Woman and Womanhood: A Search for Principles

by C. W. Saleeby

Let us turn now to the general question of the organic or physiological relations between womanhood and alcohol. Both sexes of human beings are identical in a vast majority of their characters, and the various reactions to alcohol come within this number. There is no need to repeat here any of the facts and conclusions which have been set forth at length elsewhere. What was said there applies to women as to men. That is true so far as the individual is concerned and it is also true that, so far as the race is concerned, the germ-plasm or germ-cells in both sexes alike may be injured by the continued consumption of large quantities of alcohol.

There remains the important fact, which it is the present writer's constant effort to bring to the notice of Eugenists, that alcohol has special relations to motherhood, to which there can necessarily be no correspondence in the case of the other sex, and though motherhood, as such, is not the subject of this book, yet it would be most pedantically to limit the usefulness which one hopes it may possess if we were to omit the discussion, as brief as possible, of the effect of alcohol upon womanhood at the time when womanhood is expressing itself in its supreme function.

In my book on Eugenics there is merely the briefest allusion in a foot-note to this subject, and I confess myself now ashamed of having dealt with it in that utterly inadequate fashion. In practical eugenics,—though sooth to say when eugenics begins to become practical many professing eugenists seem to think that it is wandering from the point—the great fact of expectant motherhood must be reckoned with. To decline to do so is in effect to declare that we are greatly concerned with bringing the right germ-cells together, but have nothing to do with what may or may not happen to the product of their union. We desire, however, not merely conjugated germ-cells, but worthy men and women, and expectant motherhood is therefore part of the eugenic province. Unfortunately it is easier to invent terms and categories and get people to accept them than to control their use of one's terms thereafter. Otherwise, I should forbid the use of the term Eugenist at all by anyone who is unprepared to move a finger or utter a word on behalf of the care and the protection of expectant motherhood.

It is quite true that the question of expectant motherhood has nothing to do with heredity in the proper sense of that term. We are dealing now with "nurture," not with "nature," but we are dealing with a department of nurture which can only be understood when we realize that human beings begin their lives nine months or so before they are born, and that the first stage of their nurture is coincident with what we call expectant motherhood, whilst the second stage of their nurture, normally and properly, ought to be coincident with what we may call nursing motherhood.

Let us then acquaint ourselves with the fact, fully established by experimental and chemical observation, that alcohol given to the expectant mother finds its way into the organism of the child. Thus, as we should expect, alcohol can readily be demonstrated in a newborn child when the drug has been given to the mother just before its birth.

It must be understood that the circulation of the mother and of her child are each complete and self-contained. They come into relation in the double organ called the placenta, and it has been exhaustively proved that this organ is so constituted as in large measure to protect the child from injurious influences acting upon and in the mother. We may therefore speak of the placenta as a filter. Its protective action explains the facts, so familiar to medical men and philanthropic workers, that healthy and undamaged children are often born to mothers who are stricken with mortal disease—most notably, perhaps, in the case of consumption. It becomes a most important matter to ascertain the limits of the placental power, and by observation upon human beings and experiment upon the lower animals this matter has been very thoroughly elucidated of late years. There are many kinds of poison, and many varieties of those living poisons that we call microbes, which the placenta does not allow to pass through from the mother's blood-vessels into those of the child, and which are unable, fortunately for the child, to break down the placental resistance. On the other hand, there are certain microbes and certain poisons which readily pass through the placenta. Conspicuous amongst these are alcohol, lead and arsenic, and it is especially important to realize that alcohol injures the child not merely by its own passage through the placenta, but by injuring that organ, so that its efficiency as a filter is impaired. On the whole subject of expectant motherhood and the morbid influences which may act upon it, the greatest living authority is my friend and teacher, Dr. J. W. Ballantyne of Edinburgh. He contributed an important paper on this subject to our first National Conference on Infantile Mortality held in 1906.[22] I only wish it were possible to reproduce in full here Dr. Ballantyne's paper on the Ante-Natal Causes of Infantile Mortality. The unread critic who is so ready with the word fanatic whenever alcohol is attacked might begin to derive from it some faint idea of the quality and massiveness of the evidence upon which our case is based. Here it must suffice merely to quote the verdict at which Dr. Ballantyne arrives after surveying all the evidence on the subject that had been obtained up to the year 1906. He summarizes as follows:—

"It must then be concluded that parental and especially maternal alcoholism of the kind to which the name of chronic drunkenness or persistent soaking is applied, is the source of both ante-natal and post-natal mortality. It acts in all the three ways in which I indicated that ante-natal causes can be shown to act in relation to the increase of infantile mortality, viz.,.by causing abortions., by predisposing to premature labours, and by weakening the infant by disease or deformity so that it more readily succumbs to ordinary morbid influences at and after birth. By causing diseases of the kidneys and of the placenta it also leads to that failure of the filter to which I have already referred; the placenta being damaged, not only does the alcohol more readily pass through it itself, but it is also possible for other poisons, germs, and toxins to cross over into the fatal economy. So it comes about that the most disastrous consequences are entailed upon the unborn infant in connection with syphilis, lead-poisoning, fevers, and the like in the intemperate mother."

The foregoing was written as long ago as 1906, and various workers have helped to confirm it since that date.

We must further learn that alcohol taken by the mother who nurses her child has an organic relation to the child after birth. It is true, indeed, that according to a celebrated observer, Professor von Bunge, the influence of alcoholism in preceding generations is such that the daughters of such a stock are mostly unable to nurse their children. It is not quite certain that Professor von Bunge has proved his case, but it is definitely proved that even if alcoholism in the maternal grandparent has not altogether prevented a child from being fed in the natural fashion, it may yet suffer gravely in consequence of receiving alcohol in its mother's milk. In the case of the nursing mother, there is one fresh avenue of excretion which the organism can employ for ridding itself of the poison, and to the efforts of the lungs and the kidneys are added those of the breasts. Alcohol can be readily traced in the mother's milk within twenty minutes of its entry into her stomach, and may be detected in it for as long as eight hours after a large dose. Many cases are on record where infants at the breast have thus become the subjects of both acute and chronic alcoholic poisoning. We have numerous reports of convulsions and other disorders occurring in infants when the nurse has taken liquor, and ceasing when she has been put on a non-alcoholic diet. A most distinguished lady, Dr. Mary Scharlieb, may be quoted in this connection, or the reader may indeed refer to the chapter, "Alcoholism in Relation to Women and Children," contributed by her to the volume "The Drink Problem" in my New Library of Medicine. She says, "The child, then, absolutely receives alcohol as part of his diet with the worst effect upon his organs, for alcohol has a greater effect upon cells in proportion to their immaturity." Further, as she points out, "the milk of the alcoholic mother not only contains alcohol, but it is otherwise unsuitable for the infant's nourishment; it does not contain the proper proportions of proteid, sugar, fat, etc., and it is therefore not suited for the building up of a healthy body."

It is plain that here we cannot avoid criticism of an almost universal medical practice. Our concern in the present volume is not with children but women; and in dealing with the effects of maternal alcoholism upon childhood, the main intention is being kept in view. As regards the giving of alcohol to the nursing mother, there is no doubt that the child is more seriously in danger than she is. There is no doubt also that, as one has often pointed out, the Children Act which forbids the giving of alcohol to children under five years old is being broken when the nursing mother takes alcohol. I refer to this subject here because only thus can we come to a decision on the question whether the nursing mother owes the taking of alcohol as a duty to her child. She may be a teetotaler; she may fear to take alcohol; and she may be authoritatively told that it is her duty to do so because the quality of her milk will be improved. In such a case she may yield, though often with a wry face; and thus we have the frequent beginning of disasters to which there is no end.