The Task of Social Hygiene

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 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.

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 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

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. 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

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

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.

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 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 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

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 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 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 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 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. 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 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 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

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 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 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