education authority to make an order for the child to attend for a specified period the public school table for which the parent should be liable to pay ; or it might be convenient for the parent voluntarily to arrange for the child's attendance from the first. It would give the doctor the opportunity of watching the effect of diet upon the patient, and of giving extra or special diet in particular cases as part of the treatment. CHAPTER VI OVERWORKED CHILDREN Labour out of School-hours A GREAT number of children in the public elementary schools have their health seriously injured out of school-hours by overwork. They are employed for long hours before and after school, and are thereby deprived of rest and sleep, and come to their school work tired out and quite unfit to grapple with either the bodily or intellectual efforts required of them. The history of how this evil, tending to the serious deterioration of public health, was brought before the notice of the public authorities, and how entirely up to the present time it has proved impossible for our governments, central and local, to find an adequate remedy for it, is a most instructive lesson as to the way in which the common interests of the nation are mismanaged. Mrs. Hoares Deputation The excessive labour of school children out of school hours was brought officially to the notice of 9* 92 THE CHILDREN OF THE NATION the Government, not by the inspectors of schools who were imbued with the theory of the depart- ment that it was no business of theirs to regard the physical condition of the children, but by a private lady, Mrs. Hoare, who died without seeing even such fruits of her labour as were afforded by the attempt to legislate for these unhappy children. She had collected the facts about the employment of school children out of school hours in certain London schools, had published them in an article in the Nineteenth Century, and then, in the year 1897, asked the Education Department to receive a deputa- tion on the subject. Her request was at first refused on the ground that the matter, being one which related to the health and not to the " education " of the children, concerned the Home Office and not the Education Department ; but Mrs. Hoare, who thought the latter would be more sympathetic than the former, cleverly argued that she was going to lay facts before the department to prove that the public money which it was its function to dispense was wasted by being applied to scholars unfit to be instructed, and that she would indicate remedies which would lead to a more economic expenditure of the public grant. Mrs. Hoare's deputation was on this consideration received, and laid formally before the Education Department the facts which she had collected about London schools. An inquiry was demanded into the existence of similar evils in other parts of the country. In reply to the depu- tation the inquiry asked for was promised, but there OVERWORKED CHILDREN 93 proved to be a good deal of difficulty in instituting it. The Education Department could not move according to official etiquette without consultation with the Home Office and the Local Government Board, and the officials of these departments were unsympathetic. The deadlock was happily solved by a convenient member of the Opposition in the House of Commons, who in 1898 moved for a return such as Mrs. Hoare had asked for, which the Government found it impossible to refuse. The return was to show the number of children on the books of schools as full-time scholars who were themselves working for wages or employed for profit, with their ages, standard, occupation, hours of labour, and wages. Forms were issued to the 20,000 elementary schools in England and Wales, and returns were obtained from all but 520 — a striking testimony to the zeal of managers and teachers in promoting the physical well-being of their scholars. Education Department Return The return was a very painful one, and cast a lurid light upon the condition of a large class of the population. It fully bore out Mrs. Hoare's con- tentions, and though no doubt containing inaccuracies and exaggerations of detail, has been admitted, on subsequent inquiry, to contain a true picture of the condition of a large class of elementary school children. The returns sent in from the schools gave 94 THE CHILDREN OF THE NATION the names of 144,000 boys and 34,000 girls, as working for wages or employed for profit out of school hours ; and about 1,000 more were added after- wards ; but the returns showed upon their face that in many cases they comprised only a part of the children at work, only those in regular employment ; no notice was taken of those in casual or seasonal employment. " Many children are kept from school," says one correspondent, " for days, some- times weeks, together, for such work as picking stones, weeding, sheep-shearing, harvest, and potato- picking." " During the hat-sewing season," says another, "from about February to Whitsuntide, many girls of all ages are employed, both before and after school hours, in sewing hats for their mothers. Some have been known to work from 6 a.m. to the time for coming to school, and again from school-closing in the afternoon until bedtime." The names of none of these appear in the returns. Many omitted the names of those who did not themselves receive wages, but whose earnings were paid to their parents, of those whose employment had not been prejudicial to health, and of those who had been employed during school hours, as well as before or after. As to the mischief of the system, the opinion of managers and teachers was unani- mous. " One boy," says a manager, " begins work for his father as early as 3 a.m., and works again in the evening as late as 9 p.m. He often goes to sleep during morning school from sheer weariness. Another boy employed at 'placing OVERWORKED CHILDREN 95 skittles ' for 34 J hours per week, says he is engaged from 6 to 11 p.m. daily. The lad is often asleep in the afternoon during the progress of the lessons." " May I be allowed," says another, " to express my gratitude to the Education Department for making these inquiries, and to express the hope that that Department will be able to frame some regulations to meet and relieve the onerous conditions under which many of the young have to gain education. Without exaggeration I can truthfully assert that there are to-day in our National and Board Schools thousands of little white slaves." A School Board passed a resolution " that some appropriate action should be taken by Government to prevent the excessive amount of labour found to be customary amongst school children, which must interfere with the success of their studies or with their health." It is probable that it would interfere with both. Em- ployment of these little ones begins at a very early age — 131 were six or under ; 1,120 between six and seven; 4,211 between seven and eight; 11,027 between eight and nine; and 22,131 between nine and ten. These are some specimens of the sort of work these children did, and the amount of wages they earned. A little boy of six peeled onions 20 hours a week, for a weekly wage of 8d. Another delivered milk for 28 hours a week, for a weekly wage of 2s. Another was engaged in V turning hose " for 20 hours a week, and was paid by 6d. being credited weekly to his savings-bank account. There was a little boy engaged in pea-picking at 96 THE CHILDREN OF THE NATION 3d. a week. A little girl under six carried milk for 35 hours a week for her parents, and earned no wages. Another " seamed hose " for 15 hours at a weekly wage of id. Another was a nurse-girl — a nurse-girl under six ! — who worked for 29 hours a week for 2d. and her food. Another under six was an errand girl and ran about the street 1 5 hours a week for 6d. The educational attainments of these children were, of course, very low : 329 were in no standard ; 3,890 in the first ; 1 1,686 in the second ; 24,624 in the third ; and 36,907 in the fourth. Selling newspapers in the street occupied 15,182 ; hawking other articles, 2,435 J other occupations, such as knocking people up in the morning, 8,627 ; service in shops, 76,173; agriculture, 6,115; odd jobs, 10,636; minding babies, 11,585; house and laundry work, 9,254 ; needle- work, card-box making, &c, 4,019. The hours of labour were excessive. Only 39,355 were employed for so short a time as 10 hours a week; 60,268 from 10 to 20 hours; 27,008 from 20 to 30 hours ; 9,778 from 30 to 40 hours ; 2,390 from 40 to 50 hours ; and 793 above 50 hours a week, of whom 75 were actually em- ployed over 70 hours a week. The reader may be curious to know what these boys and girls who were employed for more than 70 hours a week worked at and what wages they received. A boy of ten in Standard IV. was returned as a farm labourer working 72 hours a week for a wage of 3s. A boy of twelve, in Standard IV., worked as a farm labourer 87 hours a week for a wage of 2s. 6d. A OVERWORKED CHILDREN 97 newspaper boy, aged twelve, in Standard VI., worked ioo hours a week, that included Sundays, and received 3s. 6d. and his meals. A boy of twelve, in Standard III., was employed in a marine store dealer's for 74 hours a week for is. 6d. and his meals. A boy of ten, in Standard IV., was a donkey driver for 80 hours a week, at a wage of 6s. There was in London a boy of twelve, in Standard V., employed in a chemist's shop for yS hours a week at a wage of 5s. There was also in London an errand boy of twelve, in Standard VII., probably from his school attainments a promising boy, employed in a dairy for 72 hours a week for 4s. and his food. It would have been economical for the country to have delivered such a boy from such conditions, as it is probable something could have been made of him of advantage to the com- munity. By this time it is too late. If alive, he is now twenty years old and probably an unskilled labourer for life. A girl of thirteen worked 72 hours in a shop for a wage of 2s. There were a number of girls of various ages and standards returned as carrying bark for wood-cutters. They worked 70J hours a week for a wage of 6s. The returns furnished examples of many concrete cases, of which the following will serve as samples. A boy rose between 3 and 4 every morning, started out at 4.30 to wake up 25 working men, who each paid him 3d. a week ; he returned from his rounds about 5.30, but did not go to bed again, as he had to go round as a newspaper boy from 98 THE CHILDREN OF THE NATION 6 to 9 when he was due at school. He was a very regular boy at school, but often half asleep. Another boy acted as a latherer to a barber for 32 hours for a wage of 2s. He worked the whole of Saturday till 11 p.m. and for 3 hours on Sunday morning. A greengrocer's boy aged twelve, Standard II., had to start for London at 2.30 a.m. every morning, returned about 9.30, and then went to school ! There were two girls aged twelve in Standard IV., one was employed in house- work and errands from 7.45 a.m. to 10, 12.30 to 1.30, and 4.30 to 8, for 3d. a week ; the other at 9d. a week and her food for carrying out parcels for a milliner from 7.30 to 9.30, 12.30 to 1.30, and 4.30 to 8. The intervals were spent by these two girls in school, with what torture to their poor brains and with what educational result the reader may conjecture. Reception of the Return These returns were laid before Parliament in 1899. They were fully explained and pressed upon the attention of the House of Commons in the official address of the then Vice-President, when submitting the Education estimates of the year to the House of Commons. He spoke of little else, and endeavoured to bring home to the conviction of members Mrs. Hoare's argument that it was a waste of public money to attempt to give instruction at school to children so wearied by overwork. But the House of Com- OVERWORKED CHILDREN 99 mons refused to pay any attention to the subject, it went off into a discussion of alleged improper teaching of the Church Catechism to Nonconfor- mist children, and of the exact personal relations then subsisting between the Vice-President and his official superiors, and passed the miserable con- dition of overworked children by as unworthy of the consideration of the Legislature in comparison with party and personal squabbles. The matter was, however, though ignored by Parliament, taken up in the course of the autumn of that year by local authorities in various parts of England and Wales. The condition of the children, and the remedies that should be applied, were discussed by Town Councils, by Boards of Guardians, by School Boards, and by the representatives of Voluntary Schools. Joint Committee So great a public interest upon the subject was aroused that the Government found itself con- strained, at the beginning of 1900, to appoint a joint committee of the Home Office and the Board of Education (as the department was then to be called by Act of Parliament) to consider the question afresh and to advise what legislation should be recommended to remedy the mischievous social evils which had been laid bare. The committee so appointed acted with marvellous promptitude. Unlike Government committees in general, it did not waste any time in rediscovering all the facts that 100 THE CHILDREN OF THE NATION had been brought to light by the returns from the 20,000 elementary schools, nor in testing every individual case in which it was alleged that those returns were incorrect or exaggerated. It accepted the fact that a large number of children attending as full timers in the public elementary schools were overworked out of school hours, and that the exact number or percentage was of no importance, and set itself to discover a practical remedy. The committee reported in 1901, recommended legis- lation, and submitted the draft of a Bill which gave to County and Borough Councils power to make by-laws for regulating the employment of children ; they were empowered by the clauses of the Bill to prescribe the age below which and the hours beyond which all working of children for wages or profit should be illegal and to restrict the employ- ment to occupations neither harmful to their health nor dangerous to their morals. A Bill, practically identical with that recommended in the Report of the committee, was introduced in the following year, 1902, but was not proceeded with owing to the time of Parliament being occupied with subjects more interesting to the governing classes. It was, however, again introduced in 1903, and had the good luck in that session to pass into law. Theatrical Children An alteration was made in the Bill while passing through the House of Commons that is worthy OVERWORKED CHILDREN 101 of notice, as illustrating the immense influence which what is called " Society " then exercised over the British Government. The managers of fashion- able theatres in London took it into their heads that the local authority, which in London was the County Council, might so use the powers entrusted to them as to interfere with the performances of children in pantomimes and fairy extravaganzas, and they stirred up " Society," alarmed at the possi- bility of a curtailment of its pleasures, to demand the exemption of theatrical children from the pro- tection of the proposed Act. Their influence was great enough to induce the Home Office to propose a clause in committee exempting children employed in theatres and circuses from the operation of the Act. In the Standing Committee to which the Bill was referred the proposal was rejected by an almost unanimous vote. The proposal was then discussed and voted on by those who had heard the arguments on both sides. There are no children who stand more in need of protection than those who are to be found in touring theatrical companies and travel- ling circuses. The existing law, which merely required such children to be licensed by magistrates in the town at which the company had arrived for performance there, had proved quite insufficient to secure their proper care in many companies while on tour. Children who are regularly employed in the theatres in London, Manchester, Liverpool, &c, are well treated and well paid. But it is quite different with those who go about with some of the 102 THE CHILDREN OF THE NATION touring companies and circuses. They are dragged in misery and discomfort from town to town, and so far from being well cared for, they are often let out by drunken mothers and given in charge of the woman who keeps the theatre wardrobe or whoever will take care of them at the cheapest price. They are ill paid and ill taught, they are made to beg from the audience, the condition in which they live is injurious to health, and they are altogether objects deserving of pity and protection. The company usually travels from town to town on Sunday, and first thing on Monday morning the children are dragged before the police court, amongst drunken people and thieves, to be licensed. No theatrical manager would ever allow his own children to be taken about in a travelling company, or even to go on the stage at all, till they arrived at years of discretion. So great, however, was the social influence brought to bear on the Government that they made use of their resistless majority to reverse by a vote in the House of Commons the almost unanimous decision of the committee. In a proceeding of this kind most of the supporters of the Government have not heard any arguments at all ; they often do not know what they are voting about, but they rush in, at the sound of the division bell, from the terrace, the library, or the smoking- room, and go into the division lobby, which is indicated to them by a gesture of the Government Whip, who stands at the door. This is party discipline, and no one is thought by the governing OVERWORKED CHILDREN 103 classes to be fit to be a member of Parliament who does not meekly and subserviently yield thereto : it is called " loyalty." How the Act is Administered The Act became law on January i, 1904, but in most places the deliverance of the overworked children is still a long way off. The local authorities belong, to a very great extent, to the governing class, and are not much under the influence of working-class opinion ; the people themselves are apathetic ; the matter for the most part affects only the very poor ; it is hard for them in their desperate struggle for bread to forego even the miserable earnings of these wretched children ; if they were even convinced of the fact that child labour lowers wages, their needs are too urgent to admit of the delay while economic laws operate. It has thus come to pass that many authorities, in the absence of any pressure from without, have not moved at all. The Government were very careful that the law should be permissive only, and refused to allow clauses to be inserted that would have obliged all authorities to make some provision for the protec- tion of children. In some cases the convenience of the richer classes has stimulated the Town Council into action. In a fashionable residential town like Leamington the street boys and girls may become a nuisance to the visitors, and their regulation adds to the amenities of the place. In Liverpool a local 104 THE CHILDREN OF THE NATION Act has long been in operation to mitigate the nuisance of street sellers, boys and girls. It has not only preserved order in the streets to the advantage of the rich ; it has also promoted the moral and physical welfare of the children of the poor. No child may sell newspapers, matches, or anything else in the street without a licence from the police authorities. The child must wear a badge, showing by its colour whether it is exempt from school attendance or not. The hours of selling are regulated : no child not exempt from school attendance may sell during school hours. Licensed children must be decently dressed and may not enter a public-house. Breach of these regulations involves loss of licence. By-laws Great delay has been caused in those places where the authorities are eager to put the Act in force by the provision that their by-laws must be approved by the Home Office. Such a condition is common in all Acts of Parliament dealing with social questions, and always gives rise to procrasti- nation and red tape. The department in such a case does not confine its criticism to seeing that the by-laws submitted contain nothing repugnant to the general law or to the ordinary maxims of justice ; they assume that they can determine what is for the interest of the people of Leeds or Birmingham better than the City Council which directly represents OVERWORKED CHILDREN 105 them ; they are ready to listen to powerful interests, to institute local inquiries, and to review generally the action of the City Council in making by-laws. In the case of London the whole subject was rein- vestigated in 1905 by a Home Office inquiry into the by-laws made by the London County Council. Mrs. Hoare's labours, the Education Office returns, the Report of the Joint Committee, the discussions in Parliament, and the Bill as settled by the Stand- ing Committee, all went for nothing ; the policy of restricting child labour in London was all gone into anew. I do not know whether the evidence taken in this inquiry has been published, but I heard from a medical witness who had just been giving evidence a significant fact worthy of the attention of the reader. Reference has been made in a previous chapter to the care which the poorest of the Jews take of the health of their children. Investigation into the barbers' shops in the poorest quarters of London showed that there was a considerable number of Jew barbers, but not a single Jew "lather-boy" was to be found. The Jews let their children sleep till it is time for breakfast and school. It is not surprising to learn that at the date when this is written — ten years after Mrs. Hoare published her facts — out of 266 local authorities capable of making by-laws for the protection of children, only 90 have framed by-laws and sub- mitted them for approval by the Home Office. In 49 cases only have by-laws been approved and are now in force. The London school children, on 106 THE CHILDREN OF THE NATION whose behalf Mrs. Hoare originally moved, are still unprotected. Child Labour in Berlin The brassworkers of Birmingham, whose inquiry into the social condition of the people of Berlin will be referred to in a subsequent chapter, reported on the subject of child labour there. "If children " (at school) " desire to work at any employment in the afternoons they must get permission from the police. At this school " (one of 2,000 children) " from fifteen to twenty boys are so occupied, mostly on errands ; and from ten to fifteen girls as little minders of children. No child vendors of newspapers are seen in the streets. No young girls are permitted by the authorities to stand in the gutters selling flowers. Schoolboy smoking is not allowed. The boy would have his cigarette knocked out of his mouth if seen by a workman in the street, and the workman would be thanked by the parents for doing so." Incompetence The story of this attempt at reform illustrates the impotence which threatens the stability of our present social system and the incapacity of the governing classes to carry out the simplest measure of social reform, even one which does not affect their interests and on the necessity for which they are themselves agreed. It seems to justify the people in revolting against both parties into which the governing classes have divided themselves, in OVERWORKED CHILDREN 107 forming independent labour parties, and in en- deavouring to take the regulation of society into their own hands. The present holders of power, according to the view of the rising party of the people, have had their opportunity ; they have failed to avail themselves of it, and the carrying out of necessary reforms must now pass into other hands. CHAPTER VII CHILDREN S AILMENTS THE medical examination of children in the public elementary schools which has already taken place, though partial and incomplete and quite insufficient to furnish reliable scientific data, does give notice of the kinds of ailments and diseases which a more perfect examination would disclose, and of the sort of provision the public authority will have to make if it is either to under- take remedial treatment itself or see that such treatment is carried out by parents or charitable societies. Heredity The extent to which disease is transmitted from parent to child is still a subject of scientific discus- sion. But it is generally admitted that the amount of such disease is relatively small ; that it is about equally spread over all classes of the population ; and that only two species, syphilis and alcoholism, are common enough to demand the attention of the 108 CHILDREN'S AILMENTS 109 social reformer. Both these diseases will be dis- cussed more in detail in a subsequent chapter ; it is enough to remark here that they affect adults at first more than children, and that it is only by the spread of temperance, soberness, chastity, and cleanliness amongst the general body of the people that they can be got rid of. Much can, no doubt, be done by public authority to instruct children in the schools and young people in the continuation classes as to the physical effects of alcohol on the human body, but public opinion does not at present sanction any effective restraint upon those who have become victims of dipsomania. Still less will it sanction any instruction of the young on the subject of the latter disease or any compulsory hospital treatment of those who disseminate it. The experi- ment of examination and hospital treatment was tried forty years ago, but it had to be given up owing to the violent hostility of opponents, though it is remarkable that in those towns where the Con- tagious Diseases Acts had been for some years in force there was an almost unanimous opinion in their favour on the part of doctors, clergy both of the Church and of Nonconformist bodies, magis- trates, and, last but not least, of the workers them- selves. In the case of school children they suffer, if at all, from the secondary effects of these diseases, and it is the secondary symptoms that have to be treated. The medical inspector can advise in each case the course to be adopted. 110 THE CHILDREN OF THE NATION Diseased Glands In all the medical examinations that have taken place a large proportion of the children are found to be suffering from diseases of the glands, more or less advanced. They are not dangerous in them- selves, but they are the signs of incipient deteriora- tion and the beginnings, if neglected, of more serious disease. The cause is malnutrition, insani- tary surroundings, all those depressing influences in which the children of the poor are brought up. The cure is fresh air, good food, healthy exercise of mind and body ; the remedy is almost certain in its effect, but to the poor child quite unattainable. No medicine prescribed by a school doctor will be of much benefit so long as the causes which pro- duced the mischief continue to exist ; but the con- dition of children affected with disease of the glands affords a text on which an official visitor who repre- sents the school authority may enlarge in visiting the child's home, and may be the means of stirring up the sanitary authority to action and the parents to such efforts for improvement as their poverty may admit of. The progress of such children should be watched by the teacher and by the nurse or doctor at each visit to the school. In bad cases, where the diseased glands are developing into serious disease such as deafness or tuberculosis, it would be, of course, much more economical as well as more humane for society to take the case in hand in time and remove the child before it is too late CHILDREN'S AILMENTS 111 from its unhealthy surroundings. Several of the medical witnesses before the Committee on Physical Deterioration advocated the establishment of special schools for backward and ailing children, where better conditions and a generous diet could be secured which would soon make them sound ; but the bugbear of undermining parental responsibility frightened others. In Germany, where the State takes more care of children and where the taxpayers are more alive to true economy, such schools are common. In a subsequent chapter some details are given of one of these — the Forest School at Charlottenburg. Adenoids One of the commonest forms of glandular disease is what is called "adenoids," which is enlargement of the glandular tissue at the back of the nose. Some children are born with it : it is prevalent in all classes of society, rich as well as poor. It produces mouth- breathing with all its attendant evils, contracted chest, and stunted growth. It is a very common cause of deafness. For this common disease there is one remedy and one remedy only — the removal by a surgical operation of the adenoids. The medical inspector would at once diagnose the presence of adenoids in the noses of scores of children. The cost of the remedial operation, simple as it is, is beyond the means of most poor parents. Would it undermine parental responsibility, would it be a 112 THE CHILDREN OF THE NATION reckless plunge into Socialism if the State were to undertake the cost of removing adenoids ? There would be no temptation to the thriftless parent to indulge unduly in this cheap public luxury. The gain from the public outlay would be that of the community at large, which would escape a great deal of subsequent expenditure upon deafness and other diseases by the performance of this safe and simple operation upon all children who stood in need of it. It would be an act of justice to the children, who are entitled to proper care as well as maintenance. Tubercle Tubercle is a deadly and dangerous disease, very common amongst neglected, ill-nourished children. It is generally considered now not to be hereditary, as was formerly supposed, but to be produced by a definite microbe, against the ravages of which pre- cautions may be taken, although a condition of the mucous membrane favourable to the reception and propagation of the microbe may be inherited. In its early stages, and especially in a child patient, it is considered to be almost always curable : fresh air, cleanliness, and good food are the medicines. But if neglected it becomes tabes mesenterica in the child or phthisis in the adult, and is certainly fatal ; and during all the time that the patient continues to live he is shedding infection about him and risking the lives of others. There are probably few schools in CHILDREN'S AILMENTS 113 the land, elementary or secondary, in which there are not children suffering from this terrible disease, unsuspected by parents or teachers but capable of certain detection by a medical expert. Merely to ascertain the fact that there are such children in a school is of little use unless public authority is pre- pared to go further. Such children ought, if the disease has reached an infectious stage, to be segre- gated from the rest just as much as smallpox patients. They should receive prompt treatment in fresh-air hospitals, and could in nearly all cases be quickly restored to their friends freed from the terrible danger to which they have been exposed and from the risk which association with them causes to their comrades. If this matter were pro- perly understood and appreciated by the richer classes no fear of undermining parental responsi- bility would be allowed to stand in the way of energetic action for stamping out this fatal disease. It spares no class of society and causes in this country one-half the deaths of those who perish in the prime of life, between 25 and 35 years of age ; it is Nature's visitation of the rich to punish them for their neglect ; the former might be free from consumption if they were not infected by the poor. Heart Disease A diseased condition of the heart is very com- monly found amongst young children in the schools. Taken in time and treated while the organs of the m THE CHILDREN OF THE NATION body are still capable of vigorous growth, it is in some cases curable, and with proper precautions its fatal progress can be to some extent arrested. But it is an ailment that neither parent nor teacher is likely to discover ; it requires the examination of an expert. Children who are suffering from any affection of the heart are quite unfit to go through the ordinary physical exercises of the school ; all bodily strain is highly dangerous ; cases have been found in which such children were performing gymnastic exercises, in the course of which they might at any moment have dropped down dead. If there was no other ground on which to require medical inspection of school children, the absolute necessity for children to pass the doctor before being allowed to perform some of the physical exercises prescribed in the school course would of itself furnish one. In Prussia, where all children are examined medically during their school life, a number of children in every school are forbidden to take part in the gymnastic exercises ; in our schools, where no such precaution is taken, there must be thousands of children who, unsuspected by teacher or parent, are daily aggravating the mischief which diagnosis and remedial treatment might cure or at least mitigate. Rickets Rickets is a disease of infancy which has usually laid hold of the child before it comes into the CHILDREN'S AILMENTS 115 elementary school. It makes its first appearance from six to twelve months after birth. The direct cause of this disease is bad feeding. M When there is bad feeding," says Dr. Ashby, of Manchester, " or when there is indigestion, the digestive process goes wrong, and certain toxins or deleterious substances are formed in the stomach and intestines, and these are absorbed into the blood. Sweating is one of the first signs, later the formation of the bones and muscles are interfered with and nutrition generally." Children who suffer from rickets in infancy come to school undersized, and often already deformed. In bad cases, where no remedial treatment is applied, the deformity may last for life, but up to seven years there is hope of recovery. Dr. Hall, in Leeds, found 50 per cent, of the children in a poor Gentile school suffering from rickets ; in a poor Jewish school, 7 per cent. ; and in the good schools, frequented by the children of well-to-do artizans, 8 per cent. During the year 1903 at the Manchester Hospital 901 infants and young children were admitted as out-patients, suffering from rickets in the early stages ; and in addition to them 539, mostly children over 3 or 4 years of age, were admitted for various deformities, as knock-knees and bow legs, the result of rickets. The disease is much more prevalent in the north of England than in the south. Dr. Ashby examined in Manchester 750 school children, who were selected for examination because of their inability to learn in class. Eighteen 116 THE CHILDREN OP THE NATION were suffering from marked rickety deformities, being much undersized, with knock-knees and flat feet, while their mental status was much less than that of average children, in spite of their having attended school. They were not only backward, but had dull brains. Many of the others were of poor physique, with curved or limp spines and flat feet, due to rickets. " I do not wish to say," adds Dr. Ashby, " that there were only eighteen of these suffering from rickets, because I could see traces of rickets in a large number of them, but these were bond fide dwarfs." If these rickety children were picked out by medical inspection when they first came to school, and a diet of good food secured for them, a great number would be cured of the mischief done to them in the early years of life and might grow up healthy men and women. Eyes Defective vision arises from two causes, quite separate and distinct — (i) disease, and (2) defective construction of the eye. The various forms of ophthalmia are nothing like so prevalent in the elementary schools as they are in the Poor Law schools, though the class of children is much the same in both, and those in the latter are much better fed and cared for. It is the much closer association in dormitories and lavatories in boarding schools, where large numbers of children are assembled, that causes any outbreak of eye CHILDREN'S AILMENTS 117 disease to become epidemic. Many children in slum schools suffer from blight and sore eyelids, but the disease does not seem to spread. In the Glasgow school examined by Dr. Scott, the certify- ing factory surgeon in Glasgow, there were 25 children suffering — 2*92 per cent, of the whole school. Very simple remedies, which teacher or nurses can apply, seem to be sufficient to stop eye disease in its early stages. Defective vision which arises from optical defects is prevalent in all schools frequented by the children of rich and poor. There are no data, from which any just opinion can be formed as to whether bad sight from this cause is on the increase or not. Children's eyesight of late years has received much attention, and two facts seem to be estab- lished : first, that a great number of children come to school with good sight but become short-sighted during the school period, and secondly, that this defect is aggravated, if not caused, by the treat- ment which they receive while under instruction. Defective eyesight is now generally known to be a cause of headache, and children's eyes are therefore better looked after by their parents, whereas formerly no connection between the two was sus- pected. There is evidence both from the Census and the statistics of the London School Board, that in recent years blindness and deafness have decreased, both amongst the general population and amongst school children. There is still, however, an enormous amount of defective vision 118 THE CHILDREN OF THE NATION amongst school children which urgently demands attention. In the Dundee examination, very nearly half those examined had defects of the eyes of one kind or another, more than half of the girls and less than half of the boys. Similar results have been obtained by inspection in other schools. That a number of these defects are caused by school work, and that we might reasonably expect girls to be worse than boys, admits of little doubt. Dr. Kerr, Medical Officer to the London School Board, who tested the eyes of more than a thousand children in the London schools with great care and trouble three times over says : " The method of the usual infant teaching is much too fine in hand and eye adjustments required, and leads to nervous strain as a routine part of educa- tion at this age, and to permanent habits of close eye work with stoop and contracted chest. The work expected from young children is also of too accurate a nature, 95 per cent, between the ages of 6 and 6 J managed to get normal visual acuity in London ; whilst in the standards 10 per cent, are found with vision not exceeding two-thirds normal. The conditions which exist in infant schools are fatal to the eyesight. The majority of children go through them without much danger, but any children who have a tendency to weak sight are sure to succumb. The conditions are bad for infants' eyesight in every way ; the work is too fine." Dr. Kerr is of opinion that teachers should refuse to set infants to do fine work, but let them CHILDREN'S AILMENTS 119 go to the blackboard and do coarse work. One common employment for the youngest children in infant schools is to thread needles ; this exercise is often kept up for as long as twenty minutes. The infants are quiet, while their eyes are being destroyed. In most country schools, and in many of the older town schools very insufficient attention is paid to the light. Children are constantly set in the full glare of the window, facing it : in other schools they work with insufficient light in dark corners ; both extremes are injurious to eyesight. It is a common practice to strain the children's eyesight by using blue or red instead of white chalk on the blackboard. Sufficient attention is not always paid to the place in which a child is sitting. The teacher lectures upon the blackboard with many of the scholars right out at the side, where they either cannot see at all or see only very imperfectly. Straining the eyes is very bad, besides the risk of being caned for not seeing something which is beyond their visual powers. If medical experts looked into some of these matters, as well as into the eyes of the children, a good many practices injurious to eyesight would be reformed. Any examination of the eyes of school children will result in the prescription of many pairs of spectacles. Whence are these to be procured? It is undoubtedly the duty of a parent, according to existing law, to provide his child with spectacles, if necessary, as well as with food and clothes. But the cost of spectacles is a serious charge upon a 120 THE CHILDREN OF THE NATION family which is barely able to earn enough to pay the rent, and feed and clothe the family. If any charitable body will in any district undertake to provide for those who cannot provide for them- selves, well and good : it is I suppose a charity as unlikely to pauperise or undermine parental responsibility as any that can be imagined. But if there is no charitable agency to step in, spectacles should be provided at the public expense as part of the cost of education. The child's education cannot go on without them, except at the risk of permanent danger to the eyes ; it is the interest of the public that its education should not be discontinued, nor its eyes damaged. Ears il Adenoids," says Mr. Cheatle, the aural surgeon, M are one of the greatest causes of deafness." Remove them, as before suggested, and you will remove a great deal of deafness now existing in elementary schools, and save the cost of more expensive treatment. Defective hearing is thus much more easily and cheaply dealt with than defective eyesight, which is not so closely connected with the child's general health. On the other hand, deafness exercises a much more baneful effect on the general mental condition of the child than defective eyesight. Mr. Cheatle says : " There is a marked difference intellectually between those who are deaf and those who are not." It is not CHILDREN'S AILMENTS 121 only that deaf children do not receive and appre- hend the same number of external impressions that normal children do. " It is more than that. They are dull mentally, as well as unable to receive stimuli." Besides deafness there are discharges from the ears which are specially dangerous to health and life. " It is due," says Mr. Cheatle, "to invasion of the middle ear by a specific organism, that is to say, the poison gets into the middle ear behind the drum, from the back of the nose. It is a very common result of scarlet fever, diphtheria, measles, and small-pox, but a common cold will set it up, and if neglected, a certain number of lives will be lost." In the examination of the Edinburgh schools, some 40 per cent, of the children had diseases of the ear more or less serious ; in Dundee it was 44 per cent. Attention to general health, and removal of adenoids would produce an immediate and signal improvement in the hearing of children. How many boys and girls are daily caned for not having heard something they cannot hear, as well as for not seeing some- thing they cannot see, it is impossible to estimate. Teeth The British Dental Association made, a short time ago, an investigation into the teeth of school children by properly qualified practitioners to acquire a more exact knowledge of the condition of children's teeth at various ages, and to show the 122 THE CHILDREN OF THE NATION disabilities under which they suffer in their health and development by reason of the condition of their teeth. They examined upwards of 10,500 boys and girls from Industrial Schools, Training Ships, National and Board Schools, &c, and found amongst them only 1,508 sets of teeth free from decay, or 14*2 per cent. There were upwards of 37,000 unsound teeth in the mouths of those examined. This result may be taken as typical of the condition of the teeth of the poorer classes in Great Britain : the healthy teeth and mouths were as fairly tabulated as the unhealthy. It appears from these tables that decay .begins at a very early age, before 4, that there is a rapid increase from bad to worse in the decayed sets with each year of life, and that the inevitable fate of such sets in the course of years, unless controlled by treatment during childhood, is to become very bad, i.e., nine or more of the permanent teeth are decayed, extracted, or dropped out. British skulls in the museum of the Royal College of Surgeons show that dental caries, in skulls of ancient date, was almost entirely absent, and, where present, it was trifling in extent. Skulls of modern date show evidence of dental caries to a considerable extent. During the Boer war more than three thousand men were invalided home on account of defective teeth, and that notwithstanding the fact that dentists were sent out to attend the troops in the field, and that local dentists were employed at the base. Hospital statistics show that a largely increasing CHILDREN'S AILMENTS 123 number of patients require to be referred to the dental departments. There is also a largely increasing number of patients suffering from diseases of the stomach, and from other affections due to bad teeth. The rejection of recruits due to bad teeth has increased fivefold in the twelve years 1 891-1902. With these facts before us, it is obviously desirable that the children in the public elementary schools should be looked after by public authority, and parents instructed in the value and care of their children's teeth. Infectious Disease If proper precautions were taken in the homes, by the visitation of competent and responsible visitors, and by providing easy access in suspicious cases to medical advice, it should be a rare thing for any case of infectious disease to find its way into public elementary schools. Such cases under our present lack of system are only too frequent, and constitute a terrible public danger, and a source of great public expense. It is impossible to guard against them by the inspection of doctors and nurses alone, however frequent may be the visits paid by these to the school. The only remedy is to be found in the institution of proper care and attention to symptoms in the children's homes, and in constant vigilance on the part of the teacher. Every class should be examined daily by its teacher, just as men in the Army or Navy are examined daily by their officers. The local health 124 THE CHILDREN OF THE NATION officer could easily frame circulars for teachers, giving them the symptoms of the various infectious diseases, and any child which exhibited them should at once be segregated from the rest and sent off to the nearest dispensary or hospital. Nothing can be done in the homes of the children, until the practice of the Poor Law officials, to which the attention of the reader has been already called, has been entirely altered and parents encouraged to seek medical advice, whenever they have reason to suspect infectious disease, or until some better system of affording medical aid to the poor has replaced the clumsy and antiquated methods of the Poor Law. What this system should be I propose to discuss in the next chapter. CHAPTER VIII MEDICAL AID Existing Provision MEDICAL aid embraces diagnosis by a quali- fied practitioner, medicines, surgical and medical appliances, special diet, and the care of serious cases, unfit for domestic treatment, in a hospital. All these are well and sufficiently pro- vided in our country for those who can afford to pay for them. The nursing homes and the paying wards of hospitals give the rich the opportunity of hospital treatment, not so complete perhaps as can be obtained in most foreign countries, but adequate, and no doubt destined in the near future to considerable improvement and develop- ment. But the great mass of the people, who can ill afford to pay the great expense which serious illness involves, are very meagrely provided with medical aid. There are first of all the destitute, who cannot even defray the normal cost of living for themselves and their families ; then there are those who, under ordinary circumstances, as long as everything goes well, can just keep their heads 125 126 THE CHILDREN OF THE NATION above water, but whom sickness in their family must, in the absence of extraneous aid, promptly submerge ; and lastly, there are the prosperous and well-paid workers ; of these some have made provision against sickness, and some have not ; to these latter improvident persons the arrival of sickness means their reduction from prosperity to adversity and even destitution. For these classes, who constitute the overwhelming majority of the population, it is desirable, in the interests of public health, that better provision should be made, especially for their children. Otherwise all the medical inspection and care suggested in the previous chapters becomes of none effect, and the physical improvement of the growing genera- tion cannot be attained. The present public pro- vision of medical aid for those unable, when the need arises, to pay for it themselves, consists (i) of workhouse infirmaries established under the Poor Law and controlled by the Boards of Guar- dians ; (2) of charitable hospitals and dispensaries maintained by voluntary subscriptions, entirely exempt from public control, and having no support out of public funds ; (3) of friendly societies, sick clubs, and those trade unions which give aid in sickness ; and (4) of municipal hospitals which re- strict their aid not by law but by practice to certain kinds of infectious disease. Nothing like the muni- cipal hospitals which are to be found in almost every Continental city exist in our country. In these every citizen is entitled to medical care ; MEDICAL AID 127 and those only who are able to pay are required to do so. Workhouse Infirmaries Workhouse infirmaries have in recent years been greatly improved. Formerly most of them were wholly unfit for the reception and care of the sick. The buildings were insanitary, and kept in a condition of dirt, the nurses were old incapable paupers, the medical staff was insufficient and some- times inefficient, medicines and invalid diet were parsimoniously provided ; the great object was to save the rates and let the inmate of the infirmary die without public scandal. Some of these old- fashioned infirmaries doubtless linger still in benighted places, but great reforms have taken place of late years, and many of the workhouse infirmaries compare favourably with the best hospitals ; sanitary improvements and cleanliness have been introduced, trained nurses are ex- clusively employed, the medical staff is of first- rate quality, and everything that is ordered by them for the patients is at once supplied. These infirmaries are intended, according to law, for the destitute only — that is, for those who are unable to pay for the hospital treatment which their condition demands. But children, whose parents from any cause whatever, whether from poverty or neglect, fail to provide medical aid are therefore M destitute," and are by law entitled to partake of the public medical aid, which the 128 THE CHILDREN OF THE NATION Guardians are, by the Poor Law, under an obligation to provide. But in this, as in so many other particulars, children have, by the governing class, been robbed of their just rights, and the administra- tion of the law by Boards of Guardians has too well succeeded in preventing parents from claiming their children's rights, and in abandoning them to struggle through their illnesses not in a well-ordered in- firmary, but in the misery of a slum house. It is to no purpose that in recent statutes the principle has been that medical relief does not pauperise. The Guardians declare that it does, and make the law of none effect by their administration. The medical inspection of schools, and the visitation of the homes of the poor by persons accredited by public authority, would bring to light a vast amount of medical aid of which the children of the poor stand urgently in need. This the Boards of Guardians, so long as the physical care of children is left in their hands, would have to take measures to supply. It is especially desirable that better provision should be made for the treatment of children suffering from certain infectious diseases. Measles is by far the most fatal disease of child- hood amongst the poor. It is not so amongst the rich, because their children are in illness better cared for. In Germany, all children suffering from diphtheria, scarlatina, measles, whooping-cough, &c, are sent to hospital and treated in separate wards. Small-pox is a disease unknown in Germany. In Great Britain it is only a certain limited class of MEDICAL AID 129 infectious diseases that is in practice treated in hospitals at the public expense, and in this class measles is not included. Children are by law, however, entitled to the public care in all their diseases, in default of being properly cared for by their parents. If the law were effectively carried out, children's epidemics and children's deaths would be greatly diminished. The Boards of Guardians should establish children's wards in their infirmaries for cases fit for hospital treat- ment. They might also organise public dis- pensaries, at which medicines, special diet, and medical or surgical appliances, ordered by the school doctors, could be obtained. Charitable Hospitals Hospitals are a good example of the attempt to discharge by private charitable enterprise functions which properly belong to the State, but which the State has neglected to perform. Every Sanitary authority under the Public Health Acts has power to establish and maintain general hospitals for the sick. It is their neglect to exercise this power that obliges charity to step in : the partial occupation of the ground by charity, affords an excuse to the State for continuing its neglect ; and thus we revolve indefinitely in a vicious circle, from which there is apparently no outlet. In nearly every other country the establishment of public hospitals, for all the inhabitants of a town 130 THE CHILDREN OF THE NATION or district, is regarded as one of the most necessary and important functions of the Municipal Authority, and such a scandal as that which has occurred at St. Mary's, Paddington, where a new wing, built by voluntary subscriptions, cannot be opened for patients for lack of funds, would be impossible. To hospitals in Germany every citizen, nay every foreigner, resident in the city for the time being, is entitled, on medical recommendation, to admission. If he can pay he is required to do so — in Berlin the charge is about 3s*. 6d. a day — if he cannot, he is treated gratuitously. In most places all patients are treated alike — sickness is regarded as a democratic leveller of all social distinctions — but in some hospitals there are higher classes, to which admission is obtained by extra payment, and in which superior comforts, but not better medical treatment, are to be obtained. The class for which charitable hospitals provide is an ambiguous and uncertain one. The authorities of a hospital have only a secondary interest in the domestic condition of their patients ; they have far too many other, and to them more important, matters to attend to, to waste much time in either investigating the economic condition of those who occupy their beds and frequent their out-patient rooms ; it is not possible for them to make any attempt to obtain payment for the services they have rendered. They there- fore pay little regard to anything but the physical condition of those with whom they have to deal. First of all they have the great question of ways MEDICAL AID 131 and means to attend to. There is not, I suppose, a hospital in Great Britain whose usefulness is not impaired by lack of funds ; and a great part of the time and thought of the managers of a British hospital is taken up with the vital question of how to provide the funds, which the managers of a German or French hospital obtain from public sources without trouble on their part. Then they have to pay attention to the real purpose for which the British hospital primarily exists — to be a school of medicine and surgery for students seeking admission to the medical profession, and for the women who qualify themselves there for the nursing profession. It is the received principle that hospital patients should be above the destitute class, which has in sickness to seek relief from the Poor Law, and below the class which is able to pay for private medical attendance. But no serious attempt has ever been made to delimit the class, or to see that the patients received belong to it. The physical condition of the applicant is the point most re- garded. A millionaire or a pauper, who had sus- tained some rare and interesting fracture, would be received with the warmest welcome, not for his riches or poverty but from the nature of his accident : a man, rich or poor, suffering from some mere vulgar ailment would be treated, if at all, without much interest or concern. Many enjoy the advantage of hospital treatment gratis, who could well afford to pay ; and some, it is alleged, disguise themselves as poor persons in order to obtain it : 132 THE CHILDREN OF THE NATION many who cannot afford seek admission in vain. As a provision for the requisite medical aid for the nation, hospitals do not cover the ground. They perform their work excellently in the case of those whom they treat ; but there is a large class of people left out in the cold, whom the hospital treat- ment established by private enterprise does not reach. Friendly Societies Voluntary clubs and societies in Great Britain which undertake to give relief to their members in sickness, exhibit every possible variety in the contributions they require, the benefits they promise, and their capacity to fulfil their contract with their members. Provision for old age and invalidity is undertaken by many, in addition to provision for sickness. These friendly societies play a very great part in the provision of medical aid for the people of Great Britain. They have as many as 6,000,000 members, and hold property for the fulfilment of their obligations to the sick and aged amounting to upwards of ^40,000,000. They are grouped into Orders with fantastic names, quaint ceremonies, and mediaeval costumes, the United Order of Oddfellows, the Ancient Order of Foresters, the Ancient Shepheards, the Order of Druids, the Order of Buffaloes, and so on. But each Order has numerous branches, conducted according to the general regulations of the Order UNSVfcKOl I T MEDICAL AID 133 but financially independent. All these branches are not actuarially solvent, but efforts have been made of late years to bring them all to a standard of complete solvency, with great success ; and as there is generally a power to make a levy in case of emergency on the members, no worker who insures in any of those old-established societies runs any risk of being left in the lurch in time of sickness. Accounts are regularly audited by public auditors. As a specimen of these Orders, the Ancient Order of Foresters has 923,662 members, and funds amounting to more than ,£8,000,000. It has 4,838 branches, and embraces in its membership both women and children. During one year it paid sick pay to 184,387 members, who received an average allowance per member for 51*42 days. It does business in life assurance and old age pensions. It held its annual '•High Court" in 1905, in the Town Hall at Newcastle-upon-Tyne, which was presided over by the " High Chief Ranger." Addresses of welcome were presented by the Mayor and Sheriff of the City and County, and the representatives in Parlia- ment. Lord Armstrong invited the High Court to an afternoon entertainment at his country seat near Newcastle. The friendly societies of the United Kingdom, with their 6,000,000 members, thus com- pare very favourably even with the compulsory assurance system of Germany, with its 10,000,000 subscribers. As far as the better-paid workers are concerned, the system leaves little to be desired, 134 THE CHILDREN OF THE NATION except its gradual extension and development ; and any reform which destroyed all this voluntary effort would be most injurious, at any rate at its commencement, to the social interests of the people. Unfortunately the system does not reach the worst paid and most needy. It is just those who are too poor to make provision for sickness, and who, when sickness comes, are plunged into the worst misery and destitution, that the friendly society system fails to provide for. It is by the inclusion of all workers, well- and ill-paid, that the German system manifests its superiority. The very poorest and their children have by it medical aid assured. It is worthy of observation how little those public authorities, who administer the Poor Law, encourage the thrifty worker to make provision for sickness by putting his savings in a friendly society. It was long the policy of the Poor Law Board, and the Local Government Board which succeeded it, to instruct the Poor Law Guardians not to give any further relief to members of sick benefit societies, beyond the amount which would put them on an equality with those who had never saved at all. Membership of a friendly society was to afford no other benefit that that of " avoiding the degradation of parish support." "Degradation" was the insulting name applied by public authority to the conduct of a citizen, who, on behalf of him- self, his wife, or child, claimed the legal right to that relief in sickness which the law provided for him. No such epithet would be thought of in the case MEDICAL AID 135 of any member of the richer classes who enforced his legal right, even at the expense of the public. Through the strenuous exertions of the friendly- societies an Act of Parliament has recently been passed, expressly empowering the Guardians to do their duty, and give relief to persons notwith- standing membership of a friendly society, and to grant such relief without deduction of the money received from the society. This statute is per- missive only, but if the people will elect Boards of Guardians which will carry the law into execu- tion, subscriptions to friendly societies will in future enure to the benefit of the member and his family, and be no longer a contribution which he is de- luded into making in relief of rates. Municipal Hospitals Every municipality has under the Public Health Acts, as the Sanitary authority, the most ample and unrestricted power to provide hospitals for the sick, for the use of the inhabitants of their district. They can either build them, or rent them, or enter into a contract with the managers of an existing hospital, to pay for patients sent by the municipality. This, however, is one of the dormant powers of the Public Health Acts, which has never been fully carried out. The Local Government Board, which seems to exist for the purpose of checking municipal enterprise in the supposed interest of the wealthy, has no authority to prevent the provision of 136 THE CHILDREN OF THE NATION hospitals, under the general power of the Public Health Acts ; and the electors of any borough could, if they chose, at any time elect a Town Council, pledged to the establishment of a system of public hospitals, financed and managed by the Town Council in the same way as those which exist in almost every city in Europe. The public authority can charge those who are able to pay with the cost of their maintenance in hospital, and recover the amount from them as an ordinary debt. In practice, the provision of hospitals by municipal authorities has been restricted to those infectious diseases, of which, by law, notice has to be given to the Sanitary authority. These are defined by Act of Parliament, and to them no addition can be made without the consent of the Local Govern- ment Board. The diseases mentioned in the Act are small-pox, scarlatina, diphtheria, typhus and typhoid fevers, plague, and Asiatic cholera, and to these have been added in Bolton and Sheffield by local Acts — phthisis. In the case of these diseases, the British Legislature has taken an entirely new departure, and has established the principle of free medical aid in sickness of this particular kind, in as absolute and unqualified a manner as the most ardent socialist could desire. The dread of infectious disease on the part of the governing classes has proved strong enough to conquer even the dread of socialism. Measles and whooping-cough are not included. Measles amongst the poor is the most common and fatal of all infantile MEDICAL AID 137 diseases, but the children of the rich, though they have measles, do not die of it : the mortality amongst them is practically nothing. Any person who is suffering, or who has a child that is suffering, from any " notifiable " disease, is under a legal obligation, enforceable by penalties, to notify the fact to the municipal Officer of Health. He is under a further obligation to conform to regulations made for the isolation of the patient, the disinfecting of the house, furniture, and bedding, and other means of preventing the spread of infection. Unless the patient can be satisfactorily isolated in a private house, he must be removed to the public hospital, and there cared for till he dies or recovers. The cost of the ambulances by which the sufferer is taken to hospital is defrayed by public authority. Few public authorities, so far as I have been able to ascertain, require any payment from the patient for his main- tenance in hospital, though entitled to this in case he is able to pay. The Metropolitan Asylums Board in London give gratuitous treatment in their hospitals without any charge whatever. In London there are fifteen hospitals for infectious diseases, and in the year 1904 there were admitted to them 11,155 cases of scarlet fever; 4,687 of diphtheria; 750 of enteric ; 3 of typhus ; and 449 of small-pox. They have besides two schools, which are practically hospitals, for children suffering from ophthalmia, and two for children suffering from ringworm, with 498 in the former and 569 in the latter. In London the Borough Councils are the Sanitary 138 THE CHILDREN OF THE NATION authority, and it is by them that the general powers of maintaining hospitals for the sick under the Public Health Acts can be exercised. The Paddington Town Council has full power to maintain the empty ward of St Mary's Hospital out of the rates. Thus, so far as this particular class of infectious disease is concerned, the socialistic principle of free medical aid in sickness is fully established, and has, without our recognising it, been long in actual practice. The ground on which this remarkable departure from individualistic principles would be defended is public safety. The isolation and treatment of these infectious diseases is a matter of common interest to all, and the common purse, therefore, properly bears the cost. But there are many other diseases to which precisely the same argument may be applied ; nothing but the conservative obstruction of the Local Govern- ment Board has kept them so far out of the category. There are three diseases, the admission of which to the category of " notifiable " diseases has been discussed by many Sanitary authorities — measles, syphilis, and tuberculosis — but so far, except as to the last, without practical result. The first, which is the most fatal infectious disease of child- hood, is not in principle distinguishable from scarlet fever or diphtheria, but is less fatal to adults and to the children of the rich : otherwise it would have been included long ago. Syphilis is more dangerous and destructive than any other infectious disease in this, that its effects descend to children yet unborn, MEDICAL AID 139 and even to a second and third generation, innocent of the moral sin which is often, but not always, the cause of its original contraction. Tuberculosis, now recognised as an infectious disease, capable by proper means of being stamped out, is generally excluded for no reason whatever ; in two cases at least, Sheffield and Bolton, it has, with the assent of the Local Government Board, been included by local Acts. The power of veto of the Central Government only extends to preventing any disease from coming under the provisions as to notification and isolation, and to its exclusion from the hospitals of the Metropolitan Asylums Board. The provincial Sanitary authority can, under the general powers of the Public Health Acts, provide hospitals for measles, syphilis, phthisis, and any disease they think fit, and admit people without payment if they choose. They can, under the existing law, carry out to the fullest extent the socialistic principle of free medical aid in sickness, so far as hospital treatment is concerned. Free Medical Aid It is evident from the foregoing considerations, that if any real effort is to be made by public authority for the improvement of public health and for securing a sound and vigorous race in time to come, one of the first essentials is to make a radical reform in the public provision of medical aid. Every poor man must be in a position to 140 THE CHILDREN OF THE NATION command in time of sickness or accident the necessary advice, medicines, and appliances for himself, his wife, and children. The British volun- tary system, built up by the friendly societies, is admirable as far as it goes, but it does not reach the poorest and most necessitous. Municipal hospitals are at present confined to diseases dangerous to the governing classes : measles, the grim destroyer of the children of the poor is excluded — it does not kill the children of the rich. The workhouse infirmary, which in well conducted Poor Law Unions is as good as any hospital, is, it is true, always available ; but the poor are taught that it is "degradation" to claim its benefits even in vindication of the legal rights of their children. It is evident that some further supplementary provision is required. There are two plans possible : one is to make medical aid free, as education and vaccination are free ; the other is to provide by a system of universal and compulsory insurance against sickness, so that every poor man will, by his savings, have purchased the right to free medical aid for himself and his family should illness or accident overtake them. Of these two plans the first would be at once denounced and dismissed by the great majority of rich people as flat socialism ; the latter would have a much better chance of being accepted. But in truth there is little difference in principle between the two. The result is in both cases the same — a right of every poor man to necessary MEDICAL AID HI medical aid without further payment. The only difference is in the method by which the cost is to be defrayed. In the one it is met out of the national revenues to which every citizen contributes according to his means or out of that part of the unearned increment of land which is appropriated to public purposes ; in the other, by a special tax on the earnings of the workers. Free medical aid is no doubt socialism, but it is no more so than free education or free vaccination. It is defensible upon exactly the same principle as that upon which the whole of our national expenditure has to be justified. The State may and ought to do what it is the interest of the whole community to have done, and what the State can do collectively for the people better than they can individually do for themselves. It is this principle that justifies taxation to keep up the Army and Navy to preserve us from foreign aggression ; it is this which justifies the expenditure on police and magistrates to keep order at home. The strong man armed has no longer to keep his house himself that his goods may be at peace. If a poor man's illness injured nobody but himself, society might leave him to his own provision against it and decline to meddle in his affairs. But his sickness injures the com- munity, the sick man from a helper becomes a burden, and it is the interest of all to put a stop to this state of things as speedily as possible. To accomplish this by providing aid in sickness, the State may as properly tax itself as it may for any 142 THE CHILDREN OF THE NATION public purpose useful to the commonwealth. It is socialism of that kind without which modern society cannot continue to exist. To any proposal for free medical aid in sickness unless restrictions were attached to it, the most strenuous opposition would be offered by all the existing friendly societies and their officials. It would be denounced as interfering with their vested interests, for if medical aid was free to all, who would think of becoming a member of a friendly society ? But the aid which was free might be restricted to medical advice and medicines, and might include no provision for the maintenance of the sick man and his family during his inability to earn wages. Friendly societies would then still have an im- portant function to perform. It would still be the interest of all workers to become members of a friendly society, in order to secure a maintenance provision for themselves and their families during the time of sickness. In the absence of such provision they might be driven, notwithstanding the State's offer of free advice and medicine, to dependence upon the Poor Law. The right to free medical aid might also be restricted to children. Friendly societies, it is true, have juvenile branches, but the number of juvenile members is comparatively small, and the societies would not fight so strenuously for their retention. In this case no new State obligation would be created — the State is now liable for medical aid to children in the event of parents failing to provide MEDICAL AID 143 it — only the chance of recovering the amount expended from the parent would be given up, and this is not generally of much value. The parent would still remain liable for the ordinary main- tenance in food, clothing, and lodging of his sick child, just as he is for his sound child ; he would only be relieved of the extra cost occasioned by sickness, and of nothing more. Sick children are a source of much greater danger to the State than sick adults, and .this is ample justification for the State assuming the cost of attending and curing them. State Insurance against Sickness If the opposition of the friendly societies, and the terror which the richer classes feel at anything which is called " socialism," prevent the adoption by the State of free medical aid, the same objections cannot be urged against a system by which all workers insure themselves against sickness. In- deed the absence of such a system is in some sense an injustice to those thrifty members of the working class who have joined friendly societies. Sick people and their families have after all to be cured and maintained. You cannot economise medical treatment in sickness. It is cruel and it is wasteful. Yet you are constrained to give to those who have made no provision at all treatment as good as that which the member of a friendly society has provided out of his 144 THE CHILDREN OF THE NATION earnings. This plan of compulsory insurance against sickness and accident has been carried out with great elaboration and success in Germany. Thirty or forty years ago the political necessity of taking steps to improve the social condition of the workers struck simultaneously many great minds in Europe, amongst others those of Mr. Disraeli and Prince Bismarck. The former in reorganising his party after its crushing defeat in 1868 appealed to the workers for their support and promised social and sanitary reform as the first constructive policy of his party if he was again entrusted with power. The Conservative working man and the Conservative majority of 1874 were the answer to his appeal. The Parlia- ment of 1874 was distinguished above every other Parliament of the last century for its social and sanitary legislation. Since Mr. Disraeli's death, the zeal of his party for social reform has gradually evaporated. The rise of the new Labour party has been the result, and the confidence now lost by the governing classes may never be restored. Prince Bismarck, who was under no necessity of courting the democracy, went upon a different line. After the conclusion of the French war he impressed upon the German Emperor and upon his colleagues in administering the affairs of the Kingdom of Prussia and of the German Empire, the necessity of furthering the welfare of the working people in Germany. He suggested to the aged Emperor that he should MEDICAL AID 145 carry with him to the grave the consciousness of having given to his country an additional and lasting assurance of internal peace, and the con- viction that he had rendered to the needy that assistance to which they were justly entitled. In order to realise these views the great insurance laws of Germany were carefully and elaborately prepared and enacted. They have been amended since their enactment as the result of experience obtained in their practical working, but their principle has not been altered. They provide for all workers throughout the German Empire protection against pecuniary loss resulting from industrial accidents, from sickness, from invalidity, i.e., incapacity any longer to earn a living, and from old age. The funds for these purposes are provided partly by the workers themselves, partly by the employers, and partly by the State. In the case of sickness there was no interference with existing benefit societies provided they were actuarily solvent and gave the minimum of sick benefits required by the State system. But every worker was obliged to be insured either in them or in the State insurance. His weekly contribution was regulated by the amount of his weekly wages and other conditions, but roughly it amounted to something like threepence per week all round, some more some less. The amount was deducted by the employer on pay-day, and was paid in by him with an addition of 50 per cent, to the insurance society or the State, as 146 THE CHILDREN OF THE NATION the case might be. This is of course a tax on wages, and both the direct contribution and the 50 per cent, augmentation paid by the employer, come ultimately out of the worker's pocket, and diminish to that extent the wages he would other- wise obtain. It is the compulsion exercised on the worker by a paternal and benevolent Govern- ment compelling everybody to do that which the prudent and thrifty would do of their own accord. Probably the wild independence of the British worker would make it difficult to induce him to accept such a legal obligation. In the case of industrial accidents the whole of the funds required are provided by the employers and are regarded as part of the costs of production. Compensation is obtained by the injured worker or his family not directly from the employer, as the discharge of a legal claim or as the result of costly litigation, but is awarded to him or them by an insurance society. In case of dispute the claim is decided by a tribunal of arbitration composed of a judicial officer, a representative of the employers and a representative of the workers ; the proceedings are prompt and involve no expense to the claimant. In the case of invalidity and old age an amount varying according to age and wages, roughly amounting to a little more than a penny a week all round, is contributed by the worker and deducted as the sick insurance from his wages. To this the employer adds an equal amount and pays the whole sum into the State insurance office. MEDICAL AID 147 When invalidity or old age {i.e., the attainment of 70 years of age) supervene and the weekly pension becomes payable, the State adds to it a sum of 50 marks per annum. The minimum relief under these insurance laws, to which all the insured have a legal claim, includes — 1. Free medical attendance and medicines from the beginning of the illness, likewise spectacles, trusses, bandages, &c. 2. In case of incapacity for work from the third day of the illness for every working day for twenty-six weeks a sick pay amounting to one-half the daily wages on which the contributions have been based ; or, if the case is one for hospital treatment, free admittance to a hospital together with half the sick pay for the family. 3. Burial money amounting to twenty times the average daily wages. 4. Sick relief to women during six weeks after confinement. Extra relief may be given for increased contri- butions. The law allows the double insurance of sick pay up to the full amount of the daily earnings. It also authorises the extension of relief for a whole year instead of twenty-six weeks, and for women to twelve instead of six weeks after confinement. The relief may be extended to other members of the family and to convalescents. The compensation in case of accident consists of— 148 THE CHILDREN OF THE NATION i. In case of bodily injuries from the beginning of the fourteenth week after the accident {i.e., in continuation of the sick insurance) free medical aid, including the necessary medicines and remedies, and a pension during the period of disablement, amounting in case of total disablement to two-thirds of the yearly earnings ; or free hospital treatment until the cure is finished, and a subsistence pension for the family in the meanwhile. 2. In the case of fatal injuries, burial money equal to a fifteenth part of the yearly earnings but not less than 50 marks, and pensions to dependent survivors, including widows, children under 15, orphan grandchildren, needy parents and grand- parents, from 20 to 60 per cent, of the yearly earnings. The invalidity and old age pensions and the contributions required to purchase it vary according to the class to which the worker belongs. The wage-earners have been divided for this purpose into five classes : I., those whose yearly earnings amount to 350 marks or under; II., to 550; III., to 850; IV., to 1,150; V., above 1,150 marks. The weekly contribution varies from 14 pfennige in Class I. to 36 in Class V., i.e., from i*68d. to 4'32d. The old age pension obtained amounts in Class I. to no marks per annum; in II. to 140; in III. to 170; in IV. to 200; and in V. to 230. The invalidity pension consists of the State subsidy of 50 marks, and of a sum paid out of the insurance fund which is increased as time goes on. At MEDICAL AID 149 present this sum varies from 60 marks in Class I. to 100 in Class V. It is estimated that in fifty years, when the increasing charges have reached the highest point and the pensions annually coming on and going off the funds will balance each other, the invalidity pensions will be — in Class I., 185 marks per annum; in Class II., 270; in Class III., 330; in Class IV., 390 ; and in Class V., 450. The invalidity pension is much higher than the old age pension, and rightly so. No man, whatever his age, is in need of a pension for himself at least, so long as he retains the capacity to work. If unable to work he has not in Germany to wait till he is 70 years of age — he can claim and obtain his pension at once. At 70 he gets a pension even though still able to work ; but his old age pension can be turned into an invalidity pension of greater amount whenever his vigour fails. It is almost impossible to overestimate the beneficial effect on the social condition of the German nation which these great insurance laws have produced. The funds have no doubt been mainly supported by the taxation of the workers themselves. The contributions of the capitalists are rather illusory. But the result of having the best medical aid in sickness and accident brought within reach of every man has told upon the health and vigour of the people, and is producing a race which must inevitably leave us far behind unless some vigorous reforms are promptly insisted on by the people of Great Britain themselves, and the governing classes find themselves constrained, 150 THE CHILDREN OF THE NATION in order to preserve their political power, to have such reforms carried into execution. The day of amateur dilettanti public men has gone by ; the nation demands serious statesmen, who will employ competent administrators. Testimony of the Birmingham Brassworkers In 1905 the brassworkers of Birmingham sent a deputation to Berlin for the purpose of comparing the condition of the brassworkers of the two cities. Nothing can more strikingly illustrate the contrast between British and German methods of education than the result of their inquiry. They were "greatly impressed with the cleanliness and tidiness of the children playing about in the streets, courts, and squares. Of all the thousands of children there was not one who was not clean, neat, and tidy." They visited a public school for two thousand children in the Rigaef Strasse — a quarter in- habited by the poorer classes. They saw "no case of underfed, poorly clad, or untidy children, either in the streets or in the school. They must come clean and well dressed. There are thirty- six official school doctors in Berlin, each having a group of about seven schools to attend to. Every new scholar is examined by them, and doubtful children are thoroughly examined in the presence of their parents. If needful they are kept under medical supervision, and special seats are provided where defective vision or hearing render it ad- MEDICAL AID 151 visable. Spectacles or instruments are provided. The Director has funds supplied with which to help needy children with food ; but the sum required was practically nothing, for it only amounted to £2 among the two thousand. In the basement were extensive bathing accommodations, principally warm shower baths. Each of the two thousand children received a shower bath weekly. Soap was provided but they brought their own towels." The same deputation visited a Birmingham Board School in a workman's neighbourhood, inhabited by the poorer classes. " The children," they reported, " were mostly dirty and tattered ; a large number wore very bad boots, not cleaned ; and some with soles so dilapidated that the toes showed through. The physique of the children was puny. The morning was warm, and although the windows were wide open the smell was oppressive and unclean. The class-rooms and desks were washed seven times a year and swept daily. The closets were on the yard and flushed daily. They smelled offensively. Outside the school there were evidences that the children of the neighbourhood were un- disciplined and out of control. In comparison with the Berlin school everything was very dirty and untidy. There was one thermometer in the large class-room and none in the smaller class-rooms. A great number were employed as Daily Mail boys, in barbers' shops, on errands, or in small businesses. There were many underfed children. There is one medical officer in Birmingham and one assistant 152 THE CHILDREN OF THE NATION lady medical officer. He visits this school once a year, and the parents of the children who are unfit are advised to get them attended to." The contrast observed by the brassworkers between these two schools is the best possible illustration of the difference between the care which Germany takes of the children of the nation and the care which Great Britain is taking of hers. CHAPTER IX THE FOREST SCHOOL AT CHARLOTTENBURG THE municipality of Charlottenburg, which is already famous in the educational world for its great technical school, established two years ago a sort of hospital school in a pine forest near the town for physically weak children who were under medical treatment. The school is a concrete example of what a prudent State should do for the rising generation, in order to secure that the future race of citizens shall be healthy and strong. The plan is one that any municipality in England could imitate without further statutory powers under the provision of the Public Health Acts. For the benefit of any authority which may be disposed to establish a similar health resort for school children, I will describe the school in some detail. Origin of the Idea The idea sprang simultaneously from the Edu- cation and Sanitary departments of the Municipal Government, and was worked out by them in 153 154 THE CHILDREN OF THE NATION concert. They agreed that it was eminently desir- able that some care should be taken by public authority of children who were feeble in body, as had already been taken of children who were feeble in mind. The plan of open-air treat- ment was the natural development of the open-air sanitoria for the treatment of consumption, which form now a regular municipal institution in every German city — an institution which efforts are now being made by charity to copy in this country. The Education department cherished the hope that through increased care for the children's health, which would be attained by stimulating the mind and strengthening the body through a life in the woods amidst light and air, the educational results would be much more satisfactory ; the Sanitary department looked for a great improvement in the muscular and vital conditions of the sickly school children through transplanting them from the streets and alleys of the town to the healthiest environ- ment that was attainable. When these two authori- ties came to an actual examination of the school children, they found that there were some whom the teachers would gladly weed out for the purpose of obtaining a better scholastic result, and there were some whose physical condition, from the stand- point of the school doctors, required amending and strengthening, and that the two classes were prac- tically identical. A considerable number of scholars, in consequence of anaemia and bodily feebleness, were used up in body and mind by a few hours of FOREST SCHOOL AT CHARLOTTENBURG 155 school work ; their attention flagged ; they could no longer follow the instruction with the necessary effort ; and by the daily recurrence of this lack of freshness, they ended by falling hopelessly behind their fellow-pupils. Many of these were children of bright mental powers, quite fit to take their place at the head of the class, if their bodily deficiency was made good. In looking through the classes, the schoolmaster and the doctor, each from his different point of view, pitched upon the same children as requiring more separate and individual care both for their mental and corporal well-being. The Education and the Sanitary departments were thus united in the opinion that there should be es- tablished in the fresh, bracing air of the pine forest by Charlottenburg a school for ailing and convales- cent children, at which the pupils should receive special care for their bodily infirmities, and should at the same time go on with their education, so far as their health permitted. The Establishment of the School In the beginning of the year 1904 the attention of the Municipal Council of Charlottenburg had been called independently to the general desirability of establishing sanitoria for sickly school children. Meanwhile the forest had been explored and a suitable site discovered, about eight minutes' walk from a station of the electric railway which passes through the forest. It was an undulating sandy 156 THE CHILDREN OF THE NATION spot, carpeted with short, springy turf, and thickly covered with fir-trees. The wood contained clumps of bramble bushes. There was fresh air free from dust, and a silent stillness in the forest, inviting to rest and restoration. A private company to which that part of the forest belonged conceded the right to use the land for the purpose of a school for several years. The " Vaterlandische Frauenverein " undertook the domestic arrangements of the school for costs out of pocket and gave for the use of the school a wooden building worth 4,500 marks. In May the project was definitely adopted by the Education department. On June 7th the con- ference of school doctors declared themselves satisfied with the details of the plan ; on the 9th the scheme was approved by the magistrates ; and on the 10th it was brought before the Municipal Council. It was recommended to the Council on the ground that in the public elementary schools there was to be found a considerable number of boys and girls whose condition of health was such as urgently to demand that they should not be instructed with the other children in the school classes. For them the atmosphere of a room, in which fifty or more scholars had been engaged for a whole morning, was especially dangerous ; the intervals of rest were too short ; and the exigence of a four or five hours' course of study was too great for their attention to last out till the end. Such children were those who were suffering from serious chronic disease of the lungs or of the heart, FOREST SCHOOL AT CHARLOTTENBURG 157 from extreme ansemia, and from scrofula, not ill enough to obtain admission into a regular hospital, but too ill to keep pace with healthy children. Re- maining in the crowded classes brought upon these children the risk of their lighter ailments developing into serious disease. To separate them from the rest, and to instruct them with the most active regard to the condition of their health, in a common school in pure, fresh air was just as much for the interest of the sick as for that of the healthy, and just as much for the interest of the school as for that of the home. Unanimously and without adjournment the Municipal Council adopted the scheme of the Forest School and voted 32,000 marks for the establishment of the school, and for current expenses to the end of the summer. The Prussian Government gave its sanction on July 5th ; and the Forest School, with ninety-five scholars, was opened on August 1, 1904. No children with infectious disease, or suffering from epilepsy, violent hysteria, St. Vitus' dance, or complaints of that kind were admitted ; they are otherwise cared for in Prussia. The children were selected by the school doctors from the public elementary schools of the town, and were finally examined and admitted by Dr. Bendix, who had medical charge of the Forest School. The Buildings The site of the school occupies about one hectare of forest, enclosed by a wire fence, a metre and a 158 THE CHILDREN OF THE NATION half high. It is entered by a gateway over which the blue and yellow flag of Charlottenburg floats. The buildings are all of one storey, inexpensive, and temporary. The school-house, which is on the right of the entrance, contains two roomy class- rooms, 8 metres by 6 metres for the children and small rooms for the teachers. There are large windows up to the ceiling generally kept open, besides other ventilation ; the rooms are full of light and air. These rooms are sometimes used in bad weather for dining-rooms and play-rooms, and have furniture provided for those purposes as well as for school. There is an annexe at each end for cloak- rooms for boys and girls respectively ; each child has a hook and a shelf of its own. Separated by a short distance from the school-house is a large shed, open on the south side but with an overhanging roof as a protection from rain. This is a refuge for the children in bad weather. On the left of the entrance, at some distance from the school -house, are the domestic buildings. There is a room for the sisters, who manage the domestic arrangements, a kitchen, store-rooms, and servants' bedrooms, a milk-cellar, and a kennel for the dog which pro- tects the premises at night. Adjoining the domestic buildings are washing and bathing rooms, very freely used by those children who are not restrained from cold water by doctor's orders. An abundant supply of pure water is furnished by the Charlotten- burg waterworks. Far removed from school-house and domestic buildings are the offices for the FOREST SCHOOL AT CHARLOTTENBURG 159 children, clean and sanitary. In front of the school-house tables and benches are set out under the high trees a table with its two benches for each class, graduated according to the size of the children ; to keep their feet from damp, foot-boards are laid under the tables. These tables may be used at any time ; their primary purpose is for meals and the preparation of school work. All around within the limits of the school site are scattered seats and benches of various kinds, many with a thatched roof ; they are much frequented by the older girls for reading and sewing. In a sheltered nook are swings, parallel bars, and other gymnastic appa- ratus, for children to whom these exercises are not prohibited by doctor's orders. Between the gym- nasium and the school-house is a large open space, shaded by trees, where the children dance and play games under the supervision of a young girl teacher. At the extremity of the site is a sandy bank honey- combed by the excavations of the boys, who give free rein to their imagination in the objects which they construct in the sand. In the summer of 1904 Port Arthur was many times stormed and taken ; when I visited the school in the following year I was introduced to a more peaceful scene ; I saw the Bavarian Highlands, entrance 5 pfennige, depicted in a sand hole. There were forests and green Alps ; there was a picket of soldiers in tents ; there were waggons and horses on the roads and tourists on the hillside ; there was even a waterfall down which a confederate at the right moment poured 160 THE CHILDREN OF THE NATION water from a watering-can ; and there was a rare flower which grew only in the Bavarian Alps, which the showman, a bright little boy of 10, plucked and presented to me. In front of the school-house and in other suitable places are beds of flowers and flowering shrubs, intended not only for ornament but to give lessons in gardening to the children, and especially to the girls. Lessons For teaching the children were divided into six classes, no separation being made between boys and girls. This mixing of the sexes is not usual in Prussian schools ; but the novel experiment was satisfactory. In the view of the authorities it had not merely no drawback, but even advantages of various kinds. Many a clumsy, heavy boy felt stirred up to greater activity when a lively little girl next to him held up her hand before he did to answer the teacher's question. The girls, on their side, took a lesson from the greater calmness of the boys, and answered with more reflection. On the rougher manners of the boys the presence of the neater and gentler-behaved girls had a moderating influence. The school hours were for the lowest class two hours a day, for the three next two-and- a half hours, and for the two upper classes thirteen or fourteen a week. The classes were so small and the individual attention that could therefore be given to each child was so great, that FOREST SCHOOL AT CHARLOTTENBURG 161 in spite of the shortening of hours the knowledge and capabilities that could be instilled into each child were not less than could have been acquired in the ordinary school. On their return to the ordinary school, they found themselves on the same level as their former class-mates. Instruction in singing, physical exercises, and nature knowledge, was given, as far as weather permitted, in the open air. School Life of the Children The life in the Forest School was as follows. The children, about 120 in number, arrived ata quarter before eight o'clock in the morning. Those who lived near came on foot ; those who lived at a distance, by the electric tram to the " Ruhwald " station. The Charlottenburg Street Railway pro- vided reserved carriages at a stated hour at certain fixed stopping stations, and brought the children up into the Forest at a charge of 3 marks a month. On their arrival they each received a bowl of soup and a slice of bread and butter. At eight o'clock school began for two classes, but in order to pre- serve them from undue fatigue, the time was divided into half-hour lessons ; after each half-hour there was a five minutes' rest and a ten minutes' rest after each hour. Longer than two hours at a time no instruction was continued. This arrangement proved itself effective in the most important branches of study. If, for example, these ailing children had 162 THE CHILDREN OF THE NATION vigorously worked at arithmetic for half an hour, their capacity for work of that kind was exhausted, and rest was urgently required. But a few minutes run into the invigorating air of the woods so freshened them up as to enable them to follow with attention instruction in a fresh subject. In the interest of their health it was inexpedient after the rest to go back to arithmetic, or a subject of the same nature. At ten o'clock all the children received a basin of milk and a slice of brown bread and butter. Then two other classes went into the school, while the rest of the children occupied themselves as they pleased ; they played or visited the gymnasium, or they sewed or read. At half-past twelve the bell rang for dinner. The school classes took their proper places at the long tables under the trees. The dinner consisted of meat, potatoes, vege- tables, and fruit. A sister of the Red Cross with three servants attended to the domestic arrangements and the cooking. The food was good and appetising, and was varied from day to day ; the life in the woods generally produced a great increase of appetite. There was no stint ; they might ask for more as often as they liked, and get it. After dinner all children are required by medical orders to rest for two hours. Rugs and reclining chairs are provided for each child. At first it was extremely difficult for many of them to keep still even for an hour, but in time the teachers succeeded in procuring absolute stillness ; most of them spent the two hours in sleep. At three o'clock the last two classes, not the same FOREST SCHOOL AT CHARLOTTENBURG 163 every day, went to school. At four all the children received their afternoon basin of milk with brown bread and jam. Then followed one or two hours more school for the older classes ; but for most the afternoon was given up to play. The last meal, cocoa or pudding and bread and butter, was given at half-past six o'clock, and at seven they set off home again. For thirty poor children the Munici- pality provided the tram-fare ; ten others had free tickets given them by the directors of the Street Railway. The Teachers The staff to which this important experiment in education was entrusted consisted of three men and one woman teacher, transferred for the purpose by the Education department from their ordinary schools : two of the former had themselves suffered from phthisis, and been cured in the public out-of- doors sanatoria, and so brought special knowledge and experience to the work of the Forest School ; the woman was a Roman Catholic, and was en- trusted with the religious education of twelve Roman Catholic children who were among the scholars. In the afternoons several volunteer women teachers placed themselves at the disposal of the school authorities to help in the children's games. At first there was considerable difficulty in amalgamating the children into anything like uniform classes : they came from different schools, and almost all had, in consequence of continued 164 THE CHILDREN OF THE NATION sickness, been absent from school for long periods, leaving gaps in different stages of the school course to be filled up. The teachers, however, by honest work, combined with patience and perseverance, succeeded in the almost impossible task ; they had the advantage of being continually with their pupils out of school hours, so that they could give to those who stood in need of help much informal attention, and even special teaching. In this way defects in the individual scholars were found out and remedied, and the work of the classes improved from month to month. Discipline had also to be modified to suit the circumstances of the children. Anything like corporal punishment was out of the question, and was absolutely prohibited ; deprivation of a meal or exclusion from play was objectionable ; even scolding and ridicule were with such delicate subjects out of place. The teachers had to be very sparing of blame, and very generous with praise, and that, not only in school hours but in playtime as well. The shortness of the lessons made it necessary to go forward promptly, to pass over side issues, and not to devote precious time to the few who failed to understand, but rather give to them further explanation at some opportunity after the lesson was over. Visitors to the School At first all the arrangements of the Forest School aroused the most varied objections on the part of the FOREST SCHOOL AT CHARLOTTENBURG 165 parents : it was difficult to persuade them to con- tribute the moderate cost of maintenance. But by degrees, as the children grew better and happier in the green woods, as the pale cheeks turned red, as the eyes became bright and the movements more lively and fresh, so confidence was developed among the parents — they listened in the evenings to the tales of their children, who seemed to bring a breath from the forest into the hot, close city dwelling, and they began to visit the Forest School, to convince themselves, with their own eyes, of the benefits offered to their children. The number of visitors became so great that they had to be restricted to two afternoons in the week and Sunday afternoon. There were also visitors from German states and municipalities, from foreign countries, from educational and medical societies, even from the other side of the Atlantic. All went away praising the experiment of making sick children healthy and happy. In the merry, rosy- cheeked children jumping about upon the grass under the pine-trees it was difficult to recognise the feeble, pale-faced patients brought up from the streets of Charlottenburg. " I thought " said a lady visitor, " that the Forest School only took in sickly children." Medical Treatment The medical head of the Forest School selected the children for admission, as before stated, out of 166 THE CHILDREN OF THE NATION those picked out of the elementary schools by the school doctors, and kept them under medical care and observation during the whole period of their stay. Their condition of health was, during the first weeks, carefully examined, especially their heart and lungs, and particulars of their colour, muscular strength, nutrition, &c, were registered ; they were weighed every fortnight, and other neces- sary medical examinations were made. At the close of the summer all were again medically examined and their condition again recorded. Besides the general regulations of the school, special orders were given in individual cases, such as the dress of those suffering from heart troubles, prohibition of physical exercises, of excessive running about. Warm baths were ordered for the anaemic and nervous ; salt-baths for the scrofulous. Thus, during the first year, thirty-two children had each three salt-baths a week, and twenty-five had regular warm baths two or three times a week ; every child had two or three warm spray-baths a week. At the beginning and end of the time daily visits were paid to the school by the medical superintendent, and in the interval his duty called him there two or three times during the week. But so absorbing was the interest taken in this unique experiment that he was continually paying unofficial visits to witness the bodily and mental progress of the scholars, and to enjoy the sight of their healthy life and occupation in the fresh air. FOREST SCHOOL AT CHARLOTTENBURG 167 Health Results The report made on the improvement of the health of the children in the Forest School at the end of the three months for which it was open in 1 904, was most encouraging. The general symptoms of improvement after a few weeks' residence were astonishing. Their appetite was extraordinarily improved, their disposition became joyous and merry, their attention was lively, and the appear- ance of almost all thoroughly satisfactory. In 1905 the school was again opened on the 1st of May, and remained open till the 28th of October. There were 132 children in the school — 10 more than in 1904. By the kindness of Dr. Neufert, the Stadtschulrat of Charlottenburg, I am able to give the medical results of the second year's work, as officially reported to the Municipal Council by Dr. Bendix, the medical head of the school. The children were reported on in four divisions : — 1. The Ancsmic. — Out of 42 children — 24 girls and 18 boys — none had grown worse, 5 were un- altered, 19 had got better, and 18 were cured. 2. The Scrofulous. — Out of 50 children — 24 girls and 26 boys — none had grown worse, 6 were unaltered, 34 had got better, and 10 were cured. 3. Those suffering from Heart Affections. — Out of 7 children — 4 girls and 3 boys — none had grown worse, none were unaltered, but all had got better. In these diseases cure is out of the question. 4. Those with Lung Disease. — Out of 1 2 children 168 THE CHILDKEN OF THE NATION — 4 girls and 8 boys — none had grown worse, 3 were unaltered, 9 had got better, and none were cured. The weight of almost all the children increased greatly during their residence at the Forest School. Of those who had remained during the whole time the school was open, the average increase of weight was 3*316 kilo each in 1904 and 3*825 in 1905. Even during the cold and rainy weather in October, notwithstanding some deficiency in shoes and stockings, none of the children caught cold or suffered from catarrh of the nose or of the air vessels of the lungs. Education Results On the character of the children the Forest School exercised a favourable influence, especially in good order, cleanliness, and punctuality, as well as in consideration for one another. Life in the still wood, removed from all mischievous influences, the association with people of culture, the lively thankfulness for the good done to them — all this worked upon the children, so that they strove to show themselves worthy of the benefits received ; there was far less naughtiness in the latter than in the first weeks. An important factor was the influence which the children exercised on one another ; those who at first were dirty and untidy, or had uncouth manners were soon improved by the influence of their school-fellows. The school FOKEST SCHOOL AT CHARLOTTENBURG 169 work was satisfactory : only in five cases did the teachers express any dissatisfaction — in one case, it was because the sick child had been employed to distribute newspapers before the beginning of school. A few weeks after the return, in 1904, of the first batch of the children to the ordinary schools, the school authorities inquired of the headmasters of three different schools, and received, without excep- tion, favourable reports on the returned scholars, their greater freshness and keener interest in the lessons was again remarked. In January of 1905 an official report from all the schools on the condition of the children who had been in the Forest School was called for, especially on the point whether the children had so benefited by the instruction in the Forest School as to be fit to go on in their former classes. In twelve cases only had their school capacity weakened ; all the rest had lost no ground and some had notably advanced. But it must be remembered that in some cases the bodily condition of the children had meanwhile worsened, from the unhealthy condition of their food and their homes, from the overpressure of four or five hours a day of school, and sometimes from acute attacks of their malady. Three months, or even six months as in 1905, in the woods is too short a time to produce all the improvement possible in an ailing child. As the result of two years' experience of the Forest School, Dr. Bendix recommends — 1. That a greater number of sick children should 170 THE CHILDREN OF THE NATION be sent continuously year after year to the Forest School. 2. That the extension of the school buildings should be in the first instance directed to making it available in the winter months. 3. That the school should be enlarged so as to enable more children to be taken in. Cost The installation of the Forest School cost 21,296 marks (a little more than ,£1,000) ; the current ex- penses for the three months that it was open in 1 904 were 9,380 marks. The cost of each child's food worked out at half a mark per diem, and this the parents, if able, were required to pay ; for very poor children the whole cost of maintenance was undertaken by the town authorities. Before the child was received into the school the parent was required to sign a document containing particulars of his family, and his wages and means of sub- sistence, and undertaking to pay for the child's maintenance half a mark a day, or such smaller sum as, on consideration of his means, was demanded. The Municipality of Charlottenburg is now con- sidering the desirability of keeping open the school all the year round, winter as well as summer, and of making domestic arrangements whereby some of the children could remain all night on the premises, so as to convert the summer day school into a permanent sanatorium for children, with the FOREST SCHOOL AT CHARLOTTENBURG 171 accession of a large number of day scholars during the summer months. I had the great pleasure and satisfaction of visiting the school in June, 1905, and can bear testimony, so far as my observation goes, to the correctness of the account given in the official report. What struck me most was the air of extraordinary joyfulness which pervaded the whole establishment, from the medical super- intendent down to the smallest and poorest child ; and I marvelled at the administrative ability which had, at so small a cost, provided such a great portion of health and happiness to brighten at least the beginning of life to these poor children, so neglected in our country. It may justly be said to every Sanitary authority in the United Kingdom — " Go, and do thou likewise." CHAPTER X INFANT SCHOOLS AT three years of age children are invited to come to the public school. At five they are compelled. Even at the latter age they are far too young for serious instruction and school discipline : in most countries school does not begin until children have completed their sixth year. That is quite early enough, as physiology teaches us that the brain is not fully developed till seven years of age. Mothers must Work The real reason for beginning "school," as it is hypocritically called, at so early an age, is to set the mothers free to go out to work. The same demands of industry which rob the infant of its mother's milk, rob the little child of its mother's care and love. It is not the mother's fault ; she has to yield to the dire necessity of providing bread for her little ones. But it is surprising that in this case again, as in that of creches for children too young for the " infant school," we hear so little of the undermining of parental responsibility, which the INFANT SCHOOLS 173 maintenance, in public nurseries or in "infant schools " at the public expense, of children who should be playing about under their mother's care, undoubtedly brings about. There are homes, par- ticularly in the slums of cities, from which children cannot be delivered too soon — they are unfit even to be born in ; but as far as health and education is concerned, in almost all country districts and in many town homes it would be far better to let little children run about free like the young of other animals, and leave their growing brains fallow, than to coop them up in stuffy schoolrooms and force them to pretend to learn. The evidence of those well acquainted with the habits of the poor in the United Kingdom is that mothers, and especially Irish and Jewish mothers, are nearly always kind to the little children, and will care for their welfare so long as they are left in their charge ; but their sense of responsibility and their love for them is weakened by having them torn away from home at so early an age to go to M school." The areas within which mothers have to go out to work are in many towns few and well defined, and could easily be provided for by special and exceptional measures, if discretion in such matters were left, as it should be, to local authority. Premature Schooling There is another reason, besides that of enabling mothers to go out to work, which has induced 174 THE CHILDREN OF THE NATION " educationists " to prescribe schooling at the earliest possible age. When boys and girls have attained the age of 1 1 or 12 their labour becomes valuable, and the parents, who have been hardly pressed by the cost of maintaining their children during the years in which they are at school, are eager to increase the scanty income of the family by their earnings. The poverty of the workers' families, combined with the supposed interests of certain employers to secure an abundant supply of cheap child labour, has produced a steady opposition on the part of both employers and employed to all proposals for raising the age up to which children must remain at school. In this respect other nations have advanced in social reform more rapidly than Great Britain, and we now employ children at a much younger age than most of our commercial rivals. In this difficulty persons who desire to secure a certain number of years schooling for every child, have thought that if we cannot add at the end, we may add at the beginning, that by commencing earlier we can leave off earlier, as if torturing the immature brain of a baby could compensate for ceasing to instruct just when the mind is most fitted to learn. The first thing we have to recognise is that l( infant schools" are not "schools" at all, but nurseries for children a little older than those in the " creches," and that any attempt to make them into schools is cruelty. INFANT SCHOOLS 175 Practical Compulsion Although attendance from 3 to 5 is nominally optional, it is not so in reality. The managers of schools have an interest in getting the largest attendances they can, and their officers press mothers to send the children not only after but even before 3 years of age. The returns to the Board of Education, on which the grant is based, take the same account of those under as of those over 5 years of age. Many of the local Educa- tion authorities require their attendance officers to reckon the attendances of the little ones below the compulsory age of 5 in making out the average of those upon the books which they have succeeded in getting to school. The officers them- selves complain that by this regulation they are compelled, for their professional credit, to urge mothers to send their babies to school when they would be better at home. Cruelty and suffering is by this practice caused to the little children them- selves. When the officer goes his rounds, legs and bodies may be seen in many houses sticking out from under sinks or from behind piles of firewood, where children have vainly tried to hide themselves. They cry bitterly when discovered and dragged into the light. Foolish mothers use the officer as a bogey-man to frighten the babies when naughty, and there is a story of one falling down in a fit at the sight of him coming suddenly round the corner. The reports made in 1905 by all the women 17G THE CHILDREN OF THE NATION inspectors of the Board of Education on the condition of children in infant schools, following as it did a recommendation to close the infant schools from the Committee on Physical Deterioration, induced the Board to give notice that they would withdraw the grant for the attendance of all children under 5. This prompt and drastic proceeding affected too many vested interests of employers and school authorities to be carried out. It has now been revoked and the old state of things, con- demned unanimously by the women inspectors, has been restored. If it is necessary, from our social and industrial conditions that the State should in its system of national education take charge of children at the early age of 3, the whole method of treat- ment of those under the age at which serious schooling can begin, which most authorities place at 7, should undergo revision and reform, and should be made the subject of more humane and rational regulations. Injury to Mind and Body There is little doubt that in many of the infant schools a great deal more mischief than good is done to both the bodies and minds of the children. Many of the more progressive School Boards and some of the Voluntary School managers had established schools on the kindergarten principle, and these are still carried on under the new Educa- tion authorities. But these schools are generally INFANT SCHOOLS 177 much too large, and even the kindergarten methods fail when applied wholesale to huge classes. Spon- taneous and original thinking cannot be developed where sixty or seventy infants have to do exactly the same thing in exactly the same way under the supervision of one teacher who requires perfect uniformity. The kindergarten teaching degenerates into drill ; the learning, into the performance of a trick. But in a great number of infant schools, the place is made a real school. There was, and still is if it has not been destroyed, in the archives of the Education Office, a serious report by a man inspector, in which he takes note that "the mental arithmetic of the baby class leaves much to be desired." There are many good inspectors, learned in Greek and the Differential Calculus, but pro- foundly ignorant of babies, who still demand results from the teachers in the infant school in the shape of reading, writing, and arithmetic, both mental and performed upon a slate. The poor women teachers cannot help themselves. They certainly know a great deal more about babies than the man in- spector who directs them or the men secretaries and examiners who move the man inspector from Whitehall ; they would if left to themselves set their little charges to play, and never dream of taxing the little immature brains to do work for which they are unfit. But needs must when the devil drives ; the teacher's bread depends on her doing as she is told, and she sets sorrowfully to work to addle the poor little children's brains and 178 THE CHILDREN OF THE NATION to nip by our foolish system of instruction the little expanding minds in the bud. There used to be a school in the suburbs of London conducted by a clever and original mistress to whom the London School Board had wisely given a perfectly free hand. She banished reading, writing, and arithmetic from the school. The staple subjects of instruction were drawing and painting from nature, and clay modelling, which used to be called in pre-School- Board days " making mud pies " — a process to which the interest of the youngest child is irresistibly attracted. The zeal with which the little infants addressed themselves to these lessons was remark- able ; and their achievements extraordinary. The painting consisted chiefly in imitating, by mixing water-colour paints of blue, red, and yellow, the bright tints of flowers which the children brought to school themselves. Towards the end of their time, a little reading, writing, and arithmetic was thrown in as an extra to prepare them for the school for older children. But their powers of observation and their capacity to handle a pen or pencil had been previously developed by drawing, and their intellects had been expanded by the other work, so that they learnt rapidly and went up to the older school better readers, better writers, and better arithmeticians than if they had plodded at these subjects, as most infants have to do, during the whole of their infant school career. The unanimous report of the women inspectors above referred to, confirmed by the chief inspector of the Board INFANT SCHOOLS 179 of Education, was that children admitted to school at a later age could in six months reach the same standard of attainment as those who had been in the school for two years previously. The system of mechanical drill, which the too great number of children in one class compels the teacher to adopt has the effect of dulling the curiosity, the imagi- nation, and the keen observation, with which healthy children are endowed by nature. They are not allowed to ask questions or seek for knowledge for which a natural child thirsts. They have to answer the questions put to them in words put into their mouths by the teacher and repeated a hundred times or more, till all sense of meaning is crushed out. We thus establish elaborate machinery to make the infants as stupid as we can, in order to pre- pare them for " education" in the schools for older children. The Board of Education have discovered recently that this system is a very extravagant one, requiring as it does the services of a staff of expensive teachers, highly trained and certificated, who would be much more usefully employed in teaching older children. Hundreds of thousands of pounds could be economised by turning the infant schools into nurseries and hundreds of competent certificated teachers could be set free for the work for which the number of certificated teachers is at present wholly insufficient. " There is a general agreement," says the chief inspector, " that the best-informed teacher is not necessarily the best baby-minder. In London schools, where almost 180 THE CHILDREN OF THE NATION every teacher is trained and certificated, the results are declared to be inferior to those schools in which the teachers may not have distinguished themselves in examination, but are motherly girls. In the present dearth of teachers great relief could be obtained at once if it were understood that the ordinary training college course fitted students for upper classes, but was not necessary for the teach- ing of babies. . . . Might not two supplementary teachers of good motherly instincts be as good for sixty babies between 3 and 5 years of age, as one clever ex-collegian ? " Most people, certainly most women, would without hesitation answer the chief inspector's question in the affirmative. Corporal Punishment The mental condition to which infants are reduced by the discipline of the infant school reacts most unfavourably upon their health and development. But their physical well-being is injured in some schools by more direct method. In many schools order and quiet, most unnatural to all young creatures, are enforced by terror of being caned. The Board of Education declare that they "have for some years stated that caning is not permitted in infants' departments." This declaration is not accurate. The Board have for some years, in their Instructions to Inspectors, expressed a cautious disapproval of caning in infant and girls' schools, but they have never gone so far as to prohibit it, INFANT SCHOOLS 181 and no effective steps have ever been taken to put it down. It goes on to this day in a multitude of schools, never inquired into by the inspectors and unchecked by the Board of Education. Great Britain is the only civilised country in the world in which the birch, the cane, and the tawse are still used as instruments of education. Germany, France, the United States, our Colonies, even Egypt under our control, have abolished the practice. The reason for its retention here is that corporal punishment is fashionable amongst the governing class, as the occasional revelations of the proceedings in " smart" regiments show. Most of our legislators, our officials, and our judges and magistrates have undergone such discipline in their youth, and are proud of it. Men will stand up in the House of Lords or House of Commons and declare with great personal satisfaction how they were flogged at Eton or Harrow and how much good it did them. The nation may tolerate the con- tinuance of such proceedings amongst healthy, well- fed boys whose parents are in a position to take care of them and stop the practice if they choose. It may be regarded as a quaint survival of an idiosyn- crasy of the British aristocracy interesting to the social philosopher. But to the mass of the people, who are by law compelled to send their children to schools in the management of which they have no direct voice, who are not proud of having been themselves flogged in their youth, the existence of caning in girls' and infants' schools (putting boys 182 THE CHILDREN OF THE NATION out of the question as designed by nature to be knocked about) is an intolerable tyranny. Now and then an exasperated parent breaks out and, if wise enough to abstain from personal violence on the teacher, takes out a summons for assault. The defendant's cause is championed by the National Union of Teachers, with its ample funds and great influence. The magistrate, who was probably him- self flogged at Eton or elsewhere, sympathises with the teacher, and unless the case proves to be one of excessive brutality no conviction is obtained. The parent is compelled, under pain of fine and imprisonment, to go on sending his little infant or his girl to the school where caning is practised, and has no redress. Girls are constantly caned by men. It is not approved of by the Board of Education, but is nevertheless done. Caning is in many public elementary schools the regular punish- ment for the most trivial offences, such as coming late to school, inattention in class, and is not at all confined to moral delinquencies. I once officially investigated a case myself, in which a dozen girls had absented themselves from school on a Monday to take part in a Wesleyan Sunday School treat, with the knowledge and presumed approbation of the head mistress. They were all caned on the Tuesday morning for omitting the formality of bringing notes from their parents to account for and excuse their absence. Many head teachers have entirely abolished corporal punish- ment in their schools of their own accord, with INFANT SCHOOLS 183 great advantage to discipline. I once visited a school incognito in the island of Jersey, which struck me, before I knew that no corporal punish- ment was permitted in it, as one of the most orderly and best disciplined I had ever seen. Lest the reader may suppose that effeminacy was thereby encouraged, I may mention that in coming round a corner of the road after leaving the school, I came upon two boys engaged in a good stand-up fight with fists, to settle some point of friendly difference. Some School Boards and Education authorities have already prohibited the practice: it is strange that all have not by this time been compelled to do so. It is a notable example of the indifference of the masses of the people to their own interests that they elect authorities who permit little children and girls to be beaten by school- masters and mistresses in the name of " education." The Board of Education may be too much under the influence of the " grown-up public school boys" by whom we are governed to dare to prohibit flogging in schools ; but I marvel that a spirit of " passive resistance " has not been evoked. I think that if a little girl of mine had been beaten by a schoolmaster, no fine and no imprisonment would have induced me to send her to that school again. Baby -rooms The purposes for which the enforcement of dis- cipline is required in an infant school are for the 184 THE CHILDREN OF THE NATION most part highly deleterious to the health and development of young children. They are kept sitting still in some schools for as much as an hour at a time, and even more. This, to young creatures bursting with the desire for movement in every limb, is of itself torture, even when not enforced by the cane. "In all infant schools," says Miss Munday, one of the women inspectors, "more time is spent in sitting than in any other posture, though if children of 3 to 5 years of age be watched when quite free, this is the posture they will use least, at any rate in the morning." They are made to sit with their arms folded — a position notoriously injurious to a young child of 3 years old. No provision is made for sleep, which is beneficial and even necessary at this age. They slumber as they can, lying in a corner of the floor, sitting with their arms on the desk and their heads pillowed upon them, the spine twisted meanwhile into an unnatural curve. Their occupations are physically as well as mentally injurious, being regulated not by women or medical men, but by man inspectors and the clerks at Whitehall. Writing and drawing upon ordinary lined or squared foolscap paper, threading and sewing with small implements in dimly-lighted corners, are some of the causes to which the prevalence of defective sight in older children may properly be attributed. This is Miss Munday's description of the ordinary babies' room : " The furniture of our infant babies' room still chiefly consists of a INFANT SCHOOLS 185 huge gallery constructed to hold forty to sixty children, but often containing as many as eighty at the end of the educational year, or if classes have to be put together owing to the lack of sufficiency of staff. In some cases the gallery occupies the chief amount of floor space of the room, to say nothing of the accumulation of rubbish which takes place on the floor beneath, generally un-get-at-able to floor-cleaners. When this type of baby-room obtains, the class can have little scope or space for movements of any right kind ; and if the school has no hall, or has a hall but the baby class does not use it, as is too often the case, the children suffer physically and quite unneces- sarily." When it is remembered that numbers of these infants are allowed to come to school with their clothes and persons filthy and verminous, the agonies of a clean child, crammed with eighty others into a gallery built for forty to sixty, may be imagined. It has no room to sit ; it is over- whelmed with the horror of the smell. The evil of the sitting posture is further aggravated by the form of the seat or desk. These have to be made of one pattern to fit the average child. But the child who has the misfortune not to be at the time of the average size and build, may of necessity have to be put into a desk too small for it, and the more it grows the more it is hurt thereby. Desks are frequently without backs. If it could be conceived that the President of the Board of Education could be obliged to sit in a desk too small for him without 186 THE CHILDREN OF THE NATION a back, amidst eighty dirty men brought in from a casual ward, and with unsavoury rubbish heaped up underneath, until the baby-rooms in the infant schools were improved, a much more rapid reforma- tion would undoubtedly take place. School Offices The school "offices," as the places are now called in which the natural wants of children are relieved, are worse in infant schools than in the schools for older children. The teachers are all women ; the inspectors are all men, except for the brief and now superseded intervention of women inspectors. The former have a natural and par- donable delicacy in discussing such matters with men, and evils accordingly remain undiscovered and unremedied. In some schools these places are too close to the infants' rooms. One case is mentioned in the Women Inspectors' Report, in which the offices for all departments were under the baby- room, and the smell came through the floor. In other cases the baby-room is the farthest from the offices, necessitating the opening and closing of sometimes as many as five doors when the children pass in and out. At another school the mistress of an infant school told the woman inspector that she was obliged to leave the door from the street into the playground unlocked for half an hour after the opening of the school to admit late-comers ; and that a neighbouring doss-house where tramps INFANT SCHOOLS 187 were accommodated took advantage of this fact and used the offices ; the little children came back frightened by finding the tramps inside the offices. While the mistress was speaking, a most filthy and low class of tramp crossed the playground from the offices in the sight of the woman inspector, on his way to the street. Infant Nurseries If the State is to continue to take charge of little children too young for serious instruction, the whole system of infant schools, as at present carried on, should be forthwith abolished ; the State would then at least cease to do the children positive mischief. The places in which they were cared for should be modelled on the idea of a nursery, and not of a school. They should be presided over by a woman, selected not for her intellectual acquirements, but for her knowledge of hygiene and medicine, and for her gentleness and tenderness to little children. The assistants should be women of the same character : it would be a legitimate employment for thousands of young women with good hearts and kind manners, but low scholastic attainments. They should be inspected exclusively by women. The Board of Education some years ago tried the experiment of appointing half-a-dozen women inspectors, but they brought to light so many defects and abuses in the schools, which no office manipulation of 188 THE CHILDREN OF THE NATION their reports could conceal, that they have now been withdrawn, and the infant schools are again inspected regularly by men, mostly ignorant of the wants of little children. They should be under the supervision of a woman's department of the Board of Education, so as to secure that woman's knowledge will no longer be thwarted by man's ignorance. The children should be kept in these nurseries till they are 7 years of age, and then transferred to the older schools, not all at once, but gradually ; at first for a few hours in the day only, afterwards for increasing periods, till by the time they are 10 they might become attendants for the full five hours daily. The physical, economical, and educational results of such a plan would be a great reform upon the present system of infant schools, long ago condemned but still unreformed. CHAPTER XI SCHOOL HYGIENE THE most ardent defender of the supposed interest of the ratepayers in the reduction of all social expenditure to a minimum will not deny the obligation of the public authority to make the schools, in which the children of the nation are confined for five hours a day on five days in the week, perfectly sanitary. This obliga- tion, however, is very imperfectly fulfilled. The first thing required is fresh air. If you take the children out of the pure air of the country, or even the less healthy air of the streets and parks of towns, you must take care not to put them into air unfit to breathe in your school. Ventilation In the building of new schools, all the plans have to be submitted to and passed by the Board of Education before the school can be recognised as a public elementary school. The greatest care is now taken to have the structural provision 189 190 THE CHILDREN OF THE NATION for ventilation as perfect as the progress of science suggests. Formerly there was less care and less knowledge, and some of the older schools, especially village schools, built before fresh air was so much appreciated, are very defective in construction and can never be made fit for the reception of large numbers of children. But it is not from the construction of buildings, it is from the refusal of teachers, managers, and in- spectors to make proper use of the ventilation provided that the chief evils of foul air and consequent injury to the school children arise. Objection to fresh air, under the name of " draughts/' is very widely spread. Any traveller, young or old, male or female, who alleges that he or she feels a draught in a railway carriage considers this a sufficient ground for insisting on every window and every ventilator being at once closed. The shrinking from fresh air is not confined to the ignorant. The British Associa- tion has met in an elementary schoolroom to discuss hygiene, with windows closed and in an atmosphere which if existing in the room when used for its normal purposes would have justified the withdrawal of the Exchequer grant. At a meeting for promoting Garden Cities an eminent doctor illustrated the badness of the air in the slums by assuring his audience that it was almost as bad as that which they were themselves breathing. Windows in country cottages are often made not to open, and any one who looks SCHOOL HYGIENE 191 at the houses as he passes through a village will generally see every window shut, summer and winter. Modern improvements in house-building have, in truth, made matters worse : doors and windows shut more closely, and the fresh air that forced its way indoors through chinks and crevices is now effectually excluded. The careful planning of school ventilation is made of no effect by the objection of all concerned to draughts of fresh air, the intake is blocked up, and the children do their work in a vitiated atmosphere. Some years ago there was a scientific inquiry into the condition of the atmosphere in schools in Manchester and Salford conducted by Dr. Bayley, of Owen's College. He classified the schools examined into five classes according to the degree of foul air and smell which prevailed in them. No schools rose to the first or second class. There were only two in the third class, and in them the class-rooms were reported to have " air very oppressive, giving rise to head- ache." In other schools, M the odour in the class-rooms especially was simply unbearable." The air was tested for carbonic acid. The standard accepted in the wards of hospitals is that if there are more than 6 parts in 10,000 of carbonic acid gas the air is regarded as polluted and unfit for the patients to breathe. Not one of the schools examined came within the unpolluted zone. In the best school there were 7 parts in 10,000, and 10 in the class-rooms : in the worst 192 THE CHILDREN OF THE NATION 12*8 parts in 10,000, and 14*5 in the class-rooms. The air was also tested for micro-organisms. Pure mountain air is quite free from micro- organisms, and air in the streets of Paris contains only 25 per cubic foot, whereas it was found in one of the Salford schools examined that in the infant school there were 213; in the boys' school, 236 ; and in the girls' school, 286. In many town schools there is now excellent ventilation, but many are still in the condition in which Man- chester schools were when examined by Dr. Bayley. In the country, especially, where there is the best of air all round the schools waiting to be let in, the air which the children are made to breathe is atrociously bad. The Royal Com- mission on Physical Training in Scotland called attention to the too frequent neglect of the proper ventilation of schoolrooms. "It is often found," they say, " that, even in large and well-con- structed rooms, the atmosphere is allowed to get into a condition that must be detrimental to health, and this is much more marked where the school- rooms are inadequate to the attendance, and where they are not provided with proper means of ventilation." Dr. Kerr, who had a very long experience as medical officer first of the Bradford and then of the London School Board, says, "Prac- tically all schools are defective in point of venti- lation." He further declares that schools "are generally not either healthy, or well ventilated. At present there is nothing like hygienic inspection SCHOOL HYGIENE 193 of schools by the Board of Education." The whole of this evil state of things can be immediately cor- rected by teachers and managers themselves, and would be if they practised what they would all admit in theory, that fresh air is an indispensable necessity for children. "As regards fresh air," says Dr. Eichholz, " I suffer a good deal from what I am compelled to encounter on my visits round the schools. I constantly begin my work in a class-room by opening the windows. I consider a draught of less importance than the constant inhalation of fetid, vitiated air. I have seldom come across any evils of ventilation in a school that could not be altered in five minutes. If the windows are not open, you can open them ; and the children can be cleared out of the room if necessary. The draught is not a real objection, but is often an excuse for tolerating irrespirable air." Warming In Ireland the Education Board does not pretend to warm all the schools at the public expense. It was stated in evidence by Dr. Kelly, the Bishop of Ross, and repeated in the House of Commons without contradiction, that the plan is to require the children to bring a turf or two under their arms when they come in the morning as a provision for keeping up a fire during the day. This fact shocked the Committee on Physical Deterioration, for in Great Britain nobody would think of warming the schools by a tax 194 THE CHILDREN OF THE NATION of this kind levied from the children ; but in the desire to keep down expenditure there is always a temptation to managers to stint the amount of firing and warm the school more economically by the children's bodies. It is the necessity for warmth that is the chief cause of the bad ventila- tion we have just been considering. It is less painful to be asphyxiated in foul air than to endure the pangs of cold in fresh. " The question of ventilation," says the Report of the Scottish Royal Commission, "is a difficult one, and some- times it is found that the most modern and carefully constructed systems are not satisfactory in operation, owing to the want of expert skill on the part of those in charge of them. But it is at least certain that, while ventilation of a fairly satisfactorily kind may be provided in any properly constructed school at a comparatively moderate expense, this must be combined with proper methods of heating. Where a schoolroom is not sufficiently heated, it is plain that on a cold day windows, and indeed every aperture by which air is normally admitted, are kept almost hermetically closed, so that good ventilation is practically impossible." Dr. Smith, of the East London Children's Hospital, describing the homes of children in that part of London, says the housing arrangements are awful, the whole family often sleeping in one room. For warmth, as a rule, they keep all the windows shut. The atmosphere is shocking. They can only afford one room. SCHOOL HYGIENE 195 I don't see what the Medical Officer of Health can do really." Another medical witness says, " Children should be properly clothed and should be housed in pure warmth, not the shut-up window and the heated lamp, which are so often the sole way in which the warmth is produced among the lower classes." The poor in the slums can only warm their children by shutting them up in a polluted atmosphere : but it is monstrous that the Education Boards and authorities either in Ireland or Great Britain should have recourse to similar expedients. All schools should be adequately warmed at the public cost, as well as properly ventilated. Miss Bathurst, a woman inspector of schools, in the Report of the Women Inspectors before referred to says, " Thermometers are often omitted from school furniture, but I remember several instances of schools where the thermometer registered down to 3 2° in cold weather." A school is mentioned where the children sometimes cried with cold. " It is customary to delay lighting fires till late in the autumn." On the other hand, it is important that fires in schools should be protected by fire- guards. " For lack of them," says the same inspector, " accidents have occurred in two schools on my list. In both cases the managers had ignored the strongest possible recommendations in log-books. It is habitual to allow children to have their midday meal unsupervised inside the school premises. I have found children alone 196 THE CHILDREN OF THE NATION at midday with an unguarded tortoise stove." In a school in Cheshire, recently visited by Mr. T. C. Horsfall, he says, "Not only were the rooms badly lighted and miserably ventilated, but also so badly heated that the temperatures taken by a thermometer whose accuracy I tested have been at 10 a.m. on four successive days 43 , 42° 45 , and 45 . Most of the children and of the teachers looked sickly." Water A healthy child constantly wants to drink, and it is most desirable for its health that abundant draughts of pure water should be easily within its reach. This is generally provided in the newly-built schools in large towns, which have invariably an excellent water supply. But in country schools good water fit to drink is not so easily procured. A child that cannot get pure water will quench its thirst with foul. Evidence was given in the Poor Law Schools Inquiry in 1895, that at a certain workhouse school there was no provision by which the children could obtain water to drink, and that they drank from puddles in the school-yard. In many places rain- water seems the only source possible. But unless the tanks in which rain-water is stored are con- stantly cleaned out, the water soon becomes polluted and is the cause of sore throats and other ailments. No school can be considered fit for the reception of children unless there is a provision of good water within the reach of every child. SCHOOL HYGIENE 197 Lighting In many schools no proper attention is paid to light. The desks are so placed that the children have to sit facing the light, staring into it. The new building rules of the Board of Education provide for the proper lighting of schools, but a great proportion of our schools were built before the importance of proper lighting was appreciated. In many cases an alteration of the arrangement of the desks would effect a great improvement and save the children's eyesight. A great deal of the teach- ing is done by means of words and figures written on a blackboard : blue instead of white chalk is often used, to the great injury of the children's eyes. Besides this the undue size of the classes obliges a number to be seated at the side ; to these every- thing drawn on the blackboard is foreshortened and strains the eyesight, and to some so much that it is impossible to decipher what is drawn. Desks The effect of school life in promoting curvature of the spine has never been sufficiently understood in this country. Mr. T. C. Horsfall called the attention of the Committee on Physical Deterioration to some startling facts which scientific investigation in Germany and Switzerland has disclosed. There are no infant schools in these countries ; but in a number of schools examined by Bardenheuer and 198 THE CHILDREN OF THE NATION Castenholz it was found that while there was no appreciable curvature of the spine among children in their first school year, that is, from 6 to 7, 6 per cent, of those in their second year, 19 per cent, of those in their third, 27 per cent, of those in their fourth, and 52 per cent, of those in their fifth and sixth, suffered from curvature. In Lausanne, an examination of upwards of 1,000 boys and 1,000 girls by Scholder, Weith, and Combe disclosed the fact that 23 per cent, of the boys and 267 per cent, of the girls had curvature of the spine. The number of cases increased rapidly as the length of time passed in school increased, till nearly the end of school life. Dr. Wilhelm Schultheiss, of Zurich, indicates as the means needed to counteract the tendency of school to cause curvature of the spine, a considerable shortening of the time during which children are compelled to sit, the giving an interval for play every hour, systematic gymnastic exercise for an hour each day, the proper lighting of school- rooms, and the provision of proper school benches and desks. I have seen in schools in Bradford a praiseworthy attempt to mitigate the physical mis- chief that may be caused by the desk and the scholar not fitting each other. The desks in a class- room are made not of uniform size but graded from front to back — the smaller in front, the larger behind. On each is printed the height of boy or girl for which that particular bench is designed. The teacher sorts the class so that each scholar, as far as possible, sits upon a bench suitable to his or her size. SCHOOL HYGIENE 199 Similar arrangements are to be found in most schools on the Continent : they cannot, of course, be perfect, but they are at least a great improvement on the common practice of fitting all the class into desks of the same size. The German Army statistics confirm the view that school life is not favourable to physical development. The young men who have a longer and higher education and pass the Leaving Examination are entitled to serve as one- year volunteers : of them only 20 per cent, pass as physically fit for military service. Of the ordinary recruits who, as less highly educated, have to serve for three years, 50 to 55 per cent, are passed as efficient. Playgrounds Playgrounds attached to the schools, and recrea- tion grounds to which children can resort on holi- days and summer evenings, are most essential for healthy development. Sir Lauder Brunton would make the provision of playgrounds in all schools compulsory. In the centre of great cities the enormous price of land makes this almost an impossibility unless the playground is placed on the school roof as is done in many cases. In country places where land is cheap playgrounds are less necessary, though it is in those places that the provision of playgrounds is most zealously insisted on by the Board of Education. I recollect a school in Westmoreland which opened upon the side of a mountain, where a fenced playground was neverthe- 200 THE CHILDREN OF THE NATION less required. Sir Lauder Brunton thought it was easier to secure the provision of playgrounds through a voluntary association than through the State. " The State as a rule shunts everything upon voluntary work that can be shunted. But the necessity of having playgrounds is very great, and I think we should get playgrounds provided as soon as possible. If these things cannot be done voluntarily, then we must get the State to do it ; we must have compulsory powers." A suggestion was made by the Royal Commission on Physical Train- ing in Scotland, that an appeal should be made to football clubs, cross-country running clubs, and other like associations to organise games for elementary school children, quite of a different kind from formal drill and running about in the school-yard ; and it was thought that they might lend their own private grounds on certain days for the purpose. In the United States special provision is made in the parks and open spaces in cities for children's play, such as is now attempted in London and other great cities. Paid attendants, men and women, are employed by the Municipalities, who have experience of kindergarten methods to organise and superintend the children's play. Municipalities in this country have power, under the Public Health Acts, to incur such expense ; but like many other provisions of the Public Health Acts the power is seldom used. In Salford, where there are 42,000 school children, of whom 15,000 are of the poorest class, it is said that they have forgotten how to play. SCHOOL HYGIENE 201 They are stunted, underfed weaklings. " It will take three boys from Salford," said a witness, "and from that type of school to make two Rugby boys. The figures are there, I have original measure- ments." In a small country town like Chippenham we are told by another witness that the children have no recreation ground at all ; only one school has a playground; they have no place except in the streets and roads. There is a good deal of traffic in the main streets of Chippenham. The best common land is now enclosed, and it is not allowed to be used at all ; it is in the hands of the burgesses — a certain number of good people who will not let the children play — and there is no other grass near. The school-yard, even when provided, is not enough for the proper development of physical activity. The children require games. These can be provided by the Municipal authority in the parks and open spaces which they already possess. Attendants are necessary, whom the Municipality has already power to pay. No legislation is required, only proper administration of powers already possessed. If the mass of the people had an enlightened care for the welfare of their little ones and used their electoral power, the reform needed would speedily be accomplished. CHAPTER XII PHYSICAL TRAINING Its Conditions THE physical training of Children in the public elementary schools is highly ap- proved of by the governing classes : it will make better soldiers, better servants, and better workmen. But the conditions under which alone such training can be given are sedulously ignored. So long as a large proportion of school children are underfed, underclothed, and in a miserable physical condition, any attempt to make them perform physical exercises is merely an additional act of cruelty. It is not more cruel than making them exert their emaciated, undeveloped brains in efforts to learn and remember, but the cruelty is rather more patent to the unthinking mind. However we may shut our eyes to the waste of tissue involved in exercise of the brain, no medical testimony is required to establish the necessity of feeding children before exercising their muscles ; the recommendation made to the Royal Commis- sion on Physical Training in Scotland by Dr. PHYSICAL TRAINING 203 Mackenzie and Professor Matthew Hay, who had been employed to sample the children in the Edinburgh and Aberdeen schools is conclusive — M Physical exercise, unsupported by adequate food and adequate clothing, must result in early physio- logical exhaustion and infirmity." In this, as in all other branches of education, we are face to face with the dilemma which the Board of Education, the Government, and the governing classes, persist in trying to evade — Are all the children in the schools to be subjected to physical drill, and is a gross act of cruelty to be thus perpetrated by public authority upon a large proportion ? or is a system of selection to be established, whereby those only who are fit will be subjected to drill and the rest sent back hungry to their homes? Military Drill The first idea in this country was that the drill in public elementary schools should be military. The governing classes see the need of breeding stout, well-developed youths as recruits for the Army, on the strength of which their power of intervention in foreign affairs so largely depends. Compulsory military service at 17 or 18 years of age is politically impossible ; our rulers would gladly have it if they could ; but as they cannot they fall back upon the little boys in the elementary schools of whom they 204 THE CHILDREN OF THE NATION have the control, and desire to drill them as soldiers and teach them to handle a rifle. They make just the same mistake as that made in all other branches of useful knowledge and practice which it is desired to engraft upon the coming race. If time and opportunity cannot be afforded when the young person is old enough to learn, it is impossible to compensate for this by prematurely forcing the instruction on undeveloped children. Nearly all the scholars in the public schools are of tender age; many leave school at 12; they have weak bones, their muscles are not fully formed, and the only kind of drill which is known to military sergeants — very beneficial, no doubt, to a stout ploughboy, fresh from agricultural labour — is utterly unsuitable to the weak and growing frames of these little children. Girls as well as boys have to be drilled at schools ; more than half the children are girls. Drill sergeants have no special knowledge of the muscular anatomy of girls, nor even of how they are dressed ; you cannot provide gymnasium suits for all the children in the elementary schools, and their common, every- day dress limits the benefit of bodily motions in general school drill. In many country schools children have to walk long distances from their home : the muscular exertion they have in their walk to and fro is physical exercise enough for the day, and to put further strain upon bodies not too abundantly nourished is cruel and unreasonable. In the first syllabus of Physical Drill put forth PHYSICAL TRAINING 205 for the guidance and instruction of school teachers and managers by the Board of Education a year or two ago, as the outcome of the labours of a committee of men, the existence of girls was ignored and the physical exercises prescribed were identical with those used at military depots for licking into shape the raw recruits. It was uni- versally admitted to be entirely inapplicable to school children and was immediately withdrawn in deference to public and professional criticism. Nothing would be more calculated to defeat the desire of the governing classes for soldiers than the establishment of military drill in elementary schools. Almost every boy desires at some period of his life to be a soldier, and an extraordinary charm surrounds the idea of military drill until it has been experienced. But actually to undergo military drill has a very disenchanting effect, especially in early youth ; and if military drill were imposed on boys even of 14 or 15 years of age, it would disgust them prematurely with militarism altogether, and when they were 17 or 18 years old they would be much less likely to join even the Volunteers. The Peace Society should encourage military drill in the public elementary schools. Swedish Drill A great deal of attention has been paid in foreign countries to the proper system of physical 206 THE CHILDREN OF THE NATION training for growing children, especially in Swit- zerland and Sweden. In the latter country a system has been established on scientific principles, the object of which is the due development of all the muscles of the human body, including, for instance, the muscles of the lungs by breathing exercises. The Swedish system of drill has been carried to great perfection ; there are college pro- fessors and teachers devoted to the inculcation and advancement of this kind of scientific training. Before such a system our military drill is a piece of primitive barbarism. Many of the elementary teachers in our schools in Great Britain and Ireland have devoted both time and money to the study and acquisition of the method of Swedish drill, and persons interested in education have visited Sweden for the purpose of acquainting themselves with it. After the withdrawal of the first syllabus of the Board of Education, a committee was appointed to draw up a new and more rational syllabus, on which a woman was for the first time placed — Miss Deverell, one of the women inspectors. She was sent over to Sweden by the Board of Education to study the system of Swedish drill ; and the result of the labours of the committee was the adoption of a new syllabus, founded upon the Swedish system, which has given general satis- faction to managers and teachers, and is now practised in elementary schools to the great advantage of the children. The physique of the PHYSICAL TRAINING 207 girls is not neglected, and the boys enjoy a kind of training that will fit them better than military drill to become soldiers, if their services are required in that capacity when they grow up to manhood. Jiu-jitsu But a much more remarkable system of physical exercise not yet generally introduced into our schools has come to us from our new Eastern allies, the Japanese. The system is applicable alike to boys and girls, to men and women, to the weak and to the strong. " From remote antiquity " (I quote from Mr. H. Irving Hancock's Book on Physical Training for Women by Japanese Methods), u there has existed in Japan a system of bodily training known as Jiu-jitsu. Its age is established by reasonably authentic records as being at least twenty-five hundred years ; undoubtedly the science is older than that. In feudal Japan knowledge of the science was imparted only to the Samurai, and only under the strongest oaths of secrecy. The Samurai were the men and women of the privileged military class. The men did the fighting, but the women, who were to rear the ' sons ' of the next generation, were required to understand all the principles of Jiu-jitsu. In the initial stages of the training it was considered always advisable to have a boy and girl contestant as nearly equal in age and height as was possible, but the girls entered 208 THE CHILDREN OF THE NATION the arena upon equal terms with the boys, and proved their fitness to do so. Grown men and women practised at Jiu-jitsu, nor did any woman find it necessary to take refuge in her sex. She did not need to. Other conditions being equal, she could show an amount of strength that paralleled that of her husband or brother." The science of Jiu-jitsu, so long kept secret by the Samurai, is now open to and practised by the whole of Japan and it will at no distant date modify the gymnastic exercises of the civilised world. It is practised without gymnastic apparatus by pairs of students, each acting as a gymnastic apparatus to the other. It qualifies every student to be a wrestler, but the due development of every muscle in the human body is the object and result of the exercises pre- scribed. These consist of attacks by each student in turn upon the muscles of the other, which are resisted just enough to make the accomplishment of the exercise physically difficult. It is not necessary that the two should be of the same strength, pro- vided the stronger restrains his muscular power sufficiently to allow the weaker to overcome when it is his turn to do so. After the physical powers displayed by the Japanese in the war with Russia, it is probable that even military authorities will look favourably upon Jiu-jitsu. It is difficult to imagine a system of training more fitted for school children. It requires no extensive gymnasium, no expensive gymnastic apparatus ; it can be practised in the open air, in a shed in the school- PHYSICAL TRAINING 209 yard, in the hall or in a class-room of the school itself. It has been tried experimentally, as I was informed by the headmaster at a large higher grade school in the North of England, and the children liked the exercises very much. General Requirements All physical exercise of whatever kind should if possible be performed in the open air or, in wet weather, under an open shed. Very well-ventilated rooms with open windows may do occasionally as a makeshift, but it is better not to have any physical exercises at all than to give them in a stuffy, closed- up schoolroom. The dust in rooms from which air and sunshine are excluded contain countless germs of disease ; these would be raised by the shuffling of the children's feet, and if inhaled by them sore throat, bronchitis, or even phthisis might be the result. Attention should also be paid to the manner in which children are dressed while per- forming physical exercises, and such modification of their clothes as is practicable should be carried out by the teacher. Feet bare or in stockings only are much better than heavy, ill-fitting boots or shoes. Stays on girls' bodies would make even the most scientific exercises harmful. Nor should any exercises of a strenuous kind s be permitted in any case without proper medical supervision. If no proper medical inspection is available, it is better to remit altogether all violent exercises than to 210 THE CHILDREN OF THE NATION run the risk of injury to the children thereby. Every school, even those frequented by children of well-paid artizans, contain numbers, unsuspected by teachers or parents, who are suffering from phthisis or heart disease, to whom physical drill should be prohibited as injurious and even dangerous to life. In some infant schools little children are allowed to go through dumb-bell exercises for which the tender muscles of their baby arms are wholly unfit. One of the great advantages of Jiu- jitsu is the impossibility of this overstrain. In Japan physical training begins from birth, and the exercises are practised without risk at 4 or 5 years old. Neglect of Physical Training Neither in the elementary nor in the higher schools of Great Britain is adequate attention paid to physical education. There is a general lack of qualification in the teachers of both classes of schools to teach and supervise proper exercises, and no sufficient energy is shown in the training colleges to supply this deficiency. The residential colleges seem doomed to soon disappear, and in the day collegiate institutions which are taking their place the necessity of a teacher being competent to give physical as well as mental instruction is scarcely yet recognised. In higher class schools complaint is often made that too much attention is paid to games ;. the complaint seems to be in too many cases just, but it is to games and not to physical PHYSICAL TRAINING 211 development that the encouragement of the school authority is directed. The curriculum of the elemen- tary schools and of those higher schools which receive Government grants is practically at the discretion of the Board of Education, and they could secure a proper devotion of time to physical training by an alteration in their codes and regu- lations. But a great deal of the time now spent on grammar and other useless attainments would have to be given up. More capacity and knowledge would, no doubt, in the end be acquired by the children, but old habits of teaching and antiquated prejudices so dear to the conservative British mind would have to be given up. In the elementary schools proper playgrounds in lieu of the dismal paved backyard would become necessary. Upon this point very strong observa- tions are made on the provision of playgrounds by the Scottish School Boards for the elementary and higher schools under their charge, by the Royal Commission on Physical Training in Scotland. They observe that : — " No higher school could subsist for a year unless it provided ample playground accommodation for its pupils ; . . . yet the same School Boards appear to think that they have done all that is required for the elementary schools if, along with large and admirably equipped schoolrooms, they provide a small paved yard in which the children can get an occasional breath of air, but where games are entirely out of the question. Higher 212 THE CHILDREN OF THE NATION class schools frequently have the use of fields of some acres in extent, situated at some distance from the school ; not in a single instance did we find that such fields were provided, even for a combination of several elementary schools. This contrast is very striking. Money has been spent lavishly in stone and lime, where the more formal school work can be carried on. . . . But gymnasia and play- grounds, which would not have cost nearly so much and are equally necessary for the welfare of the poorer scholars, have been much neglected." In England the public elementary schools suffer under the same inequality and injustice. While the children of the rich play too much, the children of the poor do not play at all. They do not know how to play ; they have no place to play in if they did. Instead of building new schoolrooms, the local authorities should establish for the children of the poor playgrounds and playing fields, and turn the children out into them ; so that more time should be spent in physical, and less in mental, exercises. Such a plan would be cheaper and far more healthy. Evening Classes Physical, like mental, training ought not to come to an abrupt stop when the boy or girl leaves school, but should be carried further in continuation classes. Such classes are, under our present system of education, purely voluntary ; but it is easy to provide physical exercises agreeable to the students PHYSICAL TRAINING 213 as well as valuable in themselves. They would attract, and not repel. It is impossible to devise beforehand a time-table that would suit all persons and all places. Anything prescribed by the Board of Education should be very elastic. The physique of the population and their daily employments would have to be taken into consideration. Some of the best attendants at evening classes come for purely technical instruction applicable to the trades in which they are workers ; to make physical exercises compulsory on these students would tend to drive them away. But this is no objection to the provision by local authorities of opportunities for physical training for those who desire it; and in the case of evening school instruction which is complementary to that given in the elementary schools, certain physical exercises might be pre- scribed in the curriculum from which those only should be excused, if they desired it, who gave satisfactory evidence of proficiency and adequate previous training. Hooligans There is a class of lads and young men, who spring up in every great city, to whom the name of " Hooligans " has been lately given. They are beyond the school age and cannot be dealt with as truants in the truant schools. They have emanci- pated themselves from all home influences and restraints. They belong to no skilled trade, but 214 THE CHILDREN OF THE NATION have learnt to maintain a shifty existence on odd jobs and casual employment. They loaf about at street corners in the day, and assemble in bands at night to the terror of peaceable citizens. They are not starving, they are not physically incapable, but they are shy of restraint and regular work. They prefer the railway arch to the continuation school. These boys are very good material running to waste. The University Settlements have succeeded in taming and civilising some of them, and it is said that when a boy of this class begins to learn to box his reformation has commenced. The Royal Commission on Physical Training in Scotland makes an admirable suggestion for dealing with boys of this class. They refer to the type of school known as a ''Truant School" lately established, and to the fact that of 34,000 children who had up to 1900 passed through, such schools more than half had done so once and no more ; while only about one in six had had to be admitted more than twice. "It would be well if some local authority had power to establish a similar school for the older class of whom we have been speaking. . . . The short detention school should be as brisk and lively as strenuous in the activity of the schoolroom and the workshop and of the drill-yard or gym- nasium as the best organised truant school ; and a license, conditional on regular attendance at a continuation class should be easily earned. There seems no reason why such an institution should not be as effective as a truant school, and we PHYSICAL TRAINING 215 suggest that the proposal is at least worth a trial." If there were such a thing as real local self-govern- ment in Great Britain, every local authority would have power to establish such an institution without the interference of Parliament or the Central Government. But assuming the Royal Commission to be right in its estimate of the impotence of local authority, it is significant that more than six years have elapsed and no attempt to confer authority to make an experiment either in Scotland or England has been made. CHAPTER XIII FACTORIES AND MINES Child-workers THE obligation of public authority to protect the health of children and young persons in establishments of organised industry is now admitted by every civilised nation in the world. Until twenty or thirty years ago Great Britain enjoyed the illustrious position of guiding all countries which had betaken themselves to factory industry in estab- lishing laws for this purpose : she is now a good way behind many of her disciples, who owed their first lesson to her example. Protection involves the limitation of the age at which children may begin to work, and the prescription of suitable hours of labour, and healthy conditions of employ- ment. It is both against the capitalist employer and the necessities or cupidity of parents and guardians that such protection is needed. The former imagines himself to have an interest in employing child labour wherever it is procurable and effective : it is itself apparently cheap and it 216 FACTORIES AND MINES 217 helps to keep down the wages of adults. In this, as in other cases, the responsibility of the parent was, at the beginning of factory industry, loudly and persistently invoked as the proper and sufficient protection of the child. But the horrors which free trade in the lives and limbs of children brought about in factories and mines were exposed more than a hundred years ago, until at last the con- science of the nation was aroused, and for more than a century a series of laws and amending laws relating to the employment of children and young persons in factories, workshops, and mines have continuously and successively been enacted. Factory Legislation These proposed laws were from time to time vehemently opposed by good and well-meaning persons, exactly upon the same grounds and with the same confidence in their own rectitude that care of the physical condition of children in the public elementary schools is now being objected to. The time-honoured appeal was made to all the disastrous social consequences that must ensue from weaken- ing parental authority and parental responsibility. Parental authority and the love of parents for their children did, it must be admitted, prove at first an effective restraint upon the cupidity of employers. Parents would not in the early days of steam industry allow their children to be employed in factories: the names of " factory boy" and "factory 218 THE CHILDKEN OF THE NATION girl " were terms of opprobrium and disgrace. But circumstances were too strong for parental love. Their own wages were, by the employment of children from outside, reduced to starvation point, and their own children's labour became essential to the support of the family. During the period when parents refused to send their children to the mills the " Guardians of the Poor " had no such scruples : they sold parish children from 5 years old and up- wards to the manufacturers ; these hapless children were conveyed to the manufacturing districts on canal boats in a manner which recalls the horrors of the slave-trade ; they worked sixteen hours at a stretch ; they were driven by the whip ; they fed with the pigs ; and the mortality was awful. | Mr. Spargo, of New York, in his book, " The Bitter Cry of the Children," says truly : " There is no more terrible page in history than that which records the enslavement of mere babies by the industrial revolution of the eighteenth century in England. Not even the crucifixion of twenty thousand slaves along the highways by Scipio excels it in horror." By very slow degrees, by incessant inquiries and committees, by the labours of generations of kind- hearted men, and by some enlightenment of the workers themselves as to their own interest and that of their children, this state of things has been gradually altered, until at the present time horrors such as those generally prevalent in Great Britain in the ranks of child industry a hundred years ago are relegated to the small, obscure workshops which FACTORIES AND MINES 219 manage to escape the vigilance of the inspector. The condition of child-workers in the larger factories and shops is anxiously cared for by public authority ; there may be evils still prevalent, but they are not perpetrated with the sanction of the law and under the shelter of the local government. Children are, however, still grievously oppressed in many highly civilised countries. The energies of Miss Jane Adams and the Women's University Settlement in Hull House, Chicago, were more than ten years ago directed to obtaining some relief for the miseries to which child-workers are in that city subjected, and Mr. Spargo's book, above quoted, contains a terrible account of the condition in which large classes of children are at the present time compelled to labour in one of the greatest and freest countries in the world. Berlin Conference The Labour Conference at Berlin, called by the Emperor of Germany in 1890, was mainly occupied with the question of child labour. The right of children to State protection was not contested by the plenipotentiaries of any country represented at the Conference. The universal sentiment of modern nations was eloquently expressed by M. Jules Simon and agreed to by all the nations represented : 11 Prot£ger l'enfant, c'est veiller au sort des gene- rations a venir, et s'acquitter dune dette humanitaire vis-a-vis de ceux qui ne peuvent pas toujours se 220 THE CHILDREN OF THE NATION defendre eux-memes, ou auxquels les protecteurs naturels font defaut." The Conference, after long and mature deliberation, arrived unanimously at the conclusion that it was desirable — i. That children of both sexes under a certain age should be excluded from labour in industrial establishments. 2. That this limit of age should be fixed at 12 years, except in southern countries (Italy and Spain) where the limit should be 10 years. 3. That these limits of age should be the same for all industrial establishments, and that no distinc- tion should be admitted in this respect. 4. That the children should have previously satisfied the requirements of elementary instruction. 5. That children under 14 years of age should not be employed at night nor on Sunday. 6. That their actual labour should not exceed six hours per diem, and should be broken by a rest of half an hour at least. 7. That children should be excluded from pro- cesses that were unhealthy or dangerous, or should only be admitted to take part in them under conditions that would protect them against injury. None of the plenipotentiaries were more loud in their approval of these conclusions than those of Great Britain ; they even demurred to the con- cession of 10 years as the limit of age in southern countries ; they were in this, as in all their conduct at the Conference, acting in obedience to telegraphic instructions from the British Foreign Office. FACTORIES AND MINES 221 British Faith The sincerity of the British Government was soon put to the test. The limit of age at which children could be employed in factories and work- shops in Great Britain was at that time 10. In the year following the Berlin Conference an amending Factory Bill was laid before Parliament by the British Government. Notwithstanding the professions made by the British plenipotentiaries in the face of all Europe at Berlin, the Government Factory Bill contained no provision for raising the limit of age. In the course of the passage of the Bill through the House of Commons a clause was proposed by a member of the Opposition raising the limit not to 12, but to 1 1 only — half-way in the direction of the Berlin pledge. But the influence of the capitalists on the Government had become too strong to be resisted. Since the death of Mr. Disraeli, the leaders of the Tory party have been always too weak *to protect the interests of the workers against any fixed determination of the capitalists. It was said that the latter class were before the Berlin Conference of opinion that the legislation of Great Britain on the subject of factory employment was more restrictive than that of foreign countries in general and especially than that of Germany, and that this handicapped the British manufacturer in the industrial competition of the world. It was expected that one result of the Conference might be to prevail on other countries 222 THE CHILDREN OF THE NATION to make their laws as stringent as ours : it has indeed had the result of making the general laws of the civilised world more stringent than our own. But the British capitalists had no intention of restricting their own supply of child labour ; and the amendment proposed by the Opposition was therefore vehemently resisted. On this, as on most occasions when the interests of children and capital- ists come into conflict, the Government of the day sided with the latter, and the benevolent amend- ment, notwithstanding an eloquent appeal by Mr. Burt, who was one of the British representatives at Berlin, was opposed with all the influence and authority of a powerful Government. The Government were, however, defeated on a division in the House of Commons, and the age was raised to ii. Many years afterwards, when the same party again held the reins of power, a Bill was brought in by a Liberal member raising the age to the Berlin standard of 12. On this occasion the Government, still afraid of their capitalist sup- porters, absented themselves altogether from the House of Commons ; they were not present at any of the discussions or divisions, and the British limit was finally raised to 12 without their help or concurrence. Mines The expediency of State interference in the working of mines rests upon even stronger grounds FACTORIES AND MINES 223 than in factories. The condition of a mine affects not only the health of the children and young people employed underground, but the lives of everybody in the mine. This subject also was much discussed at the Berlin Conference, which arrived at the unanimous conclusion that it was desirable — i. (a) That the limit of age at which children could be admitted to work underground should ^>e gradually raised, as experience proved the possi- bility, to 14 years. For southern countries the limit should be that of 12 years. (&) That underground labour should be prohibited to persons of the female sex. 2. That in cases where the science of mining was insufficient to remove all danger to health from the conditions, natural or artificial, of the working of certain mines or portions of mines, the hours of labour should be restricted. 3. (a) That the security of the worker and the healthiness of the works should be assured by all the means at the disposal of science, and placed under the surveillance of the State. (b) That the managing engineers should be exclusively persons of experience and technical competence duly established. (c) That the relations between the workers and managing engineers should be as direct as possible, so that they might have a character of mutual confidence and respect. (d) Relates to the encouragement of friendly 224 THE CHILDREN OF THE NATION societies and insurance against sickness and accident, and, (e) To the means of preventing strikes and lock-outs. In Great Britain, at the time of the Berlin Con- ference, underground labour had long been for- bidden to girls ; though girls still work at the pit mouth, this labour is healthy though rough, and there is no reason for State interference on sani- tary grounds. The age at which boys might go underground was 12 : it has since been raised to 13. There was not, and is not now, any restriction as to their hours of labour. In Durham and Northumberland the Miners' Unions have long obtained short hours for the men, who work in three shifts, and whose hours of labour amount to six or seven hours per diem. But the boys, who work in two shifts, have as much as 10J hours of labour per diem : and the Annual Bill which limits the labour in mines to eight hours is regularly opposed by the representatives of the Durham and Northumberland miners upon the ground that it would upset this arrangement. The ventilation of mines is the object of very precise legislation and of constant supervision by the Government. The competence of the managers and engineers, who have the direction of the works, is also secured by specific regulations and is not left to the individual interest of the mine-owner. In all mines there are regulations having the force of law to protect the safety, the health, and the comfort, not only of the FACTORIES AND MINES 225 children and young persons but of the adult men employed. Hours of Labour in Mines The chief controversy that now remains is whether the hours of underground labour should be restricted by law. The second resolution of the Berlin Conference on mines, quoted above, which recommends such a restriction in certain cases does not refer to ordinary coal-mines, but to such mines as those in Westphalia, where labour is restricted by law to six hours per diem, when the temperature goes above 29 (Reaumur), or as those of Almaden, in Spain, where mercurial vapours render peculiar precautions necessary, and where labour is restricted by law to six hours, and even this limit cannot always be attained. In the mines of argentiferous lead in the Sierra Almagrdra, the temperature in workings at the sea-level often exceeds 45 (Centi- grade) and in these cases hours of labour are restricted by law. But it is contended in our country that on physical grounds of health and conservation of vigour, underground labour ought to be restricted in every mine whether specially unhealthy or not ; that eight hours per diem is as much as any boy or man can spend in the artificial conditions of a miner's life, without detriment to his well-being ; and that on this ground the State is justified in placing restriction upon labour of this kind. That some restriction should be placed upon 226 THE CHILDREN OF THE NATION the underground labour of boys of 13, few will be disposed to deny. It is sixteen years since the Berlin Conference, and the time has surely arrived when some serious effort should be made to carry out the reforms which the British Government then so ardently desired. CHAPTER XIV STATE CHILDREN Derelict Children THERE is a considerable number of children for whose bringing up the State is directly and solely responsible, either permanently, as in the case of orphan and " deserted children ; or temporarily, as in the case of those whose parents are paupers in the workhouse or criminals in prison. The name " pauper children," by which they are often called, is a misnomer. A child cannot be a " pauper," for it is born with a right to be maintained by others till old enough to maintain itself; and the child of the rich is as dependent upon others as the child of the poor ; parents may be paupers, but children always possess a legal right to maintenance ; to call a child by the oppro- brious name of "pauper" because its parents are such, is as unjust as it would be to call it criminal because its parents are in prison. It is interesting to inquire how the State itself deals with those children who are thus in a special sense its own, 227 228 THE CHILDREN OF THE NATION how it fulfils its own parental responsibilities, and how far it avoids those errors and shortcomings which are justly reprobated in the poor. It would be unfair to the present order of society to recur to the days not more than one hundred years ago, when the public authorities sold the children, for whose bringing up they were responsible, to slavery in the Lancashire cotton mills, and transported them thither in canal boats, of which the horrors resembled those of the slave-ships in the middle passage ; or to the criminal neglect and starvation to which poor children were exposed in the days when Charles Dickens was inspired to write " Oliver Twist/' and awaken the humanity and conscience of the British people : it is enough to consider the present, when the highest public virtue is proffered, when the oppression of the poor is conducted upon philanthropic and scientific prin- ciples, and when children are deprived of their legal rights only from defective administration. Evading Responsibility The State is just as ready as the most pauperised parents, to shift its liabilities if it can on others. Thousands of destitute children, for whose main- tenance and education the State is liable, but for whom the State neglects to provide, are being brought up by charitable and semi-charitable societies. In some few cases the Guardians are paying, as they are legally liable to do, for the cost of maintaining such children, but these cases are STATE CHILDREN 229 exceptional ; as a general rule, their obligations are evaded. Deserted babes, as young as six years old, fit only for a mother's care, are brought as criminals to the police courts, charged with the crime of being " found destitute." They can then be committed till 16 to an industrial school, and part of the cost of their maintenance can by this expedient be shifted from the rates to the Con- solidated Fund. Outdoor Relief One of the commonest expedients by which rural Guardians, in particular, evade their respon- sibilities for bringing up fatherless children, is by imposing the cost of maintaining them upon their widowed mothers with very inadequate public help. A great part of the population of country villages is composed of widows with large families of young children. To bring these children up the mother must work herself almost to death ; it is amongst such women that you find the noblest examples of courage, industry, self-devotion, and patient endurance of poverty. They have a pittance of outdoor relief ; they get something from the religious charities of their parish ; some are befriended by richer neighbours ; and these sources of income they supplement by unremitting and often ill-paid toil. They thus drag up a family of " valuable national assets " in the best way they can. If Guardians treated a widow as responsible for bringing up one or two of her children, and the 230 THE CHILDKEN OF THE NATION rest as State children, for whom the public was liable ; if they paid her a weekly sum for main- taining and taking care of these children, subject, of course, to all necessary supervision ; the present oppression of the fatherless and widows would cease, and the children would be better fed and better clothed, would be fit to profit by public education, and grow up into better men and women. State Children in Workhouses More than ten years ago, a committee was appointed by the Local Government Board to inquire into the existing systems of maintaining and educating children who were under the charge of Boards of Guardians. They reported in 1896. One of their recommendations was that no child above 3 years of age should be allowed to enter a workhouse, but that small homes outside the workhouse, containing not more than twenty children, should be provided for their temporary reception pending arrangements for their future allocation. The evils of keeping children in work- houses were universally admitted and deprecated by every Poor Law official. In most workhouses there was an entire absence of educational pro- vision ; where such had been made it was reported to be very defective ; in some they were being instructed by a pauper inmate, taken off the rates to serve as schoolmaster ; at the best they were STATE CHILDREN 231 attending a neighbouring public elementary school, but this arrangement broke down whenever there was an epidemic of infectious disease either in the district or in the workhouse, and they then had to be kept at the workhouse without instruction. Besides being deprived of education, the children were not, in general, kept under proper classification and supervision : they associated with adult paupers of a class sometimes verging on the criminal, whose influence on them was admitted to be very undesirable ; they lived, fed, and slept without the needed separation from the other inmates ; and it was unreasonable to expect that they would ever shake off the pernicious influence of early days spent within the walls of the workhouse. Many children remained in this position for months and even years. The recommendation of the com- mittee was universally accepted. The only reason given for retaining children in workhouses was the absence of proper accommodation for them elsewhere. Promises were made that the necessary provision should be at once made, and the mischievous practice of keeping children in workhouses put an end to. In November, 1894, there were in the Metropolis 2,994 children in workhouses and workhouse infirmaries; in January, 1906, the last date from which a return is available, there were 3,039. So much for our promises of reform ! The number of children in workhouses and workhouse infirmaries in England and Wales was in January, 1906, 21,769, and shows no sign of diminution. 232 THE CHILDREN OF THE NATION In Midsummer, 1906, the medical officer of the West Ham Board of Guardians reported that — 4 'The condition of the infants' school block is disgraceful in the extreme. There is accommoda- tion for 44, there are 118 in it. The day-room is 26 feet by 18 feet, and its condition when the children are in can be better imagined than described. Disease has been rife during the past half-year. Thirty children now have measles. Disease always follows upon gross overcrowding, and I cannot be responsible for what may happen next." This has occurred in spite of repeated protests of the State Children's Association, and remon- strances from the inspectors of the Local Govern- ment Board. District Schools The first plan of providing for destitute children out of the workhouses was the establishment of large barrack schools situated usually in the midst of country air and healthy surroundings, where they were lodged, boarded, and instructed, entirely separated from adult paupers. Buildings and grounds for recreation were provided with great liberality. The mistake made was that these institutions were much too large ; in some more than a thousand children were massed together. In 1888 a Select Committee of the House of Lords called attention to the disadvantages of the system, ''which are," they said "inseparable STATE CHILDREN 233 from any system under which a number of children are brought up together without home influence or any contact with the outer world, but we cannot doubt that they are much aggravated by the overgrown size " (of the schools). " The great size of the schools," says Mr. Knollys, Chief Inspector of the Local Government Board, " is due to the prevailing opinion on the part of the managers, that a large school is cheaper than a small one." The aggregation of large numbers of children in one institution has been universally condemned by medical authority. It has tended to the dissemination of infectious disease, especially of ophthalmia, ringworm, and skin complaints generally. " The bigger the school," says Dr. Sykes, Medical Officer of Health of St. Pancras, " the bigger the danger of a serious outbreak." Experience has fully proved the correctness of medical opinion. As long ago as 1862 experts were employed to inquire into the prevalence of ophthalmia in district schools. In spite of every effort to prevent the disease, short ot breaking up the large schools, and providing for the children in smaller ones, there had been continual outbreaks of ophthalmia in the district schools, causing not only great pain and distress to the children but sometimes blindness and other defects of vision, which unfitted them to be a support to society in after life. Statistics have proved that the longer a child is kept in the atmo- sphere of the dormitories and day-rooms of crowded 234 THE CHILDREN OF THE NATION schools the more liable it becomes to this disease. Children when housed together in large numbers suffer also from mental dulness ; they are not so apt and intelligent as other children. Although they have had the advantage of better sanitary conditions and liberal dietary, they have become dull and wooden probable from the machine-like monotony of their life, and are very slow in everything they do. The fact of having to make provision for large numbers forbids indi- vidual treatment, and any originality with which a child enters an institution is soon crushed down and rolled out into a featureless uniformity. As regards formation of character, Dr. Barnardo, who had a larger experience than any other man of modern days, in the management of destitute and deserted children, thought the schools of the workhouse type, unless they took the form of industrial schools, not desirable for boys, and for girls " an unmixed evil " : the worst cases that had been under his care came from the Poor Law institutions. " The mental condition of the girls," he says, " has been a source of great amazement to me, their dulness and incapacity, and especially the animalism of their tempers. I have had some of these cases which have been the most perplexing I have ever had in all my experience, and I have been compelled to reject most of these girls as unfitted for emigration. . . . I am bound to say that evil habits are much more prevalent than I think the public have any STATE CHILDREN 235 conception of in all Poor Law establishments of a barrack class in which girls are aggregated." Dr. Barnardo himself began with a barrack school : he gave it up because of the revelations that came home to him as to the certain result ; M when a number of females are massed together, girls or women, they seem to react on each other in a degrading way ; the standard gets lower. I believe," he says, "the daily monotony of even the best barrack institution affords no channel for the nervous energy of the inmates to run safely in. The normal excitements of ordinary life, excitements which come to all children in the natural family, are the most healthy stimuli in the formation of character. The dull monotony of institution life, and its weary routine which reduces everything to the dead level of a colourless experience, has much to answer for in the evil habits contracted by these girls." The industrial training which it is possible to give in district schools compares unfavourably with that given by Dr. Barnardo, where all boys, even the cripples, are apprenticed to trades at which they can earn a living ; they are not turned out into the world to shift for themselves, but are sent to situations and a kindly supervision is maintained over them as long as it is required. In very few of the district schools has there been any efficient technical training. The boys and girls must be generally got rid of at 14, which is too early an age to have them fitted for anything 236 THE CHILDREN OF THE NATION but unskilled employment. The boys learn to play musical instruments, and the most successful become bandsmen ; some are employed in fields or gardens, but not in such a way as to qualify them to become small farmers or gardeners ; the girls perform much of the domestic and laundry service of the institution, but the experience of the machinery and appliances requisite in a great establishment does not fit them either for domestic service or to manage houses of their own. The youths and maidens turned out from the Poor Law schools are far less fitted for useful employment in the world than those who proceed from Dr. Barnardo's homes. The West Norwood Education Committee in 1906 reported on the Poor Law children of Lambeth, who attend public elementary schools in Norwood from the Norwood barrack school ; their report shows that the blighting influence of barrack school life is still discernable in such children, even when it is mitigated by their communication in the council schools, with the children of the normal population. Village Communities To mitigate the evils of district schools, many Boards of Guardians have established little colonies of separate homes to take the place of one large residential establishment. This system is an improvement on the district school, just as STATE CHILDREN 237 that is an improvement on the workhouse. At Banstead, in Surrey, was placed the first village community which formed the model for most of those that have been since established in London. In it the cottages are detached, some for boys, some for girls ; each is occupied by about three dozen of the former, or two dozen of the latter. Each cottage has its dining-room, its kitchen, its two or three bedrooms, and its garden and play- ground ; in the girls' cottages is also a small wash-house. The boys' cottages are placed under the care of a married couple ; the girls under that of a single woman or widow. Boys under 7 are put into girls' cottages. The domestic life of the children is thus restricted to smaller numbers ; only the schooling and industrial training is common to all ; the cottage father and mother can take some interest and accord some love and affection to individual children ; and the domestic surroundings are more like those of a natural home. There is a much higher standard of health maintained in these cottages than is to be found in schools of the institution type ; the children are brighter and their physical development greater ; they are much more free from ophthalmia, ringworm, and skin diseases. The village community does, however, retain a great many of the evils of district schools. The population of the village is composed entirely of one class, Poor Law officials, and Poor Law children ; there is no admixture of the outer world 238 THE CHILDREN OF THE NATION The separation of boys and girls, which obtains in most of these communities, is artificial and mischievous. The numbers, which for economic reasons are assigned to each cottage, are far too great ; there are large kitchen ranges and boilers, and all the mechanical contrivances necessary for cooking for three dozen inmates, and there is nothing like real family life. In some of the more modern village communities, as, for example, at Sidcup, where the children from the Greenwich Union are placed, blocks of buildings to accom- modate as many as sixty boys, have been erected. This introduces an embryo barrack school into the community, and is getting half-way back again to institution life. The attempt to make real village children of the inmates of village communities is vain. They usually do not attend the village schools, they do not play with the village children, or roam with them in fields and lanes, they are confined within an iron fence ; they do not attend the village church or chapel ; they do not get absorbed into the village life ; when they leave school they often go back to the workhouse and the town. Scattered Homes More than ten years ago a system of dealing with Poor Law children, in the teeth of the most strenuous opposition on the t part of the Local Government Board, was invented in Sheffield, which has since been imitated by a great number of STATE CHILDREN 239 public authorities. All children under 3 years of age are turned away at the door of the work- house, which they never enter, and go at once into the children's receiving-house from which they are drafted, as soon as their physical condition has been ascertained, into a probationary home in the immediate vicinity. From this they are removed as soon as possible to isolated or scattered homes, each of which contains about sixteen children. These homes are not grouped together, but are, as far as possible, scattered in different healthy suburbs of Sheffield : they are ordinary dwelling-houses, undistinguishable from other dwellings of respectable artizans. The children in each home are of both sexes and all ages from 3 to 8 for boys and 3 to 13 for girls ; they are presided over by a foster-mother who cooks, cleans, mends, washes, and irons for the home, with the help of the elder children and a charwoman one day in the week ; the cooking is done in ordinary utensils and by an ordinary fire. Each child has a pigeon-hole for its belong- ings and a box for its clothes. " It is contrived," says Mr. Ashberry, one of the inventors of the scheme, "to have 'our baby' in each home, the pet of the household. When this is taken away for adopting, boarding-out, or discharged with its parents, the home is plunged in grief. At one home an elder girl who had been much attached to one taken away said that the 'house seemed empty/ " The children in the home are dressed 240 THE CHILDREN OF THE NATION like other children, and are sent unattended to the ordinary public elementary schools in their neighbourhood; they are well spoken of by the teachers as quite equal to the average in intelli- gence, power of learning, and conduct; they play with their school-fellows ; on Sundays, they attend the neighbouring churches, chapels, and Sunday schools ; they are enrolled in Bands of Hope, and share in all the treats and entertainments ; nobody treats them as a separate class. The children are kept under medical supervision ; their general health is excellent ; ophthalmia is almost unknown; and they show no signs of that low vitality which is so characteristic of children in large aggregated schools. The greatest care is, of course, taken in the selection of foster- mothers ; but this has not proved an insuperable obstacle to the adoption of the system : a real and lifelong affection springs up in a multitude of cases between her and her charges. The cost per child is considerably less than in district schools or village communities. Boarding-out The most natural and ideal method of dealing with a deserted and homeless child is to place it in a real home where it can enjoy the love and affection of foster-parents. The home life draws out the child's individual character instead of suppressing it as institution life does. It grows up STATE CHILDREN 241 with other children, learns with them, plays with them, gets into childish scrapes, and loses that sense of separation and strangeness of position which in the rearing of children is above all things to be avoided. Even afflicted children seem to acquire in a wonderfully short time the devoted affection of a foster-mother. Their appearance may be repulsive, their ailments troublesome, their habits dirty, but nothing seems able to suppress the love with which women are inspired for any creature which is dependent upon them. Children boarded out in private families become absorbed in the general life of the village in which they are placed, and thus escape the evils inseparable from the dreary routine of a great school. In many cases they have been known to assume their foster- parents' names : they receive their education in the village school, in which from their regularity of attendance and their general quickness they are welcomed by managers and teachers alike. As regards health, boarded-out children are un- doubtedly better off than those brought up in institutions. Dr. Barnardo found the health of the children whom he boarded out very much higher than that of the children in his institutions, and on this and other accounts he ended by almost entirely abandoning the latter system for the former. They are, of course, not exempt from measles and other epidemics of rural life, but they enjoy an almost complete immunity from ophthalmia, ringworm, and eruptions of the skin from which children in neither 242 THE CHILDREN OF THE NATION country nor town workhouses can be pronounced free. Most boarded-out children become in every respect members of their foster-parents' families ; they acquire a home in which they can take refuge in after-life, during intervals of employment or in times of sickness. The cost of boarding out children is about half that of maintaining them in district schools. Under these circumstances it is surprising that boarding-out has not been more generally adopted in England. In Scotland it is almost universal ; ten years ago it was stated that more than 80 per cent, of the children chargeable to parochial authorities are provided for by boarding out. Ireland is the country in which, more than half a century ago, the system was first invented for the benefit of Protestant orphans in districts where the bulk of the population was Roman Catholic. In all the Australian colonies, in Tasmania, and New Zealand, the system has long been in operation, with the most satisfactory results. It is adopted in many of the United States of America, and in some Continental nations. It has also been chosen by voluntary societies. The Church of England Society for providing Homes for Waifs and Strays boards out a considerable number of their young children, and provides small homes for the rest. Dr. Barnardo, who began by trying large institutions, and afterwards village communities, adopted boarding- out twenty years before his death, as superior to both. He told the committee on Poor Law STATE CHILDREN 243 children that he would not create another large institution under any circumstances, and that although he had had many opportunities of adding to his institutions he had declined to do so, V because boarding-out is so much better." As regards technical training, although the boys boarded out in villages may be little better off than those in insti- tutions, the girls are, because cottage life is more educative than the domestic drudgery of a large school. The girls are thus better fitted to be wives and general servants. Dr. Barnardo did more for his children than the State attempts. He gave them a technical training before turning them out to earn their living. How fortunate was the destitute child who fell into the hands of Dr. Barnardo, rather than into that of the State ! Experience has shown that in a system of this kind, there are difficulties to overcome, but that these are not insurmountable. Foster-parents have to be carefully chosen, but of these the supply does not seem to be yet exhausted. In the first instance they may be taken for profit, to which I cannot see any objection, but Miss Mason, the inspector of the Local Government Board, testifies that in many instances the foster-parents become so attached to the children that they would ultimately keep them without payment rather than part with them. The weekly payment is small, the number of children in each home is restricted, and it is impossible, with proper safeguards, that the system should degenerate 244 THE CHILDREN OF THE NATION into baby-farming. The number of boarded-out children in any one village should be limited. The children should be properly watched over and inspected by public authority, but not in such a manner as to harass and irritate the foster-parents. The public authority which pays for the main- tenance of these children has a right to satisfy itself that they are properly cared for ; it has no right to treat the foster-parents as unworthy of trust and as desirous of evading the responsibilities they have undertaken. The present Boarding-out committees do their work well, and if Health committees were everywhere established on the Elberfeld system, like the ladies' committee in Manchester, there would always be a suitable body to which public authority could entrust the supervision of boarded- out children. Inspection should not be too in- quisitorial ; the best inspectors would be women with medical qualifications, who could give professional advice at their visits as to how the children should be treated as well as criticism of their condition. Dr. Barnardds Homes No chapter on destitute children would be complete without some description of the work to which Dr. Barnardo, whose opinions have been frequently quoted in the course of the chapter, devoted forty years of his valuable life. Dr. Barnardo began his life-work while a medical student in the London Hospital, Whitechapel Road. UN1VER5IT> STATE CHILDREN 245 He tells himself the story of the first boy he rescued and of the revelation of street misery and destitution which this child revealed to him. From this time his good works increased and multiplied, so that at the time of his death there were between eight and nine thousand children at any one time under his care. The two most remarkable features of his system are — First, that he appeals to the love and affection dormant in the heart of every child, however its soul may have been starved and repressed. The child's love awakens love in the breast of the person who has charge of it, whether a woman with whom it is boarded out, a cottage mother, a teacher in the school, or the manager of a kitchen, a laundry, a sewing-class, a ship, or a workshop. The relation which Dr. Barnardo's system seeks, and that not in vain, to establish is that of parent and child, not that of master and servant. Any social student who investigates Dr. Barnardo's establishments cannot fail to be struck with the singular spirit of love which pervades the whole atmosphere. Secondly, the work does not cease when the child has grown old enough to gain its own living and stand alone. It is projected forward into its work- aday life, so long as it needs sympathy and support. Every boy and girl is brought up "to learn and labour truly to get their own living and to do their duty in that state of life to which it shall please God to call them." Such of the children as are suitable are sent out young as emigrants to Canada ; 246 THE CHILDREN OF THE NATION but their welfare is still carefully and efficiently watched over from Dr. Barnardo's homes. All boys and girls leave the school with attainments fit for the work of life ; places are found for them ; they can return to the homes if in distress. Even cripples, whom industrial schools reject, and many of whom are doomed to an early death, are sent out with the rest, and brought back when their strength gives out, to end their days in peace. The social significance of Dr. Barnardo's homes is certainly not appreciated by the public. It is a work not of charity but of ransom. Few of the eight or nine thousand children in the homes are without a legal right to maintenance and education by some public authority, which shovels off its re- sponsibilities upon Dr. Barnardo. If the Poor Law statute of Queen Elizabeth were faithfully carried into execution, such a thing as a destitute child should not exist in the land. It is in consequence of public neglect of duty, called by the President of the Local Government Board ''defective adminis- tration," that the necessity for such a work as Dr. Barnardo's came into existence. And while we admire the wisdom and self-devotion which has established so great a national institution, and while we make every exertion to maintain its efficiency now that its author has gone, we must never relax our efforts to summon the nation to discharge its duty to its children, and to make the existence of the destitute objects who now crowd into Dr. Barnardo's ever-open doors an impossibility. CHAPTER XV HEREDITARY DISEASE Its Causes ALTHOUGH the conclusion to be drawn from the best medical testimony available is that 90 per cent, of children born come into the world free from hereditary taint, fairly healthy and well nourished, and sent forth by nature with the capacity of growing up into capable men and women, there is a residuum of 10 per cent, in whom the sins of their fathers have sown the seeds of disease, and from whom the greatest care may fail to avert their pre-natal doom. This unhappy class is, we are assured by medical experience, pretty evenly distributed amongst all sections of society : the poor have no monopoly of it. No consideration of the question of the health of the children of the nation would be complete without some reference to it. The two great causes of hereditary disease are alcoholism and syphilis. There are others, but their effect upon the general health of the people is insignificant in comparison with that of the two 247 248 THE CHILDREN OF THE NATION mentioned : these other diseases may at present be safely left to be dealt with by medical science in private practice and in hospitals. Not so with alcoholism and syphilis. If any effort is to be made to prevent the deterioration of the race, which is brought about in the 10 per cent, residuum by these forms of disease, the subject, however unpleasant, must receive the careful consideration of public opinion and authority. There are two distinct questions to be answered : first, what can be done to extinguish the causes of these hereditary diseases, so that they shall no longer be transmitted to innocent children yet unborn ? And secondly, what remedial measures can be taken to avert from the victims the consequences of hereditary taint ? Alcoholism A great prelate of the Church is reported to have once said that he would rather see the British people free than sober ; and this saying is treasured up and constantly repeated by those who champion the vested interests of brewers and publicans. But it is certain that no man who is habitually drunken can be in any real sense free ; he is the slave of his own passion for drink. It is also confidently alleged that you cannot make people sober by Act of Parliament. That is perfectly true — " leges sine moribus vance " — but it is equally true that you can by Act of Parliament give every encouragement to the provision and sale of drink, so that the poor HEREDITARY DISEASE 249 worker, whose sensuous pleasures are few, is beset on every hand by the temptation to the only form of indulgence which his lot opens to him. The subject of licensing reform and temperance legisla- tion is too vast to be discussed in a section of a chapter of this book ; it is enough to observe that the result of more than half a century of strenuous effort in the cause of temperance reform is that the towns and country villages, and even the roads and lanes, are still covered with an admitted super-abundance of public-houses and beer-houses, under the management of persons who have, in almost every case, a strong personal interest in selling as much intoxicating liquor as they can possibly contrive to do, without infringing a very imperfectly administered law. The amount spent in drink in the United Kingdom would, if applied to the proper maintenance of the people, feed all the children, render the labour of mothers un- necessary, and place every home in a condition of domestic comfort ; many a family now in penury and wretchedness would be in solvency and comfort, if the bread-winner had the moral strength to pass by the temptation of the public-house, and pay his weekly earnings into the hands of his wife to be spent on his children and his home. I should like to see the working people of Great Britain sober, for then they would become free. In the eighteenth century the richer and well- educated classes in Great Britain were notoriously drunken. The vice is indulged in now, but secretly, 250 THE CHILDREN OF THE NATION and with the general reprobation of the classes. Education is producing a similar effect now amongst the masses of the people. The reduction of public revenue derived from the importation and manu- facture of beer and spirits is inconvenient to the Chancellor of the Exchequer, and is depressing to the shareholders in brewery and distillery com- panies, but it is a phenomenon that every true patriot must regard with unmixed satisfaction, as evidence of a salutary change in the habits of the people. The Committee on Physical Deterioration, who were " convinced that the abuse of alcoholic stimulants was a most potent and deadly agent of physical deterioration," recommended that efforts should be made to bring home to the community at large the gravity of the issue, and the extent to which individual effort could promote temperance. Dr. Eichholz, in his evidence, called attention to a proclamation put forth by the " Assistance Publique " at Paris, in which it was stated that — " L'alcoolism est l'empoisonnement chronique qui resulte de l'usage habitual de l'alcool, alors meme que celui-ci ne produirait pas l'ivresse. " C'est une erreur de dire que l'alcool est n^ces- saire aux ouvriers qui se livrent a des travaux fatigants qu'il donne du cceur a l'ouvrage, oil qu'il r£pare les forces : l'excitation artificielle qu'il pro- cure fait bien vite place a la depression nerveuse et a la faiblesse ; en realite* l'alcool nest utile a personne ; il est nuisible pour tout le monde. " L'habitude de boire des eaux-de-vie conduite HEREDITARY DISEASE 251 rapidement a l'alcoolisme ; mais les boissons dites hygienique contiennent aussi de l'alcool ; il n'y a qu'une difference de doses : l'homme qui boit chaque jour une quantity immoddr^e de vin, de cidre, ou de biere, devient aussi surement alcoolique que celui qui boit de l'eau-de-vie. " L'habitude de boire entrafne la disaffection de la famille, Toubli de tous les devoirs sociaux, le dugout du travail, la misere, le vol, et le crime. Elle mene pour le moins a l'hopital ; car l'alcoolism engendre les maladies les plus variees et les plus meurtrieres ; les paralysies, la folie, les affections de l'estomac et du foie, l'hydropysie ; il est une des causes les plus frequentes de la tuberculose. Enfin, il com- pliques et aggrave toutes les maladies aigues : une fievre typhoide, une pneumonie, un e'risepele, qui seraient b6nins chez un homme sobre, tuent rapidement le buveur alcoolique. 11 Les fautes d'hygiene des parents retombent sur leurs enfants ; s'ils ddpassent les premiers mois, ils sont menaces d'idiotie, ou de lepilepsie, ou bien encore, ils sont emport£s, un peu plus tard, par la m6ningite tuberculeuse ou par la phthisic u Pour la saute" de l'individu, pour l'6xistence de la famille, pour l'avenir du Pays, l'alcoolism est un des plus terrible f!6aux." An authorised public document of this kind should be put forth by every public authority ; it should be posted up in the free libraries, the post-offices, the 252 THE CHILDREN OF THE NATION doors of churches and chapels, the courts of justice, and every other public place. The physiological facts which it contains should be taught to teachers in all training colleges, elementary and secondary, subsidised by public money, and taught in all Government schools. The effects of the alcoholism of parents upon their offspring is not, as in syphilis, the production of any peculiar specific disease, but a general increased tendency to idiocy, epilepsy, and other diseases which arise from other causes. There is no call upon the public authority to provide special hospitals for them : they only require more care, but of the same sort, as other children, to which, born with a disadvantage through no fault of their own, they seem to have an overwhelming claim. If adequate provision were made by society for the proper bringing up of all children, those of drunken parents would require no special treatment. As it is they have a somewhat stronger claim upon society than others for the performance of that duty which, at present, society impartially neglects. Syphilis There are persons who view with disapproba- tion any attempt by public authority to suppress syphilitic disease. They regard it as a specially designed punishment for incontinence ; they look upon the fear of the disease as a valuable incentive to chastity ; and they doubt whether the condition HEREDITARY DISEASE 253 of the people would be morally improved if it could be entirely stamped out. Whether such persons constitute a majority of the people or not, their honest and vehement opposition has success- fully thwarted all efforts by the Government of this country to deal with this disease as it has been dealt with by almost all the civilised States in the world. Into the ethical question I do not propose to enter, but the ravages of the disease are so extensive, visiting as they do the sins of the fathers upon the children, literally to the third and fourth generation, that it is impossible to pass the matter by in silence in a book about the children of the nation. The Committee on Physical Deterioration did not venture to make any recommendation upon the subject, except " the appointment of a com- mission of inquiry into the prevalence and effects of syphilis, having special regard to the possibility of making the disease notifiable, and to the adequacy of hospital accommodation for its treat- ment." No such inquiry has been instituted, either by the late or present Government. Possibly both considered further inquiry to be useless ; the facts are well known : what is wanted is not inquiry, but action. Ravages amongst Children Of the cruel suffering and disease caused by this hereditary taint amongst innocent children, abundant evidence was given before the Committee on Physical Deterioration. "It is the great 254 THE CHILDREN OF THE NATION element," says Dr. Kerr, "in congenital blindness and deafness, and in the cases that go blind and deaf — children who have gone to the age of 10 or ii gradually getting blind and deaf. These cases are practically all due to syphilis ; they present the other characteristics of syphilis — interstitial iritis and internal ear deafness, and they have generally the brain deterioration that goes with it. A certain number become nearly blind, nearly stone-deaf, and frequently feeble-minded during school life from the development of the hereditary disease. There is no doubt in my own mind that inherited syphilis is responsible for a much larger amount of gross defect and permanent ill-nutrition among children than can be definitely assigned to it. The disease should be properly controlled." " Numbers of children," says Sir Victor Horsley, " die within the first six months of life from what is called bronchitis. A number of those are cases of congenital syphilis of the lungs. Of course there is ordinary infective bronchitis, but a great many of them are syphilitic. Syphilis in the female is still more prejudicial to the children than in the male. I think that is a source of general physical deterioration. When a female becomes infected at the child-bearing period, the mucous membrane of the womb becomes altered, and with the first syphilitic child which is born, you find the placenta has actual organic changes in it, consequently the womb must be affected permanently for the rest of that woman's life. From the moment the first HEREDITARY DISEASE 255 syphilitic child is born, you can say that damage is done to that woman as a child-bearing individual for the rest of her life." The same witness describes the downward progress of a syphilitic child, "who is going to live, and who will be a deteriorated member of the community. Soon after birth the child will present snuffles and rashes on the skin ; perhaps nothing more. The mucous orifices are inflamed, and perhaps nothing more. Then as it goes on to second dentition, you will find that its growth is proceeding slowly ; as its teeth appear you will find them presenting the ordinary signs of congenital syphilis — notched and peg-like. By the time the child has arrived at puberty it is obviously a stunted individual ; the bones are small, and the muscles are small and poorly developed. There is a very large class of mentally deficient children, whose condition is due to congenital syphilis alone. As soon as they arrive at puberty, syphilitic children then are liable to get diseases of the eye, and of the bones. It is often not actual caries ; but it is an inflammatory thickening and often causes destruc- tion of the bone. Finally, when they come to the stress of life, when they get to about 35, even before 30, at 27 sometimes, they begin to break down from various nervous diseases. Their expectation of life is very limited. The children of a syphilitic family are all hit more or less. The infection at one end of the family may be slight, but you cannot say that any child of such a family whom you can trace escapes during his 256 THE CHILDREN OF THE NATION whole life, and is really a healthy individual." The evidence of Sir Victor Horsley was abundantly corroborated by other medical witnesses. Sir Alfred Cooper, who twice represented Great Britain at the Brussels International Conference on this disease, was asked to describe the ravages and complications that ensued from it. He re- plied, " I should place insanity as almost one of the first things ; idiocy ; diseases of the bones, producing deformity and disfigurement ; diseases of the eyes, producing blindness ; diseases of the ear, producing deafness ; diseases of the internal organs, causing defective nutrition and deficient development ; diseases of the nervous system, producing insidious forms of paralysis, locomotor ataxy ; and it is responsible for a large proportion of the cases of lunacy and idiocy in our asylums." It was further shown by medical testimony that the other cause of hereditary diseases, alcoholism, aggravated in many cases the mischief of syphilis. " That is very well realised in the profession," says Sir Victor Horsley. " Alcohol is a particularly aggravating factor in the progress of syphilis. If a person becomes at all alcoholic, he breaks down more quickly from all forms of syphilitic trouble." The effects of the disease are visible in the second generation, and may even extend to the third, though of this last fact there is no reliable scientific evidence. Owing to a mistaken delicacy in writers and speakers on public health, a most profound ignorance pervades all classes of society as to HEREDITARY DISEASE 257 the extent to which the disease prevails, as to its shocking consequences upon innocent persons, and as to the means which are available for its prevention and cure. Preventive Measures It is on behalf of the innocent victims of the disease, and especially of children whose lives may be blasted from birth through no fault of-their own, that the intervention of public authority is demanded. If public morality demands that no special steps should be taken to protect the primary sufferers from this disease, it seems equally obvious from the same point of view that no special privileges and immunities should be accorded to it ; it should be treated in the same manner and on the same principles as all other contagious diseases are treated, and the sufferers from it should be required to surrender so much of their individual liberty as is essential to public safety. A person affected is as much a source of public danger to other people and to innocent children as a person who is suffering from small-pox. Why should such a man or woman be exempted from the obligation to notify his or her condition to the officer of health, and to submit to such treatment either in hospital or elsewhere as the interest of the public may require? To permit concealment of the danger from the public officers of health is a privilege not accorded to sufferers from scarlet fever or small- 258 THE CHILDREN OF THE NATION pox. There is nothing at all impracticable in requiring and enforcing such a notification. M It is what they do in Russia," says Sir Alfred Cooper. "I was in St. Petersburg in 1875, an d they have greatly checked syphilis there. Directly there is a case it is reported, whether it is a prince or princess, or duke or duchess, or even one of the grand dukes. If one of the grand dukes gets syphilis it would have to be reported, and he would be surrounded by police regulations, and it would be quite impossible for him to pass it on to anybody." One would be very reluctant to admit that the law in this country is less powerful than in Russia, or that, if notification and submission were prescribed by statute, any person, of however high rank and social influence, would be able to set himself up against the law and refuse to be treated. In Scandinavia, hospital treatment for syphilis is compulsory : there are no special hospitals — what are called " lock hospitals " in this country — for the disease ; patients are treated in the general public hospitals, so that the most perfect records of the cases of syphilis and its sequelae are obtained. It was from these that general paralysis was first ascertained to be frequently of syphilitic origin. In our country a patient may receive his first treatment in a " lock hospital " ; after his discharge some secondary symptom supervenes ; he is treated in another hospital where his antecedents are unknown ; and his disease is not attributed to its true cause. Such HEREDITARY DISEASE 259 records as we possess of the extent and complica- tions of the disease are thus rendered fallacious. Hospitals If the hospital accommodation for the treatment of this or any other disease is insufficient, the municipalities have, as the Sanitary authority under the Public Health Act, the power to supply it, and can recover the cost of treatment from the patient if he is able to pay. Treatment in a general hospital is, in the opinion of most medical authorities, to be preferred to provision by special " lock hospitals." There is nothing to prevent Municipal authorities, without establishing any general hospital of their own, entering into arrangements with the managers of any hospital to provide accommodation for syphilitic patients at a fixed charge. It would be probably an abuse of the charitable funds, which are the means of support of most hospitals, to apply them to such objects, and might in the present state of public opinion lead, if known, to a diminution of hospital subscriptions ; but there is no such objection if the cost is defrayed by public authority, and no charge is imposed on the funds of the hospital. But there is another obstacle to effective treatment. Sir Victor Horsley says that his hospital takes in cases of syphilis. The real trouble is that an ordinary syphilitic patient does not feel so ill as to consent to enter a hospital in the vast majority of cases. The most dangerous 260 THE CHILDREN OF THE NATION patients are not ill bodily, and therefore they will not enter a hospital ; they persist in going on with their occupation and become sources of infection to innocent people. Dr. Mott, of the Charing Cross Hospital, says that the poorer people do not seem to know the dangers of syphilis. Perhaps they may go to the hospital, but as soon as the sore has healed they do not attend any longer. Unless they had some serious nervous disease, Dr. Mott would not take them into the general hospital because he has no room for them. The necessary course of treatment is a long one. "As a rule," he says, "the poorer classes are either not treated at all or are treated by quacks and chemists, or else as soon as the sore has passed away and they have no further trouble, and when it does not interfere with their work, they go away and do not come back." Detention All this evidence points to the conclusion that some power of detaining in hospital those who are suffering from this disease is essential to any attempt to deal effectively with its ravages. It is quite true that of late years the primary disease has, in the opinion of medical authority, become less virulent ; it does not necessarily follow that the secondary effects upon the victims of the disease and their offspring have also become less extensive and less michievous. Our hospital records do not HEREDITARY DISEASE 261 enable us to speak with certainty upon this point ; because the cause of these secondary effects are, in so many cases, hidden and unrecorded. The detention of a person, whose freedom is a source of public danger, is politically and ethically justifiable. It is entirely a question of possibility and expediency. What is done in Russia and Norway cannot be wholly impracticable in Great Britain. A person, with the infection of small-pox upon him, is now restrained by law from mixing with his fellows in such a way as to spread infection ; there is no reason why a person suffering from syphilis should not be put under similar restraint. It is entirely a matter dependent on public opinion. If the people realised the frightful misery which this disease brings upon their innocent children, and the economic injury to the nation which is caused by breeding a class of degenerates, Governments, imperial and local, would soon find themselves compelled to adopt remedial measures. t CHAPTER XVI THE HOME Its Antiquity THE family and the home in which it lives are the most ancient of human institutions. They have probably descended to us from pre- human times and from ancestors who were not yet men. Without a home it is impossible for children to be properly brought up, and their character and faculties healthily developed. To this proposition no objection would in general be made, and yet in our country both in the towns and villages there are thousands of families who possess nothing deserving of the name of home. In Chinese civilisation, the oldest and most stable that the world has yet produced, the home and the family are made the basis of society. Every Chinaman belongs to a family, and has a home in which in trouble or destitution he can take refuge, unless he has by misconduct forfeited his rights and been expelled from his family. It is these outcasts who form the bulk of Chinese 262 THE HOME 263 coolie emigrants ; their great hope and object is to get back again to their own country and obtain re-admission to their families. Unfortunately it is from these that Western civilisation for the most part derives its conception of Chinese character. We know little or nothing of the Chinese who stay at home. Overcrowding Great efforts have been made in late years in this country to grapple with the problem of housing the population, and to provide in town and country wholesome and decent homes for the poorest of the people. Much, however, still remains to be done. It is useless to expect reform from the discontent of the people inhabiting their squalid dwellings. Custom makes them contented with their lot. Misery drives them to the consolation of drink, and drink blunts their sensibility to the squalor with which they are surrounded, and deadens all desire, if it ever existed, for improvement. Salvation must come to such people from without. If trans- planted into better surroundings, the love of home may revive. Overcrowding in unhealthy dwellings is one of the main causes of drink and vice, and reformation in such an environment is impossible. The first active steps which have been taken by public authority have been accordingly directed to the destruction of unhealthy slum dwellings and to the clearing of slum areas in London and the great towns. There are ample powers in the 264 THE CHILDREN OF THE NATION Public Health Acts for this purpose ; the difficulty is to get the Sanitary authorities to put these powers into force. If the people themselves who are most interested in the destruction of dwellings not fit for human habitation would take sufficient interest in their own welfare to elect municipal councils that would put into operation all the provisions of the Public Health Acts, reform would speedily be effected. Municipal Activity Many Town Councils have been leading the way in enterprises of this kind. In the report of the Committee on Physical Deterioration attention is called to some of these. In Manchester the conditions as to housing are very greatly improved. The majority of the worst type of houses have been entirely cleared away and a great many courts have been opened out ; but there are still 3,000 back-to-back houses in the city, and in the centre 206 common lodging-houses, described as insanitary, containing 5,821 inhabitants. From Liverpool, Preston, Wolverhampton, and Sheffield reports tell the same tale in varying degrees. In Glasgow, where a generation ago the conditions of existence were perhaps harder and more depressing than in any other in Great Britain, there is great improvement to record. In the opinion of Dr. Scott, certifying surgeon in that city, the Cor- poration have done their very best. Rickets, which had reached terrible proportions twenty THE HOME 265 years ago, has been reduced owing to the improve- ment effected in the conditions under which people now live. Dr. Chalmers, Medical Officer of Health in Glasgow, thinks that but for the one-roomed house difficulty the death-rate would be something like 1 8 or 19 per thousand. In London the number of cubic feet which each individual should have is prescribed by a special Act of Parliament, but as the enforcement of the law is in the hands of the Borough Councils, its application is varying and irregular. Under the apathy of the people in Borough Council elections, the councillors have the fear of vested interests before their eyes, more than the fear of the people. The standard is very low, 300 feet for each person in a room occupied by night only, and 400 feet for a room occupied by day as well ; but even this low standard the County Council cannot get enforced. The London County Council has cleared many insanitary areas, has done something towards the provision of dwellings, and has assumed control of common lodging-houses and effected a marked improvement in them. On the other hand, Tyneside, Dundee, Edinburgh, the Staffordshire Potteries, and to some extent Sheffield, are mentioned as districts which have suffered in whole or in part from the neglect of the local authorities to deal with glaring evils. In Dundee the factory inspector regards the men and women working in certain jute-mills as the poorest specimens of humanity he has ever seen. " There are," he says, "a great number of 266 THE CHILDREN OF THE NATION single-room and two-room tenements in Dundee, and big blocks having no privy accommodation at all except a common one in the yard." In the poorer districts of Edinburgh, according to Dr. Mackenzie, no less than 45 per cent, of the population are living in one- or two-roomed dwellings. In his Report to the Royal Commission on Physical Training he calls attention to the fact that the children from these dwellings were very markedly inferior in health, in physique, and in mental capacity to the average. The children from one-roomed houses were distinctly worse than those from two-roomed. Mrs. Mackenzie, who assisted her husband in his inquiry, told the committee that 76 per cent, of the population lived under these conditions, and in these one- and two- roomed dwellings there were often as many as nine children besides the father and mother — a home probably far more overcrowded than those of the Simian forefathers of our race. The City Council of Edinburgh took no heed of these reports, nor did the Scottish Local Government Board, which in such a case had complete power to initiate reform. In Sheffield, which has, however, now awakened from its apathy and begun vigorous reform, Mrs. Greenwood, a sanitary inspector, described the drainage as bad, many rubble sewers being still in existence, and the sanitary conditions shocking in respect to a large number of unpaved courts which receive the contents of the middens, and are therefore saturated with filth. There are THE HOME 267 15,000 back-to-back dwellings, most of them with no more than three rooms, and sometimes occupied by eight, ten, or even twelve persons. Miss Garnett, the head of Fenton House, a settlement of ladies for working amongst the poor in the Potteries, says that more than two bedrooms in a house are rarely to be found in that district, and these houses are sometimes occupied by eight adults. Most of the bad houses are owned by members of the local bodies, and the sanitary inspectors are too much in awe of their employers to carry out their duty, the only hope of a change, short of a drastic interference from headquarters, lay, in her opinion, in a registration of the owners of slum property and the rendering the Medical Officer of Health independent of the local authority. Apathy of the People As to the relative proportion of towns which do, and do not, put in force the provisions respecting overcrowding in the Public Health Acts we have no data to determine. The Committee on Physical Deterioration attributed the neglect which had been brought to their notice, partly to a reluctance to incur the necessary expenditure, a principle of wasteful and extravagant economy which pervades our whole public administration, and partly to the fact that while the interests of manufacturers and property owners have been alleged to interfere 268 THE CHILDREN OF THE NATION with the proper exercise of the functions of local administration, there is behind the whole system no sufficient driving power to secure that adequate pressure shall be brought to bear on those public authorities which are careless or indifferent. Stimulants to Reform Many people, like Miss Garnett in the Potteries, hope for such a driving power in the Local Govern- ment Board, but the experience of thirty years shows that to look for the initiation of reforms from that quarter is hopeless. With a professional and scientific administration like that of Germany, an impulse from headquarters may guide and stimulate the local administration, but in our British system such an influence can only be spasmodic and ineffective. The permanent official, whose sympathies and associations are entirely those of the richer classes, is no ardent reformer, ready to spend himself in the interest of the poor ; he is always disposed to leave things as they are. The Parliamentary Minister is an amateur, unskilled in the art of administration, dependent on his permanent officials to preserve him from making a fool of himself in public life, and seldom holds his office long enough to acquire the experience essential to the reformer's task. He loses his office before he becomes qualified. There is a driving force latent in our midst, which, if it could be THE HOME 269 aroused into activity, would exercise an irresistible pressure upon local administrators who are careless or indifferent — the power which the people possess but never exercise at local elections. It is the people who elect, or rather who have the power to elect, the local authorities which are, as the committee complains, reluctant to incur the expendi- ture necessary for public health, and who succumb to the interests of manufacturers and property owners. If some modern Prophet could stir up the common people to take an enlightened interest in their own welfare and that of their wives and children, an interest strong enough to induce them to go and record their votes at the election of Municipal Councillors and Poor Law Guardians, there would be a driving force called into action which would sweep all obstacles from before it, and establish a reform of public health that would change the face of the present life of the poor. There were two other suggestions made by Miss Garnett and other witnesses and approved by the Committee. One was the registration of the owners of slum property. The bargain made between the owner and the tenant is not of a kind which greatly advances the welfare of the com- munity. What the owner stipulates is in reality this : "I will give you the occupation of a single room in which you and your family may herd like pigs, in a condition destructive to the health and morality of yourself, your children, and your neighbours, so long as you can contrive to scrape 270 THE CHILDREN OF THE NATION together 5s. a week and pay it to my agent." The tenant either earns this sum by the sweated labour of himself, his wife, and children, or he begs, borrows, or steals it. The owner receives the money weekly and lives on it in a more aristocratic quarter of the town in comfort and respectability. The community has a right to know by whom such a contract, greatly detrimental to public interest, is made. The second reform proposed to grant security of tenure to Medical Officers of Health, who as a rule in England hold office at the goodwill of the local authority. The com- mittee observed that such security was enjoyed in Scotland and in London, and were of opinion that in no case, unless convicted of misconduct, should a Medical Officer of Health, not engaged in private practice, be removed without the consent of the Local Government Board, and that in all areas above a certain population he should be required to give his whole time to the work. New Slums It is, however, of little use to clear insanitary areas and displace slum tenants, unless those who are turned out have some better home to go to. All round London and the great towns which are increasing in population, may be witnessed the creation of new dwellings crowded together as closely as the law will permit, which will in time become new slums and require to be in their turn THE HOME 271 destroyed by future local authorities. The sanitary powers of* a city do not in general extend beyond its own limits. It is just outside the limits that the mischief arises. Land which a few years ago had only an agricultural value becomes what is known as "building land." The owner becomes suddenly enriched by no exertion of his own. He lets the land to the jerry-builder who covers it with as many monotonous streets of ugly houses as can be crammed upon it. There are no gardens, only little squalid back-yards, no open spaces, no broad streets, no reserve of natural beauty. If there are trees, they are all promptly cut down. The law T might have interfered and provided that the land over which a town grows should be laid out according to some predetermined plan, with open spaces, broad avenues, gardens to every dwelling-house, and so forth. This would be no injustice to the owner. He already realises a great unearned increment on the value of his land, because without any act or contrivance of his own, the town has grown in that particular direction ; and he has no grievance to complain of if the community by which this increased value is created attaches such conditions to the buildings to be erected as will make the new suburb healthy and pleasant. But vested interests have been too powerful for the public interests, and new suburbs are laid out in most cases with the sole object of making as much profit out of them as the owner and builder can jointly contrive, with the 272 THE CHILDREN OF THE NATION result that the new dwellings are as ugly, as squalid, and will soon become as unhealthy as the old ones. Rural Life for Workers Professor Cunningham, who was Chairman of the Anthropometrical Committee of the British Association, does not think it would be possible under the very best conditions of town-life to produce conditions in which the poor could live, which would equal those of the country. " The more nearly," he says, " you can approach the rural life, the greater amount of certainty you will have that there will be an improvement in the physical condition of the people." The establish- ment of healthy garden cities, and of healthy garden suburbs in the vicinity of existing cities, in which workers could dwell and be carried to their labour in the towns by the cheap, rapid, and easy methods of transport which are now undergoing such extensive development, would ensure a great improvement in the physical conditions of the workers themselves, and a still ereater one in that of their wives and children. A sufficient number of experiments of this kind have been tried by private benevolence and by employers who appreciate the advantage of having healthy workers, to prove that such an enterprise would be practicable for public authorities on a large scale. Country villages in which some branch of manufacture is carried on are to be THE HOME 273 found in various places. There is one at Wookey Hole near Wells, where a factory for hand-made paper — a small but highly-paid trade — is situated on a pure stream issuing from the Cheddar cliffs. There is one in Suffolk, near Manningtree, to which many years ago a xylonite manufactory was trans- planted from the East of London, together with the workers employed therein ; the workers were housed in good cottages with gardens ; their children played in the country lanes and grew hearty on country air and food ; although the men declared that the place was dull for their wives, and the wives that it was dull for their husbands, both agreed that it was a paradise for their children. Scarcely any availed themselves of the agreement made when they migrated from London that they should be sent back if they did not like the change. There is a considerable movement now in the industrial world for scatter- ing the factories of which the concentration was first brought about by the use of steam. With the increasing use of electric power such con- centration becomes no longer necessary ; it is more economical to bring electricity to distant works erected where land is cheap, than to crowd the works round power-stations where land is dear. Electric trams, motor omnibuses, and all cheap modes of transit, tend still further to spread the population into the fields ; and the day may not be so far distant when the houses in the mean streets of mean suburbs will be left empty on the 274 THE CHILDREN OF THE NATION hands of the speculators who built them, and the workers go further afield where gardens and flowers and fruit and vegetables can be had as a universal addition to a sanitary and well-built cottage. Many trades are already leaving the town, of which the printing trade is a conspicuous example, and many are preparing to follow ; the cost of any enlarge- ment of premises, and the difficulty of getting dwellings for the workers in the vicinity of the works are the impulses which are driving capitalists to seek sites for manufacture elsewhere. The First Garden City The Garden City at Letch worth, in Hertfordshire, holds out advantages to both employers and em- ployed. It is the first experiment of its kind and is based on sound principles, though it may not yet be sufficiently advanced to be pronounced an economic success. The town is to be limited in size and population, and there is to be an agri- cultural belt all round it, so as to render vitiation of the air impossible. Land is to be let for factories and dwelling-houses upon such conditions as will promote the health and welfare of the inhabitants ; and all profits and the unearned increment which elsewhere enriches the landowner will, after allotting a 5 per cent, dividend on the original capital, be available for the common interests of the town. The whole area dealt with is 3,800 acres, and of this only 800 acres will be covered by the buildings THE HOME 275 of the town, the rest will form the agricultural belt, and be laid out in allotments, market-gardens, and small farms. There will be no " slum " in the ^ town, not more than six or eight cottages to the *- acre will be permitted, and overcrowding in these can be prevented under the Public Health Act. Every cottage will have a garden or an allotment within easy reach. The sites for factories are laid out in a quarter of the town adjoining the Great Northern Railway, which runs through the centre of the city, and are provided with railway sidings and every convenience for manufacturing processes. In this way every employer can obtain a site suitable for his manufacture, and can easily arrange for houses for his workers. The streets of the town will be broad avenues planted with trees, letting light and air into the heart of the city, and there will be parks, playgrounds, and open spaces, so as to make the place beautiful as well as healthy. In this city the worker will have a healthy home, and his wife and children will live in conditions nearly approaching those of country life. He will be supplied on the most favourable terms with water, light, power, and heat, and his house will be properly drained. All the increment in the value of land will be applied to the benefit of the inhabitants. The market-gardeners and farmers who cultivate the agricultural belt will have a market close at hand for their fruit, vegetables, dairy and agri- cultural produce ; the industrial workers will have each a bit of land if he chooses, upon which he and 276 THE CHILDREN OF THE NATION his family can expend their surplus labour, and the fruits of that labour will belong to themselves. The town will be large enough to provide audiences for theatres, concerts, lectures, and other enter- tainments. There is no reason why life should be dull. Garden Suburbs There are many garden suburbs already in existence in various parts of the country. At Bourneville, near Birmingham, one has been for some time established by Messrs. Cadbury near their works, but not restricted to persons in their employment. About half the houses in Bourneville are inhabited by Messrs. Cadbury 's workpeople, and about half by persons employed in other industries, in or near Birmingham. The houses are built and the roads laid out on the plan which is being followed by the First Garden City ; indeed, Bourneville has afforded an excellent example for enterprises of this kind. Every house has its garden, by no means restricted to the growth of saleable produce. There are luxuriant flowers in front of each dwelling, as well as useful fruits and vegetables behind, and it is estimated that a net profit of two shillings per week all round is derived from the cultivation of the soil in these gardens, by men who are working during the day in factories and workshops. An object-lesson to public authorities in London is now being set THE HOME 277 by Mrs. Barnett, of Toynbee Hall. An addition of 80 acres to Hampstead Heath was, a year or two ago, purchased through her exertions from the trustees of Eton College. A company pro- moted by her has now purchased 245 acres, contiguous to this new piece of Hampstead Heath and extended thence to the Finchley Road. This land is now being laid out as a garden suburb, within easy access of the heart of London by tubular railway. The company is restricted to a dividend of 5 per cent, upon its capital. All profit beyond that will be devoted to the benefit of the inhabitants. There will be houses for rich and poor and persons of middle estate. The roads and smaller dwellings will be designed on the same system of health and beauty as those of Bourne- ville and the First Garden City except that there are to be no manufactories on the site. The workers will go to their work elsewhere. There are many enterprises of the same kind being promoted in other places by private persons and public authorities. Sheffield has made the last addition to its municipal dwellings in the form of a garden suburb in the outskirts of the borough, in country surroundings, but within reach of some of the great Sheffield works. A preference by the workers for housing accommodation of this kind may lead to the disestablishment of the jerry- builder, and to the early destruction of modern streets of squalid houses. 278 THE CHILDREN OF THE NATION Housing in Country Villages The insanitary condition of country cottages is a great drawback to the healthiness of country life, and will, unless remedied, put a stop to the breeding of the stout and vigorous country race, which has so far reinvigorated the deteriorating race of the towns. The reformer of rural housing finds himself entangled in insuperable difficulties. Wages are so low that a countryman cannot afford a rent which will pay the cost of providing a decent cottage ; and the possibility of renting a cottage unfit for habitation keeps wages at a low level. No builder who is looking for a return on his capital outlay will put up houses in the country : landowners, impoverished by agricultural depression, have not the means to do it ; the Rural District councils, who are mostly farmers, will not do it, because it will increase rates, which they have been taught to believe are a charge upon themselves. Many country cottages which are unfit for human habitation are not worth repair ; if a movement for reform were made in the district, they would have to be closed, and there are no other cottages to take their places. The inmates would be driven out of the country into the towns. I once visited an Irish labourer in County Cork who was living, with a large family and much live stock, in one of the worst houses I ever saw. It had several times been properly condemned by the local authority as unfit for human habitation. The man and his THE HOME 279 family seemed contented with their lot ; their chief fear was that their house might be pulled down. There was no other place to which they could go, and they would be compelled to migrate to the town of Skibbareen, many miles away, where they had no prospect of work. The Rural Sanitary authorities will not build houses in places where they are scarce on what they regard as sound economic principles ; the only policy to which they cling is opposition to anything that can increase the rates. The Committee on Physical Deteriora- tion reported that since 1900, when the powers of the Rural Sanitary authorities in England under the Housing Act of 1890 had been extended, only two District Councils had actually built cottages. The drift of population from country to town is a feature of modern society which everybody laments, as tending to the deterioration of the race. The condition of rural houses stimulates, and in many cases actually compels, this migration. The insanitary condition of so many country cottages is a great obstacle to the spread in England of the system of boarding out Poor Law children. The Local Government Board will not allow children for whom the State is responsible to live in such places. This is just as far as it goes ; but the Government should carry its reforming energies further, and procure such a change in rural cottages as shall fit them to be homes for State children. CHAPTER XVII FINANCE Cost of Reform ALL the measures of reform suggested or referred to in the preceding pages will cost money. The expenditure will be in almost every case a saving in the end, but there will be an initial outlay. Where is the money to come from ? There are in our country two separate sources of public revenue — the Imperial Exchequer and Local Taxa- tion. In public expenditure for social purposes there is always some difference of opinion as to the source from which it should come. The principle generally professed is that measures which specially benefit the people of a particular locality should be financed from local funds, and that the Imperial revenue should bear charges which are incurred for the advantage of the whole population. But this principle is constantly departed from in practice. There is a strange delusion abroad that money raised by local taxation comes out of the pockets of the people, while that derived from the 280 FINANCE 281 Imperial Exchequer comes down like manna from heaven, as if every penny of the Imperial revenue, except that derived from the Post Office, Crown Lands, &c, was not contributed by the people themselves! Direct and Indirect Taxation The Imperial taxation is not only paid by the people, but it is alleged that an undue share is paid by the poorest classes of the people. What goes by the name of direct taxation — the Property and Income Tax, Estate Duty, and Stamps — does not in the main come from the working classes. These taxes affect them indirectly by curtailing enterprise and limiting the capital applied to industries. But the indirect taxation — Customs and Excise — is paid by all classes alike. Every man, however poor, who purchases an article on which a duty is laid — beer, spirits, tobacco, tea, or sugar — pays an en- hanced price because of the tax, and this increased price finds its way into the Exchequer. Calculations have often been made and expounded in Parliament to show that the result of this double system of direct and indirect taxation is that the sum which a poor man pays in the shape of the increased price of the dutiable articles which he buys bears a greater proportion to his means than the direct and indirect taxes which a rich man pays. If the just system of taxation is that all should pay accord- ing to their means, the poor man is unjustly burdened so long as he pays in taxation a greater proportion 282 THE CHILDREN OF THE NATION of his income than the rich. It is to put an end to this injustice that there is a constant agitation to reduce the amount of revenue raised by indirect taxation, and it is to perpetuate it that the present system of indirect taxation is kept up. Local Rates Local authorities have one source only from which they can themselves raise funds, namely, rates ; although, as we shall see, other sources of revenue have in recent years been provided for them. A rate is paid, in the first instance, by the occupier of the land, house, factory, or shop, and is proportional to the annual letting value of the premises in respect of which it is paid. The question out of whose pocket the rate ultimately comes is one of some intricacy, and the real incidence of the tax is obscured by the fact that it is from the occupier of the premises taxed that the rate is demanded, that he is under a legal obligation to pay it, and that in the first instance he actually does pay it out of his own moneys. But the principles of Political Economy teach that, notwithstanding, it is not really a tax upon the occupier at all, but upon the owner of the premises ; it is that part of the annual value of the property which the State does not permit the owner to receive for his own purposes, but intercepts through the agency of the occupier and appropriates to public purposes. The working FINANCE 283 people who live in small houses do not themselves in most places pay any rates at all ; an agreement is made by the owner with the rating authority whereby he compounds, as it is called, for the rates upon his small houses, and pays a fixed and stipulated sum in respect of them ; this causes him to receive less for the letting of his property than he would be able to realise if there was no payment to be made in respect of the rates. The price which a tenant pays for the occupation of a house is determined, like all other prices, by the law of supply and demand. If there are many houses in any neigh- bourhood and few people seeking to occupy them rent has a tendency to fall ; if there is a scarcity of houses and a brisk demand for them it has a tendency to rise ; and the rent in the long run so adjusts itself that at the price at which it ultimately fixes itself houses in the neighbourhood can find tenants who are willing to pay that sum for the occupation of the normal house. No ordinary tenant is willing to pay more than the amount at which the higgling of the market fixes the rent, and no tenant can get a house unless he is ready to pay the amount of rent which the law of supply and demand thus fixes. In the case of all these smaller houses so compounded for the only sum paid by the tenant out of his own pocket is the sum demanded under the name of rent ; he knows nothing about rates ; he is not asked for them ; he does not pay them ; his rent is as much as he can be made to pay ; there is no more to be got out of 284 THE CHILDREN OF THE NATION him. His landlord has made his own arrangement with the rating authority ; he has compounded for the rates and has paid to the rating authority a lump sum, considerably less than that which the rates on the houses separately would come to. This system of compounding for the rates on small houses is a great advantage to the public ; it saves the cost of collecting the rate. When, for political reasons, it was abolished in Mr. Disraeli's Repre- sentation of the People Act, 1867, it soon grew up again on the ground of its economic convenience. In such cases the tenants pay no rates at all, they pay nothing but a rent ; it does not matter to them whether the rate is much or little ; it does not alter the sum they pay for the occupation of their houses, and it does not matter to them how much goes into the pockets of their landlords and how much the latter have to pay over to the local authority. In the case of larger houses the tenant does himself pay the rate in the first instance, but he takes the amount of the rate which he has to pay to the local authority, as well as the amount of rent he has to pay to his landlord, into consideration in determining the amount which he is ready to give for the occupa- tion of the house. If the law of supply and demand fixes the price of the sort of house he wishes to take at ^125 per annum, and if the rates in the district are 5s. in the £, he will be ready to give ^100 rent and to pay £2$ to the rate-collector. If there were no rates the landlord could command a rent of ^125 for the house, but with £25 to be paid in rates he FINANCE 285 cannot get more than ^ioo, because the law of supply and demand fixes the price of such a house at ^125 per annum. It is evident that the rates in such a case come as really out of the landlord's pocket as in the case in which the rates are com- pounded for. What a substantial increase of the rates or the imposition of some new local burden really does is to disturb the existing relation between landlord and tenant, and to furnish the occasion for a revision of the bargain and for raising the rent if the law of supply and demand admits of it — that is, if the supply of house accommodation is falling short of the demand. In recent times rents in towns have risen greatly, and even at present show a tendency in many places to rise still further. The landlord has therefore been in a position to alter, whenever a revision of the bargain took place, the amount of rent, and thus the continuous rise in the rates which has been going on for some years has apparently fallen on the tenant. This has brought about the false notion that it was the tenant who paid the rates, and that it was on him and not on the landlord that the burden of rates ultimately fell. In the case of agricultural land the same law holds good. It was the landowner and not the farmer who really paid the rates — at least he had to do so until he was partially relieved of his obligation by the Agricul- tural Rating Act and the consequent contribution out of Imperial Funds. Some years ago, when rents were rapidly falling and agricultural land was difficult to let, the farmer could, and did, stipulate 286 THE CHILDREN OF THE NATION with his landlord to pay any fresh burdens under threat of throwing up his farm. But at any time when rents were rising it would be the landlord and not the farmer who would occupy the position of advantage, because the former would be in a position to increase the rent, and the payment of any increased rate by the tenant would be equivalent to a raising of the rent. In a case where house or land is let on lease, with a covenant by the tenant to pay the rates during the term, the increased rate imposed is really paid by the tenant during the currency of the lease ; it is no burden on the owner. But when the lease comes to an end the tenant takes the increased rate into consideration in deter- mining what price he is willing to pay for a further occupancy of the house or land, and the landlord in determining what rent he shall ask. Whatever rate is imposed by a local authority on either house or land is thus in the long run paid by the owner ; if the occupier had not to pay it the owner could exact the sum from him in the form of an increased rent. Popular Delusion about Rates If, therefore, rates are paid by the owners of property, and if the workers who are tenants and not owners of their houses would have to pay just the same amount for the occupation of them if there were no rates at all, the widely prevalent idea that high rates are a burden not so much upon the rich as upon the poor is a most extraordinary delusion. FINANCE 287 It is greatly for the interest of the owners of pro- perty that such a fiction should be believed in. They have no interest in convincing their tenants of their error or in opposing themselves to the demand which is so often made by the democracy for the transfer of charges from local taxation, which the mass of the people do not pay, to the consolidated fund, to which they do contribute. Yet there are circumstances which might have led the people to suspect that their theories about local and Imperial taxation were not wholly correct. A much greater zeal has always been evinced by the govern- ing classes for the reduction of rates than for the reduction of taxes, other, at least, than the income- tax. If they really believed that the rates were paid, like the tea and sugar duties, mainly by the workers and in an undue proportion by the poorest, would they be so eager to bring about their reduc- tion ? Would the House of Lords, which specially represents landed property, be so eager for the reduction of rates and for local economy ? It is from the representatives of property in Parliament and in local assemblies that charges of extravagance against municipalities mainly proceed. They always oppose any expenditure out of rates for social pur- poses, and always urge that any experiment in social reform, such as the feeding of school children or the formation of labour colonies, should be made by private, irresponsible persons out of charitable funds, rather than by public authority out of the rates. The Local Government Board is specially designed 288 THE CHILDREN OF THE NATION to act as a protector of the owners of property and to check in their supposed interest any novel pro- posal for local expenditure out of the rates, even when desired by the inhabitants. Almost all reforms in the administration of the Poor Law have been carried by enlightened Boards of Guardians in the teeth of the opposition of the Local Government Board. When the Poor Law Guardians of Sheffield invented the system of scattered homes for the reception of the children of paupers not eligible for boarding out they had the greatest difficulty in getting the sanction of the Local Government Board to the small expenditure involved in the experiment. They were not permitted to build, but only to rent, the houses required, and they were hedged in by all sorts of restrictions in the interest of so-called economy. The system turned out a complete success, and is now imitated all over the land, and even recommended by the Local Government Board itself ; but the improved method of dealing with these children is due to the persist- ence of the Sheffield Guardians, not to the initiative or even sympathy of the central authority. In all modern Acts of Parliament the control of the central authority is carefully preserved ; free local self- government and independent local administration are no longer tolerated ; and you have to go back to an old Act like the Public Health Act of 1875 to find general discretionary powers, such as the power to provide hospitals for the sick, left to the local authorities. FINANCE 289 Local Revenue The system of local taxation certainly demands reform. Its incidence upon one kind of property only is as unjust to the rich as the incidence of indirect taxation in an undue proportion is to the poor. It is indeed urged by some that, in the case of towns at least, the ground landlord can justly be called upon to defray all the costs of local expenditure and development. The value of his land is continually increased by the labour of others without exertion on his part, and the rates are only that part of the unearned increment which the State appropriates; it would be no injustice if the whole unearned incre- ment were appropriated. On the other hand, the levy of rates and the expenditure of their proceeds is entirely in the power of the local electors so far as discretion is left to them. So long as they do not in fact raise the local revenue out of their own pockets the situation is obviously dangerous and unfair. One class of citizens provide the local funds and another class dispose of them. That taxation and representation should go together is a sound political maxim ; that one class should be taxed and another class practically command the representation is a mischievous anomaly. Several remedies have been proposed, most of which are admitted to be stop-gap expedients only. Of late years large and increasing grants have been made out of the Imperial Exchequer for local purposes. The effect of this is to shift part of the burden from the 290 THE CHILDREN OF THE NATION shoulders of the rich to those of the poor, and so make the latter really bear some share of local expenditure as contributors to the Imperial grants by which it is subsidised. Another expedient is to transfer to local authorities the produce of some of the Imperial taxes, public-house licenses, dog licenses, carriage licenses, &c, as an addition to the local revenue from rates. The reform of local taxa- tion, on which Royal Commissions have sat and which has been promised year after year, seems still as far off as ever. German System In Germany every citizen contributes to the local revenue upon the same basis as to the revenue of the entire State to which he belongs. Everybody is assessed at an annual sum according to his calling and position, and upon that he pays so much in the pound to local and State revenues. The Municipal Council, which holds the purse-strings and controls all local expenditure, is elected upon a peculiar principle. The payers of local taxes are divided into three sections : one consists of those who pay the highest amounts and whose contributions form a third of the total revenue ; one, of those who pay the lowest amounts and whose contributions form another third of the revenue * i**J the remainder of those whose contributions are between the two and who furnish the remaining third. Each of these sections elects separately one-third of the Municipal FINANCE 291 Council. It is evident that under such a system the richer classes, who pay most, have a far greater influence on local administration than the property owners with us, and that the poorer classes do not possess the potential power which they might at any time seize upon under our democratic system if they took it into their heads to go to the poll at election times. The remarkable thing is that German municipalities, in which the rich have so preponderating a voice, are more liberal with public funds and show more readiness to promote local enterprise and municipal trading, which is such a bugbear to us, than our more democratic bodies. They seem to have learnt the lesson that by judicious public expenditure they enrich themselves. They not only maintain all the schools and hospitals with much less help than our local authorities from the Central Government, but they provide water, gas, electric light and power, trams, parks, abattoirs, and even theatres and orchestras, for the people, and none of the citizens, rich or poor, seem to think the money ill spent or the interest of the poorest citizen neglected. Social Reform How much of the expenditure required to amelio- rate the health of the British people is of a national and how much of a local character it is difficult to determine. The publicity of Parliament and the control which the Treasury still exercises over 292 THE CHILDREN OF THE NATION public expenditure are a sufficient safeguard against the lavishing of the consolidated fund upon any schemes for improving the health of the people which are not national in their scope. Local revenues are at present protected by the delusion of the mass of the people that rates come out of their own pockets, while grants from the taxes are not paid by themselves ; but it is at any time in the power of the local electorate, which itself pays only a very small portion of the local revenue, to elect an administrative council which, in spite of the Local Government Board, would be legally com- petent liberally to apply local revenues to improve the condition of the people. It is probable that such expenditure, if judicious, would greatly increase the value of property and prove to the richer classes, who are now so opposed to outlay for such purposes, a blessing in disguise. INDEX Adenoids, hi „ a cause of deafness, 120 „ removal, 1 1 1 Air, 33 „ in Elementary Schools, 189, 190 „ in Manchester and Salford Schools, 191 Airy, Dr., cost of feeding children, 73 „ „ indifference of parents, 72 Alcohol, French proclamation, 250 „ Hereditary effects, 252 „ Syphilis and alcohol, 256 Ancoats, Manchester, back to back houses, 64 Anderson, Miss, neglect of children, 42 „ „ prejudice against creches, 41 Baby rooms, 183, 184 Barnardo, Dr., on barrack schools, 234 „ „ on boarding out, 241 „ „ Homes, 244 Barrack schools, 232 Bathurst, Miss, on temperature of schools, 195 Berlin Conference, 219 „ „ its recommen- dations, 220, 223 Blackness Board School, Dundee, 55 Birmingham brassworkers, 150 „ St. Mary's infant death-rate, 19 Birth-rate decreasing, 15 Board of Education : its limited scope, 50 Boarding out children, 240 Boys, reclamation of, 214 British Dental Association's report on children's teeth, 121 Broadbent's experiment at Hud- dersfield, 23 Broadbent, Sir William, phthisis, 39 Charity, 10 Charlottenburg Forest School, 153 buildings, 157 cost, 170 „ establishment, 155 „ results, 167, 168 „ school life, 161 „ teachefs, 163 Child- workers, 216 293 294 INDEX Circulars of the Local Government Board and Board of Education of 1905, 87 Circulars of the Local Government Board and Board of Education of 1905 : their operation, 88 Clay modelling in infant schools, 178 Clay, Rev. John, infant insurance^ „ „ „ reduction of in- fant death-rate in a strike, 42 Collie, Dr., children feeble-minded from lack of food, 77 Cologne, care of infant life, 22 Cooper, Sir Alfred, on syphilis, 256 Corporal punishment, 180 Cost of free meals to school chil- dren, 75 Compulsion of infants, 175 Country cottages, 278 Creches in France, 40 „ objection to, 45 „ instruction of girls in, 44 Cruelty to children by public authority, 52 Death-rate of infants in various countries, 18 Delusion about rates, 286 Derelict children, 227 Desks in schools, 197 Diarrhoea a cause of infants' deaths, 28 Dirt : mixture of clean and dirty children, 185 „ cleanliness of German chil- dren, 150 „ baths in German schools, 151, 158 Drawing in infant schools, 178 Drill, Jiu jitsu, 207 „ military, 203 „ Swedish, 205 Dundee Social Union report on school children, 55 Edinburgh school children, 55 Eichholz, Dr., on underfeeding, 68, 78 „ „ on ventilation, 193 Evasion of State obligations, 228 Eyesight, 116 Factory labour of children, 216 Feeding by hand, 24 Food, unsuitable, 35 Foresters, Ancient Order of, 133 France cantines scolaires in Paris, 81 „ care of nursing mothers, 23 „ proclamation against alco- hol, 250 Friendly Societies, 132 Games, 211,212 Garden City, 274 Garden suburbs, 276 Germany, contribution to local expenditure, 290 „ medical inspection of children, 54 „ State insurance, 145 Glands, disease of, 1 10 Glasgow's provision for working widow's children, 43 Hall, Dr. : cost of feeding school- children, 74 Health visitors, Manchester, 63 Health officers should have security of tenure, 270 INDEX 295 Hearing, 120 Heart disease, 113 Hereditary disease, 108, 247 Hoare, Mrs., appeal for over- worked children, 92 Home, its antiquity, 262 Hooligans, 213 „ reformed by learning to box, 214 „ schools for, recom- mended by Scottish Royal Commission, 214 Horsfall, on curvature produced in schools, 197 „ on warming schools, 196 Horsley, Sir Victor, on syphilis, 254> 2 S6 Hospitals, charitable, 129 „ municipal, 135 „ Poor Law, 127 Hours of labour of school chil- dren, 94, 95, 96, 97 Housing, 264 Illegitimate children, care of, in Leipsig, 24 Industrial schools, babes com- mitted to, 229 Infant mortality, 18 Infant schools suppressed by the Board of Education, 175, 176 Infants healthy at birth, 17 Infectious disease, 37, 123 Injury to mind and body in infant schools, 176 Insurance of young children, 47 Irish children better cared for, 70 Irish medical relief, 37 „ „ midwives, 17 Irish schools, how warmed, 193 Jewish children, 69 Jiu Jitsu, 207 Johanna Street School, Lambeth 55,86 Kerr, Dr. on eyesight, 118 „ on syphilis, 254 „ on ventilation, 192 Lancashire infant mortality, 19 Law as to cessation of labour at childbirth a dead letter, 21 Licensing Reform, 249 Lighting schools, 197 Liverpool, street selling in, 103, 104 Local authorities neglect to pro- tect children, 104 „ power to improve dwellings 264 „ power to provide hospi- tals, 135 Local Government Board's power to protect milk, 29 London School Board's visiting committees, 65 Manchester Ladies' Health So- ciety, 63 Medical inspection of school chil- dren, 50 Medical officers of health, 270 Metropolitan Asylums Board, 137 Midwives, 17 Mines conclusions of Berlin Con- ference, 223 „ hours of labour in, 225 Military drill, 203 Milk, 29 „ contamination of, 30 „ municipal supply of, 31 296 INDEX Mothers taken off to work, 20 Mother's influence in education, 76 National interest in health of children, 6 Needle-threading in infant schools, 119 Neglect of maternal duty, 21 Newman, Dr., on infant mortality, 18 Norway infant mortality, 18 Notification of diseases, 136 Nurseries, 40, 187 Occupier of rated premises, 284 Old age in Germany, 148 Ophthalmia in Poor Law schools, 2 33 Outdoor relief to widows, 229 Overcrowding, 263 Painting in infant schools, 178 Parliament and overworked chil- dren, 98 Phthisis, 38 Physical training, dress, 209 „ „ evening classes, 212 „ „ medical inspec- tion necessary, 209 - „ „ Scottish Royal Commission on, 211 Playgrounds, 199 Poor Law Guardians and medical relief, 36 „ „ conflict with Sanitary authority, 5, 39 Premature schooling, 173 Prevention of contagious dis- eases, 3, 257 Preston, infant mortality, 42 „ child insurance, 49 Public economy, 4 „ safety, 3 „ Health Acts, 129 Purpose of the book, 1 Race, propagated by the most unfit, 16 Raising the age of factory children, 221 Rates, the only source of local revenue, 282 Rent, 283 Return of overworked children, 93 Rickets, 114 School meals, 80 Sheffield scattered homes, 238 Simon Jules, on duty of State to children at Berlin Conference, 219 Sleep in infant schools, 184 Slums, pulling down in centres, 263 „ re-established in suburbs, 270 Slum property, registration of owner, 269 South African war, men invalided home for bad teeth, 122 Spain, unhealthy mines in, 225 Spine curvature , produced in school, 197 State insurance, 143 Still births, need for registration, 17 Street trading, children employed in, 96 INDEX 297 Street trading, Liverpool regula- tions, 103, 104 Survival of the fittest, 27 Swedish drill, 205 Switzerland, two months' cessation of labour at childbirth, 20 Syphilis, 252 „ detention, 260 „ hospitals for, 259 „ prevention in Russia, 258 „ ravages amongstchildren, 253 Taxation, direct and indirect, 281 Teaching hygiene to the people, 25 Teeth, 121 Theatrical children, 100 Tuberculosis, 112 Underfed children, 67, 68 United States, condition of child workers, 219 Urgency of the children's need of food, 79 Vaccination, 4 Vagrants' children, 34 Ventilation, 189 Village communities for Poor Law children, 236 Visitors for the Education Com. mittees, 59, 62 Wages earned by school children, 95, 96, 97 Water supply for schools, 196 Weight increase at Charlottenburg Forest School, 168 Women inspectors in infant schools, 187 Workhouses, children in, 230 Workhouse infirmaries, 127 Ube Gcesbam f>rcss, UNWIN BROTHERS, LIMITED, WOKING AND LONDON. 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