It is an interesting question as to whether there is a definite gap—a difference of kind between these poor, defective children and the markedly stupid boys and girls of some village schools. I am inclined to believe that there is. The one group does not pass by a gradual series into the other. It has been stated that in some remote country districts of England only one-third of the school children can be taught more than the merest elements of writing, reading, and arithmetic; the majority are immovably dull, only the minority are as bright as ordinary London children. But even the dull village children get so far as to master the elements of learning, and probably their brains are not structurally defective, but only inactive for the time being. They may hereafter become village Hampdens. It certainly does seem to be the fact that the villages are continually deprived of the more intelligent members of their population by the attractions of the big towns, and that only the duller portion stay to breed in the village like the blind animals in a cave. But dullness is not identical with feeble-mindedness.
It is maintained that even in towns the multiplication of the hard-working, cautious, and capable section of the community is at a standstill. Its members seek comfort, intellectual exercise, and self-culture; they refuse to deprive themselves of these things, which cost money, and to spend that money on bringing up large families. On the other hand, the far more numerous “working-class” has no such ambition as a rule, and no anxiety as to what is to become of its offspring, however numerous. The more children the larger are the earnings of the family, and all in turn shift for themselves at an early age. The rates pay for such education as they require, and their parents have no desire to push them up the social ladder; but food, lodging, and clothes cost money. The working-man who desires to read, see things for himself, and be more than an animated cog on a wheel, cannot afford to have children and transmit to them that modicum of intelligence above the average which distinguishes him from his fellows, and demands for its cultivation the money with which he might keep a large family. Consequently the population is more and more largely replenished by the unenterprising poor and the unenterprising rich; the group which is enterprising and capable, and directs the work and thought of the civilised world, is, by the very qualities which make the increase of its strain desirable, debarred from contributing its fair proportion to the increase of the population. Is it possible for the community, by any system or by legislation, to overcome or evade this unfortunate tendency?
The neglect by both the local and central government to provide any supervision of feeble-minded children has had a special result of a strange and unhappy description. Let me hasten to say that now that we have secured by recent legislation the vitally important medical inspection of children in connection with Board schools, and the registration and official inspection of feeble-minded children which will surely be made compulsory before another year has passed, the danger of which I am about to speak will very shortly no longer exist. It is this. Feeble-minded children (whose condition falls short of that of actual idiocy) are almost impossible to manage as members of an ordinary family or household. Their condition is often not properly recognised; their parents or guardians find them to be obstinate, unteachable, and dirty. Often, when the family is poor, they are, under these circumstances, “boarded out” for a very small payment, or even taken charge of, out of charity. None of the persons concerned in these transactions know that they are dealing with a hopelessly unteachable child, born with this defective brain. They find scolding has no effect in guiding the child, mild chastisement fails, and the poor ignorant foster-parent (sometimes even the child’s own mother) becomes exasperated and determined to subdue what seems to be mere obstinacy and indifference. The awful demon of cruelty is let loose. What seems at first a virtuous determination to control and regulate the child’s behaviour for its own good leads to the infliction upon it of blows of savage violence, then to the less dangerous but revolting attempt to enforce obedience by the pain caused by a burn, and to starvation as a final instrument of discipline. A very large number of the cases of cruelty to children and adolescents which from time to time are brought into the law courts have their origin in the fact that the victim was “feeble-minded,” and that the guardian found guilty of cruelty did not (any more than do the judge and jury) understand or, indeed, know anything at all about such a condition. Often the feeble-mindedness itself has been attributed to the cruel treatment of the child, whereas the latter really was set going by the former. To a large extent the community is to blame for allowing “feeble-minded” children to be boarded out except in proper medical institutions, guaranteed and inspected by State authority. It is the same story as that which was once common enough in regard to “lunatics,” but has now been put an end to by the law. The boarding-out of children, whether healthy or weak-minded, should in all cases be illegal, except under proper official sanction and guarantee. It is not only for the sake of the children that this provision is necessary. It is certain that foolish people have been led, in the absence of all restraint and interference by public authority, to undertake without evil intention the care of discarded children, and have been led on by the hopeless dullness and obstinacy of a child with defective brain into cruel treatment of it; and when in some cases the child has died as the natural consequence of its congenital feebleness, the miserable guardians have been found guilty of causing its death. Though little excuse can be made for such miscreants, it is greatly to be desired that the law should step in at an earlier period, and both ensure proper care for the feeble-minded child and remove from unqualified guardians the chance of developing from a state of mere ignorance into one of criminal responsibility.
The Government Commission on the Treatment of the Feeble-Minded, which has recently reported, has adopted the view which I have explained in this article as to the origin of feeble-mindedness. A large amount of evidence was taken by the Commission from medical experts and others. A certain number of the witnesses maintained the opinion that feeble-mindedness arises from the action of deficiency of food, of overcrowding, and possibly of drunkenness upon individuals of healthy strain, whose offspring, as a consequence, exhibit feeble-mindedness. Some naturalists, who have committed themselves to a pious belief in what is vaguely called “the transmission of acquired characters,” think themselves called upon to support this opinion, in consequence of a notion that their belief would be rendered more reasonable than it is at present were such an origin of feeble-mindedness demonstrated. Apart from the fact that it is not demonstrated, it is difficult to see how, supposing it were, such a causation could be considered as a transmission of an acquired character. The ill-fed, drunken parent of a feeble-minded child (when discovered and examined) is not found to have “acquired” a condition of the brain agreeing with that of his or her feeble-minded offspring, though sometimes such parent is found to have been himself or herself born with a defective brain. No theory of organic memory, of engrams, inscripts, or transfer of molecular vibrations can enable us to present a plausible mechanical scheme of the way in which the acquired general condition (restricting ourselves to what is new and acquired) of an ill-fed parent can be definitely and specifically re-embodied in his or her offspring, as the peculiar structural condition of brain which is called “feeble-mindedness.” It has not been shown, so far as I am aware, that privation in regard to the food of a parental organism gives rise to new congenital qualities in the reproductive germs which that organism throws off.
[XXX]
DEATH-RATES
The chief index or measure of the health of any locality is what is called “the death-rate” of that locality. Although there are several other important evidences as to the healthiness or unhealthiness of any given area, the “death-rate” is the chief and most obvious indication of the advantageous or disadvantageous action of the conditions of any given city or other chosen area upon human life. Its records are more easily kept with an approach to accuracy than are records of cases of sickness not terminating in death. The cause of death has to be certified in civilised communities by a medical man; the total number of deaths in a year is given by the number of burial certificates. The death-rate is stated at so many per thousand of the population per annum. Thus, in a city of 5 million inhabitants,—that is to say, 5 thousand thousands—a record of eighty thousand deaths in the year gives 16 deaths for every thousand persons living. That is called “an annual death-rate of 16.” The record for any single month may be stated (as it is stated at intervals in the newspapers) “as at the rate of so many in the thousand per annum,” by multiplying the actual monthly number per thousand by 12. Thus, in the case of the city just cited, if the death-rate were the same in every month of the year—namely, 16—it would mean that 6500 persons died regularly every month. But we should probably find that in some month or other as few as 5417 persons died. That would be reported “as at the rate of” 13 per thousand per annum; since, if every month gave only 5417 deaths, we should get 65,000 deaths a year, which works out at 13 in the thousand in a population of 5 millions. In other months it might run as high as 19 or 20 (representing over 8000 deaths a month), although, taking all the months together, the deaths are at the rate of 16 in the thousand for the year.
The bald statement of the death-rate, of course, admits of much analysis where proper records are kept. Thus the death-rate from different diseases and groups of diseases can be stated, and the death-rate in each group at different ages and for the two sexes can be given where proper records are kept. In this country the records of population in various areas and for the whole country, and of the deaths from various causes, and at different ages, are collected and tabulated by the Registrar-General and his officials. The annual reports issued by him show what an amazing progress has been made in increasing the security of life in our great cities within the last fifty years. Thus, in London, the death-rate was, fifty years ago, 24 in the thousand. In 1906 it was only 15.1 in the thousand—it has gradually fallen, year by year, so that now it is less than two-thirds of what it was half a century ago. In Manchester and Liverpool it was about 26 twenty years ago, and has fallen to 19 in Manchester and to a little over 20 in Liverpool. In the same period the improvement has been (omitting fractions) from 19 to 14 in Bristol; from 20 to 16 in Birmingham; from 20 to 14 in Leicester. This great diminution in the death-rate has been coincident with the expenditure of public funds on the improvement of the water supply and the sewage arrangements of those cities, as well as with the enforcement of regulations to prevent overcrowding, and with the demolition of the most insanitary houses. Rules as to the removal of filth from the neighbourhood of dwelling-houses have been obeyed, and sick persons suffering from infectious diseases have been removed from dwelling-houses and conveyed to special hospitals. There is no doubt that the diminished death-rate is due to the action thus taken, and more will be done in the future to the same end. The proper provision of pure milk (at a reasonable price) for the food of the youngest children, of regular meals for older children, and the protection of adults from the too frequent inducement to indulge in the use of distilled spirits, will be taken in hand by the municipalities, and lead to a further diminution in the death-rate.
We may, indeed, soon have to ask whether, in a population which has become so much less subject to diminution by death than was formerly the case, there is not too great an increase by birth—too great, that is to say, for the existing means of employment and food-production. A most serious, indeed, an alarming fact, has recently come to light in the study of this question, namely, that the increase of the population is due (as pointed out on [p. 279]) to the proportionately larger number of births amongst the poorer, and even destitute, sections of the community who have not the means of training and rearing their children satisfactorily, and are themselves likely to transmit incapacity of one kind and another to their offspring; whilst those who have valuable hereditary qualities and are prosperous have—it is clearly established—relatively few children—and, in fact, do not increase the population. Whether this condition of things constitutes a real danger, how it will ultimately work out if left alone, and how the difficulty is to be met, are problems for statesmen which cannot be solved off-hand, but require knowledge not only of the crude facts of statistics, but also of the causes at work. Scientific knowledge—that is to say, thorough and unassailable knowledge—of the laws of heredity, of psychology, and of the natural history of human populations, are among the essential qualifications for those who have to face and deal with this difficult matter. And who is there who has this knowledge or is even trying to obtain it? Not the State in this country or its officials: for in every department of government (however capable some of the subordinates may be) there is a determined opposition to and fear of Science on the part of the political and highly paid chiefs—the jealous fear due to complete and deadly ignorance.