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MINISTRY OF INFORMATION
HOME INTELLIGENCE SPECIAL REPORT
CONFIDENTIAL

No. 47 July 1943

PUBLIC KNOWLEDGE AND BELIEFS ABOUT SOME ASPECTS OF HEALTH

Contents

1. INTRODUCTION.

2. THE SCOPE OF THE ENQUIRY.

3. SOURCES OF THE PUBLIC'S “KNOWLEDGE” ABOUT HEALTH MATTERS.

4. SLEEP.

5. CLEANLINESS.

6. BRINGING UP CHILDREN.

7. SUPERSTITIONS AND BELIEFS.

8. SUGGESTIONS FOR A HEALTH CAMPAIGN.

9. CONCLUSION.

1. INTRODUCTION

In March 1943, there were discussions between the Ministry of Health, the Central Council for Health Education, and Home Intelligence Division of the Ministry of Information about the possibility of a detailed investigation by the Wartime Social Survey into health attitudes of the public. These discussions came to nothing; but before they were abandoned, a preliminary qualitative enquiry had been made, through the Intelligence Officers in the Regions. This report sets out the results of the enquiry.

2. SCOPE OF THE ENQUIRY

A. Limiting factors

(i) Time : Since the Intelligence Officers' investigation was intended as a preliminary to a more detailed survey, a rather drastic time limit had to be imposed, and Intelligence Officers had only four weeks at their disposal. More than one stated that the time allowed was far too short for a thorough investigation. The South Western Regional report goes on to point out that the time limit did not allow enquiries to be made of such people “as district nurses in the remoter areas - where information would have been most curiously detailed and full, concerning the least articulate elements of the population. It is probable that a single West Country village would yield enough material for a complete book on the given subjects, but it would take some years to collect it, in all its richness and depth.”

(ii) Subjects chosen for investigation : The size of the problem and the lack of time necessitated the preliminary enquiry being limited to certain specific subjects. Intelligence Officers were asked, therefore, as a first step, to find out the public's habits and beliefs in connection with:

It was added that any ideas or suggestions which contacts put forward for improving people's knowledge on these subjects would be welcomed. This report, then, deals only with these questions, and health matters arising from them.

(iii) Two Regions not investigated : Certain temporary difficulties prevented any enquiry being undertaken in the Southern and South Eastern Regions. The counties of Bucks., Oxford, Berks., Hants., Dorset, Surrey, Sussex and Kent are therefore unrepresented. The fact that reports received show a large measure of agreement on main aspects, suggests that reports from these two Regions would have added only minor variations on the principal themes.

B. Methods of investigation

Each Intelligence Officer covers a Region of from 3 to 5 counties, primarily by means of representative contacts (who are in touch with considerable numbers or with special sections of the public), and only incidentally by personal investigation. The representative nature of contacts does not mean that they are inevitably people in positions of some responsibility - a number are “very ordinary members of the public, bus drivers, factory hands, working-class women, etc.”; but the very fact that they are willing to be Intelligence contacts does mean that they will possess the elements of social responsibility, and are themselves likely to be free from the more primitive habits and superstitions to be described here. As a result, much of the material for this report was “comment concerning ‘other people's’ ideas and ways of living”, rather than “direct evidence as to contacts' own beliefs - except in so far as their comment has thrown light on their own misconceptions and attitudes”.

For this investigation Intelligence Officers made use of: (i) Their usual contacts - or a selection of them; (ii) Local Information Committees; (iii) Doctors and health visitors; (iv) Clergy; (v) Teachers; (vi) Various types of social worker, including factory Welfare Officers, workers in Welfare and Youth Organisations, C.A.B. secretaries and W.V.S. Officers.

C. Sections chiefly studied

Most of the material collected appears to relate to the lower income groups. This is partly intentional, and partly inevitable:

Intentional , because “experience shows that ignorance, dirt, and irresponsibility in the matter of bringing up children - although by no means confined to this group, and possibly, no more common than among the middle and lower middle class - is, nevertheless, greater in degree”.

Inevitable , because “people above the level of the working class, immediately upon the introduction of the enquiry, gave their views of the attitudes and habits of the poor, and rather side-tracked their own attitudes and habits, except on the subject of sleep”.

Rural opinion seems to be well represented, and has been considered in some detail in several reports.

3. SOURCES OF THE PUBLIC'S “KNOWLEDGE” ABOUT HEALTH MATTERS

(Though information on this subject was not asked for, a certain amount was given spontaneously. The subjects covered by the enquiry may account for the emphasis on knowledge about children and child-bearing.)

The sources of people's knowledge about health matters may be grouped under two main headings: tradition and family experience; and knowledge derived from outside sources - of which easily the most influential appear to be Health Clinics, Child Welfare Centres, Nursery Schools, and School Medical Services. Tradition and family experience appear in the main to be opposed to the more scientific knowledge from the clinics; further, tradition and family experience appear to be fighting a losing battle.

A. Tradition and family experience

“The unthinking sections of the public, no matter what social group they belong to, learnt what they know from their parents and grand-parents.” .... “Knowledge concerning health matters, the bringing up of children, etc., has been handed down from generation to generation.” More than one report suggests that “granny is a source of great danger, particularly if she happens to live in the same house as her grandchildren”. There is, however, “evidence to show that a grandmother's advice, though still remaining an influence, has no longer the authority it once possessed”.

The influence of tradition and family experience is said to be at its strongest in all matters related to the bearing and rearing of children: “the woman who has had seven and buried four is still regarded as a great authority”. There is “a hard-dying belief that experience in having children is the best or only qualification for knowing how children should be handled”.

B. Knowledge derived from outside sources

Tradition seems to be losing much of its power; “the bogey of old wives' tales, handed down by previous generations”, is gradually being “laid by enlightened knowledge”. At the same time, “new-fangled ideas must pass the test of practicability”. It is pointed out that “a very general criticism of modern advice concerning children is that it calls for enough time ‘at the right moment’; and, however anxious the mother may be to carry this out, the pressure of multitudinous tasks in running a house may make it impossible. Nor will ideas be readily accepted, unless they produce satisfactory results that are either visible or immediate”.

Nevertheless “the generation age 20 - 40”, and particularly the women, are said to be making ever increasing use of “clinics and centres”; though “this reliance is primarily utilitarian”, the long term educative influence and the example of a better standard are stressed in a number of reports. Reference is made in several reports to the enlightening influence of the following:

The following sources of health knowledge, appear to play a considerably smaller part:

4. SLEEP

A. Popular beliefs and superstitions about sleep

Most people's sleeping habits have been modified to some extent - and many people's, drastically - by war conditions. In war time, people's theories and beliefs about sleep play a smaller part in determining their practice than such material factors as the blackout, the sirens, and the shift system. Nevertheless beliefs and superstitions about sleep still persist. Of the following widely held beliefs, the first three appear to be general:

(i) An adult needs eight hours of sleep : Some people “lay down the rule that men require seven hours, women, eight”, and that “brain workers require more sleep than manual workers”. “The theory of ‘eight hours' work, eight hours' play and eight hours' sleep’ is widely accepted as truth”, even if “not put into practice”. Children are generally thought to need “an hour or two more”.

(ii) An hour before midnight is worth two after : “It seems generally to be believed that beauty sleep, i.e. sleep before midnight, is more valuable than any in the morning hours”. Some, indeed, hold that “the last three hours of rest do little good”.

(iii) It is better to sleep on the right side : Sleeping on the left side is thought to injure the heart by “crushing” or causing pressure on it, and to cause nightmares. Sleeping on the right side “rests the heart and prolongs life”. Nevertheless some believe that “sleep comes easier and quicker on the left side”.

(iv) The bed should lie North by South, with the head to the North : A reason is not always offered for this belief; some hold it is “because of the magnetic forces between the North and South Poles”; others say it is because “the sleeper should lie the same way as the earth moves and not at right angles to it!”; others, again, say that it is because “East by West is the direction of a grave”. Some people also refuse to sleep with their feet towards the door, as this is “considered some kind of invitation to death to claim them”....... “You are all ready to be carried out”.

(v) It is dangerous to sleep with the moon - particularly the full moon - shining on one's face : This opinion is “often strongly held when a reason for it cannot be given”, but most people believe that it results in lunacy or “witlessness”.

(vi) The night air is unwholesome : Alternative versions are that “fresh air at night lets in the damp”; fog is considered particularly “injurious”.

(vii) The taking or avoiding of food before sleep is the subject of “innumerable theories” and two main schools of thought.

One school stresses the need of having something to eat before retiring to avoid waking hungry in the night. “‘Night Starvation’ has become a popular catch phrase”, and great faith is placed in “the magic of Horlick's or Ovaltine”. “There is even a belief that a heavy meal helps sleep by drawing the blood from the head to the stomach and allowing the brain to rest”, and many Lancashire people are said to “go to bed rather late, after a meal of fish and chips, cheese, pickles, beer, strong tea, fried-up vegetables and other left-overs”.

The other school maintains that “a heavy meal at night keeps you awake”.

The effect of particular articles of food is also the subject of various theories, the most popular being that cheese last thing at night induces dreams and indigestion. Onions are thought, by some, to induce heavy sleep, while “a drink of milk will go solid inside you”.

(viii) Sick people : From 2 to 3 a.m. is the most dangerous hour for sick people, their vitality being then at its lowest. In coastal areas it is held that “sick people may die as the tide is on the ebb, as it draws away any soul whose earthly tenure is uncertain”.

(ix) Sound sleep is impossible with a high pillow .

(x) Dreamless sleep is the most beneficial .

(xi) Too long sleep makes for sluggishness .

(xii) It is unhealthy for a young person to sleep with an old person : It is thought that, by some means, the older one “abstracts vitality from the younger”.

B. Amount of Sleep

(i) General

(Children's sleep is dealt with later - Section 6. C.)

In spite of the very general belief that an adult needs eight hours, sleep does not seem to be universally regarded as “a positive health factor”. Many people are said to be “ignorant of the value and necessity of adequate sleep”, and “not to understand that the amount of sleep that they themselves obtain very materially affects their own health”. Many of the “chronically tired working class attribute their fatigue to some ailment, never realising that it may in part be due to sleep deficiency”. Old people, on the other hand, are “frequently worried over loss of sleep; it is often difficult to assure them that they do not require as much as younger people”.

Some of “those who realise the value of sleep, and are aware of its connection with health, do not fully appreciate that quality is just as important as quantity”, and that, for example, “one cannot have refreshing sleep on top of a heavy meal late at night”. Such wartime duties as firewatching, however, are “bringing home to people that it is the amount of sound unbroken sleep which is the important factor, not necessarily the number of hours of sleep”.

The material on which this report is based contains almost no reference to the amount of sleep which people took before the war, their minds now being occupied with their wartime experiences. In general, the middle class is thought to have more sleep than the lower class, who usually get up one or two hours earlier in the morning without necessarily making up for it by going to bed earlier. “Black coated workers, agricultural workers, mill-hands and miners are mentioned as the types who are most regular in their habits and hours of sleep, aiming at the ‘traditional eight’.”

(ii) Wartime Changes

It is generally agreed that “war conditions have brought about a marked change with regard to sleep”. Most people feel it to be a change for the worse because the majority appear to be getting less sleep, interrupted sleep, or - in many cases - both. Some increase in sleeplessness is also reported, and reference is made to “the terrific taking of Aspro and aspirin”. “A Chemist with a very busy business said that he had never before sold so many sedatives for sleeplessness - mostly to men who were working and doing additional Home Guard or Civil Defence duties.”

Reasons given for the civilians getting less sleep in wartime include:

It will be noticed that many of the above factors do not in themselves inevitably result in curtailed or disturbed sleep, though they do involve an increase in hours of work or working at unfamiliar times. The consequence, for many, is that sleep is robbed to compensate for the extra claims on people's time. Thus, “shift work plays havoc with the regularity of sleep habits: young people on night shifts tend to spend the afternoon at a cinema, and men probably work in their gardens when they should be in bed. Boys and youths of 16 - 20, working in shipyards, frequently do not go to bed until after midnight or later when on the day shift and, rising at 6.0 a.m., consequently get insufficient sleep - 6 hours or less being quite the normal thing.”

“The average housewife” is spoken of in several reports as getting insufficient sleep. “She is the last to go to bed and the first up” - particularly if she has to be up early enough to get shift workers off to work. When she is doing a factory job in addition to looking after her home, her hours of sleep are apt to be even shorter, and women on night shift “often attend to housework in the daylight hours which should be spent in rest”.

Very often the worker on night shift, though willing, is unable to sleep the usual length of time during the day owing to noise. Callers, children, wireless, traffic and dogs are all said to cause disturbances, while those who spend much of Sunday in bed to make up lost sleep complain of church bells. One report says that “the majority of night workers say that they can do with five or six hours sleep in the day-time without any detriment to their health”, but this is not confirmed in other reports.

C. Hours of Sleep

(i) General

The belief that an hour before midnight is worth two after seems to be one more honoured in the breach than in the observance, even in peacetime. Most of the available information relates to wartime habits, but certain tentative generalisations are made. Thus, it is said that:

(ii) Wartime changes

Apart from the obvious changes brought about by the shift system, the war seems to have made considerable changes in the hours, as well as in the amount, of people's sleep. Three factors are mentioned in this connection:

D. Sleeping Conditions

(i) Sleeping quarters

Incidental information on sleeping quarters relates mainly to overcrowding. There are familiar references to “three and four people often having to share a room, sometimes three - and not infrequently more - in a bed”. Housing limitations account for much of this, and the report from the Northern Region - the only one to treat this aspect fully - refers to families of 8, 9 and 10 members in many colliery districts living in two-roomed houses, the bedroom sometimes only a garret, reached by a ladder. The same report speaks of children sleeping on the floor, of parents and perhaps the baby sleeping in the kitchen, and of a girl of 14 sleeping in the same bed as her parents.

It is evident, however, that lack of space by no means accounts for all the overcrowding, even though, according to the Welsh report, “popular opinion is that homes should have enough room for proper sleeping arrangements”, and though mothers, according to the London report, are “nowadays aware that sharing a room with the children is unsatisfactory”.

It seems clear that aversion to congested sleeping arrangements is often not as strong as fear of bombing: “crowded downstairs sleeping is still persisted in on account of raids”, even in areas which have not suffered from really heavy raids. Thus one city, which had its only “blitz” in November 1940, had an alert on Good Friday (1943), since when many families have started sleeping downstairs again and, according to a Local Authority Medical Officer, “will continue to do so for weeks”. Sometimes this is “the result of so many fathers being away in the Services, as the women do not like the responsibility of ‘getting all the kiddies down if anything happens’”. Sometimes, however, it “appears to be due to laziness, as it has been found to be less trouble to have everything on the same floor. People are now sleeping in rooms full of stuffy furniture.” It is said that “many people who have brought their beds into the kitchen on account of air raids will never be persuaded to take them upstairs again”: in peacetime some people used to sleep in the kitchen in winter, “because the bedroom is too cold”.

In areas where the possibility of bombing is not a consideration, “in the houses with a front room downstairs, this room is not used as a bedroom in spite of the overcrowding, except in cases of long-standing invalidism where the person wants to avoid the exertion of going upstairs”.

The fact that “adolescent girls and young women, working in a multiple store and living away from home, often prefer to share a bed with a companion - even though each is provided with her own bed” - suggests that the habit of sleeping in company, once acquired, is not easily given up.

Only one report refers to the bedroom itself. According to this, “many visitors to slum tenements and other working-class homes agree that less pride is taken in the bedroom than the sitting-room or kitchen. The same is true of many homes in other sections of the community. The kitchen and sitting-room may be clean and tidy and show evidence of care having been taken on their furnishing, yet the bedroom is untidy, dusty and drab - any old stick of furniture will do.”

(ii) Ventilation

There is said to be an increasing knowledge of the value of fresh air, particularly among younger people, but many still seem content to take it on trust. “The majority will tell you that they should sleep in well-aired bedrooms”, according to the Scottish report, “but actually few do so”. A report by a doctor is quoted as saying that “90% of the less educated classes keep their windows shut”; an investigation carried out among 167 Barnsley children between the ages of 11 and 14 showed that only 84 slept with their windows open; while a lecturer at a Sea Scout meeting in the North Midland Region recently asked: “Hands up those who sleep with their windows open”, and not one hand went up.

The following reasons are given for people sleeping with the windows shut:

(iii) Beds and bedding

(a) Beds : “Single beds for husbands and wives are considered almost indecent - even in cases of long illness”, by rural populations in the West Country, though the Welsh report suggests that double beds are “slowly going out of fashion in the wake of feather beds and nightshirts”. They are still, however, said to be the most popular among married couples, even if for no other reason than that “modern houses do not allow enough room in the bedrooms for single beds”, and a double bed usually costs less than two singles.

(b) Mattresses : Feather beds, though still cherished in rural areas, are widely regarded as out of date and unhealthy, and are “rejected by the younger generation in favour of something firmer”. Interior spring mattresses are said to be the most popular, because of their resilience and also because of “a belief that a mattress that sags, or is hollowed in the middle, is likely to induce spinal curvature”. Where a good mattress cannot be afforded, “a flat palliasse, or a hair or wool overlay mattress, is favoured”. In many of the poorest homes mattresses are said to be non-existent: in many cases, where they once existed, they became rotten through soiling and could not be replaced through poverty.

(c) Sheets, blankets and other coverings : There seems to be a general feeling that weight and warmth are synonymous. Many people, and particularly the working class, prefer a heavy weight of bed-clothes, and do not feel comfortable in beds with warm light coverings. Many lack sufficient blankets and make up the deficiency with old coats and rugs.

Two reports refer to a preference for thin flannelette blankets instead of sheets, “as they are warmer”.

(d) Bed-making : There is not sufficient information to provide more than a few unrelated glimpses. Bedding is said to be changed nowadays, usually at the rate of one clean sheet per week, the top sheet being put to the bottom, and the pillow-case changed weekly, but it is clear that such a routine is unknown to a considerable section of the public who do not possess sheets and whose beds remain as undisturbed as possible for as long as possible. “The custom of stripping the bed and opening the window to air the bed-clothes appears to be very much neglected by many of the public” and, though “the shiftless, lazy or apathetic mother of the slum is the worst offender, many middle-class people merely pull up the coverings as they get out of bed, or even leave the bed unmade”. Apart from conditions caused by ignorance or poverty, circumstances often compel “night shift workers to sleep in the same beds as day shift workers, and often the beds are not made between shifts as the second comer likes to inherit the warmth”.

(iv) Night-clothes

According to one report, “even those who can afford or possess traditional night garments do not in many cases take off their daytime underwear”, but, for want of evidence to the contrary, the assumption is that the middle and upper income groups undress completely before going to bed and put on pyjamas or nightdress. The working class and the lowest income groups for the most part appear to follow one of three practices. These are:

5. CLEANLINESS

A. Personal Cleanliness

(i) General

The very great dependence of personal cleanliness on the facilities for washing and bathing available in the home is emphasised in nearly all reports. The “lack of bathrooms, baths, even of water laid on or easily available, is mentioned again and again. If a majority of people are clean at all, it is in spite of hindrances.”

In many areas the majority of houses are still bathroomless. In others - country and urban districts - water has still to be carried from the pump or from “the tap in the yard”. The lack of privacy in crowded, bathroomless homes adds to the difficulties - particularly for the adolescent girl.

The theory of working-class people “using the bath to store coal” is discounted. When moved to more modern accommodation, the habits of cleanliness are generally quickly acquired. Pit head baths are quoted as having brought about a great change by fostering the desire to keep clean.

(ii) Standards

The popular conception of cleanliness is widely thought to leave very much to be desired. “Freedom from lice and a washed face” on the one hand, and “a change of underwear and a bath once a week” on the other, are the poles between which the majority's views are classed. A surface cleanliness which is satisfied if face, hands, and what can be seen of the neck, are clean, is the chief requisite; “powder and paint” often replace soap and water, and a “spotlessly clean exterior” can cover dirty skins and underwear. Even where standards are higher, cleanliness is thought to be more a question of appearance and comfort than of any realisation of the connection between cleanliness and health.

Even so, there is thought to have been considerable improvement during the last twenty or thirty years; reports from doctors, nurses and teachers tend to bear this out. With the exception of a small class of the lazy and ineducable, the “really dirty” person is thought to be comparatively rare. The return of men and women from the Forces, with their new standards of fitness and cleanliness, will, it is suggested, further this improvement.

Praise is given to the work done by teachers, by nurseries, and by school medical services in helping to bring about this improvement. At the same time elementary schools are said to make no attempt to promote better standards among the young, short of telling children they must get washed at home; the schools themselves often having no supply of hot water which would encourage the practice of greater cleanliness. The need for instilling a sense of pride in cleanliness is stressed; much education is admitted still to be needed.

Some stress is laid on the different standards of town and country people. With the exception of a small percentage of the slovenly and careless, the country folk are thought to be more cleanly generally. Those who have come into contact with the worst kind of evacuees are said to be appalled at their “complete lack of house training” and cleanliness. Townspeople, in turn, complain that country people billeted on them have no knowledge that indoor lavatories need flushing.

(iii) Habits

Washing habits generally vary with social levels, although certain types break through their own strata. “The clean poor are amazingly clean despite all hindrances”; and even above the lower middle-class level there are some, it is reported, who have a daily wash only of the exposed parts of the body.

The “popular” habits are:

Failure to have a weekly bath is found chiefly where facilities are poor, the slum or the cottage where water has to be carried, the crowded bathroomless house where women and adolescent daughters have little or no privacy. Also among old people, both those who live alone and those who fear bathing.

Although the belief that bathing makes for colds is said to have gone out, fears are still fairly widely held that to go out after a bath will cause a chill. Working people have a “holy terror” of catching cold, and bathing is consequently made a “ritual affair” before going to bed. To bath if one has a cold is considered very unwise.

Some belief that “baths are bad for you” also exists; they are thought “weakening” or to “take away too much of the natural oils of the body”. Many miners still believe that washing the back weakens it, but where the pithead bath has been installed, this superstition has usually been overcome.

Among the “well-to-do or well-educated”, daily bathing used to prevail, but has been cut down by the need for water and fuel saving.

(iv) Effects of the war

Not much emphasis is laid on the effects of the war on personal cleanliness. Some mention is made, however, of increased difficulties due to soap rationing, fuel restrictions, laundry difficulties, and coupon shortage. Mention is also made of general fatigue - as a result of which people are inclined to tumble into bed unwashed - and of the neglect of children whose mothers are employed in factories.

(v) Care of the body

Hair

A marked increase in the incidence of head lice is thought to have taken place in the last few years. Formerly “it was exceptional to find vermin in the heads of women and girls. Plenty of children were affected but not their elders. Now it is common.” The “lack of washing, brushing and combing of the hair, all factors making for the multiplication of the head louse”, are generally held to be the results of the cult of the ‘perm’; there is fear of “disturbing the wave”. “The more elaborate the ‘perm’ the less frequently hair is washed”, and complaint is made of “beautifully permed heads, seen to be running with lice”.

Modern, long styles of hairdressing are also held to be unhygienic; “if one can fairly successfully imitate the style of a celebrated film star, cleanliness must go, for the style will be ruined by washing”. The high cost of shampoo and set is a further deterrent to cleanliness; the difficulties of re-setting prevent hair being washed at home.

The superstition that head lice are a sign of health is reported to be slowly dying, though references are made to the still current belief that “they are natural”. Some people are regarded as “breeders”, and there is an attitude of: “What is the use of doing anything? They always come back.” There is also said to be some unawareness of the relation between nits and lice, hence “nits are natural” or “common to children”.

A fair amount of belief that over-frequent washing is bad for the hair is quoted. It is thought to dry up the natural oils which keep the hair in good condition and prevent it going grey.

Some fear of catching cold as a result of washing the hair, particularly among women, is also mentioned.

Teeth

“Considerable class distinction” and “widespread ignorance” appear to apply to the care of the teeth, particularly as regards attendance at a dentist. A proportion of the community do attend regularly, but the majority only when attention is urgently needed. Few working-class people have their teeth stopped and in country districts it is very usual for people to “wait for them to fall out”. Some still tend to feel that once decay takes hold it is better to have all the teeth out and “be done with it”. In the North a large number of young people favour artificial teeth; “they are by no means uncommon at eighteen or twenty”.

The use of toothbrushes, “though becoming more common, is by no means a universal cult”. The increase is ascribed partly to attention at schools and partly to “much advertised” dentifrices. Poor people, it is suggested, are cleaner over their teeth than over their bodies; “they fear the cost of a dentist”. Salt and water, or soot, are often used, but a good many are “attracted by toothpaste”.

When toothbrushes are used, they are not always reserved to the individual but sometimes passed from one member of a family to another if they are needed at school or camp.

Hands

There is very little comment on the care of the hands. Nail varnishes and cuticle removers are thought to have brought about a better standard, particularly among girls, by whom cleanliness is desired for the sake of appearance.

The washing of hands before meals or after visits to the lavatory, though generally realised to be advisable, is usually ignored.

Feet

There seems to be general agreement that feet are often very badly neglected, particularly among “the lazy, shiftless, or mentally dull”. Neglect of the feet, it is thought, may be connected with absence of baths: “while many people strip and wash their bodies, perhaps over the sink, they do not at the same time cleanse their feet, which are allowed to become filthy and dirt-encrusted”. Toe nails are left uncut for months; stockings are allowed to become sweat-sodden, dark ones being washed only when they, are thoroughly dirty. In the worst cases, they are never washed but worn until they become useless. In country districts it is sometimes believed that washing the feet softens them and the practice consequently is discouraged.

The flat heels now fashionable for women and the modern tendency to wear sandals are praised as helping to improve the deplorably ugly feet caused by mass-produced high heeled shoes. Chiropodists are now said to be better appreciated and foot clinics well attended.

Skin

Very little comment is made on care of the skin. There are complaints of the sharing of family towels, face flannels, soap, etc. and of the practice of using the same bathwater for the whole family which is said to be prevalent in very poor homes. There are also complaints of the use of cheap “powder and paint”, to which it is thought some skin complaints are due.

The increase in scabies, impetigo, etc. is attributed to wartime conditions and evacuees are blamed for carrying them to rural districts. They are linked with dirt, in the public mind, and consequently carry a great deal of shame. There is reluctance therefore to go to a doctor when they are recognised.

(vi) Menstruation

The subject of menstruation is “wrapped in secrecy and surrounded by taboos”. It is linked with a tradition of shame: “women find greater difficulty in discussing it even than V.D.”. There is thought to be need for definite education of women and especially of girls on this topic. Few young girls obtain any systematic instruction of bodily hygiene during the periods.

The custom of not taking a bath, and of neglecting to wash the hair, feet, hands or genital regions, though said to be dying out among the middle class and more educated, is still very widely observed. Many superstitious beliefs are attached to this theory. Chills, consumption, mental derangement, seizures, convulsions, recurrent fits, blindness, “eyes popping out” or the stopping of menstruation altogether, might result from breaking any of the injunctions. It is thought that, since a cold or chill may sometimes terminate or delay menstruation, the ‘taboos’ may be linked with a fear of pregnancy, and the consequent anxieties brought about by any irregularities.

The use of sanitary towels, though general, is by no means universal because of the cost. Girls who go out to work can generally afford them, though even here the high price is censured. The working-class housewife uses substitutes, butter muslin and cotton wool, or carefully prepared linen and towelling. But not infrequently old scraps of rags and dusters are all that can be managed.

Women from the poorest homes sometimes wear nothing extra, particularly now that the odd pieces of cloth have gone; “they merely pin up their petticoats”. Some factory girls are reported as using nothing but wads of toilet paper.

Various superstitions attached to menstruation besides those connected with bathing are as follows:

B. Cleanliness in the home

(i) General

While available facilities are considered an important influence, they are thought to have less effect on the cleanliness of the home than on personal cleanliness; pride and tradition appearing to play a far greater part in determining habits of cleanliness in the home than they do of the person.

The “average” British housewife takes a pride in her home “which often becomes a fetish”. Some complaints, however, are made of “top dressing”, where “a scrubbed doorstep and whitewashed window sills may cover no end of dirt inside”. Fresh air is sometimes excluded to protect curtains and fabrics from smoke-laden atmosphere; living rooms receive attention where scullery sinks, lavatories and bedrooms will be very much neglected. Some improvement in real cleanliness, is thought, however, to have taken place in recent years.

Opinion is divided as to the reasons for uncleanliness in the home:

On the whole, country people are thought cleaner and more fastidious than town people, cleanliness of the home being a matter of pride and emulation in most rural homes. In the industrial areas there is less inducement to expend energy on cleaning: “What's the use? It only has to be done again in five minutes.” Apart from having less dirt to battle with, the country housewife also has greater facilities for airing of mats, bedding etc., as well as for washing and drying clothes.

(ii) Sanitation

Lack of adequate sanitation, which is believed to be very widespread, is deplored. Dirty habits “particularly at night”, are most generally attributed to it; “the best means of promoting sanitary habits is the provision of proper sanitation”.

The sharing of one closet by several households meets with “general disgust”. It is said to have a particularly bad effect on young people, who often suffer considerable embarrassment as a result.

Lack of indoor sanitation is also criticised. “Cases of ulcerated stomach in later life are laid down to youngsters not getting out in the middle of the night, or during cold or wet days when it means going out across garden or yard.” It is also blamed for much constipation, especially among older people. Some, however, believe that an indoor W.C. is unhealthy. Among “council house” dwellers there is said to be a preference for an outside W.C., but approached by a covered way. It is also said that some people with lavatories downstairs are too lazy to come downstairs at night to use them.

There is also complaint that where adequate sanitation is provided, it is not always properly appreciated: “too few realise that the standard of cleanliness in the W.C. should be as high as in any other room”. The country dweller's earth closet is said to be often kept in better condition than the water closet of the town.

The absence of easily accessible sanitation means that chamber pots, commodes, or pails are used, and there are complaints that these are often very inadequately cleaned. Among the council house and slum dweller particularly “there is often no great readiness to get rid of slops”.

(iii) The family wash

The keeping of a set day for the “weekly wash” is still widely prevalent, though less general than formerly. Heavier clothing and bed linen, however, are increasingly being sent to laundries and cleaners, and the lighter washing consequently done at any convenient time. Partly because of the cost and partly because of the personal pride taken in doing one's own washing, working-class housewives still make little use of laundries. Modern clothing is thought to have done much to improve standards by its lightness and ease of washing, but heavy top clothing is still often never cleaned.

In preparation for the “weekly wash”, bed, table and personal linen are usually changed beforehand on Sundays. Some, however, change underwear and bed linen only at fortnightly intervals. Among the poorest groups, under-clothes are worn for much longer periods; in some cases people only have one set of underwear, and washing is then very much neglected. Corsets, particularly, are rarely - if ever - washed. Boys' trousers are sometimes worn unwashed, and without pants underneath, until they are worn out.

Specific factors which make it difficult to keep the house and clothing clean include:

C. Miscellaneous

(i) Public conveniences

There is considerable criticism and concern about the state of public lavatories. Railway stations and trains, cinemas and theatres, factories, hostels and schools are all complained of. Many people, children particularly, misuse these places badly, pools of urine being left on the floors, and seats soiled. Working-class mothers are also said often to allow their children to make pools in the passages and waiting-rooms of public buildings.

A considerable body of opinion is said to be anxious about this state of affairs, believing that public lavatory seats are dangerous, and that germs, particularly V.D. germs, can be picked up there. Women who are not normally factory workers, are particularly indignant at the conditions which exist in factories.

There is also complaint of the “increasing tendency by boys and youths to urinate in the streets”. Among very small children this is often encouraged by mothers. In London, however, the custom is thought to be on the decline.

(ii) Drainage

Among country people particularly, there are complaints of lack of proper drainage. In Devonshire it is said that dirty water has to be emptied in the garden.

Badly kept drains are believed to cause fever, particularly diphtheria. Children are consequently warned against playing near to gutter grids.

(iii) Salvage

There are complaints of pests of flies, mice and rats due to the storing of salvage. Local arrangements for the collection of salvage are sometimes on a long term policy; in semi-rural areas the collectors may come only once a month. In some places women are afraid to go out after nightfall because of the rats, and it is felt that there should be a Government service for getting rid of them.

6. BRINGING UP CHILDREN

A. General attitudes of parents

“No two persons seem to agree as to what is the right method”, appears at first to be the only satisfactory summing up of the great variety of parents' attitudes to the bringing up of children, their own and other people's. At the same time, although exceptions must be made, it is possible to classify parents, according to their attitude to bringing up their children, in two main groups:-

Reference is made to another class of parents, who may be “traditionalists”, “spoilers”, or “healthy neglecters”. They are the parents who “look on children, especially boys, as a financial asset and who send them, immediately they reach school leaving age, to augment the family exchequer, without consideration being given to the child's scholastic attainments or physical condition”. This attitude, said to be very prevalent among working-class families, is thought to be “the origin of much of the parents' lack of interest in their children as individual personalities with individual problems”.

B. Food

(i) Infants' food

The prejudice against breast-feeding is diminishing; according to one report, “one rarely meets a mother now who is disinclined to breast-feed her baby; twenty years ago, about 50% refused to do so”. It continues, however, to be out of the question for working women, who are “too often in factories or in some form of employment, which makes it impossible”. There is also some feeling that “the Government policy of Wartime Nurseries has unfortunately discouraged breast-feeding, as children are accepted from the age of one month”.

“There is a widespread and firmly held belief among working-class women that they cannot be got with child again as long as they continue to feed the last baby. In view of this belief, children are sometimes kept at the breast for several years, as a safeguard.”

(ii) Children's food

In working-class homes, there is “often an easy acceptance of the point of view that, ‘once a child is weaned, it is a good idea to give it a little of anything that is going, so that it won't be fussy about food’”. There is said to be “particular ignorance as to the correct feeding of a toddler during the transitional period from milk to adult food”. Cases are mentioned of “a baby being given the juice out of a salmon tin”, and of another baby being given “its nightly supper of beer, the father being proud of his ability to take it”. There is more than one reference to the unsuitable meals given at unsuitable hours, such as “fish and chip suppers late at night”.

School dinners are welcomed, not only for relieving the over-worked mother of providing midday meals, but also for checking the children's inclination to say: “I don't like this, and I won't eat that”. “A case is reported of a mother with four children who made four separate puddings every day to suit their individual tastes.”

The availability of good dinners is quoted as “one of the considerations influencing mothers in favour of their children's attendance at Nursery Schools”.

Sometimes, however, “children complain that school dinners are inadequate. They frequently go on to the chip shop or British Restaurant after a school meal, or run home for something to eat. It is alleged that more often than not the school dinner is ‘a sloppy conglomeration of quondam vegetables. Children not only remain hungry, but crave for something sweet.”

C. Sleep

There is said to be a general vague idea that children should sleep the clock round, or should have from 10 to 14 hours' sleep, according to age. Nevertheless, in spite of this, all reports agree that the majority of children get far too little sleep.

They are said to get:

Less sleep in the lower income groups;

Less in the towns than in the country;

Less in the summer than in winter;

Less in war than in peace.

In towns particularly, it is said to be common for children to be allowed to play in the streets till 11 p.m. in summer, or even later. Some reports give statistics: thus, an investigation conducted in Barnsley among 167 children between the ages of 11 and 14 showed that only two went to bed regularly before 8 p.m.; 48 went between 8.0 and 9.0; 107 between 9.0 and 10.0, and 10 between 10.0 and 11.0. The headmaster of a large elementary school for senior boys of 11 - 14 years, in the Northern Region, issued a questionnaire to the boys: this revealed that of the 13 - 14 age group, “more than 50% go to bed about 11.0 p.m.”.

Teachers are loud in their complaints of children who are tired or irritable in class as a result of late hours. There is said to be “a noticeable difference at school between alertness of children in winter and summer”: in summer there is “greater lethargy” due to “the shorter sleeping time” - though the higher temperature may also have something to do with it.

There are but few references to children being allowed to lie in bed late in the mornings, though they often “tumble out of bed only just in time to get to school or work, often without breakfast and sometimes unwashed”. There is, therefore, no compensating factor to make up for time lost by going to bed late.

Reasons given for children going to bed late are:

(i) Parents' indifference to the amount of sleep their children have : One report speaks of “the prevailing custom of allowing children to choose their own bed time”, and others confirm this. Although the results are the same, this indifference of the parents usually springs from one of two causes.

Some parents merely “pursue their own selfish amusement to the neglect of their duty, and stay out at the pub or pictures till 10.0 or 10.30, and leave their children to play till they return”. Mothers are “seen taking their babies in arms to cinemas, remaining there till after 10.0 p.m., their reason being that otherwise they cannot go to the pictures themselves”.

Other parents have “mistaken ideas of what is good for the young, and allow them to stay late at the pictures, even in blackout time, and take them out even later in the light evenings”. Such parents often prefer to know the children are at the cinema, “where they are safe, than to leave them alone in bed, while they are out having a good time themselves”. More than one report refers to children being taken to the last house at the cinema.

(ii) Parents' inability to get the children to bed early appears to be a considerable factor, and two reports say that there is “some demand for a children's curfew to impose a discipline that parents feel themselves incapable of exacting”. When a child's playground is the street, it is obviously far from easy to control his movements or his “aversion to going to bed before dark”. Some mothers “find it very difficult to get their boys, from 12 - 14, to come in at night: some say they stay out till midnight and that, if the siren goes, they often do not know where their boys are”.

(iii) The light evenings, particularly double summer time : There are many references to the difficulty of making children go to sleep while it is daylight, even when they have been induced to go to bed. To the distractions of the light are added the noises of the street, and particularly of other children at play. Some parents deliberately keep their children up late “in the hope that they will go to bed tired”. While it is common for parents to blame double summer time for their children being up late, it looks as if many of them were glad of an excuse to cover what they were powerless to prevent.

(iv) The conditions of the home : A circumstance which makes children go to bed late (and disturbs their sleep once they are there) is the fact that in many of the poorer homes they share a bedroom, frequently a bed, with an older member or members of the family. There is, too, a tendency for the whole family to go to bed at the same time, often after a late and heavy meal.

It is clear, however, that sharing a room and even a bed with other members of the family has not the disturbing effect that those who are not used to it might suppose. The contrary is often the case. Thus, according to the Scottish report, “comparatively few children have beds to themselves. Baby has its own cot but older children sleep two, three, four and even five in one bed. In fact, they become so used to this that, when in hospital, they find it difficult to settle down.” A school teacher who took a group of unemployed girls to camp found great difficulty in persuading them to sleep by themselves. “Though the bunks were about three feet wide, she continually found in the morning two girls sleeping together. They said they felt cold and ‘weren't used to it’.”

(v) Wartime conditions , apart from double summer time, often mean disturbances in the home routine which interfere with children's sleep.

Thus, “parents who have to be early at the factory probably need to waken their children at 6 a.m. in order to wash, dress and feed them before leaving for work”. A parent or other member of the household on shift work will interfere with the household routine, and disturb the child's sleep. Even conscientious parents, who are out at work all day, with wartime duties added, find that the only chance they have of seeing their children is in the evenings and are reluctant to send them to bed at the hour they know to be best.

It is hardly necessary to mention the disturbance to children's sleep as the result of air raids and the precautions against raids. In addition there is a tendency in some areas to keep children up, “for fear the siren may go”.

D. Washing of children

The nightly washing of babies is discontinued in varying stages. “The working-class mother may decide at any time between three or twelve months after the birth of the baby that ‘baby has been clean long enough’.” Older children receive varying treatment. Up to eight or nine, the children of the better type of working class or lower-salaried middle class are bathed two or three times a week, but the majority receive only a nightly washing and a bath once a week. Many working-class children, like their parents, have only a daily wash of hands, face and neck.

E. Enuresis

No effort has been made in this enquiry to discover the extent of enuresis; as one report points out, “bed-wetting by evacuee children has received so much notice that no attempt will be made to consider in any detail the behaviour of children in this respect”. One point of possible interest has, however, emerged: many parents, accepting enuresis as “part of growing up”, are content to wait until the child “grows out of it” while doing little or nothing to hasten the process. Many working-class mothers “appear content that their children should wet until about three years”. This is particularly so with families at the lowest social and intellectual level. (It is said, however, that when - as is often the case among the poor - a child shares a bed with an adult, bed-wetting may cease at a comparatively early age; this is because the child is able to indicate its needs, and the adult has a vested interest in gratifying them). Some parents, having “made absolutely no attempt to train the child in any way, expect the school teacher to teach them bladder control. When asked why they have taken no active part in this very necessary training, or why they will not co-operate with the teacher, many are reported to adopt an injured tone and to say: ‘what are we paying all your high wages for?’”

Some parents believe that it is “dangerous to encourage self control in urination in a boy child, as weakness or rupture is likely to result” - though girls are believed to be capable of unlimited self-control.

“The attitude of the mother whose child is untrained in bladder control is often one of sympathy for the offspring: ‘Poor little thing; he can't be expected to stop it. I couldn't at his age.’ They do not seem to realise that children can be trained quite early in habits of self-control, and make no attempt to teach their children regular habits, or how to restrain their natural impulses.”

F. Illness

The most noticeable feature of people's attitude is over the question of infectious diseases. Many parents accept them as inevitable and, when one child has whooping-cough or measles, “cheerfully put the infected child among the others, as they believe they all have to have it and want to get it all over at once”. Not only is no attempt made to isolate cases, but many parents think “it is not worth bothering to call the doctor in”.

G. Discipline and punishment

Although the subject is not directly connected with health, reports contained a good deal of comment about the discipline and punishment of children.

It appears that discipline usually means physical punishment rather than “depriving the child of any projected pleasure, such as a visit to the cinema, or of pocket money”. “A good thrashing” is said to be the only kind of punishment that many parents can ever think of: it particularly seems to be the case that, “where the mother is tired, lazy or irresponsible, slap and spoil methods will inevitably ensue”.

There seems to be a feeling that “the modern child is undisciplined”; many consider that the children of to-day “have lost respect for their elders, are more selfish, disobedient, destructive and rude”. This is put down to lack of parental control, and particularly to lack of any consistent method in the early training. “The old adage of ‘sparing the rod’ has, it is thought, been replaced by the belief that too much discipline is bad for children and will make them even more stubborn and headstrong”. There is said to be “a reaction against the view of a generation back that a child should be seen and not heard”. People believe that “children should enjoy themselves - After all, they'll have plenty of troubles when they grow up”.

It is suggested that the majority of parents lost many of their conventions and beliefs in the years during and after the last war, and that this, with the decline in religious practice and training, accounts for “the slackening of control of the younger generation”. “The present period seems to have all the disadvantages and discomforts of a transition period from rigid parental control to more liberal ideas of self-development.” In the meantime, however, “many parents do not quite know what to think”.

H. Leisure and recreation

The cinema now seems to be the chief recreation, at any rate of town children. Parents are said to encourage this taste rather than not, either by taking children to the pictures or by giving them generous pocket money which, now that sweets are rationed, can only be spent at the pictures. More than one report speaks of “the large sums of pocket money given to young children at the present time; children of between 9 - 12 years are regularly given 4/- to 6/- a week and allowed to go to the pictures as long as the money lasts”. In Aberdeen, “the Saturday ld of a generation ago is now a weekly allowance of from 2/- to 5/-”. A recent informal investigation in one of the schools in a Scottish city showed that “all the children - with the exception of those whose parents were Plymouth Brethren - went to the cinema every week, some four or five times”.

In other respects also, children's recreation is said to show a similar “tendency towards passivity”. Thus, “children are very seldom to be seen in school playgrounds indulging in group games - such as the singing games which were so popular some time ago. Rather they hang about doing little or nothing, or indulging in ‘gangster play’.” “Traditional street games are forsaken for the cinema.”

The Boy Scouts and Girl Guides and other such organisations are praised as offering some “antidote to such tendencies”.

7. SUPERSTITIONS AND BELIEFS

In addition to those superstitions and beliefs incorporated in the text under the subjects relating to them - i.e. Sleep, Menstruation, Infants' food, etc., etc., - a considerable number of miscellaneous superstitions were collected. These may be summarised under the following headings, each - unless otherwise stated - being reported from only one Region.

A. Pregnancy and birth

A pregnant woman should not have teeth extracted (Two Regions). “It is held wiser to suffer agonising toothache or neuralgia for months, and many dentists are said to refuse to extract teeth for expectant mothers.” Some believe that “for every tooth a pregnant woman has extracted, the baby as well will go short of one”. “‘For every child a tooth’ is an old and popular saying; each pregnancy is supposed to cause the complete decay of one tooth, as the foetus draws upon this.”

A husband will suffer “sympathetic pains” (toothache, earache, etc.) while the wife is pregnant (Two Regions).

If a pregnant woman lies on the right side, she is more likely to produce a boy.

Tea made from raspberry leaves assures an easy delivery.

A child is born at the same time of day as that at which it was conceived. This is supposed to explain why so many are born at night.

The seventh child of a seventh child will have second sight, and the sixth child, if a daughter, will never bear a child.

It's lucky to be born with a caul.

Working-class women who have had to get up and resume their work a day or two after their confinement sometimes return to bed for the ninth day after the birth when, in some mysterious way, “the organs are believed to slip back into place”.

B. Children

Although, according to one report, “nurses and doctors all agree that former superstitions about the cure of baby ailments and habits are fast dying out”, a great variety are still reported and it appears that “many superstitions still hold sway”.

Eating baked mouse will cure a child of enuresis (Two Regions). One report mentions that “the picking or holding of dandelions is said to cause bed-wetting”. (c.f. the French name for dandelion: “pissenlit”).

A baby with hiccoughs is thriving (Two Regions).

Whooping-cough can be cured by “holding the child over a tar barrel, or near a coke oven, to cause violent vomiting which will release the obstruction” (Two Regions). Another popular belief is that the head should not be washed in cases of whooping-cough. In County Durham some people believe that “a mother can prevent her child getting whooping-cough by brushing her hair over it for the first seven days of its life”. Another belief is that, if whooping-cough is contracted at certain times of the year, the attack lasts 12 months.

“Children's milk teeth should not be touched by the dentist, but should be loosened and pulled out by the parent or the child himself. If the tooth is then put in the child's hand with a spoonful of salt and thrown into the fire, another tooth will come in its place.”

Rickets can be cured by tying a red woollen thread round the child's arm.

Thrush can be cured with a urinated napkin. It is also believed that “a wet nappy straight off the child will, if placed on its face, improve its complexion”.

Inflammation of a baby's eyes can be cured by mother's milk.

Hernia in a child can be cured by “passing the child through a riven tree”. Some people fear that if boy babies are allowed to cry too long or too lustily, they will rupture themselves.

A baby needs “a headshawl, belly band and binders”.

A dummy and gripe water “should be in every pram in case the baby cries”.

Pains in a child's back are always growing pains.

Healthy children breed lice - “the healthier the child, the more robustly it propagates the lice”.

It is unlucky to cut a baby's nails until it is over twelve months old. The mother should bite them. “If you cut a baby's nails he will become a thief.”

To wash the palms of an infant's hands robs the child of its wealth. This superstition is said to be dying out rapidly, but Welfare Officers in Scotland “used to find the little palms inflamed and raw with dirt and fluff”.

It is unlucky to weigh a baby.

Meeting deformed people is supposed to have a bad effect on a baby, according to old women who depress young wives by telling them this.

C. Cures and Preventives

The great variety of cures and preventives mentioned are summarised below.

Rheumatism : Wearing iodine lockets, or carrying a potato in the pocket are regarded by many as cures for rheumatism (Two Regions each). Other less popular cures are: to carry a lump of nutmeg; to wear the G string of a violin round the waist; to be stung by a bee; to take celery or bog beans.

Warts : These can be “charmed away” by incantation by a suitable person (Two Regions). Failing this, warts may be “rubbed with slugs” or with dandelion “milk” (particularly if the sufferer is a child), or licked every morning. A “certain cure”, from Wales, is to rub the wart with a piece of fat bacon and then bury the bacon in the earth. An alternative version is to “steal a piece of beef and bury it secretly: the wart will disappear as the beef rots”.

Styes : Many people believe that a stye may be cured if a gold wedding ring is rubbed nine times over it (Two Regions).

Corns : “An onion on a corn will cure it.” Another cure is to rub spittle on every morning for 14 days, letting it dry on the corn, which will then disappear.

Colds : These can be cured if a worn stocking is tied round the throat, and prevented by wearing beads (of an unspecified kind), or a tarred rope round the neck; also by the smell of a ferret. “Feed a cold and starve a fever” is taken literally, and parents encourage children to eat when they have a cold

Coughs : A mixture of butter, sugar and vinegar is said to be good for a cough.

Chest complaints : These can be cured by wearing “gamgee” - a piece of wool soaked in oil and re-oiled periodically. “It is customary for devotees to clip off one inch each bath night.” Goose grease on the chest is recommended for a chest cold, and a “linseed meal poultice with green oil for lung trouble”. Brown sugar and onion juice will relieve asthma. Blue fannel wrapped round the chest will cure bronchitis.

Sore throat and tonsillitis : A slice of fat bacon may be tied round the neck for a sore throat, or the sufferer may “take an old woollen stocking from the foot, turn it inside out and tie that round his neck”. A cure for quinsy is to wear round the throat “an old-fashioned, cured kipper”.

Skin complaints : Vinegar, lemon or onion are recommended for certain skin diseases. Soot is thought to heal erysipelas.

Bleeding : A cobweb will staunch bleeding.

Consumption : Chopped snails is suggested for this, and also lard. Some believe that “fair persons are prone to tuberculosis, while dark people are immune”.

Ear-ache : “Apply a baked potato in an old stocking”, say some. Others recommend house leek, though without instruction as to its application.

Toothache : Vinegar and pepper on brown paper is the cure for this. The use of tobacco is also mentioned as a cure.

Inflammation of the eye : Apply cold tea-leaves. A black eye is cured if you put a steak on it.

Pains in the wrist : White worsted round the wrist is the cure for this. Some miners are of the opinion that “the wearing of a piece of worsted round the wrist will help the man to grip more strongly”.

Swellings : Boiled comfrey leaves or the grated root of the comfrey are good for reducing swellings. A cold coin on any part of the head which has been hit is said to prevent a lump rising.

Burns : Potato peel relieves a burn.

Wounds : “The use of tobacco” for healing wounds is mentioned. Tobacco smoke is said to kill germs.

Anaemia : Eating raw steak and drinking blood will cure this.

Poor appetite : Wormwood tea will restore it.

Infection : Camphor bag worn next the skin wards off infection.

D. Miscellaneous superstitions

The following beliefs are also reported:

Cutting the hair, and piercing the lobes of the ears , both strengthen the eyes. Hair should be trimmed only at the new moon, in case the ends bleed and cause premature baldness. “An additional superstition is said to be linking deafness, and in one case dumbness also, with hair cutting.” “Long hair saps the strength of adolescent girls.”

Rubber boots and shoes “draw” the feet and cause bad eye-sight.

“Bugs are lucky” . “People leaving houses condemned under a Huddersfield slum clearance scheme are reported to have taken a few bugs with them, boxed up, for release in their new homes.”

8. SUGGESTIONS FOR A HEALTH CAMPAIGN

Members of the public themselves have made a number of suggestions about the need for a campaign to dispel the widespread ignorance on health matters. Any such campaign must, however, bear in mind the material factors which words cannot overcome. It would obviously be futile to suggest to a family of ten, living in a two-roomed house without water laid on, that each child must have his own bedroom, and his own bed, with light warm coverings, and that he should be washed and dressed in clean night-clothes before being put to bed.

A. Material conditions

Most of the material obstacles to health and cleanliness are connected with housing. As one report points out, “the connection between dirt and insanitary habits and bad housing is so obvious as to need no emphasis”. The smallness, age and inconvenience of many houses, though often mentioned, seems to be less of a burden than inadequate water supply. This, though a matter of “particular concern in both rural and urban areas”, often seems to be an almost insurmountable obstacle in towns; here, “the results of the incessant struggle against dirty houses, clothes and bodies, by tired people without the necessary equipment, show themselves in the habitual indifference to dirt of many slum dwellers”. Separate lavatories for each household in slum districts of towns is another “urgent need”.

Other material problems mentioned, besides housing, water and sanitation, are the need for (i) more public laundries for working-class women; (ii) more clinics, nurseries and playgrounds for children and (iii) an extension of school feeding.

Apart from material shortcomings, two powerful factors operating against greater attention to health are:

B. Mental attitudes

There is thought to be a particular need for the following:-

(i) More extensive training in mothercraft and homecraft in schools : “Interest in and desire for help and information about bringing up children exist in some degree among all classes, partly because people want to do their best for their children and partly because it is a sufficiently difficult task for help to be welcomed.” It is thought that there should be a “much greater emphasis in home-making as a school subject for girls” and that its teaching should not be in the hands of “inexperienced young women teachers”, but entrusted to older - and in some cases married - women who have actually brought up a family and managed a house and can speak convincingly from real experience. At present it is thought that girls are taught too little about such things as hygiene, cooking, home budgeting, babycraft, etc., and that teachers concentrate too much on their winning scholarships.

(ii) Instruction about the normal working of the human body : The ordinary person is said to know little about “the construction and functioning of his own inside”, and “the total lack of knowledge of elementary physiology is thought to be one of the most important factors in connection with health education”. Opinion is divided as to whether sex instruction should be given to young people by their parents or in school.

(iii) Instruction about the importance of cleanliness, and the connection between cleanliness and health : It is thought that every effort should be made to stress “positive health” and “the pleasure of physical well-being” with particular emphasis on the value of fresh air. The teaching of swimming is particularly advocated as inducive both to cleanliness and health.

“Hygiene lectures for girl and women factory workers like those given to service women” are suggested; and it is thought that these “might well be extended to the whole of the civilian population”. “These talks should be given as far as possible by women of the same social background as the members of the group in question, and should be empirical as well as informative. Social workers agree that many of the ignorant, when in doubt, take advice more readily from their friends who have experience of a similar matter, than from an informed but impersonal source.” It is thought that wide use should be made of existing women's organisations for educating the public, chiefly by talks to women on subjects related to hygiene.

Women's Institutes, Women's Co-operative Guilds, Townswomen's Guilds, Y.W.C.A., Girls' Clubs and Girl Guides are all suggested.

Special instruction is thought to be needed on menstruation, particularly in view of the widespread belief that washing or bathing are harmful during menstruation. “Some system must be devised whereby the working-class family can buy sanitary towels at a price well within their purse.”

(iv) Training in the recognition and cure of minor ailments , such as “childhood infections, cuts, burns, boils, colds, etc.”: Good results are said to have been achieved already from First Aid Classes since the war.

(v) Instruction about food and diet : War conditions are thought to have made people “more interested in food, food values and the preparation of food”, and the Ministry of Food's advertising is praised as both stimulating and satisfying interest. At the same time there is said still to be much more to be done, particularly in connection with children's food. “Much higher standards of food cleanliness, in transit and delivery, storage provision and cooking, are also urged.”

(vi) Encouragement to use existing services , such as Infant Welfare Centres and Day Nurseries. Some people still seem hardly to know of their existence, and others consider that a certain amount of social stigma attaches to them.

Other suggestions include:-

9. CONCLUSION

From this limited enquiry, it is clear that the ignorance of the public, especially the lower social classes, about health matters is extensive. It must be remembered that an attempt was made to cover only four out of a possible ten or twelve major health subjects. Ignorance on these other subjects is probably equally extensive.

Exactly how extensive this ignorance is can only be determined by the method of social survey.

There would appear to be a very strong case for a large extension of health education. The precise targets to be aimed at, and the best methods of approach to these targets are again matters which can only be determined by social survey.