Impulses may be abnormal from hereditary predisposition, as e.g. the impulse to drink, but only through strengthening inhibition can these impulses be controlled,—their existence must be accepted.
But whether the defect is an abnormal impulse, or a normal impulse abnormally strong, or an abnormally weak or defective inhibition, the condition is hereditary, and such defectives propagate their kind.
It has been shown that they are more fertile than any other classes because of the very defect that makes them a danger to society.
The defective restraint that allows them to commit offences against person and property, also allows their procreative impulse unrestrained activity.
Defectives, therefore, are not only fertile, but they propagate their kind, and a few examples will serve to show to some extent the fertility, and to an enormous extent the hereditary tendencies, of the unfit.
The above diagrammatic histories of eight families are taken from Dr. Strahan's "Marriage and Disease."
The State's ideal in relation to the fertility of its subjects.—Keen competition means great effort and great waste of life.—If in the minds of the citizens space and food are ample multiplication works automatically.—To New Zealanders food now includes the luxuries as well as the necessities of life.—Men are driven to the alternative of supporting a family of their own or a degenerate family of defectives.—The State enforces the one but cannot enforce the other.—New Zealand taxation.—The burden of the bread-winner.—As the State lightens this burden it encourages fertility.—The survival of the unfit makes the burden of the fit.
The multiplication of the fit is of the first importance to the State. It supplies competent producers and courageous defenders, and the more of these, consistent with space and food (using these terms in their fullest significance), the better off the State.
If healthy happy citizens are the State's ideal, then limitation of population well within the space and food will be encouraged. If national wealth and prosperity in its material aspect are the State's ideal, the harder the population presses on the means of subsistence the sooner will that ideal be realised. For it cannot be denied, that the greater the stress and hardship in life, the more strenuous the effort put forth to obtain a foothold. The greater the competition the keener the effort, and the higher the accomplishment; while to ensure an adequate supply of labour in time of great demand there must always be a surplus.
The waste of life must always be greater; but what of that! National wealth is the ideal—the maximum amount of production. Child labour, and women labour, are called in to fill the national granaries, though misery and death attend the process.
If this be the ideal of the State, life is of less value than the product of labour, for it can be more easily and readily replaced.
But the ideal of the perfect state is not wealth but the robust happiness of its members.
The happiness of its members is best promoted by the maximum increase in its numbers, consistent with ample space and food. With ample space and food multiplication works automatically, being kept up to the limit of space and food by the procreative instinct.
If it can be shown that multiplication is not sufficiently stimulated by this instinct, then it must be concluded that, in the minds of the citizens the space and food are not ample.
In New Zealand the procreative impulse does not keep multiplication at an equal pace with the apparent supply of food and space, and this is due, as has been shown, to the fact that our citizens are not satisfied that the supply is ample.
They have come to enlarge the definition of "food," and this term now includes luxuries easily obtainable for themselves and their families.
But the luxuries of life and living can only be easily obtained when individual effort to obtain them is unhampered. Every burden which a man has to bear (only the best are here referred to,—the fit members of the State) limits his power to provide for himself, and any he may bring into the world.
If the State decrees that a citizen shall support himself, his mate, and his progeny, well and good,—if he has no other burden to bear, no other responsibility, he knows exactly where he is and what he has to do, and directs his energies and controls his impulses, and enlarges his desires to suit his tastes and purposes.
But if the State decrees that a citizen shall not only support all for whose existence he is responsible, but also all those unable to support themselves, born into the world in increasing numbers as congenital defectives, and manufactured in the world by legalised drinking saloons, and by pauperising charitable aid and benevolent institutions, then our self-respecting right-respecting citizen must decide whether he will forego the luxury and ease that he may enjoy, and rear the normal family, or curtail his own progeny, and support the army of defectives thrown upon society by the State-encouraged fertility of the unfit.
It has already been shown, that in this colony the best fit to multiply are ceasing to do so, because of a desire to attain a social and financial stability that will protect them and their dependents from want or the prospect of want. There is every reason to believe, that when this stability is assured the normal family soon follows.
The love of luxurious idleness and a passion for excitement, which were typical of the voluntarily barren women of ancient Rome, have little place with us, as a cause of limited nativity.
Men and women reason out, that they cannot bear all the burdens that the State imposes upon them, support an increasing army of paupers, and lunatics and defectives, and non-producers, and that luxuriously, and at the same time incur the additional burden of rearing a large family.
Let us examine these burdens, and see if the complaint of our best stock is justified.
The amount raised by taxation in New Zealand (including local rates) during the year 1902-03, amounted per head of population (excluding Maories) to £5 4s. 7d. The bread-winners in New Zealand number according to official returns, 340,230, and the total rates and taxes collected for the year 1902-03 amounted to £4,174,787 or £12 5s. 4d. for each bread-winner for the year.
On March 31st, 1901 (the last census date) there were 23.01 persons per thousand of population over 15 years of age, unable to work from sickness, accident and infirmity. Of these 12.72 were due to sickness and accident, and 10.29 to "specified infirmities."
The proportion of those suffering from sickness and accident in 1874 was 12.64 per 1000 over 15 years, practically the same as for 1901, while disability from "specified infirmities" (lunacy, idiocy, epilepsy, deformity, etc.)—degeneracies strongly hereditary—rose rapidly from 5.32 in 1874 to 10.29 in 1901, or taking the total sickness and infirmity, from 17.96 in 1874 to 23.01 in 1901.
On the last census date there were 340,230 bread-winners, and 12,747 persons suffering from sickness, accident, and infirmity, or 26 fit to work and earn for every one unfit.
The cost to the Colony per year of—
A total of £705,756. This constitutes the burden due to defectives and defects in others, a handful of workers have to bear in a sparse population of 800,000 souls in one of the finest countries on which the sun of heaven ever shone.
The burden which the fit have to bear has often been referred to by Dr. MacGregor, who states in one of his reports, "Wives and husbands, parents of bastards, all alike are encouraged by lavish charity (falsely so called) to entirely shirk their responsibilities in the well grounded assurance that public money will be forth-coming to keep them and their families in quite as comfortable position as their hardworking and independent neighbours."
The state can not decree that men shall marry, or that women shall marry, or that women shall procreate. All it can do is to discover why its subjects are not fertile, and remove the causes so far as it is possible.
As people become educated they become conscious of their limitations, and endeavour to break through them and better their conditions.
The more difficult this process is, the less likely will men and women be to incur the burden of a large family. The more the conditions of existence are improved, the more completely is each man's wish realized, and the more readily will he undertake the responsibilities of a family.
If the State can and will lighten the burden of taxation and modify the strain and stress of life, it will indirectly encourage procreation.
No direct encouragement is possible. It was tried and it failed in Sparta, it was tried by Augustus and it failed in Rome, it must fail everywhere, for the most willing and the most ready to respond to any provision made to encourage increase, are the unfit, and it is the fertility of the unfit that is the very evil that has to be attacked.
It is the fertility of the unfit that makes the burden of the fit, and a tax on bachelors, or a bonus on families, would be responded to by the least fit, long before it affected those whose response was anticipated, and the problem sought to be solved would only be aggravated thereby.
No encouragement whatever can the State afford to give to the natural increase of population till it has successfully grappled with the propagation of defectives.
The burden of life would be lessened by nearly one-third if the fertility of defectives could be stopped.
The State would have to support only those who acquired defects, the scars of service more honourable than wealth, in their efforts to support themselves and families, and these would be few indeed, if inherited tendencies could be eliminated or reduced to a minimum.
It is the purpose of this work to attempt to describe a method that will help to bring about this end.
Ancient methods of preventing the fertility of the unfit.—Christian sentiment suppressed inhuman practices—Christian care brings many defectives to the child-bearing period of life.—The association of mental and physical defects.—Who are the unfit.—The tendency of relatives to cast their degenerate kinsfolk on the State.—Our social conditions manufacture defectives and foster their fertility.—The only moral force that limits families is inhibition with prudence.—Defective self-control transmitted hereditarily. Dr. Mac Gregorys cases.—The transmission of insanity.—Celibacy of the insane is the prophylaxis of insanity in the race.—The environment of the unfit.—Defectives snatched from Nature's clutch.—At the age of maturity they are left to propogate their kind.
The humanitarian spirit, born 1900 years ago, effectually checked all inhuman practices for disposal of the unfit. Christ is the Author of this spirit. The noisy triumph of His persecutors had scarcely died away before His conception of the sanctity of human life found expression in the mission of those Roman maidens who in His name devoted their lives to collecting exposed infants from the environs of their city—that they might rear and educate them and bring them to the Church.
Not only has it done this, but it has taught society that its first and highest duty is to its weaker brethren, who constitute the unfit. All our modern institutions are based on this sentiment, and what is the result? Weaklings are born into the world and the weaker they are the more carefully are they tended and nursed. The law of the struggle for existence, i.e., the law of Justice is suspended or modified, and the unfit are allowed to live, or at least allowed to live a little longer, long enough indeed to propagate their kind.
Hospitals and Homes and Charitable institutions all combine their energies, and direct their efforts to nurture those whom the laws of nature decree should die.
Sympathy and not indignation is aroused when a defective is born, and the result of all the effort which that sympathy evokes is that the little weakling and thousands such are safely led and tended all the way to the child-bearing period of life, only to repeat their history, in others.
Not only do defects "run in families," but they run in groups, and a physical defect such as club-foot, cleft palate, or any arrested development, is apt to be associated with some mental defect, and it is the mental more than the physical defects of individuals that prevent them being self-supporting helpful members of society.
In the "North American Review" for August, 1903, Sir John Gorst declares that:—
"The condition of disease, debility, and defective sight and hearing, in the public elementary schools in poorer districts, is appalling. The research of a recent Royal Commission has disclosed that of the children in the public schools of Edinburgh, 70 per cent, are suffering from disease of some kind, more than half from defective vision, nearly half from defective hearing, and 30 per cent, from starvation. The physical deterioration of the recruits who offer themselves for the army is a subject of increasing concern. There are grounds for at least suspecting a growing degeneracy of the population of the United Kingdom, particularly in the great towns."
The following table gives the charges before Magistrates in our Courts:—
| Year. | Proportion per thousand of |
| mean population. | |
| 1894 | 24.76 |
| 1897 | 26.87 |
| 1898 | 29.42 |
| 1899 | 29.48 |
| 1900 | 31.54 |
| 1901 | 33.20 |
| 1902 | 35.19 |
Now who are the unfit? Are they more fertile than the fit? and do they propagate their kind?
The following defects constitute their victims members of that great class of degenerates who are unfit to procreate healthy normal offspring. Many of these conditions are partly congenital and partly acquired, but in the majority of defectives a transmitted taint is present.
With the exception of the very young and the very old, all members of society, who have to be supported by others, constitute the unfit. Many are supported by friends and relatives, but year by year, it is becoming more noticeable, that the moral guardians of the unfit are shirking their responsibility and handing their defective relatives over to the State and demanding their gratuitous support as a right.
Dr. MacGregor, Inspector of Asylums and Hospitals, N.Z., in his report for 1898, p. 5, says:—
"As if the State had a vested interest in the degradation of its people, I find that they, as fathers, mothers, brothers, sisters, are responding to our efforts to sap their self-respect by doing their utmost to throw the cost of maintaining their relatives on the ratepayers. I constantly hear the plea urged that as taxpayers and old colonists they have a right to send their relatives to State institutions."
Our social conditions manufacture defectives, and foster their fertility. The strain and stress of modern competition excite an anxiety and nervous tension under which many break down, and much of the insanity that exists to-day is attributable to nervous strain in the struggle of life.
The strong attractive force of one social stratum upon the next below, excites in the latter a nervous tension which predisposes to a breakdown in the face of some adversity.
The passion for ease and luxury, and the dread of poverty tend to overstrain the nervous system, and numberless neurotic defectives fall back upon society, and give themselves up to the propagation of their kind.
Our charitable aid institutions tend largely to swell the numbers of the great unfit.
Dr. MacGregor in one of his valuable and forcible reports upon our charitable aid institutions, says:—
"Our lavish and indiscriminate outdoor relief, whose evils I am tired of recapitulating,—our shameless abuse of the hospital system,—the crowding of our asylums by people in their dotage, kept there because there is no suitable place to send them to, and many of them sent by friends anxious only to be relieved of the duty of supporting and caring for them,—what is it all coming to?"...
"The practical outcome of our overlooking the continued accumulation of degenerates among our people by our fostering of all kinds of weakness will necessarily be, if it continues, that society will itself degenerate. Taxation will increase by leaps and bounds, and the industrious and self-respecting citizens will rebel, especially if taxation is expected to meet all the demands of a legislature that puts our humanitarian idea of justice in the place of charity."
It has already been urged that there is no evidence of any physiological defect in any class of society interfering with fertility. Sexual inhibition, from prudential motives is the real cause in New Zealand.
Sexual inhibition implies well-developed self-control, the very force in which almost all defectives are most deficient, and the absence of which makes them criminals, drunkards and paupers. In almost all defectives too, prudence is conspicuous by its absence.
The only moral force we know of, that has curtailed, or will curtail, the family within the limits of comfortable subsistence, is sexual inhibition with prudence. But this force is absolutely impossible amongst defectives.
It is not only a powerful force among the normal, but with us to-day it is powerfully operative. Amongst the defectives it does not and cannot exist.
Apart from observation and statistics, therefore, it can be shown that the birth-rate amongst the unfit is undisturbed. They marry and are given in marriage, free from all restraint save that of environment, and worst of all they propagate their kind.
Dr. Clouston says (Clinical Lectures on Mental Diseases, 4th Ed., p. 330) "As we watch children grow up we see that some have the sense of right and wrong, the conscience, developed much sooner and much stronger than others; just as some have their eye teeth much sooner than others; and looking at adults, we see that some never have much of this sense developed at all. This is notoriously the case in some of those whose ancestors for several generations have been criminals, insane or drunkards." Again (p. 331) "We know that some of the children of many generations of thieves take to stealing, as a young wild duck among tame ones takes to hiding in holes, and that the children of savage races cannot copy at once our ethics nor our power of controlling our actions. It seems to take many generations to redevelop an atrophied conscience. There is no doubt that an organic lawlessness is transmitted hereditarily."
Mr. W. Bevan Lewis says (A text-book of Mental Disease, p. 203) "It is also notable, that in a large proportion of cases, we find the history of ancestral insanity attached to the grand-parents, or the collateral line of uncles and aunts, significant of a more remote origin for the neurosis. The actual proportion of cases revealing strongly-marked hereditary features (often involving several members of the subject's ancestry), amounts to 36 per cent;" while Mr. Briscoe declares (Journal of Mental Science, Oct. 1896) that 90% of the insane have a heredity of insanity.
The following table from Dr. MacGregor's reports gives an account of two families in New Zealand and their Asylum history.
In his report for 1897, the same writer says:—"I know of a 'defective' half-imbecile girl, who has had already five illegitimate children by different fathers, all of whom are now being supported by the Charitable Aid Board, while, of course, the mother is maintained, and encouraged to propagate more;" while in an appendix to a pamphlet on "Some Aspects of the Charitable Aid question," he gives the following history of two defective cases:—
J.A. admitted to Lunatic Asylum, May, 1897.
Three medical men report on her as follows:—"She appears imbecile, but without delusions: natural imbecility, stupid, idiotic expression; baby one month old; age between 30 and 40. Suffering from dementia; lactational."
J.A., husband aged 69; labourer, average earnings 15s. week. He wishes to get admission into some Old Man's Home.
This couple have six children—four girls and one boy. A. aged 12; B. 10; C. 9; D. (boy) 5; and E. 3 years. These children are all in the Industrial School. There is also one baby, born April, 1897; has been put out to nurse by the County Council.
The sister of Mrs. J.A. in Salvation Army Home. There are two brothers, whereabouts not known. The police report on this case that the whole of the relatives of Mrs. J.A. were partly imbecile, always in a helpless condition and state of destitution, and have been for years supported partly by charity of neighbours and help from the Charitable Aid Boards.
J.J., the father, now dead, reported as a "lazy, drunken fellow."
A.J., the mother, "a drunken prostitute" (police report 1886). "Makes a precarious living at nursing" (police report 1897); in destitute circumstances, living with a man known as a thief.
This couple had seven children—six boys and one girl:—
A., committed to Industrial School, 1877; discharged from there 1890; aged 18. Sentenced in 1896 to three years for burglary.
B., committed to Industrial school for larceny in 1883; discharged from there, 1887; aged 17.
C., committed to Industrial School for breaking into and stealing, 1886; aged 16; discharged, 1890.
D., aged 14; E. 9½; and F., 7 years; were sent to Industrial School in 1891 by the Charitable Aid Board, the father being dead and the mother in gaol.
D. was discharged last year, aged 18. F. is in hospital for removal of nasal growth, and defective eyesight. E. was admitted to a lunatic Asylum, September, 1897. Four medical men report on him as follows:—"A case of satyriasis from congenital defect." "His depraved habits result of bad bringing up by his mother." "Probably hereditary." "A case of moral depravity associated with mental deficiency, and cretinism." The youngest of the family, a girl aged 11, is said to be dependent on her mother.
With regard to the hereditary nature of Insanity, John Charles Bucknill and Daniel Hack Tuke, M.D.'s, in "A Manual of Psychological Medicine," 4th Ed., p. 65, says:—
"Certainly, if in ever so small degree there is to be a stamping out of insanity, we must act on the principle, better let the individual suffer than run the risk of bequeathing a legacy of insanity to the next generation.... With regard to males, marriage would no doubt be highly beneficial in many instances, and if the risk of progeny is not run, may well be encouraged."
Esquirol, quoted by Bucknill and Tuke, p. 58, says:—"Of all diseases Insanity is the most hereditary."
Bucknill and Tuke, p. 647, say:—
"Of marriage it may be said that the celibacy of the insane is the prophylaxis of Insanity in the race, and although a well chosen mate and a happy marriage may sometimes postpone or even prevent the development of insanity in the individual, still no medical man, having regard to the health of the community, or even of that of the family, can possibly feel himself justified in recommending the marriage of any person of either sex in whom the insane diathesis is well marked."
Again (pp. 647 and 648) "It is thus that the seeds of mental diseases and of moral evils are sown broadcast through the land; and other new defects and diseases are multiplied and varied with imbecilities, and idiocies, and suicidal and other propensities and dispositions, leading to all manner of vice and crime. The marriage of hereditary lunatics is a veritable Pandora's box of physical and moral evil."
The least fit, then, are the most fertile, and the most fertile are subject to the common law of heredity, and the defects are transmitted to their offspring, often accentuated by the intermarriage which their circumstances favour or even necessitate.
But this is not all. The least fit have the worst environment, and in the worst possible surroundings the progeny of the unfit multiply and develop. They are born into conditions, well described by Dr. Alice Vicery, in a paper on "The food supplies of the next generation." "Conditions in which the food, warmth, and clothing which are necessary for the mere maintenance of the functions of the body in their normal state, cannot be obtained; in which men, women, and children are forced to crowd into dens wherein decency is abolished, and the most ordinary conditions of healthful existence are impossible of attainment; in which the pleasures within reach are reduced to bestiality and drunkenness; in which the pains accumulate at compound interest in the shape of starvation, disease, stunted development, and moral degradation in which the prospect of even steady and honest industry is a life of unsuccessful battling with hunger, rounded by a pauper's grave."
What possible hope can there be for the progeny of defectives born with vicious, criminal, drunken or pauper tendencies, into an environment whose whole influence from infancy to maturity tends to accentuate and develop these inherited defects?
In this pitiable stratum of human society, vice and misery, as checks to increase, reign supreme, but as no other check exists, fertility is at its maximum, and keeps close up on the heels of the positive checks.
The State in her humanitarian sympathy, and in New Zealand it is extravagant, puts forth every effort to improve the conditions of its "submerged tenth." Insanitary conditions are improved, the rooms by law enlarged, the air is sweetened, the water is purified, the homes are drained. The delicate and diseased are taken to our hospitals, the deaf and blind to our deaf-mute institutions, the deformed and the fatherless to our orphan homes. And all are carefully nursed as tender precious plants. They are snatched from Nature's clutch and reared as prize stock are reared and kept in clover, till they can propagate their kind.
We feed and clothe the unfit, however unfit, and then encourage their procreation, and as soon as they are matured we foster their fertility.
No want of human sympathy for the poor unfortunates of our race is in these words expressed,—a statement simply of the inevitable consequences of unscientific and anti-social methods of dealing with the degenerate.
No State can afford to shut its eyes to the magnitude of this problem. The procreation of the unfit must be faced and grappled with. And the greater the decline in the birth-rate of our best stock, the more urgent does the solution of the problem become. For is not the proportion of the unfit to the fit yearly increasing!
It has become the most pressing duty of the State, in face of the great change that has so rapidly come over our natural increase, to declare that the procreation of the unfit shall cease, or at least, that it shall be considerably curtailed and placed among the vanishing evils, with a view to its final extinction.
Education of defectives in prudence and self-restraint of little avail.—Surgical suggestions discussed.
For the intelligent mind, which I assume has already been impressed with the importance of such an inquiry, I think I have set forth the salient truths with sufficient clearness, but holding that a recitation of social faults, without a suggestion as to social reforms, is not only useless but mischievous, I shall endeavour to show not only that the situation is not hopeless, but that science and experience have, or will reveal means to the accomplishment of all rationally desired ends, and that it remains only for intelligence to enquire that sentiment may move up to the line so as to harmonise with science, with justice, and with the demands of a growing necessity.
These questions of population are not new. More than two thousand years ago, many of the wisest philosophers of all the centuries meditated deeply upon the tendencies of the population to crowd upon subsistence, and in many ages and many countries, the situation has been discussed with serious forebodings for the future.
In all ages thinking men have regarded war with aversion, yet with peace and domestic prosperity other dangers arose to threaten the progress of the race, and as the passing generations cried out for some remedy for the ever pressing evils, thinking men have been proposing measures somewhat harmonising with the knowledge or the sentiment of the times. Whether we are wiser than our ancestors remains an unsettled question.
The old Greeks faced the problem boldly. There were two dangers in the minds of these ancient philosophers. There was the danger of over-population of good citizens, and there was the danger of increasing the burden good citizens had to bear by the maintenance of defectives. However good the breed, over-population was an economic danger, for, said Aristotle, "The legislator who fixes the amount of property should also fix the number of children, for if the children are too many for the property the law must be broken." (Politics II, 7-5.) And he further declares (ib. VII. 16 25) "As to the exposure and rearing of children, let there be a law that no deformed child shall live"; and the exposure of infants was for years the Grecian method of eliminating the unfit.
A century ago "Parson Malthus" dealt with over-population without regard to the fitness of individuals to survive, and he advised the exercise of moral restraint expressed in delayed marriage, to prevent population pressing on the limits of food, which he maintained it invariably tends to do. After the high souled Malthus, came the Neo-Malthusians, who, although they retained the name perverted the teaching of this great demographist, and some Socialist writers of high repute still advocate the systematic instruction of the poor in Neo-Malthusian practices.
The rising tide of firm conviction in the minds of present day sociologists, that the fertility of the unfit is menacing the stability of the whole social superstructure, is forcing many to advocate more drastic measures for the salvation of the race. Weinhold seriously proposed the annual mutilation of a certain portion of the children of the popular classes. Mr. Henry M. Boies, the most enlightened analyst of the problem of the unfit, in his exhaustive work "Prisoners and Paupers," urges the necessity of effectively controlling the fecundity of the degenerate classes, and he points to surgery, and life-long incarceration as the solution of the problem. Dr. McKim, in an exhaustive work on "Heredity and Human Progress," after declaring that he is profoundly convinced of the inefficiency of the measures which we bring to bear against the weakness and depravity of our race, ventures to plead for the remedy which alone, as he believes, can hold back the advancing tide of disintegration. He states his remedy thus:—"The roll then, of those whom our plan would eliminate, consists of the following classes of individuals coming under the absolute control of the State:—idiots, imbeciles, epileptics, habitual drunkards and insane criminals, the larger number of murderers, nocturnal house-breakers, such criminals whatever their offence as might through their constitutional organization appear very dangerous, and finally, criminals who might be adjudged incorrigible. Each individual of these classes would undergo thorough examination, and only by due process of law would his life be taken from him. The painless extinction of these lives would present no practical difficulty—in carbonic acid gas we have an agent which would instantaneously fulfil the need."
These briefly are some of the remedies which have been advocated and in part applied for the protection of the race from degeneracy. I quote them, not with approval, but merely to show how grave and serious the social outlook is, in the minds of some of the best thinkers and truest philanthropists that have taught mankind. If the fertility of the fit could be kept uniformly at its normal rate in a state of nature, the race would have little to fear, for the tendency to further degeneration and consequent extinction amongst the defective would be sufficient to counteract their disposition to a high fertility. But in all civilized nations, the fertility of the fit is rapidly departing from that normal rate, and Mr. Herbert Spencer declares, with the gloomiest pessimism, that the infertility of the best citizens is the physiological result of their intellectual development. I have already expressed the opinion that prudence and social selfishness, operating through sexual self-restraint on the part of the best citizens of the State, are the cause of their infertility. It is impossible for the State to correct this evil, except by lessening the burden the fit man has to bear; and the elimination of the unfit, by artificial selection, is the surest and most effective way of bringing this about.
We have learned from the immortal Pasteur the true and scientific method of artificial selection of the fit, by the elimination of the unfit. We have already seen that he examined the moth, to find if it were healthy, and rejected its eggs if it were diseased. Medical knowledge of heredity and disease makes it possible to conduct analogous examinations of prospective mothers; and surgery secreted in the ample and luxurious folds of anæsthesia, and protected by its guardian angels antiseptics, makes it possible to prevent the fertilization of human ova with a vicious taint. It is possible to sterilize defective women, and the wives of defective men by an operation of simple ligature, which produces absolutely no change whatever in the subjects of it, beyond rendering this fertilization impossible, for the rest of life. This remedy for the great and growing evil which confronts us to-day is suggested, not to avenge but to protect society, and in profound pity for the classes who are a burden to themselves, as well as to those who have to tend and support them.
The problem of the unfit is not new. The burden of supporting those unable to support themselves has been keenly felt in all ages and among all peoples.
The ancients realized the danger and the burden, but found no difficulty when the stress became acute in enacting that all infants should be examined and the defective despatched.
To come nearer home, Boeltius tells us, that, "in old times when a Scot was affected with any hereditary disease their sons were emasculated, their daughters banished, and if any female affected with such disease were pregnant, she was to be burned alive."
Aristotle declared (Politics Book II, p. 40) that "neglect of this subject is a never failing cause of poverty, and poverty is the parent of revolution and crime," and he advocated habitual abortion as one remedy against over-population. The combined wisdom of the Greeks found no better method of keeping population well within the limits of the State's power to support its members than abortion, and the exposure of infants.
Since Aristotle's time abortion has been largely practised by civilized nations. Mutilation and infibulation of females have been practised by savages with the same end in view, while vasectomy, orchotomy, and ovariotomy, have had their avowed advocates in our own time.
The purpose of all these measures was to limit population with little or no distinction as to fitness to survive. The Spartans in ancient times, and many social reformers of to-day have discussed and advocated the artificial limitation of the unfit. The exposure of defective infants was the Spartan method of preserving the physical and mental stature of the race.
The surgical operations on both sexes advocated by some social writers of recent date, have not been received with much favour, and, as a social reform have not been practised. As operations they are grave and serious, profound in their effect upon the individual, and a violation of public sentiment. Anæsthetics and antiseptics have, however, made them possible, and if a surgical operation could be devised, simple and safe in performance, inert in every way but one, and against which there would be no individual or public sentiment, its application as a social reform, would go far to solve the grave and serious problem of the fertility of the unfit.
The unfit are subject to no moral law in the matter of procreation. They can be taught nothing, and they will practise nothing. Like the lower animals they obey their instincts and gratify their desires as they arise.
It has been seriously suggested that the poor should be systematically taught Neo-Malthusian methods for the limitation of their offspring.
The best among the poor might practise them, the worst certainly would not, and the limitation among the best would only stimulate the fertility of the worst. This is the most innocent and harmless of the numerous suggestions made by reformers for controlling the fecundity of the poor.
Of surgical methods, castration of males, Oophorectomy or the removal of the ovaries in women, and vasectomy, or the section of the cords of the testicles, have all been suggested.
Annual castration of a certain number of the children of the popular classes was not long ago seriously proposed by Weinhold.
Boies, in his "Prisoners and Paupers," declares that surgical interference is the only method of dealing with the criminal, and preventing him from reproducing his kind. He says:—"These organs have no function in the human organism except the creation and gratification of desire and the reproduction of the species. Their loss has no effect upon the health, longevity, or abilities of the individual of adult years. The removal of them therefore by destroying desire would actually diminish the wants of nature and increase the enjoyments of life for paupers. A want removed is equivalent to a want supplied. In other words, such removal would be a positive benefit to the abnormal rather than a deprivation, rather a kindness than an injury. This operation bestowed upon the abnormal inmates of our prisons, reformatories, jails, asylums, and public institutions, would entirely eradicate those unspeakable evil practices which are so terribly prevalent, debasing, destructive, and uncontrolled in them. It would confer upon the inmates health and strength, for weakness and impotence, satisfaction and comfort for discontent and insatiable desire."
Anæsthetics have ensured that these operations may be performed without the slightest suspicion of pain, and with careful sympathetic surgery, pain may be absent throughout the whole of convalescence. Antiseptics have made it possible to perform these operations with practically no risk to life.
Though castration and Oophorectomy can be performed with safety and without pain, they are absolutely unjustifiable operations, if done to produce sterility.
Every incision and every stitch in surgery, beyond the necessities of the case, are objectionable, and to remove an organ, when the section of its duct is sufficient is to say the least of it, bad surgery.
Vasectomy is the resection of a portion of the duct of the testicles, followed by ligature of the ends. No doubt ligature alone would be sufficient for the purpose, but up to the present, a piece of the duct has been removed, when this operation has been found necessary in the treatment of disease.
This duct is the secretory tube of the testicle, so that when it is occluded, the secretion is dammed back, and degeneration and atrophy of the organ are induced. It soon wastes, and becomes as functionless as though it were removed.
This operation can be performed in a Surgery with the aid of a little Cocaine, and the patient may walk to his home, sterilized for the rest of his natural life, after the complete loss of any accumulated fluid.
Of these two operations for the sterilization of men, vasectomy is preferable. The major operation for the purpose of inducing artificial sterility should never for a moment be considered.
But vasectomy, though surgically simple, and a less violation of sentiment than castration, cannot be justified except in exceptional cases.
Neither of these operations makes the subjects of them altogether or at once impotent, certainly not for years. It sterilizes and partly unsexes them and in the end completely so.
But the physical and mental changes that follow the operation in the young adolescent are grave and serious, and a violent outrage upon the man's nature and sentiment.
Society can hope for nothing but evil from the man she forcibly unsexes; but if he must be kept in durance vile for the whole of his life there is little need for such an operation.
The criminal cases bad enough to justify this grave and extreme measure should be incarcerated for life.
The cases, it has been thought, that fully justify this operation are those guilty of repeated criminal assaults.
Such a claim arises out of insufficient knowledge of the physiology of sex, and the pathology of crime. Emasculation would have little influence in preventing a recurrence of this crime, for the operation does not render its subjects immediately impotent, nor does it change their sexual nature any more than it beautifies their character.
The instinct remains, and the power to gratify it remains at least for some years. With the less knowledge of surgery of earlier times, a social condition in which such a practice might be rationally considered, is conceivable, but with the present state of our profession, such measures would be unthinkable.
The fertility of the criminal a greater danger to society than his depradations.—Artificial sterility of women.—The menopause artificially induced.—Untoward results.—The physiology of the Fallopian tubes.—Their ligature procures permanent sterility.—No other results immediate or remote.—Some instances due to disease.—Defective women and the wives of defective men would welcome protection from unhealthy offspring.
There is a growing feeling that society must be protected, not so much against the criminal as against the fertility of the criminal, and no rational, practicable, acceptable method has as yet been devised.
The operations on men to induce sterility have been discussed and dismissed as unsatisfactory.
But analogous operations may be performed on women. And if women can be sterilized by surgical interference, whence comes the necessity of sterilizing both?
Oophorectomy, or removal of the ovaries is analogous to castration. It is an equally safe, though a slightly more severe and complicated operation.
It can be safely and painlessly performed, the mortality in uncomplicated cases being practically nil.
The changes physical and mental are not so grave as in the analogous operation on the opposite sex, and they vary considerably at different ages and in different cases. The later in life the operation is performed the less the effect produced. At or after the menopause (about the 45th year) little or no change is noticeable.
In many, and especially in younger women however, grave mental and physical changes are induced. The menstrual function is destroyed, the appearance often becomes masculine, the face becomes coarse and heavy, and hair may appear on the lips and chin. Lethargy and increase of weight are often noticed, and not a few, especially in congenitally neurotic cases, have an attack of insanity precipitated.
On the same principle on which the radical operation on men was condemned, Oophorectomy must also be condemned. It is a serious operation, often attended with grave mental and physical disturbances, not the least of which is the partial unsexing of those subjected to it.
While these are delicate they are also pressing questions, questions which, like the mythical riddle of the Sphynx, not to answer means to be destroyed, yet the sentimental difficulties, are accentuated by modern progress, for the public conscience becomes more sensitive as problems become more grave. But as science has prepared the bridge over which society may safely march, so, with rules easily provided by an enlightened community all remedial measures formerly proposed—wise in their times, probably, may now be waived aside.
With our present knowlege, the simple process of tubo-ligature renders unsexing absolutely unnecessary in order to effect complete and permanent sterility. As the lesser operation vasectomy, is effectual in men, so is a lesser operation, tubo-ligature effectual in women. And it has this paramount advantage that, whereas vasectomy being an occlusion of a secretory duct, leads to complete atrophy and destruction of the testis, ligature of the Fallopian tube, which is only a uterine appendage and not a secretory duct of the ovary, has absolutely no effect whatever on that organ.
A simple ligature of each Fallopian tube would effectually and permanently sterilise, without in any way whatever altering or changing the organs concerned, or the emotions, habits, disposition, or life of the person operated on.
The Fallopian tubes are two in number, attached to the upper angles of the uterus, and communicating therewith. Each is about five inches in length, and trumpet-shaped at its extremity, which floats free in the pelvic cavity.
Attached to the margin of this trumpet-shaped extremity, is a number of tentacle-like fringes, the function of which is to embrace the portion of the ovary, where an ovum has matured during or immediately after menstruation.
At all other times these tubes are practically unattached to the ovaries. Ova may and do mature on the surface of the ovaries, but do not always pass into the Fallopian tubes; being almost microscopic, they are disintegrated and reabsorbed. If they do pass into a tube they are lost or fertilized as the case may be.
It can be seen that the function and vitality of the ovaries are in no way affected by the tubes. The ovarian function goes on, whether the tubes perform their function of conveyance or not, and if this function can be destroyed, life-long sterility is assured. There is no abdominal operation more simple, rapid and safe, than simple ligature of the Fallopian tubes. It may be performed by way of the natural passage, or by the abdominal route, the choice depending on various circumstances. If the former route be taken, there may be nothing to indicate, in some cases not even to a medical man, that such an operation has been performed.
The Fallopian tubes have been ligatured by Kossman, Ruhl and Neuman for the sterilization of women with pelvic deformities; but all testify to the danger of subsequent abnormal or ectopic pregnancy, and several instances are given. Mr. Bland Sutton relates a case in an article on Conservative Hysterectomy in the British Medical Journal.
After numerous experiments on healthy tubes, I have found that simple ligature with even a moderate amount of force in tying will cut the tube through in almost any part of its length. The mucous lining is so thrown into folds that its thickness in relation to the peritoneal layer is considerable. Because of this, the tube when tied alone is brittle, and a ligature applied to it will very easily cut through, and either allow of reunion of the severed ends or leave a patent stump. In a recorded case in which pregnancy occurred after each tube was ligatured in two places, and then divided with a knife, a patent stump was no doubt left.
In order to obviate this danger the peritoneal layer must be opened, and the mucous membrane, which is quite brittle and easily removed, must be torn away for about one quarter of an inch. A simple cat-gut or silk ligature lightly tied would then be sufficient to insure complete and permanent occlusion.
Nature often performs this operation herself, with the inevitable and irrevocable result, lifelong sterility, with no tittle of positive evidence during life of its occurrence.
Here are a few examples:—A young married woman has a miscarriage; it is not severe, and she is indiscreet enough to be about at her duties in a day or two, but within a few days or so she finds she must return to bed, with feverishness and pelvic pain. Before a month is past she is up and quite herself again. But she never afterwards conceives. What has happened? To the most careful and critical examination nothing abnormal is detected. Her general health, her vitality, her emotional and sexual life, her youthful vigorous appearance, all are unimpaired. But she is barren, and why? A little inflammation occurred in the uterus and spread along the tubes. The sides of the tubes cohered, permanently united by adhesive inflammation, and complete and permanent occlusion resulted.
The operation of tubo-ligature is an artificial imitation of this inflamatory process.
Pelvic inflammation, sometimes very slight, following a birth, or the same process set up by uterine pessaries used for displacements, may induce adhesive inflammation in the tubes, and simple and permanent sterility is the incurable result. It is a well known fact that prostitutes are usually sterile, and this arises from the prevalence of venereal disease, which produces gonorrhœal inflammation of the Fallopian tubes, resulting in complete and permanent occlusion.
This process could be best imitated, if cauterisation of the tubes were a safe and reliable procedure. An electric cautery passed along the tubes would result in a simple and speedy occlusion. But in the present state of our gynecological knowledge this appears impracticable.
We have therefore at our hand, a simple, safe, and certain method of stopping procreation by the sterilization of women by tubo-ligature.
This operation would entail no hardship on women. It is so easy, safe and painless, that thousands would readily submit to it to-morrow, to be relieved from the anxiety which a possible increase in their already too numerous families excites. Hundreds of women and men to-day are living unnatural lives, because of their refusal to bring children into the world with the hereditary taint they know courses in their own veins.
Many men are living loose and irregular lives, amongst the easy women of society, because the indiscretion of their youth has damned them for ever with a syphilitic taint, which they could not fail to transmit to their progeny.
Many virtuous men and women are living a life of abstinence from even each other's society, because their physician has taught them something of the law of heredity. Would not all these women readily submit to sterilization?
As it produces no mental nor moral, nor physical change, it violates no law, and outrages no sentiment. It is an outrage upon society, and a greater upon an innocent helpless victim to bring a defective into the world; it is a moral act to prevent it by this means.
And of all the methods yet suggested or devised, or practised, tubo-ligature is the simplest, most effective, and least opposed to sentiment and prejudice.
It will of course be asked:—What about criminals and defective men? Let their wives be sterilized. The wife of any criminal would deem it a boon to be protected from the offspring of such a man, so would society.
If he is not married, then society must take the risk, and it is not very great. The women who will be his companions will be either sterilized by disease or by tubo-ligature, because they are defectives. This protection from the progeny of defective men, though not absolute, is complete enough for all practical purposes.
If all defective women and the wives of all defective men are sterilized, a greater improvement will take place in the race in the next 50 years, than has been accomplished by all the sanitation of the Victorian era.
The State's humanitarian zeal protects the lives and fosters the fertility of the degenerate.—A confirmed or hereditary criminal defined.—Law on the subject of sterilization could at first be permissive.—It should apply, to begin with, to criminals and the insane.—Marriage certificates of health should be required.—Women's readiness to submit to surgical treatment for minor as well as major pelvic diseases.—Surgically induced sterility of healthy women a greater crime than abortion.—This danger not remote.
The fertility of the unfit goes on unrestrained by any other check, save vice and misery. The great moral checks have not, and cannot have any place with them. But the State is, by its humanitarian zeal, limiting the scope and diminishing the force of these natural checks amongst all classes of the community, but especially amongst the unfit, so that its policy now fosters the fertility of this class, while it fails to arrest the declining nativity of our best citizens. The greater the fertility of the unfit, the greater the burden the fit have to bear, and the less their fertility.
The State's present policy therefore, fosters the fertility of the unfit, and discourages the fertility of the fit. This disastrous policy must be changed without delay. The State can arrest the gradual degradation of its people, by sterilizing all defective women and the wives of defective men falling into the hands of the law. Mr. Henry M. Boies in "Prisoners and Paupers" suggests life-long isolation. He says:—"It is time however that society should interpose in this propagation of criminals. It is irrational and absurd to occupy our attention and exhaust our liberality with the care of his constantly growing class, without any attempt to restrict its reproduction. This is possible too, without violating any humanitarian instinct, by imprisonment for life; and this seems to be the most practicable solution of the problem in America. As soon as an individual can be identified as an hereditary or chronic criminal, society shall confine him or her in a penitentiary at self-supporting labour for life.
"Every State should have an institution, adapted to the safe and secure separation of such from society, where they can be employed at productive labour, without expense to the public, during their natural life. When this is ended with them, the class will become extinct, and not before. Then each generation would only have to take care of its own moral cripples and defectives, without the burden of the constantly increasing inheritance of the past. When upon a third conviction the judicial authorities determine the prisoner to belong to the criminal class, the law should imperatively require the sentence to be the penitentiary for life, whatever the particular crime committed."
M. Boies defines a criminal as one in whom two successive punishments, according to law, have failed to prevent a third offence.
If such a criminal is a woman, she should be offered the alternative of surgical sterility or incarceration during the child bearing period of her life; if a man, his wife should be offered this remedy against the procreation of criminals in exchange for her husband, on the expiry of his sentence, or the protection of divorce.
No woman in the child-bearing period of life should be released from an Asylum, until this operation has been performed. If a man is committed, his wife should have the option of divorce or be sterilized before his release.
A central Board should issue marriage certificates, after consideration of confidential medical reports upon the health, physical condition, and family history of the parties to a proposed marriage contract.
Medical officers should be appointed in the various centres of population by the central Board, and fees on reports should be paid after the manner of Life Insurance fees.
In fact the Life Insurance system would serve as a good model, for the establishment of a system of marriage control, and if questions involving a more detailed family history were added to a typical Life Insurance report form, it could hardly be improved upon, for the purpose of marriage health reports.
If upon consideration of the medical report of the contracting parties, in accordance with the law upon the subject, a certificate of marriage were refused, a certificate of sterilization by tubo-ligature, forwarded to the Board by a Surgeon, should entitle to the marriage certificate.
No law should attempt to step in between two lovers, who have become attached to each other by the bonds of a strong affection, lest a greater evil befall both themselves and society.
A marriage certificate of health should state the complete family history as well as the physical condition of the parties to a proposed marriage, and such certificates should be issued only by the Central Board of Experts, who would receive the medical reports of its own medical officers.
When the principle of artificial sterilization is accepted by the State, the organization necessary to ensure that only the fit shall procreate, will only be a matter of arrangement by experts.
One danger looms ahead however if the operative means of producing artificial sterility are popularised.
Every surgeon of experience knows how readily large numbers of married women encourage surgical treatment for ovarian and even uterine complaints, if they become aware that such treatment is followed by sterility. It is not at all an uncommon thing for women in all ranks of life, to encourage, and even seek removal of the ovaries in order to escape an increase in the family.
They become acquainted with persons who have submitted to this operation for ovarian disease, and noting nothing but improvement in their health, attended by sterility, their intense anxiety to enjoy immunity from child-bearing makes them eager to submit to operation.
It would be distinctly immoral to sterilize healthy women, who become possessed with the old Roman passion for a childless life, or who simply wish to limit their families for any selfish or personal reason.
Any law which recognizes the induction of artificial sterility should make operative interference with those fit to procreate a healthy stock an offence.
Induced sterility should rank with induced abortion, and be a criminal offence, except in certain cases which could be defined.
There is much evidence to suggest that artificial sterilization may become as a great vice, as great a danger to the State as criminal abortion.
Artificial abortion, as commonly performed, is a much more dangerous operation than tubo-ligature. Of the two operations, any experienced surgeon would readily declare that the latter is the simpler and the safer; the one less likely to lead to unfavourable complications, and the one, moreover, that would leave the subject of it with the better "expectancy of life."
Anæsthetics and anti-septics have made this comparison possible and true.
Any surgeon who performs tubo-ligature should be liable to prosecution, unless he can justify his action according to the law relating to the artificial sterility of the unfit.
While the law would eventually require to be obligatory, with regard to the absolutely unfit, it would require to be permissive in all other cases.
Many voluntarily abstain from marriage, because of a strong hereditary tendency to certain diseases such as cancer and tubercle.
There must of necessity be many on the border-land between the fit and the unfit, and clauses permitting sterilization under some circumstances would be required.