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p There is no doubt whatever that the sense of contentedness wants the elimination of the threats to health. The widespread maxim that happiness is health is regarded by it as the crowning wisdom.

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p At first glance there seems to be no reason for any particular anxiety. The plague has been wiped out long ago, medicines have been developed giving immunity against malaria, in industrialised countries the death rate from scarlet fever has dropped to less than one-hundredth, and the measles death rate is today negligible. Undisputed progress has been made in fighting venereal diseases; modern methods of treatment have diminished people’s fear of pneumonia and bronchitis; and enteric fever and paratyphoid have been conquered. Polio has been struck off the list of killers, and appreciable headway has been made in the fight against dysentery and tuberculosis, which some 50-100 years ago was considered the most fearful disease.

p In short, progress in medicine and health protection is beyond doubt. Nevertheless, even many well-informed medics remain haunted by fears. Against the background of its helplessness or weakness in face of some diseases, medicine’s triumphs are not very convincing. Although the diminished death rate and the longer expectancy of life are important indicators of improved health, they do not mirror the situation as a whole. In some countries the death rate has dropped, but this is not due to any decrease of the incidence of disease. There are diseases, which, to quote doctors, are not as lethal as, say, infectious diseases, but they cause immense suffering. If they do not shorten life (as a matter of fact, they figure indirectly in death rate statistics) these diseases impede the attainment of the desired growth of the expectancy of life, disabling people early and mutilating their lives. Diseases causing prolonged physical and mental weakness undermine people’s health and capacity for work and are causes of poverty and suffering. These diseases may be much more significant than some killer diseases. The British scientist John Stamp writes that hardly anybody dies of caries, catarrh or the common cold, but these diseases collect an abundant tribute from the human species, hindering its happiness and reducing its capacity for work. A much higher tribute is taken by mental and some other diseases of civilisation.

p In the case of some diseases the situation has, as we have already noted, deteriorated with the growth of towns, with congestion, with people’s isolation from nature and 59 with the noxious effects of the waste of industry and transport. Attention is drawn to industrial accidents and to the growth of the number of accidents in everyday life. The spotlight is justifiably directed on the diseases in capitalist society linked with the state of the spirit and on the factors that pathologically affect this state.

p Plague has been eradicated, but drug-addiction is reaching fantastic proportions in capitalist society. There are magnificent clinics, but alcoholism and occupational diseases are spreading. We are on the threshold of defeating tuberculosis, but half of the total number of hospital beds in Britain and the USA, for example, are occupied by people suffering from one form of mental disorder or another (chiefly schizophrenia and maniac-depressive psychosis), while a great number of people suffer from emotional disorders, various chronic neuroses, insomnia and heightened irritability. The myocardial infarction rate has gone up, and many diseases have rejuvenated. In capitalist .society a destructive role is played by people’s lack of interest in their work, by their growing discontent with life as a whole. Countless volumes have been written about loneliness in capitalist society, the harmful effects of social atomism on health, the lack of communication between people, the growing bureaucratisation of more and more aspects of vital activity, and sexual permissiveness. The death rate has dropped, but the number of suicides is rising in capitalist society. While apathy, unbearable boredom, endless fatigue and accumulating irritability resulting from exhausting work, fears and conflicts do not directly lead to disease, they in any case sharply increase the chances that people’s health will be impaired.

p How does the sense of contentedness visualise the way out of this far from bright health situation? It is precisely here, where one must pass from a simple statement of facts to an analysis of their causes, to assessments and forecasts, that the social essence of the sense of contentedness is brought most fully to light. The term “sense of contentedness" characterises not simply a voluntary or involuntary acceptance of alienated bourgeois reality, a way of reconciliation with it (it may, after all, also be purely external or even compulsive), but also satisfaction with that reality.

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p The sense of contentedness quite naturally, therefore, considers that the causes of civilisation’s diseases can be easily separated from civilisation—from bourgeois civilisation, of course. A number of reforms are planned to remove these causes while leaving—and this is the main thing—-capitalism’s social structure untouched. In other words, the conclusion drawn by the sense of contentedness is that under capitalism it is possible to maintain society at the maximum level of health. From this angle medicine and health protection are regarded almost as a universal saviour from all evils and vices. They determine the character of the reforms designed to improve the social and psychological environment, and they find the means of adaptation to that environment, produce tranquillisers, and so forth. Whitesmocked reformers are allegedly able to integrate the individual in capitalist society and create an euphoria—a happy, tranquil and confident life, without irritability and protests, a life in which each person will willingly perform the role prescribed for him and avoid conflicts.

p It is preached that with the aid of the medical technocracy it is even possible to adapt the nervous system to local wars, the nuclear threat, the growing bureaucracy and alienated labour. It is said that the standard of hygiene can be raised by persuading the powers that be that it is in their interest to spend more on hygiene than on military preparations and the apparatus of suppression. Of course, there is a humanistic aspect in the demands for a higher standard of hygiene, as in the above-mentioned demands for the modernisation of towns. But in the approach to these demands, in their isolation from the problems of a fundamental social restructuring of capitalism, as is being done by the champions of medical technocracy, the accent is placed not on humanism but on social demagoguery.

Small wonder that people say it is easier to build castles in the air than to destroy them. The sugared hopes of remaking the world in accordance with the recipes of medical reformers, recipes that are successfully put over to the sense of contentedness and become part of its ideology, are forts preventing the remaking of reality. It is quite apparent that state-monopoly capitalism’s economic and political interests and the administrative acts conforming to these 61 interests took and will continue to take medical recommendations least into consideration. The possibilities for action are limited also in the sphere of hygiene. Although tranquillisers are evidence of scientific advancement they cannot by themselves avert the tragedy of capitalism, develop a taste for life and create an euphoria on the basis of health and happiness. Disharmonious society cannot mould a harmonious, healthy individual.