{"collection":"philosophy-ethics","full_text_available":true,"graph_url":"https://unchartedknowledge.5gfusion.net/v2/api/page/gutenberg_73050/graph","html_url":"https://unchartedknowledge.5gfusion.net/v2/page/gutenberg_73050","id":"gutenberg_73050","license":"Public Domain (US)","rights_basis":"gutenberg_metadata_copyright_false","source":"gutenberg","source_url":"https://www.gutenberg.org/ebooks/73050","summary":null,"tags":["Birth control","Category: Health & Medicine","Category: Philosophy & Ethics","Category: Politics"],"text":"BIRTH CONTROL\n                             AND THE STATE\n\n\n\n\n                             BIRTH CONTROL\n                             AND THE STATE\n\n                         A PLEA AND A FORECAST\n\n\n                                  BY\n                             C. P. BLACKER\n                    M.C., M.A., M.R.C.S., L.R.C.P.\n\n\n                            [Illustration]\n\n\n                               NEW YORK\n                        E. P. DUTTON & COMPANY\n                           681 FIFTH AVENUE\n\n\n\n\n                            Copyright, 1926\n                       By E. P. DUTTON & COMPANY\n\n                         _All Rights Reserved_\n\n\n                PRINTED IN THE UNITED STATES OF AMERICA\n\n\n\n\n                               FOREWORD\n\nThe pioneer battles on behalf of Birth Control, as everybody knows,\nhave been fought in this country by Dr Marie Stopes, who has largely\nborne the brunt of that abuse which is meted out to all popular\nexponents of ideas that do not harmonize with traditional morality. The\nfact that Dr Stopes has been criticized, and at times attacked by the\nmedical profession (which until recently refused to acknowledge that\nthe subject of Contraception fell within its sphere) on the grounds\nthat she does not possess a medical degree, and the fact that she has\nretaliated with vigour\u2015\u2015and continues to do so in most of her public\nutterances, have led to a breach between her and the more orthodox\nelements of the profession, which to a certain extent, has impeded the\nrealization of her ultimate aim, namely the undertaking by the State of\nthe work she performs on a small scale in her privately-run clinique.\n\nIn what follows I have drawn attention to drawbacks attending the\ndissemination of knowledge of Contraception by General Propaganda. I\nhave done so, however, fully realizing that this propaganda was, in\nthe first instance, necessary to override the barrier of prejudice\npresented by orthodox morality, and equally realizing that if it had\nnot been for Dr Stopes and her propaganda this book would probably\nnever have been written. In its essential plea that advice on\nContraception, now obtainable only at private institutions, be made\ngenerally available by the Ministry of Health at the centres under\nits control, this book is at one with the wider aim expressed by Dr\nStopes in the words that commemorate the founding of her first private\nclinique.\n\nI know that in the past it has proved nearly impossible in a single\nbook to appeal effectively both to the general public, and to the\nmedical profession. Yet I have attempted to do that here. The task has\nbeen made perhaps less difficult than usual by the fact that until\nrecently the subject of contraception has been completely ignored by\nthe medical profession, which as a whole seems to remain as uninformed\nof its wider implication as does the general public. It will be found\nthat the book ends with a practical suggestion taking the form of an\nappeal to the medical profession.\n\nThe substance of the first part of what follows originally appeared as\na series of articles in The Saturday Review, to which I am indebted for\npermission to publish the book in its present form.\n\n                                                            C. P. B.\n\n\n\n\n                      BIRTH CONTROL AND THE STATE\n\n                         A PLEA AND A FORECAST\n\n\nSince the War, the subject of Birth Control has been widely discussed,\nand much has been written about it. By some of its advocates it has\nbeen extolled to the point where any criticism, however tentative,\nis resentfully repudiated. By its enemies it has been represented as\na pernicious and unnatural practice leading to the degeneracy and,\nultimately, to the extinction of the race. So wholeheartedly felt, and\nyet so profoundly opposed are these views, that it has been difficult\nfor the average person to find his bearings on any other basis than\nthat of his own sentiment.\n\nIt is clear that the implications of Birth Control, or, rather, what\nis generally, though not logically understood by the term, of the\npractice of contraception, are far reaching. It profoundly affects the\nlife of the individual; it reacts upon the internal economy of the\ncommunity; and it has a most important bearing upon the international\nfuture of the country wherein it is practised. It is therefore\nincumbent upon all serious students of contemporary world-problems to\nrealize clearly what is to be said on both sides, and to form thereon,\nas far as lies in their power, an unbiassed opinion. This obligation\nweighs especially heavily on medical men since, if the practice is to\nbe tolerated at all, it is by them that it should be administered and\ncontrolled.\n\nIt is a general survey of this sort that is attempted here. The book\nwill begin with a consideration of the more important arguments that\nhave been advanced on each side. These will then be discussed, and\nthere will follow a conclusion as to the bearing of the practice upon\nthe future of civilization.\n\nIt will be convenient first to review the more serious arguments used\n_against_ Birth Control, the problem being considered throughout both\nas a world-problem and as one with a special significance for this\ncountry. They fall into two distinct categories concerning (A) the Race\nand (B) the Individual.\n\nA. 1. The \u2018military\u2019 argument finds exponents among Nationalists, who\nare convinced that the essential merit of a country lies in its powers\nof offence and defence, or who are persuaded that future wars are, by\nthe constitution of human nature, inevitable, and that it is therefore\nnecessary for the country to which they belong to be fully equipped.\nBy such persons, Birth Control is opposed in so far as it would impair\ntheir country\u2019s man power.\n\n2. An argument allied to the above, yet one which must be distinguished\ncarefully from it, deserves close scrutiny. It is to the effect that\nquite apart from military considerations the practice of Birth Control\nin a country is capable of acquiring in a short time such universality\nthat the population may decrease, and eventually dwindle to proportions\nwhich would place that country, whatever its status, in a position of a\nsecond or third-rate power. From history the approximate generalization\ncan be made that prolific races get the better of infertile races in\nthe struggle, first for existence, and then at a later stage, for\npower. This generalization is likely to hold good in an economic\nsphere. Thus a graphic picture has been drawn of what will happen to\nEngland, in the matter of its population, if it follows in the wake\nof France. It will come to assume the proportions of an insignificant\nlittle island in the North Sea, the possessor, actually, of a mighty\npast, but in the present counting for nothing beside the densely\npeopled territories of Southern and Eastern Europe, Asia and America.\nBirth Control uncontrolled means race suicide.\n\n3. There is an \u2018economic\u2019 argument against Birth Control, which itself\ntakes two forms.\n\nIn the first place it is felt, in under-populated countries like New\nZealand, Australia, and perhaps to a less extent the United States,\nthat since it is desirable in the general interests that the population\nshould increase, it is to be preferred that this increase be effected\nfrom native-born stock rather than through the process of accretion\nby often undesirable aliens. Hence in most under-populated countries,\nBirth Control is opposed.\n\nIn the second place it is probably felt (though probably not admitted)\nby the Governments of those capitalistic countries confronted with\na labour problem, which are at the same time desirous of limiting\nimmigration, that the unrestricted multiplication of their working\nclasses, by causing a competition for wages, will create a cheap labour\nmarket. It is highly unlikely that this view has much weight here,\nthough it may easily be otherwise in the United States, where the\nlabour problem is acute and where it is universally desired to limit\ncoloured immigration and immigration from South-Eastern Europe.\n\n4. There is an argument against Birth Control, which has special\nreference to the position of this country as the original founder of\na great Empire. Since most of the Dominions are still under-populated\nand wish their numbers to increase, and since the increase of native\nstock, even though fully encouraged, is unable to supply the demand for\nlabour, it is contended that Great Britain should always be able to\nturn out a numerical surplus to send to the Dominions each year, which\nin addition to satisfying a need for better-class immigrants would\nserve to consolidate the racial and cultural bonds that keep the Empire\ntogether.\n\nB. The above arguments concern the race. The remainder which follow\nrefer primarily to the individual.\n\n5. A \u2018medical\u2019 argument has been heard to the effect that the\nactual practice of Birth Control or, more precisely, the use of\ncontraceptives, is inimical to health, being capable of causing both\nlocal disease and more general constitutional disorders. Emotional\ninstability and various neuroses have been quoted as such products.\nNo woman making use of a contraceptive for the first time can escape\na feeling of revulsion at such a callous interference with a process\nthat above all others should be spontaneous and instinctive. No woman\ncan then fail to experience a sense of aversion from such a deliberate\nthwarting of Nature\u2019s most fundamental purpose.\n\n6. Very potent also, is a \u2018conventional\u2019 objection which in practice\nis often associated with the religious argument next to be considered,\nthough in reality it is distinguishable from it. On these grounds it\nis felt that all that pertains to the province of sex is indecent,\ndisgusting, and unfit for discussion. The topic of Birth Control is\nthus stigmatized as \u2018immoral\u2019 by many people of no deep religious\nconviction.\n\n7. The \u2018religious\u2019 objection nowadays finds its chief exponents among\nthe Japanese and Roman Catholics, though it is also strongly upheld by\nmany Anglicans and others. By the Japanese, Birth Control is condemned\non grounds that seem to be, partly at any rate, nationalistic. The\nJapanese religion, intimately connected as it is with Ancestor Cult,\nholds that it is the duty of every man to marry young, and to produce\nthe largest possible number of children, especially males, who may\ncarry on the tradition of the family and at the same time grow up into\nsoldiers capable of fighting for the Mikado in war. By the Japanese,\nthe Mikado is believed to be a Deity incarnate, not in the symbolical\nsense in which some people have thought of the divine right of kings,\nbut in a real and vital sense, as \u2018the occupant of a sacred throne\nwhich was established at the time when the heavens and the earth\nbecame separated.\u2019 To die for him in war is the most supreme, the most\nglorious duty. The objection to Birth Control here would thus seem\nclosely allied to the \u2018military\u2019 objection first advanced.\n\nBy Roman Catholics it is held to be a mortal sin to employ any chemical\nor mechanical means to prevent conception, the only permissible form\nof control being voluntary abstinence from each other on the part of\nboth parents. The abstinence of one parent against the will of the\nother is also considered a mortal sin on the part of the refractory\nparent. An exception to this rule is now made which permits parents\nnot desiring children to make use of a moment in the periodic life of\nthe mother during which conception is less likely to take place than\nat other times\u2015\u2015the so-called \u2018safe\u2019 period. It is, however, generally\nagreed nowadays that the \u2018safety\u2019 pertaining to this period is in many\ncases quite illusory and devoid of serious physiological or medical\nbasis. Opponents of the Roman Catholic Church have represented its\ninsistence on this prohibition as dictated by a desire to extend her\nspiritual empire throughout the world, since obedience to it must\nbring about a greater relative increase of believing Roman Catholics\nthan of adherents to other religious denominations tolerating Birth\nControl. But its attitude would further appear to express a conviction\n(manifested elsewhere in the insistence upon celibacy among Catholic\npriests and in its systems of penances and abstinences) that sexual\nindulgence is somehow incompatible with devotion to a purely spiritual\nlife, and when excessive produces a demoralizing effect upon human\nnature, tending to make it weak, lazy, selfish and often vicious.\nProbably the Catholic Church feels that the use of devices to prevent\nconception would abolish the necessity for salutary self-restraint,\nand would promote promiscuous and excessive indulgence. The effect of\nthis prohibition is that most Catholics who are conscientious about\nnot using contraceptives have large families. There are some, however,\nparticularly in France, who do not take the prohibition very seriously.\n\nAt the bottom, however, of the religious objection, would appear to\nlie the conviction that excessive sexual indulgence, dissociated\nfrom the sequel of procreation and rendered possible by the use of\ncontraceptives, is morally harmful to the individual.\n\n8. An objection of a pseudo-political nature is sometimes heard which\nenvisages a bureaucratic extension of Birth Control. The phrase is here\nunderstood to imply a \u2018National Control of Births\u2019 and not a \u2018Voluntary\nRegulation of Births\u2019, its more usual acceptance. Such a bureaucratic\ninterference in people\u2019s private lives is held to constitute an\ninfringement of the liberty of the individual\u2015\u2015in this case his\nliberty to have as many children as he likes, when he likes. The\nprinciple of individual liberty, the corner-stone of nineteenth century\nLiberalism, still has a certain number of adherents.\n\n9. The last outstanding argument is to the effect that the\npopularization of Birth Control will lead to a general increase in\npromiscuity, both among married and unmarried people. The temptation\nto illicit indulgence would be made greater, the process of seducing\nan innocent girl would be made easier, the ever-present lure of\nprostitution to the underpaid girl worker would be made more difficult\nto resist, if an assurance could be felt that the subsequent birth of\na child\u2015\u2015hitherto a generally prevalent and effective deterrent\u2015\u2015could\nbe prevented by the exercise of a popularly known technique. The\nrestraint imposed by fear may not be one of a high moral order, yet the\nend which it serves is here, by common consent, socially desirable.\nIn face of the absence of any authoritative source of information on\nBirth Control, and of the indifference of the medical profession with\nregard to it, certain popular works on the subject have acquired an\nimmense vogue and have enjoyed an enormous sale. Though not intended\nfor this purpose, they are purchased and read extensively by young\npersons in much the same spirit that improper literature in general is\nread. Further, the sale to adults of these works containing as they do\na magnification and eulogy of the sexual act _per se_ (to be conceived,\nexpressly, apart from its normal biological sequel of child-birth as\na salutary and health-giving process), and containing also minute\ninstructions as to the technical use of contraceptives, has not been\nconfined to married persons. Such works have been held to inflame and\npervert the imagination of the young, and on pseudo-medical grounds,\nto incite adults to promiscuity. It is to be noted, however, that the\nabove is an argument directed not so much against Birth Control itself\nas against the method by which knowledge of it is communicated to the\npublic.\n\n                   *       *       *       *       *\n\nThese appear to be the most important arguments currently advanced\nagainst Birth Control.\n\nIt will be noted that several have been omitted from consideration.\nThe one based upon biblical condemnation is too futile to merit\nrestatement. The argument that contraception is \u2018unnatural\u2019 is equally\nundeserving of repetition. The contention that it is anti-biological\nwill be discussed later.\n\n                   *       *       *       *       *\n\nArguments on the other side will now be considered. They divide\nthemselves into three groups, which may arbitrarily be designated as\nInternational, Social, and Individual arguments.\n\n\n(_a_) _International._\u2015\u2015The connexion between over-population and war is\nnowadays fairly obvious and is particularly manifest in those countries\nwhich are both industrially organized and consciously nationalist in\nspirit. In the absence of these two conditions over-multiplication need\nnot be followed by war. India and China, for instance, are very densely\npopulated countries where over-multiplication frequently takes place.\nThis process does not, however, give rise to much danger of\ninternational disturbance, in that both countries are, from the nature\nof their organization, incapable of conducting war on modern lines, and\nneither has a generally-felt, or a unifying national consciousness.\nExcessive increase is here frequently checked by famines, which, though\ncausing incalculable suffering, do not readily generate wars.\n\nWithin recent years two countries have demonstrated the relation\nbetween over-population and war, or the threat of war, namely Germany\nand Japan.\n\nIn Germany before the war, where the \u2018military\u2019 objection to Birth\nControl, first advanced, was prevalent, there existed an ethical code\nby which German mothers were persuaded that they were fulfilling the\nhighest spiritual purpose of which their sex was capable by producing\nmale children destined to be soldiers, prepared to fight for their\ncountry in a victorious war. It is now generally recognized here\nthat it was this attitude of mind, involving an expectation and a\nglorification of war, associated with the distinctively German powers\nof efficient organization centred in implicit obedience to the Kaiser,\nwhich served to produce that exultant pride of power and aggressive\nnational consciousness which precipitated, if it did not actually\ncause, the late war. The increase in the population of Germany was\nadvocated and extolled without regard to that country\u2019s capacity to\nsupport her swelling populations. To-day, though Birth Control is\nlargely practised by the upper and middle classes in Germany as\nit is in this country, the old ideal still lingers on, and to it\nis attributable that fear of Germany which, until recently, has so\nconspicuously directed French policy since the Armistice.\n\nIn Japan the connexion between numerical increase and a possible war is\nnow coming to be recognized here. Australia, New Zealand and the United\nStates are already definitely conscious of it. The Japanese religion,\nbased upon piety towards ancestors (to whom every man is bound to\nperpetuate his family), and upon loyalty to the Mikado who, as Emperor\nGod, is held to be divine, imposes upon all faithful subjects the duty\nof marrying young and of producing many children. This injunction\nis again promulgated irrespective of the native resources of Japan,\nand in the past has necessitated a considerable annual emigration\nto other countries. The recent restrictions imposed by America upon\nJapanese immigration, themselves prompted by motives common to most\nEnglish-speaking races, have led directly and inevitably to the\nexisting tension between America and Japan. As things stand at present,\nit appears that this tension is likely to increase and may easily\neventuate in a war, in which there would be a greater probability\nof our being involved than there was, initially, of America being\ninvolved in the late war. Both the Americans and Japanese are sensitive\nand proud people. After further tension has accumulated, a trivial\nincident\u2015\u2015the possible murder of an American official in Japan by some\nirresponsible person\u2015\u2015might lead to the despatch of a curtly-worded\nnote or to the formulation of an abrupt ultimatum out of which a second\nworld war might, like the last, suddenly flare up, to reduce modern\ncivilization to ruins and ashes.\n\nStress is laid on this particular aspect of the population problem\npartly because it is felt that few nations now hold the desirable ideal\nof adapting their numbers to their particular economic optimum, and\npartly because it would seem that in face of this nationally encouraged\nincrease of population and of certain apparently unalterable race\nantipathies, _no amount_ of international pacifism, or of condemnation\nof violence, or of genuine humanitarian goodwill can prevent war.\n\nGermany and Japan display the connexion between numerical increase\nand wars most clearly to-day. It is possible that in the future other\nnations may become conspicuous in this respect. Thus America, where\nthe teaching of contraception is illegal (in so far as anything is),\nmay, in another 50 or 100 years, develop an aggressive foreign policy.\nAnd now that restrictions have been imposed on the entry of Italians\ninto America, it is conceivable that Italy may at some time discover an\nImperialist mission on the shores of the Mediterranean.\n\n\n(_b_) _Social._\u2015\u2015This aspect of Birth Control has been much discussed\nand is concerned with the dimensions and quality of the population\nof these islands. The argument, in the form in which it is usually\nadvanced, distinguishes a quantitative and a qualitative point of view,\nthe latter further possessing two aspects.\n\nQuantitatively, it has been pointed out that in the last hundred years,\nthe increase in the population of this country has been excessive.\nBecause England was the pioneer of the Industrial Revolution, she\nenjoyed initially an unprecedented national prosperity, unharassed by\ncompetitors and with the world as her market. Though the conditions of\nmany of the early factory-workers were unquestionably appalling, the\nwealth and economic importance of this country increased so rapidly\nthat she was enabled to support immensely greater numbers than at any\nprevious period of her history.\n\nThus in 1821 the population of England and Wales was just over 12\nmillions; in 1921 it had risen to nearly 38 millions. That is to say\nthat in a hundred years our population had more than trebled.\n\nWhen, however, at the beginning of this century other countries began\nto enter into competition with us, and to produce manufactured goods\non a large scale often underselling British goods, our hitherto\nunchallenged industrial supremacy gradually commenced to suffer\neclipse. But our numbers have not adapted themselves to our diminished\npower of employing labour thus created. On the contrary, the population\nhas continued steadily to increase, with the result that by slow\ndegrees the unemployment problem which, at present, looms so large on\nour political horizon began insidiously to disclose itself. The present\nformidable figure of nearly a million and a quarter of unemployed,\ntogether with a large number of workers on short hours, testifies to\nthe fact that at the present time in relation to existing economic\nconditions, this country seems to be over-populated.\n\n                   *       *       *       *       *\n\nFrom the point of view of quality it has been pointed out that there\nare two factors which now tend to impoverish the race. They might\nbe distinguished and arbitrarily named as \u2018Dysgenic\u2019 and \u2018Economic\u2019\nrespectively.\n\nThe dysgenic factor may be propounded as follows: Though the Birth-rate\nin England has fallen from 36 per 1000 in 1877 to 20 per 1000 or less\nto-day, this decrease has not been accompanied by a decrease in the\npopulation, since the Death-rate has dropped correspondingly. This has\ntaken place by reason of the complete suspension, if not the actual\nreversal, in civilized countries to-day of the principle of Natural\nSelection, operative amongst animals and primitive peoples.\n\nThere are three outstanding reasons to which this suspension is\nattributable. They are the advances in sanitation and medical science,\nthe increase in humanitarianism, and the method of obtaining votes\nwhich prevails in democratic countries.\n\nThe advances in sanitation and medical science made in the last 60\nyears have resulted in an enormous reduction of infant mortality in\nlarge towns, and also in an average prolongation of life. Epidemics\nof smallpox, cholera, typhus, diphtheria, scarlet fever, etc., which\ntook such a heavy toll in the past, are now effectively controlled by\nthe existing system of isolation hospitals, and of efficient public\nhealth supervision. To-day it is possible for the medical student to\ntraverse his six laborious years of training without seeing a single\ncase of typhoid fever\u2015\u2015a disease which in the times of his elders\nused to be one of the commonplaces of a hospital. These improvements\nin sanitation, the progress made in aseptic surgery, in prophylactic\nmedicine, and in the general treatment of disease, have been largely\nresponsible for the lowering of the death-rate already mentioned.\n\nThe increase of humanitarianism in civilized countries has resulted in\nthe creation of an enormous number of philanthropic institutions and\ncharity organizations, through the channels of which much relief is\nbrought to the impoverished classes. This spirit now makes it difficult\nfor those endowed with a superfluity, or even a sufficiency of wealth,\nto contemplate with indifference the misery and degradation of less\nfortunately placed fellow human beings.\n\nAnd lastly, since the entry to power of any given political party\nis conditioned by the acquisition by that party of a sufficient\nnumber of votes, given by a mainly proletarian electorate, it follows\nthat politics are likely to be framed in such a way as to commend\nthemselves to such an electorate. It would seem unfair to omit this\nfact from consideration, though it has been over-emphasized by a school\nof political cynics who deny the participation of humanitarian feelings\nin politics (outside the realm of speech-making), and who attribute to\npolitical expediency an excessive if not an exclusive r\u00f4le in improving\nthe lot of the very poor.\n\nIn virtue, then, of these factors it would nowadays be very difficult\nfor any individual, however worthless, actually to starve, and many\npeople of defective stock and bad physique who, in the ordinary course\nof nature would perish, are now artificially kept alive to perpetuate\ntheir kind.\n\n                   *       *       *       *       *\n\nThe \u2018economic\u2019 factor tending to produce deterioration in the race,\npresupposes the dysgenic.\n\nAmong uncivilized peoples it is the biologically superior type which is\nmost prolific. In advanced civilized countries, which are democratic\nin social organization, the reverse obtains. Thus among most primitive\npeople, the Chief\u2015\u2015_i.e._ the man with most courage, initiative,\nresourcefulness and power of leadership\u2015\u2015enjoys the possession of most\nwives, and therefore produces most offspring. The analogue of the\ndrunken unemployable of to-day would probably not be permitted to marry.\n\nIn England now, however, the drunken unemployable finds his nearest\napproach to an occupation in endowing his ill-fated wife with a stream\nof children, the regular succession of which is only eventually\ninterrupted by the breakdown, age, or premature death of the wife, or\nby the death of the husband. And the only discouragement extended to\nsuch a man is forthcoming from the strictures passed upon him by his\nslum neighbours. None is forthcoming from the Government, and none from\nthe hospital, which gratuitously delivers the wife of her children. In\nfact, information as to how she may arrest this devastating succession\nof children is deliberately withheld from her by nearly all hospitals,\nbecause it is felt that the condition of public opinion, upon which the\nhospitals largely depend for their finances, is averse from her being\nenlightened in this respect.\n\nThe organization for relief in this country is now so comprehensive and\nfar-reaching that every necessity can be obtained gratis by those who\ncannot afford to pay for it. Thus the wife of the poor man is delivered\nof her children free of charge; the children are educated for nothing;\nif employment is not available for them at the time of leaving school,\nthey are supplied with doles and relief free of obligation. And when\nthey become senile, they are given old age pensions gratuitously. The\nfunds necessary for the administration of these works are levied from\nthe middle and upper classes, in rates and taxes.\n\nNow the Englishman possesses a strong sentiment for institutions. A man\nwho has himself received a certain kind of education, and who has been\nbrought up according to a certain tradition, likes to provide the same\neducation and the same tradition for his children. And if in the face\nof the increase in taxation, the rise in the cost of living, and the\nexpenses of education, he cannot afford this, sooner than have children\nto whom he must deny what he considers a good start in life, he prefers\nto limit his family. This obtains of the man who suffers from a sense\nof obligation towards his children. The opposite holds good of the\nunemployed man at the other end of the social scale. He feels that he\nhas sunk as low as is possible for him while still remaining out of\nprison. Insidiously his ambition and his self-respect become sapped by\nthe soul-killing experience of finding himself a useless parasite upon\nthe community. Frequently, as prison reports show, he takes to crime\nor drink. And slowly he is overcome by that sense of irresponsibility,\nof bitterness, of carelessness of the future, of improvident fatalism\nthat takes possession of those living under continuously adverse\ncircumstances.\n\nIt is a matter of indifference to him how many children are born to him\nsince with each one his dole is increased. None of the restraints which\nenter into the longer view of the future held by the middle classes is\nfelt by him. And so he goes ahead, and has as many children as time and\nthe health of his wife (of which last he does not always show excessive\nconsideration) will permit.\n\nThe following figures clearly illustrate this state of things. Whereas\nthe number of children produced annually by a thousand teachers is 95,\nby Church of England ministers is 101, by doctors is 103, the average\nnumber produced by general labourers is 231. And among these general\nlabourers it is the least desirable individuals\u2015\u2015those, with least\nself-restraint, least foresight and with least consideration for their\nwives or the future of their children\u2015\u2015who have largest families. And\nthe undesirability may be of another kind. Mental defectives generally\nare very prolific. Girls of this condition, if left unwatched, are\nconstantly becoming pregnant, there being apparently no shortage of\nmen prepared to take advantage sexually of such unfortunate victims.\nIt is to be noted that the economic situation following war is\nespecially favourable to this discrepancy of fertility between classes.\nIt would seem that the recent experience of the significance of war,\nthe existing sense of social instability, the universal prevalence of\nunrest, hatred and international discord, make the more considerate\nparents feel that the world is not a very desirable place to bring\nchildren into. And this feeling is emphasized if they have to pay in\ntaxation four times what they had to pay before, after which what\nmoney remains is worth about sixty-five per cent. of its previous\nvalue. But these considerations hardly affect the classes whose\noccupation is manual labour, or who have accustomed themselves to no\noccupation at all.\n\nThus from a social point of view it is to be observed that\nquantitatively, in relation to the present resources of the country,\nEngland is at the present day considerably over-populated; and\nqualitatively that many persons of all classes possessing inferior\nphysique are now artificially kept alive to perpetuate their stock,\nwhile at the same time those elements of the population who, by lack\nof intelligence or thrift or steadiness, or who by possession of other\ndefects have been reduced to the lowest level of the social structure,\nto-day constitute the most fertile strain in the country.\n\n\n(_c_) _Individual._\u2015\u2015The argument has frequently been heard that it\nis desirable to communicate knowledge of Birth Control to the poorer\nclasses in the interests of the mother and the children.\n\nIt is difficult to know what percentage of the unwanted children born\nin the poorer quarters of our large towns are conceived as the result\nof a culpable aggression on the part of the husband upon his wife\u2015\u2015as\nwhen he returns home drunk on Saturday night and threatens her with\nphysical violence if she refuses to submit to his conjugal rights\u2015\u2015or\nas the result of an ignorance of Birth Control methods which are\nfamiliar to the more educated classes. Certain it is that a large\npercentage of the children born are unwanted, and equally certain that\namong the very poor ignorance of contraception is such as to appear\nincredible to those who have not had personal experience of it.\n\nThus in the Autumn of 1924 a group of seven externs, working in the\ndistrict covered by Guy\u2019s Hospital, made inquiries of the mothers\nwhose confinements they attended as to whether the child just born\nhad been wanted or not. The inquiries were made, when possible, on\nthe tenth day, when the patients were last visited, in such a way\nthat their answers were more likely to be favourably influenced by\nfondness for the child than unfavourably by recollection of the pains\nof labour. Furthermore, where any doubt existed, as for instance when\na woman replied that she had not particularly desired the baby before\nit was born, but would not part with it for the world now, she was\ngiven the benefit of the doubt and the baby was counted as wanted. In\nall, inquiries were made in the case of seventy-eight children born.\nOut of these, forty-seven were definitely not wanted, and thirty-one\nwanted; and the writer can vouch for the fact that if these figures\nerred at all, they did so on the side of moderation. Thus, in at least\none poor quarter of London, well over half of the children born were\nemphatically not wanted.\n\nThe hardships imposed on the mother by such conditions are sometimes\nvery cruel. Numerous cases have been quoted by advocates of Birth\nControl in their propaganda which there is not space to reproduce\nhere. The reader can, however, picture to himself the experience of\na woman suffering from the sickness, shortness of breath, emotional\ninstability, and deformity of pregnancy, having to maintain life in\nsome squalid slum, house-keeping, cooking, cleaning and tending the\nchildren without change of air or scene and without holidays, up till\nthe incidence of the final labour pains. And no sooner is a child born\nthan the husband reasserts his \u201crights,\u201d and the same dismal cycle\nrepeats itself without prospect or hope of change, or of relief from a\nbody that has ceased to know the easy freedom and self-forgetfulness of\ngood health.\n\nIndifference to the children appears. They are looked after out of\na stern sense of duty. The native impulse of spontaneous maternal\nfondness is killed by the deadly routine, and when, as frequently\nhappens, the child dies, after a few pangs of grief, an easy\nreconciliation (perhaps not without a deep-seated sense of inward\ngratitude), is made to what is acknowledged as the \u201cWill of the\nAlmighty.\u201d Sometimes, the mother makes no secret of her relief. But\nno man who has come for any length of time in contact with these\nworking-class mothers can fail to admire the patience, the stoicism and\nthe grim fortitude with which they face their dreary lot.\n\nTheir ignorance of Birth Control, in face of the publicity the subject\nis now given in the Press, is almost incredible. The same quality of\nfatalism and resignation felt by the soldier in the war before the\nprospect of wounds or death, is still evinced by these women in the\nmatter of child-birth. One frequently meets with a sentiment that\n\u201cwe must take what comes without grumbling,\u201d that \u201cwhat is fated must\nbe,\u201d and even that \u201cwe must not fly in the face of the Almighty.\u201d\nThere further exists a superstition that any object requiring internal\nadjustment, like a pessary, runs the risk of being lost in the woman\u2019s\ninside.\n\nA further aspect of the problem is the prevalence under the existing\nsystem of the practice of abortion. It is difficult, of course, to give\nany trustworthy figures in this connexion, since in many cases the fact\nthat the mother has attempted to induce an abortion is not revealed\nto the medical man who attends her, or to the hospital authorities\nwho take her in. The methods usually resorted to are of an amazing\ncrudity. They vary from the pregnant mother jumping three or four\ntimes consecutively off a table on to the floor or throwing herself\ndownstairs, to her swallowing large quantities of lead, ergot, quinine\nand other substances as well as nocuous doses of emetics, irritants and\npurgatives.\n\nFrequently the woman practises local violence upon herself, or engages\nthe services of a professional abortionist, a class more numerous than\nis generally supposed. Such a person, after practising his art, is in\nthe habit of instructing the woman as soon as she feels the pain or\nnotices any haemorrhage, to report herself to a medical man or present\nherself at a hospital where she is taken in as an ordinary case of\nthreatened abortion. The responsibility for what may subsequently\nhappen to the woman is thus effectively removed from the abortionist\u2019s\nshoulders, it being in the interest of everyone concerned to preserve\nsilence as to the part he has played.\n\nThe damage done to the health of many poor women by such practices is\nenormous, and might largely be avoided by a judicious instruction in\nBirth Control.\n\nWhen the effects of all this upon the children are considered, it is at\nonce found that the question of Birth Control is intimately connected\nwith the housing problem. The overcrowding in large slum families is\nnotorious. At an early age the day is passed by these children in\nthe street, where, filthy and untended, they receive little by way\nof notice from their elders except hard words or blows. Their nights\nare spent packed, in a fetid atmosphere, several together in the same\nbed from which they may witness their parents in sexual intercourse,\nsometimes their mother in labour, and where they are free to indulge\nin what, later in life, would be called incestuous practices with one\nanother. The writer has on more than one occasion attended a woman in\nconfinement while several children were watching her from a bed in the\nsame room, there being, in the urgency of the situation, no time to\ndispose of them and nowhere immediately available to send them.\n\n                   *       *       *       *       *\n\nSubstantially this is what has been said on each side of this complex\nquestion.\n\nBefore proceeding to discuss the arguments heretofore propounded, it is\nnecessary to emphasize the fact that from the technical point of view\n_a really satisfactory contraceptive does not yet exist_.\n\nThe chief disadvantage attaching to the contraceptive used by the man\nis that it is quite impossible to induce the type of individual whose\nprocreation we would wish to restrict to use any contraceptive at all.\n\nThe child is usually begotten by such a parent when he is drunk, and\neveryone who has had experience of the conditions prevailing in bad\nslums will know that it is futile to expect to achieve anything along\nthese lines through the man. The problem must be met through the\nwoman who, unlike the man, has to put up with the discomfort and the\npain of repeated pregnancies, and has to shoulder the main burden of\nlarge families. Were it not for this elementary human fact all attempts\nto teach Birth Control to the very poor and destitute would fail\ncompletely.\n\nEssentially, contraceptives which the woman can use are of two sorts,\nand involve two principles\u2015\u2015namely, a mechanical or occlusive, and a\nchemical or spermicidal principle.\n\nThe objections to the first are two, namely that they are far from\nbeing fool-proof, and that unless sanctioned by a doctor their use can\nbe followed by serious harm. It will be clear to any medical man that\nfor a patient suffering from gonorrh\u0153al cervicitis, or indeed from\nany condition involving a chronic cervical discharge, the use of an\nocclusive pessary may lead to disastrous consequences. The broadcasting\nof promiscuous advice as to the utilization of these objects in the\nabsence of an examination by a competent medical man or woman is\ntherefore to be strongly condemned.\n\nThe drawback, to all existing spermicidal suppositories is simply their\nuncertainty, though they are as nearly fool-proof as anything of the\nkind can be. It is possible that by further research a suppository,\nphysically harmless but of certain action may be discovered, in which\ncase, from its practical and sociological aspect, the problem of birth\ncontrol will be greatly simplified. It remains, however, a little\ndoubtful whether the chemical principle, however actively spermicidal,\nwill ever dispense with the necessity of some occlusive device. But\nthis is a sphere in which later research may prove of great value,\nand nothing but a tentative statement is now possible. The statement\nmay, however, be made that if there is one method of Birth Control as\nto whose harmfulness there is little room for doubt, it is the method\nof coitus interruptus. In both sexes it gives rise to a condition\nof chronic anxiety which, nowadays, is far from uncommon. In the\nabsence of local disease any of the above methods of contraception is\npreferable to this one.\n\nThe effectiveness of those women\u2019s contraceptives now in vogue is\ndifficult to estimate. There is little doubt that an unduly high\nestimation of their success has been formed in certain quarters,\nbased on the assumption that in cases of failure, the working woman\nwill promptly report the event to the centre where the contraceptive\nwas obtained. The writer is persuaded that this is often a mistaken\nassumption, and that many cases of failure pass in consequence unnoted.\nThere is also difficulty in knowing whether the instructions in the\nadjustment of the occlusive pessary have been adequately followed out.\nThis process is not always easy, and as has been said above, is far\nfrom fool-proof.\n\nThe arguments above advanced will now be considered in their relation\nto (_a_) the Individual and (_b_) the Race.\n\n\n(_a_) _The Individual._\u2015\u2015The arguments relating to the individual are\ndivisible into those applicable to (1) married, and (2) unmarried\npersons.\n\n(1) It is to be noted that some of the contentions advanced on each\nside apply to the different phases of the married life of the woman.\n\nThus the revulsion of feeling against the use of contraceptives is\nexperienced chiefly by the woman who has had either no children or few\nchildren. On the other hand, the woman who has the greatest need for\na knowledge of Birth Control is the one who has had many children and\ndesiring no more would probably feel little or no aversion from taking\nprecautions against conceiving them. It appears to the writer that\nthere is no adequate objection to communicating to such a multiparous\nmother this much needed information.\n\nThe difficulty in the case of the newly-married woman is of another\ntype. The discrepancy between the ages at which human beings\nreach sexual maturity and at which they find themselves capable\nof maintaining a family, raises a number of exceedingly difficult\nproblems. Seeing that the sexual requirements of man constitute a\nfactor varying very greatly from individual to individual, and to\na large extent depending, as is now realized, upon a very complex\nbalance of glandular functions, it is more difficult than most popular\nmoralists seem to realize to lay down general rules applicable\nimpartially to every body.\n\nQuestions such as the following are raised: Can it reasonably be\nexpected of _every_ man to live ten or more years of his sexually\nadult life in complete continence? If not, is it better for him to\nmarry young and probably unequipped to support children, having\nremained continent till that time, or to marry later, probably better\nequipped financially to become a father, yet having had promiscuous\nexperience of women before marriage? And if he does marry young, can\nhe be expected to remain continent in his married life till he and his\nwife feel that they can satisfactorily maintain a family? If he finds\nhe cannot do this, should he proceed to have children whom he cannot\nproperly support, or is it better for the couple to overcome their\ndislike of contraceptives\u2015\u2015a feeling which it is idle for advocates of\nBirth Control to ignore\u2015\u2015and thus avoid having children till they are\nwanted? These are a few of the general questions which are raised in\nthis connexion to which no comprehensive answer can possibly be given.\n\nMuch controversy has revolved round the question of the desirability\nof self-control as a means of regulating births, and of its universal\npracticability. It is here contended that where possible this is\nimmeasurably the best means of regulating births. At the same time, it\nis futile to advance a counsel of such perfection and difficulty that\na highly probable failure to observe it will be followed by socially\ndisastrous results. Everyone would acknowledge that the Medical Officer\nof a military unit who refused to instruct the soldiers under his\nsupervision in the precautions they should take against contracting\nvenereal disease, on the high moral grounds that they should never\nexpose themselves to such risk, would be carrying his idealism to\nsocially harmful lengths. Yet it is a much more difficult task for two\npeople in love with each other and living together in the intimacies\nof married life to exercise continuous self-denial over long periods\nextending to years, than it is for the soldier to abstain from\noccasional promiscuity. In both cases it is clear that the correct\ncourse is to start by putting the case for restraint as clearly and\nforcibly as possible, and then to explain what steps must be taken\nin the event of that restraint proving too great a task. In the Army\nand Navy such appeals, when tactfully made, have met with a response\nwhich justifies the view that, within limits, more can be done in this\nway than might be supposed. As a general rule, then, it would appear\ndesirable that contraceptives should be used as little as possible,\nespecially in the early years of married life.\n\nIt also seems to the writer that in the case of normal married\npeople, too much has been made of the demoralizing effect of the\n\u2018excessiveness\u2019 of that indulgence which is supposed to be permitted by\nthe practice of contraception and which forms the basis of the \u2018moral\u2019\nobjection advanced in this country. This argument frequently emanates\nfrom ecclesiastical sources, where knowledge of the sexual aspect\nof human nature as well as of the technical side of contraception\nis apt to be restricted and biassed. In effect, the man who is\nsufficiently provident and considerate of his wife to encourage the\nnecessary precautions (which\u2015\u2015a point too often ignored by prejudiced\ncritics\u2015\u2015from the immediately selfish point of view both parties would\nfar sooner forego), is not the kind of man to indulge in reprehensible\nexcesses. Actually, demoralization seems rather to be produced in those\nmen who insist on gratifying themselves regardless of their means, or\nof the welfare of the children they so abundantly procreate, or of the\nfeelings and health of their wives.\n\n(2) The case of unmarried persons clearly falls into a different\ncategory. There can be little doubt that the publicity given to the\nsubject of Birth Control has kindled the imagination of many young\npeople and led to various transgressions. The requirement here is to\ndiscover a method by which at the same time this publicity may be\ndiminished and information made selectively more available. Both\nthese results could be achieved if the subject were taken up by the\nMinistry of Health, and facilities created for the appropriate giving\nof knowledge thereon by responsible qualified persons. By such means\nthe particular advice suited to each individual case could be privately\ngiven, precisely where it is required, and steps might be taken to stop\nthe journalistic broadcasting of information and discussion which has\nbrought the subject into such discredit.\n\nThe effects of this measure would be comparable to the arrest of the\nliterature upon the subject of venereal diseases, and to the reduction\nof their incidence that has been brought about by the institution of\nspecial departments for the treatment of these diseases in the large\ntowns.\n\nIt is clear, however, that all arguments relating to the individual\nare limited in their appeal to those in whose minds the conception\nof morality is somehow related to that of individual harmony and\nhappiness and to the ideal of the general good. To those for whom the\nword \u2018morality\u2019 has an ulterior meaning, unconnected with the affairs\nof this world and relevant, solely, to the destiny of the individual\nsoul\u2015\u2015I refer, here to those who enlist the \u2018Will of God\u2019 of which they\nare the self-constituted interpreters, on their side\u2015\u2015no argument can\nbe of any avail. Since the subject is thus removed from the sphere of\npractical controversy, no further discussion is possible, and the only\nthing to hope is that with the passage of time such persons will become\nless numerous.\n\n                   *       *       *       *       *\n\nConsideration of the arguments bearing upon the individual, it is\nsubmitted, points to the desirability of (1) the Ministry of Health\ngiving the subject recognition and sanction, and (2) limiting the\npublicity that now attaches to it.\n\n\n(_b_) _The Race._ Turning now from the individual to the race, we\nenter on a more difficult part of the subject. Adhering to our\noriginal conception of the question we find that the solution (if it\nis to be accepted as such) of the quantitative difficulty, and of\nthe qualitative problem described as \u2018economic\u2019 in nature, are one\nand the same. The remedy for that aspect of the qualitative problem\ndistinguished as \u2018dysgenic\u2019 is different and must be considered\nseparately.\n\nThe quantitative difficulty reduces itself to this. Admitting the\ngreater fertility to-day of those whose occupations are manual, or who\nhave no occupation at all (in other words, of the less select type) and\nadmitting that _at the present moment_ the country is overpopulated,\nhow are we to be certain that we are not within sight of more\nprosperous times when unemployment will disappear? And how are we to\nfeel assured that the dissemination of knowledge of Birth Control will\nnot, in the long run, lead to a disastrous decline in the birth rate,\nproducing an irretrievable diminution in our numbers?\n\nThe practical difficulty is here to prophesy what will be the optimum\npopulation (i.e., that at which average return of labour per individual\nwould be greatest) for a given country fourteen years ahead\u2015\u2015at the\ntime, that is, when the children born to-day would enter the labour\nmarket. And here we are in the realm of almost pure guesswork, and\nprobably no economist could be found who would venture upon more than a\ntentative speculation. What the optimum is at the moment remains even a\ndisputed question. There is reason to suppose that unemployment returns\nare not necessarily a trustworthy guide to the figure. A consensus of\nopinion however exists (including that of Mr. Baldwin) that _at the\nmoment_ our numbers are above their optimum, though expectations vary\nalmost infinitely as to what the optimum will be in a few years. Those\nwho hope for a boom in trade are satisfied with the present condition.\nOthers who do not anticipate such an event, would more willingly see\nan alteration brought about. In the absence of any definite knowledge,\nthe best we can do is not to try to look too far ahead but to consider\nthe solution of our problems as we find them to-day. _At the moment_\nthe indisputable facts of the problem in this country are that we are\nover-populated, that contraception is practised too much by the upper\nand middle classes\u2015\u2015perhaps even by the skilled working classes\u2015\u2015and\nnot enough by the improvident unskilled masses at the bottom of the\nsocial edifice.\n\nThe outstanding question is whether, as a result of a reduction of\nour numbers to a point somewhere in the neighbourhood of the economic\noptimum for this country\u2015\u2015by which reduction the existing burden of\ntaxation, an increasing element of which is now devoted to charity\nand relief, will be correspondingly diminished\u2015\u2015our upper and middle\nclasses would be enabled to produce more children, and to continue to\nproduce enough to maintain our numbers in the neighbourhood of their\noptimum.\n\nThe answer to this question depends on a further question. To what\nextent is the relative sterility of the professional and skilled\nworking classes attributable to the heavy taxation now imposed on them,\nand to the rise in the cost of living due to the war, and to what\nextent is it the result of a preference shown by many people for a more\nor less luxurious life, with few or no children, to a simpler life with\nseveral children? In other words, to what extent is it attributable to\nan economic factor and to what extent to motives of selfishness?\n\nTo what extent does that quality of self-interest play a part which\nprompts a woman to refuse to breastfeed her baby because she is afraid\nof the effects thereof upon her figure, which causes her to abstain\nfrom having children because she dislikes the discomfort and deformity\npreliminary to, and the actual pains of, childbirth, or which makes her\nvalue amusements and expensive forms of pleasure and recreation more\nhighly than the experience of maternity? To what extent is the relative\ninfertility of the upper and middle classes accounted for by the kind\nof egotism which induces the husband to go in for entertaining, for\na motor, and a house with several servants, and generally to live\nin comparative affluence rather than do without his superfluities\nand bring up a family of children? This attitude nowadays certainly\nplays a part. Dissatisfaction with the elementary pleasures of life,\nthe craving after artificial stimuli and new sensations, have always\nbeen, and probably will always remain, the surest way to decadence in\na race, and as such should be combated. It is more in the interest of\nthe race that the professional and artisan classes should produce\nplenty of good children than that the families of the very poor should\nbe restricted. The argument is sometimes advanced by complacent and\nwealthy individuals that the working classes should be encouraged to\nreproduce freely in order to keep up the country\u2019s numbers. The dirty\nwork is thrown, so to speak, on the shoulders of those least qualified\nto discharge it. It must appeal to the sense of justice of everyone\nthat if the maintenance of numbers of the race is to be conceived as\na burden (which of course it should not), the burden should be borne\nequally by all classes.\n\nThe writer, who has had occasion to witness the results of\nover-multiplication among the very poor, feels that it is only in\nfairness to them that they should be equipped with every possible\nmeans of improving their lot. At present one of the most important of\nsuch means is the creation of facilities by the Ministry of Health\nfor the giving of information to those mothers who need it about how\nthey may limit their families and space their children. The immediate\nsocial results of such a measure would unquestionably be good. The\nremote results are more open to doubt. And it is this doubt which\nrenders it of the utmost importance to add that every form of pressure\nand persuasion be brought to bear on the other classes, to make them\nrealize that it is morally incumbent on them, in the interests of the\ncountry and of the race, to have as many children as they can possibly\nafford, even at the expense of the minor luxuries of life.\n\nUp till now no such pressure has been exerted, and most people regard\nit as a matter of moral indifference, whether, when married, they have\nchildren or not. The problem as to whether the general public, once it\nhas been educated to realize the national importance of the question\nof having children, would act upon it and thereby avert the threat of\na dwindling population is again one of great difficulty. Admittedly,\nthe example set us by France is not encouraging. What is the likelihood\nof our following in her footsteps? It is a delicate and important\nquestion. The writer is of the opinion that our national character\ndiffers from that of the French in a way that would make us more\nresponsive to such an appeal for children than the French have shown\nthemselves to be. But again we are in the realm of conjecture, and each\nperson is entitled to his opinion.\n\nThe fact remains, however, that as long as the advertisement now given\nto Birth Control is permitted to continue, its practice will become\nyearly more prevalent. Its spread will certainly not be limited by an\nattitude of official negativism towards it while the propaganda is\nallowed to continue unchecked.\n\n                   *       *       *       *       *\n\nThere remains the other process above distinguished as \u2018dysgenic,\u2019 the\neffect of which upon the quality of the race is probably as detrimental\nas the one just considered, namely, the nurture and perpetuation of the\nmorally and physically unfit. This tendency can only possibly be met by\nsome form of Eugenic legislation. The existing opposition to anything\nof the sort in this country probably springs from a deep-seated\ndislike of bureaucratic interference in people\u2019s private lives, and is\nassociated with a failure to realize the harmful consequences of the\nexisting order. It is of interest, however, to observe that in America,\nwhere, in practice if not in theory, individual liberty is valued less\nhighly than in this country, various enactments have been passed with\na definitely Eugenic object. Thus in the State of Nebraska marriage\nis forbidden to anyone afflicted with venereal disease, and all\napplications for marriage licenses have to be accompanied by affidavits\nof freedom from such disease. Nobody acquainted with the nature of the\ninfant mortality produced by congenital syphilis can fail to approve of\nthis measure.\n\nIn 1895 the State of Connecticut forbade the marriage of epileptics\nand feeble-minded persons, under penalty of three years\u2019 imprisonment.\nEveryone possessing knowledge of the Neurological Out-patients\u2019\nDepartment of any large hospital must realize the existing prevalence\nof epilepsy and appreciate how this hereditary disease may incapacitate\nand stultify its victims. Montana provides for the sterilizing of\nidiots, epileptics, feeble-minded and insane persons, which measure\nmust again commend itself to those aware of how prolific such types can\nbe if left unwatched. In males, sterilization can be effected by a very\nminor operation, the use of X-rays for this purpose being a procedure\nwith regard to which there is still medical controversy.\n\nThe principle might even be extended to individuals who, by a record of\ncrime or misdemeanour, prove themselves to belong to a type which the\nnation does not want perpetuated. The sterilization of the male leaves\nquite undisturbed his sexual function, though it destroys his power\nof reproduction. The infringement which it therefore involves of the\nliberty of the individual is far less than that made by the State when\nit takes it upon itself to hang a man. Yet the social benefit arising\nfrom the two measures cannot be compared. Though it is difficult at\nthis stage to define the details of Eugenic legislation it seems likely\nthat the physical and moral standard of the race could broadly be\nraised by such a qualitative Birth Control.\n\nThe number of emigrants which we are in a position to send to the\nDominions each year is limited by difficulties of transport, and could\nnever amount to more than a fraction of our present unemployment\nfigure. There is further the important consideration that the Dominions\nthemselves do not relish the idea of our regarding them as dumping\ngrounds for our superfluous undesirables. The type of emigrant they\nwant is a courageous, hardworking, physically healthy type, capable of\ninitiative, of withstanding hardships without grumbling, and of making\na good citizen. Such do not tend to become unemployed here, though,\nunder very adverse circumstances, they often may. A decrease of our\npopulation need not therefore be opposed to our Imperial interests\nif, in the process, we raise the standard of the race and improve our\nnational stock.\n\n                   *       *       *       *       *\n\nWhat will be the bearings of such enlightened Birth Control upon\nthe future? It will affect the Individual directly in his immediate\nrelation to his family, and it will influence him indirectly through\nits effect upon the community as well as through the international\nrelationships of the country to which he belongs. The international\nimplications will be considered first, since they are the most\nfar-reaching.\n\nThe most obvious of these is the connexion between unrestricted\nincrease of population and wars. To what extent was the late war due\nto this cause, and to what extent has the world learnt from it the\nnecessity of regulating such increase?\n\nThe causes of the late war were complex and are not yet wholly\nunderstood. A fact however stands out clearly now that we contemplate\nit in retrospect and now that changes in international feelings have\nforced upon us a consideration of the point of view of our late\nenemies. It is that the causes now recognized are essentially different\nfrom what those causes were represented to be in the war propaganda of\nthe various belligerents.\n\nIt is to the interests of each belligerent to place the whole blame\nfor a war upon its enemies and completely to exculpate itself. Thus\nin the late war both sides were convinced that they were fighting\nfor Righteousness, Liberty, Justice, Law and Order, Civilization,\netc., against enemies inspired by cruelty, subtlety, insatiable greed,\njealousy and lust for world-power. When, however, we contemplate\nthe war after a lapse of several years through an aftermath of much\nsuffering and disillusionment, we realize that it was the product\nof historical causes and racial antipathies and of certain social\nand economic phenomena rather than of any unequal partition of moral\nqualities.\n\nBefore the war, Great Britain was the most powerful nation in the world\nand was naturally jealous of any other nation that coveted, or aspired\nto usurp, her enviable status.\n\nRussia found herself in a condition of acute social instability,\nmomentarily threatened by the event which in 1917 cast her beyond the\npale of western civilization. To Russia the war came as a happening\nwhich could dissipate the revolutionary ferments, mobilize her\nrefractory workers into the army, and, through the tremendous appeal of\na national crusade, sidetrack the forces of anarchy in precisely the\nway that those forces were sidetracked in Ireland in 1914. Had the war\nbeen won quickly\u2015\u2015as there were grounds for hoping when it began\u2015\u2015the\nCzar would probably still be on the throne of an enlarged and yet more\npowerful Russia.\n\nBy the events of the last hundred years Germany had been elevated\nfrom a position of relative unimportance to that of the most highly\norganized and perfectly industrialized power in the world. In achieving\nthis promotion she had earned the venomous hatred, born of her\nhumiliation, of France, and the slowly growing, disquieting suspicion\nof Great Britain.\n\nConscious of her growing industrial strength, becoming restive within\nthe frontiers which confined her swelling population, aware of the\nhostility of her neighbours, and never allowed to forget that her\nkingdom had been built upon the sword, the youthful soul of Germany\nfound, in her Emperor, a fitting symbol for her aspirations. He was the\ncreation of her mood, and together with the party of which he was the\nmouthpiece led her to her downfall.\n\nIt would not be a fair statement to assert that population pressure in\nGermany was the cause of the war. It was unquestionably a part-cause\nand a predisposing cause, as it was of migration in prehistoric times\nand of most wars since. But it was here complicated by other factors\nboth inside and outside Germany.\n\nThe universal desire to avert a similar catastrophe in the future has\nmaterialized in the League of Nations. It is hoped that through its\nagency many precipitating causes of war will be eliminated. By it\nprovocation will be made more difficult and commitment more perilous.\nBut the essential predisposing cause, that of over-multiplication,\nremains unassailed. Like some dull-witted monster it is left to wax in\nstrength and malignancy within its fetters, till at last, no longer to\nbe denied, it will break all bounds, turn, and rend the world. From the\nlate war no lesson as to the importance of population control has been\nlearnt. Will another war be necessary to teach us this lesson?\n\nEarlier in the book reference was made to the possibility of a war\nbetween Japan and either America or ourselves. Though this contingency\nis being thought out in detail by the naval authorities of all three\ncountries, care is taken in diplomatic circles to assert that such\npractical measures as the equipment of Singapore imply no unfriendly\nor suspicious attitude toward Japan. Few people, however, are deceived\nby these utterances. The mutual fear and distrust is growing and will\nprobably continue to grow. There is little doubt, that, if this war\ncomes about, its essential cause, the increase of Japanese in excess\nof the power of maintenance of their country, will be obscured by\nthat outburst of vilification of the enemy and glorification of self\nwhich is now demanded by popular sentiment in the conduct of wars. Yet\nthis cause will remain here incomparably the most important of the\npredisposing causes. After such a war will there remain any vestige of\ncivilization to profit from the hard-won lesson?\n\nThe principal aim of Soviet Russia to-day is the spread of her\ncommunistic principles throughout the world. The chief obstacles\nto this are the firmly entrenched and powerful capitalism of the\nUnited States, and the more diffused and essentially more vulnerable\ncapitalistic organisations of the British Empire. These last the\nRussians are doing their best to undermine now. A second world war\nwould give them a long-coveted opportunity. Realizing that prolonged\nwars and the social unrest that follows them are the soil from which\nrevolutions most readily spring, Russia would probably associate\nherself with Japan. The secret treaty between the two countries whose\naspirations and political ideals have otherwise little in common, gives\na premonition of this. By the time a war comes it is possible that the\nexploitation of China by Japan will be more complete, and the effects\nof anti-foreign propaganda, carried on by Russia, more far-reaching.\nThe increase of anti-British feeling in India, also stimulated by\nRussia, will co-operate to unify Asia and European Russia in a solid\nblock, determined to shake off the yoke of the Western Powers and of\nAmerica.\n\nSuch a war could never be conclusive, however prolonged. The vast\nlength of the fighting front, the colossal numbers of active\nbelligerents, and the enhanced destructiveness of war would probably\nlead, after initial successes, to a collapse of the organized fighting\nforces of the West. The seeds of revolution in Europe, by then more\ndeeply sown, would germinate, and the present social order would come\nto an end. The continent would then embark upon a new phase of its\nhistory, with the first chapter steeped in the bloodshed of revolution,\nand founded upon the ruins of our industrial civilization. The centre\nof civilization might then shift to the southern hemisphere where\nto-day there is less to destroy.\n\nThe fact remains that if the price that humanity will have to pay for\nlearning to regulate its over-multiplication is to be a second world\nwar\u2015\u2015the much talked of war, this time, between East and West\u2015\u2015it is\ndoubtful if there will be left a civilization capable of learning the\nlesson. It seems worth while, therefore, to try to put the principle\ninto effect before we are taught its necessity in such a way. To this\nthere are at present two obstacles, namely the nature of certain\nreligions and the criterion of national evaluation that is still\nprevalent.\n\nThe first obstacle rests in the fact that two powerful religions have\nnot adapted themselves to the changes of human relationships imposed\nby the unification through science of the human race. These religions\nremain with their eyes fixed either on the next world or on the\nexclusive welfare of the tribe.\n\nBy the Catholic Church a mode of behaviour is imposed calculated to\nachieve salvation in the next world irrespective of its effects on\nthis one. Omitting from consideration, as probably unjust, the motive\nof wishing to increase the number of its adherents, with which the\nRoman Catholic Church has been charged by reason of its attitude\ntowards Birth Control, there remains a motive arising from a theory\nof a relation between salvation in the next world and certain modes\nof behaviour in this. Contraception is condemned because it is held\nto incur damnation. It is not condemned because it leads to social\ninjustice, to wars, to human suffering. The point is that it is still\ncondemned in spite of its leading away from these things. It is\ntherefore devoutly to be hoped that in the event of the population of\nany Catholic country at any time in the future expanding to proportions\nthat threaten the peace of the world, the Pope will see his way to\nmodify the Church\u2019s attitude in the matter before it is too late.\nFailure to do so would result in the depressing spectacle of the leader\nof the religion of \u2018Peace and Goodwill\u2019 among men deliberately refusing\nto take a step to avert war.\n\nThe second type of religion is represented in Japan and is tribal in\nthe sense that it is avowedly concerned with the glorification of the\nJapanese, irrespective of the consequences to the world that this may\ninvolve. In its object of elevating Japan to the status of a first\nclass power the cult of revived Shinto has succeeded admirably and has\nproved itself, in several wars, to be a splendid fighting creed. The\npresent increase of the population of Japan by 700,000 a year is wholly\nin accordance with its precepts. Again we may devoutly hope that it\nwill not overreach itself and plunge Japan, as well as the rest of\nus, into a world war after which we would probably cease to exist as\ncivilized countries. It is, of course, obvious that a modification of\nJapanese policy where Birth Control is concerned would be welcomed with\ninexpressible relief by the rest of the world.\n\nThe militancy of Mohammedanism will probably have little effect on the\nfuture of the world, because Mohammedan countries are at present poorly\norganized for extensive modern war. The Church of England is more\nconcerned with the social and international implications of religion\nthan any other, and the above remarks have little relevance to it.\n\nIf, therefore, the cataclysm above contemplated is to be averted\nthe first necessity would seem to be a revision of the standards of\nexisting religions, in consideration of the unification of the human\nrace, so as to accord with a formula of something of this sort: That\nis good and morally right which will promote the general happiness and\ngoodwill of humanity, and the harmony of the world. It is clear that\naction leading to the limitation of over-multiplication would in this\nsense be good and in accordance with religion.\n\n                   *       *       *       *       *\n\nThe second obstacle to the realization of a control of population is\nthe standard by which the merit of a nation is now generally appraised,\nand to which most nations aspire. This merit is largely estimated in\nterms of power of offence and defence. This is a bad criterion and\nshould be altered for a better one which will now be considered.\n\nEarlier in the book reference was made to a biological argument against\ncontraception, consideration of which was deferred. This argument holds\nthat in so far as reproduction is a primary biological function, a\nthwarting of that function is not only unnatural but anti-biological.\nThis view has a certain plausibility but does not stand close scrutiny.\nThe criterion of biological value or fitness is essentially racial, not\nindividual. That is biologically good which will improve or benefit the\nrace, that is bad which will harm or weaken it.\n\nUnder stable conditions of racial equilibrium there is a reasonable\nexpectation that instincts and structures which have had survival value\nin the past will continue to have such value in the future. But during\nmoments of crisis, at those turning points in the history of living\nthings when new forms appear, such a presumption is quite unjustified.\nThus if we picture to ourselves, allegorically, an event which probably\ntook many thousands of years to accomplish, we might imagine the\ncomments of a conservative piscine critic upon the emergence of the\nfirst Dipnoid from some muddy river on to land.\n\nThe development of fore and hind limbs from fins, of lung from\nswim-bladder, and of instincts appropriate to the new medium, would\nstrike all conservative fishes as highly immoral deviations from that\nbiological tradition which had given stability to the glorious race\nof fishes. Nothing could seem more a-biological. Similarly with the\ndevelopment of fur and feathers and of the parental instinct, all of\nwhich were probably, in part at any rate, invested with survival value\nby the spell of cold which followed the Secondary period, and which\nperhaps conditioned the substitution of birds and mammals for the\nhitherto ubiquitous reptile as dominant vertebrates on the earth. From\nthe point of view of the conservative reptile such changes would appear\nhighly anti-biological. In moments of racial crisis, therefore, it is\ndangerous to generalize as to what is biologically good from past\nexperience alone. In the past a high degree of fertility has been, for\nmost species, a biologically valuable asset. It does not follow that\nit will continue to be so for the human race. In fact there are good\nreasons for supposing that it will not.\n\nThe human race is now passing through a biological crisis unprecedented\nin the history of life. It has achieved a mastery over nature such\nthat mankind is now economically unified throughout the world by the\nastounding feats of intercommunication and transport. But as yet the\nhuman race has achieved little ethical unification. It is directly in\nthe interests of the race that such unification should take place, and\nall things which promote it may therefore be considered biologically\ngood. And of those things a restriction of human fertility is one of\nthe most important.\n\nWhat then is to be our biological criterion of racial fitness and our\nstandard for judging of a nation\u2019s merit?\n\nIt is clear that our biological criterion must be racial rather than\nindividual. Division of labour and differentiation of function are\ncarried to such lengths in civilized societies that it does not seem\npossible to hold up any individual type as an ideal of biological\nfitness. Qualities which, to the solitary animal, would irrevocably\nspell extinction may for the gregarious animal have the highest\nsurvival value. Thus no attribute would be more irremediably fatal to\na non-social animal than sterility. Yet the sterility of 999 out of\n1000 female bees in the community of the hive has endowed the species\nwith a vitality and a biological importance such that it has largely\nconditioned the appearance on the planet of many kinds of entomophilous\nflowers. Our biological criterion must therefore, with our standard\nof merit, be social rather than individual, and the following general\noutline is suggested.\n\nThe population of each country should be proportionate to its\nresources. The numerical adjustment should be such that there be no\nunemployment and that individual productivity be highest without idlers\nat either end of the social scale. The physical average of the race\nshould be good with no congenital diseases of mind or body and with\nthe minimum of other diseases, and of crime. There should be a high\naverage standard of comfort, self-respect and happiness, and a high\nmoral standard of honesty, tolerance, and kindliness. One would hope\nfor a wide prevalence of that \u2018joie de vivre\u2019 and contentment which is\ndoubtless largely temperamental in origin and which contributes more\nto an individual\u2019s happiness than any number of worldly possessions\ncan ever do. And the social cleavage between classes, and the now\nstupendous discrepancies between the very rich and the very poor should\nbe reduced to a minimum. Such conditions all would wish generally\ndistributed. It is a question whether a uniformly high degree of\nintelligence should be equally ubiquitous. In every community,\nprimitive or civilized, an immense amount of crude physical labour has\nto be done. The soil has to be tilled, someone has to dig coal and iron\nout of the ground, and endless other kinds of manual work have to be\nperformed. It is doubtful whether the possession of a very high degree\nof intelligence would make such workers happier or more efficient. But\nwhatever we may individually feel about this point, we would all wish\nsuch workers to be healthy, happy, well housed, contented with their\nlot, fond of their children, and both appreciated by, and on good terms\nwith, the rest of the community.\n\nAnd obviously it is a condition of this sort which an enlightened Birth\nControl could help to achieve.\n\nThe above is intended both to be a criterion of biological fitness for\nthe human race, and a more satisfactory standard of national evaluation\nthan the one that is in vogue to-day. It will be noted that there is\nnothing in it about capacity for wars. If we could substitute some such\nstandard in place of the armament standard by which to grade countries\nin an order of merit, we should be in a better position to avert the\ncatastrophe of another world war than we are at present. According to\nsuch a standard the country most deserving of admiration, respect and\nimitation to-day would probably be Switzerland. Knowing that she cannot\ndefend herself against her powerful neighbours, she does not aspire\nto large armies. When other countries can, by a simultaneous control\nof population, realize a similar security, it will be open to them to\nfollow in her footsteps. The ideal may not appeal to the romantic, but\nmuch that passes for romance is frequently pernicious nonsense, like\nthe sentiment by which war is glorified in the eyes of many women and\nelderly men who have never participated in it.\n\nFrom an international equilibrium based upon a modification of\nreligions as above suggested and upon an alteration in our standards\nof national evaluation, social harmony would follow fairly readily.\nIt is unlikely that the antagonism between capital and labour will be\nmuch affected by a control of population beyond removing that source\nof social unrest which is furnished by a large body of unemployed.\nIt remains doubtful, however, if the essential political issue will\nbe much modified by a solution of the unemployment problem. The\npsychological forces which give the Labour party its driving power are\nnot such as to produce the fullest economic prosperity in this country;\nbut none the less they demand and must ultimately receive satisfaction.\nThe best that can be hoped is that those forces will gradually be\nappeased, and will not lead to bloodshed, too great a dislocation of\ntrade, or too drastic a loss of international status.\n\nThe gain to the individual following the general application of\nknowledge of Birth Control will be twofold. In the first place parents\nwill be able to space their children in accordance with their physical\nand financial resources; in the second they will feel more confident of\nproducing healthy well-balanced children, untainted by disease, than\nthey can feel at present. Their children would further be welcomed by\nthe community, and their future would be assured.\n\n                   *       *       *       *       *\n\nSuch are the bearings of an enlightened Birth Control upon the\nfuture. It is obvious that such advantages could only be gained by\nslow and laborious degrees. The writer is far from the opinion that\nthe application of his views will immediately transform the world\ninto a Utopia. He is convinced however that if the existing form of\ncivilization is to have any permanence, the necessity for controlling\npopulation will have to be realized and striven for by all educated\npeople.\n\nIn practice, the \u2018plea,\u2019 referred to in the sub-title, is that the\nMinistry of Health should give the subject of contraception its\nsanction. In May of 1924 a petition supported by twenty-two Labour\nmembers of Parliament was presented to the Minister of Health by a\ndeputation of eighteen persons, some of them well known, requesting\nthat official permission be accorded to doctors in charge of Welfare\nCentres to give information on Birth Control to such working women\nas desired it and were considered fit for it. Though the existing\ntechnique is not wholly satisfactory it is avowedly worth something,\nhaving already proved of great help to many women.\n\nThis permission was refused in deference, it seems, to ecclesiastical\nopinion, to certain reactionary political forces which, in the House,\nwere opposed to it, and to popular prejudice. It is possible that\nby the time this book is published the Ministry of Health may have\nchanged its attitude. At present, however, information on contraception\ncan only be obtained from a few private organizations such as those\nof the Malthusian League in Walworth and Kensington, of Dr Stopes in\nHolloway, and from another centre in the Edgware Road. The Malthusian\nLeague has worked quietly, unostentatiously, and, so far as its means\nallow, with the utmost effectiveness in one of the poorest quarters of\nLondon. For what it has done there can be nothing but praise.\n\nBut however valuable the work of these organizations, they cannot\npossibly meet the requirements of our large slums, where such\ninformation as exists is handed about by irresponsible midwives and\ngamps, often with the worst results. It also seems desirable to the\nwriter to restrict the often vulgar publicity by which this subject\nis frequently attended, and to which attention was drawn when the\nobjections to Birth Control were reviewed. After the first blast of\ncriticism which it would evoke from the baser organs of the press, such\na sanction from the Ministry of Health would render further newspaper\nadvertisement of Birth Control superfluous. If it does not cease of\nits own accord steps should be taken to suppress it. How best can this\nsanction be obtained?\n\nClearly through an appeal from the medical profession. An expression\nof unanimity, or relative unanimity, from doctors in this country as\nto the desirability of this sanction would constitute an argument\nwhich the Ministry of Health could not easily ignore. If the sanction\nwere thus obtained it would be open to those medical men who had\napproved the measure in this country to invite their colleagues in\nother countries to follow in our footsteps. It would seem best to begin\nwith Germany and America, where there is reason to suppose that such\nan appeal would meet with response. If support were forthcoming from\nthese countries, others might be approached\u2015\u2015such as Japan, Italy and\nperhaps India, in which last the suffering caused by an excessive birth\nrate and a high early death rate is immense and almost wholly avoidable.\n\nIn this way the medical profession in whose hands the health of each\ncommunity lies would take the first step in the direction of an\ninternational control of population, and would thereby lay the basis\nfor a genuine and permanent world-peace.\n\n                   *       *       *       *       *\n\n\n\n\n Transcriber\u2019s Notes:\n\n \u2015\u2015Text in italics is enclosed by underscores (_italics_).\n\n \u2015\u2015Punctuation and spelling inaccuracies were silently corrected.\n\n \u2015\u2015Archaic and variable spelling has been preserved.\n\n \u2015\u2015Variations in hyphenation and compound words have been preserved.","title":"Birth control and the state : $b A plea and a forecast","tradition":"philosophy-ethics","translated_text":null,"word_count":13853}