Social Hygiene

The Aim of Social Hygiene—Social Reform—The Rise of Social Reform out of English Industrialism—The Four Stages of Social Reform—(1) The Stage of Sanitation—(2) Factory Legislation—(3) The Extension of the Scope of Education—(4) Puericulture—The Scientific Evolution corresponding to these Stages—Social Reform only Touched the Conditions of Life—Yet Social Reform Remains highly Necessary—The Question of Infantile Mortality and the Quality of the Race—The Better Organization of Life Involved by Social Hygiene—Its Insistence on the Quality rather than on the Conditions of Life—The Control of Reproduction—The Fall of the Birth-rate in Relation to the Quality of the Population—The Rejuvenation of a Society—The Influence of Culture and Refinement on a Race—Eugenics—The Regeneration of the Race—The Problem of Feeble-Mindedness—The Methods of Eugenics—Some of the Problems which Face us.

Social Hygiene, as it will be here understood, may be said to be a development, and even a transformation, of what was formerly known as Social Reform. In that transformation it has undergone two fundamental changes. In the first place, it is no longer merely an attempt to deal with the conditions under which life is lived, seeking to treat bad conditions as they occur, without going to their source, but it aims at prevention. It ceases to be simply a reforming of forms, and approaches in a comprehensive manner not only the conditions of life, but life itself. In the second place, its method is no longer haphazard, but organized and systematic, being based on a growing knowledge of those biological sciences which were scarcely in their infancy when the era of social reform began. Thus social hygiene is at once more radical and more scientific than the old conception of social reform. It is the inevitable method by which at a certain stage civilization is compelled to continue its own course, and to preserve, perhaps to elevate, the race.

The era of social reform followed on the rise of modern industrialism, and, no doubt largely on this account, although an international movement, it first became definite and self-conscious in England. There were perhaps other reasons why it should have been in the first place specially prominent in England. When at the end of the seventeenth century, Muralt, a highly intelligent Swiss gentleman, visited England, and wrote his by no means unsympathetic Lettres sur les Anglais, he was struck by a curious contradiction in the English character. They are a good-natured people, he observed, very rich, so well-nourished that sometimes they die of obesity, and they detest cruelty so much that by royal proclamation it is ordained that the fish and the ducks of the ponds should be duly and properly fed. Yet he found that this good-natured, rich, cruelty-hating nation systematically allowed the prisoners [3]in their gaols to die of starvation. "The great cruelty of the English," Muralt remarks, "lies in permitting evil rather than in doing it." [1] The root of the apparent contradiction lay clearly in a somewhat excessive independence and devotion to liberty. We give a man full liberty, they seem to have said, to work, to become rich, to grow fat. But if he will not work, let him starve. In that point of view there were involved certain fallacies, which became clearer during the course of social evolution.

It was obvious, indeed, that such an attitude, while highly favourable to individual vigour and independence, and not incompatible with fairly healthy social life under the conditions which prevailed at the time, became disastrous in the era of industrialism. The conditions of industrial life tore up the individual from the roots by which he normally received strength, and crowded the workers together in masses, thus generating a confusion which no individual activity could grapple with. So it was that the very spirit which, under the earlier conditions, made for good now made for evil. To stand by and applaud the efforts of the individual who was perhaps slowly sinking deeper and deeper into a miry slough of degradation began to seem an even diabolical attitude. The maxim of laissez-faire, which had once stood for the whole unfettered action of natural activities in life, began to be viewed with horror and contempt. It was realized that there must be an intelligent superintendence of social conditions, humane regulation, systematic organization. The very intensity of the evils which the English spirit produced led to [4]a reaction by which that spirit, while doubtless remaining the same at heart, took on a different form, and manifested its energy in a new direction.

The modern industrial era, replacing domestic industry by collective work carried out by "hands" in factories, began in the eighteenth century. The era of social reform was delayed until the second quarter of the nineteenth century. It has proceeded by four successively progressive stages, each stage supplementing, rather than supplanting, the stage that preceded it. In 1842 Sir Edwin Chadwick wrote an official Report on the Sanitary Condition of the Labouring Population of Great Britain, in which was clearly presented for the first time a vivid, comprehensive, and authoritative picture of the incredibly filthy conditions under which the English labouring classes lived. The times were ripe for this Report. It attracted public attention, and exerted an important influence. Its appearance marks the first stage of social reform, which was mainly a sanitary effort to clear away the gross filth from our cities, to look after the cleansing, lighting, and policing of the streets, to create a drainage system, to improve dwellings, and in these ways to combat disease and to lower the very high death-rate.

At an early stage, however, it began to be seen that this process of sanitation, necessary as it had become, was far too crude and elementary to achieve the ends sought. It was not enough to improve the streets, or even to regulate the building of dwellings. It was [5]clearly necessary to regulate also the conditions of work of the people who lived in those streets and dwellings. Thus it was that the scheme of factory legislation was initiated. Rules were made as to the hours of labour, more especially as regards women and children, for whom, moreover, certain specially dangerous or unhealthy occupations were forbidden, and an increasingly large number of avocations were brought under Government inspection. This second stage of social reform encountered a much more strenuous opposition than the first stage. The regulation of the order and cleanliness of the streets was obviously necessary, and it had indeed been more or less enforced even in medieval times; [2] but the regulation of the conditions of work in the interests of the worker was a more novel proceeding, and it appeared to clash both with the interests of the employers and the ancient principles of English freedom and independence, behind which the employers consequently [6]sheltered themselves. The early attempts to legislate on these lines were thus fruitless. It was not until a distinguished aristocratic philanthropist of great influence, the seventh Earl of Shaftesbury, took up the question, that factory legislation began to be accepted. It continues to develop even to-day, ever enlarging the sphere of its action, and now meeting with no opposition. But, in England, at all events, its acceptance marks a memorable stage in the growth of the national spirit. It was no longer easy and natural for the Englishmen to look on at suffering without interference. It began to be recognized that it was perfectly legitimate, and even necessary, to put a curb on the freedom and independence which involved suffering to others.

But as the era of factory legislation became established, a further advance was seen to be necessary. Factory legislation had forbidden the child to work. But the duty of the community towards the child, the citizen of the future, was evidently by no means covered by this purely negative step. The child must be prepared to take his future part in life, in the first place by education. The nationalization of education in England dates from 1870. But during the subsequent half century "education" has come to mean much more than mere instruction; it now covers a certain amount of provision for meals when necessary, the enforcement of cleanliness, the care of defective conditions, inborn or acquired, with special treatment for mentally defective children, an ever-increasing [7]amount of medical inspection and supervision, while it is beginning to include arrangements for placing the child in work suited to his capacities when he leaves school.

During the past ten years the movement of social reform has entered a fourth stage. The care of the child during his school-days was seen to be insufficient; it began too late, when probably the child's fate for life was already decided. It was necessary to push the process further back, to birth and even to the stage before birth, by directing social care to the infant, and by taking thought of the mother. This consideration has led to a whole series of highly important and fruitful measures which are only beginning to develop, although they have already proved very beneficial. The immediate notification to the authorities of a child's birth, and the institution of Health Visitors to ascertain what is being done for the infant's well-being, and to aid the mother with advice, have certainly been a large factor in the recent reduction in the infantile death-rate in England. [3]

The care of the infant has indeed now become a new applied science, the science of puericulture. Professor [8]Budin of Paris may fairly be regarded as the founder of puericulture by the establishment in Paris, in 1892, of Infant Consultations, to which mothers were encouraged to bring their babies to be weighed and examined, any necessary advice being given regarding the care of the baby. The mothers are persuaded to suckle their infants if possible, and if their own health permits. For the cases in which suckling is undesirable or impossible, Budin established Milk Depôts, where pure milk is supplied at a low price or freely. Infant Consultations and Milk Depôts are now becoming common everywhere. A little later than Budin, another distinguished French physician, Pinard, carried puericulture a step further back, but a very important step, by initiating a movement for the care of the pregnant woman. Pinard and his pupils have shown by a number of detailed investigations that the children born to working mothers who rest during the last three months of pregnancy, are to a marked extent larger and finer than the children of those mothers who enjoy no such period of rest, even though the mothers themselves may be equally robust and healthy in both cases. Moreover, it is found that premature birth, one of the commonest accidents of modern life, tends to be prevented by such rest. The children of mothers who rest enjoy on the average three weeks longer development in the womb than the children of the mothers who do not rest, and this prolonged ante-natal development cannot fail to be a benefit for the whole of the [9]child's subsequent life. The movement started by Pinard, though strictly a continuation of the great movement for the improvement of the conditions of life, takes us as far back as we are able to go on these lines, and has in it the promise of an immense benefit to human efficiency.

In connection with the movement of puericulture initiated by Budin and Pinard must be mentioned the institution of Schools for Mothers, for it is closely associated with the aims of puericulture. The School for Mothers arose in Belgium, a little later than the activities of Budin and Pinard commenced. About 1900 a young Socialist doctor of Ghent, Dr. Miele, started the first school of this kind, with girls of from twelve to sixteen years of age as students and assistants. The School eventually included as many as twelve different services, among these being dispensaries for mothers, a mothers' friendly society, milk depôts both for babies and nursing mothers, health talks to mothers with demonstrations, courses on puericulture (including anatomy, physiology, preparation of foods, weighing, etc.) to girls between fourteen and eighteen, who afterwards become eligible for appointment as paid assistants. [4] In 1907 Schools for Mothers were introduced into England, at first under the auspices of Dr. Sykes, Medical Officer of Health for St. Pancras, London. Such Schools are now spreading everywhere. In the end they will probably be considered necessary centres for any national system of puericulture. Every girl at the end of her school life [10]should be expected to pass through a certain course of training at a School for Mothers. It would be the technical school for the working-class mother, while such a course would be invaluable for any girl, whatever her social class, even if she is never called to be a mother herself or to have the care of children.

The great movement of social reform during the nineteenth century, we thus see, has moved in four stages, each of which has reinforced rather than replaced that which went before: (1) the effort to cleanse the gross filth of cities and to remedy obvious disorder by systematic attention to scavenging, drainage, the supply of water and of artificial light, as well as by improved policing; (2) the great system of factory legislation for regulating the conditions of work, and to some extent restraining the work of women and of children; (3) the introduction of national systems of education, and the gradual extension of the idea of education to cover far more than mere instruction; and (4), most fundamental of all and last to appear, the effort to guard the child before the school age, even at birth, even before birth, by bestowing due care on the future mother. [5]

[11]It may be pointed out that this movement of practical social reform has been accompanied, stimulated, and guided by a corresponding movement in the sciences which in their application are indispensable to the progress of civilized social reform. There has been a process of mutual action and reaction between science and practice. The social movement has stimulated the development of abstract science, and the new progress in science has enabled further advances to be made in social practice. The era of expansion in sanitation was the era of development in chemistry and physics, which alone enabled a sound system of sanitation to be developed. The fight against disease would have been impossible but for bacteriology. The new care for human life, and for the protection of its source, is associated with fresh developments of biological science. Sociological observations and speculation, including economics, are intimately connected with the efforts of social reform to attain a broad, sound, and truly democratic basis. [6]

[12]When we survey this movement as a whole, we have to recognize that it is exclusively concerned with the improvement of the conditions of life. It makes no attempt to influence either the quantity or the quality of life. [7] It may sometimes have been carried out with the assumption that to improve the conditions of life is, in some way or other, to improve the quality of life itself. But it accepted the stream of life as it found it, and while working to cleanse the banks of the stream it made no attempt to purify the stream itself.

[13]It must, however, be remembered that the arguments which, especially nowadays, are brought against the social reform of the condition of life, will not bear serious examination. It is said, for instance, or at all events implied, that we need bestow very little care on the conditions of life because such care can have no permanently beneficial effect on the race, since acquired characters, for the most part, are not transmitted to descendants. But to assume that social reform is unnecessary because it is not inherited is altogether absurd. The people who make this assumption would certainly not argue that it is useless for them to satisfy their own hunger and thirst, because their children will not thereby be safeguarded from experiencing hunger and thirst. Yet the needs which the movement of organized social reform seeks to satisfy are precisely on a level with, and indeed to some extent identical with, the needs of hunger and thirst. The impulse and the duty which move every civilized community to elaborate and gratify its own social needs to the utmost are altogether independent of the race, and would not cease to exist even in a community vowed to celibacy or the most absolute Neo-Malthusianism. Nor, again, must it be said that social reform destroys the beneficial results of natural selection.

Here, indeed, we encounter a disputed point, and it may be admitted that the precise data for absolute demonstration in one direction or the other cannot yet be found. Whenever human beings breed in reckless and unrestrained profusion—as is the case under some conditions before a free and self-conscious civilization is attained—there is an immense infantile mortality. It is claimed, on the one hand, that this is beneficial, [14]and need not be interfered with. The weak are killed off, it is said, and the strong survive; there is a process of natural survival of the fittest. That is true. But it is equally true, as has also been clearly seen on the other hand, that though the relatively strongest survive, their relative strength has been impaired by the very influences which have proved altogether fatal to their weaker brethren. There is an immense infantile mortality in Russia. Yet, notwithstanding any resulting "survival of the fittest," Russia is far more ravaged by disease than Norway, where infantile mortality is low. "A high infantile mortality," as George Carpenter, a great authority on the diseases of childhood, remarks, "denotes a far higher infantile deterioration rate"; or, as another doctor puts it, "the dead baby is next of kin to the diseased baby," The protection of the weak, so frequently condemned by some Neo-Darwinians, is thus in reality, as Goldscheid terms it, "the protection of the strong from degeneration."

There is, however, more to be said. Not only must an undue struggle with unfavourable conditions enfeeble the strong as well as kill the feeble; it also imposes an intolerable burden upon these enfeebled survivors. The process of destruction is not sudden, it is gradual. It is a long-drawn-out process. It involves the multiplication of the diseased, the maimed, the feeble-minded, of paupers and lunatics and criminals. Even natural selection thus includes the need for protecting the feeble, and so renders urgent the task of social reform, while the more thoroughly this task is carried out with the [15]growth of civilization, the more stupendous and overwhelming the task becomes.

It is thus that civilization, at a certain point in its course, renders inevitable the appearance of that wider and deeper organization of life which in the present volume we are concerned with under the name of Social Hygiene. That movement is far from being an abrupt or revolutionary manifestation in the ordinary progress of social growth. As we have seen, social reform during the past eighty years may be said to have proceeded in four successive stages, each of which has involved a nearer approach to the sources of life. The fourth stage, which in its beginnings dates only from the last years of the nineteenth century, takes us to the period before birth, and is concerned with the care of the child in the mother's womb. The next stage cannot fail to take us to the very source of life itself, lifting us beyond the task of purifying the conditions, and laying on us the further task of regulating the quantity and raising the quality of life at its very source. The duty of purifying, ordering, and consolidating the banks of the stream must still remain. [8] But when we are able to control the stream at its source we are able to some extent to prevent the contamination of that stream by filth, and ensure that its muddy floods shall not sweep away the results of our laborious work on the banks. Our sense of social responsibility is developing into a sense of racial responsibility, and that development is expressed in the nature of the tasks of Social Hygiene which now lie before us.

[16]It is the control of the reproduction of the race which renders possible the new conception of Social Hygiene. We have seen that the gradual process of social reform during the first three quarters of the nineteenth century, by successive stages of movement towards the sources of life, finally reached the moment of conception. The first result of reform at this point was that procreation became a deliberate act. Up till then the method of propagating the race was the same as that which savages have carried on during thousands of years, the chief difference being that whereas savages have frequently sought to compensate their recklessness by destroying their inferior offspring, we had accepted all the offspring, good, bad, and indifferent, produced by our indiscriminate recklessness, shielding ourselves by a false theology. Children "came," and their parents disclaimed all responsibility for their coming. The children were "sent by God," and if they all turned out to be idiots, the responsibility was God's. But when it became generally realized that it was possible to limit offspring without interfering with conjugal life a step of immense importance was achieved. It became clear to all that the Divine force works through us, and that we are not entitled to cast the burden of our evil actions on any [17]Higher Power. Marriage no longer fatally involved an endless procession of children who, in so far as they survived at all, were in a large number of cases doomed to disease, neglect, misery, and ignorance. The new Social Hygiene was for the first time rendered possible.

It was in France during the first half of the nineteenth century that the control of reproduction first began to become a social habit. In Sweden and in Denmark, the fall in the birth-rate, though it has been irregular, may be said to have begun in 1860. It was not until about the year 1876 that, in so far as we may judge by the arrest of the birth-rate, the movement began to spread to Europe generally. In England it is usual to associate this change with a famous prosecution which brought a knowledge of the means of preventing conception to the whole population of Great Britain. Undoubtedly this prosecution was an important factor in the movement, but we cannot doubt that, even if the prosecution had not taken place, the course of social progress must still have pursued the same course. It is noteworthy that it was about this same period, in various European countries, that the tide turned, and the excessively high birth-rate began to fall. [9] Recklessness was giving place to foresight and self-control. Such foresight and self-control are of the essence of civilization. [10]

[18]It cannot be disputed that the transformation by which the propagation of the race became deliberate and voluntary has not been established in social custom without a certain amount of protestation from various sides. No social change, however beneficial, ever is established without such protestation, which may, therefore, be regarded as an inevitable and probably a salutary part of social change. Even some would-be scientific persons, with a display of elaborate statistics, set forth various alarmistic doctrines. If, said these persons, this new movement goes on at the present pace, and if all other conditions remain unchanged, then all sorts of terrible results will ensue. But the alarming conclusion failed to ensue, and for a very sufficient reason. The assumed premises of the argument were unsound. Nothing ever goes on at the same pace, nor do all other conditions ever remain unchanged. [19]The world is a living fire, as Heraclitus long ago put it. All things are in perpetual flux. Life is a process of perpetual movement. It is idle to bid the world stand still, and then to argue about the consequences. The world will not stand still, it is for ever revolving, for ever revealing some new facet that had not been allowed for in the neatly arranged mechanism of the statistician.

It is perhaps unnecessary to dwell on a point which is now at last, one may hope, becoming clear to most intelligent persons. But I may perhaps be allowed to refer in passing to an argument that has been brought forward with the wearisome iteration which always marks the progress of those who are feeble in argument. The good stocks of upper social class are decreasing in fertility, it is said; the bad stocks of lower social class are not decreasing; therefore the bad stocks are tending to replace the good stocks. [11]

[20]It must, however, be pointed out that, even assuming that the facts are as stated; it is a hazardous assumption that the best stocks are necessarily the stocks of high social class. In the main no doubt this is so, but good stocks are nevertheless so widely spread through all classes—such good stocks in the lower social classes being probably the most resistent to adverse conditions—that we are not entitled to regard even a slightly greater net increase of the lower social classes as an unmitigated evil. It may be that, as Mercier has expressed it, "we have to regard a civilized community somewhat in the light of a lamp, which burns at the top and is replenished from the bottom." [12]

The soundness of a stock, and its aptitude for performing efficiently the functions of its own social sphere, cannot, indeed, be accurately measured by any tendency to rise into a higher social sphere. On the whole, from generation to generation, the men of a good stock remain within their own social sphere, whether high or low, adequately performing their functions in that sphere, from generation to generation. They remain, we may say, in that social stratum of which the specific gravity is best suited for their existence. [13]

[21]Yet, undoubtedly, from time to time, there is a slight upward social tendency, due in most cases to the exceptional energy and ability of some individual who succeeds in permanently lifting his family into a slightly higher social stratum. [14] Such a process has always taken place, in the past even more conspicuously than in the present. The Normans who came over to England with William the Conqueror and constituted the proud English nobility were simply a miscellaneous set of adventurers, professional fighting men, of unknown, and no doubt for the most part undistinguished, lineage. William the Conqueror himself was the son of a woman of the people. The Catholic Church founded no families, but its democratic constitution opened a career to men of all classes, and the most brilliant sons of the Church were often of the lowliest social rank. We should not, therefore, say that the bad stocks are replacing the good stocks. There is not the slightest evidence for any such theory. All that we are entitled to say is that when in the upward progression of a community the vanishing point of culture and refinement is attained the bearers of that culture and refinement die off as naturally and inevitably as flowers in autumn, and from their roots spring up new and more vigorous shoots to replace them and to pass in their turn through the same stages, with that perpetual slight novelty in which lies the secret of life, as well as of art. An aristocracy which is merely an aristocracy because it is "old"—whether it is an aristocracy of families, or of races, or of species—has already ceased to be an aristocracy in any sound meaning of the term. We need not regret its disappearance.

[22]Do not, therefore, let us waste our time in crying over the dead roses of the summer that is past. There is something morbid in the perpetual groaning over that inevitable decay which is itself a part of all life. Such a perpetual narrow insistence on one aspect of life is scarcely sane. One suspects that these people are themselves of those stocks over whose fate they grieve. Let us, therefore, mercifully leave them to manure their dead roses in peace. They will soon be forgotten. The world is for ever dying. The world is also for ever bursting with life. The spring song of Sursum corda easily overwhelms the dying autumnal wails of the Dies Iræ.

It would thus appear that, even apart from any deliberate restraint from procreation, as a family attains the highest culture and refinement which civilization can yield, that family tends to die out, at all events in the male line. [15] This is, for instance, the result which Fahlbeck has reached in his valuable demographic study of the Swedish nobility, Der Adel Schwedens. "Apparently," says Fahlbeck, "the greater demands on nervous and intellectual force which the culture and refinement of the upper classes produce are chiefly responsible for this. For these are the two personal [23]factors by which those classes are distinguished from the lower classes: high education and refinement in tastes and habits. The first involves predominant activity of the brain, the last a heightened sensitiveness in all departments of nervous life. In both respects, therefore, there is increased work for the nervous system, and this is compensated in the other vital functions, especially reproduction. Man cannot achieve everything; what he gains on one side he loses on the other." We should do well to hold these wise words in mind when we encounter those sciolists who in the presence of the finest and rarest manifestations of civilizations, can only talk of race "decay." A female salmon, it is estimated, lays about nine hundred eggs for every pound of her own weight, and she may weigh fifty pounds. The progeny of Shakespeare and Goethe, such as it was, disappeared in the very centuries in which these great men themselves died. At the present stage of civilization we are somewhat nearer to Shakespeare and Goethe than to the salmon. We must set our ideals towards a very different direction from that which commends itself to our Salmonidian sciolists. "Increase and multiply" was the legendary injunction uttered on the threshold of an empty world. It is singularly out of place in an age in which the earth and the sea, if not indeed the very air, swarm with countless myriads of undistinguished and indistinguishable human creatures, until the beauty of the world is befouled and the glory of the Heavens bedimmed. To stem back that tide is the task now imposed on our heroism, to elevate and purify and [24]refine the race, to introduce the ideal of quality in place of the ideal of quantity which has run riot so long, with the results we see. "As the Northern Saga tells that Odin must sacrifice his eye to attain the higher wisdom," concludes Fahlbeck, "so Man also, in order to win the treasures of culture and refinement, must give not only his eye but his life, if not his own life that of his posterity." [16] The vulgar aim of reckless racial fertility is no longer within our reach and no longer commends itself as worthy. It is not consonant with the stage of civilization we are at the moment passing through. The higher task is now ours of the regeneration of the race, or, if we wish to express that betterment less questionably, the aggeneration of the race. [17]

[25]The control of reproduction, we see, essential as it is, cannot by itself carry far the betterment of the race, because it involves no direct selection of stocks. Yet we have to remember that though this control, with the limitation of offspring it involves, fails to answer all the demands which Social Hygiene to-day makes of us, it yet achieves much. It may not improve what we abstractly term the "race," but it immensely improves the individuals of which the race is made up. Thus the limitation of the family renders it possible to avoid the production of undesired children. That in itself is an immense social gain, because it tends to abolish excessive infantile mortality. [18] It means that [26]adequate care will be expended upon the children that are produced, and that no children will be produced unless the parents are in a position to provide for them. [19] Even the mere spacing out of the children in a family, the larger interval between child-births, is a very great advantage. The mother is no longer exhausted by perpetually bearing, suckling, and tending babies, while the babies themselves are on the average of better quality. [20] Thus the limitation of offspring, far from being an egoistic measure, as some have foolishly supposed, is imperatively demanded in the altruistic interests of the individuals composing the race.

But the control of reproduction, enormously beneficial as it is even in its most elementary shapes, mainly concerns us here because it furnishes the essential condition for the development of Social Hygiene. The control of reproduction renders possible, and leads on to, a wise selection in reproduction. It is only by such selection of children to be born that we can balance our indiscriminate care in the preservation of all children that are [27]born, a care which otherwise would become an intolerable burden. It is only by such selection that we can work towards the elimination of those stocks which fail to help us in the tasks of our civilization to-day. It is only by such selection that we can hope to fortify the stocks that are fitted for these tasks. More than two centuries ago Steele playfully suggested that "one might wear any passion out of a family by culture, as skilful gardeners blot a colour out of a tulip that hurts its beauty." [21] The progress of civilization, with the self-control it involves, has made it possible to accept this suggestion seriously. [22] The difference is that whereas the flowers of our gardens are bettered only by the control of an arbitrary external will and intelligence, our human flowers may be bettered by an intelligence and will, a finer sense of responsibility, developed within themselves. Thus it is that human culture renders possible Social Hygiene.

Three centuries ago an inspired monk set forth his ideal of an ennobled world in The City of the Sun. Campanella wrote that prophetic book in prison. But his spirit was unfettered, and his conception of human society, though in daring it outruns all the visions [28]we may compare it with, is yet on the lines along which our civilization lies. In the City of the Sun not only was the nobility of work, even mechanical work,—which Plato rejected and More was scarcely conscious of,—for the first time recognized, but the supreme impulse of procreation was regarded as a sacred function, to be exercised in the light of scientific knowledge. It was a public rather than a private duty, because it concerned the interests of the race; only valorous and high-spirited men ought to procreate, and it was held that the father should bear the punishments inflicted on the son for faults due to his failure by defects in generation. [23] Moreover, while unions not for the end of procreation were in the City of the Sun left to the judgment of the individuals alone concerned, it was not so with unions for the end of procreation. These were arranged by the "great Master," a physician, aided by the chief matrons, and the public exercises of the youths and maidens, performed in a state of nakedness, were of assistance in enabling unions to be fittingly made. No eugenist under modern conditions of life proposes that unions should be arranged by a supreme medical public official, though he might possibly regard such an official, if divested of any compulsory powers, a kind of public trustee for the race, as a useful institution. But it is easy to see that the luminous conception of racial betterment which, since Galton rendered it practicable, is now inspiring social progress, was already burning brightly three centuries ago in the brain of this imprisoned [29]Italian monk. Just as Thomas More has been called the father of modern Socialism, so Campanella may be said to be the prophet of modern Eugenics.

By "Eugenics" is meant the scientific study of all the agencies by which the human race may be improved, and the effort to give practical effect to those agencies by conscious and deliberate action in favour of better breeding. Even among savages eugenics may be said to exist, if only in the crude and unscientific practice of destroying feeble, deformed, and abnormal infants at birth. In civilized ages elaborate and more or less scientific attempts are made by breeders of animals to improve the stocks they breed, and their efforts have been crowned with much success. The study of the same methods in their bearing on man proceeded out of the Darwinian school of biology, and is especially associated with the great name of Sir Francis Galton, the cousin of Darwin. Galton first proposed to call this study "Stirpiculture." Under that name it inspired Noyes, the founder of the Oneida Community, with the impulse to carry it into practice with a thoroughness and daring—indeed a similarity of method—which caused Oneida almost to rival the City of the Sun. But the scheme of Noyes, excellent as in some respects it was as an experiment, outran both scientific knowledge and the spirit of the times. It was not countenanced by Galton, who never had any wish to offend general sentiment, but sought to win it over to his side, and before 1880 the Oneida Community was brought to an end in consequence of the antagonism it aroused. [30]Galton continued to develop his conceptions slowly and cautiously, and in 1883, in his Inquiries into Human Faculty, he abandoned the term "Stirpiculture" and devised the term "Eugenics," which is now generally adopted to signify Good Breeding.

Galton was quite well aware that the improved breeding of men is a very different matter from the improved breeding of animals, requiring a different knowledge and a different method, so that the ridicule which has sometimes been ignorantly flung at Eugenics failed to touch him. It would be clearly undesirable to breed men, as animals are bred, for single points at the sacrifice of other points, even if we were in a position to breed men from outside. Human breeding must proceed from impulses that arise, voluntarily, in human brains and wills, and are carried out with a human sense of personal responsibility. Galton believed that the first need was the need of knowledge in these matters. He was not anxious to invoke legislation. [24] The compulsory presentation of certificates of health and good breeding as a preliminary to marriage forms no part of Eugenics, nor is compulsory sterilization a demand made by any reasonable eugenist. Certainly the custom of securing certificates of health and ability is excellent, not only as a preliminary to marriage, but as a general custom. Certainly, also, there are cases in which sterilization is desirable, if [31]voluntarily accepted. [25] But neither certification nor sterilization should be compulsory. They only have their value if they are intelligent and deliberate, springing out of a widened and enlightened sense of personal responsibility to society and to the race.

Eugenics constitutes the link between the Social Reform of the past, painfully struggling to improve the conditions of life, and the Social Hygiene of the future, which is authorized to deal adequately with the conditions of life because it has its hands on the sources of life. On this plane we are able to concentrate our energies on the finer ends of life, because we may reasonably expect to be no longer hampered by the ever-increasing burdens which were placed upon us by the failure to control life; while the more we succeed in our efforts to purify and strengthen life, the more magnificent become the tasks we may reasonably hope to attempt and compass.

A problem which is often and justly cited as one to be settled by Eugenics is that presented by the existence among us of the large class of the feeble-minded. No doubt there are some who would regret the disappearance of the feeble-minded from our midst. The philosophies of the Bergsonian type, which to-day prevail so widely, place intuition above reason, and the "pure fool" has [32]sometimes been enshrined and idolized. But we may remember that Eugenics can never prevent absolutely the occurrence of feeble-minded persons, even in the extreme degree of the imbecile and the idiot. [26] They come within the range of variation, by the same right as genius so comes. We cannot, it may be, prevent the occurrence of such persons, but we can prevent them from being the founders of families tending to resemble themselves. And in so doing, it will be agreed by most people, we shall be effecting a task of immense benefit to society and the race.

Feeble-mindedness is largely handed on by heredity. It was formerly supposed that idiocy and feeble-mindedness are mainly due to environmental conditions, to the drink, depravity, general disease, or lack of nutrition of the parents, and there is no doubt an element of truth in that view. But serious and frequent as are the results of bad environment and acquired disease in the parentage of the feeble-minded, they do not form the fundamental factor in the production of the feeble-minded. [27]

[33]Feeble-mindedness is essentially a germinal variation, belonging to the same large class as all other biological variations, occurring, for the most part, in the first place spontaneously, but strongly tending to be inherited. It thus resembles congenital cataract, deaf-mutism, the susceptibility to tuberculous infection, etc. [28]

Exact investigation is now showing that feeble-mindedness is passed on from parent to child to an enormous extent. Some years ago Ashby, speaking from a large experience in the North of England, estimated that at least seventy-five per cent of feeble-minded children are born with an inherited tendency [34]to mental defect. More precise investigation has since shown that this estimate was under the mark. Tredgold, who in England has most carefully studied the heredity of the feeble-minded, [29] found that in over eighty-two per cent cases there is a bad nervous inheritance. In a large number of cases the bad heredity was associated with alcoholism or consumption in the parentage, but only in a small proportion of cases (about seven per cent) was it probable that alcoholism and consumption alone, and usually combined, had sufficed to produce the defective condition of the children, while environmental conditions only produced mental defect in ten per cent cases. [30] Heredity is the chief cause of feeble-mindedness, and a normal child is never born of two feeble-minded parents. The very thorough investigation of the heredity of the feeble-minded which is now being carried on at the institution for their care at Vineland, New Jersey, shows even more decisive results. By making careful pedigrees of the families to which the inmates at Vineland belong it is seen that in a large proportion of cases feeble-mindedness is handed on from generation to generation, and is traceable through three generations, though it sometimes skips [35]a generation. In one family of three hundred and nineteen persons, one hundred and nineteen were known to be feeble-minded, and only forty-two known to be normal. The families tended to be large, sometimes very large, most of them in many cases dying in infancy or growing up weak-minded. [31]

Not only is feeble-mindedness inherited, and to a much greater degree than has hitherto been suspected even by expert authorities, but the feeble-minded thus tend (though, as Davenport and Weeks have found, not invariably) to have a larger number of children than normal people. That indeed, we might expect, apart altogether from the question of any innate fertility. The feeble-minded have no forethought and no self-restraint. They are not adequately capable of resisting their own impulses or the solicitations of others, and they are unable to understand adequately the motives which guide the conduct of ordinary people. The average number of children of feeble-minded people seems to be frequently about one-third more than in normal families, and is sometimes much greater. Dr. Ettie Sayer, when investigating for the London County Council the family histories of one hundred normal families and one hundred families in which mentally defective children had been found, ascertained that the families of the latter averaged 7.6 children, while in the normal families they averaged 5. Tredgold, specially investigating 150 feeble-minded cases, found that they belonged to families in which 1269 children had been born, that is to say 7.3 per family, [36]or, counting still-born children, 8.4. Nearly two-thirds of these abnormally large families were mentally defective, many showing a tendency to disease, pauperism, criminality, or else to early death. [32]

Here, indeed, we have a counterbalancing influence, for, in the large families of the feeble-minded, there is a correspondingly large infantile mortality. A considerable proportion of Tredgold's group of children were born dead, and a very large number died early. Eichholz, again, found that, in one group of defective families, about sixty per cent of the children died young. That is probably an unusually high proportion, and in Eichholz's cases it seems to have been associated with very unusually large families, but the infant mortality is always very high.

This large early mortality of the offspring of the feeble-minded is, however, very far from settling the question of the disposal of the mentally defective, or we should not find families of them propagated from generation to generation. The large number who die early merely serves, roughly speaking, to reduce the size of the abnormal family to the size of a normal family, and some authorities consider that it scarcely suffices to do this, for we must remember that there [37]is a considerable mortality even in the so-called normal family during early life. Even when there is no abnormal fertility in the defective family we may still have to recognize that, as Davenport and Weeks argue, their defectiveness is intensified by heredity. Moreover, we have to consider the social disorder and the heavy expense which accompany the large infantile mortality. Illegitimacy is frequently the result of feeble-mindedness, since feeble-minded women are peculiarly unable to resist temptation. A great number of such women are continually coming into the workhouses and giving birth to illegitimate children whom they are unable to support, and who often never become capable of supporting themselves, but in their turn tend to produce a new feeble-minded generation, more especially since the men who are attracted to these feeble-minded women are themselves—according to the generally recognized tendency of the abnormal to be attracted to the abnormal—feeble-minded or otherwise mentally defective. There is thus generated not only a heavy financial burden, but also a perpetual danger to society, and, it may well be, a serious depreciation in the quality of the community. [33]

It is not only in themselves that the feeble-minded are a burden on the present generation and a menace [38]to future generations. In large measure they form the reservoir from which the predatory classes are recruited. This is, for instance, the case as regards prostitutes. Feeble-minded girls, of fairly high grade, may often be said to be predestined to prostitution if left to themselves, not because they are vicious, but because they are weak and have little power of resistance. They cannot properly weigh their actions against the results of their actions, and even if they are intelligent enough to do that, they are still too weak to regulate their actions accordingly. Moreover, even when, as often happens among the high-grade feeble-minded, they are quite able and willing to work, after they have lost their "respectability" by having a child, the opportunities for work become more restricted, and they drift into prostitution. It has been found that of nearly 15,000 women who passed through Magdalen Homes in England, over 2500, or more than sixteen per cent—and this is probably an under-estimate—were definitely feeble-minded. The women belonging to this feeble-minded group were known to have added 1000 illegitimate children to the population. In Germany Bonhoeffer found among 190 prostitutes who passed through a prison that 102 were hereditarily degenerate and 53 [39]feeble-minded. This would be an over-estimate as regards average prostitutes, though the offences were no doubt usually trivial, but in any case the association between prostitution and feeble-mindedness is intimate. Everywhere, there can be no doubt, the ranks of prostitution contain a considerable proportion of women who were, at the very outset, in some slight degree feeble-minded, mentally and morally a little blunted through some taint of inheritance. [34]

Criminality, again, is associated with feeble-mindedness in the most intimate way. Not only do criminals tend to belong to large families, but the families that produce feeble-minded offspring also produce criminals, while a certain degree of feeble-mindedness is extremely common among criminals, and the most hopeless and typical, though fortunately rare, kind of criminal, frequently termed a "moral imbecile," is nothing more than a feeble-minded person whose defect is shown not so much in his intelligence as in his feelings and his conduct. Sir H.B. Donkin, who speaks with authority on this matter, estimates that, though it is difficult to obtain the early history of the criminals who enter English prisons, about twenty per cent of them are of primarily defective mental capacity. This would [40]mean that every year some 35,000 feeble-minded persons are sent to English prisons as "criminals." The tendency of criminals to belong to the feeble-minded class is indeed every day becoming more clearly recognized. At Pentonville, putting aside prisoners who were too mentally affected to be fit for prison discipline, eighteen per cent of the adult prisoners and forty per cent of the juvenile offenders were found to be feeble-minded. This includes only those whose defect is fairly obvious, and is not the result of methodical investigation. It is certain that such methodical inquiry would reveal a very large proportion of cases of less obvious mental defect. Thus the systematic examination of a number of delinquent children in an Industrial School showed that in seventy-five per cent cases they were defective as compared to normal children, and that their defectiveness was probably inborn. Even the possession of a considerable degree of cunning is no evidence against mental defect, but may rather be said to be a sign of it, for it shows an intelligence unable to grasp the wider relations of life, and concentrated on the gratification of petty and immediate desires. Thus it happens that the cunning of criminals is frequently associated with almost inconceivable stupidity. [35]

Closely related to the great feeble-minded class, and from time to time falling into crime, are the inmates of workhouses, tramps, and the unemployable. The so-called "able-bodied" inmates of the workhouses are frequently found, on medical examination, to be, [41]in more than fifty per cent cases, mentally defective, equally so whether they are men or women. Tramps, by nature and profession, who overlap the workhouse population, and are estimated to number 20,000 to 30,000 in England and Wales, when the genuine unemployed are eliminated, are everywhere found to be a very degenerate class, among whom the most mischievous kinds of feeble-mindedness and mental perversion prevail. Inebriates, the people who are chronically and helplessly given to drink, largely belong to the same great family, and do not so much become feeble-minded because they drink, but possess the tendency to drink because they have a strain of feeble-mindedness from birth. Branthwaite, the chief English authority on this question, finds that of the inebriates who come to his notice, putting aside altogether the group of actually insane persons, about sixty-three per cent are mentally defective, and scarcely more than a third of the whole number of average mental capacity. It is evident that these people, even if restored to sobriety, would still retain their more or less inborn defectiveness, and would remain equally, unfit to become the parents of the coming generation.

These are the kind of people—tramps, prostitutes, paupers, criminals, inebriates, all tending to be born a little defective—who largely make up the great degenerate families whose histories are from time to time recorded. Such a family was that of the Jukes in America, who, in the course of five generations, by constantly intermarrying with bad stocks, produced 709 known descendants who were on the whole unfit for society, [42]and have been a constant danger and burden to society. [36] A still larger family of the same kind, more recently studied in Germany, consisted of 834 known persons, all descended from a drunken vagabond woman, probably somewhat feeble-minded but physically vigorous. The great majority of these descendants were prostitutes, tramps, paupers, and criminals (some of them murderers), and the direct cost in money to the Prussian State for the keep and care of this woman and her family has been a quarter of a million pounds. Yet another such family is that of the "Zeros." Three centuries ago they were highly respectable people, living in a Swiss valley. But they intermarried with an insane stock, and subsequently married other women of an unbalanced nature. In recent times 310 members of this family have been studied, and it is found that vagrancy, feeble-mindedness, mental troubles, criminality, pauperism, immorality are, as it may be termed, their patrimony. [37]

These classes, with their tendency to weak-mindedness, their inborn laziness, lack of vitality, and unfitness for organized activity, contain the people who complain that they are starving for want of work, though they will never perform any work that is given them. [43]Feeble-mindedness is an absolute dead-weight on the race. It is an evil that is unmitigated. The heavy and complicated social burdens and injuries it inflicts on the present generation are without compensation, while the unquestionable fact that in any degree it is highly inheritable renders it a deteriorating poison to the race; it depreciates the quality of a people. The task of Social Hygiene which lies before us cannot be attempted by this feeble folk. Not only can they not share it, but they impede it; their clumsy hands are for ever becoming entangled in the delicate mechanism of our modern civilization. Their very existence is itself an impediment. Apart altogether from the gross and obvious burden in money and social machinery which the protection they need, and the protection we need against them, casts upon the community, [38] they dilute the spiritual quality of the community to a degree which makes it an inapt medium for any high achievement. It matters little how small a city or a nation is, provided the spirit of its people is great. It is the smallest communities that have most powerfully and most immortally raised the level of civilization, and surrounded the human species (in its own eyes) with a halo of glory which belongs to no other species. Only a handful of people, hemmed in on every side, created the eternal radiance of Athens, and the fame of the little city of Florence may outlive that of the whole [44]kingdom of Italy. To realize this truth in the future of civilization is one of the first tasks of Social Hygiene. [39]

It is here that the ideals of Eugenics may be expected to work fruitfully. To insist upon the power of heredity was once considered to indicate a fatalistic pessimism. It wears a very different aspect nowadays, in the light of Eugenics. "To the eugenist," as Davenport observes, "heredity stands as the one great hope of the human race: its saviour from imbecility, poverty, disease, immorality." [40] We cannot, indeed, desire any compulsory elimination of the unfit or any centrally regulated breeding of the fit. [41] Such notions are idle, and even the mere fact that unbalanced brains may air them abroad tends to impair the legitimate authority of eugenic ideals. The two measures which are now commonly put forward for the attainment of eugenic ends—health certificates as a legal preliminary to marriage and the sterilization [45]of the unfit—are excellent when wisely applied, but they become mischievous, if not ridiculous, in the hands of fanatics who would employ them by force. Domestic animals may be highly bred from outside, compulsorily. Man can only be bred upwards from within through the medium of his intelligence and will, working together under the control of a high sense of responsibility. The infinite cunning of men and women is fully equal to the defeat of any attempt to touch life at this intimate point against the wish of those to whom the creation of life is entrusted. The laws of marriage even among savages have often been complex and strenuous in the highest degree. But it has been easy to bear them, for they have been part of the sacred and inviolable traditions of the race; religion lay behind them. And Galton, who recognized the futility of mere legislation in the elevation of the race, believed that the hope of the future lies in rendering eugenics a part of religion. The only compulsion we can apply in eugenics is the compulsion that comes from within. All those in whom any fine sense of social and racial responsibility is developed will desire, before marriage, to give, and to receive, the fullest information on all the matters that concern ancestral inheritance, while the registration of such information, it is probable, will become ever simpler and more a matter of course. [42] And if he finds [46]that he is not justified in aiding to carry on the race, the eugenist will be content to make himself, in the words of Jesus, "a eunuch for the kingdom of Heaven's sake," whether, under modern conditions, that means abstention in marriage from procreation, or voluntary sterilization by operative methods. [43] For, as Giddings has put it, the goal of the race lies, not in the ruthless exaltation of a super-man, but in the evolution of a super-mankind. Such a goal can only be reached by resolute selection and elimination. [44]

The breeding of men lies largely in the hands of women. That is why the question of Eugenics is to a great extent one with the woman question. The realization of eugenics in our social life can only be attained with the realization of the woman movement in its latest and completest phase as an enlightened culture of motherhood, in all that motherhood involves alike on the physical and the psychic sides. Motherhood on the eugenic basis is a deliberate and selective process, calling for the highest [47]intelligence as well as the finest emotional and moral aptitudes, so that all the best energies of a long evolution of womanhood in the paths of modern culture here find their final outlet. The breeding of children further involves the training of children, and since the expansion of Social Hygiene renders education a far larger and more delicate task than it has ever been before, the responsibilities laid upon women by the evolution of civilization become correspondingly great.

For the men who have been thus born and taught the tasks imposed by Social Hygiene are in no degree lighter. They demand all the best qualities of a selectively bred race from which the mentally and physically weak have, so far as possible, been bred out. The substitution of law for war alike in the relations of class to class, and of nation to nation, and the organization of international methods of social intercourse between peoples of different tongues and unlike traditions, are but two typical examples of the tasks, difficult but imperative, which Social Hygiene presents and the course of modern civilization renders insistent. Again, the adequate adjustment of the claims of the individual and the claims of the community, each carried to its farthest point, can but prove an exquisite test of the quality of any well-bred and well-trained race. It is exactly in that balancing of apparent opposites, the necessity of pushing to extremes both opposites, and the consequent need of cultivating that quality of temperance the Greeks estimated so highly, that the supreme difficulties of modern civilization lie. We see these difficulties again [48]in relation to the extension of law. It is desirable and inevitable that the sphere of law should be extended, and that the disputes which are still decided by brutal and unreasoning force should be decided by humane and reasoning force, that is to say, by law. But, side by side with this extension of law, it is necessary to wage a constant war with the law-making tendency, to cherish an undying resolve to maintain unsullied those sacred and intimate impulses, all the finest activities of the moral sphere, which the generalizing hand of law can only injure and stain.

It is these fascinating and impassioning problems, every day becoming of more urgent practical importance, which it is the task of Social Hygiene to solve, having first created the men and women who are fit to solve them. It is such problems as these that we are to-day called upon to illuminate, as far as we may—it may not yet be very far—by the dry light of science.