The Task of Social Hygiene

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

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, 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 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 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 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 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, 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, 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. 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 kingdom of Italy. To realize this truth in the future of civilization is one of the first tasks of Social Hygiene. ³⁹