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births 011 the one hand, or from immigration on the other ; the ages, habits, the immigrants, the state of health that they bring with them into a district,
and the wliolesomeness or unwholesomeness of the places from which they have
migrated. Again, both as respect differences in death-rate in the same place at
different times, and between different places at the same time, much will depend
upon the chance introduction of certain morbid contagici; or, if we regard theso
seeds of disease as ever present among us, to the co-existence at one time and not
at another of these meteorological or other conditions which favour their energetic
operation upon the human system. Add to all this that unhealthiness is at any
time promoted by lack of employment, by scarcity or dearness of food, or of some
important or essential variety of food, such, for instance, as vegetables on the one
hand, or meat on the other; and I think we shall have run over a sufficient
number of possible circumstances, the influence of which must be eliminated before
we fall back upon local causes of unwholesomeness, to explain the fact of a mere increase
in an annual death-rate, or of the death-rate of one place being in excess of
that of another. If we would argue from death-rates to relative local wliolesomeness or
unwliolesomness, we must then compare similar things, and, if things that we wish to
compare are not similar, then we must sub-divide each, until we find sections of each
that are similar, and so comparable with a view to the sort of result desired. Sometimes
this can be done satisfactorily, at other times it cannot, at least without a very
dis-proportionate expenditure of labour; in the latter case we must content ourselves
with making allowances for such conditions as are dis-similar. In this way
if we fail in gleaning all the truth, we can at least avoid picking up the errors
which over lie, and so fatally resemble it.
So much then for "healthiness" as a term applied to a people. Wo should also
have a clear idea of " wholesomeness" as a term applied to a place. The term
" wholesome" implies the absence, more or less complete, of local causes of disease;
their causes being principally the following:—An atmosphere tainted with such
gaseous or vapourous matters as experience has demonstrated to effect the human
frame injuriously; or having suspended in it and blown about by it such dust-like
matters as are capable of developing disease when coming into contact with the skin
or lungs; or when they chance to have fallen upon any food that is eaten. A
position which lays the place open to suffer inordinately from climatic influences,
such as cold in winter, heat and atmospheric stagnation in summer, dampness on
the one hand, or draught and dustiness on the other. A supply of water for domestic
use either contaminated with poisons such as lead; or with such matters of an
organic nature, and perhaps even diseased origin, as when received into the human
body disorder functions. Lastly, in our idea of local unwholesomness, we include a
crowded and ill-ventilated condition of habitations, crowded by close packing together
of the houses themselves, crowded by tho close packing of the rooms within
each house, and crowded by close packing of inhabitants within each room. All
other things being equal, the locality most wholesome, most free from these and
similar local causes of disease, will be most free from disease, most healthy—and
the converse is also true. But neither docs this law nor its converse always hold
good when the other conditions are not equal.