Our Synthetic Environment
CHAPTER EIGHT: HEALTH AND SOCIETY
Individual and Social Aspects of Health
A new approach is likely to gain easier acceptance if it involves individual rather than social action. The majority of people tend to look for immediate, practical solutions that they can adopt without having to face major social and environmental problems. They search for personal recipes and formulas for physical well-being. This attitude is understandable. Health and illness are intimate problems, involving the ability to survive and enjoy full lives. Health is enjoyed by the individual, not by such abstractions as "man" and "the community." Any discussion of health usually evokes the query: "What can I do right now to remove hazards to my health and assure my physical well-being?"
This question has been answered, to a great extent, by authorities cited in the previous chapters - implicitly if not always directly. Diet should be highly varied. If at all possible, it should be based on foods that receive minimal or no treatment by processors, such as whole-wheat breads, fresh meat, vegetables, and fruit. Weight control is desirable in all stages of life, not only in middle age. Urban man should put his body to frequent use, with an emphasis on mild daily exercise, such as walking, rather than on sporadic sessions of competitive sports. Certainly smoking is utterly incompatible with good health and should be reduced or eliminated.
There is a good deal of evidence to indicate that a high intake of starches, sugars, and polysaturated fats predisposes the individual to coronary heart disease. At any rate, a diet that is ordinarily regarded as suitable for active growing children seems to be very undesirable for adults. (Let us pause to note that as little as fifteen or twenty years ago any plea for a reduction in the intake of eggs and dairy fats would have been furiously denounced by most nutritionists as "cultism" and "food faddism." Nutritionists tend to form ironclad opinions that are difficult to alter without long, often heated controversy, it is not uncommon to find nutritionists who still regard the dietary suggestions of Ancel and Margaret Keys in Eat Well and Stay Well as being a hairbreadth away from "quackery." The study of the human diet and its effects on health would benefit immensely if more investigators were willing to follow less conventional and more independent lines of inquiry.)The food intake of the individual should be carefully scaled to his age, to his work load, and to his activities during leisure hours.
The individual should attempt to cultivate a serene attitude toward the surrounding world, an outlook based not on a psychoanalytic accommodation to the ills of society, but rather on a critical sense of values that places the trivia of daily life in a manageable perspective. To seek an uncritical, brainless state of euphoria is self-debasing. On the other hand, to respond with equal sensitivity to every disquieting aspect of daily life is spiritually paralyzing and physically harmful. In trying to reduce the tensions that an overly urbanized, bitterly competitive society engenders in the individual, there is no substitute for a truly humanistic philosophy that helps us to discriminate between problems that warrant a strong emotional response and those that should be dismissed as inconsequential. To live a life without intense feeling is as dehumanizing as to live one that is filled with ill-defined, persistent agitation.
Health is the result of a lifelong process. It cannot be acquired by a pill or by a "magic" food. Physical wellbeing presupposes a rounded mode of life and a comprehensive diet geared to the needs of the body. Any attempt to prescribe a single "health-giving" recipe that fails to encompass the totality of the individual - his past as well as his present - is irresponsible. Neither "royal jelly" at one extreme nor a "miracle drug' at the other will provide an individual with health if his environment and manner of life are deteriorating. Attempts to resolve health into a single formula may be well-meaning, but they are woefully incomplete.
The need for a comprehensive approach to health is stressed in Iago Galdston's critique of modern medicine and his argument for social medicine. Modern medicine has failed, in Galdston's opinion, not because it has "no cure for cancer, for essential hypertension, or for multiple sclerosis. Were it to achieve these and other cures besides, it still would have failed." Its failure is due to the fact that "modern medicine is almost entirely preoccupied with diseases and with their treatment, and very little, if at all, with health. It is obvious that an individual sick with pneumococcus pneumonia can be effectively treated by chemo-therapeutic agents, or by antibiotics. But such an individual, though cured of his pneumonia, may, and most likely will, remain a sick man unless, in addition, efforts are made to help him regain his health." Galdston advocates more than convalescent care. He proposes a change in medical education, medical outlook, and medical methods. A physician trained according to the principles of social medicine "would not be moved to inquire 'what's he got and what's good for it,' but, confronted by an ailing individual, he would attempt to determine the nature and extent of the disability as it is manifest, not merely in the presenting symptoms, but in the overall performance of the individual according to his position in life; that is, in the light of his age, educational, vocational, social, and other prerogatives and obligations. He would not affirm 'this man has a peptic ulcer,' and undertake to treat the ulcer, but would by the presence of the ulcer recognize that the individual is sick and seek to determine and to correct, or amend, what ails the individual; what, in other words, impedes the individual in the fulfillment of his adventure in living."'
Galdston's remarks constitute a much-needed attempt to widen the contemporary medical outlook. Efforts to expand prevailing notions of illness, treatment, and health beyond the germ theory and the emphasis on specific cures for specific diseases were thwarted at the turn of the century. This defeat culminated in tragedy when Max von Pettenkofer, the great German sanitarian, took his life in 1901 in despair over the rejection of his viewpoint. Pettenkofer had never denied the germ theory of disease, regardless of popularizations of medical history to the contrary. The controversy in his time centered around whether germs alone caused disease or whether environmental conditions and the constitution of the individual should also be considered in the study of individual illness and epidemics. As John Shaw Billings, the great American authority on public health, put it in 1883: "It is important to remember... that the mere introduction of germs into the living organism does not ensure their multiplication, or the production of disease. The condition of the organism itself has much influence on the result... Pasteur has certainly made a hasty generalization in declaring that the only condition which determines an epidemic is the greater or less abundance of germs."
Today, three generations later, the issue is being raised again - and in what appears to be a much broader sense than even Galdston has suggested. Many of the biological problems created by poor sanitation and slums have been resolved, at least in the Western world. We are no longer as deeply concerned with killing epidemics of Icommunicable diseases as were Pasteur, Pettenkofer, and Billings. But we are very much concerned with harmful environmental influences on some of the most intimate aspects of individual life. The necessities of life, even its pleasures, are now being manufactured for the millions.
As a nation of urban dwellers in a mass society, we are becoming increasingly dependent upon the decisions of others for the quality of our food, clothing, and shelter. These decisions affect not only our diet and our private lives; they affect the water we drink and the air we breathe. To speak of an environmental "influence" on health is an understatement; there is a distinct environmental and social dimension to every aspect of human biology. Man today is more domesticated than he has ever been in the long course of his history.
It is here that we encounter the limits of the individual's ability to attain health on his own. The average man finds it extremely difficult to reorganize his mode of life along lines that favor well-being and fitness. If he lives in the city, he cannot possibly avoid exposure to air pollutants. Similarly, there are hardly any rural areas in America where the individual is not exposed to the assortment of pesticides that are currently employed in agriculture. Any serious attempt to limit the diet to pure foods, free of pesticide residues, artificial coloring and flavoring matter, and synthetic preservatives, is well beyond the financial means of the average person. But even if the individual can afford it, he will find that untreated foods are difficult to obtain, for relatively few pure foods are grown in the United States and those that reach urban centers are rarely sold in large retail markets. The layout of the modern city and its routine demands on the urban dweller tend to discourage a physically active way of life. Movement in the large city is organized around the automobile and public means of transportation. Most of our occupations and responsibilities demand mental dexterity, a routine of limited physical work, or rapid communication. It requires a heroic effort to walk instead of ride, to do instead of see, to move instead of sit. Although a few exceptional individuals may succeed in modifying their mode of life in a way that promotes health, the overwhelming majority of urban dwellers can be expected to go along with things as they are.
Does this mean that modern man will never attain optimal health, that it is, in fact, a "mirage"? Rene Dubos has argued rather persuasively that health is a relative concept. Man's criteria of health change with the economic, cultural, and political goals of each social period. "Clearly, health and disease cannot be defined merely in terms of anatomical, physiological, or mental attributes," Dubos writes. "Their real measure is the ability of the individual to function in a manner acceptable to himself and to the group of which he is part... For several centuries the Western world has pretended to find a unifying concept of health in the Greek ideal of a proper balance between body and mind. But in reality this ideal is more and more difficult to convert into practice. Poets, philosophers, and creative scientists are rarely found among Olympic laureates. It is not easy to discover a formula of health broad enough to fit Voltaire and Jack Dempsey, to encompass the requirements of a stevedore, a New York City bus driver, and a contemplative monk."
Perhaps so. But the truth is not exhausted by the limited notions men form of a given event or situation. That which individuals, classes, or communities really believe to be health in a given historical period - all pretensions aside - does not tell us what health could be or what it should be in a broader biological and social perspective. It is one thing to say that historical notions of health have been limited; it is quite another to contend that they will always be limited. Although Dubos may be correct in describing life as a series of ideals for which men can be expected to sacrifice their health and even their lives, there is no reason to believe that health, defined primarily "in terms of anatomical, physiological, or mental attributes," is incompatible with a rational manner of life. On the contrary, a manner of life that promotes health is likely to be more satisfying culturally and socially than one that militates against the attainment of fitness and well-being. Health is nourished by all the environmental and social factors that advance thought, creative effort, and a rounded personality. The social factors that promote health also promote the adventure of life.
On the other hand, the more cloistered the man, the more cloistered the mind. The more one-sided the way of life, however "challenging" or "adventurous" it may seem on the surface, the more limited the range of thought and art. Voltaire was a brilliant writer but a superficial thinker. His life, spent for the most part at the chateau of Cirey and in his '1airs" on the Franco-Swiss border, shows in his work. One is entitled to wonder whether he would have acquired greater depth had he been exposed, like his more profound contemporary, Diderot, to an earthier life in the streets of Paris. Similarly, Olympic laureates seldom become poets and philosophers because their limited notions of "adventure" are focused entirely on physical activity for its own sake. Far from challenging the "Greek ideal of a proper balance between body and mind," the very incompleteness of their lives and thought is evidence of its validity.
Dubos, in effect, tends to equate health with adaptation. The environments to which men are expected to adapt are conceived of as dynamic, emergent phenomena - a rather ambiguous approach that seems to take the environment too much for granted. Unlike other animals, man can consciously remake his environment, within certain limits, and the real issue to be faced is whether it is man or his unsatisfactory environment that should be changed. Viewed from this standpoint, the problem becomes much clearer. One can conceive of many circumstances in which health is not an end in itself and even of circumstances in which the achievement of certain ends is worth the loss of health. By and large, however, a health-promoting environment encourages social and cultural progress. There need be no conflict between health and a truly creative, rational civilization.
On the whole, however, Dubos has performed a notable service in focusing attention on the relationship between human fitness and social development. We cannot conceive of progress in the field of public health without advances in society. Management of the soil has always depended upon the prevailing forms of land tenure. The quality of today's food is partly determined by whether the interests of food manufacturers or the interests of consumers determine technological changes in the industry. The form and direction taken by urban life are guided by the kind of social relations men establish in the management of their affairs. Any attempt to preserve the health of individuals which does not also aim at creating social patterns that will favor the health of mankind as a whole may result in limited improvement but not long-range solutions. The majority of individuals who seek optimal health as soloists in a deteriorating environment have far too much to cope with in attaining their ends.
At the same time, today, more than at any other time in history, every social change has deep-seated biological consequences. Man has developed extremely effective methods for changing the world around him. The results of his activity over the face of the earth are far-reaching. The natural world can no longer successfully oppose dense forests, vast bodies of water, and climatic rigors to his penetration. The developments of modern technology have deprived nature of its old defenses against the invasion of man. But the natural world can strike back in the form of disease, exhaustion of the soil, and desiccation of the land. The importance of caution and the need for exercising reason in changing the world around us can hardly be given too much emphasis. 'What is new is not necessarily good," Dubos observes, "and all changes, even those apparently the most desirable, are always fraught with unpredictable consequences. The scientist must beware of having to admit, like Captain Ahab in Melville's Moby Dick, 'All my means are sane; my motives and objects mad.'"
The Problems of Remedial Legislation
How much progress can we expect from attempts to improve the health of the American public by means of legislation? More, certainly, than we can expect from isolated individual efforts. The United States has by no means exhausted all the possibilities of welfare legislation; it has lagged behind many European nations in fulfilling its responsibilities to the sick and the infirm. Its national health programs consist of ad hoc aid and a patchwork of laboratories and clinics to meet the mounting needs of research and therapy. Food and drug laws have not kept pace with the rapid changes in food technology, and the operations of federal agencies responsible for administering them leave much to be desired. An account of the advances, conflicts, and retreats in the field of food and drug control offers a valuable perspective on what remedial legislation can and cannot be expected to do.
The problems of food and drug control have been surrounded by such a dense fog of official overstatement that almost any criticism of existing laws and agencies invites countercharges of "quackery" and "faddism." Consider the following blurb, made up in part of official statements, which the public is expected to accept as good coin:
'When the American housewife pushes her shopping cart through the supermarket, she can select attractively packaged foods and drinks with the confidence that they are honestly labeled, pure and wholesome. Her confidence is based on the existence of good laws that are vigilantly enforced. Most American food manufacturers today have the will and the know-how to produce the pure foods that she wants. They accept the Food, Drug, and Cosmetic Act as a blueprint of their obligations to the Nation's consumers. The additives that go into food are there to improve the food and bring it to the housewife in better condition and in a more convenient form. Reliable food processors have not reduced the nutritional quality of our foods or created inferior products through the use of chemical additives. Actually, the quality and sanitary characteristics of our food have been improving."
Most of these complacent remarks can be dismissed as rubbish. Without doing any injustice to the facts, the blurb might be rewritten as follows:
"When the American housewife pushes her shopping cart through the supermarket, she encounters many products whose packaging often misleads her concerning the quality, quantity, and nutritive value of their contents. Generally, the enforcement of food-labeling laws and regulations has been handled in a very slovenly fashion by federal and state authorities. Most processed foods are certainly not 'pure,' if by a pure product is meant one that does not contain chemical additives. Food and drug control is far from satisfactory, and it has often been necessary to prod federal agencies into discharging their responsibilities to the consumer. The F.D.A. has shown an unusual susceptibility to influence from the food industry; the agency's performance has been distinguished by its leniency and patience with food manufacturers. More often than not, food processors and drug manufacturers have bitterly opposed improvements in regulatory legislation. Although some of the chemicals that are added to food may possibly improve them, the safety of many food additives is very doubtful. Finally, reliable food manufacturers have definitely reduced the nutritive value of certain common foods, and additives have often served to conceal inferior products."
The first statement attempts to evade the problems of modern food control; the second, to face them. It is almost begging the question to claim that producers of food accept the Food, Drug, and Cosmetic Act as "a blueprint of their obligations to the Nation's consumers" when the law is not as demanding as it should be and those who administer it are satisfied with a second-rate achievement. Nor is the case for the law strengthened by smuggling the housewife's "wants" into the issue. The wants of many consumers are created by high-pressure advertising and salesmanship. The average consumer knows far too little about nutrition to evaluate advertising claims. Food purchases are guided partly by sales technique, partly by the appearance of the food. Thus, the food industry tends to generate the very wants it professes to satisfy, and conventional books and articles on nutrition tend to equate the satisfaction of these industry-created wants with improvements in the quality and purity of our food.
The truth is that federal food and drug legislation has always been a poor, unstable compromise between the interests of the food industry and the demands of an aroused public opinion. More than a quarter of a century separates the first unsuccessful attempts to enact a general anti-adulteration law (1879) and the adoption of the basic Food and Drug Law of 1906. The story behind these and later conflicts in the field of pure-food legislation indicates the amount of effort that has been required to preserve the integrity of our food supply. The needs of industry were consistently given priority over those of the public; during this entire period, Congress was quick to favor special interests. It put an end to the export of adulterated products only when the reputation of American food began to decline on the world market. It enacted legislation against oleomargarine in behalf of domestic dairy interests. On the whole, the public interest was served only indirectly. At the turn of the century, the most flagrant cases of adulteration were the work of small-scale producers, whose adulterated goods placed major producers at a competitive disadvantage. In these cases, both Congress and most of the food manufacturers responded readily to the need for specific anti-adulteration legislation, but the food industry's support for a general food law was, at best, hesitant, and in the halls of Congress support for a pure-food law gathered very slowly.
It is extremely doubtful whether any general food and drug legislation would have been adopted in 1906 were it not for the efforts of Harvey W. Wiley and the unexpected support his efforts received from the publication of Upton Sinclair's The Jungle, a novel which criticized the social and sanitary conditions in the Chicago stockyards. Wiley was a gifted physician and chemist whose pioneering research in sugar, soil, and food analysis brought him to the position of chief of the U. S. Department of Agriculture's Bureau of Chemistry. His prestige as a scientist, his Hoosier wit, and his engaging personality gained him wide professional and public admiration. The task of ensuring a pure food supply for the American consumer became Wiley's life work. His lectures, articles, reports, and congressional testimony mobilized widely disparate groups - from urban civic clubs to farm organizations - behind the demand for a general anti-adulteration law. The food industry at first followed Wiley cautiously, later reluctantly, and finally, with few exceptions, turned against him. In the spring of 1906, when the issue reached its climax in Congress, opposition from the food industry nearly succeeded in preventing the enactment of an effective pure food and drug law. As late as June 1906, after much wrangling in the House of Representatives, Wiley despaired of getting a law. "No serious attempts, so far as I know," he wrote, "have been made to set a date for its consideration."
The publication of The Jungle in book form (January 1906), however, had aroused widespread public indignation against the meat-packing industry. The scales were tipped in favor of the law when President Theodore Roosevelt released part of a report by a federal investigating commission which fully corroborated the details in Sinclair's novel. The national uproar that followed these disclosures threw the industry into retreat, and on June 30, 1906, the first federal Pure Food and Drug Act was signed into law. Its administration was placed largely in the hands of Wiley and his Bureau of Chemistry. Although the law had many shortcomings, some of which were corrected in later years, the high standards of food and drug control which Wiley sought to establish during his tenure in office have never been equaled by his successors. The history of the fight for pure food after Wiley's departure from government service reads like an anticlimax to the vigilance and dedication that marked earlier policies.
These policies were guided by two basic principles. The first was that the consumer should know precisely what he is getting and that he should get precisely what he wants. Wiley bitterly opposed labels or claims that misrepresented a product to the buyer, even if the use of a spurious description was harmless to public health. He stubbornly fought attempts by food manufacturers to describe glucose as "corn syrup" or to represent whiskey made partly of neutral grain spirits as "blended whiskey," a name that generally denoted a blend of several genuine whiskeys. For Wiley, a label had to be complete and truthful. He expected the food manufacturer to disclose all the artificial ingredients added to a product. The name on a package, can, or bottle had to convey the nature of the product without any ambiguity or misrepresentation.
Wiley's second principle was that if any doubt exists about the toxicity of a chemical additive, the doubt should be resolved in favor of the consumer. As it is impossible to prove a negative such as "harmlessness," Wiley argued, it is not permissible to use any questionable additive that is not indispensable to the production, storage, or distribution of food. If an additive contributed nothing to health or to the availability of a food, and if its use might conceivably prove harmful, the Bureau of Chemistry sought to have it removed. Wiley seldom wavered on this score; his decisions almost invariably favored the public interest.
Many people in the food and chemical industries felt differently, however, and their complaints evoked a sympathetic response from the government. By 1912, Wiley's attempts to execute his policies were being frustrated to such an extent that he left government service. With his departure, the law underwent steady reinterpretation. An increasing number of doubts about the toxicity of new chemical additives were resolved in favor of food growers and food processors. The Bureau of Chemistry and its successor in the enforcement of the law, the Food and Drug Administration, began to exhibit undue sensitivity to the financial welfare of industry. The improvement of food was equated with lower costs, attractive packaging, and sales-promotion devices. Wiley had combined the zeal of a crusader with the knowledge of a physician; with his departure, the policies of the federal regulatory agencies were guided increasingly by lawyers and professional administrators who began to give priority to legal considerations instead of problems of public health.
The consumer could ill afford this development. Although an overhaul of the food and drug law was made in 1938, the situation began to deteriorate to an appalling extent. After the end of World War II, the American food supply was deluged with an unprecedented variety of new chemical additives. DDT and other organic insecticides, unknown in 1938, were being used extensively in agriculture and the home. The responsibility for proving that a chemical additive was harmful to the consumer rested with the F.D.A. Food growers and food processors were free to use what they chose until such time as the government could establish that the additives involved were toxic substances. Testing standards in many laboratories were inadequate; experimental work on new additives was often limited to sixty - and ninety-day feeding trials on one or two species of rodents.
In September 1958, Congress changed the law drastically; it made the manufacturer responsible for establishing the safety of a food additive and inserted the Delaney anti-cancer clause, a provision that flatly prohibits the use of additives "found to induce cancer when ingested by man or animal..." Although the anti-cancer clause was strongly supported by the American Cancer Society and by leading cancer specialists, it was opposed by the F.D.A. Testifying in April 1958 before a House committee studying pending revisions of the law, F.D.A. Commissioner George P. Larrick observed: "Two of the bills before you make specific mention of cancer." The F.D.A.-supported bill, H.R. 6747, does "not mention it specifically... This bill bars the use of an additive unless it is established that it is without hazard to health. Thus, the bill would prohibit the addition of any chemical additive to the food supply until adequate evidence, acceptable to competent scientists, shows that it will not produce cancer in man under the conditions of use proposed." Although Larrick endorsed the goal of "seeing that cancer-producing foods are not on the American market," Congressman Delaney reminded the National Health Federation that "in 1956 an FDA ruling permitted, at a certain concentration, residues of a pesticide to remain on marketed fruits and vegetables, even though it had been shown to induce cancer in test animals. Later tests showed this chemical to be even more injurious than the earlier tests demonstrated, and the FDA has now taken action to prohibit any of its residues on raw agricultural commodities."
The credit for finally adding an anti-cancer clause to the 1958 law must be given to Delaney, who saw to its enactment despite strong opposition from the food industry and the F.D.A. By 1960, the F.D.A. had reversed its position and, at the hearings on food colors conducted by the House Committee on Interstate and Foreign Commerce, expressed its fervent support for the Delaney clause. Presumably all is well that ends well, but the F.D.A. refuses to let the clause remain as it is. At the food-color hearings, the Secretary of Health, Education, and Welfare, Arthur S. Flemming, began to nibble at the Delaney clause by suggesting that it "should be modified to provide that additives used in animal feed which leave no residue either in the animal after slaughter or in any food product obtained from the living animal be exempt from the provisions of the clause. A comparable amendment to the anti-cancer clause in the color additive legislation under consideration would be appropriate." Experience with Yellow OB and Yellow AB suggests that such standards of purity are impossible to achieve (see page139).
The sweeping legislative revisions of 1958 were not gained without a sacrifice. For all its shortcomings, the 1938 law had one redeeming feature: It flatly prohibited the use of any toxic chemical additives in food other than those that were clearly indispensable to food production. Although the burden of proof rested with the F.D.A. instead of the manufacturers, the 1938 law set a new functional standard for chemical additives in food. This criterion was dropped in the 1958 revisions of the law, largely on the urging of the food industry and the F.D.A. The burden of proving that the additives are safe has been shifted to the manufacturers, but toxic chemicals can now be added to food provided they are used in amounts that are deemed to be "harmless" to consumers.
Thus, after the passage of a half century, the law makes no attempt to resolve Wiley's original problem: Does an additive contribute to the nutritive value and availability of a food or does it merely function as a dispensable technological aid? Modern refrigeration and canning techniques have eliminated the need for many artificial preservatives in our food supply. Hardly anyone will contend that coloring and flavoring matter are indispensable to food production. If consumers really desired artificial colors and flavors, they could be marketed as independent products and the public could use them at its own discretion. The food industry could modify its production methods so as to operate with a minimum number of chemical additives and with a view toward retaining many nutrients that are now lost because of an overemphasis on mass production and highly processed foods. Many synthetic additives that have no nutritive function could easily be replaced with valuable nutrients. For example, ascorbic acid (vitamin C) is a good antioxidant and an excellent flour bleach, but as it is relatively costly, it would be unprofitable to use it.
The food industry has demanded complete freedom in determining the function of chemical additives in food. The following remarks by the National Association of Frozen Food Packers are fairly typical: 'We join with other segments of the food industry in fundamental opposition to provisions which would permit the Food and Drug Administration to determine the composition of food products upon the basis of its conception of functional value or utility of food ingredients." This seems to be a matter of principle, not a lack of confidence in the F.D.A. After asserting that the chances are "rather remote" that a food processor would engage in costly tests of a toxic additive, the association adds: "In any case, the question of usefulness of an ingredient shown to be safe is one which the manufacturer of a food is entitled to resolve upon the basis of his own experience, and is not properly a matter of the opinion of the Food and Drug Administration."
The F.D.A.'s superficial approach to food and drug legislation has largely been exhausted. The next overhaul of the law must return to the principles that guided Wiley a half century ago. Moreover, we require not only a better food and drug law but comprehensive national legislation that will confront the problems raised by urban and industrial pollution, radioactive contaminants, the misuse of X radiation, and industrial carcinogens. Water pollution can be appreciably reduced if all sizable communities are required to treat their sewage and if an effective national program is developed to reclaim and re-use water to meet industrial needs. The highest-quality water, that which requires a minimum of chemical treatment, should be reserved for drinking purposes. The problem of air pollution should be met resolutely, without qualms about cost and without fear of offending industrialists, motorists, or homeowners. Recently developed catalytic and non-catalytic burners, for example, can remove many harmful agents from automobile exhausts. "Automobile engineers know now that for perhaps $10 per car they can eliminate 50 per cent of the hydrocarbons; for something over $300 they can eliminate them almost totally," observes George A. W. Boehm, of Fortune magazine. "Any city or state that decides to apply air-pollution regulations to cars will have to decide how much the motorist can be made to pay for how much purity, and how far it is prepared to go in enforcing purity regulations."
But let us not deceive ourselves; an environment based on mammoth, expanding cities will never be a healthy one. In the United States, the ecological and nutritional problems created by monoculture and the land factory are likely to grow worse, and many chemical additives will be required in the mass production of our food. Insecticidal residues will undoubtedly continue to pervade our food staples. The substitution of nuclear energy for mineral sources of fuel will be accelerated in the years to come, and more radioactive substances can be expected to enter man's environment. Urban life will undoubtedly become increasingly one-sided as cities expand and occupations become more sedentary. The improvements that our technicians, sanitarians, and city planners have projected for the "world of tomorrow" may meliorate some of these problems, but they are not likely to eliminate them if our society continues to develop in the pattern of the giant metropolis. We can no more expect engineering devices to give us a healthful environment than we can expect the therapeutic agents of modern medicine to create a healthy individual.
Without having read any books or articles on human ecology, millions of Americans have sensed the over-all deterioration of modern urban life. They have turned to the suburbs and "exurbs" as a refuge from the burdens of the metropolitan milieu. From all accounts of suburban life, many of these burdens have followed them into the countryside. Suburbanites have not adapted to the land; they have merely adapted a metropolitan manner of life to semi-rural surroundings. The metropolis remains the axis around which their lives turn. It is the source of their livelihood, their food staples, and, in large part, their tensions. The suburbs have branched away from the city, but they still belong to the metropolitan tree. It would be wise, however, to stop ridiculing the exodus to the suburbs and to try to understand what lies behind this phenomenon. The modern city has reached its limits. Megalopolitan life is breaking down-psychically, economically, and biologically. Millions of people have acknowledged this breakdown by "voting with their feet"; they have picked up their belongings and left. If they have not been able to sever their connections with the metropolis, at least they have tried. As a social symptom, the effort is significant. The reconciliation of man with the natural world is no longer merely desirable; it has become a necessity. It is a compelling need that is sending millions of people into the countryside. The need has created a new interest in camping, handicrafts, and horticulture. In ever-increasing numbers, Americans are acquiring a passionate interest in their national parks and forests, in their rural landscape, and in their small-town agrarian heritage.
Despite its many shortcomings, this trend reflects a basically sound orientation. The average American is making an attempt, however confusedly, to reduce his environment to a human scale. He is trying to recreate a world that he can cope with as an individual, a world that he correctly identifies with the freedom, gentler rhythms, and quietude of rural surroundings. His attempts at gardening, landscaping, carpentry, home maintenance, and other so-called suburban "vices" reflect a need to function within an intelligible, manipulatable, and individually creative sphere of human activity. The suburbanite, like the camper, senses that he is working with basic, abiding things that have slipped from his control in the metropolitan world-shelter, the handiwork that enters into daily life, vegetation, and the land. He is fortunate, to be sure, if these activities do not descend to the level of caricature. Nevertheless, they are important, not only because they reflect basic needs of man but because they also reflect basic needs of the things with which he is working. The human scale is also the natural scale. The soil, the land, the living things on which man depends for his nutriment and recreation are direly in need of individual care.
For one thing, proper maintenance of the soil not only depends upon advances in our knowledge of soil chemistry and soil fertility; it also requires a more personalized approach to agriculture. Thus far, the trend has been the other way; agriculture has become depersonalized and over-industrialized. Modern farming is suffering from gigantism. The average agricultural unit is getting so big that the finer aspects of soil performance and soil needs are being overlooked. If differences in the quality and performance of various kinds of soil are to receive more attention, American farming must be reduced to a more human scale. It will become necessary to bring agriculture within the scope of the individual, so that the farmer and the soil can develop together, each responding as fully as possible to the needs of the other.
The same is true for the management of livestock. Today our food animals are being manipulated like a lifeless industrial resource. Normally, large numbers of animals are collected in the smallest possible area and are allowed only as much movement as is necessary for mere survival. Our meat animals have been placed on a diet composed for the most part of medicated feed high in carbohydrates. Before they are slaughtered, these obese, rapidly matured creatures seldom spend more than six months on the range and six months on farms, where they are kept on concentrated rations and gain about two pounds daily. Our dairy herds are handled like machines; our poultry flocks, like hothouse tomatoes. The need to restore the time-honored intimacy between man and his livestock is just as pronounced as the need to bring agriculture within the horizon of the individual farmer. Although modern technology has enlarged the elements that enter into the agricultural situation, giving each man a wider area of sovereignty and control, machines have not lessened the importance of personal familiarity with the land, its vegetation, and the living things it supports. Unless principles of good land use permit otherwise, a farm should not become smaller or larger than the individual farmer can command. If it is smaller, agriculture will become inefficient; if larger, it will become depersonalized.
With the decline in the quality of urban life, on the one hand, and the growing imbalance in agriculture, on the other, our times are beginning to witness a remarkable confluence of human interests with the needs of the natural world. Men of the nineteenth century assumed a posture of defiance toward the forests, plains, and mountains. Their applause was reserved for the engineer, the technician, the inventor, at times even the robber baron and the railroader, who seemed to offer the promise of a more abundant material life. Today we are filled with a vague nostalgia for the past. To a large degree this nostalgia reflects the insecurity and uncertainty of our times, in contrast with the echoes of a more optimistic and perhaps more tranquil era. But it also reflects a deep sense of loss, a longing for the free, unblemished land that lay before the eyes of the frontiersman and early settler. We are seeking out the mountains they tried to avoid and we are trying to recover fragments of the forests they removed. Our nostalgia springs neither from a greater sensitivity nor from the wilder depths of human instinct. It springs from a growing need to restore the normal, balanced, and manageable rhythms of human life - that is, an environment that meets our requirements as individuals and biological beings.
Modern man can never return to the primitive life he so often idealizes, but the point is that he doesn't have to. The use of farm machinery as such does not conflict with sound agricultural practices; nor are industry and an urbanized community incompatible with a more agrarian, more natural environment. Ironically, advances in technology itself have largely overcome the industrial problems that once justified the huge concentrations of people and facilities in a few urban areas. Automobiles, aircraft, electric power, and electronic devices have eliminated nearly all the problems of transportation, communication, and social isolation that burdened man in past eras. We can now communicate with one another over a distance of thousands of miles in a matter of seconds, and we can travel to the most remote areas of the world in a few hours. The obstacles created by space and time are essentially gone. Similarly, size need no longer be a problem. Technologists have developed remarkable small-scale alternatives to many of the giant facilities that still dominate modern industry. The smoky steel town, for example, is an anachronism. Excellent steel can be made and rolled with installations that occupy about two or three city blocks. (For example, by using Sendzimir's planetary rolling mill, which reduces a 2 1/4 inch - thick steel slab to 1/10 of an inch in a single pass through a set of work rolls.. The conventional continuous strip mill involves the use of scale-breaker stands, about four roughening stands, six finishing stands, long roller tables, and other machines -a huge and costly installation.) Many of the latest machines are highly versatile and compact. They lend themselves to a large variety of manufacturing and finishing operations. Today the more modern plant, with its clean, quiet, versatile, and largely automated facilities, contrasts sharply with the huge, ugly, congested factories inherited from an earlier industrial era.
Thus, almost without realizing it, we have been preparing the material conditions for a new type of human community-one which constitutes neither a complete return to the past nor a suburban accommodation to the present. It is no longer fanciful to think of man's future environment in terms of a decentralized, moderate-sized city that combines industry with agriculture, not only in the same civic entity but in the occupational activities of the same individual. The "urbanized farmer" or the "agrarianized townsman" need not be a contradiction in terms. This way of life was achieved for a time by the Greek polls, by early republican Rome, and by the Renaissance commune. The urban centers that became the wellsprings of Western civilization were not strictly cities, in the modern sense of the term. Rather, they brought agriculture together with urban life, synthesizing both into a rounded human, cultural, and social development.
Whether modern man manages to reach this point or travels only part of the way, some kind of decentralization will be necessary to achieve a lasting equilibrium between society and nature. Urban decentralization underlies any hope of achieving ecological control of pest infestations in agriculture. Only a community well integrated with the resources of the surrounding region can promote agricultural and biological diversity. With careful planning, man could use plants and animals not only as a source of food but also, by pitting one species of life against another, as a means of controlling pests, thus eliminating much of his need for chemical methods. What is equally important, a decentralized community holds the greatest promise for conserving natural resources, particularly as it would promote the use of local sources of energy. Instead of relying primarily on concentrated sources of fuel in distant regions of the continent, the community could make maximum use of its own energy resources, such as wind power, solar energy, and hydroelectric power. These sources of energy, so often overlooked because of an almost exclusive reliance on a national division of labor, would help greatly to conserve the remaining supply of high-grade petroleum and coal. They would almost certainly postpone, if not eliminate, the need for turning to radioactive substances and nuclear reactors as major sources of industrial energy. With more time at his disposal for intensive research, man might learn either to employ solar energy and wind power as the principal sources of energy or to eliminate the hazard of radioactive contamination from nuclear reactors.
It is true, of course, that our life lines would become more complex and, from a technological point of view, less "efficient." There would be many duplications of effort. Instead of being concentrated in two or three areas of the country, steel plants would be spread out, with many communities employing small-scale facilities to meet regional or local needs. But the word "efficiency," like the word "pest," is a relative term. Although a duplication of facilities would be somewhat costly, many local mineral sources that are not used today because they are too widely scattered or too small for the purposes of large-scale production, would become economical for the purposes of a smaller community. Thus, in the long run, a more localized or regional form of industrial activity is likely to promote a more efficient use of resources than our prevailing methods of production.
It is true that we will never entirely eliminate the need for a national and international division of labor in agriculture and industry. The Midwest will always remain the best source of our grains; the East and Far West, the best sources of lumber and certain field crops. Our petroleum, high-grade coal, and certain minerals will still have to be supplied, in large part, by a few regions of the country. But there is no reason why we cannot reduce the burden that our national division of labor currently places on these areas by spreading the agricultural and industrial loads over wider areas of the country. This seems to be the only approach to the task of creating a long-range balance between man and the natural world and of remaking man's synthetic environment in a form that will promote human health and fitness.
An emphasis on agriculture and urban regionalism is somewhat disconcerting to the average city dweller. It conjures up an image of cultural isolation and social stagnation, of a journey backward in history to the agrarian societies of the medieval and ancient worlds. Actually the urban dweller today is more isolated in the big city than his ancestors were in the countryside. The city man in the modern metropolis has reached a degree of anonymity, social atomization, and spiritual isolation that is virtually unprecedented in human history. Today man's alienation from man is almost absolute. His standards of co-operation, mutual aid, simple human hospitality, and decency have suffered an appalling amount of erosion in the urban milieu. Man's civic institutions have become cold, impersonal agencies for the manipulation of his destiny, and his culture has increasingly accommodated itself to the least common denominator of intelligence and taste. He has nothing to lose even by a backward glance; indeed, in this way he is likely to place his present-day world and its limitations in a clearer perspective.
But why should an emphasis on agriculture and urban regionalism be regarded as an attempt to return to the past? Can we not develop our environment more selectively, more subtly, and more rationally than we have thus far, combining the best of the past and present and bringing forth a new synthesis of man and nature nation and region, town and country? Life would indeed cease to be an adventure if we merely elaborated the present by extending urban sprawl and by expanding civic life until it completely escapes from the control of its individual human elements. To continue along these lines would serve not to promote social evolution but rather to "fatten" the social organism to a point where it could no longer move. Our purpose should be to make individual life a more rounded experience, and this we can hope to accomplish at the present stage of our development only by restoring the complexity of man's environment and by reducing the community to a human scale.
Is there any evidence that reason will prevail in the management of our affairs? It is difficult to give a direct answer. Certainly we are beginning to look for qualitative improvements in many aspects of life; we are getting weary and resentful of the shoddiness in our goods and services. We are gaining a new appreciation of the land and its problems, and a greater realization of the social promise offered by a more manageable human community. More and more is being written about our synthetic environment, and the criticism is more pointed than it has been in almost half a century. Perhaps we can still hope, as Mumford did more than two decades ago in the closing lines of The Culture of Cities:
"We have much to unbuild, and much more to build: but the foundations are ready: the machines are set in place and the tools are bright and keen: the architects, the engineers, and the workmen are assembled. None of us may live to see the complete building, and perhaps in the nature of things the building can never be completed: but some of us will see the flag or the fir tree that the workers will plant aloft in ancient ritual when they cap the topmost story."
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