The Task of Social Hygiene. Ellis Havelock

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

26

The term "feeble-minded" may be used generally to cover all degrees of mental weakness. In speaking a little more precisely, however, we have to recognize three main degrees of congenital mental weakness: feeble-mindedness, in which with care and supervision it is possible to work and earn a livelihood; imbecility, in which the subject is barely able to look after himself, and sometimes only has enough intelligence to be mischievous (the moral imbecile); and idiocy, the lowest depth of all, in which the subject has no intelligence and no ability to look after himself. More elaborate classifications are sometimes proposed. The method of Binet and Simon renders possible a fairly exact measurement of feeble-mindedness.

27

Mott (Archives of Neurology and Psychiatry, Vol. V, 1911) accepts the view that in some cases feeble-mindedness is simply a form of congenital syphilis, but he points out that feeble-mindedness abounds in many rural districts where syphilis, as well as alcoholism, is very rare, and concludes by emphasizing the influence of heredity; the prevalence of feeble-mindedness in these rural districts is thus due to the fact that the mentally and physically fit have emigrated to the great industrial centres, leaving the unfit to procreate the race.

28

"Whether germinal variations," remarked Dr. R.J. Ryle at a Conference on Feeble-mindedness (British Medical Journal, October 3, 1911), "be expressed by cleft palate, cataract, or cerebral deficiency of the pyramidal cells in the brain cortex, they may be produced, and, when once produced, they are reproduced as readily as the perfected structure of the face or eye or brain, if the gametes which contain these potentialities unite to form the ovum. But Nature is not only the producer. Given a fair field and no favour, natural selection would leave no problem of the unfit to perplex the mind of man who looks before and after. This we know cannot be, and we know, too, that we have no longer the excuse of ignorance to cover the neglect of the new duties which belong to the present epoch of civilization. We know now that we have to deal with a growing group in our community who demand permanent care and control as well for their own sakes as for the welfare of the community. All are now agreed on the general principle of segregation, but it is true that something more than this should be forthcoming. The difficulties of theory are clearing up as our wider view obtains a firmer grasp of our material, but the difficulties of practice are still before us." These remarks correspond with the general results reached by the Royal Commission on the Feeble-minded, which issued its voluminous facts and conclusions in 1908.

29

See, for instance, A.F. Tredgold, Mental Deficiency, 1908.

30

The investigation of Bezzola showing that the maxima in the conception of idiots occur at carnival time, and especially at the vintage, has been held (especially by Forel) to indicate that alcoholism of the parents at conception causes idiocy in the offspring. It may be so. But it may also be that the licence of these periods enables the defective members of the community to secure an amount of sexual activity which they would be debarred from under normal conditions. In that case the alcoholism would merely liberate, and not create, the idiocy-producing mechanism.

31

Godden, Eugenics Review, April, 1911.

32

Feeble-mindedness and the other allied variations are not always exactly repeated in inheritance. They may be transmuted in passing from father to son, an epileptic father, for instance, having a feeble-minded child. These relationships of feeble-mindedness have been clearly brought out in an important investigation by Davenport and Weeks (Journal of Nervous and Mental Disease, November, 1911), who have for the first time succeeded in obtaining a large number of really thorough and precise pedigrees of such cases.

33

It may be as well to point out once more that the possibility of such limited depreciation must not be construed into the statement that there has been any general "degeneration of the race." It maybe added that the notion that the golden age lay in the past, and that our own age is degenerate is not confined to a few biometricians of to-day; it has commended itself to uncritical minds in all ages, even the greatest, as far back as we can go. Montesquieu referred to this common notion (and attempted to explain it) in his Pensées Diverses: "Men have such a bad opinion of themselves," he adds, "that they have believed not only that their minds and souls were degenerate, but even their bodies, and that they were not so tall as the men of previous ages." It is thus quite logically that we arrive at the belief that when mankind first appeared, "there were giants on the earth in those days," and that Adam lived to the age of nine hundred and thirty. Evidently no syndromes of degenerescence there!