“If we compare the nature of delinquents, abandoned children, vagabonds, etc., in a country where little or nothing has been done for the people (Russia, Galicia, Vienna, etc.), with that of the same individuals in Switzerland, for example, where much has already been done for the poor, we find this result: In Switzerland, these individuals are nearly all tainted with alcoholism, or pathological heredity; they consist of alcoholics, incorrigibles, and congenital decadents, and education can do little for them because nearly all those who have a better hereditary foundation have been able to earn their living by honest work. In Russia, Galicia, and even in Vienna, we are, on thecontrary, astonished to see how many honest natures there are among the disinherited when they are provided with work and education.”
“If we compare the nature of delinquents, abandoned children, vagabonds, etc., in a country where little or nothing has been done for the people (Russia, Galicia, Vienna, etc.), with that of the same individuals in Switzerland, for example, where much has already been done for the poor, we find this result: In Switzerland, these individuals are nearly all tainted with alcoholism, or pathological heredity; they consist of alcoholics, incorrigibles, and congenital decadents, and education can do little for them because nearly all those who have a better hereditary foundation have been able to earn their living by honest work. In Russia, Galicia, and even in Vienna, we are, on thecontrary, astonished to see how many honest natures there are among the disinherited when they are provided with work and education.”
The Lack of Criteria for Judging Fitness.—Barring the untold hordes of actual defectives who have gravitated into this lower stratum, there are few positive criteria by which we can measure the real fitness of the remainder. Before we can set out on a campaign of positive eugenics we must have some standard by which to steer, and it would be a rash advocate indeed who would assert that class distinction alone, or even success as measured by public opinion to-day should be our whole criterion of fitness. Shall we measure fitness in terms of how successfully one can acquire worldly goods, or in other words, by the property test, or what shall be our standard?
The College Graduate.—Many of our modern critiques of the birth-rate situation make much of the fact that our college graduates as a group are scarcely reproducing themselves. According to Davenport, Bryn Mawr College between 1888 and 1913 has graduated 1,193 bachelors of arts, but these women have produced up to January, 1913, only 263 girls to take their place in the next generation. He also points out that statistics on some of the graduate classes of Harvard of twenty years ago or earlier show that they are little more than maintaining themselves; thus one class of 328 graduates twenty years later had produced 195 sons, and in another case a class of 278 individuals had produced, twenty-five years later, 141 sons. Relatively similar statistics can be cited for other eastern colleges.
All such cases of college graduates cited as especially deplorable declines in birth-rate are based on the assumption that these individuals are a particularly superior stock.[19]But one might question this premise as a generalization. It may or may not be true. Are they superior or have they had mainly a combination of luck and incentive, luck in that their parents had sufficient means, acquired possibly through their own superiority, possibly not, to send them to college, and incentive derived from a fortunate environment which awakened a desire in them—or in their parents for them—for college education? Is the woolly-witted son of opulence, so abundant in our colleges to-day, who is boosted through by hook or by crook, of superior eugenical value to the alert eager boy—and his name is legion—destined for economic reasons to go to work at or before the completion of his high-school course, perhaps because of the very fact of an unlimited fecundity in his own family which necessitates his help for the general support?
When one first learns of the declining birth-rate among college women and men he feels appalled, but immediately the question flashes up, if this isthesuperior stock, and up to date it has died out or is dying out rapidly, whence then this ever augmenting rush of young folk who fairly deluge our universities and colleges to-day? Does it not rather point to the fact that in our own country at least, the man who willand can take a college education successfully is not so much the product of breeding from college men, but of a prosperity which leaves a sufficient surplus in the family exchequer to enable sons and daughters to go to college, and is it not reasonable to suppose that there is yet an abundant stock back of these who similarly await but the golden touch of opportunity? When we consider such men as Carlyle, Lincoln and a host of others who were not the sons of collegians, although we may be university pedigreed ourselves we can not but feel doubtful of the validity of a premise which takes a college stock unqualifiedly as having any considerable monopoly of innate superiority. After all, college can mean little more than opportunity, and the obtaining of such opportunity in this world of economic maladjustments and accidents of social position is too largely a matter of chance, at least in America, to stamp the possessors of these advantages, on this criterion alone, as of inborn superiority. Undoubtedly much that is intrinsically good now slumbers in the lower strata of society because of lack of favorable environment to call forth the latent possibilities.
Native Ability, Independence and Energy Eugenically Desirable.—Although we can not sift out with certainty the superior from the inferior in our normal population by the property test or the educational standard alone, it is undoubtedly true that, on the whole, native ability, independence and energy are present to a higher degree in our well-to-do and prosperous families than in the stocks which merely holdtheir own or which gradually decline, and there is no gainsaying the fact that in so far as the lower classes are where they are through actual deficiency—and there are enormous numbers in this category—they threaten our very existence as a race. It is imperative that the great middle class in particular establish in some way a selective birth-rate, by increased fertility on their own part, and diminished fecundity on the part of inferior stocks, which will offset or more than offset the disproportionate increase of the socially unfit.
Four Children to Each Marriage Required to Maintain a Stock.—It is estimated that under present conditions an average of at least four children should be born to each marriage if a stock is to maintain its numbers undiminished. Some of our most valuable strains are falling far short of this average. In a statistical table on the relative fertility of different stocks, prepared by Pearson, we find the mentally defective, criminal, deaf-mute and degenerate stocks heading the list with averages ranging from five to seven children per family, while the American graduate (based on Harvard statistics) and the English intellectual types average less than two children per marriage. While the death-rate is higher in the undesirable classes mentioned, it is by no means enough higher to compensate for the difference in birth-rates. Thus while certain very desirable types are not maintaining themselves genetically, other extremely undesirable ones are rapidly more than replacing themselves. Investigations made by Heron in London show that this condition as regards English desirables didnot exist sixty years ago; then the richer a community was in professional men and well-to-do families, the higher was the birth-rate.
Factors Contributing to Low Birth-Rate in Desirable Strains.—Most students of the subject believe that the fecundity of much of the best blood in our country has reached such a low ebb as to threaten the whole fabric of our commonwealth. How to correct this is the pressing problem to which no one has found a solution. However much one may deplore it the fact remains that always in the history of the civilized world with the rise of material conditions in any class of a population there has come an accompanying limitation of child-birth. Explain this as we may in modern times—whether as an awakened individualism which looks only to the immediate interest of the individual as against the ultimate interest of the race, or a desire for luxuries or for a better opportunity for smaller numbers of children, or as a determined effort of the wage earner to better his conditions, or to the feminist movement with its accompaniment of a greater personal freedom of married women and the recognition of the fact that marriage and child-bearing are often bars to employment, or to general increasing pressure of economic burdens—in brief whatever the cause or causes, there is no denying the fact of a diminishing birth-rate among our abler men and women. Moreover, no amount of coaxing, cajoling or dire prophecy seems to avail in altering the conditions. Various partial remedies, many of them of questionable practicability, have been proposed, but so far there has been no far-reaching effortmade to put any of them into effect. It has been suggested that society return to the simple life so that our young folk may marry earlier and live more easily on limited means, but so far few volunteers have appeared to lead the procession. While there is no doubt that present economic conditions tend to penalize parenthood, the simple life will not return for the mere asking. It has been pointed out that the father is in unfair competition with the bachelor and is also unfairly taxed in comparison, and some would therefore tax unmarried men more heavily. Others would pay a direct bounty on reproduction, but it is probable that such rewards would merely stimulate families of the lower types to increased fruitfulness. And so one panacea after another may be weighed and found wanting.
The Educated Public Must Be Made to Realize the Situation.—It seems probable that the most success will be met with through the slow and unspectacular methods of education. The necessity of the situation must be driven home so that it becomes part and parcel of the collective intelligence of the educated public. Different ideals of life will have to be established in the young. If knowledge of the facts of heredity is thoroughly disseminated among the people and ideals regarding parenthood are fostered, then much will have been accomplished by the psychic power of suggestion alone toward the end desired.
Utilization of Family Pride as a Basis for Constructive Eugenics.—There are few more powerful incentives to make the best of one’s abilities, or few greater deterrents from vice than family pride; andthere is no reason why this same sentiment may not be aroused in behalf of unborn generations. The sentiment of caste or aristocracy in some form is well nigh universal in mankind. The family of Mr. A came over in the Mayflower and is therefore worlds above the family of Mr. B, who arrived fifty years later. Mr. X’s income is $5,000 a year, Mr. Y’s only $1,500. The poor family in the front suite of the tenement regards itself as far superior to the one in the rear. Among criminals the professional house-breaker feels himself to be of higher caste than the sneak-thief, and in turn is surpassed by the bank-burglar. Even in the insane asylum the feeling is rampant. With such a wide-spread tendency for a foundation the creation of a sentiment of eugenic aristocracy is by no means a visionary undertaking.
The Tendency for Like to Marry Like.—Even now there is a decided though unconscious tendency for like to marry like and thus create particular strains. We have lines, for instance, which produce notably families of scholars, others which yield mainly statesmen, and still other strains of inventors, of financiers, of naval men, of soldiers, and of actors respectively. And there is little doubt that people, with the facts of inheritance of ability once before them, will be led to act more or less in accordance with their knowledge. On the other hand, due apparently to the same unconscious tendency for like to marry like, we find produced criminalistic, feeble-minded, deaf-mute and tubercular stocks. The first type of family is often termedaristogenicand the second or defective type,cacogenic.
Public Opinion as an Incentive to Action.—Much of our social conduct is the result of the pressure of public opinion, yet so accustomed are we to this that we ordinarily do not feel it as a hardship. There is little doubt that similarly the more wholesome attitude toward parenthood advocated by the eugenist would be taken as a matter of course, once the idea became prevalent. It would come to be one of those socially preconceived ideas which are as much actualities and which become unconscious guides to action no less certainly than do the more obvious personal habits of the individual. And just in the degree that we as a race get the “feeling” that intellect, morals and skill are highly desirable attributes in marriage selection, just in that degree will one’s affections in their earlier stages gravitate toward individuals who possess such qualities in high degree. In the main, those stocks which have shown by ancestral as well as personal achievement their superiority will tend to insure most certainly a continuation of this superiority in offspring.
Choosing a Marriage Mate Means Choosing a Parent.—Although marriages, as all young folks know, are made in Heaven, it is interesting to see what a vast number of these foreordained matches coincide with propinquity in college, in church, or in the same social set. Moreover, children are born here on earth. The one thing of all things that the eugenist desires is for these young folk to get a clear-eyed vision of the fact that in choosing a marriage mate they are also choosing the future father or mother of their children with all that this implies.
The Best Eugenic Marriage Also a Love Match.—A few recent writers, who show an utter misconception of what the aim of modern eugenics is, have raised the cry of give us the old-fashioned love match instead of the eugenic marriage, as if the eugenist’s ideal of moral cleanliness, freedom from transmissible physical taints or mental enfeeblement, and an attitude of special approval toward marriages which bring together individuals of more than average mental or spiritual endowment, had anything in it that was inimical to love. No one better than he realizes the sordid depths to which marital relations devoid of mutual affection and regard must reach. Certainly there is nothing in the eugenic ideal when its full import is understood that can shock the sensibilities of the most delicate-minded. Indeed it is people of fine susceptibilities who will be the first to feel repugnance toward a marriage which means mental or physical deterioration of their own blood.
Good Traits No Less Than Bad Ones Inherited.—An inspection of such charts as those shown in Figs. 37, 38 and 39,pp. 313,314,316—and an abundance of such encouraging records may now be found—reassures us in our convictions that good traits are no less inheritable than bad ones. And what any healthy, mentally well-endowed person may be depriving the world of if he or she declines to enter into a fruitful marriage can not be better exemplified than in the following excerpt from Davenport:
“Many a man at the opening of his life work vows, as Judge John Lowell of the middle of the eighteenth century did, as he was being graduated from HarvardCollege, that he will never marry. But nature was too strong for John Lowell and he married three times, and among his descendants was the director of a great astronomical observatory, the president of Harvard College, a principal founder and promoter of the Massachusetts General Hospital and the Boston Atheneum; the founder of the city of Lowell and its cotton mills; the founder of the Lowell Institute at Boston; the beloved General Charles Russell Lowell and his brother, James, both of whom fell in the Civil War, and James Russell Lowell, poet, professor and ambassador; besides brilliant lawyers and men entrusted with large interests as executors of estates. Do you think John Lowell would have taken that vow could he have foreseen the future?”
“Many a man at the opening of his life work vows, as Judge John Lowell of the middle of the eighteenth century did, as he was being graduated from HarvardCollege, that he will never marry. But nature was too strong for John Lowell and he married three times, and among his descendants was the director of a great astronomical observatory, the president of Harvard College, a principal founder and promoter of the Massachusetts General Hospital and the Boston Atheneum; the founder of the city of Lowell and its cotton mills; the founder of the Lowell Institute at Boston; the beloved General Charles Russell Lowell and his brother, James, both of whom fell in the Civil War, and James Russell Lowell, poet, professor and ambassador; besides brilliant lawyers and men entrusted with large interests as executors of estates. Do you think John Lowell would have taken that vow could he have foreseen the future?”
Fig. 37
Pedigree of family with artistic (dark upper section), literary (dark right section) and musical (dark left section) ability (from Davenport).
The Elimination of the Grossly Unfit Urgent.—But even if, under present conditions of partial knowledge and lack of an adequate standard, the constructive phase of eugenics must be left in the main to the awakening conscience of the individual as humanity improves in general enlightenment, the second phase,the elimination of the grossly unfit is one of the greatest social obligations that confronts us to-day. For if there is an alarming amount of mental impairment in civilized nations, and if the problems of pauperism, inebriety, prostitution and criminality are closely interwoven with the problems of mental unsoundness, as we have every reason to believe from available data, then any means which will operate toward securing normally functioning brains will at the same time operate toward diminishing, defects and delinquencies. And inasmuch as a considerable proportion of defects, both mental and physical, are inheritable, it is obvious that if we can diminish the number of children born into the world with defective brains or bodies we have made a long stride in the right direction.
Fig. 38
Inheritance of ability (from Kellicott after Whetham).
Suggested Remedies.—But how go about it? Various schemes have been proposed, of which the chief are as follows:
1. Laws restricting marriage.2. Systems of mating with the purpose of covering up and gradually diluting out defective traits.3. Segregation during the reproductive period.4. Sterilization.5. Education in the principles of eugenics.
1. Laws restricting marriage.
2. Systems of mating with the purpose of covering up and gradually diluting out defective traits.
3. Segregation during the reproductive period.
4. Sterilization.
5. Education in the principles of eugenics.
Inefficacy of Laws Which Forbid Marriage of Mental Defectives.—The utter inefficacy of the first proposition, namely the enactment of laws restricting marriage, at least as regards the socially unfit whose condition is based on impaired mentality, has been demonstrated time and again. If they are forbidden marriage, they merely have children without getting married. Most states have laws to prevent the marriage of such individuals but these laws are almost wholly ineffective in preventing procreation on their part. We might as well recognize once for all that in such cases nothing short of close custodial care or sterilization will accomplish the end desired.
As to the second proposition, systems of mating with the purpose of covering up and gradually diluting out defective traits, this has been shown to be possible with certain types of defectives. Whether it is desirable or not is a different question.
Fig. 39
Inheritance of ability (chart condensed and incomplete) in three markedly able families (from Kellicott after Whetham):
1, Charles Darwin; 2, his cousin, Francis Galton, founder of the modern eugenic movement.
Systems of Mating Impracticable in the Main.—By systems of mating, it should be said, is not meant the arbitrary marrying of two individuals willy-nilly, but rather it is the prevention from marriage of two individuals having similar defects. In general the facts at our command indicate that in the majority of cases the offspring from a marriage of an insane, feeble-minded or epileptic person with a normal individual free from all neuropathic taints are normal or at most show but slight effects of the taint. But what normal individual would knowingly marry into such a stock? With few exceptions such traits where inheritable are apparently negative, that is, not represented by some positive abnormal factor but due to the lack of some element or elements necessary to the proper working of the normal brain. In the offspring of such a union the necessary missing factors are supplied by thenormal parent. Or in Mendelian phraseology, the defective traits are recessive and are dominated by the normality of the other parent. Such offspring, however, while apparently normal of body are not normal of germ-plasm, inasmuch as half of their germ-cells will carry the abnormality of the defective parent as earlier explained (page 119) under Mendelism. We have already seen (page 119) how by continually marrying into strong strains the liability to recessive defect can be diluted out until the descendants are no more likely to have defective children than are members of our ordinary population. If, however, as is estimated in Bulletin No. 5 of theEugenics Record Office, about thirty per cent. of our general population already carry recessive neuropathic taints, it certainly is a hazardous proceeding to attempt thus to breed out nervous defects unless one is absolutely sure of the normality of the strain into which it is proposed to marry. The great difficulty is in determining whether or not there is a defective ancestry in a given stock. We have at present no criteria for identifying normal individuals who have defective germ-plasm. As a practical test, however, if no defect has appeared in the stock for three or four generations back, the marriage would be relatively as safe as are the marriages of our average population to-day.
Corrective Mating Presupposes Knowledge of Eugenics.—But such a scheme of corrective mating presupposes a relatively high degree of intelligence and judgment on the part of the participants, and this is just what we do not have and in the natureof things can not get, in the types of feeble-minded, epileptic and degenerate strains we are striving to eliminate. All our evidence shows that when unrestricted there is a marked tendency for feeble-minded to mate with feeble-minded, degenerate with degenerate. About sixteen per cent. of the feeble-minded, in fact, come from consanguineous marriages. If we try to legislate them into specific types of marriage then we encounter the same futility pointed out under our discussion of restrictive legislation, they will produce offspring without the formality of marriage.
In certain cases of insanity and in other than neuropathic defects one can see how the system might be inaugurated with greater prospects of success, but even then a knowledge of the principles of eugenics would be necessary to the participants, or in other words we could only accomplish our end through our fifth proposition, education.
Segregation Has Many Advocates.—As to the third proposition, segregation during the reproductive period, this seems to have a larger number of advocates than any other coercive measure. While on theoretical grounds it is plausible enough, when we face the actual putting of the method into practise we are confronted by the fact that tremendous sums of money would be required to sequestrate and maintain colonies or industrial refuges.
When one realizes that no state now provides for more than a small minority of its defectives, and knowing also of the pressure that must be brought to bear on legislatures to secure sufficient funds to provide for these cases of extremest urgency, one can notbe overly optimistic about the practicability of extensive sequestration.
E. R. Johnstone, the superintendent of a large training school for feeble-minded in New Jersey, points out that no state in the Union is providing for many more than one-tenth of her feeble-minded and epileptics. If his estimate is true, to place in institutions, treat and train all its feeble-minded and epileptics would even now almost swamp any state treasury. But whatwillit be in the future if we permit this unrestricted nine-tenths to go on and multiply their kind?
Leaving out of account the enormous sums spent in private charities even now from one-fifth to one-seventh the total public expenditures of almost any one of our states is going to maintain its defectives, dependents and criminals. From the 1912 report of the secretary of state, in the state of Wisconsin, for instance, I learn that of the total expenses for 1912, sixteen per cent. was for charitable and penal institutions. The situation is even worse in some other states. Think of it! Think what a large total of expense it becomes! And the expense is far secondary from the humanitarian standpoint to the misery involved.
In theSurveyof May 24, 1913, we find Mr. Hastings H. Hart, Director of the Department of Child Helping of the Russell Sage Foundation, proposing very specifically “a working program for the extinction of the defective delinquent,” which involves segregation during the reproductive period. He gives the number of feeble-minded under public care as 20,000 in institutions for the feeble-minded, 16,000 in almshouses, 5,000 in hospitals for the insane, and 26,000 in prisonsand reformatories, or a total of 67,000 already under custodial care. And he asserts that as nearly as can be judged, this is one-third of the feeble-minded persons in the United States.
Between this estimate that one-third of our feeble-minded are in institutions and Doctor Johnstone’s that we are not providing for many more than one-tenth of our feeble-minded and epileptic, there is a wide discrepancy, but I know of no accurate data[20]whereby the matter can be settled definitely. One point of difference may be that Doctor Johnstone specifically includes epileptics and another may be one of definition of feeble-minded. However, supposing that we could get them all into institutions, institutional care at present by no means also implies prevention of propagation. It is not an unusual history of feeble-minded women in our county poor-houses that they alternate between periods of housework in some family and periods of residence in the almshouse, the return to the latter being only too often to bear an additional child.
Not a few students of the problem, however, advocate a rigid segregation as the only reasonable preventive measure, no matter what the expense. They point out that the cost is mounting up higher each year and that we are only increasing it ultimately by procrastination. They urge, moreover, that when countingthe cost of the segregation of the feeble-minded we should bear in mind also that we are reducing the expenses of our other charity and penal institutions, since much of degeneracy, pauperism and petty criminality centers in mental enfeeblement. Some believe that colonies can be established which are in considerable measure self-supporting. Doctor Johnstone, for instance, although his estimates of the number of feeble-minded and epileptic is one of the highest, sketches out in a recent paper (inPediatrics, August, 1912) a plan which he considers feasible.
But what assurance have we that we can prevent the production of defectives by segregation? In reply may be cited a recent experiment on an extensive scale. Cretinism is a condition due to disease of the thyroid glands. It is characterized by goiter, marked deformities and imbecility. It is hereditary and has been very prevalent in certain valleys of southern Switzerland and northern Italy. Cretin mated with cretin and consequently a large new supply was constantly produced. In recent years in certain communities the sexes have been segregated (seeEugenic Review, 1910, Jordan) with the result that in such places cretinism has about disappeared.
Coming now to the fourth solution proposed, namely, sterilization,[21]let us consider some of its alleged advantages and disadvantages.
Sterilization.—First of all, since there is some considerable popular misunderstanding on the subject, it should be made plain that by sterilization is not necessarily, nor in fact generally, meant asexualization, or the removal of the reproductive glands. On the contrary, in the male, sterilization is ordinarily accomplished by an operation known asvasectomy, in which a small piece of each sperm duct is removed. Such reports on it as I have found indicate that it is a comparatively simple minor operation which involves no special inconvenience or hardship on the subject beyond the deprivation of offspring. In fact, according to Doctor Sharp’s report, in the majority of cases where it has been put into practise the patient has usually submitted voluntarily after having the details of the situation explained to him and has often advised fellow delinquents to do likewise.
Even should later developments show that a mistake had been made, in all probability the matter could be remedied by a second operation in which the cut ends of the ducts can be reunited. This has been accomplished experimentally in dogs, and furthermore, in men rendered sterile by occlusion of the duct through inflammatory diseases, the sterility has been remedied by removing the blocked area and reuniting the ends of the duct on either side.
In women the corresponding operation—a section of the oviduct—is termedsalpingectomy. Here, however, the operation is a more serious one as it usually involves opening the abdominal cavity and the accompanying hazard of infection, a danger sufficiently greatthat it is safe to say that the operation will be resorted to more rarely than vasectomy in man.
As a Eugenic Measure.—Sterilization as a eugenic measure has many advocates and perhaps more opponents; and among the latter, it must be said, are many competent and thoughtful students of the subject who recognize existing conditions and deplore their continuance as much as any one. They maintain that while we may have to come to it as a last resort, we are yet too ignorant of the actual effects of the operation, or are too little informed on the inheritability of the specific traits we are trying to eradicate, to launch forth on so radical a program. We must not forget that when we put sterilization into effect we are going to have to deal with individual cases, not general averages.
To What Conditions Applicable.—And just here, it seems to me, is the crux of the situation. When confronted by the defective individual, in a practical case, just what criteria are we going to use to determine whether this particular individual should be sterilized or not? Nearly all of the twelve states which have sterilization laws specify insanity, feeble-mindedness, epilepsy and criminality.
In Insanity.—When it comes to insanity I strongly suspect that those who have the selection of the examining board will have difficulty in finding an alienist who is willing to take the responsibility of deciding on just which insane individuals shall be operated on and which not. For among the insane there are so many kinds and degrees of mental unsoundness,and these are of such varying and as yet unknown eugenical significance, that a positive decision is frequently out of the question. Of the twenty-seven or more recognized forms of insanity who knows with any considerable degree of certainty which are heritable, which not? Shall we treat all manic-depressives alike? Shall we treat them as, for instance, we would those suffering from dementia precox? Who will take the responsibility of answering positively? Again, what shall we do in cases of paresis, or general paralysis of the insane, an affliction which probably invariably has syphilis as its antecedent? Yet it constitutes one of the commonest forms of insanity found in asylums. Doctor George H. Kirby, director of Clinical Psychiatry, Manhattan State Hospital, says that with one exception there are more admissions of paretics to Manhattan State Hospital than sufferers from any other form of mental disorder. He continues, “We find that when either the father or the mother suffers from paresis that many other members of the family may be infected with syphilis, and furthermore, we find that a surprisingly large number of children in these families are feeble-minded, nervous, or in other ways abnormal.” But here, it is clear, the patient has done the damage before he reached the hospital, nor was it paresis as such that did the harm but the syphilitic infection of which paresis itself was but the outcome.
Certainly the one fact which stands out conspicuously when we face most concrete cases, is that at present we need more urgently than sterilization laws for the insane, exhaustive studies of the inheritabilityof specific mental infirmities that we may know with some degree of certainty which warrant sterilization.
Yet on the other hand one of the most disquieting facts that confronts us to-day is the large number of patients who are on parole from our hospitals for the insane, subject to recall. What shall we do with them? Shall we submit them to the tremendous hardship of still remaining under custodial care although to all intents and purposes sane, or shall we make their release contingent upon their submission to vasectomy or salpingectomy?
In a few cases such as Huntington’s chorea (Figs. 26, 27,pp. 114,115) we can proceed with a fair degree of assurance, for we know that this dreadful malady is transmitted as a positive trait and that in all probability half of the children of an afflicted individual will inherit the defect. Such patients, if they ever rally sufficiently temporarily to leave the hospital, or where encountered outside the hospital should certainly be restrained from procreation. It is questionable if even their children, though apparently normal, should be allowed to have offspring, for usually the disorder does not manifest itself until middle life and then it is too late to try to prevent its transmission since the affected individual has already probably married and had children. But Huntington’s chorea is a comparatively rare form of insanity, and one of only a few about which our knowledge as regards its transmissibility is fairly satisfactory.
In Feeble-Mindedness.—When we come to institutions for the feeble-minded, however, there seems to be much more unanimity of opinion among physiciansin charge of such institutions that sterilization would be an effective and satisfactory disposition to make of many cases, if we are to release the patients in question from custody. Unquestionably in cases of imbecility it is easier than in insanities to pass conclusive judgment on the inheritability of the condition in a large class of cases. Practically all are agreed that either permanent custodial care through the reproductive period or sterilization should be enforced. Some maintain that such individuals should remain permanently in institutions anyway and that therefore to sterilize them is needless, while others urge that if sterilized many capable of making their own living could be freed and allowed to do so.
According to Goddard the feeble-minded woman is about three times as likely to find a mate as a feeble-minded man, hence it would seem to be of much greater importance to sterilize the woman than the man.
Again it might be urged with much justification, that even though sterilized, the feeble-minded individual because of lack of self-control will transgress sexually and will thus certainly become a menace to society in the spread of venereal diseases. If Mr. Hart’s estimate is anywhere near correct, that there are 60,000 feeble-minded women in the United States of child-bearing age, and that 13,000 are already in custody, then the task of getting all women of this class into custody is not so insurmountable as would at first appear.
In Cases of Epilepsy.—As to epilepsy, I find a very decided difference of opinion among physicians.Some consider it, on account of its apparently strong inheritability, together with the shocking crimes perpetrated by epileptic criminal types, one of the most serious menaces, while others point out that we know nothing of the real cause of epilepsy, that there are all degrees and shades, that it is probably referable to different causes in different cases and that no one is able to say what the offspring of any given epileptic will be.
As to criminal types, here again we face the difficulty of deciding any particular case. Let us suppose that twenty-five per cent. of criminals are mental defectives, how shall we sift them out from the seventy-five per cent. who are supposed to be eugenically normal? Doubtless in many of the twenty-five per cent. class, the indications of defective mentality are sufficiently evident to prevent mistakes, but a considerable number of uncertain status must also remain near the border-line.
Sterilization Laws.—Although twelve of our states already have sterilization laws, only two, Indiana and California, seem to have made any active attempt to enforce them. The situation is too new yet in Wisconsin, Michigan and Pennsylvania for these states to have shown what they intend to do. Although the Indiana law says, “it shall be compulsory for each and every institution” to maintain the practise, it has fallen into disuse since 1911, presumably because the governor believed the law unconstitutional. It is of interest to see the motive underlying the law in various states. In the majority it is purely eugenic. In Connecticut it is mainly eugenic though partlytherapeutic. In California it is apparently in part therapeutic, since it is stated as being for the physical, mental or moral benefit of inmates of various state institutions, and in part punitive and eugenic, since individuals twice committed for sexual offenses or three times for other crimes are subject to the operation.
In Washington and Nevada the object is purely punitive, the persons specified being habitual criminals and persons adjudged guilty of carnal abuse of female persons under ten years of age, or of rape. In these states also the court orders the operation instead of leaving it to the decision of a board of medical experts.
Social Dangers in Vasectomy.—It has been urged against vasectomy that it will work untold harm because it relieves of the responsibility of a probable parentage. This argument does not appeal to one as very weighty as far as the imbecile or other degenerate is concerned, because one of the very traits characteristic of such individuals is lack of any sense of responsibility. By this same token, however, we have a very good argument for sequestration as against sterilization, for the degenerate, even though sterilized, will not be restrained sexually and will be likely to disseminate venereal diseases or commit rape. Furthermore, there will be the temptation to sterilize and liberate certain types that would otherwise have been kept permanently in custody.
Our Present Knowledge Insufficient.—When all is said and done, after we take into account the meagerness of our present knowledge on the subject, it is not to be wondered at that many thoughtfulstudents of a conservative turn of mind, feel that any considerable practise of sterilization is premature. The problem has so many phases, and despite occasional bits of positive knowledge, we are yet in such a sea of ignorance regarding it, that in no field is the good Friar Laurence’s admonition of “wisely and slow; they stumble that run fast,” needed more at present than it is here.
There is little doubt that in theory the feeble-minded and similar defectives should be sent to institutions and kept there, but the important practical question is, can this be done? We can have no final answer until it is tried. While the initial expense would undoubtedly be great, if we could keep our defectives from propagation for a single generation we could very materially lessen their numbers and in succeeding generations the expenses of their care would rapidly diminish.
The one crying need that stands out most prominently in this whole field is that of careful investigation of individual cases and specific types of malady, together with an accurate census of conditions as a whole. Our knowledge of individual malign heredities is too meager to carry us very far at present. When we have found after adequate investigation in just which specific types of defects heredity is an important factor—and we shall undoubtedly find it to be one in many cases—then we can proceed confidently with sterilization, if it will prove to be more practical and desirable than sequestration.
Sterilization Laws on Trial.—It will be of great interest and instruction to see how extensively, in thevarious states which have recently passed sterilization laws, the experts selected will find it expedient to carry on sterilization, and what criteria they will use in deciding on individual cases. That sterilization can be put into effect is indisputable, as may be seen from the fact that several hundred operations have been performed in Indiana. If the board on whom the decision depends happens to be one which feels that many people are likely to distress themselves unduly over the border-line cases, and overlook the fact that there is always a goodly residue with which to proceed without great risk of mistake, then we may expect to see a vigorous campaign inaugurated, and those of us who are still undecided in the matter will have an opportunity of learning more certainly the merits or the failings of the scheme.
Certain married degenerate types would seem to be the ones most urgently demanding attention. Having already begotten several defective children and with nothing else in prospect but the production of the same kind, it is difficult to see from any standpoint why a vasectomy on the male would not be a merciful act. There are not a few such families where the father is periodically in the hands of the law and yet not in permanent restraint. Once in custody his release could be made contingent on vasectomy.
An Educated Public Sentiment the Most Valuable Eugenic Agent.—Coming now to the last proposition, education of the public in the principles of eugenics, this is the method calculated to be of more far-reaching service than any other, in the negative as wellas in the positive phases of eugenics. Education is necessary before we can have effective restrictive measures for the mentally incompetent established and enforced, and it is also a prerequisite to intelligent procedure on the part of normal individuals in considering their own fitness for marriage.
Of greatest importance in preventing undesirable marriages, as far as people of normal intelligence is concerned, will be the sentiment of disapproval which will arise on the part of society itself when it becomes really convinced that certain marriages are inimical to social welfare. Public opinion is, in fact, one of the most potent influences in marital affairs, simply because refusal to abide by the dictates of the community means social ostracism.
That social disapproval of certain unions can become a very real factor in preventing such marriage is evinced on all sides by the numerous barriers to marriage already in existence based on race, religious sect or social status. Even in our much vaunted democracies one is looked down on who marries “beneath” his or her social set. This sentiment of taboo, so readily and often so senselessly cultivated in our present human society, will inevitably spring up in consequence of a wide-spread knowledge of the facts of human heredity. It is to such a growth, to the establishment of a disapproval which is the product of its own sentiments rather than to legislative enactments, that society must look for the greatest furtherance of the eugenic program.
Necessary as legal restraint is in certain cases, itmust obviously be restricted to only the most glaring defects. Moreover, legislation can not run far in advance of public opinion.
The Question of Personal Liberty.—It must be admitted that there is a reluctance on the part of many even thoughtful individuals to the application of methods which savor in any way of restraint. An objection not infrequently urged by such persons against the application of certain eugenic principles is that they demand an unwarranted curtailment of personal liberty.
To those who hoist the flag of personal liberty, it may fairly be asked, how much personal liberty does the syphilitic accord his doomed and suffering wife and children, or how much personal liberty is the portion of the offspring of feeble-minded parents? Or, what quota of personal liberty will accrue to the ill-fated descendants of the epileptic, the habitual drunkard or criminal, the gross moral pervert, the congenially deaf and dumb, or to even the progeny which may result from the union of two well-established tubercular strains?
We do not hesitate to send the pick of our stalwart healthy manhood to war to be slaughtered by the thousands and tens of thousands when an affront is offered to an abstraction which we term our national honor, and, sublimely unconscious of the irony of it all, we throw ourselves into a well-nigh hysterical frenzy of protest when it is proposed to stop the breeding of defectives by infringing to a certain extent on their personal liberties.
Society has already found it necessary to suppresscertain individuals and yet we hear little complaint about loss of personal liberty in such cases. But if it is necessary to restrain the man who would steal a purse or a horse, is it not still more urgent to restrain one who would poison the blood of a whole family or even of an entire stock for generations? Surely there can be but one answer; society owes it to itself as a matter of self-preservation to enforce the restraint of persons infected with certain types of disease and of individuals possessing highly undesirable inheritable traits, so that perpetuation of such defects is impossible.
Education of Women in Eugenics Needed.—One of the most crying needs of the present is the awakening and educating of women to the significance of the known facts. For they are perhaps the greatest sufferers, and once informed, as a mere matter of safety if for no other reason, they will see the necessity of demanding a clean bill of health on the part of their prospective mates. Furthermore in the last analysis woman is the decisive factor in race betterment, for it is she who says the final yea or nay which decides marriage and thus determines in large measure the qualities which will be possessed by her children. Above all, young women must come to realize that the fast or dissipated young man, no matter how interestingly or romantically he may be depicted by the writer of fiction, is in reality unsound physically, and is an actual and serious danger to his future wife and children.
Much Yet to Be Done.—But plain as is our duty regarding the application of facts already known, whenwe consider that the student of heredity has made only a beginning, it is equally evident that he must be urged on in his quest for new facts, and the establishment of new principles. There is imperative need to carry on proper experiments with plants and animals, to collect necessary data regarding man, and for what is scarcely less important, the publication of the facts already acquired so that the public may be guided aright.
Just at present it is of the utmost importance to secure more trustworthy statistics in order that we may intelligently go about instituting suitable restrictive measures for undesirable human strains. We must know the exact number and kinds of feeble-minded, epileptic and insane in our population, and we must have more insight into the personal status and pedigrees of our delinquents and criminals. For purposes of rational procedure such information is indispensable. Much can be done by hospitals, “homes” and penal institutions by determining and recording more accurately all obtainable facts regarding the ancestry of their charges. Moreover, in such states as Wisconsin, where the state hospitals for the insane have each an “after-care-agent,” the duties of such officers might well include the collection of more adequate data regarding the hereditary aspects of their patient’s condition. And lastly, if in every census, whether state or national, it were made an important part of the work to secure accurate vital statistics, particularly as they pertain to human heredity, the contribution toward enabling us ultimately to purgethe blood of our nation of certain forms of suffering, degeneracy and crime would be inestimably great.
A Working Program.—And now after reviewing at some length various aspects of man’s hereditary and congenital endowment, the important question arises as to whether it is possible, with the knowledge at present available, to go ahead with a practical program which will insure to the child of the future its right of rights, that ofbeing well-born. When one considers the matter it is evident that much can be done at once. Most of the needs set forth in the preceding paragraph can clearly be met in a fair degree by instituting the procedures indicated.
One of the obvious duties in a restrictive way that confronts us right at the start is the care and control of the feeble-minded and of the defective delinquent in such a way as to prevent procreation. Much help can be given also through intelligent agitation for the establishment of colonies for epileptics and the higher grades of feeble-minded which can be made in considerable measure self-supporting. A given colony must, of course, be for one sex alone. Much can be done, furthermore, by putting into operation, both in and out of institutions, effective systems of registering births and deaths together with accompanying facts which may prove of eugenical significance.
Again, we should more surely identify and exclude undesirable immigrants and also undertake thoroughgoing investigations to determine which races we can not profitably assimilate into our own blood.
Physicians should pay more attention to the hereditaryand congenital aspects of their cases and make it more a matter of conscience than they do at present to advise patients with regard to marriage. Prenuptial medical inspection should become the custom, if not by law at least as a voluntary procedure. Every parent must come to realize the grave risk to which he is subjecting his daughter if a guarantee of physical fitness, even more than assurance of financial standing or social position, is not forthcoming from her prospective mate.
Wholly apart from the field of heredity though in a realm intimately concerned with the birthright of the child, much practical good can be accomplished by pondering the facts and the fictions of prenatal influence and in the light of the knowledge thus gained, seeing that while foolish and unnecessary worries are abolished, the conditions of health, nutrition and occupation surrounding the expectant mother are the best obtainable. It is the sacred duty of every individual, moreover, to see that the maximal possibilities of his own germ-plasm are not lowered by vicious or unwholesome living.
As individuals we can cultivate a greater sense of responsibility regarding marriage and parenthood in those for whose training we are responsible. We can study this whole subject conscientiously, keep pace with new knowledge and see that other people are likewise informed. In showing an enlightened interest in the ideals of eugenics and a sympathetic approval of wholesome marriages, a sentiment toward parenthood will gradually arise which will make it seem more desirable to many worthy people than it does atpresent. If we are of good stock ourselves we should recognize that it is highly desirable that we give to the race at least four children. On the other hand, if we come from a strain which is eugenically undesirable we should with equal conscientiousness refrain from contributing to human misery. For where serious obstacles to a union exist, renunciation is certainly a higher manifestation of love than is consummation of a marriage which will result in untold misery to the object of the affections. As a matter of fact, with adequate preliminary knowledge as to what actually constitutes a serious drawback to marriage, where such really exists and is recognized by the associated individuals, love of the kind that leads to marriage is not likely to arise.
As has been suggested by various students of eugenics, it is even at present perhaps not infeasible for earnest individuals to start in a quiet way local centers for the keeping and filing of accurate records of their family traits for the future use of their descendants. Such groups, voluntary though they be, would soon acquire a degree of distinction that would make other people of good endowments wish to join in and go on record as eugenically desirable.
Lastly, it should not be forgotten that good traits are inherited as certainly as bad ones. Moreover, in the realm of human conduct, even though the fundamental features of behavior are based on an inherited organization, man is not always driven by an inexorable linkage of inherited neutral units into only one line of conduct, since more or less capacity for alternative action is also inherited. It is the personal dutyof every member of society to aid in affording the opportunity and providing the proper stimuli to insure that out of the many possibilities of behavior which exist in the young at birth, those forms are realized which are best worth while to the individual and to society. And while we recognize that improved environment alone can not correct human deficiencies we must nevertheless not relax our efforts to get cleaner foods, cleaner surroundings, cleaner politics and cleaner hearts.
Why go on alleviating various kinds of misery that might equally well be prevented? When one squarely faces the issue, surely the absurdity of our present practises can not but be evident to even the most thoughtless.
Which Shall It Be?—As a matter of social evolution, human homes originated in the necessity of an abiding place for the nurture and training of the young past their first period of helplessness. Well in the foreground of the mental picture which arises when we hear the very wordhome, are children. What shall the home of the future be with regard to its most important assets, the children? Shall we as a people continue to be confronted at every turn by the dull countenance of the imbecile, the inevitable product of a bad parental mating; or the feeble body and the clouded intellect of the child sprung from a parentage of polluted blood; or the furtive cunning of the born criminal, the will-less mind of the bred degenerate, or the shiftless spawn of the pauper? Or shall it be a type with laughing face, with bounding muscles, withunclouded brain, overflowing with health and happiness—in short,the well-born child?
The answer is in our own hands. The fate of many future generations is ours to determine and we are false to our trusteeship if we evade the responsibility clearly laid before us. How conscientiously we heed known facts, how actively we acquaint ourselves with new facts, and how effectively we execute the obvious duties demanded by these facts, will give us the answer.
THE END
GLOSSARY
Acquired Characters, traits developed in the body through changes in environment or function, in contra-distinction to those which have their specific causes in the germ-cells.
Adaptation(L.ad, to;aptus, fit), fitness to environment.
Albinism(L.albus, white), a condition of deficiency in pigment.
Allelomorph(Gr.allelon, of one another;morphē, form), one of a pair of alternate Mendelian characters.
Ameba(Gr.amoibē, change), a primitive single-celled animal.
Amphibian(Gr.amphi, both;bios, life), capable of living both on land and in water.
Anthropoid(Gr.anthropos, man;eidos, form), man-like.
Aristogenic(Gr.aristos, best;genesis, origin), pertaining to the genetically most desirable human strains.
Association Areas, those regions of the brain in which presumably the higher mental processes are effected.
Atavism(L.ad, before;avus, grandfather), a return in one or more characters to an ancestral type. Seep. 8for restricted modern usage.
Atrophy(Gr.a, negative;trophē, nourishment), a wasting away of a part of a living organism.
Axon(Gr.axon, axis), the process from a nerve cell which becomes a nerve fiber.
Binet-Simon Scale, a series of tests graded to age and previous training of the average normal child, much used in measuring mental deficiency.
Biology(Gr.bios, life;logos, discourse), the study of life and of living things.
Biometry(Gr.bios, life;metron, measure), the study of biological problems by means of statistical methods.
Blastomere(Gr.blastos, germ;meros, part), one of the early cells formed by the division of the ovum.
Blastophthoria(Gr.blastos, germ;phtheiro, destroy), deterioration of the germ as the result of direct pathogenic or other disturbing agents.
Blending Inheritance, inheritance in which the characters of the parents seem to blend in the offspring.
Cacogenic(Gr.kakos, bad;genesis, origin), pertaining to genetically undesirable human strains.
Cell, the fundamental unit of structure in plants and animals.
Centrosome(Gr.kentron, center;soma, body), a small body which functions in indirect cell-division.
Character, any distinguishing feature, trait or property of an organism.
Chemotropism(chemical and tropism), defined,p. 198.
Chromatin(Gr.chroma, color), deeply staining substance of the cell-nucleus.
Chromosomes(Gr.chroma, color;soma, body), characteristic deeply staining bodies, typically constant in number and appearance in each species of animal or plant, which appear in the cell during indirect division.
Chromotropism(Gr.chroma, color;tropē, turning), defined,p. 198.
Cleavage, the division of the egg-cell into many cells.
Congenital(L.con, together;gigno, bear), present at birth.
Conjugation(L.con, together;jugum, yolk), the union of germ-cells or unicellular individuals for reproduction.
Constructive(or positive)Eugenics, a system of securing a superior race through propagation of the fittest individuals.
Cortex(L.cortex, bark), the outer or investing layer of the brain.
Cytoplasm(Gr.kytos, cell;plasso, form), the protoplasm of the cell outside of the nucleus.
Daltonism, the commonest form of color-blindness in which the affected individual is unable to discriminate between red and green.
Dendrites(Gr.dendron, tree), branching processes which spring from nerve-cells.
Determiner(L.determinare, to determine), the distinctive cause or unit in a germ-cell which determines the development of a particular character in the individual derived from that cell. The termsgeneandfactorare sometimes used as synonyms of determiner.
Dihybrids(L.di, two;hybrida, mongrel), the offspring of parents differing in two characters.
Diploid(Gr.diploos, double;eidos, form), the dual or somatic number of chromosomes.
Dominant Character(L.dominare, to be a master), a character from one parent which manifests itself in offspring to the exclusion of a contrasted character from the other parent.
Drosophila, a genus of fruit-flies of which there are several species.
Duplex(L.duo, two;plico, fold), the condition in which a character is represented by two determiners, one from each parent.
Electrotropism(Gr.electron, amber;tropē, turning), defined,p. 198.
Embryo(Gr.embryon), the young organism in its earliest stages of development.
Embryogeny(Gr.embryon;genesis, generation), the development of the embryo.
Eugenics(Gr.eugenes, well-born), the science relating to improvement of the human race through good breeding.
Factor, the determiner of a particular hereditary character.
Feeble-Mindedness, deficiency in mental development. For grades, seep. 244.
Fertilization, union of the sexual cells.
Fetus(L.feuere, to bring forth), the unborn young animal in its later (after the second month in man) stages of development.
Flagellum(L.flagellum, little whip), a vibratile, thread-like organ of locomotion.
Gamete(Gr.gamos, marriage), a mature germ-cell.
Genetics(Gr.genesis, origin), the science which deals with heredity and the origin of individuals in general.
Genotype(Gr.genea, race;typto, strike), the germinal constitution of an organism.
Geotropism(Gr.ge, earth;tropē, turning), defined,p. 198.
Germ-Cell, a reproductive cell.
Germinal Variations, variations which owe their origin to some modification in the germ-cells.
Germ-Plasm, the material basis of inheritance.
Gonad(Gr.gonos, generation), a germ-gland.
Haploid(Gr.haploos, single;eidos, form), the single or reduced number of chromosomes as found, for instance, in the mature germ-cells.
Heliotropism(Gr.helios, sun;tropē, turning), defined,p. 198.
Heredity(L.heres, heir), resemblance of individuals to their progenitors based on community of origin.
Heritage(L.heres, heir), all that is inherited by an individual.
Heterozygote(Gr.heteros, other;zygon, yolk), an individual produced through the union of germ-cells which are unlike in one or more determiners. Adjective,heterozygous.
Homozygote(Gr.homos, same;zygon, yolk), an individual produced through the union of germ-cells which are alike in determiners. Adjective,homozygous.
Hybrid(L.hybrida, mongrel), the offspring of parents which differ in one or more characters.
Identical Twins, twins which show identical inborn characters, both having come presumably from the same ovum.
Idiot(Gr.idios, peculiar, private), defined,p. 244.
Imbecile(L.imbecillis, weak), defined,p. 244.
Inheritance(L.in, in;heres, heir), the sum of all characters which are transmitted by the germ-cells from generation to generation.
Inhibitor(L.in, in;habeo, hold, have), that which checks or restrains.
Instinct(L.in, in;stingno, prick), defined,p. 203.
Intra-uterine(L.intra, within;uterus, the womb), within the womb.
Irritability(L.irrito, excite), the property of responding to stimuli.
Linin(L.linum, flax), filaments of the cell-nucleus not readily stained by dyes.
Luetin Test(L.lues, pest), a test for syphilis; seep. 188.