Being Well-Born: An Introduction to Eugenics

by Michael F. Guyer

Between this estimate that one-third of our feeble-minded are in institutions and Doctor Johnstone’s that we are not providing for many more than one-tenth of our feeble-minded and epileptic, there is a wide discrepancy, but I know of no accurate data[20] whereby the matter can be settled definitely. One point of difference may be that Doctor Johnstone specifically includes epileptics and another may be one of definition of feeble-minded. However, supposing that we could get them all into institutions, institutional care at present by no means also implies prevention of propagation. It is not an unusual history of feeble-minded women in our county poor-houses that they alternate between periods of housework in some family and periods of residence in the almshouse, the return to the latter being only too often to bear an additional child.

Not a few students of the problem, however, advocate a rigid segregation as the only reasonable preventive measure, no matter what the expense. They point out that the cost is mounting up higher each year and that we are only increasing it ultimately by procrastination. They urge, moreover, that when counting the cost of the segregation of the feeble-minded we should bear in mind also that we are reducing the expenses of our other charity and penal institutions, since much of degeneracy, pauperism and petty criminality centers in mental enfeeblement. Some believe that colonies can be established which are in considerable measure self-supporting. Doctor Johnstone, for instance, although his estimates of the number of feeble-minded and epileptic is one of the highest, sketches out in a recent paper (in Pediatrics, August, 1912) a plan which he considers feasible.

But what assurance have we that we can prevent the production of defectives by segregation? In reply may be cited a recent experiment on an extensive scale. Cretinism is a condition due to disease of the thyroid glands. It is characterized by goiter, marked deformities and imbecility. It is hereditary and has been very prevalent in certain valleys of southern Switzerland and northern Italy. Cretin mated with cretin and consequently a large new supply was constantly produced. In recent years in certain communities the sexes have been segregated (see Eugenic Review, 1910, Jordan) with the result that in such places cretinism has about disappeared.

Coming now to the fourth solution proposed, namely, sterilization,[21] let us consider some of its alleged advantages and disadvantages.

Sterilization.—First of all, since there is some considerable popular misunderstanding on the subject, it should be made plain that by sterilization is not necessarily, nor in fact generally, meant asexualization, or the removal of the reproductive glands. On the contrary, in the male, sterilization is ordinarily accomplished by an operation known as vasectomy, in which a small piece of each sperm duct is removed. Such reports on it as I have found indicate that it is a comparatively simple minor operation which involves no special inconvenience or hardship on the subject beyond the deprivation of offspring. In fact, according to Doctor Sharp’s report, in the majority of cases where it has been put into practise the patient has usually submitted voluntarily after having the details of the situation explained to him and has often advised fellow delinquents to do likewise.

Even should later developments show that a mistake had been made, in all probability the matter could be remedied by a second operation in which the cut ends of the ducts can be reunited. This has been accomplished experimentally in dogs, and furthermore, in men rendered sterile by occlusion of the duct through inflammatory diseases, the sterility has been remedied by removing the blocked area and reuniting the ends of the duct on either side.

In women the corresponding operation—a section of the oviduct—is termed salpingectomy. Here, however, the operation is a more serious one as it usually involves opening the abdominal cavity and the accompanying hazard of infection, a danger sufficiently great that it is safe to say that the operation will be resorted to more rarely than vasectomy in man.

As a Eugenic Measure.—Sterilization as a eugenic measure has many advocates and perhaps more opponents; and among the latter, it must be said, are many competent and thoughtful students of the subject who recognize existing conditions and deplore their continuance as much as any one. They maintain that while we may have to come to it as a last resort, we are yet too ignorant of the actual effects of the operation, or are too little informed on the inheritability of the specific traits we are trying to eradicate, to launch forth on so radical a program. We must not forget that when we put sterilization into effect we are going to have to deal with individual cases, not general averages.

To What Conditions Applicable.—And just here, it seems to me, is the crux of the situation. When confronted by the defective individual, in a practical case, just what criteria are we going to use to determine whether this particular individual should be sterilized or not? Nearly all of the twelve states which have sterilization laws specify insanity, feeble-mindedness, epilepsy and criminality.

In Insanity.—When it comes to insanity I strongly suspect that those who have the selection of the examining board will have difficulty in finding an alienist who is willing to take the responsibility of deciding on just which insane individuals shall be operated on and which not. For among the insane there are so many kinds and degrees of mental unsoundness, and these are of such varying and as yet unknown eugenical significance, that a positive decision is frequently out of the question. Of the twenty-seven or more recognized forms of insanity who knows with any considerable degree of certainty which are heritable, which not? Shall we treat all manic-depressives alike? Shall we treat them as, for instance, we would those suffering from dementia precox? Who will take the responsibility of answering positively? Again, what shall we do in cases of paresis, or general paralysis of the insane, an affliction which probably invariably has syphilis as its antecedent? Yet it constitutes one of the commonest forms of insanity found in asylums. Doctor George H. Kirby, director of Clinical Psychiatry, Manhattan State Hospital, says that with one exception there are more admissions of paretics to Manhattan State Hospital than sufferers from any other form of mental disorder. He continues, “We find that when either the father or the mother suffers from paresis that many other members of the family may be infected with syphilis, and furthermore, we find that a surprisingly large number of children in these families are feeble-minded, nervous, or in other ways abnormal.” But here, it is clear, the patient has done the damage before he reached the hospital, nor was it paresis as such that did the harm but the syphilitic infection of which paresis itself was but the outcome.