Sir Arthur Newsholme

“ In a west window in summer towards night the sun grows low and even familiar, with more light than delight. A north window is best for butteries and cellars, where the beer will not be sour from the sun shining on it. ”

“ In every American city visited by me I have been struck with the earnest desire of voluntary and official public health and social workers to profit by English experience, to adopt what is good, to secure the abolition of the short tenure of office of competent officers under the present political system, and to introduce civil service conditions for them. There is in many respects a close parallelism between the course of public health on both sides of the Atlantic; in some cities the English hygienist has much to learn in respect of advanced and original work ”

“ Physiological Considerations.—In the strict sense of the word, exercise signifies the performance of its functions by any part of the body; thus, digestion is exercise of the stomach, respiration is exercise of the lungs, thinking is an exercise of the brain. But the term is usually applied chiefly to muscular contraction, and restricted to contraction of voluntary muscles. Involuntary muscles, which are concerned in the carrying on of the unconscious organic functions of life, are not directly controllable, and so their growth and state of nutrition cannot be regulated. ”

“ We scarcely realize how far we have gone in the socialization of medicine. It is impossible to go back, or to stand still. The services of the medical profession are needed, not only to provide the necessary service, but in helping to determine its conditions. One essential item will be the substitution for fees during sickness of an annual payment to private practitioners by each family for supervising its members in health, for inquiry into their industrial and domestic life, so far as it contains elements inimical to health, and for giving preventive more than curative advice. ”

“ Parasites (Greek, para, upon, and siteo, I feed) , in the broadest sense of the word, are living organisms, which derive their nourishment from other living organisms. They may belong to the vegetable or animal kingdoms, and may live on the skin, in the alimentary canal, or in some one of the internal organs. Some, like the fungus causing ringworm, feed on the living tissues of the animal infested; others, like tape-worms, on the partly digested food; while other parasites, like fleas, only pay temporary visits to the surface of the body, for the purpose of obtaining food. ”

“ If the air in a chimney flue is cooler than the air of the room with which it communicates, it will flow down into the room. It is the object of an economical fire-place to cause the chimney to act as an outlet for the products of combustion and for the impurities of the air of the room with the smallest possible waste of heat. Short of producing a down draught of cold air and smoke, the smaller the difference between the temperature of the air of a room and of the air escaping near the top of the chimney, the greater the economy of fuel. ”

“ The first lesson, then, which has already been partially learnt, is that no member of a community can live to himself. We now believe in the solidarity of society; that the sores of one section of it means peril for all. And we are gradually learning to appreciate that this is true not only in respect of the acute infectious diseases, and of chronic infectious diseases, such as tuberculosis and syphilis, but of every disease and of every other factor in life which causes individual inefficiency, and which consequently inflicts additional burdens on the competent section of the community. ”

“ Classification of Foods.—Inasmuch as milk supplies all the food necessary for health and growth during the first year of life, it may reasonably be expected to afford some guidance as to the necessary constituents of a diet for the adult; although the conditions of life being altered in the latter, we can hardly expect the same proportions of the different materials to hold good. In the infant rapid growth and building up of new tissues and organs are going on, involving the necessity for a larger proportional amount of nitrogenous food than in the adult. ”

“ Thanks to the great discovery of Jenner and to the complete organization of measures for isolation of the sick, and for vaccination and surveillance of contacts, we can make the same claim for smallpox, whenever this mysterious disease begins its occasional world travels.
But we have to confess our continuing relative helplessness in preventing the spread of measles, and of acute catarrhs, among our endemic infections, and still more of influenza when—as recently—it makes its devastating swoop on the entire world, and secures a larger number of victims than the World War itself. ”

“ An accurate statement of population forms the natural basis of all vital statistics. Thus the comparison of the number of deaths in one with the number of deaths in a second community has no significance unless we know also the number living out of which these deaths occurred. Even then our knowledge would be defective, without further particulars as to the proportion in each population living at different ages, and the number dying at the corresponding ages. ”

“ This may imply—and in England it does imply—the urgent need for reform and reconstruction of local as well of central public health administration; but to attempt to separate medical from public health provision is to repeat the blunders which, despite skilled advice to the contrary, have been made on two great historic occasions.
A complete service, adequate to the needs of the community, cannot be secured by a session’s legislation. It must grow as the result of steady advance. The motto in growth might well be, “First things first.” ”

“ The cubic space of a room is really of less importance than the capacity for frequent interchanges of air. Even the largest enclosed space can only supply air for a limited period, after which the same amount of fresh air must be supplied, whether the space be small or large. Thus, supposing that as large a space as 10,000 cubic feet per head were allowed, the limit of purity would in the absence of ventilation be reached in three hours, and after that time an hourly supply of 3,000 cubic feet of air would be just as necessary as if the space were only 200 cubic feet. ”

“ When we read of administrative scandals, it is desirable to have a sense of proportion, and to remember, as the reader of old records or even of Pepys’ diary will scarcely need to be reminded, that corruption was rampant in the past, and especially to remember that the best way to remove that most subtle and mischievous form of corruption which consists in giving and accepting appointments as political rewards, is by ourselves taking a part in local government, or by steadily upholding those who are doing so with integrity. ”

“ If communal provision has been recognized as a duty for police protection, for sanitation, for elementary education, should it not likewise be admitted for the more subtle and maleficent enemies of health which have been recognized, but which in no community have hitherto been completely combatted? ”

“ Whose ignorance is it proposed to enlighten? Ignorance is common to all classes, and it is fundamentally important that systematic instruction in physiology and hygiene should be given in all our schools; and that especially every teacher should have adequate training in these subjects, and in the recognition of the common mental and physical defects of children. If [Pg 169] a course of instruction were given for all, approaching that which is given for public health nurses at Yale University, how much more hopeful would be the prospect of public health progress, both in New and Old England. ”

“ What is public health work? It is best defined by stating its object, which is to secure the maximum attainable health of every member of the community, so far as this can be secured by the authorities, local, state, or federal, concerned in any part of government, acting in coöperation with all voluntary agencies whose [Pg 44] work conduces to the same end. The connotation of public health becomes wider year by year. It embraces physiological as well as pathological life; being as much concerned with improving the standard of health of each person as with the prevention and cure of disease. ”