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CHAPTER XXVIII
TRANSFORMATIONS IN INVALID LIFE

Legislation for the helpless in health or in sickness the exclusive feature of the Victorian age. Early interest of the English Court through the Prince Consort in the housing of the poor. This coincided with, and helped forward, the organized public movements for popular sanitation. General summary of these, as shown by results. The new nurse contrasted with the old. Hospitals to-day twice blessed.

Specific progress of sanitary reform. Demonstrable connection between these improvements and figures of the death rate. Preventive and curative medicine also entitled to credit. General course of medical progress. Special researches of English physicians. Their ascertained usefulness and their latest aspects. Improvement in English doctors, with particular instances.

Before the Victorian age, there had been no legislation for the purpose of helping the helpless, housing the homeless, providing for the health of those whose birth-right was the squalor, the starvation, the disease, that come from systematic neglect. Here, as in other things, the representative of the Crown, transformed from a political power into an agency of social good, led the way. The Prince Consort, moved by the condition and by the address of the ballast heavers in the East End of London took the initiative; the legislature gradually followed. Thus was the principle established and acted on that one of the prime duties of the State is to those for whom from any other quarter there is no help.

The last instance of that wholesome truth was the Dilke Commission for the better housing of the poor aptly presided over by the Prince Consort’s eldest son in 1885. Exactly forty-five years earlier than this, Colonel Slaney’s⁹⁸ motion in the House of Commons produced an enquiry into the health of towns. Local Improvement Acts had been multiplied to the number of 500. There was still no proper drainage. The Duke of Buccleuch’s Commission of 1848 led to the Public Health Act of the same year. As the cholera invasions of 1853 and of 1865-6 showed, the Local Boards established by the Act of 1848 were too permissive in their operations to be fully effective. Edwin Chadwick, and Southwood Smith had from the first co-operated with the Queen’s husband. Their activity did not cease when the earliest steps to reform had been taken: 1858 witnessed fresh improvements.⁹⁹

It was not till 1875 that the confused mass of sanitary laws was consolidated. Then the Local Government Board which, with the powers of the superseded Poor Law Board, had been established in 1871 was in full and in most beneficent work. Still the Commission that last investigated the matter, due as it was largely to Lord Shaftesbury, showed many evils still to remain. Overcrowding was worse in the West London rookeries than it had been in the East. In 1885 the Dilke Commission Act gave fresh power to local authorities to destroy unhealthy dwellings.

The machinery which thus exists as the sixth decade of our epoch draws to its close, is therefore tolerably complete. Guarantees for its promptly being put into motion are still wanted. Not only the credit, but the very conception of this wholesome function of the State belongs entirely to our era, and arises out of the enlarged idea of Royal service which fills the modern mind.

Strictly consistent with family tradition is the effort of the Prince of Wales to help those who are only one degree more helpless than the dwellers in city and suburban alleys and courts in time of need. To free the London hospitals of debt will crown the edifice of sick relief that in Crimean days the Queen and her husband began.

From the departure of Miss Florence Nightingale¹⁰⁰ and her trained staff for the Crimea in 1854 must be dated the birth of nursing as a polite profession. But for that mission of mercy one would hear nothing of the contemporary parade of nurses in the height of the London season in the grounds of Marlborough House. The fashionable vogue of the vocation may sometimes attract modish recruits who have not counted the cost.

Amiable sympathy is not the sole qualification which the lady nurse needs. Self-consciousness is as much a disqualification as a shuddering dislike of sick room scenes. It is also the attribute that the patient is the most quick to observe. Not a few of the sick whom the ministering angel of the new school desires to relieve may still sigh for the presence by their bedside of the displaced Mrs Gamp instead of the young lady in the coquettish muslin cap and dainty grey frock who casts complacent glances at herself as she passes the mirror, and with an air not quite suited for a sick room offers her patient his medicine or his barley water as if she were suggesting black coffee, green Chartreuse, and a cigarette after a whitebait dinner. These defects will no doubt be mended when the lady nurse is more habituated to her calling. Decayed billiard markers, and scripture readers who have gone wrong, will not eventually figure so largely among the self-sacrificing males who also find their career in tending the invalid. The scandals of which the nurse (old style) was sometimes the heroine still live in the pages of Dickens. They arose from the rumoured hastening of the sick man’s death by the scriptural practice of laying a wet cloth over his mouth. Any scandals with which the nurse (new style) might be connected would perhaps come from the desirable marriage that she arranges for herself in the sick room or from the legacies made to her by grateful patients, but disputed by thankless relations. These things, therefore, should be no doubt regarded not as slurs upon her disinterestedness, but as tributes to her efficiency.

Inside the hospital the same transformation has been effected as in the aspect of the ministering angels themselves. The grave young gentlemen in training for the medical profession have nothing about them left of the lamp breaking, policemen baiting, medical student of Albert Smith. If sometimes one reads of the too engrossing attractions for these youths of the sylphs who flit to and fro in the wards, the answer is obvious – ‘Evil be to him who evil thinks.’

Hospital management is the subject not for a few pages in a single book, but for a library in itself. One or two not controversial facts may be given. Throughout the Victorian age a marked feature in medical charities has been the supplementing of the historic hospitals with many new dispensaries and establishments for special diseases. If the latest hospital endowments are smaller than those originating in an earlier century, the explanation is less a decline in eleemosynary purpose or power than the development of the value of the property assigned to the older foundations.¹⁰¹ Thus the revenue of St Bartholomew’s in the middle of the sixteenth century seems to have been only £371 a year. Towards the close of the nineteenth century it is £32,000 a year. During our own era hospital benefactions approaching a quarter of a million are far from unknown. These do not include such special and comparatively recent hospitals as that for consumption, with the 40 new dispensaries connected with it.

To epitomize the facts; the total of London hospitals or infirmaries with wards for the sick amounts to 49. The movement still goes forward. So vast is the scale on which these buildings, less houses than towns in themselves, were first planned that in many of them there is yet room for fresh beds. This is only a specimen of what has been, and is being, done throughout the kingdom. There thus seems a fresh argument in favour of continuing to London itself an institution like St Thomas’s, Southwark, the removal of which to the country was not long since suggested.

Like all gracious works, these places are twice blessed. They relieve those who are in need. They humanize those whom prosperity and comfort might make callous. Before our age began, no one thought of sending game or fruit to the sufferers or convalescents within these places of refuge. Now it is the exception for the millionaire not to make the spoils of his fashionable battue pay tithe to those for whom such food is often the best of physic. The costly flowers that decorate the drawing rooms or dining rooms during the season are not discarded as rubbish when the festivity is over. They are scrupulously tended so as not to lose their freshness. Presently their hues and fragrance will relieve the bleak expanse of white-washed wall in those places where our sick are nursed away from their own homes.¹⁰²

The contrasts of our age include a marked connection between the organization of the healing art and the advance of medical science on the one hand and the reduction of the death rate on the other. In 1855 the mortality of the United Kingdom was 23 per 1,000. In 1875 it was 21 per 1,000. In 1895 it had fallen to 18 per 1,000. The figures,¹⁰³ and the conclusions to which they point, are tributes, not only to medical skill in healing disease, but to sanitary reform in preventing it.

Before the Victorian age began the whole population of these Islands awaited the periodical onsets of pestilence with the resigned fatalism of the Turk, or with the passive submission of latter day London to the incubus of snow. The notorious consequences of unhealthy living prompted no preventive measures. Divine wrath was believed to express itself in deadly epidemics. When that anger was assuaged health would return. Till then human remedies could do little. Meanwhile, the truth that Providence helps those who help themselves was being scientifically shown. Hence in 1838, a State enquiry into the whole matter was instituted. In 1848 the legislation began which, by promoting cleanliness, at once disarmed disease. John Simon proved the propagation of pestilence to proceed by impure particles. In 1858-65, on his initiative, the Government strengthened the defences of public health. The entrance of foreign plagues was stopped at our ports. Three sons of a clever West of England doctor named Budd¹⁰⁴ had been trained from their childhood in practical medicine by their father. These doctors showed the connection between impure water and typhoid fever, as before them Snow had shown between cholera and water. When the improvements suggested by these researches were adopted health generally benefited. Consumption statistics became less alarming every year. Fevers of all kinds were successfully combated. Since vaccination had become general, smallpox cases had fallen by at least one-half.

Meanwhile, the discovery of anæsthetics, of chloroform by Professor J. Y. Simpson of Edinburgh in 1848, of ether in 1846 by Morton and Robinson of the United States, at once robbed surgical operations of their terrors, and rendered them practicable in cases where till then they could not safely be tried. In 1860 came the antiseptic treatment of Sir Joseph, since Lord, Lister. Before then, the nervous system had been explored successfully by Carpenter.¹⁰⁵ Instruments for examining by reflected lights the hidden parts of the human frame had been invented by several English surgeons. Operations for certain internal tumours, that had hitherto defied removal, were first performed by Cæsar Hawkins, born 1798, brother of the famous Oriel Provost, a pupil of Brodie at St George’s; and more recently by Spencer Wells.

More than a half of the medical discoveries of the period are English. The latest perhaps, certainly not the smallest if the least known, was the treatment by the late Sir William Gull of the swellings technically known as myxœdema by an entirely new process, that of supplementing deficiences of the thyroid gland with matter taken from animals. The throat specialists of Germany found much to learn from the late Morell Mackenzie. Not till 1860, was the scheme of medical education perfected in its present shape by the College of Physicians, which to-day, under its President and two Censors, arranges all examinations; while the Medical Association represents the whole profession, bringing its grievances and needs before the legislature. The average of ability throughout the practitioners of the country is as noticeable as the achievements of its scientific pioneers. The treatise on Heredity in disease by Dr Douglas Lithgow, on gout and allied complaints by Dr Robson Roose, and on the medical uses of electricity by Dr W. S. Hedley, are instances of permanent contributions by busy practitioners to the scientific knowledge of their daily labours.

The late Dr Quinn, the late Oscar Clayton, are men who have improved the status of their calling by their social services and gifts, and have helped to extend the authority of the physician over every department of life. We have long since shaken off the rule of priests. Some may think we have already placed ourselves under a despotism of doctors, who by their word can make or mar the reputation of places and climates if not of characters and of men; and on whom the obligations of professional etiquette seem at least equal to their sense of responsibility to the public.¹⁰⁶

CHAPTER XXIX
TRANSFORMATIONS OF RELIGIOUS THOUGHT

The vicissitudes of religious thought in the Victorian age illustrated by the quaint saying of an Oxford verger. Changes in the organization of the Church of England during the present reign. The revival of Convocation; the Ecclesiastical Commission. Facts and figures illustrating the results of these and the progress made at home and abroad. Activity and efficiency of other religious bodies, Protestant and Papist. Special influence of individuals in the Churches. In the Anglican, Dean Arthur Stanley, Professor Jowett, Professor Mansel. In the Nonconformist bodies, R. W. Dale, and C. H. Spurgeon. A friendly critic on the abuse of religious liberalism. How this re-acts, even on the new High Church critics, e. g. Lux Mundi and The Sermon on the Mount.

A verger at St Mary’s Church, Oxford, during the sixties used devoutly to thank his Maker that after having heard University sermons for thirty years, he still remained a Christian. Conflicts within, attacks without, at least as severe as any to which either was exposed during the Georgian epoch, have been the lot of the Christianity whose depository is the Church of England during the Victorian age. Neither Christian faith, nor the Church that is its national expression, has come forth maimed or weakened from that ordeal. Modern scepticism scarcely aims at substituting for a Divine Being any tangible object of faith. It retires from the discussion with the remark that high and invisible things are beyond human knowledge. Hence nothing in agnosticism, however hostile its tendency to, need be inconsistent with, Revelation. The mere statement of difficulties in the way of belief and of purely abstract alternatives to belief makes no proselytes.¹⁰⁷

Freethinkers of the last century appealed, and were limited, to the rich. The secularists who are their successors since 1840 pose as the friends of the poor. Neither school can consider itself a power. The Victorian age is in fact above all others an age of religious revival. This has been largely due to the influence of the Court. From the entourage of the later Georges and of William IV. the best of their subjects held aloof. Had the year of Revolution come then instead of in 1848, the English throne, whose possessor lacked all personal hold of the people, might have shared the fate of continental crowns.

The Queen saw nothing of any Court until she presided over a transformed Court of her own. Her subjects no sooner knew their fresh ruler than they were powerfully impressed by the contrast of her blameless life and society to anything of which they had read, heard, or seen. Under such a sovereign, a change in the whole spirit of the nation’s religious life naturally followed. Thinking minds had indeed long been in a state of spiritual ferment. The Tractarian movement had begun with Keble’s Assize Sermon five years before the Queen’s accession. Its full results were not to be seen till 1846.

Meanwhile, in the third year of the reign the idea of reviving Convocation, which since 1717 had been suspended, of which Burke had said that it was without functions save to pay compliments to the king and then dissolve, took form; since 1850, that body has met. Unreformed this clerical parliament still remains. As in 1864 it declared Essays and Reviews heretical, but could not punish the men whom it branded, so, to-day, a canon of Convocation, though approved by the Crown, has no binding power. But the days when the Times, long since convinced of its Erastian errors, could sneer at Convocation as ‘a clerical debating society with a long name’ are altogether gone by.

Many who are by no means ardent Churchmen, or are outside the Church Communion, are interested to know the actual opinion of Convocation on social and industrial questions of the hour, as this opinion is expressed by educated men who reflect the views of their cloth at least as faithfully as the House of Commons reflects the views of the people. Thus, during the recent sittings of a single year, Convocation in its two provinces with their divisions into lower and upper Houses, has discussed and suggested solutions of subjects so varied as sisterhoods and deaconesses, betting and gambling, popular education, soldiers’ marriages, marriage law amendment Bills, spiritual provision for workhouses, clergy discipline Bill, the relations between the Church and State in the Colonies. Even in its unreformed condition, this body can scarcely fail to be of some use in officially telling Parliament men the opinion of the Church, which, on any view of it, is at least a considerable corporation, on matters affecting clerical interests or popular morals. In the remote event of the Church being disestablished, Convocation is a useful drilling ground on which Churchmen of all degrees can be trained to collective action.

What are the facts relating to the Church to-day? At the opening of this age, the beneficed clergy were often unfit for their posts; they were very largely indifferent to their duties. The attacks on the Establishment led by the Lord Henley of that day and others, shortly after the 1832 Reform Act, were more organized and plausible than anything which has been witnessed since. There are, after all, not many things more national in England than the Church. Even the differences of the clergy, and the professed desire of some among them to be free from State supervision, have not lessened the national regard for the Established Faith. The attack from within, therefore, seems likely to be weathered not less successfully than the attack from without.

The parochial system of the Church – its clergy resident in every village where the squire is often an absentee, has struck its fibres too deep into the soil of English life, to be rooted out by any sectarian agitation. The best proof that Church endowments do not check, but rather encourage, private beneficence is the amount of money donations to the Established Church during the present age. Gifts to the Church, whether in the shape of lands, tithes, other rent charges, stock or cash, represent roughly a sum of £5,500,000, yielding a perpetual yearly income of £181,940.

The second of the two Acts establishing the Ecclesiastical Commission is of Victorian date. The operations of this body have increased the incomes of Church livings by £1,016,775 a year, or by a capital sum of £30,599,100; and this during the twelve years ending 1896-97. Queen Anne’s bounty does not, indeed, seem to have been uniformly administered with such wisdom. Its funds have sometimes been granted to incumbents to enlarge houses, schools, and other buildings beyond the point at which there was an assured income for the maintenance of these fabrics. The Tithes Commutation Act is not blamed for the periodical return of hard times for the clergy. The distress itself is partial, sometimes exaggerated. Still, there seems to have been a general reduction of incomes in rural districts by 25 per cent. No offertories, which in towns greatly help the clergy, can make the country deficiency good. The suggestion of repealing the Act which put down pluralities so as to concentrate several poor preferments in one incumbent is not likely to be acted on. But some relaxation of the Act might be a feasible concession to a growing opinion. Rich livings are sometimes the worst served. Some re-adjustment of stipends after a new enquiry seems, therefore, likely to be proposed.

So much for the purely English aspect of clerical activity in our age. The alliance in the foreign enterprise of the Church with the State coincides exclusively with the Victorian reign. In 1841 the Colonial Bishopric fund was begun. By 1851 the Colonial episcopate was fairly organized. Four years after the Queen’s accession there were 10 Anglican dioceses out of England. Sixty years after that accession there are 92.¹⁰⁸ These sees are grouped into provincial Synods. This foreign Church, one in doctrine with the Established Church at home, is modified in its agency and development to suit the soil to which it is transplanted. The late Sir J. R. Seeley, with respect to its calming influences amid jarring faiths, has in a familiar passage dwelt on the Christianity of the English Church as a reconciling element between the rival creeds of the Eastern world. Add to this the organization of episcopal Protestantism of the Anglican type, not only in the West Indies and in our Canadian Dominion, but in the United States themselves.¹⁰⁹

A fair idea may thus be formed of the State Church in its character of a veritable catholic, not less than a national, power. Improved organization does not always argue increased efficiency. The machinery of the Roman Empire was never more elaborate than when it was in a state of atrophy. Coinciding, however, with the unmistakable signs of spiritual life at home and abroad, the domestic resources and the foreign work of the national religion are tributes alike to the efficacy of the Church as a world-wide instrument of righteousness, and to the increased motive power of religion during the Victorian age. With the spiritual work that has been done, certain names very briefly must be associated. The Oxford Tractarianism between 1832-46 is only one of many manifestations of religious life which mark that epoch, and which nearly perplexed into infidelity the Oxford verger aforesaid. In extreme Evangelicalism outside our Church, the followers of Wesley, regardless of their founder’s injunction not to form a separate sect, were perfecting their system when the reign began. In 1833, an English clergyman at Plymouth, J. L. Darby, left the National Church and founded the sect of ‘Brethren’ who take their name from the Western seaport where he had officiated. Fifteen years later, in 1848, Plymouth Brethrenism was itself divided by one of Darby’s followers, named Newton; he created a clique of his own now called by their rival religionists, the loose, or open, Brethren. The missionary and literary activities of this little sect are really remarkable. In 1843 Presbyterianism across the Tweed had a schism of its own. The secession of Chalmers on the issue of State patronage resulted in the founding of the Free Kirk. The religious activity of the epoch has been universal. Among the older dissenting bodies, Congregationalists, in point of numbers, influence, in national repute of their leaders, perhaps come first. These in 1837, numbered 170,000 full members. Now they number nearly 400,000. Of the Baptists there were, in 1837, 125,000. Sixty years later they are 340,000. This increase is due to the single agency of C. H. Spurgeon, whose personal influence is not yet fully realized but may be judged from the circulation by millions of his posthumous Sermons, as well as by the pulpit imitations of him in all Communions, not excepting the high Anglican pulpits. Hence of course Nonconformist numbers depending largely on individual attractions, are subject to greater fluctuations than in the Establishment. Roman Catholics have increased in the large towns of England and in the Colonies. In 1837 their priests were less than 1,000. Fifty years later they were in round numbers 2,500. Their Churches have risen from 600 to 1,350. The activity of British Evangelicalism is farther shown by the doubling of the income of the British and Foreign Bible Society during the reign, by the cost of a New Testament being ten-pence in 1837, a penny in 1897. Similarly the income of the Propagation of the Gospel Society is very nearly twice, and of the Church Missionary Society almost thrice, as much to-day as it was in the Accession year.

Among Nonconformist bodies, numbers vary according to the eminence of individual leaders, rising by bounds with a Spurgeon, diminishing temporarily with some of his successors. Similarly, among Anglican Communicants numbers fluctuate according to the influence of the leaders of the great schools, a Liddon, or a Ryle, a Maurice, a Webb Peploe, or a Lefroy. R. W. Dale, of Birmingham, whose work on the Atonement is a recognised text book, even among many Anglicans, did as much as A. P. Stanley of Westminster, to soften down sectarian differences, and to command the respect of other Communions. Nor has Dale had any lack of worthy successors now living. Unless religion had been ineradicable in the national, because in the human, mind, results very different from this general increase in the number of all religious Communions, judged by whatever test, would have been witnessed.

Scarcely had the Church recovered from the shock of Newman’s secession, and the agitating effects during two decades of High Church and Low Church controversies¹¹⁰ when Dr Mansel, then an Oxford tutor and professor,¹¹¹ in his ardent, but not wholly discreet zeal, expressed views on the relations of the Infinite to the finite which, as F. D. Maurice perceived, declaring the Deity to be unknowable by man, might be perverted into an apology for agnosticism. That religion did not really suffer is due in some degree to Benjamin Jowett. This good and honest scholar’s life was spent in educating young men into useful Christians, into serious citizens, and into sincere believers. He claimed liberty; he loved truth. He ridiculed with quiet satire the religious nescience and despair which Mansel’s terrific propaganda had been distorted into making the vogue. When Dr Temple was made Primate: – the first and greatest tribute was paid to the variety of Oxford ecclesiasticism that would be rightly described not as the broad, or high, but as the hard Church. There could be no more striking instance of the transformation in religious ideas witnessed during our age than the fact that the volume to which Dr Temple and Mr Jowett both contributed, Essays and Reviews, was branded by Convocation as heretical during the sixties, and is discovered to be harmless during the nineties.

So qualified a judge on these matters as Mr Stopford Brooke deplores the declension of religious liberalism into something indistinguishable from unbelief. But as Professor Mansel’s orthodox zeal for the dignity of his faith helped his enemies rather than his friends, so the services rendered by his devout successors are not always unmixedly conducive to the old faith. The ‘higher criticism’ has been a dubious ally of Biblical Christianity. Lux Mundi distinguished between the historic and mythic elements in the Pentateuch. The gifted editor of that work has more recently¹¹² applied the same method to the sayings of the Founder of Christianity, and has seemed to some to sanction the evaporation into proverbs of some Divine utterances.¹¹³