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Page 57
Disease plays such a large part in the life of man and is so closely
related to all of his activities that the changes in this period must
have exerted an influence on disease. We have already seen that within
the period we have obtained knowledge of the causes of disease and the
conditions under which these causes became operative. The mystery
which formerly enveloped disease is gone; disease is recognized as due
to conditions which for the most part are within the control of man,
and like gravity and chemical attraction it follows the operation of
definite laws. There has been developed within the period what is
known as preventive medicine, which aims rather at prevention than
cure, and the resources of prevention are capable of much greater
extension.
Have there been new conditions developed within the period, or an
increase of existing conditions which can be regarded as disease
factors and which counterbalance the results which have come from the
knowledge of prevention and cure? There has been an increase of
certain factors of immense importance in the extension of disease.
These are:
1. The increase in industrialism, involving as this does an increase
in factory life. In many ways this is a factor in disease. (_a_) By
favoring the extension of infection, particularly in such diseases as
tuberculosis. (_b_) The life indoors, and frequently with the
combination of insufficient air and space, produces a condition of
malnutrition and deficient general resistance. (_c_) The family life
is interfered with by the mothers, whose primary duty is the care of
home and children, working in factories, and the too frequent
conversion of the house into a factory. (_d_) The influence of factory
life is towards a loss of moral stamina rendering more easy of
operation the conditions of alcoholism and general immorality. How
great has been this increase in industrialism, fostered as it has been
by conditions both natural and artificially created by unwise
legislation, is shown in the figures from the last census. The number
of factory operatives increased forty per cent between 1899 and 1909
and the total population of the country in the period between 1900 and
1910 increased twenty per cent. It is probable that the future will
see an extension rather than a diminution of mass labor.
2. The increase in urban life is as conspicuous as the increase in
industrialism. In 1880, twenty-nine and five-tenths per cent of the
population was urban and seventy and five-tenths per cent was rural;
in 1910, forty-six and three-tenths per cent was urban and fifty-three
and seven-tenths was rural, the increase being most marked in cities
of over five hundred thousand inhabitants. Of the total increase in
population between 1900 and 1910, seven-tenths per cent was in the
cities and three-tenths per cent in the country. City life in itself
is not necessarily unhealthy and there are many advantages associated
with it. The conditions which have chiefly fostered it are the
immigration of people who are accustomed to community life, the
increase in factory life and the increased number of people of wealth
who seek the advantages which the city gives them. The city has always
been the favored playground for the social game. The unhealthy
conditions of city life are due to the crowding, the more uncertain
means of livelihood, the greater influence of vice and alcoholism.
Prostitution and the sexual diseases are almost the prerogatives of
the cities.
3. All means of transportation have increased and communication
between peoples has become more extended and more rapid. In the past
isolation was one of the safeguards of the people against disease.
With the increase and greater rapidity of communication there is a
tendency not only to loss of individuality in nations as expressed in
dress, customs, traditions and beliefs, but many diseases are no
longer so strictly local as formerly--pellagra, for example. Only
those diseases which are transmitted by insects which have a strictly
local habitat remain endemic, although the region of endemic
prevalence may become greatly extended, as is seen in the distribution
of sleeping sickness. Diseases of plants and of animals have become
disseminated. Any plants desirable for economic use or for beauty of
foliage and flower become generally distributed, their parasites are
removed from the regions where harmonious parasitic inter-relations
have been established, and in new regions the parasites may not find
the former restrictions to their growth. There have been many examples
of this, such as the ravages of the brown-tail and gypsy moths which
were introduced into New England and of the San Jose scale which was
introduced into California. There have been many other examples of the
almost incredible power of multiplication of an animal or plant when
taken into a new environment, removed from conditions which held it in
check, as the introduction of the mongoose into Jamaica, the rabbit
into Australia, the thistle into New South Wales and the water-plant
chara into England.
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