London's Pulse: Medical Officer of Health reports 1848-1972

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Stoke Newington 1901

[Report of the Medical Officer of Health for Stoke Newington, The Metropolitan Borough]

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"Let us take the births for a year in Great Britain at a million,
and let us assume that in inferior health conditions one-tenth of
these will, during the first ten years of life, fall below the line of
viability, and will cease to live. That, it may be urged, is a good
thing, as they are better dead, being unfit to remain. Let us suppose,
however, that the environment is improved, so that this tenth
remains above the line of viability and survives into manhood and
womanhood. That, it may be said, is bad, as it tends to propagate
an unhealthy race. But let it be observed that when this tenth is
raised from non-viability into viability, all the superimposed ninetenths
of the million are raised through a similar space in our
imaginary scale. The lowest tenth, which formerly rested on the
level of viability, is now one place higher, and so throughout the
column. The gain is nine times the loss. And if, in obstinate
determination to get rid of that unhealthy tenth we return to the old
and inferior conditions of life, it is true that the lowest tenth goes
below the line, but the second lowest takes its place. If pursuing
this course we determine to get rid of the second tenth by making
still harder its struggle for life, no doubt we succeed, but then the
third tenth takes the place of the second, and so on, until, endeavouring
to improve the species, we exterminate the race. Fortunately, in
this matter science and natural affection, social economy and philanthropy,
go hand-in-hand. The quality of mercy is not strained, and
the same conditions which strengthen the weakest make also for the
survival of the fittest." (Dr. J. C. McVail.)