What is health? It depends on the your point of view. The average man considers himself healthy when he is not ill, and many a person who is suffering from an endemic disease, e.g., malaria or hookworm, considers himself well, just because he is not seriously sick. The physiologist would consider health as a normal functioning of the cell, because he takes that as the unit of his investigation. The sociologist, on the other hand, looks upon the body from the point of view of action, and he must describe health in terms of the whole man as he reacts upon the various stimuli which come either from within or from without. These reactions are, however, ultimately mediated in the brain or in the mind, and they will be the more perfect and economical, the less friction there is in the physical organism. Hence we may say that a person is healthy when he is, except incidentally, unconscious of his body. The definition may seem strange at first sight, but it implies all the elements which enter into a full description of health. It means the state of body which enables it to perform every function which can reasonably be expected of it, to accommodate itself to each ordinary task, and to be equal to some exertion without painful sense of fatigue. This implies as external signs erectness and firmness; as internal requisites, good construction, ability to adapt itself to widely divergent conditions of life or of climate without deterioration of energy; endurance, resistance to morbific influences; and finally, it means selfcontrol—mental, emotional, and sexual; briefly, a balance between organs and organism, so as to produce a coördinated whole, well equipped for action.
This description does not refer to robust health, but merely to a person who is well. It may be illustrated briefly as follows: The healthy man wakes in the morning without any recollection of what happened since he went to bed, since he has had a continuous, unbroken, refreshing sleep. He is ready to get up and has no desire to linger in bed; his toilet is performed without delay, for he is hungry, and has visions of breakfast. When this is over, he proceeds to the business of the day at once, whatever that may be, since he loves his work. This he does with all diligence and dispatch, because his body answers to the summons of the mind with ease and accuracy. Hence he will not be exhausted when the day's work is done, but will have some energy left over for exercise, friendly intercourse, or mental improvement. Then he goes to bed, and is soon asleep. This man has scarcely been conscious of his body either by night or by day except incidentally when washing, dressing, and eating. If he had any sensations at all about it, they were pleasant, at least mildly so, since the sense of organic well-being is one of diffused pleasure. He enjoys his meals, but never has to care what becomes of the food afterward, since his digestive organs perform their work automatically; he may perhaps remember his meals again through an increase of strength and well-being.
Perhaps the best thing about good health is the fact that work does not weary us, but helps to develop our various faculties. Hence the day's work always leaves us in better condition than it found us; it has opened new possibilities before us, has given us opportunities for exercising our various powers and for spending our surplus energy. The healthy man is able to make every movement graceful, effective, and adaptive; and the profit from the day's experience will enable him to do tomorrow's work better. He recreates himself constantly.
It is not necessary to point out that good health is not identical with athletic strength or endurance. The tasks of life differ, and each task requires a slightly different physique, as Aristotle observed in his Politics. The health and strength of a hod-carrier must be different from that of a professional man; the former needs a well-developed muscular system, the latter an especially fine brain and nervous system. If each is able to perform his particular work well and without exhaustion, he fulfills his destiny, and renders not only a social service but gets profit and pleasure from it.
Health may be identified with good vitality, or surplus energy. Good vitality means simply a reserve fund beyond what is immediately needed. The greater this reserve, the better prepared is the organism to meet all kinds of exigencies with ease, and to stand shocks without serious injury.
"Two men undergo operations of the same character in a hospital. The same surgeon does the work. The conditions are identical. Equal care is exercised in each operation, and each is successfully performed. Yet one man recovers, the other dies..
"There is a tremendous business pressure which does not let up for months. It puts men under terrible strain. One man goes to pieces and his business is wrecked. He cannot keep the pace; he loses control of himself. His rival has no better brains than he—perhaps not so good—yet he pulls through successfully.
"We say that there is a difference in vitality; that one man has more of it than the other.
"I once saw a man in a hospital who was suffering from five fatal diseases; and yet he would not die. He kept on living year after year in spite of everything. He refused to succumb.
"We find the same thing illustrated every day. In a shipwreck there are many who seem to give up their lives without a struggle, without any power to resist. Others cling to an open raft for days without food, almost frozen, constantly whipped by the waves, but for some reason they survive. The vitality in them is strong.
"Notice how rapidly and surely one man recovers himself after a nervous breakdown, while another drags along through years of semi-invalidism. Notice the results upon two men of a long, cold drench of rain. One of them comes down with pneumonia; the other suffers no ill effects. How is it to be explained?
"He has a reserve somewhere, an inner power of resistance, an aggressive something that will not be downed—and we call it vitality. A man cannot have a more valuable asset than that. It means joy instead of dumps, success instead of failure, life, perhaps, instead of death."
No one will contend that under the circumstances just quoted, a healthy man is unconscious of his body; but these men were sick for the time being, and their cases are cited merely to show that men who enjoy good health store up surplus energy or vitality which stands them in good stead in an emergency. At such times there is still a vast difference between the man in good health and the one in poor condition. When special stress is to be borne calling for great exertion, the man in poor condition will dread the necessity, become apprehensive, and thus spend his energy ineffectively; while the well man will look forward with confidence to the trial of strength and react efficiently. He is able to do this because when he becomes clearly conscious of his body, he is aware of his strength and power; his whole organism seeks relief from the tension of stored-up energy; while the other, always more or less conscious of its existence, now becomes more than ever aware of its weakness and slender resources. Under normal conditions the well man is, however, as a rule unconscious of his body, unless it be an awareness of diffused organic well-being.
This fact may be illustrated in other ways. A healthy child who laughs and runs and romps, acts spontaneously, not deliberately. When he has to be urged and coaxed to do these things, he is not well; he is conscious of an effort, he must exert himself, and the more he does so, the more conscious he becomes of his weakness. A young dog who for no reason whatever will run up and down the avenue as fast as he possibly can is unconscious of his body. Only after he has spent his surplus energy and needs rest and food is he aware of his legs and stomach.
Health means, then, spontaneity and freedom of action. "It is as the outward sign of freedom, the realization of the universal will' that health may be set at once as sign and goal of the harmonious operation of the whole system—as sign and goal of the realization of life."
A healthy man is able to turn his energy in any direction desired, because his body responds promptly and efficiently; its energy is always ready to be expended. It is usually the man in poor health who has to "make up his mind"; the one in good health is able to decide quickly, because with a clear brain and efficient nervous system he can instantly "feel the situation," devise a plan immediately, and say "yes" or "no." The other man must in reality get his body ready; he has too little energy to meet the new situation at once, and asks for delay in order to "think it over" when he is not otherwise occupied. To conclude, then, health means freedom of action because it implies being unconscious of the body—owing to surplus energy.
This principle may be proved by a reference to the meaning of disease. In health all life-functions proceed without any friction and self-assertion on the part of the organs, hence the individual is normally unaware of his body. But let some organ get out of order, and we soon become aware of its existence. The very fact that pain is a danger signal implies that generally the operations of a well-ordered body proceed smoothly and unconsciously. Pain means, therefore, that a particular part of the organism is unable to carry on its work unconsciously; while usually so contented to serve the organism in obscurity and oblivion, it asserts itself vigorously the moment it can no longer do so, and notice is given to the whole body through the nervous system that help is needed. For pain is merely the cry of nerves that are either starved, poisoned, or throttled. And the finer the organism is constructed, and the more delicately balanced the various parts are, the better is the signal service of danger organized. Hence the higher species of animals and the more finely grained human beings are more susceptible to the slightest disturbances. The ox-cart of a Montenegro peasant will render fair service after many parts are out of repair and some even broken; but the automobile of fine construction will "go out of commission" the moment one small screw is loose or lost. So the savage will bear a fracture of an arm or even a slight one of the skull with comparative equanimity after the first shock; he usually recovers quickly without medical attendance: the finely grained European may suffer intensely and take considerable time for recovery; he cannot even witness pain in other men or animals without sympathy, or suffering with the other. Homer unconsciously intimated that the Greeks were more highly civilized than the Trojans when he said that the former felt pain more keenly as witnessed by their outcries, while the latter were mute even when wounded severely. The same principle applies to Mars, of whom we are told that he roared with pain when struck by the spear of Diomedes, for as a divine being his nervous system would naturally be more highly organized.
In the anxiety to avoid injury, i.e., to disturb the balance between the various parts, nature has devised innumerable schemes through division of labor in order to scent danger before it actually reaches us. This principle is most ingeniously elaborated in the case of the curious antennae, or feelers, which are thrust out from the surface of the body in animals of all sorts, especially in insects. Its most striking development is the well-known whiskers of the cat, and the less familiar, but much more highly developed, tactile hairs about the head of the bat. These feelers extend from half an inch to an inch from the body in order to warn it of approaching danger through the sense of touch. In more highly organized animals the senses of sight, hearing, and smell are, in part at least, intended to be guards against danger, extending their sphere over much larger areas. The reason for this extraordinary sensitiveness to pain and these precautions against danger is the extreme care which the organism takes in preserving its integrity or wholeness. For if the danger signal is to be of any value, it must be accurate so as to report the slightest deviation from the normal, and must be placed as far in the foreground of the battle as possible so as to give time for measures of avoidance.
Accuracy in interpreting danger signals is, however, possible only in good health, whether the danger is from within or from without. An organ which is in poor condition asserts itself so peremptorily and constantly, that other organs may be neglected or are made to suffer, and thus became unable to do their work properly. The nose is a useful organ and performs valuable services to the organism all more or less unconsciously to ourselves; for while it is in a sound condition we act promptly on the information it gives us, and are hardly aware of its existence for weeks at a time. A cold in the head very quickly changes this relation. Our sense of smell suffers almost instantly and we are less able to judge accurately of the information received from that quarter. But that is not all. This organ asserts itself so vigorously at such a time that we are but little able to do anything else than attend to it. Neighboring organs are likewise affected, e.g., the eye, which becomes watery, and the ear, which becomes less acute and discriminating—we hear noises rather than distinct sounds, and fewer of them. The three main sentinels against external danger are thus invalidated. And what happens to the organism? It is more or less out of working order, less aggressive, less capable, perhaps incapacitated. Why? Because the nose asserts itself so vigorously that most of the energy produced by the organism is drawn into service for repairing the breach made in its wholeness. For the system must be whole if it is to function properly in the various exigencies of life. If a more important organ is hurt, we call ourselves sick and go to bed, so as to give the organism an opportunity to attend to its repair work exclusively for at least some time.
Health means, moreover, economy of expenditure. While there is much friction in the organism during sickness in performing even the most elementary work, there is hardly any during health. We simply go ahead, unmindful of our body. It is a ready instrument of the mind, and we realize its existence only at night when tired out. That feeling of lassitude is simply a signal to stop and rest. It is not an unpleasant, but rather an agreeable feeling to relax and go to sleep. A few hours of rest are sufficient to restore our energy, and we wake up automatically, ready to go to work again. Comparatively little food is needed to keep a healthy person in good condition, because no repair work is needed and the power of assimilating all nutrient elements is strong. A physician said a few years ago concerning a patient who suffered from consumption of the throat, that her food had sufficient nutrient values to keep seven ditch-diggers in good health. Still, that young woman could hardly move in bed without severe pain. We are surprised when we read of the black bread, a piece of cheese, and the small amount of sour wine, which keep many European peasants not only in good health, but literally in good working condition. There is no secret about it, though; the system does not waste anything, and new energy is quickly supplied by simple food and sleep. The Chinaman with his handful of half-cooked rice is even a better example. He works hard and continuously on this scanty food, and seems to be untiring. Such energy can be explained only on the basis of good assimilative power and high vitality, as seems to be indicated also by his resistence to high fevers and by his bluntness of nerve which enable him to recover rapidly from terrible injuries.
This economy of expenditure has a very important effect upon the development of the higher faculties. When there is little or no friction in the organism and assimilative powers are good and work is not too exhausting, a surplus of energy is easily produced. This energy can be used for experimentation along various lines, either through play or through more serious attempts at invention in abstract thinking, imagination, and actual recombination of mechanical contrivances. There is no need to discuss the theory of play here; suffice it to say that a certain amount of unused energy must exist in the organism if play is to be indulged in. No doubt instinct directs play along certain lines, and nature selects only animals which play efficiently and which thus prepare themselves better for the more serious duties of adult life—but no animal or human being will play when fully exhausted. He may fight his teasing friends with his last ounce of strength for the right to rest or sleep, but he will not play. He may change his occupation from reading to walking, and thus rest his tired eyes and brain while exercising his unused legs, but when he is tired all over, he will rest if he possibly can. If he attempts to force himself, the result is as a rule pitiful. We are familiar with the official smile and joke at the President's reception—and elsewhere—with its mirthless laugh and forced friendliness. It deceives only the gushing girl who cannot distinguish between spontaneous humor as the result of abundant vitality and the make-believe interest of a tired man who wants and ought to be in bed. This surplus energy enables those who direct it properly to develop both mentally and physically, and leads thus to an enrichment of life with the possibility of arriving at new and possibly useful variations. The theory of the leisure class in social science is based on such a surplus. It is, however, not so much a greater supply of goods than is needed for the maintenance of life, as it is a greater amount of vitality for the ordinary duties of life, that is of real importance. It is, in other words, not so much a question of wealth as the economists and sociologists would maintain, as it is a question of health. This may be proved briefly in two ways. A rich patient confined to bed more or less all his life consumes, but rarely creates wealth, while a poor man with surplus energy will study, write, experiment, and produce something beneficial for society. Again, the fact that many inventors have come from the better class mechanics and that many discoveries have been made by teachers in colleges and universities is explained better on the theory of health than on that of wealth. For after all, there is nothing that interests the man of low vitality except his own condition, and he could not as a rule make use of extant knowledge as a basis for extending it, even if he would. Why not? Because such men do not develop any surplus energy. A brief consideration will make this clear.
We have seen that even a less serious defect in one or another organ causes the whole organism to divert its energy toward the ailing part and interferes thus with its general functions of being a good working machine for the mind. To give one more illustration. Adenoids are not a serious defect in themselves. Yet this slight derangement of normal breathing may have serious effects upon the mentality of a child, because it diverts the functions of the body from their usual and mutually helpful character to a particular organ in order to remove the obstruction. The organism becomes thus self-centered, so to say, instead of being an unconscious agent of the mind. That means that no surplus energy can be developed while the obstruction lasts, since whatever energy is developed goes first of all into the maintenance of the vegetative functions, and secondly into the removal of the obstruction. The body as a whole is thus not properly nourished. This explains on the one hand the proverbial fertility of the poorly nourished part of the population, since nature is bent on the continuation of life at all costs and every ounce of surplus energy is turned into reproductive activities; on the other, the many cures which the organism effects without medical aid, since it must work with the least friction possible and as a whole, if it is to work well. But some parts must suffer from this under-nutrition. The nervous system and the brain are the ones which do not receive proper nourishment under these conditions. They are kept at the lowest minimum possible for regulating the organism; but they cannot be alert, accurate, and aggressive: neither can they be finely wrought and sensitive. The associative centers or the cortex suffer most from this lack of proper nutrition, hence they cannot exercise the necessary control over the body, and the latter acts in an erratic manner; that is, without properly valuing its actions in proportion to their importance to the organism as a whole. Lack of unity of action is the result, and mentality remains at a comparatively low level. It is evident that a person in that condition is unable even to organize new information received, or much less to originate anything new by recombining the elements of knowledge already in his possession.
It is different with people in good health. Just because they are well nourished, the brain has at least an opportunity to be kept in proper condition owing to the surplus energy of the organism. Whether an individual will use that energy for building up his brain or his muscle, is, of course, a different question. He may prefer to exercise his muscles and build up an athletic body, or to use his brain more and perfect its functions. Whichever he does, the law of the growth of the most used part holds, and that part will develop correspondingly in power. If it is the brain he exercises most, its ability to form new adaptations and combinations quickly and accurately will increase, and the individual may contribute something new to society. The question whether there is an increase in the mass of the brain through exercise is not yet definitely settled; the increase in power by means of more numerous and better organized association-paths is, however, undisputed. It seems a natural inference that a higher brain power draws more nutrition from the body as a whole. Whether that is true, is still unsettled; experience seems to point that way, since people with massive brains—finely organized and capable of much hard work—rarely belong to the high vitality class, but usually to the medium, according to Professor Giddings. The body of the great thinker is, in other words, organized for action along a particular line—that of mental exertion in poetry, art, philosophy, science, statesmanship, administration, or similar vocations where facts have to be seen from a new angle or to be classified under new generalizations.
We have thus far considered chiefly the lack of proper power of action of the organism due to more or less serious illness or defect. In each case the body was deficient through the self-assertion of some organ. Malnutrition has the same effect, but more continuously. The body in that case is unable to supply the various parts, particularly the brain, with proper power, and hence the whole organism suffers from inability to act properly and efficiently. And just as the sick man becomes self-centered, so does the man of low vitality. He is continually conscious of his inability to adapt himself to new conditions and is reminded of his failures. His mental attitude is self-centered; he looks inward, not outward; he is always concerned with himself, and must of necessity be so, as long as his body is an inapt agent of the mind. A healthy man is as a rule a social man; a sick one is usually unsocial. If a well man is self-centered, he is so deliberately; but one in poor health is so by necessity, since he is always conscious of the limitations of his body.
Sickness or malnutrition may, however, happen to a whole race. Many savage tribes and many poor classes among civilized nations suffer from the latter defect and are unable to rise to a higher mental life because of poorly nourished brains, or to a higher social level owing to the inherent social limitations of men of low vitality. The larger part of mankind has, however, suffered from diseases of various kinds. If these were malignant or epidemic, men died, and only the strongest remained. If they were benign and endemic, a gradual deterioration took place, since just as in a serious illness the energy of the organism is diverted from its proper uses to the repairing of "broken down ramparts," so in endemic diseases there is a constant endeavor merely to ward off danger and to build fortifications against invading enemies. Among nature-peoples malnutrition and endemic diseases often combine, and the organism is unable to resist the double strain. Hence hundreds of tribes have succumbed, and only a few have survived. These were generally so exhausted from the struggle that their power of resistance was very small, and any new disease that might be introduced would kill them. Whether as individuals or as a race, people with low vitality have poorly nourished brains, small power of adaptation and any new strain or exigency will upset them completely; hence they either perish or spend proportionately so much energy, that a more serious exhaustion results, and this prepares the way for a further loss of power of resistance, since there is no way to create surplus energy. Whether in the case of the individual or in that of a race, low vitality produces an attitude which centers in the individual rather than in society.
High vitality produces, as a rule, social action. "The natural glowing fire of health—superb health—is seen and felt. It is magnetic. It makes for itself place and following. It is constructive. It is initiative. It is happy. It is humane. It is beautiful. It radiates strength and brightness. It agitates for the good of others. It compels pleasantly to be and do one's best." There is an expansive quality about good health which we realize only when in the presence of a man abounding in vitality—good-natured and buoyant. Such a man is always master of himself, because he is unconscious of his body. Not having any ills of his own, he is happy, and his happiness is contagious, because it is spontaneous. He not only radiates peace and contentment, but wants to see others happy and cheerful. Being always master of himself, he is tactful and spares the feelings of others. If he has the gift of humor—as he usually does—it is good-natured and not sarcastic or sardonic like that of the dyspeptic who trusts nobody because he is not sure of his own power. The healthy man wants a well-ordered environment, since his own mind and body make a harmonious whole. He generally succeeds, too. For he who is master of himself is best able to bring order out of chaos among those around him. He has few, or no, troubles of his own, and his abounding energy seeks an outlet in helping others. His whole activity is directed outward toward conquering difficulties which he attacks with zest and vigor because they furnish good practice for his various powers. He is, in other words, not merely moral, but social, for sociality rises above morality.
"Objectively viewed, morality consists of that 'walk and conversation' which the community as a whole approves. It includes not only acts, well adapted to the achieving of those ends that on the whole are held to be good, but also outward expressions of thought and feeling, so far as these are approved. Subjectively, morality is self-respect, and that desire for the good opinion of others, and that endeavor to deserve it, which Mr. Spencer has called ego-altruism…
"As the name itself implies, sociality comprises those qualities of mind and character, of disposition and conduct, which are eminently and characteristically social.
"Objectively viewed, sociality is a cheerful and efficient par ticipation in the normal comradeship and cooperation of society.
"Subjectively viewed, sociality is altruism—thoughtfulness for others, sympathy with others, kindliness and helpfulness toward others, even at some cost of self-sacrifice, and happiness in the companionship of one's kind."
A person with low vitality may be moral; by precept and training he may be able to overcome the tendencies toward self-centering activities to which he is naturally inclined; but it takes a positive, and sometimes a strong, effort to do so. This fact is well and frequently illustrated by numerous people who, cursed with a low vitality, sometimes make herculean efforts to reform, only to backslide after many failures. They may be charged with moral delinquency or even depravity; but the blame for their failures should be laid at the door of low bodily vigor or some physical defect. Where vitality is somewhat higher, we still have only a limited morality. A rich person may refrain from definitely unsocial or immoral acts; he may even give from the abundance of his possessions to poorer people out of self-respect or to maintain the good opinion of others; but he cannot give cheer, hope, buoyancy, and efficient service, because he needs whatever strength he has for himself. The sour-faced man may solemnly declare in a prayer meeting that he loves his fellowman with his whole soul, but the fulfillment of his promise is not in his power, since in his case the spirit may be willing but the flesh is literally weak; and no man can give what he does not have. It is the same way in larger matters. A person of low vitality may be willing to lay down his life for his country; he will not go far before he is in need of Red Cross nurses. The Athenian of the times of Philip of Macedon avowed his patriotism in the strongest possible terms, but Demosthenes informs us that Athens talked about hiring 10,000 or 20,000 soldiers; for this malaria-ridden Athenian could not take the field like his ancestor of the previous century. He was not a hypocrite in protesting his love for Athens