THE SMALL FAMILY SYSTEM 
 
THE 
 
 MALL FAMILY SYSTEM 
 
 IS IT INJURIOUS OR IMMORAL? 
 
 By 
 C. V. DRYSDALE 
 
 D.Sc. (Lend.) 
 
 ff^it^ thirteen diagrams of population movements ^ etc.y at home and 
 abroad, and Trefatory CN^te by 
 
 Dr. Binnie Dunlop 
 
 NEW YORK 
 
 B. W. HUEBSCH 
 
 1914 
 

PAGE 
 6 
 
 7 
 
 12 
 
 34 
 46 
 
 «3 
 103 
 
 106 
 i'5 
 
 CONTENTS 
 
 Prefatory Note By Binnie Dunlop, M.B., Ch.B. - - . 
 
 Introduction - 
 
 Chapter I. Opinions of Medical Authorities - - _ 
 Chapter II. Opinions of Clerical Authorities - 
 
 Chapter III. Conduct of Authorities 
 
 Chapter IV. The Public Health : Birth, Death, and Infantile 
 Mortality Tables, England, Germany, 
 France, Holland, Australia, and New 
 
 Zealand ; Summary 
 
 Chapter V. Do Preventive Methods Cause Cancer ? - 
 Chapter VI. Morality ; Crime 5 Alcoholism ; Pauperism ; 
 Sex Morality ; Divorce ; Illegitimacy ; 
 
 Disease 
 
 Chapter VII. General Conclusions 
 
 Chapter VIII. Family Limitation and Social Reform - 
 Chapter IX. The Judgment of the Hungarian Medical Senate 
 
 LIST OF DIAGRAMS 
 
 page 
 Fig. I. Variations in Birth Rate, Death Rate, and Infantile 
 
 Mortality in England and Wales - - - <;2 
 Fig. 2. German Empire : Growth of Population, Birth and 
 
 Death Rates --56 
 
 Fig. 3. France : Birth and Death Rates - - - - 58 
 Fig. 4. The Netherlands : Birth, Death, and Infantile 
 
 M.irtality Rates 60 
 
 Fig. 5. AustraVa : Birth, Death, and Infantile Mortality Rates 6^ 
 Fig. 6. New Zealand : Birth, Death, and Infantile Mortality 
 
 Rates 65 
 
 Fig. 7. Canada : Birth, Death, and Infantile Mortality Rates 69 
 Fig, 8. Cancer in England and Wales : Corrected Death 
 
 Rates at all ages, 1861-1910 - - - - 75 
 Fig. 9. Variation of Cancer in Persons at Different Ages — Men 77 
 Fig. 10. Variation of Cancer in Persons at Different Ages — 
 
 Women .-------77 
 
 Fig. II. Cancer in Various Parts of the Body — Mortality at 
 
 all Ages, 1897-1910: Women - - - - 79 
 Fig. 12, Various Countries : Fertility and Cancer, 1 901-5 80 
 Fig. 13. Fertility and Illegitimacy: England and Wales, 
 
 1876-1909 98 
 
PREFATORY NOTE 
 
 It gives me great pleasure to write a prefatorial note for 
 this book. The question that forms its title, and with which 
 it deals in an original and admirably scientific manner, is by 
 far the most important question of the day. If those who 
 are best qualified to answer it were to reply with an open and 
 emphatic " No," the immediate and continuous benefit to 
 humanity would be enormous and unprecedented. Poverty 
 would, in two or three years time, be banished from this 
 country, and, in a generation or so, from the whole world ; 
 there would be a rapid improvement in the quality of the 
 race ; and the day of the abolition of war would actually be 
 in sight. A decision, therefore, as to the justifiabiHty of 
 family hmitation is of the greatest possible moment. Dr. 
 Drysdale has done full justice to the adverse evidence on the 
 subject, and his readers will at all events be able to decide 
 whether or not the title question has yet been satisfactorily 
 answered. I can at present wish nothing better for mankind 
 than that this book should be read by every clergyman, 
 doctor, and open-minded person in the land. 
 
 BiNNIK DUNLOP, M.B., Cm.B, 
 
THE SMALL FAMILY SYSTEM 
 
 Is it Injurious or Immoral ?* 
 
 INTRODUCTION 
 
 BY far the most important question of our time, to those 
 who take more than a superficial or transitory interest 
 in social matters, is the question of limitation of families. 
 Since the year 1876 when Mr. Charles Bradlaugh and Mrs. 
 Annie Besant were prosecuted for publishing Dr. Knowlton*s 
 pamphlet, T:he Fruits of Philosophy, in which practical 
 information concerning the means of limitation was given, 
 the birth-rate in practically all civiHsed countries has rapidly 
 declined although it was rising before this date. This fact, 
 combined with the inquiry made by the Fabian Society in 
 1905, and the testimony of many medical men, renders it 
 beyond doubt that this fall of the birth-rate is not only due 
 to the voluntary restriction of famihes within marriage, but 
 also to the employment of means of preventing conception 
 which do not otherwise interfere with the sexual life of the 
 parents. That the fall of the birth-rate is due to restriction 
 of famihes is practically proved by the record of the fertility 
 of married women, which has fallen from 292.5 births per 
 thousand married women in 1870-72 to 209.4 per thousand 
 in I909t in England and Wales, and similarly in other 
 countries ; while one strong piece of evidence against this 
 being due to what is sometimes termed " moral restraint '* 
 from intercourse by married people is that it did not occur 
 
 *NoTE.— Throughout this pamphlet the terms artificial restriction or 
 limitation are used in the popular sense of restriction of families without 
 cessation of sexual life. The appropriateness of the term " artificial " 
 may well be questioned. 
 
 t Reg.-General's Report, 1909, p. xxx. 
 
8 The Small Family System 
 
 before 1876, although the necessity for restriction of famihes 
 and the advice of " moral restraint " had been most strongly 
 before the pubhc ever since the commencement of last 
 century. The inquiry made by the Fabian Society in 1906 
 showed that 242 out of 316 married couples admitted having 
 dehberately Hmited their families.* Moreover a well-known 
 EngHsh gynaecologist has put the matter in the following 
 strong terms, in 1904 : — "j" 
 
 " Artificial prevention is an evil and a disgrace. The 
 immoraHty of it, the degradation of succeeding generations 
 by it, their domination or subjection by strangers who are 
 stronger because they have not given way to it, the curses 
 that must assuredly follow the parents of decadence who 
 started it ; all of this needs to be brought home to the minds 
 of those who have thoughtlessly or ignorantly accepted it, 
 for it is to this undoubtedly that we have to attribute not 
 only the diminishing birth-rate, but the diminishing value of 
 our population. 
 
 It would be strange indeed if so unnatural a practice, one 
 so destructive of the best life of the nation, should bring no 
 danger or disease in its wake, and I am convinced, after 
 many years of observation, that both sudden danger and 
 chronic disease may be produced by the methods of preven- 
 tion very generally employed . . . The natural deduction is 
 that the artificial production of modern times, the relatively 
 sterile marriage, is an evil thing even to the individuals 
 primarily concerned, injurious not only to the race, but to 
 those who accept it. 
 
 Since I delivered my Presidential address I have found 
 such widespread agreement and approval of all that I said 
 among my own professional brethren everywhere, that I 
 have no hesitation in bringing the whole body of professional 
 opinion in evidence, at least of practical unanimity, in the 
 tracing of the dechne of the birth-rate to the use of artificial 
 checks or preventives ; and this body of skilled opin ion is 
 
 * A further examination of the figures led to the conclusion that during 
 the decade 1890-99 "only seven or possibly eight unlimited fertile 
 marriages are reported out of a total of 120." See Fabian Tract No. 131. 
 
 t Dr. F. W. Taylor, late President of the Gynaecological Society, 
 quoted in The Falling Birth-rate, by Lieut.-Col. H. Everitt, Hon. 
 Secretary of the White Cross League, 7, Dean's Yard, S.W. 
 
Introduction 9 
 
 not founded on any theory, but on the ascertained facts of 
 daily experience. . . . The cause of the stationary popula- 
 tion of France has been threshed out and acknowledged for 
 years, and the Report of the Royal Commission on the similar 
 decline in New South Wales not only traces the cause directly 
 to artificial prevention, but stigmatises the married state of 
 those who practise it as one of ' monogamous prostitution.' 
 
 It is no good trifling with facts : — 
 
 (i) Our birth-rate is steadily decHning. 
 
 (2) This is due to artificial prevention. 
 
 (3) This is slowly bringing g.ievous physical, moral, and 
 social evils on the whole commi.nity." 
 
 There is no hesitation here as to the cause of the fall in 
 the birth-rate, nor as to the writer's opinion concerning it. 
 Leaving the latter for consideration below, we must regard 
 it as accepted by all educated people who not only study the 
 external evidence, but have their own experience to go upon, 
 that " artificial " restriction is practically the sole means by 
 which limitation of families is brought about, and that the 
 " moral restraint " preached by the Bishop of London and 
 other Church dignitaries is responsible for a neghgible 
 fraction of it. It is most important to reahse tliis fact, as 
 many people who are practising artificial restriction them- 
 selves, have the impression that " moral restraint " is the 
 ideal which they ought to follow, and which others are 
 perhaps following ; and they are therefore ashamed of their 
 conduct and maintain 'secrecy concerning it. This is a 
 serious matter. For if artificial restriction is an evil we 
 ought to know the extent of it, and how to fight it ; while 
 if it is good for the educated classes, it is evidently far more 
 necessary on all grounds for the poor, and the former ought 
 honestly to declare their actions and join in extending to the 
 poor the knowledge which they have applied for themselves. 
 All the evidence goes to show that artificial restriction is now 
 well nigh universal among people of education and refine- 
 ment, so no one has any reason for feehng shame as being 
 below the general level in having adopted it. 
 
lo The Small Family System 
 
 The only question therefore really before us is whether 
 this artificial restriction is or is not injurious to health and 
 morality ; and this question has been brought forward with 
 special prominence lately by Mr. Commissioner Beale's 
 work on Racial Decay * and by the evidence before the 
 Select Committee on Patent Medicines now sitting. 
 
 Those who wish to hear the case against artificial restric- 
 tion of births put with the strongest possible force and com- 
 pleteness may be recommended to read Commissioner 
 Beale's extensive work on Racial Decay. Indeed the 
 existence of this book will absolve the present writer from 
 doing more than quoting the strongest and most official 
 pronouncements against the practice. A brief though 
 emphatic indictment against it is also given in ^he Falling 
 Birth-raUy a pamphlet compiled by Lieut.-Col. H. Everitt, 
 and issued by the White Cross League in 1909. At the time 
 of writing, the evidence given before the Select Committee 
 on Patent Medicines on this subject has not been very 
 remarkable, but those who may like to know of it will find 
 reports of the proceedings in the columns of the Chemist and 
 Druggist and the Pharmaceutical Journal notably for June 
 and July, 19 12. 
 
 It will be noticed that many of the writers quoted in this 
 book speak of artificial restriction of famiHes as Neo- 
 Malthusianism. This is so far true that the advocacy of 
 such methods and the invention of many of them originated 
 with the neo-Malthusians, but neo-Malthusianism is a 
 doctrine which teaches that the control of births is necessary 
 for the improvement both of the economic conditions and the 
 quahty of the human race ; and at the same time recognises 
 that delayed marriage or ceHbacy inevitably leads to serious 
 sexual irregularities and diseases. It therefore advocates 
 general early marriage, combined with the voluntary 
 Hmitation of famiHes to those children which the economic 
 
 * London : A. C. Fifield, 5s. net. 
 
Introduction 1 1 
 
 :onditions or health of the parents will permit them to bring 
 ap as efficient citizens, and it approves of the employment 
 of all devices for this purpose which are not injurious to 
 health. 
 
 But mere indiscriminate prevention of conception by 
 artificial means is no more neo-Malthusianism than is the 
 indiscriminate dabbHng in drugs or patent medicines, by 
 ignorant people, the science of medicine. No one in his 
 senses would condemn the medical profession or the use of 
 drugs because ignorant people made bad use of them, nor 
 should neo-Malthusianism be necessarily blamed for any 
 possible evil results of preventive devices. Abusus non 
 tollit usum, and we do not condemn explosives or firearms 
 because serious results occasionally arise from their un- 
 skilful use. 
 
 There are three methods of coming to a conclusion on this 
 all-important question ; (a) by ascertaining the opinions 
 of medical authorities and morahsts, (b) by considering the 
 conduct in this respect of these authorities themselves, and 
 (c) by studying the course of the health and morality of the 
 community as limitation of families has become more 
 general. This we shall now proceed to do. 
 
CHAPTER I 
 
 OPINIONS OF MEDICAL AUTHORITIES 
 
 THE opinion of Dr. F. W. Taylor, above cited, is that of 
 an acknowledged gynaecological authority in this 
 country. Although we have not come across any other 
 example of such wholesale and unsparing medical condem- 
 nation, we beheve that many of his statements would have 
 been endorsed by other medical men at the time. But it is 
 unnecessary to investigate this in detail as the consensus of 
 medical opinion in this country was supposed to be ex- 
 pressed in the following Resolution passed in 1905 by the 
 South Western Branch of the British Medical Association, 
 and afterwards endorsed by the Devonport Branch of the 
 Association : — 
 
 " That the growing use of contraceptives {means to prevent 
 conception) and ecbolics {substances to empty a pregnant 
 womb) is fraught with grave danger both to the Individual and 
 the Race; and that the advertisement and sale of such appli- 
 ances and substances^ as well as the publication and dissemina- 
 tion of literature relating thereto, should be made a penal 
 offence.''^ 
 
 It is perhaps unnecessary to go further for examples of 
 strong condemnation. Those who are accustomed to put 
 their faith in official authority will feel that the matter is 
 thereby settled. But there are others who will remember 
 that authority in all departments has frequently been used 
 to bar progress. For these the following facts may lead to a 
 reconsideration of the matter. 
 
 Dealing first with the resolution just quoted, we may 
 observe that two things are coupled together for censure — 
 preventives and ecbolics. The latter term implies aborti- 
 facients, which are drugs or other devices for producing 
 
Opinions of Medical Authorities i 3 
 
 ibortion ; that is, for destroying the embryo after concep- 
 ion has taken place. This is not only a destruction of Hfe 
 ilready commenced (albeit unconscious hfe), and a criminal 
 )ffence ; but, when attempted or carried out by drugs or 
 mskilled interference, is generally attended by serious 
 njury to the health of the mother. It is therefore most 
 ;trongly to be discountenanced.* The prevention of con- 
 :eption, on the other hand, is not a destruction of life 
 , rehgious fanatics notwithstanding). So far as any kind of 
 llestruction is concerned it does not differ in any way from 
 ;trict continence. It is not illegal, and its effects on the 
 lealth, which are now in question, are at any rate of a quite 
 lifferent order to those of the taking of poisonous aborti- 
 "acients. 
 
 To anyone having medical or physiological knowledge, 
 :he mere fact of these two methods being coupled together 
 n the same sentence, as if deserving of equal condemnation, 
 iffords a strong ground for suspicion of the whole Resolution. 
 [f any body of people were to pass a resolution stating that 
 :he growing prevalence of murder and of sport in the 
 United States is fraught with grave danger to the individual 
 and the State, and that therefore the sale of revolvers and 
 sporting appliances as well as the pubHcation and dissemi- 
 nation of the literature relating thereto should be made a 
 penal offence, the public would immediately regard them 
 as some puritanical fanatics who were endeavouring to 
 obtain legislation against practices which might be either 
 hurtful or beneficial, by couphng them with a great and 
 unquestioned evil. Whether prevention is harmful or not, 
 it is on an absolutely different plane from abortion. The 
 inclusion of the two in the same category can only be re- 
 garded as an evidence of ignorance or of prejudice. This is 
 
 * It will be remembered, however, that the majority of papers, even 
 of the most respectable kind, have freely opened their columns (until 
 quite recently) to advertisements of means for the " correction of 
 irregularities," which refer to drugs of this kind, 
 
14 The Small Family System 
 
 perhaps a strong statement, so it will be well to examine tb 
 evidence in detail. We shall commence by seeing what medi- 
 cal authorities in other countries have to say concerning 
 preventive methods. 
 
 Dr. Hector Treub, Professor of Gynaecology at the i 
 University of Amsterdam, in his widely adopted Handbook I 
 of Gyncecology, 4th Edition, 1903, pp. 656 et seq,, describes 
 several of the methods of preventing conception as perfecth 
 innocuous, and says : — 
 
 " And the fact in itself that pregnancy is preventec 
 cannot be said to be a source of danger. In the numerous 
 sterile marriages nothing is to be seen of such dangers, anc 
 when you look around you at the present time, you observe 
 that voluntary sterility is just as harmless." 
 
 The same eminent authority in his Verspreide Opsteller. 
 Haarlem^ p. 8, says : — 
 
 " So my conclusion is, that in society as it is now, neo 
 Malthusianism, carried out in all respects in as satisfactory 
 a manner as possible, is only deserving of praise." 
 
 Dr. J. Rutgers, of The Hague, in his book on Race 
 Improvement (Rasverbetering), p. 50, says : — 
 
 " There is but one method of saving women from the 
 risk of Gynaecological diseases depending on infection, and 
 that is cleanUness. Now cleanHness is the most essential 
 feature in the appHcation of preventive means. Preventing 
 infection and preventing fecundation are in principle 
 parallel problems." 
 
 Dr. Alletta H. Jacobs, the first lady doctor in Holland, 
 has for more than twelve years given a gratuitous gynaeco- 
 logical and neo-Malthusian consultation twice a week foi 
 poor women. Between 1880 and 1898 she instructed more 
 than 2,200 women in the use of mechanical preventives, and 
 testifies that she never observed any injury to health arising 
 from it. 
 
 Dr. H. Rohleder, of Leipzig, an eminent specialist on sex 
 questions, has recently written a brochure entitled Neo- 
 Malthusianism and the Physician^ in which he speaks of the 
 
Opinions of Medical Authorities 1 5 
 
 great importance of preventing parenthood in cases of 
 diseases of the heart, kidneys and lungs ; and in cases of 
 feeblemindedness, and of chronic alcoholism and poverty ; 
 and he says : — 
 
 " Indeed I beheve that in such cases the recommendation 
 of neo-Malthusian methods by the doctor is not only a duty 
 from which there is no escape, but that his failure to do so is a 
 crime against our present and future generations and the 
 community." 
 
 Dr. August Forel, M.D., Ph.D., LL.D., late Professor of 
 Psychiatry at the University of Zurich, and a well-known 
 authority on sex questions, says in his Sexual Ethics (New 
 Age Press), p. 61 : — 
 
 " Moreover, we must no longer be content to remain in- 
 different and idle witnesses of the senseless and unthinking 
 procreation of countless wretched children, whose parents 
 are diseased and vicious, and whose lives are for the most 
 part destined to be a curse to themselves and their fellow 
 men." 
 
 " We must therefore recommend to all persons who are 
 sickly or infirm in body or mind, and especially to all 
 suffering from hereditary ailments, the use of means for the 
 prevention and regulation of conception, so that they may 
 not, out of pure stupidity and ignorance, bring into the 
 world creatures doomed to misery and misfortune, and pre- 
 disposed to disease, insanity and crime." And in a footnote 
 he says : " We refer, of course, to such preventive methods 
 as are completely harmless to the persons making use of 
 them. Methods for the prevention of conception in general 
 fulfil this condition." 
 
 These citations are amply sufficient to show that many 
 Continental medical men of high reputation take a diame- 
 trically opposite view to that expressed by the Resolution 
 of the South Western Branch of the British Medical Asso- 
 ciation in 1905 . Here is another unhesitating utterance from 
 a well-known American, Dr. W. J. Robinson of New York, 
 editor of a medical paper, T^he Critic and Guide. In the 
 issue of the paper for March, 191 2, he wrote the following : — 
 
1 6 The Small Family System 
 
 THE THREE MOST IMPORTANT MEASURES FOR THE 
 IMPROVEMENT OF THE HUMAN RACE. 
 
 " The three most important measures for the improvement 
 of the human race from a eugenic standpoint ? What are 
 they ? I suppose everybody who has given the subject any 
 thought has his remedies. I have studied the subject for 
 years, and my answer is : (i) Teaching the people the 
 proper means of the prevention of conception, so that people 
 may only have as many children as they can afford to have, 
 ana have them when they want to have them ; (2) Demand- 
 ing a certificate of freedom from venereal and other trans- 
 missible disease from all candidates for a marriage licence. 
 This is bound to come, and come soon ; (3) The sterilisa- 
 tion by vasectomy and oophorectomy of all degenerates, 
 imbeciles, and vicious criminals. This measure has already 
 been adopted by some States, and it is but a question of 
 time when it will become universal. 
 
 Of the three measures the first one is the most important, 
 and still it will be the last to come, because our prudes think 
 it will lead to immorahty. And nevertheless, I will repeat 
 what I said several times before, that there is no single 
 measure that would so positively, so immediately contribute 
 towards the happiness and progress of the human race as 
 teaching the people the proper means of regulating repro- 
 duction. This has been my sincerest and deepest conviction 
 since I have learned to think rationally. It is the convicion 
 of thousands of others, but they are too careful of their 
 standing to express it in pubHc* I am happy, however, to 
 be able to state that my teachings have converted thou- 
 sands ; many of our readers who were at first shocked by 
 out plain talk on this important subject are now expressing 
 their full agreement with our ideas. And Congress may pass 
 Draconian laws, the discussion of this subject cannot, must 
 not be stopped." 
 
 In the February issue of this paper, Dr. Robinson also 
 
 * It is worthy of note, in confirmation of this statement, that a few 
 months ago a banquet was given in honour of Dr. Robinson by two 
 hundred of his fellow medical practitioners, presided over by Dr. Jacobi, 
 the President of the American Medical Association. The occasion was 
 the tenth anniversary of Dr. Robinson's paper, the Critic and Guide, 
 in which he has so strongly and continually advocated teaching all 
 adult persons the methods of prevention. 
 
Opinions of Medical Authorities 17 
 
 had a short note on " The Maternal Instinct," in which he 
 relates the case of a woman who had lost five children in 
 succession, but who was so anxious to have a living child as 
 to undergo Csesarean section twice ; and he concludes : — 
 
 " Incidentally this again shows that the fear of our prudes 
 that knowledge of the means of the prevention of con- 
 ception would depopulate the earth is unfounded. The 
 maternal instinct is still strong enough in the breasts of a 
 sufficiently large number of women to keep the race satis- 
 factorily replenished ; the only difference being, as we have 
 said so many times before, that the people would have their 
 children when they wanted them and only as many as they 
 wanted." 
 
 And the following quotation from Dr. Robinson's book 
 on Sexual Problems of the Day leaves not the slightest doubt 
 as to the importance he attaches to the question : — 
 
 "And one of the central thoughts of my discourse to-night, 
 one of the thoughts I would Hke you to carry away with you 
 and ponder at your leisure, is this : Let the district physi- 
 cians and district nurses who visit the poor be not only 
 permitted, but instructed to teach the poor mothers how to 
 avoid having more children than they can properly support 
 and care for. And let us also Institute a propaganda which 
 will work a change in public opinion, so that it may not be 
 considered a matter of pride, but a matter of shame, to give 
 birth to children for which the parents must invoke public 
 aid." — "The Limitation of Offspring: The Most Important 
 Immediate Step for the Betterment of the Human Race, 
 from an Economic and Eugenic Standpoint." A discourse 
 read by Dr. W. J. Robinson before the American Society of 
 Medical Sociology (of which he Is now the President), March 
 4th, 191 1. 
 
 One other quotation which may be given is from an 
 EngHsh medical man. Dr. C. KlUIck Millard, M.D., D.Sc, 
 Medical Officer of Health for Leicester. Writing in the 
 Church paper, 7he Guardian, of 3rd Nov., 191 1, in answer 
 to one of the Bishop of London's characteristic attacks, and 
 referring to the resolution of the Lambeth Conference of 
 Bishops in 1908, to be dealt with later, he says : — 
 
 6 
 
I 8 The Small Family System 
 
 " In order to justify it [the condemnation on moral 
 grounds] and increase the conviction of this very sweeping 
 indictment, the Committee next proceed to give an appar- 
 ently scientific endorsement for their ban, and state that 
 ' there is good reason to believe that the use of artificial 
 methods of prevention is associated with serious local 
 ailments.' Nervous enfeeblement, loss of mental and moral 
 vigour, neurasthenia, ovarian disease, cancer, and even 
 insanity are all hinted at as possible results, on the authority 
 of ' many eminent physiologists,' the two principal names 
 invoked being the late Professor Taylor and Professor 
 Bergeret. Now I venture to submit that in its scientific 
 aspect the Report is open to serious criticism. Having 
 appealed to science, the Committee ought in fairness to have 
 been at some pains to have obtained the true verdict of 
 science, and not have been satisfied with a loose citation of a 
 few selected opinions all on one side. Nothing is easier than 
 to bolster up a cause in this way. It would have been better 
 had the Committee stated frankly that scientific opinion 
 was very far from being unanimous as to the alleged physi- 
 cal ill-effects of preventives. They might truly have said 
 also that there was little if any evidence of these alleged ill- 
 effects, and they might have quoted on the other side the 
 opinions of authorities such as Professor P. Fiirbringer, in 
 his article on ' Sexual Hygiene in Married Life,' in Senator 
 and Kaminer's Marriage and Disease — an exhaustive and 
 standard work — to the effect that while certain methods 
 might possibly be injurious, others were harmless." 
 
 These opinions, to which many more could be added, are 
 sufficient to show that doctors have disagreed most strongly 
 on this subject, so it may be asked. Who then is to decide ? 
 The only answer is that people must decide for themselves. 
 The following considerations may assist them to do so. 
 
 We have already called attention to the fact that the 
 South Western Branch of the British Medical Association 
 has coupled together preventives with abortifacients in its 
 resolution, which the Continental writers never do. This 
 can only be due to great ignorance, or to a desire to cloak 
 the real issue. Dr. Taylor's strong remarks do not in any 
 way inform us as to whether attempts at prevention or at 
 
Opinions of Medical Authorities 19 
 
 ibortion* were the cause of the evils he mentions ; and 
 everyone will agree as to the terrible results of unskilled 
 ittempts at abortion. There can be no doubt that a large 
 lumber of medical men in this country are lamentably 
 ignorant of the general scope of contraceptive means 
 'although they employ particular ones themselves), and are 
 :juite prepared to confuse them with abortifacients. In 
 :onversation with a medical graduate from one of our 
 premier colleges, and of considerable experience,we gathered 
 from him that he had no general knowledge whatever of 
 :ontraceptive methods, and that the majority of medical 
 practitioners had no opportunity of gaining scientific 
 knowledge concerning them. An eminent Medical Officer 
 of Health informed us, that although he and such of his 
 colleagues as he had privately enquired of considered con- 
 traceptive methods quite harmless, the ignorance of the 
 subject among them was astonishing. When we hear such 
 statements we can quite understand that the confusion 
 between prevention and abortion, combined with theological 
 prejudice and self-interest, could easily lead to statements 
 such as those of Dr. Taylor, or to resolutions such as that of 
 the South Western Branch of the British Medical Asso- 
 ciation. 
 
 On the latter point the following quotation from the 
 British Medical Journal of 9th September, 191 1, throws a 
 light of some importance : — 
 
 " The prospects of private practice are inferior to what 
 they used to be. Complaints of lessened incomes and 
 increased expenses began, indeed, to come in a few years ago 
 in such numbers that the subject was specially investigated 
 by this Journal, and the results recorded in two articles on 
 * The Financial Prospects of Medicine ' . . . The net out- 
 come of these articles was to prove that not only was the 
 possible number of patients less, but each one of those that 
 
 * It is, of course, quite open to anyone to include abortion under the 
 term prevention^ in the more general sense of prevention of child-birth 
 instead of prevention of conception. 
 
20 The Small Family System 
 
 remained needed less medical attendance than formerly, 
 especially for the zymotic diseases, which used to furnish so 
 much work. In this connection must be mentioned the 
 decHne in the birth-rate, which not only affects the medical 
 men of this generation, but must seriously influence the 
 prospects of those who may succeed them." 
 
 It is indeed unpleasant to have to suggest that medical 
 prejudices on this matter may not be entirely unconnected, 
 albeit unconsciously, with questions of self-interest ; and I 
 should not have done so but for having seen this possibility 
 referred to elsewhere.* Apart from this the foregoing 
 quotation is of importance ; it contains no indication of any 
 injury to health from the restricted birth-rate. On the 
 contrary, we are told that less medical attendance is now 
 necessary, and that there is every prospect of this con- 
 tinuing as the birth-rate falls. How is this compatible with 
 the remarks of Dr. Taylor ? 
 
 It must further be noted that in the past five years the 
 opinions of British medical men appear to have been under- 
 going a very rapid change on this subject. No legislation 
 has occurred since the above resolution was passed, and the 
 birth-rate has been falHng even more rapidly. It would only 
 have been natural if, when the matter came up before the 
 British Medical Association in 1910, the resolution of 1905 
 
 * See " Is there a Medical Conspiracy ? " John Bull, October Sth, 1910. 
 
 See also The Vote, September 24th, 1910, which, referring to a dis- 
 cussion on the question of medicine as a profession which had just 
 appeared in The British Medical Jouryial, says : " Amongst the causes 
 quoted for the present bad condition and the worse prospects of the 
 medical profession is the decline in the birth-rate. The clause deserves 
 to be quoted in full. The article says the decline of medicine as a pro- 
 fession is due to ' the lowered birth-rate, which has fallen to 26.3 per 
 thousand. This has had a dual effect. There are not only fewer confine- 
 ments, but fewer babies for medical men to attend.' We are quite 
 willing to admit this, and further, to admit the bearing of this factor 
 on the doctor's income 5 but we are not willing to admit that this gives 
 the doctor any right to preach the doctrine of large families. We go 
 further, and say that it does not justify the medical profession in 
 encouraging the coming of unfit children into the world, and in failing 
 to warn women unfit for motherhood." 
 
Opinions of Medical Authorities 21 
 
 had been reaffirmed iwith a note of increasing urgency. 
 Instead of this, all that happened was a very mild discussion, 
 in which perhaps the strongest adverse point was made by 
 Dr. J. W. Ballantyne in the following remarks : — 
 
 " There is first, the dissemination of the knowledge of the 
 possibility of Hmiting the number of pregnancies by other 
 means than the dangerous induction of abortion, and in 
 ways that do not include continence ; this information has 
 been industriously propagated by the supporters of neo- 
 Malthusianism, and is being quietly handed on from one 
 married man or woman to another all over the country. 
 Time will tell whether the use of ' checks ' is indeed harmless, 
 but there is already some evidence that a perfectly healthy 
 state of the reproductive organs cannot be looked for when 
 these organs are constantly being stimulated to a certain 
 point, and as constantly being prevented from experiencing 
 the natural consequences of the stimulation. It will be 
 strange if bodily and mental well-being in women are found 
 to be compatible with the frequent production of the sexual 
 orgasm unaccompanied by its reproductive consequences, 
 namely, pregnancy, child-birth, and lactation." 
 
 This is indeed an anti-climax to the thunders of Dr. 
 Taylor and the resolution of the South Western Branch. 
 The distinction between abortion and prevention is clearly 
 brought out, and all we have is simply a vague suggestion 
 of possible harm from the use of preventive checks. And 
 even this suggestion is not allowed to pass unchallenged. 
 In the Editorial article on '' The Medical Profession and the 
 Falhng Birth-rate " in the British Medical Journal of 3rd 
 September, 1910, the following remarks appeared : — 
 
 " Of such unproved assumptions — possibly correct, pos- 
 sibly wrong — as were made by any speaker, it is proposed to 
 mention only one. This is that an ordinarily active sexual 
 life in which pregnancy is intentionally prevented is directly 
 inimical to the physical well-being of women. It is a state- 
 ment constantly made, and on the strength of it medical 
 men are told that it is their duty to preach the same doc- 
 trines on the subject as those of the Roman Catholic Church, 
 which, however, are based on a totally different order of 
 
22 The Small Family System 
 
 ideas. As already indicated, the assumption may be per- 
 fectly true, hut the proof has yet to be furnished* The (ques- 
 tion merits consideration, if only because the point is so 
 constantly brought up ; but many difficulties surround its 
 thorough examination. If the idea can be shown to be well 
 founded, medical men will then have truly medical — and 
 indeed imperative — grounds for joining hands with those 
 who express themselves as seriously disturbed by the fall in 
 the birth-rate, and for co-operating with them as far as this 
 particular factor is concerned, 
 
 " Meantime emphasis should be laid on the circumstance 
 that the factors at work are numerous, and that the action 
 of most of them can probably be negatived rapidly, if at all, 
 neither by individuals nor the State, and that in any case 
 most of them are of such a kind as little to concern medical 
 men as a profession. It is hardly possible to sum up these 
 factors in a single sentence, but they are covered in a measure 
 by the statement that while most people would admit that a 
 childless family was one of the bitterest of ironies, and while 
 love of children is no less characteristic of normal adults 
 than formerly, many men and women feel that they can 
 best develop their capabilities by remaining unmarried, and 
 many married couples esteem it a duty alike to themselves 
 and to unborn possible progeny to limit their families to a 
 number which they feel able to educate and place out in life 
 in thoroughly satisfactory fashion. 
 
 " It would indeed be somewhat paradoxical if in an age 
 when the need for endowment, life, sickness, and other 
 insurances is constantly being put before the public, doc- 
 trines such as ' Take no thought for the morrow, what ye 
 shall eat or what ye shall drink,' and ' Happy is the man 
 who hath his quiver full ' were felt to have their original 
 force." _ 
 
 " It is quite possible that these new scruples and such 
 part of the fall in the birth-rate as results from their exercise 
 IS an inevitable incident in the evolution of civilised human- 
 ity, and is the answer which Nature makes when it finds 
 modern man departing so essentially in respect of environ- 
 ment and mode of life from those for which she first designed 
 his ancestors. 
 
 " It does not follow, however, that medical men have 
 
 * Italics mine.— C.V.D. 
 
Opinions of Medical Authorities 23 
 
 nothing to do with the subject. If a distinction is drawn, as 
 it should be, between conception-rates and birth-rates, this 
 becomes more obvious. With the former it is no concern of 
 medical men to interfere* but the latter they can influence 
 materially in respect of height, and beneficially in point of 
 effectiveness. . . . The effectiveness of the birth-rate can 
 also be influenced by continuing the study of heredity, 
 which has already been in progress so long, and by pressing 
 on the notice of the pubhc such facts as have been definitely 
 ascertained. They may be few, but they offer the strongest 
 ground for holding that a check should, he placed on the 
 fertility of certain classes of individuals whose offsprings if not 
 defective from the beginnings almost inevitably grow up into 
 citizens of a very undesirable type* In both these directions 
 there is plenty of work for the medical profession to do." 
 
 So that we actually find the official organ of the British 
 Medical Association stating that there is no proof yet forth- 
 coming of any evil results of artificial prevention, that this 
 restriction of famihes is the result of praiseworthy prudence, 
 and that doctors ought to help in checking the fertiHty of 
 the obviously unfit — a doctrine which has always been part 
 of the programme of the neo-Malthusians. 
 
 But the change of opinion still progresses. Since the 
 above was written the British Medical Association has met 
 again twice, and the subject has been referred to on both 
 occasions. Here are some extracts from the Presidential 
 Address of Sir James Barr to the British Medical Associa- 
 tion at Liverpool on July 23rd, 191 2. 
 
 '* We have successfully interfered with the selective death- 
 rate which Nature employed in ehminating the unfit, but, 
 on the other hand, we have made no serious attempt to 
 establish a selective birth-rate so as to prevent the race 
 being carried on by the least worthy citizens. The same 
 maudlin sentimentality which often pervades the pubHc not 
 infrequently infects the medical profession. We have often 
 joined forces with self-constituted moralists in denouncing 
 the falling birth-rate, and have called out for quantity 
 regardless of quahty. . . . We readily forget that utiHty, as 
 
 •Italics mine.— C.V.D. "" 
 
24 The Small Family System 
 
 long ago pointed out by John Stuart Mill, lies at the 
 basis of all morahty. We are also apt to forget that a high 
 birth-rate is practically always associated with a high death- 
 rate, and a low birth-rate with a low death-rate ; the former 
 is Nature's method, a method which has always produced a 
 fine race, though very slow in doing so ; but, with the ad- 
 vance of civiHsation, Nature's method is too cruel and 
 barbarous, and, as Man rises superior to Nature and obtains 
 more and more control over her laws, such barbarities are 
 replaced by more humane methods. 
 
 I know that in the expression of these views I am coming 
 into direct conflict with at least some of the Churches, of 
 which there are almost as many varieties as there are of 
 human beings. The majority preach in favour of quantity 
 rather than quality ; they advocate a high birth-rate 
 regardless of the consequences, and boldly tell you that it is 
 better to be born an imbecile than not to have been born at 
 all. They forget the saying of Jesus of Nazareth that it 
 would have been well for this man if he had never been born. 
 With the man-made morahty of the Church I can have 
 neither art nor part. There must be a high racial morality 
 based on utihty and the greatest happiness not merely of the 
 individual but of the race. Medical men, when they are 
 consulted, as they often are, on questions of matrimony and 
 reproduction incur a very serious responsibihty when they 
 encourage the mating of mental and physical weakHngs. It 
 is their duty not to pander to the selfish gratification of the 
 individual, but to point out to everyone his positive and 
 negative duties to the race." 
 
 And lest the opponents of " artificial " Hmitation should 
 console themselves with the reflection that Sir James Barr 
 has only blessed the falHng birth-rate, and not the means of 
 its attainment (although he says nothing of any evil con- 
 sequences of the dechne), here is his quotation of Dr. Mott : 
 
 " The profound psychical influence of the sexual glands, 
 by reason of their internal secretions during the period of 
 ripening of the germ-cells, is beyond all dispute, and the 
 repression of the instinct of propagation, and attendant 
 mental dejection or excitation, is a powerful exciting cause 
 of mental or nervous disorders." 
 
 According to this, it is " moral restraint " which is 
 
Opinions of Medical Authorities 25 
 
 provocative of evil consequences to the health, as the neo- 
 Malthu&ians have always contended, and this view is 
 strongly mpported by Continental medical testimony. 
 
 It has been claimed that the body of each individual is 
 totally renewed every seven years. As this is the interval 
 between the resolution of the South Western Branch of the 
 British Medical Association in 1905, and Sir James Barr's 
 Presidential Address of 191 2, it appears that this apphes 
 equally to a corporate body, and that we may now expect 
 a new regime. 
 
 A remarkable fact in this connection is that Professor 
 Barr's pronouncement has come upon the heels of an even 
 stronger one by the President of the American Medical 
 Association, Dr. A. Jacobi, in his Presidential Address. In 
 the Critic and Guide for July, 191 2, a report of this address 
 appeared from which we take the following extracts (the 
 itahcs are due to the Editor, Dr. Robinson) : — 
 
 " Is there no way to prevent those who are born into this 
 world from becoming sickly both physically and mentally ? 
 It seems almost impossible as long as the riches provided by 
 this world are accessible to a part of the living only. The 
 resources for prevention or cure are inaccessible to many — 
 sometimes even to a majority. That is why it has become an 
 indispensable suggestion that only a certain number of babies 
 should be born into the world. As long as not infrequently 
 even the well-to-do limit the number of their oifsprmg, the 
 advice to the poor — or those to whom the raising of a large 
 family is worse than merely difficult — to limit the number of 
 children^ even the healthy ones., is perhaps more than merely 
 excusable. I often hear that an American family has had ten 
 children, but only three or four survived. Before the 
 former succumbed they were a source of expense, poverty, 
 and morbidity to the few survivors. For the interest of the 
 latter and the health of the co?nmunity at large, they had better 
 not have been born.^^ 
 
 " Consumptives and epileptics and semi-idiots are per- 
 mitted to propagate their own curse, both what is called 
 
2 6 The Small Family System 
 
 legitimately and illegitimately. Human society should have 
 pity on itself and on its future. 7he propagation of its 
 degenerate, and imbecile, and criminal should be prevented. 
 We have no positive laws yet for the syphiHtic and gonorr- 
 heic who ruin a woman'' s life, deteriorate her offspring — if she 
 have any — and impair the human race. We have come to 
 this : that half of us are obliged to watch, and nurse, and 
 support the other half, most of whom should never have been 
 bornr 
 
 " Modern industry reduces the vigour and vitality of 
 men, and woman and child labour exhausts the mothers and 
 fathers of the future and present generations. MilHons of 
 men are prevented from contracting a marriage by pecu- 
 niary want and the impossibility of satisfying their sexual 
 hunger except with prostitutes." 
 
 Again we see in this pronouncement not only the need 
 for family Hmitation completely recognised, but the remedy 
 of abstention from marriage rejected. Sex hunger is 
 regarded as an overmastering impulse, and the remedy 
 which Dr. Jacobi obviously intends for the evils he describes 
 is early marriage combined not with sexual abstinence but 
 with preventive measures. There is not the sHghtest 
 suggestion that the limitation of families by the well-to-do 
 has any injurious physiological consequences. 
 
 At the meeting of the British Medical Association at 
 Brighton this year (1913), a new Section of Medical Sociology 
 was inaugurated, in which laymen deliberated in co-opera- 
 tion with the medical profession upon questions of general 
 pubHc importance. In the opening meeting the question of 
 Eugenics was discussed, and the only reference to family 
 Hmitation of famiHes in the papers read was made by Dr. 
 Harry Campbell in his paper on '' Eugenics from the 
 Physician's Standpoint," in which the following remarks 
 (quoted from the British Medical Journal of August 2nd) 
 occurred ; — 
 
 " It is scarcely necessary to say that those possessing 
 serious congenital defects, such as of sight and hearing, 
 should not propagate their kind. 
 
Opinions of Medical Authorities 27 
 
 There are other diseases, equally serious in themselves, 
 but the having suffered from which is not usually regarded 
 as a bar to marriage. I allude to all those cases of non- 
 accidental diseases in which life is saved by the surgeon's 
 skill. Most individuals of this kind should be regarded as 
 procreatively unfit. Take the case of a person vv'ith stran- 
 gulated hernia, fulminating appendicitis or ovarian cyst. 
 But for the surgeon, such a one would be weeded out as unfit, 
 and thus prevented from handing on his unfitness. Let us 
 use all the means at our command to rescue such sufferers 
 from death, but it must be on the clear understanding that no 
 children shall be born to them afterwards.''''* 
 
 And he concludes his paper with the following excellent 
 pronouncement : — 
 
 " It is for us to insist upon the wrongness of bringing into 
 the world, through dehberate disregard of parental unfitness, 
 of degenerate offspring, and we shall be unworthy of the 
 traditions of our profession if we do not, each of us in his 
 own particular sphere, strive to bring nearer the day when 
 not in a heritage of woe, but of blessing, the deeds of the 
 fathers shall be visited upon the children." 
 
 As a number of the defects or diseases mentioned by 
 Dr. Campbell might not, and probably would not, be dis- 
 covered till after marriage, it is clear at least that he ap- 
 proved of restriction of births within the marriage relation. 
 
 In the discussion which followed. Sir James Barr made the 
 following remarks, which emphasise the rebuke he adminis- 
 tered to the medical profession in his presidential address of 
 the previous year, and show clearly that he beHeves in 
 restriction of births among married people if there is reason 
 to expect that their offspring will be defective : — 
 
 " When it is a question of healthy or unhealthy children 
 in the homes of your patients you are silent. You know the 
 coming misery that is inevitable, but no word of warning is 
 allowed to escape your lips. ' Medical etiquette ' is your 
 Mrs. Grundy : she is chaste as the cold Diana. And when I 
 remonstrate, you only whisper : ' Hush ! how indehcate ; 
 
 h ow utterly unprofessional ! ' " __^ ^__ 
 
 ~* Italics mine.— C.V.D. 
 
28 The Small Family System 
 
 Next we have a direct advocacy of the teaching of pre- 
 ventive methods by the medical profession, emanating from 
 a medical man : — 
 
 " Dr. Binnie Dunlop described eugenics as almost entirely 
 a question of the reduction of the present fertiHty of the 
 economically and biologically unfit. When the Malthusian 
 League was founded thirty-five years ago one of its leading 
 points was that race improvement depended upon this 
 reduction, and it appealed to the educated classes to spread 
 the new knowledge of the control of reproduction among the 
 poor. But it appealed in vain, mainly on account of clerical 
 opposition. So the fitter classes continued more and more 
 to limit their f amiUes, while the fertiHty of the poor and the 
 unfit continued almost unchecked. Some people blamed the 
 doctors for a good deal of this. But it was not easy for 
 the medical profession to go ahead of pubHc opinion. Fortu- 
 nately, the Churches' opposition had been markedly lessen- 
 ing in the last few years. That medical men were only 
 awaiting a public sanction to give advice freely on family 
 limitation might be inferred froro. recent authoritative 
 pronouncements. Dr. Dunlop quoted several of these, and 
 expressed the view that British public opinion was turning 
 in the same direction. This, he urged, afforded justification 
 for the claim, that the medical profession should now take 
 up the matter in the interests of the individual, the family, 
 and the race." 
 
 And the same view was of course taken by the present 
 writer : — 
 
 " Dr. Charles V. Drysdale thought the essential point to be 
 recognised w^as that if natural selection was to continue to 
 be a race-improving factor its selective elimination must not 
 be prevented. The whole tendency, how^ever, of humani- 
 tarianism, of Christianity, of medical and surgical science, 
 and of hygiene had been against this elimination ; to pre- 
 serve the diseased, the weakly, and the inefficient, and to 
 permit their full rate of reproduction — thus preserving the 
 evils of the struggle for existence, while eliminating its 
 useful selection. The advocates of natural selection, there- 
 fore, must either candidly avow themselves anti-humani- 
 tarians, and allow the struggle to do its cruelly beneficent 
 selection through death, or they must abandon the struggle 
 
Opinions of Medical Authorities 29 
 
 altogether and imitate the natural by rational selection. It 
 became the duty of society and the physician to say : ' We 
 will alleviate your misfortunes or your disease, but, as you 
 would not survive unless we do so, you ought not to have 
 children to inherit your defects.' This simply meant that 
 the poor and those suffering from hereditary disease should 
 regulate their families in accordance with their reasonable 
 prospect of bringing up their children decently." 
 
 Although these two speeches gave a direct invitation to 
 the medical authorities present to show cause why family 
 restriction should not be extended to the poorer classes ; 
 and they were made in the presence of clergymen and various 
 social reformers, not a single objection was made in the 
 whole of the subsequent discussion. A distinguished 
 Roman Cathohc priest who was present sympathetically 
 referred to the last two speakers' remarks and deprecated 
 the idea that the Church had been blind to its responsibili- 
 ties as regards the race. Not a single medical or other 
 warning was given that there was risk of any kind associated 
 with family restriction, and Dr. Campbell in his reply re- 
 affirmed the great importance of restriction on the part of 
 the unfit. 
 
 The great International Medical Congress has just termi- 
 nated. Over eight thousand medical men of all nations have 
 gathered in London to discuss every phase of medical science 
 The extent to which the practice of family limitation has 
 been adopted in Europe alone is such that from a million 
 to a milHon and a half fewer births now take place every 
 year than would have done if the birth-rate of 1876 had been 
 maintained. This must mean that very many mllHons of 
 married people have adopted preventive methods. But the 
 great medical congress has met and separated without a 
 single allusion to the question. In view of the thunders of a 
 few ye^rs ago when the practice of prevention was less rife 
 than at present, this silence can only mean that the pro- 
 fession has changed its opinion and that it prefers to ignore 
 
30 The Small Family System 
 
 the matter rather than to openly confess its former mistake. 
 The paper by Dr. Hall to be referred to below should have 
 given an opportunity for renewed denunciations, but none 
 were forthcoming. 
 
 It is hardly credible that such an overwhelming change 
 can have come about in the short space of seven years, and 
 these facts show clearly that medical luminaries have not 
 always been exempt from violent prejudice or ignorance. 
 But, it will no doubt be remarked, surely the strong con- 
 demnation from a man of such undoubtedly great gynaeco- 
 logical experience as Dr. Taylor must have had some 
 foundation. Most certainly it had, and the following 
 quotation from the British Medical Journal of February 
 24th, 1906, may help to explain it. In that issue appeared 
 a paper by Dr. A. Hall, M.A., M.D., F.R.C.P., and Dr. W. B. 
 Ransome, M.A., M.D., F.R.C.P., Physicians to the Hospitals 
 of Sheffield and Nottingham, entitled " Plumbism from the 
 Ingestion of Diachylon as an Abortifacient," or in other 
 words. Lead Poisoning from the taking of Diachylon for 
 procuring Abortion. Diachylon, or " lead plaster," is 
 mainly composed of oxide of lead, and it has been taken to a 
 large extent by unfortunate women in the form of lumps or 
 " female pills." Here are a few actual remarks : — 
 
 " During the last few years outbreaks of lead-poisoning 
 of varying extent and severity have occurred in different 
 localities, which could not be traced to the ordinary sources 
 of plumbism, such as water contamination or dangerous 
 occupation. The cases were always limited to women of 
 child-bearing age, and eventually the source of the poison- 
 ing was traced to the custom of taking diachylon as an 
 abortifacient." After referring to a previous paper on the 
 subject, it goes on: "This custom of taking diachylon, 
 instead of diminishing, has spread over such a large area of 
 country, and assumed such serious proportions, that steps 
 must be taken to check it, or if possible to stop it altogether. 
 How this may best be done remains to be settled, but it is 
 not so simple as might at first sight appear." ..." I believe we 
 
Opinions of Medical Authorities 3 i 
 
 shall not be far wrong in saying that several hundred women 
 have taken diachylon in this district alone during the last 
 few years." The paper also quotes several cases of deaths 
 due to lead poisoning which were traced to " female pills " 
 containing diachylon. 
 
 At the recent International Medical Congress Dr. Hall 
 read another paper on the same subject in wliich he says he 
 has noticed that the amount of lead poisoning from this 
 cause depends considerably upon the state of trade, in- 
 creasing in times of economic depression. This indicates 
 very decidedly that it is due to the fear of inability to sup- 
 port another child by the married woman. If the practice 
 were common among unmarried women in order to avoid 
 discovery it would not be affected by the state of trade. 
 
 It is highly probable that Dr. Taylor must have come 
 across many cases of this and other attempts at preventing 
 not conception but child-birth, and the horrible results both 
 for the mother and the child would have been quite suffi- 
 cient to justify his outburst, if he had taken the trouble to 
 ascertain the real cause and to lay the blame at the proper 
 door. What a picture arises before us of these poor mothers 
 — and the authors tell us that it is principally married women 
 who are affected — actually undergoing the pains of lead- 
 poisoning in order to attempt to escape from the ever- 
 lasting burden of undesired maternity, and from the dread 
 of another child to be starved or to starve her other children. 
 This is what the opponents of " artificial " restriction bring 
 us to. 
 
 As a conclusion to this section we may refer to an im- 
 portant judgment which has quite recently been dehvered 
 by the Hungarian National Medical Senate. The limitation 
 of famihes appears to have become more and more common 
 among the peasant proprietors of Hungary ever since the 
 Napoleonic visitation early in the nineteenth century, and 
 to have been recognised as quite rational and praiseworthy 
 by most parties. Recently, however, the small but powerful 
 
32 The Small Family System 
 
 Agrarian Party has come into office, and with the desire of 
 obtaining more cheap labour for their large estates, they 
 have started a campaign against preventive devices. 
 Knowing that popular opinion was against them, they be- 
 thought themselves of getting medical support, and referred 
 their proposed law to the Medical S'^nate, of which 
 Professor Wilhelm Taufer, the eminent gy^^aecologist, is the 
 President. A literal translation of the judgment is given 
 at the end of this pamphlet as a supplementary chapter, but 
 the saHent points of it are, first, that not only has the 
 limitation of famihes not been shown to be injurious from 
 the hygienic point of view, but that the evils of unlimited 
 families are undoubtedly greater than any possible evils of 
 prevention. The Agrarian League having contended that 
 early marriages and restricted families leads to sexual 
 disorders, childlessness, or defective offspring, it is informed 
 that these contentions are entirely unwarranted. It is 
 further informed that abortion is even now practised to a 
 great extent, with the most evil consequences, and that 
 restriction of the circulation of preventive devices can only 
 lead to its increase, in view of the economic situation. The 
 Senate further considers that rational feelings of duty must 
 lead to the limitation of families, and also rebukes the 
 Agrarians and others for setting the most extreme example 
 of the conduct they deplore. This judgment was delivered 
 by Professor Taufer with presumably the full weight of the 
 medical profession of Hungary, and is a striking contrast 
 to the disingenuous resolution of the South Western Branch 
 of the British Medical Association in which prevention and : 
 abortion were treated as equally reprehensible. One of the 
 chief objects of neo-Malthusian reformers is the aboHtion i 
 of prostitution, abortion, and venereal diseases by enabling \ 
 people to marry early and to Hmit their famihes by hygienic j 
 methods, and this judgment fully endorses their claim. ' 
 
 We may fitly conclude this section with the private* 
 
Opinions of Medical Authorities 33 
 
 remark of an English medical authority of the highest 
 standing, who was asked his opinion of the neo-Malthusian 
 movement. " The cause seems to me, however, to be won, 
 and active medical co-operation in the future certain." 
 
CHAPTER II 
 
 OPINIONS OF CLERICAL AUTHORITIES 
 
 WE need not dwell long on their adverse utterances as 
 they are so well known. The names of Father 
 Bernard Vaughan, the Bishop of London, and of Dr. Boyd 
 Carpenter, late Bishop of Ripon, and others have been 
 frequently before the pubHc in this connection. The resolu- 
 tion passed by the Lambeth Conference of Bishops in 1908 
 will serve to summarise their attitude : — 
 " " The Conference regards with alarm the growing -practice 
 of the artificial restriction of the family^ and earnestly calls 
 upon all Christian people to discourage the use of all artificial 
 means of restriction as demoralising to character^ and hostile 
 to the national welfare^^ 
 
 Nothing could be clearer, more definite, or more satis- 
 factory, for those who desire that this important question 
 should be definitely stated and faced. There is no attempt 
 here even to distinguish between preventives and aborti- 
 facients. Artificial Hmitation, as such, is definitely banned 
 as demoralising. 
 
 We need not pause to inquire whether the Church's 
 pronouncement on questions of morality have always been 
 found to be infallible ; for, just as in the case of the medical 
 men, we have other means of judging of the value of their 
 remarks. 
 
 It should be observed at the outset that voices have not 
 been wanting even within the Church itself for some time 
 past which are totally opposed to this resolution. A few of 
 these may be cited : — 
 
 The Rev. A. E. Whatham, in a pamphlet, Neo-Malthusian- 
 ism : a Defence^ has said : — 
 
 34 
 
Opinions of Clerical Authorities 35 
 
 " I shall endeavour to show that neo-MalthusIanism is the 
 only means of preventing the alarming increase of pauperism, 
 sickness, crime and immoraHty, and, from a Christian point 
 of view, is perfectly lawful. ... I say it becomes the duty of 
 every thoughtful man and woman to think out some plan to 
 stop, or even check, the advancing tide of desolation ; and 
 the only plan, to my thinking, that is at all workable, is 
 artificial prevention of childbirth. . . . Immorality would 
 largely disappear, and the Christian ideal of marriage be 
 raised." 
 
 The Rev. H. R. Haweis, M.A., in an article entitled " Two 
 Shows," in the Weekly Times and Echo of November 6th, 
 1886, said :— 
 
 " Until it is thought a disgrace in every rank of society, 
 from top to bottom of the social scale, to bring into the 
 world more children than you are able to provide for, the 
 poor man's home, at least, must often be a purgatory — his 
 children dinnerless, his wife a beggar — himself too often 
 drunk. . . . Here, then, are the real remedies : first, control 
 the family growth, according to the means of support." 
 
 And again, in Winged Words^ Edition of 1885 (published 
 by Wm. Isbister Ltd., London), p. 64, occurs the following 
 passage by the same writer : — 
 
 " Over-population is one of the problems of the age. The 
 old blessing of ' increase and multiply,' suitable for a sparsely 
 peopled land, has become the great curse of our crowded 
 centres. . . . You may say children are from God. I reply, 
 so is the cholera. I suppose you are here among other 
 things to determine when and how God's laws shall operate. 
 . . . Some of the happiest couples I have known have been 
 childless. Mutual society, help and comfort count for some- 
 thing, aye, sometimes take the place of everything." 
 
 The Rev. Leonard Dawson said, in a lecture which was 
 reported in the Alnzvick and County Gazette of February 
 nth, 1888:— 
 
 " How rapidly conjugal prudence might lift a nation out 
 of pauperism was seen in France. . . . Let them therefore 
 hold the maxim that the production of offspring with fore- 
 thought and providence was rational nature. It was 
 immoral to bring children into the world whom they could 
 
36 The Small Family System 
 
 not reasonably hope to feed, clothe and educate. . . . Let 
 them rest assured that he considered his views truly Christ- 
 ian, and likely to promote the cause of temporal happiness 
 and religion in this land and all over the world." 
 
 Coming to modern times, the Rev. Dr. Horton, writing in 
 The Problem of Motherhood* although deploring the de- 
 clining birth-rate in general, says : — 
 
 " But there is one thing that I feel bound to mention out 
 of my own personal experience and that is this, I have seen 
 instances of married people exercising the strongest self- 
 control for the very noblest of reasons ; sometimes because 
 their means do not enable them to face the responsibilities 
 of a family ; sometimes because the health of one or other of 
 them would make a family dangerous ; and sometimes 
 because of hereditary tendencies which might possibly be 
 transmitted to the children, if there were any children. And 
 I have learned to regard such self-control with so profound a 
 reverence that it makes me very fearful of passing a general 
 judgment upon the phenomenon causing our present anxiety. 
 
 " Many a man remains single, or, having married, remains 
 childless, from motives as high and as praiseworthy as the 
 motives that induce a Catholic to renounce the world and 
 lead a cloistered life ; and although the birth-rate may fall 
 to an appalhng degree, it is difficult to see how one should 
 point an accusing finger at such a man." 
 
 Let us not be understood for one moment to claim the 
 remarks of the last writer as implying approval of " arti- 
 ficial " prevention. We have Httle doubt that the " self- 
 control " referred to implies simply the old " moral re- 
 straint " which Malthus preached — though with practically 
 no success. But the motives which Dr. Horton extols are 
 surely not confined to those extremely few who exercise 
 '' moral restraint." They are the motives which have been 
 steadily in the minds of the neo-Malthusians throughout 
 their propaganda. In the latter part of last year the Bishop 
 of London in his Congress Sermon at Stoke, referred to the 
 " sin " of family limitation. The result was a flood of 
 
 * Cassell & Co., 191 1, p. 20. 
 
Opinions of Clerical Authorities 37 
 
 protest from both clergy and laity, and the feehng ran so 
 high that at a mass meeting held shortly after at the Queen's 
 Hall to protest against the Ne Temere decree, the mention 
 of his name was received with hisses. In fact he was 
 obliged to write to the Guardian of 27th October, stating 
 that he had been misunderstood as regards limitation in 
 general : — 
 
 " I was by no means denouncing the limitation of families 
 by self-control. My point is that there is no check allowed 
 by the Church except the check of self-control." 
 
 This letter was immediately followed by a long reply from 
 the Medical Officer of Health for Leicester, C. Kilhck 
 Millard, M.D., D.Sc, writing as a churchman, in which he 
 pointed out that the practice of family limitation was admit- 
 tedly practised by the " ablest and most intelHgent part of 
 the working-class population," who most certainly regarded 
 it as an act of prudence and decidedly the reverse of 
 immoral. 
 
 " The Bishop of London, we know, deplores the breach 
 between the Church and the People, but it is scarcely to be 
 expected that intelligent persons will feel drawn to a Church 
 which denounces them as guilty of ' immorality ' for doing 
 that which their own conscience and better judgment 
 approve. Of course if the practice be really immoral it is the 
 Church's duty to denounce it at any cost ; but is it quite 
 certain that the practice is immoral ? Is it immoral under 
 any circumstances and irrespective of motive ? " 
 
 Dr. Millard then went on to state, as already mentioned, 
 that the Bishops in their resolution had only accepted a few 
 statements from medical authorities all on one side, and that 
 authorities were very far from agreed in condemning them. 
 And he proceeds : — 
 
 " The Bishop of London, in a letter in ^he Guardian for 
 October 27th, replies to ' Married Priest,' and explains that 
 he does not object to limitation of the family provided it be 
 accompHshed by self-control. Surely the Bishop, even 
 though himself unmarried, must realise that ' self-control ' 
 within the bonds of matrimony, however commendable in 
 
38 The Small Family System 
 
 other respects, is practically useless as a preventive measure. 
 The most abstemious and self-controlled of husbands may- 
 have the largest families — witness many of the clergy them- 
 selves ! To recommend the poor to employ an unrehable 
 method in a case like this is merely to mock them. On the 
 other hand, the employment of artificial means, whilst far 
 more effectual, undoubtedly involves a certain amount of 
 self-control and self-denial, and this is one chief reason why 
 they are not resorted to by the more reckless, selfish, and 
 depraved sections of the community.'* 
 
 The whole of Dr. Millard's letter is a strong plea for the 
 decided morahty of hmitation from a man of undoubted 
 authority — and the Bishop of London has not deigned to 
 reply. 
 
 The latest clerical pronouncement on the question has 
 come from the Dean of St. Paul's, who in presiding at a 
 meeting of the Sociological Society on 13th February, 19 12, 
 spoke strongly on the over-population difficulty.* 
 
 " With regard to the reduced birth-rate among the middle 
 and upper classes, some people had used very strong lan- 
 guage about the selfishness of persons who deUberately had 
 small famiHes. It was only fair to say that, though in some 
 cases small families were due to selfishness, in many cases 
 they were due to unselfishness, and involved a great deal of 
 self-denial, for the benefit of the children; ... At present, 
 happily, there was room for eugenic children, however many 
 were born, in the waste places of the earth. This would not 
 be the case very long, and he repeated that this question of 
 overcrowding was a thing which must not be shirked. After 
 all, quaHty was better than quantity, and the great menace 
 to our civilisation was not so much the stationary birth-rate 
 of the upper classes as the great increase among the poor and 
 ill-fed population of our great towns." 
 
 And on May 20th, Dr. Inge wrote : — *j* 
 " But I must add that in my opinion the main cause of 
 tension is the excessive increase in the population of an over- 
 crowded country (the figures for 1909 are : births, 1,146,118; 
 deaths 687,765), and the unfortunate fact that we are 
 
 * Daily Telegraphy February 14th, 191 2. 
 
 t Daily Mail symposium on Labour Unrest (May 20th, 1912). 
 
Opinions of Clerical Authorities 39 
 
 breeding chiefly from inferior stocks. As long as our social 
 reformers and agitators shirk these problems I find it diffi- 
 cult to have much confidence in their intelligence or 
 honesty." 
 
 Within the last month a discussion under the heading of 
 " One-child Homes " has appeared in the Standard in which 
 a number of writers approved of small famiHes. Several, 
 however, while agreeing with the necessity of Hmiting the 
 family, strongly protested against preventive methods. 
 Immediately after these letters, appeared the following, on 
 September 4th, from a well known clergyman : — 
 To the Editor of The Standard. 
 
 Sir, — There is no greater act of selfishness than to bring 
 a large number of children into the world without the 
 wherewithal to provide for them. We have Scriptural 
 authority in certain cases for the limitation of family. — I am, 
 Sir, yours truly, 
 
 Crowhurst Rectory. J. P. Bacon-Phillips. 
 
 I do not profess to have studied the Scriptures sufl[iciently 
 to give chapter and verse for this statement, but it should be 
 abundantly clear to those who will study the words of 
 Christ, Matt. xx. 10-12 ; and of St. Paul, I Corinthians vii. 
 I, 2, and 5, as well as of the Church marriage service under 
 the heading " Secondly," that if restriction of births within 
 the marriage tie is permissible under any circumstances 
 " moral restraint " is certainly not to be advocated. 
 Marriage is definitely instituted for those who " have not 
 the gift of continency," and St. Paul expressly warns against 
 the results of attempting it within the marriage state. When 
 the Bishop of London stated that the only check that the 
 Church could recognise was the check of continence he was 
 both unclerical and unscriptural. 
 
 Again we find, as with doctors' utterances, that clerical 
 ones against artificial Hmitation are becoming less vehement, 
 if nothing more. But the most astonishing development is 
 now to be recorded. In 1910 a " National Council of PubHc 
 
40 The Small Family System 
 
 Morals " was formed, of distinguished clerical dignitaries 
 aided by a quota of scientific men, in order to combat all 
 undesirable social tendencies, and taking as its motto the 
 words of our present King : — 
 
 ** The foundations of National Glory are in the homes of 
 the people. They will only remain unshaken while the 
 family life of our race and nation is strong, simple and pure.'* 
 
 The personnel of this Council is so weighty that it may be 
 given in extenso : — 
 
 NATIONAL COUNCIL OF PUBLIC MORALS 
 
 (For Great and Greater Britain). 
 President, 1911-1912 — The Lord Bishop of Durham. 
 Fice- Presidents — 
 His Grace the Archibishop of Dublin. 
 The Hon. Viscount Chfden. 
 The Rt. Hon. Lord Kinnaird. 
 The Rt. Hon. Lord Peckover. 
 The Rt. Hon. Lord Avebury. 
 The Rt. Hon. Lord Emmott. 
 The Rt. Rev. The Lord Bishop of London. 
 The Rt. Rev. The Lord Bishop of Truro. 
 The Rt. Rev. The Lord Bishop of Liverpool. 
 The Rt. Rev. The Dean of Westminster. 
 The Rt. Rev. The Dean of Manchester. 
 The Rt. Rev. Pearson M'Adam Muir, D.D. 
 The Rt. Hon. H. L. Samuel, P.C, M.P 
 The Rev. the Hon. E. Lyttelton, M.A. 
 The Rev. A. R. Buckland, M.A. 
 The Rev. W. J. Townsend, D.D. 
 The Rev. Canon S. A. Barnett, M.A. 
 The Rev. Principal C. Chapman, M.A., LL.D. 
 The Rev. Principal A. M. Falrman, M.A., D.D. 
 The Rev. Professor Hermann Gollancz, M.A. 
 The Rev. Professor T. WItton Davles, D.D., Ph.D. 
 The Rev. Principal Alexander Whyte, D.D. 
 The Rev. D. Brook, M.A., D.C.L. 
 C. W. Saleeby, M.D., F.R.S.E., F.Z.S. 
 H. Vickerman Rutherford, M.D. 
 H. Grattan Guinness, M.D. 
 
Opinions of Clerical Authorities 41 
 
 Sir John Kirk, J.P. 
 
 Sir Compton Rickett, D.L., M.P., P.C. 
 
 J. Ramsay MacDonald, M.P. 
 
 The Rev. Principal A. E. Garvie, M.A., D.D. 
 
 The Rev. R. J. Campbell, M.A. 
 
 The Rev. A. Taylor, M.A. 
 
 The Rev. R. F. Horton, D.D. 
 
 The Rev. John Clifford, M.A., D.D. 
 
 Howard WilHams, Esq. 
 
 George Cadbury, Esq. 
 
 His Eminence Cardinal Bourne. 
 
 The Rt. Rev. The Bishop of Menevia. 
 
 The Rt. Rev. W. Boyd Carpenter, D.D., late Bishop of 
 
 The Rt. Rev. The Lord Bishop of Hereford. [Ripon. 
 
 The Rt. Rev. The Lord Bishop of Bristol. 
 
 The Rt. Rev. The Lord Bishop of Rochester. 
 
 The Rt. Rev. The Bishop of Barking. 
 
 The Very Rev. The Dean of Durham. D.D. 
 
 The Very Rev. The Dean of Canterbury, D.D. 
 
 The Rev. Canon Wilham Barry, D.D. 
 
 The Rev. Prebendary Carlile. 
 
 The Rev. J. Monro Gibson, M.A., LL.D. 
 
 Lady Battersea. 
 
 Lady Henry Somerset. 
 
 Lady Aberconway. 
 
 Mrs. Bramwell Booth. 
 
 Mrs. Price Hughes. 
 
 Mrs. Mary ScharHeb, M.D., M.S. 
 
 The Rev. Principal P. T. Forsyth, M.A., D.D. 
 
 The Rev. Principal J. H. Moulton, M.A., D.D. 
 
 The Rev. C. Silvester Home, M.A., M.P. 
 
 Professor Sir T. Clifford Allbutt, K.C.B., M.D., D.Sc, LL.D., 
 
 Sir Thos. Barclay, LL.B., Ph.D. [F.R.S. 
 
 Sir Francis F. Belsey, J.P. 
 
 SirT. Fowell Buxton, G.C.M.G., D.L. 
 
 Sir Dyce Duckworth, M.D. 
 
 Sir A. Pearce Gould, K.C.V.O., M.S. 
 
 Emeritus Professor Sir Alex. Simpson, M.D., LL.D. 
 
 Professor G. Sims Woodhead, M.A., M.D., LL.D. 
 
 Percy Alden, Esq., M.A., M.P. 
 
 John Murray, Esq., J.P., D.L. 
 
 Wilham Baker, Esq., M A., LL.B. 
 
42 The Small Family System 
 
 The most public action of this highly responsible Council 
 has been to issue a series of sixpenny booklets entitled 
 " New Tracts for the Times."* The first of them, The 
 Problem of Race Regeneration, issued in 191 1, is by Dr. 
 Havelock ElHs. The passages in it approving of a reduced 
 birth-rate are far too long and too numerous to be quoted 
 in full ; but the followmg will give some idea of their tenor : 
 
 " The new sense of responsibility — of responsibility not 
 only for the human lives that now are, but the new human 
 lives that are to come — is a social instinct of this fundamen- 
 tal nature. Therein Hes its vitahty and its promise. 
 
 " It is only of recent years that it has been rendered 
 possible. Until lately the methods of propagating the race 
 continued to be the same as those of savages thousands of 
 years ago. Children * came,' and their parents disclaimed 
 any responsibility for their coming ; the children were sent 
 by God, and if ihey all turned out to be idiots the respon- 
 sibihty was God's. That is all changed now. We have 
 learnt that in this, as in other matters, the Divine force works 
 through us, and that we are not entitled to cast the burden 
 of our evil actions on to any Higher Power. It is we who are, 
 more immediately, the creators of men. We generate the 
 race ; we alone can regenerate the race. 
 
 " The voluntary control of the number of offspring, which 
 is now becoming the rule in all civihsed countries in every 
 part of the world, has been a matter of concern to some 
 people, who have reahsed that, however desirable under the 
 conditions, it may be abused. But there are two points about 
 it which we should do well always to bear in mind. In the first 
 place it is the inevitable result of advance in civilisation. 
 Reckless abandonment to the impulse of the moment and 
 careless indifference to the morrow, the selfish gratification 
 of individual desire at the expense of probable suffering to 
 lives that will come after — this may seem beautiful to some 
 persons, but it is not civilisation. All civilisation involves an 
 ever increasing forethought for others, even for others who 
 are yet unborn. 
 
 " In the second place, it is not only inevitable, but it 
 furnishes us with the only available lever for raising the 
 
 * Cassell & Co. 
 
Opinions of Clerical Authorities 43 
 
 level of our race. In classic days, as in the East, it was pos- 
 sible to consider infanticide as a permissible method for 
 attaining this end, or for terminating at the outset any hfe 
 that for any reason it might seem desirable to terminate. 
 That is no longer possible for us. We must go further back. 
 We must control the beginnings of life. And that is a better 
 method, even a more civilised method, for it involves greater 
 forethought and a iiner sense of the value of life. 
 
 " To-day all classes in the community, save the lowest 
 and the most unfit, exercise some degree of forethought in 
 regulating the size of their famihes. That it should be 
 precisely the unfit who procreate in the most reckless manner 
 is a lamentable fact, but it is not a hopeless fact, and there is 
 no need of the desperate remedy of urging the fit to reduce 
 themselves in this matter to the level of the unfit. That 
 would merely be a backward movement in civilisation. . . . 
 
 '' It used to be feared that a faUing birth-rate was a 
 national danger. We now know that this is not the case, for 
 not only does a falHng birth-rate lead to a falling death-rate, 
 but in these matters no nation moves by itself. Civilisation 
 is international, though one nation may be a little before or 
 behind another. Here France has been ahead, but all other 
 nations have followed ; in Germany, for instance, which is 
 sometimes regarded as a rival of England, the birth-rate is 
 falling just as in England Russia, indeed, is an exception, 
 but Russia is not only behind England but behind Germany 
 in the march of civilisation ; its birth-rate is high, its death- 
 rate is high ; a large proportion of its population live on the 
 verge of famine. We are not likely to take Russia as our 
 guide in this matter ; we have gone through that stage long 
 
 ago." 
 
 The second book of the series is by Dr. C. W. Saleeby, 
 entitled The Methods of Race Regeneration, in which he deals 
 with the various methods by which the principles of Euge- 
 nics or heredity may be directed towards race improvement. 
 In it he says (p. 24) : — 
 
 *' There are cases, however, not merely imaginable, but 
 actual, as a record of my private correspondence alone would 
 abundantly show, of persons who certainly should not have 
 children, and whom many would therefore seek to keep 
 asunder, yet who are married and live happier and better 
 
44 The Small Family System 
 
 lives therefor, whi'st faithfully regarding their duty towards 
 negative eugenics. We must recognise that, as human beings 
 become more responsible, the number of such cases will 
 increase ; and in the name of many of the best men and 
 women, in whose blood, perhaps, there may run some insane 
 taint or what not, I protest against the notion that marriage 
 and parenthood are to be regarded as identical because 
 marriage is primarily for parenthood, or because it is con- 
 venient to assume that they are so in pubHc discussion. 
 
 " What can conceivably be the explanation of such argu- 
 ments as those of the Bishop of London and others, who, in 
 the face of our monstrous infant and child mortality, the 
 awful pressure of population and overcrowding in our great 
 cities, where every year a larger and larger proportion of the 
 population lives, and is born and dies — plead for a higher 
 birth-rate on moral grounds, of all amazing grounds con- 
 ceivable ; and those also who, from the mihtary or so-called 
 Imperial point of view, regarding men primarily as ' food for 
 powder,' in Shakespeare's phrase, read and quote statistics 
 of population in order to promulgate the same advice ? 
 
 " To the moralist we need make no reply except simply to 
 name the infant mortality, which is at last coming to be 
 recognised everywhere as, perhaps, the most abominable of 
 all our scandals." 
 
 Elsewhere* Dr. Saleeby has said : — 
 
 " Professors of divinity and other distinguished theolo- 
 gians and popular preachers have lent their names to eu- 
 genics. The time has come when we cannot possibly descend 
 from aspiration to practice without the innocent and, in 
 point of fact, indispensable aid of neo-M althusianism. . . . 
 Only by the aid of neo-Malthusianism can we attain the ideal 
 which I have defined in my outhne study of Eugenics, that 
 every child who comes into the world shall be desired and 
 loved in anticipation." 
 
 It would be hard to imagine a more absolute anti-cHmax 
 to the accusations of immorality in connection with limi- 
 tation of famlHes, even when effected by " artificial " 
 means. 
 
 In the third book of the series, by Dr. A. Newsholme, 
 
 * The Malthusian^ May 15th, 19 10, p. 35. 
 
Opinions of Clerical Authorities 45 
 
 M.R.C.S., on The Declining Birth-rate^ we find a statement 
 of some of the facts concerning it with some carefully 
 guarded expressions. While, on the whole, expressing 
 regret at the phenomenon, he tells us on p. 42 that : — 
 
 " It would not be fair to omit from consideration what is 
 probably one of the chief factors tending to restrict families. 
 This is the desire of parents with small incomes to educate 
 their children more satisfactorily than they themselves were 
 educated, and to give their children the means for rising in 
 the social scale. 
 
 " The motive here is far removed from that of the well- 
 to-do who love ease and luxury and pursue it ; and however 
 much the supposed need for this regulated family may be 
 deprecated in these instances, a harsh judgment in regard to 
 it cannot be maintained." 
 
 In the face of such statements emanating from the first 
 three books of the series, it can hardly be said that the 
 National Council of PubHc Morals with its distinguished 
 clerical representation has even attempted to make out a 
 strong case against the Hmitation of famihes. All the ideals 
 concerning the glory of limited maternity and the welcom- 
 ing of desired children, with the responsibilities of race 
 improvement, were realised and taught by the neo-Mal- 
 thusians thirty-five years ago, and we may close this section 
 with the oft-quoted remark of John Stuart Mill, who was 
 described by Mr. Gladstone, in spite of his religious preju- 
 dices, as the " Saint of RationaHsm," but who appears to 
 have taken part in the actual distribution of leaflets giving 
 practical information on " artificial Hmitation." 
 
 " Little advance can be expected in morality* until the 
 producing of large families is looked upon in the same Hght 
 as drunkennness or any other physical excess.*}* 
 
 * Italics mine.— C.V.D. 
 
 t Political Econotny^ bk. ii, ch. xili. 
 
CHAPTER III 
 
 CONDUCT OF AUTHORITIES 
 
 WE now come to the second point. How far do the 
 medical and clerical opponents of family Hmitation 
 carry out the principle they profess ? It is surely common 
 knowledge that nowadays the majority of medical men 
 and clergy, Hke other educated people, have decidedly small 
 famihes. But those who do not remember the large families 
 of thirty-five years ago may suppose that this is an automa- 
 tic result of their higher culture, etc. Unfortunately, how- 
 ever, apart from records in fiction such as given by George 
 EHot and many others, we have in the enquiry made on 
 behalf of the National Life Assurance Society by Mr. C. 
 Ansell in 1874, just before the Knowlton Trial, a definite 
 statement which gives the following table of average 
 families in various professions : — 
 
 Profession. 
 
 Total Results 
 I including 
 I Still-born. 
 
 Born Alive. 
 
 Clergymen . . 
 Legal Profession . . 
 Medical Profession . . 
 
 General (Aristocracy,Merchants, Bankers, 
 Manufacturers, etc.) . . 
 
 5-36 
 5-32 
 4.96 
 
 5.50 
 
 5-25 
 5.18 
 4.82 
 
 5-39 
 
 About the same time, according to the Registrar-General's 
 Report for 1877 (P- ^'^)i ^^le average number of births to 
 marriages was 4.63 for the whole of England. 
 
 The result of this enquiry is therefore to show that the 
 famihes of both medical men and clergymen were then, on 
 
 46 
 
Conduct of Authorities 47 
 
 an average, just as high as those of the remainder of the 
 community ; or, in other words, that their fertihty was in 
 no way lower, despite their greater culture, than that of the 
 poorer classes. But although no such exhaustive enquiry 
 appears to have been made recently,* no one who observes 
 can have the sHghtest doubt as to what has happened since. 
 In Paris an enquiry made by Dr. Lutaud showed that 1,200 
 medical families had only 2,700 children between them, or 
 an average of only 1.5. We have recently asked some friends 
 to ascertain the number of children in medical and clerical 
 families in their districts, with the result of finding very few 
 famihes of more than three children in either case. 
 
 An interesting sidelight on this question was given by a 
 friend quite recently. She had been staying in the country 
 at the house of a young married couple who had felt that 
 their means did not permit them to undertake a family. 
 The wife of the local medical man was so distressed at this as 
 to take the young woman to task. On the retort being made 
 that she had only one child herself, she said that the cost of 
 educating him made it impossible to have more, but that 
 there was no excuse for the poor who had so much done for 
 them. When the middle classes realise that they are 
 heavily taxed for the large famihes of the poor, and that 
 they have to Hmit their own famihes the more in conse- 
 quence, they will be in a condition to fully appreciate this 
 anecdote. 
 
 It is hardly worth discussing a matter which is so obvious 
 to all, and we can only come to one of the following conclu- 
 sions, so far as doctors are concerned : either : — 
 
 {a) they do not beHeve in the hygienic evils of artificial 
 restriction, or 
 
 (b) they have methods which they consider satisfactory 
 for themselves, but which are unknown to the pubHc, or 
 
 * Possibly the detailed figures of the 191 1 Census may give us the 
 information, when they appear. 
 
48 The Small Family System 
 
 (c) that the evils, whatever they may be, are less than 
 those of large famiHes. 
 
 The only one of these alternatives which really concerns 
 us is the third. Personally, I have every reason to beHeve 
 that the majority of EngHsh medical men have no better 
 knowledge on the subject than the most enlightened section 
 of the pubhc. But if they have, is it honest to condemn 
 Hmitation because the pubhc are ignorant of the best 
 means ? Is it not rather their duty to help the poor, who 
 suffer so much from the burden of their large famihes, to a 
 knowledge of the means which they use with so much success 
 themselves ? 
 
 Now we come to the clergy. Again the facts speak for 
 themselves. Where among the married clergy do we find 
 the large famihes of thirty-five years ago .? Instead of an 
 average family of five, as found by Ansell, this number is 
 much more like the maximum, and two or three children is 
 decidedly the usual order of things. It may of course be 
 that this limitation is simply due to the " moral restraint " 
 or " self-control " of the Bishop of London. But how is it 
 that, just as with the rest of the community, it has only taken 
 place since the Knowlton Trial ? In a controversy which I 
 had a few years ago with the Secretary of a certain clerical 
 purity organisation, I became so disgusted at his methods of 
 attack as to challenge him to institute an enquiry among the 
 members of his Society, on similar lines to that carried out 
 in the Fabian Society, by asking them to make a solemn 
 declaration in each case as to whether they had lived lives 
 of complete " self-control." In making this challenge, I 
 pointed out that if he really beheved in his mission and his 
 supporters, he would welcome the suggestion, as affording 
 the most effective means of showing the good example of the 
 clergy, and the practicabiHty of " moral restraint." The 
 only result was a letter marked " private," abusing me for 
 the suggestion. A month or two later, I read in a provincial 
 
Conduct of Authorities 49 
 
 paper that this gentleman had attempted to recruit members 
 for his Society at a local meeting ; and that when he ap- 
 parently found some hesitation among his audience, he 
 stated that many might feel unworthy to join such a move- 
 ment as they had not previously been able to live up to its 
 high ideals. He would remind them, however, that by 
 joining in the good work their past sins would be forgiven 
 them. Are the sins, I would ask, which lead to the com- 
 munication of loathsome contagious diseases to innocent 
 women and to their helpless children to be wiped away by 
 turning puritan in later Hfe ? Are those who have run the 
 gamut of dissipation themselves and have treated women as 
 mere ministers to their pleasure to turn round and condemn 
 those who are undertaking married Hfe in a responsible 
 spirit, refusing to burden their wives with the pain and 
 anxiety of unlimited child-bearing and to bring children into 
 the world regardless of their probable future prospects ? 
 And are the lives of countless young men and women to be 
 ruined by the hypocrisy that sets up a standard of life which 
 violates all the needs of their physiological organisation, 
 and which inevitably leads a large number to have recourse 
 to really injurious practices, instead of the pretended one of 
 artificial Hmitation ? No wonder my challenge was evaded. 
 Among the chief weapons which the clerical party has 
 employed against family restriction are the appeals to 
 women that such restriction is degrading to them, that it 
 results in premature old age, and that it may dispose to 
 cancer and other diseases. With this question of disease 
 we will deal presently. But the opinion of women as to 
 whether they are more degraded and prematurely aged by 
 restriction or by unHmited child-bearing, may be to some 
 extent gauged by the experience of New Zealand, where 
 women have been voters since 1893. Towards the end of 
 1910 a Conference on PubHc MoraHty, consisting apparently 
 of six clergymen with Bishop Julius as chairman, forwarded 
 
So The Small Family System 
 
 the following resolution to the Government of New 
 Zealand : — 
 
 " Preventives : — We, ministers of the Gospel, assembled 
 in conference, hold, that, except in special cases, which can 
 only be pronounced upon by medical authority, the use of 
 preventives is absolutely immoral ; But in view of their 
 unrestricted sale, which encourages immorality, and is 
 tending, in our opinion, to an alarming decrease of the birth- 
 rate of the Colony, we recommend : (i) That the sale of 
 preventives be restricted to quahfied chemists ; (2) That the 
 sale of preventives to any person under twenty-one years of 
 age be subject to penalty ; (3) That the hawking of preven- 
 tives be made a criminal offence ; (4) That the wholesale 
 dealers in preventives, whether such preventives are im- 
 ported or manufactured within the Colony, be required to 
 keep a register of their sales ; (5) That any advertisement 
 of notification of preventives, except in trade catalogues, be 
 made illegal." 
 
 At that time it appeared that the hawking of such devices 
 was quite common all over New Zealand. The birth-rate 
 was at its lowest, 25 to 26 per 1,000. There can be no doubt 
 that restriction was almost universal. But the feehng of the 
 women as well as of the men of New Zealand on the question 
 was shown by the fact that when a Bill was introduced by 
 Mr. Seddon in the Parhament of 1901, under the title of 
 " The Sale of Preventives Prohibition Act," proposing penal- 
 ties of fines or imprisonment upon those found guilty of 
 selling " any contrivance for hindering, or preventing, 
 conception," it was thrown out after a brief discussion. It 
 is said that women took a prominent part In the agitation 
 against this Bill ; and in any case, as Women's Suffrage 
 had been granted eight years previously, women had every 
 opportunity of getting their wishes attended to. The death- 
 rate and infantile mortality In New Zealand have continued 
 to be the lowest in the world, and the rate of increase of Its 
 population nearly the highest, owing to the excellent health 
 pf its people. (See Fig. 6 on page 65.) 
 
CHAPTER IV 
 
 THE PUBLIC HEALTH 
 
 THE best approximate guide to the progress of the 
 general health of the community is the variation of the 
 death-rate. In the Annual Report of the Registrar General 
 of Births, Deaths and Marriages for England and Wales, 
 tables are given showing how both the birth and death rates 
 and the infantile mortahty have progressed in no less than 
 29 countries over the world. The results, when put into the 
 form of diagrams, are most striking, and enable us to come 
 to a very definite conclusion as to the effect of family 
 limitation. 
 
 If " artificial " limitation of births were productive of 
 either direct physical, or even moral, injury to the com- 
 munity, the result should have been a rise of the death- 
 rates — either by the increase of disease, or of crimes or 
 accidents. It will have been noticed, however, that, al- 
 though the announcement has been made with monotous 
 regularity in recent years that each successive birth-rate 
 was the lowest on record, it has been followed, no less 
 monotonously, by the statement that the death-rate was also 
 the lowest yet recorded. When we add to this the lament of 
 the British Medical Journal that the prospects of the medical 
 profession are declining, owing to the fewer births and the 
 consequently improved health of the children, we may sus- 
 pect that there is not much wrong with the world. 
 
 Let us now turn to the facts concerning the death-rate, 
 remembering that these are more accurately known than 
 any other social phenomena. The annexed diagram. Fig. i, 
 shows the variation of the birth-rate, the death-rate, and 
 
52 
 
 The Small Family System 
 Fig. I. 
 WMATIONS iN BiRTH'RAT£ Sfe.JN 
 ENGLAND Sf WALES. 
 
 4.0^ 
 
 
 V^ 
 
 4lOI 
 
 *«is»8r»A» GtntifALS »ePo^Tj ./tsj^.c 4 /yoy ^ 
 
 the infantile mortality in England and Wales. The birth- 
 rate for each year (the number of births for each thousand 
 of the population) is represented by a white strip ; the 
 death-rate (the number of deaths per thousand) by a 
 
The Public Health 53 
 
 shaded strip, partly covering the white strip, and the in- 
 tantile mortality (the number of infants out of each hundred 
 born who die before the age of one year) by a black strip. 
 Such a diagram enables us to see at a glance both how the 
 birth-rate and the health of the community are varying, 
 and how the population is naturally increasing. For ex- 
 ample, if we take the year 1861 we see that the birth-rate 
 in that year was 34 J per 1,000, the death-rate 21 J, and the 
 infantile mortaHty a httle over 15 per cent. Also, that since 
 there were between 34 and 35 births for each thousand 
 people, and between 21 and 22 deaths, there was an excess 
 of 13 births over deaths per 1,000, or that .1,000 people 
 increased to 1,013 people in the year. This is represented 
 by the amount of the white strip visible above the shaded 
 strip, enabling one to see at a glance, by watching the 
 length of the white portion, what effect the change of the 
 birth-rate has had upon the rate at which the population 
 increases. 
 
 Now if we study what has happened in our own country, 
 we see that from the year 1853 (when accurate statistics 
 began to be kept) up to 1876, the birth-rate rose fairly 
 steadily from a little over 33 to more than 36 per 1,000. In 
 1876, however, commenced the famous trial of Mr. Bradlaugh 
 and Mrs. Besant for pubHshing the Knowlton Pamphlet. 
 It attracted enormous attention to the question and means 
 of family Kmitation, and the result was the instant setting 
 in of that rapid and steady dechne of the birth-rate which 
 we now hear so much about. In 19 10 the birth-rate had 
 fallen to as low as 25 per 1,000, and it has since gone lower 
 still. 
 
 Let us now examine the variation of the death-rate. If 
 family Kmitation is so terrible from the medical and moral 
 point of view as the South Western Medical Association or 
 as Dr. Taylor made out, we ought to have seen a rise in the 
 death-rate from 1876 onwards. But the facts are all the 
 
54 The Small Family System j 
 
 other way. Before this date the death-rate was rising and i 
 faUing, but was certainly showing no definite sign of a 
 tendency to dechne ; while from a date somewhere about j 
 that time a rapid and steady fall has set in. So great has i 
 been this fall in the death-rate, that it has almost made up I 
 for the loss of births, and the population of this country is\ 
 now increasing almost as fast as it did before the fall of the \ 
 birth-rate set in although something like 400,000 fewer births 
 now take place every year than if the birth-rate of 1876 had 
 been maintained. It would be hard to imagine a more 
 absolute contradiction to the impression given by the reso- 
 lutions of the doctors and bishops. The only possible 
 justification for these resolutions in the face of this fact 
 would be a belief that the improvement is due to the stren- 
 uous fight of the medical profession and of modern sanita- 
 tion to counteract the evil effects of this terrible innovation. 
 If there were any grounds for this belief we should certainly 
 have to congratulate them on having most successfully 
 dealt with these evils by turning them into blessings. In 
 this connection it should be mentioned that the Public 
 Health Act was passed in 1875, and most hygienists attri- 
 bute the dechne of the death-rate to the era which it 
 inaugurated. Even if we granted it, we are forced at least to 
 the conclusion that modern hygiene is fully competent to 
 rectify all the evils supposed to arise from artificial preven- 
 tion — a result which is at all events reassuring. 
 
 Turning to infantile mortality, we find that it oscillated at 
 a figure of about 1 5 per cent, up to somewhere about 1875 or 6, 
 after which there was an improvement for a few years. It 
 then rose to about its former level, or a little higher in 1900. 
 Since then it has plunged down very rapidly, so that it is 
 now only about 10 instead of 15 per cent. Again, although 
 one could wish it much lower, there is no sign of any evil 
 result to infantile life, either from disease engendered by 
 artificial restriction, or from the supposed degeneration of 
 
The Public Health 55 
 
 maternal feeling and care which is claimed to follow such 
 " unnatural " practices, or from the higher education of 
 women. 
 
 There is no getting away from these facts. Even if the 
 whole medical profession were unanimous in condemnation 
 of artificial restriction, it could not weigh one iota in the 
 balance against evidence which is so incontestable as that 
 of the death-rates ; unless it could be shown that there has 
 been an increasing struggle amongst the medical profession 
 to preserve the health of the middle classes, who practise 
 this hmitation — a contention which is hardly maintained by 
 the claims of the profession itself. The one objection which 
 is occasionally urged against the death-rate criterion is that 
 it ought to be " corrected " to allow for alterations in the 
 proportions of young and old people, etc. in the country ; 
 but " corrected " figures (whenever they are available) 
 always show that the differences from the " crude " death- 
 rates are very small in comparison with the great improve- 
 ment which has followed the fall of the birth-rate. 
 
 In order to come to a just conclusion upon this all- 
 important point, it will be well to obtain evidence from other 
 countries. As before stated, the Registrar-General gives 
 particulars in his annual Reports of twenty-nine countries, 
 but as it would over-load the present small volume to deal 
 with them all, we will take a few of the most notable 
 examples. 
 
 Germany. — The German Empire, having only been formed 
 after the war of 1871, does not give us a long period to deal 
 with. But it will be seen from Fig. 2 that the birth-rate was 
 rising very rapidly before the year 1876, and that it has 
 since declined nearly as rapidly as our own. As its highest 
 value was nearly 41 per 1,000, or nearly 5 per 1,000 higher 
 than the highest figure for England and Wales, the German 
 birth-rate has always been in excess of our own, although 
 declining similarly. In this case we find that the death-rate 
 
56 
 
 
 The Small Family System 
 
 
 GERMAN EMPIRE. 
 
 
 Fig. 2. 
 
 
 1 1 
 
 1 III 
 
 36r 
 
 TrHTfrh 
 
 1 1 
 1 1 
 
 — 
 
 1 ' 1 1 
 
 ' i 1 ' 
 1 1 1 1 
 
 i. 1 : . 1 
 
 34.- 
 
 
 
 L : ; 1 
 
 3ir 
 
 
 
 
 1 ' 
 
 
 iffm' 
 
 ->Wf_ 
 
 ' ' 
 
 
 
 
 
 SLO 
 
 
 
 
 I 1 1 
 
 
 
 T ■ 
 
 1 1 1 
 
 
 
 1 1 • 
 
 -It 
 
 -to 
 
 
 ^^ S ^ i i 
 
 
 1 1 1 
 
 
 
 Hji 1 
 
 -/fl 
 
 
 
 
 I-Hl I 
 
 ? '<^ 
 
 
 
 IBi 
 
 (A 
 
 KrjL 
 
 
 
 |^» 
 
 - /Z 
 
 L^ 
 
 
 
 JB 
 
 
 
 
 
 
 1 
 
 
 
 
 
 ^ 
 
 
 
 
 
 1 
 
 - i. 
 
 - 2 
 
 - 
 
 *ea tf/v4r /ie/>c/fTj ttts J, Ctr ^ /^lo /.. /ti. 
 
 has rapidly fallen over the whole period, and indeed to a 
 greater extent than the birth-rate, so that the excess of 
 births over deaths has been getting larger and larger as the 
 birth-rate falls. Surely again this hardly bears out the con- 
 
The Public Health 57 
 
 tention that the limitation of births has been attended with 
 disastrous results either from the point of view of health or 
 of the vitality of the people. It will be noticed also that 
 although the German birth-rate is higher than our own, its 
 death-rate is decidedly higher (instead of being lower) and 
 its infantile mortality very much higher. Instead, there- 
 fore, of Germany having an advantage over us in conse- 
 quence of its lesser restriction of births, it appears that the 
 health both of its general public and of its infants is much 
 behind ours, despite the praises of the German hausfrau as 
 compared with her more emancipated and less prolific 
 Enghsh sister. 
 
 France. — We now turn to one of the most interesting 
 countries in connection with this question. France is 
 continually held up to us as the example of an effete and 
 " dying " nation, owing to the fact that it has the lowest 
 birth-rate known, and that it occasionally has fewer births 
 than deaths in a year. It is also of special interest because 
 it is one of the very few countries in which " artificial 
 restriction," as distinguished from cehbacy or late marriage, 
 had been systematically practised long before the Knowlton 
 Trial of 1876. In fact it started almost immediately after 
 the Revolution. In Fig. 3 we see the course of the birth and 
 death-rates in France from 1781 onwards, taken from the 
 official Annuaire. In 1781-84 the birth-rate of France was 
 38.9 per 1,000, higher than any value recorded for our own 
 country, and nearly as high as the highest recorded in 
 Germany. It has since fallen to 21.1 in the period 1901-06, 
 or by the large amount of 17.8 per 1,000. But now observe 
 what has happened to the death-rate. In the period 1781-84, 
 before the Revolution, the death-rate was no less than 37.0 
 per 1,000, and it has since fallen to 19.6 per 1,000. In other 
 words a fall in the birth-rate of 17.8 per 1,000 has been 
 accompanied by a fall in the death-rate of 17.4 per 1,000, or 
 of a practically equal amount, so the rate of increase of the 
 
Fig. 3 —FRANCE. 
 
 A/r^<//^//fe. 'f<^^ /a.i/3 
 
 /fe& GfAf /fffVirs /SiS ^ CV/ 4r /f/tf />/3S. 
 
 French population is hardly any lower now^ with a birth-rate 
 
 of 21 per 1,000, than it was with one of 39 per 1,000.* During 
 
 the period of the dedining birth-rate the average duration of 
 
 Hfe in France has doubled, and the progress of its population 
 
 has not been checked. The explanation of the very slow 
 
 •since this was written the figures for 1906-10 have come to hand, 
 and are shown on the diagram. The increase has been rather smaller 
 during that quinquennium, but it is not a decline as has been so often 
 stated. 
 
The Public Health 59 
 
 rate of increase of population in France both at the end of 
 the 1 8th century and to-day is probably that France was the 
 most civiHsed and densely populated country in the Middle 
 Ages, and had already come nearly to the Hmit of its agri- 
 cultural productivity. At the same time it has apparently 
 no store of minerals which would enable it to compete 
 successfully with the industries of England and Germany. 
 After the Revolution the feudal system was destroyed and 
 the land became better distributed among the people. This 
 somewhat increased the output of food, so the death-rate 
 fell faster than the birth-rate, and the population increased 
 more rapidly. After 1830, however, this advantage began 
 to be used up by the increased population, and the country 
 has returned to the position of very slowly increasing its 
 production and population. There is no doubt that the 
 health of the French people has enormously improved during 
 the whole period of the falling birth-rate, and that its 
 population has not been checked thereby — although the 
 bulk of the Hmitation in France has admittedly been carried 
 out by a method which has been specially denounced by 
 both theologians and doctors. If anyone contends that 
 artificial limitation of famihes is injurious and degrading to 
 women, the example of the French women (of the middle 
 classes and provinces as distinguished from the gay set of 
 Paris) ought to prove a corrective. There are few countries 
 in which women exercise so much authority, in which they 
 are so strong and free from nervous disorders, and in which 
 maternal affection and love of home are so strong. 
 
 Holland. — The only other example we need give of a 
 European country with a f alHng birth-rate is that of Holland. 
 This country is chosen, not because it shows an exceptionally 
 great decline in the birth-rate, but because, wonderful to 
 relate, the Society which has sought to instruct the poorer classes 
 as to the means of restriction (through the agency of medical men 
 and midwives) has had the countenance of ministers of State 
 
NETHERLANDS. 
 
 Fig. 4. 
 
 i*ecnr^«9 ^eA£g4i'4 ^fOSlS /99f ftJ/ .4 fit'Os"* 
 
The Public Health 6i 
 
 and has been recognised by royal decree since 1895 as a society 
 of public utility. The essential point in this connection is 
 that Holland is the only country in which artificial restric- 
 tion has been extended to the poor, instead of, as in other 
 countries, being adopted by the rich and educated classes 
 only. As the diagram in Fig. 4 shows, the birth-rate rose 
 as usual to the year 1876, when it was about 37 per 1,000, 
 and has since fallen steadily to about 29. But it will be 
 observed that the death-rate and infantile mortality have 
 fallen more rapidly and satisfactorily than in any other 
 country — so much so, indeed, that the excess of births over 
 deaths is increasing astonishingly. At the same time there 
 seems to be httle or none of the physical deterioration which 
 we hear so much of in England and Germany and many other 
 countries. Holland is the one and only country where some 
 members at least of the medical profession have openly 
 approved and helped to extend artificial restriction ; and 
 not only has its health, as shown by its death-rate and in- 
 fantile mortaHty, improved faster than in any other country 
 In the world, but it was stated at the recent Eugenics Con- 
 gress that the stature of the Dutch people was increasing 
 more rapidly than that of any other country — by no less 
 than four Inches within the last fifty years. According to 
 the Official Statistical Year Book of the Netherlands the 
 proportion of young men drawn for the army over 5 ft. 7 In. 
 In height has increased from 24J to 47 J per cent, since 1865, 
 while the proportion below 5 ft. 2|In. in height has fallen 
 from 25 per cent, to under 8 per cent. The explanation is, 
 without much doubt, that the medical co-operation in 
 Holland enables the Dutch people to employ the most 
 hygienic methods of limitation ; and In the second place 
 that the knowledge of such methods by the very poor enables 
 them to have smaller families which they can look after 
 better, and also prevents that recruiting of the race mainly 
 from the poorest and most reckless classes wliich Is so often 
 
62 The Small Family System 
 
 deplored in England. One of the factors in this admitedly 
 unfortunate circumstance is that the educated classes tend 
 to Hmit their famihes unduly on account of the heavy 
 taxation for the education and support of the large families 
 of the poor. There is no doubt that in Holland, where the 
 poor are taught to restrict, the famiHes are not so much 
 reduced among the wealthier people. 
 
 Australia and New Zealand. — These two countries form a 
 remarkable culmination to the examples of declimng 
 birth-rates (see Figs. 5 and 6). In both of them the means 
 of artificial restriction are in free circulation, and the 
 restriction of famiHes is almost universal. Mr. Octavius 
 Beale in his Racial Decay waxes especially eloquent over 
 the terrible degeneracy of these countries. In 1888, how- 
 ever, when Mrs. Annie Besant's Law of Population was 
 prosecuted in AustraHa, Mr. Justice Windeyer, in a judg- 
 ment dehvered in the Supreme Court of New South 
 Wales, most strongly upheld the book as necessary and 
 valuable.* 
 
 The following extract from this judgment forms a sharp 
 contrast to the views we are generally accustomed to hear 
 expressed : — 
 
 " A court of law has now to decide for the first time 
 whether it is lawful to argue in a decent way with earnestness 
 of thought and sobriety of language the right of married 
 men and women to limit the number of children to be be- 
 gotten by them by such means as medical science says are 
 possible and not injurious to health. Of the enormous im- 
 portance of this question, not only to persons of limited 
 means in every society and country, but to nations, the 
 populations of which have a tendency to increase more 
 rapidly than the means of subsistence, there cannot be the 
 slightest doubt. Since the days when Malthus first an- 
 
 * Mrs. Besant repudiated this book after her conversion to Theosophy. 
 But she has recently written that " if the premises of Materialism be true, 
 there is no answer to the neo-Malthuslan conclusions. . . . Not until I 
 felt obliged to admit that neo-Malthusian teaching was anti-Theosophical 
 would I t^ke this step." — Theosophy and the Law of Population. 
 
The Public Health 
 
 AUSTRALIA 
 (Commonwealth). 
 
 Fig; 5. 
 
 63 
 
 ^AA/DSCaA /=-0/i AUSTRAL /A l<^0/-/^Of /> 238, 
 
64 The Small Family System 
 
 nounced his views on the subject to be misrepresented and 
 viHfied, as originators of new ideas usually are by the 
 ignorant and unthinking, the question has not only been 
 pressing itself with increasing intensity of force upon thinkers 
 and social reformers dealing with it in the abstract, but the 
 necessity of practically dealing with the difficulty of over- 
 population has become a topic pubHcly discussed by states- 
 men and poHticians. It is no longer a question whether it is 
 expedient to prevent the growth of a pauper population, 
 with all its attendant miseries following upon semi-starva- 
 tion, overcrowding, disease, and an enfeebled national 
 stamina of constitution ; but how countries suffering from 
 all these causes of national decay shall avert national 
 disaster by checking the production of children, whose lives 
 must be too often a misery to themselves, a burden to 
 society, and a danger to the State. Public opinion has so far 
 advanced in the consideration of a question that has be- 
 come of burning importance in the mother country by reason 
 of its notoriously increasing over-population, that invectives 
 are no longer hurled against those who, Hke John Stuart 
 Mill and others, discuss in the abstract the necessity of 
 limiting the growth of population ; but they are reserved 
 for those who attempt practically to follow up their teaching 
 and show how such abstract reasoning should be acted upon. 
 It seems to be conceded by public opinion, and has indeed 
 been admitted in argument before us, that the abstract 
 discussion of the necessity of limiting the number of children 
 brought into the world is a subject fitting for the philosopher 
 and student of sociology. The thinkers of the world have so 
 far succeeded in educating it upon the subject, and public 
 attention is so thoroughly aroused as to its importance, 
 that every reader of our EngHsh periodical literature 
 knows it to be constantly discussed in magazines and 
 reviews. Statesmen, reviewers, and ecclesiastics join in a 
 common chorus of exhortation against improvident 
 marriages to the working classes, and preach to them the 
 necessity of deferring the ceremony till they have saved the 
 competency necessary to support the truly British family of 
 ten or twelve children. Those, however, who take a prac- 
 tical view of life, will inevitably ask whether the masses, for 
 whose benefit this exhortation is given, can be expected to 
 exercise all the powers of self-denial which compliance with 
 
The Public Health 
 NEW ZEALAND (Fig. 6). 
 { 
 
 65 
 
 MtVi ZtALAMD Of^tCtAL YCAR MOOK. tlfl/. /.^ i^JL $ 4A* 
 
 it would involve. To what period of life is marriage to be 
 postponed by the sweater in the East End of London, 
 
66 The Small Family System 
 
 earning his three or four shillings a day, without any hope 
 of ever being able to educate, decently house, and bring up, 
 eight or ten children ? The Protestant world rejects the idea 
 of a celibate clergy as incompatible with purity and the 
 safety of female virtue, though the ecclesiastic is strength- 
 ened by all the moral helps of a calling devoted to the 
 noblest of objects, and by every inducement to a holy life. 
 With strange inconsistency, the same disbelievers in the 
 power of male human nature to resist the most powerful 
 instincts, expect men and women, animated by no such 
 exalted motives, with their moral nature more or less 
 stunted, huddled together in dens where the bare conditions 
 of living preclude even elementary ideas of modesty, with 
 none of the pleasures of life, save those enjoyed in common 
 with the animals — expect these victims of a social state, 
 for which the educated are responsible if they do not use 
 their superior wisdom and knowledge for its redress, to 
 exercise all the self-control of which the celibate ecclesiastic 
 is supposed to be incapable. If it is right to declaim against 
 over-population as a danger to society, as involving condi- 
 tions of life not only destructive to morals but conducive 
 to crime and national degeneration, the question immediately 
 arises, can it be wrong to discuss the possibiHty of limiting 
 births by methods which do not involve in their application 
 the existence of an impossible state of society in the world 
 as it is, and which do not ignore the natural sexual instincts 
 in man. 
 
 Why is the philosopher who describes the nature of the 
 diseases from which we are suffering, who detects the causes 
 which induce it and the general character of the remedies 
 to be applied, to be regarded as a sage and a benefactor, but 
 his necessary complement in the evolution of a great idea, 
 the man who works out in practice the theories of the 
 abstract thinker, to be denounced as a criminal ? " 
 
 We have already referred to the Conference on Public 
 Morality instituted by distinguished clerical representatives 
 in New Zealand in 1901 and to the fate of the attempt to 
 restrict the circulation of preventive devices, although 
 Bishop Julius had said in an interview with a representative 
 of the Christchurch Truth : " Recent enquiry has proved a 
 
The Public Health 67 
 
 very large sale of preventives in this city (Christchurch, 
 N.Z.), also that they are manufactured in Christchurch, and 
 that they are being hawked about from door to door." 
 Mr. Beale has spoken of Australia as being in a very similar 
 state. As such freedom is certainly much greater than exists 
 in this and most other countries, Austraha and New 
 Zealand ought to be the most awful examples of physical 
 and moral decadence. 
 
 But are they ? The fall of the birth-rate, of course, is 
 most striking. In Austraha it has fallen from 43.4 per 1,000 
 in 1862 to 25.5 in 1904, and it has since remained a Httle 
 over 26 per 1,000. In New Zealand the decline did not 
 definitely commence till 1878, but it has since been phenome- 
 nal, dropping to 25.2 in 1899, °^ ^V ^t)out 17 per 1,000 in 
 20 years. Since this it has revived somewhat, but this is 
 due simply to a higher marriage rate, as the fertihty rate (or 
 number of births per thousand married women) has steadily 
 continued to decline as follows : — 
 
 Year ... 1878 1881 1886 1891 1896 1901 1906 
 Fertihty... 337.2 313.3 295.5 276.3 252.1 243.8 227.6 
 
 But when we come to consider the death-rate, we are 
 immediately confronted with the fact that Australia and 
 New Zealand (see Figs. 5 and 6) are the healthiest countries 
 in the world, whether regarded from the standpoint of general 
 or of infantile mortahty. Not only so, but even here the fall 
 in the birth-rate has been followed by a small but decided 
 improvement in the death-rate. How is it that, despite the 
 lamentations of the prophets, the facts zvill persist in abso- 
 lutely repudiating their contentions ? According to the 
 statements of these moralists, Austraha and New Zealand 
 should compare with Sodom and Gomorrah in their resolute 
 determination to pursue a course of iniquity. Yet we find 
 them the most healthy and prosperous countries of the 
 world, certainly among the most virile. Ex-President 
 
68 The Small Family System 
 
 Roosevelt in his review* of Mr. Beale's book has told us 
 that " the rate of natural increase in New Zealand is 
 actually lower than in Great Britain, and has tended 
 steadily to decrease," The truth is that the rate of natural 
 increase (excess of birth-rate over death-rate) in New 
 Zealand is nearly double that of Great Britain, and has also 
 been growing steadily of late years. Mr. Roosevelt also 
 informs us that in AustraHa, " even if the present rate were 
 maintained, the population would not double itself in the 
 next century." With the present excess of births over 
 deaths of i6per l,ooo, the Australian population will double 
 itself in 44 years, and increase 4.8-fold in a century. Such 
 glaring misstatements will give our readers an idea of the 
 way in which people are misled by those whom they are 
 accustomed to look upon as authorities on such questions. 
 
 Since this was written the Bishop of London has been on a 
 visit to AustraHa and has given forth similar views to Mr. 
 Roosevelt at the Annual Meeting of the North-West 
 AustraHa Diocesan Association. This repeated attack has 
 at last been too much for the AustraHan Government, and 
 the High Commissioner for AustraHa communicated a 
 protest to the press. He pointed out that there were two 
 sides to a birth-rate, the other being the numiber of infants 
 who survive their first year of life. " If he [the Bishop of 
 London] will look at the statistics he will find that while 
 the crude birth-rate of AustraHa is comparatively low in the 
 Hst, nevertheless, on account of the equally comparatively 
 low death-rate, AustraHa stands at the very top of the Hst 
 in effective natural increase." 
 
 Summary. — It is quite a fascinating as well as an extremely 
 profitable study to deal with all the countries in extenso, but 
 that will be done in a later volume. We can, however, call 
 attention to the chief points in the following summary. 
 
 * Reproduced at the commencement of Mr. Beale's Racial Decay. 
 
The Public Health 
 
 69 
 
 CANADA. 
 
 (Ontario). 
 
 Fig. 7. 
 
 Of the twenty-nine countries given in the Report of the 
 Registrar General — 
 
 I. There are eighteen in which the birth-rate has fallen. 
 In fifteen of these the death-rate has fallen by an amount 
 nearly corresponding to the fall in the birth-rate ; in two — 
 New Zealand and Australia — the death-rate has only 
 fallen sHghtly, but theirs is the lowest in the world. 
 
70 The Small Family System 
 
 2. There are four in which the birth-rate has remained 
 approximately stationary (Russia, Roumania, Jamaica and 
 Ireland). In these four countries the death-rates and in- 
 fantile mortality have remained practically stationary 
 (except that there may be a small fall of the death-rate in 
 Russia). Russia with the highest birth-rate in Europe 
 (nearly 50 per 1,000) has the highest death-rate, about 36 
 per 1,000, and the highest infantile mortahty, 26 per cent. 
 In the other three countries the general and infantile 
 mortalities are lower, the lower their birth-rates. 
 
 3. There are four countries only in which the birth-rate 
 has risen (Bulgaria, Ceylon, Japan and Ontario [Canada]). 
 In every one of the four the birth-rate and infantile mor- 
 tahty have risen, and in close correspondence with the rise 
 of the birth-rate. Is it not most remarkable (see Fig. 7) that 
 even in Canada (a new and promising country whose 
 prosperity is supposed to be somewhat retarded by in- 
 sufficiency of inhabitants) a rise in the birth-rate has not 
 increased numbers — except in the grave-yards ? 
 
 4. When we compare different countries or towns, or 
 different parts of the same country or town, we find as a 
 whole that high birth-rates are accompanied by high rates 
 of general and infantile mortality, while low birth-rates are 
 accompanied by lower mortality rates. 
 
 5. The two most extreme variations of the birth-rate 
 which have been sho^vn among the great towns, are in the 
 case of Berlin, where it has risen from 32 to 45 per 1,000 
 between 1841 and 1876, and has since fallen to 21 per 
 1,000. The death-rate and infantile mortality have risen 
 with the rising birth-rate and have fallen with its fall in 
 almost exact correspondence, except for occasional irregu- 
 larities due to war and epidemics. 
 
 Toronto, on the other hand, is the only example of a 
 town in which the counsels of the morahsts appear to have 
 been taken seriously to heart, and which has returned to a 
 
The Public Health 71 
 
 high birth-rate after joining in the general fall. The death- 
 rate fell step by step as the birth-rate declined — and to prac- 
 tically the same extent, but rose again immediately the birth-rate 
 began to go up, and in 1909 zvas higher than in 1880-85. 
 
 What do we learn from these incontrovertible facts ? Not 
 only that medical science has succeeded in bringing down 
 the death-rate when family restriction has been practised, 
 but that it has utterly failed to do so when the birth-rate 
 has been maintained. Worse still, in every case where the 
 command to increase and multiply has been obeyed by 
 more rapid reproduction, the whole power of medical science 
 has failed to prevent the death-rate from rising. And in 
 Toronto, where for some reason the people have stopped in 
 their downward path and have restored their birth-rate to 
 its former high value, they have been rewarded not by 
 greater health, but by a steady increase of the death-rate. 
 In face of this it is difficult to find words adequate to deal 
 with the attempt of the medical profession to stem the tide 
 of the declining birth-rate. If the aim of the medical pro- 
 fession is to allay suffering and to prolong life, the facts show 
 that the whole profession is practically incompetent to effect 
 this for the community as a whole, unless helped by family 
 restriction. 
 
 There are those who will attempt to escape from this 
 conclusion by appeahng to " corrected " statistics, so it may 
 be well to repeat that although the question is rendered 
 more complicated by such modifications, the general con- 
 clusion is unaffected, or indeed strengthened, that family 
 limitation is a decided advantage for the health of the 
 community. France, for example, which is always held up 
 as such a dreadful object lesson, comes out much better 
 when its corrected death-rate is given. 
 
CHAPTER V 
 
 DO PREVENTIVE METHODS CAUSE CANCER ? 
 
 SPECIAL reference must be made to this terrible disease 
 as it appears to be increasing, and as opponents of 
 family limitation, Mr. Beale especially, have sought to 
 ascribe this increase to the practice of family limitation. 
 Although he has brought together several instances of 
 serious evils arising from abortion (probably mixed up with 
 venereal disease) and of medical opinion connecting it with 
 cancer, he does not seem to have been able to cite a single 
 authoritative medical utterance associating cancer with 
 preventive, as distinguished from abortifacient, practices. 
 No suggestion of such a consequence appears in the addresses 
 of Sir James Barr or of the President of the American Medical 
 Association in their remarks upon the declining birth-rate, 
 while with regard to the contention that mechanical devices* 
 and the employment of antiseptic fluidst are provocative of 
 irritation to the mucous membranes, the same might be 
 said of artificial teeth, and of antiseptic mouth washes. 
 If wrongly fitted, artificial teeth will cause serious irritation ; 
 and an impure or too concentrated dentrifice may do the 
 same. But that does not alter the fact that properly fitted 
 artificial teeth, and suitable, regularly used mouth washes 
 are powerful aids to health, and that they are safeguards 
 against both irritation and disease. A very large number 
 
 * Is this contention ever advanced against the very similar mechanical 
 devices which many women have, under medical advice, to wear constantly 
 over long periods for displacements — the result of excessive child- 
 bearing .? 
 
 t For as Dr. Rutgers has said, preventive methods and personal 
 hygiene are almost equivalent. 
 
 72 
 
Do Preventive Methods Cause Cancer? 73 
 
 of refined persons are wearing mechanical devices in their 
 mouths sixteen hours or more out of the twenty-four, and 
 are daily, or even more frequently, scrubbing the mucous 
 membrane of their mouths with fluids that are sometimes 
 identical with, and even more concentrated than, those 
 employed for family limitation. The very antiseptic pre- 
 cautions recommended by medical men themselves for 
 women after childbirth and at other times are practically 
 identical with the best means for preventing conception. 
 So far from conceding that anti-conceptional means are an 
 evil, or a lesser evil than excessive and burdensome mater- 
 nity, those who have studied the subject know that many of 
 them are most beneficial and that they should be employed 
 even when prevention is not desired, the only diiTerence 
 being the time at which they are used. This may seem a 
 starthng contention after the diatribes of Mr. Beale and his 
 coadjutors, but when it is remembered that the majority of 
 the pubhc have no opportunity given them to differentiate 
 between the good and the bad, and that every effort has 
 been made to confuse harmless preventives with noxious 
 abortifacients, it is not surprising that a strong case can be 
 made out against prevention in general from the records of 
 unfortunate ignorance. Indeed it is wonderful that such 
 good results have followed, and they enable us to realise 
 what splendid results should arise from a humane and 
 intelligent extension of the knowledge. A quotation from 
 a gynaecologist of the eminence of Professor Hector Treub, 
 such as given on p. 14 of this book, is sufficient to show that 
 no harm need follow preventive means. So the duty of the 
 medical profession is not to denounce them indiscriminately, 
 but to instruct the public in employing the harmless and 
 beneficial methods. 
 
 One more opinion on the subject of cancer may be given. 
 In the fourth scientific report issued by the Imperial Cancer 
 Research Fund, Dr. E. F. Bashford, the Director, says : — 
 
74 The Small Faaiily System 
 
 " For the first time it is fully demonstrated that it is 
 erroneous to make statements of a disquieting nature about 
 the increase of cancer in general," and he points out, as 
 has been frequently pointed out by neo-Malthusians, that 
 an increase of cancer is naturally to be expected, since 
 cancer is a disease of later Hfe, and since the average dura- 
 tion of Hfe is increasing. As the present writer has often 
 argued, the reduction one by one of various diseases by 
 prevention or cure must inevitably lead to an increase of the 
 diseases that we have not yet learned how to prevent. Those 
 who to-day Hve long enough to be attacked by cancer would, 
 in the majority of cases, had they Hved in years gone by, 
 have succumbed earlier to small-pox, consumption and other 
 scourges which have since been so greatly reduced in 
 frequency. As all who are born must die sooner or later, 
 the conquest of one disease after another means that more 
 people will die of old age and of the unconquered diseases. 
 As cancer is the most important of the latter, it is not at all 
 surprising that it has increased. In fact, paradoxical as 
 it may seem, the increase of cancer might actually be re- 
 garded as a sign of improvement rather than of deterioration 
 of the health of the community, until the day comes, as we 
 hope it soon will, when its prevention or easy and certain 
 cure are arrived at. 
 
 So much for theory ; now for facts. In Fig. 8 is reproduced 
 the diagrams given for the variation of cancer by the 
 Registrar-General in his Report for 1910, the figures being 
 " corrected " for the age and sex distribution of the popu- 
 lation in 1901. The rapidity of the increase is unquestion- 
 able, but there are certain features to be noticed about it. 
 
 Firstly, the increase of cancer, both in men and women, 
 was taking place just as rapidly before the commencement 
 of the dechne of the birth-rate in 1876 as it has done since. 
 The comparison between this period and that of the last 
 fifteen years, 1894-1910, during which the decline of the 
 
Do Preventive Methods Cause Cancer? 75 
 
 Fig. 8. 
 
 £AfGlA/if£f Bi Mai£S. 
 
 CAAfCSR. 
 
 CO/f/^£CT£D i?£'AT/^'/^AT£S AT All ACSS 
 
 AA^o ^,4^/<i^^y sr~rrr,^s ot/jf/>vo r/^e yf^/vs /s6/-/<^/^ 
 
 
 t> 1 1 JJ_iJ^ 
 
 
 AT££> //V /gOf 
 
76 The Small Family System 
 
 fertility rate has been most rapid, is clearly shown in the 
 following table : — 
 
 
 Cancer Mortalities. 
 
 Can'cer Mortalities. 
 
 
 1861. 
 
 1876. 
 
 Per cent. 
 Increase. 
 
 1894. 1 1901. 
 
 1 
 
 Per cent. 
 Increase. 
 
 Males 
 Females 
 
 220 
 
 517 
 
 320 
 645 
 
 44-5 
 24.8 
 
 560 
 875 
 
 855 
 
 1,070 
 
 34-9 
 22.3 
 
 Birth-rate . . 
 
 36.4 
 
 36.3 
 
 5 
 
 29.5 
 
 24.8 
 
 —15.9 
 
 According to tliis, therefore, cancer among males increased 
 by 45 per cent, when the birth-rate actually increased by 
 5 per cent.,* and has only increased by 35 per cent, during 
 the last 15 years during which the birth-rate has fallen 
 16 per cent. For females, the rise of cancer mortahty has 
 been reduced from 24.8 to 22.3 per cent, with this change of 
 the birth-rate. There is nothing whatever on the curves of 
 cancer mortahty to show the shghtest influence of the sud- 
 den reversal in 1876 from a rising to a falhng birth-rate, and 
 there is no evidence here to show that the rise of cancer 
 mortality would not have been the same if the falling 
 birth-rate had never set in. 
 
 But the diagrams indicate more than this. They give us 
 — unfortunately only for the past fourteen years — the 
 mortahty from cancer of the generative and mammary 
 systems, which are, of course, the really important factors 
 in the question. As regards males, the position is obvious ; 
 cancer of the generative organs is extremely small, and shows 
 no perceptible tendency to increase. On the other hand, as 
 regards females, cancer of the generative and mammary 
 systems forms a most serious proportion of the total, and it 
 
 *Probably because premature deaths from violence and epidemics were 
 decreasing. 
 
Do Preventive Methods Cause Cancer ? 77 
 
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yS The Small Family System 
 
 is perhaps Increasing a little faster than the general female 
 cancer mortahty. When we come to study the matter a 
 httle further, however, we find two interesting facts. 
 
 In the first place, the increase of cancer among women, 
 instead of being greatest at the ordinary years of mother- 
 hood (as would have been expected if artificial prevention 
 were responsible for it), is actually less and shows signs of 
 being arrested. Figs. 9 and 10 are diagrams given by the 
 Registrar-General for the increase of cancer mortality in 
 men and women at different ages. From these we see at 
 once that while among men (where cancer of the generative 
 system is unimportant) the increase has been very rapid at 
 all ages, among women (where cancer of the generative 
 organs is important) there is actually an arrest of the 
 increase up to the age of 45 (the end of the child-bearing 
 period) and signs of a decHne. It is only above the age of 65, 
 long after any preventive methods have become unnecessary, 
 that the increase of cancer among women is unaffected. It 
 thus appears that, relatively to men and older women, the 
 women at the child-bearing periods are positively bene- 
 fitting rather than suffering by the new custom. When we 
 remember that frequently repeated pregnancy and child- 
 birth are themselves a serious source of irritation and of 
 disorders, this result is by no means unintelligible.* 
 
 In the second place, the surmise just made is decidedly 
 confirmed by the fact that the very organ which is the most 
 concerned in the matter, is the only one in which cancer has 
 not increased (at any rate during the last thirteen years), 
 and in which it actually shows signs of a decrease. The 
 Registrar-General's Reportf .contains diagrams showing the 
 
 * It is worth noticing that the women above 65 years of age among 
 whom cancer has been principally increasing, probably never used pre- 
 ventives^ as their child-bearing period must have ceased before the 
 practice of prevention became at all general. This goes to confirm the 
 statement just made. 
 
 t Annual Report for 1909, p. Ixxx, 
 
Do Preventive Methods Cause Cancer? 79 
 
 ENGLAND AND WALES. 
 • Cancer in various parts of the body. 
 
 Mortality at all Ages, i 897-1910. 
 WOMEN (Fig. i i). 
 
 ^^r^ ^ §. §: I ^ § 5 5 
 
 
 2^5 
 st/a 
 
 /so 
 
 /6s 
 
 /so 
 
 /55 
 
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 90 
 
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 60 
 
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 30 
 
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 yr^jS (SiT/f- /r(/V/fT /f/O 
 
 variation of cancer in various organs of the body in males 
 and females since 1897. A glance at one of these (Fig. il) 
 will convince anyone that the case for connecting the in- 
 crease of cancer with the employment of preventive devices 
 breaks down at the most critical point. 
 
 Before leaving this subject, reference must be briefly 
 made to other countries. It may be said as a general rule 
 
VARIOUS COUNTRIES. 
 Fertility and Cancer. 
 
 1901-1905. 
 Fig. 12. 
 
 § 
 
 15 
 55 
 
 "6 sat 
 
 Ilill^li^il 
 
 5t0 
 
 80 The Small Family System 
 
 that the increase of cancer has been noted in all countries — 
 even in Ireland, for instance, where the birth-rate has 
 remained practically constant for the past twenty-five years. 
 In Holland, where, as has been said, artificial restriction has 
 been largely taught to the poor, cancer has actually dimin- 
 ished during the past five years. 
 France, with a birth-rate of 21 
 per 1,000 in 1901-5, had a 
 cancer mortality of only .^6 
 per 1,000 as against .95 in 
 England and Wales, and 1.3 
 in Switzerland. Both of these 
 countries had birth-rates of 
 28 per 1,000 at that time. The 
 most satisfactory comparison, 
 however, is that between the 
 cancer mortality and the fer- 
 tility rate, i.e., the birth-rate 
 compared with the number of 
 married women. In Fig. 12 we 
 have a diagram exhibiting this 
 comparison for all the countries 
 in which these particulars are 
 given in the period 1901-5. 
 This appears to show that there 
 is practically no relation be- 
 tween the average amount of 
 child-bearing and cancer. 
 
 Those who have read Mr. 
 Beale's book will very probably 
 feel, however, that all these 
 statistics and reasoning do not 
 affect the terrible examples he 
 cites of disease following upon 
 what he calls " conjugal frauds." 
 
Do Preventive Methods Cause Cancer? 8i 
 
 To this it may immediately be replied that Mr. Beale in 
 his zeal has omitted to tell us two things : firstly 
 whether the "conjugal frauds," which he alleges to have 
 given rise to terrible consequences, were prevention or 
 abortion ; and secondly what was the real nature of these 
 consequences. No one would be surprised to hear that 
 terrible effects had followed from repeated induction of 
 abortion, either by drugs or unskilled interference ; and the 
 Hungarian National Senate has warned us that such evils 
 are due to ignorance of, and not to knowledge of, preventive 
 methods. Again Mr. Beale ought to know that an immense 
 amount of sterihty and suffering are caused by horrible 
 diseases which are the direct results of the fear of early 
 marriage on account of the large families which naturally 
 follow from it, and that the want of knowledge of preven- 
 tive devices is thus directly responsible for such evils. When 
 we add that the effects of such diseases are often hardly to 
 be distinguished from those of cancer, even by experienced 
 medical practitioners, it is easy to see that a strong case can 
 be made out for the apparent production of cancer by pre- 
 ventive methods. Such evidence, therefore, appears to have 
 very little weight in comparison with the positive evidence 
 of the falling death-rate, and of the arrested increase of 
 cancer in women at the period of motherhood, and in the 
 generative organs, etc. It is also of very little weight in 
 comparison with such negative evidence as the absence of 
 any warning from the eminent medical authorities who have 
 recently dealt with the birth-rate question. When we con- 
 sider the anguish caused to millions of poor women by their 
 eternal burden of bearing children one after another Into 
 wretched conditions and by seeing half of them die from 
 want and unnecessary disease, some of us may have our own 
 opinions of Mr. Beale's attempt to hound these poor mothers 
 away from hope of relief by scaring them with the threat of 
 cancer. Doubtless he would heartily subscribe to the words 
 
82 The Small Family System 
 
 of Luther : " If a woman becomes weary, or at last dead, 
 from bearing, that matters not ; let her only die from 
 bearing. She is there to do it." 
 
 Prevention and Sterility. — Another favourite device of 
 the opponents of artificial limitation is to claim that it leads 
 to sterility, so that when couples who have employed 
 preventive methods for some time wish to have another 
 child they find themselves incapable of having one. How 
 absurd this statement is is well known to those who have 
 had experience of the subject. On the contrary there is 
 some evidence that the fertile period is even prolonged by 
 preventive methods, as cases have occurred when couples 
 have abandoned preventive methods only after passing the 
 end of normal fertile life, and have immediately had another 
 child. This statement is confirmed by Dr. W. J. Robinson, 
 the President of the American Society of Medical Sociology, 
 in his Practical Eugenics^ chap. III. 
 
 " Another argument is that the use of the means of 
 prevention renders a woman sterile, so that when she after- 
 wards wants to have children she cannot do so. This is 
 absolutely and unqualifiedly untrue. Here is again confu- 
 sion between prevention and abortion. It is true that re- 
 peatedly performed abortions may render a woman sterile 
 on account of the inflammations and infections that abor- 
 tions often set up. But. properly used means of contracep- 
 tion have no such effect. Thousands and thousands of 
 women use these means as long as they do not want to have 
 any children ; when they want a child they discontinue their 
 use and very soon afterwards become impregnated." 
 
CHAPTER VI 
 
 MORALITY 
 
 WE now come to the evidence concerning the actual 
 moral effects of family restriction, and for this 
 purpose we can appeal both to opinion and to facts. As 
 regards opinion, it is hardly necessary to mention that 
 several eminent persons who consider themselves entitled 
 to speak with authority, unhesitatingly declare that we are 
 undergoing a terrible moral decline, comparable with that 
 which brought about the decline and fall of the Roman 
 Empire. The words of Horace, Vitio parentum, rata 
 fuventus^ are thought by them to apply equally to the 
 present day. Among the chief expositors of this view are 
 Father Bernard Vaughan and the Bishop of London in this 
 country, Dr. J. Bertillon in France, and ex-President 
 Roosevelt in the United States. The following quotations 
 are the strongest denunciations we have read, emanating 
 from each of these gentlemen in turn. 
 
 " With a sigh I look back to the early days of my boy- 
 hood, when the birth-rate, instead of being what it is now, 
 was 37 or 38 per thousand. For my experience goes to show 
 that, quite apart from the vaster questions involved, the 
 larger the family the healthier and merrier the children. 
 But the parents of to-day ridicule the notion of having big 
 families. Instead of being proud, Society is becoming 
 ashamed to own a nursery full of children. And motherhood, 
 instead of being looked upon as a blessing, is regarded as a 
 curse, and disregarded as a duty. . . . There is no wealth 
 Hke human life — no health like that of an increasing popu- 
 lation ; and the outlook for any country whose birth-rate is 
 on a decreasing scale is black indeed. I wish I did not find 
 in the story of our own times so many chapters that recall 
 Gibbon's Decline and Fall of the Roman Empire ; but the 
 
84 The Small Family System 
 
 points of resemblance are so striking that no student of 
 history can avoid comparing them." (Father Bernard 
 Vaughan. "A Doctrine of Destruction," in The Problem of 
 Motherhood. Cassell & Co.) 
 
 " In his charge to the clergy of the diocese of London at 
 his annual visitation at St. Paul's to-day, the Bishop of 
 London again referred to the question of the birth-rate. 
 
 " His lordship remarked that the birth-rate in 1905 was 
 27.2 per 1,000; in 1906, 27.1; 1907, 26.3; 1908, 26.5; 
 1909, 25.6 ; 1910, 24.8. 
 
 " In 1876 the birth-rate attained its highest point on 
 record, napiely 36.3 per 1,000, and since then it had fallen 
 year by year. 
 
 " In Australia they found a similar fall for the last six 
 years, but not quite so great. 
 
 " He could only repeat his words of six years ago : ' It 
 is as completely proved as anything can be that the cause of 
 all this is the dehberate prevention of conception.' " 
 
 To use the eloquent words of Professor Taylor, " This 
 which was first encouraged in England some thirty-five years 
 ago has gradually spread like wildfire among the middle- 
 class population of the land, and the true wealth of the 
 nation, ' the full-healthed, bright-eyed, and happy-hearted 
 children,' have more or less gone down before it." 
 
 '' Now it is to stem this gigantic evil," said the Bishop, 
 " that I summon the forces of the Church to-day. 
 
 Let teaching be given in suitable ways and at suitable 
 times on the responsibility which married life entails, on the 
 glory of motherhood, and the growing selfishness which 
 thinks first of creature comforts, of social pleasures, and then 
 of the ordinary duties and joys of life. 
 
 It is all part of this miserable gospel of comfort which is 
 the curse of the present day, and we must live ourselves and 
 teach others to live the simpler, harder life our forefathers 
 lived when they made Britain what it is to-day, and handed 
 down a glorious heritage, which unless we amend our ways, 
 must surely slip from our nerveless fingers." {Evening 
 Nezvs, 1 2th October, 191 1). 
 
 Now we come to Mr. Roosevelt : — 
 
 " Even more important than ability to work, even more 
 important than ability to fight at need, is it to remember that 
 
Morality 85 
 
 the chief of blessings for any nations is that it shall leave its 
 seed to inherit the land. The greatest of all curses is the 
 curse of sterihty, and the severest of all condemnations 
 should be that visited upon wilful sterihty. The first 
 essential in any civilisation is that the man and the woman 
 shall be the father and mother of healthy children, so that 
 the race shall increase and not decrease." (Lecture at the 
 Sorbonne, April, 1910, quoted by the Daily Chronicle of 
 April 25th, 1 910.) 
 
 As a matter of fact, however, few people seem to have 
 committed themselves to a definite assertion that the morals 
 of the nation are really deteriorating, although it is fre- 
 quently insinuated that the limitation of births must 
 certainly be causing them to do so. Here, for example, is 
 a recent utterance from Canon J. W. Horsley's just pub- 
 lished work, Hozv Criminals are Made and Prevented : — 
 
 " Infecundity is the symptom and the cause of a decom- 
 posing Society. The violation of Nature's laws and the 
 prostration of Nature's ends must always create their own 
 Nemesis, and that not merely in the region of economics, 
 but in that of general morality ; for as Professor Nitz says, 
 ' when pleasure is desired and sought for its own sake, 
 without the responsibility and consequence of having 
 children, matrimony loses its entire purpose, and becomes 
 nothing else than a form of monogamic prostitution.' 
 
 Honour be to fecund marriages, honour to virtuous 
 celibacy, but dishonour to all else. Not a word is to be said 
 against child restriction, when necessary, by conjugal 
 prudence, moral restraint, and self-denial in things lawful, 
 as advocated by Malthus ; but nothing is more dishonest 
 than the claim of his authority by neo-Malthusianism or the 
 Malthusian League. As Professor Flint says, ' Malthus 
 would have disowned with horror the Malthusian League,' 
 which has advocated and promoted with appalhng success 
 child restriction by genetic frauds, family suicide leading to 
 racial decay. Marriages in the upper and middle classes 
 are now made to be so sterile that quite an undue and dan- 
 gerous proportion of the rising generation is formed of the 
 lower and more ignorant population. Three crimes are 
 common and increasing — the destruction of the seed, of 
 
86 The Small Family System 
 
 the unborn, and of the body. They only vary in accident ; 
 the criminal motive is the same. The disastrous effects to 
 the race, to morahty, and commonly to the health of the 
 woman are the same. Nor can anyone pretend that in 
 teaching the way of child-prevention he or she is not also 
 making seduction easy by depriving it of the salutary fear 
 of consequences." 
 
 And yet, after showing what a moral decline these prac- 
 tices must " inevitably " lead to, Canon Horsley has a 
 chapter, in the same book, entitled "Are We Improving?" 
 in which he confesses himself an optimist, and goes on as 
 follows : — 
 
 " An improvement in general morality as regards its 
 outward manifestation seems to me obvious. It must have 
 been some twenty years ago when I heard a venerable man, 
 Mr. Scott, the City Chamberlain, contrast the sights and 
 the language of the streets at that time with what he remem- 
 bered when younger, and he found reason to thank God for 
 the great improvement. After twenty years I take up that 
 parable again. Vice is to be found in the streets^ if you 
 search for it and know where to search ; but it is not 
 flaunted in our main thoroughfares and outside our railway 
 stations as it used to be. Music halls are improved out of all 
 knowledge, partly through the pressure of public opinion 
 exercised through the L.C.C., and while the humour of most 
 comic songs is such as to make the lover of literature, or 
 even of sanity, to groan, it is no longer demonstrative or 
 suggestive of foulness. . . . 
 
 " And certainly the common language of the street is 
 another tongue compared with that of thirty years ago. 
 Oaths and obscenity are now the effervescence of drunken 
 quarrels rather than the Homeric epithets of normal speech. 
 
 " I can well remember too, when houses of ill-fame were 
 thick in some streets in all boroughs, and the most persistent 
 energy on the part of the Vigilance Society or of individuals 
 (like my friend Canon Jephson in Lambeth) was necessary 
 to induce Borough Councils to take reluctant action. Now, 
 however, neither police nor civil bodies require urging from 
 outside, and other boroughs besides my own are insistent in 
 pressing magistrates to imprison brothel -keepers instead 
 
Morality 87 
 
 of giving an ineffective fine, which used, at any rate, to be 
 paid by an association of such folk," 
 
 Meanwhile the birth-rate goes on dechning, and the 
 middle classes, who are foremost in the matter of family 
 hmitation, are also foremost in the efforts to bring about 
 these reforms ! 
 
 It would, of course, be easy to call up a fairly strong array 
 of opinion in favour of an advance in pubhc morahty, but 
 it is not now proposed to do so, as we prefer to deal with 
 facts. The above quotations have only been given in order 
 to do full justice to the opponents of family hmitation. But 
 we cannot resist giving a few quotations from another part 
 of the work of Dr. Bertillon, who appears to be alone among 
 the opponents of family hmitation in showing any capacity 
 for collecting and assimilating real evidence. He gives us 
 some particulars of a few cantons in France with high and 
 low birth-rates. At Fouesnant in Brittany, where the 
 birth-rate is extremely high, he informs us that the children 
 are brought up in mud huts with the pigs, while the people 
 can hardly write their own names. At Lillebonne on the 
 Seine, an industrial canton, where the birth-rate has risen 
 to 37 or 38 per 1,000 (higher than in almost any part of 
 Great Britain, and equal to that figure which Father 
 Bernard Vaughan so extols), the death-rate has not only 
 increased to an equal extent and the infantile mortahty 
 enormously, but Dr. Bertillon mentions that while in the 
 days of the low birth-rate they were careful and honest they 
 are now careless concerning the future, live on credit, and 
 that :— 
 
 " Several of them consume daily at the cabaret, or more 
 frequently at home with their wives and families, enormous 
 quantities of alcohol. It may sometimes happen that, 
 retiring in a state of intense drunkenness, they engender 
 nothing except for the cemetery. But what is certainly 
 frequent, is that semi-intoxication combined with fatigue, 
 inspires them with a profound indifference concerning the 
 
88 The Small Family System 
 
 responsibilities of the family which they produce, or rather 
 renders them totally incapable of caring for it." 
 
 So that, according to such a denunciator of the falling 
 birth-rate as Dr. Bertillon, the moral evils wliich are ascribed 
 to France as a consequence of family limitation are shown to 
 the most extreme degree among those who do not practise 
 it. Now let us hear him concerning an industrial canton of 
 low birth-rate, Conde sur Noireau. The people are " clean, 
 honest, polite, economical, and peaceable," they save and 
 they read a great deal. " Cases of drunkennness are not very 
 rare, but chronic alcohohsm is." ..." They do not kill, 
 they do not steal, they do not commit adultery — at least 
 to the extent of being certain that there shall be no conse- 
 quences — they do not squander their money, they do not 
 resist the authorities, they insult no one, they never have 
 revolts or nocturnal brawls, but they also very rarely have 
 illegitimate children, they marry late or remain celibate, 
 and only have too few legitimate children." He also speaks 
 of their simple and healthy food in contradistinction to the 
 unwholesome food of the inhabitants of Lillebonne. 
 
 Elsewhere in the same volume Dr. Bertillon quotes from 
 the well-known writer, M. Arsene Dumont, concerning the 
 inhabitants of the French islands of Re and Oleron. 
 
 " Their only passions are very innocent ; they are reading 
 and dancing. The dancing, always decent, is the prepara- 
 tion for marriage ; illegitimate births are very rare. One 
 could not imagine manners more pleasant or more honour- 
 able. Nevertheless the birth-rate in these islands is among 
 the lowest. It is because everyone there is more or less of a 
 proprietor. Each person has some property to protect ; 
 each is ambitious for his children." 
 
 It must not be supposed that these passages have been 
 abstracted from Dr. Bertillon's book to show one side of the 
 case. They are perfectly representative of the evidence he 
 gives. That he himself would admit this, is shown by the 
 fact that he deplores all these evidences of prudence, and 
 
. Morality 89 
 
 expresses great pleasure at the reckless disregard of the 
 future which leads to the " admirable " high birth-rates. 
 
 It has become the fashion to speak of the depravity of 
 France, of her alcoholism, of her disregard for law and order, 
 and of her terrible cri?nes passionels, and to ascribe them 
 to the falHng birth-rate. If this were the case it is obvious 
 that these evils would be most intense where the process 
 had gone furthest, i.e., in the cantons of lowest birth-rate. 
 But v/e have the authority of Dr. Bertillon himself to show 
 us that it is just these cantons in which the greatest moral 
 improvement has taken place ; and that where the French 
 have obeyed the Church's command to increase and multi- 
 ply, there alcoholism and crime abound. If we can judge 
 from Dr. Bertillon's own evidence, France might escape 
 from all these evils, not by avoiding the sin of family 
 limitation, but by adopting it more universally. 
 
 The pictures given by Dr. Bertillon himself of the results 
 of family limitation appear to be in striking contrast to those 
 we would have expected from his comparisons with the 
 dechne of Rome. Are the hardworking, self-reHant, prudent 
 and temperate peasants of those cantons of France where 
 family hmitation is most practised, comparable with the 
 lazy, sullen, pauperised proletariat of Rome, dependant for 
 their Hving on the bounty given them by their masters and 
 wrested from others by war, and kept from rebeUion by the 
 panem et circenses distributed by their rulers ? 
 
 So convinced indeed is Dr. Bertillon that prudence, 
 sobriety and education go with a low birth-rate, that he 
 actually proposes legislation calculated to encourage irres- 
 ponsibility, such as complete liberty of disinheriting some 
 children for the benefit of others, so that large families would 
 not involve the division of property as they do at present. 
 This will hardly commend his advocacy of large famihes to 
 lovers of justice. 
 
 We may now leave the realm of asseition and come to 
 
go The Small Family System 
 
 those of fact. The term " morahty " is, unfortunately, 
 very loosely employed, some people using it in its larger 
 sense of the general conduct in relation to the welfare of the 
 community, while others restrict it to the very narrow sense 
 of the relationship of the sexes. We must, of course, take 
 the larger view here, although, as the question of family 
 limitation is so intimately connected with marriage and sex 
 relationship in general, we shall lay stress on sex morahty. 
 The most important items concerning general morality are 
 those of crime, alcohohsm and pauperism. ; while as regards 
 sex morality we have to consider divorce, prostitution, ille- 
 gitimacy, and venereal disease. 
 
 Crime. — In dealing with the question of crime, it must be 
 remembered that this is a matter of law, and that the 
 addition of new laws to the Statutue Book or the repeal of 
 old ones may make a considerable difference.* The tendency 
 of modern times is also certainly to reduce the severity of 
 punishment. The best indication therefore appears to be 
 the number of convictions, apart from the punishment 
 awarded. Tested by this the moral progress of our own 
 country is most satisfactory. According to Mulhall's 
 Dictionary of Statistics^ the number of convictions per 
 million of the population has steadily fallen from 1,280 in the 
 decade 1841-50 to 299 in 1896, and it seems to have dropped 
 continuously since that time. The Report of the Commis- 
 sioners of Prisons issued in 191 1 says that the total number 
 of offences fell from 152,511 in 1900 to 141,555 in 1909, 
 despite the increase of population, while " in the year ending 
 31st March, 191 2, the ratio of the prison population to the 
 general public reached the lowest point within statistical 
 record." 
 
 Here is an extract from the Commissioners' Report : — 
 " It is a matter for satisfaction that, in a year marked by 
 
 * The amount of crime, in fact, in a progressive community represents 
 the difference between the progress of its laws and that of its actions. 
 
Morality gi 
 
 so much social unrest, and in some places by disorder, fewer 
 persons should come to prison relatively to population than 
 in any year on record. The low prison population was 
 maintained throughout the year, the daily average in local 
 prisons being over i,ooo less than for the preceding year."* 
 
 They also call attention to a considerable diminution in 
 Juvenile Crime, the convictions of male offenders between i6 
 and 21 having dropped from 18,000 to 8,000 in the past 20 
 years, and those of females from 4,000 to less than 1,000 in 
 the same period. 
 
 Beyond the statistical evidence there has also been a most 
 remarkable increase of the number of occasions on which 
 white gloves have been handed to the judges on circuit. 
 And after occasions of public rejoicings, such as the Corona- 
 tion Festivities or the Bank Holiday celebrations, the press 
 have informed us that the number of police court cases has 
 been surprisingly small. There seems to be no doubt that, 
 on the whole, respect for law and order is increasing in 
 England at a very rapid rate ; and although this improve- 
 ment certainly started long before the dechne of the birth- 
 rate set in, all that concerns us is that it has been maintained 
 during the whole of the decline. 
 
 Reference may also be made to AustraHa as having had 
 the most rapid fall in the birth-rate of any country — fiom 
 35 to 26 per 1,000 between 1889 and 1908. According to the 
 Official Handbook for Australia, the convictions decreased 
 from 69 to 26 per 10,000 for the population from 1881 to 
 1908, or to a little more than one-thiid of its previous value. 
 
 In face of these two examples it is idle to pretend that 
 family limitation predisposes to criminahty, even if we 
 admit (though there is strong reason to doubt it) that crime 
 has increased in France in recent years. According to the 
 French Annuaire Statistique for 19 10, the number of con- 
 victions at the Assize Courts has steadily fallen from 3,900 
 
 * Daily News Tear Book, 191 3, p. 233. 
 
92 The Small Family System 
 
 per annum in the quinquennium 1 873-77 to 2, 1 80 per annum 
 in the year 1908-9, while the population increased from 
 36.6 millions to 39.4 millions. The convictions per million 
 of population have thus fallen from 106 to 55.5 per million, 
 or to little more than half. Before the correctional tribunals 
 they have increased from 5,050 per million in 1873-7 to 
 5,750 per miUion in 1893-7, but have fallen since to 5,150 
 in 1908-9. 
 
 Of course we are always hearing of the extreme leniency 
 of the French courts and juries. But there has been a 
 decided tendency to greater severity of late years, and yet 
 the convictions are decreasing. In any case, family 
 restriction commenced so long ago in France that it is no 
 longer very rapidly extending ; and apart from this. Dr. 
 Bertillon's examples show that crime and other evils are 
 associated with large famiHes rather than with small ones. 
 On the whole it may be confidently decided that family 
 restriction has not in any way tended to increase the 
 criminahty of the people. 
 
 Alcoholism. — It hardly needs statistical evidence, as far 
 as our own country is concerned, to show the improvement 
 which has taken place in this matter. The immense strides 
 which temperance and total abstinence have made of late 
 years are surely patent to all. When we see half the guests 
 at a public banquet to-day drinking mineral waters, while 
 our grandfathers were proud of being " three bottle men," 
 hardly any further evidence is needed. In fact statistics are 
 of very Httle use here, as cases of drunkenness are now 
 severely dealt with which would have been looked upon as 
 amiable weaknesses a generation ago. Even so, the convic- 
 tions for drunkenness seem to be steadily on the decrease. 
 As regards the consumption of alcohol per head, the figures 
 show a fall in the consumption of spirits from 1.23 gallons 
 per head in 1876 to .8 gallon per head in 1909. The consump- 
 tion of beer showed an increase from 27.6 gallons in 1881 to 
 
Morality g^ 
 
 33 gallons in 1898, the eve of the South African War, but 
 it has since rapidly dropped to 26 gallons. On the other 
 hand, deaths from alcoholism rapidly increased from 39 to 
 III per milHon from 1870 to 1900, but they have since 
 fallen extremely rapidly to 43 per milHon in 1909. It is 
 clear that there is httle relation between this phenomenon 
 and the decline of the birth-rate. Indeed it is a somewhat 
 curious reflection that the maximum consumption of spirits 
 and beer, as well as the increased number of deaths from 
 alcoholism, seem to have been evoked, not by the falHng 
 birth-rate, but by the very wave of imperiahsm and patriot- 
 ism called forth by the South African War. 
 
 It has often been stated that the consumption of alcohol 
 in France is increasing. It is certainly true that it is now 
 higher than it was thirty-five years ago. But the official 
 figures given in the Annuaire Statistique for 19 10 show that 
 the consumption of alcohol in drink has steadily fallen from 
 4.2 Htres per head in the quinquennium 1888-92 to 3.48 
 Htres in 1908-9. The fall has recently been practically as 
 rapid as in Great Britain. According to Dr. Bertillon him- 
 self, alcoholism in France is specially great among the 
 parents of numerous children ; and he agrees that this is a 
 most serious factor in infantile mortaHty and degeneration. 
 It is somewhat remarkable that when we are told that family 
 limitation is due to selfishness and love of luxury, we find 
 that it is the fathers of large families who indulge in excess 
 of alcohol, while the fathers of small families frequently live 
 the simplest and most abstemious lives. 
 
 As Dr. Bertillon says : — 
 
 " The alcohohc persons most often have very many 
 children. I take this statement from a great number of 
 doctors whom I have questioned on the birth-rate ; those 
 of the Orne, a department where the drunkards are numer- 
 ous, have affirmed it strongly. This may be understood ; 
 it is through excess of prudence that the French do not have 
 children ; but the drunkards are the least prudent of men." 
 
94 The Small Family System 
 
 Of course there are those who will not regard the con- 
 sumption of alcohol as having much to do with moraHty ; 
 and there are no doubt many who will consider that if 
 drunkenness leads to the sublime imprevoyance (to use 
 Zola's phrase) of casting children on the world without 
 consideration, it should be regarded as a virtue. But this 
 view will hardly commend itself to the majority ; and quite 
 apart from any ordinary views as to the morality or other- 
 wise of drinking, it appears to be established that any great 
 consumption of spirits has a most seriously deleterious effect 
 upon the quality of offspring, by poisoning the parental 
 germ plasm. 
 
 Pauperism. — We need not dwell upon this question, as the 
 amount of pauperism depends upon a large variety of cii- 
 cumstances. But it is satisfactory to note that pauperism 
 in England and Wales, i.e., the number of persons relieved 
 annually per thousand of the population, has fairly steadily 
 fallen from 34.5 in 1875 to 26.4 in 1910, or by 23.5 per cent, 
 during the period of the declining birth-rate. This is so far 
 reassuring, in that it indicates that the easier circumstances 
 engendered by smaller families do not lead to idleness, as is 
 frequently contended. The industry and saving habits of 
 the French peasantry are world-renowned, and it is worthy 
 of note that France is almost the only country in which the 
 real wages of the working classes have been increasing of 
 late years, while they have dropped 15 per cent, in this 
 country, and nearly 25 per cent, in prolific Germany. 
 
 Sex Morality. — We now come to the great question of sex 
 moraHty, and it is here that the denunciations are strongest, 
 and here also that it is most difficult to obtain reliable 
 evidence. The contention of the orthodox moralists is that 
 the general knowledge of preventive methods tends to relax 
 chastity in the unmarried, and that it lowers the standard 
 of married life into one of legalised prostitution — thus 
 tending to a lower respect for the marriage tie and to increase 
 
Morality g^ 
 
 of divorce ; and also that the mistakes made from careless- 
 ness in prevention lead to a greater frequency of abortion. 
 
 Such statements are very easily made, but not so easily 
 
 either confirmed or disproved. Before taking such statistical 
 
 evidence as is available, however, we should like to 
 
 ask those who make such assertions whether they have ever 
 
 paused a moment to compare (as Canon Horsley has done, 
 
 see p. 86) the general standard of morals of to-day with that 
 
 of thirty-five years or more ago ? The present writer does 
 
 not claim to have a great deal of worldly experience, but 
 
 everything he has ever read or heard shows most strongly 
 
 that the code of sexual ethics a generation or two ago, 
 
 though more rigid in name, was far less so in fact than that 
 
 of our own times. It is a common mistake to suppose that 
 
 because sex questions and evils are now openly recognised 
 
 and discussed by both men and women, there are more of 
 
 these evils than in the days when such things were never 
 
 mentioned. Persons who take this view forget the famous 
 
 dictum of John Stuart Mill that " the diseases of society can 
 
 no more than corporeal maladies be cured without being 
 
 discussed in plain language " ; and theie are many who see 
 
 in these discussions a much higher degree of purity than in 
 
 the silence or innuendo of former times. Anyone who 
 
 contrasts the after-dinner speech at a banquet to-day with 
 
 that of even ten years ago will be forced to recognise that 
 
 women are being held in increasing instead of decreasing 
 
 respect, whatever Father Bernard Vaughan may say to the 
 
 contrary. Where are women, and especially mothers, held 
 
 in such esLcem as in France and New England, where the 
 
 birth-rate is lowest ? And when we see young men and 
 
 women thrown into continual contact in all professions and 
 
 industries, and observe their demeanour towards each other, 
 
 will anyone seriously contend that there is really a greater 
 
 degree of laxity in the relations of the sexes than in former 
 
 times ? If Father Vaughan, President Roosevelt, and other 
 
96 The Small Family System 
 
 denunciators would turn their eyes from the " 
 to the plain hard-working middle classes (where, be it 
 noted, the fall of the birth-rate has been most marked) it 
 would be impossible for them to talk as they have done. 
 Family limitation may possibly have bred a love of ease 
 and luxury, but it most certainly has not relaxed chastity 
 in the unmarried, or decreased respect for womanhood. 
 
 Divorce. — It is here that the orthodox moralists have their 
 strongest case, if not against family limitation in particular, 
 at any rate against the tendencies of the times in general. 
 Divorce is assuredly increasing in this and most other 
 countries at a fairly considerable rate. Between the period 
 1876-80, just after the decline of the birth-rate set in, and 
 the year 1909, divorces had increased from 22.1 to 41.5 per 
 million of the population, or had practically doubled in 
 frequency.* But it remained practically stationary during 
 the fifteen years from 1881 to 1895, although the birth-rate 
 was falling rapidly during the whole of that time. Since then 
 however, divorce has rapidly become more common, and 
 the same tendency is observable in practically all countries, 
 even in Belgium, where the Roman Catholic Church still has 
 a strong hold. 
 
 Those, therefore, who cling to the indissolubility of 
 marriage, are justified in regarding the tendencies of modern' 
 times as decidedly in the wrong direction, and they are 
 probably so far correct in coupHng it with the spYfead of 
 family limitation, that both these phenomena are due to the 
 modern inclination to look at social questions rather from 
 the point of view of earthly happiness than from that of 
 ecclesiastical dogma. This is clearly shown by the recent 
 majority report of the Divorce Law Commission. There is a 
 large and increasing body of men and women to-day who 
 
 * Dr. Bertillon does not recognise any relation between divorce and 
 the birth-rate, and points out that in Saxony, where the birth-rate is still 
 extremely high (about 40 per 1,000), divorce is very frequent. 
 
Morality 97 
 
 regard the spectacle of a refined and delicate woman tied to 
 a brutal or unfaithful husband and condemned to bear 
 weakly or diseased children, as infinitely more immoral than 
 greater ease of divorce. In New Zealand, for example, the 
 electoral power of the women has led to the estabhshment 
 of the equality of divorce between the sexes, and a large 
 increase of divorce has taken place as a consequence. But 
 those who deplore this as immoral must have an extra- 
 ordinary idea of the real interests of the human race. 
 
 The matter may be left for settlement between the ad- 
 vocates and opponents of easy divorce. One other impor- 
 tant matter, however, should be referred to here. In the 
 Judicial Statistics for 1909, Sir John Donnell mentioned that 
 the greatest proportion of divorces took place among 
 couples with no children, and that they were less in pro- 
 portion as the families grew larger. Many newspapers have 
 seized upon this as indicating the demorahsing effects of 
 family restriction. But childlessness is not only the result 
 of restriction. It is frequently the result of the diseases 
 caused by an irregular life before marriage. It would be 
 surprising, therefore, if a large number of divorces did not 
 take place among childless couples, for very few married 
 people voluntarily remain without any children at all. 
 Similarly, the restriction of famihes no doubt sometimes 
 takes place on account of want of affection, or of later 
 irregularities. And lastly, there is no doubt that a woman 
 who has borne a numerous family is often bound, by want of 
 means and by her maternal feelings, to endure a bondage 
 which she would otherwise have broken for her own advan- 
 tage and that of her posterity. Those who deHght in the 
 picture thus indicated, are welcome to their disapproval of 
 the modern tendencies. 
 
 Illegitimacy. — As far as statistics are concerned, the most 
 valuable evidence is that relating to illegitimacy. The 
 Registrar General's Reports contain a useful amount of 
 
98 The Small Family System 
 
 ENGLAND AND WALES. information upon this 
 Fertility and Illegitimacy. Fig. 13. point, and give us the 
 
 number of illegitimate 
 births per thousand un- 
 married women within 
 the fertile period, be- 
 tween the ages of 15 and 
 45. This illegitimacy 
 rate for England and 
 Wales is represented in 
 Fig. 13, and it is notice- 
 able that the fall since 
 the year I 876 has been 
 extremely rapid, much 
 more so in fact than that 
 of the fall in the general 
 birth-rate or in the fer- 
 tihty rate of the married 
 women. While the gen- 
 eral birth-rate has fallen 
 from 36.3 to 25.6 (or by 
 26.5 per cent), the ille- 
 gitimate birth-rate has 
 fallen from 14.6 to 7.9 
 per thousand unmarried 
 women (or by nearly 50 
 per cent.). This is most 
 striking and satisfactory. 
 An extreme instance is 
 
 ifVtf G£M /r£/^£T. 4fOf.y^ //s^ 
 
 given in the county of Radnorshire, which in 1870-2 had a 
 fertihty rate of 308.6 births per 1,000 married women, which 
 sank to 188.7 ^^ 1909, or by 39 per cent. In the same 
 interval the illegitimate birth-rate fell from 41.8 per 1,000 
 unmarried women to 7.2, or by no less than 83 per cent. In 
 Holland a drop of the legitimate fertihty from 347 to 315 per 
 
Morality gg 
 
 1,000 coincided with a fall of the illegitimate fertihty from 9.7 
 to 6.8 per 1,000, i.e.^ at a much greater rate. It is true that 
 France, with its low and decreasing fertihty rate (from 196 
 to 158 per 1,000 between 1881 and 1901), has had a com- 
 paratively high and increasing illegitimacy rate (from 17.6 
 to 19. 1 per 1,000) ; and that Ireland, with a somewhat 
 high and sHghtly increasing fertihty (from 283 to 289 per 
 1,000), has the lowest and a falhng illegitimacy rate (from 
 4.4. to 3.8 per 1,000). But this has been heavily outweighed 
 by Austria with an equally liigh and steady fertihty (from 
 281 to 284 per 1,000) with the highest illegitimacy rate 
 known (43.4 to 40.1 per 1,000), while Germany comes 
 second with an illegitimacy rate of 27.4 per 1,000 in 1901. 
 Though it cannot be said, therefore, that the lowest birth- 
 rate produces the lowest illegitimacy rate, it most certainly 
 cannot be said that family limitation has had any evil effect 
 in increasing illegitimacy. The bulk of the evidence is quite 
 decidedly the other way. In the case of the most notable 
 exception — that of France — we have the authority of Dr. 
 Bertillon for saying that the greatest decency and lowest 
 illegitimacy are found where the birth-rate is lowest. We 
 may also quote from our own Registrar General, who said 
 in his Annual Report for 1909 : — 
 
 " Except in the cases of the German Empire, Sweden, 
 France, Belgium, and the Australian Commonwealth, the 
 falls shown in illegitimate fertihty in Table LXXXIV are 
 greater than the corresponding falls in legitimate fertility." 
 
 So far as the evidence of illegitimacy is concerned, there- 
 fore, it may be taken as definitely established that the 
 adoption of family restriction has not led to greater laxity 
 among the unmarried. But it would, of course, be quite 
 unjustifiable to claim that this evidence is final. It may not 
 mean that there is less lax conduct but only that there are 
 fewer results of lax conduct. It is perfectly open for the 
 orthodox moralist to claim that the greater knowledge of 
 
loo The Small Family System 
 
 preventive methods has permitted an increase of laxity with 
 a reduction of the ordinary effects. Thus must remain a 
 matter of conjecture. When we find, however, that not only 
 has illegitimacy decreased, but also deaths from abortion 
 and from the diseases ordinarily associated with irregularity, 
 there seems no justification whatever for the contention that 
 chastity has been relaxed. It must not be forgotten in this 
 connection that the encouragement to early marriage 
 afforded by the possibility of avoiding the economic burden 
 of a too early or too large family affords the most likely of all 
 methods for removing the temptations to unchastity and 
 for conquering the hitherto untractable " social evil." 
 Although the average age of marriage in this country has 
 been rising somewhat lately (probably on account of the 
 increasing cost of Hving), it is interesting to note that it is 
 lower and fairly steadily decreasing in France. For first 
 marriages the average age at marriage of French men has 
 fallen from 28.6 in 1856 to 27.88 in 1896-1900, and of French 
 women from 24.25 to 23.5 in the same period.* This cannot 
 be regarded as otherwise than a very good sign. 
 
 Disease. — We have just referred, in connection with the 
 question of illegitimacy, to the diseases associated with 
 unchastity. This is not only an unpleasant subject to deal 
 with but a most unsatisfactory one, as the evidence con- 
 cerning it is of a most conflicting character. It appears 
 necessary here to give a warning concerning some of the 
 so-called evidence as to the prevalence of such diseases. 
 The bulk of the statistics on tliis point are gathered from 
 the Army, where inspections are made from time to time, 
 and where, by altering the frequency of the inspections, the 
 number of cases may be apparently increased or diminished 
 at will. Those who have studied the question of the Con- 
 tagious Diseases Acts well know that there has been a most 
 determined and persistent attempt on the part of some 
 
 * Dr. J. Bertillon, Depopulation de la France, 
 
Morality loi 
 
 Army authorities to revive these Acts. To show justifica- 
 tion for this effort they have constantly attempted to repre- 
 sent these diseases as increasing, and it has been stated that 
 this has been done by increasing the frequency of inspection. 
 
 We cannot therefore rely upon evidence based on the 
 number of cases of disease, but only on the number of deaths. 
 Of course this is open to the objection in the other direction, 
 that improved medical knowledge may have reduced death 
 while the cause has remained unchecked. It may be 
 questioned, however, whether during the last twenty years 
 any striking improvement in the treatment occurred, 
 except, perhaps, the introduction of Salvarsan in 191 1.* 
 But according to the Registrar-General's Report for 1910 
 the death-rate for the principal venereal disease steadily fell 
 from 71 per miUion in 1890 to 46 per milhon in 1910. If this 
 is an indication of the frequency of the disease, it is a com- 
 plete refutation of the charge of increased laxity ; and it is 
 a very decided rebuke to the assertions of Mr. Beale. At any 
 rate the onus of proof most certainly Hes with those who 
 assert the increase of unchastity. ^ 
 
 Another thing of great importance in this connection is 
 the frequency of abortion or miscarriage. It will be remem- 
 bered that traducers of family limitation, such as Dr. J. W. 
 Taylor, have sought to associate prevention with abortion 
 and to imply that an increase of the one means an increase 
 of the other. On the other hand, both economic considera- 
 tions and medical evidence, such as that of the Hungarian 
 Medical Senate, indicate that prevention and abortion are 
 really alternatives ; that women will seek to avoid the 
 burden of excessive famihes, and that an extension of 
 preventive methods should therefore lead to a reduction of 
 abortion. But we have no figures as to the actual extent of 
 
 * In Germany an Immense reduction of these diseases has been effected 
 by instruction in prophylactic methods, but such methods are practically 
 unknown in this country. 
 
I02 The Small Family System 
 
 abortion, and our own authorities have only just begun to 
 •enumerate the still births, which would have given some 
 clue. The Registrar-General, however, does give us the 
 number of deaths from abortion and miscarriage. They have 
 fallen from 9 per million in 1892 to only 2 per million in 
 1910. It seems hardly likely that medical treatment im- 
 proved to such an extent in the interval, so the natural 
 presumption again is that the frequency of abortion has 
 diminished. 
 
 It would be a difficult and wearisome task to pursue this, 
 investigation throughout other countries, although it ought 
 to be done by some competent authority. But enough has 
 been said here to show that the immense preponderance of 
 evidence-is against the detractors of family Hmitation, and 
 that we have a right to expect more definite evidence from 
 them before we need to investigate more deeply. 
 
 Since this was written the author has come across a 
 pamphlet entitled Preventive Hygiene, pubhshed by John 
 Bale & Sons, in which it is clearly shown, by diagrams pre- 
 pared from figures suppHed by the Registrar-General and 
 Army Medical reports, that the prevalence of venereal 
 diseases in both the civil and miHtary population has been 
 rapidly decreasing from 1884 to 1910. 
 
CHAPTER VII 
 
 GENERAL CONCLUSIONS 
 
 OUR enquiry has now been carried out sufficiently, and 
 it may be well to summarise briefly the conclusions we 
 have arrived at. They are as follows : — 
 
 I. Both opinion and statistics go to show that Hmitation 
 of families is practically universal among educated married 
 persons at the present day, and that this is due to " arti- 
 ficial restriction " rather than to " moral restraint." 
 
 II. On collecting the evidence as to the hygiene and 
 morahty of such " artificial restriction " we find : — 
 
 {a) As to opinion. Both medical and clerical opinion in 
 this and other countries was most strongly condemnatory of 
 such restrictions a few years ago, although there were 
 isolated opinions to the contrary. Smce that time, although 
 the prevalence of artificial restriction has meanwhile enor- 
 mously increased, the adverse opinions have diminished- in 
 number and intensity. Many eminent medical authorities 
 have testified to the harmlessness of such restriction, and 
 the Official Judgment of the Hungarian National Senate for 
 Social Hygiene, as well as the addresses of the Presidents of 
 the British and American Medical Associations, have shown 
 a decided justification for i't. Clerical opinion, though still 
 hostile as a whole, is markedly less so than formerly. In 
 fact we find a Council of Public Morals, comprising an Arch- 
 bishop, ten Bishops, 26 Reverend Deans, Canons and other 
 clerical gentlemen, and one Cardinal, publishing books in 
 which the lalHng birth-rate is defended by men who have 
 publicly endorsed neo-Malthusian methods. 
 
 {b) As to conduct. The enquiry made for the National 
 Life Assurance Society in 1874, just before the Knowlton 
 
 103 
 
1 04 The Small Family System 
 
 Trial which led to the decline of the birth-rate, showed that 
 both medical men and clergy had families which were as 
 large as the average of the whole community. The small 
 famihes of the medical profession to-day, as well as of many 
 of the clcxgy, show that family restriction has been widely 
 adopted by them. There is no question as regards medical 
 men that this has been carried out by artificial means. As 
 regards the clergy it is probable that a " moral restraint " 
 has been adopted by a few ; but there can be no doubt that 
 a large number have also adopted artificial restriction. 
 
 (c) As to the Health and MoraHty of the Community. 
 The Vital Statistics of various countries show most con- 
 clusively that the national health has rapidly improved as 
 the birth-rate has decHned, and that in all probabihty the 
 death-rate would not have decHned without a diminution 
 of the birth-rate. Wherever the birth-rate has remained 
 stationary or has risen, all the advances of medicine and 
 hygiene have failed to diminish the death-rate or to keep it 
 from rising. The most satisfactory improvement in the 
 general death-rate, the infantile mortahty and the stature 
 of the people of any country in the world has been shown in 
 Holland, where alone " artificial restriction " has been 
 countenanced by the State, and taught to the poorer classes 
 with medical co-operation and supervision. 
 
 With regard to specific diseases, there has been a satis- 
 factory diminution in all important ones, except in cancer, 
 which has increased. An analysis of the organs aflPected, 
 however, fails to show any connection between this increase 
 and the adoption of artificial restriction ; while in women, 
 who have been threatened with such terrible consequences, 
 cancer of the generative system actually appears to be on 
 the decrease. 
 
 Finally, the morahty of the Community, so far as can be 
 judged from crime, alcoholism, pauperism, illegitimacy and 
 venereal disease, appears to be most decidedly improving. 
 
General Conclusions 105 
 
 Even in France, where we hear so much of moral decadence, 
 the evidence by no means justifies this view, and the state- 
 ments of the strongest opponents of restriction show that 
 such evils exist most among those who do not Hmit their 
 famihes, and very httle among those who do. 
 
 In view of all these investigations, it is impossible to 
 avoid the conclusion that the case against artificial re- 
 striction is certainly not made out. In fact the great bulk of 
 the evidence is most remarkably in favour of the hygiene of 
 the practice, and of there being no moral objection to it. 
 Such a conclusion will doubtless be indignantly repelled by 
 moraHsts of the old school. It is possible, of course, that 
 there may be better evidence on their side than they have 
 yet brought forward. Meanwhile, having carefully read 
 every hostile criticism of any importance, and having sought 
 to do the fullest justice to it, we feel strongly that until this 
 new and satisfactory evidence is forthcoming, every rational 
 person must conclude, not only that " the artificial sterili- 
 sation of matrimony is the most revolutionary discovery of 
 the nineteenth century," as Mr. Bernard Shaw has said, 
 but also that it is the most beneficial of modern discoveries 
 for the well-being of the community. 
 
CHAPTER VIII 
 
 FAMILY LIMITATION AND SOCIAL REFORM 
 
 THE preceding chapter has terminated our enquiry as to 
 the permissibiHty or otherwise of family restriction. 
 But those who have any interest in social questions will 
 hardly fail to see that this one has the most intimate relation 
 to almost every other question of economic or racial im- 
 provement. We may, therefore, fitly conclude our book by 
 briefly indicating a few of the more important consequences 
 of admitting the justification of artificial restriction. 
 
 Few people have not heard at one time or another of the 
 doctrine of Malthus — that unchecked human fertihty causes 
 population rapidly to catch up with food supply and then 
 continually to press against it, thus leading to poverty, 
 famine, disease, and -^Gax- Economists of the highest standing, 
 such as John Stuart Mill, have accepted this doctrine as 
 unanswerable. It is only of recent years — since the decline 
 of the birth-rate has set in, since the improved means of 
 transport have brought food from abroad, and since the 
 iSocialists have claimed that under their regime plenty could 
 •be produced for all — that it has suffered a temporary eclipse. 
 Yet during this period the accumulating vital statistics 
 of various countries have been proclaiming the truth of 
 Malthus' law, and that improvement in social conditions, as 
 evidenced by the death-rate, has only been rendered possible 
 by the reduction of the birth-rate. Within the last few years, 
 too, the rapidly increasing cost of Hving has made many 
 people recognise that the temporary respite granted by a 
 larger area of food supply has been checked by the great 
 increase of population in the United States and elsewhere, 
 and that the law of Malthus has again to be admitted and 
 
 io6 
 
Family Limitation and Social Reform 107 
 
 reckoned with. The very strong pronouncement of a 
 churchman Hke the Dean of St. Paul's shows that the 
 question presents itself as a most serious one to some, at 
 least, of our leaders of thought. It is not proposed to go into 
 the evidence here which shows most conclusively that over- 
 population {i.e., the pressure of too high a birth-rate against 
 the necessities of life) does exist, and is the chief factor in 
 the social evils of to-day. But it is sufficient for anyone to 
 look at the progress of the birth and death-rates in Fig. i to 
 see that by reducing the birth-rate to 20 per 1,000 we may 
 reduce our death-rate to 10 per 1,000 — the value found in 
 New Zealand and Austraha, where poverty and misery as 
 we know them hardly exist. 
 
 Again, apart from questions of quantity, everyone knows 
 that a most serious question to-day is the high birth-rate 
 among the least desirable classes of the community — the 
 indigent, the unemployable, the reckless, the drunken, and 
 the mentally and physically deficient. On this account 
 many Eugenists, especially in Germany, have been calHng 
 out for the educated and successful classes to redress the 
 balance by having larger famihes, and thus to kill out the 
 unfit by the struggle for existence. To this, however, there 
 are tv/o objections. One is that the educated classes have 
 not responded, and will not respond to the call. They know 
 too well the advantages they and their children gain by 
 limitation. Indeed, the very people to call out for the larger 
 famihes, whether in Germany, France, Hungary or England, 
 are, as the Hungarian Medical Senate pointed out, the chief 
 offenders against their own doctrine. The other objection is 
 that, in these days of humanitarianism, society has an ob- 
 jection to the kilHng out process. The victims, strangely 
 enough, have a habit of protesting. Anyhow, society does 
 everything possible to maintain them (usually at a minimum 
 of vitahty) and to allow them to propagate to the fullest 
 extent. Is it wonderful then that we have overcrowding, 
 
io8 The Small Family System 
 
 disease, and physical and mental deterioration ? Mephis- 
 topheles himself could not have devised a better system for 
 ruining the race than the one we have at present — the full 
 licence to the unfit to breed at the expense of the fit, who 
 limit their famihes more and more in order to maintain 
 workhouses, hospitals and asylums for these poor creatures. 
 There are only two alternatives for race improvement — 
 either the fit must increase their own multipHcation, and 
 refuse all help to the unfit (with the spectre of the French 
 Revolution to cheer them), or they must see to it that the 
 unfit do not reproduce. The combined wisdom of the age 
 can find no escape from this dilemma — unhmited reproduc- 
 tion and brutahty, or humanitarianism with restricted 
 reproduction of the unfit. The recent Mental Deficiency 
 Bill is a first recognition of the latter principle. But why 
 deal only with the extreme cases of mental deficiency ? 
 There are milHons of poor physically and mentally unfit 
 creatures who, if voluntary restriction were known to them, 
 or they were not told it was unhealthy or immoral, would 
 only be too glad to escape burdening themselves and the 
 community with a numerous and weakly progeny. What 
 is the use of deploring the increase of the unfit when the poor 
 mothers among the working classes are only too anxious to 
 avoid the misery of bearing child upon child in wretched 
 surroundings, on miserably insufficient wages, and of seeing 
 half of their children perish from semi-starvation before their 
 eyes ? 
 
 What is the use, too, of simply segregating the mentally 
 deficient when we have a huge factory of mental deficiency in 
 our midst in the terrible amount of venereal disease caused 
 by prostitution ? If all young people were able to marry at 
 a suitable age, instead of waiting to provide for a family, this 
 great source of defect would be stopped, and it would do far 
 more to check mental defect than any other measure which 
 could be devised. In fact, we should probably never have 
 
Family Limitation and Social Reform i 09 
 
 needed the recent Mental Deficiency measure if our educa- 
 ted classes had done their duty in extending the knowledge 
 of hygienic means of family Hmitation to the poor when they 
 adopted them themselves. 
 
 Let us now look at the matter from the point of view of 
 present day pohtics. We have before us the question of 
 housing and overcrowding, of a minimum wage, of the land, 
 etc., and both political parties are endeavouring to show how 
 they will solve them. We need not take up a position of 
 hostihty to either party, but simply point out a few simple 
 facts. 
 
 First as to the housing question. We are not concerned 
 either to assert or to deny that much better accommodation 
 should be available, or that rents should be lower. Even 
 when we find that about four millions of working men at the 
 present time have a wage of 25s. a week or less, we feel that, 
 even as things are, a man and his wife and one or two child- 
 ren can have two rooms and live in some approach to 
 decency. With a greater number of children the position is 
 hopeless. More accommodation is needed with more child- 
 ren, though the margin for rent gets less. Hence we have the 
 spectacle of whole famihes herding together, Hke beasts, in a 
 single room. However much we may urge the necessity for 
 better and cheaper accommodation, we cannot get over the 
 fact that while this is being settled — and it will only be 
 settled slowly — the most acute phases of the housing prob- 
 lem would be solved in a year or two by the adoption of 
 family limitation by the poor. 
 
 Next take the question of the minimum wage. Opinions 
 may vary as to the justification or possibiHty of it. But 
 there is one simple question which is never raised in the con- 
 troversy, namely : What do you mean by a minimum wage ? 
 Is it a family wage ? If so it must mean a minimum of sub- 
 sistence for each member of the family. If no restriction is 
 to be practised, and the size of family left to chance, it must 
 
1 1 o The Small Family System 
 
 include a certain sum for each child. Is Mr. Lloyd George cr 
 any other advocate of the minimum wage prepared to enact 
 a scale of wages based on the size of famihes ? Mr. Rowntree 
 has clearly shown that in a provincial town a family of three 
 can only with the utmost economy be maintained on 23s. 8d. 
 per week, without the shghtest margin for amusements, 
 luxuries, or contingencies. In London the wage would have 
 to be higher. Whenever pohticians talk of a minimum wage 
 of ^l or 25s. a week, they really imply that the family must 
 not include more than one or two children, and it is dishonest 
 not to say so. In the same way, when they talk of cottages 
 with certain accommodation, it will always be found that 
 they provide only sufficient for two or three children. Yet 
 they never say that the workers are to restrict their offspring 
 to this number, although they well know that families of 
 ten or twelve children are quite common among the poor, 
 and indeed make political capital of this very fact. So long 
 as marriage implies unlimited parenthood, the principle of 
 the minimum wage or of adequate housing implies provision 
 in proportion to the number of children. Are the middle 
 classes, who regulate their own families to their means and 
 who provide the bulk of the taxation, prepared to assent to 
 this proposition ? 
 
 Nothing has here been said about ceHbacy as opposed to 
 marriage. Even were celibacy desirable, it would be no 
 solution of the above difficulty, so long as married people 
 had very large families. Of course one may preach very late 
 marriages, as advocated by Malthus. But this means the 
 delaying of marriage in the case of women of the poorest 
 classes till the age of 35 or over. Even them famihes of six' 
 or more children would still be common. But no one can 
 contend that such an age would be an ideal one for com- 
 mencing marriage or child-bearing. Nor would hardly any 
 medical man or clergyman to-day advocate either celibacy 
 or long delayed marriage, certainly not for the working 
 
Family Limitation and Social Reform i i i 
 
 classes. On the contrary, early marriage, apart from its more 
 ideal character, is the one and only possibihty of reducing or 
 ehminating the evil of prostitution, which evil has defied all 
 other efforts to check it. The only reasonable possibihty of 
 securing general early marriage is by removing the burden of 
 unhmited famihes, and if hmitation in itself were regarded 
 as necessary and moral, and led to this result,* it should do 
 more for the promotion of a really moral state of society 
 than any reform hitherto proposed. 
 
 Nowadays, one hardly ever finds a person who in 
 private conversation does not fully admit the position. Any. 
 father or mother of a family will tell you more or less freely 
 that they cannot properly feed, clothe and educate their 
 children as useful citizens and do justice to their own indi- 
 vidualities with more than three or four children at the 
 outside. They see in a moment that if their workmen or 
 charwoman only had small famihes they would be much 
 better off. Th^ey will often tell you how foohsh these people 
 are to have so many children. But they never seem to 
 realise that the poor are largely ignorant on such matters, or 
 that they have been frightened off from limiting their 
 families by statements of the kind we have been investigat- 
 ing. Nor do they seem to feel it their duty in the -name of 
 humanity and of patriotism to see that the necessary know- 
 ledge is extended to the poor. This is probably partly 
 because of conventionaHty, and partly because there is some 
 belief that the country will suffer from want of workers or of 
 defenders if family hmitation became general. A httle study 
 of the question would show anyone that this is a complete 
 delusion. Will the country suffer by having a smaller 
 number of the poorest and most ineffective workers or un- 
 employables ? Family limitation has now been adopted by 
 nearly 'all the intelhgent and efficient people in the country ; 
 and if that be an evil, it has done its worst work. All the 
 
 * The age of marriage is diminishing in Holland, and so is the 
 illegitimate birth-rate, proportion of still births, etc. 
 
I I 2 The Small Family System 
 
 more necessary Is it to extend the knowledge now as rapidly 
 as possible to those who are inefficient. As the Bishop of 
 Ripon himself admitted at the Church Congress of 1910, 
 " If the diminution of the birth-rate could be shown to 
 prevail among the unfit, we might view the phenomenon 
 without apprehension, and we might even welcome the fact 
 as evidence of the existence of noble and self-denying 
 ideals." 
 
 It cannot be too strongly impressed upon everyone that 
 family limitation within reasonable limits does not mean the 
 slightest slackening of population. Not even in France, 
 which is held up as such a terrible example, has it done so 
 or is it even likely to do so. Increase of population is due to 
 survivals^ not to births^ and the rate of survival may be 
 greatly increased by diminishing the birth-rate in the right 
 place. When the State of Ontario in Canada had a birth- 
 rate of 19 per 1,000, the figure which France has now at- 
 tained, it had a death-rate of only 10 per 1,000, and its rate 
 of natural increase was therefore 9 per 1,000, or as high as 
 many European countries to-day. Those who, like Dr. 
 Bertillon, imagine that the slow increase of France is due 
 to its low birth-rate, must simply be asked to explain why 
 its death-rate is 18 instead of only 10 per 1,000. We are all 
 famihar with the motto, " the more haste the worse speed." 
 The more haste we make to increase population by a too 
 high birth-rate the worse confusion we get into, the more 
 complex are our social evils, and the less rapidly does our 
 population increase. The golden rule for population, as for 
 everything else, is — Festina lente. 
 
 While we have the example of Holland (the only country 
 in which family limitation has been fairly tried on its merits, 
 and been extended to the proper quarters by the co-opera- 
 tion of statesmen and medical men — with such splendid 
 results in increasing the population, while reducing the 
 general and infantile mortality and improving the physique) 
 
Family Limitation and Social Reform 1 1 3 
 
 we must ask ourselves whether we should not do better to 
 concentrate upon educating our poorest people to limit their 
 famiHes in the best possible manner. It is greatly to be 
 hoped that in view of the declarations of the Presidents of 
 the British and the American Medical Associations our 
 medical men will now come forward to the task. 
 
 An inspection of Fig. i, representing the course of the 
 birth and death-rates in our own country, reveals the fact 
 that within the thirty-five years during which the birth-rate 
 has fallen, the death-rate has fallen from 22 to 13.3 per 
 1,000. It also shows that at the present rate of progress the 
 death-rate will fall to 10 per 1,000 (the figure for New 
 Zealand and AustraHa) by the year 192 1, if the birth-rate 
 falls to 20 per 1,000 as it appears Hkely to do. When that 
 time is reached It will mean that there is practically no prema- 
 ture death from actual want of the necessities of life, or in other 
 words, that poverty in its worst sense is abolished. It Is 
 quite certain that this result will be attained by 1921, even 
 If no greater efforts are made than at present. It Is equally 
 certain that if the educated classes of the community 
 reahsed their duty In this matter, and would help In bring- 
 ing about restriction of famihes In the places where It Is 
 most required, the death-rate could be brought down to 10 
 per 1,000 zvithin five years. Yet during these five years there 
 zvould probably be a greater increase of population than at 
 present, since we should be checking the supply of Ineffect- 
 ives rather than than that of effectives. 
 
 It sounds strange talk of doing away with Indigence In such 
 a short period of time, but those who make an unprejudiced 
 study of vital statistics will quickly realise that the above 
 statement is perfectly warranted. It Is for the medical 
 profession and the educated classes to decide whether arti- 
 ficial restriction is or Is not healthy and moral, and, if they 
 decide in the affirmative, to use their utmost endeavours to 
 direct It wisely for the benefit of the race. Without their 
 
1 1 4 The Small Family System 
 
 aid it has done wonders ; with it, it will perform miracles. 
 We may close by repeating the words of that ardent pioneer 
 of Eugenics, Dr. Saleeby : « Only by the aid of neo- 
 Malthusianism can we attain the ideal which I have defined 
 in my outhne study of Eugenics, that every child who comes 
 into the world shall be desired and loved in anticipation. 
 
CHAPTER IX 
 
 THE SINGLE CHILD SYSTEM 
 
 Judgment of the Hungarian National Medical 
 Senate delivered 27th October 1911, by Professor 
 Dr. William Taufer, in reply to tlie Minister of the 
 Interior concerning a Memorandum presented by 
 the National Agrarian League and referred to the 
 Senate for its opinion. 
 
 [As this remarkable judgment does not appear to be known in this 
 country, and is in such striking contrast to earlier medical pro- 
 nouncements, I venture to include a literal translation from a 
 German copy of the Judgment made for me by the late Dr. Gustav 
 ^ Dirner, Professor of Gynaecology at Budapest.] 
 
 TME Agrarian League deals in its Memorandum with the 
 Single Child System, and asks from the Ministry certain 
 enactments which, in its opinion, will mitigate or arrest this 
 sel'ious social evil. It demands legislation, but only to a 
 very small extent of a social hygienic character; and we 
 observe that even it does not contend that the Single Child 
 or Small Family System is injurious from the hygienic point 
 of view. For the truth is, of course, that too many children 
 ' — that is, more than the parents can feed properly — are not 
 to be desired from the hygienic standpoint. 
 
 The Memorandum enumerates the measures which the 
 League considers necessary. Only the following paragraphs, 
 however, are really concerned with the question of social 
 hygiene. 
 
 I. Especially conducive to the Single Child System are 
 inter alia the absurdly permitted marriage of 18 year old 
 youths with 15-16 year old girls. What a danger for the 
 race is implied in these early marriages ! They simply ought 
 not to be allowed by the laws. Such early sexual life results 
 in "female diseases," premature old age, 'sterility — or, at 
 least, in defective offspring. 
 
 "5 
 
I 1 6 The Small Family System 
 
 These contentions of the Agrarian League, regarded from 
 the hygienic point of view, are entirely unwarranted. Early 
 marriage can bring with it many social evils — perhaps also 
 ethical and economical disadvantages, which we will not 
 consider — but never " female diseases," premature old age, 
 steiiHty or defective offspring. It cannot be supposed that 
 the marriage of youthful persons (assuming they are physi- 
 cally fit, as should be medically ascertained) gives rise to 
 hygienic evils. If the Agrarian League calls for legislation 
 against early marriages, it cannot do so on medical grounds. 
 
 2. The League states that the Ministerial decree Z. 50981 
 of 1901, which aims at the reduction .of the circulation of 
 preventive devices, has practically not been appHed. 
 
 This is quite true ; and the Senate can only repeat what 
 it recently decided when considering the proposition of the 
 Komitate Somagy Borsod und Heves. No new Ministerial 
 action is here necessary, but only the strict application of the 
 above-mentioned decree. 
 
 As the Single Child System is referred to as a " social 
 disease," the Senate cannot abstain from calHng your 
 Excellency's attention to the circumstance — which weighs 
 much more heavily in the balance than the dangers urged by 
 the Agrarian League — that, in order to avoid the blessing of 
 children, the practice of abortion prevails to a horrible 
 extent not only in the capital and the great towns, but also 
 in the country. This social disease devours the life force of 
 the people, for it is a source of much injury and Hfe-long 
 invalidism. We must also point out that under any strin- 
 gent restriction of the circulation of ordinary means of 
 prevention this great evil would grow even greater. Its 
 diminution — there can be no question of its extirpation — . 
 must be the highest aim of any civilised community. The 
 splendid hygienic conditions in Germany have had astonish- 
 ing results. The supervision of midwives — in combination, 
 of course, with the improvement of economic conditions — 
 
The Single Child System i 17 
 
 has led to an increase of population so amazing as to cause 
 France the greatest apprehension. In Hungary, where 
 social hygiene has always been the step-child of State 
 administration, there is at present no possibihty of great, 
 costly, health-giving reforms such as the fundamental 
 establishment and maintenance of hygiene administration 
 on every side ; nevertheless, we must in this connection 
 be ahve to the deep-rooted and far-reaching evil above 
 mentioned. 
 
 The second great danger which our population has in its 
 germ, so to speak, is the very serious infantile mortahty. 
 To a gieat extent this is also due to unorganised administra- 
 tion in hygienic matters ; but also to the poverty of the 
 people, and to the want of education. We are convinced 
 that the growth of population will best be promoted by intel- 
 ligent organisation of the administration and far-reaching 
 regulation of midwives, and by State attention to the care 
 and feeding of infants. The rational procedure would be : 
 improvement of the standard of comfort and education, the 
 building up of a hygienic administration, and State super- 
 vision of midwives and of infant feeding. 
 
 Social science has shown that a people reproduce more 
 rapidly the poorer and less educated they are ; and, on the 
 other hand, that with the extension of civiHsation, and the 
 increase of education and improvement of economic con- 
 ditions, the number of births falls off. This holds good not 
 only .for Europe, but for the whole world. Almost every 
 legislative body has occupied itself with this question. The 
 French Chamber has just issued a report which draws 
 attention to the fact that the increase of population in 1909 
 was only 13,000, and that in 1907 there was actually a 
 diminution of 20,000 souls. 
 
 The three items of proposed legislation are : — 
 
 I. Men who have not married up to their 29th year are 
 again to be called to mihtary service. 
 
1 1 8 The Small Family System 
 
 2, Whoever has not married before his 25th year cannot 
 receive any appointment under State or municipaHty. 
 
 3. Whoever has at least three hving children shall have 
 higher salary and higher pension. 
 
 But all these propositions must be rejected — not, however, 
 on the grounds of hygiene, but on the grounds of political 
 economy. The greater number of children desired by the 
 Agrarians may serve the military and capitaHstic interests, 
 but never the interests of hygiene. From the hygienic 
 standpoint the increase of population is a food question, the 
 answer to which is that the unrestricted physiological 
 reproductive power of humanity increases rapidly, while the 
 food-producing power increases very slowly in the most 
 favourable cases, and is m any case limited. So an unlimited 
 number of children can even threaten the existence of a 
 family from the hygienic point of view. Inevitably then, 
 human beings will guard against a number of children dis- 
 proportionate to their social conditions. Equally readily 
 can we understand that educated and thinking parents 
 will wish to ensure their children the same amount of well- 
 being which they possess. The result of this rational line of 
 thought is apparent even among the best educated and most 
 capable classes of the community — including our ground 
 landlords, who have sent up their cry for help through the 
 Agrarian League. It would seem that in this cry a strong 
 class interest finds expression, and that the League asks for 
 State help against an evil of which the landlords are quite as 
 guilty as the lower classes whom they accuse. 
 
 Neo-Malthusianism (the international title of the Single 
 Child System) is a natural consequence of civilised environ- 
 ment, and can only be uprooted by the destruction of civili- 
 sation. Forel says on this point that " hypocrisy hes in the 
 fact that each class brands the limitation of births as im- 
 moral, and itself practises this immorahty. It is well- 
 known that the members of the propertied classes bring only 
 
The Single Child System i i 9 
 
 a few cliildren into the world, in order that the standard of 
 Hfe of the children should not fall below that of the parents. 
 The whole neo-Malthusian practice owes its origin to the 
 propertied classes. The very moment, however, that the 
 working classes commence the adoption of this practice, the 
 ruHng classes proclaim all such conduct as immoral, which 
 they, by their own conduct, have recognised as moral." 
 
 The State possesses neither the power nor the means to 
 prevent or diminish family hmitation ; for when the 
 working classes have reahsed that excessive reproduction 
 puts a burden on their progeny, and have learnt the means of 
 restriction, there is no law or power which can bring them 
 back to renewed over-reproduction. Moreover, Social 
 Hygiene can only benefit the working classes after improve- 
 ment in their material existence — so even it will be thereby 
 furthered, and not set back. The contentions of those who 
 consider and decide upon this question on the grounds of 
 rehgion, moral philosophy, patriotic mihtarism or capital- 
 ism, and who discuss by what means the inevitable might 
 be postponed, cannot form a subject for the dehbexation of 
 the National Senate for Pubhc Health. 
 
 THE END 
 
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