The Task of Social Hygiene

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

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

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

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

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