Chapter 2

He quoted the opinions of eminent scientific men to show that it was possible, under proper methods of burning coal, to lessen the intensity of fogs, and so to lessen materially the causes of ill-health, terminating in fatal disease of those subject to them. In dealing with the wide subject of the "general effect of sanitary conditions upon health," he gave some remarkable facts showing that sanitary work had reduced the death-rate of the European army in India from 60 per 1,000 to 16 per 1,000; that the deaths from tubercular disease in the army at home used to be 10 per 1,000--the sum total now of the total deaths from all causes in a time of peace--a reduction due to the improved hygienic conditions under which soldiers now live; that the death-rate in a certain part of Newcastle (now removed) used to be 54 per 1,000, and of the entire borough 26.1 so lately as seven years ago, while now it was 21.8; that in parts of London, where the people were ill-lodged and crowded, as in parts of Limehouse, Whitechapel, Aldgate, and St. Giles's, the death-rates were 50 per cent. above the death-rates in more open parts of the same districts, and that when proper dwellings were erected the death-rates fell from 50 in the 1,000 to not more than 20 per 1,000. He then spoke of the advantage arising to the health of the population generally by the new dwellings for artisans.

He remarked that these improved dwellings "afford accommodation to a population per acre as dense as, and in most cases even denser than, that afforded by the buildings which they replaced. Within limits it is not the density of population which regulates the health. But if a dense population is spread over the surface or close to the surface of the ground, by which means all movement of air is prevented, and if there are numerous corners in which refuse is accumulated, it will be difficult to prevent disease. Dr. Angus Smith's experiments show that while there is less oxygen and more carbonic acid in the eastern and in the more crowded parts of London, yet in open spaces the amount of oxygen rises and the carbonic acid diminishes very considerably; and that we are exposed to distinct currents of good air in the worst, and equally to currents of bad air in the best atmosphere, in towns like Manchester.

Dr. Tyndall showed that where there is quiescence in the air the tendency of his sterilized infusions to produce organisms was increased. The conclusion from all these experiments is to show the importance of laying out the general plan of dwellings in a town so that currents of air shall be able to flow on all sides with as little impediment as possible, by which means the air will be continually liable to renewal by purer air. The dwellings which have been constructed in the place of the very defective dwellings condemned by the medical officers of health in various parts of London specially illustrate the importance of this question of the circulation of air. These dwellings replace those in which the normal mortality was as much as 33, 44, and 50 per 1,000. But these improved dwellings provide ample space all round the blocks of building, so that air can flow round and through them in every direction, and so that there are no narrow courts and hidden corners for the accumulation of refuse. The mortality in the new dwellings is as low as 13 per 1,000 in some, and does not rise above 20 per 1,000 in any of them, and upon an average of years it may be taken at from 14 to 16 per 1,000. It is to this point that I specially desire to draw attention--namely, that these facts prove the possibility of bringing down the death-rate of the class of population which inhabits this sort of accommodation to rates varying from 15 to 16 per 1,000. I say of the class of population, because habits and mode of life have an important influence on health and on longevity.

Mr. Chadwick and Dr. Richardson obtained some statistics for Westminster, for the use of a committee of the Society of Arts, which indicate the very different conditions of health to which the different classes of population are subject. It appeared from these statistics that out of one hundred deaths of the first class, or gentry, six were those of children in their first year, and nine of children within their fifth year; while out of one hundred deaths of the wage classes twenty-two are those of children in their first year, and thirty-nine within their fifth year. If we take the average duration of life of all who have died of the first class, men, women, and children, we find that they have had an average of fifty-five years and eight months of life; while of the wage classes they have had a mean of only twenty-eight years and nine months. And if we take the average duration of life of those who have escaped the earlier ravages of death up to twenty years of age, the males who have died of the first class have had sixty-one years of life, while of the wage class the males have had only forty-seven years and seven months. Moreover, of the first class in Westminster, the proportion who have attained the old age, and died of natural causes, is 3.27 per cent., but of the wage classes only a fraction, or two-thirds per cent., did so. I have obtained similar returns for this town. It was considered desirable, for the purpose of this return, to divide the population into the following five classes: First, gentry and professional men; second, tradesmen and shopkeepers; third, shipwrights, chain and anchor smiths, iron forge laborers, etc., fourth, seamen, watermen, fishermen, etc.; fifth, other wage clashes and artisans; and each of these classes represents distinct sanitary conditions and habits of life. The healthiest class is that of the seamen, watermen, and fishermen. The mean age at death of all who died of that class, men, women, and children, is thirty-seven years, as compared with thirty five years for gentry and professional men; while the mean age of shipwrights, chain and anchor makers, and iron forge laborers is only twenty-two years. The President considered that these points gave much food for reflection. He then touched upon the important question of the effect of occupation upon health, and remarked: If we take the professional and merchant class, who attend at their offices during the daytime, we may be sure that, as a rule, they are placed in unhealthy surroundings during that time, and in many cases have to breathe during their hours of work as bad an atmosphere as that in which the wage classes work. He also quoted returns showing that the great mortality among the tradesmen class in Westminster was explained from the fact that the best rooms in the houses in which they live were let for lodgings, the tradesmen contenting themselves with living in the basements or back premises, which were frequently unhealthy. He looked for great improvements in the health of the wage classes by the construction of improved dwellings; but, he confessed, in many cases workmen required to be taught to attend to precautions devised for their health.

On the subject of sickness caused by insanitary conditions, he quoted the remark of an East London clergyman that the "poor go on living in wretched places, but have much ill-health." He showed from Mr. Burdett's figures that the London voluntary hospitals and dispensaries cost nearly £600,000 a year to administer--an expenditure incurred mainly for the purpose of "patching up" the wretched poor who had been injured by bad drainage, want of ventilation and the like; and he urged that it might be safely assumed preventive measures would bring down the death-rate of the wage class to one-half, reducing also the sickness rate in at least a similar proportion. By means of this item alone the wage-earning power of the industrious classes would be enlarged by some millions of pounds, and their comfort correspondingly increased. There would also, he contended, be other distinct economies, for there would be less need for much of the accommodation in prisons, reformatories, and workhouses now needed from evils incident to unhealthy circumstances and crowded dwellings.

He dwelt upon the economic advantages of sanitary measures generally, dealing first with the subject of the conversion of sewage into manure, and then, in relation to the provision of healthful dwellings, such as those of the Metropolitan Association for Improving the Dwellings of the Industrial Classes, he showed that the cost of such dwellings had been about £1,900,000 for 11,000 persons. By the saving in life and health, through the continuance in earning power of men, whose lives would otherwise have been cut short, he estimated that the expenditure of the £1,900,000 for the 11,000 persons, by the addition often years' earning power to the heads of families, brought in a return of £4,600,000, and urged these facts as showing the pecuniary advantages accruing to the nation from sanitary improvements which led to decreased death and sickness rates. On the one hand, he said, insanitary dwellings and insanitary conditions of life engendered sickness, entailed poverty, and fostered crime, while improved dwellings insured improved health, and by affording a security for the more continuous earning of wages created the possibility of a comfortable home. Advanced sanitarians had long preached these doctrines, and he was happy to think that they were at last beginning to hear some results, and in those results he saw the means of developing morality, contentment, and happiness among the people.

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[NATURE.]

PSYCHOLOGICAL DEVELOPMENT IN CHILDREN.

[Footnote: _Die Seele des Kindes Beobachtungen ueber die geistige Entwickelung des Menschen in den ersten Lebensjahren_. Von W. Preyer, ordentlichen Professor der Physiologie an der Universitaet und Director des physiologischen Instituts zu Jena, etc. Leipzig: Th. Grieben. 1882.]

This is a large octavo volume, extending to over four hundred pages, and consisting of daily observations without intermission of the psychological development of the author's son from the time of birth to the end of the first year, and of subsequent observations less continuous up to the age of three years. Professor Preyer's name is a sufficient guarantee of the closeness and accuracy of any series of observations undertaken with so much earnestness and labor, but still we may remark at the outset that any anticipation which; the reader may form on this point will be more than justified by his perusal of this book. We shall proceed to give a sketch of the results which strike us as most important, although we cannot pretend to render within the limits of a few columns any adequate epitome of so large a body of facts and deductions.

The work is divided into three parts, of which the first deals with the development of the senses, the second with the development of the will, and the third with the development of the understanding.

Beginning with the sense of sight, the observations show that light is perceived within five minutes after birth, and that the pupils react within the first hour. On the second day the eyes are closed upon the approach of a flame; on the eleventh the child seemed to enjoy the sensation of light; and on the twenty-third to appreciate the rose color of a curtain by smiling at it. Definite proof of color discrimination was first obtained in the eighty-fifth week, but may, of course, have been present earlier. When seven hundred and seventy days old the child could point to the colors yellow, red, green, and blue, upon these being named.

The eyelids are first closed to protect the eyes from the sudden approach of a threatening body in the seventh or eighth week, although, as already observed, they will close against a strong light as early as the second day. The explanation of their beginning to close against the approach of a threatening body is supposed to be that an uncomfortable sensation is produced by the sudden and unexpected appearance, which causes the lids to close without the child having any idea of danger to its eyes; and the effect is not produced earlier in life because the eyes do not then see sufficiently well. On the twenty-fifth day the child first definitely noticed its father's face; when he nodded or spoke in a deep voice, the child blinked. This Professor Preyer calls a "surprise-reflex;" but definite astonishment (at the rapid opening and closing of a fan) was not observed till the seventh month. The gaze was first fixed on a stationary light on the sixth day, and the head was first moved after a moving light on the eleventh day; on the twenty-third day the eyeballs were first moved after a moving object without rotation of the head; and on the eighty-first day objects were first sought by the eyes. Up to this date the motion of the moving object must be slow if it is to be followed by the eyes, but on the one hundred and first day a pendulum swinging forty times a minute was followed. In the thirty-first week the child looked after fallen objects, and in the forty-seventh purposely threw objects down and looked after them. Knowledge of weight appeared to be attained in the forty-third week. Persons were first distinguished as friends or strangers in the sixth month, photographs of persons were first recognized in the one hundred and eighth week, and all glass bottles were classified as belonging to the same genus as the feeding-bottle in the eighth month.

With regard to the sense of hearing, it is first remarked that all children for some time after birth are completely deaf, and it was not till the middle of the fourth day that Professor Preyer obtained any evidence of hearing in his child. This child first turned his head in the direction of a sound in the eleventh week, and this movement in the sixteenth week had become as rapid and certain as a reflex. At eight months, or a year before its first attempts at speaking, the infant distinguished between a tone and a noise, as shown by its pleasure on hearing the sounds of a piano; after the first year the child found satisfaction in itself striking the piano. In the twenty-first month it danced to music, and in the twenty fourth imitated song; but it is stated on the authority of other observers that some children have been able to sing pitch correctly, and even a melody, as early as nine months. One such child used at this age to sing in its sleep, and at nineteen months could beat time correctly with its hand while singing an air.

Concerning touch, taste, and smell, there is not so much to quote, though it appears that at birth the sense of taste is best developed, and that the infant then recognizes the difference between sweet, salt, sour, and bitter. Likewise, passing over a number of observations on the feelings of hunger, thirst, satisfaction, etc., we come to the emotions. Fear was first shown in the fourteenth week; the child had an instinctive dread of thunder, and later on of cats and dogs, of falling from a height, etc. The date at which affection and sympathy first showed themselves does not appear to have been noted, though at twenty-seven months the child cried on seeing some paper figures of men being cut with a pair of scissors.

In the second part of the book it is remarked that voluntary movements are preceded, not only by reflex, but also by "impulsive movements," the ceaseless activity of young infants being due to purposeless discharges of nervous energy. Reflex movements are followed by instinctive, and these by voluntary. The latter are first shown by grasping at objects, which took place in Preyer's child during the nineteenth week. The opposition of the thumb to the fingers, which in the ape is acquired during the first week, is very slowly acquired in the child, while, of course, the opposition of the great toe is never acquired at all; in Preyer's child the thumb was first opposed to the fingers on the eighty-fourth day. Up to the seventeenth month there is great uncertainty in finding the mouth with anything held in the hand--a spoon, for instance, striking the cheeks, chin, or nose, instead of at once going between the lips; this forms a striking contrast to the case of young chickens which are able to peck grains, etc., soon after they are hatched. Sucking is not a pure reflex, because a satisfied child will not suck when its lips are properly stimulated, and further, the action may be originated centrally, as in a sleeping suckling. At a later stage biting is as instinctive as sucking, and was first observed to occur in the seventeenth week with the toothless gums. Later than biting, but still before the teeth are cut, chewing becomes instinctive, and also licking. Between the tenth and the sixteenth week the head becomes completely balanced, the efforts in this direction being voluntary and determined by the greater comfort of holding the head in an upright position. Sitting up usually begins about the fourth month, but may begin much later. In this connection an interesting remark of Dr. Lauder Brunton is alluded to ("Bible and Science," page 239), namely, that when a young child sits upon the floor the soles of his feet are turned inward facing one another, as is the case with monkeys. When laid upon their faces children at earliest can right themselves during the fifth month. Preyer's child first attempted to stand in the thirty-ninth week, but it was not until the beginning of the second year that it could stand alone, or without assistance. The walking movements which are performed by a child much too young to walk, when it is held so that its feet touch the ground, are classified by Preyer as instinctive. The time at which walking proper begins varies much with different children, the limits being from eight to sixteen months. When a child which is beginning to walk falls, it throws its arms forward to break the fall; this action must be instinctive. In the twenty-fourth month Preyer's child began spontaneously to dance to music and to beat time correctly.

A chapter is devoted to imitative movements. At the end of the fifteenth week the child would imitate the movement of protruding the lips, at nine months would cry on hearing other children do so, and at twelve months used to perform in its sleep imitative movements which had made a strong impression while awake--e.g., blowing; this shows that dreaming occurs at least as early as the first year. After the first year imitative movements are more readily learned than before.

Shaking the head as a sign of negation was found by Preyer, as by other observers, to be instinctive, and he adopts Darwin's explanation of the fact--viz., that the satisfied suckling in refusing the breast must needs move its head from side to side. In the seventeenth month the child exhibited a definite act of intelligent adjustment, for, desiring to reach a toy down from a press, it drew a traveling-bag from another part of the room to stand upon. We mention this incident because it exhibits the same level of mental development as that of Cuvier's orang, which, on desiring to reach an object off a high shelf, drew a chair below the shelf to stand upon. Anger was expressed in the tenth month, shame and pride in the nineteenth.

Between the tenth and eleventh month the first perception of causality was observed. Thus on the three hundred and nineteenth day the child was beating on a plate with a spoon and accidentally found that the sound was damped by placing the other hand upon the plate; it then changed its hands and repeated the experiment. Similarly at eleven months it struck a spoon upon a newspaper, and changed hands to see if this would modify the sound. In some children, however, the perception of causality to this extent occurs earlier. The present writer has seen a boy when exactly eight months old deriving much pleasure from striking the keys of a piano, and clearly showing that he understood the action of striking the keys to be the antecedent required for the production of the sound.

The third part of the book is concerned, as already stated, with the development of the understanding. Here it is noticed that memory and recognition of the mother's voice occurs as early as the second month; at four months the child cried for his absent nurse; and at eighteen months he knew if one of ten toy animals were removed. In Preyer's opinion--and we think there can be no question of its accuracy--the intelligence of a child before it can speak a word is in advance of that of the most intelligent animal. He gives numerous examples to prove that a high level of reason is attained by infants shortly before they begin to speak, and therefore that the doctrine which ascribes all thought to language is erroneous.

Highly elaborate observations were made on the development of speech, the date at which every new articulate sound was made being recorded. The following appear to us the results under this head which are most worth quoting.

Instinctive articulation without meaning may occur as early as the seventh week, but usually not till the end of the first half year. Tones are understood before words, and vowel sounds before consonants, so that if the vowel sounds alone are given of a word which the child understands (thirteen months), it will understand as well as if the word were fully spoken. Many children before they are six months old will repeat words parrot-like by mere imitation, without attaching to them any meaning. But this "echo-speaking" never takes place before the first understanding of certain other words is shown--never, e.g., earlier than the fourth month. Again, all children which hear but do not yet speak, thus repeat many words without understanding them, and conversely, understand many words without being able to repeat them. Such facts lead Professor Preyer to suggest a somewhat elaborate _schema_ of the mechanism of speech, both on its physiological and psychological aspects; but this _schema_ we have not sufficient space to reproduce.