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CONCEPTION CONTROL

AND ITS EFFECTS ON THE INDIVIDUAL AND THE NATION

BY FLORENCE E. BARRETT

C.B.E., M.D., M.S., B.Sc.

Consulting Obstetric And Gynæcological Surgeon To The Royal Free Hospital. President Of The Federation Of Medical Women.

With A Foreword By His Grace The Archbishop Of Canterbury.

1922

PREFACE.

This small book has been written in response to many requests for some statement regarding the individual and national effects of the widespread practice of conception control.

It is not intended to give medical advice on the subject for, in my judgment, that is best given to the individual by his or her medical adviser, and will vary in different circumstances.

The question as to whether control of conception shall or shall not be practised is a decision ethical and not medical in character when husband and wife are healthy, and in the last resort will be decided by the individual pair for themselves; but they will be wise to discuss the question with their medical attendant in order to realise all that is involved in their decision.

Space forbids anything like a full discussion of the national issues, but that aspect of the subject demands quite as careful study as personal needs or desires.

FOREWORD

The Archbishop of Canterbury allows me to use the following letter as a Foreword to this little book.

Dear Lady Barrett,

I have read with great interest the manuscript of your pamphlet. Very many of us who have daily to do with the problems and perplexities of our social life and to give counsel to the anxious or the penitent or the perturbed will thank you for these clear and cogent chapters. To arguments based on moral and religious principle you add the weight of ripe experience and of technical scientific knowledge. Your words will gain access to the commonsense of many who would perhaps regard the opinions of clergy as likely to be prejudiced or uninformed. I am of course not qualified to express an independent judgment upon the medical or physiological aspects of this delicate problem, but I desire on moral and religious as well as on social and national grounds to support your general conclusions, and to express the hope that your paper may have wide circulation among those who are giving attention to what is becoming an urgent question in thousands of English homes.

CONTENTS

CONCEPTION CONTROL

AND ITS EFFECTS ON THE INDIVIDUAL AND THE NATION

CHAPTER I

THE PROBLEM OF TO-DAY

In the late seventies of last century a pamphlet entitled The Fruits of Philosophy was republished by Mrs. Annie Besant and Mr. Charles Bradlaugh, in their desire to mitigate the suffering of poor women who were overburdened by work and further weakened by frequent child-bearing. They resolved to face public obloquy and even legal prosecution in order to bring to these women knowledge of how to prevent conception, which, in their opinion, would give the relief they so sorely needed. As is well known, the later pamphlet on the same subject written by themselves was withdrawn from publication by Mrs. Besant in 1886 on religious grounds.

During the last few years the idea of the need for conception control has again become prominent, partly as a revolt against the bondage of women in child-bearing, partly accentuated by the difficulties and uncertainties of an adequate livelihood, and the desire to have a few children well educated and cared for rather than many who shift more or less for themselves.

But also the claim is made that marriage exists at least as much for the fulfilment of happiness in union with the beloved as for the procreation of children; and that it should be possible for a married pair to have the fullest gratification without fear of children unless they desire them.

Others, but these are extremists, go so far as to claim that apart altogether from marriage vows, sexual intercourse should be the experience of all, and that knowledge of how to avoid the birth of illegitimate children should be given to all.

The discussion of this subject has taken place under the title of Birth Control, but the control or regulation of births is not really the point under discussion. A very big factor in the diminution of births comes under the heading of abortions, whether voluntary or through conditions which might be remedied. That subject is not touched upon in this paper, but only methods which avoid conception, which is, of course, a very different subject from the larger one of avoiding births.

At first sight it might seem a comparatively simple thing, in view of the knowledge which already exists of the physiological processes involved in conception, to advise a method which shall prevent conception at will without harmful effect upon man or woman and yet leave intercourse unimpaired. But even at first sight it is obvious that whatever knowledge may be available, and whatever methods may be devised, it would not be easy to convey this knowledge rightly to the individual it is hoped to benefit without doing harm to others. Further thought shows that the national problems involved are so important and far reaching in effects that they might well arrest the attention of the most careless advocate of indiscriminate conception control.

This is a subject, therefore, which requires careful consideration from the point of view of the individual, of public morality, and of national welfare—and the more closely it is studied the more apparent are the far reaching issues involved. It is improbable that the practice of using contraceptives will continue for even a generation without revealing the harmful effects which must to some extent ensue.

In the whole discussion of this subject it is important to keep in mind that the physical is only one aspect of the sex relation.

In the evolution which sex has shared with all else, the psychic side appears even in the higher animals. In them the desire is not for mere indiscriminate physical satisfaction, but the element of choice comes in, a factor which sometimes upsets the plans of breeders. In man this aspect of the relation is all important. The higher side of sex, or what we may call the psychical secondary sex characters, seem to extend through the whole range of mental and spiritual activities. Because of this there is freshness of contact in mental and spiritual intercourse between men and women which differs somewhat from that between individuals of the same sex, and very much of the joy of life springs from the impact of these differing yet completing selves the one upon the other.

Where the whole being enters into the union of the sexes the complete joy of marriage is realised, the characteristic of which is that it does not fade, but becomes ever deeper and more fully realised, a sure indication that the highest pleasure of sex union is only attained when it consummates a love which involves mutual sympathy and consideration. Physical union alone produces dissatisfaction the more quickly in proportion as it is physical only; on the other hand, when all parts of the nature find their counterpart in another, the joy of such intercourse pervades the whole life, and frequent repetition of physical intercourse is not essential to its highest development.

This is well known to all true lovers who have for varied reasons exercised some voluntary self-control in regard to the physical side of sex in marriage, either in deference of the one to the desire of the other, or to avoid too frequent child-bearing, or in special seasons such as Lent.

On the other hand it has been observed by most people that many marriages which seem to promise well, quickly lose even to the eye of the outsider all the romance of the days of courtship. Is not too frequent physical indulgence sometimes the cause?

Even the time of courtship is spoiled by unrestrained demonstration of affection, and the beauty of the higher side of love is apt to lose its delicate bloom by over accentuation of the physical in marriage; husband and wife sadly admit to themselves that disillusionment has come—the real truth being that in seeking only physical satisfaction in each other, their eyes have become blinded to those higher qualities which each glimpsed in the other during the happier days of courtship, and the "road of the loving hearts," which they hoped to tread through life, has been missed because they have forgotten that "man is a spirit and doth not live by bread alone."

To many the introduction of this aspect of the question may seem beside the mark. For them the practical question in a world of sense is how to avoid having children when for any reason they are not wanted, and yet leave unimpaired facilities for married life. It is true the problem is not always stated so bluntly. The uses of contraceptives are explained, together with a recommendation for moderation in physical intercourse; but as will be shewn below, if such moderation is really practised, it is possible to live a natural married life such as renders unnecessary the use of artificial contraceptives with all their attendant evils and yet limit the size of the family.

But it is necessary to consider more carefully the claim made to-day that contraceptives are both necessary and harmless, and that public propaganda on the subject is desirable.

There are several different groups for whom relief is claimed:—

1. Women who are suffering from chronic or from temporary ill-health are frequently not in a condition to bear the strain of child-bearing, and indeed it may become a real danger to their future health, either mental or physical.

2. There are cases of inherited disease, mental or physical, which ought to prohibit child-bearing.

3. There are over-worked women whose daily work, added to child-bearing, destroys their health and vitality. These people are found not only among the so-called working classes; the same conditions with somewhat different types of strain are found in wives of professional men with very slender incomes.

4. Some parents wish to "space" their children, that greater attention may be given to each, or they wish to limit the number of their family on account of financial and other difficulties.

With these and other considerations in view, the widespread teaching of methods of preventing conception is advocated because it is claimed:—

(a) That except for general propaganda, the greatest sufferers, viz., poor women with constantly recurring pregnancies, would otherwise never learn of any method of relief.

(b) That many young people who for various reasons, such as housing or financial difficulties or inherited disease, feel themselves unable to have a family, would if such knowledge were available marry much earlier, and their natural desires would be satisfied, while apart from marriage they might resort to promiscuous intercourse.

(c) That homes where the growing difficulties and strain of a continually increasing family are leading to estrangement between husband and wife, are restored to happiness when saved from the difficult choice between continence, which they have never trained themselves to practice, or many children with which they cannot cope.

There are, however, serious fallacies in these contentions.

The propagandists of conception control appear to take it for granted that after preventive measures in early youth, children may be conceived at will whenever they are desired; and, moreover, it is assumed that apart from such precautions every woman will conceive annually and will continue to do so until 10-12 children have been born.

Neither of these suppositions is supported by facts. On the contrary, there are large numbers of married couples who would give anything to have children, but have postponed it until circumstances should seem quite desirable, and then, to their grief, no children are given to them. It is very unfair to teach people that they may safely postpone the natural tendency to bear children in youth and rely upon having them later in life. Probably gynæcologists are consulted more often by women who desire children but do not have them, than by those who wish to avoid having them—the truth being that the tendency among people in comfortable surroundings is towards relative sterility rather than towards excessive fertility.

Those who are interested in this aspect of the question will find the facts admirably set forth in Mr. Pell's book on The Law of Births and Deaths, being a study of the variation in the degree of animal fertility under the influence of environment.

He finds that the all-important factor which determines fertility is the amount of nervous energy of the organism, and that nervous energy is produced or modified by three specially influential factors, viz., Food, both quantity and quality; Climate, hot or cold—moist or dry; and, lastly, all those varied conditions which make for greater or lesser mental and physical activity.

Fertility, broadly speaking, varies in inverse proportion to the degree of nervous energy or what we may call vitality.

Conditions, therefore, which lower the general vitality below the normal produce abnormal fertility. This excessive child-bearing under present conditions still further lowers the standard of life and the health of the mother, hence a vicious circle is set up, the only escape from which will come by such consideration of the laws of health relating to work, housing, food and recreation as shall ensure the maximum of vitality to the workers. This is the true method of conception control.

There comes a point in the development of nervous energy which is productive of sterility. It is true that principles based on so many varying factors will necessarily appear to fail in individual cases. Environment with its influence on the nervous energy of the individual will be modified by the inherited tendency of that individual towards fertility or the reverse. We find, therefore, isolated cases of large families among the well-to-do and small families among those whose vitality is below the normal, but if the general principle is true we should expect to find a larger number of sterile marriages among the well-to-do than among those whose lives are more full of hardship, and this undoubtedly is the case.

This aspect of the problem is deserving of careful study. The desire for children in so many homes where every advantage could be given, may be gratified when more knowledge of how wisely to modify the environment of the rich is within our grasp.

It may be that the more simple life among those who have much will give to them the prize of children which they covet more than things which wealth can buy.

But let us return for a moment to the false expectation that children will come to all unless prevented.

The results of this assumption are really serious. They involve the training of large numbers of people in unnatural practices, which in many cases are unnecessary, even if they were desirable. They rob many families of the children who would have been the delight of their parents through middle and later life.

Moreover, it is obvious that advice which may be quite necessary in cases of ill-health or special conditions, may be fundamentally wrong to give broadcast to all individuals, for apart from the fact that when given to all it is largely unnecessary, there are other serious objections, as follows:—

1. A public opinion at the present time is being gradually produced which takes it for granted that as a matter of good form young people should not have children for a few years after marriage, and it is becoming a common practice to start married life with sordid and unnatural preparations for a natural act; yet many of these young people, men and women alike, are most anxious to have children, and only seek to know how to prevent them because they believe it to be "the thing to do."

One or two illustrations which have come to my personal knowledge will perhaps show the kind of idea which is conveyed to the mind of young people by books and speeches on this subject, though such results may not have been desired by the authors or speakers.

A young bride came to her mother on returning from her honeymoon and said, "Mother, how long must we wait before having children—is it really necessary to prevent them for a year or two? We are both dying to have babies."

A young couple on the eve of marriage consulted a gynæcologist regarding the question of using the cap pessary to prevent the possibility of having children for a few years.

The bride, who was greatly distressed, produced the pessary which she had purchased, and said she could not possibly use it; her fiancé, however, had been advised that she could, and ought to do so, hence the first serious dispute had arisen between them, clouding the future.

She was told by her doctor that it was quite impossible for her, and this fully satisfied the future husband.

The next point was if this method were impossible what should be used.

They were a splendid young couple, with ample means to support a family, and the doctor naturally asked—"But for what purpose do you need any methods to prevent children at all?" They hesitated and looked at each other, and then said—"I don't know, but we thought it was the thing to do."

They left with the whole nightmare put aside, determined not to spoil the perfect consummation of their happiness.

Many similar cases might be quoted where young people, without any considered motive, are acting in accordance with the vogue of the moment.

2. The use of contraceptives does not encourage self-control, yet the cultivation of self-control is a far higher gain to the individual and the nation than any apparent advantages obtained by its abandonment.

By no means unimportant is the influence that wide diffusion of the knowledge of how to prevent conception would have in causing more irregular unions and greater promiscuity in sex relations. The effect of this would not only loosen, rather than strengthen, the marriage tie, but would inevitably lead to an extension of venereal disease. Many people seem to think that contraceptives prevent venereal disease at the same time that they prevent conception. But this is not so. The use of methods of prevention by women is no protection to them from infection.

3. We have, moreover, to take a wider view, and consider who will receive and act upon the advice given, and hence what the result will be on the differential birth-rate of the community.

It is quite obvious that the educated classes can most easily follow instructions which result in protection from conception, and since such knowledge most easily circulates among the more highly endowed classes, it has been claimed that it is important to make efforts to let the knowledge be so widespread that it may reach all. The result, however, could only be that the practice of conception control would spread throughout the upper, middle and more intelligent of the working classes, and this would involve a very serious reduction in the births of those who furnish the leaders and efficient workers in all branches of life, and in those only.

For the birth-rate amongst the least intelligent, least efficient and the mentally deficient will be unaffected. It must be apparent that after a very few generations of such weeding out of the best, with the continuous multiplication of the worst type of citizen, the general standard of efficiency, enterprise and executive skill of the nation would be seriously impaired. Such, briefly stated, is the problem before the public at the present time.

CHAPTER II

THE DEMAND FOR KNOWLEDGE AND FROM WHOM TO OBTAIN IT

Even the brief survey given in the first chapter will have suggested to the reader that the people who ask for knowledge seek it for various reasons. Indeed, the first thing that strikes anyone who gives consideration to the subject is the difference in type and circumstance of the people for whom relief is claimed. We begin to realise at once that the subject of conception control is an intimate and individual one, and can only really be dealt with by advice which is given to the individual and not to the public at large.

This is perhaps most obvious in the first group mentioned on page 17, where the woman is suffering from chronic or acute disease, and the necessity for preventing conception is clear to her medical adviser. If disease renders child-bearing a danger to the life and health of the mother, it becomes a positive duty of her doctor to prevent such a catastrophe—but the method advised will differ according to the special nature of the case.

Again, where in the case of husband or wife there is a serious inheritance of mental or physical disease, and especially when the same weakness exists in both families, it is justly regarded as a duty by the married pair not to bring children into the world. It may be contended that men and women with such an inheritance should not marry, but that is a matter for the decision of the individuals concerned. It not infrequently happens that marriage has taken place before they know of the inherited tendency. In such cases clearly the advice of the family doctor should be given as to the best course to pursue in order to avoid conception.

The case of the overworked and burdened mother with a large and increasing family is nearly allied to that of a woman with disease, though in her case the causes for ill-health are more complicated.

While it is true that ill-health and premature ageing in working women are the result of many causes, yet where child-bearing still further injures health it is essential that she should consult her medical adviser on this point, for she not only needs treatment to restore her health, but also advice specially suitable to her own case, as to the best method to avoid conception for the time being, and such advice will vary according as the disability is temporary or permanent.

It is, happily, as possible for the poor woman to obtain advice in all matters of health as it is for the rich. The mothers of the country are in touch everywhere with maternity clinics, where doctors advise them on all questions of health relating to pregnancy, and treat each woman as a separate individual.

But the case of the poor working woman overburdened with work which she cannot accomplish—yet with the added burden of bearing more children than her more fortunate sisters, deserves some further consideration.

What is it that prematurely ages so many of these women of the slums—is it child-bearing alone?

The answer to that is immediately in the negative, for women in comfortable circumstances may have large families, with no sign of weariness and dejection. No, the causes of ill-health and debility are diverse, and to pretend to solve the question by conception control is a mockery, for it salves the conscience of the community without really dealing with the question of the disabilities of the working woman, or the true cause of her excessive fertility.

Ill-health in working-class mothers often has its origin in inherited weakness and lack of care in childhood. It is further accentuated by overwork, with no labour-saving devices; lack of suitable food; too few, if any, hours of recreation, and hence very little out-door exercise. Badly ventilated homes deprive the mother of necessary supplies of oxygen, and insufficient sleep is often the last straw which breaks down the patient burden bearer. A true and haunting picture is given in a recently published book called The Woman in the Little House (which first appeared in a series of articles in the journal "Time and Tide"), describing the anxiety of a working woman at night to keep her baby quiet that the husband may sleep.

Now it is quite true that a small family instead of a large one will diminish the work and anxieties of such a mother, but it will not give her the remedies which she needs, nor will it diminish the excessive sexual demands made upon her.

Everyone who knows these women intimately realises what an exhausting feature is this habit of excess due to lack of knowledge or self-restraint on the part of the husband.

I believe if facilities were provided whereby the woman could do her laundry with modern appliances outside her own home, if family meals were arranged in service rooms equivalent to the arrangements in service flats, and if there were crêche rooms where children might be left for an hour or two in safety while necessary work was done—we should find a greatly increased standard of comfort even in existing homes, and a great improvement in dietary for the whole family. Such relief, added to teaching both to husband and wife as to the times of conception, would revolutionise the life of women more than any teaching of artificial birth control, and would lift it up to a higher level instead of degrading it to the grossly physical.

We come to very different considerations in group 4, p. 18, where choice rather than necessity impels the parents to limitation of the family. The teaching now being advocated by certain books and pamphlets advises deliberate delay in child-bearing for a period after marriage, and the spacing of certain periods between the births of such children as are allowed to come into the world, with limitation of the number in each family.

Teaching on these lines, if followed, would involve an artificial mode of sex life always—natural spontaneous union would find no place. Already young wives are seeking advice for some relief from methods of preparation which they say have destroyed in them all spontaneous desire. The tragedy of it all is that even to attain the end in view—moderation in the size of families—such methods are to a large extent unnecessary. Not to every young married couple does a child arrive at the end of a year. Some, using no artificial checks, wait two or three years before the first baby comes. Even if it does come, however, at the end of a year, there are many advantages to counterbalance the small means and perhaps hard living of the young pair. For when people are young they can put up with small means, because they are strong enough to work hard and help each other; indeed, the demand for little work and many luxuries in youth is not a healthy one, it is a sign of decadence in the race.

Moreover, even though an early family involve real hardship for awhile, it has the great advantage that parents and children later on are still young together, and that means far more to the child in understanding friendship and helpfulness during the most critical period of life than extra comforts or pleasures would have meant to the parents, and if young parents realised this, would they not put the child first?

The so-called advantages of a few years between one child and the next so that the parents may give fuller care and attention to each, are far outweighed from the child's point of view by the advantages of playmates in the nursery of nearly its own age, who are a source of education in the give and take of life such as no adult can supply. If parents wish to have only three or four children, it is to the advantage of the mother as well as of the children, to have the little family early in life—they are then all in the nursery together, and later all at school, and her life work is in this way so arranged that she may give most service to the world in addition to carrying on the race.

Our conclusion is that for mothers and children it is very desirable that no contraceptives should be used in the early years of married life.

In the vast majority of families where no restrictions or unnatural means are used and where mothers nurse their children for eight or nine months, children only come every two years. Even if a young couple decide that they cannot afford to bring up more than four children, they have first to prove that four children will be given them—in many cases they will not have so many, and as years go by the fertility of the mother becomes progressively less, so that if child-bearing is postponed till after thirty, in a certain number of families no children are born. There are many men and women who bitterly regret having let the years go by in which children might have been born to them, and it is only fair that young couples of to-day should fully understand this risk.

CHAPTER III

METHODS

There are certain points in regard to methods of preventing conception which should be made clear.

It is, of course, obvious that conception can be voluntarily controlled by abstention from intercourse except when children are desired. This has been called a counsel of perfection. It could only rightly be so described where such a method of life was both desired and approved by both husband and wife. It would not be a fair thing for either to enforce a practically celibate life on the other without the fullest understanding and consent before the marriage vows were taken.

But conception can also be controlled by avoidance of those parts of the monthly cycle in which conception most commonly takes place. That in the great majority of women there is a time in the monthly cycle when no conception occurs has been noted for a long time. The rough-and-ready method of reckoning the date of birth in relations to the last menstrual period is an example of the assumption that conception will probably have taken place a week later, and the frequency with which such reckoning is justified shows that it is not altogether unfounded. During the war it was possible to make some more exact observations owing to the short leave granted to soldiers to visit their homes. Seigel has published a paper in the "Münchener Medizinische Wochenschrift," 1916, in which he gives information regarding the conception of between two and three hundred children born during the war. He finds that the likelihood of fertilisation increases from the first day of menstruation, reaching the highest point six days later, the fertile period remains almost at the same height till the 12th or 13th day, and then declines gradually until the 22nd day, after which there is absolute sterility.

This suggests that conception control can be attained without artificial methods if intercourse is confined to one week in the month.

Such control of conception, though natural, does not make it any more desirable to space the births unduly so that the children are brought up in separate units instead of in a happy family group in which they can share games and interests—but it does avoid the risks which are associated with artificial methods of conception control.

It is not proposed to discuss in detail artificial methods in this pamphlet, because no advice can be wisely given on this subject in a general way. Those who after careful consideration choose to use artificial means to prevent child-bearing will be wise if they consult their medical attendant as to those methods which are least harmful for their individual case, and ask for careful instruction in their use.

Most of the methods so widely advertised are productive of diseased conditions, whether from the nature of the method itself or from the way in which it is used, and all of those recommended to women interfere with normal physiological processes. The object aimed at in methods recommended to women, is either to produce, by drugs or otherwise, conditions in the vagina inimical to the life of the male cell, or to prevent by mechanical means the reception of the semen into the uterus. Owing to the uncertainty in the results of either of the above methods of prevention, the later editions of books which teach conception control now advocate the use of both methods at the same time in order to approximate more closely to certainty of result.

All these artificial preparations for intercourse demand from the woman an investigation of and interference with her own internal organs, which is revolting to all decent women, and such teaching is directly opposed to the advocacy of cleanliness and non-interference with the genital organs, which is the natural habit of healthy-minded women.

The effects, however, go further than this. Nature has provided in the healthy vaginal secretions an antidote to infection which quickly destroys harmful germs. If the natural secretions are altered it is difficult to restore them to their natural quality.

Professor Arthur Thomson, F.R.C.S., has shewn ("British Medical Journal," January 7th, 1922) from observations of the lining of the womb in animals and in women that "the weight of evidence goes to prove that its function is more likely to be absorbent than excretive, and that as such it plays an important part in the animal economy."

After describing at length the evidence that the male secretion consists largely of the secretions from special glands as well as the sex cells, he refers to the fact that these are all largely received into and absorbed by the glands of the womb, and he discusses the probability that such absorption profoundly and beneficially affects the physiological reaction in the woman. He points out that the use of artificial checks "while preventing fertilisation may also be the means of depriving the female of certain secretions which may exercise a far reaching influence on her economy"; and he concludes, "As a rule we cannot interfere with the normal course of nature without some consequent evil result. May this not be an instance in which for some apparent gain in one direction, the woman pays the penalty?"

CHAPTER IV

THE EFFECT OF WIDESPREAD CONCEPTION CONTROL
ON NATIONAL EFFICIENCY

In every nation individual capacity varies within wide limits. We have men and women of brilliant attainments, and of all grades of intelligence ranging downwards to the mentally defective. There is no doubt that all grades of intelligence can be improved by education, but there appears to be a limit to the capacity of development of each individual. Lower intelligence, therefore, is not only due to lack of opportunity, but to an inborn constitutional defect.

Further study has shewn this defect to be hereditary—the parents or grandparents of such people shew defective intelligence, and their offspring are likely to do the same; indeed, if two mentally defective people marry it is fairly certain that their children will all be mentally defective.

There are, however, no sharply defined classes of intelligence; just as the mentally defective are in many grades, so ordinary men and women vary from low or average intelligence up to outstanding cases of genius or capacity.

By the newer methods of mental testing it has been shewn that children of various classes of the community, as well as men and women of different races, can be grouped according to their intellectual capacity, and that no educational facilities will develop that capacity beyond a certain point.

Professor W. McDougall, F.R.S., in his most useful and interesting book on National Welfare and National Decay, reaches the important conclusion "that innate capacity for intellectual growth is the predominant factor in determining the distribution of intelligence in adults, and that the amount and kind of education is a factor of subordinate importance." He claims that the evidence is overwhelming as to the validity of the results obtained by mental testing.

A few examples of experimental work given in Professor McDougall's book will suffice to show the trend of these results.

Tests of intelligence were carried out on recruits for the American Army, white and coloured, and they shewed marked superiority of the white race.

A special test was carried out in Oxford by Mr. H.B. English, who compared the capacity of boys in a school attended by children of the intellectual classes with that of boys in a very good primary school, whose fathers were shop-keepers, skilled artisans, etc., coming from homes which were good, with no sort of privation. The result showed marked superiority of the sons of intellectual parents. Mr. English concludes that the children of the professional classes, between 12 and 14 years of age, exhibit very marked intelligence, and he is convinced that the hereditary factor plays an altogether predominant part.

In another experiment, Miss Arlitt, of Bryn Mawr College, tested 342 children from primary schools in one district, who were divided into four groups:—

Marked differences between the groups were shewn. The intellectual capacity was represented by figures as follows:—

A further research of 548 children, grouped according to the occupation of their father, gave its results in terms of the percentage of children in each group who scored a mark higher than the median for the whole 548. They are as follows:—

In the "Journal of Educational Psychology," Vol. IX, 1916, Mr. A.W. Kornhauser gives evidence from the examination of 1,000 children drawn from five schools in Pittsburgh.

Schools A and B were attended by children of unskilled manual workers.

Schools C and D by children of skilled artisans and small shopkeepers.

School E by children of parents in very comfortable circumstances.

The results are tabulated as—

These experiments all shew the trend of intelligence (and with it will power or power of concentration, and what we may call general capacity) to be more concentrated in the so-called higher grades of society, and to be less and less evident as we descend in the scale from skilled to unskilled workers. It would, of course, be clear to all that the children of mentally deficient parents can only be a burden on the State or can rarely contribute anything of value to the common weal.

Now the teaching and advocacy of methods of conception control is most easily assimilated and practised by the intelligent classes; indeed, we may say with certainty that such methods can only be used effectively by the intelligent members of the community, such as leisured, professional and mercantile classes, skilled artisans and better class workers, whereas the lowest type of casual labourers whose home conditions render the use of preventive methods difficult or impossible, and the mentally deficient and criminal classes, are unaffected by such teaching.

The result in a few generations must be a marked decrease in the numbers of the intellectual and efficient workers, while the hopelessly unfit continue to produce their kind at the same rate as before.

The figures given do not suggest that individuals with marked ability are to be found in the upper classes only, but they do indicate that there is a larger proportion of boys and girls in the more comfortable classes whose inherited ability is above the average, though this may be partly due to the more intellectual atmosphere in which their early childhood has been passed.

The provision of education for all, with facilities for children of every class to pass on to higher grades of work, is essential if the latent powers in all, whatever they may be, are to be developed to the utmost.

The point for our consideration at the moment, however, is that if the production of all capable workers, whether mental or manual, is to be curtailed and the numbers of the population maintained in greater proportion from the mentally deficient or criminal classes, the result must be national disaster. For in a very short time there will not be enough leaders of real capacity to occupy positions of initiative and responsibility in the various activities of the country at home and abroad, nor will there be an adequate supply of good practical work: a lowered standard of efficiency must result. From a national point of view, therefore, we regard the propaganda in favour of conception control to be a real and increasing danger.

The problem of the mentally deficient is of another order. In this case another kind of control is urgently needed, but it is one which can only be undertaken by the State, and not by the individual. It is to put in force such a method of compulsory segregation as would ensure the comfort and contentment of the mentally deficient, and safeguard them and the nation from the reproduction of their kind.

The problem also of the insane and criminal classes in relation to heredity is one which demands careful consideration by those competent to give it.

SUMMARY OF CONCLUSIONS

1. There are certain women who for medical reasons should be prevented from bearing children.

2. There are couples with undesirable inheritance who rightly decline to bear children.

3. There are many women of the poorer classes in whom child-bearing is sometimes the last straw in circumstances all of which tend to destroy health and vitality.

4. Public teaching on contraceptives, like medical advice advertised in newspapers, is generally applied to cases for which it is unsuitable and applied in the wrong way.

It is therefore detrimental to public health as well as being detrimental to public morality.

5. A public opinion in favour of small spaced families does not serve the best interests of the children or of their mother.

6. Married love should express itself at once in the usual way without the use of artificial contraceptives.

7. The diminishing fertility of the more capable classes is a national peril.

To counteract this tendency every encouragement should be given to the intelligent and efficient classes of the community to bear healthy children.

The study of problems which give rise periodically to a propaganda in favour of the practice of conception control reveal the fact that excessive child-bearing is found in those classes who suffer the greatest privation, and in whom large families are a real hardship, while many couples among the well-to-do are childless though greatly desiring children.

Such facts suggest that the true remedy for the general problem lies in raising the standard of living among working-class mothers and advising a more simple life to the more richly endowed.

8. It is desirable that the Government should make provision for methods which will arrest the propagation of the mentally deficient, insane and criminal classes.