"[Figure A and B], shows the share of each class of operation in the total number for the various periods. A more leading part is taken by aftermath operations, by artificially induced premature birth, by perforation of the head and by Caesarean section on the living. Aftermath operations depend (like the use of the forceps) to such a degree on the teachings of the various schools for midwifery (and on the time at the doctor's disposal) that they can hardly serve as a standard of birth capacity. The Caesarean section, too, can hardly be taken as a guide, as a much wider view is taken now of the indications for this operation. But the equally increasing numbers of perforations of the head and artificially induced premature birth are well worthy of attention. For these two operations exclude one another. With the existing tendency to avoid perforation of the head by artificially inducing premature birth, a rise in the curve of premature births should correspond with a sinking of the perforation curve. 1871 to 1879 a maximum of the former actually coincides with a minimum of the latter; but from there on both curves rise, though not in the same degree. Premature births have become since then (see [Fig. 2]) more than eight times as frequent; perforations of the head have trebled; and dismemberments of the child have doubled. This fact must be considered as a sign of lessened birth capacity."
"[Figure 4] shows the decrease of the total number of stillbirths."
"[Figure 5] gives the share which abnormal position of the child has in this total, and a comparison of the two shows that whilst the total has decreased by 1.42% the decrease (1880 to 1889) has been 2.35% in the case of stillbirth through abnormal position. The conclusion is, that there is now more opportunity for hereditary transmission of the tendency to faulty position of the child than three to four decades ago."
"But [Figure 6] proves that up to now an increased inheritance of this tendency has not taken place. The curves of these positions not only show irregularities but (with the exception of cross births) a tendency to sink."
"Recapitulation. The growing frequency of surgically assisted births cannot be taken as evidence of a diminished birth capacity, but is closely connected with the growing number of doctors. Against the indications of a diminished birth capacity stand at the moment those which previously could be taken as pointing in the opposite direction. It would, therefore, appear that medical interference at birth has brought to the race advantages as to quantity and no drawbacks as to quality. But it is probable that the picture will change during the coming decades, because only then will the daughters of mothers who could not have brought forth living children without surgical assistance become themselves mothers. The renunciation of motherhood on the part of the women least suited for this function and the war against rickets might act as preventatives."
The great anxiety about the elimination of the severest struggle for existence is based on the undoubtedly erroneous fundamental conception that the organism is a sorry product of necessity which can barely manage to maintain a laborious existence by the constant straining of all its faculties, and that it requires the continuous use of the whip of necessity to prevent an organism from giving way to its inherent tendency to degeneration. In fact, however, no organism is conceivable which has not the "Tendency" to maintain itself and to react accordingly. There are many facts which prove that a wealth of capacities and tendencies is dormant in organisms which for innumerable generations have not been active, or, perhaps, have, never functioned in every possible way, and that, therefore, if the occasion arises replacements or accommodations of an unprecedented character may occur. In an unprejudiced system of race-hygiene these facts must not be overlooked. The exhibition in this section gives two specially striking instances; the one from animal the other from plant life.