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PROCEEDINGS 



OF THE 



First National Conference on 
Race Betterment 

January 8, 9, 10, 11. 12, 1914 
BATTLE CREEK, MICHIGAN 



PUBUSHED BY THE RACE BETTERMENT FOUNDATION 



EDITED BY THE SECRETARY 



r"To be a good animal is the first requisite to] 
success in life, and to be a Nation of good animals I 



success in life, and to be a Nation of good animals ( 

prosperity." 
Herbert Spencer. 



\ is the first condition of national prosperity." | 



CONTENTS 



Purpose of the Conference xi 

OflBcers xi 

Central Committee 



xu 

A Partial List of Organizations Represented xiii 

Local Cooperating- Organizations xvi 

Addresses of Welcome— 

Dr. J. H. Kellogg 1 

Hon. John W. Bailey 3 

PRESIDENT'S ADDRESS 

The Basic Principles of Race Betterment 

President Stephen Smith, M.D 5-22 

STATISTICAL STUDIES 

The Significance of a Declining Death Rate 

Frederick L. Hoffman 23-66 

The Causes of the Declining Birth Rate 

Prof. J. McKeen Cattell 67-72 

The Need of Thorough Birth Registration for Race Bettennent 

Dr. Cressy L. Wilbur 72-78 

Differential Fecundity 

Prof. Walter F. Willeox 79-89 

GENERAL INDIVIDUAL HYGIENE 

The Importance of Frequent and Thorough Medical Examinations 
of the Well 

Dr. Victor C. Vaughan 90-96 

Euthenics and Its Founder 

Mrs. Melvil Dewey 96-104 

The Relation of Physical Education to Race Bettennent (Abstract 
of address) 

Dr. D. A. Sargent 104-106 

Apparent Irierease m Degenerative Diseases 

Elmer E. Rittenhouse 106-113 

Discussion 

Prof. Maynard M. Metcalf (Race Degeneration) 113 

Some Suggestions for a More Rational Solution of the Tuberculosis 
Problem in the United States 
Dr. S. Adolphus Knopf ..,.:. 113-136 

V 



vi KlKiST NATTOXAIi CONPERKNCE ON RiVCE BETTKRMBNT 

Discussion 

Prof. Robert James Sprague (Wonieu's Work in the Opeii 

Air) 136 

The Prevention of Arteriosclerosis 

Dr. Louis Faus:eres Bishop 137-139 

Hookworm Disease 

Dr. Lillian South 139-142 

Disease and Its Prevention 

Dr. Guilford H. Sumner 142-167 

Function of the Dentist in Race Bettennent 

C. N. Johnson, D.D.S 157-160 

Unbiological Habits 

Dean William W. Hasting-s 161-166 

The Increase of Insanity 

Dr. James T. Searcy 167-169 

Discussion 

Prof. Walter P. Willcox 169-170 

Deterioration of The Civilized Woman 

Dr. Richai-d Root Smith 170-175 

Old Age 

President Smith 176-170 

Service 

Acting Chairman Rev. Charles C. Creegan 179-lSO 

ALCOHOL AND TOBACCO 

The Effect of Alcohol on Longevity 

Arthur Hunter 181-192 

Alcohol— What Shall We Do About It? 

Dr. Henry Smith Williams 192-197 

Discussion 

Dr. Amanda D. Holcomb (The Sacrifice of Boys and Girls) 197 
Daniel A. Poling (The Worst Diy Town vs. The Best Wet 

Town) 198-200 

JPres. E. G. Lancaster (Proportionate State Consumption of 

* Alcohol) 200 

Edward Bunnell Phelps (Caution in Use of Statistics) 200-201 

Dr. Charles G. Pease (Expedients in Violation of Principle) 201-202 
Dr. Heni-y Smith Williams (The Rising Tide of Alcohol 

Consumption) 202-203 

Prof. Robert James Sprague (Licensing Light Drinlcs) .... 203-205 

' Mrs. J. L. Higgins (The "Booze Special") 205-206 

George B. Peak (The Saloon and the Tax-Payer) 207-208 

Mrs. Maud Glassner (A "High Class" Saloon) 208-209 

Melvil Dewey (A League of Publishers) 210 



Dr. Edith B. Lowry (Soothing Synips and Alcohol Crav- 
ing) 211 

Dr. James T. Searcy (Prohibition and Dnig Consumjjtion ) . 211-213 
Frederick L. Hoffman (International Committee on Liquor) 213 

Mrs. Charles Kimball and Elizabeth Hewes Tilton (Alcohol 

Posters) 213-222 

Tobacco A Race Poison 

Dr. Daniel Lichty 222-232 

Discussion 

Miss Lucy Page Gaston (The Cigarette) 232-234 

Dr. Amanda D. Holeomb (The Cigarette-Smoking Hero of 

Fiction) 23;'3 

S. S. McClure (Magazine Advertising of Tobacco) 235 

Melvil Dewey (A League of Employers) 236-238 

Dr. Charles G. Pease (The Non-Smokers' Protective League 

of America) 238-240 

CHILD LIFE 
The Bad Boy 

Hon. Jacob A. Riis 241-250 

The. Delinquent Child 

Judge Ben B. Lindsey 250-202 

The Dependent Child 

Dr. Gerti-ude E. Hall 262-265 

Education for Parenthood 

Dr. Lydia A . DeVilbiss 265-272 

Better Babies 

Robbins Gilnian 272-278 

Discussion 

Edward Bminell Phelps (Baby Saving) 278-279 

Dr. E. G. Lancaster (Adolescence) 279-280 

Dr. Miller (The American Institute of Child Life) 280-282 

SEX QUESTIONS 

Public Repression of the Social Evil 

Graham Taylor 283-288 

Discussion 

Dr. S. Adolphus Knopf (Scattering Prostitution) 288-289 

Graham Taylor (Vice and Mental Defect) 289 

Dr. James T. Searcy (Race Degenerates) 290 

Dr. S, Adolphus Knopf ("Waverly House") 290 

Dr. Charles G. Pease (The Florence Crittenton Mission) . . 291 

Miss Lucy Page Gaston (Prostitution and the Cigarette) . . 291-292 

Dr. Luther H. Gulick (The Girl Who Goes Right) 292-294 



Vlll FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Prof. Samuel Dickie (The Single Standard) 294-295 

Dr. Amanda D. Holcomb (The Boy's Temptations) 295-29G 

Dr. Luther H. Gulick (Real Moanini-- of the Doiil^le Stand- 
ard) 296-297 

Mrs. D. W. Haydock (Educating- the Child) 297-29S 

Mrs. F. F. Lawrence (The Americixn Mother) 29S 

Prof. Robert James Sprague (Vocational Education) 298-300 

H. A. Burgess (Use of Newspapers) 300 

The Social Evil (A special address to women) 

Dr. J. H. Kellogg 300-304 

Venereal Disease (A special address to men) 

F. O. Clements 304-311 

A Man's Problem (A special address to women) 

Dr. J. N. Hurty 311-318 

A Woman's Problem (A special address to women) 

Dr. Carolyn Geisel 318-323 

The Relation of Education in Sex to Race Betterment 

Dr. Winfield Scott Hall 324-334 

SCHOOL AND INDUSTRIAL HYGIENE 

Some Changing Conceptions of School Hygiene 

Dr. Ernest Biyant Hoag 335-342 

The Race Bettennent Movement in Women's Colleges 

Dr. Carolyn Geisel .'^ 342-349 

Discussion 

Mrs. Melvil Dewey (College Courses in Euthenics) 340 

Faetoiy Degeneration 

Rev. Newell Dwight Hillis 350-355 

Industrial Welfare 
■ F. 0. Clements 356-364 



CITY, STATE AND NATIONAL HYGIENE 

Function of Individual, City, State and Nation in Race Bettennent 

Sir Horace Plunkett . .V. 365-366 

Miss M. E. Bingeman 366-367 

Community Hygiene, with Special Reference to Meat Inspection 

Rev. Caroline Bartlett Crane 367-376 

The National Department of Health 

President Stephen Smith (Introductory Remarks) 376-379 

D?. Henry Baird Favill " 379-385 

What the United States Public Health Service is Doing for Race 
• .Betterment 
,,Dr. H. W. Austin .385-390 



CONTENTS IX 

The Cost of High Living as a Factor in Race Degeneracj' and 
Limitation of Families 

Dr. J. N. Hurty 390-392 

Government 

S. S. McClure 393-400 

Discission 

Prof. Richard T. Ely (The Goveniment of a German City) 401 

Byron W. Holt (High Cost of Living) 401-403 

SeRTegation 

^Hastings H. Hart , 403-410 

The Negro Race 

Booker T. Washington 410-420 

Discussion 

Hasting-s H. Hart (Sanitary Kitchens) 420-421 

The Social Progi'am 

Dr. Luther H. Gulick 422-425 

Mrs. Luther H. Gulick 425-428 

Dr. Luther H. Gulick 428-430 

EUGENICS AND IMMIGRATION 

Needed— A New Human Race 

Dr. J. H. Kellogg 431-450 

The Importance to the State of Eugenic Investigation 

Dr. C. B. Davenport 450-45(i 

y Relation of Eugenics and Euthenics to Race Betterment 

Prof. Maynard M. Metcalf 45(i-4C)4 

The Psychological Limit of Eugenics 

Prof. Herbert Adolphus Miller 464-471 

Discussion 

Dr. G. B. Davenport (Relative Effects of Heredity and ' 

Environment) 471-472 

The Impoi*tance of Hygiene for Eugenics 

Prof. Ii-ving Fisher 472-470 

The Methods of Race Regeneration 

. Dr. C. W. Saleeby 476-477 

4 Calculations on the Working Out of a Proposed Program of Steri- 
lization 

H. H. Laughlin 478-494 

The Relation of Philanthropy and Medicine to Race Betterment 

Prof. Leon J. Cole 494-50.S 

The Health Certificate— A Safeguard Against Yicious Selection in 
Marriage 
The Very Reverend Walter Taylor Sumner 509-513 

Discussion 

Mrs. Maud Glassner (Health Certificates in :\Iicliigan ) .... 51 3-515 



X FlUST NATIONAL CONKEKENCE ON KACE BETTERMENT 

MaxTiage Selection 

Prof. Roswell II. Johnson 515-532 

Some Eilicient Causes of Crime 

Prof. R. B. von KleinSmid 532-542 

Kat^ Betterment and Our Immigration Laws 

Prof. Robert DeC. Ward , 542-546 

Race Bettennent and America's Oriental Problem 

Prof. Sidney L. Gulick 546-551 

Discussion 

Prof. Herbert Adulphus Miller (Immigranl < 'ia.ssitication 

by Mother-Tongue) 551-552 

Prof. Maynard M. Metealf (Immigration) 552-553 

Dr. Lulher H. Gulick (The Socially Assiuiilnied ) 553 

Constnietive Su^u^gestions for Race Betterment— Suunnarized 554-589 

Elesolutions 590-593 

Report of the Secretaiy 594-599 

Exhibits and Moving Pictures 

Through a Child's Eyes 

Dr. Anna Louise Strong 6CK)-603 

Physical and Mental Perfection Contests 

I. School Children 
Report of Contest 

Dean Wm. W. Hastings 694-619 

Award of Prizes * 

Mayor Bailey 619-620 

II. Babies 

Report of Contest 

Dr. Walter F. Martin 620-624 

Award of Prizes 

Mayor Bailey 624-625 



THE PURPOSE OF THE CONFERENCE 

To assemble evidence as to the extent to which degenerative tend- 
encies are actively at work in America, and to promote agencies for 
Race Betterment. 

OFFICERS 

President 

Stephen Smith^ A. M., LL.D., M.D., Vice-Pi-esident State Board of Chari- 
ties, New York, N. Y. 

Honorary Presidents 

Judge Ben B. Lindsey^ LL.D., Juvenile Court, Denver, Colorado. 
Hon. Woodbridge N. Ferris. LL.D., Governor of Michigan, Lansing, Mich. 
Right Hon. Sir Horace Plunkett, K.C.Y.O., F.R.S., Ex-Minister of Agri- 
culture for Ireland, Dublin, Ireland. 

Vice-Presidents 

Irving Fisher, Ph.D., Professor of Political Economy, Yale University, 
New Haven. Conn. 

Rev. Newell Dwight Hillis, A.M.. D.D., L.H.D., Pastor Plymouth Church, 
Brooklyn, N. Y. 

J. N. Hurty, M.D., Commissioner of Health, State of Indiana, Indianapolis, 
Indiana. 

Hon. Robert L. Owen, A.M., LL.D., U. S. Senator fi-om Oklahoma, Wash- 
ington, D. C. 

Executive Committee 

Irving Fisher, Ph.D., Professor of Political Economy, Yale Univei-sity, 
New Haven, Conn. 

Rev. Newell Dwight Hillis, A.M., D.D., L.H.D., Pastor Plymouth Church, 
Brooklyn, N. Y. 

J. H. Kjxlogg, LL.D., M.D., Supt. Battle Creek Sanitarium, Member Michi- 
gan State Board of Health, Battle Creek, Mich. 

Right Hon. Sir Horace Plunkett, K.C.V.O., F.R.S., Ex-Minist«r of AgTi- 
culture for Ireland, Dublin, Ireland. 

Jacob A. Riis, Henry Street Settlement, New York 

Acting Chairman 
Reverend Charles C. Creegan, D.D., President Fargo College, Fargo, N. D. 

Secretary 
Miss Emily F. Robbins, New York, N. Y, 



Xii KIRST XATIOXAT, COXFKRKNCK ON RACE BETTER:MKXT 

Central Committee 

C. B. Day FA- PORT. A.j\I.. I'li.!).. Director of the ("iinio.iiic Station for Ex- 

perimental Evolution, Cold Spriiii;' Harbor, N. Y. 

Vu'TOR ('. Yauchan. LL.D,. M.D., Pi-es. Elect American Medical Association, 
President Michigan State Board of Health, Ann Arbor, Mich. 

J. N. McCoRMACK, LL.T)., M.D., Secretary State Board of Health, Bowling 
Green, Ky. 

Charles TY. Eliot, A.M., LL.D.. Ph.D., President Emeritus. Hansard Uni- 
versity. Cambridge, Mass. 

GiFPORD PiNCHOT, A.M., LL.D., Consei-vationist, Washington, D. C. 

Harvey W. Wiley, LL.D., M.D., Director Bui-eau of Foods, Sanitation and 
Health, ''Good Housekeeping" Magazine," Washington, D. C. 

Hon. Jacob A. Ens, Heniy Street Settlement, New York, N. Y. 

S. Adolphus Knopf. M.B., Professor Phthisio-Therapy, Post Graduate Medi- 
cal School and Hospital, New York, N. Y. 

W. A. Evans, M.S., LL.D., M.D., D.P.H., Medical Editor Chicago "Tribune," 
Professor of Hygiene, Northwestern University Medical School, Chicago, 
Illinois. 

D. A. Sargent, A.M., M.D., S..D, Director of Hemenway Gymnasium, Har- 

vard University, Cambridge, Mass. 

Very Reverend Walter Taylor Sumner, D.D., Dean of the Episcopal 
Cathedral of Saints Peter and Paul, Chicago, Illinois. 

Hon. Charles E. Townsend, L'nited States Senator from Michigan, Wash- 
ington, D. C. 

Hon. Morris Sheppard, LL.B., LL.M.. United States Senator from Texas, 
Wa.shin^on, D. C. 

Oscar H. Rogers, M.D.. Medical Director New York Life Insurance Com- 
pany. New York, N. Y. 

Winfield S. Hall, M.S., A.M., Ph.D.. M.D., Professor of Physiology, North- 
western Univereity Medical School, Chicago, 111. 

R. L. Dixon, M.D., Secretary Michigan State Board of Health, Lansing, Mich. 

Mrs. Melvil Dewey. Honorary Chairaian, Institution Economics. American 
Home Economics Association, Lake Placid, N. Y'. 

Mrs. Ella Flagg Young. LL.D.. Ph.D., Superintendent of Schools. Chicago. 
Illinois. 

Rev. Caroline Bartlett Crane, A.M., Kalamazoo, Mich. 

R. Tait McKenzie, A.M., M.D., Professor Physical Education, University of 
Pennsylvania, Philadelphia, Pa. 

John M. Coulter, A.M., Ph.D.. Professor Botany, University of Chicago, 
Chicago, 111. 

S. S. McClure, A.m., L.H.D.. President. The McClure Company, New Y'ork. 

Ernest B. Hoag, A.M.. j\I.D., Leland Stanford University, California. 

Frank E. Bruner, Ph.D.. j\LD., Board of Education, Chicago, lU, 

Henry Smith Williams, LL.D.. M.D., Writer, New York, N. Y. 

Graha^i Taylor. President Chicaizo School of Civics and Philanthropy, 
Chicago. 111. 

Hon. John W. Bailey, LL.B.. Mayoi, Battle Creek, Mich. 

J. H. Kellogg, LL.D., M.D., Supt. Battle Creek Sanitarium. Member Michi- 
gan State Board of Health, Battle Creek, Mich. 

Reverend Charles C. Creegan, D.D.. President Fargo College, Fargo,- N. ,1). 



IN-STITUTIONS AND ORGANIZATIONS REPRESENTED 



A PARTIAL LIST OF REPRESENTATIVES OF INSTITUTIONS AND 
ORGANIZATIONS PARTICIPATING IN THE CONFERENCE 

Physicians 

Austin, Dr. H. W., Representative U. S. Health Service, Detroit, Mich. 

Bishop, Dr. Louis F., Fordham University. 

Bemstein, Dr. Charles, Custodial Asylum, Rome, N. Y. 

Carbaugh, Dr. Harriett M., Health Officer Orange Township, Portland, Mich. 

Carstens, Dr. J. H., Chief Gyneologists, Harper Hospital, Detroit, Mich. 

Davenport, Dr. C. B., Director Carnegie Station for Experimental Evolution, 

Cold Spring Harbor, Long Island, N. Y. 
DeVilbiss, Dr. Lydia Allen, Woman's Home Companion, New York, N. Y. 
Dewey, Melvil, President Lake Placid Club, Lake Placid, N. Y. 
Emeriek, Dr. E. J.. Supt. Institution for Feeble-Minded, Columbus, Ohio. 
Favill, Dr. Heniy B.. Prof. Clinical Medicine, Rusch Medical College. Chicago, 

Illinois. 
Green, Dr. Frederick R., Secretan' American Medical Association, Chicago, 

Illinois. 
Geisel. Dr. Carolyn, Shorter College, Rome, Ga. 
Guliek, Dr. Luther H., Pres. Camp Fire Girls, New York, N. Y. 
Gulick, Dr. Sidney L., Author, Missionary, Kyoto, Japan. 
Hall, Dr. Gertnide E., State Board of Charities, Albany, N. Y. 
Hall, Dr. Winfield S., Noi'thwestern University Medical School, Chicago, 111. 
Hurty, Dr. J. N., Commissioner of Health, Indianapolis, Ind. 
Knopf, Dr. S. Adolphus, New York Post-Graduate Medical School and 

Hospital, NeAV York, N. Y. 
Kennedy, Dr. J. B., Detroit, Mich. 
Lichty, Dr. Daniel, City Hospital, Roekford, 111. 

Noi-thrup, Dr. "Wm., Anti-Tuberculosis Society, Grand Rapids, Mich. 
Paulson, Dr. and Mrs. David, Hinsdale Sanitarium, Hinsdale, 111. 
Robinson, Dr. Wm. J., Chief Visiting Surgeon, Bronx Hospital, New York, 

N. Y.' 
Sargent, Dr. D. A., Director, Hemeuway Gymnasium, Harvard University, 

Cambridge, Mass. 
Searcy, Dr. J. T., Superintendent, Alabama Insane Hospital, Tuscaloosa, Ala. 
Shennan, Dr. G. H., Mich. St. and Wayne Co. Medical Societies, Detroit, 

Michigan. 
Smith, Dr. Stephen, Vice-President State Board of Charities, New York^ N. Y. 
Smith, Dr. Richard Root, Surgeon, Buttei-woi-th Hospital, Grand Rapids, 

Michigan. 
Strong, Dr. Anna Louise, National Child Welfare Exhibition Com., New 

York, N. Y. 
Sumner, Dr. Guilford H., State Board of Health, Des Moines, la. 
South, Dr. Lillian B., State Bacteriologist of Kentucky, Bowling Green, Ky. 
Vaughan, Dr. Victor C, President American Medical Association and of State 

Board of Health, Ann Ai'bor, Mich. 
Warthin, Dr. Aldred Scott, University of Michigan, Ann Arbor, Mich. 
Weeks, Dr. David Fairchild, Skillman, N. J. 



XIV VIEIST XATIOXAl, ( OX FlOKKXl 'K OX HACK ItKTTKRl^rENT 

College Representatives 

Cole. Prof. Leon J., rnivcrsity of Wisconsin, Madison, Wis. 

Coulter, Prof. John INI., I'niversity of Chieajio, Chicago, 111. 

Creegan, Rev. C. C, President, Fargo University, Fargo, N. D. 

Dickie. Sam'l, LL.D., Pi-esident, Albion College, A11)ion, Mich. 

Ely, Prof. Richard T., University of Wisconsin. Madison, Wis. 

Giibei-t. Prof. Arthwell W., ComeW University. Ithaca, N. Y. 

Grover. Prof. Frederick ().. Oberlin College, Oberlin, Ohio. 

Johnson, Prof. Roswell Hill. University of Pittsburgh. Pa. 

Johnson, Alexander. Director, Training School, Vineland, N. J. 

Lancaster, E. G., President Olivet College, Olivet, Mich. 

Keoier. Prof. Fred L.. Superintendent, T)e]>t. of Public Instruction. Lansing, 

Michigan. 
MacDonald, Miss Gertrude L., Supt. Maine Industrial School for Girls, Hollo- 
well, Maine. 
Metcalf, Prof. Maynard M.. Oberlin College, Oberlin, Ohio. 
Miller. Prof. Herbert A.. Olivet College, Olivet. Mich. 
Reigliard, Prof. Jacob, I"'niversity of Michigan, Ann Arbor, Mich. 
Ritchie. Prof. John W.. College of William and Mary, Williamsbui-gh, Va. 
Stagg, Prof. A.A., Ph.D., University of Chicago, Chicago. 111. 
Washington, Prof. Booker T.. Tuskegee Normal and Industrial Institute, 

Tuskegee. Alabama. 
Willcox. Prof. Walter F., Cornell University. Ithaca, N. Y. 

Social Workers 

BussoU. Reulali. Anti-Tuberculosis Society. Grand Ra]iids. Mich. 

Bussell. Nellie Eileen. Sec. Anti-Tuberculosis Society, Grand Rapids, Mich. 

Dilley. Cora B., Chicago Boys Club Farm, Paw Paw. Mich. 

Gaston, Lucy Page, Anti-Cigarette League. Chicago, 111. 

Oilman. Robbins. Head Worker, I'^niversitv Settlement Society. New York 
City. 

Hart, Hastings H., LL.D.. Kus.sell Sage Foundation. New York City. 

Holt, Byron W., Committee of 100 on National Health, New York City. 

Kimball. Mrs., Alcohol Poster Committee, Boston, Mass. 
Laughlin, H. H., Superintendent Eugenics Record Office, Cold Spring Har- 
bor, N. Y. 

Lindsey, Judge Ben B., Juvenile Court, Denver, Colo. 

McDowell, Miss. University Settlement, Chicago, 111. 

MeCullock, Gen. J. E., Southern Sociological Congress, Nashville, Tenn. 

Riis. Jacob. Henry Street Settlement, New York City. 

Taylor. Graham. Presid(>nt Chicago School of Civics and Philanthropy, 
Chicago. 

Van Hartzveldt, Miss, Anti-Tuberculosis Society, Grand Rapids, Mich. 

Von KleinSmid, Prof. R. B., Indiana Reformatory, Jeffersonville. Ind. 

Walton, Miss Carol F., Secretaiy Michigan State Association, Prevention and 
Relief of Tuberculosis, Ann Arbor, Mich, 

Witter, John H., Supt. Boys Club, Chicago. 



INSTITUTIONS AND ORGANIZATIONS REPRESKNTKD XV 

Women's Clubs 

Glassner. Mrs. Maud, State Federation Women's Clubs. Nashville, Mich. 
Haydoek, Mi-s. D. W., Missouri Federation of Women's Clubs. St. Louis, Mo. 
Roenigh, Marion Chase, Michigan State Federation of Women's Clubs, Green- 
ville, Mich. 

Y. M. C. A. 
Rowe, C. L., Traveling Secretary Y. M. C. A., Jackson, Michigan. 

Publicists 

Cattell. Prof. J. McK.. Editor Popular Science Monthly, Ganison. N. Y. 

Dingley. Edward M.. Editor ProgTessive Herald. Kalamazoo, Mich. 

Evans, Dr. W. A., Health Editor Chicago Tribune, Chicago, 111. 

Johnson, Dr. C. M., Editor Dental Review, Chicago, 111. 

MeClure. S. S., McClure's Magazine, New York City. 

Popenoe, Paul B., Editor. Journal of Heredity-, Washington, D. C. 

Spencer, George B., The Outlook. New York. 

Henry Smith Williams, Author, New York City. 

Phelps, Edward Bunnell, Editor, American Underwriter, New York City. 

Payne, Kenneth W., Newspaper Enterprise Association, Chicago, 111. 

Ministers 

Beardslee, Rev. John W., Holland, Mich. 

Bishop, Rev. Edwin W., Pastor Park Churcli. Grand Rapids, Mich. 

Crane, Rev. Carolyn Bartlett. Crane Building, Kalamazoo. Mich. 

Glass. Rev. D. H., Oavosso, Mich. 

Hillis, Rev. Newell Dwight. Pastor Plymouth Church, Brooklyn, N. Y. 

Sumner, The Veiy Reverend Walter Taylor, Dean, Episcopal Cathedra! of 

Saints Peter and Paul, Chicago, 111. 
Hinzman, Rev. W. T., Tipton, Mich. 
Siebert, Rev. John A.. Adrian. Mich. 

Insurance 

Hunter. Arthur W., New York Life Insurance Co., New York City. 
Hoffman, Frederick L., Statistician Prudential Life Ins. Co., Newark, N. Y. 

W. C. T. U. 

Leiter, Frances Waite, National W. C. T. U., Health Dept., Mansfield, 0. 

Miscellaneous 

Bigelow, M. Edna. Representative American Medical Association, Chicago, 111. 

Bingemann, Miss M. E., Board of Education, Rochester, N. Y. 

Pathe Freres Representative, Wm. J. Helm, Jr., 1 CongTess St., Jersey City, 

New Jei-sey. 
Ritchie, John W., Williamsburg, Va. 

Sprague, Prof. Robert J.. Massachusetts Agricultural College, Amhei-st, Mass. 
Thome, Hazel, Eugenics Field Worker, Lapeer, Mich. 

Wilbur, Dr. Cressy L., Chief Statistician, Dept. of Commerce, Bureau of 
Cetisus, Washington, D. C. 



XVI FlliST XATlOXAh COX FKKKNCK ON RACK IJKTTKRAI KNT 

Ixyaii, Desalcf, School Supi'i'visur, Battle (Jreek, Mich. 
Cobuni, W. G., Principal Battle Creek Schools, Battle Creek, Mich. 
Clements, F. O., Representative National Cash Register Co., Dayton, Ohio. 
Gillette, C. P., Director State Agi-icultui-al College, Ft. Collins, Colo. 
Reid, Dr. Chas. E., Surgeon, Culver Military Academy, Culver, Ind. 

Local Co-operating Organizations 

Battle Creek Ministers' Association. 

Calhoun County Medical Society. 

Battle Creek Dental Society. 

Battle Creek Chamber of Commerce. 

Battle Creek Board of Education. 

Nonnal School of Physical Education 

Battle Creek Sanitarium and Hospital Training School. 

Nurses' Alumni Association of the Battle Creek Sanitarium and Ho.si)ital 

Traming- School. 
Battle Creek Sanitarium School of Home Economics. 
Young Men's Christian Association. 
Young Women's Christian Association. 
Charitable Union. 
Woman's Club. 
Woman's League 

The Ladies' Aid Societies of Nine Churches of Battle Creek. 
Woman's Society of the Congregational Church. 
Dorcas Society. 

Women's Christian Temperance Union. 
Sanitanum Women's Christian Temperance L'nion. 



ADDRESS OF WELCOME TO THE CONFERENCE 

J. H. Kellogg, LL.D., M.D., Superintendent of the Battle Creek Sanitarium, 
Battle Creek, Michigan. 

I feel it an honor, as well as a great privilege, to extend to you in 
behalf of the Board of Trustees of this Institution a most cordial wel- 
come to this Conference, the first of its kind to be held. And I wish 
to tell you that if you esteem it a privilege to gather here for the dis- 
cussion of great questions which concern the w^elfare of the race, you 
are most of all indebted to our greatly esteemed friend, the eminent 
Doctor Hillis, of Plymouth Church, for it was he w^ho last summer 
suggested to me and to other members of the Central Committee the 
idea of this Conference. I said to him in reply, "But, is it possible to 
bring to this small town the busy men who are giving serious thought 
to altruistic questions of this sort?" 

"Certainly it is," said he, "and I'll help do it." 

Professor Irving Fisher happened to be here at the time, and when 
consulted, he said, "By all means, let us have the Conference," and 
he also promised to help. Both of these men, who are individually 
doing such splendid things for the uplift of their fellows, have helped 
so efficiently that the program which is in your hands has been ar- 
ranged and the Race Betterment Conference is launched. 

It is not expected that this Conference will be great in numbers. 
Those who attend come by special invitation, and as indicated by the 
names of speakers shown on the program, are representative thinkers 
and leaders in various lines of work which have for their aim the ad- 
vancement of human welfare. 

From the start it has been most gratifying to note the unanimous 
interest shown in the great purposes of this Conference. Practically 
every person who has been asked to take part in the program has 
readily consented to do so unless prevented by some previous engage- 
ment. The questions which will be discussed here are the greatest 
problems which face the world today. They are not merely questions 
of sect or section, finance or politics : they are race questions, biologic 
questions, whose roots run back to the very childhood of the race 
and whose branches cast their shadow over eyery phase of human 
life. 

The real purpose of the Conference is not to formulate conclusions 
nor to propagate doctrines, but simply to raise in a more definite way 
certain questions of world-wide significance which have in recent years 
been more or less casually discussed, and to set in operation methods 

(2) 1 



2 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

of iiuiuiry which it is lioped may lead to a disrlosurc of facts of tre- 
mendous importance. If the race is deg-enerating. it is highly impor- 
tant that the world should know it and that such agencies should be 
set in operation as will save the race of man from the common fate of 
all other living forms as told and foretold by the geologic records of 
the earth's crust. 

The Conference is to be congratulated in having for its Central 
Committee and Executive Officers a body of men eminently qualified to 
^ve expert guidance to the studies and discussions which may be 
opened up, and to protect us and the public from the evils of sensa- 
tionalism on the one hand, and the dangers of preconceived opinions 
and conventional blindness on the other. 

We are all to be congratulated that we have with us as the Presi- 
dent of this first Conference on Race Betterment, our young and 
greatly beloved and honored friend, Dr. Stephen Smith, whose whole 
life has been devoted to the very objects of this Conference, and who 
at the age of ninety-two years — thanks to Eugenics and Euthenics — is 
still one of the most active men engaged in the service of the ^eat 
State of New York. 

After seventy years of public service, fifty years as State Commis- 
sioner of Charities, Doctor Smith is still active as ever. As President 
of the Tree Planting Association he is transforming the desert wastes 
of New York City into pleasant groves and parks. After waiting 
two average life-times for Doctor Smith to show some symptoms of 
old age, the people of New York have finally become convinced that 
he is endowed with eternal youth, and possesses the vitality of his 
beloved elms and oaks, and so have recently commissioned him for 
another six years' term as Vice-President of the State Board of 
Charities, a Board which carries a heavier load of responsibility for 
human life and happiness than any other like body of men on earth. 
We hope he will unfold to us and to the world the secret of his per- 
ennial youth land vitality. His example and his presence here are a 
proof and promise of the possibility of race betterment. 



ADDRESS OF WELCOME 

Hon. John W. Bailey, LL.B., Mayor of Battle Creek, Michigan. 

After this exceedingly appropriate address and welcome by Doctor 
Kellogg, it is somewhat embarrassing and quite unnecessary for me to 
make any remarks of the nature in which the Doctor has indicated, but 
I assure you that even though it may seem unnecessary, it is a great 
pleasure for me — in behalf of the thirty thousand citizens of Battle 
Creek — ^to welcome to our city these honored guests, ladies and 
gentlemen, who have left their work and their homes and their fields 
of usefulness to come here to take part in this first great Conference 
on Race Betterment. We are very glad indeed to welcome this Con- 
ference to the best town in Michigan, and, when I say that, I may 
welcome you to the best town in the best state in the best country on 
earth. Nature has done a great deal for our city, located as it is in 
the fertile valley of two streams, surrounded by beautiful lakes and 
having a beautiful climate. Everything that vegetation and foliage can 
do for it has been done. The citizens have done much to improve the 
natural advantages which they found here. We have many great fac- 
tories of which we are all very proud. We are very proud of our school 
system, very proud of our churches, of our societies and of our people. 
It is our claim here that we have the most cosmopolitan people in the 
whole world. We are not very poor, not very rich, but we are all able 
to make a living and enjoy ourselves. We have one thing which above 
all others we are the most proud of, and that is this great Sanitarium. 
This institution and its managers have for the last forty or fifty years 
been laboring day and night, in order that they may do good to their 
fellow-men ; in order that this race, our brothers and sisters, may be 
improved. And we who live here know well how successfully they have 
labored. We are exceedingly proud that this institution has been able 
to bring to Battle Creek the distinction of having the very first Race 
Betterment Conference. 

If I understand it correctly, it is the object of this Conference to 
work together, exchange ideas in order that there may be some 
definite understanding as to what is best for the great mass of 
the people of this world, and to give those ideas to the great masses 
of people who cannot possibly be here and who cannot possibly 
know very much about these things, and thus to inaugurate re- 
forms. Many people in the past have been at work exerting their 
great energies to the betterment of the trees and flowers, and to 



4 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

the bettoriiient of animals, but there has not l)eeii that j^reat eoneerted 
effort for the bettennent of the huiiiau race that we iiiid in other 
fiekls. It is to these honored gentlemen who come here for this Con- 
ference that we must look for a start in this most practical and most 
important of all subjects. I sincerely hope that the work of this 
Conference may be such as to lay the foundation for future Confer- 
ences, so that this work may go onward and upward for all genera- 
tions, in order that the boy and girl of the distant future may look 
back upon a father and upon a mother and upon a pedigree reaching 
back into many generations, every line of which represents good, strong- 
men and good, strong women, well-educated men and well-educated 
women — men and women who have used their bodies and their minds 
for the best interests of the race in order that their descendants may 
properly represent the image of their Creator. 

We wish for this Conference every possible success. I know we 
shall all be proud of its results. It is not necessary for me to say a 
word in introducing the President of this Conference. Doctor Kellogg 
has said briefly and better than I could possibly say it all that is neces- 
sary. I will simply say this, that from the appearance of Doctor 
Smith, he represents the idea that he is bringing to us. He comes of a 
long-lived family, a family whose ancestry has given to him the in- 
heritance which has enabled him to do the great work which he has 
done, and to come here at the age of ninety-two, full of life, full of 
strength, full of hope and full of a desire to lift up and glorify the 
human race. 

I take great pleasure in introducing to this Conference, Dr. Stephen 
•Smith, its President. 



PRESIDENT'S ADDRESS 

THE BASIC PRINCIPLES OF RACE BETTERMENT 

Stephen Smith, M.D., LL.D., President of the Conference; Vice-President 
New York State Board of Charities, NeAV York City. 

Mr. Mayor, Members of the Conference, Ladies and Gentlemen : — 
An ancient symbol of the genius of Medicine represented a female 
figure sitting with downcast eyes and a finger on her closed lips, 
signifying that the proper position of the physician is one of silence 
and meditation. That symbol illustrates the mental attitude which I 
should prefer to assume in this Conference. But, as with many of 
the more responsible duties in my experience, it was not for me to 
determine the position I was to occupy in the Conference, and I have 
humbly accepted the decision of the Central Committee, only too 
thankful that I was deemed worthy of an invitation to become a 
member. 

I enter upon the duties assigned me with a full appreciation of the 
honor which the Presidency of this Conference confers and inspired by 
the desire to render it an open forum for the initiation, discussion and 
determination of the kind, quality and employment of the agencies 
for the promotion of race betterment. 

OBJECTS OF CONFERENCE 

It is fitting, on establishing a new organization, to define its objects 
and explain its methods. As officially annoimced, the objects of the 
Conference are two-fold, as follows: 

1. To assemble evidence as to the extent to which degenerative 
tendencies are actively at work in America, and, 

2. To promote agencies for race betterment. 

Giving to the word "degenerative" its ordinary meaning — a loss or 
impairment of the qualities peculiar to the race — our inquiry and re- 
search includes every matter or thing which in any wise, nearly 
or remotely, affects unfavorably the normal physical development and 
functional activitj^ of any member of the race. 

The second object of the Conference — To promote agencies for 
race betterment — opens a world-wide field for observation, research 
and practice, for these agencies are innumerable. The term "Race" 
includes the ' ' Human Family, " " Human Beings as a Class, " " Man- 
kind." "Betterment" means improvement in its broadest and largest 
sense. 

s 



6 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Reducing these objects as stated to a practical standard, the outlook 
upon the human race from the view-point of this Conference recog- 
nizes two features in its developments: 

1. The tendency to degenerate ; 

2. The capacity to regenerate. 

In our estimation of the tendency of the race to degenerate we 
must carefully distinguish between an inherent tendency or predis- 
position to degeneracy under any and all conditions, and a suscep- 
tibility to degeneracy under certain favoring conditions. All experi- 
ence proves, and science confirms experience, that degeneracy of the 
race is not due to any structural peculiarities of the individual other 
than the normal susceptibility to impressions, which may be greater 
in one person than in another, owing to heredity. On this account, 
environment, or the conditions under which an individual lives, is a 
most important determining factor in our estimation of race de- 
generacy and race regeneracy. 

On the very threshold of his existence man is confronted with 
conditions which powerfully tend to degeneracy. All animal and 
vegetable life appears alien to this planet and has to struggle for ex- 
istence amid hostile forces which beset it on every hand. What vast 
quantities of germinal matter the bountiful hand of nature supplies 
to every form of life to perpetuate "its kind" and yet scarcely one 
germ in a million lives. In summer the fields and forests are strewn 
with waste germs. 

Man himself is only one of the thirty-thousand possible sons and 
daughters with which his parents were endowed. His birth is a 
successful incident; his first breath is an accident; his nourishment 
is by the grace of another. If he survive the perils of infancy and 
reach maturity, innumerable evils — physical and mental — sickness, im- 
becility, insanity, crime, death — assail him at every stage of progress 
as if they were his inheritance. 

Endowed for a vigorous, healthy life of a hundred years, man 
suffers from every form of disease and lives but a moiety of his pre- 
destined longevity. Of the children bom, what large percentage never 
see their first anniversary birthday ! What other large percentage 
dies under five years ! Few comparatively reach the age of ten years ; 
at twenty the generation has dwindled to an insignificant minority 
and at forty-five it disappears altogether. But three in a thousand 
reach the normal period of human life — one hundred years. 

But while the evidences of a tendency of the race to degenerate 
are apparent to common observation in every period of human history, 
there is an obverse of this sad picture of the most hopeful and in- 
spiring character. The same impressionable peculiarity of his nervous 



PRESIDENT S ADDRESS i 

centres which tends to make him yield to degenerative influences may 
be relied upon by skilled treatment to promote and effect his regenera- 
tion. Estimating man 's inherent mental capacity by his achievements 
in the past, we can place no limit upon the possibilities of his better- 
ment. Consider how he has subdued the hostile forces of the earth 
and made them subservient to his comfort and his well-being ! Though 
the most unprotected of animals, he excels all others in his means of 
defense; he lays the entire world under contribution for his food 
supply and reduces his foods to the most digestible and assimilable 
forms ; if he loses a limb, or a tooth, or an eye, another immediately 
supplies its place, quite as serviceable and often more ornamental; 
the lightning as his messenger annihilates time and space, and while 
it transports him also supplies him with heat and light. Thus on all 
sides he is capable of warding off danger, decay and death and demon- 
strates his ability to exercise dominion "over all the Earth." 

These facts suggest the question of the ages, ' ' What is the ultimate 
purpose of human life on this Earth?" And it is very desirable that 
we have a working hypothesis that will be most useful in selecting and 
promoting agencies for the betterment of the race. There can be no 
more helpful and hopeful answer to that question than the following 
last utterance of the great scientist, Alfred Russell Wallace: 

"This earth with its infinitude of life and beauty and mystery, 
and the universe in the midst of which we are placed, with its over- 
whelming immensities of suns and nebulne, of light and motion, are as 
they are, firstly, for the development of life culminating in man; 
secondly, as a vast schoolhouse for the education of the human race in 
preparation for the enduring spiritual life to which it is destined." 

What higher conception can we have of the world in which we 
live than that it is ,a " vast schoolhouse for the education of the human 
race," and what more pointed lesson can be taught as to the conduct 
of our o-wn lives and our duties to the race than that this life is 
*'in preparation for the enduring spiritual life to which it is des- 
tined?" 

PAST AND PRESENT METHODS OF RACE BETTERMENT 

To appreciate fully the great service which this Conference will 
render to humanity, if it establish the principles of race betterment on 
the immutable basis of science, we need to consider for a moment the 
past and present unscientific and inefficient methods of betterment 
of the degenerates of the race. Looking backward we learn that man 
has usually been regarded as an unknown entity, a mysterious com- 
bination of the animal, the satanic and the divine, the two former 
attributes being usually the most conspicuous. Efforts to benefit him 
were limited to improving his personal appearance, supplying evident 
wants, and punishment of criminal acts. The result was that neither 



8 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

the iiulividual nor the race was made permanently better by the 
remedies employed. The diagnosis was based on false premises and 
the remedial measures were useless or harmful. 

No one personally familiar with the management of the charitable, 
reformatory, eleemosynary and other institutions for the degenerate 
classes can doubt that we signally fail to accomplish the objects of 
their creation — the betterment of their inmates. "We mass these un- 
fortunates together under one name, and make one prescription for the 
lot that has not the merit of several ingredients. Too often the insane 
of every form and grade, curable and incurable, are crowded into 
asylums, where their individuality is merged in the seething mass; 
the criminals, young and old, thieves, highwaymen, adulterers, 
murderers, crowd the prisons, without the slightest effort or even pre- 
tense on the part of officials to individualize them and employ suitable 
measures to render them capable of self-care, possibly of self-support, 
and certainly to insure humane treatment. 

The experience of a generation in official visitation and supervision 
of the charitable, reformatory and eleemosynary institutions of the 
State of New York has deeply impressed me with the conviction that 
our efforts to benefit the vast population in public and private care^ 
idiots, feeble-minded, insane, criminals, deaf, blind, epileptic, vagrants 
— is in a primitive stage of development. The institutions for their 
care and treatment are becoming less and less curative and more and 
more custodial. The result is the gathering and support at public ex- 
pense of an immense population of more or less able-bodied men and 
women who on account of their various ailments, physical and mental, 
are allowed to pass their lives to old age in complete idleness. No 
sadder sight awaits the visitor to these institutions than groups of 
such people, well-fed and clothed, sitting in idleness in and around 
the buildings on a bright summer day and in view of farm lands 
largely cultivated by paid laborers. 

One is reminded of Carlyle's picturesque Tourist's description of 
the Workhouse of St. Ives on a bright autunm day. He says, ' ' I saw 
sitting on wooden benches, in front of their Bastille and within their 
ring w^all and its railings, some half hundred or more of these 
men, tall, robust figures, mostly young or of middle age, of honest 
countenance, many of them thoughtful and even intelligent-looking 
men. They sat there near by one another; but in a kind of torpor, 
especially in silence, which was very striking. In silence ; for alas, 
what word was to be said? An Earth all lying around crying, Come 
and till me ; come and reap me ; — ^yet we here sit enchanted ! In 
the eyes and brows of these men hung the gloomiest expression, not of 
anger, but of grief and shame and manifold inarticulate distress and 



president's address 9 

weariness ; they returned my glance and with a glance that seemed to 
say, 'Do not look at us. We sit enchanted here, we know not why. 
The Sun shines and the Earth calls; and by the governing powers 
and impotence of England, we are forbidden to obey. It is impossible, 
they tell us. ' There was something that reminded me of Dante 's hell 
in the look of all this ; and I rode swiftly away. ' ' 

Many of these institutions could place on the lintel of their en- 
trance door the famous motto, ' ' Who enters here leaves hope behind. ' ' 
An eminent physician, disappointed at the few discharged from these 
charities, compared with the large number admitted, characterized 
them as ''Great Hospitals of Lethargy." It has recently been re- 
marked by an eminent statesman and acute observer, Sir Horace 
Plunkett, that, "rightly or wrongly, it is generally felt that the 
service which science renders in the cultivation and preservation of 
our health lags far behind its marvelous achievements in the region 
of the industries and arts." This statement is eminently true when 
applied to our efforts to improve the mental and moral condition of 
the degenerate class. Ignorance of man's physical constitution has 
unfavorably influenced every effort for his betterment and still is the 
greatest obstacle to .success in our treatment of the defective and de- 
pendent classes. Though we live in the noon-day effulgence of the 
sciences of biology and physiology, their light illumines only the 
upper atmosphere, and does not penetrate the dense gloom which 
envelops the degenerate of our race. 

unscientific and scientific methods 

There is no better illustration than that furnished by medical art 
of the disastrous influence of ignorance of man's intimate physi(5al 
nature upon efforts to relieve his disabilities, and the power of scien- 
tific knowledge of these essential facts to apply with precision the 
exact remedy required to give relief. 

In the days of ignorance "the mysteries of physic" was a term in 
common use by the profession. Diagnosis was merely guesswork and 
therapeutics was grossly empirical. Diseases of organs were treated 
in the mass as a single affection. "Lung disease," "heart disease," 
* ' liver disease ' ' were common terms, each now laiown to cover a multi- 
tude of ailments, but unknown to the practiser of that time because 
he was ignorant of the minute structure of the organs and of the 
consequent great variety of affections to which each organ was liable. 
In the treatment of the diseases of an organ, the physician made but 
one prescription, and for any new symptom which might appear he 
added another drug, until the single prescription sometimes contained 
ten or a dozen different remedies. This was the famous "shot-gun" 



10 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

prescription, which was "sure to kill something." Possibly this in- 
cident exphiins the familiar story of the old physician who said that 
when he began practice he had ten remedies for one disease, but in 
later life he had one remedy for ten diseases. 

The great revolution in medical practice came when Virchow, the 
German medical scientist, revealed the fact that the ultimate elements 
of man 's physical organism are a commonwealth of infinitesimal bodies 
Imown as cells ; that everj^ organ is a wonderful mechanism adapted to 
its special function by the multiplication and arrangement of its cells 
numbering thousands of millions in a single organ ; that each cell-unit 
has its own special function, its own diseases, its own symptoms and 
requires its own special remedies. 

It is quite impossible for one who was not a contemporary with this 
discovery to appreciate its remarkable influence on medicine as an 
art. The scales fell from the eyes of the practiser, and where previ- 
ously he had known imperfectly but two or three diseases of an organ, 
as of the heart and lungs, he now recognized scores, each with well- 
defined symptoms, and each requiring a special remedy. The entire 
field of medical practice was revolutionized ; diagnosis became exact ; 
treatment precise ; the saving of life enormous. Evidently, the basic 
principles of medical practice are: (1) Exact knowledge of the struc- 
ture and functions of the organ affected ; (2) the nature of the diseases 
to which it is liable; (3) the symptoms peculiar to each disease. "With 
this knowledge the medical practiser no longer masses diseases and 
gives a multiple dose, but carefully discriminates between the symp- 
toms, determines the single disease and its progress, and then ad- 
ministers the appropriate remedy and secures the desired results. 

BIOLOGY AND PHYSIOLOGY THE FOUNDATION OF RACE BETTERMENT 

But there is a hopeful future dawning for all classes of delinquents, 
degenerates, and deficients, however handicapped by heredity, environ- 
ment, accident or disease. The science of biology and of physiology', 
which reveals to medical art the minute structure and function of 
the ultimate elements of the vital organs and thus makes it exact 
in practice to the great saving of human life, is penetrating further 
and further into the hitherto mysterious mass of apparently homo- 
geneous matter, the brain, and astonishing the world with its won- 
derful revelations. Here it has found the very springs of human 
existence — the centers of consciousness, thought, action — the home of 
the soul, the Ego, the man. 

In these discoveries we find the basic principles of race better- 
ment. The adage is still true, that it is "the mind that makes the 



president's address 11 

man," and all our efforts to improve the individual and through him 
the race must center in the normal development and physiological 
action of the ultimate elements of the brain, the organ of the mind. 
Every effort we make to improve man's physical condition should be 
subordinate to its effect on the brain. A recent writer says, ''What- 
ever elevates the physiological above the psychological, the body above 
the mind, is an enemy of the race and no method for its regeneration." 
Henceforth, all our efforts to better his condition should be based on 
an intimate knowledge of the brain, admittedly the organ through 
which that mj^sterious entity, the mind, finds expression. 

In order to obtain a more thorough understanding of the subject 
matter of this paper, especially by lay members, it will be necessary to 
explain in a familiar way some features of the structure and functions 
of the elements of the brain. 

THE CIOLI. — THE NEURONE 

Reduced to its simplest form and expression, the ultimate element or 
unit of the brain is a cell which with its nerve is now called a "neu- 
rone." This infinitesimal body is recognized by scientists as the 
source of all mental phenomena — thought, word, act. In efforts to 
express their estimation of brain-cells in the relation which they bear to 
the mentality of the individual, the most eminent physiologists of our 
time have used the following emphatic terms : One states that "the cell 
is a unified organ ; a self-contained living being ; " a second regards it 
as ' ' the sole active principle in every vital function ; " a third asserts 
that it is "the medium of sensation, will and thought, the highest of 
the psychic functions;" a fourth says, "As are his neurones (brain 
cells) so is the man." 

Recently, Ernest Haeckel. the German scientist and philosopher, 
has made the following contribution to the cell theory, "We have now 
ascertained in the clearest, most indisputable manner that all which 
we term the 'soul' is in a scientific sense nothing more than the total 
effect or function of the ' Soul Cells of the numerous neurones in the 
brain '. ' ' 

Though the cell is so "extraordinarily complicated that its essential 
constitution eludes our observation," its general structure and more 
important features are well known. The following facts in regard to it 
have been recorded by physiologists : A cell is "an individuated mass 
of protoplasm, generally of microscopic size, with or without a nucleus 
and a wall. " Protoplasm is an albuminoid substance capable of mani- 
festing vital phenomena, as motion, sensation, assimilation, reproduc- 
tion ; the least particle of this substance, a single cell, may be observed 
to go through the whole cycle of vital functions ; it builds up every 



12 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

vog'ctabU' and animal fabric ; it is the physical basis of life of all plants 
and animals. 

The protoplasm of the brain cells is so extremely sensitive that by 
proper instruments a change can be detected in its substance when a 
cloud passes over the sun ; also a thermometer v^ill detect a rise of its 
temperature during any great mental effort ; and, again, delicate scales 
■will weigh the amount of blood which rushes to the excited brain cells 
for their nutrition when a person in a recumbent position has sudden 
mental excitement. 

The cells, estimated to be upwards of two thousand millions in the 
human brain, are implanted before birth in a rudimentary form and 
undergo an evolution from the cell of the lowest animal life to the 
complex cell of the human brain. Though at birth the cell has been 
perfected, so far as regards its structural adaptation to its special 
future function, yet it will remain in an inert state and undergo no 
further change or development until excited to activity. Each cell has 
its own special function to perform and hence has its own special 
stimulant; the cells of the auditory center are stimulated by sound, 
those of the ophthalmic center by light, those of the olfactory center by 
odors. 

Physiologists believe that in the human brain there are large num- 
bers of nerve-cells that remain undeveloped because never excited to 
functional activity, and also that at any period of life, cells hitherto 
inert may receive their proper stimulus and become active. They assert 
that if to the born-blind there is no world of light, and to the born-deaf 
there is no world of sound, may it not be a fact that worlds exist 
around us other than those revealed by the five special senses ; worlds 
which we do not recognize because the special nerve centers for that 
purpose have not as yet been stimulated to activity? St. Paul hints 
at that opinion when he declares that spiritual truths cannot be dis- 
cerned except the spiritual (cells) sense has been awakened and 
Haeckel now asserts that the soul is the output of the functional 
activity of "Soul Cells." Along the same line of conjecture may we 
not suggest that many strange mental phenomena — dreams, telepathy 
— hypnotism — find their proper explanation. 

Cells, like other tissues, are constantly undergoing change in the act 
of nutrition and owing to their extreme susceptibility to impressions, 
their functions are easily disturbed by the food we eat, the fluids we 
drink, the condition of our digestion, in addition to the infinite number 
of impressions which they daily receive from causes internal and ex- 
ternal to the body. For this reason our mental moods are constantly 
changing ; we are not the same this year that we were last year, this 
month that we were last month, this evening that we were this morn- 



president's address 13 

ing. It follows that any change in the constitution or structure of the 
cell must be attended by a derangement of its function that would 
find expression in the mental acts of the individual. If a group of 
cells should from any cause cease to act, the mental attributes which 
they manifest, when acting normally, must cease. Equally, if the 
same cells are overstimulated, their fiuictional activity is correspond- 
ingly increased. Or, again, if the properties of the cells are changed, 
as by alcoholic intoxication, or by any other toxic agent which finds 
access to the brain and for which any cells have an affinity, the normal 
function as expression would be changed to the extent that the aff'ected 
bodies contribute to the mentality and personality of the individual 
and in the particular feature involved therein. 

The wise Diotama said to Socrates most truly (Symposium of 
Plato) : "In the same individual there is succession and not absolute 
unity; a man is called the same, but yet in the short interval which 
elapses between youth and age ... he is undergoing a perpetual 
process of loss and reparation. . . . And this is true not only of the 
body but also of the soul, whose habits, tempers, opinions, desires, 
pleasures, pains, fears never remain the same in any one of us, but are 
always coming and going." 

Physiology teaches that these cells endow all forms of animal ex- 
istence with that degree of intelligence necessary to their personal wel- 
fare in the sphere in which they live — man, cosmopolitan in his habits, 
standing at the head with two thousand millions as his requirement; 
and the animalcule, fixed in its place, with few to meet its simple wants. 
It follows that these cells, so far as they exist and are brought into 
functional activity, constitute the personality of the individual, the 
"ego," whether of man or animal. 

And wherever these cells are found, whether in the brain of man 
or l)east, fish or fowl, insect or creeping thing, they only await the 
skill, the cunning, the patience of the expert educator or animal trainer 
to show the world an idiot working at his trade, a horse responsive to 
every word or gesture of his keeper, a dog going on an errand by com- 
mand of his master whom he does not see and always selecting the right 
article, a learned pig solving arithmetical problems, seals performing 
difficult stunts, ants learned in military tactics, fleas expert in social 
functions. 

The perfect brain must be one in which all of its cells have their 
full and normal functional development. But the degree of develop- 
ment depends upon so many conditions personal to the individual that 
it is doubtful if a perfect human brain ever did or ever will exist on 
this^ planet. In every community, and often in the family, we recog- 
nize vast differences in the mental development of individuals, though 



14 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

they seem to be living under precisely the same conditions. But under- 
lying, or interwoven in, these external and recognized similar condi- 
tions are undiscovered incidents that account for the differences so ap- 
parent. 

Traced to its true source it will be found that the want of opportu- 
nity to apply the greater number and variety of stimulants to the 
brain through the special senses — seeing, hearing, feeling, tasting, 
smelling — accounts for much of what we call degeneracy. The farm 
laborer toiling alone has none of the intelligence and vivacity in con- 
versation, of the village tailor, cobbler or blacksmith, though equally 
endowed mentally. The farmer has few brain stimulants, while the 
latter are abundantly supplied through constant contact with cus- 
tomers. A schoolboy rated as deficient saw an older scholar sketch a 
horse on the schoolroom door ; he was so profoundly impressed by the 
picture (that is, his art nerve-centers were so stimulated) that he 
devoted himself constantly to sketching and became the most dis- 
tinguished portrait painter of his time. Sir Isaac Newton states that 
he "stood very low in his class" but the sight of a falling apple 
aroused dormant brain cells which revealed to the world the law of 
gravitation and made him forever famous. History is replete with 
incidents of the sudden awakening of hitherto unstimulated brain 
cells of persons accounted defectives. Can we, therefore, wisely and 
justly determine the mental capacity of any living being, man or 
animal, until we have given the opportunity for development. But 
however handicapped by heredity or disease, or environment, science 
teaches wdth unerring certainty that, unless their organic properties 
are destroj^ed by accident or disease, cells promptly respond to such 
curative measures as are adapted to relieve them of their disabilities. 

I may ?;eem to have dwelt on these scientific facts wdth too much 
minuteness and, perhaps, repetition, but as they are the basic princi- 
ples upon vs^hich all future progress in the improvement of the so-called 
defective classes must rest, and as they are obscure to a layman, I have 
been impressed vdth the importance of discussing them more fully 
at this first session of the Conference on Race Betterment. 

The most interesting and practical feature of these cells evidently 
is the absolute control that w^e may exercise over their functions. 
They enlarge and become active when we stimulate them, and atrophy 
and become passive when we withhold stimulants. As each cell, or 
group of cells, has its own special function to perform, we can select 
the group that will accomplish the object we have in view, and stimu- 
late it to the degree necessary to reach the desired result. Or we may 
reduce an active group of cells to their rudimentary state of quiescence 
by withholding its proper stimulant. 



president's address 15 



METHODS OP IMPROVING THE RACE 



Reduced to its simplest expression the question that confronts us is, 
How can we secure to each individual of the race a normal develop- 
ment of brain cells? Applying these basic principles to the better- 
ment of the race, two methods of procedure naturally occur to the 
scientific student. First is prevention, or the adoption of such meas- 
ures as will prevent the birth of degenerates ; and, second, an effort to 
improve the condition of existing degenerates. 

Two methods of preventing the propagation of degenerates are 
practiced; viz., (1) Sterilization, and (2) segregation of the sexes. 
These methods are efficient means of preventing the increase of those 
who submit to the test. But however effective sterilization and segre- 
gation may be in arresting the increase of degenerates, they are 
methods which must necessarily have limited application. The great 
problem before this Conference and all workers in the field of philan- 
thropy is the betterment of the defectives as we find them in every 
grade of society. 

If we adopt the basic principles of race betterment as herein set 
forth, that problem may be stated as follows: How can me make the 
brain of the defective most useful to its possessor? Considering the 
remarkable sensitiveness of the nerve cells of the brain to impressions 
both within and without the body, it is evident that the measures which 
ma}^ be employed to arouse the cells to activity and restore their nor- 
mal functional capacity are innumerable, and their effectiveness will 
depend upon the intelligence, patience and perseverance of the re- 
sponsible caretaker. 

THE EDUCATION OP IDIOTS 

The first efforts in this country to teach the idiot strikingly illus- 
trate the preceding statement of the basic principles of race better- 
ment. More than a half century ago Dr. Harvey B. Wilbur reduced 
the theories of science to practice and demonstrated their truth. I 
was witness of his experimental work on idiots and feeble-minded, and 
it is interesting to note that it is founded on the modern teaching 
of physiology in regard to the structure and function of the brain 
cells. His explanation of his method was to the effect that the idiot 
had a dormant nervous system, and the first step in his education must 
be to arouse the brain to activity; that the best method of making a 
first impression was through the sense of feeling ; that the shock com- 
municated by a metallic substance through the sensitive surface of the 
hand was the most effective. His argument was logical. In practice 
he placed the idiot-child on the floor and laid a dumb-bell by his side, 
fixing the child's hand on the shaft. Standing in front of his pupil. 



16 FIRST NATIONAL CONFERENCE ON RACE HETTERMENT 

the doctor delilxn-ately struck the boy's dumb-bell with a dumb-bell in 
his own hand. The first trial was on a boy whose idiocy was so pro- 
found that he scarcely noticed anything. The clash of the metals 
startled the boy so that he involuntarily removed his hand from the 
dumb-bell. This w^as the first trial, as he had just been received. The 
doctor pronounced him a promising pupil, as his nervous system was 
sensitive to impressions. 

Three other pupils under training were tested, each showing im- 
provement in proportion to the length of time of teaching ; the first of 
these raised his eyes and was excited as the Doctor's dumb-bell de- 
scended ; the second removed his hand before the dumb-bell was struck, 
and laughed ; the third imitated the Doctor in the use of the dumb- 
bell. 

Doctor Wilbur explained that this method of arousing a dormant 
brain (unconsciously referring to the cells) had this advantage, that 
he stimulated at once three of the five special senses — feeling, seeing, 
hearing. If we could trace the far-reaching connections of the cells of 
the special centers with other centers higher in the brain and leading 
up to the great centers of ideation, we should have seen himdreds of 
thousands of inert and hitherto dormant cells awakened to activity and 
the performance of their proper function. 

REFORM OF CRIMINALS 

The treatment of the criminal class on the physiological or hu- 
mane system strikingly illustrates its value compared with the punitive 
methods still practiced. It is interesting to notice the conclusion of the 
last meeting of the International Prison Congress which was to the 
effect that no criminal is hopelessly bad and incapable of reform. 

Socrates replied to an Athenian who inquired as to the best method 
of correcting the vicious and criminal tendencies of his son, ' ' Remove 
from him all conditions which incite to vice and substitute the allure- 
ments of virtue. ' ' In physiological language he said, ' ' Cease to stimu- 
late the vicious brain cells which are now excited and govern his 
thought and they will waste and cease to influence him ; stimulate the 
virtuous cells and they will enlarge until they control his acts." 

"When you pass through the gate to this place, you left your past 
life behind you; I do not wish to have you ever refer to it; my 
only concern is as to what your future life will be, and to determine 
that question you are here." Such was the reply which the superin- 
tendent of a prison for convict women made to the threats of homicide 
of a young woman who was declared by a Boston judge to be the most 
desperate criminal ever known in the courts of that city. She boasted 
of having been in every prison in Ireland and in many of this country. 



president's address 17 

The treatment was physiological; all incitements to vice and crime 
were removed and every possible stimulant to virtue substituted ; the 
cells of the former wasted while the cells of the latter grew and became 
dominant. Today the priest of her parish in Ireland writes that she 
is the most helpful person he has in his work among the \dcious classes. 

' ' Try me, ' ' said a prisoner to the sheriff who asked him if he would 
work for wages. These two words reformed the management of a 
Vermont prison and made it a school for the making of useful citizens. 
The prisoners go out to work in the city of Montpelier and command 
by their conduct universal respect. They are seen on the streets on 
holidays without attendants; they receive wages for their work and 
thereby support, not only their families, but the prison itself. They 
leave the prison prepared to lead the lives of good citizens and few fail 
to meet that test of true reform. 

"I am going to make men and not brutes of these fellows," said 
Governor West, of Oregon, when he began his famous prison reforms. 
His "first trick" with a convict, it is reported, stirred the state from 
the lowest to the highest. He requested the warden of the prison to 
give one of the most desperate prisoners a dime and direct him to call 
at the executive office. The warden replied that to give Jim Baggs a 
dime and his liberty meant that Jim would soon be scarce in Oregon. 
He, however, complied and the prisoner soon appeared at the state 
house ; he was in prison dress but was very proud, informing every 
officer who he was and that he came on the Governor's invitation. A 
position was found for Jim Baggs on a farm where he did good service 
and the Governor made him his first "honor man." This reform 
in prison discipline resulted in the release of prisoners on parole "in 
droves, ' ' who found situations outside and earned their living and be- 
came respectable citizens. It is stated that, when one of his "honor 
men" broke parole, the Governor went out himself and captured him. 
Since that time the other convicts have made that prisoner's life 
miserable. The Governor sent a crew of forty convicts, without prison 
dress and unattended, to a distant town to work on a road. He says, 
"Oregon won't need a penitentiary at an early date." 

"Arizona State Prison, a School for Developing Manhood," is the 
startling headline of a daily paper. Governor Hunt's policy in the 
management of prisons is physiological. He says, "Shall we go on 
making penitentiaries schools of crime, or make an effort to build up 
the man's character, restore his self-respect, strengthen his weakness, 
and cultivate in him a proper appreciation of his relation to others, and 
to society in general? You can never do these things hy continually 
reminding him that he is a criminal, dy suhmMting him to small hu- 
miliations or to cruelties." 



18 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

The result of the management based on these principles is given by 
a prisoner: "The Governor thinks we are worth saving and he is 
willing to let us come back. Pie has taken away all our useless humili- 
ations that kept before us our condition. The Governor trusts to our 
honor to obey the prison laws and there is not an English-speaking 
prisoner, at least, who would do anything to bring discredit on the 
Governor's policy. You have no idea already of the difference in the 
men among themselves. We used to have fights every day. Oh ! it 
M'as hell. Now, although we are restless, and every man longs for 
liberty, we are at peace. ' ' 

Other states are adopting the humane policy and converting their 
prisons into schools of reform and with marvelous results ; prisoners of 
all grades respond to the influences which remove from their thoughts 
the incentives to vice and crime and yield to the allurements of virtue. 
The punitive or savage policy in treating convicts is generally domi- 
nant and the result is that prisons are schools of vice and a dead 
weight of taxation. 

CURATIVE TREATMENT OP THE INSANE 

The curative treatment of the insane received a stunning blow by 
the publication of some ancient statistics showing that large numbers 
discharged as cured relapsed. This report by an eminent alienist had a 
blighting effect upon the faith of medical men in the real curability of 
the insane, and revived the old but popular belief, "Once insane al- 
ways insane." The result was that their treatment became more em- 
pirical than scientific, the state hospitals custodial rather than curative, 
and the rate of cures a meager 25 to 30 per cent. An expert alienist, 
familiar with the management of institutions for the insane, has re- 
cently stated that 75 per cent of the insane are curable, and 90 per 
cent are capable of self-support, if adequate measures are taken for 
their cure, and for their training. "Adequate measures" embrace an 
exhaustive study of each case by a competent physician and persistent 
treatment. 

Finally, I can only allude to the vast but practically unexplored 
field of medical therapeutics, which we have reason to believe abounds 
with agents for which brain-cells have a selective affinity. As we have 
stated, each cell has its own special stimulant and its own power of 
selecting from the blood the kind of nutriment and stimulant adapted 
to its function. When we know the affinity which any cell or group of 
cells has for a particular medicine we can medicate that particular 
cell or group with perfect accuracy. Thus, the oculist wishes to ex- 
pand the pupil of the eye in order to explore its deeper recesses and 
with perfect certainty he uses atropine, w^hich temporarily paralyzes 
the nerves that supply the iris. 



president's address 19 

Many similar instances of the specific action of medicinal remedies 
upon special brain cell-centers could be mentioned, but the investiga- 
tions in that department of research have not advanced sufiQciently to 
establish a code of practice. We can only conjecture that medical 
therapeutics vrill give us many agencies whose direct action on nerve 
centers will change their functions at our will. 

THE RELIGIOUS CONSCIOUSNESS 

Examples of the awakening of the religious consciousness — the 
"Soul Cells" of Haeckel — illustrate our subject. Perhaps the in- 
cident of St. Paul's conversion as related by himself is most illumi- 
nating. "Suddenly there shone from Heaven a great light ... I 
fell unto the ground, and heard a voice. ' ' A great light and a voice 
— sight and sound — aroused to intense activity the dormant "Soul 
Cells" (of Haeckel), which from that moment dominated every 
thought, word, and act of his life. 

The power of the Christian consciousness, when awakened to 
activity, to change the most savage tribes into highly civilized com- 
munities is related as an incident in the experience of Darwin, the 
projector of the theory of "Evolution." In his first scientific voyage 
he found a tribe of savages in South America which seemed so hope- 
lessly animal that he was inclined to believe he had found the missing 
link. Soon after his visit a pious Scotch captain of a trading vessel 
visited the tribe and was so impressed with their savagery that he 
felt impelled to attempt their conversion to Christianity. He returned 
home, secured a company of devoted Christians, stocked his vessel with 
the necessities of the colony and returned to the tribe. Several years 
later Darwin visited the tribe on one of his scientific explorations, in- 
tending to study the people more thoroughly. He was surprised on 
reaching the place to find a flourishing community with its schools, 
churches, and various industries under the government of the natives. 
On returning home he visited the rooms of the British Foreign Mis- 
sionary Society in London and related the incident, stating that he 
desired to become a subscriber to the propagation of a religion which 
could effect such changes in savages. 

It would be interesting and instructive to review the efforts 
hitherto made to improve the mental capacity of the degenerate, but 
time will allow the notice of only the most recent and promising 
methods now under trial. 

THE ELECTRIFIED SCHOOLROOM 

The first is known as the ' ' Electrified Schoolroom to Brighten Dull 
Pupils," of Nikola Tesla. It is well known that eminent experimental 



20 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

psyc'bologfists believe that tlie liigh-fre(iueiicy current intensifies cere- 
bration ; that it is a mental stimulant like alcohol, but instead of being 
harmful to the brain cells as is alcohol, the electricity is harmless and 
confers lasting" benefits. 

Mr. Tesla's attention was attracted to this subject by noticing the 
efi:*ect of electricity on one of his assistants who, while making certain 
high-frequency tests, was very stupid in carrying out instructions 
concerning laboratory adjustments equipped with a coil generating 
high voltage currents. After a time ]\Ir. Tesla noticed that his assis- 
tant became brighter and did his work better, but supposed the change 
was due to his becoming more familiar with his duties. On observing 
the actions of the man more closely, he concluded that his assistant's 
increased aptness and alertness was due to a much deeper cause than 
mere experience ; that the elements of "mental life" — the brain cells — 
had been stimulated to greater functional activity. This new, novel and 
practical method of awakening to activity dormant brain cells, has 
been subjected to trial on a large scale in Stockholm, Sweden. Two 
sets of fifty children each, averaging the same age and physical condi- 
tion, were placed in separate classrooms exactly alike except for the 
concealed wires in one of the rooms. The regular school work was 
pursued and the test lasted for six months. 

The results recorded were as follows : The children in the magne- 
tized room increased in stature two and a half inches, those in the 
unmagnetized room increased one and one-fourth inches;; the former 
also showed an increase in weight and physical development greater 
than the latter. More remarkable was the difference between the 
mental development of the two classes, viz. : Those exposed to the 
electric rays averaged 92 per cent in their school work, compared 
with an average of 72 per cent of the children in the other rooms; 
fifteen pupils in the electrified room were marked 100, and nine in the 
other class. It is stated in the report that the electrified children ap- 
peared generally more active, and less subject to fatigue than those 
not electrified and that the teachers experienced a quickening of the 
faculties and an increase of endurance. 

The method of applying the electricity is thus stated : Carefully 
insulated wires will be inserted in the walls of the experimenting class- 
room and the tests will be carried on without the knowledge of either 
the teachers or the pupils ; the air of the room will be completely 
saturated with incalculable millions of infinitesimal electric waves vi- 
brating at a frequency so great as to be unimaginable and capable of 
measurement only by a most delicate volt meter. 



president's addeess 21 



THE CLEARING HOUSE 



The second plan proposes to establish a "Clearing House for 
Mental Defectives" and is being matured in the Department of Public 
Charities of New York City. It will co-ordinate all organizations 
which have supervision of children in a common effort to separate the 
defectives and place them under proper care and treatment. 

To this Bureau are to be sent all defective children that come under 
the supervision of the Department of Charities, the Board of Educa- 
tion, the Department of Health, the Society for the Prevention of 
Cruelty to Children, the Department of Immigration, children 's courts, 
state institutions, dispensaries, social workers, etc. 

The bureau will be under the immediate control and management of 
a staff of experts in mental and nervous diseases. It will also be 
equipped with every recognized device or appliance for determining 
the mental grade of each child admitted, and the particular nature 
of feeble-mindedness. Each will be subjected to the Binet test, finger 
prints will be taken, and field workers will make an investigation into 
the heredity of each case. The examination also will determine 
whether the applicant is likely to be dangerous to the community by 
reason of any criminal tendencies. 

The Clearing House will name the proper course of action in each 
case, and send a report on each child to the department or society 
which may refer the case. It will also co-ordinate all activities into 
one bureau organized to keep scientific records of the mentally de- 
fective individuals in this community. 

BUREAU OF SOCI.VL SCIENCE 

Organized on the same principles there is maturing in the Bedford 
Reformatory, New York, a state system of expert examination of con- 
victs and an assignment of each to a special institution adapted to 
correct the physical, mental or moral defects found to exist. The 
plan is to have a branch of service of the reformatory, but entirely 
separated from it, where preliminary investigations will be made. 
To this so-called "Bureau of Social Science" the convict is first ad- 
mitted and remains there until her exact physical and mental condi- 
tion is determined. This examination may require much time, but 
when it is completed the committing magistrate and the managers 
have learned to place her with precision under such discipline and 
influences as will most powerfully tend to effect her reform. 

In this scheme we recognize the practical development of the 
Basic Principles of Race Betterment, viz. (1) The thorough study of 
each individual degenerate who is a candidate for public care, and 
(2) his or her immediate placement under conditions best adapted to 



22 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

correct, permanently, the physical defect which is found to be the 
predisposing or exciting cause of degeneracy. Adopted and intelli- 
gently enforced as a state policy, we cannot doubt that the Bureau of 
Social Science would convert our custodial into curative institutions, 
our prisons and reformatories into ''Schools for Developing Man- 
hood," as in Arizona, and our almshouses into industrial, self-sup- 
porting colonies. Indeed, might not these burdensome public charities 
become valuable assets rather than dependencies of the state? 

Members of the Conference, we organize today and place in full 
operation in the field of philanthropy a new force. The field is the 
world of degenerate humanity and the force is the regenerating power 
of applied science. Our efforts hitherto to better the race have been 
largely actuated by sentiment and hence have failed of that directness 
and efficiency essential to the highest degree of permanent success. 
It should be the constant aim of the promoters of this Conference to 
establish its work on an enduring basis and to promulgate no opinions, 
nor conclusions, nor recommendations that are not sustained by the im- 
mutable truths of science. 

The Conference is to be congratulated upon the favorable conditions 
of its first session in the Battle Creek Sanitarium. We cannot express 
in terms too complimentary our appreciation of the efforts of the 
Medical Director and the officers to render this initial meeting of the 
Conference in the highest degree successful. Every possible provision 
has been made for our comfort and entertainment and for the orderly 
conduct of the sessions of the Conference. 

But perhaps the most important feature of our meeting is that we 
are guests of an Institution whose beneficent mission is to promote race 
betterment by teaching and practicing ' ' The Art of Healthful Living. " 
The entire Institution is instinct with the "Battle Creek Idea," which 
is also the basic principle of the Conference on Race Betterment, 

Mens Sana in Corpore Sano. 



STATISTICAL STUDIES 

THE SIGNIFICANCE OF A DECLINING DEATH KATE 

Frederick L. Hoffman, LL.D., Statistician of the Prudential Insurance 
Company of America, Newark, N. J. 

INTRODUCTION 

The social and economic problems which arise out of a considerable 
decline in the general death rate, extending over a prolonged period of 
time, are much more serious and far-reaching than is generally assumed 
to be the case. In practically all civilized countries there is annually 
a considerable excess of births over deaths, the numerical excess being 
conditioned more generally by a low mortality than by a high fecun- 
dity. For illustration, a given country might have a birth rate of 
40 and a death rate of 30, with a resulting annual natural increase of 
10 per 1,000, whereas another country might have a birth rate of only 
30 but a death rate of 15, with a resulting natural increase of 15 per 
1,000. From an economic and social point of view a low birth rate 
and a low death rate would unquestionably be more advantageous than 
the opposite condition, which involves much needless waste of human 
energy and pecuniary expenditure. 

For reasons which require no discussion, every civilized country 
desires a normal increase in population, though a high degree of social 
and economic well-being is not at all inconsistent with even a station- 
ary population condition, such as for some years past has prevailed 
in France. It has properly been observed that the term population 
embraces the most extensive .subject of political economy, and most of 
the observations and conclusions which follow, comprehend the prob- 
lem of population increase throughout the world rather than the 
underlying elements of fecundity and mortality. 

On account of the world-wide migratory movements of modem 
populations, involving the transport of vast numbers from one region 
to another, it has been necessary to include in the present discussion 
some very general and rather approximate statistics of population in- 
crease, resulting from an annual excess of births over deaths, 
with, however, numerous and necessary illustrations for the several 
continents and countries in detail. The population problem is no 
longer merely a local one, but practically conditions the material, 
moral, and political well-being of the inhabitants of the entire world, 
though, of course, to a variable degree. 

S3 



24 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

THE POPULATION PROBLEM OP MODERN TIMES 

From the time when Malthus first visualized in popular language 
the menace of a rapidly increasing population on the assumption of a 
less rapidly increasing food supply, much speculation has been in- 
dulged in as regards the ultimate results of population growth on the 
strictly limited laud area of the globe. Much of what goes by the 
name of IMalthusianism stands for something never said by Malthus 
in his classical "Principles of Population,"' just as much that stands 
for evolution or Darwinism was never given utterance or sanction by 
Darwin in his "Origin of Species," and the "Descent of Man." 

Pre-Malthusian doctrines of population are of historical rather than 
practical interest, largely because of the imperfect statistical basis 
upon which most of the earlier estimates of population growth were 
based by writers in many respects sound in their philosophical and 
economic theories. 

We have no modern contributions to the population problem which 
correspond to the elaborate and well-reasoned inquiries of William 
Godwin on "The Power of Increase in the Numbers of Mankind," 
published in 1820; of Michael Thomas Sadler on "The Law of Popu- 
lation," published in 1830; and Archibald Alison's treatise on "The 
Principles of Population, and Their Connection with Human Happi- 
ness," published in 1840. 

Sir William Petty, in his famous essays on "Mankind and Political 
Arithmetic" (1682-87), assumed that a given population would double 
itself by a natural increase during a period of twelve hundred years. 
This estimate was well sustained by the experience of a period when 
plague, pestilence, famine, and wars frequently resulted in a stationary- 
condition of population, or even in a substantial actual diminution. 
Petty, in one of his twelve considerations of the conditions which affect 
the increase in the numbers of mankind, properly included methods of 
preventing "the mischief of plagues and contagions," which, although 
only a theoretical assumption at that early period, foreshadowed the 
enormous sanitary progress of modern times and the realized ideals in 
the administrative control of the public health. There is nothing more 
instructive in this respect than the sanitary evolution of the city of 
London, so admirably set forth in a work by Henry Jephson, and the 
still larger and more useful work by Creighton on "The History of 
Epidemics in Britain," which is a monumental contribution to the 
progress in medical science, and all that is summed up in the term 
civilization, which is fundamentally conditioned by the highest at- 
tainable average duration of human life. 

The world of today is not free from pestilence and plague, or 



STATISTICAL STUDIES 25 

famine and war. but, comparing the ]3resent with the past, it is an 
absolutely safe assumption that the waste of human life was never 
relatively as small in the world's history as is the case at the present 
time. There are still vast areas of the world, such, for illustration, 
as India, where fevers, cholera, and plague cause an enormous annual 
mortality, best illustrated by the fact that during so recent and short 
a period as 1896-1912, there should have been over eight million deaths 
from plague in India, to say nothing of other sections of Asia similarly 
afflicted to a greater or less extent. 

The relative significance of preventable diseases in their relation 
to the general death rate is best illustrated in the ease of the Presidency 
of Bengal, where, during the year 1911, out of a total mortality of 
32.69 per 1,000, 20.60 represented deaths from fevers;* 2.37, deaths 
from cholera; and 1.44, deaths from plague. These three groups of 
causes combined, therefore, accounted for a death rate of 24.41 per 
1,000, or 74.7 per cent of the mortality from all causes. Considered by 
local areas in which cholera was particularly virulent, it appears that 
there were towns in which the death rate attained to the almost in- 
conceivable proportion of 97.35 per 1,000 (Gaya), of which 11.87 was 
caused by cholera, 35.61 by fevers, and 19.99 by plague. Such condi- 
tions are extremely rare in modem civilized communities, although as 
illustrated in the cholera epidemic of the city of IIamburg,t 
the menace of serious local outbreaks is by no means a remote possi- 
bility. 

The sanitary security of modern countries depends largely upon 
the highest attainable degree of efficiency in the control of so-called in- 
ternational diseases, and in this respect no country in the world has a 
better public health service than the United States. 



* In explanation of the term "fevers" as used in the vital statistics of 
India, the following explanation is quoted from the First Report on Malaria 
in Bengal, by Major A. B. Fry, M.D. ; Calcutta, 1912 : 

"Everything not cholera, smallpox or something equally obvious is put 
down as fever. In etfect we have to accept the fact that fever deaths as re- 
ported comprise all deaths not due to these obvious diseases. Marasmic and 
premature infants, infants dying of tetanus neonatorum, impi:oper feeding 
and bowel diseases, nearly all deaths from respiratory diseases, including both 
phthisis and pneumonia, measles, enteric fever, etc., etc., are included under 
the fever heading. Even cholera and plague are often returned as fever, espe- 
cially at the commencement of an epidemic." 

t During the cholera year of 1892, the general death rate of Hamburg was 
39.5 per one thousand population. There were 13,948 eases of cholera, of 
which 5,805, or 41.6 per cent, were fatal. The cholera death rate for the year 
was 12.7 per one thousand, equivalent to 32.2 per cent of the death rate from 
all causes. 



26 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

POPULATION DENSITY 

The effect of excessive death rates on population increase is so 
obvious as not to require extended consideration. India, in 1911, had 
a birth rate of 38.6 per 1,000, and a death rate of 32.0. But for the 
prevalence of epidemic and largely preventable diseases the natural 
increase in population would have been much greater than was actu- 
ally the case. Some observations regarding the world's population, its 
continental distribution and relative density, are, therefore, pertinent 
to the general discussion of the significance of a declining death rate, 
particularly with reference to population growth. 

The number of inhabitants of the globe is conservatively estimated 
at 1,750,000,000, and assuming that the land area of the earth is about 
52,000,000 square miles, the resulting density is approximately 34 
persons per square mile. For the European continent the density is 
121 persons; for Asia, 57; for Africa, 12; for North America, 15; 
for South America, 7 ; and for Australia, including New Zealand, 
2.3. The facts, in detail, are given in the table following : 

APPROXIMATE DENSITY OP THE WORLD'S POPULATION, ESTIMATED BY 
CONTINENTS FOR. THE YEAR 1911 

Continent Area in Sq. Miles Population Pop. per Sq. Mile 

Europe 3,833,567 463,997,000 121.0 

Asia 16,997,639 962,233,000 56.6 

Africa 11,760,689 135,987,000 11.6 

North America 8,631,657 127,993,000 14.8 

South America 7,184,021 51,193,000 7.1 

Australasia 3,317,762 7.572,000 2.3 



Total land area* 51.725,335 1,748,975,000 33.8 

* Does not include the practically uninhabited polar regions. 

It seems unnecessary on this occasion to discuss in detail the rela- 
tive density of population of different countries or political sub- 
divisions, but it may be said that for the more important countries 
the range in density is approximately from an extreme of 659 persons 
per square mile in Belgium, 475 in the Netherlands, 374 in the United 
Kingdom, and 343 in Japan, to a minimum of 31 for the United States, 
13 for the Union of South Africa, 6 for Brazil, 2 for Canada, and 1.6 
for the Commonwealth of Australia. 

Contrarily to the common assumption as regards the ' ' teeming mil- 
lions" of the Far East, it may be pointed out in this connection that 
the density of population for China is approximately 100 persons per 
square mile,, and for British India, 178. The term ''density of popu- 
lation" is, of course, only relative in that the same has no reference 
to the actual distribution of population over a given area.* A country 

* For an interesting discussion of what is assumed to be a new law of 
population concentration, see an ai-tiele in Peterraanns Geogr. Mitteilungen, 
Februaiy, 1913, entitled "Das Gesetz der Bevolkerungs Konzentration," by 
Dr. Felix Auerbach. 



STATISTICAL STUDIES 27 

may have a relatively high density, due to a vast aggregation of popu- 
lation in a few cities, and another may have a relatively low but more 
widely dispersed density of far greater economic importance. The 
latter condition, for illustration, prevails in India, which in part ex- 
plains the extreme difficulties of effective methods of local sanitary 
control. 

It would also be an error to forecast, on the basis of the foregoing 
estimates of density, the probable future limits of population growth. 
Belgium, with the highest relative density, is one of the most pros- 
perous countries of Europe, but is dependent almost entirely for its 
food supply upon other countries, in which as yet the density of popu- 
lation is very considerably below the average for at least the European 
continent. There can be no question of doubt but that vast opportun- 
ities still exist for a very substantial increase in the number of the 
earth's inhabitants, but considering the attained degree of density in 
certain countries, and the unconditional dependence of population ag- 
gregates for their food supply upon more sparsely settled areas, as- 
sumptions regarding the future possibilities of population increase are 
likely to be exaggerated since the pressure upon the limited available 
means of subsistence must become more generally operative than is 
the case at the present time. 

GROWTH OF THE WORLD 's POPULATION 

The growth of the world's population is naturally determined by 
the excess of births over deaths and the resulting gradual accumula- 
tion of the new-born over the diminishing remnants of previous genera- 
tions. A persistently and rapidly declining death rate, therefore, un- 
less offset by an equal decline in the birth rate, must, in course of time, 
result in a proportionately more rapid increase in population than has 
been observed to have taken place during historic periods of time. The 
ultimate effect of such an accumulation of births over deaths must be 
in geometrical rather than in arithmetical proportions, in the same 
manner as in pecuniary calculations the results of compound interest 
are considerably in excess of the yield of money invested at simple in- 
terest only. 

Accepting, for the present purpose, the estimate of the world's 
population for 1900, of 1,607,000,000, as given by Sundberg, and my 
own estimate for 1911 of 1,749,000,000, there has been an annual in- 
crease during the intervening period of 12,883,000, or at the rate of 
7.7 per 1,000. For purposes of comparison, it may be stated that 
during the same period of time the population of the continental 
United States has increased from 75,994,575 in 1900 to 93,927,342 in 
1911, the annual increment of population being 1,680,252, equivalent 



28 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

to 19.45 per 1.000. Tlu' density of population in tlie eontinental 
United States ])ef scjuare mile has increased since 1860 from lO.H to 
16.9 in 1880 and from 25.6 in 1900 to 32.1 in 1932. 

Comparing or contrasting the present population conditions of 
this country with other relatively well-developed sections of the globe, 
we are far from having reached a point which can be considered par- 
ticularly alarming, but it would certainly be a serious error to reason 
from general principles in a matter of this kind, since the problem of 
over-population, especially with reference to economic conditions, is 
always, in its final analysis, largely a local one. Thus, for illustration, 
the present density of Ehode Island is 508.5 persons per square mile ; 
of Massachusetts, 418.8 ; of New Jersey, 337.7 ; of Connecticut, 231.3 ; 
and of New York, 191.2. For all of New England the density is 105.7, 
and for the Middle Atlantic States, 193.2. 

All of the available statistical information seems to justify the con- 
clusion that the world's population in general, and of the more civi- 
lized countries in particular, is increasing at the present time at a more 
rapid rate than in earlier years — a condition largely the result of a 
persistent and considerable decline in the death rate, which is more 
than an offset to the observed decline in the birth rate. There are, of 
course, important exceptions to this conclusion, which has reference to 
vast continental aggregates rather than to some of even the largest 
political subdivisions of the same. In some of these the conditions of 
population growth are so seriously disturbed by migration, immigra- 
tion and emigration, and variations of fecundity and mortality due to 
racial distribution, that precise conclusions are hardly warranted in 
the present imperfect state of population and vital statistics. 

FORECASTS OF POPULATION GROWTH 

Estimates of the future population of the United States have been 
many and in a number of instances they have been verified with re- 
markable accuracy when limited to a reasonable period of time. 
Darby, for illustration, in his "View of the United States," published 
in 1828, made a forecast of the white population, which for 1850 was 
placed by him at 20,412,000, and which was ascertained by the census 
to be 19,553,000. Many similar estimates have been sustained by subse- 
quent experience, but as a rule the rate of fecundity has been taken 
too high, especially for the colored population, by writers basing their 
views upon the observed rate of increase of the negro population 
during a condition of slavery. Even DeBow conceded a diminishing 
proportion of negro population with an increase in aggregate growth 
in population fully sustained by subsequent experience. DeBow, in 
1862, estimated the negro population of the United States for 1880 at 



STATISTICAL STUDIES 29 

6,591,000, whereas by the census for that year the same was ascertained 
to be 6,580,000. All estimates of this kind are certain to fail 
if projected too far forward, but they are unquestionably approxi- 
mately trustworthy for relatively short periods of time, and for many 
purposes are of considerable practical value. On the assumption, 
therefore, that the decennial rate of increase in the population growth 
of the United States will gradually diminish, partly because of a 
probable decline in immigration and a possible further reduction in 
the birth rate, the following forecast is included in this discussion as 
a concrete illustration of the probable population conditions likely to 
exist in the continental United States within a measurable period of 
time. 

POPULATION ESTIMATE FOR THE CONTINENTAL UNITED STATES, 1910-1960 

Year — Census Population Density per Sq. Mile 

1910 91,972,000 30.93 

1920 109,999,000 36.98 

1930 130,019,000 43.72 

1940 151,862,000 51.06 

1950 175,248,000 58.92 

1960 199,783,000 67.17 

According to this table the approximate density of the United 
States by 1960, assuming a normal rate of increase during the inter- 
vening period, would only.be 67 persons per square mile, or about 
one-fifth of the present density of the German Empire. Glranting that 
the immediate outlook for the future is not as serious with us as with 
some other nations, it is self-evident that the social, economic, and po- 
litical problems resulting from an augmentation in the number of in- 
habitants and the gradual accumulation of vast aggregates of people, 
aside from the mere problem of density itself, must be among the most 
serious conceivable and, therefore, as such, they are properly entitled 
to an extended critical and impartial consideration at the present time. 

TENDENCY TO CITY GROWTH 

The trend of the population all over the civilized world is today 
towards the cities, which now contain a vastly larger number of in- 
habitants than during any other period of time in recorded history. 
The problem of urbanization, from a historic, geographic and an econo- 
mic point of view, has been ably treated by Prof. PieiTe Clerget, who 
includes in his discourse estimates of population for ancient cities, 
which, however, are more or less conjectural. The same conclusion 
applies to the dissertation on the "Numbers of Mankind in Ancient 
and Modern Times," by Robert Wallace, published in Edinburgh in 
1809 ; and the speculations of Sir William Petty, Gregory King, and 
others whose writings on population estimates were previous to the 
nineteenth century, which marks the dawn of modern census inquiries. 



30 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

or the accurate enumeration of the numbers of mankind, for at least 
the civilized portion of the globe. Sufficient information, however, of a 
general nature is available to warrant the assumption that in earlier 
periods the proportion of urban population was much less than at the 
present time, and this certainly is true of the United States, for which 
we have accurate data since 1790. During the twelve intercensal periods 
the proportion of urban population has constantly increased. The pro- 
portion of urban population (which term includes all incorporated 
places of 2,500 inhabitants or more) has increased from 29.5 per cent 
in 1880 to'4i6.S per cent in 1910. During the last decade the urban 
population has increased 34.8 per cent, or in actual numbers 11,014,- 
000, as against an increase of only 11.2 per cent for rural territory, or 
4,964,000. 

RATE OF NATURAL INCREASE IN POPULATION 

The sanitary progress of civilized countries, to which primarily 
must be attributed the observed decline in the death rate, to be sub- 
sequently discussed in more detail, has naturally been more effective in 
the large cities than in the smaller communities or the strictly rural 
territory. Granting that the birth rate of cities is below that of rural 
sections, it is quite possible that there is a larger excess of births over 
deaths in modern cities in consequence of the remarkable results of 
sanitary administration and control. The annual excess of births over 
deaths varies, however, quite widely for the different countries, geo- 
graphical subdivisions and cities of the world, and in some exceptional 
cases even in civilized countries the deaths may exceed the births, as is 
well known to be true of modern France. On the basis of the best 
estimate possible, the present rate of natural increase for the world 
as a whole is approximately 7.6 per 1,000 of population, equiva- 
lent to an actual increase per annum of 13,260,000. This estimate is 
based largely on the registration returns of civilized countries having 
an aggregate population of 834,000,000, and an excess of births over 
deaths of 9.3 per annum. The birth rate for these countries is 34.3 
per 1,000, and the death rate 25.0. The estimate, therefore, is quite 
conservative, and in all probability the actual increase is greater than 
that assumed. For the non-registration countries I have assumed an 
annual excess of births over deaths of only 5.8 per 1.000, which is 
considerably below the normal excess of births over deaths in the reg- 
istration countries of Asia, which include nearly all of India, the 
Island of Ceylon, the French possessions in Cochin-China and the 
Empire of Japan. For these four countries combined the natural in- 
crease per annum, or excess of births oyer deaths, is 7.3 per ],000,or the 
annual difference between a birth rate of 38.4 and a death rate of 31.1. 



STATISTICAL, STUDIES 31 

It seems a safe assumption that in the remainder of the world, for which 
information is not available, the probable rate of natural increase is 
about 5.8 per 1,000. With an annual increase of 7.6 per 1,000, assum- 
ing no further improvement in the general death rate, which, however, 
is most likely to occur, the world's population may be expected to 
double itself in about ninety years. Since the death rates throughout 
the civilized, as well as the uncivilized, world are known to be gener- 
ally declining, the rate of doubling the population is quite possibly to 
be achieved in even a shorter period of time. A summary statement of 
the estimated natural increase of the world's population is given in 
the table below: 

ESTIMATED ANNUAL NATURAL INCREASE OF THE WORLD'S POPULATION 

AS BASED ON THE MOST TRUSTWORTHY REGISTRATION RETURNS 

FOR RECENT YEARS, CHIEFLY FOR 1911 

„ ^. ^ Estimated Estimated No. of i^_2-J £ <» 

Continents "S'3'R.s 'S'3 § 

Population Births Deaths •-^'''l, ■§ a " 

la's S O « t' c 

H ;z; ftO^ H <1 M 

Europe 463,997,000 15,545,640 10,657,220 10.5 4,888,420 

Asia 962,233,000 37,306,800 31,753,670 5.8 5,553,130 

Africa 135,987,000 5,279,140 4,348,324 6.8 930,816 

North America 127,993,000 3,495,400 2,286,800 9.4 1,208,600 

South America 51,193,000 1,950,940 1,368,150 11.4 582,790 

Australasia 7,572,000 214,718 118,071 12.8 96,647 

Total* 1,748,975,000 63,792,638 50,532,235 7^6 13,200,403 

*The world's birth rate is estimated at 36.5, and the death rate at 28.9, per one thou- 
sand of population. 

DECLINING DEATH RATES OF CIVILIZED COUNTRIES 

It is only for comparativelj^ recent periods that trustworthy vital 
statistics are available for a considerable portion of the world with 
local climatic, racial or other conditions sufficiently varied to disclose 
the approximate range in the rate of mortality and the evidence of 
its reduction or increase, as the case may be. For the registration 
area of the world the mortality rate at the present time is approxi- 
mately 25 per 1,000 per annum, which is considerably in excess of the 
death rate for the more important civilized countries such as, for il- 
lustration, the German Empire, where the rate is 17.3 ; England and 
Wales, 14.6; France, 19.6; United States, 14.7, and the Common- 
wealth of Australia, only 10.7. These comparatively low death rates 
contrast with the still prevailing excessive death rates of certain other 
countries, as, for illustration, 23.7 per 1,000 for Spain, 25.0 for Hun- 
gary, 30.5 for Eussia, 31.1 for Mexico, 33.2 for India, and 40.9 for 
twenty cities of Egypt. During the last thirty years, however, the 
general death rate in most of the principal countries of the world has 
declined, but since the evidence in detail does not permit of a con- 



32 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

venieut suniniary discussion, the following comparisons are limited to 
the two five-year periods ending, respectively, with 1885 and 1910. 
The observed decrease in the rate is, in each case, the reduction per 
one thousand of population, carefully calculated on the basis of avail- 
able census returns.* 

During the thirty years under observation the general death rate 
declined in the Australian Commomvealth from 15.7 to 10.7; in 
Austria, from 30.1 to 22.3 ; in Denmark, from .18.4 to 13.7 ; in England 
and Wales, from 19.4 to 14.7; in Finland, from 22.2 to 17.4; in 
France, from 22.2 to 19.2 ; in the German Empire, from 25.3 to 17.9 ; 
in Hungary, from 33.1 to 25.0 ; in Ireland, from 18.0 to 17.3 ; in Italy, 
from 27.3 to 21.0; in the Netherlands, from 21.4 to 14.3; in New 
Zealand, from 10.9 to 9.7; in Norway, from 17.2 to 13.8; in Scotland, 
from 19.6 to 16.1 ; in Spain, from 32.6 to 24.3 ; in Sweden, from 17.5 
to 14.3 ; and, finally, in Switzerland, from 21.3 to 16.0. For a few 
of these countries the decline in the rate has not been of much actual 
importance, but in practically all of the countries the tendency of the 
death rate during the last thirty years has been persistently downward, 
and the present indications are that there has been a still further de- 
cline in the rate during the last three years. Combining the mortality 
of the principal civilized countries, there has been a general reduction 
in the crude death rate from 25.09 per one thousand during the five 
years ending with 1885 to 19.26 per one thousand during the five 
years ending with 1910, an actual decrease of 5.92 per one thousand, 
equivalent to 23.2 per cent. The relative decrease in the rate has been 
most pronounced in the Netherlands, where the present rate is only 63 
per cent of the rate prevailing thirty years ago. The corresponding 
figure for the registration area of the United States is 76 per cent ; 
and for a few other countries, respectively. England and Wales, 71 
per cent; Denmark, 71 per cent; Belgium, 72 per cent; the Aus- 
tralian Commonwealth, 71 per cent; Finland, 66 per cent; German 
Empire, 72 per cent ; Italy, 71 per cent ; and Switzerland, 67 per 
eent.t 

It requires to be said in this connection that the foregoing rates 
are not corrected or standardized for variations or changes in the age 

* The international vital statistics are derived most conveniently from the 
annual reports of the Registrar-General of England and Wales. 

t The remarkable nnifonnity in the rate of mortality decrease for repre- 
sentative countries dixring the last thirty years suggests that the diminution 
is the result of more or less uniformly oper^ating' causes making for the delib- 
erate reduction of the death rate in consequence of practically identical 
methods in sanitary administration and persistent progress in the practice of 
medicine, surgery, and personal hygiene. 



STATISTICAL STUDIES 33 

and sex constitutions of the respective populations considered. Such 
corrections would have involved much labor, with but a slight prob- 
ability that the resulting conclusions would have been materially modi- 
fied. The results are verified and otherwise sustained by numerous 
specialized mortality studies on the basis of scientifically constructed 
life tables for the more important countries and geographical sub- 
divisions of the world, particularly the German Empire and its con- 
stituent states, England and Wales, the Australian Commonwealth, 
New Zealand, etc. The observed decline in the general death rate and 
the corresponding increase in human longevity may, therefore, safely 
be accepted as a world phenomenon, and granting this, it is difficult 
to conceive of a more important conclusion affecting the future well- 
being of all mankind. 

DECLINE IN THE DEATH RATE OP THE UNITED STATES 

In the foregoing discussion no reference has been made to the 
statistics in detail for the United States, since for the earlier period no 
data are available which would be strictly comparable with those of re- 
cent years. Most of the following observations are, therefore, limited to 
the decade ending with 1910, for which the registration returns are, 
broadly speaking, representative for the country at large. Comparing 
the five-year period ending with 1905, with the corresponding period 
ending with 1910, there has been a decline in the general death rate 
from 16.2 to 15.1 per 1,000. In the table following are brought 
together the official statistics for the United States from 1880 down to 
1913, when the rate was only 14.1 per 1,000 of population. Taldng 
the approximate rate for 1880 as 100, the corresponding rate for 1913 
was only 71. In part, of course, it is quite probable that the decline 
in the mortality has been slightly affected by the large immigration 
during the last thirty years, but in a general way the evidence is con- 
clusive that the reduction in mortality is the result of a nation-wide 
improvement in sanitary conditions and increasing effectiveness of 
federal, state and municipal sanitary control. 



GENERAL DEATH RATE OF THE UNITED STATES REGISTRATION AREA, 
1880-1913 

Year Population Deaths Rate per 1,000 

1880 8,5.38,000 169,060 19.8 

1890 19,659,440 386,212 19.6 

1900 30,765,618 539,939 17.6 

1905 34,094,605 545,533 16.0 

1910 53,843,896 805,412 15.0 

1911 59,275,977 839,284 14.2 

1912 60,427,133 838,251 13.9 

63,299,164 890,823 14.1 

(3) 



34 FIRST NATIONAL CONFERENCE ON RACE liETTERMENT 

REDUCTION IN DEATH RATE, BY AGE AND SEX 

Information is fortuuately available for the United States regis- 
tration area of 1900 to establish with approximate accuracy the 
changes in the death rate, by divisional periods of life during the in- 
tervening decade, ending with 1911. The table following has been 
derived from Bulletin No. 112 of the Division of Vital Statistics of 
the Bureau of the Census. The table exhibits the death rates per 1,000 
of population at specified age periods, and the percentage which the 
death rate in 1911 represents of the rate prevailing in 1900, with the 
required distinction of sex : 

COMPARATIVE DEATH RATE OP THE UNITED STATES REGISTRATION 
STATES BY DIVISIONAL PERIODS OF LIFE, 1900-1911 

Death Rate* per 1000 Population Per Cent Death 

A?e Group for States** included in Registra- Rate in 1911 

tion Area in 1900. Represents of 

1911 1900 That in 1900: 



All ages : 



§ [S pqm % £h «!» 1^ 



Crude rate 14.9 15.8 14.0 17.2 17.9 16.5 87 88 85 

Corrected rate *** 14.6 15.3 13.9 17.0 17.6 16.5 86 87 84 

Under 5 years 36.6 39.8 33.3 49.9 54.1 45.7 73 74 73 

Under 1 year 125.5 138.6 112.1 161.9 178.4 145.0 78 78 77 

1 to 4 years 12.8 13.3 12.2 19.8 20.4 19.1 65 65 64 

5 to 9 years 3.2 3.4 3.1 4.7 4.7 4.6 68 72 67 

10 to 14 years 2.2 2.4 2.1 3.0 2.9 3.1 73 83 68 

15 to 19 years 3.5 3.7 3.3 4.8 4.9 4.8 73 76 69 

20 to 24 years 5.0 5.3 4.7 6.8 7.0 6.7 74 76 70 

25 to 34 years 6.3 6.7 6.0 8.2 8.3 8.2 77 81 73 

35 to 44 years 9.4 10.4 8.3 10.3 10.8 9.8 91 96 85 

45 to 54 years 14.5 16.1 12.9 15.0 15.8 14.2 97 102 91 

55 to 64 years 28.4 30.9 26.0 27.3 28.8 25.8 104 107 101 

65 to 74 years 58.3 61.6 55.1 56.5 59.5 53.7 103 104 103 

75 years and over 143.0 147.4 139.2 142.4 145.9 139.3 100 101 100 

* Exclusive of still-births. ** Group includes Connecticut, the District of Columbia. 
Indiana, Maine, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Rhode 
Island, and Vermont. *** Based on the standard million of England and Wales, 1901. 

The foregoing table emphasizes the fact, not generally known or 
thoroughly understood, that the observed decline • in the American 
death rate has been chiefly at ages under 35, and that at ages 35-44, 
for illustration, the relative rate for 1911 was 91 per cent of the rate 
for 1900 ; at ages 45.54, it was 97 per cent ; at ages 55-64 it was 104 
per cent ; at ages 65-74, 103 per cent ; and at ages 75 and over it was 
100 per cent. In other words, at ages 55 and over the death rate has 
actually increased, which is the more significant when the rela- 
tively considerable decrease at the earlier ages is taken into account. 

DECLINE IN THE DEATH RATE BY .STATES 

The next table shows the decline in the death rate r-orrected for 
age in the several registration .states of the United States as existing in 
the year 1900 : 



STATISTICAL STUDIES 35 

COMPARATIVE DEATH RATES BY STATES, 1900-1911 

Per Cent Death 
Corrected* Death Rate per 1,000 Rate in 1911 

Population Represents of 

Area :^911 1900 That in 1900: 

og ^ log's I og'S I 

States included in registration area of 

1900 14.6 15.3 13.9 17.0 17.6 16.5 86 87 84 

Connecticut 14.8 15.7 14.0 17.4 18.1 16.7 85 87 84 

District of Columbia 18.9 20.8 17.2 24.4 26.1 22.6 77 80 76 

Indiana 12.3 12.4 12.2 14.4 14.2 14.6 85 87 84 

Maine 13.0 13.3 12.6 14.9 14.7 15.0 87 90 84 

Massachusetts 15.0 16.0 14.1 18.1 19.0 17.3 83 84 82 

Michigan 12.4 12.9 12.0 13.9 14.0 13.8 89 92 87 

New Hampshire 14.2 14.7 13.8 16.3 16.4 16.3 87 90 85 

New Jersey 15.1 16.1 14.3 18.2 19.3 17.0 83 83 84 

New York 15.7 16.7 14.8 18.3 19.1 17.4 86 87 85 

Rhode Island 15.7 16.8 14.8 20.9 21.6 20.2 75 78 73 

Vermont 12.6 12.7 12.5 13.8 13.7 13.9 91 93 90 

* Corrected on basis of standard million of England and Wales, 1901. 

The table is self-explanatory and requires no discussion, but it 
may be pointed out that there has been a decrease in the death 
rate corrected for age in all of the registration states, but to a variable 
degree, the decline for both sexes combined having been greatest in 
the state of Rhode Island and least in the state of Vermont.* 



DECLINE IN THE DEATH RATE OF CITIES 

The evidence of a declining death rate is still more conclusive and 
suggestive for the large cities of the United States and of other civil- 
ized countries o£the world. Combining all of the American cities for 
which trustworthy data were available in 1870, the rate for that year 
was 25.5 per 1,000. which by 1872 had increased to 28.6; by 1890 the 
rate had declined to 21.8 ; by 1900 to 18.8; by 1910 to 16.5; and by 
1911 to 15.6. The evidence already available seems to prove that the 
rate for 1912 was the lowest on record. The rate for recent years is 

* The following table exhibits the changes in the age distribution of the 
population of the United States on a percentage basis, showing respectively 
for the several census years the proportionate population at ages under 5, 
5 to 64, and 65 and over since 18S0. The obsen'ed changes cannot be con- 
sidered sufficient to seriously impair the conclusion that the crude death rate 
of the registration area indicates with approximate accuracy the mortality 
tendency of the United States during the last thirty years. 

PERCENTAGE DISTRIBUTION BY AGE PERIODS OF THE POPULATION 
OF THE UNITED STATES— 18S0-1910 

1S80 1890 1900 1910 

Ages % % % % 

0-4 13.8 12.2 12.1 11.6 

5-64 82.8 83.9 83.8 84.1 

65-over 3.4 3.9 4.1 4.3 

All ages 100.0 100.0 100.0 100.0 



36 FIKST NATIONAL CONFERENCE ON RACE BETTERMENT 

based upon Ihe eombiiicd returns for fifty cities, with an aggre^^ite 
population of nearly twenty millions.* 

During the last thirty years the death rate of large cities of this 
and other countries has declined as follows, the comparison being 
limited to the quinquennial periods ending respectively with 1885 and 
1910: The death rate of London decreased from 20.9 to 14.0 per 
1,000; of Dublin, from 27.5 to 21.6; of Paris, from 24.4 to 17.5; of 
Amsterdam, from 25.1 to 13.] ; of St. Petersburg, from 32.8 to 
25.5 ; of Berlin, from 26.5 to 15.5 ; of Vienna, from 28.2 to 17.0 ; of 
Budapest, from 31.5 to 19.5; of Milan, from 30.3 to 19.3; of Mel- 
bourne, Victoria, from 20.1 to 13.1 ; of Sydney, New South Wales, 
from 20.8 to 10.5 ; of New York, from 27.5 to 17.0 ; of Chicago, from 
21.5 to 14.5 ; and of Philadelphia, from 22.3 to 17.7. This comparison 
is exceedingly instructive, emphasizing, as it does, on the basis of 
trustworthy data, the conclusion that the decline in the death rate is 
world-wdde, and that in practically all the large centers of population 
the rate has declined, the decrease varying from approximately one- 
fifth to one-third or more during the thirty-year period, with 
definite indications of a further reduction in the rate since 1910 in 
nearly all the localities, states and countries considered in the present 
discussion. 

IMPROVEMENTS IN THE LONGEVITY OF PRIMITIVE RACES 

The foregoing conclusions are based entirely upon the returns for 
civilized countries with well established sanitary departments and 
effective statutory requirements providing methods and means of 
sanitary control. Evidence, however, is also available for the so- 
called non-civilized countries of the world to warrant the conclusion 
that the longevity of primitive races is increasing and that the con- 
ditions favorable to the acclimatization of white races in the tropics 
are constantly and rapidly improving. This conclusion applies par- 
ticularly to the vast areas inhabited by the primitive or non-European 



* The death rate of the registration area for the year 1912 was 13.9 per one 
thousand. During 1913 the rate increased slightly, to 14.1. The rates for the 
five largest cities down to 1913 were as follows: 

DEATH RATES OF LARGE AMERICAN CITIES, 1901-1913. 

(Rate per 1,000) 

Years New York Chicago Philadelphia St. Louis Boston 

1901-05 19.0 14.5 18.1 17.9 18.8 

1906-10 16.9 14.9 17.7 15.6 17.9 

1911 15.2 14.5 16.6 15.4 17.1 

1912 14.5 14.8 15.3 14.9 16.4 

1913 14.3 15.1 15.7 14.9 16.4 

From Prolimiiiarv Announcement of Division of Vital Statistics, U. S. Census Office, May 
19, 1914. 



STATISTICAL STUDIES , 37 

races of Asia, chiefly of China, Formosa, the English and Dutch East 
Indies, Ceylon, the Straits Settlements, and Siam. The conclusion 
also applies to most of the European possessions in Africa and to 
vast territories in South and Central America and Australia. For 
India the evidence is quite conclusive that a material improve- 
ment is taking place in the health of the people, which is best illus- 
trated by the statistics of European troops since the beginning of the 
nineteenth century. The death rate has declined from 84.6 per 1,000 
during the period 1801-30 to 19.3 during the decade ending with 
1879, a further reduction having taken place during the subsequent 
period, the rate for 1901-05 having been 12.2 ; for 1906-09, 8.7 ; and 
finally, for 1911 the rate w^as only 4.9. A corresponding decline in the 
death rate of native troops has taken place, but limiting the discussion 
to recent years, it declined from 10.0 during 1901-05 to 6.5 during 
1906-09, and to 4.5 during 1911. These are exceptionally encourag- 
ing statistics, which have their most interesting parallel in the remark- 
able sanitary achievements in the American administration of the 
Panama Canal Zone under the efficient direction of Col. W. C. 
Gorgas. During the French administration, 1881-90, the average 
death rate of the Isthmian Canal employees was 61.3 per 1,000. Dur- 
ing the American administration, 1904-]2, the average rate was only 
16.3 ; and during the last year of the period, only 9.2 — an achieve- 
ment probably without a parallel in sanitation history. The annual 
death rate of the city of Panama in 1887 had reached the almost in- 
credible proportions of 121.7 per 1,000. but the rate has gradually 
been reduced until in 1912 it was only 29.3. As another interesting 
illustration of the observed decline in the death rate of tropical coun- 
tries, a reference may be made to the mortality of non-native British 
officials in West Africa since 1905, the rate having been reduced from 
an average of 28.1 per 1,000 during that year to ]7.3 by 1909, and to 
only 12.4 by 1912.* At the same time, there has been an increase in 
the average length of service from three years and six months in 1905 
to six years and three months in 1912 ; and a substantial reduction 



• * See also the Reports for 1912 on Blackwater Fever in the Tropical Afri- 
can Dependencies, published as Parliamentary Paper Cd. 7211, London, 1914. 
Also "Medizinal-Berichte uber die Deutschen Schutzgebiete," published Berlin, 
1913, including reports on all the Gennan Colonies, with extended observa- 
tions on tropical diseases and the mortality of Europeans. Interesting in this 
connection is the Statistical Analysis of the Mortality of Scandinavian Mis- 
sionaries in the Congo Free State, 1878-1904. That the improved tropical 
mortality is also reflected in the experience of life insurance companies trans- 
acting business in tropical countries is brought out by a paper on the subject 
in the Proceedings of the Actuarial Society of America for 1908, by Arthur 
Hunter, with an extended discussion by other members of the society. 



38 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

was also obtained in the rate of invaliding, from 62.3 per 1,000 in 
1905 to only 28.2 in 1912. The death rate of Algeria, which was once 
considered extremely unhealthful, has been reduced to 19.6 per 1,000 
in 1911. and a large portion of the country has become a health resort 
for Europeans. The death rate of Madagascar in 1911 was 26.5 
per 1,000, and of Cochin-China, 26.2. In the West Indies the death 
rates are diminishing, the rate for Cuba being only 14.7 per 1.000; 
for the Dutch West Indies, 16.9 ; for Guatemala, 18.5 ; for Honduras, 
18.7; for Salvador, 22.8; and British Guiana, which in former years 
had a very high death rate, has now a rate of only 31.7, whereas for 
Venezuela the rate for 1911 was 20.3. All of these rates may safely be 
accepted as evidence of a gradual diminution in the mortality of so- 
called non-civilized, or only partly civilized, countries, largely in- 
habited by primitive or other than white races living chiefly in the 
temperate zone.* 

SANITARY PROGRESS OF TROPICAIj COUNTRIES 

A truly vast amount of instructive information is available for so- 
called uncivilized countries illustrating the sanitary progress which 
is being made, largely, of course, in consequence of the white man's 
conquest of tropical regions, and which is -bound, in course of time, 
to afford almost inconceivable opportunities for settlement and the 
rational development of natural resources. Attention may properly 
be directed on this occasion to the annual reports on the moral and 
material progress and condition, of India, of which the 58th was pub- 
lished during the present year ; the report of the International Plague 
Congress, held at Mukden in April, 1911, which constitutes one of 
the most notable contributions to epidemiology; the annual medical 
reports on the German Colonial Possessions ; the reports of the Ad- 
visory Committee of the Tropical Diseases Research Fund; the pro- 
ceedings of the International Conference on the Sleeping Siclcness, the 
English reports on Blackwater Fever in Tropical African Depen- 
dencies ; the scientific reports of the Wellcome Tropical Research Lab- 
oratories in Khartoum, Egypt; the scientific publications and special 
local investigations in tropical countries of the tropical medical schools 
in Liverpool, Hamburg, Townsville (Queensland), London and New 
Orleans. Mention also requires to be made of the excellent report of 
Prof. W. J. Simpson, on sanitary matters in various West African 



* The mortality statistics for Central and South America require of course 
to be accepted with extreme caution. The favorable conclusions regarding 
the decline in the South and Central American death rates are based upon 
an extended study of the facts, with particular reference to Yellow Fever and 
Malaria. A full discussion of the mortality of the Western Hemisphere is 
resei-\'ed for future consideration. 



STATISTICAL STUDIES 39 

Colonies, and on the outbreak of plague on the Gold Coast. For all 
of the British and German West African colonies thoroughly scien- 
tific reports are now being published which, without exception, 
reflect the evidence of more or less rapid strides in necessary sani- 
tary reforms. The late Sir Hubert Boyce has admirably re- 
ported upon the health progress in administration in the West 
Indies ; and the Japanese Government has brought about a veri- 
table hygienic revolution in the administration of Formosa, par- 
ticularly in the reduction of the incidence of malaria. All of these 
efforts, which are but a mere fragment of what is actually being done 
in the sanitary administration of Colonial possessions throughout the 
world, including the Philippines,^ Hawaii, and Porto Rico, indicate 
a g'radual reduction in the mortality from preventable diseases among 
both native and white races in the tropics. The inevitable consequence 
must be a larger rate of natural increase and a proportionately more 
rapid augmentation of the population of those sections of the globe 
which constitute to a not inconsiderable extent the future sources of 
the world's food supply.t 

THE PRINCIPAL CAUSES OP DEATH 

The human death rate is the resultant of a large number of known 
or imknown. obvious or obscure, causes and conditions destructive to 
human life. Many of these causes are now known to be preventable 

* A practical illustration of the methods of sanitary administration in the 
Philippines is the "Sanitary Inspector's Handbook," published by the Bureau 
of Health of the Department of the Interior of the Government of the Philip- 
pine Islands. Also the Special Report of Dean C. Worcester on the History 
of Asiatic Cholera in the Philippine Islands, published in 1909. The progress 
which is being made in the control of beriberi is best illustrated in the Studies 
of the Institute for Medical Research of the Federated Malay States, pub- 
lished in 1911, and the monogTaph on the Etioloay of beriberi by Frazer and 
Stanton, derived from the same source and reprinted in the Philippine Jour- 
nal of Science for 1910. For a more extended study of this important subject, 
with particular reference to the diagnosis and prevalence of the disease, the 
elaborate Treatise on beriberi by Edward Vedder, M.D., published by 
William Wood & Co., 1913, should be consulted. In 1912 there were 12 deaths 
from beriberi in the reg'istration area of the United States, but there are con- 
vincing reasons for believing that the disease is much more prevalent than is 
generally known. 

t Indications of health progress in arctic regions are to be foimd in the 
Medical Handbook for the Alaska School Sei-vice, issued by the United States 
Bureau of Education in 1913, and the Special Reports of the United States 
Public Health Service on Tuberculosis among Eskimos. A material improve- 
ment in the health conditions of the population of Labrador and the northern 
outposts of Newfomidland has resulted from the admirable work of the 
Grenfell Medical Missions at Battle Harbor and other far northern points. 



40 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

and subject to administrative control. The immediate or remotely 
contributory causes of death are comparatively few and simple among 
primitive races, and relatively numerous and complex among civilized 
mankind. The hygiene of transmissible diseases is a modern branch of 
medicine, based upon the epoch-making discoveries of Koch, Pasteur, 
Ross, Reed, and others whose work has been of incalculable benefit to 
all mankind. Cholera, malaria, plague, smallpox, typhoid fever, and 
yellow fever are no longer a serious menace to civilized countries, 
since their nature and mode of transmission are thoroughly under- 
stood, and preventive measures are applied with increasing effective- 
ness, and in some cases with absolute certainty, as is well illustrated in 
the history of recent sporadic outbreaks, or the occurrence of isolated 
cases of plague and leprosy on the East and "West coasts of the United 
States. The best Imown of these diseases, typhoid fever, has gradu- 
ally been reduced from an average rate of 35.9 per one hundred thou- 
sand during 1900 to 16.5 during 1912. In the United States during 
1911 the ten principal causes of death, accounting for 66.6 per cent 
of the mortality from all causes, were, in the order of their importance, 
organic diseases of the heart (10.0 per cent), tuberculosis of the 
lungs (9.7 per cent), acute nephritis and Bright 's disease (6.9 per 
cent), accidents and homicides (6.4 per cent), pneumonia (6.3 per 
cent), respiratory diseases other than pneumonia and tuberculosis of 
the lungs (5.6 per cent), congenital debility and malformations (5.6 
per cent), diarrhea and enteritis, under two years (5.5 per cent), 
cerebral hemorrhage and softening of the brain (5.4 per cent), and, 
finally, cancer and other malignant diseases (5.2 per cent). In marked 
contrast, the mortality of India during the same year was chiefly 
the result of six principal causes, being, in the order of their im- 
portance, fevers, accounting for 55.0 per cent, plague for 9.6 per cent, 
cholera for 4.6 per cent, dysentery and diarrhea for 3.5 per cent, 
respiratory diseases for 3.1 per cent, and smallpox for 0.8 per cent. 
'The six groups of causes combined accounted for 76.6 per cent of the 
mortality of India from all causes. 

INDIA MEDICAL STATISTICS 

The general death rate of the registration area of the United 
States in 1911 was 14.2 per 1,000, while the corresponding rate for the 
registration area of India was 32.0. The combined fever death rate, 
including typhoid, typhus, and malaria, was only 2.4 per 10,000 of 
population for the United States, against 176.3 for India. If, there- 
fore, in the course of time the fever problem in India can be solved 
along much the same lines as has been the case in some other tropical 
countries, the general death rate of the Far East would be reduced 



STATISTICAL STUDIES 41 

to perhaps one-half of its present proportions. Astonishing medical 
and sanitary progress has been made in India, as is evident from the 
numerous official and other accounts, but mention can here only be 
made of the proceedings of the Second All-India Sanitary Conference, 
held at Madras in 1912, and the report on investigations into the 
causes of malaria in Bombay, to give emphasis to the conclusion that 
a material reduction in the fever death rate of India will unquestion- 
ably be brought about \\dthin another generation. The problems await- 
ing solution are truly of colossal proportions, complicated as they are 
by the economic condition of the people, their exceptional racial and re- 
ligious distribution, the profound adherence to caste and custom, etc. 
Should this expectation be fulfilled, the present small natural increase 
of India of only 6.58 per 1,000 of population, or the annual difference 
between the birth rate of 38.59 and the death rate of 32.01, could easily 
be doubled, or in any event be made to attain the normal average for 
fairly well civilized countries, of approximately 10 per 1,000 per an- 
num. If, in addition thereto, the cholera mortality of India, which noAv 
accounts for about 390,000 deaths per annum, and the even larger an- 
nual mortality from plague could be brought under control and ma- 
terially reduced, it is self-evident that there are almost inconceivable 
possibilities for a much more rapid increase in the population of India 
and other countries of the Far East than have prevailed in historic 
periods of time.* 

REDUCTION IN THE DEATH RATE BY CAUSES 

An extended consideration of the diminution in the death rate 
from specified causes would unduly enlarge the present discussion. 
The following observations are therefore limited to the registration 



* There ai*e no better illustrations of sanitary progress in its relation to 
population increase than the reports of sanitary conferences in the different 
provinces of India. The Report of the Punjab Sanitarj^ Conference, held 
under date of August, 1913, includes an extended consideration of such im- 
portant questions as rural sanitation, town-planning, sanitation in connection 
with schools and the problem of control in the case of specific diseases, par- 
ticularly malaria, tuberculosis, plague and cholera. After calling attention to 
the reduction in the urban death rate in the Punjab, amounting to about 4.5 
per one thousand of population, it is calculated that this reduction is equiva- 
lent to the saving of some 8,700 lives every year in the municipal towns, which 
would otherwise have been sacrificed. It has been pointed out in this connec- 
tion in a review of the census of India for 1911, by Sir J. A. Baines, that half 
the net increase in the population of India during the past decade took place in 
subdivisions which had less than 150 persons per square mile, and very little 
of it in those which had over 450 ; a substantial reduction in the death rate 
of large centers of population must therefore result in a considerable addi- 
tional increase in population. 



42 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

area of the United States, which may be accepted as fairly typical of 
other civilized countries of the world. The rates are limited to the 
two quinquennial periods ending respectively with 1905 and 1910, 
since no earlier comparative data are conveniently available for the 
registration area of this country. The rates for specified causes are 
given on the basis of 100,000 population, and for the principal causes 
the reduction during the last five-year period, compared with the first, 
has been as follows : typhoid fever has been reduced from 32.0 to 25.6 ; 
smallpox, from 3.4 to 0.2 ; diphtheria and croup, from 29.6 to 22.4 ; in- 
fluenza, from 19.9 to 16.4 ; purulent infections, from 6.1 to 3.8 ; tetanus 
from 3.5 to 2.7; tuberculosis, all forms, from 192.6 to 168.7; chronic 
rheumatism and gout, from 3.6 to 2.2 ; alcoholism, chronic and acute, 
from 6.1 to 5.8; meningitis, from 31.7 to 19.4; softening of the brain, 
from 3.7 to 2.5 ; paralysis (not otherwise specified), from 20.1 to 16.1 ; 
general paralysis of the insane, from 6.8 to 5.5 ; epilepsy, from 4.4 
to 4.2 ; convulsions of infants, from 21.4 to 12.8 ; neuralgia and neu- 
ritis, from 6.9 to 5.5 ; non-tubercular respiratory diseases, from 220.5 
to 188.1 ; and finally, diseases of the skin, from 7.3 to 6.1. With prac- 
tically no important exception the death rates for these eighteen speci- 
fied and all more or less important causes, which account for 33.6 per 
cent of the mortality from all causes during the five-year period end- 
ing with 1910. have undergone a further reduction during 1911 and 
1912. 

CAUSES OF DEATH WHICH ARE ON THE INCREASE 

The only important causes of death which have increased* during 
the five years ending with 1910, as compared with the previous five 
years, are briefly the following : syphilis increased from 4.1 to 5.4 per 
100,000 of population; cancer and other malignant tumors, from 
67.9 to'72.6; diabetes, from 11.5 to 13.7; locomotor ataxia and other 



* Two important diseases which have increased, thoug'h as yet numerically 
of relatively small importance, considering the country as a whole, are anterior 
poliomyelitis and pellagra. There are few better illustrations of the thor- 
oughly systematic manner in which public health activities are now adminis- 
tered than the highly specialized studies which have been made of the epidemi- 
ology of infantile paralysis. See particularly in this connection Bulletin No. 
90 of the Hygrienie Laboratory of the United States Public Health Service, 
and the Special Report on Infantile Paralysis of Massachusetts, in 1909^ 
published by the State Board of Health. See also the results of Investiga- 
tions on Epidemic Infantile Paralysis, published in English, by the State 
Medical Institute of Sweden, and the Reports and Papers on Epidemiologic 
Poliomyelitis, published by the Local Government Board, London, 1912. 

Even more extended attention has been given to the subject of pellagra, 
the mortality of which in the registration area for 1012 amounted to 674. 
The disease is apparently rapidly on the inci-ease throughout the Southern 



STATISTICAL, STUDIES 13 

diseases of the spinal cord, from 7.3 to 8.4; all diseases of the cir- 
culatory system combined, from 161,2 to 177.7 ; ulcers of the stomach, 
from 2.9 to 3.6 ; diarrhea and enteritis, under two years, from 89.0 to 
96.2 ; diseases of the puerperal state, considered as a group, from 14.2 to 
15.5 ; malformations, chiefly congenital, from 12.2 to 14.9 ; diseases of 
early infancy, chiefly congenital debility and premature births, from 
73.9 to 75.0; suicide, from 13.9 to 16.0; accidents, from 84.9 to 86.0; 
and, finally, homicide, from 2.9 to 5.9. In some cases, no doubt, the 
changes are the result of improved medical diagnosis, and, still more, 
the consequence of changes in methods of death classification, but this 
objection is not likely to impair materially any of the foregoing general 
conclusions. Combining the thirteen principal diseases which have 
increased, the resulting total death rate was 536.9 per one hundred 
thousand for the first five years, against 590.3 for the last. The actual 
increase in this group of causes was, therefore, equivalent to 53.4 per 
one hundred thousand of population, or the average combined death 
rate from the thirteen causes during the last five years was 9.9 per 
cent in excess of the rate during the first five-year period under con- 
sideration. Combining the eighteen principal diseases which have 
decreased, the resulting total death rate was 63 9.6 per one hundred 
thousand for the first five years, against 508.1 for the last. There Avas, 
therefore, an actual decrease in this group of causes equivalent to 
111.5 per one hundred thousand of population, or 18.0 per cent. 

Of the diseases which have decreased, the most important are un- 
questionably typhoid fever, diphtheria and croup, tuberculosis of the 
lungs, and non-tubercular respiratory diseases. Since most of these 
are of the strictly preventable class, there are the strongest reasons for 
believing that a still further, and substantial, reduction in the death 
rate, at least of civilized countries, will be obtained in the near future, 
and that as a result of such diminution the excess of births over 
deaths will be increased. 

PROBLEMS OP CELLULAR PATHOLOGY 

Momentous questions arise out of these considerations, which can- 
not be adequately considered, even in part, in the remaining portion 

states. A concise summary of the epidemiology of pellagTa has been published, 
as reprint No. 120, by the United States Public Health Keports, Washington, 
1913. 

Another new disease is spotted or tick fever of the Rocky Mountains, 
which has become a problem of great interest to the physicians, zoologists 
and sanitarians. The report on the subject by Dr. John F. Anderson has 
been published as Bulletin No. 14 of the Hygienic Laboratory of the United 
States Public Health Service, Washington, 1903. 



4-1 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

of this addross. The economic aspects of tlie probh'in are of the first 
order of importance and less difficult of discussion than the more in- 
volved biolojjical questions, which are largely beyond my own under- 
standing. In a most interesting summary account of the nature, origin 
and maintenance of life, Prof. E. A. Schiifer has brought forward 
much apparent evidence that the dividing line between animate and 
inanimate matter is less sharply drawn than has hitherto been 
believed, and that the elements composing living substances are few 
in number — chiefly carbon, hydrogen, oxygen and nitrogen. He 
therefore concludes that it is not a hopeless anticipation that the 
possibility of the production of living material is not as remote as is 
generally assumed. These views have not been generally accepted, 
and among others, not by H. E. Armstrong and Sir William 
Tilden, who are of the opinion that Professor Schafer's address 
"leaves us exactly where we w^ere. " Even if it is conceded that 
the problem of the origin of life is at root a chemical one, and that 
carbon stands alone among the elements which condition the functions 
of the living substance, it is an incontrovertible fact, in the words of 
Armstrong, that ' ' organic growi;h is clearly a process of extreme com- 
plexity, one that involves the association by a variety of operations of 
a whole series of diverse units. ' ' Of the vast strides which have been 
made by all the sciences during the nineteenth century, none have been 
more astonishing than those in the domain of biology, foremost among 
the new discoveries of which is the cell structure of plants and animals, 
which has given rise to a new branch of knowledge known as ' ' Cellular 
Pathology." It has properly been observed that a new era was en- 
tered upon with the discovery of protoplasm and the promulgation of 
the cell theory, as the result of refined methods in microscopical re- 
search. It has been established that the cell " is a microscopic chemical 
engine where the energy of the foodstuffs is finally set free and applied 
to the work of life." In proportion as the nature and the function 
of the cell become better understood, the factors of control in the 
duration of life become obviously greater, and assume, in fact, almost 
inconceivable proportions. The discovery of the functions of the 
hormones, or chemical agents circulating in the blood, by means of 
which the activities of the cells constituting our bodies are controlled, 
and their relations to the internal secreting glands, the uses and im- 
portance of which were not understood until within recent years, fore- 
shadows a time when many of the now obscure diseases will also be 
brought under control, with a consequential further improvement in 
the duration of life. This conclusion applies particularly to the func-' 
tions of the thyroid and parathyroid glands, the pituitary gland, which 
is a small structure no larger than a nut attached to the base of the 



STATISTICAL STUDIES 45 

brain, and the suprarenal glands, which are adjacent to the kidneys. 
Human life, in the words of Schafer," is an aggregate life; and the life 
of the whole is the life of the individual cells." The first condition of 
the maintenance of the life of the aggregate is fulfilled by insuring that 
the life of the individual cells composing it is kept normal ; the second 
essential condition for the maintenance of life of the cell aggregate 
being the co-ordination of its parts and the due regulation of their 
activity so that they may work together for the benefit of the whole. 
From this point of view the vast domain of cellular pathology as- 
sumes the greatest possible practical importance, and it is an en- 
couraging indication of medical progress that increasing attention is 
being given to this subject.* 

PROBLEMS OF AGE, GROWTH AND DEATH 

The most important practical contribution to the problems which 
arise out of the foregoing considerations is the work by Charles S. 
Minot, on * ' Age, Growth and Death. ' ' Minot discusses the condition of 
old age, the cellular changes of age, the rate of growth, differentiation 
and rejuvenation, regeneration and death, the four laws of age, the lon- 
gevity of animals, and a new theory of life. Some of his observa- 
tions are exceedingly suggestive, particularly those on the rate of 
growth, which unfortunately fail in the required support of adequate 
statistical data for man, though, as pointed out by Minot. if statistics 
of the growth of man could be gathered with due precautions, "it 
would fill one of the gaps in our knowledge which is lamentable. ' ' The 
important and almost startling conclusion of Minot on the rate of 
growth may be briefly summed up in the statement that the period of 
youth is the period of most rapid decline in the rate of growth, and that 



* The literature of life pathologically considered is quite extensive. Per- 
haps the most comprehensive review of the whole subject is the "Wonders of 
Life," by Emst Haeckel, published in 1905. The address on "Life: Its Na- 
ture, Origin and Maintenance," by Prof. E. A. Schafer, was published by 
Longmans, Green & Co., London, 1912. The essay on "The Origin of Life, 
by H. E. Armstrong, was republished in the Smithsonian Report for 1912. 
The biological essays on "The Mechanistic Conception of Life," by Jaques 
Loeb, M.D., were published by the University of Chicago Press, in 1912. The 
observations and conclusions of Charles Sedgwick Minot on "Modem Prob- 
lems of Biology," originally delivered in the form of lectures at the University 
of Jena, in December, 1912, were republished by Blakiston's Son ik Co., 
Philadelphia, 1913. The more popular aspects of the problem have been 
made available in the treatise by H. W. Conn, in the story of "The Living 
Machine," published in New York, in 1899, and "Disease and Its Causes," by 
W. T. Counselman, in the Home University Library of Modem Knowledge, 
1913. 



46 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

the period ot" old age is that in which the decline in the rate of growth 
is slowest. He emphasizes the originally enormous power of growth in 
the embryo and the rapid proportionate decline almost immediately 
after birth. He therefore argues that it is not from the study of the 
old, but from the study of the very young, of the young embryo and of 
the germ, that we are to expect an insight into the complicated ques- 
tions which confront the seeker after truth in the innermost secrets of 
the problem of life and death. 

THE PROBLEM OF OLD AGE 

For immediately practical purposes, however, the study of old age 
will continue to attract attention and deservedly so. No one has 
written to better purpose on the means available for the deliberate 
prolongation of life than Sir Herman Weber, whose treatise includes 
observations on the natural duration of life, the etfects of an unfavor- 
able heredity, the value of respiratory exercise, the importance of 
great moderation in food, the scientific aspects of the alcoholic and 
neurotic affections, and, finally, the psychology of old age. In a still 
more recent work on the care and treatment of old age, in health and 
disease, Robert Saundry, M.D., thoroughly covers the entire field, 
and following an important introduction on the duration of life, based 
upon the fundamental concept that senility is not identical with old 
age, or that, in other words, the problem of longevity is not merely one 
of a quantitative increase in duration, but also one of a qualitative im- 
provement in the physical, mental and moral faculties, he gives much 
practical advice wiiicli must needs prove of much service to the physi- 
cian called upon to render qualified aid to the aged. Out of considera- 
tions like these naturally arise new conditions which, singly or com- 
bined, in no small measure affect a further improvement in the rate 
of mortality, with a consequent decline in the death rate in adult life, 
which as yet has been only very slight in the experience of modem 
countries. While at some age periods, in fact, the rate is higher now 
than in former years.* The solution of the problem depends largely 
upon the clear recognition of the important truth that the causes of old 
age and premature death in adult life lie probably as largely without 
the body as within it and that, in fact, no definite limit can safely be 
placed upon human longevity in the present inadequate state of our 



* For an extended discussion of the close association of cancer with the 
degenerative periods of life and of the general subject of the nature of old 
age and senility, see a paper by Hastings Gilford, F.K.C.S., in the British 
Medical Journal for Dec. 27, 1913. 



STATISTICAL STUDIES 4 ( 

knowledge regarding the whole problem of life, its nature, mainte- 
nance and continuity.* 

THE ASSUMED LAW^ OF MORTAIjITY 

No one can forecast the future consequences of these scientifically 
tenable and far-reaching conclusions. The chances of death are not 
fixed, nor is there a true law of mortality in the sense of natural law 
as distinct from scientific law, which, in the words of Karl Pearson, is 
essentially a product of the human mind and has no meaning apart 
from man. In the sense of this definition there is a law of mortality 
which is merely a descriptive expression of as wide a range as possible 
of the sequences of our sense impressions, describing but not explain- 
ing the orderly manner in which human life terminates in the mass of 
mankind, with a due regard to age and sex. Numerous efforts have 
been made to establish w'ith scientific precision the natural and mathe- 
matical laws concerning population vitality and mortality, but no ef- 
fort of this kind has been successful, chiefly for the reason that so 
large a proportion of the causes of death among all mankind are pre- 
ventable, or postponable, as the ease may be. Corbaux, in 1835, made 
an elaborate attempt to establish the natural law, according to which 
what he called ' ' the waste of human life ' ' takes place, but he properly 
observed that to admit as universal ' ' any law whatsoever of mortality 
under the present constitution of society would be an error. ' ' He never- 
theless concluded that, "on the other hand, a very extraordinary notion, 
that the law of mortality had undergone a material alteration within 



* In the May 29, 1914, issue of the London Times (weekly edition) a 
statement is quoted by Professor Metchnikoff with regard to the ultimate result 
of the campaign against preventable diseases, in which it is said that, "rid of 
these teiTible scourges, humanity will be able to concentrate upon its intel- 
lectual development." "Mortality among civilized peoples has certainly di- 
minished," he said. "People live longer and though the strain of life may be 
said to be more intense, improved communication allows them to live away 
from the great centers and in the purer air of the country." 

With reference to Professor Metchnikoff's views on the ultimate effect of 
the lengthening of human life, the correspondent states that "his theories are 
admirably exemplified in his own power to work, which is one of the reasons 
why he has not given more to the world in the form of scientific exposition; 
he considers he can still be of use to the present generation in directing their 
studies. This ambition, wholly justified by the fact that his laboratory assist- 
ants continually consult him in their work, is proof of his splendid vitality. 
In his cosmos, as revealed in 'The Nature of Man,' the septuagenarian and 
those of more advanced age have still work to do. Political conditions in 
Russia would have improved, he thinks, if older heads had directed the reform 
movement. The rashness of young men has been disastrous to the country^ 
because it has provoked reaction." 



48 KIKST NATIONAL CONFERENCE ON RACE I5ETTERMENT 

a century, seems to have gained credit with many who failed to reflect 
upon the immutable character of all Nature's laws, without excep- 
tion." This conclusion by C'orbaux is absolutely contrary to the facts 
of human experience, for, as fully brought out by the present dis- 
cussion, the rate of mortality is not only subject to a wide range of 
variation, but a permanent reduction in the rate may result from 
sanitarj' and other improvements which more or less condition the 
termination of life. Slissmilch and many other writers aside from 
Corbaux have erroneously assumed an immutable law of mortality, 
but the facts of human experience for half a thousand years, at least, 
sustain the conclusion that the birth rate, the death rate, and human 
multiplication, are largely matters of human control.* 

HEREDITY AND THE DEATH RATE 

How far a tendency to longevity is inherited cannot be fully dis- 
cussed on this occasion. It is no doubt true that "the organism and 
its inheritance are, to begin ivith, one and the same," but the external 
factors which condition longevity are of much greater importance, at 
least through all the early years of life, than the internal disease-re- 
sisting and possibly inherited tendencies of the organism. Unquestion- 
ably there is much in inherited individual or race traits, but there 
are also innumerable exceptions which have yet to be explained by 
scientific theories and which will continue to perplex and confuse the 
wisest of mankind. Only a scientific mind of a high order could even 
attempt to unravel the interrelations of the apparent law of human 
mortality, or the chances of death, to the biological phenomena of a 
selective death rate, and the perhaps equally important problem of 



* The improvement in longevity, actuarially considered, for the nineteenth 
centuiy was discussed in a number of important papers on the occasion of 
the Fourth International Actuarial Congress, held in New, York in 1903. Of 
special interest are the papers on the Improved Longevity in England and 
Wales, by Samuel G. Warner, and the Improvement in Longevity in the 
United States during the Nineteenth Century, by John K. Gore. The sub- 
ject was further considered on the occasion of the Seventh International Con- 
gress of Actuaries, held at Amsterdam, in 1912, including observations on the 
Decline in the Mortality of Assured Persons since 1800. Of special interest 
are the reports on the Experience of the Gotha Life Insurance Company, 
1829-1895; the Experience of the Leipzig Insurance Company, 1830-1899; 
the Experience of the State Insurance Institutions of Denmark during the 
Nineteenth Century, and the Changes in the Rates of Mortality among As- 
sured Lives during the Past Century, by Messrs. Bum and Sharman of the 
Prudential Assurance Company, London. Mention also requires to be made 
of an extremely interesting paper on a comparison between the Mortality Ex- 
perience of the Equitable Life Assurance Society at the Beginning and the 
End of the Nineteenth Century, by Henry William Manly. 



STATISTICAL STUDIES 49 

reproductive selection. The selective death rate, with regard to which 
as yet very little is actually known but much assumed, represents 
the inherited longevity, but becomes operative as a general principle 
only during the adult portion of life. Pearson has briefly considered 
this phase of the subject in his papers on "Data for the Problem of 
Evolution in Man," with particular reference to the principle laid 
down by Wallace and Weissmann, that the duration of life in an organ- 
ism is fundamentally determined by natural selection. According to 
Pearson also, the selective death rate represents a considerable por- 
tion of the total death rate, and, in his words, "having demonstrated 
that the duration of life is really inherited, it has also been demon- 
strated that natural selection is very sensibly effective among man- 
kind." He proves, or at least attempts to prove, for his data are 
hardly sufficient for entirely safe assumptions, that there is certainly 
a well-established correlation between the ages at death of fathers 
and sons, for he adds, "the heredity is not absolute, since there is a 
sensible divergence from the law of inheritance, in that the death rate 
is only in part selective. ' ' There is a vast literature on inherited dis- 
eases, much of which fails to meet the test of impartial and strictly 
qualified scientific criticism. Pearson himself, in his interesting ad- 
dress on "Social Problems: Their Treatment, Past, Present and 
Future," has emphasized the serious possibilities of far-reaching 
errors in crude methods of statistical analysis, but, speaking broadly, 
the liability to grave mistakes is even greater in mathematical-statis- 
tical researches, resting, as is frequently the case, upon an insufficient 
numerical basis of facts.* 



* See in this connection a paper on "The Supposed Inferiority of First 
and Second Bom Members of Families," and statistical fallacies inherent in 
discussions of this kind, by T. B. Macaulay, Montreal, Canada. The Path- 
ology of the Order of Birth, with Special Reference to Tuberculosis, has been 
discussed by W. C. Rivers, briefly reviewed in the Medical Record, New York, 
for Oct. 28, 1911. The Influence of Parental Age on certain characters 
in offspring has been considered on the basis of statistical investigations in 
Middlesborough by Robert G. Ewart, M.D., briefly reviewed in the Lancet of 
Oct. 26, 1912, and a further review of the same discussion is contained in 
the British Medical Journal, in Dec. 21, 1912, issue. 

For an admirable discussion of the subject of the Inheritance of Fecun- 
dity, by Dr. Raymond Pearl, see Popular Science Monthly for October, 1912, 
the paper having originally been read at the First International Eugenics 
Congress, London, 1912. The Comparative Fecundity of Women of Native 
and Foreign Parentage in the United States has been discussed in a paper 
contributed by Joseph A. Hill, published in the Quarterly Publication of the 
American Statistical Association for December, 1913. See also in this con- 
nection a monograph by Elderton, Karl Pearson, etc., on the Correlation of 
Fertility with Social Value, published by Dulau & Co., London, 1913, and an 



50 F1R8T NATIONAIi CONFERENCE ON RACE BETTERMENT 

CENTENARIANS 

A brief refeiviu'e must here be made to the subject of centenarians 
and the cliances of extreme old age, which- are apparently in- 
creasing in many civilized countries for which the data are available. 
It is well known that annuitants are more likely to attain to old age 
than persons badly provided for with the necessaries of life, and it 
therefore follows that substantial improvements in the social and 
economic condition of the population must necessarily tend towards 
the same result. The economic importance of this question is quite 
considerable in view of the increasing extent to which the pecuniary- 
needs of the aged are provided for now by state, corporate ^ or 
private pensions, best indicated. in the case of England and Wales, 
where, in 1912, there w^ere 642,524 old age pensioners, equivalent to 
59.9 per cent of the population ages 70 and over. In the United 
States in 1910 the proportion of population ages 65 and over was 4.4 
per cent, against 4.1 for the year 1900. The actual number of aged 
persons in this country in 1910 was 3,950,000. If half of these were 
provided for with non- contributory old-age pensions of only $5.00 a 
week, the resulting cost to the nation would be now about $520,000,000 
per annum.* As an illustration of the extent to which extreme old age 
is at present attained in this country, the census returns may be 
quoted, though it is practically certain that they are proljably erro* 
neous, at least in the age returns for persons beyond the century mark. 
In 1910 there were 7,391 persons enumerated as of the age period 
95-99, and 3,555 persons were returned as being over 100 years old. 
A serious question of doubt naturally arises as regards the accuracy of 
age returns for centenarians, since thorough research in individual 
eases, as a rule, fails to provide the required documentary evidence of 
fact. In a monograph on centenarians, by T. E. Young, published in 
1899, which constitutes one of the few thoroughly scientific contribu- 



extremely valuable work by Dr. Max Hirsch on the prevention of conception 
in its relation to the declining- birth rate, published under the title "Frueh- 
tabtreibung und Priiventivverkehr in Zusammenhang niit deni Geburtenriick- 
gang," Wiirzburg, 1914. 

* I have quite fully discussed the subject of Old Age Pensions in an- 
address on the Problem of Poverty and Pensions in Old Age, National Con- 
ference of Charities and Con-ections, 1908; State Pensions and 'Annuities in 
Old Age, an address before the Massachusetts Reform Club, published in the 
Quarterly Publication of the American Statistical Association, March, 1909; 
and' an address on the American Public Pension System and Civil Sei-vice 
Retirement Plans, Seventh International Congress of Actuaries, Amsterdam, 
1912. See also in this connection the exceptionally interesting and valuable 
report on the Police Pension Fund of the City of New York, published by 
the Bureau of Municipal Research, 1914. 



STATISTICAL STUDIES 51 

tions to the subject, a discussion is included of the dependence of the 
duration of life upon external physical conditions, which quite fully 
sustains the earlier conclusions of the present discussion, that the hu- 
man death rate is largelj^ the resultant of external conditions, most 
of which are subject to human control. Young quotes the definition of 
life by Bichat, the physiologist, • as "the sum of the functions by 
which death is resisted," and all the foregoing considerations make it 
clear that there is apparently a gradual increase in disease resistance 
on the part of an increasing number of mankind, partly, no doubt, in 
consequence of the economic improvement in the condition of the 
population, providing better food, housing, medical attendance, etc. 

LIFE TABLES AND THE AVERAGE AGE AT DEATH 

The improvement in human longevity resulting from a decline in 
the death rate finds its most scientific expression in the so-called mean 
after-lifetime, or the expectation of life. There are no life tables for 
the United States as a whole, nor for any particular section thereof, 
for very recent years which afford the means of comparing accurately 
the changes which have taken place in the expectation of life during a 
considerable period of years.* The two Massachusetts life tables 
which have been constructed for the '50 's and '90 's, it is true, indicate 
a considerable degree of progress, but for reasons which need not be 
discussed heije, they are not strictly applicable to the country as a 
whole. For the present purpose, therefore, the discussion is limited 
to the three English life tables for healthy districts, which have been 
constructed with extreme care for three periods of time. According 
to these tables the expectation of life at birth for males living in 
healthy districts increased from 48.56 years during the period 1849-53 
to 52.87 years during 1891-1900. The corresponding improvement in 
the longevity of women was from 49.45 years to 55.71 years. These dif- 
ferences, apparently slight, are of very considerable economic impor- 
tance M'hen applied to the whole population. Stated in another form, 
according to the English healthy-district life tables, out of 1,000,000 
males born during the period 1849-53, the number surviving to age 

* A life table for the United States has been in course of preparation by 
the Division of Vital Statistics of the Bureau of the Census for several years, 
but work on the same has of late been discontinued. There would appear 
to be no technical reasons why at least an approximate life table for the 
United States should not be constructed with the same degree of accuracy as is 
'obtained for life tables of many other countries of the world. The life tables 
published for certain American states and cities by the Census Office in former 
years are useful, but are somewhat out of date. The most recent United 
States life table, for the city of New York, has not been published in suffi- 
cient detail to make the same practically useful in the manner in which the 
corresponding life tables of London and certain other large English cities are. 



52 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

sixty Mas 485,014, wheivas, for the period LS91-1 !)()(), the number thus 
surviving was 551,973. 

Aeoordiny to the vital statistics of the United States for 1910, the 
average age at death attained by those dying during the year was 
38.7 years, which compares with an average of 35.2 years for 1900. 
The average age at death, of course* must not be confused with the ex- 
pectation of life, which is arrived at by fundamentally different mathe- 
matical processes. In the absence of life tables for the United States, 
however, this rather crude indication of an improvement in American 
longevity is the only statistical evidence available which can be relied 
upon as approximately accurate. The improvement has been chiefly 
the result of the diminishing mortality from the acute infectious dis- 
eases of infancy, typhoid fever, malaria, and tuberculosis.* The eco- 
nomic value of such a reduction must be very considerable, but it is 
far from being the equivalent of a real improvement obtainable in 
consequence of a material reduction in the death rate of the adult 
population, by means of which the more valuable lives as representing 
accumulated human skill and experience would be substantially pro- 
longed. 

THE MORTALITY FROM CANCER 

Foremost among the causes of death in adult life which require 
present consideration is cancer, or the group of malignant diseases 
conveniently combined under that term. Cancer is unquestionably on 
the increase in this and other civilized countries, and the aggregate 
mortality therefrom in the United States approximates 75,000 deaths 
per annum, and throughout the civilized world over half a million. 
There are the strongest possible reasons for believing that by means 
of improved and early diagnosis, operative technique, and surgi- 
cal treatment, a material reduction in the cancer death rate can be 
brought about within a comparatively short period of years. This con- 
elusion applies primarily to the external cancers, chiefly of the breast, 
but also to some of the internal cancers, particularly of the uterus. 
In proportion, of course, as these efforts, whether medical or surgical, 
are successful, a further decline in the death rate must follow, with 
even greater economic consequences than would result from a cor- 
responding diminution of the mortality of infancy or early youth. t 



* For a full discussion of the decline in the death rate from tuberculosis, 
see my address on the Reduction in the Tuberculosis Death Rate, ninth annual 
meeting of the National Association for the Study and Prevention of Tuber- 
culosis, Washington, 1913, also my discussion of the Care of Tuberculous 
Wage-earners in Germany, Bulletin No. 101, U. S. Bureau of Labor, 1912. 

t See in this connection my address on the Menace of Cancer, thirty-eighth 
annual meeting of the American Gynecological Society, Washington, 1912. 



STATISTICAL STUDIES 53 

ACCIDENTS, HOMICIDES AND SUICIDES 

Last, but not least, among the preventable causes of death, a brief 
mention requires to be made of accidents, homicides and suicides. In 
the United States there are approximately 80,000 deaths from acci- 
dents annually, of which about 25,000 are accidents in industry. In ad- 
dition thereto there are about 15,000 suicides and over 6,000 homicides 
per annum, of which it is safe to say a considerable proportion could 
be prevented by thoroughly effective methods of moral and social re- 
form. There is nothing more lamentable than the growing disregard 
for the sanctity of human life, as forcibly illustrated in the truly 
astonishing number of suicides and murders often for most trivial 
causes. The nation-wide campaign for safety and sanitation is one 
of the encouraging evidences of a higher humanitarianism, resulting 
from more rational conceptions of social and political justice, best 
illustrated in the comparatively rapid progress of workmen's 
compensation legislation, which, in course of time, is bound to include 
compensation for industrial diseases. The problem, however, is not 
fully met by compensation for injuries and diseases, but more effec- 
tively by the removal of the causes and conditions responsible for fatal 
accidents and injuries known to be preventable and needless. A meas- 
urable reduction in the number of accidents must necessarily affect 
the general death rate and contribute substantially towards a further 
decline than has thus far resulted from the efforts, which have in the 
main been limited to preventable diseases. 

THE DECLINE IN THE BIRTH RATE 

The interrelation of a declining death rate to a declining birth 
rate and population growth is so self-evident as not. to require ex- 
tended discussion. The evidence is quite conclusive that the birth 
rate of civilized countries is declining, and particularly so among the 
more prosperous and well-to-do elements of the population. The in- 
vestigations of Karl Pearson and his associates into the problem of 
fertility and its relation to social worth, are but indications of more 
elaborate methods of inquiry, which are bound to disclose facts and 
conditions as yet very imperfectly understood, if at all. The aston- 
ishing evidence presented to the Royal Commission on the decline in 
the birth rate in New South Wales, finds its parallel in nearly every 
specialized study of the subject. It is encouraging to find, therefore, 
that the fall in the birth rate was recently discussed at a conference 
held at Edinburgh under the auspices of the Scottish Council of 
Public Morals, at which the causes for the fall in the birth rate were 
pointed out to be the high standard of living, the love of pleasure, the 
consequent shirking of parental responsibility, and the higher educa- 



54 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

tion of women and their wider entrance into industrial and profes- 
sional pursuits. It was therefore suggested that the subject should be 
made one of private rather than of government inquiry, so that the 
underlying facts and conditions might be ascertained with less diffi- 
culty, although the experience of the Royal Commission of New 
South Wales abundantly proved the perfect willingness of important 
Avitnosses to come forward with the truth. In an address of mine on 
the decline in the birth rate, published in the North American Review 
for May, 1909, and a brief statistical study on the maternity statistics 
of Rhode Island, contributed to the proceedings of the First Inter- 
national Eugenics Congress, I have quite fully enlarged upon the de- 
tails of these phases of the present discussion, of which, however, a 
brief mention could not well be avoided. The birth rate of the Aus- 
tralian Commonwealth betw^een 1886 and 1911 decreased from 35.4 
to 27.2; of Austria from 38.3 to 31.4; of England and Wales from 
32.8 to 24.4; of France from 23.9 to 18.7; of the German Empire 
from 37.0 to 28.6 ; of Hungary from 45.6 to 35.0, and of the Nether- 
lands from 34.6 to 27.8 per 1,000 of population. There are no corre- 
sponding statistics of births for the United States, and for the few 
New England States for which they are available the results are hardly 
applicable to the country as a whole.* 

POSSIBLE FUTURE POPUT.ATION GROV^^TII 

Passing from these biological and general considerations to the 
economic significance of a declining death rate, it is necessary to con- 
sider the statement made at the outset of the numerical relation of 
such a decline to the world's growth in population. It was shown 
that the annual increase is approximately 13,260,000, which is a con- 
servative estimate and quite likely an understatement of the facts. 
Further advances in sanitation, the practice of medicine, safety in 
industry, etc., will tend to bring about a still further reduction in the 
death rate, equivalent to a higher general rate of natural increase 
than prevails at the present time. As a single concrete illustration, it 
may be pointed out that wiiile for all India the natural increase in 
1910 was 6.3 per 1,000 of population, the rate was as high as 11.25 in 
the northwest frontier provinces and 10.5 in the central provinces. It 
is therefore self-evident that there are vast possibilities for an augmen- 
tation in the natural rate of increase in the world's population, and 
there are the strongest possible reasons for belie"vang that, largely be- 

* The national and international sigiiifieanee of the declining birth rate has 
been discussed with admirable brevity by Dr. Arthur Newsholme in the new 
Tracts for the Times, issued by the National Council for Public Morals, 
London, 1911. 



STATISTICAL STUDIES 55 

cause of a declining death rate, the future rate of human increase will 
be greater than the rates prevailing in the recent past. The economic 
results of such an augmentation of the world's population will unques- 
tionably be quite serious, particularly with regard to the available food 
supply resulting chiefly from the employment of productive human 
energy upon the land. 

DECLINE IN RURAL POPULATION 

The present indications in this respect, however, are not alarming, 
for apparent!}" the area devoted to the principal food crops is increas- 
ing even faster than the corresponding growth in population. But the 
data are far from satisfactory. In practically all the civilized coun- 
tries the tendency of the population is largely toward the cities, and 
the employment of productive energy in manufacturing industries, 
governmental or corporated administration, the professions, and the 
modern methods and requirements of distribution. The recent rise in 
the price of agricultural products is largely to be attributed to this 
condition. As previously pointed out, the urban population in the 
United States during the last decade has increased 35 per cent, whereas 
the corresponding increase in the rural population was only 11 per 
cent. In many of the most important agricultural sections of the coun- 
try there has been but a slight increase in the rural population or 
an actual decline. Such an actual decrease in rural population oc- 
curred, for illustration, in such typically agricultural states as New 
Hampshire (5.4 per cent), Vermont (4.2 per cent), Ohio (1.3 per 
cent), Indiana (5.1 per cent), Iowa (7.2 per cent), Missouri (3.5 
per cent). In the state of New York 15 counties decreased in popula- 
tion during the past decade, including many in which the agricultural 
opportunities are distinctly encouraging ; in Michigan there was a de- 
crease in population in 26 counties; and a corresponding decline oc- 
curred in 20 counties of Wisconsin. The rural population of Michigan 
increased only 2.0 per cent; of Wisconsin, 5.7 per cent; and of Min- 
nesota, 7.7 per cent. In contrast, the urban population in these three 
states increased 87.3 per cent in Michigan, 23.8 per cent in Wiscon- 
sin, and 38.6 per cent in Minnesota. In contrast to an apparent 
decline in the growth of agricultural interests there has been a de- 
cided increase in farm values, for while the improved acreage in farms 
increased for the United States during the last decade only 4.8 per cent, 
the value of farm lands increased 118 per cent, and the average 
value of farm land per acre increased from $15.57 in 1900 to $32.40 
in 1910, or at the rate of 108 per cent.* 

* For additional details, see "Rural Health and Welfare," published by the 
Prudential Insurance Company of Araeriea, 1912, in connection with the New 
York Agricultural Exposition. 



56 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

PROBLEM OF CONSERVATION OF NATURAL RESOURCES 

The corresponding increase in the cost of living during the last 
two decades affects practically all of the necessaries, including every 
essential item of the food supply. It would seem that the methods of 
general agriculture have not made anything like the progress which 
has been attained in the mechanical industries, although the results in 
the latter are of much less immediate importance to the consumers 
than the former. A constantly increasing urban population must 
tend to bring about a further increase in the price of agricul- 
tural products, unless in the future a much -larger proportion 
of human energy is employed in the productive industries which min- 
ister to fundamental human wants. All that is summed "up in the 
modem conception of the governmental duty of conservation of 
natural resources for the needs of future generations is primarily con- 
ditioned by the indisputable indications of a larger future rate of 
natural increase in the world's population than has prevailed in the 
past. Foremost, it would seem, as a public problem, is the essential 
need of improved methods of agriculture, as best emphasized in the 
relatively low yield of agricultural products obtained in the United 
States, in comparison with foreign countries where the soils must long 
ago have been exhausted to a more considerable degree. The average 
yield of wheat per acre, for illustration, during the decade ending 
with 1912, was only 14.1 bushels for the United States, compared 
with 18.4 for Hungary, 19.8 for Austria, 20.4 for France, 30.1 for 
Germany, and 31.7 for the United Kingdom. The average yield of 
oats, which is a food product of considerable value, was 29.6 bushels 
per acre for the United States, against 29.8 for France, 30.8 for Hun- 
gary, 31.1 for Austria, 44.3 for the United Kingdom, and 51.9 for 
Germany. A corresponding condition is shown by the comparative 
statistics of the average yield of rye, which was 15.8 bushels for the 
United States, 18.3 for Hungary, 20.6 for Austria, 27.0 for Germany, 
and 28.4 for Ireland. It seems, therefore, an entirely sound conclusion 
that there remain vast opportunities for increased agricultural pro- 
duction without any necessary enlargement of the area devoted to the 
raising of cereal crops, but as a brief contribution to the practical side 
of this question, the following international crop statistics are given as 
derived from the Yearbook of Agriculture for 1912 : 

INTERNATIONAL CROP STATISTICS 

The area of the world imder wheat in 1908 was 242,472,000 acres, 
which by 1912 had increased to 265,736,000 acres. The increase in 
area, therefore, was equivalent to 9.6 per cent, which compares with 
3.9 per cent of corresponding increase in population. The world's 



STATISTICAL STUDIES • 57 

wheat crop in 1895 was 2,593,000,000 bushels, which by 1912 had in- 
creased to 3,759,000,000 bushels. The increase in the wheat crop was, 
therefore, equivalent to 45.0 per cent, which compares with an in- 
crease of 12.6 per cent in the world's population during the inter- 
vening period of time. 

The world's area under com, in 1908, was 160,707,000 acres, which 
by 1912 had increased to 168,154,000 acres, or 4.6 per cent. The cor- 
responding increase in population during the same period was 3.9 per 
cent. The corn crop of the world increased from 2,835,000,000 bushels 
in 1895 to 4,055,000,000 bushels in 1912. The increase in corn pro- 
duction during this period was, therefore, equivalent to 43.0 per cent, 
which compares with a corresponding increase of 12.6 per cent in the 
world's population. 

The area of the world under oats in 1908 was 128,897,000 acres, 
which by 1912 had increased to 142,935,000 acres. The increase in 
area, therefore, was equivalent to 10.9 per cent, which compares with a 
corresponding increase of 3.9 per cent in population. The world's 
oat crop in 1895 was 3,008,000,000 bushels, which by 1932 had in- 
creased to 4,585,000,000, an increase equivalent to 52.4 per cent, as 
compared with a corresponding increase of ]2.6 per cent in the world's 
population. 

The world's area under barley, which is a food crop of no small 
importance, increased from 65,663,000 acres in 1908 to 67,819,000 acres 
in 1912, an increase equivalent to 3.3 per cent, which compares with a 
corresponding increase in the world's population of 3.9 per cent. The 
world's barley crop increased from 915,504,000 bushels in 1895 to 
1,458,000,000 bushels in 1912. There was, therefore, a relative increase 
in barley production of 59.2 per cent, which compares with a cor- 
responding increase of 12.6 per cent in the world's population during 
the intervening period of time. 

The world's area under rye, which is also a crop of considerable 
importance as a source of food supply, increased from 106,121,000 
acres in 1908 to 108,292,000 acres in 1912, an increase equivalent to 
2.1 per cent, corresponding to an increase of 3.9 per cent in the 
population of the world during the same period of years. The 
world's rye crop increased from 1,468,000,000 bushels in 1895 to 1,901,- 
000,000 bushels in 1912. an increase equivalent to 29.5 per cent, which 
compares with a corresponding increase in population of 12.6 per 
cent. 

The world's rice crop increased from 91,000,000,000 pounds in 
1900 to 174,000,000,000 pounds in 1911. The increase in production 
during this period was equivalent to 91.2 per cent, which compares 



58 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Avith a corrospondinfj incroase of 8.8 per cent in the population of the 
world. 

The available evidence, therefore, is distinctly encouraging, some 
exceptions to this view notwithstanding, that a considerable further in- 
crease in the world's population is entirely consistent with at least 
an equal rate of growth in the production of the cereals required for 
the world's food supply. The same conclusion, though to a lesser de- 
gree, applies to the products of animal industry, which, however, it is 
not possible to discuss on this occasion. 

EVIDENCE OF xVUGMENTED POPULATION GROWTH 

The progress of the race as an economic problem is, therefore, ap- 
parently not as yet seriously affected by the material decline in the 
general death rate, wdth a resulting proportionately larger increase in 
population. The problems of the immediate future are social, moral 
and political, as perhaps best emphasized in the following table, ex- 
hibiting the population growth of Europe and the United States com- 
bined, since the commencement of the nineteenth century and east 
forward to the year I960: 

POPULATION OP EUROPE AND THE UNITED STATES 

Annual Increase 

Year Europe United States Total per 1,000 

1800 187,693,000 5,303,000 193,001,000 

1810 198,388,000 7,240,000 205,628,000 6.3 

1820 212,768,000 9,638,000 222,406,000 7.8 

1830 233,962,000 12,866,000 246,828,000 10.4 

1840 250,972,000 17,069,000 268,041,000 8.2 

1850 266,228,000 23,192,000 289,420,000 7.7 

1860 282,893,000 31,443,000 314,336,000 8.3 

1870 305,399,000 38,558,000 343,957,000 9.0 

1880 331,745,000 50,189,000 381,934,000 10.5 

1890 362,902,000 62,980,000 425,882,000 10.9 

1900 ....400,577,000 76,303,000 476,880,000 11.3 

1910 449,520,000 91,972,000 541,492,000 12.7 

1920* 506,151,000 109,999,000 616,150,000 13.0 

1930* 571,081,000 130,019,000 701,100,000 13.0 

1940* 645,901,000 151,862,000 797,763,000 13.0 

1950* 732,506.000 175,248,000 907,754,000 13.0 

1960* 833,127,000 199,783,000 1,032,910,000 13.0 

* Based on an annual increase of 13.0 per 1,000, and the assumption that in the 
future a larger share of European emigration will go to countries other than the United States. 

During the period of recorded population growth for Europe and 
the United States there has been a rise in the rate of natural in- 
crease from 6.3 per 1,000 during the decade 1800-10 to 12.7 per 1,000 
during the decade ending with 1910; and the actual population of 
Europe and the United States combined has, during this period, in- 
creased from not quite 200.000,000 to over 540,000,000. 

POLITICAL PROBLEMS OF POPULATION GROW^TH 

Foremost among the political problems resulting from .such an in- 
crease in population, with a corresponding increase in density, are the 
' increasing expenditures on account of government, best illustrated in 



STATISTICAL STUDIES 59 

the simple statement of the fact that in 1912 the approximate revenue 
of civilized countries was $11,574,000,000, and the corresponding ex- 
penditures, $11,687,000,000. Of the expenditures, $1,686,000,000 was 
on account of interest and other annual charges upon an accumulated 
debt of $41,737,000,000. In practically every civilized country these 
burdens of fixed charges on account of debts, largely of a non-pro- 
ductive character, are increasing ; but particularly so in the case of 
local governments, chiefly large cities, which are not included in the 
foregoing statement of revenue, expenditures, debts and interest 
charges, which have reference only to national obligations and fiduci- 
ary responsibilities. As a single concrete illustration, limited to 
American cities, it may be pointed out that the per capita govern- 
mental cost payments for 1910 amounted to $31.32, ranging from 
$37.15 for large cities to $19.66 for small cities. The increase in 
municipal indebtedness during recent years has been enormous, with 
much of the expenditures for non-productive or only temporary pur- 
poses, though the burdens resulting therefrom will have to be largely 
borne by future generations. Against a per capita national debt of 
only $10.60 for the United States and an annual per capita interest 
charge of 23 cents, the per capita debt of New Zealand is $371.27, and 
the per capita annual interest charge $11.26; for France, the per 
capita debt is $158.67, and the per capita annual interest charge 
$4.69 ; for the German Empire the respective figures are $18.78 and 
88 cents. All statistics of this kind require to be accepted with great 
caution on account of variations in underlying elements, since no 
data are available regarding the total governmental debts of any coun- 
try, including the federal, state and local governments. The data are 
only referred to as an illustration of the serious problems confront- 
ing the future, and which arise particularly out of the rapid actual 
growth in population, which in modern countries is without a parallel 
in historic times.* 

FIRST CONCLUSION CONSERVATION OF FOOD-PRODUCING NATURAL RE- 
SOURCES IN LAND AND SEA 

As observed at the outset of this discussion, the social, economic and 
political problems which arise out of a declining death rate and the 



* The most convenient sources of information regarding- international 
statistics of public finance are contained in the statistical abstract of the 
United States, published annually by the Bureau of Statistics, of the Treasury 
Department. The financial statistics of American cities are annually reported 
upon in considerable detail by the United States Census Office. The most re- 
cent critical observ^ations on the wealth of nations are contained in a treatise 
on "Wealth and the Causes of Economic Welfare," by Edwin Cannan, pub- 
lished by P. S. King & Sons, London. 



60 FIRST natioxaij confewence on race betterment 

resultinjr pDpulatioii growth, are of vast importance and entitled to 
public consideration. Much has of necessity been left unsaid which 
has immediate reference to the factors conditioning race progress as 
measured by changes in the death rate, but the most pressing question 
is the more intelligent, and if necessary the radical, conservation and 
control of the natural resources of the earth, including the food re- 
sources of the sea. On the last-named subject alone a well-reasoned 
plea might have been advanced, for it is a remarkable fact, as pointed 
out in the report of the Canadian Commission on Conservation, that 
Canada is the only country in the world with a governmental organi- 
zation with administrative powers over all the fisheries of the Domin- 
ion. The Canadian Department of Marine and Fisheries has ample 
powers of protection and conservation, which in course of time must 
prove of vast benefit to the future generations of that country. Such 
power should be exercised by other governments with an interest in 
the food resources of the sea.* 

SECOND CONCLUSION — IMPROVED METHODS OP AGRICULTURE 

The second conclusion, partly resulting from the first, is the im- 
perative need of improved methods of agricultural production and dis- 
tribution and the more successful prevention of waste of soil, seed and 
labor. The extent of destructive soil-erosion is enormous and the an- 
nual waste of soil or impaired fertiliity in the United States is one of 
the most lamentable aspects of our national life. Large areas are be- 
coming practically useless for remunerative methods of farming, be- 
cause of neglect and lack of proper attention to well-understood princi- 
ples of soil-conservation. The progress in the reclamation of arid and 
swamp lands is gratifying, but considering the vast possibilities, only 
a small beginning has been made. The work of the United States 
Bureau of Soils and the United States Reclamation Service is proving 
of incalculable benefit to the people and it is entitled to more adequate 
and well-considered state and federal support. The nation-wide move- 
ment for the improvement of the social conditions of coiuatry life and, 
in connection therewith, of rural sanitation, demands a properly 
guided and persistent public interest. One of the most hopeful signs 
of the times is the gradual development of a deliberate governmental 
policy in the matter of rural credit, or agricultural finance, and the 

* See in this connection the admirable reports of the Scottish Departmental 
Committee on the North Sea Fishing Industry, published as a Parliamentary 
Paper, London, 1914. No such exhaustive investigations have been made of 
the fishery resources of the United States, though obviously called for on ac- 
count of the growing importance of this industry. 



STATISTICAL STUDIES 61 

related subject of intelligent cooperative distribution of farm products. 
All efforts of this kind foreshadow a time when agriculture will be- 
come the first interest of the nation, not only as regards remunerative 
pecuniary results, but also as regards health and happiness on the 
farm.* 

THIRD CONCLUSION — UTILIZATION OF WASTE 

Third: The utilization of wastes and by-products is an economic 
question of far-reaching practical national importance. The losses re- 
sulting from crude or otherwise ill-considered methods of production 
are enormous, but particularly so in the lumber and mining industries. 
What can be done in the direction of conserving our forestry resources 
has been clearly established by numerous investigations of the Bureau 
of Forestry. What can be done in the direction of conserving our fuel 
resources, by more efficient methods of production, is best illustrated 
in a recent bulletin of the United States Bureau of Mines on the 
petroleum industry. The almost infinite possibilities of utilizing waste 
products to economic advantage are best illustrated in the commercial 
success of the cotton-seed-oil industry, modern meat-packing plants 
and by-product coke-ovens. Improved efforts in this direction will go 
far to mitigate the economic consequences of an increasing population, 
resulting from a reduction in the death rate. 

FOURTH CONCLUSION — TOWN PLANNING 

Fourth : There is the utmost urgency for the earliest possible adop- 
tion of rational town-planning schemes for American cities, in con- 
formity to the principles laid down in the Proceedings of the Third 
National Conference on City Planning, held in Philadelphia in 1911. 
The fundamental facts of a housing-reform propaganda are gradu- 
ally being ascertained by means of local surveys and given wide 



* See in this connection the exceptionally valuable and interesting report 
of the United States Commission on Agricultural Cooperation and Rural 
Credit in Europe, Washing-ton, 1913; the Joint Hearings before the Sub- 
Committee of the Committee on Banking and Currency of the Senate and the 
House of Representatives charged with the Investigation of Rural Credits, 
Washington, 1914 ; the Report to the Board of Agriculture and Fisheries of 
an Inquiry into Agricultural Credit and Agi*icultural Cooperation in Germany, 
by J. R. Cahill, published as Parliamentary Paper Cd. 6626, London, 1913; 
also, Bulletin No. 56, Department of Agriculture, State of New York, on 
Agricultural Cooperation in Europe (this report contains some exceptionally 
useful facts and observations on the business organization of agriculture in 
Europe, and the commercialization and industrialization of agriculture for 
the purpose of securing higher returns to the producer and reduction of cost 
to the consumer). 



62 FIRST XATIONAli CONFERENCE ON RACE BETTERMENT 

publicity by the National Confprenee on Housing.* There is a strong 
tendency, at least in the development of suburban territory, towards 
the adoption of European town-planning methods, as admirably set 
forth in recent reports of the London Garden Cities and Town-Plan- 
ning Association and the Westphalian Leagne for Housing and Build- 
ing Reform. The American aspects of the problem have been dis- 
cussed with admirable clearness and an unusual breadth of vision at 
a meeting of the American Academy of Political and Social Science, 
held in Philadelphia in 1914. This conference included observations on 
the important question of the relation between transit and housing and 
of the equally important problem of properly considered plans for the 
most suitable location and most effective distribution of industrial 
establishments. In view of a rapidly increasing urban population 
throughout the world, the most effective and suitable control of build- 
ing operations, particularly in badly congested cities, and with special 
reference to the housing of wage-earners, assumes the greatest possible 
practical importance. 

FIFTH CONCLUSION — EDUCATION IN PRACTICAL DOMESTIC ECONOMY 

• Fifth: There is greater need of emphasis being placed in educa- 
tional courses on the principles and practices of domestic economy and 
the required reduction of per capita food consumption, with a larger 
proportionate and easily obtainable increase in nutritive values, con- 
forming to the results of qualified studies of dietaries, such as have 
been made by Atwater, Chittenden, and others. It is gratifying evi- 
dence of an increasing extent of public interest in this extremely im- 
portant problem that more or less drastic national food laws, aiming 
chiefly at the prevention of adulterations, should have been enacted 
within recent years, mth the certainty of far-reaching benefits to the 
health of the nation. The physiology and pathology of metabolism 

* The direct relation of model dwellings to the death rate has been pre- 
cisely established by English experience. The following table shows the 
general death rate of groups of model dwellings in London, compared with 
the death rate of the city as a whole. For additional information on this im- 
portant question, see my report on the sanitary condition of Trinity Tene- 
ments, published in 1895, and my address on the relation of the suburb to the 
city, published in the Proceedings of the Federation of Churches, New York, 
1912. 

The Improved Metropolitan Asso- 

Industrial The ^''''^t'?" ^"^"^ I'?^" Peabodx- 

Years Dwellin, Co., Guine.. 'i::^!^^t Donation Greater 

Ltd. Trust rtustrial Classes Fund London 

1908 8.0 13.3 9.0 12.4 13.6 

1909 8.6 14.7 11.5 13.7 13. S 

1910 6.3 13.8 6.6 10.8 12.4 

1911 10.8 13.4 10.2 11.3 13.8 

191:4 9.4 11.3 12.6 10.4 12.3, 



STATISTICAL STUDIES 63 

are as yet but imperfectly understood, and further progress in this 
direction is bound to have a decided effect upon the death rate. What 
can be done in educating the general public in the elements of nutri- 
tion is best shown by an admirable set of fourteen charts on the com- 
position, functions and uses of food, prepared by C. F. Langworthy, 
expert in charge of nutrition investigations of the United States De- 
partment of Agriculture. 

SIXTH CONCLUSION — RATIONAL CONTROL OF MARRIAGE, FECUNDITY, 
AND DIVORCE 

Sixth : The increasing complexity of social and sex relations, re- 
sulting partly from the vast migratory movements of modern peoples, 
suggests the necessity of more qualified studies than have heretofore 
been made of the actual extent of such changes and their effect upon 
the stability of the family and its intrinsic social worth. State regu- 
lation of marriage within reasonable limitations and with special ref- 
erence to the required prevention of the marriage of the obviously unfit 
is a first step in the direction of deliberate race-betterment on the basic 
principle of social control. The actual and relative increase in divorce 
indicate a large amount of prevailing marital discontent, as well as 
the possible necessity of more effective legal safeguards against the 
dissolution of the family. The economic problem of widowhood in- 
creases in seriousness with an increase' in the duration of life and 
the consequent necessity for more prolonged pecuniary support in old 
age. The present status of family-desertion and non-support laws is 
far from satisfactory, largely because of a rapid augmentation of 
urban population, chiefly by migration from the south of Europe. 
In its fundamentals the progress of the race is determined by the 
progress of the family and its greater stability and intrinsic moral 
worth.* 

SEVENTH CONCLUSION — IMPROVED METHODS OP GENERAL EDUCATION 

Seventh : Our methods of general education are unquestionably far 
from being as practical as they require to be made in view of an 
increasing complexity of social, economic and political problems, 
which necessitates the elimination of all evidently useless courses im- 
parting mere information or rules and formulas never likely to be 
applied in the solution of practical, every-day problems. 

* For a discussion of the rates of moi-tality, with special reference to mar- 
riage and fruitfulness of miarriage, see the Transactions of the Faculty of 
Actuaries for 1912 ; the classical treatise on Fecundity, Fertility and Sterility 
by J. Mathews Duncan, New York, 1871; my address on the Maternity Sta- 
tistics of Rhode Island, First International Congress of Eugenics, London, 
1912 ; and the work by Chas. Letourneau on the Evolution of Marriage of the 
Family. 



64 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

EIGHTH CONCLUSION — PHYSICAL TRAINING AND MEDICAL SUPERVISION 

Eighth -. The physical training of the young, and the medical super- 
vision of schools and factories, including periodical examination for 
the purpose of correcting physical defects in the initial stage, or treat- 
ing incipient disease, with a reasonable chance of cure, have become 
accepted principles of modern government. In course of time these ef- 
forts must profoundly modify not only the health of the young, but 
what is equally important, the health of adult persons employed in in- 
dustry. Furthermore, there must come about in consequence of such 
efforts, a decided improvement in physique and more general con- 
formity to a normal physical type, and the gradual elimination of the, 
at present, disproportionately large number of persons physically de- 
fective or infirm, and by inference, or obviously, less efficient for the 
economic needs of society. 

NINTH CONCLUSION — LOCAL HEALTH ADMINISTRATION 

Ninth : A decided improvement is required in local health adminis- 
tration and the more intelligent coordination of health-promoting 
public and private agencies and institutions. There is a considerable 
amount of needless waste in present efforts, but even more important 
is the abundant evidence of inefficiency, particularly in the health 
administration of small communities and rural districts. With an in- 
creasing appreciation of the economic value of health must come a 
higher regard for the scientific and practical utility of accurate vital 
statistics on the one hand, and a thoroughly efficient administrative 
control of the public health on the other. Every improvement in this 
direction tends towards a lowering of the general death rate, at least 
from the more easily preventable diseases, and in course of time a 
reduction may also be anticipated in the chronic degenerative dis- 
eases less subject to public control but more amenable to a rational 
mode of living, personal hygiene, progress in medical and surgical 
diagnosis and treatment, and a higher standard of life generally. 

TENTH CONCLUSION MODERN LIFE CONCEIVED AS SOCIAL SERVICE 

Tenth -. Coincident with a more rational education must come the 
inculcation of new and higher ideals of life conceived as social service, 
and therefore primarily for the benefit of the community as a whole. 
The purely individualistic view of personal aims and pleasures is 
bound to give way to higher conceptions of social duty, without in the 
least diminishing the chances for individual development, conceived 
as an economic function, or as a life-long struggle for intellectual, 
moral and spiritual perfection. 



STATISTICAL STUDIES 65 

ELEVENTH CONCLUSION ECONOMIC UTILITY OF LONGEVITY 

Eleventh : An increasing average duration of life, on the one hand, 
and a larger proportion of aged persons on the other, must mean new 
economic problems, particularly with regard to the social and in- 
tellectual utilization of old age. It has beautifully been observed by 
Jean Finot that ' ' our life is nothing but a long and implacable battle 
with death." But life is also for the mass of mankind an incessant 
struggle against poverty and economic dependence and the more or 
less degrading and always humiliating necessity of private charitable 
aid or state support in sickness, invalidity and old age. No modern 
agency for the amelioration of the economic condition of mankind has 
been of greater benefit to the masses than life insurance in its various 
forms. To an increasing extent, the needs of even the poor in sickness 
and premature death are now being provided for on the basis of in- 
surance principles, gradually developed into the ministry of a uni- 
versal provident institution. For a tranquil and otherwise happy old 
age, a modest but certain amount of financial support is absolutely 
essential, but it is equally important on the ground of public mortality 
that such support, to the largest possible extent, should be the result of 
individual thrift, or, in other words, represent voluntary methods, the 
reward of a rational economy, enhanced in value by the use of sound 
and profitable methods of savings and insurance. It is on this ground 
that non-contributory universal old-age pensions are to be looked upon 
with apprehension and as a hindrance, rather than a help, in the 
struggle for a genuine and lasting betterment in the social condition of 
the poor. It is for the same reason that voluntary methods of savings 
and insurance afford the most satisfactory means within the reach of 
all but the very poor, to provide in however modest a manner for self- 
support in sickness, infirmity and old age. 

The suitable occupation of persons advanced in years in some ca- 
pacity useful to themselves and society, is another serious social prob- 
lem, which as yet has received but slight consideration. The most 
helpful suggestions along this line are those advanced by the late 
Professor Shaler, in his book on ' ' The Individual ; " by William Ed- 
ward Hartpole hoeky, in ' ' The May of Life ; ' ' and by Professor Metch- 
nikoff's books on "The Prolongation of Life" and "The Nature of 
Man." That old age has its own and properly assigned function in 
the human economy, as applied to the needs of society, is best brought 
out in the admirable discourse on "The Age of Mental Virility," 
which is an inquiry into the records of achievement of the world's 
chief workers and thinkers, by W. A. Newman Borland. 

(4) 



66 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 
TWELFTH CONCLUSION HIGHER EDUCATIONAL IDEALS 

Twelfth : .\jul last, it may be suggested that one of the most im- 
portant problems resulting from a declining death rate and the pro- 
longation of life and its consequential relation to the progress of the 
race, is the imperative duty of self-culture, the adoption of new edu- 
cational standards, emphasizing, on the one hand, the economic limita- 
tions of life, but on the other, the practically unlimited possibilities 
of individual, intellectual, moral and spiritual development. There is 
nothing more discouraging to the mass of mankind than the obvious 
evidences of inherent economic limitations as regards the distribution 
of wealth and the individual actiuisition of articles of necessity or 
luxury which only money can buy. There is the most urgent need for 
higher standards of education, resting upon the incontrovertible argu- 
ment by Bishop Spalding, in his masterly treatise on "Education and 
the Higher Life," that the true ideal is summed up in the aim to he 
rather than to have more ; and to he more spiritually, morally and in- 
tellectually is practically within the power of every individual whose 
eyes have once been opened to the truth. It is true that the standard 
of economic well-being has risen all over the world, and unquestionably 
an inconceivable amount of good, has resulted from the comparatively 
recent economic progress of mankind; but there is great danger in 
overemphasizing the value of such progress, at least in the individual 
case, and in underrating the social value of a disciplined imagination 
and the more readily attainable ideals of the intellectual life. With 
an increasing population and an increasing struggle for the possession 
of the land and the means of subsistence, it would seem to be of the 
utmost importance that these more subtle and less readily definable 
elements of the problem of race progress should not be lost sight of. If 
the prolongation of life resulting from a diminishing death rate is to 
be really worth while, the present disharmonies of human existence 
must be, as far as practicable, eliminated, but whatever changes for 
good may result from improved methods of production, from more 
abundant means of subsistence, from increased earnings and shorter 
hours of labor, they will all be of small consequence unless balanced 
by an even greater advance in the moral, intellectual and spiritual 
type of the generation which is yet to be. 



STATISTICAL STUDIES 67 

THE CAUSES OF THE DECLINING BIRTH RATE 

Professor J. McKeen Cattell, LL.D., Editor Popular Science Monthly, 
Gan-ison-on-Hudson, N. Y. 

From prehistoric times the population of the world has been held 
in check by war, pestilence and famine. Towards the close of the 
eighteenth century these were relaxing in severity, thanks to the 
applications of science and to a gradually ameliorating civilization, 
and the population of Europe was increasing at the rate of about one 
per cent a year. It is no wonder that Malthus Avas appalled by this 
geometrical compounding of human beings, which would exhaust the 
food supply and even leave no standing room on the earth, and that 
his point of view dominated the economic theory of the nineteenth 
century. But two factors already in existence soon gained force. The 
applications of science — the use of the steam engine in manufactures 
and transportation and innumerable other advances — increased the 
means of subsistence more rapidly than one per cent a year, and the 
birth rate was beginning to decline. 

Owing to a remarkable balance between a decreasing birth rate and 
a decreasing death rate, the population of Europe continued to in- 
crease throughout the nineteenth century at a rate in the neighborhood 
of one per cent a year, rising from 175 million in 1800 to 420 million 
in 1900. The population increased about as rapidly as it could be con- 
veniently assimilated, with gradually improved conditions of living, 
for all. A new factor in the adjustment of population was emigration 
on a large scale, some thirty-five million people leaving Europe in the 
course of the century, more than half of whom came to the United 
States, where the increase in population has been in the neighborhood 
of two per cent a year. 

The adjustment of population to means of subsistence appears at 
first sight to be so exact that there is likely to be an assumption of a 
controlling mechanism such as exists in a state of nature. The fact of 
the matter is, however, that the food supply and the other necessities 
of life are not fixed quantities, but increase in proportion to the num- 
ber of men who both use and produce them. In an era of the applica- 
tions of science, there are no diminishing returns with increasing 
population, but rather increasing returns, owing to the production 
of larger numbers of men who make discoveries and improvements for 
the benefit of all. The average well-being is about the same in France 
with a stationary population, as in Germany with a rapidly increas- 
ing population ; but Germany through its greater share in the ad- 
vancements of science and its applications is contributing more to the 
world than is France. The first effect of a lowered birth rate is to 



68 



FIRST NATIONAL CONFERKNCE ON RACE BETTERMENT 



increase Aveallh — tlioii,i>ii it is <2^enerally consuiued in luxuries — by 
saving the cost of the rearing of children, but later when the produc- 
tive workers are lacking there is an economic loss. France, as com- 
pared with Germany, saves each year over a billion dollars by having 
fewer children to support; but the gain in wealth is temporary. In 
fact it ended in 1895, whereas the increase in wealth in Germany in 
the course of the next generation will be enormous. 

It is a fundamental question whether the relation between the 
birth rate and the death rate will be maintained under existing condi- 
tions so as to give an increasing, or, at all events, a stationaiy popu- 
lation. Will both continue to decrease or remain approximately as at 
present, or will the balance of the nineteenth be lost as has apparently 
happened in France? The death rate has been halved by the partial 
abolition of war, pestilence and famine in their grosser forms, and by 
alleviation of their milder aspects — improved conditions for the strug- 
gling classes, the limitation and mitigation of disease, and better condi- 
tions of living. There is abundant room for further improvement ; it 
is stated that the death rate can again be halved. But this is impos- 
sible ; indeed, it seems that in certain nations the death rate has now 
reached its minimum. Australia and New Zealand report a death rate 
of ten. This means that in a 
stationary population the average 
age at death is one hundred years. 
For every infant that dies, a man 
must live to be two hundred years 
old, or ten men live to be one 
hundred ten. This is beyond the 
limit of possibility. The death 
rate in England and Wales is 
about thirteen. It is so low be- 
cause decreasing birth rates and 
death rates have given a popula- 
tion so constituted that an un- 
usually large part is of the age 
when deaths are few. The death 
rate in England will probably de- 
crease a little further and will 
then begin to rise. 

The relation between births, 
deaths and marriages in England 
and Wales is shown on Chart I. 
The marriage rate fluctuates, but 
is now as high as it was in 1880. 



35 

30 
^5 
10 

15 

10 
li 




BIRTH 


RATES 














V 


V, , 




















- 


--, 


"\ 




A 


DEATH 


RATES 












\ 




V 




^ 


\'\. 


\' ■ . 




M 


ftRRIAGf 


RATES 








\' 


\ 


76 Ifi 


31 1(86 1691 18 


96 1901 m 15 





STATISTICAL STUDIES 



69 



The maximum birth rate in 1876 may be due to the introduction 
of compulsory registration in 1874. From that time it has fallen 
steadily; if it should continue to decline at the same rate it would 
reach the minimum death rate of ten in about forty years. 
The death rate has also fallen constantly, though with greater 
fluctuations, dropping from 21 in 1876 to 13.3 at the present 
time. In France, with its small birth rate and stationary population 
there are relatively about four-fifths as many young children and 
nearly twice as many old people as in England. When the latter coun- 
try attains a stationary population its death rate must increase, and 
unless there is a change in the birth rate curve the population will 
soon become stationary and will then begin to decrease. 

The declining birth rates of the three great cultural nations of 
Western Europe are shown on 
the curves (Chart II), and 
they have continued in the 
same course. Thus in Eng- 
land and Wales the rate was 
24.4 in 1911 and 23.8 in 1912. 
The decline for France has 
been very regular since the 
beginning of the last century 
at the rate of one and one- 
half per thousand for each 
decade. The decline for Eng- 
land since 1876 is also nearly 
in a straight line and twice as 
rapid as for France. The de- 
cline for Germany, beginning chart n. 
later than for England, as that was later than for France, has since 
1895 been more rapid than for England. These three curves, if con- 
tinued, give the queer result that births in these three nations will 
<3ease altogether in about the same time one hundred years hence. 
Such results are of course absurd. Still it should be remembered 
that there are now only three births to replace four deaths in some 
French departments and in the native population of New England. 

The vital statistics of the United States are entirely inadequate. 
Where registrations of deaths and births exist, they are imperfect, and 
the changing population, its age, composition, and the amount of im- 
migration, render them difficult to interpret. But some information 
concerning birth rates is given by the proportion of children as de- 
termined by the census. If the percentage of children under sixteen 
years of age in the population should continue to decrease as it did 



^ 




-\ 










30 
25 
20 

15 
10 
5 

n 


\ 




\ 




TOP - GERMANY 
MIDDLE- ENGLAND 
BOTTOM - FRANCE 






\ 


\ 


\^ 






V 


^ 


N 


^\.^ ^\^ 














\ 










^"n^ 














^N ^^^ ^ 












'*X 




81 


85 51-95 m 1910 1950 20OO | 



70 



FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 



from 1880 to 1900. there would be no children two humlred years 
hence. 

From a special study by Mr. Kuczynski it appears that the birth 
rate of the native population of Massachusetts was 63 per thousand 
women of child-bearing age, as compared with 85 in France, 104 in 
England and 143 in Russia. As the French population is stationary, 
the native New England population, even apart from any further 
decline in the birth rate, decreases to three-fourths in one generation. 
Its birth rate was 17, the size of family 2.61 and of the surviving 
family 1.92. Special statistics have been gathered for college gradu- 
ates. President Eliot in his report for 1901-02 stated that 634 married 
Harvard graduates of the classes from '72 to '77 had an average 
family of 1.99 surviving children. Other data concerning the families 
of college graduates have been published by Pl^ofessor Thorndike, 
President Hall and others. The Harvard graduate has on the 
average three-fourths of a son, the Vassar graduate one-half of a 
daughter. Curves are here drawn for some of the data, which show 





6 

5 


1 
























^.^ 
^^\^ 


\ \ 












3 


3 
2 

1 







^^v'\\ 


, 
















x\ 


















'■■■•■■.. 












EBURY 
EYAN 
YORK 








'■■. 

■■■.... 












- 


NEW 




I8!5 1835 1855 1875 1895 1915 1935 | 



CHABT ni. 



STATISTICAL STUDIES 



71 



that the gross size of the family of college graduates has decreased 
from 5.6 at the beginning of the century to 2.5 and 2 for classes 
graduating in 1875. A projection of these curves gives the curious 
result that students graduating in 1935 would have no children. 

"What, then, are the causes leading to the recent decline of the 
birth rate, and are they likely to alter so that the rate may again in- 
crease, to maintain the existing state of affairs, or to produce a further 
decrease ? There is a biological adaptation which limits the fertility of 
a woman to about twelve children, and social conditions have led to 
one-half of the women of child-bearing age being unmarried. The 
further decrease of the average family to three or four — in the case 
of American scientific men or college graduates to two — must be due to 
infertility or to voluntary limitation. Both causes have been recog- 
nized since the time of the writing of the book of Genesis ; both have 




CHART IV. 



72 



FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 



doubtless increased in force in the course of tlie nineteenth century. 
It is generally believed that the principal cause of the small size of 
the modern family is voluntary limitation. A definite answer is sup- 
plied by information given to me by 461 leading scientific men. 

The curves of Chart V show the distribution of these families 



20% 
15% 
10% 
5% 








,AM 


ERI 


:an 


5 


CIE 


NT! 


FIC 


M 


EN 














/ 
/ 




\ 






























/ 




\ 


































NEV 


L\5 


OUT 

\ 


H \ 


^AL 


E5 
"■•., 


MO 


rHE 


RS 






















\ 


\ 








■x 


■"■- 


"'X 


^^^ 








( 


1 2 3 4 5 6 7 8 9 10 II 12 13 14 15 16 1 



CHART V. 

of scientific men in comparison with the families of some twenty thou- 
sand New South Wales mothers who died toward the close of the last 
century. In both cases all children, whether they survived or not, are 
included and no more children would be born. The New South Wales 
families of from one to eight are nearly equally numerous and there 
is then a gradual decrease to families of sixteen and larger. The 
families of American scientific men — which may be regarded as typical 
of the professional classes and other college graduates — show a re- 
markable contrast. Nearly one-fourth are childless ; less than one in 
four is larger than three, only one in seventy-five is larger than seven, 
none is larger than nine. The average size of family is 2.2. Excluding 
the earlier marriages, it is 2 ; the surviving family is about 1.8 and 
the number of surviving children for each scientific man is about 1.6. 

THE NEED OF THOROUGH BIRTH REGISTRATION FOR 
RACE BETTERMENT 

Cressy L. Wilbur, M.D., Chief Statistician Divisiun of Vital Statistics, 
Bureau of the Census, Department of Commerce, Washington, D. C. 

The main purpose of my coming here as representing the Bureau 
of the Census, Department of Commerce, was to see that the subject of 
vital statistics was one of the fundamental planks of this new organi- 
zation, and since coming here, since looking over the program, the dia- 



STATISTICAL STUDIES 73 

grams and other things over in the Annex and hearing the remarks 
of Mr. Hoffman, I am sure that there will be no difficulty about the 
main proposition — that is to say, the necessity, the absolute impor- 
tance of vital statistics, especially birth registration, as the foundation 
of all intelligent effort for race betterment. 

You will find in the corridor of the other building a little diagram 
entitled, ' ' The United States Registration Area for Deaths. " It is a 
map of the states showing the space in which the registration of deaths 
is sufficiently complete to be used for statistical purposes, with this 
inscription below it: "Vital statistics are the bookkeeping of health 
and we cannot economize health any more successfully than we can 
economize money unless we keep books. — Irving Fisher." 

That is so absolutely true, it is not worth while to argue about it. 
Yet, look at the condition in this country in regard to our bookkeeping 
of public health. For a large proportion of the country, the registra- 
tion of deaths is so worthless that we cannot have any reliable statistics 
in regard to it. Even the great state of Illinois, the state of Iowa, 
the state of West Virginia and practically all the Southern States 
have not any successful death registration. The registration of vital 
statistics in the United States began in 1880 when we had only two 
states, Massachusetts and New Jersey. In 1890 the area had grown 
so that it took in all New England. New York, New Jersey, and Dela- 
ware was added by mistake in 1900. You see some of the Middle West 
added Michigan and Indiana, and I am very proud as a native Michi- 
gander to be able to say that Michigan was the first state, west of 
New York, that had an effective law for registration of deaths and the 
first state to be accepted by the Bureau of Census, before my time 
there, as belonging to the registration area for deaths. Michigan was 
added for the census in the year 1900, whereas Indiana, which fol- 
lowed, was not added until half a year later. Since 1900 we have 
been making a srood deal of progress. A large number of states are 
now added, some of them in the Far West, We are now beginning in 
the South. Missouri was added in 1911 ; Kentucky in 1911 ; Virginia 
added in 1913, together with the partial registration in North Caro- 
lina. A law establishing registration went into effect this month in 
Arkansas and Tennessee. A law has been in operation in Mississippi 
since November. 1912, The whole South is awakening to the impor- 
tance of death registration, so that I can predict that perhaps by the 
year 1920. all the states of the Union will be covered with adequate 
death registration laws — although some of them will not be properly 
enforced, but enforcement must follow the passage of proper legis- 
lation. 

When we turn to the condition of birth registration, we have rather 



74 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

a dili'erent picture. The only states in I!)!! in which statistics of birth 
were practically complete were Rhode Island, Massachusetts and 
Connecticut. 

We have a test in birth registration that can be applied to the 
operation of the state law. As you Imow, every ten years we have an 
enumeration of the population. In that enumeration, the proportion 
of infants under one year of age is always given. Now the number of 
infants under one year of age as enumerated in the population is al- 
ways considerably less than the number of births. By comparison 
of international statistics of leading European countries, it will be 
found that the number of births will usually exceed the number of 
infants under one year of age, as enumerated by the census, by per- 
haps ten or fifteen per cent, or even more. Now, applying the com- 
parison to 1910 or 1911, we find that the only states in which the 
registration of births gives results greater than the enumeration of in- 
fants under one year of age in population are Connecticut, Indiana, 
Maine, Massachusetts, Michigan, New Hampshire, New York, Ohio, 
Pennsylvania, Rhode Island and Vermont. The remainder are confined 
to New England, New York, Pennsylvania, Michigan, Indiana, Mis- 
souri and Utah. In Kentucky the first registration law went into efi'ect 
in 1911. It is not fair, therefore, to compare the results in Kentucky^ 
for the first year of operation of the law, with states in which the law 
has been in operation for some time. It would be better to compare the 
results in Kentucky for the next year of operation, 1912, in which the 
number of births slightly exceeded the number of deaths under one 
year of age, very much like Indiana, Missouri and Michigan. 

The results in Michigan are of special interest because there is 
beginning to be some improvement. Michigan had no vital statistics at 
all, so far as complete figures are concerned, until 1908, when the new 
death registration law went into effect. The death registration law 
was not passed until 1905 and went into operation in 1906. In 1910, 
five years after that, the number of births registered only very slightly 
exceed the number of infants under one year of age in population — 
I think about one per cent. Since that time, in 1911-12 and I suppose 
in 1913, there has been some improvement, so that Michigan now shoAvs 
a death registration about four per cent in excess of infants under one 
year of age. But I do not believe birth registration will ever be 
approximately accurate until it exceeds at least by ten or fifteen per 
cent the nutaber of infants under one year as in Massachusetts, Con- 
necticut and Rhode Island. So there is yet much to do in Michigan 
to bring up the registration of births so that they will be of real 
statistical value, not only for purposes of race betterment, but for the 
special application to the study of infant mortality. In fact, even 



STATISTICAL STUDIES 75 

in our best states, calculating their registration exclusive of the great 
metropolitan cities of five hundred thousand population and over, — 
even in Massachusetts, which has the highest percentage of births to 
infants under one year of age — the city authorities do not claim that 
the registration is even as fairly complete as that of the ordinary 
European country. 

I say, therefore, that the time must surely come — and I hope it may 
be the function of this organization to bring about that time more 
rapidly — when we shall have fully dependable, fully reliable, statistics 
of births for use in connection with the subject of race betterment. 
The time and place to begin this is right now and here, in Michigan, 
I presume the majority of this audience is composed of Michigan peo- 
ple, who can lend effective aid in bringing about this result. It is 
only necessary to see that the first law is enforced. Michigan has the 
best law- for this purpose of any state in the Union, because it places 
the full responsibility, the undivided responsibility for uniform state 
enforcement upon one man, the Secretary of state. He has the means 
for obtaining information in regard to the failure to register births. 
Every physician and every midwife in Michigan who registers births 
is paid fifty cents. It is a large sum compared to the amount paid in 
some states. In some states it is not thought necessary to give any 
compensation for this purpose. There can be no reasonable excuse, 
therefore, for failing to enforce the law in cases of delinquency every 
time a physician or midwife fails to register a birth. If the public 
sentiment of the state is aroused to this purpose, so that the state reg- 
istration authorities and the local legislation authorities will be obliged 
to do this, we may then have,, for the first time in the history of the 
United States, a state where the registration records of births are re- 
liable for the important purposes for which they should be used. 

In Kentucky, for the second year of registration, the second year 
of the operation of the law, the rates in a general way are graded from 
the lowest. Certain counties have birth rates below twenty. Along 
the Ohio River, up in the mountains, and in the extreme southM-estem 
portion 9f the state, the registration is imperfect. Remember this is 
the second year of the operation of the law. Then we have quite a 
number of counties showing the next higher rate, twenty to twenty- 
five. We can comprehend the significance of this when we consider that 
twenty -five is about the birth rate of England, the lowest they have 
recorded in the history of that country and a very low rate. Of course, 
below twenty is absurd for any county. The counties having the rates 
twenty-five to thirty-five are usually accepted as approximately rep- 
resentative of conditions. The point that is of special interest is the 
great uniformity of registration in the state after the second year of 



76 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

operation. Nearly all of the mountain counties undoubtedly have 
very high actual birth rates, and the birth rates recorded are all in 
excess of thirty-five. The great bulk of counties range between twenty- 
five and thirty-five. You may be able to find some interest in a com- 
parison with Michigan. For the county birth rates of Michigan in ]912 
the real population of which compares exactly with the population of 
Kentucky, for practically all of the southern part of the state of 
^lichigan, the rates are under twenty. Other counties are twenty to 
twenty-five, others from twenty-five to thirty-five, and others from 
thirty to thirty-five. Then the only two counties having rates of 
thirty-five and over are Keweenaw and Gogebic. Now this is of in- 
terest. If these rates be correct, we certainly have a great problem 
before us in the low birth rates in the rest of the state. But I don't 
believe the Secretary of the state of Michigan would assert, and I 
certainly cannot assert on the comparative evidence, that we are get- 
ting, as we should have, absolutely complete registration of births in 
Michigan. These facts are of the most absorbing interest, in the com- 
parative study of the growth of our population. 

One point I should like to make is in regard to the number of in- 
dividuals in Michigan by counties and minor civil divisions. The 
growth of the rural population of the state can be compared with the 
rural birth rates. Almost half or two-thirds of the lower counties 
of the state show a decrease in rural population, corresponding to the 
extremely low birth rates prevailing in the state. 

I should like to make reference to one very important use of the 
birth rate statistics in connection with the saving of infant life. Many 
of you have seen, I presume, the pamphlet published on birth registra- 
tion, the first pamphlet issued on that subject. A New York investi- 
gation showed the great difficulty of conducting the work of prevent- 
ing infant mortality, for the reason that we do not know what infant 
mortality is. It is the ratio of deaths under one year of age to the total 
deaths. The infant mortality in a great number of European coun- 
tries has been declining somewhat. It has been brought down from 1901 
to 1905 on the basis of statistics published by the French Government. 
Sw^eden goes away back in statistical data valuable for this study to 
1801 to 1805, beginning last century, the first century for which such 
data w^ere available. Then comes France, then comes the German Gov- 
ernment, and England and Wales begin as late as 1851 to 1855. But 
practically now all civilized countries in the world have effective 
registration of births, and of course, the registration of deaths, so 
they can tell what the ratio of infant mortality is from year to year. 
Some countries, China, Africa and the United States even, yet possess 
no records of infant mortality. Unless the American people wake up^ 



STATISTICAL STUDIES ' < 

China and Turkey will have satisfactory data for infant mortality 
long before the United States. 

A pamphlet published by the Children 's Bureau states, ' ' Convinced 
that the most effective work in behalf of the public health that can be 
done in this country today lies in the prevention of infant mortality." 
The Children's Bureau is brought to the necessity of appealing for 
legislation, and for such local records as will indicate where and when 
the babies are born and where and when they die, as a preliminary 
to an intelligent study of the subject." 

I have a letter from Miss Lathrop which I received since coming to 
this meeting, dated Washington, Jan. 6, 1914: "In answer to your 
message with reference to Children's Bureaus concerned in the ques- 
tion of raising the standard of birth registration in this country, I 
can say that I am glad of any opportunity to express our deep interest 
in this subject. The registration of all births is regarded as of so 
much importance as a mechanical expedient necessary in the abler care 
of children that it was made a subject of the first publication of the 
Children's Bureau. The possibility of taking advantage of the in- 
terest shown by women in the Bureau is suggested as a second step 
toward improvement of registration, a .systematized co-operation with 
the General Federation of Women's Clubs and other associations in 
making a test of birth registration in different states. The response 
has been very gratifying. Committees of women are now working in 
many of the cities and towns of New Hampshire, Connecticut, Iowa, 
Kentucky and Colorado, and the work will soon be organized in the 
states of Washington and California. The club women are taking the 
names of a certain number of the babies bom in 1913 and learning by 
inquiry of the local authorities whether births have been registered. 
The attitude of the state toward local health officers and registration 
authorities has been sho\\Ti friendly throughout the investigation. 
The authorities can assist most especially by giving publicity to their 
endorsement of the club women 's work in making the test. 

''In some instances a little difficulty has been experienced in con- 
vincing the woanen that the proposed investigation is not intended 
as a critical test of the work of the registration officials, but is pri- 
marily a propaganda to stimulate public interest and very complete 
registration, and thereby to be a distinct help to the authorities. In- 
terest and friendly attitude on the part of the health officials will do a 
great deal toward removing the impression that the test is not welcomed 
by all earnest state officers." 

There I see a very important opportunity for this Conference to 
demand that such registration be complete in this state, and in our 



78 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

other states, and to stand behind the healtli authorities and urge upon 
them the neeessity of enforeing the hiw. 

I will close now by a brief reference to the birth rates of certain 
countries, and the general decline in birth rates and death rates. The 
difference between the birth rates and the death rates in England, and 
in Wales, for instance, is an actual increase of population. That de- 
termines the growth of a country, aside from immigration. If we have 
interest in our national existence, if we believe in ourselves as Ameri- 
cans, or if any other country believes in itself, it should be a very ap- 
prehensive time when the difference between the death rate and the 
birth rate is wiped out. I have no idea that the science of eugenics 
will ever become a science of nogenics, but it is certain that there is a 
marked tendency in some of the more civilized populations to a very 
great reduction in this difference. 

I have called your attention to the Michigan death rates because 
they were utterly worthless up to this time and to show the great 
waste of effort given in this country in collecting statistics that are of 
no value, because the laws for collecting are either not properly 
regulated or not properly enforced. The Michigan birth rate, until 
the passage of the law that went into effect Jan. 1, 1906, was 
equally worthless. In 1890 the record went up higher than it was 
for the first year of the operation of the new law, but the Michigan 
birth rate records from about 1877 to 1891 were the result of fraudulent 
efforts employed, and should be wiped out. Beginning in 1906, the 
law ran along without the improvement which should have resulted 
the first few years. It was naturally not enforced. In 1911 and 
1912, there has been some increase, but I do not believe it means an 
increase in the birth rate of Michigan but simply means an increase 
in the returns of births owing to better registration. 

I will conclude by simply making the suggestion that it might be 
well, perhaps, if this organization would formally take some action in 
regard to the importance of birth registration, and perhaps appoint 
a committee to take up the matter as a national and state question. 

Acting CnAniMAN Cbbegan 

Dr. Wilbur has given us a wonderfully interestino: address, but his modesty 
has omitted something that will be of intense interest to all of you. He said 
Michig'an was the first to start off with vital statistics, but he did not tell us 
that Doctor Wilbur was the man who started the thing off with Michigan. 
The distinction he won for himself— without trying to do it— carried him to 
Washington to take the whole United States under his care, on this matter 
of vital statistics. Let us all help him to carry out his program. 



STATISTICAL STUDIES 79 

DIFFERENTIAL FECUNDITY 

Walter F. Willcox, LL.D., Professor of Political Economy and Statistics, 
Cornell University, Ithaca, N. Y. 

Having been honored with an invitation to address you upon the 
subject of ' ' difterential fecundity as one of the causes of the need for 
race betterment, ' ' I have felt it both a privilege and a duty to accept 
the invitation. 

At the start it is well to define fecundity. This is the more neces- 
sary because the definition used in biology and medicine differs some- 
Avhat from that used in statistics. The definition propounded by 
Prof. Raymond Pearl, in his paper before the First International 
Eugenics Congress at London in 1912, was as follows: "the innate 
potential reproductive capacity of the individual organism as denoted 
by its ability to form and separate from the body mature germ cells. ' ' 
For human statistics this definition is inapplicable and useless. Sta- 
tistics disregards potential as distinguished from actual or realized 
fecundity and makes fecundity a characteristic, not of men or women, 
husbands or wives, but of marriages. For present purposes, then, 
it is a term applied to marriages which have proved fruitful in the 
birth of at least one child, and is thus the opposite of sterility. 

In some technical discussions a distinction is drawn between fecun- 
dity and fertility, the former being applied indiscriminately to every 
marriage which has resulted in the birth of a child, the latter taking 
into account also the number of children born to the marriage. 
If we were to accept this distinction, two marriages, to one of 
which a single child had been born and to the other of which six chil- 
dren had been born, would be equally fecund, for fecundity has no 
degrees, but the marriage which had resulted in six children would be 
more fertile than the other. In the present paper, which must be 
general in character, this distinction between fecundity and fertility 
will be ignored. For our purposes, fecundity means the yield of living 
births in any population group in a unit of time, usually a year. 
This yield can seldom be effectively stated as a total number of births, 
for such a number ignores variations in the size of the group which 
produces it. To avoid this difficulty fecundity is stated ordinarily as 
a proportion or ratio, called the birth rate. 

The word differential also must detain us a moment. The differ- 
ences which it implies are differences in the fecundity of various popu- 
lation groups and, in consequence, differences in the rates at which 
these groups perpetuate themselves and multiply by Nature 's processes 
of birth and death. The real things to be compared are the rates of 
increase or of decrease resulting from the balance between these 



80 KIKST NATIONAL CONFERENCE ON RACE BETTERMENT 

natural procH'sses. The birth rate or fecundity gives only one term, 
when what is wanted is the difTerenee between two terms, the birth* 
rate and the death rate. A population group may increase either by ex- 
cess of births over deaths, or by excess of immigration over emigration 
or by various combinations of these two kinds of change reenforcing or 
antagonizing each other. An increase by excess of births, or what is 
called natural increase, differs from an increase by excess of immigra- 
tion over emigration, or migratory increase, in that it is more likely to 
carry on into the next generation through heredity the main char- 
acteristics of the parent stock. Where the group is increased by immi- 
gration there is less warrant for supposing that its qualities will be 
perpetuated. 

My real theme, then, may be phrased as "Differences in 
the Rates of Natural Increase," a more accurate title than "Differ- 
ential Fecundity." In addition to defining my subject more exactly 
this has an incidental advantage. The fecundity or birth rate of the 
population of the United States is unknown ; the fecundity of any of 
the numerous groups into which that population may be divided, with 
the possible exception of a few states, is likewise unknown. Neither 
do we Imow the mortality or death rate of the population of the 
United States, although we do know the death rate of many states 
and are rapidly advancing towards a determination of the rate for the 
entire country. These facts might seem to make a paper on "Differ- 
ential Fecundity" or "Natural Increase" almost impossible. But if 
a group is unaffected by migration, its total increase at one date over 
the number at a prior date determined from two successive censuses 
is a measure of its natural increase. The population of the United 
States is far from satisfying this condition, yet within it there are 
certain groups, e. g., Negroes and Indians, so little affected by mi- 
gration that we may measure their natural increase from census re- 
turns, though neither their fecundity nor their mortality is Imown. 
Even for the whites the effort to measure the natural increase by al- 
lowing for the increase due to immigration is not absolutely hopeless. 

My subject, then, assumes that the population can be divided into 
groups the natural increase of which can be determined and compared, 
and my aim is to review the present state of statistical knowledge re- 
garding the natural increase of such groups. The American popula- 
tion groups of whose natural increase I shall speak briefly are the white 
and the negro races, the native and the foreign born, the several 
nativity strains among the foreign born, the urban and the rural 
population. 

Among savage or semi-civilized people, where the overwhelming 
majority live little above the starvation point, there is a reciprocal re- 



STATISTICAL. STUDIES 81 

lation between births and deaths. When the deaths increase, the 
births decrease; when the deaths decrease, the births increase. For 
example, in European Russia in the famine year 1892 the deaths ex- 
ceeded the annual average of the years before and after the famine by 
more than half a million and the births in that year fell below the 
annual average for the years before and after by more than 300,000. 
Conversely, in such countries a bountiful crop lowers the death rate 
during the time the food lasts, and raises sharply the birth rate a few 
months later. Most civilized countries have emancipated themselves 
from this close dependence upon food and in them no relation can be 
traced between the crop of grain and the crop of babies. In such 
countries the only surviving relies of this reciprocal relation between 
births and deaths are found in cases of war and pestilence. Thus, in 
Massachusetts, the effect of the Civil War was apparently more marked, 
in reducing the birth rate than in raising the death rate. The first of 
the recent epidemics of influenza, sweeping rapidly from Russia over 
Europe and her outposts in the winter of 1889-90, was the main reason 
that in nearly every civilized country 1890 was a year with a very 
high death rate. But no attention has been called to the fact that the 
births in Europe during that year were 200,000 below the average of 
the preceding five years and that these losses of life by reduction of 
the births came in each country from eight to ten months after the 
mortality from the influenza reached its height. 

During the last fifty years or less the most marked change in the 
birth rates and death rates of civilized countries has been the gradual 
decline and almost complete disappearance of this reciprocal rela- 
tion between births and deaths, whereby the most significant changes 
w^ere those between one year and the next and these changes were 
usually in opposite directions, and the appearance in its place of a 
tendency for birth rates and death rates to decrease slowly but steadily 
for a long series of consecutive years. The annual variations are 
much less, but the total change in ten or twenty years much greater 
than under the earlier conditions. Usually the decline began with the 
death rate and in that case its effect would necessarily be to magnify 
the natural increase. But a decline in the birth rate soon set in and 
is proceeding now in most civilized countries about as fast as the 
death rate. Indeed, such a change was inevitable, if the natural in- 
crease was not to be more rapid than the increase in wealth or food. 
We must never forget that the decline in the birth rate and that alone 
has enabled mankind to hold fast the advantages promised by the 
advance of civilization and the sharp fall in the death rate. The 
serious and disturbing fact is not the mere decline in the birth rate 
but the differential decline. Apparently many strains or lines of de- 



82 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

sceut which one might most dosire to see continued and increased are 
strains which are losing ground rehitively, if not absolutely, by a de- 
crease of the birth rate more rapid than that of the death rate. 

The largest and in some respects the most important population 
groups about whose rates of natural increase I wish to speak 
are the great races of man — the European, Asiatic, and Afri- 
can. Their increase has been and still is in the main dependent upon 
diiferences in the certainty and sufficiency of the food supply. The 
great reason for the rapid multiplication of the European folk and 
their descendants in other parts of the world from perhaps 130 mil- 
lions in the middle of the eighteenth century to more than 550 mil- 
lions now, Mobile during the same period the numbers of other races 
have altered but little, is found in the fact that new territorial dis- 
coveries and new methods of stimulating agricultural production and 
the transportation of persons and goods have concurred to increase 
enormously the supplies of food available for the white race. There is 
no reason to suppose that the fecundity or fertility of this race is 
greater than that of other races or greater than it formerly w^as. Its 
natural increase has been unprecedented not because its birth rate 
has risen but because its death rate has fallen, and fallen more rapidly 
than its birth rate. 

In our own country and especially in the Southern States this 
divergence in rates of natural increase is working out results of in- 
terest for the two great races. That the white race is slowly dis- 
placing the negroes in the United States is now well knowTi. That 
this is due to the differences in the rates of total increase is equally 
familiar. But the whites are being constantly reinforced by immi- 
grants and the negroes are not. Where migration is a potent factor, 
total increase is 'an untrustworthy clue to natural increase. For this 
reason w^e may get nearer the truth by confining attention to the 
Southern States. Under the slavery regime and the saturnalia of re- 
construction which followed, i. e., from 1790 to 1880, the increase of 
the two races in the South, and — so far as w^e may disregard the ef- 
fects of migration and identify natural increase with total increase — 
their natural increase was at about the same rate. During these ninety 
years, when the negroes were fewest relatively, they were 35 per cent 
of the total population of the South ; when they were most numerous, 
they were 38 per cent, a difference of only 3 per cent. But since ] 880 
the Southern whites have increased much more rapidly than the 
Southern negroes and as a result the proportion of the latter is 
dwindling. In thirty years that proportion has decreased more than 
six per cent, or more than two per cent in each decade. 

In the United States as a whole the more rapid increase of the 



STATISTICAL STUDIES 83 

whites is due not only to the influx of himdreds of thousands of white 
immigrants, but also to the fact that in the registration area in 1910 — 
an area including nearly three-fifths of the whites and more than one- 
fifth of the negroes and so a fair index of conditions in the country 
at large — the negro death rate exceeded the white by about two- 
thirds. If the fecundity of the darker race likewise exceeded that of 
the whites by two-thirds, the difference in the death rates would not 
entail a different rate of natural increase. Although no exact mea- 
sure of fecundity can be gained until there is an effective registration 
of births, a rough substitute for it has been found in the proportion 
of living children under five years of age to one thousand women of 
child-bearing age. Measured in this way, the fecundity of the Ameri- 
can negro is and has been for the sixty years since 1850 greater than 
that of the white. During the thirty years since 1880 — and those are 
just the years within which the proportion of negroes in the South has 
been falling — the excess in the proportion of negro children to mothers 
over white children to their mothers in the country has likewise been 
falling. The present difference in fecunditj^ between the races is little 
more than one-fourth of that in 1880 and at present rates of change 
it will have disappeared entirely before the next census is taken. Itf 
the South the proportions of children in the total population and in 
each race are notably above the corresponding proportions in the 
North. Indeed it is probable that a main reason for the greater fe- 
cundity of the negro race is found in the fact that this race, of which 
nearly nine-tenths live in the South, has the high fecundity character- 
istic of the South, while the white race, of which the majority live 
in the North, has the lower fecundity characteristic of the North. For 
in the Southern States the proportion of children to women among 
the whites already exceeds that among the negroes by ten per cent. 

The evidence, then, points to a differential natural increase as an 
important factor, a factor in my opinion at least as important as im- 
migration, in determining the present and future relative proportions 
of the two main races in this country. 

Among the whites, the main classes whose differential fecundity has 
been somewhat studied are the native and the foreign-born stock. This 
branch of the inquirj^ is difficult not only because of that lack of data 
which almost baffles one in studying the differential fecundity of 
white and negro, but also because the lines between the two classes are 
fluid and variable. A son born of immigrant parents the day after 
their landing is of the same stock as they, yet in the statistical tables 
he stands as a native American and they as foreign-born or immigrant. 
Although efforts have been made to measure the proportion of the 
white population of the United States at the end of the nineteenth 



84 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

ceutiiry wliifli sprang from tlie whiU's who were in this country at its 
beginning and the proportion due to immigration during the century, 
yet none of the results seems to have won or to be entitled to general 
acceptance, and for that reason I must pass this topic as still a happy 
hunting ground for conjecture, 

A careful and illuminating study of the comparative fecundity of 
the native and the foreign-born population of Massachusetts and of 
the various strains of the foreign-born in that state during the fifteen 
years 1883-1897 was made in 1901 by Dr. R. R. Kuczynski.* The pro- 
portion of married women who had outlived the child-bearing age with- 
out ha\ang borne any child was 9 per cent among the foreign-born, and 
15 per cent among the native, indicating tbat the proportion of sterile 
marriages is about two-thirds greater among natives than among 
foreign-born. The average annual number of births among 1,000 
immigrants was more than three times as great as among 1,000 na- 
tives of the United States. But a large proportion of the natives and 
a small proportion of immigrants are children, and for this reason a 
fairer comparison of fecundity was made by excluding the children 
both from the native and from the foreign-born. After this correc- 
tion had been made, the fecundity of the foreign-bom was found to 
be a little more than twice that of the native. The birth rate varied 
with the place of birth of the mother, the lowest rate being found 
when the Massachusetts wife was born in some other New England 
state, the highest rate when the Massachusetts wife was bom in Portu- 
gal, the latter rate being more than four times the former. When all 
women over fifty years of age and all younger unmarried women 
were excluded, the foreign-bom birth rate was found to be greater 
than the native by about three-fourths. 

Another study of the fecundity of married women, comparing na- 
tive and foreign-born wives in New Hampshire and introducing a 
classification by age, added the interesting result that, while the birth 
rate of foreign-born wives at all ages was twice that of native wives, 
this was a resultant or average of differences which grew steadily 
greater with the age of the classes compared. The birth rate of foreign- 
bom wives at ages under 20 exceeded that of native wives by less than 
one-fourth, but at ages 25 to 34 it was more than double and at ages 
35 to 44 w^as almost treble that of native wives.t This suggests that 
a large part at least of the difference between the fecundity of the 
native and the immigrant stock in New Hampshire is due to psycho- 



* In the Qimrterhj Journal of Economics for November, 1901, and Feb- 
ruary, 1902. 

tA. A. Young, "Birth Rate in New Hampshire" in Am. Stat. Assn., 
Quart. Puhs., IX (September, 1905), p. 280. 



STATISTICAL STUDIES 85 

logical rather than physiological causes, or causes which express them- 
selves in the voluntary choice of small families rather than in sterility. 
An attempt to estimate the comparative fecundity in 1900 of native 
and foreign-born women in the United States, including wives and 
spinsters and with no allowance for differences in age distribution, 
indicated that the fecundity of foreign-born women exceeded that of 
native women by more than fifty per cent.* 

The statistics of Massachusetts, although they were probably as 
good as those of any state, did not and do not yet afford the informa- 
tion needed for a thorough study of the death rate, and so of the dif- 
ference between birth rate and death rate, or natural increase, of the 
native and foreign-born. But a comparison of the existing material 
with that furnished in Berlin, where a similar problem has been 
studied, perhaps as carefully as anywhere in the world, led Doctor 
Kuczynski to conclude that the native population of Massachusetts 
is probably dying out at a rapid rate. 

Since his articles were written, material has accumulated making 
it possible to compare the mortality of the native and the foreign-born 
in 1900 in the registration area of the United States, which embraced 
two-fifths of the population of the country and much more than that 
proportion of the foreign-bom, t and in 1910 in New York State. 
These results show that for ages between ten and forty there is very 
little difference between the death rate of natives and of foreign-born 
of the same sex and age and that what differences do exist are quite 
as often in favor of the foreign-born as the native. Since the fe- 
cundity of the foreign-bom is at least fifty per cent greater than that 
of the native and the mortality is about the same, the difference be- 
tween them, or the natural increase of the foreign-bom, must be far 
above that of the native population. 

Another classification of the population has been employed in 
studies of differential fecundity, that into the urban and the rural 
population. Under urban is included all residents of cities each hav- 
ing at least 25,000 inhabitants, all the rest of the population being 
treated as rural. The division line of 25,000 is much too high, but the 
form of the printed tables makes it impossible to put the limit lower. 
The fecundity of city women 15-44 years of age is only about two- 



* Twelfth Census, Supplementary Analysis, p. 420. 

t This is the only fact brought out, I believe, for the first time in the 
present paper. The results for New York State in 1910 will he found in my 
last report as consulting statistician to the New York State Department of 
Health; the confirmatoi-y results for about forty per cent of the population 
of the United States in 1900 have been computed from a ms. table kindly 
furnished me by the Census Bureau. 



S6 FIRST NATIONiVL CONFERENCE ON RACE BETTERMENT 

thirds that of country women. But in the United States cities are 
massed at the North and the North, has a low fecundity. The low 
urban fecundity, then, may be due to the northern location and not to 
city life. To test this, a comparison has been made between the 
cities of the North and the country districts of the North and between 
the cities of the South and the country districts of the South. Such 
a comparison indicates that in all main divisions of the United States 
fecundity in country districts is greater than fecundity in cities. It 
indicates also that the difference between city and country in this re- 
spect is at a minimum of about 10 per cent in the North Atlantic 
group and at a maximum in the Southern groups where rural fecun- 
dity is about double urban fecundity. This geographic difference may 
be plausibly explained as due to the numerous immigrants in Northern 
cities and their high fecundity and to the numerous negroes in South- 
ern cities and their low fecundity. For the fecundity of city negroes 
is only about two-thirds the fecundity of city whites, but the fecundity 
of country negroes is much above that of country whites. The growth 
of cities, especially in the South, and of a negro urban population 
seems likely to increase the differences in the fecundity of whites and 
negroes. 

The twenty-eighth volume of the Report of the Immigration Com- 
mission, printed in 1911, contains a contribution to our subject, en- 
titled "Fecundity of Immigrant Women," the main conclusions of 
which have been summarized by the author in an article in a recent 
issue of the Quarterly PuUications of the American Statistical Asso- 
ciation.* The tables were compiled from manuscript data in the 
United States Census Bureau and deal in the main with nearly 80,000 
married women under 45 years of age living in the second decade of 
married life and with the number of children they have had. 

This is the most important American study of fecundity and sup- 
plements in many ways what we previously knew. It classifies white 
wives as native of native parents, native of foreign parents and 
foreign-born and adds scanty data about negro wives. Of the negro 
wives who had been married between ten and twenty years, one in 
five had had no child ; of the native white of native parents, one in 
eight ; of the native white of foreign parents, one in sixteen ; and of 
the foreign-born wives, one in nineteen. The proportion of sterile 
marriages was determined for the various nationality classes of the 
foreign-bom ; it is highest among wives bom in Scotland or England, 
lowest among wives bom in Poland, Bohemia, or Russia and the pro- 

* Joseph A. Hill, "Comparative Fecundity of "Women of Native and 
Foreign Parentage," in Am. Stat. Assn. Quart. Puhs., XIII, pp. 583-604 
(December, 1913). 



STATISTICAL STUDIES 87 

portion of sterile marriages among those where the wife was born in 
one of the first-mentioned countries was about four times as great as 
among marriages where the wife was born in a country belonging to 
the second group. Among no group of foreign-born wives, however, 
is the proportion of sterile marriages as great as among marriages 
where the M'ives were born in the United States. 

With reference to the average number of children born to these 
groups of wives of various countries of birth, the smallest number is 
to wives of native American birth and parentage. Ten such mar- 
riages have resulted in 27 children ; ten negro marriages, in 31 chil- 
dren ; ten marriages in which the wives were born in England, in 34 
children ; and at the other extreme, ten marriages with wives born in 
Russia, in 54 children ; ten A\dth wives bom in French Canada, in 
56 ; and ten with wives born in Poland, in 62. 

The average interval of time elapsing between births is for wives 
born in the United States 5.3 years ; for wives born in Poland, 2.3 years. 
This interval between births is uniformly greater in the second genera- 
tion of immigrants than in the first. But the proportion of sterile 
marriages does not rise similarly. So the tendency is to a reduction in 
the size of families rather than to a larger proportion of sterile unions. 

The influence of rural conditions upon fecundity is best measured 
by the statement that among wives born in this country of native 
parents and married between ten and twenty years, t^n living in 
urban districts have had on the average 24 or 25 children, Avhile ten 
living in rural districts have had on the average 34 children, indicating 
that the fecundity of wives of a given nativity class living in the 
country is about two-fifths greater than it is in the city. 

Perhaps the most important body of information regarding dif- 
ferential fecundity or comparative rates of natural increase in the 
United States has been secured as an immediate or remote result of 
the addition to the Massachusetts census schedule of 1875 of the ques- 
tion, "Number of children borne by women, " the object of which "was 
to ascertain the relative fecundity of women of different nationalities 
and to settle . . . the question which continually arises concerning 
the growth of our native population as compared with that of our 
foreign-bom."* Ten years later similar information was sought in 
fuller detail by asldng of each married woman two questions: 
' ' Mother of how many children ' ' and * ' Number of those children now 
living. ' ' The results of 'tabulating the answers to these questions were 
carefully analyzed in the state census and were also of importance to 
Doctor Kuczynski in the preparation of his articles. The interest 
aroused in these questions and their answers was so great that five 

* Massachusetts Census of 1875, Vol. 1, p. xli. 



88 FIRST NATlONiVL CONFERENCE ON RACE BETTERMENT 

years later, in 1890, the same questions were placed on the schedules 
of the United States census, but unfortunately no tabulation of the 
results was ever made. In 1900, after much consideration by the 
office, the same questions were asked again, and again, after much 
preliminary work had been done upon the answers, the work was 
discontinued and no results ever reached the public except for the 
fragmentary tabulation made by the Immigration Commission and 
applying to about four per cent of the population. 

Yet again at the census in 1910 these questions were repeated a 
third time and in the report of the Director of the Census to the 
Secretary of Commerce and Labor for that year one may find the 
following passage: "It is also proposed ... to work out from the 
returns on the schedules statistics with regard to fecundity as indi- 
cated by the number of children bom and the number living for 
women of different classes in comparison with their age and the dura- 
tion of marriage. ... A considerable amount of preliminary work 
on this subject was undertaken at the census of 1900 but the results 
were never tabulated or published. It is respectfully suggested that 
the Secretary recommend to Congress that the Director of the Census 
be authorized to tabulate the more important information on this sub- 
ject for the 1900 census as well as that for 1910. . . . This subject is 
one of profound importance and the census schedules furnish data by 
which conclusions of the utmost value can be readily drawn. A plan 
has been devised by which the expense of . . . tabulating the results on 
this subject for the census of 1910 will be much less than would have 
been necessary to complete the work on the lines begun in 1900. ' '* 

At the present time no funds are available for completing this 
work and there is danger that for the third time the inquiry wdll 
suffer shipwreck. This investigation has been imitated abroad, some 
of the most interesting and significant results of the last French 
census being derived from the answers to similar questions. In my 
opinion the failure to utilize the answers to these questions was one of 
the main defects of the census of 1890, was the most serious defect of 
the census of 1900 and now bids fair to be the most serious defect of 
the census of 1910. In Doctor Hill's paper already quoted and written 
a few months ago. we read : " It is to be hoped . . . that the returns 
obtained at the census of 1910 will not be similarly neglected, but as 
yet no steps have been taken towards their tabulation." If it had 
been the policy of this Conference to adopt resolutions or make rec- 
ommendations, I should have proposed the adoption of some such reso- 
lution as the following : 



* Beport of the Director for 1909-10, pp. 45-6. 



STATISTICAL STUDIES 89 

Resolved, that the National Conference on Race Betterment ap- 
point a committee with power : 

1. To memorialize the Congress of the United States in the name 
of this Conference, urging it to provide the funds needed for com- 
piling the returns now on the schedules of the census of 1910 and 
thereby measuring the fecundity of the races and national elements 
within the United States; 

2. To attempt to secure the presentation of similar petitions from 
other organizations or from individuals interested in this subject. 

Whether such a resolution would be welcome or not, I sincerely 
hope that individuals will write to individual Congressmen urging 
such action as is here proposed. 

In my judgment, no statistical result could come from this Con- 
ference more valuable than a concerted effort to increase the available 
information regarding the comparative fecundity of the various strains 
in our population, for this information lying unused in the government 
files is of more value and importance than the entire sum of informa- 
tion on differential fecundity now possessed by the American people. 



GENERAL INDIVIDUAL HYGIENE 

THE IMPORTANCE OF FREQUENT AND THOROUGH MEDICAL 
EXAMINATIONS OF THE WELL 

Victor C. Vaughax, LL.D., M.D., President-Eleet American Medical Asso- 
ciation ; President Michigan State Board of Health, Ann Arbor, Mich. 

What I have to tell tonight is iu a little different form than that 
announced to you. I am going to read to you Dr. Smith's dream: 

THE doctor's dream 

Doctor Smith is a practitioner in one of the large cities of the 
Middle West. He is a man of good training, a classical graduate, 
took his professional course in one of our best schools, and did hospital 
service both at home and abroad. He is a general practitioner, and 
keeps well posted in all that he does. He makes no claim to universal 
knowledge or skill, but is conscientious in all his work, and when he 
meets with a case needing the service of a specialist he does not hesi- 
tate to call in the best help. He has made a good living, demands fair 
fees from those who are able to pay, and gives much gratuitous service 
to the poor. He is beloved by his patients, held in high esteem by his 
confreres, and respected by all who know him. He is a keen observer, 
reads character for the most part correctly, and is not easily imposed 
upon. Wliile he recognizes the value of his services, he is not in the 
practice of medicine with the expectation of getting rich, and his in- 
terests are largely human and scientific. He has deep sympathy for 
those whose ignorance leads them to sin against their own bodies, but 
he is devoid of weak sentimentality and does not hesitate to admonish 
and even denounce the misdeeds of his patients, whatever their social 
position. During twenty years of practice in the same locality he has 
become acquainted with the vices and virtues of many families. He 
is not looking for the coming of the millennium, but he is often im- 
patient of the slow pace with which the race moves towards physical, 
mental and moral betterment. One of his patients is a large manu- 
facturer employing many unskilled laborers. Doctor Smith has often 
pointed out to this man that the efficiency of his working force would 
be multiplied many times were the men paid better wages, the work 
done in rooms better lighted and ventilated, and in general with a 
little more humanness sho\vn them. Another is at the head of a 



GENERAL INDIVIDUAL HYGIENE 91 

large mercantile house which employs clerks at the lowest possible 
wages and makes the conditions of life well-nigh unendurable. A 
wealthy woman gives largely to church and charity from her revenues 
which come from the rental of houses in the red light district. An- 
other of the doctor's patrons is a grocer who sells "egg substitutes" 
and similar products ' ' all guaranteed under the pure food law. ' ' We 
Mali not continue the list of the doctor's patrons and it must not be in- 
ferred that all are bad, for this is not true. The majority are honest, 
conscientious people, as is the case in all communities. Our country 
has a population of nearly one hundred millions. Millions of these are 
decent, respectable citizens, not altogether wise, but for the most 
part well intentioned. Thousands are brutal in their instincts, crimi- 
nal in their pursuits, and breeders of their kinds. We claim to be 
civilized, but there are those among us who w^ould be stoned to death 
were they to attempt to live in a tribe of savages. But I must stop 
these parenthetical excursions and get back to Doctor Smith and his 
dream. 

On a certain day in November of the past year he had been 
unusually bu.sy. even for one whose working hours frequently double 
the legal limit. During his office hours he had seen several cases which 
gave him grave concern. There was William Thompson, the son of 
his old classmate and college chum, now Judge Thompson. William 
finished at the old University and is now an embryo lawyer promising 
to follow in the footsteps of his honored and honorable father, but 
William belonged to a fast fraternity at college and came to Doctor 
Smith this morning with copper colored spots over his body and a 
local sore. The doctor easily diagnosed the case and pointed out to 
William that he was a walking culture flask of spirochetes, a constant 
source of danger to all who should come in contact with him, and that 
years of treatment would be necessary to render him sound again. 
On the lip of a girl, the daughter of another old friend, the doctor 
had found a chancre caused by a kiss from her fiance, a supposedly up- 
right man prominent in church and social circles. He had seen a 
case of gonorrhea in a girl baby contracted from her mother, the 
wife of a laboring man. A case of gonorrheal ophthalmia in a young 
man whose only sin was that he had used the same towel used by an 
older brother next demanded his attention. Several cases of advanced 
tuberculosis among those who had been told by less conscientious physi- 
cians that the cough was only a bronchial trouble made Doctor Smith 
lament the standard of skill and honor among some of his professional 
brethren. Rapid loss in weight in an old friend who had been too 
busy to consult him earlier was diagnosed as neglected diabetes. In 
another instance dimness of vision and frequent headaches persisting 



92 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

for luonths h;id not sufficed to send an active business man to the 
physician. This proved to be an advanced ease of Bright 's disease, 
which should have been recognized two years earlier. Urinary, oph- 
thalmoscopic and blood-pressure tests demonstrated the seriousness of 
the present condition. A breast tumor on the wiie of an old and re- 
spected friend showed extensive involvement of the axillary glands 
and the operation demanded promised only temporary relief, while 
had it been done months before, complete removal of the diseased 
tissue would have resulted. In making his calls for the day Doctor 
Smith had experienced both among the well-to-do and the poor many 
things Avhich had brought within the range of his vision more and 
darker clouds than those which floated in the dull November sky. 

More than a year before he had become estranged from the family 
of one of his oldest and best friends. The breaking of this relationship, 
which had continued from his earliest professional service and had 
been filled with the common joys and sorrows shared only by the 
family physician and those under his charge, had cast a deep shadow 
over the doctor's life. He had officiated at the birth of each of his 
friend's five children, and he felt a parental love and pride in them 
as he saw them grow into healthy womanhood and manhood. A little 
more than a year ago, he learned that the oldest of these children, a 
beautiful and healthy girl of eighteen, was engaged to a young man 
whom he knew to be a rake. In a spirit of altruism he had gone to 
the father and mother and protested against the sacrifice of the 
daughter. This kindly intended intervention was met with a stormy 
rebuff, and the doctor was rudely dismissed from his friend's house. 
But when the young woman, whose life with her unfaithful husband 
had made her deeply regret her fatal infatuation, felt the first pains 
of childbirth she begged of her parents that her old friend might be 
sent for, and that morning he had delivered her of a syphilitic child. 
How unlike the previous births at which he had officiated in this 
friend's house! It had been the custom to have the doctor at every 
birthday dinner given the five children, and one of the boys bore his 
name. There would be no birthdays for this, the first grandchild, and 
what could the future promise the young mother? Surely, the No- 
vember day was overcast with clouds for Doctor Smith before its gray 
light awoke the slumbering city. As he walked the few short blocks 
from his friend's to his own home, he cried in deepest sorrow. How 
many thousands of daughters must be sacrificed before their parents 
will permit them to walk in the light of knowledge and not in the 
shadow of ignorance? After a breakfast, which was scarcely tasted, 
he read in the morning paper the announcement that "Damaged 
Goods," which was to have been given in his University town, had met 



GENERAL INDIVIDUAL HYGIENE 93 

wdth such a storm of protest from the learned members of the faculty 
that the engagement had been canceled. "Surely," he said, "the 
fetters of prudery and custom bind both the learnecl and the un- 
learned. ' ' 

After his morning office hours Doctor Smith visited his patients 
at the city hospital. Here is a wreck from cocaine intoxication, the 
poison having been purchased from a drug-store owned by a promi- 
nent local politician. In a padded cell is a man with delirium tre- 
mens, a patron of a gilded saloon run by another political boss. In 
the lying-in ward are a dozen girls seduced in as many dance halls with 
drinking alcoves. Time will relieve these girls of the products of 
conception, a longer time will be required to free them from the dis- 
eases which they have contracted, but all time will not wash away the 
stains on their lives, and what of the fatherless children to be bom? 
Thirty beds are filled with typhoids, who under the best conditions 
must spend long weeks in the bondage of a fever, which day by da;y 
gradually but inexorably tightens its grasp. The furred tongue, 
glazed eyes, flushed cheeks, bounding pulses, emaciated frames, de- 
lirious brains were all due to the fact that a large manufacturer had 
run a private sewer into the river above the water works. The greed 
and ignorance of one business firm had been permitted to endanger 
the lives of half a million of people. In his family calls the doctor 
met with conditions equally lamentable. A fond mother in her ignor- 
ance had nursed a sore throat in one of her children with domestic 
remedies. The membranous patches on the tonsils, extending up- 
ward into the nasal passages and downward into the larynx, and the 
cyanotic face with labored breathing showed that even the magical 
curative action of diphtheria antitoxin, that wonderful discovery of 
modern medicine, would be of little avail in this individual case. The 
other children were treated with immunizing doses and the doctor had 
the consolation of knowing that death's harvest in that household 
would be limited to the one whom the mother's ignorance had doomed. 

The next call brought Doctor Smith to a home in which the condi- 
tions were equally deplorable and still more inexcusable. One of the 
children some months before had been bitten by a strange cur which 
soon disappeared in the alley. The wound was only a scratch and was 
soon forgotten. Now, the child was showing the first symptoms of 
that horrible disease hydrophobia. But dogs must not be muzzled — 
women, with plumes torn from living birds in their hats, had formed a 
society for the prevention of cruelty to animals, and had so declared. 

It must not be inferred that all of Doctor Smith's experiences on 
that November day were sad. Men are mortal ; all siclmess is not pre- 
ventable, accidents will happen and distressing injuries result. This 



94 FIRST NATIONAL CONFERENCE ON RACE HETTERMENT 

worlil is not, ail Kdcu and no onr cxiXH'ts tliat all soi'r-ow will be 
banislied from it. Decay and death approach with advancing years. 
Strength and weakness are relative terms and those possessed of the 
former must helj) bear the burdens of those afflicted with the latter. 
Doctor Smith, being a hard-headed, reasonable, scientific man, is no 
Utopian, and he frequently meets in sick rooms experiences which 
greatly increase both his interest and his confidence in man. He 
finds the young and vigorous denying themselves many pleasures iu 
order to brighten the pathways of the old and infirm, the fortunate 
lending a helping hand to the unfortunate, and the wise leading the 
unwise. No one, more than the family physician, can measure and 
appreciate the innate goodness that springs, without an effort, from 
the heart of humanity. It is difficult for the physician of large ex- 
perience to unreservedl}' condemn anyone, and he is inclined to regard 
all sins as due to either heredity or environment. However, it must 
be admitted that on this day Doctor Smith had seen but little sun- 
shine and the clouds that had gathered about him had hidden the 
virtues and magnified the vices of his community. Especially was this 
true of the vice of ignorance, for ignorance which results in injury to 
one 's fellows is not only a vice, but a crime, a moral if not a statutory 
one. 

Late that night as the doctor sat before his grate he fell asleep, 
and now he is busy among his patients in a way hitherto quite un- 
known to him. His w^aiting-room is filled with people, old and young, 
of both sexes, who have come to be examined in order to. ascertain 
the exact condition of their health. A young man before proposing 
marriage to the woman of his choice wishes a thorough examination. 
He wishes to know that in offering himself he is not bringing to the 
woman any harm. He desires to become the father of healthy children 
and he is hot willing to transmit any serious defect to them. He tells 
the doctor to examine him as carefully as he would were he applying 
for a large life insurance. The doctor goes through the most thorough 
physical examination and tests the secretions and blood with the ut- 
most care. He nnderstands his own responsibility in the matter and 
appreciates the high sense of honor displayed by his patient. A young 
woman for like reasons has delayed her final answer to the man who 
has asked her hand in order that the doctor might pass upon her case. 
Here is the doctor's old friend, William Stone. Mr. Stone is in the 
early fifties. He has been a highly successful, honorable business man, 
has accumulated a sufficiency and enjoys the good things which his 
wife prepares for the table. A careful examination of the urine leads 
the doctor to caution Mr. Stone to reduce the carbohydrates in his 
food. Mr. Perkins, a la^^'yer who throws his whole strength into every 



GENERAL INDIVIDUAL HYGIENE 95 

■case he tries, of late has found himself easily irritated, shows in- 
creased urinary secretion and a blood-pressure rather high. A vaca- 
tion with light exercise and more rest is the preventive prescription 
wliieh he receives. Mrs. Williams, after being examined by Doctor 
Smith, undergoes a slight operation under local anesthesia, and is re- 
lieved of the first and only malignant cells found in her breast. 
Richard Roe, who is preparing for a long journey, is vaccinated against 
typhoid fever, a disease no longer existent in Doctor Smith's city 
since pollution of the water has been discontinued. John Doe, who is 
a mineralogical expert and wishes to do some prospecting in high alti- 
tudes, has his heart examined. There are numerous applicants for 
pulmonary examination. This is done by Doctor Smith and his as- 
sistants in a most thorough and up-to-date manner, and advice is 
given each according to the findings. It has been many years since 
Doctor Smith has seen an advanced case of pulmonary tuberculosis 
and the great white plague will soon be a thing of the past. Every^- 
body goes to a physician twice a year and imdergoes a thorough exami- 
nation. The result of this examination is stated in a permanent record 
and no two consecutive examinations are made by the same physician, 
in order that a condition overlooked by one may be detected by an- 
other. Cases of doubt or in which there is difference of opinion are 
referred to special boards. The average of human life has been greatly 
increased and the sum of human suffering has been greatly decreased. 
Preventive has largely replaced curative medicine. Tenements are 
no longer kno\\ai ; prostitution and with it the venereal diseases have 
disappeared. Institutions for the feeble-minded are no longer needed, 
because the breed has died out. Insanity is rapidly decreasing be- 
cause its chief progenitors, alcoholism and syphilis, have been sup- 
pressed. These and many other pleasing visions come to Doctor 
Smith in his dream, from which he is startled by the ring of the tele- 
phone at his elbow. The call says: "Come quickly to Pat Ryan's 
saloon at the corner of Myrtle and Second. There has been a drunken 
row. Bring your surgical instruments. ' ' Then the smiles which had 
played over the face of the doctor in his dream were displaced by 
lines of care and he went forth into the darkness of ignorance and 
crime. 

There are many Doctor Smith 's and they have been seeing pleasing 
visions in their dreams, and meeting with stern realities in their wak- 
ing hours. Nearly fifty thousand Doctor Smith's constitute the 
American Medical Association, which is expending thousands of dollars 
annually in trying to so educate the people that unnecessary disease 
may be prevented. The doctors are asking that the work of the na- 
tional, state, municipal and rural health organizations may be made 



96 FIRST NATIONAI, CONFERENCE ON RACE BETTERMENT 

more effective, that the knowledge gained in the study of the causation 
of disease may he utilized. The world has seen what has been done 
in Havana and on the Canal Zone, how yellow fever and malaria have 
been suppressed, and how the most pestilential spots on earth may be 
converted into healthful habitations for man. Scientific medicine has 
made these demonstrations and the world applauds, but seems slow to 
make general application of the rules of hygiene. 

Doctor Foster had experienced the doctor's dream when he said 
in 1909 : "I look forward with confidence to the time when pre- 
ventable diseases will be pi'evented, and when curable diseases 
will be recognized in the curable stage and will be cured, and I believe 
the grandest triumphs of civilization will be the achievements which 
will result from a realization of the possibilities of preventive medi- 
cine. ' ' 

Professor Fisher, a most earnest and intelligent student of means 
for the prevention of sickness and the deferring of death, has stated 
that "by the intelligent application of our present knowledge, the 
average span of human life may be increased full fifteen years. ' ' 



ETJTHENICS AND ITS FOUNDER 

Mrs. Melvil Uewey, Honorary Chairman, Institution Economics of the 
American Home Economics Association, Lake Placid, N. Y. 

Genius has been defined as an "infinite capacity for taking pains." 
Thomas Edison's formula for genius is perhaps more forcible — "two 
per cent inspiration, ninety-eight per cent perspiration." 

Mrs. Ellen H. Richards, who named the science of better living, was 
endowed with a genius for hard work. America has not yet produced 
a woman her equal in grasp and breadth of scientific attainments. 
The list of her degrees, societies and publisht writings fills six pages in 
the Memorial number of the Journal of Home Economics, which she 
founded in 1909. Prof. Maria Mitchell, of Vassar College, claimed to 
have first discovered her unusual gifts thru her devotion to astronomy. 
Her chosen life work was sanitary chemistry and as a pioneer she first 
opened the doors of the Massachusetts Institute of Technology to 
women. She was also at home in her husband's chair of Mining and 
Metallurgy and was the only woman ever elected to active member- 
ship in the American Institute of IVIining Engineers. 

Like a strong magnet, she attracted to her men and women of 
earnest purpose who were doing things in the world, at the same 




Mrs. Ellen K. Richards 



GENER.VL INDIVIDUAL HYGIENE 97 

time radiating powerful currents of enthusiasm and inspiration to all 
who were associated with her intimately. To discover a new, efficient 
worker in her sphere of interests gave her the same joy that the as- 
tronomer feels when his searching eyes, sweeping the heavens with 
telescope, discover a new planet. 

Sept. 19, 1904, the sixth annual Lake Placid Conference on Home 
Economics met in the large rustic, white birch living room of an Ad- 
irondack lodge, whose windows commanded full view of the highest 
mountain peaks of the state and looked directly into the beautiful 
Indian Pass, the dividing line from the tribes of the north, of the 
famous five nations who formed the ancient Iroquois League. 

She was full of enthusiasm for the new word which had come 
to her, telling us about it before her traveling wraps were fairly re- 
moved, but it was during a discussion on nomenclature that she 
formally referred to the word coined by Sir Francis Galton to express 
race betterment, Eugenics, and suggested that Euthenics, better living, 
might be used to represent this work in higher education, adding that 
"the manufacture of new words is not easy. To suit the public a 
word must be correctly formed, it must please the public ear and fit 
the popular tongue." With her usual scientific accuracy she had 
studied well its etymology and brought ample authority for its mean- 
ing from Demosthenes, Herodotus and Aristotle. It seemed much the 
best word yet offered and it was voted:' That the following nomen- 
clature be recommended as the suggestion of the Conference : 

HANDWORK in elementary schools. 

DOMESTIC SCIENCE in secondary schools. 

HOME ECONOMICS in normal and professional schools. 

EUTHENICS in colleges and universities. 

(Household arts and science and Household Economics have also 
been widely used.) 

Nature had denied her children of flesh and blood and the children 
of her brain w^ere of absorbing interest. Would the new word be 
adopted? Would it live? 

The new edition of the Standard dictionary gives full definitions 
of both Eugenics and Euthenics. Their place in the Decimal Classifi- 
cation of literature for libraries has been assigned for the general sub- 
jects and will be included in the next edition, now in preparation. 

575 Evolution. 

.3 Environment, Euthenics. 

.6 Development. Survival of the Fittest. Eugenics. 

This Conference on Race Betterment proves abundantly the hold 
they have taken in public sentiment, wath promise of large results. 

From the very beginning the purpose of her work in home eco- 



98 FIRST NATIONAL CONFERENCE ON U ACE BETTERMENT 

noiuics was educational, dealing' with eeonoiuic and sociologic study 
of the home and with problems of rit^-ht living'. Its key-note was 
"Efficieney thru health." 

To a marked degi'ee Mrs. Richards had the gift of prophetic vision, 
the clear ideal that precedes intelligent action. Recognizing that only 
the child can be educated to acquire habits of right living so perfectly 
that the suitable action takes place unconsciously, her first eiforts were 
concentrated on developing courses of study correlated with science in- 
struction in all grades of our school system. In a paper before the 
National Education Association Council in 1908. her masterful plea 
for the true place of Home Economics in the teaching w^orld as the 
4th R, Right living, — to be incorporated in the education of the peo- 
ple — ^not only brought recognition of its assured place but was fol- 
lowed by her election for a term of six years to the N. E. A. Council, 
the highest educational authority in the country. 

History teaches that the art is developed long before the science in 
any branch of applied knowdedge. Following this logical order, she 
publisht in 1904 a small volume called "The Art of Right Living," in 
which she considers briefly the factors that make up the efficient human 
individual, showing that right living conditions demand pure food 
and water, fresh air, sound sleep, safe exercise, cleanliness and sani- 
tary conditions; while environment, shelter (the home) and the proper 
adjustment of work, rest and amusement, give true zest and happiness 
to life. 

She had a forceful, original way of saying things which often gave 
to others the stimulus for doing them. The mind is apt to grow callous 
and give little heed to oft-repeated truisms. We know perfectly well 
the importance and value of daily exercise in order to get rid of the 
waste which results from all living processes, but we are much more 
likely to take the brisk morning walk when reminded that "we must 
shake out the ashes, as it were, from the human furnace, so that the 
fuel may give energy. ' ' The fortunate guest in her Jamaica Plain 
home, coming down to a 7.30 breakfast, was often surprised to find 
that she and the Professor had already been out for a long walk or 
bicycle ride thru the beautiful park ways of the Boston suburbs and 
were full of enthusiasm in watching the daily progress of buds and 
blossoms on plants and shrubs, and to learn that this Avas their daily 
habit thruout the year, rain, snow or sunshine, before breakfast and 
the day's work, either a brisk w^alk around Jamaica Pond, or a bicycle 
ride, according to season. To them all Nature was an open book, re- 
vealing wonderful secrets to those who understand her language. 
There was great interest one spring in watching the frequent flights of 
a male robin who was evidently caring for two nests. All day he car- 



GENERAL INDIVIDUAI- HYGIENE 99 

ried food to the hungry occupants in one tree and then the other ; but 
one problem remained forever unsolved, was this busy bird a philan- 
thropist or a bigamist? 

In 1910 was publisht her book on Euthenics, the science of con- 
trollable environment, a plea for better living conditions as a first 
step toward higher human efficiency. In endeavoring to interpret the 
spirit of her ideals, her \dsion for the future of this science, world old 
in substance but new in its dedication to scientific research, her own 
words are used as far as practicable. 

The betterment of living conditions, thru conscious endeavor, for 
the purpose of securing efficient human beings, is what euthenics 
meant to her. Not thru chance but thru increase of scientific knowl- 
edge; not thru compulsion but thru democratic idealism consciously 
working thru common interests, will be brought about the creation of 
right conditions, the control of environment. 

Mrs. Richards had been greatly interested in Professor Fisher's 
Report on National Vitality, publisht about this time and quoting from 
him: "Human vitality depends upon two primary conditions — he- 
redity and hygiene — or conditions preceding birth and conditions dur- 
ing life," she added: 

Eugenics deals with race improvement thru heredity. 

Euthenics deals with race improvement thru environment. 

Eugenics is hygiene for future generations. 

Euthenics is hygiene for the present generation. 

Eugenics must await careful investigation. 

Euthenics has immediate opportunity. 

Euthenics precedes eugenics, developing better men noiv, and thus 
inevitably creating a better race of men in the future. 

Euthenics is the preliminary science on which eugenics must be 
based. This new science seeks to emphasize the immediate duty of 
man to better his conditions by availing himself of knowledge already 
at hand Avhich shall tend to increase health and happiness. He must 
apply this knowledge under conditions which he can either create, con- 
trol or modif3^ Euthenics is to be developed: 

1. Thru sanitars^ science. 

2. Thru education. 

3. Thru relating science and education to life. 

Students of sanitary science discover for us the laws which make 
for health and the prevention of disease. The laboratory, studying 
conditions and causes, can already show the way to many remedies. 

Mrs. Richards strongly urged the education of all women in the 
principles of sanitary science, as the key to race progress in the 
twentieth century. Sanitary science, above all others, when applied, 



100 FIRST NATIONAL CONFERENCE ON IJACE HETTKliMENT 

beiiofits the wholo people, raises the level of productive life. As long 
ago as 1892 the president of the British iVIedical Association said: 
"The whole future proj?ress of sanitary movement rests, for its perma- 
nent and executive support, upon the women of our land." 

It is barely fifty years since w^omen began to ask questions and in- 
sist upon knowing, to claim freedom of movement, a chance to breathe. 
Some pioneers had to enter the field of research, of investigation, in 
order that they might call to those below that the way was open, and 
in science Mrs. Richards was the pioneer. In this book she appeals to 
the women of America with faith, hope and courage, to put their edu- 
cation, their power of detailed w^ork, and any initiative they may 
possess, at the service of the state, at the same time warning them that 
much harm has been done by indiscreet, pushing women with only 
a glinuner of knowledge who too often approach city councils with 
some whim or fad, so that all women's demands are classed together. 
The question is not WOMAN, but ability and women. She advises that 
it is better, as a rule, to work out ideas thru existing organizations, 
rather than create new ones. There must be cooperation between in- 
dividual and community because the strength of combined endeavor is 
required to meet all great problems. There is a real contagion of 
ideas as well as of disease germs. 

The dangers to modern life are no less than in pioneer days when 
stockades were built as a defense against the Indians. Our enemies are 
no longer savages and wild animals. To see our crudest foes today, 
we must use the microscope. Men and women are apathetic over the 
prevalence of disease, often because of their disbelief in the teachings 
of science, coupled with a lingering superstition that, after all, it is 
fate, not will power, which rules the destinies of mankind. In the 
heedless rush of modern life, it is the indifference of the people them- 
selves which is the greatest obstacle to progress. "Where wisdom means 
effort and discomfort, many feel it folly to be wise. 

The great struggle lies with matter in the wrong place — dust, gar- 
bage, dirt (flies, mosquitoes) — and as population becomes denser, 
with crime and the death rate. But man is aw^akening at last to the 
fact that he is "the sickest beast alive," that he has himself to blame 
and that it is "wathin his power to change his conditions speedily. What 
has already been accomplished in Cuba, Panama, India, the Philip- 
pines, and recently in lighting the "black death" in Manchuria, are 
great lessons in the possibility of reform. 

Laws interfering with personal liberty have always been deeply 
resented by the American citizen. The protection of the man against 
himself, and of his wife and child against his ignorance and greed, is 
a comparatively new idea in republican democracy. The cry of pa- 



GENERAL INDIVIDUAL HYGIENE. 101 

temalism is raised on one hand, of socialism on the other. Each gain 
has been at the cost of a hard-fought battle, but it is certain that the 
individual must delegate more or less of his so-called rights for the 
sake of the race, and since the only excuse for the existence of the 
individual is the race, he must so far relinquish his authority. "It is 
only the exceptional man, almost a genius, who learns to modify his 
habits and his life to his environment and to triumph over his sur- 
roundings, his appetites, and the absurd dictates of fashion." 

Production of energy, force, power, is the main object of life and 
nutrition easily ranks first of the primal forces of all living matter and 
affects the others most pi'ofoundly. The richest food areas in the 
world have provided the most powerful stocks of men of which we 
have any record. All that we are, either as individuals or as a com- 
plex society, is made possible by the food supply, but curiously, in 
proportion as this is abundant and easily obtained, and as nations rise 
in the scale of intelligence and comforts, the birth rate is lowered, not 
increased. 

All great nations, too, have lived in a temperate climate, where 
physical and mental activity was possible for many hours a day. The 
relation of both food and environment to man's efficiency is a vital 
question. How far they are responsible for his character, his health 
and understanding, what special elements are most potent and which 
are the most readily controlled, are questions offering an interesting 
field for research. 

Probably more harm is done to health by ignoring physical law in 
the matter of eating than in any other one thing. Public men are 
dying, not from overwork but from their dinners. Habit, heedless- 
ness, inertia, are all roots of the great disease, ignorance, and the 
remedy is education, beginning with the child. 

We hear much of educating the child for life, but little or nothing 
of teaching him to live so that the life may be worth living. In our 
zeal for the mind we have starved and dwarfed the body. 

The home is responsible for the upbringing of healthy, intelligent 
children and in the well-ordered home the child is the business of 
the day. So long as affection lasts it will seek satisfactory expression 
in home life, and love of home and of what the home stands for, con- 
verts the drudgery of daily routine into a high order of social service. 
The home table should be the school of good manners and of good food 
habits of which the child ought not to be deprived, for right living 
demands the right manner of serving and eating the food. At school 
the child should become accustomed to the best conditions known to 
science, he should imbibe with the 3 R's the fundamental principles of 
right living. This is the time to inculcate facts and habits in regard 



102 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

to foods, i-leanliiu'ss, dirt, iufection and porsonal methods in eating, 
sleeping, exercising, while he is yet plastic and absorbs good methods 
as readily as bad ones. This is economic, for then he does not have 
to unlearn before he can adopt new ways. 

There was never any artificial teaching devised so good for children 
as the daily helping in the household tasks. Boys and girls, healthy, 
industrious, frugal, capable, intelligent, self-supporting, cheerful and 
patriotic, have abounded in country homes in the past and it has been 
recognized that the prevalence there of these high qualities was largely 
due to the family life, which re(iuired each individual from his earliest 
years to bear his share in providing for the' maintenance of the home. 
But the ideal American homestead, that place of busy industry, with 
occupation for the dozen children, no longer exists. Gone out of it are 
the industries, gone out of it are ten of the children, gone out of it in 
large measure is that sense of moral and religious responsibility which 
was the key-note of the whole. The child wdthout interest in work or 
play does not develop ; the man with no stimulus walks thru life as in 
a dream. The simplest tasks when well done give a glow of satisfac- 
tion. Every child naturally tries to express his thoughts in making 
things. Of course his attempts are crude but the necessity is there; 
therefore this joy of doing should be cultivated in children. 

The psychology of life includes a definite aim and purpose, there- 
fore the task or daily work is a necessity for mental and physical 
health. It must be accepted as a part of the science of right living and 
the will and energy directed to doing it well. It is astonishing how in- 
teresting a dull piece of work may become when intelligence is put into 
it. A young man who went out to California as a '49-er was one day 
digging away mechanically and listlessly, when an old experienced 
miner near him said: ''Young man, you are wasting a heap of time 
and strength." He show^ed him just how to dig, where to take and 
where to put each shovelful of earth. At the end of the day the 
youth was surprised to find that he had done twice as much and was 
only half as tired. 

The first step in civilizing a nation or tribe is to teach the people 
to want things they never had or eared to have, to suggest things to 
strive for. With savages it may not be the things that are good for 
them for which they strive, too often the reverse, but it is the incentive 
to work in order to have more that arouses ambition, stirs dormant 
faculties, and makes a man or makes a nation out of a horde of in- 
efficient people. All great men and women have had to struggle with 
obstacles, to deny themselves in order to gain the goal of their ambitions. 

A nature lover was watching the efforts of a butterfly to free itself 
from the cocoon. A period of struggle was followed by a period of 



GENERAL INDIVIDUAL HYGIENE 103 

rest till only a few threads remained. The impatient watcher cut these 
with scissors and the beautiful moth soared upward in the sunshine, 
fluttering more and more feebly till at last it fell to the ground, un- 
able to rise again. That last struggle was just what was needed to 
develop the power of sustained flight. 

If one lives for pleasure, one does not enjoy life in the degree 
possible to one who lives for work and finds his pleasures unexpectedly, 
as side lights on the pathway. Eighty per cent of so-called amusements 
are not recreations. They exhaust more rapidly than they rest. Momen- 
tary excitement is not recuperation, the re-making of nervous tissue. 
The real pleasure in life comes from the consciousness of power to do 
what the mind has willed, from seeing the work of one 's own hand and 
brain prosper. Madame de Stael defined happiness as: "Constant 
occupation upon some desirable object with a continued sense of 
progress towards its attainment." This work of creation, of trans- 
formation to desirable result, is the purest joy the human mind can 
experience. Mrs. Richards thought that fourteen hours a day was not 
too much for this kind of task. 

Finding that many distractions were breaking in upon their work- 
ing time and vitality and recognizing that work for the body and work 
for the mind must be balanced, Mrs. Richards and her husband evolved 
an acrostic, to be followed as a general rule, which they called the 

FEAST OF LIFE 

F Food — one-tenth the time. 

E Exercise — one-tenth the time. 

A Amusement — one-tenth the time. 

S Sleep — three-tenths the time. 

T Task- — four-tenths the time. 

The delight in life is what we can do with it. The unrecognized 
cause of the restless discontent so prevalent today is due to an inner 
sense of inetfectiveness, a want of the feeling of conscious power over 
things. The wage-earner is, for the most part, unsldlled. He cannot 
do well the thing he undertakes ; he has power neither over his tools, 
his materials, nor his muscles and the daily round becomes a deadly 
monotony. There is a general feeling that the task is something to be 
rid of. We have lost pride in our work and have transferred our 
distaste for poor- work to work itself, to the great danger of our physi- 
cal and moral health. The real psychology of work seems to be : that 
which one subconsciously knows one is doing badly, is drudgery. One 
who is accomplishing something, seeing it grow under his hands to 
what it was in his thought, is never discontented. The feeling of 
drudgery, the craving for something new, is strongest in those who are 
not satisfied with their daily work. 



104 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

It is a mistake to think that the fact of making- the ai'ticle for some- 
one else and not for one 's self, is the cause of dissatisfaction. The time 
pleasure of work is in the doing and not in the possession afterwards, 
in most cases. The great evil of present industrial conditions is that 
the conscious purpose is for so many limited to the week's wage, that 
is, the end of effort is expressed in money, and the thought of the pur- 
pose that money shall serve is too subconscious to be appreciated. In 
some way the average wage-earner must be brought to see the end re- 
sult; namely, a more comfortable, M'holesome, and energy-producing 
life for him and his. If he strives for pleasure only, it will elude him. 

No state can thrive while its citizens waste their resources of health, 
bodily energy, time and brain power, any more than a nation may pros- 
per that wastes its natural resources. If the scientifically trained 
man is to lead the world to better things, he must secure a suitable en- 
vironment, he must seek perfection of the body as a machine. But, 
however far eugenics may carry the race towards perfection, unless 
its sister science, euthenics, goes hand in hand, th6 race will again 
deteriorate in the future as surely as it has in the past. Accepted to- 
gether, as guiding principles in the evolution of life, man may build 
for himself a temple worthy of an unconquerable soul. 



7 HE RELATION OF PHYSICAL EDUCATION TO RACE BETTERMENT 

[Abstract of Address] 

D. A. Sargent, M.D., Director Hemenway Grymnasium, Harvai'd University, 
Cambridge, Mass. 

In considering a few of the causes which are generally conceded to 
be potent factors in the declining birth rate in most civilized countries, 
we soon come to the conclusion that the trouble is largely a conflict be- 
tween individual instincts and abilities, and racial needs. This con- 
flict may be variously expressed as poverty, or the inability of the 
individual to make headway against the many ; selfishness, or the un- 
willingness to assume the responsibility of giving and maintaining life ; 
indifi'erence, preference for other occupations, or conscious abstinence 
from marriage through the lack of physical fitness. 

Some of th€ reasons which are brought forward in defense of a 
marriage resulting in few children are unfortunately justifiable in 
the light of our social and economic conditions. It rests with thinkers 
and workers along these lines to solve this side of the problem thru 
such movements as mothers' pensions and all such agencies which 
center about child welfare. 



GENERAL INDIVIDUAL HYGIENE 105 

And it rests first with parents themselves, then with all teachers 
and preachers, to so present and exemplify the ethical significance of 
family life that youth will gravitate towards high and pure ideals of 
sex union. 

It is the province of this paper to consider those physical conditions 
which have in the past produced and maintained superior races and to 
try to point out the necessity of reconstructing an age of physical 
idealism, so to speak, which shall help to reunite the inclinations of the 
individual and the claims of the race. 

The old biblical idea of perpetuating the families of the Patriarchs 
by many ' ' begettings " must be justified in the light of heredity, the 
superior races maintaining a high birth rate in spite of individual 
preference for more ease and leisure. There was sometliing of this 
stern idea of the duty of procreation which actuated our forefathers 
in building up a new nation. There needs still to be a note of serious 
concern for the physical vigor of our nation in the pleas against ' ' race 
suicide. ' ' 

The present tendency of the superior races and individuals to 
diminish in number is contrary to the accepted theory of the ' ' survival 
of the fittest." as that law is worked out under natural conditions of 
plant and animal life. Here it is the most perfect specimens of 
tribe and race, the strongest and most adaptable, who become, as is 
desirable, progenitors of the future race. But when applied to man, 
those principles of the "survival of the fittest" through the struggle 
for existence have been forced into the background because of man's 
mental, social and sympathetic development. 

It is especially this growth of the human sympathies that has 
largely checked the action of the natural elimination of the weak, the 
sickly, and the deformed ; and while there has accrued much benefit 
to the finer emotions of the race, through exercising these qualities of 
service and care, there have also arisen many present regrettable con- 
ditions of physical unfitness, which it has become the task of our age 
to eliminate. 

And here again we confront the conflict between the individual and 
the race, for there is undeniably a contradiction between the aims of 
hygiene as applied to these two. 

Hygiene, as applied to the individual, strives to conserve the life of 
even the most wretched human being, but the hygiene of the race has 
for its ultimate aim the elimination of those of weak constitution for 
the improvement of people as a whole. 

Now it is the province of the physical educator not only to in- 
vigorate the individual for himself but through him to improve the 



106 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

race. That is, physical edueation offers at least oue coustructive so- 
lution of the problem of race betterment. Through our biological 
studies, we know that there is in the human organism iself a competi- 
tion and antagonism as well as a cooperation among the organs and 
tissues, but that these organic forces can be so influenced and harmon- 
ized by physical education as to produce a more highly perfected 
structure. This is especially true of the interdependence between 
motor or muscular exercise and efficient mental work. 

It is also important to remember that the consciousness of physical 
disability produces a reluctancy on the part of many women towards 
child-bearing, while the knowledge of a large, well-developed pelvis 
which permits the normal birth of healthy children increases assurance 
and courage. 

Statistics go to show that as the race advances, the head increases in 
size, and unless the w^oman's body is perfectly developed to meet this 
condition, it means her immolation and the deterioration of the race. 

Long experience and careful observation have shown us that physi- 
cal education, in its best' and broadest sense, is one of the most im- 
portant factors in the betterment of the race. Through improving the 
structure and function of various parts of the human organism, it 
tends to make such functions natural and normal from the moral and 
mental, as well as from the physical point of view. It so harmonizes 
the nervous processes that super-sensitiveness is allayed by motor 
activity and power and efficiency are developed through habits of 
health. 

Above all, through this individual improvement in the physical 
condition of men and women there results a better race of children, so 
that we may consider physical education an agent in our modem 
sciences of euthenics and eugenics. 



APPiLRENT INCREASE IN DEGENERATIVE DISEASES 

Elmer E. Rittekhouse, Conservationist; President The Life Extension 
Institute, Inc., New York, N. Y. 

We have good reason to rejoice over the wonderful progress made 
in recent years in the field of preventive medicine, in the spread of 
knowledge of right living, and in human uplift generally. 

The American people, however, cannot afford to rest upon these 
splendid achievements nor to permit their confidence as to the future 
to blind them to the urgency and magnitude of the task still before 



GENERAL INDIVIDUAL HYGIENE 107 

them. It is of the utmost importance that they give heed to the fact 
that in spite of the marvelous advance of our race, there are certain 
evidences of physical deterioration among our people which, if allowed 
to continue unchecked, promise not only to retard further progress, 
but possibly to turn backward the advance already made in this di- 
rection. 

We find in this Conference and in similar meetings of the serious 
students of race betterment problems, the best of evidence of their 
optimism as to the future, for they would not be apt to meet for 
the discussion of these problems if they did not believe our civilization 
competent to successfully combat them. 

SIGNIFICANT SIGNS 

The American nation has a declining birth rate. And at the same 
time an increasing death rate in the later periods of life. Moreover, 
the chronic diseases of old age are reaching dowTi into middle life and 
below and are increasing in those groups. 

Aside from all other evidences of degenerative influences, these 
alone are surely of sufficient importance to command the thoughtful 
consideration of the public. 

That children born today have a far better chance of reaching the 
age period 40-45 than had those of former generations is most gratify- 
ing. But this gain should not be permitted to obscure the fact that the 
chances of early death after that age period have materially increased 
in recent years — apparently because of the heavy increase in mortality 
from the so-called degenerative diseases of the heart, arteries, kidneys 
and other organs. 

IGNORING A PLAIN DUTY 

It is claimed, and it may be true, that these adverse tendencies 
are of a temporary character, that they will disappear as soon as we 
have had time to adjust our lives to modem conditions. But even 
those who adhere to this theory must concede that considerations of 
common humanity demand that we do our utmost through educational 
and other means to bring about the readjustment at the earliest 
possible moment. 

This being our duty, why should we longer ignore the need of a 
definite program and a vigorous campaign to reduce the excessive mor- 
bidity and mortality from these chronic afBictions of middle life and 
old age which are to so large an extent preventable or postponable ! 

The death rate from diseases of the kidneys, liver, heart and cir- 
culatory system, as indicated by our most dependable statistics, has 



108 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

nearly doubled during the past three deeack's. Surely the signihcance 
of this trend should not be overlooked in considering the future of our 
race. 

A life lost from a disease of the kidneys is just as valuable to the 
family and to the state as a life lost from a disease of the lungs, or 
from typhoid fever or accident. Should we not do something to in- 
duce our people to appreciate and act upon this self-evident fact ? 

THE UNGUARDED CROSSING 

Let us consider for a moment the example of the railway crossing. 

At our most dangerous railway crossings we put up warning signs : 
we erect gates and place on guard a man in a tower to save the 
thoughtless from their own negligence. 

At the crossing where run such destroyers of human life as typhoid 
fever, tuberculosis, diphtheria and other communicable diseases, we 
also have danger signals and a guard in a watch tower — the health 
otSjcer and the conservationist — to protect the way-passer by educa- 
tional methods, and in some instances by force, against the needless 
destruction of his life. The result is that the life waste at this crossing 
has been steadily reduced. 

Here we have another dangerous crossing w^here hundreds of thou- 
sands of lives are destroyed annually by the degenerative diseases. 
But we have no warning signs here, no watch tower, no guard to pro- 
tect the ignorant or negligent passer-by. And here the life waste has 
steadily increased. 

WAITING UNTIL IT HAPPENS 

Science has provided the knowledge wherewith to save a very large 
percentage of the victims of this crossing, but we fail to use it. Society 
seems concerned in these people only after they are maimed or killed. 
Doctors and ambulances are at hand, with hospitals hard by to care for 
the injured, and there are hearses in abundance and acres of grave- 
yards provided for the dead. 

"WTiat effort, for instance, does Philadelphia make to guard the 
7.300 lives that are lost annually in that city from these diseases, or 
Boston for its 3,000 or Detroit for its 1,300? 

Is there any sound reason why our communities should not have a 
watch tower of education to inform these people of their danger and to 
teach them how to detect their approach to this deadly crossing, that 
they may at least have a fighting chance to avoid it? 

DISREGARDING STATISTICS 

We sometimes hear the belief expressed — usually by those who 
have not given very deep study to the statistics — that the increase 



GENERAL INDIVIDUAL HYGIENE 



109 



in the mortality rate from the degenerative diseases, and in the death 
rate at the ages where these afflictions are most prevalent, has been 
more apparent than real. And the interest of many of those who ad- 



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mit the increase, has been diverted from this subject by the assump- 
tion that the increase, whatever it may have been, was natural and 
to be expected. 

AN ERRONEOUS THEORY 

Their theory is that the increase in the death rate above age 40 
is due to the saving of lives in the younger ages chiefly from cum- 
municable disease ; that these lives passing into the older periods have 
given us not only more old people to die than we formerly had, but an 
increased proportion of weakened lives. 

At first glance this is perhaps a natural conclusion, but the records 
show that there has been little or no increase in the proportion of the 
number surviving to the later years of life. Even if there were such an 
increase, it would merely lead to a correspondingly increased number 
of deaths at the later ages, and not to an increase in the death rate 
at these ages, which is the ratio between the number dying and the 
number living. 

The saving of infant and early adult lives which have been at- 
tacked by the communicable diseases has been so recent that but a 
small proportion of them have passed into the older age periods. And 
it must also be remembered that they were not all left impaired; 
that the same influences that have reduced the death rate in the 
younger ages have saved a large number of strong people from attack 
by the same diseases, and also strengthened the vitality of man,y peo- 
ple, both fit and unfit, thus permitting an increase of healthful, un- 
impaired lives also to pass over the older age periods. 



THE INCREASING DEATH RATE. 



During the past 33 years the mortality rate in England and Wales 
from diseases of the kidneys, heart, arteries, includiiig apoplexy, shows 



110 



FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 



but a slight increase — from 272 to 273 per 100,000 population, al- 
though the Registrar-General's report shows that the mortality rate 
from these diseases is slightly increasing above age 65. 



1890 I900 1912 


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DEATH RATE 

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The death rate from the same diseases in ten American registration 
states of 1900 and in the same states in 1910 shows an increase from 
308 to 365, or 19 per cent. 

In Massachusetts the increase from these diseases has been %^ per 
cent since 1880. In New Jersey in the classification of organic heart, 
apoplexy and kidneys the increase has been 108 per cent, and in 16 
American cities 04 per cent during the same period. These increases 
are reflected in the steady advance of the general death rate above 
age 40 in the same groups. 

We may make all necessary allowances for the incompleteness and 
inaccuracy of our vital statistics, and yet it will be noted that wher- 
ever the most reliable comparisons can be had, a steady and abnormal 
upward trend is found in the death rate from these maladies. 

But assuming for the sake of argument that there has been no 
increase, is there any sound reason why we should ignore the present 
loss of 400,000 lives annually from these preventable or deferable 
causes, and devote all of our time, energy and money to checking com- 
municable disease? 

THE REMEDY 



Time will not permit speculation in this paper as to the causes of 
this high mortality. In the broad sense, we know that the remedy lies 
in educating our people to adopt more healthful living habits that their 
power of resistance to the chronic diseases may be raised and the at- 
tacks prevented or postponed to the older age periods. 



GENERAL INDIVIDUAL HYGIENE 111 

We also know that the teaching of right living is one of the 
primary purposes of the nation-wide health movement now in prog- 
ress; but we have no direct, no specific campaign to check the life 
waste from these non-communicable maladies. This task is a large one, 
but it must be undertaken and it must go on permanently if our 
standard of national vitality is to be raised. 

HEALTH EXAMINATIONS 

In the meantime, while this work in the field of prophylaxis is going 
on, an enormous number of lives are being needlessly destroyed be- 
cause of failure to detect these preventable or postponable chronic dis- 
eases in their incipieney when they may be checked or cured. 

Is it not worth while, therefore, that we should also make an espe- 
cial efi'ort to teach our people the wisdom and the urgent need of 
going to their doctors for periodical health examinations for the pur- 
pose of heading off these and other affections? 

THE RATIO AMONG POLICY-HOLDERS 

"When we consider that the deaths from the chronic diseases are 
estimated to be from 60 to 70 per cent preventable or postponable, and 
that the bulk of life insurance policy-holders are in the age groups 
where this mortality occurs, it is not surprising that the life insurance 
companies are becoming interested in this subject. 

The record for all the companies is not available, but out of 8,211 
deaths in the past three years in one of the older institutions, 3,426, 
or 42 per cent, were caused by these diseases. 

If, by adopting right living habits and by having periodical health 
examinations to give the physicians a chance to detect and arrest or 
cure these troubles, 60 per cent of these deaths could have been post- 
poned on an average of but one month each, there would have been 
a saving of 170 years of life. 

If the deaths from cancer, which are largely preventable if the dis- 
ease is discovered and treated in its early stages, be added to the above. 
204 years of life would have been saved. 

UNA W^ ARE OF THEIR DANGER 

During the same period the same company rejected 20,336 applica- 
tions for insurance. Of these 8,782, or 43 per cent, were declined for 
physical impairments indicating these same diseases. 

It is entirely safe to assume that 90 per cent, or 7,900 of these peo- 
ple were not aware of the impairments and of their danger, and that 
a vast majority of them could have been cured or serious results post- 



112 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

poned for years by placing themselves under the guidance of their 
family physicians. As a matter of fact, many of them adopted this 
course and were later able to secure their insurance. 

From this may be gathered at least a faint idea of the enormous 
number of people in our population who think they are well but 
who are nevertheless developing these insidious chronic diseases, and 
whose lives could be saved or greatly prolonged by adopting the sane 
and simple practice of having periodical health examinations. 

This very day throughout the civilized world thousands of doctors 
are pronouncing the sad sentence, "No hope. Too late. If I had 
known of your affliction before it became so deeply seated I could have 
prolonged your life. ' ' And this has been going on since the dawn of 
medicine. 

TO GET DEFINITE RESULTS 

Surely human intelligence has now reached a level where we may 
be justified in believing that a campaign to bring our people into 
closer relations with the medical profession for the purpose of pre- 
venting or at least arresting sickness will accomplish definite results. 

It has been my good fortune to have had the opportunity to preach 
the need of adopting this very simple and sensible practice to a large 
constituency since I inaugurated the plan of giving policy-holders free 
medical examinations four years ago in a company of which I was 
then president. 

It has been impossible to gather statistics showing the results of 
these efforts, but I am confident that many people have been thus in- 
duced to join the constantly increasing number who have adopted the 
practice of having occasional health inspections. The group of lives 
actually taking these examinations shows a mortality far below the 
expected, as has been demonstrated by Dr. E. L. Fisk. 

A PRACTICAL SUGGESTION 

To urge upon our people the wisdom of this course and of using 
the knowledge and skill of the physicians to prevent sickness and un- 
timely death, rather than to continue the deadly habit of waiting until 
the case is hopeless before sending for them, is to my notion a thor- 
oughly practical suggestion. 

Here is a neglected but fruitful field. The need of having these 
inspections should be firmly fixed in the minds of our school children 
and of our people generally. Every individual and journal interested 
in improving the vitality of our race, and every health department 
should adopt the policy of constantly urging this inexpensive pre- 
ventive measure. It can be done almost in a sentence. And such 



GENERAL INDIVIDUAL HYGIENE 113 

action would in no way conflict with the purposes of those engaged in 
any field of effort for the promotion of health and longevity. 

It would take but little encouragement from those who are leading 
in the campaign for race betterment to set in motion a sentiment that 
would soon establish health inspections as a common practice among 
our people. 

I believe this will ultimately come about and that a vast amount 
of sickness, with its train of destitution, moral delinquency, premature 
death, and economic waste, will be prevented. 

Discussion. 

Race Degeneration 

Professor Maynard M. IVIetcalf 

Just two points : In view of the horrors of race degeneration held 
up to our view, I wish to suggest one slight gleam of comfort. Few 
of the individuals living today will have any descendants living one 
thousand years from now, A thousand years is but a moment to the 
evolutionist or the eugenist, of course. Their character and condition 
is, therefore, of less moment in the question of the permanent future 
of the race. The implications of this fact are not so simple and ob- 
vious as they may seem at first sight, but they are worth thinking over. 
The conserving of those destined to persist if possible, would be the 
real key to the situation. 



SOME SUGGESTIONS FOE A MORE RATIONAL SOLUTION OF THE 
TUBERCULOSIS PROBLEM IN THE UNITED STATES 

S. Adolphus Kkopp, M.D., Professor of Medicine, Department of Phthisio- 
therapy, at the New York Post-Graduate Medical School and Hospital, 
New York, N. Y. 

The medical aspect of tuberculosis as a disease of the masses is so 
closely interwoven with the social aspect that it demands a special 
consideration for every country. In the United States the problem is 
quite unique and its solution unusually difficult, by reason of the 
vastness of its territory, the heterogeneous population, the large and 
constantly increasing immigration from all parts of the globe, the 
large colored population, the increase in birth rate among the poor and 
socially handicapped, and the decrease among the well-to-do and those 
physically, mentally, and morally better equipped; its manifold in- 
dustries, the greatly diversified housing conditions of the masses, and 



114 FIKST NATIONAL CONFERENCE ON RACE BETTERMENT 

— last but not least — the dift'ereiu'c in Uic saiiilary laws of tlie various 
states and the absence of a Federal Department of Health. 

The subject, as you must see at a glance, is so vast that it would 
be folly to attempt to treat it in the short space of time allotted to me, 
or even in a single paper. All I can do, as the title of my paper in- 
dicates, is merely to offer soiiie suggestions tending toward a more 
rational solution of the more important phases of the tuberculosis 
problem, and thus work for the object of this national conference, 
i. €., race betterment. 

At the bottom of the great ravages due to tuberculosis lie the pre- 
disposing factors, and it is in regard to these that we must begin to 
act more rationally than we have ever done before, if we wish to make 
any impression at all on our morbidity and mortality statistics. 

A body of scientific men and women, like those I have the honor to 
address at this moment, are aware that it would be inaccurate to deny 
the possibility of direct maternal transmission of the tubercle bacillus, 
but the occurrence is relatively rare and uncertain. What we do know 
is that nearly every child born of tuberculous parents, father or 
mother, but particularly if it is the mother, brings to this world as a 
hereditary gift a physiological poverty which predisposes the child 
very strongly to tuberculosis and other infectious diseases. The 
reason why such a child becomes very frequently tuberculous can be 
explained by the many opportunities for post-natal infection from 
the tuberculous parents, particularly in infancy and early childhood. 

To withhold the marriage certificate from the acutely tuberculous 
individual is an excellent measure and of incalculable educational 
value, but alas does not prevent a tuberculous procreation. I know 
I may be called revolutionary, but I state right at the beginning of my 
address that every tuberculous adult, male or female, married or at a 
marriageable age, should be impressed with the fact that it is well-nigh 
a criminal offense to bring children into the world before they them- 
selves have been cured of the disease. I have said before, and I 
am willing to say again, that I for one am willing to take the responsi- 
bility before my God and any court of justice for every time that I 
have prevented tuberculous parents from bringing children into the 
world. I believe the most widespread education in this regard cannot 
be otherwise than productive of great good to a very large number of 
people. 

By this widespread education I mean the instruction of the legis- 
lature, of physicians, and the people at large. I would plead with the 
legislatures to legalize the operation of vasectomy on any tuberculous 
male patient who is willing to undergo this operation. I would make 
the operation obligatory for any one who is actuallv tuberculous and 



GENERAL, INDIVIDUAL HYGIENE 115 

who insists upon marrying. I would advise the ligation of the Fallo- 
pian tubes for all female patients in the same situation, or similarly 
afflicted. If an acutely ill tuberculous individual procreates wilfully 
in spite of the physician's warning, I would advise also in this in- 
stance that sterilization be required by law. I would teach even 
slightly affected tuberculous parents or married people, not only all 
the details of prophylaxis, so that they may not infect each other, their 
children, or others, but I should make it a sacred duty to teach them 
also how not to procreate while either one of them is acutely afflicted 
with the disease. To this end I should go so far as to urge parents, 
even when they feel themselves apparently well and strong and re- 
covered from a tuberculous lesion, not to decide on having a child 
without both of them submitting themselves to a careful physical ex- 
amination. Only when shown to be in really good health by a careful 
examination by a competent practitioner should they feel that they 
have a right to procreate a race. 

Tuberculous parents not willing to listen to or heed this warning 
should be told of the great danger that exists of a tuberculous mother 
losing all possible chances of recovery, because pregnancy is sure to 
make her tuberculous condition many times worse, and that a child 
of a tuberculous issue very rarely survives any length of time. The 
majority of such children die in infancy, but usually not before they 
have caused the parents a great deal of sorrow, anxiety, and financial 
sacrifice. 

It is very difficult to get accurate statistics of the morbidity and 
mortality of tuberculosis in the pre-school age, but we can get some 
idea of it by referring to the prevalence of tuberculosis in school chil- 
dren. Estimating the proportion of tuberculosis among the 20,000,000 
children attending our public schools, as low as only 3 per cent would 
make 600,000 children who are at this time acutely afflicted with tuber- 
culosis in one form or another. 

The next factor which in my humble opinion is responsible for the 
acquisition of a strong predisposition to tuberculosis in many children 
is our system of education. Splendid as it is in many respects, in 
numerous instances it lacks elements which should tend to make our 
children mentally, physically, and morally strong. I treated this sub- 
ject quite at length in my last year's address before the International 
Congress on School Hygiene in Buffalo,* and so I will only mention a 
few of my conclusions here : Our school buildings should be ideal as 
far as construction, sanitation, and particularly ventilation are con- 



* "The Physical, Mental and Moral Vigor of Our School Children." New 
ork Medical Journal, Dec. 6th and 13th, 1913. 



116 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

cerned. The more open air schools we eun have, the more outdoor 
instruction in kindergartens, public schools, and in colleges, fhe 
greater will be the physical vigor and strength of the pupils. Incul- 
cate the love for open air life into the child at school and it will be- 
come a fresh air apostle at home. The school curriculum should be so 
arranged that the mental strain should not react unfavorably on the 
physical and moral constitution of the child, and last but not least, if 
we wish to prevent tuberculosis in children the open air school, or at 
least the open air class room, must become the rule, the indoor school 
or indoor classroom the exception. 

The next predisposing factor which we have to consider as re- 
sponsible for tuberculosis, particularly in the adolescent, is child labor. 
There is, I believe, no diversity of opinion among physicians, sanita- 
rians, sociologists, and philanthropists about child labor being one of 
the greatest curses which can befall a nation. It stunts not only the 
physical growth of the future generation but also the mental and soul 
development of the child. Personally I hold child labor (not useful, 
helpful, and wholesome child occupation, but labor) such as is car- 
ried on today in factories, workshops, canneries, fields, mines, and alas 
also in not a few instances at home, responsible for the so frequent 
development of tuberculosis in our young men and women. 

The mortality from tuberculosis is greatest between the ages of 
18 and 35, and in many instances the weakened constitution of the 
adolescent can not resist the very prevalent sources of tuberculous in- 
fection in factory and workshop, and the result is the invasion of the 
tubercle bacillus. The most rigorous anti-child labor laws most strictly 
enforced will be one of the most rational means to help us in the 
solution of the tuberculosis problem in this country. 

What is the next most important factor predisposing to tuber- 
culosis after the hereditary tendency, the unsanitary school life, and 
child labor? It is bad housing conditions, and by this I mean not 
only unsanitary tenements where the masses live and sleep, but also 
unsanitary conditions in factories, shops, offices, and stores, where the 
masses work. 

The manner in which many of the well-to-do families house their 
servants in large cities is, I believe, often responsible for the frequency 
of tuberculosis among this class of workers, and in passing let me say 
that the predisposing factors of tuberculosis lurk in many of the homes 
of the well-to-do because the houses in which they live are not con- 
structed with a view to giving the maximum amount of air and light 
to the individual by day and by night. 

In my own city of Greater New York we have still thousands of 
dark bedrooms where direct light and air never enter, and everv tuber- 



GENERAL INDIVIDUAL HYGIENE 117 

culosis worker will tell you that it is in houses where the sleeping 
quarters are the worst that tuberculosis is uppermost. Good tenement 
house laws when well enforced have done a great deal in New York and 
other cities, but not by any means enough. A much more rational con- 
ception of house construction so as to give opportunities to the masses 
to rent a well-lighted and well-aired home and a space of the roof 
garden which should exist on top of every tenement house, will be 
necessary if we wish to combat the predisposition to tuberculosis which 
comes from congestion and bad, unsanitary housing. 

It has always been a mystery to me why the thousands of acres 
of roofs of tenement houses, apartment houses, and public buildings 
are not utilized for the purpose of giving the inhabitants of such 
houses more outdoor life during the day, and where feasible, even 
sleeping accommodations at night. Those of us who have made tuber- 
culosis a study know what an important preventive factor outdoor 
sleeping is, and it has been sufficiently demonstrated that with proper 
precautions this can be done in all climes and all kinds of weather. 
Our federal an d* municipal authorities should set an example by the 
utilization of the roofs at their disposal for places where the workers in 
the offices may spend their time allowed them for rest or recreation 
between the hours of labor. 

Not only wise state and city legislation but philanthropy also must 
come to the rescue by building houses for the masses such as will de- 
serve the name of human habitations, giving the occupants an abun- 
dance of light, air, and sunshine. 

Before I speak of factories and workshops for the adult, let me 
return once more to the children and remind you here that our orphan 
asylums and often even our private boarding schools need the greatest 
and most careful supervision to assure sanitary sleeping and living 
quarters to the inmates. 

We next come to the cheap hotels and lodging houses. Only those 
who have made a study of the cheap lodging houses in large cities can 
possibly have an idea of what a fruitful source these so-called habita- 
tions are for acquiring tuberculosis, and when not the disease itself, 
surely a very strong predisposition thereto. Those who desire more 
complete information on this subject I would like to refer to a paper 
recently read by Mr. Chas. B. Barnes, of the Russell Sage Foundation, 
before our Tuberculosis Clinics Association, entitled "Tuberculosis 
among Homeless Men."* 

We should do away with the cheap lodging houses and cheap 
hotels by substituting for them a gradual development of sanitarily 
constructed municipal hotels and lodging houses. Our Mills hotels in 

* Journal of the Outdoor Life, April, 1914. 



118 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

New York City give au example of how practical pliilanthropy can 
also aid in the solution of this problem. In the meantime the owners 
of the cheap lodging houses should be forced to make these houses 
sanitarily safe, and any individual who is discovered coughing and 
expectorating should not be admitted or readmitted as a guest, but 
should be referred to a tuberculosis dispensary or hospital for diag- 
nosis, proper care, and treatment. 

The proper ventilating and lighting and the necessity of excluding 
the actively ill tuberculous patient who constitutes a menace to his 
fellow-men and to himself by remaining in the overcrowded factory, 
workshop, store, or office have been so often discussed that I hardly 
think they need reiterating. All I would wish to say is that a little 
propaganda for better ventilation, ample wash and toilet facilities in 
every place where the masses work, would perhaps be more effective 
when coming from within than coming from without. The workers 
should claim their just right concerning this and the employer should 
realize that efficiency is increased by better air, more light, more 
cleanliness, and sufficient rest and recreation. An examination for tu- 
berculosis prior to admitting an individual into a workroom or faetoi'y 
where he comes in close contact with others would seem to be the 
best safeguard to others and perhaps the surest way to prevent the 
individual himself from becoming seriously ill. It would be well if our 
municipal and federal governments would take the lead in this matter 
and ha;ve every municipal employee and every employee in post- 
offices or other federal departments examined for tuberculosis. The 
offices where these men and women work should be models of sanitation 
and proper ventilation so that the dangers of contracting a predispo- 
sition to tuberculosis should be reduced to a minimum. 

Bad housing, overcrowding, and congestion, which ■ predispose to 
tuberculosis and facilitate the spread of the disease if a center of in- 
fection is present, while most frequent in congested cities, are, however, 
not confined to the city alone. Although our farmers and people liv- 
ing in the country and in small towns and villages usually have an 
abundance of good air outside their habitations, they very rarely make 
good use of it. The sleeping quarters in many farmers' families are as 
bad as those in large cities, and to see the windows nailed dovm and 
the shutters fast closed is not an unusual sight in many a farmer's 
house. The best room is used for parlor and the worst for sitting and 
bedrooms. 

In speaking of rural hygiene, I must return once more to the chil- 
dren and make a plea for better and more sanitary school houses in our 
country districts. In some sections of the country, almost any old 
bam or dilapidated building is considered good enough for a school 



GENERAL INDIVIDUAL HYGIENE 119 

house. Some pretty energetic propaganda for reform is needed in 
these districts. Rural hygiene is as essential as city hygiene if we 
wish to combat tuberculosis with any degree of success. 

Millions of people in this country spend hours and even days in 
travel; hence the sanitary condition of our public conveyances, rail- 
roads, street cars, steamers, river boats, and ferries must be considered 
when we speak of the housing conditions of the masses. I have dwelt 
at length on this subject in a contribution on "The Hygiene of Public 
Conveyances, ' '* which I read at the New York Academy of Medicine 
at the request of the Public Health Educational Committee a few 
years ago, so I will give it only a mention here. Anti-spitting ordi- 
nances with the request to hold the hand before one's mouth when 
coughing, the avoidance of overcrowding, proper ventilation and with- 
out overheating, a frequent disinfection of all street-, railroad-, and 
Pullman cars, cabins, steamboats, etc., are the only way to minimize 
the dangers from tuberculosis and other infectious diseases of the 
i-espiratory organs for the traveling public. 

Our colored population and the districts where many Chinese and 
Japanese live must receive special consideration under the subject of 
housing. It is well known that our colored population is much more 
prone to contract tuberculosis and that the morbidity and mortality is 
much greater than it was before their liberation from slavery. Edu- 
cation and hygiene is essential for the colored masses and perhaps more 
so than for our white population. The housing conditions of the 
colored people are as a rule a great deal worse than those of the whites 
with similar earning capacity. 

I do not think that the colored race is really more predisposed to 
tuberculosis from any other reason than their mode of living. As a 
rule they sleep in overcrowded quarters ; their home hygiene is deplor- 
able, their love for pleasure and recreation makes them irregular in 
their meals and hours of sleep, and last but not least, very often hav- 
ing no thought of tomorrow, they live in abject poverty. Education 
by lectures, distribution of literature, and tuberculosis exhibitions in the 
districts of colored people will doubtlessly do a great deal of good, but 
social service, personal visits by volunteer or paid workers in behalf of 
the anti-tuberculosis cause mil alone be able to make much impression 
on the fearful prevalence of tuberculosis among the colored race. 

In view of the existing race prejudice or antipathy it would be 
better for colored people to unite and by cooperation with philan- 
thropically inclined people of their own and the white race to build 
sanitary tenement houses in segregated districts, than to try to crowd 



* Medical Itecord, New York, March 18, 1911. 



120 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

iuto tlie already over congested districts inhabited by the poorer 
chisses of the white population. 

Much could be said here of the deplorable condition in which our 
Asiatic friends, the Chinese and Japanese, live, as for example on the 
Pacific Coast. I have visited the lodging houses of nearly all nations 
but never have I seen the equal in regard to congestion and unclean- 
liness to the so-called Japanese boarding houses and Chinese dens. 
This becomes a matter for the serious consideration of the local sani- 
tary authorities when one considers the frequency of tuberculosis 
among the Chinese and Japanese and how many of them act as 
servants in the households of American families. 

Our American Indians, particularly those living on reservations, 
are becoming more and more frequently subject to tuberculosis. This 
alarming prevalence of tuberculosis among the unfortunate Indians 
has resulted in the appointment of a federal commission, composed of 
Senator Robinson, of Arkansas, Senator Charles E. Townsend, Rep- 
resentatives J. H. Stephens, of Mississippi, and Charles H. Burke, of 
South Dakota, which has recently completed an investigation. I 
quote from this report : 

''For the fiscal year ending June 30th, 1912, out of 190,791 In- 
dians reported on, approximately 26,500 were estimated to have tuber- 
culosis. Thirty-two per cent of the whole number of deaths reported 
from the various reservations was alleged to be due to tuberculosis. 
A comparison of the death rate between Indians and whites from 
tuberculosis discloses that thirty-two per cent of the whole number of 
deaths reported from the various reservations was due to tubercu- 
losis. ' ' 

The explanation for this fearful situation is to be found in the 
habits and manners of living of these "civilized" Indians as com- 
pared with their inode of life prior to their being placed on the 
reservations. Thus, very .justly, the report states: "Formerly the 
Indians lived in tepees, engaged in out-of-door sports and earned their 
living by fishing, hunting, and trading. Contact with the white man 
has worked a radical change in them. They have been collected on 
reservations, their hunting grounds converted into farms and pastures, 
and every energy exhausted to change a naturally nomadic race into 
an agricultural people. The substitution of insanitary houses for 
tepees has resulted in the adoption of habits of living peculiarly con- 
ducive to the spread of tuberculosis. In many Indians' homes sani- 
tary' conditions are frightful. 

"A comprehensive remedy can be afforded by the establishment of 
camp hospitals," says the report, "in the nature of temporary sana- 
toria for the treatment of tuberculous Indians on the reservations 



GENERAL INDIVIDUAL HYGIENE 121 

where the disease is knoM^n to be common. These hospitals should be 
temporary and inexpensive and provided with necessary apparatus 
and experienced nurses and physicians." 

The report recommends a vigorous campaign throughout the In- 
dian country of systematic instruction in sanitary habits and methods 
of living looking toward the making and enforcement of reasonable 
sanitary regulations. 

I have only a few suggestions to add to those of the Commission, 
namely, first, that whenever possible a doctor of their own race (not 
a "medicine man"), educated and licensed as a regular physician, 
should be put in charge of anti-tuberculosis work among the Indians, 
or at least be an assistant to the government physician. Thus, early 
diagnosis and timely treatment in those afflicted would be secured. As 
the best possible prophylactic measure I would recommend outdoor 
sleeping with the aid of cheaply constructed lean-tos of the King- 
Loomis type. To all this should of course be added proper nutrition 
and the prohibition of the sale of alcohol on reservations or anywhere 
else to our Indian fellow-citizens. It goes without saying that the 
schools for the Indian children should be open-air schools, that clean- 
liness and the elementaries of general hygiene with the view to pre- 
venting tuberculosis and other infectious preventable diseases should 
be taught to all children according to their age and understanding. 

The mortality of tuberculosis in prisons and reformatories is 
about three times as high as that of the population outside of our 
penal or reform institutions. What are the factors responsible for 
this condition? First of all, I believe that many a young man or 
Woman who is convicted of crime comes to the prison with a strong 
predisposition if not already in a stage of incipient tuberculosis. 
They have been raised in an atmosphere of darkness with bad personal 
or general hygiene, underfeeding and unsanitary housing, not in- 
frequently combined with intemperance and other evil, demoralizing 
influences. When such an individual enters a prison of the kind 
Avhich is alas now in the majority, a five-year sentence or more is 
equivalent to a death sentence. I hardly need to say that society 
has no right to punish as severely as that. 

Segregation of the tuberculous prisoners from the non-tuberculous 
should be established and outdoor or at least healthful indoor occupa- 
tion provided under proper sanitary conditions. If cell life must be 
led, let it be in cells well aired and properly heated in winter, with the 
removal as far as possible of all the depressing psychical influences, 
which are so helpful in the development of tuberculosis. 

This is not a paper on prison reform and still if we wish to eradi- 
cate tuberculosis our prison system must be reformed. In view of the 



122 FIKST NATIONAL CONFERKNCE ON RACE BETTERMENT 

possibilities of training and supervision in a prison, the tuberculosis 
death rate should be loss there than anywhere else. I treated this par- 
ticular phase of the tuberculosis situation in full in an address before 
the National Prison Association some years ago.* My conclusions 
today are the same as then. To discharge a tuberculous prisoner with- 
out his being cured or without being assured that he will not consti- 
tute a center of infection in his family or among his friends or fellow- 
workers is criminal and the pardon of a tuberculous prisoner without 
the assurance of his being well taken care of under sanitary condi- 
tions is equally criminal. The tuberculous prisoner should be treated 
like any other tuberculous patient, and the more outdoor, that is to 
say agricultural or horticultural, work that all prisoners can do under 
proper supervision, the fewer will develop tuberculosis, and the greater 
will be the number of those restored to happy and useful membership 
in society. 

There is one more source of predisposition which I believe has 
been greatly underestimated. I refer to the susceptibility to tuber- 
culosis which arises so frequently in patients, and particularly in 
poor patients when discharged from a general hospital. Although 
cured from the acute non-tuberculous disease or affliction for which 
they have had to submit to a surgical operation, their general constitu- 
tion is, as a rule, so much below par and their vitality so lowered at 
the time when they are obliged to leave the general hospital in order 
to make room for new acute cases, that the unfortunate convalescents 
not infrequently fall a prey to the multiple sources of infection which 
they encounter in their daily lives. To have a sufficient number of 
convalescent homes where the patients discharged from general hos- 
pitals, including also the mothers discharged from the maternity 
hospitals, can remain long enough for their physiological vigor and 
earning capacity to be re-established, is the only way to overcome this 
source of predisposition to tubercul'osis. 

We will next consider the predisposition caused by malnutrition 
during infancy, childhood, adolescence, and in adult life. I am not 
going to enter here into the subject of the high cost of living, for that 
is a matter for statesmen to regulate. All I wish to say is that person- 
ally I do not believe there is any necessity for the cost of living being 
so high, because we should not have a multitude of men who must 
idle away their years in military service at a cost of billions of dollars 
to the producers while they themselves produce nothing. 

To return to my calling of a physician, I claim that underfeeding 



* "The Tuberculosis Problem in Prisons and Reformatories," New York 
Medical Journal, Nov. 17, 1906. 



GENERAL INDIVIDUAL HYGIENE 123 

of infants is due to three sources. First of all, there are not enough 
true mothers, that is to say mothers willing to give their own breasts 
to the child for its principal source of food during early life. It is 
well known that if a mother is so unfortunate as not to have enough 
milk for the child, partial breast feeding is better than no breast feed- 
ing at all. Again, it has been shown that the disuse of the mammary 
glands has a tendency to manifest itself in the inability to nurse when 
the female offspring becomes in turn a mother; and the reverse is 
equally true — the baby girl raised on mother milk, or even only par- 
tially breast-fed will be able to nurse her child in turn. The breast-fed 
baby will nearly always be stronger and better able to resist the in- 
vasion of tuberculosis than the artificially fed baby. 

The next cause of malnutrition in infancy and early childhood is 
ignorance. Llany mothers do not know how to feed the child and 
it is not always poverty or the lack of sufficient food, but the igno- 
rance of how to feed the child properly which results in malnutrition. 
Education, best accomplished by the personal visits of competent 
nurses under the direction of a bureau of child hygiene, which should 
be a part of every modern health board, will alone combat this fruitful 
source of malnutrition. With the underfed child at school the cause 
may in some instances be due to ignorance, but here in most cases it 
is poverty that we find as the real cause. When the predisposition 
to tuberculosis caused by the physical reasons of malnutrition and 
lack of development, due to bad teeth, adenoids, large tonsils, and 
nasal obstruction, is removed, we still find some of these children 
not improving because they are underfed. 

I am willing to say that I am a strong advocate of school lunches, 
and this by reason of a careful investigation carried on in New York 
where over 15 per cent of children attending the public schools were 
found to be suffering from malnutrition. In 10 per cent of cases in- 
vestigated the mother was a wage-earner and not at home to prepare 
the noon meal, and of children taking school lunches last year 75 per 
cent were from families having incomes below the living v/age. The 
children are given for the small amount of three cents, rice and tomato 
soup and bread, or pea soup and bread, or lentils and rice and bread, or 
for one more cent the child may buy either cocoa, sandAviches or cooked 
fruit. And what was the result? It was found that the children tak- 
ing the lunches had gained in weight three times as much as those not 
taking them and an immediate marked improvement in school work 
resulted in those who were formerly underfed. Here is a work for 
the municipalities and philanthropists who wish to help in the eradi- 
cation of this source of strong predisposition to tuberculosis. 

The malnutrition in the adults, or may I ,use the expression, the 



124 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

underfeeding of the masses due to increased cost of living which, as 
already stated, is a matter for governments and statesmen, can never- 
theless be ameliorated even before disarmament and regulating supply 
and demand of labor and the legislative control of prices of agri- 
cultural products, i. e., the prevention of trusts in foodstuffs. 

A great step in advance can, I believe, be made and the condition 
of the masses considerably bettered, first, by a more widespread educa- 
tion of the principles of scientific and economic housekeeping and 
cooking. There is a great deal of valuable foodstuffs wasted in the 
houses of the poor by mere ignorance. Cooking should become a 
popular science, and the mimicipality or the philanthropist who will 
establish a cooking school where practical, economic, yet tasteful cook- 
ing will be taught, will bestow one of the greatest benefits on humanity. 

An equally interesting and beneficent institution for municipali- 
ties or philanthropists to establish in view of combating the effects of 
underfeeding or bad feeding, which paves the way to tuberculosis, 
is what is knowni in Germany under the name of Volkskilchen, "a 
people's kitchen," where good and substantial food is prepared and 
sold at cost to the masses. I have tasted meals thus prepared and 
can vouch for their wholesomeness, tastefulness, nutritious quality, 
and last, but not least, their cheapness. A few of such kitchens in 
every one of our large cities will be of incalculable benefit to the 
physical and moral well-being of the masses. 

Alcoholism, that is to say, the excessive and injudicious use of 
alcoholic beverages, is to my mind one of the strongest predisposing 
factors in the adult. It not only renders the individual more sus- 
ceptible to the invasion of the tubercle bacilli, but also makes the cure 
much more difficult. In mj^ service at the Riverside Hospital-Sana- 
torium on North Brother Island a large number of patients are 
alcoholics and the prognosis in such cases is almost invariably un- 
favorable. I regret to state here that I have had in my service as 
many as 70 per cent of tuberculous patients who confessed the exces- 
sive use of alcohol prior to contracting tuberculosis. I cannot, of 
course, enter here into the discussion of the alcoholic problem. All I 
can say is that education, wise legislation, rational temperance move- 
ments, better food and better cooking, and popular healthful en- 
gagements for the masses, are to my mind the most rational means 
to combat the alcoholic evil. 

Venereal disease also predisposes to tuberculosis in a measure. 
My own conception of how to combat this evil I expressed in the ora- 
tion on medicine which I had the honor to deliver before the Illinois 
State Medical Society two years ago. I must refer my readers to this 
article, ' ' Some Modem Medico-Sociologic Conceptions of the Alcohol, 



GENERAL INDIVIDUAL HYGIENE 125 

Venereal Diseases, and Tuberculosis Problems."* All I can do here 
is to include syphilis and gonorrhea into the three great afflictions of 
the masses — alcohol, venereal diseases, and tuberculosis — which are 
more prevalent in cities than in the country, and all of which are in 
no small degree th^ result of congestion and the many unwholesome 
features of city life. I venture to say that all these diseases, and par- 
ticularly tuberculosis, will be decreased by a return to the farm. If 
our statesmen can help to make farming more attractive and profit- 
able, country life, particularly for young people, less monotonous and 
more enjoyable, a great step toward the decrease in the morbidity and 
mortality of the above mentioned diseases and a consequent betterment 
of the race will surely be attained. 

We come now to the direct causes of tuberculosis. First, contami- 
nated food substances, i. e., contaminated by the tubercle bacillus. 
We have tuberculous meat derived from tuberculous cattle and hogs, 
and have tuberculous milk derived from tuberculous cows. There 
would be no difficulty in combating bovine tuberculosis and tubercu- 
losis in hogs if we had uniform laws for dealing with this disease and 
could prevent the sale of beef or pork derived from tuberculous 
animals. As it is, one state in the Union has excellent bovine laws, 
has all cattle tested by tuberculin, destroys the tuberculous cattle, and 
compensates the farmers. A neighboring state has poor or no bovine 
laws at all, or they are not enforced. The result is of course danger 
not only to the inhabitants of the states with poor bovine laws, but 
to all those who may sojourn temporarily therein. The same holds 
good of pork and still more of milk. Testing all cattle with tuber- 
culin and weeding out the tuberculous ones, the most careful in- 
spection of all meat at the abattoirs no matter from what source, the 
prohibition of the sale of milk except from tuberculin tested cows, 
or the universal careful scientific and not merely commercial steriliza- 
tion of all milk, are up to date our only means to avoid contracting 
tuberculosis from the ingestion of food substances. 

When one considers that nearly 10 per cent of all tuberculosis in 
children is due to the bovine type of the tubercle bacillus, it would 
seem that the time for the federal authorities to take up this question 
has come. 

The most important source of infection of tuberculosis is that 
from man to man through the process of inhalation and close personal 
contact. As most frequent .of all phases we must consider what is 
known as family infection. The bacillus, being found in abundance in 
the secretion of the tuberculous individual, may be inhaled with the 



* American Practitioner, Februaiy, March, and April, 1913. 



126 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

(lust laden with diy pulvorizod tiibci-culous sputum. It may be trans- 
mitted Avith the kiss of the mother to the child, from husband to wife, 
or wife to husband, or from a tuberculous child to a healthy child, 
Not infrequently children in private homes or institutions become in- 
fected by tuberculous nurses or maids. The greatest vigilance on the 
part of family or institution physician is necessary to overcome this 
danger of infection to the children under their care. 

In close and congested quarters there arises in addition the danger 
from droplet infection. Small particles of saliva containing the tuber- 
culous germs are expelled during the cough or during loud and ex- 
cited speaking. Constant exposure to the contact of these droplets 
may lead to infection. 

The general and principal remedy for this, the greatest of all 
sources of infection (sputum and droplet infection) from man to 
man. can be expressed in one little sentence : there should not be any 
uncared-for tuberculous individual. Being cared for means of course 
that the patient is submitted to the hygienic and dietetic treatment, 
and constantly watched and supervised so that infecting others be- 
comes virtually an impossibility. If every tuberculous ease of today 
could be treated and watched, he could not infect anybody else nor 
conld the room he occupies or the house he lives in become a source 
of danger to others who inhabit it after him. Thorough disinfection 
of rooms and house would follow his removal and tul^erculosis would 
no longer be a house disease. 

An annual, or better yet semi-annual, examination of every indi- 
vidual in every community would lead to the early discovery of tuber- 
culosis in any member of the community ; his being taken care of at 
the right time and in the right place would eliminate him as a danger 
to the family, and tuberculosis would no longer be a family disease. 

What must be done in order to attain this goal is self-evident. 
Clinical facilities for the recognition of tuberculosis in every com- 
munity arranged by physicians in cooperation with the municipal 
authorities; a multiplication of such institutions as dispensaries, 
serving as centers or clearing houses to distribute the cases ; pre- 
ventoria to which to send suspected cases ; sanatoria for the curable 
cases, and hospital-sanatoria for the seemingly hopeless ones for 
isolation ; and where it is possible sanatorium treatment at home — 
these are our most efficacious weapons, up to this date, for solving this 
phase of the tuberculosis problem. 

But to send the tuberculous patient, particularly a laborer or a 
working girl or woman, for a six months' or even a year's sojourn to 
a sanatorium is not enough to make the cure lasting; it will often 
demand more time. Hence, agricultural, horticultural, and general 



GENERAL INDIVIDUAL HYGIENE 127 

industrial colonies should be attached to our public sanatoria. It is 
here where the patient has the best possible chance, by graded labor 
still under medical supervision, to make his cure a lasting one. 

The United States of America offers a welcome to all the people of 
the Avorld and an opportunity to become citizens of this Republic. 
As a result, this country stands unique as the land with the greatest 
number of immigrants arriving annually in its ports. That among 
these many are tuberculous and many more are strongly predisposed 
to the disease is evident and well known. The medical problems of 
immigration are so important a subject to this country that a year 
ago it was made the subject of discussion at the annual meeting of 
the American Academy of Medicine in Atlantic City.* The difficulty 
of diagnosing at a glance a tuberculous invalid in the first or second 
stage was there brought out. It often takes an expert a half or three- 
quarters of an hour before he can arrive at a definite conclusion, and 
that after a careful examination in the quiet of his office. The rela- 
tively small number of examining physicians at Ellis Island, for ex- 
ample, can devote but very few minutes to each of the thousands of 
immigrants who pass before them weekly for inspection. The ex- 
cellent appearance of some tuberculous immigrants, because of a ten 
days' voyage, invigorating sea air. good food and rest, has been to my 
mind in many instances the reason of the non-discovery of invalids in 
quite advanced stages. When they have been admitted to this coun- 
try, a few weeks of hard work in the ditches or in the sweat shops, with 
nights spent in overcrowded tenements or unclean or crowded lodging 
houses, usually suffice to bring about an exacerbation of the disease. 
The strain, the struggle for life, the new environments, the unac- 
customed food, and perhaps also some nostalgia and disappointment, 
likewise help to turn, in a very short time, an incipient case into an 
invalid with open tuberculosis, and thus a new center of infection is 
formed. All this accounts for the great prevalence of tuberculosis 
among the laboring classes who have come to us from foreign shores 
only relatively recently. A goodly number of them return to their 
native land, particularly the Italians, when they realize that their dis- 
ease does not permit them to struggle as they must if they wish to re- 
main here. I have been told that there are villages in Italy where 
tuberculosis has become most prevalent because of the return of 
those emigrants and because their methods of life result in infection 
of others. 



*"Medieal Problems of Immigration," being- the papers and their dis- 
cussion presented at the XXXVII Annual Meeting of the American Academy 
of Medicine, held at Atlantic City, Jime 1. 1912. Easton, Pa., American 
Acad, of Med. Press, 1913. 



128 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Some rotiini volimtarily to their native homes, but you perhaps 
are not aware that we have a deportation law* which, as a good 
American I am sorry to admit, seems unnecessarily harsh and un- 
justified, founded as it is on an unscientific basis. It is to the effect 
that any iimnigrant who has become a public charge in a hospital or 
other institution and is found to be tuberculous, can be deported even 
after a residence of three years if in the opinion. of the examining 
physician he had contracted the disease prior to his landing on these 
shores. During the year of 1911, about 1,500 of such tuberculous 
aliens were referred to the State Board of Charities for deportation. 
On the strength of this law the deportation is done at state expense. 

With all due respect to the framers of this law, I believe it abso- 
lutely impossible for the most skilled diagnostician, upon examination 
of a tuberculous chest, to state the duration of the disease with even 
approximate certainty. A declaration that an individual had tuber- 
culosis for a definite period of time, based on a physical examination 
or even on the history given by the patient, must necessarily be guess- 
work. I know of a case of deportation v^hich v^as declared legal upon 
the statement of a young physician to whom a tuberculous patient had 
admitted that he had a cough a little less than three years ago, prior 
to his coming to this country. 

How many thousands of us have a latent tuberculosis which has 
never been discovered and which may never cause us any trouble if 
we continue to live carefully and hygieuically ! Should w^e, however, 
be submitted suddenly to a life of hard physical struggle, be trans- 
ported into unhygienic environments, be underfed and badly housed, 
the development of the tuberculous trouble would be almost certain 
to take place, and in a much shorter time than three years. One must 
have witnessed such a deportation in order to comprehend its mean- 
ing, particularly when one is not at all certain that the case might 
not be one which developed right here because of hard w^ork and pri- 
vation. 

And now. to the most important question of all : what can be done 
to prevent tuberculous invalids, likely to become a burden to the 
community, from entering the United States, only perhaps to be de- 
ported after a sojourn of one, two, or three years? Tuberculosis must 
be considered a world problem, a problem for every civilized nation. 
Let European governments understand that they must take care of 
their own tuberculous people as we take care of ours, and that in the 
end, by united efforts, it may be possible to conquer the white plague 
in all countries. 



* Immigration Act of Feb. 20, 1907. 



GENERAL INDIVIDUAL HYGIENE 129 

To ascertain his freedom from tuberculosis every prospective emi- 
grant should be examined by two competent medical men, one ap- 
pointed by his home government and one by the steamship company 
which is to transport him to this country. A certificate showing free- 
dom from tuberculosis, signed by these two medical men, should be in 
the possession of every emigrant allowed to come to these shores. An 
individual discovered to be afflicted with this disease should be re- 
turned to the care of the authorities of the city or village from which 
he came with the diagnosis and recommendation for treatment. Ex- 
ceptions can and should be made in the case of an individual with 
ample means who is simply visiting, or seeking to recuperate his 
health by a change of climate, or desirous of entering an American 
sanatorium for treatment. To avoid misuse or fraudulent use of the 
physician's certificate, a photograph should be taken at the time of the 
examination in the home port and attached to the certificate. Or, 
since a photograph could be removed and another one substituted 
on the certificate, I even go so far as to suggest that it would be well 
to have the finger-print taken for identification. This is the most ac- 
curate and scientific method known for such purposes. 

The laws relating to deportation should be changed to the effect 
that if the holder of any such certificate, or any immigrant develops 
tuberculosis within six months to one year from the date of his ar- 
rival here and becomes a charge to the community, he shall be deported 
to the port w^hence he came. The expenses for this deportation should 
be borne by the steamship company who brought the immigrant to 
our shores and not by the State Board of Charities. Whether Euro- 
pean governments should desire to keep doubtful cases under 'ob- 
servation a few weeks in cooperation with the steamship companies in 
order to avoid possible mistakes in diagnosis, or increase the ex- 
amining boards by one or two more experienced diagnosticians, is a 
matter for the foreign governments to decide. There is no question 
but that the more careful these examinations are at the foreign ports, 
the fewer the cases of deportation that wall ensue. 

The suggestion has been made that physicians of the United States 
Public Health Service should be stationed at the important points of 
departure in Europe so that each e'migrant can be thoroughly ex- 
amined, and those entitled to a clean bill of health be allowed to take 
passage. I question whether the international law w^ould sanction 
such procedure. Secondly, there are too many minor points from 
which emigrants could take passage and escape the United States gov- 
ernment physician's examination. It would be of greater value for 
foreign governments and steamship companies to make it known that 
if a man expects to stay in the United States, he must not become a 

(6) 



130 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

public charge; that he must be physically, mentally, and morally 
sound. With such a policy and the additional examination in the 
manner above outlined, the United States government will be less 
burdened with the care of tuberculous aliens who, uncared-for, are a 
constant menace to the communit3^ 

An interesting suggestion in relation to this subject was made 
at the recent International Tuberculosis Congress in Rome by Dr. 
Antonio Stella, of New York. It was to the effect that every emigrant 
should be insured against tuberculosis, the cost of insurance to be ad- 
ded to the price of the steamship ticket, the policy entitling the bearer 
to return transportation and free treatment in a sanatorium, in the 
event of his contracting tuberculosis within a specified time. This 
suggestion was presented in the form of a resolution, which was 
unanimously adopted, but whether or not it will result in any imme- 
diate or definite action I am not prepared to say. . 

The suggestion of Doctor Stella leads me to the conclusion of my 
paper, namely, that it is my firm conviction that unless we have a 
general insurance against accidents, old age, and disease, including 
tuberculosis, for every individual earning less than $1,200 a year, the 
tuberculosis problem will never be solved. I realize, of course, that 
there are other factors which must be considered as contributory to- 
ward the solution of »the tuberculosis problem. I refer, of course, to the 
betterment of the social conditions of the masses in general. That 
this may occur soon is our devout prayer, but for the present let us 
bear in mind that we still lose annually in the United States well-nigh 
200,000 lives from tuberculosis and that we have among us eight times 
as inany tuberculous individuals in the various stages of invalidism. 
I venture to say that not one-tenth of these 1,600,000 are under proper 
care in institutions or at home. 

Yet to prevent infection and to assure a cure, the tuberculous in- 
dividual must be under careful medical supervision. Because of the 
widespread propaganda of enlightenment during recent years regard- 
ing general hygiene, prevention of tuberculosis, and the importance of 
the early discovery of the disease, a great deal of good has been ac- 
complished and I urge continuation and increase of proper propa- 
ganda. Education has done a great deal already, and the well-to-do 
classes particularly now frequently seek timely aid; but not so the 
poor man who knows that very often ' the discovery of his disease 
means the loss of his job. The result is that he will hide his condition 
as long as possible, infecting in the meantime a goodly number of his 
fellow-beings. If, on the other hand, he could Imow that by reason of 
his insurance he could enter a sanatorium the moment that his dis- 
ease was discovered and receive the best possible chance of being 



GENERAL INDIVIDUAL, HYGIENE 131 

cured, he would not hesitate to be examined. Of course, provision for 
the maintenance of his family in the event of his being the only bread 
winner, should be a part of his insurance policy. 

In summarizing, let me repeat then that in spite of all our efforts 
we are, as just stated, still losing about 200,000 people annually 
from tuberculosis in the United States. Of these, I venture to say, 
50,000 are tuberculous children. Estimating the average duration of 
life of the 50,000 children who die annually from tuberculosis in the 
United States at about seven and one-half years, and figuring the cost 
to parents and the community for each life as only $200 per annum, 
the financial loss thus represented is $75,000,000. These children have 
died before they have been able to give any return to their parents 
and the community. What a useless sacrifice of life and of money! 
How much needless sorrow and heartaches caused to parents! 

Besides all this, many a tuberculous mother has had her life short- 
ened because she bore one of these children. According to the report 
of the Commissioner of Education, there are at this time about 
20,000,000 children attending public schools in the United States. 
Placing the proportion of tuberculosis among them as low as only 
three per cent, would make 600,000 children afflicted with tuberculosis 
who are at this time in urgent need of open-air instruction or sana- 
torium treatment. According to available statistics, we can at present 
provide instruction in open-air classes for about 2,000 tuberculous 
children. The anemic, the nervous, and the children suffering from 
cardiac diseases, who are in equally great need of outdoor instruction, 
are not included in the three per cent. 

The 150,000 adults who die annually of tuberculosis have at th'e 
average been ill and incapacitated for work for at least two years, and 
figuring their cost to the commonwealth (either to municipality or in- 
dividual family) at only $1,000 per year, would mean $300,000,000 
uselessly spent in caring for people afflicted with a disease that might 
have been prevented and cured. Of these 150,000 adults, a large num- 
ber have been married and in many instances leave either widows or 
orphans depending upon public support. The annual maintenance of 
these widows and orphans must, of course, also run into the millions. 
"We have thus an annual expenditure of well-nigh $400,000,000. Yet 
this by no means represents all the actual loss to the community from 
tuberculosis. Our social economists tell us that between the ages of 
16 and 45 every adult life ^\dth an average earning capacity repre- 
sents an asset of $5,000 to the community. Now, as two-thirds of all 
deaths from tuberculosis in adults occur between these ages, we have 
an additional loss of $500,000,000 to the community. Thus, the actual 
direct and indirect loss caused bv death from tuberculosis in the 



132 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

United. States amounts annually to something like $900,000,000, and 
this amount we spend on a preventable and curable disease! 

We nnist also bear in mind the fact that we have at least eight 
times 150,000 tuberculous adults, for it is well known that for every 
individual who dies of tuberculosis there are eight living with the dis- 
ease, still up and about, and the majority of them with an oppor- 
tunity of spreading infection. Besides these, there are about 400,000 
tuberculous children. By reason of lack of open-air schools, preven- 
toria, sanatoria, special hospitals, and horticultural, agricultural and 
industrial colonies, the vast majority of these 1,200,000 tuberculous 
individuals continue the chain of infection and keep up our fearful 
morbidity and mortality at an expense of $900,000,000 per annum. 

Surely, the time has come for dealing more rationally with. at least 
some phases of the tuberculosis problem in this country. And what 
are we to do first? We must at once, throughout this vast country, 
strive to have no uncared-for tuberculous patients. To this end, in- 
stitutions for the treatment and care of the tuberculous who cannot be 
cared for at home without endangering others, should be multiplied 
by state and municipal appropriations and private philanthropy. 

We must not be content with merely sending the tuberculous indi- 
vidual to a sanatorium for 6 or even 12 months until the disease is ar- 
rested or his condition improved and then allow him to return to his 
former deplorable unhygienic home environments or to resume his 
former occupation under the equally deplorable unsanitary conditions, 
which were probably responsible for his contracting the disease origi- 
nally. Agricultural, horticultural, and industrial colonies, where the 
sanatorium graduate may have an opportunity to go for a year or 
more to earn a fair wage and at the same time be given a chance to 
make himself stronger and more resistant against a new outbreak or 
invasion of the disease are as essential as sanatoria or special hospi- 
tals. Without making the arrest or the cure of the disease lasting by 
such judicious after-care, the millions of dollars spent for sanatorium 
maintenance are a sheer waste of money. 

Even the smallest children, if foimd tuberculous, should receive 
institutional treatment when the parents are poor, and whenever pos- 
sible the mother should be allowed to remain with the child. For 
larger children afflicted with pulmonary tuberculosis we should have 
inland sanatoria with schools attached to them. For children afflicted 
with glandular, joint and bone tuberculosis, we should have seaside 
sanatoria. Some of our discarded battleships or cruisers may be util- 
ized for this purpose, instead of being sold as junk or made to serve 
as targets. 

Open-air schools, and as much open-air instruction as possible in 



GENERAL INDIVIDUAL HYGIENE 133 

kindergarten, school and college, should be the rule; indoor instruc- 
tion should be the exception. There should be no home lessons for the 
younger children. Love for life in the open air should be inculcated 
in young and old throughout the country. 

There should be a sufficient number of public parks and play- 
grounds in our great cities to counteract congestion and reduce it to a 
minimum. .The roofs of all city houses should be utilized to give more 
open-air life to the inhabitants by makin» them into roof gardens, 
recreation centers, or playgrounds. Outdoor sleeping should be en- 
couraged whenever feasible. 

Medical under- and post-graduate schools should give special 
courses in early diagnosis of tuberculosis, and instruction in how to in- 
augurate efficient social service for hospital cases afflicted with tuber- 
culosis. 

Early recognition of the disease should be facilitated for all classes 
by universal semi-annual examinations, by private physicians for the 
well-to-do, and by publicly appointed diagnosticians for the poor. 
The federal and municipal authorities and the employers of large 
bodies of men and women should set the example by enforcing these 
semi-annual examinations and should further what is commonly known 
as welfare work. 

Besides popular anti-tuberculosis and general hygienic educa- 
tion, demonstrations by permanent exhibits, distribution of literature, 
lectures in schools, colleges, workshops, mills, factories, mines, stores 
and offices, the examination of every tuberculous adult should be ac- 
companied by personal instruction in how to prevent infecting others. 
Anti-spitting ordinances should be enforced, but receptacles in public 
places for those who must spit should also be provided. The man 
advertising fake cures for consumption should be treated as a mur- 
derous criminal, for such he is. 

There should be state insurance against tuberculosis, so that the 
man without means may be assured that even if he is found to be 
tuberculous he or his family will not be in want. Until, as in Ger- 
many, state insurance companies have their own sanatoria, our private 
insurance companies should be permitted to establish and maintain 
sanatoria and special hospitals for their tuberculous employees and 
policy holders. 

Other sources of tuberculous infection, as for example from cattle 
or hogs, should be dealt with by federal laws since state laws, by 
reason of their diversity and often inadequacy, have proved inefficient. 
All milk, if not coming from tuberculin-tested cattle, should be thor- 
oughly and scientifically, and not merely commercially, sterilized. 

The influx of tuberculous immigrants likely to become a burden to 



KU FIKST NATIONAL CONFERENCE ON KACE BETTERMENT 

till' coiiiimniity should be i^revcntt'd by conipclliiiy- all slt'aiiishij) eoni- 
])aiii('s to assure a clean bill of health for every immigrant they bring 
to these shores and to insure ever}^ immigrant against tuberculosis'. 
The policy should entitle the bearer to return transportation and free 
treatment in a sanatorium in the event of his contracting tuberculosis 
within a specified time. The cost of the insurance could be added to 
the price of the steamship ticket. 

Procreation of the tuberculous sliouUI be prohibited by law and the 
prevention of it taught to every tuberculous adult. The individual 
wilfully violating this law should be punished in a way to make the 
repetition of the offense impossible. 

The predisposing factors, such as child labor, sweatshop labor, too 
long working hours for men and women, bad housing in tenements, 
apartments, lodging houses arid hotels in city and country, including 
farm houses, boarding schools, orphan asylums, and other institu- 
tions housing many people, must be combated by rational laws and 
their strictest enforcement. The same rigor should be applied to laws 
concerning proper ventilation and sanitation in workshops, factories, 
stores, federal, municipal and private offices, and in public convey- 
ances. 

Wherever and whenever practical, the home of the married Ameri- 
can workman should be a detached single family house. 

Maternity and convalescent homes should be provided in every city 
and town so that the laboring woman, arising from childbirth or the 
laboring man or woman recovering from a surgical or a general medi- 
cal disease, can recuperate, regain strength, and thus not be susceptible 
to tuberculosis on returning to their daily vocations. 

Tuberculosis among the Indians, Negroes, Chinese and Japanese 
must receive special attention on the part of our federal government 
with the view to combating the morbidity and mortality from tuber- 
culosis in these races (particularly in the Negroes and Indians) in this 
country, which is three times higher than that from tuberculosis in 
the white race. Nearlj^ all our reformatories, prisons and other penal 
institutions, including detention prisons, must be reconstructed or re- 
modeled, cells and workrooms made sanitary and more outdoor life 
and better food given to the prisoners if a few years of penal ser- 
vitude is not to be equivalent to a death sentence by tuberculosis. No 
tuberculous prisoner should be discharged, unless he is sent to a sana- 
toriuni so that when free he may also be well. 

Malnutrition and the underfeeding of the masses, which is so great 
a predisposing factor to tuberculosis, should be combated by beginning 
with having few^er artificially and more breast-fed; by instructing 
ignorant mothers how to feed infants and little children ; by provid- 



GENERxVL INDIVIDUAL HYGIENE 135 

ing simple but substantial school luncheons for all school children at 
cost ; by education of the mothers in economic housekeeping, cooking, 
and food values ; and by having eating places for the great army of 
unmarried laborers after the example of the German Volkskiichen 
where people can receive good, wholesome food at reasonable prices; 
by legislative and philanthropic endeavors to make farming more 
profitable and more attractive, and by a wiser statesmanship whereby 
the cost of living may be reduced for the entire people. 

Alcoholism and other excesses predisposing to tuberculosis should 
be prevented by education along rational temperance lines and wise 
and judicious legislation. 

The eradication of tuberculosis as a disease of the masses — with all 
the physical, mental, and moral suffering, and the millions in money 
now sacrificed largely in vain — is nevertheless possible ; but I em- 
phasize once more, that it is not possible unless every tuberculous in- 
dividual, in no matter what stage of the disease, is properly cared for 
at home or in an institution and all the predisposing causes removed. 
All the measures to attain this end must of course be inspired, neither 
by a blind phthisiophobia (an exaggerated fear of tuberculosis) nor 
by an hysterical phthisiophilia (allowing the tuberculous person to do 
as he pleases because of our sympathy or love for him). The intelli- 
gent cooperation of the tuberculous patient is as much needed in the 
solution of these various problems as that of the statesman, physician, 
philanthropist, and the people at large. 

The various measures which I have ventured to suggest and which 
are described in detail in my paper, must never be allowed to become 
a crusade against the tuberculous individual, who is our friend and 
brother, but for his sake and our sakes we must make henceforth a 
more rational and determined fight against the disease ''tuberculosis," 
which is our most costly enemy and the most deadly foe of mankind. 

Of course, there are certain social reasons for the prevalence of 
tuberculosis which are also responsible for some of our other social and 
physical ills. Among them I must mention first the utter ignorance 
of the vast majority of people who enter into matrimony of the re- 
sponsibilities they assume as fathers and mothers of the coming gener- 
ation. Some great philanthropist or some wise government should 
take the initiative and establish schools where the responsibilities and 
obligation of father- and motherhood would be taught. To these 
schools all candidates for marriage should be admitted gratuitous^. A 
course of one or two months would suffice and there should be night 
lessons as well as day instructions so that those occupied during the' 
day may also have an opportunity to learn. These courses should in- 
clude family hygiene, home hygiene, eugenics, the science of raising 



L36 FIRST NATIONAL CONFERENCE ON RACE BKTTERMENT 

('liiMrcii [)hysic;ill\-. iiiciitally nnd iiiorjilly licallliy, jsiul surli iiulividiial 
instructions for man and wonuin as the case may demand, all the work 
beino' directed towards enabling the future family to live a normal and 
happy lift\ 

Next, 1 nuist refer to many of llu' abnonnal industrial conditions 
of our day and the soeial injustice arising therefrom — our strikes, the 
lack of employment in some districts and the lack of workers in others, 
(>tc. These conditions must be readjusted, our deserted farms must 
be repopulated from the congested cities, the lives of the masses must 
be made happier, larger and fuller. When all this is realized, it will 
not only help in the solution of the tuberculosis problem, but will be a 
mighty factor in bringing about what this Conference has been called 
to consider — a genuine race betterment. But let us not think that 
this will come about unless we all believe in and work for a larger love 
of humanity and for more social justice and personal service to our 
less fortunate brothers and sisters. Someone has said that service to 
man is the highest service to God. I believe in this with all my heart. 

Discussion. 

Women's Work in the Open Air 

Professor Robert Ja^ies Sprague, Massachusetts Agineultural College, Am- 
herst, Mass. 

I have listened to a good many remedies for race suicide and race 
decline, etc. Some of them I believe in and some I do not, but it seems 
to me that the most vital thing that has to do with race degeneracy in 
the age in which we live has not been put forth. That sounds like a re- 
former, doesn 't it ? The Almighty somehow made us so that we needed 
to breathe air and he has not yet made any substitute that we have 
found, and the most of our racial decline, physical decline, is due 
largely to shutting off of air in one form and another. There is one 
other great fallacy that our race has adopted. Our race does not 
permit any woman of high class to do a stroke of economic work in 
the open air, and any race that adopts that policy, in my opinion, in 
the end perishes. A woman may work herself into indigestion, con- 
sumption and everything else in the house. She may pull pansies in 
the yard, she may play golf, she may motor, but she must not labor in 
the open air. Go to the great dynamic races that are multiplying so 
that the rest of the world does not know what to do with them, and 
w^hat is the great dynamic point of those races? It is free work in 
the open air for both men and women, and when we get that, we will 
get such wholesome, strong bodies that many of these great problems 
we have been discussing will simply disappear because they won't 
exist. I just wished to bring out that one idea. It seems to me that 



GENERxVL INDIVIDU.VL HYGIENE 137 

both men and women of our race have got to get to work in the open 
air and the extent to which we can do that will help to solve every one 
of these great problems we have before us. 



THE PREVEINTTION OE AUTERIOSCLEROSIS 

Louis Faugeres Bishop, M.D., Clinical Professor of Heart and Circulatory 
Diseases, Fordham University School of Medicine, New York City ; Physi- 
cian to the Lincoln Hospital; Consultant in Cardiovascular Diseases, 
Mercy Hospital, Hempstead. 

Nothing can help race betterment more than the prolongation of 
the efficiency and life of men and women over middle age, who, having 
satisfied the personal ambition of youth, can devote themselves to the 
public good. 

Never in the history of the world has the study of arteriosclerosis 
assumed so great importance as at the present time, because never 
before has this disease played so important a part in insidiously under- 
mining efficiency and shortening the lives of the most valuable workers. 

I am not in a position to make a comparative survey of the fre- 
quency of this disease, because, with heart troubles, it covers the 
entire field of my practice, but ijisurance men tell me that the mor- 
tality from the group of disorders that is covered by this name claims 
a number of victims that is more than double what it was thirty 
years ago. In 1910, one hundred thousand persons died of circulatory 
disease in this country, and I will venture the statement that there 
is not one of my hearers that has not lost a friend around sixty years 
of age during the past year from heart trouble, due, primarily, to 
arteriosclerosis. "While this has been recognized, but little has been 
done in the way of prevention. 

There are several things that need to be done: We need a clear 
definition of the disease. We need to become dissatisfied with the 
enumeration of indefinite causes, and we need an educated public 
opinion that will shield the earnest worker in the field of hygiene and 
dietetics from the thoughtlessly applied epithets of those who, seeking 
a refuge behind a bad prognosis, have no etficient regimen of their 
own to suggest. 

As to definition, arteriosclerosis is the most improperly named of 
all diseases, and yet no one has suggested a better designation up to 
the present time. While it receives its name from the blood-vessels, 
which are often conspicuously involved, it is in fact a disease of the 
whole body, characterized by irritation, and finally, destruction of 



138 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

cells in all parts of the body, the destroyed cells being replaced, ac- 
cording to the law of pathology, by connective tissue. 

For many years, there was discussion as to whether this disease 
began in the blood-vessels, in the heart or in the kidneys, and the 
Coincident involvement of the lungs, liver and digestive organs was 
noted. According to the point of view, it was called "heart disease," 
" Bright 's disease" and "autointoxication." 

In this instance, everyone was right, and everyone was wrong, for 
all the orgxms mentioned were indeed involved, and the disease might 
be named as well for one as the other. 

That it is not primarily disease of the arteries is sho\^^i by the 
now familiar fact that the disease may run its course with only slight 
changes in the blood-vessels ; or, the changes in the blood-vessels may 
be very marked and the disease itself have but little effect on the life 
of the sufferer. 

The arteries, being of universal distribution and bearing much 
of the functional stress of the disease, may be granted the honor of 
giving it a name, and, from henceforth, the disease will be known as 
"arteriosclerosis" until such time as its fundamental nature is thor- 
oughly understood and the underlying error of metabolism clearly 
designated. 

It would seem that the disease originates somewhat in this man- 
ner: A person pursuing the even tenor of his way, being fed and 
nourished on the usual mixed diet and resisting successfully the usual 
slight accidental infections, is some day overtaken by some event that 
alters the chemical functions of his cells. This event may be a great 
nervous strain ; it may be an infectious disease or surgical infection ; 
or, it may be some form of acute food poisoning. 

From that time on, the cells of this person's body are sensitive 
to particular proteins that reach these cells from the alimentary tract 
or from the bodies of bacteria originating in some focus of infection. 
So long as the supply of the offending protein continues, the irritation 
of the cells is kept up, leading to destruction and progressive sclerosis. 
Impairment of function follows and a greater and greater demand 
upon the circulatory organs, and eventually, the development of the 
picture of chronic Bright 's disease, heart disease, apoplexy or pre- 
senility. 

If, however, at any time it is possible to remove from the body 
the offending protein, the irritation ceases, compensation is developed, 
and the man is capable of being well. 

The prevention of arteriosclerosis on these premises must depend, 
primarily, upon the avoidance of sensitizing events, such as periods 
of great stress and worry, infections, acute food poisoning, and the 



GENERAL INDIVIDUAL HYGIENE 139 

neglect of foci of infection. Secondarily, upon the study of food re- 
lations of individuals from time to time, and the institution of a 
strict regimen when, on account of changes in blood-pressure, pain in 
the region of the heart on exertion, or because of nervous depression 
and loss of efficiency, arteriosclerosis is suspected. 

The great fact that must always be faced by the student of arterio- 
sclerosis is, that it is a disease without symptoms. In actual practice, 
sufferers from this condition seldom come under treatment until it 
has lasted for from three to fifteen years, and, even then, they usually 
come because a life insurance man who has examined them or a physi- 
cian who has treated them for some other disease, has discovered 
arteriosclerosis. 

Arteriosclerosis is seldom the result of a single cause, though most 
investigations reveal a sensitizing event. The effect of this sensitizing 
event might have been averted, had not the individual previously 
been a victim of too great ambition, of too long hours of labor, under 
too great strain, of the neglect of outdoor exercise, or the over-ingestion 
of food, with perhaps the immoderate use of alcohol and tobacco. 

Another element in the prevention of arteriosclerosis is the educa- 
tion of all persons in the habit of taking "cures," if this name may be 
used for periods of time set apart for the putting of the body in the 
best possible order. 

We should adopt the motto, "Attend to the health while healthy," 
and encourage the European custom of the combination of a vaca- 
tion and a visit to a cure resort. 

We must learn the secret of right living, and avoid apoplexy, heart 
failure, paralysis and sundry diseases of the liver and kidneys that 
follow in the train of errors of diet and work. 

Race betterment must always be a matter of the improvement of 
the individual. Arteriosclerosis is not your neighbor's enemy; it is 
your enemy. It is the greatest though most insidious danger to a group 
such as is gathered here to consider the welfare of the race in general. 
I trust that no one of you will neglect to study the solutions of this 
problem of health through right living that are offered by this mag- 
nificent institution, the Battle Creek Sanitarium, whose guests we are. 



HOOKWORM DISEASE 

Lillian South, M.D.. Kentucky State Bacteriologist, Bowling Green, Ky. 

Hookworm disease is international, being found in every countrv' 
in the world 36° north and 30° south, according to the recent survey 
of the Rockefeller Commission. I shall not discuss this phase of it. 



140 



FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 



but nieroly tell you how ^\■(■ Iuinc iiicl tliis coiKJilioii in Kculucky and 
its elt'ec't wyiou our ]H'opl('. irookwoi-in has been found in every 









HOOKWORM IN ITS VARIOUS STAGES OF DEVELOPMENT 



county in the state, the intensity of the infection varying in different 
localities. Of the 156,000 specimens examined during the last three 



6- # 



>#/*■ 







Kishty-fiv.. per rent of tlir .■liildn... 




A (lispriisii 



till' ddctdr :iii<l micrdscoiiist 




A schoolhouse. Cliildi 




ilv inrcctcd witli hookwi 




Dr. Mullen, of the P. H. S., treiitiiig trachoma in the Mountain Hospital. 



GENERAL INDIVIDUAL HYGIENE 141 

years, thirty-five per cent showed hookworm and fifty per cent showed 
other intestinal parasites. Hookworm disease is caused by a small 
worm about an inch long and about as thick as an ordinary pin. The 
male hookworm is smaller than the female and is distinguished from 
the latter by its fan-shaped tail. The female lays from one to three 
thousand eggs a day ; these pass out with the normal bowel movement. 
These eggs, under favorable conditions of temperature, moisture and 
shade, hatch out the young worms, called larvae, in the course of eigh- 
teen to twenty-four hours. 

Within a week the tiny worm has shed its skin twice, much as does 
a snake. It lives in a sheath, but takes no food after the first few 
days following its escape from the egg. Only in the encysted or larva 
stage is it capable of entering the body. The larva or microscopic 
worm enters the body by boring through the skin. In penetrating the 
skin the embryos produce the condition Imo-v^Ti as dew poison, ground 
itch or toe itch. After gaining entrance to the body the worm enters 
the bloodstream, passes the heart and finally the capillaries in the 
lung, these blood-vessels being too small for further navigation, the 
larv£e make their way up the windpipe, or are coughed up and 
swallowed into the stomach, and finally enter the small intestine. 
This method has been demonstrated by actual experiment upon 
human beings by Dr. Claude A. Smith, of Atlanta, Ga. 

After a short residence in the small intestine they grow to be an 
inch long and become blood suckers. 

SOCIAL CONDITIONS 

While it is true that it is chiefly among persons of poorer financial 
conditions living in unsanitary surroundings that the most marked 
cases are found, because the opportunity for infection is so much 
greater, cases are frequently found among those who are more fortu- 
nate financially and the better educated classes. The hookworm is no 
respecter of persons and will attach itself to anyone. The accompany- 
ing pictures will graphically illustrate the effect of the disease. 

TREATMENT 

The treatment of the ordinary case of hookworm disease is a com- 
paratively simple matter, usually very effective and can be taken 
without loss of time from business. The treatment should always be 
given under the direction of a physician. The thymol comes in direct 
contact with the worms and kills them, and is given in capsules, the 
size of the dose depending on the age. 

Hookworm disease is preventable. It is more easily prevented 
than are most diseases. Not only can it be prevented, but the very 



14l' first national conference on race betterment 

methods to be used in its prevention will also prevent all other diseases 
whose poisonous elements or germs are carried in the bowels and urine. 
AVhenever hookworm disease is diminished, typhoid fever and other 
diarrheal diseases are reduced in the same proportion. 

The contamination of the ground with disease-producing germs or 
parasites is called "soil pollution." "When we recall the fact that the 
worms do not multiply in the body, but that the eggs are discharged 
with the movements from the bowel and hatch out after being de- 
posited upon the ground, it must be apparent that if we can prevent 
soil pollution we will prevent hookworm disease. It is spread as a 
result of the careless disposal of bowel matter by infected persons, and 
is almost purely a question of privies, and if the people will consent 
to construct and use sanitary closets, hookworm disease will be stamped 
out. 

'The State Board of Health of Kentucky has devised a sanitary 
toilet, made of concrete, which is very inexpensive to build, is fly-proof, 
odorless, and does not have to be cleaned out. A copy of the bulletin 
of the Kentucky sanitary privy will be mailed to anyone upon request. 
The general use of these privies will not only eradicate hookw^orm 
disease but will solve the problem of rural sanitation and wall be a 
great step in preventing typhoid fever. 



DISEASE AND ITS PREVENTION 

Guilford H. Sumner, M.D., Seeretaiy Iowa State Board of Health, Des 
Moines, Iowa. 

I. Introduction. 

II. Preventive Medicine. 

III. Scientific Doctor of Today. 

IV. No Better Investment. 

Y. A Newer and Greater Enthusiasm, 

YI. People Not So Particular Formerly. 

YII. The Neglected Member. 

YIII. Certain Uprisings. 

IX. Hunting through Microscopes. 

X. The Consumptive. 

XI. Another Yirulent Communicable Disease. 

XII. Improper Things. 

XIII. Manfredi's Discoveries. 

XIY. Conclusion, (a) God's Motherhood, fb) The Charm of Life. 
(a) Transmission of Disease. (b) The Remedy — Education 




A iH.lhi-i-i 







' MPs fl^^H 

lil ' 



Same i)atieiit six nuipths later. Gained 23 ijoiinds. 
Xo pellagra symptoms. 




SwIliDL' of th.' frit and fare •■Ban:i 
;lb<lonicn.' 



GENERAL INDIVIDUAL, HYGIENE 143 



DISEASE AND ITS PREVENTION 



In these days of advanced enlightenment, people are seeking 
knowledge in all departments of life. I see a growing sentiment com- 
ing which will require that knowledge, relating to the prevention of 
diseases, shall be disseminated among the inhabitants of every well- 
regulated municipality. 

We are just beginning to live in an era of Preventive Medicine. 
Formerly the physician was trained in curative processes — instructed 
in methods of healing ills. By this procedure, communities are deal- 
ing with results of existing insanitary conditions. There are journals 
and journals which publish regularly many reports of clinical cases or 
discussions of the etiology (causes) of diphtheria, scarlet fever, ty- 
phoid fever and all transmissible diseases, but broader and more effec- 
tive methods are beginning to be employed. 

Curative processes, while very necessary, are not the most essential 
to the public in general. As we are to merge from the old lines of 
procedure into the new and more progressive methods, we must not 
only study the clinic, but the street, the alley, the back yard, the in- 
sanitary privy, the pollution of streams and all kindred subjects which 
are disease producers. These very important subjects are the doctor's 
domain, and numerous new topics must be discussed, which deal with 
the relationship of medicine to society, and bear on the economic basis 
of disease. 

Dr. Rudolph Virchow, one of Europe's foremost medical experts, 
and Dr. Oliver Wendell Homes. America's poet physician, were among 
the very first to advance the theories of transmission of disease. It 
was Doctor Holmes who first called attention to the contagiousness of 
puerperal fever. He was suspicious that his comments on this de- 
structive disease, though his subject was an unusual one, would not 
be well received by the staid representatives of the medical profes- 
sion. The article was published in an obscure medical journal of New 
England, but who can say that Doctor Holmes was not right? The 
idea advanced at the writing of Doctor Holmes' article is now taught 
and advocated by every progressive, modem physician in the world. 
Doctor Holmes is dead, but his precept lives. It was Doctor Virchow 
who was employed by the German Government to investigate an 
epidemic of typhus fever in Upper Silesia. This was when Doctor 
Virchow was a young practitioner of medicine, and it is related that 
the government, in employing Doctor Virchow, made a mistake in 
securing the services of so progressive a medical expert, for in his re- 
port of existing conditions, he did not deal in technical terminology, 
but delved into the very causes which produced and promulgated this 
disease. 



144 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Tills iil)k- ami young iiiedical man studied well all the conditions of 
the country where typhus fever was raging, and in his report, he 
spoke of the extreme poverty and ignorance of the inhabitants. He 
loUl liow the people were enslaved mentally, and how the Prussian 
bureaucracy loaded them with physical burdens. Strange as it may 
seem to us now, this wonderful young physician said: "The remedy 
lies not in medicine, Imt in education." He wrote that "the great era 
of social progress in progressive, preventive medicine is upon us, and 
it behooves us to meet conditions and educate the people." 

The German government awoke to the fact that it found itself 
reading treatises on sociological cpestions which related purely and 
solely to preventive medicine. Young Virchow w^as relieved from the 
government service, and with his dismissal, was a request that he take 
a vacation and leave the country. 

This most important era of preventive medicine which Doctor Vir- 
chow helped to install has come to stay. The cure-all doctor, the ex- 
clusively pill-and-potion doctor, the advertising quack, the so-called 
drugless healer of human ills, the so-called faith healer, the patent 
medicine man, the medical liberty league man or the teacher who 
claims that human ills are only imaginary is not the modern, scientific 
doctor of today. 

The sphere of the medical man has been enlarged, and he has dis- 
covered that tuberculosis, typhoid fever, diphtheria, scarlet fever, 
smallpox and many of the diseases are economic maladies, and that 
trade and occupational diseases will not disappear until social condi- 
tions are made better. It will soon become a self-evident truth that no 
man can become a good physician unless he is thoroughly versed in 
preventive medicine, and is willing to lend his personal influence for 
the betterment of all social conditions. A good physician will be a 
true medical sociologist. 

I do not intend to decry the medical profession — far from it — but 
to bring before an enlightened public the plain truth that medical 
men are giving to the world the results of their scientific investiga- 
tions, all of which is intended to keep the people w^ell and thereby 
prevent sickness and untimely deaths. The real physicians of today 
are now trying to make health conditions better all over the world, 
and for this reason Boards of Health are being formed, both State and 
Local Boards of Health, in order to disseminate a knowledge of 
preventive measures which will give to us, as a result, a strong, 
long-lived, healthy people. It is not economy to keep knowledge from 
the people. Ignorance goes hand in hand with poverty, and poverty 
w^alks with disease, and disease destroys. 

The government or the municipality can make no better invest- 



GENERAL INDIVIDU.AL HYGIENE 145 

ment than to make provision to keep the people well. This can be ac- 
complished only through Boards of Health, hence the National and 
State governments, as well as municipalities, should formulate uni- 
form plans whereby the people may be regularly informed in regard 
to the prevention of disease. There are those who oppose the forma- 
tion of public health boards, for no other reason than that the restric- 
tive measures, adopted by such Boards, prohibit the imposition of 
quacks and humbugs upon the innocent and defenseless. It is a note- 
worthy fact that whenever a state practices economy in public health 
measures, efficiency is not attained, but if we place efficiency first, 
economy is the essential result. 

The control of communicable diseases should be the prime motive 
of all municipalities through their health boards, and this can be 
accomplished by stopping their spread at the source, which is the 
person having the disease or existing unhealthful conditions. We must 
depend upon the medical profession to formulate all plans for pre- 
ventive medicine work, but as yet the medical man has not been of- 
fered a sufficient remuneration — too small a financial incentive — to 
abandon his private practice for public service. The people should 
understand that health boards are trying to arouse the people to the 
general problems of clean living. I wish to impress upon you that 
real clean living should begin with the basic principle embodied in the 
very first verse of the Bible: "In the 'beginning God." Real right 
living is based upon a clean life. It has been said that learning and 
education are synonymous terms. This is not true. Learning is 
knowledge stored up in the mind, but education is a bundle of habits, 
and in so far as our habits are good and pure, our lives will be made 
cleaner and better. All citizens of any community should unite in a 
campaign for clean lives and good health, and when this is done, a 
long step has been taken towards the breaking up of political partisan- 
ship, which should never exist in public health work. 

No community should stop short of a most rigid understanding 
that all diseases which are preventable should not be allowed to exist, 
and special emphasis should be placed on preventive rather than cura- 
tive processes. Control transmissible diseases by stopping their 
spread at the source, and in trying to abolish insanitary conditions, 
remember that the strength of inspection lies in frequent reinspection. 

Local interest in health work should be stirred up by practical, con- 
vincing literature and lectures that will appeal to the average citizen. 
Let the business man be shown that efficient health work pays large 
dividends, and all workers for civic improvement should see that a 
clean city offers a poor breeding place for municipal corruption. 

Let us hope that better things are in store, in public health matters. 



146 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

for the people of all cities in every state in this country, and trust 
that future legislative bodies will make ample provision for executing 
health laws and that each city will fall in line and work for more and 
bettor health regulations in the future than in the past. 

I was veiy much impressed by reading an illustration recorded in 
the congressional record, wherein a congressman said in his speech 
before the House of Representatives of the United States Congress, 
that we as a nation and a people need a newer and a greater enthusi- 
asm in the managing of the business affairs of this great country. He 
said: "We need an enthusiasm like that which the old colored^ deacon 
prayed might be given to Sam Jones from Heaven." The incident 
was related, wherein it was said that Sam Jones was invited to preach 
to a colored congregation down in the state of Georgia, and if any of 
you here in this audience have ever been present in a colored congre- 
gation where religious services w-ere being held and listened to the 
vociferous hallelujahs and typical amens of an Ethiopian congrega- 
tion, you w^ill appreciate the old black man's prayer. It is related 
that, prior to the preaching service, this old colored deacon w^as called 
upon to open the services with prayer, and with the congregation on 
bended knees, this old black man, in the fervor of his soul and with his 
face turned upward to the skies, prayed for Sam Jones on this 
wise: "0, Lawd! Gib Brudder Jones de eye ob de eagle dat he may 
see sin from afur. Gloo hiz ear to de gospel teV phone and connect him 
wid de central skies. Nail hiz hands to de gospel plow. 'Lwmioiate 
hiz brow wid a brightness dat will make de fires ob hell look like a 
tallar candle. Bow hiz head in some lonesome valley ivhere prayer 
is much wanted to be made. 'Noint his body all ober wid de ker-sene 
oil ob dy salvation and sot him on fire. Amen!" 

I am impressed when I recall the fervor manifested in the earnest- 
ness of this old black man's prayer and msh that this land of en- 
thusiasm in public health work might be manifested in the minds of 
the people of every state and municipality. One needs but to examine 
the conditions of any city or community in any locality to be convinced 
that gross insanitary problems are waiting for solution and correction. 

You have often heard the common expression: "People were not 
so particular in former times in regard to matters relating to public 
health." This is undoubtedly true, but we have progressed. People 
were not taught methods of disease prevention in former times as they 
are today. It is definitely known by all physicians that in former 
times curative measures were employed alone, and all the world was 
educated to employ measures to correct results, when the proper and 
most economical plan would have been to have prevented the results. 



GENERAL INDIVIDU^yi, HYGIENE 14 ( 

Disease, sickness and death are results of causes, and the purposes of 
health measures are to prevent rather than cure. 

Two poems, significant of conditions in the past and in the present, 
have come into my possession, and I am pleased to repeat them for you 
because they contain so much truth that is applicable at this time. 

Dr. W. C. Rucker, Assistant Surgeon-General of the United States 
Public Health Service, writes: 

'^The happy days of childhood 

I often call to mind, 
I love to live them o'er again 

By memory's light refined — 
The orchard and the meadow, 

And the loft of fragrant hay. 
The garden and the pl■i^w, 

And the well not far away. 

"The farmyard with its litter 

Of mannre romid about, 
The milking shed where flies galore 

Flew buzzing in and out. 
The pig-sty and the chicken house, 

The hens that scratched all day 
In the ground beneath the privy, 

With the well not far away. 

"We took our joys and sorrows 
As they chanced to come along. 

My brother had the ground-itch 
And he didn't grow up strong. 

And Maiy died of fever- 
It was mighty sad that day— 

But we didn't blame the privy 
Nor the well not far away. 

"In the suimner time, mosquitoes 

Used to sing the whole long night. 
But we would keep the windows closed 

And thus avoid the bite. 
But Billy got the ague 

And Lizzie pined away— 
Mosquitoes— foul air— privy. 

And the well not far away. 

"We used to think that death was just 

A punishment for sin^ 
The sin of ignorance I say! — 

So let us now begin 
To try and get the windows screened 

But open night and day, 
And a sanitary privy 

With the well quite far away. 



1-1:8 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

"Let's clean the cows at niilkiii.e;- time, 

Let's clean the barnyard too, 
. Let's rid ourselves of fevers 

And the chills and ague crew, 
Let in the air and sunshine 
But drive the fly away, 
With the ancient typhoid privy. 
With the well not far away." 

Henry Malins of Indiana, in speaking of prevention, makes a com- 
parison between the fence and the ambulance, and says : 

[This poem appears elsewhere in this volume, Ijiit is so excellent it will hear re- 
peating. — Editor.] 

" 'Twas a dangerou.s cliff, as they freely confessed, 
Though to walk near its crest was so pleasant; 
But over its terrible edge there had slipjoed 

A duke, and full many a peasant; 
So the people said something would have to be done. 

But their projects did not at all tally. 
Some said. Tut a fence 'round the edge of the cliff' ; 
Some, 'An ambulance down in the valley.' 

"But the cry for the ambulance canned the day. 

For it spread through the neighboring city, 
A fence may be useful or not, it is true. 

But each heart became brimful of pity 
For those who slipped over that dangerous cliff; 

And the dwellers in highway and alley 
Gave pounds or gave pence, not to put up a fence. 

But an ambulance down in the valley. 

"Then an old sage remarked, 'It's a marvel to me 

That people give far more attention 
To repairing the results than to stopping the cause, 

When they'd much better aim at prevention. 
Let us stop at its source all this mischief,' cried he. 

'Come, neighbors and friends, let us rally : 
If the cliff w& will fence we might almost dispense 

With the ambulance down in the valley.' 

"Better guide well the young than reclaim them when old. 

For the voice of true wisdom is calling: 
'To rescue the fallen is good, but 'tis best 

To prevent other people from falling.' 
Better close up the source of temptation and crime 

Than to deliver from dungeon or galley; 
Better put a strong fence 'round the top of the cliff. 

Than an ambulance down in the valley !" 

The sentiment expressed in these poems is characteristic of an 
age of great progress, and the time has been when Hygeia, the poor, 
neglected member of our medical family, sneaked away into oblivious 



GENERAL INDIVIDUAL HYGIENE 149 

places ; but now more brave, she has come forward to claim her right- 
ful place in the medical home. Her sisters welcome her, and her 
suitors seek her hand. Ever since I first entered an office as a medical 
student, I have been a lover of this fair mistress, whose banner I have 
unfurled and carried, holding that the advancement of hygiene has 
enlarged and beautified the medical profession, without lessening the 
value of any other branch. Though she is here to stay, her errand is 
not completed by giving her proper recognition in medicine. She now 
turns to the people, the government and the municipalities — the 
Owen bill and the Mann bill, both of which have been considered by 
the Congress of the United States, for the express ptirpose of creating 
a National Health Department — the forces apart from the medical 
profession, and demands her place in the councils that rightfully be- 
long to her. A temporary expedient has been reluctantty permitted 
a place in the councils of the hygienic interests of the land ; but the 
relentless demands of our present civilization cannot be fulfilled until 
the protector of our public health interests shall have a permanent 
place in the councils of our government at Washington, the same as 
are the other departments. "We may construct a mighty navy for de- 
struction and defense and call out vast armies ; but disease wipes 
out with a tiny weapon so minute that the eye cannot discern it and 
no military force can arrest. We may fill our storehouse with gold 
and store up wealth in other forms, thereby enabling us to purchase 
the labors of human beings for profit, distinction, lands, everything 
but God's great and free gift, health, the thing that makes man con- 
form to Deity. All the great activities of life, together with all the in- 
dustrial pursuits of mankind, which are now paramount in the minds 
of the cabinet officials, who are masters and possessors in their line, 
having a knowledge of political economy and civics, cannot flourish 
without strong, vigorous bodies, the proper vessels for healthy brains — 
vigor of human blood, brains and brawn are the mechanism of all 
successful achievements; yet not until the present time has it been 
thought that the skilled supervision of a thorough medical man was 
necessary to maintain and protect the health of the community, with- 
out which the functionaries themselves could not perform their duties 
perfectly. 

How clearly it comes to me now and how well do I remember, after 
completing a four years ' medical course, when I was about to begin my 
profession with a minimum of experience and maximum of enthusi- 
asm and an exalted opinion of the dignity and responsibility of my 
charge which the years that followed have only intensified, I was 
astonished at my own ignorance of the real causes of disease, and my 
lack of Imowledge of sanitation ! I had been taught how to cure dis- 



15() FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

ease — great stress being placed upon the giving of proper medicines. 
All of this is quite essential to the work of a successful physician ; but 
would you not prefer to pay your physician to keep you from becoming 
sick '? The results, therefore, to be attained by the health board of the 
municipality and its health officer are that all communicable diseases 
may not only be prevented but eliminated. "We have certain upris- 
ings of a spasmodic nature whenever a pestilential disease comes, and 
we grope our way under the flashlight of death in our midst ; then it 
is that we begin to look around for the cause of all our trouble. There 
is no better time to prepare for war than in time of peace, and this 
holds true in public health work — preventive methods should begin 
before the disease appears, and here is the opportunity for sanitary 
work. 

I remember reading of conditions which exist at times in cities 
and towns, related in an old leading medical journal, and I recall them 
here : 

' ' Whether cholera has or has not made its appearance at , 

which is practically one of the suburbs of , it is certain 

that the conditions reported to exist there are in the highest degree 
favorable for the introduction and spread of that disease. All ac- 
counts represent the neighborhood in which the alleged cases occurred 
as filthy beyond description and occupied by a class of persons who 
pay no attention whatever to the laws of health or personal cleanli- 
ness. Of course, the country now has the pleasant assurance that the 
place is to be thoroughly cleaned and effectively quarantined; but 
why were not the steps necessary for the protection of the public 
health taken before the resulting disease, whether cholera or not, had 
gained such a footing that already five persons have died from it? 
The time to lock the stable door is before the horses housed therein 
are stolen, and the way to treat contagious diseases is to prevent their 
appearance and not to wait for them to gain a foothold and then try 
to stamp them out. ' ' 

As health officer of the city of Waterloo, Iowa, my home state, a 
number of years ago, when smallpox first made its appearance in 
Iowa, I had a rich experience which taught me that we should never 
temporize in public health matters. A stranger came to the city with 
smallpox and it was a puzzle to the local Board of Health as well as 
myself to know what to do with him. The city at that time had no 
place to build a detention hospital — ^and here let me say that ample 
pro\dsion should be made by all communities for all such emergencies 
— and to force anyone to take care of this case of smallpox was out 
of the question. After a great deal of trouble and anxiety, a place 
was obtained and a small detention hospital was erected. We learned 



GENERAL INDIVIDUAL HYGIENE 151 

a lesson, and the result was that the city at once erected a suitable de- 
tention hospital, isolated from the city, where all such cases could be 
properly cared for; but what we most need is perfectly clean cities, 
towns and villages — so free from all forms of filth that no contagious 
disease dare enter. We were forced to temporize in the above case, 
but temporizing under the spur of emergencies does not bring perma- 
nent benefit. 

As the enlightened physician seeks to prevent his people from be- 
coming ill, so should the guardians of the public health be able to fore- 
stall these emergencies, whose pecuniary expense in money expended 
and wasted, in trade paralyzed and diverted, in labor and its wages 
lost by the sick, terrified and dead, in a single epidemic, exceeds that 
of maintaining an efficient sanitary service for the whole country for 
a whole year. May I pause here and ask, "What are you doing to help 
the medical men who are trying to bring about better methods of 
sanitation and to adopt better, purer, and nobler plans of living in 
order that sickness and untimely deaths may be averted? The fault 
of the medical profession has always been its lack of bold assertions 
of its rights; but it can no longer hesitate to declare to the trade, 
commerce, agriculture, and manufacture that the health and vigor 
which are essential to the prosperity of our people cannot be secured 
by their ovm unskilled, uninformed efforts. They must learn, as the 
military departments have learned, that the powerful armies and 
navies are the results of able and untrammeled medical departments. 
It is as unwise to confide the care of the health of a community to a 
financier, however shrewd, as to expect a fishery commissioner to best 
administer the affairs of the public school. The general health of our 
country is a national consideration involving international coopera- 
tion. No priority or clash of sectional interests should exist. Lines 
are not drawn by epidemic intruders. No state barriers can be so 
defensive and impenetrable that the toxiferous germ cannot pass 
through. 

I have spoken of uprisings of a spasmodic nature, which are only 
tentative provisions in emergencies and bring no permanent good. The 
scientific tendency of today is the hunting through microscopes instead 
of using our human eyes upon visible abominations. The sanitarian, 
official or amateur, needs only to look about him to be appalled at the 
spectacle of indifference of rich and poor, high and low, to dangers far 
greater than from any cholera microbes which confront them every 
hour and it may be worth our while to consider some of these things, 
which we complacently refuse to see, while w^e are looking through our 
microscopes. The preventable disease which kills more of the human 
race than cholera and yellow fever combined — and in its ordinarily 



]52 FIRST NATIONAL; CONFERENCE ON RACE BETTERMENT 

slow process of killing lessens the productive power of a coimniuiity, 
directly by the enfeeblement of its victims, and indirectly by its de- 
mands upon members of households and charitable institutions for 
the care of these chronic invalids — tuberculosis, is tolerated with as 
little concern as that which the Creole exhibits for yellow fever and 
malaria. 

The consumptive, whose traits no professional acumen is required 
to recognize, frequents our thoroughfares, sits beside us in unventi- 
lated street cars and at hotel tables, occupies Pullman sleeping berths, 
shares the steamship stateroom, wholly unrestrained and innocently 
ignorant that he or she may be sowing the seeds of disease among deli- 
cate women and children. Anyone may verify these statements who 
uses his eyes for the purpose along the railway and coastwise steamer 
routes to our invalid resorts. It is related by a traveler, a physician, 
of repute, that while he was journeying he had observed and he said : 

"While traveling by rail I was fellow-passenger with two invalids 
in the advanced stage of consumption, enroute South, one of whom 
occupied the opposite berth and the other one diagonally across the 
car, so that I could see and hear them coughing and expectorating 
with only such attention as well-intending, but unskilled relatives 
could render. They had no vessels for receiving their sputa, which 
w^ere discharged in their pocket handkerchiefs to be scattered over 
pillows, coverlets and blankets. They left the car in the morning and 
I saw those same berths — it is true, with change of linen, sheets and 
pillow cases, but with no change of blankets, mattresses or pillows — 
occupied that very night by other travelers, who were thus subject 
to contact with a pathogenic microbe far more tenacious of life and 
power of evil doing than the dreaded cholera spirillum." 

One has only to sit in a crowded street car on a winter day and 
watch the clouds of respiratory steam circling from the mouths 
and nostrils of the unclean and diseased into the mouths and nostrils 
of the clean and healthy, as the expiratory effort of the one corre- 
sponds with the inspiratory act of the other. The road is short but 
straight and sure from vomica and mucous patch to the receptive 
nidus in another's body. Who that has had forced upon him an 
aerial feast of cabbage, onions, garlic, tobacco, alcohol and gastric 
effluvia of an old debauchee can doubt that aqueous vapor can trans- 
port microscopic germs by the same route. I am here reminded of 
the vastness of my subject and these graphic descriptions will furnish 
you wdth ideas of what you may see if you will only use your powers 
of observation, but all this will avail nothing unless it leads you to 
advocate and adopt measures of prevention. You are being brought 
into contact with the monster w^hich is eating away the human race, 



GENERAL INDIVIDUAL HYGIENE 153 

and you, as a people, must know how to care for yourselves and give 
that timely advice to others which a waiting public ought to know. 
You are reminded that we are being constantly exposed to diseased 
conditions, and were we to care for our bodies as cities care for their 
streets, alleys and the construction of buildings, imagine our appear- 
ance. 

I feel so profoundly impressed in regard to the spread of tuber- 
culosis that I cannot refrain from further bringing before your minds 
an imaginary picture for the purpose of further illustrating condi- 
tions which are not of infrequent occurrence. 

Suppose one is on a coast steamer, journeying to some southern 
resort. The air is chilly and a dozen or more consumptives are hud- 
dled together, trying to keep warm, and all doors and windows are 
closed until the atmosphere has become so stifling and surcharged 
with their emanations and the dried sputa, which they eject on every 
side, that good breathing air is as scarce as diamonds in the fertile soil 
of any productive state. One can easily escape during the day by 
staying on deck and by sleeping in his stateroom with windows wide 
open, but the curtains, carpets, pillows and mattresses are still all 
saturated by you know not how many expectorating predecessors. 
Smallpox, yellow fever and cholera are not to be compared to the dread 
disease tuberculosis, which is fast becoming the absorbing topic of our 
leading medical lights. The Iowa death report for the month of 
December, 1912, states that there were for that month 167 deaths 
from pneumonia, and 117 deaths from tuberculosis. It is believed thnt 
there are more deaths from these two causes than any other. Tuber- 
culosis is on the increase. Our cattle are becoming infected and the 
question of conveying this disease through milk is being most seriously 
considered. Milk inspection should be in force in every place where 
milk is dispensed. Many physicians can recall their several experi- 
ences where members of a family have occupied the same chamber and 
bed with a gentle and beloved one, also those of tuberculous husbands 
and wives, who have become ill like them with consumption attributed 
to everything but the manifest cause. 

Shall I now introduce to your notice another virulent communi- 
cable disease, in the interest of helpless and innocent women and chil- 
dren ? Shall I labor to convince you as husbands and those who expect 
to be such, that there are numerous indisputable instances of innocent 
infection of syphilis? This disease may be and has been contracted 
from combs and brushes and rough-edged drinking vessels in hotels, 
sleeping cars and boarding houses, from pens, pencils and paint 
brushes that had been held between diseased lips, from dirty old bank 
notes, from street venders' toys, from a lover's kiss, a stranger's caress, 



154 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

or a nurse's ministrations. A case of a young lady in a not distant city 
demonstrates the fact that syphilis can be conveyed by a lover's kiss. 
The young man when told of the cause was confronted with the 
aphorism: ''The way of the transgressor is hard." Supported by 
an array of cases of infected children, young girls and elderly men 
and women, the committee of the American Public Health Association 
advocated the enactment of a law placing venereal diseases in the 
category of other communicable affections and punishing its trans- 
mission as a misdemeanor; but in this instance, as in many others, 
it was thought by the self-righteous ones that it was best to seek 
to exterminate this disease by ignoring its existence and never 
uttering its name — the disease that has done more harm to mankind 
than all the diphtheria, typhoid, smallpox, measles and scarlet fever 
combined, which are so carefully isolated, and their statistics so regu- 
larly collected and promulgated; a disease which travels with the 
missionary to Asia, Africa and the Pacific and decimates bodies faster 
than he can whiten souls. I think your eyes are becoming opened to 
the fact that preventive measures should be speedilj^ adopted in order 
that we may become a better people, mentally, morally and physically. 
It is not expected that all who have eyes will see these things, or 
those having ears will listen to w^hat is said. The idle, perverse 
generation of the first century will have its following in this present 
time and men and women will continue to do improper things that they 
ought not to do, and leave undone the proper precautions they ought 
to take, despite our w^arning, our imploring, our advice, or denuncia- 
tion. However benevolent and beneficent the good physician's aim, 
his unappreciated, unrequited and often unprofitable labor is enough 
to deter him from w^hat has been derisively described as only an 
effort to procure the survival of the unfit, and thus thwart Na- 
ture's own attempt to rid the world of them. He encounters 
another obstacle to success as aggravating as the disbelief in 
the necessity for his work. The authorities listen to his warnings and 
then employ their perfunctory and superficial methods of protection. 
The medical profession has stated that absolute cleanliness is the 
fundamental fact of sanitation, and in order to keep clean streets, 
cleaners are set to work brushing the surface dirt into little heaps, 
as seen in many cities on almost any day after a heavy rain or in the 
spring, which passing vehicles again distribute or the winds carry into 
open windows of adjacent residences. The refuse of the household is 
deposited in old barrels, boxes, or vessels of some kind on the sidewalks 
of crowded thoroughfares to be emptied after a time into collecting 
carts or wagons, from which clouds of dust envelop passers and cir- 
culate back into the house, living dust, for Manfredi found millions 



GENERAL INDIVIDUAL HYGIENE 155 

of microbes to the gram of the street dust of Naples, from which he 
cultivated pus, malignant edema, tetanus, tubercle and septicemia. 
Visit any alley and there find the offal of the kitchen, there observe 
the swarm of flies feed upon the decomposing contents of exposed 
garbage cans and buckets, and carry their tiny germ-laden booty into 
the butcher-shop of the poor and the kitchen of the millionaire. "Who 
can dispute the fact, for it has been demonstrated by bacteriologists 
that dogs can transport diseases in their hair, and newspapers and 
letters have carried smallpox from places where the disease was rag- 
ing to distant lands, that a cloud of dust, a swarm of flies or a single 
fly can disseminate cholera and become a focus of infection, which 
would have been impossible had ordinary care been exercised in pre- 
venting the exposure and properly destroying the discharges and ex- 
creta of those already sick ? 

In conclusion permit me to say that every city should undergo a 
cleaning often, and here let me say that I am a firm believer in cre- 
mation for all refuse matter in any city. Dumping grounds are only 
pest-houses for the hatching of germs. Here flies congregate and are 
the disseminators of disease. No city can be accounted clean until its 
ordinances require every cellar door to be widely opened to the sun 
and air, that royal pair of germicides ; every cellar to be emptied of 
its refuse, every cellar wall and ceiling to be scraped and whitewashed, 
every cellar floor to be taken up if rotten, and sprinkled with lime if 
uncovered — a tedious and expensive process, but effective prevention, 
costly as it must be, is cheap beside the outlay of a single epidemic. I 
have noticed fruit stands uncovered on street corners, bakers' wagons 
with their contents unprotected from the dust and filth of the streets, 
and waiting stations whose filth was so gross that it beggars descrip- 
tion. 

At this point I desire to digress for the purpose of speaking briefly 
upon a subject that is very closely allied to "Disease and Its Preven- 
tion." There is a name closely connected with the life and work of 
every individual, and that name is "Mother." Because of this inti- 
mate relation I desire to speak briefly upon the subject : 

god's motherhood 

When we think of the mystery of life, and how the young are 
blinded by ignorance, is it surprising that the innocent stumble into 
the pitfalls of sin and dishonor? "We should be impressed with the 
sacredness which comes with the life of the young girl. Her eyes 
should be opened and she should be taught that God has destined her 
to honored motherhood, and that any condition of life short of this is 
out of harmony with the Di\ane plan. Motherliood, the sweetest of 



156 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

God's gifts to humanity! The Creator nuulc no mistake when lie gave 
this power to woman, and every sacred and Divine instinct should be 
brought into congregated activity to preserve this God-given grace, 
which is the right of every woman to keep inviolate. The young girl 
should have the light, and as the morning sun begins to light the new 
day, so should knowledge be imparted to the young girl as she merges 
from her childhood into a sacred and newer relation — that of mother- 
hood. 

The time is now rife with splendid opportunities to begin a cam- 
paign of education that will extend into the heart life of the on-coming 
generation of young womanhood, in order that every young girl may 
be early taught to have an exalted idea of the sacredness of her calling 
and to preserve the sanctity of her own body. To this end a loiowledge 
of the dangers which may surround her, through which she may fail of 
a life in keeping with that high sense of appreciation of her individual 
or personal purity, should be instilled into her forming mind. The 
motherhood instirvct, beautiful and sublime in its extremest sense, is 
but a perfect type of Deity and a co-partner with God for no other 
purpose than to carry into the world in the generation of new beings, 
the joys and pleasures of Eden. Perversity partakes of degradation 
and a departure from the plan which God ordained in the beginning. 
]May the lost joys of Eden be restored, and may we retrace our steps to 
the Creator's original plan, and in the language of Milton: 

"The chariot of paternal deity, 
Flashing thick flames, wheel within wheel; undrawn, 
Itself instinct with spirit." 

The w^omanhood of the w-orld must be protected, and all godly men 
must come to the rescue. Christianity is the one plan ordained of 
God that will save, hence the inner life, the life we live, must be under 
the control of the teachings of the lowdy Nazarene. The girls must 
be taught the sacredness of their bodies, and men should learn that the 
honor of women is a God-given grace and not to be violated. Let us 
get back to the sacred side of life and to the teachings of former days, 
living the life that will be void of offense. Teach the girls the things 
that will save them from stumbling into the pitfalls of wicked men. 
If the manhood of this country will not respond to the call of this 
great reformation, then let the women take the reins of government 
into their own hands and rid the world of the destructive agencies that 
are destroying the motherhood, womanhood and morals of the home. 
I mean by this that, should men not see the necessity of taking this 
advanced step, then it is time for women to take matters into their own 
hands and protect that which men refuse to do. Again, educate the 
girls. 



GENERAL INDIVIDUiUlj HYGIENE 157 

I now close with a quotation from John W. Alvord : ' ' The charm 
of life, that which gives it its zest and meaning, is to do useful work 
for our time, our place and our generation; to realize that we are 
needed in the progress of things, and even at times appreciated ; to 
give more than we receive ; to place usefulness ahead of emolument ; 
to push the world a little inch up-hill, to plant a flower in everybody's 
garden but our own. ' ' 



FUNCTION OF THE DENTIST IN RACE BETTERMENT 

C. N. Johnson, D.D.S., Editor, The Dental Review, Chicago, 111. 

A consideration of this subject calls for a study of the significance 
of the teeth and mouth as factors in individual and community health. 
We are rapidly learning the lesson that to better the race we must 
better the' individual, and if w^e are to better the individual, we must 
add to his physical, mental and moral efficiency. It has long been 
recognized, in a general way, that the condition of the teeth has much 
to do with the health of the individual, but not till recently has the 
direct relationship between oral hygiene and bodily health been defi- 
nitely and undeniably traced. We all acknowledge that a poorly 
nourished body must result in inefficiency, but we have not always 
studied with sufficient care all of the causes or all of the results of 
faulty nourishment. This question concerns us most in growing chil- 
dren — ^not in the growing children of the well-to-do perhaps, so much 
as those of the great mass of humanity who today are everywhere — 
particularly in our large cities — being gradually assimilated into our 
future citizenship. 

Let one of these growing children be afflicted with decayed and 
neglected teeth, what is the result? To say nothing of the suffering 
which frequently follows with its long train of perverted function and 
incapacity, we have the immediate result of inefficient mastication. 
Without mastication we cannot have good digestion, without digestion 
we cannot have assimilation and without assimilation we cannot have 
nourishment. Many a child is starving for lack of the necessary ap- 
paratus with which to properly prepare the food which is placed before 
him. And the damage is not merely negative — it may become very 
positive. The child who is illy nourished intuitively develops a crav- 
ing for stimulants. Observation has demonstrated the fact that these 
poor children who are suffering from defective teeth and cannot masti- 
cate will consume enormous quantities of coffee or tea if they can get 
it. And it is not fanciful to go one step further. It may seem a far 



158 FIRST NATIONAL CONFERENCK ON RACE BETTERMENT 

cry from doi'eetive teeth to drimkeiitiess, and yet it is a possible and a 
perfectly logical sequence. We are not giving these children a fair 
chance in the M'orld for place, preferment or race betterment if we 
permit them to grow up with faulty mouth conditions. 

Not only this but there is a quite unsuspected and a very real 
danger to the individual and to the community as the result of defec- 
tive teeth and broken down roots left in the jaws. The inevitable 
abscesses from these roots discharge large quantities of pus to be 
taken up in the circulation or carried into the stomach or lungs, creat- 
ing a constant poison which should no longer be ignored. A general 
infection of the system sometimes results from an abscess on a single 
tooth, and it is not unusual to have a life lost from this cause. These 
decayed cavities in teeth also form an ideal culture place for patho- 
genic micro-organisms, which are a constant menace to the individual 
as well as to others with whom the individual comes in contact. Cook, 
of Chicago, demonstrated the tuberculosis bacillus in the roots of 
pulpless teeth and traced it down through the jaws to the glands of 
the neck. There is no question that there have been direct tuberculosis 
infections from this source. One writer has gone so far as to say that 
95 per cent of tuberculosis is due directly or indirectly to faulty mouth 
conditions, that aside from the cases of direct infection from the roots 
of teeth there are the numberless other cases where the system is 
rendered susceptible to tuberculosis through inefficient mastication 
and its consequent train of evils. We all know that the significant 
thing in tuberculosis is the factor of susceptibility — that practically 
every individual is exposed to the tubercle bacillus at one time or 
another on account of its almost universal existence, and that the rea- 
son some people escape its ravages is because of their resistance to its 
encroachment. Let an individual be illy nourished or ''run down," as 
the phrase is, let the system be impoverished through faulty assimila- 
tion so as to develop a lack of tonicity, and the inevitable result is an 
increased susceptibility to an attack of tuberculosis. The tubercle 
bacillus seeks a field where the tissues are lowered in tone, and its in- 
vasion is usually the result of a lessened resistance through bad air and 
lack of proper nourishment. Reasoning from this it is not difficult 
to connect this disease in its incipiency with defective and diseased 
teeth. 

In the public schools of Chicago there was at one time an epidemic 
of scarlet fever. The health department quarantined every child 
afflicted with the disease the regulation time, and yet scarlet fever kept 
spreading. It was noticed that immediately following the return of 
the quarantined children to school new cases developed among their 
associates and it was clear that in some manner these children were 



GENERAL INDIVIDUAL HYGIENE 159 

spreading the disease even after they themselves had long since passed 
the infective stage. It occurred to the then Commissioner of Health, 
Dr..W. A. Evans, that there could be only two ways in which this 
might happen — the child might carry the germs of scarlet fever in- 
definitely in the tonsils or in the cavities of decayed teeth. His first 
order was that no child who had suffered from scarlet fever should 
be permitted to return to school till all decayed teeth were filled 
and the mouth made hygienic. Immediately scarlet fever was stamped 
out of the Chicago schools. Precisely the same thing happened in 
the public schools of Valparaiso, Ind. Doctor Nesbit, the health 
commissioner, succeeded through a similar regulation in arresting an 
epidemic of scarlet fever which had persisted for so long a period that 
it had practically paralyzed the school system of that city. 

These instances are only the merest hint of what might be written 
on the relationship of defective teeth to the community health, but 
they must suffice for the present occasion, with the passing statement 
that nowhere in all the realm of medicine is there a more important 
question than this of oral hygiene or oral sepsis. 

If, then, defective teeth are such a prime factor in physical in- 
efficiency it may be well for us to consider briefly the prevalence of this 
affection. Few people have any conception of the relative number of 
children who are growing up with bad mouth conditions which prove a 
handicap to themselves and a menace to the community. In an exami- 
nation of the teeth of school children in various communities it has 
been found that at least 90 per cent of them have decayed teeth. In 
the public schools of Chicago, where nearly 70,000 children have been 
examined, the percentage runs much higher than this. During the 
month of November, 1913, there were examined 2,231 children, of 
whom 2,224 were found with defective teeth. When only seven chil- 
dren out of 2,231 in a given community are found with perfect teeth 
it is surely time that our civic authorities and our boards of health 
• give some heed to this important matter. 

In conducting ten free dental infirmaries in the public school build- 
ings of Chicago where the teeth of poor children are cared for we 
are brought face to face with the appalling enormity of the need 
of this service. The waiting lists of children seeking relief, and the 
verdict of the school principals where the infirmaries are in operation 
are sufficiently striking to impress even the casual observer with the 
significance of the work. One principal writes: "We are very en- 
thusiastic over the benefits derived from the work done by the dental 
dispensary in this school. So far this year, emergency cases and very 
badly neglected eases have kept the dentist busy every minute of the 



IGO FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

school clay. Xccdlcss lo say llic improved physical condition of these 
children has helped Ihciu accoiiiijlish more in the school room." 

Another one says: "I think there is no (piestion about the need 
of tliis dental work in the schools and the good that the service is 
doing. "We find that ])i'aetically all of the children need attention, 
and that very few of them have received any. Formerly I had to send 
many children home with toothache. Now I send none." 

This gives me the opportunity of remarking parenthetically that 
if our school boards would spend one-half the amount in a campaign 
for the amelioration and prevention of disease that they now spend 
annually for teaching the "repeaters" who are made such by reason of 
disease, it would not only be more humanitarian but it would be an 
immense saving financially. 

Another consideration in this connection having a direct bearing 
on race betterment relates to the handicap to the boy or girl who is 
allowed to grow up with deformities of the mouth and face due to 
irregular teeth. In this age of keen competition for place and prefer- 
ment the appearance of the individual so far as physiognomy is con- 
cerned has much to do with his prospects for advancement. One strik- 
ing case came under the writer's observation, and it seems worth re- 
lating as illustrative of the point under consideration. In one of the 
eastern schools for girls there is a most estimable woman endowed by 
Nature with the mentality and executive ability to be principal of the 
school, and to wield a large influence in the educational world. Only 
one thing has prevented her advancement and kept her in a subordi- 
nate position. "When she was a growing girl some one who had charge 
of her — let us hope it was not her parents— permitted her to come to 
womanhood mth such an irregularity of her teeth that it was im- 
possible for her to cover her upper anterior teeth with her lip on 
account of the undue protrusion of the upper incisors. This caused 
such a deformity of her jaws and face that it detracted immeasurably 
from the force of character of her countenance, and as one young lady 
pupil expressed it. ""Without quite knowing the reason, somehow you 
could never imagine her as a principal of a school." 

These things give us pause and make us wonder if we have any 
right to bring children into the world and allow them to grow up with 
such physical handicaps as shall prevent them from having a fair 
chance to make their way advantageously in life. 

It is to the prevention of disease, the relief of suffering, and the 
correction of deformities — thus adding to the efficiency and happiness 
of the individual and the community — that the dentist is committed in 
his function for the betterment of the race. 



GENERAL INDIVIDUAL HYGIENE 161 

UNBIOLOGICAL HABITS 

William W. Hastings, Ph.D., Dean of the Normal School of Physical 
Education, Battle Creek, Miehig-an. 

Even a fish feels the downward pull of civilization and contracts 
its diseases. In pure fresh water in a state of nature fish are healthy, 
—in private fish ponds often affected with a sort of goitre. In the 
hatcheries of Long Island the spread of disease among trout has 
occasioned much alarm. Dr. Henry B. Ward, Head of the Biological 
Department of the University of Illinois, and United States fisheries 
expert for many summers on Lake Michigan and in Alaska, said to 
me recently that the disease of trout in the Long Island hatcheries is 
a sort of goitre, a proliferation of the thyroid, a condition of mal- 
nutrition, either hyper-nutrition or ab-nutrition due to the lack of 
adaptation of the food in quantity or quality. The trout are fed on 
chopped liver. 

He stated also that the salmon in a free state in Alaska are free 
from cancer or any other abnormal growths under the normal condi- 
tions which prevail in summer at least. During one summer with the 
aid of eight Chinese butchers he inspected a half million fish, 10,000 of 
them himself. The Chinese were paid so much for all specimens re- 
ported and a higher rate for small defects. There were deformed fins, 
evidently due to some mechanical injury, but only two cases of abnor- 
mal groM^ths out of a half million, one an esophageal tumor, a benign 
growth, and the other a tumor of the viscera not of a malign character, 
a dropsical mass, a cell proliferation but not cancerous. 

The general effect of the domestication of wild animals is to reduce 
the vital energy and the tonicity of the neuro-muscular system — to 
subtract spirit, strength, endurance. In case of most diseases of ani- 
mals no attempt is made to trace them to mankind and to claim 
immediate human infection. It is an established fact, however, that 
tuberculosis is transmissible from man to animals and conversely. 
Cats are a very common carrier of diphtheria and are especially sub- 
ject to throat troubles. Whatever the inter-relationship of human and 
animal diseases, it is clear that the same conditions which tend to in- 
duce diseases in animals give rise to similar diseases in men ; namely, 
uncleanliness, ill adapted food, undue confinement, and inactivity due 
to segregation and lack of necessity to seek food. 

The first effect of such confinement upon an eagle, a leopard or any 
other animal of very active habits is to provoke an apathetic, dis- 
couraged or sullen attitude which may result in a state of malnutrition 
and ultimate physical decline or death. 

These first ill effects of the captivity of very wild things are patent 

(7) 



162 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

to all, but not the permanent racial efit'eets on domestieated animals 
for the reason that Ave have become so accustomed to these as not to 
observe such points. The popular view in fact assumes that contact 
with man is beneficial, that without his over-lordship the poor things 
would starve, ^^■ould revert in type, the fat sleek Jersey and Holstein 
become wiry, lean, wild cattle, the dog regain his wolfishness, the race 
horse become a nnistang. Usually, however, the loss would be one of 
size and adaptation of use but would be in the nature of a distinct gain 
in strength and vitality. The bear or wolf dog is not permitted by 
the experienced hunter to lie by the fire and fatten, but is exposed to 
the same battle with Nature as the w^olf with which he is to fight and 
is kept lean and hungry on a m.oderate diet and by training. 

Only in rare cases have men understood the nature of animals suffi- 
ciently well to conserve their finest qualities, speed, strength, etc. 
The intelligent trainer of race horses for example not only feeds but 
bathes and exercises his horses. All this the wild horse does for himself. 
Even a cow or a cat keeps the skin clean and hair brushed and the 
roots active and live. 

The last thing a man is learning to do is to restore and conserve his 
primitive virility and the last and hardest thing he has to learn in 
method is that this process must be one of return to Nature. 

Our whole contention then in the discussion of unbiological habits 
is against the habits of civilization, and the touchstone used in sifting 
out the habits that menace vitality, longevity and racial vigor is and 
always must be, ''Is this habit natural? Does it tend to produce the 
normal individual ? ' ' 

A man at any moment is but the summation of all that he has 
thought and done, he is a bundle of habits ; function makes structure. 
Unnatural habits mean degeneration or subtraction from the vital 
reserves and longevity, and normal habits mean on the other hand 
development, long life and a stronger heredity for the coming genera- 
tion. 

"What is true of one man is true of an aggregation of men, a nation- 
ality or a race — with the added fact that social customs involved in 
segregation are the most important factor in the determination of in- 
dividual habits. Climate and social habits are principally responsible 
for racial types; the racial stock doubtless for centuries affects the 
type thru inheritance of physique and thru traditions as to social cus- 
toms. 

Our country in its natural environment appears more favorable to 
racial development than European countries. There are differences in 
development in various parts of the United States which appear to be 
due to segregation of population more than to climate. 



GENERAL INDIVIDUAL HYGIENE 163 

Diseases are more prevalent in states containing large city popula- 
tions. Nervous diseases so common in cities are quite properly termed 
diseases of civilization. Incessant noise, foul air, exposure to infec- 
tious diseases, excess of food and ill adaptation of the same, the 
habitual use of stimulants and narcotics and muscular inactivity, are 
some of the principal causes of race degeneracy in cities. 

Dr. B. A. Gould and Dr. J. H. Baxter both observe the physical 
superiority of American Indians and white descendants of European 
stock over emigrants from the same countries who enlisted in our Civil 
War. Baxter demonstrates the physical superiority of recruits from 
Western and Southern over Eastern states, and the greater preva- 
lence of diseases, especially of nervous diseases, in states containing 
large city population. 

Thru the work of boards of health the death rate is being reduced 
in some cases below the average for the country. Chicago for example 
has in the last ten years lowered its death rate to less than the average 
for the country ; in fact, city people are becoming very much better in- 
formed as to the laws of health than country people. Only the com- 
pulsion of the necessity of covering distances in the every-day round, 
and the so-called inconveniences of country life which compel physical 
activity, are responsible for the degree of health possessed by country 
people. It appears that most men will not do muscular work unless 
they must. In most ordinary occupations and the daily round there is 
little or no work for arms and trunk muscles. We are, therefore, 
poorly developed in the upper bod}^ We still have legs, but autos and 
street cars are fast depriving us of even these. 

Race degeneracy has so touched the brains of some that they are 
willing to call degeneracy development and to proclaim the evolution 
of a new race, in which the. body becomes attenuated and the head 
mammoth-like in contrast, as in our newspaper cartoons. But big 
brains demand good, rich red blood, as much as do muscles, and how 
may one provide this except thru a big vital system. 

The student of any species of life of today is not content with 
identification and abstract classification of life; he studies it in its 
relationships, seeks to know its enemies and its friends. The biologist 
is of necessity also an entomologist and a student of horticulture. 
Conservation is the watchword of the country. The conventions of 
the Christmas holidays, whether of the various departments of the 
American Association for the Advancement of Science in Atlanta, or 
of the Athletic Associations meeting in New York, were full of the sub- 
ject of human conservation. It comes to us from every angle, scientific 
and practical. 



164 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Millions hav(> been expended by the United States and state govern- 
ments in the suppression of hog cholera, the boll-weevil, gypsy moth, 
etc., but only recently has man awakened to the fact of race degen- 
eracy, and attempted to study himself and to ascertain the unbiological 
habits which lie at the root of the decline in racial vigor and to remove 
them. 

The first and most obvious realization of forces inimical to life 
has been that of infectious diseases, diseases communicable by contact 
and aggravated in their spread by congestion of population. 
By the elimination of such acute diseases the average length of life 
has in one generation been increased ten years. Life expectation 
is now forty years instead of thirty. This is more remarkable when it 
is remembered that the death rate from diseases of heart, kidneys, 
lungs and other chronic diseases due to incorrect personal habits has 
nearly doubled in the same period. More men live to be forty but 
fewer men live to be sixty and seventy and a hundred. 

In searching for the cause for this condition we are led to the con- 
clusion that there is a prevailing lack of vitality or reserve force 
enabling men to throw off the more virulent germs of disease, and that 
we are crippled in various ways, locally weakened in lungs, stomach, 
liver, etc., by unwholesome personal habits. 

Low vitality and reserve force are principally responsible for the 
increase of the more virulent germ diseases, and the prevalence of 
anemia, neurasthenia, insanity and other so-called diseases of civiliza- 
tion or urbanization. Thru this lowered vitality of people in general 
we have discovered the physiological effects of various unbiological 
habits as was not possible when men were as a rule more vigorous. 

Ditch diggers, coal heavers, miners or other men who do strong 
muscular work, perspire freely and live in the open air, may neglect 
many habits of life which are conducive to health and development, 
and escape serious illness for many years, but the man leading a 
sedentary life cannot do so. A man doing heavy muscular work, be- 
cause of the free perspiration induced by his daily labor, and life in 
the open air, may be able to keep his skin more or less active without 
suitable baths, may preserve his teeth thru the chewing of coarse food 
and throw off the bacilli cultures of the mouth thru the antiseptic 
strength of the mouth secretions due to his splendid vitality rather 
than by the use of a tooth brush, may eat an excess of meat, drink a 
goodly amount of alcohol and escape immediate disease or breakdown, 
but for any violation of the order of Nature he must suffer a loss of 
immediate energy which corresponds to his power of resistance. There 
is no escape from Nature. She exacts her due. If a man takes poisons 



GENERAL INDIVIDUAL HYGIENE 165 

into his system thru contracting drug habits, if he overeats (a most 
common American failing) or eats ill adapted food, he must lose the 
days or hours necessary to correct the mistake — and these days or 
hours are not simply lost out of life but are subtracted from life ex- 
pectation. Nature is inexorable. 

Of all the habits which militate against life, the most deleterious is 
the muscular inactivity which is involved in city life. With the in- 
creased specialization of industries and the increase in work done by 
machinery, few occupations involve any hard muscular work. Urban 
life makes comfort and convenience and saving time its slogan, makes 
rapid transportation one of its chief efforts. No man does any work 
for himself except that connected with his own business, and that is 
specialized until there is no variety of effort. In few occupations is 
there any muscular effort left. So much is done by machinery, even 
in the country, the greater part of the old muscular work of the farm 
has been eliminated. There is nothing in the city from childhood up to 
provoke muscularity, strength and organic vigor and everything to en- 
courage the opposite. Inactivity is the most destructive of all un- 
biological habits. Street cars and autos discourage even walking to 
and from work. One may obtain a degree of health from the provision 
of the proper air, water, food, baths, clothing and rest periods, and 
the prevention of the spread of contagious diseases ; in short, by the 
provision of a wholesome environment, but these negative factors will 
not produce vigor, reserve force, the power to throw off disease and 
the power to live long and to perpetuate the race. These can result 
only thru every-day out-of-door exercise and recreation. Give us back 
the physical habits of Merrie Old England. 

The deteriorating effect of the unbiological habits of our modern 
civilization upon the heredity, the growth and development of chil- 
dren, is manifested in the decay of the teeth indicating constitutional 
feebleness, in the great increase in eye disorders, in defects of hearing, 
adenoids, enlarged tonsils, anemia, chorea, epilepsy, feeble mindedness 
and other diseases of the nervous system. Over half the children in 
city schools have some of these defects. The recent investigations in 
Battle Creek in connection with the Physical and Mental Perfection 
Contests have demonstrated the possibility of nearly perfect children 
thru good heredity and proper care. Eugenics and euthenics should 
be the study of all parents. 

You will pardon my temerity in summing up a few of the simple 
things which we all know as affecting the life of the individual and 
the race : 

It is better to have fillings in your teeth than to lose them entirely, 



166 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

l)iit ht'ttcr still to choose ^ood |)iift'iits and use n ^ooil tooth Ijnish freely 
and not need the Hllings at all. 

It is better to take the morning cool hath daily, cleanse the skin and 
tone up the arteries than to put all the work of elimination on the 
lungs and kidneys and contract some chronic disease at fifty. 

It is better to take time and take it regularly for proper elimina- 
tion than to suiifer fatigue and loss of the power of mental concentra- 
tion from the reabsorption of poisons into the system. 

It is better to stand up straight like a man than to approximate the 
all-fours habit of our cousins, the apes, and contract spinal cvirvature, 
limit vital capacity and suffer ultimately from nervous and lung 
troubles. 

It is better to eat lightly and simply of digestible food rather than 
to consume half the energy produced by this same food in the proc- 
esses of preparation for assimilation, better also to abstain from 
headaches and other symptoms of autointoxication due to wrong feed- 
ing. Better to leave the young pig in the mire than to help him out 
by being compelled to expend your vital energy in his elimination. 

It is better to sleep in a close room long and laboriously than not to 
sleep at all, but best to sleep with windows open wide or out of doors 
and save an hour of life daily. 

It is better to allow yourself some amusement daily for a. few 
minutes at least, but not preferably for several hours in a stuffy theatre 
or public dance hall until late at night. We Americans are losing our 
mental poise partly by indulging in the tense exciting things rather 
than retaining the simple home amusements of our English forebears. 

It is better to do resistive exercises in your own room or formal 
gymnastics in the gymnasium than to get no exercise at all and no 
neuro-muscular tone, but best of all to get out of doors and work or 
play where God meant you to be. Men require recreation, relaxation 
for strong life and long life. 

"It is better to marry than to burn," Paul says, but better still to 
remain single and burn out your life in the service of humanity than to 
marry without health and without perfect mating. Even the birds 
know better than this. If Avedded life is the most natural and most 
important matter in the world individual and national, why not pre- 
pare for it by seeking the greatest possible physical perfection and 
mentality and real character and by a study of the nature and func- 
tion of true love, which is the highest force in all Nature. 



GENERAL INDIVIDUiVL HYGIENE 167 

THE INCREASE OF INSANITY 

James T. Searcy, A.B., M.D., LL.D., Superintendent Alabama Hospitals for 
, Insane, Tuscaloosa, Alabama. 

As our Chairman has said, "It is the unexpected that happens.'" 
I would have prepared myself to speak more succinctly and concisely, 
within ten minutes, on such a subject, if I had knowTi I should have to 
make a talk, 

I am called sometimes down in Alabama the "Head Crazy Man 
of the State, ' ' because I am at the head of about twenty-two hundred 
insane persons. About eight hundred of them are negroes and about 
fourteen hundred are whites. My following is increasing faster than 
any other one class of people in the state. 

We feel ourselves discouraged often by the rate of increase of the 
patients who are coming into the insane hospitals. The population of 
the state of Alabama, according to the census (during the ten years 
which the census included) , increased sixteen per cent ; the admissions 
into the insane hospitals increased forty-five per cent — sixty per cent 
increase among the negroes and thirty per cent among the whites. 

These are appalling figures, but "misery likes company," and we 
can parallel them all over the United States — not like them exactly 
in each state, for they differ. The general population of the United 
States increased eighteen per cent, and that of the insane hospitals 
increased twenty-eight per cent during the years of the census. In 
Alabama we have about two million two hundred thousand people, and 
we have twenty-two hundred patients in the insane hospitals, or about 
one patient to every thousand of the population. In Georgia they 
have one to about seven or eight hundred; in Virginia one to six or 
seven hundred; in New York, they have one to less than three hun- 
dred. In these states up this way (toward Michigan), it is about one 
to every four hundred or five hundred. 

Something is wrong. This increase of insanity is prevailing in 
civilized countries more than in other countries, and, apparently, the 
more civilized, the greater the increase. This is evidently the effect of 
civilization. 

The increase of insanity is a perplexing question. A man who is 
a psychiatrist, in charge of persons of defective brains, is cross-fired 
from all directions every day with inquiries as to what is the matter. 
"Why is insanity increasing at such a rate ? 

Insanity represents the extreme end of human deficiency and de- 
fectiveness. People in insane hospitals have reached such an extreme 
grade of mental deficiency and defectiveness that the state has had to 
interpose and take charge of them. Short of that grade there are 



1()S FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

tlioiisiuuls at lar^'c, oi" every ^rade. Do you know tliat in the schools in 
this country there are more children dullards today, not able to keep 
lip with their classes, than there were five years ago? Also there are 
more wayward boys and bad girls. Among adults, all types of 
aberrance are increasing. We are building institutions — penal, cor- 
rectional and charitable — to benefit all these, by placing such people 
in them. We cannot build them fast enough. We have attempted 
to relieve the insane hospitals by starting epileptic colonies, reforma- 
tories for inebriates, schools for feeble-minded, and many such institu- 
tions. They are full. Still the insane hospitals are crying for more 
room. 

I am asked what causes prevail in civilized, more than in other 
countries, tending to this. One of the reasons, I throw out as a sug- 
gestion is that we have been taught to value all human lives alike. 
All our social work runs on these principles. Those who are defective 
and deficient reap quick advantage of these opportunities and live to 
adult life. Then they multiply themselves. Civilization is multiplying 
the deficient and defective classes in that way — by giving an equal 
valuation to all alike. In the uncivilized stage of our history they 
dropped out. 

The kejmote of this Conference should be to deny that all are 
alike valuable; to show that there are grades in excellences and in 
deficiencies; and to show that the hereditary multiplication of the 
deficient and defective ought to be discouraged in every way. 

There is another reason ; it is in harmony with a good deal of the 
talk you have heard here at this Conference. 

We have in medicine a line of drugs that are much used ; some- 
times called ''anesthetics" and "anodynes." These range all the way 
through a long list. There are chloroform, ether, nitrous oxid, chloral 
solutions, the alkaloids that we get out of opium, like morphin, codein 
and heroin, and its solutions, paregoric and laudanum. There are 
cocaine from cocoa leaves, nicotine from tobacco, alcohol from ferment- 
ing material, caffein from coffee, tea and cola-nuts. The effect of 
these drugs is to chemically act upon the sensory nerves and brain 
tracts — because they are more delicate than any other structures. 
They make a person at first feel better ; when he takes them, he likes 
them ; but, secondarily, the repeated use of any one of them impairs 
these nerve structures to such a degree that he feels generally bad 
when the drug is withdrawn. The habitual user of any one of them, 
I don't care which (whether caffeine, nicotine, alcohol, cocaine, mor- 
phine — through the whole list), is dragging a lengthening chain of dis- 
comfort, which shows itself when the drug is withdrawn. A drug 



GENERAL INDIVIDUAL HYGIENE 169 

habitue is nothing more nor less than a person with that kind of im- 
paired nerve structures. He feels bad from the chemic effects of such 
a drug and he knows he can take more to relieve it and he does it. 
Their continued use, as luxuries, is having a general effect through- 
out all the civilized land. It is producing in this country "dope 
diatheses." Children are born "feeling bad." A child of parents, 
both of them, or either of them, taking any of these agents, comes 
into the world with that kind of discomforted nervous system. He 
"feels bad," he is "born tired," and takes to the use of these drugs 
just as readily as a duck takes to water. We are increasing in this 
country this kind of neurasthenia : it is said to be more prevalent in 
America than anywhere else. And we are doing it in this very way. 
Increasing insanity comes as a final result of bad heredity and 
drug abuse of the brain, both most prevalent in civilized countries. 

THE INCREASE OF INSANITY 

Professor Walter F. Willcox 

Almost everybody who has studied insanity believes it is on the 
increase and at a very alarming rate. I have no desire to question, 
much less to deny, that statement. At the same time, I think there 
are reasons for believing that, if it is increasing, the increase is much 
less rapid than the figures, on their face, would indicate. 

For example, several years ago a paper was written by one of the 
foremost of English statisticians on the increase of insanity in Eng- 
land.* He believed that there was no conclusive evidence, from the 
statistics, to warrant the inference that insanity was on the increase. 
The Royal Statistical Society gave the writer a silver medal, on the 
ground that his was the most valuable statistical paper of the year. 

How is it in the United States? No such careful study as was 
then made by Humphreys has ever been made of the American figures 
indicating an apparent increase of insanity in the United States. But 
it should be pointed out (as to some extent qualifying the apparent in- 
ference from the facts and figures) that, in the first place, insanity is 
preeminently a disease of old age, and as a people we are living longer 
than we did a generation ago ; and thus many more people are living 
into the insanity age ; and, in the second place, our whole evidence re- 
garding the increase of insanity refers to its increase in hospitals and 
other institutions. Many people, who a generation ago or even ten 
years ago, would have been taken care of in their families and never 
gone upon the records are now admitted to institutions. They thereb/ 

* Noel A. Humphreys, "The Alleg-ed Increase of Insanity," in Royal 
Stat. Society, Journal LXX (1907), pp. 203-233. 



170 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

tend to swell the apparent increase of insanity, wliich after all means 
simply the increase of recorded insanity. 

Whether insanity is on the increase or not, I do not profess to be 
able to say. All the evidence of the facts and figures indicates thnt 
it is, but there are so many qualifications of those figures before one 
can get their correct interpretation, that I think we need in this coun- 
try a thoroughly disinterested, competent and qualified study of the 
subject. I feel sure that, if such a study were made, it would show that 
the increase that exists, if it does exist, is far less than the increase 
showm on the face of the figures. I am disposed to say that some in- 
crease would be found but nothing like the increase we ordinarily hear 
about. 



DETERIORATION" OF THE CIVILIZED WOMAN 

Richard Root Smith, M.D., Grand Rapids, Mich. 

The subject assigned me demands a note of explanation — perhaps 
I may say warning. I do not believe that modern woman is degener- 
ating or deteriorating. In our estimate of any individual as to his po- 
tential ability to obtain happiness for himself and to act for the good 
of his family, his neighbor, and the state, we recognize roughly cer- 
tain factors — the moral, the intellectual, and the physical. Eecog- 
nizing in the abstract (and I may say concretely) in many individuals 
their close interdependence, w^e may yet discuss one or another of these 
factors independently. 

In his present state, man's moral side, his intellectual side, and his 
physical side, each possesses certain elements of varying strength and 
wealmess, and the estimate of any individual, to be impartial, must 
recognize this fact and take both into account. 

It is the purpose of this paper to point out and to describe certain 
physical defects in civilized women which we must regard as marks 
of deterioration, since they are largely inherited, and represent a less 
perfect physical development, less strength, less endurance, and a 
lessened power to cope with life 's problems. These defects in varying 
degrees are found in a large percentage of our women. I must empha- 
size at the beginning that in pointing them out we must at the same 
time recognize woman 's splendid intellectual attainments, her superior 
moral status, and that physically she shows an endurance and strength 
equal to many of the strenuous demands upon her. In estimating any 
individual case, we must also recognize her strength as well as her 
weakness; otherwise we shall err into an unwarranted pessimism. 
Since, however, these defects interfere with her efficiency and her wel- 



GENERAL INDIVIDU.y^ HYGIENE 171 

fare, they may well be studied in order that we may cope with them 
more successfully. 

The word ' ' deterioration ' ' must not be taken here in any progres- 
sive sense. We have no adequate reason for believing that women are 
more vigorous or less so than for many generations back. We have 
certain factors in modem civilized life that are tending toward her 
physical betterment; others that are acting toward impairment. 
These factors vary greatly among different civilized nations, and still 
more in different walks of life. More than this, these defects are not 
confined to civilized women alone, but may be found among those 
classified as uncivilized, since here also we find certain factors in cus- 
tom and environment tending to the same end. 

It is well that we begin by defining the mature physically ideal 
woman — ideal from the standpoint of vigor, strength and en- 
durance. We find her in Greek art in the often quoted examples 
of the Venus de ]\Iilo and the Venus de iledici. The impres- 
sion we obtain at first glance from such figures is that of vigor and' 
strength. The body is sturdy, compact and fully developed. It is 
well muscled and covered with sufficient fat to round out the angles 
— in other words, well nourished. From the standpoint of vigor she is 
perfect, and from the standpoint of beauty the best ideal that art has 
produced — the two correspond closely. 

These figures have, of course, been idealized. In actual life we 
find but few women who attain this perfection. Many, however, are 
of the same vigorous type and closely approach it. The thorax is 
large and deep, and there- is plenty of width at the waist line. 

I am showing you here a figure taken from a photographic art 
study. You will note the same characteristics seen in the ideal figures 
just presented. The body is well developed, strong and well nourished. 
There is perhaps no better criterion of woman's natural vigor than 
the size and form of the chest. In women of this type it is large and 
deep, rendering the upper abdomen of ample capacity. 

Modem conditions of life (environment) vary enormously, and it 
might be seriously questioned whether the physical make-up of which 
I have been speaking, in its highest degree, is best suited to indoor 
living and a physically inactive life, for such women as a rule tend to 
obesity as they approach middle life and develop the troubles attend- 
ing it; but under circumstances which call for considerable bodily 
exertion it is well suited. We frequently have women of this type who 
have cared for their homes, who have reared large families, and have 
had the ordinary amount of responsibility, care and stress which al- 
most all modern conditions impose, tell us that they rarely if ever have 
known fatigue or physical distress. Certainly under all conditions of 



172 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

lifo a considerable degree of vigor as depicted in these figures shown 
you is necessary to meet its conditions efficiently and maintain health. 

Let us now briefly describe, in its most essential characteristics, 
another type of woman — a deteriorated type. This is a type or body 
habit variously named by medical men — the asthenic habit because 
of her lack of vigor and strength; the neurasthenic habit because oE 
her unstable nervous system ; the phthisical habit because of the pre- 
disposition to tuberculosis; the enteroptotic habit because her ab- 
dominal organs are prolapsed. 

Our first impression is that of frailness. She is slender and has 
but little fat — is in consequence angular. She strikes you as being 
lacking in vigorous development — her muscles are slender and small. 
These are the fundamental characteristics of such a woman. Asso- 
ciated with and dependent upon this we find a small, shallow chest, 
contracted at its lower end and distinctly narrowing the capacity of 
the upper abdomen. We may note also that the neck, legs and arms 
jare longer than usual. If we examine more closely w^e may note that 
the other tissues partake of this same frailness, and that the bones are 
small. Very characteristic is the softness or fiabbiness of her tissues ; 
the skin is of fine texture and the features delicate. It is this delicacy 
of form and feature, which have accentuated her feminine qualities, 
that have led artists at different periods of art to regard her as 
the highest type of beauty. 

I am showing you, for example, a picture from the gallery at 
Dresden, painted during the middle ages. Note the slenderness of the 
body, the length of the limbs, and the small shallow chest. 

Closely coupled with this form is almost constantly found a nervous 
instability, which is perhaps its most serious feature. It is by no 
means confined to this type of woman but is here peculiarly difficult 
to manage. 

Another common and more important factor is that she is lacking 
in muscular development. She fatigues easily and is, therefore, unable 
to maintain her body in a normal attitude in spite of her lightness in 
weight. We see this evidenced in round shoulders, an abnormal 
straightness of the back in the lumbar region, and flat foot. These 
muscular insufficiencies are not essential parts of her lack of vigor, for 
under satisfactory hygienic conditions they are often not outspoken. 
They follow easily, however, when she is subjected to long-continued 
fatiguing influences. 

If we examine the abdominal viscera of this frail type we will in- 
variably find them more or less prolapsed, the prolapse being on the 
whole proportionate to the degree of body frailness. The kidneys, 
especially the right, the stomach, and the large intestine are the organs 



GENERAL INDIVIDUAL HYGIENE 173 

most affected. The kidneys normally lie, one on either side, high up in 
the abdomen, beneath the diaphragm at the back. They cannot ordi- 
narily be reached by the examining hand. In these frail women as 
a rule the right kidney (occasionally the left also) is found to a 
greater or lesser degree prolapsed, in the pronounced cases even coming 
to occupy a position over the brim of the pelvis. 

By means of the X-ray and the bismuth meal the position of the 
stomach and the large intestine is easily demonstrated. In all of these 
frail women we find, as stated, a prolapse of the lower border of the 
stomach and of the large bowel. The stomach is stretched out, its 
lower border coming to occupy a much lower position than normally. 

This is but a hint at the vast amount of work that has been done 
by medical men in recent years, seeking to obtain knowledge in regard 
to the prolapse, its complications, its relation to health, and its relief. 
The problems are most complex and as yet there is little uniformity of 
opinion on many of the points involved. Students of the question are 
agreed, however (first), that a simple prolapse of the abdominal vis- 
cera, when unattended by complication, frequently exists without giv- 
ing rise to trouble ; the digestive functions are satisfactorily main- 
tained; (second) that disturbances of digestion with stagnation of 
food products in the gastro-intestinal tract are frequently associated 
with the prolapse, and that this disturbance of function gives rise to 
the gravest consequences as far as the maintenance of the health of 
the individual is concerned. Numerous mechanical devices in the way 
of abdominal supporters have been in use for a number of years, and 
recently a number of operations have been suggested and carried out, 
wdth the idea of obtaining relief. In spite of some encouraging results, 
these operations must be said to be more or less snb judice. I speak of 
this phase of the problem with w^hich -we have to deal in frail women, 
to call attention to its existence and frequent seriousness. 

I have pointed out to you the main characteristics of the two types 
of women, the one reflecting vigor, the other weakness. If we examine 
a large number of women in various walks of life, we will find usually 
that each is a mixture of these two types. In a large number of women 
the defects are so slight or so offset by points of strength as to be in- 
consequential ; in others the points of weakness are so great as to re- 
sult in marked limitations in her activities — ^marked suffering or even, 
hopeless invalidism. We may judge each one on several points — First : 
the sturdiness or frailness of ber body ; second : the stability of her 
nervous system or lack of it ; third : her state of nutrition and her 
muscular sufficiency or lack of it. 

A frail woman does not necessarily suffer ill health. She may be 
well in the sense in which we ordinarily use the term. An unusually 



17-4 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

proocl nervous system will often go a long way toward maintaining 
lioaltli and efficiency, and it is common to see such women taking their 
l)l;u'e ill tlie social system and maintaining it as well as their more vigor- 
ous sisters. Taken as a class, however, these women are not as able 
as others to withstand the strains of life. Care and responsibility, in- 
door living, overwork, and child-bearing, if carried to any excess, bring 
her to a state Avhich we may roughly describe as fatigue. In popular 
speech she breaks down. She develops a train of symptoms as well 
defined as any of the well-known diseases. She is irritable, nervous 
and easily fatigued ; she develops mental symptoms often designate*! 
as neurasthenia ; she shows signs of muscular wealmess in an abnormal 
attitude of body ; she has disturbances of many of her bodily func- 
tions, notably those of digestion, menstruation and urination; also 
eye and heart symptoms of functional origin, though these .less com- 
monly. She has backache, pains in the side and a feeling of weight 
in the lower abdomen. Many of these frail women are constantly suf- 
fering from symptoms which may be placed in one or more of these 
groups ; others easily develop them when under strain and but few if 
any can withstand it if prolonged. Indoor living or occupation, if the 
hours are long, is especially harmful unless properly balanced by out- 
door living and rest. In the contemplation of industrial conditions, 
it is these women who should perhaps receive one's first consideration, 
barring those actually suffering from disease. 

As to child-bearing, the worst of these women are manifestly unfit 
for marriage and child-bearing, but in those of less degree we may not 
nnder present social conditions advise against it without grave con- 
sideration of all the consequences. Child-bearing and child-rearing 
are essential to the happiness of the majority of women (though fre- 
quently not recognized) and necessary to the development of character, 
which in turn makes for greater nervous stability. In any instance, 
however, it is apt to be a severe tax upon her health. This applies not 
only to child-bearing, but more particularly to the labor of rearing the 
offspring. These women need careful supervision during this period. 

As a class these women do not lack intelligence — in fact, they are 
more capable mentally than the average. They are certainly not less 
moral. An active brain, in fact, and an unusual conscientiousness 
lead them to go far beyond their lessened powers of physical endur- 
ance. 

If we examine into the early history of the frail woman we will 
find that, in all marked instances at least, her fundamental characteris- 
tics may be traced to childhood, and back of this to her immediate 
progenitors. The parents and grandparents are one or more of them 
of like type. This is a fact well known to those who have investigated 



•GENERAL INDIVIDUAL HYGIENE 



175 



the matter, and which I have had occasion to verify by questioning 
some three hundred women on this point. Of all the factors in making 
the frail woman what she is, that of heredity is unquestionably the 
strongest. 

Such womeri have their counterpart in the frail child, with the 
same fundamental characteristics of slenderness, thinness of muscle, 
lack of fat and tissue tone, and backwardness in vigorous development. 
Children vary at different periods of their growth in body form. To 
bring out these characteristics we may place a frail child alongside of 
one of vigorous type and similar age. 

Up to ten or twelve years of age we find but little evidence of 
actual prolapse of the organs — the prolapse is not congenital but ac- 
quired during adolescence. At about eight years of age, or what is 
known as the bisexual age, a widening of the pelvis becomes 
apparent. This increases more rapidly at about puberty, with a 
corresponding or compensatory narrowing of the waist line. In vigor- 
ous women this narrowing is inconsequential. In the frailer ones it is 
one of the mechanical factors, though by no means the only and most 
important one, in the displacement of her organs. 

We find in these children, the type of which we are speaking, that 
many show signs of muscular insufficiency in round shoulders, curva- 
ture of the spine, and weak foot. I am showing you normal children 
and then those in whom these deformities are well marked. These 
abnormalities denoting muscular weakness or insufficiency are not con- 
fined to frail children but are very frequent among them, and similar 
to those found in frail women later in life. 

The lesson is obvious. It is safe to say that it will be many years 
before eugenics will do much to eradicate the frail individual, but a 
very encouraging fact is that a great deal may be done to better mat- 
ters by attempts to overcome this child's tendencies. These children 
need an outdoor life, an abundant, nutritious diet, a correction of their 
deformities, the removal of offending adenoids and tonsils or other con- 
ditions interfering with their nutrition, a regulation of their school 
duties and exercises graduated to their individual needs. I believe 
this can best be done through our schools and that when wisely under- 
taken and carried out on a large scale we mil do much to do away 
with the frail, neurotic woman that now forms such a serious problem 
in modern life. Intelligent school inspection and the outdoor school 
already inaugurated in this country will find a most profitable field 
for its activities when once the frail child is clearly recognized as an im- 
portant entity and one that must be dealt with during the years of 
growth. 



176 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Old Age 

(Acting Chairman Creegan: Before I call upon the next speaker, I 
i-eo-ret to announce that our honored President will be obliged, before the 
next address is concluded, to leave the hall and make his preparations to re- 
turn to his home in Now York. I am veiy sure that I speak for this entire 
body when I say to Doctor Smith that it has been a benediction to all of us 
to have him with us these days as our presiding officer. I count it one of the 
honors of my life, Sir, to have the privilege of sitting- by your side, to use my 
voice when yours seemed not to reach to the utmost part of the gTeat hall 
where our meetings have been held. Your counsel, your planning for these 
meetings, has been a blessing to us. Your life has been an eventful one. I 
undertook the other day to make out a memorandum of the various institutions 
with which you have been connected, and I concluded it was too long to read 
to this audience. Those of us who came here feeling that we would make our 
arrangements to retire from active life at seventy or seventy-five, have changed 
our minds. "We have found an example worthy to be copied. Now we want 
to take you into our confidence and we want to invite ourselves, if you will 
permit us, to meet you eight years from now when you celebrate your one 
hundredth anniversary, hale and hearty as you now are with that splendid 
phenomenal memoiy untouched by the shafts of time. We want to meet and 
celebrate that event with you. In the meantime may God's richest blessing rest 
upon you, our dear friend, and highly honored President.) 

President Stephen Smith, M.D., New York, K Y. 

I regret very much that I have engagements that will compel me to 
leave today and that I cannot remain until the close of the Conference. 
I wish to express my gratitude to Doctor Creegan for his great kind- 
ness in relieving me of the burdens of conducting these great meetings, 
which I thought probably I had not the voice to meet. That occasion 
led me to assume the position that befits the occasion that I mentioned 
In my opening address, the position of silence and meditation. 

During the period of this Conference I have enjoyed immensely the 
discussions that have been going on. The Conference has grown con- 
stantly in my estimation in its greatness and especially in its possi- 
bilities for the future. It seems to me that it combines in its program 
and in its purposes about all that is to be done or said in favor of im- 
proving the race. I look forward to this as the beginning of perhaps a 
new era. I think the interest that has been shown here shows the great 
interest of the public, that the public is ripe for a movement that will 
probably, as a gentleman said yesterday, * ' extend throughout the entire 
country and give a new life to all our efforts for the benefit of the 
race." 

I am congratulated somewhat on my age. When people speak of 
that, I generally look around to see whom they are talking about. It 
is a familiar thing to me to be called old. I was reminded of it not 
long ago in a way that was very pleasant by coming into a crowded ear 



GENERAL INDIVIDUAL HYGIENE 177 

and having a gray-haired lady some distance away beckon me to take 
her seat. I told her that I thought I was quite as capable of standing 
as she was, but she insisted, so I took the seat and bowed her my 
acknowledgment. 

An old lady patient came to me the other day. I met her at a 
gathering. I think she is past eighty. She seemed trembly and very 
much excited and had not seen me for several years and wanted to 
know how I maintained such health at such an age, and I said, ''I 
never talk with old people. ' ' And there is a great deal more in that 
perhaps than you are aware of. I realize, at any rate, that the way 
to keep healthy and strong and well and alive and live long is to live 
in the age that you are living. Shut the door behind you. As Paul 
said, "Forget the things of the past and enjoy the things of the pres- 
ent and the future ' ' and especially look forward to the development of 
the future. 

In a more serious way, I am sometimes asked what my course of 
life has been, what I would advise anyone else to do, to live long. I 
say, ' ' Be sick the first fifty years of your life and be compelled to live 
on milk and the next fifty years you will probably be compelled to 
enjoy life, and long life too." That is pretty nearly my history. 

I do not think I saw a well day from the time I had any conscious- 
ness of life until I was about sixty, when a little event occurred that 
I might perhaps mention here, although it reflects somewhat upon 
discussions of alcohol and possibly some may take the prescription. 
I do not mention it very often to young people. I was invited by 
President Cleveland to be one of the free delegates to the International 
Sanitary Conference that met in Paris in 189-4. I had always suf- 
fered so much from indigestion, and had to be so very choice of what 
I ate and so largely of the simplest kind of diet that I was opposed 
at first to going. But under some urging I went abroad — satisfied I 
could not live long on French cooking and especially to attend the 
great French dinners that I knew I should have to attend. I went, and 
the dinners began. We certainly had about twenty or thirty courses 
and about three hundred persons in the dining room. After each 
course wine was served. Well I never could drink wine, it always 
made me very sick and the menu was of a kind that did not appeal 
to me at all, one that I could not endure — at any rate for three months, 
during the time I was to be there. The first dinner we had there was 
by President Parnot at the Palais de I'Hygiene and I saw then what 
my fate was to be. These long dinners with so many courses and so 
much Avine were something I could not endure at all. At the second 
dinner given by Madame Cornell the next day, or rather breakfast at 
twelve o'clock, I found seated next to me a prominent physician of 



178 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

rai-is whoso writings I was familiar with. I thought I would ask him 
wlial my course should be. I found he could speak a little English 
and I a little French and we got along very well together. I finally 
turned to him and said, "Doctor, I am an old dyspeptic and I don't 
see how I am going to live through these dinners. I can't partake of 
them on account of so many courses, so much wine, etc." "Oh," he 
said, "I can help you out. We have a perfect understanding about 
that. These dinners are all scientifically arranged. Every particle of 
food put on the table is scientifically prepared for the occasion and the 
wine that is used after each one will digest that food before the next 
course comes on. So you need not be afraid of having any difficulty." 
He said, "You follow my prescription and you will get on perfectly 
well." I told him that was a very pleasant prescription. I didn't 
want to drink any water, for they were using it from the Seine, which 
at that time w^as said to be very foul. So I consented. I drank every 
wine that was brought on — and I have had no dyspepsia since ! 

With reference to old age, I wish to say that old age has a great 
many amenities and a great many enjoyments. I sometimes tell my 
friends I wish I could feel the weight of years for an hour or two to 
see how it seems. You are disposed to say, ' ' Pity the sorrows of a poor 
old man," but they are very few compared with what I anticipated. 
I find we have a great many sources of happiness, a great many sources 
of enjoyment. I was interested not long ago in reading an anecdote of 
Whittier and Holmes, the poets. Whittier was four years older than 
Holmes and when he became eighty years old, Holmes wrote a very 
witty poem, asking Whittier how it looked from that high ground, 
"what is there in the future that you see," and Whittier replied with a 
poem stating that it was perfectly beautiful from that point. There 
was no more hill climbing. It was all dow^n hill, very pleasant and 
for him to hurry to come up to that point where he could enjoy with 
him the age of eighty. I remember an anecdote of Victor Hugo which 
was very interesting. When he reached the age of seventy, he said 
he was very much depressed. He could scarcely write and for ten years 
that followed him, that sense of depression; but at eighty everything 
brightened and he became exceedingly interested in all his work, and 
renewed it. He began to philosophize, and to wonder what had hap- 
pened, and what was the explanation of this, and finally concluded 
that at seventy he had reached the old age of youth and at eighty he 
had reached the youth of old age. I think I have experienced that 
very decidedly. But after all, the question has risen why we live to 
be old, why we can live. I believe it is within the province of every 
one, but I think with myself it was heredity; it was having a good 
father and mother. My mother died at ninety-seven and I have a 



GENERATE INDIVIDUAL HYGIENE 179 

sister at ninety-seven now. With this heredity we had led the simple 
life, avoided everything that tends to lower the vitality later in life. 
One must do everything possible to save the stock of vitality one has, 
the stock in trade. You are born with a certain amount and you can 
use it up very early or you can prolong life very much longer than 
people ordinarily do. 

So I think that if we escape the chloroformist at sixty that Osier 
has provided for us and can reach the age of seventy and are then 
careful with our habits and bur work, we can reach the age of eighty — ■ 
where that old pessimist Moses said it would be labor and sorrow, 
which I did not find to be the case. If we still continue to be careful 
of ourselves we can reach ninety, and from ninety by the grace of God 
with the last words of Irving on our lips, "we can pass into Thy hands, 
Lord. ' ' 

(Acting Chairman Creegan: Probably not one of us here has 
ever witnessed such a scene before, a man ninety-two years of age 
being at every meeting, staying here last night for three hours, refus- 
ing to use the elevator, climbing four flights of stairs every day ! But 
what an example he has been to all of us. The younger men and wo- 
men who are here will live to see the day when nobody is going to 
marvel if a man one hundred years old should be present at this meet- 
ing or some similar meeting and perform his duties as presiding 
officer. ) 



SERVICE 



Acting Chairman Reverend Charles C. Creegan^ D.D., President Fargo 
College, Fargo, N. D. 

The object of this gathering is one that takes hold of my mind and 
moves my heart and when I was asked to come all the way from North 
Dakota, a distance of about a thousand miles, to attend this Confer- 
ence, I did not hesitate at all to respond to the call. I feel that the 
time has come for a plain speech along these various lines ; the time 
has come when we all want to put ourselves on record against the open 
saloon, against the liquor traffic in every particular ; the time has come 
when we want to learn, if we do not now know, better methods of 
living. 

When I see men like my venerable friend here at the right more 
than ninety years'of age, hale and hearty, with a phenomenal memory^ 
today practically as good, I suppose, as he was when he was forty, I 
ask the question, Why is it we do not have scores and hundreds of men 
in the country and women, too, who have memories like his and can 
climb four flights of stairs and insist upon doing it as he has been 
insisting upon doing it ever since he has been here ? Why can 't we do 



180 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

it? What vh^\\\ is tluM-e for any man to assert that we must die when 
we are thirty-live, forty, fifty or even when seventy? No man has a 
right to say anything of the kind. I have come to believe that we 
ought to live. If we have made up our minds for various reasons that 
we are not prepared to do it, we ought to teach our children and 
our grandchildren so that they may expect to live in the neighborhood 
of one hundred years and to have those years full of splendid living 
and beautiful characters. 

One of the biggest words in the English language or any other lan- 
guage is "service," and oh what fields for service open up as we hear 
these various papers and the addresses that have been delivered since 
this Conference began. Service ! service ! along so many lines ! We 
cannot sit down at a table anywhere, in a hotel or restaurant, without 
seeing that multitudes of people have not learned the first lesson in 
regard to right living. You can see that the food they call for, the 
food they have before them, the way they eat their food and all that 
sort of thing indicates that they have not learned those first principles. 
I have a growing feeling that this institution has come at the right 
time. There was a time when I had a very great prejudice against It. 
It was not until seven years ago that I would consent to come and see 
it. When Doctor Kellogg invited me on a special occasion to come here 
and deliver an address, my prejudice gradually began to shake away, 
and I have visited the institution as frequently as I could since. I 
have never been an invalid in all my life and I have not needed the in- 
stitution for that reason, but I have needed it because I knew that 
there were certain things that I needed to learn. I have been learning 
them here and so have you. 

Now let us make this Conference a great success. Do you think I 
am right when I say that up to the present moment, it has been a 
wonderful success ? What splendid papers we have had ! — W^hat 
magnificent and eloquent addresses ! How they give the true ring ! 
What a great privilege this has been to all of us, and when we go back 
home every single one of us, women as well as men, will be practical 
missionaries to the spirit, to spread the tidings and to make this world 
in which we live more like that we pray for when we say, ' ' Thy king- 
dom come. Thy will be done on earth as it is in heaven." I have quit 
worrying myself about how heaven is going to be, how beautiful it is, 
what sort of trumpet I am going to blow. I don 't care a rap about it. 
It is going to be all right if I am lucky enough to get there. What T 
want is to see that I live right here, and that the kingdom of God 
comes right do^n here in my heart and that I help so far as I have 
any influence to make earth like unto heaven. 



ALCOHOL AND TOBACCO 

THE EFFECT OF ALCOHOL ON LONGEVITY 

Arthur Hunter, Vice-President Actuarial Society of America, Actuary 
New York Life Insurance Company, New York, N. Y. 

A good way to determine the interest taken in the subject of al- 
cohol is to inspect the indexes of some of our great public libraries. 
Tens of thousands of books and articles have been written on the 
effect of alcohol on mankind, and on the legislative and other prob- 
lems connected therewith. It is a serious task to read even the writ- 
ings of prominent scientists on this subject. Before dealing with 
the effect on longevity, it may be of interest to give the results of 
my study of many articles on the use of alcohol. 

The experiments of Atwater, Reid Hunt, and others indicate that 
alcohol, in moderate quantities, is a food. This point of view "is 
almost universally accepted by physiologists, and the drift of opinion 
is certainly toward the view that alcohol is in all respects strictly 
analogous to sugar and fats, provided always that the amount used 
does not exceed that easily oxidized by the body." It is, however, 
generally considered as a dangerous food, and in this connection it 
should be borne in mind that the laboratory experiments do not 
represent the conditions as they exist in every-day life. They do 
not properly allow for the increasing need and desire for alcohol, 
and for its taking the place very largely of solid food among ex- 
cessive users. 

A large number of experiments have been made by Partridge, 
Kraepelin, Rivers, and many others, into the effect of small doses 
of alcohol upon muscular power and mental efficiency. On human 
beings it seems to have been conclusively demonstrated that even 
small doses of alcohol have a detrimental effect on muscular power. 
"The laborer who gains his livelihood by the strength of his arm 
destroys by the use of alcohol the very foundations of his efficiency. ' ' 
Noted army officers, such as Grenfell, Kitchener, and Roberts, of 
Britain, von Haeseler, of Germany, "Wahlberg, of Finland, have tes- 
tified to the fact that the abstainers from alcohol can stand far more 
hard work than those who drink in moderation. Their experience 
is based on keen observation of soldiers engaged in warfare. Doctor 
Parkes divided a number of soldiers into two gangs, each as nearly 
like the other in all respects as was practicable. The men in one 
gang had beer placed at their disposal, while those in the other were 

181 



182 ALCOHOL AND TOBACCO 

liiuitod to non-alcoholic drinks. The men in each sroup were paid 
according" to the amonnt of work accomplished. The non-alcoholic 
gang- did far more work in the day than the alcoholic gronp, al- 
thongh the former did less work than the latter in the earlier honrs. 
The men who had formerly taken beer at their work were asked to 
discontinue using it, and those in the non-alcoholic gang were asked 
to use beer. Again, the non-alcoholic gang did more work than those 
who drank beer, showing that it was not the superior stamina of 
the men in the first experiment which had determined the amount of 
work accomplished. In this, as in many other tests, it was noted 
that those who took alcohol did more work in the early hours than 
those who abstained, but at the end of the day the results were re- 
versed. The pleasant, buoyant feeling which alcohol gives is prob- 
ably the basis of the popular belief that more work can be done with 
it than without it — a belief which is not supported by the facts. 

With regard to mental efficiency, there seems little doubt that 
a deadening influence on the mental processes is produced by alco- 
hol, even in small quantities. For instance, Kraepelin makes the 
following statement : 

"The powers of conception and .judgment are from the beginning 
distinctly affected, although he who takes alcohol is quite uncon- 
scious that it has this effect. I must confess that my own experi- 
ments, extending over more than ten years, and the theoretical de- 
ductions therefrom, have made me an opponent of alcohol." 

Herbert Spencer remarks that "incipient intoxication, the feel- 
ing of being jolly, shows itself in failure to form involved and ab- 
stract relation of ideas." Tests made of translating from one lan- 
guage to another, of rifle shooting, of adding figures, of writing, 
of memory, etc., showed a marked loss of efficiency throiigh small 
doses of alcohol. The Rosanoffs concluded, after certain experi- 
ments with small doses of alcohol, that it impairs every human fac- 
ulty which has been tested, and that the higher and more complex 
the faculty, the more pronounced is the effect. 

Turning now to the opinion of the medical profession, we find 
that surgeons dread operations on alcoholic patients; that alcohol 
is generally believed to interfere with the production of immunity 
against specific infectious diseases; that it plays an important part 
in bringing about degeneration of nerves, muscles, and epithelial 
cells. "In my experience of nervous and mental diseases," says 
Dr. T. B. Hyslop, "I am of the opinion that alcohol is of little or no 
use except in some cases M'^here it may be administered as a tem- 
porary experiment to overcome a crisis. The role of alcohol in the 
nervous and mental economy is, in the healthy individual, an evil 
one." 



ALCOHOL AND TOBACCO 183 

Alcohol is not now considered a true stimulant. Sir Horace 
Horsley says that it is a narcotic ; that in all its forms it has a pro- 
longed depressant after-stage ; and that like other narcotics it pos- 
sesses the transitory so-called "stimulant" properties. 

All these experiments and experiences indicate that the use of 
alcohol probably shortens life, but in order to demonstrate this it 
will be necessary to compare the longevity of two groups under pre- 
cisely similar conditions : one of abstainers, and the other of non- 
abstainers. To obtain two such groups is impossible, because so 
many factors must be considered, such as nationality, habitat, diet, 
climate, occupation, etc. For example, it would not be proper to 
compare a group of abstainers who were heavy eaters with a group 
of moderate users of alcohol who were abstemious in their diet, al- 
though all other factors were the same. 

While it is practicalh^ impossible to obtain statistics regarding 
mortality for two groups of men alike in every other respect with 
the exception of the use of alcohol, a comparison on a fairly satis- 
factory basis may be made of men insured in life insurance com- 
panies. The statistics on some of these classes enable us to reach 
certain broad conclusions regarding the effect of alcohol on lon- 
gevity, but it is not claimed that the extra mortality which will be 
shown to exist in many classes is due solely to the use of alcohol. 

During the last three years, under the title of the Medico-Ac- 
tuarial Mortality Investigation, the Actuarial Society of America and 
the Association of Life Insurance Medical Directors have been con- 
ducting an investigation into various classes of lives insured during 
1885 to 1909 in forty-three of the leading life insurance companies 
of the United States and Canada. The classes investigated included 
persons in hazardous occupations, those with defects in physical 
condition, in family history, or in personal history, those who were 
overweight or underweight, etc. The investigation is based on the his- 
tory of over 2,000,000 lives. Three volumes of the results have already 
been published, and the fourth volume is in the press. At this time 
I shall deal only with several occupations connected with the manu- 
facture and sale of alcohol, and with certain classes of men not in 
these occupations, but who formerly used alcohol immoderately, or 
were steady users of it at the time the insurance was issued. 

Before presenting the results of this investigation, it is necessary 
to consider a standard of measurement for mortality. Just as in 
measuring height a standard foot has been chosen, for weight a 
standard pound, so for measuring relative mortality we have 
a standard mortality table showing the number of deaths per 
thousand at each age. This standard table represents the aver- 



184 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

aiie mortality for each age and for each j^ear of insurance among 
persons insured at the regular rates of premium. For example, the 
tabular mortality among- a group of men aged 37 in the first year 
of insurance would be 41 per 10,000, whereas under a group of the 
same age (37) who had been insured ten years before, at the age of 
27, it would be 53 per 10,000. While the attained ages are the same, 
the mortality is different in the two groups because one group had 
been medically examined within a year, and the other ten years 
before. These sets of ratios are applied to the classes under inves- 
tigation, and the expected or tabular deaths are calculated. Thus, 
if there were a group of 5,000 saloon-keepers insured one year ago 
at age 37, the expected mortality would be 20.5, i. e., 5,000 at the 
tabular death rate of 4.1 per 1,000, and this would be compared with 
the actual deaths. Should the actual deaths in the group be 31, then 
the actual mortality would be 150 per cent of the expected or tabu- 
lar, according to the average mortality of the various companies on 
standard lives who were not engaged in hazardous occupations. A 
ratio of actual to expected deaths of 150 per cent means 50 per cent 
in excess of the normal mortality; 175 per cent means 75 per cent 
in excess of the normal mortality ; and 200 per cent, 100 per cent 
in excess, or double the normal mortality by the standard table. 

Another way of interpreting these ratios is to consider 100 as the 
number of deaths which would normally be expected, so that if the 
ratio of actual to expected deaths were 150 per cent, there would be 
150 deaths, whereas, in a similar group of normal lives there would 
have been onl,y 100. 

The statistics of the Medico-Actuarial Mortality Investigation de- 
scribed herein were based on men who were resident in the United 
States or Canada at the date of application for insurance, and the 
results, therefore, relate to the effect of the use of alcohol in the 
temperate zone. There are no similar statistics with regard to tropi- 
cal countries, and, accordingly, the conclusions of Major Woodruff 
regarding the beneficial effect of alcohol in the tropics are neither 
confirmed nor disproved by the statistics contained in this paper. 

In all the classes connected with the liquor trade, which will be 
brought to your attention, the men insured in the different com- 
panies did not drink immoderately at the date of application for 
insurance. The high mortality in this trade cannot be ascribed to 
the inclusion of men whose habits were bad: many of them un- 
doubtedly, however, succumbed to temptation some time after the 
policy was issued. 

In accepting for insurance the men in the liquor business, the 
companies were generally as severe in their selection as in that gov- 



ALCOHOL AND TOBACCO 185 

erning the acceptance of persons in non-hazardous occupations; in 
fact, the statistics prepared by the Committee indicate that the com- 
panies accepted for insurance men engaged in unfavorable or doubt- 
ful occupations less freely than those in non-hazardous occupations. 
The first group of occupations with which I shall deal is that con- 
nected with the serving of liquor. The group covering Saloons also 
includes Billiard Rooms, Pool Rooms, and Bowling Alleys in which 
there is a bar : 

c'trrtnvc Actual Expected Ratio of Actual to Extra 

.•>Ai.uuj\/i : Deaths Deaths Expected Deaths Mortality 

Proprietors and Managers not attend- 
ing bar 222 122 182% 82% 

Proprietors and Managers attending 

bar 830 479 173% 73% 

HOTELS WITH BAR: 
Proprietors, Saperintendents and Man- 
agers attending bar 519 292 178% 78% 

It will be noted in the foregoing that the mortality is higher 
among the proprietors and managers of saloons who stated that 
they did not attend bar than among those who admitted attending 
bar ; and that the mortality among hotel-keepers attending bar is 
practically the same as among saloon-keepers. There were fully 
22,000 cases in the above classes — a nuanber large enough to give 
reliable results. 

In the following two occupations the policy-holders did not attend 
bar: 

TjriTT^T V TJ-TTTT KIT? Actval Expcctcd Ratio of Actuul to Extra 
tiui£.in-i Willi JiAK: Deaths Deaths Expected Deaths Mortality 
Proprietors, Superintendents and Man- 
agers not attending bar 529 392 135% 35% 

RESTAURANTS WITH BAR: 
Proprietors, Superintendents and Man- 
agers not attending bar 105 69 152% 52% 

It is apparent that where liquor may be had freely, there is 
danger to the men who may have it without price. 

It is unnecessary to give examples of all occupations connected 
with the liquor trade, but the following two large groups, contain- 
ing the records of men insured under 15,000 policies, are of par- 
ticular interest: 

PprirfiipTrc. Actual Expected Ratio of Actual to Extra 
rs^iiin £,A,j£,^ ; Deaths Deaths Expected Deaths Mortality 
Proprietors, Managers and Superin- 
tendents 483 359 135% 35% 

WHOLESALE LIQUOR HOUSES: 

Proprietors and Managers 992 811 122% 22% 

It is freely recognized that there is a considerable difference be- 
tween the various types of breweries and between the duties of those 
in charge of the various wholesale houses. If these two classes were 
broken up into more homogeneous groups, the mortality would 



186 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

raiiue i'roni nornial to twice the normal, depending on the habits 
of the men and their specific work. The loss of life may be readily 
seen in the case of wholesale liquor merchants. If these proprietors 
and managers had been in a non-hazardous occupation, there, would 
have been about 180 less deaths during the period under observa- 
tion. 

Other classes have been investigated, such as clerks in breweries, 
traveling salesmen, clerks in wholesale liquor houses, etc. In every 
instance the mortality was higher than among lives in non-hazard- 
ous occupations, with the single exception of the proprietors, mana- 
gers, and superintendents of distilleries. 

Valuable information regarding the influence of occupation on 
mortality may sometimes be obtained from a study of the causes 
of death. A standard of comparison is necessary, and this is ob- 
tained by tabulating the causes of death among a large group of 
persons who had been accepted by life insurance companies at the 
regular rates of premium — that is, who were considered standard 
or average lives. From such a group the normal death rate from 
each cause is deduced, and a comparison can then be made with the 
actual death rates in the class under investigation. Thus, the nor- 
mal annual death rate from tuberculosis of the lungs at age 35 is 
about 8 per 10,000 exposed to risk of death, and if, in a specific oc- 
cupation, the death rate were found to be 16, it would be twice the 
normal. The causes of death in the occupation classes just dealt with 
show distinctly the efifect of alcohol. For example, among the hotel 
proprietors, superintendents and managers who attend bar, the 
death rate from cirrhosis ,of the liver was six times the normal ; from 
diabetes and Bright 's disease, three times the normal; and from 
apoplexy, heart disease and pneumonia, twice the normal. Unques- 
tionably, some of the excess mortality among those in the liquor 
trade is due to the long hours and other unsatisfactory conditions, 
but the greater part of the excess is due to the contact with alcohol 
in its various seductive forms. 

In the reports on the Medico-Actuarial Mortality Investigation, 
there appears the mortality among several classes of men who have 
used alcohol to an immoderate extent in the past, but who were not 
in the liquor trade at date of insurance. None of the cases, there- 
fore, in the groups now to be considered entered into the classes 
which have already been considered. 

HISTORY OF OCCASION.y^ EXCESSES 

The forty-three companies in the Medico-Actuarial Investigation 
issued during a period of twenty-five years about 5,800 policies at 



ALCOHOL AND TOBACCO 187 

the regular premium rate on men who had a history of occasional 
alcoholic excesses in the past and who were not in hazardous occupa- 
tions (including as hazardous occupations the manufacture and sale 
of alcohol). The great majority of men with this history who ap- 
plied for insurance were declined, and, accordingly, the classes con- 
sisted of the very best of the applicants, so far as the companies 
were able to determine. NotA\dthstanding this extreme care in selec- 
tion, the mortality was high, as may be seen from the following 
synopsis : 

Actual Expected Ratio of Actual to Extra 
Deaths Deaths Expected Deaths Mortality 
Occasional alcoholic excesses, the last 
ivithin five years of the date of ap- 
plication for insurance 110 67 164% 64% 

Occasional alcoholic excesses, the last 
more than five years prior to the 
date of application for insurance... 58 40 145% 45% 

An excess at an indefinite time in the 

past 121 83 146% 46% 

The heavy extra mortality, averaging 52 per cent, is not due solely 
to excesses in the past only, but arises partly from excesses after 
the policy was taken out. A proportion of those who had exceeded 
the limits of moderation in the past undoubtedly became heavy 
drinkers at some time after the policy was issued. 

FORMERLY INTEMPERATE, REFORMED WITHOUT TREATMENT 

Another class consisted of those whose habits were formerly in- 
temperate as to alcohol, but who had reformed without any treat- 
ment, and who were in non-hazardous occupations. This class also 
consists of the best types only of risks presented to the companies, 
cases where there was reasonable assurance that the satisfactory 
habits at date of application for insurance would be likely to con- 
tinue. The statistics are divided according to time elapsed since the 
habits were intemperate. 

Actual Expected Ratio of Actual to Extra 
Deaths Deaths Expected Deaths Mortality/ 
The last record of intemperate habits 
within five years of date of applica- 
tion for insurance 150 113 133% 33% 

The last record of intemperate habits 
more than five years from date of 
application for insurance 154 137 112% 13% 

It may be inferred from the foregoing figures that the longer 
the time elapsed since the habits were intemperate, the more pros- 
pect there is of a permanent cure. 

TAKEN CURE FOR ALCOHOLIC HABITS, TOTAL ABSTAINER SINCE CURE 

This was not a sufficiently large class to justify a division accord- 
ing to time elapsed since alcohol was taken to an immoderate extent. 



188 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

The followiiii;:, therefore, shows all cases in which the habits were 
unsatisfactory at least two years prior to date of application: 

Actual Expected Ratio of Actual to Extra 

Deathn Deaths Expected Deaths Mortalitii 

Record of intemperate habits at least 
two years prior to application; 
policy holders took cure for alcoholic 
habits, and had been total abstainers 
since cure up to date of application 
for insurance 79 58 136% 36% 

The mortality among those who had taken a cure and were total 
abstainers from that time to date of application for insurance was 
somewhat higher than among those who reformed without treatment. 
It should not be deduced therefrom that the alcoholic cures are not 
of value; it is probable that those who had taken a cure had used 
alcohol more freely than those who had reformed without such a 
cure, and also that the men in the latter class may have been 
stronger-minded than in the former. The companies hoped to de- 
termine the mortality among men who had taken the cure for alco- 
holism and had not been total abstainers since the cure, but the 
number of cases was too small to justify an investigation. 

STEADY USE OF ALCOHOL 

Another interesting class of men investigated by the Actuarial 
Society and the Medical Directors' Association is that comprising 
those who were designated "steady, free users" of alcohol. In col- 
lecting the statistics, the decision as to the cases which would prop- 
erly fall within this designation was left to the judgment of the in- 
dividual companies. As a result, the type of cases placed in this 
class was found to vary to a considerable extent, depending largely 
on the view of the medical directors, and the class was accordingly 
divided into two groups. In one group ("Liberal") were placed all 
the cases in which the companies had used as a test Anstie 's limit of 
two ounces of alcohol in a day; and in the other ("Conservative"), 
those which considered less than Anstie 's limit as constituting a 
steady free use. In the "Conservative" section appear the cases 
where two glasses of beer or one glass of whiskey daily was con- 
sidered a steady, free use, although few persons would consider such, 
a quantity as a free use of alcohol. (In a publication of a promi- 
nent insurance company, the equivalent of Anstie 's limit is stated 
to be two wineglasses of sherry or other strong wine, one pint of 
champagne, three tumblersful of strong ale, or five tumblersful of 
beer. ) The following shows the results of the subdivision : 

Actual Expected Ratio of Actual to Extra 

Deaths Deaths Expected Deaths Mortality 
"Conservatire" : Interpretation — steady, 

but very moderate use 1,725 1,460 118% 18% 

"Liberal": Interpretation — steady, free, 

but not immoderate use 698 374 187% 87% 



ALCOHOL AND TOBACCO 189 

There can be no better evidence in my opinion of the bad effects 
of alcohol on longevity than the foregoing. These classes do not 
constitute men who were immoderate drinkers at the date of appli- 
cation, or whose standing in the community was bad. They were all 
men considered to be entitled to policies without extra premium 
by the insurance companies, their habits not being considered a 
serious detriment. Yet the extra mortality among those who used 
two ounces or more of alcohol a day was 87 per cent, and the causes 
of death showed that the death rate from cirrhosis of the liver was 
five times the normal, and from diabetes, tuberculosis, pneumonia, 
and suicide, twice the normal. The mortality among saloon-keepers 
whose habits were satisfactory at the time the policy was issued was 
slightly lower than among men not connected with the manufacture 
or sale of alcohol who took two or more ounces of alcohol each day, 
but who were not considered immoderate drinkers. 

In the foregoing presentation I have included all classes enter- 
ing into the Medico-Actuarial Mortality Investigation which were 
composed of persons who were free users of alcohol at the time of 
insuring, or had previously been immoderate users of alcohol. The 
Medico-Actuarial Investigation included thirteen classes of persons 
connected with the manufacture or sale of alcohol, and only one of 
these classes showed a mortality as low as the normal (Managers 
and Proprietors of Distilleries). It is evident, therefore, that the 
presentation here made is not unduly unfavorable. 

MORTALITY AMONG ABSTAINERS 

It may interest abstainers to know that in 1840 an application 
was received by an English insurance company for a policy on the 
life of an abstainer, and the directors of the company decided to 
charge 10 per cent more than the ordinary premium because they 
looked upon the applicant as "thin and watery, and as mentally 
cranked in that he repudiated the good creatures of God as found 
in alcoholic drinks." As the result of this action, he, with his 
friends, founded the first temperance insurance company in Britain, 
and himself lived to the age of 82. 

There has been published only one comparison between abstainers 
and non-abstainers, based on the experience among the insured in 
an American company, and this was presented by the New England 
Mutual Life Insurance Company. The insured were divided into 
four classes: (1) Total abstainer; (2) Rarely use; (3) Temperate; 
and (4) Moderate. The standard used in testing the mortality was 
the American Table, which is generallv the basis for the calculation 



190 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

of preiniiiiiis. The following- shows the approximate percentages of 

that table : 

Total abstainer 59% 

Rarely use 71% 

Temperate 847o 

Moderate . . .125% 

According to the above table, the moderate drinkers had twice as 
high a mortalitj^ as the total abstainers. There have been no other 
data published in recent years in this country of the experience of life 
insurance companies with abstainers, except that published by 
the Security Mutual Life Insurance Company, of Binghamton, 
N. Y. Unfortunately, a comparison was not made of non-abstainers 
with abstainers, but the mortality among the latter was very low, 
and, so far as may be judged, much lower than among the general 
insured of the company. The following is a synopsis of the pub- 
lished experience of insurance companies in other English-speaking 
countries : 

Morfaltty of General or Approximate excess of 
N on- Abstainer Section mortality among Non- 
compared with that of Abstainers over Ab- 
Abstainer Section. stainers. 
United Kingdom Temperance and General 
Provident Institution (England), ex- 
perience from 1866 to 1910 135% 35% 

Sceptre Life Assurance Company (Eng- 
land), experience from 1884 to 1910. . 150 50 
Scottish Temperance Life Assurance Com- 
pany (Scotland), experience from 1883 

to 1907 140 40 

Australian Temperance and General Life 
Assurance Society (Australia), experi- 
ence from 1900 to 1910 160 60 

Manufacturers Life Insurance Com- 
pany (Canada), experience from 1902 
to 1910 175 75 

From the non-abstainer section were excluded those who were 
known to drink immoderately at the date of application for in- 
surance. 

There is conclusive proof in these figures that those who are 
total abstainers live much longer on the average than those who are 
non-abstainers. It must not be assumed, however, that the very low 
mortality of the total abstainers is due solely to their abstinence 
from alcohol. Dr. Dwight, the Medical Director of the New Eng- 
land Mutual Life Insurance Company, points out that the mortality 
among men who are total abstainers from alcohol is practically the 
same as among men who are total abstainers frorii tobacco, and that, 
generally speaking, the same body of men are included in these two 
classes. There are other factors which enter into this matter, such 
as these: (1) abstainers are proportionately oftener found in non- 
hazardous occupations than in hazardous. For example, there would 
be a larger proportion of clergymen, who have normally a very low 



ALCOHOL AND TOBACCO 191 

mortality, among the abstainers than among the moderate drinkers ; 
(2) the conditions which surround the home life may be better 
among the abstainers than among the non-abstainers, and there may 
not be the samie temptation to the former to devote a large amount 
of time to club life ; (3) a man who is a crank on one subject is 
likely to be a careful liver. (A crank, says 0. W. Holmes, is a man 
who does his own thinking.) An abstainer and non-smoker is prob- 
ably abstemious in his diet, and lives in the open air as much as 
possible. It has also been suggested that those who are total abstain- 
ers are so because they are vigorous and active and do not feel the 
necessity for stimulants, whereas those who are not total abstainers 
might not be quite equal in physique. There is not a consensus of 
opinion in this matter, however, the President of the United King- 
dom Temperance and General Provident Institution of Britain giv- 
ing his opinion that there was little foundation for the belief that 
the better mortality among the abstainers is due to their generally 
careful, quiet, methodical mode of life. He believes that, other things 
being equal, abstinence from the use of alcoholic liquors as bever- 
ages is conducive to health, and promotes longevity. He states that 
a large number of persons come before him, and that he would defy 
anyone who saw them to say which was the abstainer and which 
was the non-abstainer unless he had the record before him; ''they 
lived in the same towTi, they worked at the same occupation, they had 
the same rate of income, they were practically the same kind of 
person." 

Unfortunately, there are no statistics in existence of two bodies 
of men exactly alike in every particular with the single exception 
that one group consists of total abstainers and the other of moderate 
users of alcohol. Yet, as there is always the temptation to drink to 
excess among moderate users of alcohol, and this temptation a pro- 
portion of them will not be able to resist, we may say with assurance 
that a body of abstainers would have a longer life-time on the aver- 
age than a body of non-abstainers alike in all respects except as 
to the use of alcohol. "There is no more perplexing problem of in- 
dividual psychology and physiology than the subtle differences 
which make it possible for one man to drink moderately through- 
out life without danger of excess, while another, apparently as well 
constituted and living under as favorable conditions, perishes in the 
presence of alcohol." (Partridge.) 

I have been in the actuarial profession for over twenty years, 
and have had the opportunity of studying, not only the published 
statistics, but many private investigations. I cannot recall a single 
large class of men or women using alcohol freelv but not immod- 



192 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

eratoly at the date of application for insurance, or who had used it 
in excess formerly and were now temperate, that did not have a 
higher mortality than the normal. AVhile not a total abstainer, I am 
convinced that it would be immeasurably better for this, or any other 
country, to have the production and sale of alcoholic liquors 
abolished if it were practicable. The advantages claimed for alco- 
hol are a small offset, in my judgment, to the evils which proceed 
from its use and its abuse. 



ALCOHOL — WHAT SHALL WE DO ABOUT IT? 

Henry Smith Williams, LL.D., M.D., New York, N. Y. 

I should like at the outset to subscribe to every word that Mr. 
Hunter has told us about the effects of alcohol. I should like also 
to subscribe very fully to the optimistic point of view that he pre- 
sented at the close. I, too, am an optimist. I, too, believe things are 
not nearly so bad as they might be and that they are going to be 
very much better. 

But at the same time in regard to this matter of alcohol, we are 
confronted with some very unpleasant statistics. I shall subscribe 
a third time to what he said about the unreliability of statistics, 
but the few that I must give you I think are authentic. They refer 
merely to quantities of alcohol that are being consumed. He spoke 
of the attitude of insurance companies in 1840. Now it chances that 
in 1840, the time of our grandparents, the amount of alcohol con- 
sumed in this country per capita each year was just under four gal- 
lons, specifically two and one-half gallons of distilled spirits and 
one and one-third of malted beverages, something less than four gal- 
lons. Last year for the fiscal year ending June 30, 1913, the per 
capita consumption of alcoholic beverages in this country was some- 
thing over twenty-three gallons ; that is to say, there were almost six 
times as much alcoholic beverages consumed last year as in 1840. Let 
me at once point out, however, that the case is not quite as bad as it 
seems, for, of course, we all know that last year and now-a-days we are 
consuming a great deal more beer, in proportion, and a great deal less 
whiskey in proportion. We know also that the detrimental effect of 
alcoholic beverages depends very largely and perhaps entirely on its 
alcoholic content, and that whereas whiskey or distilled liquors have 
thirty, usually forty or forty-five, up to sixty per cent of alcohol, the 
malted beverages have only from two to six per cent. Nevertheless, 
if we reduce the amount of liquor consumed last year to terms of 



ALCOHOL AND TOBACCO 193 

alcohol, and make the same reduction for the liquor consumed in 
1840, we find that there was a larger consumption of absolute alco- 
hol last year in America than in 1840. 

That is a fact of almost appalling significance, at least when we 
reflect that seventy-three years of effort have been made to combat 
alcohol. At the end of that time we are consuming more than we 
did at the beginning. The tide of alcohol has risen, decade by decade. 
There has been no decade since 1840 when the per capita consump- 
tion has not been greater than it was in the preceding decade. 

The statistics regarding the rise are very clear because they are 
based, of course, on the government records. The payment of an 
internal revenue tax must be made, so that the alcohol statistics are 
among the few statistics that we can really trust, I think. It seems 
that in 1896 the per capita consumption of distilled liquors in the 
United States was about eighty-six hundredths of a gallon per 
capita. Last year it was one and a half gallons per capita. There 
was a notable falling off in 1908, and some of us were deluded into 
hoping that the crest of the wave had been passed, that now it was 
receding; but apparently the cause of the falling off was merely 
the industrial conditions of the time, and now the tide is rising again, 
with no seeming tendency to reach the high water mark. 

Meantime there has been an incessant effort, notably in the last 
dozen or fifteen years, to combat alcohol by means of legislation. 
Needless to say I refer to the prohibition movement. In 1880 Kansas 
passed a prohibition law ; in 1884 Maine ; in 1890 North Dakota ; and 
five Southern states have come in in recent years, beginning with 
Oklahoma and Georgia in 1907. Local option has spread so widely that 
today we are told no fewer than forty million Americans are living 
in dry territory. Now if this territory were really dry, no one as- 
suredly would take greater pleasure in contemplating that fact than 
I do or I would ; but unfortunately we must recall that it is legal to 
ship alcoholics into this dry territory, even where they have state- 
wide prohibition. I have recently been making a personal investiga- 
tion to endeavor to find out what really are the conditions in the pro- 
hibition territories. I will give you one or two illustrative instances. 
In the month of September of 1913 — last September — ^there were offi- 
cially shipped into Topeka, Kans., ninety thousand quarts of alco- 
holic beverages, or ten quarts per family. The little town of Te- 
cumseh, near Topeka, a town of one hundred inhabitants, received 
fifteen hundred quarts in the month of September. Turn to the 
South. I made an investigation there recently, and, as an illustra- 
tion, in Asheville, N. C, where there is not a saloon open and 
where I verily believe the prohibition law as regards the sale of 

(8) 



194 FIRST NATIONAL CONFERENCE ON RACE I5ETTERMENT 

li([uor is eai-riod out absolutely, there were shi|)p(Ml in four thousMiid 
li-allons of alcoliolie beverages, exclusively distilled liquor, I think — 
four thousand gallons in ten days, into a worthy town of two thou- 
sand inhabitants. If we look a little more widely, we find the re- 
turns of a recent investigation of the Interstate Commerce Com- 
mission pointing out that no fewer than six million gallons of dis- 
tilled liquor are shipped by the express companies from four or five 
Southern states, almost exclusively, of course, into prohibition terri- 
tory. The city of Chattanooga, itself lying in the prohibition state 
of Tennessee, ships seven hundred and eighty-eight thousand gallons 
per year. Incidentally the entire shipment to Asheville came from 
Chattanooga. Other cities in the prohibition states shipped enor- 
mous quantities, and the estimate is made by the Interstate Com- 
merce Commission that the total shipments of liquor by express 
companies amount to not less than twenty million gallons per year. 

These are all very unpleasant facts. They seem to show that the 
legislation of recent years has discriminated in favor of distilled 
liquors against malted ones — not intentionally, of course, but in 
effect, because the distilled liquors are so easily transported, shipped 
by express. 

That is not quite all. In the South there has grown up in the 
past few years since the prohibition laws were passed in Georgia, 
North Carolina and other states, an enormous traffic in other drugs, 
morphine to a certain extent, but notably cocaine. The poor white 
population and the ignorant negro population, sometimes not being 
able to write or not having the intelligence to write for liquor as the 
more intelligent people do, or perhaps not having the dollar or two 
to send, content themselves with buying a box of cocaine from the 
nearest newsboy. I meant to bring with me, but forgot to do so, a 
little box of cocaine taken from a negro prisoner in a Southern jail. 
It looks like an ordinary pill box. Those are sold for a quarter. 
Enormous quantities of it today are being sold throughout the South. 
The effects are seen in the most disastrous way because, unfortunately, 
bad as is the effect of liquor on the negro in particular, the effects of 
cocaine are far worse. Under the influence of cocaine, the negro be- 
comes homicidal even though normally a mild person ; he becomes 
homicidal and ugly in every way. The policemen of the South are 
finding a new problem presented to them by the cocaine negro. And 
there can be no question that, very largely, increase in the use of 
cocaine is due to the fact that it has become somewhat difficult for the 
negro to secure liquor. 

A word about one other line of legislation in the South. South 
Carolina attempted to solve the problem, as you know perhaps, by 



ALCOHOL AND TOBACCO 195 

having a dispensary law. They got hold of one corner of a great 
truth. The great truth is that the real solution of the liquor problem 
must come through taking the control of the traffic out of indi- 
vidual hands, making it so that no individual and no corporation 
makes money out of the sale of liquor. That is the great truth w^hich 
originated and was promulgated in Sweden. They got hold of a 
corner of it, but they did not apply it in a rational way. 

They did take the traffic out of the hands of individuals and gave 
it over to the state, but unfortunately they applied the profits to the 
regular tax rate, and so instead of there being a few people wiio 
were interested and having profits from the liquor business, every- 
body was more or less interested. 

I chanced to find the other day the official ann'oiuicement of the 
commissioners of one county, Barnwell County, in South Carolina, 
which has a population of 35,000, asking for bids for liquor for the 
coming year and, without troubling you with figures, I may sum- 
marize them by saying that the quantity of liquor called for 
amounted to four gallons per capita of whiskey and its allies, and 
only two quarts per capita of beer. We see that by this law there 
is an enormous discrimination in favor of whiskey. That would be 
my criticism of all of the legislation of recent years. Unintention- 
ally, but none the less effectively, it is discriminating in every way 
in favor of whiskey. 

I shall make just one other reference to the investigation that I 
have made to test the effects of liquor, to judge it by its effects in the 
prohibition territory. After all we have no objection to alcohol as 
such. It has almost the formula of sugar. We have no objection to 
its particular combination of carbon, hydrogen and oxygen. What 
we object to is its effects — its effects on the brain, on the mind and 
morals of the people. And so I thought to make a test to see whether 
— since it is impossible to determine the exact amount of liquor that 
is shipped into prohibition territories — whether or not it is true that 
the effects of alcohol are as conspicuous in prohibition territories as 
elsewhere. So I made an investigation in Kansas and then in the 
South. It is not yet published but will very soon be in detail. Sum- 
marizing let me say that the records of police courts, the records of 
prisons, the records of almshouses, the records of asylums for the 
insane, all show conditions in the prohibition territory that average 
at least as bad as and very commonly w^orse than elsewhere. I fear 
there can be no question about that. 

It remains, then, to inquire, What shall we do? Accepting the 
facts as I found them, I cannot make myself believe that the pres- 
ent line of legislation is effective, or is the best that we can do. 



19f) FIRST NATIONAI, CONFERENCE ON RACE BETTERMENT 

Others feel the same way, some of those in anthority. Last summer 
Senator Works, of California, introduced a joint resolution in Con- 
gress providing for the total abolition of distilled liquor. He wishes 
to have a (Constitutional amendment passed to that effect. [Ap- 
plause.] I like to hear the applause, because I should applaud that 
move myself if I thought it had any prospect of success. But 1 fear 
it is illusory. I fear in the first place that there is no probability that 
it will become a law, and, in the second place, I fear that in the 
present state of things it would not be effective if it did. If we can- 
not enforce partial prohibition, I cannot see how we can hope to en- 
force the total prohibition of a substance that is so popular that one 
and a half gallons per capita of it are consumed each year in the 
United States. Yet this resolution marks a stage of progress in that it 
does discriminate, definitely and precisely, against distilled liquor. 
TJhe other laws have had the unfortunate effect of discriminating in 
their favor. I also consider it as epochal in another regard, in that it 
recognizes the principle that we must advance by evolution, rather 
than by revolution; that we cannot take away from a people any- 
thing that is used in such enormous quantities. 

All through history there is no example of a people changing its 
habits radically in a single generation. Always those changes must 
be slow, always by substitution. The best that I can hope, from 
my study of history and my knowledge of human psychology, is that 
we may substitute the milder drink for the stronger one, ultimately 
a still milder for that, and ultimately an altogether non-alcoholic 
one. That, it seems to me, is the principle w^e must attempt to apply. 

Speaking practically then, just a few words as to what possible 
lines of action seem to me to lie just ahead. I would say. Tax "hard" 
liquor — a modification of Senator Work's idea to put a very high tax 
on distilled beverages, double the present tax at least. Then I would 
have the saloon, since w^e must have it, pay a much higher license on 
distilled beverages. That would discriminate against whiskey and in- 
crease its price. As a mere economic result its consumption would 
therefore tend to decrease. This w^ould not keep the people who are 
the most injured by whiskey from taking it. That is a second prin- 
ciple that we must recognize. Alcoholism is always an effect. It is 
the cause of many things, but it has its effect because of the bad 
brain which the person who is injured hy it has had the misfortune 
to inherit. The normal person will not become a drimkard even if 
liquor ran free from the fountains at the street comers, but the ab- 
normal person, with a lust for alcohol, will get it if he must go through 
fire and possibly water for it. We have got to recognize that, and 
treat the dipsomaniac. Recognizing that, our present plan of sending 



ALCOHOL AND TOBACCO 19 ( 

him to jail for a day or a week and then turning him out again to do 
the same thing over is foolish. It is grotesque, and we must get away 
from it by treating him rationally, by segregating him for a sufficient 
period. 

One other point. We must recognize that the greatest dangers of 
alcohol are to the adolescent. We must make it as nearly impossible 
as it can be for the adolescent, for the youth, to secure alcohol. Let 
there be an absolute interdiction of the sale of alcohol, either to the 
drunkard or to the minor. Let the records of our police courts be 
given to the saloon-keeper, and let him be restrained from selling al- 
cohol to a person who has been arrested for intoxication within a 
period of one year, let us say, or two years, and take away his license 
if he violates that. Take away his license at once if he ever sells to 
a minor. 

Then — more important, as I see it, than anything else — let the en- 
tire proceeds, both the government revenue and of local license fees, 
be used for public utility, and not applied to the general tax rate. 
Let them be used for eleemosynary institutions, playgrounds, gym- 
nasia, music halls and other counter attractions to the saloon. That, 
of course, is the second fundamental principle of the great Swedish 
Gothenburg System. We should therefore discriminate against 
whiskey, treat the dipsomaniac rationally, keep alcohol away from 
the youths and use all the money that may come from the traffic 
to fight the traffic. 

Discitssion . 

The Sacrifice of Boys and Girls 

Dr. Amanda D. Holcomb, Mount Pleasant, Mich. 

I was intensely interested in the cure given last night by Doctor 
Williams for this liquor condition. The thing that interested me 
especially was that it is a cure that we can get. It is easy of attain- 
ment. If we want a bill to supersede the National Prohibition Bill, 
we can get the Bill that he suggested, to raise the license and to 
raise the revenue on liquor. We can get that. It will be easy. 
Money will be furnished by the breweries to put it through, and we 
will get it, and it will work, because they have our one hundred 
thousand boys who are being debauched every year by the liquor 
traffic, and this will be increased to one hundred and fifty thousand 
boys. And we shall have plenty of rescue work for women, then, be- 
cause our fifty thousand girls that are being debauched to satisfy 
that hundred thousand boys w^ll be increased to seventy-five to one 
hundred thousand girls that we will have to rescue. 



198 FIRST NATIONAL CONFEEENCE ON RACE BETTERMENT 

Discns.fiou. 

The Worst Dry Town versus the Best Wet Town 
Damei. a. Pouno, Battle Creek Sanitariiun, Battle Creek, Michigan. 
For the last fourteen years, or since my undergraduate work in 
Michigan, I have been intensely and in a very vital way interested in 
the question discussed last night by Doctor Williams. I have been 
here [at the Battle Creek Sanitarium] for the last three weeks with 
one who needed me very greath^ Because of that I have not par- 
ticipated in the Conference. Last evening I heard the paper of 
Doctor Williams and I appreciated it very much. I would say as an 
announcement, so that you will understand that I can speak with 
the authority of representation at least, that I am Citizenship Super- 
intendent of the Christian Endeavor, and, as such, represent officially 
upward of four million young people ; I am one of the National Vice- 
Presidents of the National Anti-Saloon League, National President of 
the Temperance Council of one hundred official national organiza- 
tions ; I am also educational superintendent of the Prohibition Na- 
tional Committee. I appreciate what Doctor Williams said, not be- 
cause I agreed with him in every particular, because I did not, but 
because I appreciated the way in which he dealt with the sub.iect, 
and believe he meant every word he said. 

I am very sure we shall not solve this problem, from my view- 
point or from your point of view, until we deal with every phase of 
the question, until we are quite unbiased and willing to understand 
the thing the other man sees more clearly than perhaps we see it. 
I do not disagree with the statistics quoted by Doctor Williams. I 
do disagree, in some instances, with the statistical application of 
what he said. For instance, the introduction of 90.000 quarts of 
liquor into Topeka is not conclusive. The real question is how much 
liquor was shipped into Topeka before prohibition became effective 
there. Were there more than 90,000 quarts shipped in, within the 
same time, before prohibition became operative ? We are bound not 
to forget also that Asheville, in the South, is a resort frequented by 
Northerners and that these men are men of great wealth. 

There is another thing we are bound to recognize : I agree with 
the Doctor when he says prohibition does not prohibit. He did not 
make the statement in that way; he said it Avould not be effective 
under the circumstances. Prohibition does not prohibit because it 
cannot prohibit. It is an amendatory law, but I submit to you that 
prohibition can be made effective, that it is subject to enforcement 
just in proportion as prohibition is appreciated as an opportunity. 
Just in that proportion will it be effective in accomplishing that 
whereunto it is sought. I do not say it will wipe out drunkenness. 



ALCOHOL AND TOBACCO 199 

Some people will get liquor. Proliibition is said to be a failure. So 
far as some kinds of people are concerned, it is a failure. I am talk- 
ing about the rising generation. 

I say, out of first-hand experience in every great city of our 
North American Continent, that the worst dry town is unspeakably 
better than the best wet town, so- far as the raising of children is 
concerned. I was in Maine in December. I went to Portland with 
the new sheriff of that county. I saw thousands of gallons of liquor 
confiscated. 

I believe in prohibition because I believe it is a great moral ques- 
tion. I am convinced that the Government ought to assume a proper 
attitude on this question, that the Government ought to say as a 
foundation basis, a basis upon which we can work to eugenics, a 
foundation basis upon which we may work through every depart- 
ment, especially unto the uplifting of mankind — the Government 
ought to say in the beginning whether the liquor traffic as an insti- 
tution, whether the liquor traffic as a great problem industrially, 
economically, politically and morally is right or wrong, and having 
so declared itself, then it comes to us as a greater opportunity to 
take care of the actual situation that confronts us at the present 
time. Prohibition does not prohibit, but it can be made effective. 
It is subject to enforcement. 

When men say more liquor is sold in dry territories I am sure 
we are not troubled greatly. Why is it, then, that the liquor man 
does not spend a great deal of money and time in bringing to pass 
prohibition, so that it will be possible for him to sell more liquor? 

I saw some agencies employed to make the introduction of liquor 
in Portland. Me., possible. I saw a tank that had been set in 
cement between the floors of a building. Eighty feet of pipe led 
down to the faucet. On turning the faucet one way with a given 
pressure you get whiskey : by turning it another way you get water 
— all of. which goes to show that liquor is sold in greater quantities 
in dry territory than in wet territory, all of which goes to show that 
it is easier to get intoxicated under prohibition than under license. 

But I ask you whether or not license has succeeded. We have 
had laws all over the United States against selling intoxicating 
liquors to minors. We have had laws all over the United States 
against selling intoxicating liquors to those who have become habit- 
ual drunkards. Have these laws been effective? No man here will 
say that these laws have been effective. But I charge you now, that 
inasmuch as at the end of a long period of years prohibition has been 
as supinely a failure as license, we shall find another way. The 
burden of proof rests on license today, not on prohibition. 



200 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

And T woulil remind you that this is a national question. After 
all, we have never had a loot of real prohibition territory in the 
United States. This is a national disease. It is a national problem. 
Until we deal with a national problem in a national way, until for 
national disease we bring a national remedy, we shall not begin to 
solve finally the great question that confronts us at the present time. 

I submit to you today that we are studying a many-sided proposi- 
tion, and that to arrive at a wise conclusion we need not only the 
research work of those who are already committed to prohibition, 
but we need the research work of men like Doctor Williams and 
other men who are just as honest as I ever hope to be, and who are 
doing their very best to solve the greatest problem that has ever con- 
fronted this race or any other race. 

Discussion. 

Proportionate State Consumption of Alcohol 

Dr. E. G. Lancaster, President Olivet College, Olivet, Michigan. 

There is not one onje-hundredth part of the liquor drunk in Maine 
and Kansas that there is in the "wet" states, like Massachusetts. 
I think I can prove that by the statistics Mr. Williams gave us in 
his strong paper. I appreciate the paper very much, because it is 
just in time to head off a lot of wild stampedings. He said that the 
express companies are handling twelve million gallons of liquor a 
year, and that the people drink about two or three gallons per 
capita. This means two or three hundred millions of gallons per 
year. It shows there is one hundred times as much liquor drunk in 
wet territory as there is in dry. 

Discussion. 

Caution in the Use of Statistics 

Edward Bunnell Phelps, Editor The American Underwriter, New York, 
N. Y. 

I want to say just a word in the way of general caution — on the 
strength of quite a number of years of work in statistics — that at 
best statistics are a hard lot. All of you know, of course, the old 
saying regarding the association of statistics, "lies and liars." I 
am every day more and more impressed, even in studying statistical 
publications and papers, with the ever-present perils and dangers 
and glorious uncertainties of statistics which have not been thor- 
oughly masticated and thoroughly digested. In fact, I am rather 
inclined to believe that there is room for a movement in this country 
in the direction of fletcherized statistics. 

There can be absolutely no question, Avhen a man is starting to 



ALCOHOL AND TOBACCO 201 

build a house, of the importance of the house being well grounded 
and well founded, which importance obviously increases with the in- 
creasing height and area of the building. I can distinctly recall, in 
the early days, the building of skyscrapers on Manhattan Island 
where a number of intelligent people thought certain corporations 
were really throwing away a great deal of money going so far down 
into the ground to get their foundations on a bed-rock basis. But 
as people's eyes opened to the rapidly growing height and possi- 
bilities of the skyscrapers of New York and they began to get even 
an approximate idea of the tonnage, so to speak, of thousands and 
thousands of tons of steel, iron and stone, they realized that, after 
all. it had not been a fad, but a necessity, to get down to the bed- 
rock basis. 

Now if we are going to do sane and rational and useful and 
lasting things in this Conference, for heaven 's sake, let us start on a 
sane and sound basis, and do not let us get into the published tran- 
sactions of this Conference, which certainly will circulate all over 
this country and possibly through Europe — do "not let us get in, with 
the sanction of the printer's ink, alleged facts which are not facts, 
figures which may be honestly misstated but nevertheless are in- 
correct and entirely misleading. 

Dr. Henry Smith Williams : Inasmuch as we are talking about 
alcohol, I want to ask Mr. Phelps frankly if he heard my statement 
last night and if he is referring to any figures that I may have used. 

Mr. Phelps : Your paper, sir, was one of the most sane papers that 
I have heard in a good many years. 

Doctor Williams: I thank you. I hope that my statistics were 
correct. 

Discussion. 

Expedients in Violation of Principle 

Dr. Charles G. Pease, President Non-Smokers' Protective League of 
America, New York, N. Y. 

I am opposed to the state having anything to do with the traffic 
of liquor. I do not think that we as a people can afford to profit 
through the downfall of the people of the race. We can get our 
income without taxing liquor. We want to seek principles and to 
act upon principles which, given time to work them out, will bring 
about the right condition. But to have makeshifts, or expedients, 
used in violation of a principle, it may seem to better the conditions 
slightly at first, but in the ultimate we are still presenting to the 
people the right to indulge in that which the state sanctions and 
receives a financial income from. 



202 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

I should like to sa}', in regard to the craving for alcohol, that 
Charles B. Townes, recognized authority and one who is engaged in 
bringing men out of alcoholism and drug addiction, says that if we 
can get rid of tobacco, we will get rid of ninety per cent of alco- 
holism and ninety per cent of other drug addiction. 

Discussion. 

The Rising Tide of Alcohol Consumption 

Dr. Henry Smith Williams. 

I shall not attempt in any way to answ^er anything that has been 
said. Most of it I agree with. I wish to point out just one thing, 
that a good deal of the discussion has not really been pertinent to 
the idea that I had, which was a way of getting rid of alcohol. A 
good deal of the discussion has been about alcohol. 

I am constrained to say just a personal word. I assumed per- 
haps a little over-optimism, that everyone interested in temper- 
ance knew of my work on intemperance. Probably none of you 
knew of it. Five years ago I published in McClnre's Magazine a 
series of articles on alcohol. That was regarded by Mr. McClure 
and others as perhaps the most popular series of articles on any 
scientific topic ever published in any American magazine. The 
proof of that was that there were nearly one hundred thousand re- 
quests to reproduce those articles wholly or in part. They came 
not only from temperance unions and societies all over the country, 
but from the presidents of railroads, the heads of manufacturing 
companies and all that. I set forth, as some people were kind enough 
to say, for the first time in a dispassionate way the essential facts 
and the effect of alcohol on the human body, telling it without prej- 
udice and yet without gloves. 

As I say, I assumed that my attitude in that regard was known 
to this assembly and thought it was understood by everybody that 
I regarded mj^self as one of the foremost champions of temperance 
in America and that I was only going to supplement this work with 
what I regarded as a practical effort to get some results. Mr. Mc- 
Clure happened to come out on the train with me yesterday and he 
said to me, "Doctor, how does it happen that after that exposition 
and after we have set forth the physiologic effects of alcohol so that 
everyone knows them, there has been no result," and I said, "Mr. 
McClure, that has been one of the bitterest disappointments of my 
life.'" I really did think in 1908 and 1909, when the tide of whiskey 
went down a little, that I had had a small measure in cutting out a 
few gallons of that. I said, ' ' At last it has come ; people are listening, 
they know now." These thousands of letters came from men of promi- 



ALCOHOL AND TOBACCO 203 

nenee, saying, ' ' After reading your articles I shall never again touch 
alcohol," etc. I have stacks of letters like that. The articles were 
published in book form by the Century Company and I hoped they 
were doing something to help in a little way to stem this tide. Then 
after 1909, the tide began to rise again and I saw that nothing had 
happened. When I have spoken on other occasions and have advo- 
cated the Gothenburg System, I have been bitterly assailed and 
criticized for that, so I have now attempted to find a compromise, 
something that seems to be practical. 

Now just one other word that is personal. It makes some dif- 
ference who is advocating a thing, so let me say that personally 
I have been a lifelong advocate of temperance. My mother brought 
me up to think that it was almost as bad to touch liquor as to steal, 
and I have that old Puritan strain. I do not need those things, so 
I do not take them. I don't take tea, coffee, tobacco or alcohol. At 
the same time I do not say to my fellow-man who does need them — 
I think he needs them or he wants them — "Because I don't need 
them, you shan't have them." I don't feel that is ethical. How- 
ever, I do not wish to discuss this matter. I would say this, how- 
ever. If any here are interested, or would like to see my little 
book on alcohol, which sets me right as to my attitude toward tem- 
perance, if they will leave their names with the Secretary, I shall 
be most happy to present a copy to any who may ask for it. 

Discussion. 

Licensing Light Drinks 

Professor Robert Sprague, Massachusetts Agricultural College, Amherst, 
Massachusetts. 

For about twenty-five years I have lived in various prohibition 
states, many years in Maine. I have gone through practically every 
capital of the civilized world at midnight and noon, and all the time 
with the liquor question in view. 

I should like to mention just a few things in connection with 
Maine. I am very well acquainted with Maine. Maine started her 
prohibition laws in 1851; it might have been in 1854. But it 
was in 1884 that she put it into her Constitution. Now up to two 
years ago I had been living for five years in Maine. I believe that 
there are no more polite people and no better stock on this conti- 
nent than you will find today in Maine, and certainly no people ever 
made a stronger and more gallant fight for their liberties than the 
people of Maine have in the last 60 years on the liquor question — 
against criticism, against everything that might be brought up, 
against money. They have stood firm on that liquor question. 



204 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

One of the liomls of departinents in Harvard two years a^o came 
to me and wanted to take a little trip in Maine to find out something 
about how liquor was handled. He went into one city with which 
I was well acquainted. The first place we went to was a big build- 
ing three stories high, a second-class hotel. There was a smoking 
room on the first floor and back of that there was a bar. We went 
in there and stood around a while, saw men come and go, drinking 
everything. In behind that we found another room. It was the 
room where the people who had gotten drunk were deposited. The 
men in that room were piled about four feet high on top of one 
another. We had to drink a little beer in order to stay, but while 
we stood there they were dragged in by the collar, by men who 
had the thing in charge, and thrown onto the pile. There they were 
spewing over one another. Some of them got more or less conscious. 
They would then struggle out and be taken care of in another room, 
where they were kept until they were able to go on to the street and 
take care of themselves. Around the city we went, in twenty-two 
places. There was no liquor sign in that town; there was no open 
saloon. Everything was closed. At that time there were four or 
five special state deputies in the city especially appointed by the 
government, with no other duty than to enforce the prohibitory law 
with all the power of the state behind them. 

I have seen that for years in Maine. There are more divorces 
granted in Maine today because of drunkenness than in any other 
state in the union. 

Mr. Poling: I challenge the figures. Will you give them to us? 

Professor Sprague: All right, I will refer you to the last (1910) 
report of divorces of the United States, the last regular census. I 
cannot carry the figures in mind, but will be glad to look them up 
with you. I do not think that it is because of more drinking. I 
suspect it is due to this, that the folks in Maine are more sensitive 
to drunkenness, which is the cause of divorce ; it indicates the keen 
sensitiveness of the Maine conscience on the matter of drinking. So 
do not take that in the wrong way. But there is a great deal of 
drinking in that state and in various other states. 

Then I w^ant to refer to this : In Maine today I rarely hear a real 
temperance lecture, a really out-and-out, hard-fisted temperance lec- 
ture that calls for self-control and moral suasion. 

I want to agree with what Doctor Williams said last night. It 
seems to me that we have never in this country attempted what 
he has proposed, the elimination of the strong drink by some system 
whereby the people may get the weak, the light drink, with light 
alcoholic elements, light proportions in them, but get them freely 



ALCOHOL AND TOBACCO 205 

and get them guaranteed pure. We have not tried that. Certainly 
we are forcing upon many of our prohibition states, upon the drink- 
ers, the most and worst undrinkable stuff that ever has been made by 
man anywhere on the planet, that I have ever seen. The people in 
Maine are drinking today, I believe, the worst stuff that has ever 
been poured into the human system. I can take you to places in 
prohibition states in the East where in the cellars of drug stores 
they have set up a can of sulphuric acid, a can of prune juice, a can 
of this and a can of that. These things are drawn off, and the liquor 
is made on the spot according to the demand — perfectly destructive. 
There is no question about that. I say, I agree with the effort to try 
an experiment, at least, along the line of Doctor Williams' proposi- 
tion, that we should ^try to cut out the destructive stuff and give 
some license. 

Just one more thought. I don't believe in the national prohibi- 
tion proposition. I don't believe that if a man out on the Pacific 
Coast wants to take a glass of beer, I as a citizen of Massachusetts 
have a right to say that he shall not. I believe it is contrary to the 
very spirit of American liberty. 

Disctissio7i. 

The "Booze Special" 

f Mrs. J. L. Higgins, Temperance Worker, Battle Creek, Mich. 

I want to give you just a little experience within ten miles of 
this town. You know Battle Creek was dry for two years, this city 
of thirty thousand inhabitants. They commenced first by going to 
Augusta. Then Augusta shut up its saloons. Then they went to 
Galesburg, and Galesburg shut up its saloons. Then they went on 
down to Kalamazoo, twenty-two miles away, to get their drink. 
They came back nights on the last car. It became so notorious that 
it was called the "booze special." 

One night I was in the city of Kalamazoo and coming back I 
missed my first car and got on the late car. At the first corner a few 
men got on with their grips, a half dozen more at the next corner 
with their grips. I looked at them and said, "If those are traveling 
men, they are degenerating fast." At the next corner some more 
men got on with their grips, and I recognized the fact that I was 
on the "booze special." A man sitting across saw me, knew my busi- 
ness, knew what I was doing. He had read somewhere that every 
dog has his day, and he made up his mind that his day had come. 
He said to me, "Madam, do you see this?" I certainly did. He 
said, "Does that not reveal to you that prohibition is the greatest 
farce on the face of the earth? These men have been down to Kala- 



206 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

mazoo. Their grips are full of liquor. They are taking the liquor 
back to Battle Creek." He continued, "More liquor is drunk under 
prohibition in Battle Creek than was ever drunk under a high 
licensed system. It is the biggest farce on the face of God's earth." 

I am not in the habit of making temperance speeches on "booze 
specials," but, as the Quakers say, "the spirit moved me," and I 
said to him, "Let us count them," and we counted them. There 
were just fifteen men aboard. I said, "Here are just fifteen men. It 
is Saturday night. These would not be one drop in the bucket in one 
saloon in Battle Creek on Saturday night, and we had over thirty 
saloons. Where are the rest?" He said, "They are at home with 
their families tonight," and I said, "Thank God that the tempta- 
tion is twenty-two miles away. ' ' I said, ' ' These fellows are regular 
old soaks, anyway. ' ' Then those men began to gather around me, some 
of them. They had heard me speak before and they did not want 
to hear me speak again, and I said to them, "My friends, you heard 
what I said. You are regular old soaks. The money that should be 
spent for clothes and comfort and food for your families, you have 
spent for the liquor that you have in your grips. ' ' I said, ' ' I would not 
be surprised if you are in debt to some honest dealer in Battle Creek 
for the very clothes you have on," and I continued, "That is not 
the worst of it. You are law breakers. If you had your just des- 
serts, you would be behind the bars, and the worst of all is, you'are 
not ashamed of it. We cannot do much for you. God pity you. You 
poor fellows, we cannot do much for you. All we can do for you 
is to leave you in the hands of the just and merciful God." I said, 
"We are not working for you especially. We are working to turn 
out a race of citizens, among whom such men as you will be prac- 
tically unknown. ' ' And then one of them sat down on a seat, folded 
his hands a little meekly and said, "But madam, think of the taxes." 
I looked at him a moment and I said, "My friend, I don't know 
you, but I know your kind — ragged, blear-eyed, run down at 
the heel." You have seen them many a time. And I said, "I know 
your kind and I venture to say that you don't pay taxes, one dol- 
lar." He looked at me a moment and his friend sitting beside him 
grinned a little and said, "You are just right, madam, he don't." 
I said, "You are a pitiable subject to worry about taxes." 

My friends, one thing faces us. That is what God's will is toward 
men, and God has but one method of dealing with sin — extermina- 
tion. 



ALCOHOL AND TOBACCO 207 

Discussion. 

The Saloon and the Taxpayer 

George B. Peak, President Central Life Assurance Society of the United 
States, Des Moines, Iowa. 

When we observe the increased amount of alcohol that is being 
used now, as compared to formerly, what would have been the 
amount if it had not been for the fight against alcohol? I suppose 
the use of alcohol would have been quite general and we would all 
be showing some of the effects of it. As the consumption has been 
increased some five times what it was in 1840, perhaps it would have 
been ten times or twenty times the amount. I believe, for one, that 
the fight against alcoholism has been a gaining one. We have been 
gaining on ourselves — perhaps not conquering the great evil, but 
teaching the world the great injury from alcohol and preparing 
ourselves for a more effective fight in the future. 

A few years ago the leading newspaper in our city announced 
the fact that no liquor advertisements would appear in the paper in 
the future. That paper was soon followed by the other papers and 
now, in Des Moines, a city of over one hundred thousand, it is im- 
possible to insert a liquor advertisement in any of the papers. 

I am somewhat acquainted with. Kansas, somewhat acquainted 
with Oklahoma, somewhat acquainted with the prohibition territory 
in Texas, somewhat acquainted with states that have no prohibition 
territory, and I feel very certain that the condition is far better in 
states that have made the earnest, vigorous fight against alcohol than 
where the fight has not been waged — far better. I am acquainted 
with the condition in our own state, Iowa; also the condition in Des 
Moines. You remember that in Iowa they had a state prohibitory 
law. The legislature amended it, and now the cities — ^by getting up 
a petition signed in the larger cities by the majority, which is one 
over the half of the voters — can introduce saloons. We had 
a very severe fight on the last petition, that went through all the 
gourts to the supreme court. It was decided that the petition was 
not valid, and the saloons were closed last November and remained 
closed for about a month. During that month there were just about 
one-half of the arrests for crime in Des Moines as during the pre- 
vious month. Compared with the year before, at the same time, there 
was about one-half of the criminal practice going on in the city, and 
less than one-half of the drunkenness — there was some drunkenness 
during this time, because there was a little town about four miles 
from Des Moines that had two open saloons, one bar-keeper in each 
saloon. These saloons increased their bar-keepers, one to twenty- 
five, and the other to twentj^-two men, serving out the drink to 



208 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

some of the Des Moines people, who, yon see, went out to these places 
to get drinks. Notwithstanding that, the drunkenness in the city 
and the arrests for drunkenness were reduced to about fifty per 
cent of what they were the month previously. 

Now I believe that the only successful fight against alcoholism 
is to stop the open places that educate the young man to drink. 
When they circulated this last petition, they raised the question of 
finance. These saloons paid into the city a tax of something over 
one hundred thousand dollars. Now the saloon-keeper raised the 
question of the state's need of this hundred thousand dollars. They 
finally succeeded in getting quite a number of men to sign the 
petition who would not have signed it otherwise, but that peti- 
tion is now in the courts again, and it will be tried out through the 
lower courts and the supreme court. 

I noticed the other day, in a Des Moines paper, that about twelve 
of the leading business men of Des Moines — men who pay the largest 
taxes with the exception of one taxpayer there, who rents his build- 
ings very largely for saloon purposes (these other men are not in- 
terested in renting places for saloon purposes) — that these business 
men found an affidavit and presented it to the courts. They de- 
manded that the saloon be closed on the ground that it increased 
their taxes because it increased the expenses of looking after polic- 
ing the city; because it increased the expenses of the courts; be- 
cause it filled the poorhouses, and added to the expense of the in- 
ebriate asylum, and all of those things ; because the saloon, instead 
of being a revenue producer, was an expense maker. Whenever you 
can get the people to see the saloon from that point of view, that it 
is an expense maker instead of a revenue producer, you make a gain. 

Discussion. 

A "High-Class" Saloon 

Mrs. Maud Glassner, Michigan Federation of Women's Clubs, Nashville, 
Michigan. 

I want to indorse what has just been said about the saloon and 
to add a little personal experience, if I may be pardoned for doing 
so. When we were married, my husband had a small store and we 
lived above it. We got along very happily for three years, when 
the building next door was converted into a saloon. Now I am 
convinced that the great majority of men and women in gatherings 
of this sort, who do not frequent saloons, know very little of really 
what goes on in an open saloon. So I want to tell you some of the 
things that happened when the saloon was set down eighteen feet 
from the side of our building. In the first place the saloon-keeper 



ALCOHOL AND TOBACCO 209 

who was to run the business, came into our store and ordered some 
supplies and very pompously informed us that he was an excep- 
tional man — he was a teetotaler, in fact. He did not use the vile 
stuff; he was an exceptionally good saloon-keeper; and that in the 
last town where they were his wife was such an excellent woman they 
had asked her to teach a class in a Sunday-school ; that he was going 
to run a high-class place ; that we had never known what a high-class 
saloon was, but we were going to learn. He almost persuaded me 
that there might be such a thing as a beneficent influence coming out 
of the saloon in a town of our size. So while they carried the plate 
glass mirrors into the saloon and the mahogany furniture into the 
front of this building, in back they were building a high board fence, 
enclosing a part of the back yard. Our customers were very much 
amused when I said I didn't know why they built an addition onto 
the back of the building when they did not knoAv how much busi- 
ness they were going to do. I was very much amused when I found 
that every saloon had to have some place where the men might wal- 
low as hogs in their own filth. That is what that was. Those men 
would get out there and engage in rough singing and talking and 
fighting. There never was such a storm of vile langniage and pro- 
fanity coming from any place as there was from that part of that 
saloon. The saloon-keeper used to stand in the door of the saloon to 
coax the boys into the place, while men were discussing the means 
by which they had turned themselves from men into carrions. The 
worst part of it to me was that I had been accustomed to doing my 
sewing in the sunny side of the doorway of the store. I could not 
sew, I could not rock my baby to sleep in that upstairs window, or 
hang my washing in the back yard, without hearing language that 
would scar the soul of any woman. And I said to myself, "If that 
is the sort of language and the sort of talk that goes on in an open 
saloon, the fewer we have of them, the better for our population." 
It seems to me that is a self-evident fact. The most terrible part 
of the whole thing to me was the fact that these terrible social dis- 
eases which we are trying so hard to combat now-a-days were 
laughed at and joked about. Sure cures were swapped and patent 
remedies recommended, just as if decent people were miles and miles 
away. And I faced bad men under the influence of liquor over 
the counters of our store until I really wished I had the grit of Carrie 
Nation and a stick of dynamite. It seemed to me as if it would be 
of service to humanity to wipe that thing off the globe. I know of 
young boys who got into the atmosphere, who heard that talk, who 
went out and formed clubs to carry on that vicious bruteness. 



210 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

Discussion. 

A League of Publishers 

;Melvil Dewey^ President Lake Placid Club, Lake Placid, New York. 

I think it is true tliat Avliile the people are equally sincere 
and earnest in regrard to this, there are diametrically opposite 
opinions as to what should be done. The pathology we all know. 
It is the therapeutics we should get at. Has not someone here a sug- 
gestion upon which we could all agree? The paper of Doctor "Wil- 
liams does not stand at all as the expression of the opinion of the 
Conference. The Conference itself simply publishes what has been 
said. The remarks of Doctor Williams are his, and the remarks of 
some other person are his, and people must choose what they think 
to be the right. In regard to the remark about statistics, I would 
suggest that the truth may be absolute truth and yet very mislead- 
ing. You know if you take a fish pole and look at it end ways, it 
is the size of a ten-cent piece. Look at it otherwise, and it is the 
length of an elephant. So one man looks at the thing from a certain 
point of view, another man from another point of view equally 
honest. What we see is true, but we must learn to walk all around 
it and see it in all its bearing if we are going to command the con- 
fidence of the public. 

I don't believe it would be of any use if we spent another week 
here, discussing prohibition and other regulations, for men equally 
able, equall}^ honest, equally experienced are diametrically opposed 
on these questions. But there are things on which we could agree. 
For instance, a suggestion was made last night that I wish someone 
would take up here and give some sidelight on. That is, what the 
publisher said who stated he was very ready to join in a league of 
publishers who would refuse to break into their columns the ad- 
vertising of alcohol, tobacco, and patent medicines, a get-rich-quick 
scheme, or any other thing distinctly inimical to race betterment. 
There are hundreds of publications in this country. This Confer- 
ence might unify them, form a league of that kind. All sides will 
agree on that. Whatever you may say on drink and liquor, we all 
agree that it is a bad thing for the race to have it advertised and 
thrown before them in all sorts of ways. The employers of the Em- 
ployers' League will pledge themselves not to employ users of al- 
cohol and tobacco, if you go as far as that. AVe could get a thousand 
employers in a very short time wlio would refuse to take into 
their employ any man or boy, or woman either, addicted to this 
vice that is making a race of runts. 



ALCOHOL AND TOBACCO 211 



Discussion. 



Soothing Syrups and Alcohol Craving 
Dr. Edith B. Lowry, St. Charles, Illinois. 

I have been very much interested in one of the causes of drink. I 
notice in Chicago that among the downtown offices many men would 
work in the office under stress for two or three hours, then they 
would feel the craving for something, rush out, and get a drink. I 
decided there must be a cause for that. In my own work, I found 
that sometimes when I had been working for two or three hours I 
began to have a restless feeling, a craving for something, and I felt 
that it was the same that these men had and which a great many 
would interpret to mean a need of alcohol and others would a need 
of coffee. I found out that if I kept some molasses candy on my desk 
and ate two or three pieces at that time, that satisfied the craving. 
I found that it is a craving of the system for something which can 
be satisfied only by the right diet. 

Another thing, I found that a great many of those men in the 
offices, who rush out for drinks, were eating regularly at the res- 
taurants. They did not have well-balanced meals; they did not 
have the right things in their system, the right food that the system 
craves. It seems to me one of the best solutions of this alcohol ques- 
tion is being offered now in the schools by their domestic science 
and domestic economy classes, which are teaching the girls how 
to have well-balanced meals in the home. Then the men are not 
going to have quite the same craving for alcohol. 

Another cause for this alcoholism is the training from babyhood. 
It is quite customary among a good many families to give the babies 
soothing syrups and a little whiskey and water, when they have colic, 
or various other stimulants. The system naturally becomes accus- 
tomed to the stimulation and naturally craves it. As a child grows 
older, this craving is satisfied by some soft drinks at the soda foun- 
tains and various other places. Then, as the child advances to an 
older age, it outgrows this habit of soft drinks and takes to harder 
drinks. So the training of mothers to manage their homes 
rightly, to bring up the babies rightly, feed them rightly, and also 
feed the families rightly is going to do a great deal in solving the 
alcohol question. 

Discussion. 

Prohibition and the Drug Consumption 

Dr. James T. Searcy, Tuscaloosa, Alabama. 

There is no question that, the scientific aspect of the alcohol ques- 
tion is what the whole question rests upon. When a man takes a 



212 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

driiik of alcohol or wIumi he smokes his pipe of tobacco or drinks 
his cup of coffee or takes his toff of cocaine, he does it with the 
knowledge that it is a scientific question. There is no doubt about it. 
He feels better for having taken any one of these agents. Now, 
there is a great deal of information coming up from all directions 
as to what occasions the better feeling that that man has when he 
takes any one of these drugs. Most anybody feels more or less dis- 
comfort., a great deal at times, more than others. If he can take any 
agent that will prevent his recognizing the discomfort, he has done 
something. Whatever the effect is, he recognizes it as a fact that he 
does feel better. But the chemical action of those very drugs, when 
removed, is to leave him more delicate and more sensitive. That man 
feels worse than he did before he took that agent. If he repeats this 
continually, he continues to feel bad and continues to increase his 
hyperesthesia, so he wants more of the drug and he takes more to 
satisfy him. 

Now we have gone all over this world of civilized people and 
collected from everywhere agents of this kind and are using them. 
We are using the caffeine from tea and coffee that we' get in Asia, 
using the caffeine from the cola nuts that we find in Africa and now 
are producing in South America. We find in the Andes Mountains 
that the Indians chew cola leaves. We find the Indians in this 
country using tobacco. Now it takes whole states to furnish enough 
for the country. We found that the Moors of Spain distil the milder 
fermented drinks, getting stronger alcoholics. Now we cannot get 
enough agents strong enough for us. The users of milder ones, like 
caffeine, take directly to nicotine, then they get to alcohol. The 
caffeine fiends are coming from all directions, and the morphine 
users, and sometimes the chloral, sometimes the coal-tar products. 
We are relieving our headaches everywhere through civilized society 
with the broadcast use of these things. That is having some effect. 
It is having a broadcast effect in this country of producing in every 
direction psychroesthenic hyperesthesia of the nervous system, 
from which people feel bad. As I said last night, they are born tired. 
They know they can get these things. They are advertised as stimu- 
lating, invigorating, refreshing, exciting ; these chemists having 
pushed out that kind of scientific information for the use of these 
drugs. Then they come to me for some information as to the cause 
of increasing insanity. Long before you get insanity, the indica- 
tions of nervousness come. 

I can tell the effect of the prohibition principle by its effect in 
my own institution. Birmingham, some two or three years ago. had 



ALCOHOL AND TOBACCO 213 

prohibition. We did not get the alcohol inebriates from Birming- 
ham — not nearly so many as we did before or as we have since they 
have taken away the prohibition of alcohol — but we did get drug 
fiends in greater number. They changed from one to the other. 
All through that Southern country we have prohibited the use of 
alcohol in negro districts, so poor negroes are taking cocaine and it 
makes worse fiends of them than the other. 

Doctor Williams: They are a good deal worse, aren't they, 
Doctor? 

Doctor Searcy : We cannot say that. I had brought into my office 
the other day a druggist who came into the hospital as an inebriate 
from the use of caffeine. We are manufacturing that kind of people 
by the cigar, by alcohol and we, a civilized people, have done it all 
over the world. 



Discussion. 

International Committee on Liquor 

Frederick L. Hoffman, Statistician Prudential Insurance Company, Newark, 
N. J. 

About a year ago, on the initiative of the Russian Government 
and of the French Government, in cooperation with other European 
governments, . an International Committee was formed for the 
scientific study of the liquor question entirely de novo, without any 
preconceived notion whatsoever. The United States has formed a 
Sub-Committee of that International Committee. Of the Sub-Com- 
mittee, Mr. Taft is chairman. It includes on the Executive Com- 
mittee a number of those who were on the original Committee of 
Fifty which studied the liquor problem. While they have not as 
yet seen their way clear to organize for active work, they have 
divided into five or six specific committees, each of wliich will deal 
with a separate and well-defined branch of the whole question of 
the relation of alcohol to the public in all its phases. 

Discussion. 

Alcohol Posters 

Mrs. Charles Kimball at^d Elizabeth Hewes Tilton. Boston, Mass. 

Mrs. Kimball : Just now we are carrying on aggressive work 
against alcohol in Boston. It is being done through posters in an edu- 
cational way. A little over a year ago, the first poster came out, put on 



214 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

JOHN MITCHELI. 

LABOR LEADER, 

said (Toronto, 1909). that ho was not at all 
impressed with the statement that if you closo 
down the Liquor business, you bring a calamity 
to the community. If a brewery or distillery 
were closed down, on its ruins would go up 

A FACTORY. 

Thlak>ll.Over, Poster Commlltee, II Mason St., Cambridge. 



WKo is the first man 
to be laid off, and the 
last man to be taken 
on? 

Hr Nliui Who Ibiid 



OVESFt ^J^i CENT 

MORE ACCIDENTS 

TO WORKMEN WHO DRINK 

THAN TO WORKMEN IN GENERAL 



ALCOHOL AND TOBACCO 215 

a small building; on Charles Street. It justified its excuse for being 
that day, for in a short time groups of people came up and stood long 
enough to read, ' ' One dollar in, two dollars out, for every dollar the 
street receives for license. Two dollars go out to take care of criminals, 
paupers and insane brought to our institutions through drink. 
Think it over." On the same afternoon the newspaper men came 
there and, following them, the photographers. In a little while it 
became newspaper news. We had word from all over the country 
inquiring about the poster campaign. This offers perhaps a con- 
tinuous movement that nothing else offers. The sound of 
the human voice passes. We listen to an eloquent address ; we enjoy 
it and we think of it. It comes up at times. The poster remains 
with its educational value. When the voter goes to vote for license 
or no license, he sees the poster. It brings to his mind the thing 
he should vote for. 

In our university city, Cambridge, we had a poster day. Mary 
Barry had the posters placed on all public buildings. Citizens 
loaned their fences, bankers gave their windows, and we had a roj^al 
day. We have had many such days in the state of Massachusetts. 
Doctor Southern, of the Psychopathic Hospital, looks over every one 
of our posters, in connection with Dr. Putnam, the famous neurolo- 
gist of Harvard. These posters are given careful study. Everyone 
can rely on the poster as being statistically correct. 

I submit a statement by Elizabeth Hew^es Tilton, Chairman of the 
Poster Committee, Cambridge, Mass. 

ALCOHOL EDUCATION THROUGH POSTERS FOR THINKERS NOT DRINKERS. 

Alcohol Education through Posters is a movement of Boston 
doctors and social workers, affiliated with the Boston Associated 
Charities. For thinkers, not drinkers, it aims at no specific legisla- 
tion, but works to change men's attitude tow^ard alcohol. It is not 
Prohibition: it is not No-License. It stands for the only thing that 
can make Prohibition prohibit. No License means AO EDUCATION. 

In short, it is no use legislating against what men want. You 
must educate your average man not to want, and then legislate for 
the laggard. It seems a long road, but what scientists, physicians, so- 
ciologists think today, the man on the street thinks tomorrow. The 
selected minds of the race have turned against alcohol. To take 
these facts, and without sentimentality or exaggeration pass them 
on to the average man, is the object of this health and efficiency 
campaign against liquor. 

Posters were chosen because alcohol is such a time-worn, crank- 



216 FIRST NATIOXAI. CONFERENCE ON RACE BETTERMENT 



Sl.OO m! $2.00 OUT! 

rm m $1.00 

HUT IB SM RECEIVED 

LAST YEAR FOR, 

LIQUOR LICENSES 

XT PAID OUT 

OVER 



• I 



For the CRIMINALS. PAUPERS 
and INSANE broiiglit to our In- 
stitutions tlirougli DRINK 

■ iiiiiiili 

THINK THIS OVER! 




MOi Annu«l Report. Mib. Bureau o< Lelxir 

BUCK PSIffTINO COMPANt. BOSTON ---i, -„^- 



ALCOHOL AND TOBACCO 217 

worn subject that you are forced to apply a very fresh handle to 
make the subject new and news, to carry it into that final educa- 
tion, the press. With this fresh approach, Collier's, Miuisey's, The 
Survey and The Outlook have all come forward and offered to help. 
Had it been simply Alcohol, it is doubtful if they could have got a 
hearing for the campaign. 

Now I want to call attention to a curious fact — the utter silence 
of all our social service work on the alcohol question. In the New 
Year's Survey, it summarizes all the work being done — better hous- 
ing, trade unionism, sex hygiene, but not one word about alcohol. 
I do not know but my impression is that there are few courses de- 
voted to alcohol in our schools for social science, so that it has come 
about that the average social worker does not think the question 
important. 

The real leaders never doubt its importance, but they tell you 
that it is so intricate, and men get so passionate about it, that they 
have been at a loss how to move on it. They say it is not a cause, 
but a war. But move on it we must, for it plays too great a part in 
all the things that social workers are fighting for them to ignore it 
longer. We are fighting against these things that destroy the health 
and efficiency of our nation — poverty, insanity, crime, immorality, 
disease. In every one of these alcohol plays an appreciable part. 

The Boston Associated Charities found that one-fourth of the 
poverty that comes on charity in Boston, Mass., is directly and in- 
directly due to drink. Curiously enough, the Committee of Fifty, 
working through several states, also declared one-fourth of our 
poverty due to drink. 

Only one-fourth you may say, but if you are fighting poverty 
and have found something that is making one-fourth of it, don't 
despise that one-fourth. Move on it. 

Doctors agree that alcohol is the inunediate cause of from one- 
fifth to one-third of our insanity. Insanity causes a very great ex- 
pense to a state. If you find something that is making from one- 
fifth to one-third of that expense, good judgment, good business, 
would be to move on it. 

Here I may insert, by the way, the arrests for drunkenness hav- 
ing increased in Massachusetts one hundred and sixty per cent in 
eleven years, we have a Commission to look into the matter. Doctor 
Southard invited this Commission to the Psychopathic Hospital 
and showed them one patient after another clear out of their minds 
from alcohol. I was present and no more depressing sight have I 
ever seen. At the end Doctor Southard said, "Gentlemen, individual 
liberty is a doctrine very much in vogue. From it I will not dissent. 



218 FIRST NATIONAL CONFERENCE ON RACJE BETTERMENT 



Ti 1 mniiii MiW! 



i 







96 



°o 



OF IKE IMPIRIIH 




Qwann H! 



Back Printinit Compni^. Boston <)g^g^ 



ALCOHOL AND TOBACCO 219 

But I wish to say that a state that licenses shops that sell insanity 
should pay out its millions liberally to support the victims of its 
hobby." 

Excluding- drunkenness as a crime, the IMassachusetts Bureau of 
Labor found that fifty to fifty-three per cent of our crime was due to 
drink. The Committee of Fifty found forty-nine to ninety-five per 
cent due, directly or indirectly, to drink. 

I believe in prison reform, but some of the energy ought to go, 
not toward the reform inside the prison, but in reforming the causes 
outside that send men there. Statistics are loose things, but every- 
thing shows an extremely strong connection between drink and 
crime, and if you can reduce our prison expense by one-half or even 
one-third by removing alcohol, I think it is worth while to bring this 
fact out, to make it prominent in all this splendid prison reform 
movement. In fact, I think it is the opposite of "efficiency manage- 
ment" not to bring it out. 

We had a letter on this subject, which I now submit by permis- 
sion. 

IjETTER received FROM A FORMER POLICE COMMISSIONER IN 
SAN FRANCISCO 

San Francisco. May 15, 1913. 

"I notice in the Lexington Minute Man, that I receive from my 
native town weekly, a paragi-aph to the effect that a poster is to be 
displayed in Bedford saying that 'directly, indirectly, one-half of 
our crimes are due to drink.' It may interest your committee to 
learn of my experience in that line. 

"While Police Commissioner in San Francisco in 1907-08-09, it 
was my custom to examine the records in the city prison frequently, 
showing all the crimes and other particulars attending arrests, that 
numbered about two hundred daily, and my conclusion was that 
fully ninety per cent were due, directly or indirectly, to the use of 
liquors. Again, all saloons in San Francisco were closed for thirty 
days following the great fire in April, 1906, the result being that 
there was so little police duty necessary, in spite of the great confu- 
sion growing out of the fire, that one-half the police force were given 
vacations for periods of from ten to thirty days. When the saloons 
were again opened, the officers on vacation were recalled, as it was 
deemed necessary to place the entire force on duty because of the 
increased crime and disorder. 

' ' Yours truly, 

"A. D. Cutler. 
"510 Kohl Bldg., San Francisco." 

The connection between alcohol and immorality is too well 
known to dilate on. Miss Jane Addams says that those who have 



220 FIRST NATIONAL CONFERENCE ON UACE liETTKRMENT 



ARCHBISHOP 

IRELAND 

SAYS.- 

"The Great Cause of Social Crime is 
Q||||y|4; the Great Cause of Poverty is 
QUII^K^ When I hear of a family broken 
up, I ask the cause, - DRINK. ^^ ' 9^ ^o 

the gallows and ask its victim the cause, the 

answer, -DRINKi 

Then I ask myself in perfect wonderment, 

Wliy do not men pnt a 
STOP to tills thing?" 



ALCOHOL AND TOBACCO 



221 



ALCOHOL! 



YOU MAY THINK:— 

It is only Heavy Drinkinif that harms. 

EXPERIMENTS SHOW:— 

That even Moderate Drinkin({ Injures Health, Lessens Efficiency. 

YOU MAY THINK:— 

Alcohol braces us for hard work and lessens fatiifue. 

EXPERIMENTS SHOW:— 

That ALCOHOL IN NO WAY INCREASES MUSCULAR 
STRENGTH OR ENDURANCE. 

ALCOHOL LOWERS VITALITY; ALCOHOL 
OPENS THE DOOR TO DISEASE. 

At the Massachusetts General Hospital, Boston, the nse of Alcohol as a 
medicine declined 77 per cent, in eight years. 

Most Hoders Hospitals show the same tendeaej. 

ALCOHOL IS TH£ IMMEDIATE CAUSE OF 

MUCH OF OUR INSANITY. 

MUCH OF OUR POVERTY. 

MUCH OF OUR CRIME. 

THE MASSACHUSETTS PRISON COMMISSION REPORTED THAT 96% 
OF THOSE IN PRISON IN 1912 HAD INTEMPERATE HABITS. 
LASTLY, ALCOHOL PROMOTES COMMERCIALIZED VICE. 
YET YOU MAY SAY:— We need the Revenue from Liquor. 

DO YOU REALIZE—HOW SMALL IS THE REVENUE com- 
pared with the Costs of Carrying the Victims. 

YOUR MONEY SUPPORTS THESE VICTIMS, 
FOR HIGHER TAXES MEAN HIGHER RENTS. 

IN SBOZtT 

ARRAYED AGAINST ALCOHOL arc ECONOMY. SCIENCE. EFFIQENCY. HEALTH. MORALITY. 

CITIZENS, THINK! 



SOSTOn ASSOCtATEO CHARITIIS. 



AlCOHOL EDDCAIIOd 



TREES ALONG 



-■"^^^ 



222 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

stiulied tlu> subject know that it is the iiidispciisahlc vcliidc ol' white 
slavery. 

A great American, known to all of you, said, in a private letter, 
that his recent trip around the world made him feel that alcohol, 
in conjunction with venereal disease, might carry off the white race, 
unless great educational and restrictive measures were instantly 
applied. 

All these facts should sink deep into the minds of social workers 
and come out in action: for they are their own particular subjects — 
poverty, crime, disease, immorality. To fight them efficiently, one 
must fight alcohol, fight it with education. 

The youth of the nation will be appealed to by the fact that 
alcohol is probably the greatest health and efficiency "sapper" that 
we have. 

Experiments prove that even moderate drinking injures health 
and lessens efficiency. This has made the Kaiser a total abstainer 
and caused him to beg his army to give up beer. 

Another fact that cannot fail to impress the race is that alcohol 
is dying out as a medicine because, far from giving life, it destroys 
life by lowering vitality. It really opens the door to disease. Hence 
at the Massachusetts C4eneral Hospital, Boston, the use of alcohol as 
a medicine declined seventy-seven per cent in eight years. 

In short, the passing of alcohol would restore untold amounts of 
health and efficiency now being lost, not through heavy drinking, 
hnt through moderate drinking. 

These things should not be done all at once — but education boards 
should be run through long periods. 

For information regarding Posters, please write to — 

Elizabeth Hewes Tilton, 

Chairman Poster Committee, 

Cambridge, Mass. 

TOBACCO A RACE POISON 

Daniel Lichty, M.D., Senior Consultant, Roekford City Hospital ; President, 
Trustees Roekford Municipal Tuberculosis Sanitarium. 

Man, generic man, is the greatest asset of the age, and of the 
world. It is the duty of those who dwell on the heights to conserve 
this asset. 

It should not be necessary to put the subject of tobacco on the de- 
fensive, yet, in its almost universal use, to openly declare it a 
race poison demands this; it requires the courage and 'sacrifice of 
a martyr to do it. 



ALCOHOL AND TOBACCO 223 



LIQUOR BILL 

$1,750,000,000 

IN THE UNITED STATES FOR ONE YEAR! 

THIS WOULD - 

1. Build Ten Hospitals in each of the 48 
States in the Union at a cost of $10(),- 
000 each and endowed with $500,000 

each $288,000,000 

2. Build 4 Colleges in each State each costing 

$1,000,000. and endowed with $1,000,000 384,000,000 
3 Build a Road from New York to San 

Francisco at a cost of $10,000,000, and 

give each State $1,000,000 to build 

tributary roads 58,000,000 

4. Equip 10.000 Playgrounds for Children 

at a cost of $2,000 each 20,000,000 

5. Give each State $10,000,000 for lndus= 

trial Education in the public schools 480,000,000 

6. Place 50 Libraries in each State, each cost= 

ing $100,000 and endowed with $100,000 480,000,000 

And Leave $40,000,000 

F^OK 

MUNmi RECREATION CENTRES 

IN PLACE OF THE SALOON 

By W. E. PITTENGER 
South End AlcoholiMuaitlon Commlttte II MiMon St., Cambridtt. Mass. 

Buck Friatla* Ccaipu;, BMtsn a^Sto 



224 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

However, as Abraham Lincoln said of his opi)Osition to human 
slavery, "If the end brings me out wrong, ten angels swearing I 
was right would make no difference." 

Tobacco is a poison, a narcotic poison, an acro-narcotic ; it is so 
classed in every text-book on poisons, in every book on botany. 
Every chemistry so classes its alkaloids, and every dictionary, medi- 
cal or otherwise, so defines it. Every part of the plant is poisonous. 
Even the sweet secretion of its flowers is stupefying. Only a few 
poisonous plants excel it in deadliness. In Germany tobacco is fit- 
tingly called teufel kraut, "devil's weed." 

Tobacco alone possesses the fascinating flavor and aroma that 
lures the world. Eighty per cent of the adolescent and adult male 
population are enamored of its narcotic and lethal potency. How 
some are poisoned and others are immune is the paradox of human 
physiology and pathology. Here heredity and education, maternal 
and filial affection, are all deposed and dumped into a commoir mire 
of tobacco debauchery. 

That it possesses a potency to disturb function in callow youth 
or adult decrepity, most beginners will readily attest. King James' 
counterblast against tobacco is such a worthy and graphic clinical 
recital of its systemic effect as a modern therapeutic professor might 
be proud to have composed. "A custom loathsome to the eye, hate- 
ful to nose, harmful to the brain, dangerous to the lungs, and in 
the black stinking fumes thereof nearest resembling the horrible 
Stygian smoke of the pit that is bottomless," is his characteriza- 
tion of burning tobacco. 

That it has lethal properties, stupefies and kills, neither scientist 
nor layman can successfully refute. The recital of its exclusive dis- 
covery and use in the Western Hemisphere has many character- 
istics of the recital of the ardent adventurer, or the buccaneer sailor. 
Pipes, implements, not unlike modern smoking pipes, have been dis- 
covered in Italy, Greece, Asia, Turkey, China, Ireland and the East 
Indies. Areheologists acknowledge these finds and admit that they 
may have been used for the combustion and inhaling of some nar- 
cotic substance. 

Anesthesia and narcosis, from whatever substance, are regarded 
as pathological conditions ; they produce perversions of function and 
increase morbidity. That a universally acknowledged narcotic 
and poisonous substance has found such lurement to man, the 
boasted monarch of earth, is an enigma of modern ethics and eth- 
nology. There are other pernicious, habit-forming drugs as well as 
tobacco being insidiously foisted on susceptible humanity by un- 
relenting commercial advertising that have their toxin and their 



ALCOHOL AND TOBACCO 225 

menace. National and individnal perspicacity seems already myopic, 
if not blinded, by the blandishments of their advertising. Prance 
was slow in recognizing the demoralization absinthe was working 
on her people nntil its wrecks tainted her society and blotted her 
landscape. 

China passed from dynasty to dynasty under the stupor of 
opium — an Empire in area, mines of wealth at her feet, but with a 
paucity of appreciation of these gifts or of the degradation opiuni 
was working among her people, until the sober remnant of virile 
civilization compelled her to abandon the cultivation of the seduc- 
tive poppy. Century upon century passed over opium-tinctured China, 
but her race was stupefied and retrograde among nations. Spain, 
once "the Mistress of the seas," has become a mendicant at the feet 
of nations since she introduced tobacco to her impetuous people, 
and is begging for her autonomj^ with the tobacco-shriveled ghost 
of her former proud self mocking her pleadings. 

In 1896 the National Board of Health of Mexico issued a pam- 
phlet on tobacco using, calling on all good people, especially doctors, 
saying, "We can continue our devotion to tobacco, knowing, as we 
do, its calamitous results, but let us warn the innocent who sin from 
ignorance," etc. 

Man the world over has sought and possessed a sense obtunder. 
Tobacco, alcohol, opium, cocaine, are all narcotics which make all 
races adverse to ethnic as well as ethical progress. No substance 
has become so universal as tobacco. Through his stupor he severs con- 
nection with the real source of joy and power — fresh air, pure water, 
right food, and wins false force through intoxication and narcosis. 

The recognized degenerate opium user of Eastern Asia, the betel 
chewer of the Andes and the Himalayas, the hashish eater of Arabia, 
and the absinthe wrecks of France, are graphically the antecedent 
degenerates of the Occidental tobacco inebriates, who must follow 
their trail to final race extinction. Narcotic indulgence, whether 
in Asia or America, means race degeneracy, ethnic inferiority and 
extinction, race poisomng. 

The efficiency engineer, the corporation superintendent, the 
transportation chiefs, all captains of industry, are calling for 
greater efficiency in their several departments — but the smoker 
blazes away, and the snuff and tobacco chewers roll their quids in 
stupid indifference to the requirements of comity and efficiency. 
Employers refuse the cigarette kid, while compulsion secures the 
veteran pipe fiend employment. David Starr Jordan says there is no 
use in considering the future of the cigarette boy, as he will have 
no future. 



S2b FIRST NATKINAIi CONFERKNOK ON HACK HK'I'I'KRM KXT 

The (ioc'tor. the roseareli stiidciit, tlic biological cti^iiKU'i- seem 
timid, lax or indifferent to the ethnic hlio-ht of tobacco. 

Occasionally articles appear in scientific medical or other hij^hly 
ethical and literary maf>azines deplorin{>: the spreading use, economic 
waste, and bane of tobacco and its racial wreckajje. In other 
more popular magazines, whose circulation is measured by mil- 
lions (and their readers by tens of millions), with front and back 
full -page covers in four colors we find display lines of illustrated ad- 
vertisement extolling the merits of their respective tobacco manufac- 
tures, each with positive declaration and loud boasting that their prod- 
uct has neither ' ' bite ' ' nor ' ' sting, ' ' nor poisonous nicotine. A score of 
pipes are patented every year claiming to prevent the acrid smoke 
and toxic oil and deadly nicotine from reaching the consumer. The 
anxious, hurried reader does not recognize between the lines the 
admissions of the cunning advertiser of both pipe maker and tobacco 
mixer that there is poison in his product, in the substance and in 
the advertisement. A chewing gum is now advertised to relieve 
the dryness of the mouth after smoking. No trust is so conscience- 
less in its advertising as the tobacco trust. A hundred or two 
human lives may be burned to death or horrible disfigurement in 
shirtwaist factories ; another several hundred destroyed in burning 
hotels; ships may be set on fire, mines burned, hospitals, homes, 
morgues and graves be filled, while widows wail and children 's cries 
fill the saddened air, but the news press must not tell that these 
grewsome and grief-laden tragedies were all caused by stupefied 
cigar, cigarette, and pipe smokers, indifferent and carelessly crimi- 
nal with their matches and embers and stubs. 

The nicotine from tobacco combustion and chewing enters the 
.system through the usual channels of respiration, gestation and al3- 
sorption. In chewing, the extracted toxin takes the course of foods, 
through the stomach and absorbent glands, and probably has some 
of its virulence burned out or diluted in passing through the liver 
before it enters the right heart and is admitted into the general 
circuit. In smoking, the poisonous oil and nicotine are volatilized, 
and with the carbon monoxide — the product of combustion which 
has both an affinity and an avidity for the blood — a triune toxin 
enters the pulmonary circuit. Saturates the alveoli of the lungs, and 
hits the base of the right heart and the partition between auricle 
and ventricle— Avhere are located the wondrous bundles of nerves 
that eontrol the contractions and expansions of tl\e heart's chambers 
— and paralyzes the valves and muscles of this wondrous organ. 
It taints the lung tissue, and leaves the residuum of stinking toxic 
air in the air-cells that remains for daj^s, to pollute his exhalations. 



ALCOHOL AND TOBACCO 227 

Doctors and patients need only to recall the exhaled breath of ether 
and chloroform days after the operating room, or to try to shun the 
garlic and other odors of the oriental condiments of the recent immi- 
grant days after their ingestion. Tlirough all these circuits absorp- 
tion is going on, and back-firing, and pulse-halt and ■ heart-block 
signal the examining doctor, and warn both that the track is wrong, 
weakened, wrecked. Early, too, in these rounds the centers of both 
the intellectual and functional brain and spinal cord are being as- 
saulted ; in fact, the earliest impact is here, and sensation and motion 
are crippled. Through these come also the protesting reflexes, the 
nausea, the tremors, vertigo, convulsions, and deaths. 

Why clamor for pure air when every waking breath of the to- 
bacco user is polluted with toxic fumes? The poison is absorbed 
from mucous membranes and from the skin. The snuff and tobacco 
chewers get theirs by the former waj'. In Alaska, vyhere the ex- 
treme cold cracks the lips and cheeks, while attempting to hold a 
pipe or cigar in the mouth, the dupe rubs up plug and fine cut and 
binds it in bags under the arm-pits or over his solar plexus and 
imagines he gets the effects of his cherished weed. The smoker in- 
hales and exhales, and leaves a trail of highly volatilized toxic 
residuum along the entire respiratory tract that paralyzes, benumbs, 
and easily makes a tuberculous victim, adding another race ex- 
terminator. 

When used as a poultice for spasmodic croup in infants it has 
caused alarming depression and death. Formerly used in strangu- 
lated hernia, it produced pallor, cold sweats, and such alarm that its 
use in medicine is abandoned ; it is too poisonous. Through smok- 
ing and inhalation, all these symptoms come more direct, and the 
fatal invasion is averted by the protest and paralysis that releases 
the vigil of the flexors of the jaw and lips, that drops the pipe or 
cigar from the mouth to burn the skin or clothes and arouse the 
body to salvation. 

It is said tobacco soothes perturbed nerves, calms mental and 
corporeal irritation, smooths business ruffles and domestic infe- 
licity. That is why the messenger and delivery boys must have it 
as soon as they get around the first corner; why the grocery loafer 
and dray drivers must have it. It allays itch, cures corns, relieves 
the irritation of the unwashed, and assuages the hunger of the 
pestiferous tramp. Any excuse or none suffices to win a recruit 
and hold a devotee. 

Imitation, as a relic of the simian age, remains strong in man. 
His Caucasian cousin cannot beg ancestral infirmity for his narcotic 
frailty. He insists he cannot stop it; he must have it. He denies 



228 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

thiimb-suckinfr to his woaklino- babe and «iinn-eh('vviiis- to his ner- 
vous {rirl. but he must take a "cure" to stop it. His immunity lies 
in his will that tobacco has weakened. Caesar sai(J, "To live is to 
will." The tobacco user's narcosis made him forget that "he is the 
master of his fate, the captain of his soul." He cannot escape the 
oblififations of present progressive civilization. He nnist abandon 
his quest, his habit of dru<^, whiskey and tobacco narcosis, and alij?n 
himself with men and not with monkeys or be left behind in the race. 
Real men should arise above imitation. Imitation is mere servility. 
Tobacco usinja: is drug- slavery. 

The blastopthoria, or germ damage, produced by alcohol on the 
cell wall and substance is now microscopically as well as physio- 
logically and pathologically demonstrated. The same study applied to 
tobacco gives the same results. The toxic dent of tobacco is made on 
the incalculably thin film of the cell wall and the poison is projected 
into the cell elements, even to its nucleus and nuclei. This may be by a 
vital dynamism or physical osmosis, but the law is unrelenting. It 
matters not whether this be a squamous scale from the lips or mouth 
or the palm or back of the hand, whether it be the more highly organ- 
ized cell from the cortex or the sympathetic, the sperm cell of the 
male or the sacred citadel of the ovum ; tobacco, alcohol and syphilis 
make the same sear and leave the same blight on sire, self, and progeny. 

The blood does not furnish an antitoxin, an amboceptor, against 
phytotoxins. The working principle of Ehrlich's bacterial theory 
of immunity does not apply against the alkaloidal poisons, plant 
poisons, like morphine, nicotine, soapin, etc. The body does not 
develop an immunity against these in the same sense that it does 
against bacterial toxins ; the blood serum does not manufacture or 
acquire the substance capable of neutralizing these poisons. There 
is no amboceptor between nicotine and the blood or the cell struc- 
tures. Neither has an elective affinity been found that is harmless 
to metabolism or helpful to liistogenic structure. There must, how- 
ever, be a substance in the plant, cultivated; in curing, or added by 
the manufacturer, that has an alluring as well as a paralyzing effect 
on cell life and an impairing and a destructive one on the germ plasm. 
We know that next to reptile venom and prussic acid, nicotine is 
a most hemolytic, blood-destroying, agent ; it breaks the cell-wall of 
the cell and destroys its nucleus, its vital center. Added to this 
is furfurol, carbon monoxide, by-products of tobacco combustion, 
poisons that are readily taken up by the cells and quickly dissolve 
their primary chemical elements. Within this organism, the cell, 
besides its elements, is inherent the very potential of life, the nu- 
cleus, the primal dynamism that correlates these forces and directs 



ALCOHOL AND TOBACCO 229 

them to organic function and to final destiny. Thv< is the deter- 
mdner of species, the nearest we get to the Great Directing Divinity. 
That it is atomic does not deny its existence or dynamism. 

Epilepsy, insanity, idiocy, imbecility and all the collateral 
grades of mental infirmities are on the increase. The statistics of 
increase of positive defectives over population are appalling — to 
say nothing of the criminals, substandards and repeaters of com- 
mon society. To enumerate them would be wearisome. Let this 
suffice : In Illinois the increase of insanity is 667 per cent, while 
population increase was only 50 per cent, census 1900. That 
these unfortunates, wrecks, and derelicts have been cast upon the 
moaning beach of the Sea of Life in regularly increasing winrows, 
parallel with the increasing use of tohacco, is a graphic and signifi- 
cant presentation that cannot be ignored nor denied. There may 
be comfort in this reflection, however, that blocking this blight on 
humanity in part, is absolute sterility in the male, which is also 
on the increase, in the original, in the secondary and tertiary issues 
of the tobacco user. 

Prof. Howard A. Kelly, of Johns Hopkins University Medical 
School, quotes, endorses and emphasizes the statement of the late 
Dr. Prince A. Morrow that "the unpremeditated childless marriages 
due to the husband's incapacity from gonorrhea vary from 17 
to 25 per cent, and that 75 per cent of sterility in married life is 
not of choice, but is due to the inca,pacity of the husband." But 
he does not account for the difference between the maximum of 25 
per cent due to gonorrhea and the 75 per cent of general sterility. 
This balance of infertility readily points to other toxin than venereal 
and easily admits tobacco into the ranks for competition for barrenness 
and this race extinction. 

The latest reports (1911) of the Census Bureau show that slightly 
more than 42 per cent of the infants dying under one year of age 
in the registration area did not live to complete the first month of 
life, and that of this 42 per cent almost 10 per cent died as a result 
of conditions existing before they were born — probably of paternal 
assault and toxemia before conception, or of injury or accident dur- 
ing delivery. However, with modern asepsis and manual technique 
and skill, deaths during birth are rare, and this change does not hold 
true. Of those that lived less than one week, about 83 per cent died 
of conjugal assault from venereal or other toxic projectile in which the 
very general use of tobacco would be conspicuous. Of the number that 
lived less than one day, 94 per cent died of prenatal toxins in either 
or both parents. While these figures exhibit an appalling waste of life, 
apparently at fetal conception or maturity, they in no degree represent 



230 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

the aceidontal Jiiul i^rciiKHlitattHl feticidt's in iiiircf/islcrrd districts of 
the vicious stratum of society, that without doul)t fur outnumber the 
fi^ires given in a very small registration area. Registration districts 
betoken a higlier sanitary and ethical standard than non-registration 
areas, and better conditions are expected to exist. 

There are prenatal conjugal considerations here that census re- 
porters do not recognize and enumerate. 

Procreation when either parent is alcoholized, or tobacco 
narcotized, should be prohibited, whether this be acute or chronic. 
In either way it affords a good example of transient blastophthoria 
in w^hich the germ-plasm, sperm-plasm, is damaged, so that degener- 
ative progeny is very likely to result. 

Nicotine begets very decidedly neuropathic stock. The heredity 
of nicotine-tainted stock is never on the right side. Nicotine is an ethi- 
cal as well as a race poison. Heredity as a science has made rapid prog- 
ress and is advancing. Humans are entitled to equal considera- 
tion with plants and animals. Propagation should be made selective 
from both sides. There might well be a parent inspection before 
there is the child and pupil inspection, before the "Better Babies" 
enter their contests. There needs be a standard of narcotic-free 
fatherhood before a standard of childhood and scholarship is de- 
manded. Prophylaxis should precede prosecution and segregation. 
It is realized that statistics are the mystics of argument. The aggre- 
gate of life is made up of vicissitudes of transmigration, climate, 
environment, vocational disease and accidents, habit and habit-he- 
redity, disease and disease-heredity, alcohol, syphilis, and tobacco. 
Alcohol is in almost universal use. Syphilis is all too prevalent; 
its spirochetie leave their unmistaken trail in rural and mural "Dam- 
aged Goods." But there is a bane as prevalent as all these combined. 
It is the Race Poison, Tobacco ; it is running a neck-and-wreck race 
with syphilis and alcohol for supremacy. No athletic or scholar- 
ship test has ever been made in which non-smokers did not excel 
the smokers ; a similar comparison would militate against progeny. 

Dr. Frankel-Hochwart, of Berlin, Germany, in an article in the 
Deutsche MediziniscJie Wochenschrift of December, 1911. relating 
to several thousand cases in his clinic, emphasizes the fact learned 
from his experience, that "the localization of the toxic action of 
nicotine is very much like that of syphilis." These observations are 
along the line more especially of nervous diseases, brain diseases. 

Hesse, in 1907, made similar observations in tobacco intoxica- 
tion ; Huchard and Bunge confirm these clinical data. Much ex- 
perimentation with tobacco has been done to ascertain the cause of 
the increase of arteriosclerosis and heart disease, the so-called 



AT^COHOL AND TOBACCO 231 

"hardening of the arteries," also the cause of interruption of func- 
tion and nutrition, leading to mental perversion, insanity, sudden 
deaths and the many palsies. The earliest observation on this line, 
and which establishes beyond doubt the deleterious action of to- 
bacco upon the arteries, is that of Isaac Adler, demonstrating har- 
dening in the end arteries of rabbits as a result of feeding them 
with a tea made of tobacco. Boveri confirmed these results by giv- 
ing this tea by stomach tube, and caused damage at the base of the 
aorta in ten out of sixteen rabbits, while Baylae on the same line 
got the same results in each of eight rabbits into which tobacco tea 
was injected into veins or under the skin. Jebrowsky and AV. E. 
Lee obtained the same results in other rabbits by making them 
inhale tobacco smoke. A great number of experimenters with to- 
bacco in this country and Europe obtained results so akin to these 
that no other conclusion can be entertained. The general conclu- 
sion is that a toxic principle in the tobacco is the cause of arterio- 
sclerosis. What more prevalent toxin is present than nicotine or 
other tobacco toxins? 

Chewing, more than smoking, through absorption and hemolysis, 
also causes an acidosis of the blood which increases blood-pressure, 
strains the heart, impairs the kidney's function, precipitates the soluble 
calcium into calcium carbonate, whose granules find lodgment in the 
lattice framework of the media and produces the arteritis nodosa 
of arteriosclerosis. The liigli blood- pressure will account for some 
of the flights of genius and descents into iniquity of some great 
minds otherT\dse blameless. Tobacco toxcDtiia is- more to blame than 
alcohol. A man usually knows when he is drunk, but rarely knows 
when he is tobacco inebriated. 

Dr. Ludwig Jankau, of Miinchen. carried on experiments and 
observations in his nose and throat clinic through a period of three 
years before issuing his brochure ^'Der Tabak," in which he pours 
a deluge of evidence against tobacco using. A society of scientists 
and physicians worked with him and confirmed his investigations. 

That tobacco is a causative factor in heart and blood-vessel dis- 
eases is apparent in this — that tobacco is promptly excluded in the 
treatment in all diseases of the heart and arteries. 

Dr. Hirsehfelder, of Johns Hopkins University Medical School, 
author of a classic treatise on Diseases of the Heart and Aorta, 
says, "Tobacco should be absolutely excluded in both organic and 
functional cases.'" A. Abrams, of California, places tobacco non- 
use ahead of alcohol in both prevention and treatment of heart dis- 
>ea:ses. Bovaird, of the Columbia University Medical School, New 
York, is equally emphatic in demanding immediate abstinence in 



232 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

all heart afTeetions. Similar quotations of eminent authors could be 
continued ad infinitum — and the users will say ad nauaeami. Dawn is 
coming. If abstinence aids to cure, why not total abstinence to pre- 
vent? Nowhere would the ada^j^e of ounce of prevention and pound of 
cure be more appropriate. All alienists also recofj:nize that in the in- 
sane, heart and blood-vessel diseases, congenital or acquired, prevail. 

Experiments made with plants demonstrate that solutions of 
poisonous substances, accidentally or intentionally introduced into 
the interior of the ovaries of plants, mar their form and even change 
their character. Wisconsin University has a field lecturer making 
investigation and experiment in this line. Can man saturate his 
germ with poisons and escape so great a condemnation ? Sterility 
is preferable to inferiority or imbecility. 

A neuropathic inheritance is often a nicotine inheritance. In 
Switzerland idiots and imbeciles are called Bausch-Kinder, ".jag chil- 
dren." In this country they might, with equal propriety, be called 
Rauch-Kinder or "smoke kids." If this recognition has become so 
apparent that it has reached the stage of popular jesting, should it not 
arouse the serious-minded? The Western World is shocked at the 
burning of widows on the funeral pyre of the husbands in India. 
We are slowly consuming on the pyre of tobacco beautiful boys 
in the prime of life and the vigor of manhood, father's pride, mother's 
darlings. We turn pale at the mention of the "Yellow Peril" in the 
East, while a yellow peril greater than the entire Mongolian horde is 
menacing our youth and our race. Race came from ' ' the beginning, ' ' 
race should extend far beyond the eternity of "the beginning." into 
the eternity of the future, ever advancing, never receding. 

Temples and tombs survive, but the earth is fertile with the bones 
of extinct races. No monument is so favored of God as that which 
in His image continues achievement in His name, through Race 
Betterment. 

Discussion. 

The Cigarette 

Miss Lucy Page Gastox. Anti-Cigarette Leaprue. Chicago, Illinois. 
Recently a returned missionary from China said that it was im- 
possible for the Missionaries of the Cross to go so far into the in- 
terior of that great, giant land that the cigarette missionaries were 
not there before them. That is what they themselves call "cigar- 
ette" missionaries. They make the claim that by the introduction 
of cigarettes they are helping the people to free themselves from 
the curse of opium. The American Tobacco Company, and the 
British American Tobacco Company, and the different organizations 



ALCOHOL AND TOBACCO 233 

that are preying upon China today, estimated that they could afford 
to give from fifty to one hundred cigarettes free to every man, 
woman and child to upward of four hundred millions of population 
in China. They did, and now there are hundreds of factories pouring 
forth their products in that country. There is an organization being 
formed in China by Dr. Wu and other patriots to combat the evil, 
which is only second to the opium habit. Do you people know that 
the opium addict will smoke a cigarette at the close of his debauch 
for the added pleasure that it gives? 

That is the product that is in the hands of the immature youth 
of this fair America. In this Race Bette'rment Conference I wish 
there might be some ringing protest that would reach every nook 
and corner of this land, warning the people against the dangers from 
this. Ninety per cent of the high school boys and the college stu- 
dents today are addicted to cigarettes or to some form of tobacco, 
and because tobacco in some form is the vice, the popular vice, of 
good men, it is only the most incidental mention that is given to 
this question. 

But, friends, what can we do about it — this question that we are 
struggling with at our headquarters at the Woman's Temple in Chi- 
cago and that our paper. The Boy magazine, the official organ of 
the league, is dealing with? Today we are undertaking to organize 
a force. The strength or the charm of organization to youth is well 
known. We have a plan of organization that should be introduced 
in every community in the country. There seems to be something 
about this anti-cigarette movement, this "A. C. L." button, that 
arouses the heroic element in the young American. 

Today the prohibition movement is the thing, but it is only part of 
the thing that is needed. What we need today is a great inspira- 
tional campaign for total abstinence, not forgetting tobacco and the 
other drugs that this good Doctor from Alabama brought to the 
front. We ought to have in every community a clean-life movement. 
Anti-Cigarette League stands not only for anti-cigarette league but 
for a Clean Life — yes, a Christian Life, a Consecrated Life. We have 
in our movement a thing that we can go into public schools with. 
There is a great opportunity for a getting together on that. People 
think I am loony, you know, on this cigarette question. Well, it is 
time somebody was. I see in this Conference an opportunity to 
reach out and do all of the things that are needed. 

A minister of Chicago who is very active in law enforcement 
work in civic affairs stated to me in our headquarters at the 
Woman's Temple one day, "Miss Gaston, some of us have never 
gotten to the point of total abstinence of cigarettes and things like 



234 FIRST NATIONAL CONFEKENCE ON KACE BETTERMENT 

that." He said, "AVhy, really, 1 would not care to iutroduce a total 
abstineiRH' pledge into my ehurcli." He said, "The leading mem- 
bers of my church have wine on their sideboards and beer in their 
cellars," and he said, "Other than the children, who will do any- 
thing that they are asked to do, I don't believe there would be half 
a dozen who would sign a total abstinence pledge. ' ' It was not very 
long after when that iiian came into our headquarters and said, 
"Miss Gaston, what do you think has happened?" I replied, "What, 
Doctor?" "Why," he said, "you know my little boy, Robbie?" I 
said, ' ' Yes. " " Well, ' ' he said, ' ' I found he was smoking cigarettes. ' ' 
"But," I said, "be careful, Doctor, now. Don't get hysterical." 
*Yes," he said, "but when a thing like that comes right into your 
own home, you have to wake up," and he said, "It was one of the 
boys of our own Sunday-School who w^as teaching him to smoke out 
in the alley, and his sister found it out." "What did you do, Doc- 
tor?" I said. "Oh, I sent the boy away and told him to keep off 
the premises." I said, "What I think you ought to do would be to 
organize a work in your church against the cigarette." 

In New York City I was doing work among the boys of the Postal 
Telegraph Company. About one hundred of those boys, from homes 
of all nationalities, joined our league. I spent about an hour every 
night, from 5.30 to 6.30, among those messenger boys — gamblers, 
drinkers, all kinds of boys. One night a Hungarian boy came to me 
and said, ' ' Miss Gaston, I want to sign for life against tobacco, but, ' ' 
he said, "I don't want to take the temperance pledge." (We 
have the temperance pledge on the anti-cigarette blank.) I said, 
"Why not, Frank?" He, a seventeen-year-old boy, said, "We are 
Hungarians and we have wine every night for dinner at our house 
and I don't think it Avould be very easy for me to see the others 
drinking and I not drink, but," he said, "I want wings on my but- 
ton." We put a little red ribbon on the button to indicate total 
abstinence for life from both liquor and tobacco. A boy can join 
until he is twenty-one. That boy signed up for both. The last thing 
he came to me and I said, "Well, Frank, how did you get along 
without your wine last night?" and he said, "Well, my brothers 
never did a thing to me, but my father never said a word. ' ' I said, 
"Frank, I believe your father was proud to have a boy who stood 
for what he believed to be right. Are you sorry you signed up?" 
"No," he replied, "and I am going to stick to it as long as I live." 

We are not giving the boys and the girls today a chance to have 
their blood stirred by any great splendid, heroic moral reform. We. 
have the plan and I w^ant to invite you all to help us. 



ALCOHOL AND TOBACCO 235 

Discussion. 

The Cigarette-Smoking Hero of Fiction 
Dr. Amanda D. Holcomb. 

Because of m}^ blind mother, I am obliged to read a good deal of 
fiction, and to select what she desires. I read the best fiction I can 
find. In that fiction I find the purest, sweetest, most ennobling hero 
smoking cigarettes. I believe this one thing has a very strong influ- 
ence on the best-reared boys and perhaps girls. I tried to investi- 
gate this subject. I am informed that there are only two magazines 
in the world that are absolutely independent, that cannot be bought 
and are not bought by the tobacco trust. In many instances it 
seems to me that the writer of these pieces of fiction did not put 
that cigarette into the hero's mouth, but that it was interjected in 
the publishing offices. I should like to know more about this and 
what we ought to do. 

Discussion. 

Magazine Advertising of Tobacco 

S. S, McClure, President S. S. McClure Company, New York, N. Y. 

My name is S. S. McClure, of McClure' s Magazine. I did not 
hear this address, except the last two or three words. Now, then, 
I have heard many times about newspapers and magazines being 
controlled by the trusts. Last year there was a meeting in Madison. 
Wis., of people to discuss that question. Professor Ely, of Madi- 
son, is here with us today. 

Now, there is much loose thinkiug on this question. Magazines 
are controlled by the necessity of paying their expenses and making 
some money. If a magazine were controlled by the trust and it did 
not suit its subscribers and advertisers, it would fail. It is subject 
to exactly the same economic laws that obtain in every other busi- 
ness. The main support, the life blood, of a. magazine is the confi- 
dence of and the monej^ from its subscribers, upon which, secon- 
darily, is based the revenue from its advertisers. 

Now I know the magazine business very thoroughly, and I de- 
plore the present quality of most of the magazines. I left the maga- 
zine business two years ago, since which time the magazines have 
not improved. But no magazine and no newspaper can prosper if 
it is the organ and the servant of any institution, financial or com- 
mercial, or of any trust or of any business like that. Such a maga- 
zine ceases to have revenue and ceases to have influence. When 
people supposed that Mr. Morgan, whom I greatly honored and re- 
spected, owned the New York Sun, which he did not, the New York 
Sun lost a large share of its influence. 



236 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

No publication may have what makes a publication live if it is sub- 
ject to outside control. The reason is this, that, after all, every pub- 
lication depends upon pleasing the people. If it does not please the 
people, the advertiser does not find that it pays. It has to have the 
support of the people. Now if it tries to please a particular interest, 
it cannot please the people. 

I heard that remark about the publisher putting a cigarette into 
the mouth of a hero in the office. He does not, as a matter of fact, 
I have often taken them out of their mouths. The editor, the pub- 
lisher, generally takes things as he finds them. When a chap like 
Richard Harding Davis writes, the hero smokes a pipe — almost all 
of them smoke a pipe. I had certain rules about McClure's Maga- 
zine. One was this, that nobody except Rudyard Kipling could say 
"damn" in McClure's Magazine. I did not like anybody smoking 
in McClure's Magazine. 1 did not like any picture of smoking in 
McClure's Magazine. But if they had these pictures, it is not be- 
cause of the trusts or of this or of that; it is simply because of the 
general taste of the public. 

Dr. E. G. Lancaster, President Olivet College, Olivet, Mich.: Isn't 
it true that the tobacco advertisements are so valuable to a live 
magazine that they cannot do without them financially ? 

S. S. McClure: That is not true; that is not true at all. It is 
not half true. All advertisements are valuable to the magazine in 
the way of money. The advertising in magazines has grown a great 
deal less than it was a few years ago, so that many magazines that 
a few years ago would refuse tobacco advertisements are now ac- 
cepting them. Some of them hate to accept them, but they all do 
it, they all accept them — just as Harper's Weekly for many years 
accepted whiskey advertisements, when other magazines would not. 
Magazines won't take whiskey advertisements and patent medicine 
advertisements, but their morality is just to the point where they will 
take tobacco advertisements. 

Discussion. 

A League of Employers 

]\Jel.vil Dewey. 

There are many people who feel strongly, in this race bettennent 
effort, that the tobacco evil ought to be combated as the opium evil 
is combated. Psychology teaches us that the human mind is in- 
capable of seeing in any right light the evil of a habit of which it 
is the victim. The liquor user smiles at the facts presented by those 
who are opposed to liquor. We hate to say things when we know 



AX.COHOL AND TOBACCO -237 

all our personal friends are hit. It comes back to us. A negro 
clergyman who was asked why he did not preach about chicken 
stealing in his church, said that it would create so much prejudice 
in his congregation he did not feel like taking up the topic. 

I have this practical suggestion to make in regard to tobacco. 
In talking with Dr. Kellogg, he suggested that an outcome of the 
Conference ought to be a national league of employers who would 
refuse to take into their offices, as I have for many years, a boy who 
uses tobacco or liquor or profanity or vulgarity. I have had hun- 
dreds of cases where a man says, "I won't do it in official hours. 
You don't mean to say you wish to interfere with my personal lib- 
erty?" "Not in the least," I always answer, "but you must not 
interfere with my personal liberty, and a part of my liberty is to be 
free from the annoyance of tobacco, and the people who go about 
our offices shall be free from that annoyance." I have had many 
cases where young men have given up their use of tobacco because 
they wished the position, and their wives have come back and 
thanked me heartily for breaking them of the habit, so that the men 
had no desire to return to it. 

Then we run into this difficulty, that so many of our physicians 
are tobacco users. It is almost unheard of for a man who is a drink 
addict or addicted to opium or tobacco to share in a campaign against 
it. Many of our clergymen also use tobacco. I have known delicate 
women, with high ideals, to go to a communion service and be physi- 
cally sickened and nauseated by the odor of stale tobacco on the gar- 
ments of the priest officiating. [Voices, "Shame!"] It is a shame, 
and when one goes back to the question of professing the religion 
of Jesus, it seems like sacrilege that one should be a user of tobacco. 

Now if we face frankly this question, we see that while it is a 
widespread evil and many of our friends whom we prize in the high- 
est degree, whose feelings we would be very sorry to hurt, are ad- 
dicts of this habit, we still recognize that it is a strong factor in 
making a race of runts. If we would begin with a league of em- 
ployers who should say as a matter of economics and of practical 
business wisdom, "We will not employ in our o^ces or in certain 
places any young man who uses tobacco, liquor, profanity or vul- 
garity," it would help immensely. For the boy who wants to get on 
in the world, if he knew a thousand employers in America would ab- 
solutely refuse to have him in their employ, it would help him to take 
that attitude, and as a practical example, it would be easier to com- 
bat the evil. I wish we could prohibit in the magazines and all pub- 
lications the advertising of tobacco. I believe the time is coming 
when we will recognize, as we have with the opium habit, that it is 



288 KIRST NATIONAIi CONFERENCE ON RACE liETTERMENT 

a thiiitr that is pulliiiji' down the race. We ought to push it into the 
background as persistently as we can. 

This does not appeal to us as it ought to, because we are so 
familiar with it. But just stop for a moment and consider: If a 
person went into the street car or public elevators, and burned some 
chemical that gave off a fume that the chemist told us was as poison- 
ous as they tell us the fumes of tobacco are, there would be a mob. 
The burning would be stopped. As it is, we go to the best hotels of 
the country and are put into rooms where the mattresses and the 
carpets and the hangings of the room are redolent with an odor 
that would not be tolerated from anything else in the w^orld. But 
we are used to this. 

My suggestion is the suggestion of the law. We should control 
the sale of tobacco, as the French do, and make it no longer an ob- 
ject for the small dealers to induce the boy to become a smoker. A 
woman has just as good a right to smoke as a man, and we find in 
the women's clubs of the great cities that the European habit is 
spreading, more and more women are smoking, but I believe that 
men who respect women in the highest degree feel that there is some- 
thing lowering in it to womanhood. In the Lake Placid Club we 
have put our foot squarely down. Whatever a woman's social posi- 
tion or wealth, she cannot smoke at the Lake Placid Club. We feel 
that while she has as good a right to smoke as the men, it is pulling 
down the standard, and we will not tolerate it. Let us put our feet 
squarely against that growing habit of American women and girls to 
smoke. 

Miss Lucy Page Gaston : May I add one word on that last point. 
Since the first of August, 1913 [to January. 1914], at our head- 
quarters in Chicago, we have had over sixty thousand applications 
for our cure of the cigarette and tobacco habit. Of that number 
quite a good manj^ were women who applied for the cure. So the 
women today are smoking. 

Voice : Here is a good place for another ' ' single standard, ' ' if you 
please. 

Discussion. 

The Non-Smokers' Protective League of America 
Dr. Charles G. Pease. 
My topic is the "Harm of Tobacco-Poisoned Atmosphere." The 
poisonous character of tobacco smoke is not generally appreciated. 
People know that the florist employs tobacco smoke to destro}'- the 
animal life in the greenhouse, but they make no application of that 
knowledge to the tobacco smoke in public places, as affecting the 



ALCOHOL AND TOBACCO 239 

human race. Surely, if a poison is great enough to destroy the ani- 
mal life in the greenhouse plants, it will do some harm to the human 
family. 

The poisons in tobacco smoke, or quite a number of them, have 
been enumerated by Vohl and Eulenberg and others. I will not 
attempt to name them now, on account of the hour, but I would 
refer you to the United States Dispensatory and the article on to- 
bacco therein. Smoking in public is a violation of a constitutional 
right of individuals to breathe pure atmosphere. I will read here 
the declaration of the Non-Smokers' Protective League of America, 
which I represent: 

First: "That the right of every person to breathe and to en.joy 
fresh and pure air, uncontaminated by unhealthful and disagreeable 
odors and fumes, is one of the inalienable rights guaranteed by the 
Declaration of Independence and the Constitution and the Laws of 
the Land." 

Second: "That tobacco smoking in public and from our public 
places is the direct and positive invasion of this right, that it is 
dangerous to the public health and comfort, offensive and annoying 
to individuals, and an intolerable evil in itself. We do, therefore, 
pledge ourselves first to encourage and insist on the enforcement 
of all public laws, ordinances, rules and regulations prohibiting or 
restricting tobacco smoking in public and to secure the enactment 
of any other laws, ordinances, rules and regulations which may be 
or become necessary for such purpose, and to cooperate with Boards 
of Health, Police Officers and all Executive and Administrative Offi- 
cials and Departments to secure full and effective enforcement 
thereof." 

Third : " To secure the cooperation of all persons in control of 
buildings, halls, elevators, hotels, restaurants, theatres, street ears, 
railway cars, sleeping cars, dining cars and other places provided for 
the use of the general public, to prohibit tobacco smoking therein, and 
to limit and restrict it so that only those who indulge in the habit 
may be required to inhale tobacco fumes." 

Fourth: "To create a wholesome public opinion, and to en- 
courage individuals, whose rights and comforts are disregarded by 
tobacco users, to insist upon proper respect for such rights, and to 
protect the same from invasion to the fullest extent guaranteed by 
the Constitution and the Laws of the Land." 

We issue a legal opinion in leaflet form which indicates the right 
to use force, if necessary, in terminating this most persistent Jiui- 
sance. Our League is composed of some of the most prominent men 



240 FIRST NATION^VL CONFERENCE ON RACE BETTERMJ3NT 

in this country. We desire, through the medium of this League, to 
accomplish the purposes that we have started out to accomplish. 

In New York City we have, through the Public Service Com- 
mission, which gives us a hearing upon our application, the exclusion 
of tobacco smoking from our cars and stations, from the rear plat- 
forms of cars and from the four rear seats in convertible cars in 
summer time. We are on the way, I believe, to a still better order 
of things there. The United Cigar Stores Company endeavored to 
nullify our victory through securing 72,000 signatures to a petition 
which they issued asking for smoking cars upon the elevated rail- 
way structure and upon the surface lines or compartments therein. 
We combated that, and defeated the Company. I should like to 
read here some portion of our brief, which we handed in, as it will 
be helpful to others. We claim: 

"First, that to require street railroad corporations to maintain 
a nuisance or for city corporations to maintain a nuisance would be 
a violation of a principle of law, and opposed to the provisions and 
guarantee of the Declaration of Independence and to the Constitu- 
tion of our Land. The right to make laws and to prohibit smoking 
in public places was taken to the highest court in Alabama and was 
there sustained. To show also the poisonous character of tobacco 
fumes: There was a case in Alabama, Hudler versus Harrison 26 
S. O. Rap, 294, 123 A. L. A. 292, where the fumes from a tobacco 
dry house made the people in a residence a little distance away 
very, very ill. The highest court stated in its opinion that that dry 
house was a nuisance and compelled it to be closed." 



CHILD LIFE 

THE BAD BOY 

Hon. Jacob A. Riis (deceased), The Jacob A. Riis Neighboriiood Settle- 
ment, New York, N. Y. 

They brought the kid into police headquarters between two 
policemen, bound. I was there and saw him come. I don't believe 
in all my twenty-five years in that place in New York City as a 
newspaper reporter that I had ever seen a ruffian who bore the ear- 
marks of it so plainly upon his face and over it as did that kid. He 
was all smeared over with blood and had great bumps on his head 
where the policemen had struck him. He had not been idle, appar- 
ently, for the men bore marks of his fists; their clothes were torn 
down their backs. They were the tAvo angriest policemen I had seen 
in a long while. They passed me in the hallway and I took notice 
of the fellow. I knew of him by reputation. He came from the 
neighborhood of "Hell's Kitchen," a lad about eighteen or nineteen 
years old, a husky fellow. They took him into the detective's office, 
the headquarters. There they measured him, photographed him. 
indexed him, hung his photograph in the Rogue's Gallery, did all 
the things they could to make him more sullen, if possible, than when 
he had first appeared. When they had held him up before the as- 
sembled detectives, then they brought him again through the hall- 
way on the way to the jail and to the gallows, as they said, by way 
of the Jefferson Market Police Court. That was the police verdict 
on the kid. 

As he passed me in the hall, the sunlight fell into that fellow's 
face — into the eyes of the kid — and something there made me sud- 
denly turn and go along. I think the soul in me saw the soul of the 
kid, and owned it for kin. "We walked doAvn Bleecker Street and I 
talked to the policemen. They told me what he was, what I already 
knew, and then I turned to him and said some pleasant words. He 
gave me one of the most vicious scowls I had ever seen, and he told 
me to hold my tongue and attend to my own business. And I did 
just that. I said no more. Walking so, we came to Broadway, 
which we had to cross in order to get onto the East side, to the Jef- 
ferson Market Court. In those days the cable cars ran on Broadway. 
I don't know whether or not Battle Creek has ever had experience 
with cable cars, but we had them for a little while in New York. As I 
now look back, it seems to me the one thing I sum it all up in is 
just this: They were never normal; they were either jammed, stand- 

241 



242 FlUST NATIONAL CONFERENCE ON RACE BETTERMENT 

ing on the street iiiimovjible, oi- else tliey were nmiiing away— one 
or the other. They were jammed when we reached Broadway, and 
we stopped with the prisoner between. They started across the 
street, but just as soon as they put their feet upon the other tracks, 
there came a warning cry a little farther up the street that made 
them step back quick out of the way of a runaway car. What hap- 
pened then, was. I suppose, in the flash of one or two seconds. To 
me, it seems, looking back, as if it were half an hour. I can see that 
car come rolling down the street with the speed of a race horse or a 
cyclone, and the motorman trying to brake with the grip of despair, 
and ringing the bell on the platform with his foot, trying to clear 
the way a little, his eyes bulging with a kind of stare, as he looked 
down on the track in front of him. I followed his eyes and saw the 
thing that frightened him and my heart stopped for the longest 
period I think I can remember. For right in the middle of that 
car track was a little toddling baby with yellow curls, and its little 
face showing pain. The car was only ten or fifteen feet away at 
the time I saw it, and the little baby hand was held up as if to stop 
it. I caught just a fleeting glimpse of a frantic woman on the side- 
walk, the mother evidently trying to reach out and save it, and 
three or four men holding her. The child was irretrievably lost. 
I turned away so as not to see it. Everything turned black before 
my eyes, because I had little children of my own at home. But just 
as I did, I heard another cry, and just at that moment I Icnew the 
''kid" had taken to his heels and run. It seemed an age before the 
light came back to me, and I fell mechanically in the wake of that 
car to see the mangled remains of the child, but the street was per- 
fectly clear. There was nothing there and when I came entirely to 
myself, there stood the kid alongside of me, with the baby in his 
arms, safe and sound, setting it down upon the sidewalk and dis- 
engaging its little baby hands from his big, rough finger. He had 
just about one chance in a million of saving his own life, doing what 
he did. While the rest of us stood like so many fools looking on. 
good, square citizens all of us, who had had no encounter with the 
police, the kid — then indexed, you know, in the Rogue's Gallery, 
at that very moment on the way to jail and the gallows, according 
to the police — jumped and risked his own life ten thousand times in 
saving that child. He made the longest jump I ever heard of, in 
doing it, because that was the beginning of a new life for the kid. 
He not only jumped across the street, but jumped clean out of the 
old life into the new. When I last heard of the kid he was a trusted 
workman in a factory Avith a wife and baby of his own at home to 
keep in a straight way. You see, friends, I didn't make a mistake 



CHILD LIFE 243 

when I had seen something: in that fellow's eye — the image of God 
that is in all of us, the thing we call manhood and womanhood when 
it grows up and gets a chance, if it ever gets a chance. The kid 
had never had any chance at all over in "Hell's Kitchen." He 
came out all right in that chance. A man he came out. 

Why am I telling you that? In the first place, because the kid 
was the worst boy I ever knew in all my experience, and I have 
known many, all of them in my own city ; and in the second place, 
because I want you to go home from this Conference with a true 
note of it all — regeneration, not degeneration, is the note. Regenera- 
tion along the first and only real line, better babies, born into a 
better, brighter world, made better and brighter by the hope and 
faith and the skill and the devotion that they inspire. 

We have heard friends here talk about heredity. The word has 
rung in my ears until I am sick of it. Heredity, heredity. There 
is just one heredity in all the w^orld that is ours — we are children 
of God, and there is nothing in the whole big world we cannot do 
in His service with it. That, friends, is what we are here for. Re- 
generated, reborn, as the world was when it was born into the under- 
standing at last of the Commandment that we love one another 
unto the service of the practical. 

We talk here about insanity. In the old toAvn in which I was 
brought up — in Denmark — there lived, 200 years ago, a Bishop, who 
will be remembered to the last day, because he sang some of the 
sweetest songs in the Danish tongue, hymns that began with men 
and women, trouble and suffering, the very brink of the day, to the 
last. That was the service he performed. There was in that time 
in that day, among the preachers, curiously enough, one of those 
yellow, vicious, jaundiced souls. He came to the Bishop and said: 
"It is easy for you to sing of heaven and glory and happiness, for 
you have no trouble ; you live in a fine house, you have everything 
that man's soul could wish, but what about us?" And the Bishop 
said: "Come along," and he led him upstairs, two or three stories 
up, to an attic room, and he opened the door, and there, clamped to 
two iron bolts in the wall, with chains, was his son, his only son, a 
raving maniac. That, friends, was how they dealt with insane pa- 
tients at that time. The iron bolts are still there. I remember very 
well in my childhood how" they put them into a big place behind the 
fence, in which we boys pulled out the knotholes and looked through 
and shuddered at those glooms behind the fence. 

That was the way, friends, we treated insanity even in my child- 
hood, and see what we do today, in New York City, in my own town, 
in the span of fifty years since that venerable man who has presided 



244 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

over your deliberations liere, Dr. Stephen Smith — since he broke 
the past as chairman of the Citizens' Council of Hygiene in the early 
'60 's. See what a great change has happened since then in my city. 
In the last fifty years we have rehoused the population that lived 
in our tenement houses, more than a million and a quarter. They 
lived often in an environment in which all the influences made for 
unrighteousness and tended to the development of the worst 
instincts of the young. We found pretty nearly four hundred thou- 
sand of dark, sunless, windowless, airless bedrooms in those tene- 
ment houses. We got rid of three-quarters of them. The other 
fourth we will get rid of before this Congress has met three times 
more in Battle Creek. In that day, when Dr. Stephen Smith pre- 
sided over the early deliberations of the citizens in my city, we were 
afraid of the coming of cholera. That is why that council of hy- 
giene was organized. In that day the death rate in my city was 
thirty in a thousand of the living every year. Last year, the year 
that has just closed, in my city it was something over thirteen. That 
means that in the interval we have so amended things, in the biggest 
city of our land, that there would have died in 1913 one hundred 
thousand more people than actually did die if the old death rate 
had been maintained with the present big population. These are 
some of the things that we have done. 

We have added a thousand kindergartens to our public schools, 
and if there are any here who do not know what that means in the 
education of the children of the people, I pity them. Within the last 
ten or dozen years we have made more than four hundred play- 
grounds in schools and streets everywhere for the children. There 
Avas not one before that time. We have now seventy social settle- 
ments in my city that are morning, noon and night looking after 
the lost neighbor. There was not one twenty-five years ago, friends. 

Babies — we have heard a great deal about babies here. It is all 
a matter of loving care, friends, but don't misunderstand me. The 
emphasis is upon the loving care. We find in the streets and gutters 
and sewers of our city every year something like three hundred or 
so of foundlings, of outcast babies that nobody wants. We used to 
send them to Randall's Island to the Babies' Hospital and there they 
died. The mortality among the outcast babies, the foundling babies, 
was one hundred per cent right straight along. None of them sur- 
vived. We explained it as w^e could by saying that they started out 
Avith a bad heredity, the heredity of the gutter or ash-barrel, and a 
cold night is not conducive to the long life of any baby. We tried 
every conceivable way upon the Island to mend this, but it would 
not work. It was finally not the doctors' efforts with their knowl- 



CHILD LIFE 245 

edge of science that mended it, but it was the ett'orts of the mothers 
of my town. There are two bodies there known as the State Chari- 
ties Aid Association and the Association for Improving the Condi- 
tion of the Poor. 

A lot of women connected with those, mothers themselves, one 
day decided that that scandal was no longer to be borne, so they 
Avent to the city and begged for some of those infants to experiment 
W'ith. The city gave them some. For eight years they experimented 
with those infants and in that time they had sent to them one thou- 
sand babies. These were the babies among whom the mortality used 
to be 100 per cent. In the first year they reduced the death rate 
among those babies to one-half; the next year to one-third. They 
went upon the assumption that every baby in the w^orld is entitled to 
the care of one mother 's arms and if it cannot have that, it is cheated. 
And they proved their contention. The first year they saved one- 
half the babies and the next year they saved two-thirds, and the 
third year at the same rate. By the eighth year, they had reduced 
the mortality among those babies to 11 per cent, which was a great 
deal less than the general infant mortality in the city. They were 
picked mothers, you see. The rich mothers are not always the wise 
mothers, by a good deal, you know. 

You see, friends, what it is we are doing. Have you recently 
read the parable of the good Samaritan ? That is what we are doing. 
We are finding the helpless on the roadside and we are caring for 
them, binding up their wounds, pouring in oil and wine. But we 
are doing more than that, friends, nowadays. We are policing the 
road to Jericho so there shall not be any more of the kind of rob- 
bery and assault that left a man lying- helpless on the roadside. 

And are we done? No. Thank God, there is something to do 
yet. Don't let that discourage anybody. Let us be glad that we 
have a chance to work with the Almighty, because that is emphat- 
ically what we are doing on that road. The whole thing is just 
climbing a mountain, friends. You go up, up, and the farther you 
go up the mountainside, the more you see of the landscape. You are 
always improving, therefore, for every time you set two things right, 
there are five or six or eight or ten that remain still to be made 
right. Let us be glad. The work won't give out in this generation. 

Now, I came to talk to you about the bad boy. My position on the 
bad boy is very simple, very emphatic, very direct. I believe with 
the Eastern schoolmaster, who said that there were different degrees 
of good boys, but bad boys, he didn't know of any. There are, dear 
friends, not any who are deliberately bad, but plenty whom we make 
bad. Even then the boy would rather be good than bad, as one of 



246 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

them said, ii" he was i>iven a chance. That chance is the environment 
whicli it is our business to provide. 

Let me tell you of one bad boy of my personal, close acquaintance. 
I am the boy. I ranked as a bad boy when I went to school and a 
good reason why. I was taken to school first by an angry house- 
maid who thrashed me down the street, hammering the pavement 
all the way down. I was all the time bawling, yelling and I didn't 
want to go to school. On the step of the school stood the teacher 
and she reached out one long, skinny arm, grasped me by the neck, 
yanked me into the schoolhouse, then down into the cellar, then over 
the edge of a hogshead that stood there, then put the lid on, then 
snarled through the bunghole. That was the way they dealt with 
bad boys in that school. I saw there was no chance to get out till 
I ceased howling, and I ceased howling then and there. Then at re- 
cess she introduced me to a sow with pigs in the yard. She showed 
me the ear with two long slits, and said that was because the sow 
was lazy, reaching the shears up by my ears, zip. 

The Latin school was founded in 1859 and it had all the tradi- 
tions of those old days. I no more fitted into that place, well, than 
I would fit into Kingdom Come, I suppose. Now, beside me was 
another boy of exactly the same mind, and we were exactly of the 
same size, well matched. We never could get it settled which boy 
could put it over the other one. We left before the university days 
came, and the school was glad to get rid of us. The other lad, 
Hannes, went into business and became a very successful business 
man. He is today a member of the Upper House in the Parliament, 
from the old town itself — and with good reasons. He is a splendid 
citizen, I came over here — and do you see what kind of a scalawag 
I became here? Some years past I went back to meet forty of my 
classmates. They were doctors, lawyers, clergymen, fine as silk, all of 
them, and we were the two black sheep they were glad to get rid of. 
That day I saw the King confer an honor on the other boy because 
he had been the head of the citizens' committee that had labored to 
restore the ancient Cathedral that was being rebuilt. It was the 
occasion of my going home. King Christian had conferred that very 
same honor upon me three or four years before. That is the rib- 
bon I wear in my coat now. When I looked down the buttonholes 
of all the rest of the boys, these solemn men who had come from our 
school, I was surprised that there were only two ribbons in the whole 
lot, and they were worn by Hannes and myself. You see, friends, we 
were the two bad boys. 

Now take the boy here, take the boy who lives in a tenement 
house in the city, in the environment that makes for unrighteous- 



CHILD LIFE 24: i 

ness, perfectly hopeless, underfed, stunted, boxed up at night in one 
of those terrible sleeping rooms I spoke about, without light or air 
or anything. There was a neighbor of mine, who in her back yard 
made a pile of sand, for her children to play in when they came home 
from school and they played there and the cat and the kittens and 
the dog were with them, and they had a very happy time — except 
that there was always an ancient feud between the dog and the kit- 
tens. Whenever their backs were turned and the dog could grab a 
little kitten, he would try to kill it, bury it in the sand, and get rid 
of it. One day they were too late to protect it and they found a 
dead kitten in the sand. I was in that house when the little girl 
came racing in with it in her apron with her eyes all flashing with 
anger and she said, "Mamma, there is a perfectly good cat .spoiled." 
Hundreds of perfectly good children are spoiled in that kind of 
tenement house. That is how we make bad boys. Then we turn 
them into the street and there, until ten years ago, we had no play- 
ground, none whatever. What is an American boy, anywaj^, but a 
little steam boiler with the steam always hot. The play of that boy 
is his safety-valve. Sit on it, hold it down, and bang! goes that 
boiler. We have formerly provided no outlet for their natural steam, 
and bang! went the boy every time. I am afraid it is not so dif- 
ferent in the country, either, for when the good boy has to get up 
at four o'clock in the morning to do the chores, I cannot imagine the 
kind of sentiment in that little lad's mind, but I can easily imagine 
why he gets aM-ay from the farm — and sometimes goes to the devil, 
too. 

In our school we have eliminated the old-time hogshead and pig- 
sty, but, friends, we are not out of the woods, and we will not be 
out of the woods until we make our schools places fpr boys and girls 
to be fitted for the work of the life they are to live — where we teach 
our boys not to be ashamed of overalls and rough hands, and to pre- 
fer the job of an honest mechanic to standing behind a counter in 
a boiled shirt and earning six dollars a week and looking nice. I 
know what I am talking about. I learned the carpenter's trade 
where our girls learn home-making and housewifery or where men 
and women are moulded, with college in the far background. There 
are entirely too many good mechanics spoiled to make very poor 
professors, friends. 

So with the home and the play and the school. Is it any wonder 
the boy turns out bad? But what do we mean by bad, anyway? 
Did I tell you the story of how I came into Portland, Me., and found 
the town all excited about a young Irishman who had been com- 
mitting a number of robberies? They had arrested him, a boy of 



"248 P'lRST NATIONAL CONFERENCE ON RACE BETTERMENT 

fourteen, for stealiiiu' a handbag'. Tliis })articnlar hag contained 
sixty-eight dollars. They asked me to come out and look at the lad. 
I wish I had had Judge Lindsey there; he would have been an 
expert on that lad. I saw the finest boy I ever saw in my born days, 
brimful of fun. I asked, "What did he do with the money?" be- 
cause when you can find out what the boy does with the money he 
steals, you can then get a line on what is really in him. First he 
summoned two pals and they divided it up and got one beautiful big 
feed. Then they bought a bugle to make music — and couldn 't blow it. 
Then they threw away all the rest, excepting that each one kept a 
ten-dollar gold piece in his pocket. And what do you suppose he 
did with that last ten-dollar gold piece? He took seven dollars and 
a half of it, went up to the Young Men's Christian Association and 
bought a membership ticket there. Where now is your bad boy? 

The Children's Aid Society, in the last sixty years, have sent 
seventy thousand and more boys out of the slums of the cities to the 
Western plains, where they have a chance to grow up. If you could 
see the army of clergymen, lawyers, doctors and splendid nice play- 
grounds we have turned out of the slums of my city, and two straight 
governors — good governors, too, both of them. About four per cent 
of all the boys went to the had ; about four per cent of any number 
of boys anywhere goes to the bad, anyhow, from general neglect, that 
is, running wild. They were taken too late, I presume. 

Now we have good playgrounds and the pedagogue is at work 
trying hard to class and enroll the boys' play into team play, into 
group play, and heaven knows what other kind of play. I say, let 
them run and let the boy have a show of his own — hands off the lad 
except for overseeing his play, otherwise you may see him run to 
the gang. See to it, but keep away from him, and let him have it 
and let him run it. Let him kick up his heels in perfect aimlessness 
and drop in a giggling heap somewhere, and if he wants to fight, let 
him fight. Sometimes a black eye and a bloody nose is a means of 
grace, you know. What boy is there that is worth his salt unless he 
has a good fight every day or as often as he needs. 

What mistakes we grown folks make, but we think •vre can lay 
down rules for everything. You have heard it these last few days, 
laying down rules for everything. Happily the rules won't hold. 
The youth is always renewed with just so much badness in every 
generation to keep it from souring or from petrifying. The bad 
boys have always slipped up. There is almost always a mistake — 
and we are the mistake, not the boy. I hope we shall have him with 
us always, to sharpen our wits on and our consciences on. And let 
me tell you, you women know perfectly well how to deal with him. 



CHILD LIFE 249 

The men don't know always. I think men are the greatest misfits 
in dealing with bad boj^s, that ever were — including myself. I had 
one, and I didn 't know how to deal with him at all, but my wife did. 
The women know. You believe in that bad boy. and. ten to one, yes 
ninety-nine to one, he will come out right. 

What things would the world have done in all the ages but for 
the boy who did not fit in? He was fitted bad, and so went out to 
find the place where he did fit in and broke half the task upon which 
the whole world has been following behind in his wake, to a better 
and a brighter and a happier day. Henry Ward Beecher said of 
himself that the only time he stood at the head of his class was when 
the class deserted him. That was my experience, and I remember 
very well — but I won't tell you about that. That night when I dis- 
covered that Hannes and I wore the ribbons alone of the crowd of 
us old classmates, I went to have dinner with him and sitting across 
the table, it came to me suddenly, the thing worked out in my mind 
and I looked fixedly at him and said, "Hannes, has it occurred to 
you?" and Hannes stopped me with an imperious wave of his hand 
and turned around and said to his boy, ' ' Fritz, why don 't you go out 
and tend to your business?" Fritz went out and as the door fell 
to behind him, Hannes said, "Yes, it has. I am not going to have 
him here because he is at that end of the bench now." When Gen- 
eral Grant was President one day, in a sudden panic, he wrote to 
West Point and asked them how things stood with his boy Fred, 
who was down there. Word came back from West Point, "Don't 
you worry. He stands better in everything than you ever stood in 
anything." You have all known those bad boys, friends. They are 
not bad. They are just on the fence, and haven't made up their 
minds on which side to get off. 

Let me tell you of my own little boy at home when he was five 
years old. He peeled off the la.bel on the ammonia bottle and we 
found it pasted on his door, and it said, "William Riis very strong." 
Just about that time, one day, he went to his mother and said, 
"Mamma, would you be very mad if I was to be a burglar when I 
grow up?" "Oh," she said, "a burglar! — and you might get ar- 
rested." "Well," he said, "well, all right then, I will be a sailor," 
and she pleaded with him not to be a sailor. She said, "You have 
one brother who is a sailor and shall I sit out here and think of you 
on a stormy night on the deep black sea?" And he said, "What 
shall I be? A fellow must be something when he grows up. He 
can't always be nothing." She said, "Would you like to be a little 
minister. We never had a little minister in the house, and wouldn't 
it be so nice?" and his face went right under a black cloud. He 



250 FIRST NATIONAL CONFERENCE ON RACE RKTTKRMENT 

didn 't like it for a cent, but he left his mother and after a while he 
came over and said, "Well, all right, all right, if I can't be a burg- 
lar and you won't let me be a sailor, then I will be a minister." The 
lad was simply on the fence, not having made up his mind on which 
side to get off, and our business was to help him get off on the right 
side. 



Acting Chairman Rev. C. C. Creegan, D.D. 

I scarcely know what to say about the next speaker. He lives in the 
largest city in America that has the reputation of being above the clouds. It 
is nearer heaven than any other large city that I have any knowledge of any- 
where in the world, and I have seen pretty nearly all the large cities in the 
world. But there are some things about Denver, if I am not very greatly mis- 
taken—and I lived the:-e two years— some things that do not exactly remind 
you of heaven. And if there is any one man in all the Rocky Mountains that 
the saloon-keeper, the white-slave cadet and all the bad men and bad women, 
if there are such out there, have no use for, one they hate a good deal worse 
than they do the devil, that man is the one who' is going to speak to us. If 
there were no other reason under the sun for my loving this man, it would 
be because of the enemies he has made. I want to tell you that no living man 
can go into the jungle of the beast, as he has done, and not be thoroughly 
hated by all unclean men and all unclean women. I am rather inclined to 
believe that no man has any business to call himself a refonner, probably no 
business to call himself a full-fledged Christian in this twentieth century, if 
everybody is saying soft and beautiful things about him. "Woe unto you 
when all men speak well of you." 

THE DELINQUENT CHILD 

Judge Ben B. Lindsev, Juvenile Court, Denver, Colorado. 

I am sure it is a privilege and an honor to come back to Battle 
Creek — under somewhat different auspices from those that originally 
brought me here. Yet I am not complaining about those, for I found 
that sometimes it pays to get sick if you can come to Battle Creek 
and to Doctor Kellogg. I am sure it is also a privilege to be here at this 
splendid Conference. I did suffer in not being here through the days 
of those wonderful discussions, a sample of which we have just heard 
from my dearly beloved friend, and your friend, Mr. Eiis, who was 
the inspirer of my own young manhood. I remember so well, when 
writing the story of the ''Beast and the Jungle," of getting back 
the copy from the editor one day and of finding that he had cut out 
a whole page that I had devoted to Mr. Riis. It told about hoAv I 
stopped in a drug store one day and picked up a book called, "How 
the Other Half Lives," and how I began to get interested in these 
great problems. T complained of the liberty the editor had taken 



CHILD LIFE 251 

Avith my manuscript. He said they weren't publishing the story for 
the sake of giving me an opportunity to throw bouquets at my friend. 
But now, my friends, I am not hampered by any editors and I am 
sure the Chairman will not interfere when I express nw deep appre- 
ciation to be here under these auspices in the presence of such an 
audience, upon this platform with two glorious men, who have done 
so much for this country and for you, and for me — Doctor Kellogg and 
Jacob Riis. I assure you it is a privilege, and I am also honored, far 
beyond my deserving, to share with Mr. Riis the honors of this 
evening in discussing the so-called "Bad Boy." I know Mr. Riis 
agrees with me, that "there ain't no such thing." I accept the creed 
of the Hoosier poet who expressed it for us through the lips of a 
little child : 

"I believe all ehilliiii's dood if da's only understood. 
Even the bad 'uns, 'pears to me, is just as dood as they can be." 

And we have come to find it so. 

There is a difference in the two titles, however, assigned us. I 
am given the more favorable opportunity, perhaps, when I find on 
this program assigned to me, not the "Bad Boy," but "The De- 
linquent Child." That possesses a deep meaning and significance, 
and it is this : It is the concession of the state, it is a declaration by 
the state, the acceptance by the state, of the creed I have described. 
The child is not bad, but conditions are bad — things are bad. 

That recognition in a state came first in a law passed in April, 
1899, in the state of Colorado, and June 1st, 1899, in the state of Illi- 
nois. These laws recognized the so-called "bad boy" no longer, 
but rather the bad things that got him. It was the declaration of 
the state that it would no longer fight boys or girls, but it would 
fight bad things, if you please. It was a big step forward, funda- 
mentally, that came from out there in the West to join with 
that other great reform accepted first in Massachusetts, when its 
first probation law in 1868 had been passed. It calls upon men and 
women to help rather than hurt in dealing with tliose who are 
stricken with bad things. 

And so from that day down to date, out of this great reform 
spreading over the Middle West and then circling the globe, 
has come the new influence, the new power, the new force, coming 
into the lives of men while they are children. It is a force differing 
from that of violence. Not that the days of the old-time force have 
passed away, but rather have we come to recognize new forces. How 
curious it is that it took us so long to wake up to the possibility of 
the forces of patience, of kindness, of understanding, of sympathy. 



252 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

And the last is the diviiiest instniniontality in all the world in the 
hands of the skilled when it conies to the ills of the human soul. 
Under the new justice, that recop:nizes the child as a ward rather 
than a criminal, the state has come to help and not to hurt, to up- 
lift and not to decade, to love and not to hate. It is a big step 
forward in the great struggle for justice, rather than for law, for 
law was not always justice. Do you think so ? Hardly. If we could 
go back to a proceeding within a century in the Old Bailey Court in 
the great city of London, we might find before the bar of justice 
five little boys, all under fourteen years of age. The youngest only 
twelve, and that boy the chief culprit. We listen to the examination 
of the officers. "Little boy, you stole a shawl from the house you 
entered. What did you do with that shawl ? " " Took it to the pawn 
brokers, sir." "What did you do that for?" "To get money, sir." 
And after the suggestion of Mr. Riis a moment ago, bent upon find- 
ing out what the boy did with the money, in this way proceeded: 
' ' What did you do with the money ? ' ' said the officer. ' ' Went to the 
Punch and Judy show, ' ' said the little boy. 

Just like that little boy brought to court the other day for taking 
the gunny sacks and the cement sacks from the barn to sell to the 
rag man to get money to go to the moving picture show. Not the 
best way, surely, to get money to go to the show. 

But oh, my friends, what a difference there is in the method em- 
ployed by the state in handling such cases. The mother of that little 
boy of twelve came to the Old Bailey to plead with the judge to help 
save her boy. But the judge, in the formality of the time, explained 
that under the law — the law, if you please — he was not there to deal 
with the boy, but rather wath the thing he did, and that was, break- 
ing and entering, taking something that did not belong to him, which 
was an invasion of the sanctity of property. It was a rule that had 
come down to us through feudalism, attended with all its respect 
for property rights, with corresponding disregard for human rights. 
The court had nothing to do with the boy, but rather with the thing 
he did. It could not help the boy. So there followed the sentence 
from the bench that each of the little prisoners, all under fourteen 
years of age, be taken to the Tyborne Prison, and before the rise 
of the next day's sun that they be hanged by the neck till they were 
dead, dead, dead, and may God have mercy on their souls. That was 
not a thousand years ago. It was 1833, on an October day. It was 
not a lawyer or a judge, but a schoolmaster Avho thought less of law 
and more of justice, whose appeal to the Home Secretary wrung 
an unwilling commutation of that sentence from death or life im- 
prisonment to fifteen years of hard labor — for a little boy of twelve 



CHILD LIFE 253 

who took an old shawl ! Those of us who have the accounts of the 
frightful conditions then existing in the prisons may well doubt 
whether it was a mark of consideration that the sentence was com- 
muted and may have almost wished that they had been consigned to 
a merciful death, rather than to those hell holes where souls were 
seared and bodies degraded. 

It had been only a short time before when they cut their heads 
off and put them on the gibbets above London Bridge to terrorize 
the "wharf rats," as they called the children of that day, into right- 
eousness. But they did not terrorize. Crime increased, and finallj^ 
down through the years, as pity took the place of vengeance, as un- 
derstanding took the place of violence, we began to mitigate the 
penalty. 

But we forgot the fundamental thing, that only within a decade 
or so has been recognized by the state, and that was simply this: 
The child was the ward of the state. The child indeed was the state 
and the state was the child. When we saved the child, we simply 
saved ourselves. Then, my friends, came the first step in the new 
justice, that brought this child before the bar, not as the real cul- 
prit, but rather as one who was the victim of a real culprit and that 
culprit was rather the state itself — society itself, if you please. 

It was not so recognized until within the last ten or fifteen years. 
A community responsibility for the child was but little considered 
or tolerated. I found it so in my own experience, from that very 
first ease I used to tell about — or among the first — when the district 
attorney had asked for five minutes to dispose of a case of burglary, 
and I looked about to find the burglar, but I saw nothing of the 
kind. There had been ushered in three little boys. The grouchy 
officer had said, almost under his breath, "Sit down there. I guess 
you didn't give us the hot foot that time." And lined up before the 
bench in the formal fashion of a criminal law as I faced them there, 
that day, I beheld not men, but boys, twelve to fifteen years of age. 
These were the burglars. They certainly didn't look it. In the 
center of the group of three was a little tow-headed, freckle-faced 
boy all frazzled out at the elbows of his little coat and the knees of 
his trousers and indeed some other places thereabouts. He dug his 
fist into his dirty face and began to whimper out excuses. But in- 
stead of pleading "not guilty," as he might be expected to do, the 
little fellow, with a sort of determination and independence that 
we have since come to love and mark as a good sign, rather than 
impertinence, said through his tears, "Oh, I ain't no burglary." And 
I explained in simple terms that burglary was breaking and enter- 
ing. Then that little boy began his own defense, that became classic, 



254 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

it' not iiidtHHl historic, in the annals of our court. He hadn't any 
laywer to defend him. He said, "Jud^e, I live down by the railroad 
tracks where dese yuys live, and they said there was watermelons 
in those box-cars." I have often said there was not a lawyer at the 
Denver bar who could have started with a more powerful appeal 
than that, for it did strike a responsive chord in the bosom of the 
judge, reminding him of some other days. As I was forcibly re- 
calling that other occasion when I sought to sympathize with the little 
rascal, without justifying any wrong, of course, he turned to 
me somewhat suddenly and said, "Jedge, when you was a kid, didn't 
you ever swipe a watermelon?" And from force of habit or that 
sort of self-righteousness, perhaps, that protects us sometimes, I did 
what the lawyers do when justice is not on their side. They have 
a way of side-stepping the real issue, of resorting to the technicalities 
of the case. And I said, "You little rascal, it is against the rules 
of the court to cross-examine the Judge." 

And in this Conference on Race Betterment, I want to cross-ex- 
amine you, in behalf of this prisoner at the bar, right here, for he 
is a type of nearly one hundred and fifty thousand children hauled 
up into the courts every year in this country. Do you know what 
that means? It means nearly two million in a generation of child- 
hood. What can we do about it? You think you are going to de- 
crease it by courts here and there, but courts cannot do it all. They 
never will, and they ought not to. It is a pity that we have to resort 
to such an instrumentality. It is better than the old jails, of course, 
and the criminal court. 

But to return a moment to that little boy, and take the lesson from 
him in the concrete, through his tears. I explained, of course, to that 
little boy that because the subject of temptation was watermelons, 
was not any excuse for larceny. But it seemed he had other de- 
fenses in reserve. He said, "Judge, when we got down there and 
got into those box-cars, we didn't find any watermelons." And I 
said, "Look here, little boy, you found something or you would not 
be in court." He said, "Do I have to tell?" I said, "Yes, you have 
to tell." "Well, if I have to tell, it's like this: When we got in 
there and didn't find no watermelons, Ikey said, 'There is some- 
thing good in those boxes.' Yes you did, Ikey, you needn't say you 
didn't! Then we found something that looked like figs. We got 
out something that looked like something good and we drank a 
whole bottle full and it was California Fig Syrup, it was." With 
some indignation at the smiles that broadened and rose into titters 
and passed around the room, he concluded with great feeling, "And 
I think we have suffered enough." Well, I said I thought so, too. 



CHILD LIFE 255 

That plea was not alone for the gang, but for all boys and girls that 
have suffered enough, not only from fig syrup in that case, but from 
other things. I waited for that to sink in — ^not the fig syrup, but the 
eloquence. The trouble Avas the fig syrup was not prescribed in 
bottle doses and the gang had not stopped to read the directions. 
You know, Mr. Riis, that is one of the faults and failings of the gang. 
It is a thoughtless institution, without any direction except that fur- 
nished by the policeman who was there that day to condemn. He 
was the old type of policeman, happily passing away. 

I believe a policeman, as Mr. Riis has shown us, could and should 
be a social factor, as he is coming more and more to be. I have 
known a whole neighborhood to be changed by changing the police- 
man. There was a bad gang there and the whole thing was changed. 
We didn't change the gang. We changed the policeman. That was 
all. So much for the power of personality, if you please — the soul- 
to-soul, and heart-to-heart, dealing with human beings, rather than 
with the mere things they do. A policeman of the old type glared at 
the little boy as if he wanted to eat him up, and the boy glared at 
him as if he wanted to throw a brick. One policeman said to me, 
*'He w^as stealing lumber from the builders' pile where they were 
putting up a warehouse, and every time I come in sight, he sees 
me coming, and yells, 'Jigger de bull,' and everybody runs and I 
can't catch 'em." I asked the district attorney what "jigger" 
meant. He said it had a familiar sound of a bug he knew down in 
Missouri when he was a boy. The^n I learned one of the first of 
the many lessons I had to learn from the child : for we have much 
to learn from the child, who teaches us unconsciously, perhaps, 
but nevertheless effectively. I asked the boy what jigger was, and 
he said, "That's the guy that watches for de cop and snitches 
to de gang." Don't forget, that was a peculiar duty to the gang 
— not to the policeman, but to the gang, at tha approach of danger 
to give the signal and everybody scoot. He said, "If you told on a 
boy, you snitched on him." That was against their law. It was 
quite as real as ours. Indeed, I found that our law, "Thou shalt not 
steal," had a poor chance with the first commandment of the gang, 
"Thou shalt not snitch. You will get your face smashed if you do." 

Now, my friends, what did we face here? We faced the case of 
all society. You could not try it in five minutes. Don 't forget that. 
No more than the doctor could protect the community against the 
plague just by treating each patient stricken down with a fever. 
He might better go beyond the hospital even if it led him to the 
swamp lands beyond the city, to find the condition that affects all 
the people. So our thought is for all children, for this boy was not 



256 FIRST NATIONAI, CONFERENCE ON RACE BETTERMENT 

nuu'li different from others. His environment was different. Mr. 
Riis lias taught us that perhaps better than any other man in this 
country, in his battle against the slum and the fight for the play- 
ground. One of the early cases that came to my court was a little 
gang of bedraggled, dripping boys that a policeman had dragged 
out of the only "swimming-pool" in town, down by the railroad 
track. Some prudish people couldn't stand it to see little boys in 
that unfortunate state. As I gazed out of the court house windows 
I saw two big fountains, gurgling up their artificial showers. Sport- 
ing down below were little boys of brass and iron clad in a coat of 
paint. It was shocking, but did not shock any prudish people. I 
found on investigation it cost us several thousand dollars a sum- 
mer to have those fountains, and I said to myself, if this town can 
pay several thousand dollars a summer for artificial fountains for 
boys of brass and iron, it can pay something for boys of flesh and 
blood. So the judgment of the court, in that case, was not that they 
be sent to jail. I said. "Kids, you better go swimming in the foun- 
tain since there is no swimming-pool." You know sometimes a 
community needs a jar and a jolt, to be waked up. Mr. Riis gave 
it to them in New York and he taught some of us to do it in some 
other cities. The police did not think I meant it. When they 
brought the bedraggled, dripping little kids into court again, ex- 
pecting we would send them to jail, I smiled into the faces of the 
kids and the policemen, and the verdict of the court was, "Kids, 
back to the fountain." The smile on the face of the kids was an 
interesting contrast to the frown that covered the visage of the offi- 
cer, who did not understand. But in time — when the community 
woke up to the fact that it was not the child that ought to be before 
the bar of justice, but the community — we had seven public baths 
in the park and one great big, splendid public bath in the town, 
and we didn't need to jail any more boys for that sort of thing. 

A little boy had been in jail ten days for taking lumber. I 
visited his back yard. There I saw the lumber converted into an 
elevated railroad. He pointed it out enthusiastically to me. The 
judge was now his friend and not an avenger. And there was a 
soap box on wheels, the first contribution to the rolling stock of this 
remarkable railroad. But the unfortunate thing about it all was 
that the soap box was stolen from the corner grocery and the lum- 
ber from the builders' pile, still it was not the first railroad that 
had been stolen ! The remarkable thing about it was that the cul- 
prit had been in jail. Did you ever hear of a case like that? I 
never had. If you had the patience to pursue with me "the beast 
through the jungle," you may recall that I had to try the political 



CHILD LIFE 257 

gang for stealing a railroad, a real railroad, and before we finislied 
that case, the man who had had the most to do with stealing that 
railroad came a good deal nearer getting to the Senate of the United 
States than he did in jail. We had a great deal of difficulty in 
keeping him out of the Senate. 

But, my friends, we went beyond the court down to the railroad 
track, out into the streets, and alleys, and we found that the only 
place to play was there where the wheels went round and something 
w^as doing, doing all the time. But when the community felt the 
jar and the jolt, and waked up on the question of the public play- 
ground, that sort of lawlessness decreased more than one-half in 
six months. And it was so much better and cheaper than that jail 
we had used as our remedy for delinquency. We are waking up, 
my friends. With this fact has come the "Boy Scouts" and the boy 
clubs, the Y. M. C. A. and don't forget the Camp Fire girls, as I 
see Brother Gulick, their director, sitting here. I don't say much 
about the girls and we haven't much on the program about them, 
but it is not because we want to neglect the girls, but because they 
are so much better than the boys. One boy said to me once, "How 
could they get in trouble? If they throwed a rock, they couldn't 
hit anything anyhow." And I know a very dear little boy 
whose sister had violated the law of the gang — or rather did not 
know what it meant and had told on him. He was very indignant, 
and I said, "Jimmy, what do you think of girls?" "Oh," he said, 
"they were just born as a joke on the boys." And there was that 
other little girl whom I spoke to once. I said, "Jennie, how do you 
make it out that we have about twenty little boys in court to one 
little girl." With that feminine determination not to be outdone 
even by the boys in demanding suffrage and a few other things these 
days, she said, "That's nothin'; one bad girl is worse than twenty 
bad kids any day." However that may be, we are now getting deep 
into this case. It leads into what is sometimes called the sociology 
of this case, to the home and the parents in the home or that ought 
to be there. The mother of one of our little prisoners worked all 
day. The father was on a bed of pain right in the last stages of 
lead poisoning, that came from sixteen years of work in the mills 
amid the poisonous fumes and gases of a great industry. And he 
was only one of a hundred thousand fathers stricken down by occu- 
pational disease evers^ year in this country. Now how are you 
going to prevent delinquency unless you put a father and a mother 
in the home and keep them there. They are the natural judges, if 
you please, to look after the child. How are you going to reduce 
delinquency when six hundred and fifty little children were made 

(10) 



258 FIRST NATIONAL CONPEHENCK ON RACU'; l?KTTKRMENT 

oi-pliiiiis l)y exi)l(»sions in coal mines in one or two counties in our 
state within four years. Sixteen thousand children made orphans 
in a few years in three or four states in this nation from explosions 
in coal mines, a large part of which could have been avoided, ac- 
cording- to the government reports, if they had used the right kind 
of safety appliances. You can't get rid of delinquency unless you 
put the child in the bosom of the home and the father and mother 
there to look after him. Don't forget that. That means that Denver 
had to get into politics, because we could not change conditions un- 
less we could change laws, and we couldn't change laws unless Ave 
got into politics. Then you might go to a home and find no father 
there at all. In one home, the man was a deserter from wife and 
child. There are a hundred and fifty thousand deserters every year 
— more than from any army in times of war, more dangerous than 
deserters in times of war. But here is the story of one of the thou- 
sands of suffering mothers every year in this country. The father 
had gone to the gambling den, the dive, the brothel. We pray, 
"Lead us not into temptation, but deliver us from evil," and then 
do nothing, if you please, to answer our own prayers. Men are be- 
set by temptation on everf hand. Husbands, fathers and sons go 
down to ruin every year, that a certain type of business, if you 
please, may flourish. And then those of us who hold up our hands 
and cry against the evils that threaten to undermine the American 
home are rebuked for interfering with business and knocking the 
town, if you please. 

The lesson from the child is that it is all children up, all children 
down, and I am my brother's keeper. No home is safe unless all homes 
are safe, in the final analysis. We owe a duty to one another. We find 
that in the sociology of the case. It is a long story that I cannot follow 
now. But the fight for industrial, social and economic justice in 
this country is a fight for the child. Don't forget that. There is 
no child problem that is not a parent problem. Don't forget that. 
And there isn't any parent problem that is not a social, economic 
and industrial problem. Don't forget that. 

Then there is the psychology of the case. We are dealing with 
human souls. We are here no longer to save the old shawl. We 
are not here to save the gunny sacks except as a secondary 
purpose of our work. We are here to save the boy. But 
how long it took us to put the boy above the gunny sack! Hun- 
dreds of years ! That means that we must deal with him and un- 
derstand him. Now. friends, we are looking into his soul. No matter 
how calloused or covered up it may be by bad environment, — ^much op- 
portunity for evil and none for good, — down in every human soul we 



CHILD LIFE 259 

know there is the image of God, as I heard Mr. Riis say once, if we 
only know how to bring it out. That becomes one of our great duties 
in the home, in the school, in the church. These are the great institu- 
tions upon which our civilization must depend ; these are the founda- 
tion stones upon which it all rests. We in homes and schools owe a 
duty to the citizenship of this country, by discharging well their 
functions toward the childhood of the nation. That means that we 
must know how to put our lessons over. 

Sometimes the appeal comes unconsciously from the soul 
of the child. I asked a little boy, "You will always do 
right?" I was speaking to a group of petty pilferers about my 
table. "Yes." he said, "I will do right." I said, ."Why will you 
do right?" He said, "Oh, de cop will get me." "Yes, he will if 
you keep it up," I said. The next little boy, after struggling and 
fighting with himself, finally gave the same answer in a different 
way. "I would get a licking. I got two." "Yes, I suppose you 
deserved them," I said, "but there is a better reason for doing right." 
The next boy said, "I will get in jail." "But there is a better 
reason than that." As I appealed to the next little boy, who was 
a tow-headed, freckle-faced little fellow, I said, "What is it?" He 
said, "I would go to hell." Well, my friends, we must know how 
to teach these children to do right because it is right, and not be- 
cause they will get in jail if they don't do right. You can't trust 
any citizen who has been reared with the artificial restraints ever 
above his head; in the home it is the nag and the lash, and from 
the bench of the court, the bars and stripes. Not that these things 
are not necessary, as one poison is an antidote for another poison, 
and therefore, poisons are necessary, but there is another restraint 
and that is the restraint that is self-imposed, that comes through the 
human heart, through the divine speaking in the soul of the Small 
Voice to the conscience and commanding man to stand up in the 
face of temptation and difficulties and do right because it is right; 
to be willing to suffer for the right. When we get that kind of 
citizenship, the days of graft, the days of the shame of cities, wall 
then pass away and there will be less need for the artificial re- 
straint, for the boy who does not learn his lesson right, any more 
than did little Jimmie whom I used to tell about. I saw him a few 
days after he attended Sunday-school and I said, "Jimmie, what do 
you think of Sunday-school?" "Oh," he said, "it's de place where 
all de little kids go and dey gives up a penny and don't get nothin' 
back." I said, "You little rascal, you learn tilings there that you 
ought to know." "Yes," he said, "learned about de angels that 
have wings just like de chickens but those guys didn't learn me 



260 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

whetlier tlu\v Inid eogs or not." It iii;iy not have been altogether 
the fault of little Jimmie or the Sunday-school, but little Jimmie 
was like some men. The lesson had fallen on deaf ears. He saved 
his precious pennj^ for the sake of the candy he could get at the 
corner grocery. He had no conception yet of those values that con- 
cern the hmnan soul, the spiritual values. We must know how to 
endow men while they are children with the spiritual values. They 
are not to be measured in dollars and cents or material things. 
Here is where we sometimes fail. The child grows up to be that 
man in the world of business who, because he is more intelligent, is 
simply more dangerous; who is a practical man, and through his 
injustice robs thousands and thousands of people — the big sinner 
in society, the big crook in society, who is too sharp to get caught, 
gets away with the goods and goes unwhipped of justice. Let us 
learn how to make the school and church most effective so as to 
give our children their greatest heritage, that sort of equipment 
that means moral and industrial efficiency, so that in the future 
we will have citizens who will last, not only over night, but — as I 
used to say to the boy that I sent to the reform school alone — a 
week, a month, a year, forever. So much for the psychology of this 
case. We in the courts are merely trying to help the home, 
the school and the church; for every little child that goes astray 
means simply there has been a failure somewhere along the line, 
not altogether with the Sunday-school or the home perhaps, or the 
school, but because of certain conditions in society that we permit 
to flourish and exist and make no effort to cure. 

Then there is the physiology of the case. Of this I might speak 
just a few words in closing. It was never better illustrated than by 
a certain little "Mickey," a little Irishman, who came to my court 
years ago after his trouble with the police. He was a boy who brought 
the witnesses up before the Governor and the Legislative Committee 
to tell the evils of the jails and the brutalities that have been visited 
upon the youth in those days of struggle for the Detention Home 
School to supplant the jail for children. Mickey came in a few days 
after a successful light to say, "Jedge, didn't I help yer get that 
law through?" I said, "Yes, you did, Mickey. We could not have 
gotten it through without your help." "Well," he said, "where 
do I come in?" For a moment I couldn't understand just what he 
meant until he explained. He said, "Jedge. do you know big Peter- 
son?" I said, "Yes, I laiow Peterson." Peterson was a big police- 
man w^ho, when he couldn't catch the right boy, arrested Mickey 
on general principles. He said, "Jedge, that law only keeps kids 
out of jail under fourteen years old." He looked at me quizzically 



CHILD LIFE 261 

and said, "Did I ever tell you I was fifteen?" I said, "Yes, you 
did, Mickey, come to think of it." He said, "Can you do me another 
favor? Can you forget that?" He added, "If this legislature can 
keep kids out of jail under fourteen years old,, it can set my age 
back two years and I am thirteen from now on." And he said, 
"Jedge, the law don't help me a bit until this trouble blows over. 
I think I will join the navy." I said, "You better see the recruit- 
ing officer." He said, "I've been down to see that guy and he 
said, ' Say, kid, go eat some more. ' ' ' That flippant remark of the re- 
cruiting oifieer had more truth than flippancy in it. 

This brings us to the final head under which I like to discuss the 
problem of delinquene.y and to which we must come if we are going to 
save the child. Doctor Kellogg has told us and he is telling the people 
of this country that what a man is depends largely upon what he 
eats. He has been telling us that and other men have been telling 
us that. We in the courts are not going to decrease delinquency 
permanently unless we remember the lessons of this Conference. 
"What the child is, depends upon how well he is nourished, — what 
he eats, — how well he is clothed and what Idnd of parents he has 
and how free they are from diseases before he comes into this world. 
That is the phj^siology of the case. We cannot neglect that. 

So, my friends, let me at this Conference on Race Betterment 
•impress upon you as best I can, after more than fifteen years in a 
children 's court in a city of a quarter of a million people and some 
experience in the children 's courts of every city in this nation, that we 
cannot save this child that comes to the court unless we save all the 
children that do not come to court. They are all mixed up together in. 
the same problem. They are all our children. Don't forget that. 
Their salvation depends upon how v/ell we solve their problems 
under the sociology of the case, the psychology of the case and the 
physiology of the case. The sociology of the case means the great 
social, industrial and economic problems that concern the home and 
the parent in the home. The psychology of the case means the ever- 
lasting soul, that divine instrument, if you please, upon which we 
are called to play. It was a master teacher who said that skill in 
handling marble is as nothing compared to the skill in handling 
men, and the best time to handle men surely is in childhood and 
youth, when character is plastic and can be molded as clay in the 
potter's hand. We are putting our prisons in charge of skilled 
men and women. My friend, Tom Tynan, at the head of our Colo- 
rado penitentiary, said four years ago, "Lindsey, you have been 
sending hundreds of boys to these prisons alone without officers and 
without handcuffs, and never lost a prisoner. Why can't we do some- 



2()2 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

thiug by trusting men?'' We said we believed it could be done. Men 
are only children grown up ! And so, my friends, when a man like 
Tom Tynan puts hundreds of convicts upon the road camps in our 
state without the emblems of degradation or the restraint of vio- 
lence, he brings out the godlike image rather than that of hell itself. 
Why, I am told he does not even have to have a firearm in camp 
and he has less escapes than he had in the old days. He came to 
see me one day and said, "Lindsey, we have had to get a gun in 
the road camp." I said, "What on earth has happened?" "Oh, 
he said, "the infernal natives are robbing the convicts and we had 
to get a gun to keep them off. ' ' 

After all in this world there are only people. There are the eternal 
currents of good and evil. Our work on earth is to fight evil and not 
men and to encourage good in men. 



THE DEPENDENT CHILD 

Dr. Gertrude E. Hall, Director Biu-ean of Analysis and Investi.ffation, 
Department of State and Alien Poor, State Board of Cliarities, Albany, 
N«w York. 

All children are naturally dependent upon their parents and 
guardians, for it is characteristic of the human species that its young- 
are born more helpless and remain dependent longer than the young 
of any other spedies. When, however, parents die or try to dispossess 
themselves of their children, and to make others responsible for their 
physical and moral welfare, the children, if accepted as public or 
private charges, become thereby what is technically known as "de- 
pendent children." The several states treat dependent children in 
various ways. Some place them in institutions, others send them to 
foster homes and asylums, while still others have a system of home re- 
lief or so-called "pensions for dependent mothers." Each system is 
criticized by thoughtful observers, for it is said that the indoor method 
of relief "institutionalizes the children;" that in the placing out to 
work "undesirable children are sometimes transferred in large num- 
bers to communities where they later become social burdens;" and that 
the "pension" system, unless wisely applied, "leads to corruption and 
the pauperization of families." 

The recognized defects of child-caring work warrant us in analyz- 
ing its results. Both as individuals and as a nation we should give 
serious- study to this problem, for it is one of the largest that con- 
fronts public and private charity today ; it involves the investment of 
millions of dollars annually, and decides the destinies of thousands of 



CHILD LIFE 263 

the states' future citizens. Charities for children are always popular, 
for no philanthropic theme appeals so strongly to the hearts and 
' pocketbooks of right-minded persons as the promotion of the hap- 
piness and welfare of little children. But the impulse to give liberally 
in response to appeals should not be followed without first weighing 
the good and the harm that may result therefrom. The efficacy of 
methods of relief should not be measured in terms of so much food 
and clothing, but broadly in those of child, race and social welfare. 
The problem is therefore to know what conditions make it necessary 
for children to be supported outside their homes, what kind of chil- 
dren are becoming dependent, what effect their previous life had upon 
them, and also the influence of the institutional or other new environ- 
ment provided. We should know whether our children, like Romulus 
and Remus, the first dependent Roman children, grow up to be kings 
and rulers, if not of others, at least of their own hearts, or whether 
they tend to swell the ranks of unskilled labor, or even of vagrancy 
and vice. 

A special study along this line is in progress in New York State 
and while it is far from completed, some of the indications are signifi- 
cant. First, as to the causes of dependency, not more than half are 
legitimate causes, such as the illness or death of one or both parents, 
and even some of these catastrophies might have been averted, as. for 
example, deaths due to industrial accidents and dissipation, and ill- 
ness from communicable disease. The other causes of dependence are 
desertion of parents, improper guardianship, destitution, illegitimacy 
and the intemperance of parents. The desertion of parents amounts 
to twenty-five per cent of the causes so far studied, and reflects a 
weak phase of family life. This unfortunate condition is by no means 
confined to the poor, for certain boarding schools patronized by the 
rich are said to have as large a percentage of children who are sent 
away from their homes because of marital troubles and separations, as 
occur among the class of dependent children. One means to lessen 
the amount of child dependency and misery would be to strengthen 
home life in America and exalt its sanctity. 

The children proposed for commitment should also be studied and 
compared with other children, for if we are to care for the children 
of others, we must know what manner of children they are. before we 
can wisely decide on the best method of training them. Our studies 
in New York State indicate that only one-half of the dependent chil- 
dren we have examined and tested mentally are up to normal standard. 
More than twenty -five per cent are a year retarded, nine per cent two 
years retarded, eight per cent three years retarded, and seven per' 



26-i FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

cent more than three years retarded. Most of this seven per cent 
grroup are feeble-minded, although they are found in an institution 
Avhich intends to receive only normal children. This is a rather bad 
showing considering that we are speaking of one of the best groups 
of dependent children, for this paper does not deal at all with the 
large quota of delinquent and defective children. It would seem that 
the dependent child is not on the average a satisfactory child, and 
that it is desirable racially to have a better breed of children than he 
represents. 

We pass now to a study of the effect upon the parent and his 
child of the acceptance of that child as a public or private charge. 
Supposing the parent has neglected his child and the public assumes 
its care, society seems thereby to side in with the parent and say: 
"Why, yes, you may neglect your child altogether. We will support 
it. Spend all your money on yourself." Or even if the parent is 
required to pay a weekly stipend, it is not a wholesome thing to re- 
lieve him from moral responsibility for his child's upbringing. If, 
however, the parent is good but needy, the breaking up of the home, 
which has frequently been advised, is a serious matter, for the effort 
to keep a family together acts as a moral tonic on the parent, whereas 
nothing in the world will recompense a child for the loss of his 
mother's love. A few more clothes or a little more to eat will not 
requite him. 

We must admit that some parents are intemperate, cross, unwise, 
neglectful and vicious. In these cases the removal of one group of 
children probably means that others will be born, and this shows that 
the removal of children from the home does not really solve the prob- 
lem, but only aggravates it. As a temporary expedient the child i^ 
snatched as a brand from the burning, but radical social measures are 
needed to prevent such vicious homes. 

Another type of home is poor and ignorant, but not vicious. Often- 
times social workers, born to higher social development, cannot under- 
stand these homes of retarded civilization Avhich are found here and 
there, as for example the Jackson-Whites within thirty miles of New 
York City, and exclaim: "This is too bad, it must not continue." 
But one of the first things a eugenics investigator comes to realize is 
that in this nation which claims to be so advanced and civilized, there 
are nevertheless communities which are still in the age of barbarism. 
Their food, raiment, tools, moral ideas and general knowledge are 
those of barbarians. If this condition existed only in a few families, 
we might perhaps hold that these families should be broken up. But 
there are thousands of such families, mostly healthy, contented with 



CHILD LIFE 265 

their lot, doing little harm except petty thieving, who live out their 
lives in some mountain retreat or secluded valley, making baskets, 
living on cornmeal and pork, inured to cold and scanty clothing. It 
would seem to be a sounder policy to bring the school and the church, 
social centers and a better paying industry to these people, than to 
place them forcibly in an altogether different environment to which 
they are not yet adapted. 

It w'ill be no easy task to improve the race to the point where there 
will be few or no dependent children, but the elimination of the de- 
pendent child will be one of the best indices of superiority in our 
national stock and in our civilization. This country of ours is big 
enough and rich enough so that every family ought to find room 
enough to live, and be sure of steady employment at a living wage, 
so that the little home groups can be kept together, and the parents 
can see the reward of their hard toil and faithfulness in the vigor and 
virtue of their children. A child, more than one dreams, forms his 
whole philosophy of life and the universe before he is six or seven 
years old. Who feels more trusting and confident of the Heavenly 
Father's love than the little child chanting his evening prayer at his 
mother's Imee? His faith in God is built by analog}^ on his faith in 
this mother 's love. Beneficent home life is a national institution which 
must be sacredly preserved. Society should take measures to prevent 
the grinding poverty and discords which wreck some homes, and 
thereby create a better parenthood and neighborhood life, so that 
the problem of the dependent child may be eliminated as far as 
possible. American civilization must be built on sound home life, on 
devotion of parents to their offspring, on respect of children for their 
parents, and finally on the protection of the home by philanthropic 
agencies and by the state itself. 



EDUCATION FOR PARENTHOOD 

Dr. Ltdia a. DEVnjBiss, Director Better Babies Bureau, Woman's Home 
Companion, New York, N. Y. 

Without exception, all the vitally important papers presented 
so far at this Conference have borne directly or indirectly upon edu- 
cation for parenthood. Every evil discussed, every remedy sug- 
gested, should be known to the men and women who -yvould do their 
duty to society as parents. But those of us who are engaged in 
public health educational work, those of us who try to leaven life 
in our big cities, our towns, even our country districts, with what 
might be termed popular knowledge on sanitation and hygiene, know 



200 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

that more simple means must be taken to I'oach the average man 
and woman, the average parental conscience. 

The mother or father who will pass over sensational headlines 
in the dail}' papers dealing with problems of eugenics and euthenics, 
regarding such material as thought for scientific minds only, will 
drink in slowly, but fully, less spectacular ideas brought to their 
attention through the medium of their OAvn children, or, what we 
might better term parental pride. The man who does not know 
his child, naturally thinks it fit. He finds that it is unfit, abnormal, 
subnormal, only when he is forced to compare it with the children 
of other men. He does not think of himself as an unfit parent until 
he realizes that he has brought forth offspring physically and men- 
tally unfit to stand comparison with the children of his neighbors. 

The average man does not pay much attention to the children 
of his neighbors, whether they be better or worse than his own. 
He does not go to public gatherings where he will hear talks on 
life, hygiene, parenthood. Nevertheless, he has a certain instinctive 
pride in the child which he has brought into the world. For that 
reason, if he hears of what is commonly known as a "baby show." 
he is not averse to having his child washed, curled and beruffied, 
and taken by his wife to be compared with the children of his neigh- 
bor. If the child wins a prize at the baby show, the father is properly 
puffed up. If the baby fails to win a prize, he has the ready excuse 
— it was merely a matter of beauty, of dimples, of influence, of 
prejudice, on the part of the judges, altogether a matter of opinion. 
He does not take the decision very seriously. But the fact remains 
that he did want to know how his child stood by comparison with 
others. 

Upon this instinct, upon this very primitive method of reaching 
the unthinking parent, there has been founded a movement which 
promises to do a great deal toward the betterment of the human 
race. This movement has been worked out in various forms in dif- 
ferent parts of the country, but it is most commonly known now as 
the Better Babies Campaign. 

During the past year at least one hundred thousand babies have 
been examined for physical and mental development, as part of this 
campaign for race betterment. The parents of these babies have 
been taught that the unfit child is not a visitation of Providence, 
but the natural result of ignorance or sin. They have also learned 
that in this day of scientific care of children, practically every baby 
can be made a better baby if properly and intelligently brought up. 
Tens of thousands of these parents have had their first lesson in 
child hygiene, their first instruction in the important branch of 



CHILD LIFE 267 

medical science known as infant feeding. There are one hundred 
thousand better babies in America today because of this instruction 
received by parents. More important still, one hundred thousand 
babies have been started right. 

The first step has been taken in teaching them respect for their 
bodies. With each successive year these children will leaam more 
about their bodies, the care of the body, the functions, and the right 
use of the functions, sex hygiene and sex relations, on a clean Imowl- 
edge of which the greatness of this nation will be founded. The 
work which these awakened parents have begun will be carried on 
by the teachers in the schools, by social workers in settlement houses, 
in welfare clubs and in social centers. 

As Medical Director of the Better Babies Bureau of the Woman's 
Home Companion, it is my privilege to tell something of this work, 
how it has been promoted and placed upon a solid foundation by 
those who believe it a vital factor in the betterment of family life 
in America. 

The scheme of the Better Babies Contest is extremely simple. 
Babies are scored by physicians for physical and mental develop- 
ment, and a dozen or more clear questions," printed in connection 
with these results, show Avhat influence breeding and care have had 
on the child's condition. The mental tests are the Simon-Binet tests. 
The weight and measurements are taken and then compared with 
standards furnished by authorities in Europe and America. The 
physical examination is made according to schedule furnished by 
pediatrists and men who have had long experience in examining 
children at clinics and dispensaries. 

The person least interested is the child examined, but parents 
are aroused, not only to the condition in which the child is found, 
but to the realization of the wa^ong they have done society and the 
child, in a union which results in subnormal or abnormal offspring, 
the propagation of the unfit. In this way the Better Babies Con- 
test is working in its correlative features, talks by physical expertS; 
diagrams and literature, toAvard Education for Parenthood. 

In the Better Babies Movement, the Woman's Home Companion 
does not lay claim to originality. Before the Better Babies Bureau was 
fonned. a dozen agencies at different points of the country had at- 
tempted, in rather scattered fashion, to conduct the work. The editors 
of the magazine do claim, however, that by giving proper and dignified 
publicity to the plan through its pages, which reach over a million 
homes every month, it has accomplished in six months the work 
which the race betterment organizations, without a mouthpiece, 
would have taken years to accomplish. It has assisted social workers 



2G8 FIRST NAT1(,)NAL CONFEHKNCE ON RACE BETTERMENT 

all over the country to start these contests and to reach parents by 
this very simple method of education in hygiene and supplying, with- 
out cost, the literature needed for the contests, and encouraging con- 
tests by donations of medals, certificates, and cash awards. 

The growth of the Better Babies Bureau has been one of the 
marvels of the publication world. It was organized in March, 1913, 
to supply the score cards, literature about contests, and to answer 
queries from contest managers, usually officials of state and county 
fairs. Within a few months the fair officials made up but a small 
part of the men and women interested in^ this movement for race 
betterment. Club women and public-spirited citizens wanted to 
know how to hold a Better Babies Contest. Physicians asked for 
information about judging and scoring of babies. Mothers desired 
instruction in the care and feeding of their babies. "How can I 
bring my baby up to the standard of a prize winner?" was a com- 
mon question. Three-fourths of the mail proves that the writers have 
received no education for parenthood. 

At last, the public recognizes — what educators have known for a 
long time — that the subject of parenthood should be made one of 
the vital subjects in a young man's and a young woman's prep- 
aration for life. You will notice that I do not say motherhood, im- 
portant as that is, but parenthood, which includes good motherhood 
and good fatherhood. We are inclined, perhaps, to lay too much 
stress on the education for motherhood, forgetting that a perfect 
child must have a good father as well as a good mother. 

It is a sorry state of affairs when a great public school system 
entirely ignores, or overlooks, education for parenthood. Pro- 
gressive educators and a few parents have recognized this. But 
between our great political school boards, who know little and care 
less about eugenics and euthenics, and the great mass of American 
citizens, who are indifferent, those who know the crying need of 
education for parenthood are sometimes discouraged at the slow 
progress of introducing this and allied subjects into our great public 
school curriculum. 

The Better Babies Contests are filling in this great gap in a won- 
derful way. We cannot say to parents, "You are not a good mother 
and father," or "You could be a better mother and father." They 
would resent this, and justly, too, but we can reach their hearts and 
their pride through their babies. Wlien fond parents bring their 
babies to the contest to be scored, love casts a softening veil over 
infantile defects. They believe that their particular baby will most 
certainly take all the medals and the certificates in sight. When 
a doctor points out baby defects which they did not know existed. 



CHILD LIFE 269 

their pride is touched. They are alive immediately to the necessity 
of knowledge that they may remedy these defects. The parent is 
now ready for a course of education for better parenthood. He will 
come of his own free will to the educators for this knowledge of 
which he feels a real and crying need. 

Every contest is unlike every other contest. Each has its own 
little tragedies and its humorous side. I learn much from each con- 
test I am privileged to attend. One Western mother of a prize win- 
ner told us a very interesting story. From childhood she herself had 
been delicate in health, and she knew through bitter experience the 
humiliation and sorrow of the child who cannot play like other chil- 
dren. She resolved that her baby should be spared this suffering if it 
lay within her power. From the very inception of this new little life, 
she placed herself under the intelligent direction of her doctor. She 
exercised regularly, followed the proper diet, kept herself free from 
worry and in the best possible condition. At birth her child was a 
normal child. The same intelligent care has been given him every 
day of his life. As a result this one-time invalid is not only the proud 
mother of a prize-winning baby, but her own health is established. 
It is more than a coincidence that our prize babies are in almost 
every instance babies who have been fed regularly, who have had 
plenty of fresh air and sleep, and whose mothers have followed, to 
the best of their ability, the schedule for the scientific care of babies 
laid down by leading pediatrists. 

In contrast to this baby is one scored at a contest in a great 
Western stock-raising state. The father of this baby was a promi- 
nent and wealthy ranch owner and breeder of fine stock. He had 
made the trip to the state fair to enter his blooded stock and had 
won many first ribbons. Learning that there was a baby contest at 
the fair grounds, he decided to enter his little son. A few days later 
the physicians were engaged in re-examining the highest scoring 
babies, when the wife of the man whose stock was taking prizes at 
'the stock show approached the doctors nervously: "I did not get any 
card to bring my baby back for re-examination, but I thought that 
as we were strangers here, it might have gone astray, so we just 
brought our baby down to see if it was not wanted for this final ex- 
amination." It had never occurred to these parents that their child 
might not have come up to the standard required for the re-examina- 
tion. The doctor, thinking perhaps the card had gone astray, ran 
through the score cards of the previous examination until she found 
written in stern figures the tale of this baby's failure to qualify. 
Flabby flesh, slightly bowed legs and inability to concentrate, were 
among the points, indicating that the mother was overworked and 



270 FIRST NATIONAIi CONFERENCE ON RACE BETTERMENT 

the l)aby undornoiirislied. A dull Hush overspread the man's face, 
"Come on,"' he said, "we are goini^- to see the best doctor ri^ht now 
and find ont what's wrong." The family doctor in his home town 
might have suggested nndernonrishment and been laughed at. 
The mother might have poured her worries into unhearing ears. 
But when a group of judges, expert authorities, scored his child far 
below his live stock, this father received a lesson which struck home. 
He learned that straight legs are as important in boys as in mules, 
and that ability to concentrate is a sign of high breeding in humans 
as well as in horses. Let us hope that this father and mother w^ill 
carr}"" the gospel of better babies back to their Wyoming home. 

At these contests even the brief conferences betw^een mothers and 
doctors develop a surprising change in the mental attitude of the 
former. For the first time they seem to recognize the scientific value 
of the contest. Maternal pride and confidence give w^ay to maternal 
anxiety. Some of the women w^ho enter the contest smiling and con- 
fident and, perhaps, feeling just a trifle superior, at the close of the 
contest turn to the doctor nervously, "Even if my baby doesn't win 
a prize, you'll let me have his score card, won't you? I want to take 
him to our doctor right away and, if there is anything wrong, I want 
to know how to make him better." So another mother is started 
on the road tow'ard liberal education in parenthood. 

I hope that most of you have seen some of the examinations con- 
ducted here at the Battle Creek contest. One of my pleasantest duties 
at this Conference has been to assist in the final re-scoring of the 
baby candidates for the medals. Nearly six hundred children, five 
years and under, of Battle Creek and vicinity, had been examined by 
the local doctors. A number of the highest scoring children in each 
class were brought back for the final contest. An interesting inci- 
dent was that of a little boy scored by one of the Sanitarium doctors 
and given a total of 940 points out of the possible 1.000, or 94 per 
cent. Taking a fresh score card, another physician and I scored this 
boy again. When our score was totaled it w-as found that we had' 
also given him 940 points. This proves that scoring babies can be 
made accurate and scientific. 

The indirect results of the Better Babies contest are perhaps 
greater than the direct results. Parents w^ho have had their children 
in 1913 contests will not need to be urged to enter their babies in 
the 1914 contest. Thousands of visitors w^ill carry the news of Better 
Babies to every part of the country. Women and men like to be in 
style. There is every indication that parenthood is going to be more 
fashionable once again. 

There is a commonly accepted belief that the marriage ring be- 



CHILD LIFE 271 

stows the gift for parenthood magically — works a miracle of under- 
standing in the newly wedded couple. The divorce court, the juve- 
nile court, the reformatories, the homes for defective children, 
thoroughly disprove this theory. We train our citizens for every 
other worth-while profession. Is it not the most glaring incon- 
sistency to fail to train them for the most important profession of 
all — Parenthood ? 

There has been great agitation over the question of introducing 
certain phases of education for parenthood into the public schools. 
Most of this has been due to misrepresentation and ignorance of 
methods to be used. It is better if certain phases can be taught in 
the home, better for the child and better for the parents, but these 
subjects are not taught in the homes, and very few parents possess the 
requisite scientific knowledge to teach them successfully. If more 
parents will attend the lectures planned by those having this phase 
of the work in charge, much of the now existing prejudice will be 
overcome. 

To have a home, with all that word implies, we must have a 
mother and a father endowed with talent by their Creator and 
trained in the use of their talents by their educators. We must have 
a certain economic independence, or, in other words, our legislators 
must secure to a great army of American citizens, men toiling with 
hand and brain, an equitable share of the product of their labor, in 
order that they may be able to support homes and children. And 
last, and most important, we must have that love and harmony be- 
tween man and wife without which truly healthy and beautiful chil- 
dren are not possible. 

In the past, education for parenthood has been a system of don't'sv 
repression, negation. Ignorance, and morbidity, and crime have 
been the natural outcome of these pernicious teachings. The new 
education for parenthood will be characterized by its scientific 
foundation, its clarity, its sacredness, its loveliness, and its holiness. 
This is the work to which we have set our hand. If we begin with 
Better Babies, in a few years there will be Better Boys and Girls', 
Better Men and Women— BETTER PARENTS. 

In conclusion, I should like to present a few concise thoughts for 
parents : 

There is no man so manly as the man with the tender heart of a 
woman; there is no woman so womanly as a woman with the cour- 
age of a man. We prate about the "eternal womanly," when we 
mean only the expedient feminine. 

A man cannot sow his wild oats alone. He must sow them at the 
expense of some other mother's carefully nurtured daughter. 



272 FJllST NATIONAL CONFERENCE ON RACE BETTERMENT 

xVs a stream canuot rise above its source, so a uatiozi cannot rise 
above the potential greatness of its mothers. 

The mother who risks her life to produce a child, surely does as 
great service for the state as the man who kills another mother's 
son in defense of it, and she ought to be so recognized, and pen- 
sioned if in need. 

Only a mother knows the worth of a man. She alone knows what 
it costs to produce a man. 



BETTER BABIES 



RoBBixs GiLMAX, Head Worker University Settlement Scciety, New York, 
N. Y. 

Better babies are but a means to an end. That end is the object 
for which we are gathered here — race betterment. However, race 
betterment is not necessarily synonymous with better babies. 

The remarkably widespread and apparently intelligent grasp of 
the underlying ideas of the science of Eugenics augurs well for the 
future of our race. The seed of the eugenic ideal, which was sown 
so broadcast by the First International Eugenics Congress held in 
London a year ago last summer, seems to have fallen on fertile soil 
where it has germinated and already brought forth good fruit. When 
a popular interest can be aroused in taking better care of ourselves 
for the sake of bringing into this world better children, or in so 
taking care of our children that they may bring forth better children, 
the dim dawn of a better civilization may truly be said to have 
broken. There are unmistakable signs of an ever-deepening popu- 
lar interest in race culture, and that not by scientists alone but by 
fathers and mothers, both actual and prospective. This interest 
manifests itself in various ways, and while all of its manifestations 
may not have been the result of conscious efforts toward the fulfil- 
ment of the eugenic ideal, nevertheless they represent the first glow 
of color in the dim dawn. One of the most practical, if not scientific, 
phases of popular interest in the underlying principles of Eugenics 
is the many Baby Health Contests that are being held throughout 
our broad land today ; they tend to lay stress on race culture, which 
is wholesome. 

The ordinary "Better Babies" Contest brings to the mind a com- 
posite idea made up of a very few elements — healthy babies, com- 
petition and prizes. There are other ideas, fundamental, important, 
and consequently enduring, — which I \vish to bring out briefly in this 
paper, — that resulted from a contest held at the University Settle- 



CHILD LIFE 273 

ment last May in the heart of the most congested section of New 
York City. 

Concisely stated they are : 

(1) The relative unimportance of the healthy babies in a contest. 

(2) The need of offering two prizes in addition to those for per- 
fect health. 

(3) The inadequacy of a national conference. 

At the expense of seeming to make a paradoxical statement, I 
wish to say that I think the healthy babies, and especially the prize 
winners, in a contest are the least important part of the contest. This 
is so simply because health, whether in baby or adult, represents a 
satisfactory present state or condition, and unhealth or ill health calls 
for attention. Therefore, the babies which need no immediate care 
should not absorb our time and attention while there are sick or un- 
Avell babies to be looked after. One of the most important phases, 
therefore, of a Baby Health Contest is the detecting of unhealthy 
babies, which because of their unhealth need care and proper nursing 
for the purpose of fitting them for the race of life — to start them off 
with the least possible handicap. After a careful record has been 
made of the names and addresses of the imperfect babies entered in 
a contest, and their homes have been visited, and further and more 
careful examinations have been made, they should then become the 
special care of the municipality or private baby welfare organiza- 
tion, and the first great result of your contest has been achieved, 
"Without any lengthy clarification, you can easily see that without 
having had the contest, without having offered your prizes, you 
would no doubt have never found that this need for the care of these 
below-par babies existed. 

Another important phase of a contest is its educational side ; I 
mean that side of it which gets people to talking about, to thinking 
about, and reading about better babies. One of New York's most 
conservative newspapers headed a column article "Babies All the 
Rage" during our contest last spring. When the press of the cos- 
mopolitan city of New York carry for a week, as most important 
stuff, something, — not a murder, nor a divorce, nor a kidnapping, nor 
the mysterious disappearance of a prominent person, — that subject 
has become of unusual interest to the reading public. Mothers, old 
and young, and even prospective parents, were interested in babies 
last May in New York. Motherhood seemed to take on a more im- 
portant aspect. The effect of arousing so much talk was most whole- 
some and I believe could never have been produced except by hold- 
ing a Contest, by offering prizes. While competition was keen, and 
the spirit of rivalry rife, and the desire to win eager, yet these paled 



274 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

into insi^iiiHc'iiiu'e beside the fact that fjjroni)S of mothers gathered 
here and there in the crowded East Side of New York and wanted 
to know, "Was this good for the baby," or "I wonder should I do 
this," or "Don't do that, it ain't good for him," or "Don't face him 
to the sun, it'll hnrt his eves," or best of all, "Have you seen the 
nurse at the Milk Station about it ? " 

Now turning to the babies in the contest, those eligible for the 
prizes, — the healthy ones,— I ask this question, honestly. What does it 
amount to to find a perfect baby ? Of what great importance per se ? 
If the contest is to consist in finding a physically fit baby, to single 
out one from 100, or 200, or even 1,000, and to give to its parents the 
proud distinction of bearing such a prodigy, and incidentally arous- 
ing bad blood in the parents of the bab^^ who came so near to win- 
ning but didn 't. then I say let us have very few contests. As a social 
worker, I am more interested in the possibility of an imperfect baby 
growing up into fairly fit physical manhood or womanhood than 
in searching out a physically perfect baby who may not so grow 
up. but above all am I interested in having a perfect or imperfect 
baby grow up into moral and spiritual fitness for parenthood and 
citizenship. Temperamental endowment, or better, "emotional con- 
trol," to use Doctor Davenport's words, is, from the social stand- 
point, from the standpoint of the society of tomorrow, much more 
important than physical health, important as that most certainly is. 

To make a Baby Health Contest of more than passing importance 
it therefore should be followed by two distinct additional examina- 
tions, one into the environmental conditions surrounding each baby, 
and another into — as far as we are with our present knowlege able 
to gauge it — the possible inheritance that the baby is to fall heir to. 

In other words, I think that each contest should otfer three prizes : 
one, as at present, to the most perfect physical baby ; another to that 
baby whose parents have sought to keep and have kept his environ- 
ment best, and the other — and possibly the most important — to the 
best selected parental union, to the baby which has the best parents. 

In examining into the environmental conditions of babies en- 
tered in a contest, we may find very direct causes why a certain 
baby, or a number of babies, did not win or stood no chance of win- 
ning. We may find, for instance, that the mother worked at some 
trade or occupation during pregnancy which sapped her vitality. 
This might have been made necessary to supplement inadequate in- 
come. We may find sanitation of home, court yard or street to 
have a direct bearing on the ill health of the baby. We may dis- 
cover that on account of midwife or physician, or through lack of 
instruction and care of mother before childbirth, the babv comes into 



CHILD LIFE 275 

the world, or soon after becomes, handicapped. Home manufactnre 
may have filled the living rooms with bad air, as for instance es- 
caping gas, with a tailor. Such things have prevented an otherwise 
normal baby from being normal. Lodgers in the family, lack of 
windows, or windows opening on air shafts, or on a swill barrel 
where flies congregate, or a defective milk supply (if bottle fed) — 
any or all of these might v/ell be, and possibly are, the causes of 
many babies growing u^ physically imperfect. As a result of this 
supplementary examination into environment, laws might be en- 
acted which would materially affect for good the health of genera- 
tions to follow. In other words, the measuring of a baby up to a 
fairly perfect physical standard, no matter by whom devised, should 
not be the end and aim of a Better Baby Contest. 

Nor should we stop at bettering or endeavoring to detect adverse 
physical conditions in their possible relations to ill health or future 
growth. "We should go back of the baby and ask, "What kind of 
parents have you ? At what age were your parents married ? Have 
either of them any defect in vision, hearing, speech or teeth? What 
are the diseases to which there has been liability ? Have either of 
them undergone any surgical operation ' What is their mental abil- 
ity! In what condition does your mother keep her home, herself, 
"your sisters and brothers? What is her general reputation in the 
community ? How did she select her husband ? How many times has 
she been pregnant? Did your father use alcohol before marriage 
and does he now use tobacco and in what form? When did he be- 
gin to use it? Has he ever had specific diseases, especially syphilis? 
Questions should be asked also of each of the brothers and sisters 
of the baby, and information sought about the surviving brothers 
and sisters of the father and mother. Schedules with questions along 
both these lines of investigation have been prepared through the 
assistance of Doctor Davenport and of Professor Chaddock of Co- 
lumbia University, and are now being used by us at the University 
Settlement in connection with our recent, contest. 

The many suggestions we hear of and see in print in reference to 
a further restriction of immigration, because of the menace to our 
racial stock in the influx of "foreigners," are based largely, it seems 
to me, upon ignorance of facts as same pertain to the character of 
our immigrants. Apart from the perfectly proper restrictions which 
are at present incorporated in our immigration laAvs, such as relate 
to criminality, physical deformity, impeeuniosity. etc.. any fur- 
ther restrictions, merely as restrictions, would amount to selfishness 
on a national scale.' Race Betterment should be a world-wide slogan, 
not an isolated American, or British, or German, or French, attempt. 



276 FIRST NATIONAL, CONFERENCE ON RACE BETTERMENT 

"Of one blood hath He made all peoi)les. " Let ns take an interna- 
tional stand in this matter. If we restrict undesirables from our 
shores, they remain on some other shores. If we prevent certain 
peoples from coming hither, it is possible that we shut forever the 
door of hope in their faces ; we blight their spirits. Under, ordinary 
conditions we cannot as a nation meddle with or suggest changes in 
another nation's internal, political, economic, or social arrange- 
ments. We have no right to say to England, for instance, you must 
cease from having any unemployed, or, you should give women the 
vote. To France we cannot say that syndicalism or sabotage must 
not be interfered with, when the workers insist upon either. How- 
ever, we can say that as the world grows smaller in circumference, 
due to improvements in means of travel and communication, we all 
must get together, all nations, and agree that, as international inter- 
course, so to speak, becomes easier and more general, each nation 
is to a large extent concerned in the general health and mental and 
moral stamina of all others, because such things are of mutual inter- 
est in this day of interchange of population. 

As another expedient to limit immigration into this country, it 
has been suggested that agents be sent to all foreign countries for 
the purpose of inquiring into the qualifications of prospective immi- 
grants. It is said that such a system would not be a very difficult 
one to inaugurate, and I am perfectly willing to grant that it could 
easily be done. But what is its objects To keep from our shores un- 
desirable aliens. We are here today to confer on Eace Betterment. 
I ask, do you mean the American race (whatever that may mean) or 
do you mean the English-speaking race — if there is such a thing — 
or the Teuton race, or the Indo-Iramic, of which latter I have never 
heard. It is not so much a question of what w^e do mean as what 
we should mean. My humble contention is that when we speak of 
Race Betterment we should include within our meaning all the na- 
tions of the w^orld, the human race. If, when thinking of Race Bet- 
terment, we simply mean the United States, then we are not only 
parochial, but essentially selfish. 

Coming down to something concrete, I not only believe that there 
is room for race improvement, but I believe that some immediate 
steps should be taken to improve it. I believe that because of ignor- 
ance, upon which ground we should no longer excuse ourselves, and 
because of selfishness on a national scale, which we should be 
ashamed to offer further as an excuse, we have allowed conditions 
not only to exist but to grow until today Ave cannot say positively 
that our civilization is not actually threatened with rot at the core. 
As science reveals to our wondering eve the marvelous inter-relations 



CHILD LIFE 277 

between and inter-play of forces wh^cli up to a comparatively short 
time ago we thought of as isolated and independent, we should begin 
in our social endeavor to coordinate agencies for the dissipating 
or cohering of these forces, as by so doing they may be made to, work 
for the good of society the world over. "What does the importation 
to this country of a few million, more or less, of immigrant unde- 
sirables amount to ? What is that as a burning question to the pres- 
ent-day almost world-wide extent of a syphilitic infection, or of 
inheritable mental deficiencj^ ? "What is needed is a world-wide move- 
ment to look into and study this most important of all subjects, be- 
cause it lies at the very bottom of our existence or civilization. As we 
grow broad in our vision, as we expand our sympathies so that they 
both become world-wide in extent, we will see that what is needed 
is a concerted action by the civilized nations of the world on the 
subject of Race Betterment. World movements are not so rare to- 
day as one hundred years ago. International conferences are in this 
day, indeed, quite common, and it is with this belief in the urgency 
of the matter, and in the practicability of the scheme, that I offer 
you this suggestion, to- wit : 

That this Conference set in motion machinery for the calling to- 
gether of delegates from all the leading nations of the world for a 
conference to discuss ways and means by which such nations, each 
acting for itself but for the good of all, can, through governmental 
action, or otherwise, better the ra^e of man from the standpoints of 
physical health, mental attainments and moral stamina. This would 
be more than a Eugenics Congress, although eugenists would be, it 
is hoped, delegates: it would be more than a Health Congress, al- 
though doctors would be in attendance ; it would be more than an 
Ecumenical Conference, although spiritual leaders would be there; 
it would be more than a Peace Conference, although peace advo- 
cates would attend. It would be a gathering of statesmen, scien- 
tists, humanitarians, and government officials, all optimists, with 
national and international barriers knocked down, interested in 
the welfare of each because the welfare of each is inseparable 
from the welfare of all. Prison reformer, social and unemploy- 
ment insurance advocate, child labor expert, the missionary, the 
teacher, the doctor, the social worker, physiologist, psychologist — 
they would all be present to discuss the relationship of syphilis, alco- 
hol and tuberculosis to racial betterment, and the direct and indirect 
bearing thereon of medicine, education in matters of sex, proper 
care and treatment of infectious and communicable diseases, mental 
deficiency, housing and living conditions, city planning, hours of 
labor and recreation. And above all would such a Conference dis- 



278 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

CUSS tlie positive side oL' Race Hettenuent; eufj:eiiics and not dys- 
genics ; constrnctive work as opposed to destructive ; perfectibility 
and not deformity or defjeneration or disease. 



Discussion. 

Baby Saving 
Edward Buxxell Phelps, New York, N. Y. 

I believe that I am to be allowed five m.inutes in which to discuss 
the problem involving in this country the annual birth of possibly 
two and a half million babies and the annual death in this country 
of probably approximately one thousand babies a day. It is rather 
a larg-e subject for rather a short time. 

One of the basic principles of race betterment is "The Saving of 
Babies." In the investigation by the Interdepartmental Committee 
of the British Government on physical deterioration in 1904, a most 
expert testimony from all over the British Empire was taken. I will 
summarize in three or four lines the conclusions regarding a very 
important phase of the whole subject. 

The deliberate conclusion of the specialists who testified was, 
briefly stated, that, ' ' as though Nature were giving every generation 
a fresh start, something like eighty-five per cent of all children born 
in the world are born physically healthy," notwithstanding the ex- 
ceedingly popular notion to the contrary, and. furthermore, that 
these children would be capable of living a normal physical exis- 
tence were it not for neglect, poverty, and ignorance. 

It seems to me that is an encouraging start. If Nature apparently 
wipes out the so-called slight of degeneration and with that wonder- 
ful kindliness of Providence, of God, or Nature — call it what you will 
— gives the child at least for a moment after birth a fair start, an 
equally good start with all the other babies, what remains to be 
done? Why simply give that baby what God intended it should 
have, — that primary article of food for which alone its little diges- 
tive organs are adapted, — mother's milk, — plenty of air, plenty of 
water, plenty of sunshine, and keep out of its stomach for the first 
six months as you would a virulent poison any semblance of solid 
matter. I finally believe, after some years' study of the statistical 
side of this subject, that if we could accomplish this much, we could 
cut the w^orld's infant mortality rate in the middle. 

The milk stations and the various other agencies that have been 
employed for the betterment of infant mortality have done ad- 
mirable work and are lowering the rate. But why bother with 



CHILD LIFE 279 

minnows when whales are right within reach? Twenty million 
children are regularly attending the public schools of this coun- 
try. At least one-fourth of that number, or five million children, 
eventually become mothers. Why not systematize the teachings of two 
or three or four fundamentals of motherhood in the public schools 
for the girls between, say, eight or nine and fifteen or sixteen years? 
Why not properly put before them moving pictures, manikins, illus- 
trations, as you please, and teach them the fundamentals of mother- 
hood, and thereby insure, at least for the next generation, proper 
motherhood for our two and a half million babies a year. 

Discussion. 

Adolescence 

Dr. E. G. Lancaster, President Olivet College. Olivet, Michigan. 

There is one thing that has interested me particularly — because 
I am interested in child study, both professional and otherwise — 
the adolescent period, as some of you know. Something was 
said here about the study of adolescence. I had a brief moment 
with Doctor Hoffman in regard to the adolescent suicide. Much has 
been said here about the care of mothers and the habits of fathers 
and the importance of good breeding of children. But it does not 
make any difference how w'ell the child is bred if you are going to 
rear that child to be fifteen or eighteen years and then let it commit 
suicide because of lack of sympathy, because no one understands it, 
because the child feels that it has tremendous power and possibilities 
and yet no opportunity for self-expression. 

This has been brought home to me within the last month in a 
very appalling way. A young woman of great promise, whom I knew 
very well, committed suicide in a neighboring city this vacation. 
I do not know the cause, and presume she gave none — no cause is 
usually assigned for the adolescent suicide. But as nearly as I can 
find out, it was lack of appreciation. 

We have talked a great deal about feeding and care for babies. 
After quite a little study of the adolescent period, I am convinced 
that the period from twelve or thirteen to about twenty or twenty- 
one, or possibly later, is quite as delicate a period for the child to 
pass through as the first year and a half of its life. It needs the 
mother's and father's sympathy more at that time. Only about half 
of them are alive then, as you know, of those who are born, but 
there is far more likelihood at that time that that child will do 
something that will either destroy its physical life or its moral life 



280 FIKS^T NATIONAL CONFERENCE ON RACE BETTERMENT 

or its intellectual life than there is at any other period of its ex- 
istence. I know of no more terrific arraignment of our present ig- 
norance and civilization than the fact that we allow a large number 
of our most promising boys and girls to commit suicide in the ado- 
lescent period and in almost every instance, as I have said, because 
no one understands them. They have no friends to whom they can 
go and really speak out their heart. 



THE AMERICAN INSTITUTE OF CHILD LIFE 

Dr. Miller, Philadelphia, Pa. 

During the Rooseveltian administration a call came from the 
President for a Child Welfare Congress to be held at Washington, 
D. C. Educators, and those interested in the welfare of the child, 
came from all over the country in response to this call. 

As the result of that meeting. Child Welfare has become an es- 
tablished fact. There have been two practical expressions of this 
interest. First, the organization of the Children's Bureau, under 
the leadership of Mrs. Julia C. Lathrop in the Department of Labpr 
in Washington ; second, but not as generally known and recognized, 
The American Institute of Child Life. 

The American Institute deals with the normal child, almost ex- 
clusively, and the work is formative rather than reformative. 

The purpose or end for which the Institute is working includes 
two things: Equipped Childhood and Efficient Parenthood. It is 
the one institution which exists "for the individual parent, for help 
for the time in the home, drawing parents and children together. 

The greatest asset of the nation is the child, and it is the 
bounden duty of the home, the school, and the state to conserve 
this asset, and make life worth while. 

The Juvenile Court Record of July says: "When you save a man 
or woman, you save a unit, but when you save a boy or a girl, you 
save a whole multiplication table." 

The American Institute of Child Life affiliates with over sixty 
other organizations concerned with childhood, from which the In- 
stitute continually draws counsel and help, and with which it is 
working in sympathetic cooperation. 

As representative of the American Institute, I am here with 
you to join hands in every constructive movement for Race Better- 
ment. 

Edward J. Ward, advisor of Civic and Social Center Develop- 
ments, says, ' ' The American Institute of Child Life is the expression 



CHILD LIFE 281 

of a grand idea. It aims to tell the future what we expect of it." 

One of the leading problems of the hour is the twentieth-century 
child. So much does it occupy the thoughts of men that nine na- 
tions of the world are busy with the solution, and are taking giant 
strides to open ways and means to produce "future good citizen- 
ship, future right relations between individuals and Nations, be- 
tween human entity, societj^ the state and the Godhead." 

The hardest task before us today is parenthood. We need train- 
ing to study and know our own child. 

Plato said: "The best way to train the young is to train yourself 
at the same time." 

The pertinent question, "How shall Ave put the results of child 
study into the home in a way that will be helpful and practical to the 
busy mother?" is being answered through the work of the Ameri- 
can Institute of Child Life. A practical educator says of it: "Here 
is an educational institution which is undertaking in a very definite 
and practical manner to establish an understanding between Ameri- 
can parents and American children which will improve the stand- 
ard of the home, enrich its resources and contribute in a large and 
important way to the culture, efficiency and moral status of the 
coming generation." 

No one person can be said to be author of the movement, but 
the late Doctor Canfield, of Columbia University, Dr. Melvil 
Dewey, State Librarian of New York, and other equally well-known 
educators, saw visions and dreamed dreams over this inspiration 
until they finally interviewed Mr. John D. Morris, of Philadelphia, 
a practical educational worker, and asked him if it were possible 
to bring the ideas before parents in a usable, common-sense manner. 
Thomas R. Patton, of Philadelphia, a wealthy philanthropist, fur- 
nished the money to make it practical. Doctor Brumbaugh, the 
Superintendent of the Philadelphia public schools, says the Ameri- 
can Institute of Child Life is one of the greatest and newest ideas 
in home education. 

It is an endowed corporation chartered under the laws of the 
state of Pennsylvania as an educational institution, without profit, 
to interpret the best that is known about children to those who 
love and care for them, and to give children and young people an 
appreciation of the best things in life, and to equip them with just 
the right material for their individual needs. 

The scope of the plant is such that it is believed the Institute 
will mean as much to the individual parenthood of Americans as 
the Children's Bureau at Washington hopes to be to the collective 
parenthood. The Institute will not attempt the social interests 



282 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

of the Bureau. The Bureau cannot undertake the personal en- 
deavors of the Institute. 

The American Institute of Child Life approaches the work of a 
university. A competent board of trustees holds the funds. Its 
work is directed by an Administrative Board of sixteen organized 
scholars, among whom are President G. Stanley Hall, Judge Ben 
B. Lindsey, Mary E. Woolley. Joseph Swain, Ex-President David 
Starr Jordan, and Martin G. Brumbaugh. 



SEX QUESTIONS 

PUBLIC REPRESSION OF THE SOCIAL EVIL 

Graham Taylor, President Chicago School of Civics and Philanthropy, 
Chicago, Illinois. 

Under the conspiracy of silence and secrecy there has come to pre- 
vail a system of commercialized, segregated, police-protected vice, the 
results of which so deteriorate and demoralize the very stock of the 
race that there is little use of thinking of race betterment without at 
least reckoning with these sinister and everywhere present evils, the 
elimination of which must be a primary condition for any formative, 
constructive policy for race betterment. The magnitude of this system 
is little imagined. It is only guessed at. Its proportions are estimated 
by wild guesses of numbers. They can be measured to a degree by 
the areas in towns and cities deliberately given over to it. Here and 
there, now and then, we have a chance to estimate the magnitude of 
this evil by the diseases which come directly from it in our hospitals, 
under our child welfare and public saving efforts, schools for the blind, 
institutions for the feeble-minded, in the infirmaries for the insane, and 
by the victims of vice whose gruesome, never-ending procession files 
through our police stations and courts. We have some chance to esti- 
mate the financial investment in this commercialized vice by the forms 
of those investments, the profits that are made, the blackmail that is 
levied, the bribery of public officials — all counting up into the millions 
in our large cities. The clandestine type of this evil can never be esti- 
mated and possibly can never be directly dealt with. More and more 
nowadays a larger and larger number of men and women who have 
looked to see and know, have made up their minds that commercialized, 
police-protected, segregated vice can and must be suppressed. 

The Mayor of Chicago, by the authority of the City Council, ap- 
pointed thirty citizens to inquire into the conditions of vice in Chicago 
and to report to the City Council recommendations as to public policy. 
At the head of that committee was Dean Sumner, at whose suggestion 
the appointment was made, backed up by resolutions of the United 
Ministers' Meeting of the city. The commission was very representa- 
tive. It had upon it .judges and lawyers and doctors and business men, 
men of affairs, public officials and teachers and social workers, clergy- 
men and two women. They worked for nearly two years as an official 
body. I shall not try to tell you of its statistics, but I will of its 
methods. 



28-1 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

None of us knew how the others thought of it. If we had any 
theories, we kept them to ourselves. We were an investigating, not a 
prosecuting body. We had our sub-committees, one on the relation of 
the liquor traffic to the social evil, another on the sources of supply of 
\'ictims of the vice, another on the relation of amusements to the social 
evil, and so on. Each sub-committee prosecuted its own inquiry, of 
course, under the direction of the central organization and the chief 
investigator. Investigations were made fearlessly and absolutely with- 
out regard to consequences. Official investigators were employed. 
Th«y were carefully and conscientiously checked up by investigators of 
a different class. When the evidence was gotten in, it was laid before 
the sub-committee in typewritten form with affidavits, and sometimes 
supplemented by personal interviews with the victims with whose 
careers or destinies the facts dealt. These sub-committee reports were 
turned in to the main committee. Every word of every sub-commit- 
tee's report was heard by the main committee and then given back to 
the executive committee and — only after the most careful correlation, 
challenge, checking up, and verification — was published. I do not 
believe up to that time in the history of the world any such frank, 
fearless report of the grim and terrible facts was ever dug up out of 
the common earth and held up in the light of the common day where 
everybody could see it and where a large proportion of the citizens of 
Chicago had to see it. At last we had a body of authenti- 
cated, verified, authoritative facts that no one, not even the police, 
could gainsay. Then we published those facts in that awful volume, 
concealing nothing except the names and the means of identification of 
the people we referred to. Those i-eferences remained in cipher and 
that cipher was locked up and placed in a safety deposit vault in the 
custody of two of our members, and has not been and will not be sur- 
rendered even at the demand of the City Council of the city of 
Chicago. If we surrendered it, we would make the most atrocious 
breach of confidence. W^e gave our word that much of this informa- 
tion was confidential. There was in it, moreover, the basis for black- 
mail that would last a quarter of a century. The report must stand 
for what it was intended to be — an investigation of conditions. 

Now, how to discover and deal with the sources of the supply of this 
system, and what hopes there are of suppressing by public means, sup- 
plemented by private effort, the commercialism and the semi-public 
recognition of this infamy, is of direct concern to every one of us, I 
am thankful to say that for all the toils and risk and perils and hell on 
earth through which we passed, we have this to show, that across the 
continent to the westward slope and to the Atlantic coast, the high 
note struck by this commission has found echo in city after city, In 



SEX QUESTIONS ' 285 

town after town, in village after village, which has started upon the 
eradication of the local phases of the same persistent, prevalent evils — 
present everywhere and absent scarcely anywhere. 

This was the note that startled the land : ' ' Constant and persistent 
repression of prostitution, absolute annihilation the ultimate ideal." 
Now, it was almost a psychological miracle that brought that setitenee 
abroad. I presume that there were very many of those thirty com- 
missioners who really believed that some form of prostitution was an 
absolute necessity. I am very sure that some of the commissioners be- 
lieved that the segregation of so much of that social evil as could be 
segregated and placed under police surveillance was the least of two 
evils. But the facts from Chicago and fifty other American cities and 
from abroad, the facts from tlie cities where it was licensed, where the 
city became a partner in the infamous traffic, the facts from the 
armies and the navies, the facts from police records despite police 
opinion, were simply overwhelming, and drove us together and brought 
us out a psychological and moral and spiritual unit. And not a man 
or woman of us has gone back on that declaration. To this day, there 
is scarcely a chief of police or a to\\Ti marshal who would- not stand up 
in this presence and say, ' ' That is a false conclusion. ' ' I will, however, 
deal with the police phase of it a little later. I wish first briefly to 
spfeak of the occasions rather than the causes, the occasions which ac- 
count for the victims of this evil. There were over twenty-four hun- 
dred life stories studied by one of the sub-committees of this commis- 
sion. These stories were gotten from the girls and women themselves 
or from the records which they had left in public tribunals and institu- 
tions. It was a wonderful panorama, tragic, pathetic, heart-breaking, 
thought-begetting. The most of them were so young, they seemed 
so much more victimized than guilty. A woman of twenty-nine 
came before us, angry at having been ejected from the house which 
she managed. ' ' When did you enter this vice life ? ' ' With a far away 
look the poor thing said, ' ' It was when I was very young, sir. It was 
the summer after I made my first communion. ' ' I shall never forget 
that answer. "How did you come to do it?" "What was your first 
experience?" "Well, you know% sir, I married." "What had that to 
do with it?" "When my husband married me, he put me in a resort 
and I worked for him so many years, and then I worked for so and so, 
so many years, and then I worked for myself. We w^omen have to 
bear all the risk of disease and suffering, and give the profits to the 
men. The police have driven me out of one street and forced me into 
another, out of a house that I can rent on my own terms, into a house 
that I have to rent on a vice king's terms. Is that a manly thing to 
do ? " she asked, and then she told us nameless things of the indignities. 



286 FlUST NATIONAL CONFERENCE ON RACE BETTERMENT 

the .iti'Ot'itios. the inispeakable desecration of uU the sanetities of life. 

Now she is only one of very many. Most of these girls fell before 
they knew what it was to stand. Because of that term "white slave" 
there is a eurrent belief that a great many of them are absolutely 
eoereed by physical force. A comparatively small proportion are :so 
eoereed. as far as we eould find, and yet, those that were, made you 
blush for your civilization. This was the story of the United States 
District Attorney of the district centering in Chicago : 

A little Italian girl was brought up before the United States Court, 
as having been imported for immoral purposes. The District Attorney 
said that she had the most frightfully disfigured face he ever saw, 
though there were traces of original beauty in the little thing. That 
child told this man, representing the Federal Government, this story : 
She was playing in the streets of her native village in Italy when a 
well-dressed American woman, who spoke Italian, came through and 
said, ' ' "What a pretty little girl you are. Wouldn 't you like to come to 
America and be my daughter?" And the child said, "You will have 
to ask mamma." And she went and saw this poor peasant mother and 
offered to educate the child. She sent the mother one hundred dollars, 
and the child was given her little bundle of belongings and put on the 
great steamship, and on arrival was seized and outraged in New York, 
put into a resort, shipped and sold to Chicago, charged eight hundred 
dollars for the toggery-finery with which they decked her when they 
stole her clothes away from her so that she could not be seen on the 
street. Then, when she had supposed she had earned that, charged her 
four hundred dollars more for something else. Then her Italian blood 
arose, and she made a dash for her liberty. There stood a cruel, in- 
fernal scoundrel with a razor, and he just slashed her face as she went 
out of the door. Of course, the District Attorney took possession, of the 
child, tried to find out where her home was in Italy, tried to return her 
to her family. That is the kind of traffic that has been given the name 
of the White Slave Traffic. But it includes the least pro- 
portion of the victims that have thus been caught like wild animals by 
people that go out gunning for them. 

But then, there are conditions of life and labor that are almost as 
powerful. Don 't go on saying that little people subjected to these con- 
straining conditions are wilfully wicked, "ruined." God forgive us 
for saying that awful word, "ruined." Why don't we say it against 
the men ? We counted fifteen men for every tw^enty-four hours, with 
every inmate. Talk about your fallen girl. There are fifteen of your 
brothers and husbands and fathers, to every one of those, and equally 
ruined. They may be dangerous purveyors of disease, of demoraliza- 
tion, just because of the double standard. Children really have been 



SEX QUESTIONS -^ ( 

literally stolen from their homes by offers of employment or by the 
temptation to deck themselves a little more gaily ! Hair ribbons and a 
new hat, a pair of shoes, is an offer that the child takes without know- 
ing where it is going to lead to at all. There was an awful case, not 
long ago, where a man of forty years of age had for ten years, per- 
sistently and by every diabolical device that you could imagine, tried to 
debauch two as dear little children as you ever laid your eyes on. A 
lawyer turned to me and said, after the infamy of this wretch had been 
testified to by these little girls, "How strange it is," said this man, 
"that girls that are so pretty and so bright should be so depraved." 
"Depraved," I said, "they are not depraved. The man is the de- 
praved wretch and he stands acquitted by a jury of men." 

Now these constraints are impossible to define. They are subjective, 
but they are subtle and strong. It would take a stronger will than maybe 
your daughter has or a greater experience than she ought to have 
had to extricate herself from the network that is insidiously and by 
prolonged efi'ort woven around the victim. There are groups of men 
called "cadets" who do nothing but betray and marry young girls and 
deliver them to houses of ill fame. One of those scoundrels wdll have 
twelve girls and go round regularly and collect their blood money. 
They are known to the police, they are known to the keepers of these 
places, and some are officially recognized. That awful durance vile 
has been tolerated under this conspiracy of secrecy and of silence, and 
without warning the unwary of the dangers into which they are going. _ 

Now, beyond that, there is the love of innocent pleasure. There 
are also the economic pressures, since low wages have considerable 
to do, not only directly but indirectly, wdth opening the life to tempta- 
tion — if not directly because of economic want upon the part of the 
victim, then because of the overcrowding in tenement houses, or per- 
haps because of the lack of a due amount of innocent pleasure. 

In addition to all else there lies underneath the mysterious fact of 
the unnecessarily strong passion upon the part of the male which is 
like the surge of the sea, always everywhere, like the awful atmos- 
pheric pressure. There is an artificial stimulation, by the allowance 
of these segregated districts and by the connivance of the police. In 
those bad old days when the international trade first was attacked in 
Chicago, Federal Secret Service men were needed to prevent the police 
from "tipping" off the cases of the United States District Attorney. 
"When he got his own detective from Washington he routed those gangs 
and had men jumping twenty-five-thousand-dollar bails in four weeks' 
time. He cleaned out the whole mess almost as by magic, demon- 
strating the fact that with an honest police force, the commercialized, 
segregated vice could not exist. 



288 KIKST NATIONAL CONFERENCE ON RACE BETTERMENT 

Tlu'ii we have ^'ot to hinnani/.e our eourts, and we will liavc to have 
women jurors, and we will have to do what Judge Piekney of the 
Juvenile Court has done — see to it that a woman assistant judge hears 
the eases of delinquent girls in chambers with no one present except the 
children's parents and the witnesses. "We will have to enlist all the 
agencies that lie back of the family life. The investment of twelve 
millions of dollars in the public playgrounds and field houses and 
recreation centers of Chicago is the best investment of public money 
that I have ever seen anywhere. Thousands and thousands of young 
people are innocently amusing themselves, and making amusement and 
pleasure a source of education. The great segregated districts were 
broken up by one determined effort of the State's Attorney. The 
houses were closed and darkened and silenced. Now and then, here 
and there, one opened up. 

I say that the guilt for the consequences of disease and deaths and 
demoralization and temptation and advertising and of flagrancy of 
these nameless and shameless groups of evil, lies with the people who 
persist in the declaration that there must be silence and secrecy about 
it. One of the recommendations of the vice commission was not only 
better police, not only stronger spiritual forces, but a safe, sane train- 
ing in sex hygiene. It was begun with the parents and it was con- 
tinued last year by authority of the Board of Education with about 
tw^enty-one thousand high school pupils, by forty carefully selected 
.physicians in very carefully supervised and censored lectures, under 
the masterful and sane and visioned leadership of Ella Flagg Young. 
She is holding still the fort. I hail Chicago, the first great city 
to have taken such a strong, aggressive, affirmative, formative, con- 
structive policy toward one of the greatest shames and most unspeak- 
able and unnecessary evils of civilization — segregated, commercialized, 
police-protected vice, w^hich should be immediately repressed and ulti- 
mately annihilated, as it can be, if you and I will stand up to the job. 

Discussion. 

Scattering Prostitution 

Dr. S. Adolphus Kxopf, New York, N. Y. 
I should like to ask one question of our distinguished guest, Doctor 
Taylor. Will he kindly tell us what has become of all the women who 
have been driven out of these houses? I am in greatest sjinpathy 
-^-ith his work. I don 't believe anyone has ever done any better work in 
behalf of social w^elfare, and of redeeming the unfortunate. But there 
are thousands and thousands of our unfortunate sisters — sometimes 
called fallen because we men caused them to fall — for whom I believe 
something should be done along the line of race betterment. We are 



SEX QUESTIONS 289 

doing some very modest work in New York compared with that done 
in Chicago, but we have done something. I should very much like to 
know of Doctor Taylor whether there is something similar done in 
Chicago, or of anyone here who can tell me of anything similar being 
done in other cities. We have established a house. "We do not call it 
a Magdalene Home, but simpty "Waverly House," located at 11th 
Street, in New York, near the Night Court. There, any poor girl, 
tired of that life, w^ho wishes to leave it, is received with open arms, 
given instruction, taught some kind of trade and, if possible, returned 
to her family or given an opportunity of earning an honest living. 
Some girls are sent there who have committed an offense for the first 
time, sent there by the judge and a probation officer. A noble-minded 
woman, Miss Miner, is at the head of it. I do believe we can do a 
great deal for them, and I want to repeat here, we have done some- 
thing. We have thirty -three per cent of cures, and that is a good per 
cent, I believe. Thirty-three per cent of those unfortunate women 
have been returned to their homes, have been returned to society as 
useful and noble women. We have also looked after their physical 
welfare and have tried to make them healthy as future mothers, for 
they are entitled to the same privileges that we are. 

Discussio7i. 

Vice and Mental Defect 
Graham Taylor. 

About thirty-three per cent of the women studied by the vice com- 
mission were found to be feeble-minded through retarded develop- 
ment. That ought to be taken into account from the start. 

When a drastic sudden raid was made, which none of the social 
workers or the vice commission had anything to do with, I had circu- 
lated a notice all up and down the red light district that a hotel had 
been procured and that any person ejected from a disorderly resort 
would be taken into that hotel. Not one single applicant applied for 
shelter, not one, and I suppose there were 600 thrown out without any 
notice at all that night. Every one of them was taken care of by her 
manager. 

We have houses, but not quite up to the standard of the 
"Waverly House," which Miss Miner presides over. There are 
very few Miss Maude Miners. I think those women, especially 
those who have any indication of retarded development, should l)e 
taken possession of, just as the feeble-minded girl is, and should be 
segregated and kept under the protection of the state until fit, if ever, 
to be at large. There is nothing short of that kind of long-distance 
championship that will ever win out. 

(11) 



290 FIRST NATIONAL CONFERKNCK ON RACK BKTTKRM KNT 

Discu.^sion. 

Race Degenerates 

Dr. Ja^iks T. Searcy^ Tuscaloosa, Alabaitia. 

I started to rise a minute ago when the statemerit was nia(h' that a 
large number of the women who occupy houses of ill fame are imbeciles 
or weak minded. That is a fact, and the commercialized part of the 
business largely deals with that kind. They can be coiinnercializcd. 
bought and purchased and shipped. 

Two elements enter into immorality, as I find it in my institution, 
as I have observed it. One element is the inability to hold to the right 
and avoid doing wrong, inherent in the person, a sort of imbecility, if 
temptation and opportunity offer. The other element is a perverted 
morality, which delights in doing wrong. These are two extremes, in 
the cpiestion of immorality, illustrated in police courts all over the 
country. They are race degenerates who come into the police courts 
continually. Any mental discipline, any instruction, any effort put 
upon them, and they come back. 

Discussion. 

"Waverly House" 
Dr. S. Adolphus Knopf. 

I have been watching throughout this Conference to hear just one 
word said by the women about a large number of your sisters. I refer 
to the thousands and thousands and thousands of poor girls who have 
been led astray and who are now what is wrongly called "fallen." 
If anybody caused them to fall I presume it was a man. Now, Mr. 
Chairman, ladies and gentlemen, I want to ask you whether they ought 
not to be included in race betterment. I want to ask the women here 
today, to do as we have done in New York, to open a house and to call 
it anything but a Magdalene Home, and to try to get into it those un- 
fortunate sisters who are willing to leave that life voluntarily, who are 
tired of it, and give them another chance. 

Now I want to tell you of our statistics and show you what can be 
done if you women and we men hold out a helping hand to those poor 
sisters of ours. We have thirty-three per cent of cures. That means 
out of 100 women who voluntarily came to us, or who were sent to us 
by the judge of the Night Court, to give them a trial, we have thirty- 
three per cent of cures. We watch them for a year or two after they 
have returned to their homes. Many of them have become mothers and 
I hope good mothers. As our little movement, which we call the 
"Waverly House," has also added a little bit to the betterment of the 
race, I ask that you going out, going home, will try to start such a 
movement and give your sisters another chance to be mothers also and 
thus help in the betterment of the race. 



SEX QUESTIONS 291 



Discussion. 



The Florence Crittenton Mission 

Dr. Charles G. Pease, New York, N. Y. 

If you are not able to start that work of salvation at home, a 
rescue home for women, then you can assist the Florence Crittenton 
Mission. They have eighty homes for girls in this coimtry. You 
can assist them and they need your assistance. I am identified closely 
with both those organizations in New York City and about 80 per cent 
stand true. They have a league that i\\ey join afterward. It is a 
wonderful work and it needs more support. 

Discussion. 

Prostitution and the Cigarette 

Miss Lucy Page Gaston, Chicag-o, Illinois. 

I want to give you one incident of my experience. A call came to 
the Woman's Temple the other day pleading for rescue. It gave the 
number, 34 Custom House Place. This was before the red light dis- 
trict was moved down to the 22d Street district. I called up the Chief 
of Police. He Sent two of his trusties down to that place and within 
an hour that girl, bag and baggage, was at our Anti-Cigarette head- 
quarters. A man had told her, when he found her crying on the stairs, 
that there were women at the Woman 's Temple who would help her if 
she would only make the appeal. They gave that poor, persecuted 
child my name. She told me her story. It is the story of thousands 
of girls who are going wrong. She was not an immoral girl. She was 
simply a silly, foolish girl. Here in a little city of Michigan she 
entered upon a flirtation with a traveling man. That man was a pro- 
curer from Chicago. She was a seamstress. He offered to pay her as 
much per week for se\Wng in his own home as she was maldng and 
offered to give her board. She very naturally accepted the offer. She 
found herself a prisoner with her clothing hidden and unable to make 
her escape. 

I know hundreds of those girls. They have told me stories that 
have stirred my very blood. It seems to me that the people in all these 
little villages and country places ought to be warned of this sort of 
thing. I tell you, before High God, that the churches and the good 
people are to blame because there are not organizations that will take in 
hand every boy and girl and pledge them to total abstinence. 

Doctor Taylor will bear me out, that it is not the girl who is a 
temperate girl, who never touches beer or liquor or cigarettes, it is not 
that kind of girl who goes wrong, but the girl that has loose notions 
upon these lines. 



292 FlUST NATlOXAh CONKKKKNCK ON RACK HKTTKKMKNT 

Oil. tViciuls. W(* outi'lit to do more in the Wiiy of pt'cvciilioii. It stirs 
my lu'arl wIumi ^-ootf Doctor Knopf gets ui) to appeal for tiiese girls 
who liaxc gone wrong. Here we are, seeing them going the route tli-it 
has led to ruin, and we are doing so very little. In a dance hall last 
winter in the city of Chicago I saw the boys and girls there, not one of 
them 21 years of age. The boys were drinking, not beer, but whiskey, 
and smoking cigarettes. Those young people were on the road to ruin, 
if they were not already ruined, and they were school children. 

I tell you the conditions today in our high schools, yes, and in our 
grade schools, call for a much greater amount of attention than we are 
having. You have got to have heart interest as well as head knowledge. 
I do not know that I Dught to say this here, but I feel it to the depth 
of my being — who today knows more of the effects of drugs, of cigar- 
ettes, of drink, than do the doctors, and yet in every community Ave 
have doctors who are not above suspicion on these things. 

DiscnssioH. 

The Girl Who Goes Right 
Dr. Luther H. Gulick, New York, N. Y. 

I had hoped in telling you of the Camp Fire Cirls that I had 
aroused some interest in the girl who is going right, but nobody 
seems to have followed my cue. So I want to follow my owti trail 
for a moment more and make about six definite suggestions. The rank 
of a Fire Maker is the first real rank a girl makes. We try to be pretty 
careful not to run foul of prejudices, hence we do not use the word sex 
hygiene or sex instruction nor anything of the kind. But to become 
a Fire ^laker one of the requirements is that the candidate must know 
what a girl of her age ought to know^ about herself. That is enough 
for the guardian and for the mother and for the teacher. 

I should like to ask you to ask yourselves these questions, filling in 
the name of your ow^n city. I will put in Battle Creek because that is 
where we li-ve for the present moment. AVhat chance is there for a 
girl to go right? I do not know the answers; there may be good 
answers to all of these — what chance is there for boys and girls to go 
swdmming in Battle Creek under good conditions? That is a right 
of childhood. Life, liberty and the pursuit of happiness — I have 
heard those w^ords somewhere ! 

Second, What provision do you make in Battle Creek whereby 
groups of girls. Camp Fire girls or others, or groups of boys, or groups 
of boys and girls together wdth guardian or chaperon or whatever 
you choose to call them, can go off for a tramp of five miles and find 
a good place to make a fire and a place to bake some potatoes and have 
a good time together and come back home again, normal, good kinds 



SEX QUESTIONS 293 

of things ? Is there anybody in Battle Creek who will furnish that kind 
of an opportunity to be right outdoors? 

Third. Do you laiow that the love of Nature, I'm not now re- 
ferring to knowledge about Nature, to scientific knowledge, I am re- 
ferring to just plain liking flowers and the stars, and the birds and 
the bees — this love of Nature is established before ten? Very few 
people establish it later. What chance do you people in Battle 
Creek give to the children under ten to come in contact with real 
Nature at first hand with somebody that loves and understands it? 
I do not mean a pot in school or a window garden. I mean plain 
outdoors. I understand you have some outdoors near here. What 
chance is there for your children under ten to get it down into 
their souls so they will have it as a precious possession all the 
rest of their lives? What chance is there for yotir boys and girls to 
spend a week or a month out camping under proper conditions (where 
you will know there won't be tramps or any other improper people 
coming around) within a radius, a tramping radius, of Battle Creek, 
where it is beautiful, where they can swim, where they can build a 
fire and where they can do the things that every human being ought 
to do in their teens? If there is not such an opportunity, get up a 
committee and get such a place and administer it and see that Boy 
Scouts, Camp Fire Girls, or any young people at proper times get 
the chance to establish this neuro-nuiscular habit of wholesomeness. 

[Voices, "Good!"] 

When young people want to have birthday parties, can you get 
the use of a room in a school building for that purpose ? If not, why 
not ? These buildings belong to the taxpayers. They ought to pay for the 
extra expense for light, janitor service and the like, but there is no 
reason why the schools should not be used by the citizens for their 
social purposes. People say sometimes that it is undemocratic to give 
the use of the school room to one group and not let everybody come in. 
That is a false notion of democracy. Let me illustrate. There is room 
for 40 baseball games going on at one time at the playground in 
Prospect Park in Brooklyn. Now by application your baseball team 
can have the use of one ground at 2.00 on Saturday and you are pro- 
tected in that right and it is not called undemocratic. If you allowed 
everybody to use that ground all of the time the result would be there 
would not be any baseball at all. Now, social life cannot be carried on 
without the recognition of the fact that clean life and social grouping 
has got to be recognized. W^hen my daughter has a birthday and I 
want to surprise her and get her and her friends and their friends and 
form a party, it is not probable that I have got a room big enough in 
my house for it. It will be better for the entire community if I can be 



2*14 KIKST NATIONAl; CONFERENCE ON RACE BETTERMENT 

allowed to use a school room for that purpose and it will be better for 
the school. 

Are there men and women in Battle Creek who love boys and girls 
enough to give their time to go with them ? I do not mean as a duty. 
Young people hate to have other people do their duty to them. Are 
there any men who remember how to make kites and bows and arrows 
and push-mobiles, who like to work with tools and who have a tool 
bench and will work Avith boys ? You can do anything if you have such 
men and women here. If you haven't, then you haven't that kind of 
parenthood which is large enough to reach beyond your own children. 

It is easy for us to get up in this room and talk about race better- 
ment. The real thing happens w^hen we get right straight at it with 
the boys and girls and we can shape them as we please if we like to do 
it. Is there any chance in Battle Creek for boys who have a mechanical 
turn of mind to make things with tools and benches? There ought 
to be. It will be to the advantage of Battle Creek, and every other 
place is going to employ skilled labor later on. A great many boys 
and a great many girls will have tools and a chance to work. During 
all the ages they have had it in the home, because the tools used to be 
in the home. But the tools have gone from their home. Are there 
any places where boys can do things who are motor mindied, who love 
tools and who want to make engines and automobiles and bicycles and 
steam boats and all those things ? If not, it is too bad. Do you have 
any appreciation of those instinctive feelings that lead boys a great 
deal and girls somewhat to compete in athletics, that is, do you have a 
sane public school athletic league? I do not mean an athletic league 
that merely takes the biggest interest in boys and trains them hard 
for public exhibition. I mean an athletic league that gets 80 per cent 
of all boys into action who love it. If you have not, you have not 
one of the most important social inventions. Is there anybody here 
who realizes that all of this conquering of air has grown out of our 
knowledge about kites and that boys love kites and that a kite flying 
contest in Battle Creek or the model aeroplane club would occupy the 
time of some hundreds of boys probably ? It does at New York, en- 
thusiastically, earnestly and they are learning things. Are there any 
men and women in Battle Creek who realize that to think up things 
of this kind and put the machinery back of them to make them happen 
is the kind of thing that will really deliver the goods? 

Discussion. The Single Standard 

Prof. Samuel Dickie, President Albion College, Albion, Michigan. 
I confess to being taken somewhat by surprise in being called to the 
platform. All Lneed to do and all I can do is, after good Methodist 



SEX QUESTIONS ' 295 

fashion, to say Amen to everything I have heard. It is a trite old say- 
ing that the time to make a man what he ought to be is to begin at 
least with his grandfather. Some advocates of race betterment think 
possibly that the great grandfather would be the proper point of be- 
ginning. I want to emphasize if possible the sentiment set forth in 
Doctor Taylor's address demanding the wiping out of this double 
standard of morality. And may the time soon come when men and 
women will be judged by precisely the same standard. 

I attended, several years ago, a great gathering of women in the 
city of Buffalo. Unexpectedly called to the platform immediately 
following a very eloquent Baptist minister who had been giving the 
ladies great compliments, I said, at the outset, to a vast audience of 
women, "Ladies, if the time ever comes when the women of this coun- 
try are as good as the men, we shall have made considerable progress." 
And you could just have heard all those women drawing in their 
breaths. I feared that the roof of the opera house would descend 
upon us, and made haste to explain. I said, "Of course, ladies, with 
the prayer meeting full of women, and the penitentiaries full of men, 
I am not talking about the question of simple conduct, but," I said, 
' ' let me tell you what I sincerely believe : If the time eiver comes, God 
grant that it comes speedily, when the women of America, and the 
young women, and the marriageable women, demand as high a stand- 
ard on the part of the men who are to walk through life by their 
sides, as even we men now demand of the women, great progress will 
have been made. ' ' 

Do not think me criticising womankind, for I believe in woman, 
and I trust woman, and I want to give woman the ballot, and I want 
woman to do everything that a woman can do, but I want to say to 
you that the women of America can do more to wipe out the double 
standard than the men can do. 

Discussion. 

The Boy's Temptations 

Dr. Amakda Holcomb, Mount Pleasant, Michigan. 

I Avant to speak for the benefit of our boys who become men 
who do not get a square deal. When we talk about the one stand- 
ard of morals, give them an equal part. As a school-teacher I 
taught boys and girls together for seven years. I found my boys just 
as square and clean as my girls — and a little more to be trusted. I am 
raising boys and girls in my own home. My children, my boys, have 
just as good a standard of morality as my girls. In my work in 
Chicago I met a woman who, when her child was born, said, "Oh, I 



29(5 FIRST NATIONAIi CONPERENCP: ON RACE BETTERMENT 

am so o-lad it is a l)oy/' T didn't like that beeause I like girls and 
boys, too, and 1 said. "Why?" ''Well, if this boy does wrong he 
won 't be blamed, ' ' was her answer. 

That is the beginning of the double standard — in the minds of the 
mothers, at the birth of children, 

[Voices: "Oh, no. No."] 

I find it so in my experience. Our girls are kept in the home, 
are watched over, are taught and they are protected by every wo- 
man and by every man. I had my eyes opened firs't at the age of 
twenty-four when I was a medical student in Chicago. The President 
of the social purity work of Iowa said to me, "You girls think you are 
mighty fine, and you are, but I want to tell you that when young men 
stand straight and clean, at this time of the world, they are a hundred 
times better than you are. ' ' That is what he said, and I thought of it 
for weeks and months, and I found it was true. He said, "You girls 
can w^alk these streets of Chicago and there is not a man who dares to 
offend you — he would be brought up in the courts ; but we boys can- 
not go one block from this college without being invited. We are 
tempted from within and from without. If we stand firm we shall 
have no credit, while you girls have few temptations within, and no 
temptations without, and you consider yourselves better than we." 
Doctor Taylor said these girls were so young. I have had more con- 
fessions from the young men in Michigan than I have from young 
women, in my practice of medicine, in the state of Michigan. In 
w^riting up their cases they turn pale and they say, "Doctor, I was 
only 17." And a boy of 17 is only as old as a girl of 14. Why haven't 
we laws to prosecute the women who desecrate our boys of 16 and 17 ? 
It is only the older women who do that. We should have laws. We 
cannot demand an equal standard until we give our boys an equal 
chance. 

Discussion. 

Real Meaning of the Double Standard 
Dr. Luthee H. Gulick. 
It seems to me there is much misunderstanding with reference to 
the double standard. During all the ages those women who have been 
true to their children and their husbands have been in the line of se- 
lection, because their children survived. We men have not been in 
that line, ever. The men were eliminated who could not stand for the 
tribe and fight. Next there arose two kinds of morality : The ability to 
stand together whether life was involved or not, team work. That is 
masculine, and the man who cannot do that is not a man. Then the 
ability to love one's children, and to be true to the home. And that is 



SEX QUESTIONS 297 

feminine. We each are true to our kind. Naturally the world is de- 
manding of us men that we be clean. We are finding- it hard. But we 
are going to learn. And the world is demanding of you women that 
you stand by one another, and you are finding it just as hard as we are. 
And it is a new kind of morality, for the women of the world, who 
have never stood by one another. What chance is there to abolish 
prostitution when young men and young women do not have a chance 
for wholesome relation to each other day by day. That is the thing 
that is in the hands of women and not in the hands of men. 

Discussion. 

Educating the Child Regarding the Secrets of Life 
Mrs. D. W. Haydock^ Missouri Fedei-ation of Women's Clubs, St. Louis, Mo. 

The point of this convention has been education or at least I came to 
this convention feeling that that was why I came. At 65 I need more 
education. I believe the most of the rest of us do. As a 65-year-old 
mother I want to tell you I began with my boys and my girls when 
they were three years old to tell them parables, as the Lord taught, 
trying to follow in His footsteps regarding the secrets of life. I was 
a city missionary for years before my marriage, and I know how those 
poor girls want to come back into life. There is nothing that can be 
done for them that will not bring its reward eventually. Before my 
marriage one of these poor girls said to me, "If ever you are married 
and God gives you children, see that you teach them. That is why I am 
here, because I did not know." 

After my marriage I felt that the one thing that God had given me 
to do was to see that no city missionary was needed for my child. 
When my son was a little over three, not quite four, and my daughter 
six, I had given those years to the thoughts of how I should at last tell 
those children. One night I had gathered by my side a bird 's nest, the 
softest thing that I could find, and a chestnut burr with its coating of 
velvet inside, a fern with its folded and unfolded fronds, and I told 
those children that in the body of every woman there was a nest softer 
than this because God made it, God built it. I also had a plant with 
the seeds ripening on the outside. I told them that in the body of this 
woman, whom God made some day to be a mother, there was something 
like these fairy fingers. 

To my little boy I said, "Some day in this world God will have 
for you a woman. Do not dare offer her a life less pure than that you 
demand of her. ' ' All of my life my boys and I have been comrades. 
They can talk to me, the immarried boys or the third, a married boy 
who is younger — they can talk to me as if I were a young man. 
There is nothing concealed. 



298 FIRST NATIONAL CDNFEHKNCE ON KA(;E BETTKKMKNT 

For a time, of course, this parable satisfied. Later otliers began to 
instruct, but I told them not to listen to others, that mother knew all 
and would tell them the truth. At ten the boy with whom I bad begun 
came to me and told me that an older boy had begun instruction. At 
ten that boy of mine knew because his mother told him. At thirty he 
said to me, "You don't know what you did." He then had charge t,f 
several groups of young engineers. He said, "I have wished sixty-five 
thousand times that I might send for you to come and talk to my boys" 
—but he did it himself. That is one of the things of my life for Avhich I 
Ijave never wished I had taken another way. If today, even about some 
little matter of the nursing, if I have anything to say to these boys of 
mine, it is because somew^here in the world there is some woman and 
they must give to her what they ask of her. 

Discussion. 

The American Mother 
Mrs. F. F. Lawrence, Columbus, Ohio. 
Of all titles that have ever been given me, I am proudest of the 
one, ' ' The American Mother. ' ' I believe that the world itself depends 
upon the American mother and therefore my interests are principally 
centered on the American girl or future mother. "While I have taken a 
deep interest in the boys, I have felt a little closer to the girls and have 
wished that I might protect them more. I believe in that old adage, 
"An ounce of prevention is worth a pound of cure." You know all 
over this country it is dotted with institutions for the unfortunate 
girls. Did you ever hear of a home for the fallen men ? Right there 
is where you are going to get your protection through the girl. Every 
fallen man, married or single, should have an institution that he can 
get into and he should be committed there according to his crime, and 
in that institution he should have the crime itself brought right up be- 
fore him, so that it wall really be a remedial work. If he is a young 
boy, we pity him, and we pity him because he is ignorant, so it is 
with the young girl ofttimes. For that reason I say, give the young 
boy nine months, and the old criminal ninety-nine years. 

Discussion. 

Vocational Education 
Professor Robert James Sprague, Massachusetts AgTicultural Colleg-e, 

Amlierst, Mass. 

I should like to make just one suggestion. I should like to preface 
it with this: It seems to me that in much of this discussion we are 
trying to deal wdth remedies. We are trying to deal with appearances. 
"We are not getting at causes. There has been quite a little said here at 



SEX QUESTIONS 299 

this convention with regard to prostitution and all these other things, 
but very little said about a situation in the country that will produce a 
system of real, easy home living, of ideal homes. 

For a moment, look at some of the cities of Germany, where they 
come out and take the land round about the city, put in the public 
utilities, the street cars, transportation, loan the money for building, 
prescribe the kinds of ideal dwellings, etc., make it easy for the normal 
home to develop. Ladies and gentlemen, there is no cure for the prosti- 
tution evil until we get the normal home. There is an economic basis 
for this whole business. We may drive the bad houses out of one 
street and drive them out of another for a while and they Mdll turn 
up somewhere else. We have got to get the normal home. 

Another point right along that line : In the United States the most 
of our criminals come from the roving bachelor class of the twenties. 
In this country we have an enormous number of young bachelors, who 
come out from all parts of the country, who have had no opportunity 
to learn a trade — along in the twenties without a trade — with all the 
impulses of manhood. They struggle through those twenties and 
come to the cities before they get settled in life. Gentlemen, an effi- 
cient system for vocational education in this country will do many of 
those things that the German system of education is doing. It will give 
boys an earning power at the age of 22 or 23 so that they can marry 
at 23 or 24 or 25 and support a family. That will do much for the re- 
duction of our criminal classes, a large majority of which come from 
that zone of life. It will do much toward abolishing prostitution in 
this country, because every time a wage-earning boy marries a girl and 
establishes a home under the right conditions, he removes the material 
for all of that kind of thing. 

We have got to work on a sounder economic basis for the preven- 
tion of these things that we are trying to get rid of. When we get the 
normal home, so that the boy can have a normal life and a normal 
•earning power, and can marry the normal girl with a normal educa- 
tion, and when the state and the city come in and establish conditions 
so that he can make a normal home and get a dwelling under easy con- 
ditions, we have solved — not solved, but w^e have relieved — a very great 
social problem of society. 

Shall we not go home and try to get into our state establishments 
for charities a little more of a constructive eugenic program? The 
state associations in which I have been more or less interested are 
dealing largely with the negative side of eugenics. I think that there 
is good opportunity for getting in a little more of the constructive 
eugenics into those programs. I think there is a chance for large 
things, because those things have the interest, they have the prestige, 



300 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

tlu'V hold llu' atti'ution of the i)('()i)k'. I believe that by doin<;' that, 
by getting into the directory of these establishments, we can get into 
those programs matter which will have a great deal of influence in 
arousing the people to think along these lines. 

Discussion. 

Use of Newspapers 
II. A. Burgess, Chicago, Illinois. 
This world is getting better. The newspapers of today are getting 
better. I have heard talks about patent medicine advertisements. 
You would be surprised how they are being eliminated out of 
the newspapers today. The great agencies in Chicago and. New York 
have hard work placing these advertisements in a great many papers. 
Here is my suggestion : Why not, in every community, each week, have 
a column given to the newspapers, which I am sure they would gladly 
print, in reference to just such suggestions as are being made in this 
convention ? 

THE SOCIAL EVIL 

(A Special Address to AVonien — Illustrated by Stereopticou.) 
Dr. J. H. Kellogg, Battle Creek, Mich. 

I made up my mind a good many years ago that there are three 
things in the world that are especially bad : One of these is the slavery 
of animals to men, because of the brutality sometimes involved. Even 
worse than this is the slavery of men to men. But the worst thing in 
all the world, the most dreadful thing, is the slavery of women to men. 

By and. by the ballot will give women freedom. When women get 
the franchise, I believe the white slave traffic, and all other kinds of 
slavery of women to men, will be abolished, and' the world will be 
freed from this greatest evil. 

Now, ladies, in our chapel, and down at the Congregational church, 
some views are being thrown upon the screen to give to men a picture 
of some of the terrible things for which vice is responsible. I have 
selected just a very few views to throw upon the screen here, that you 
too may be informed. You have a perfect right to be informed with 
reference to the physical aspect of such diseases, since they are more or 
less prevalent in nearly every community. We need to get the same 
dread and the same repugnance for these diseases of vice that we have 
for smallpox and other communicable maladies. If you know there is 
smallpox in the house, yon are afraid of it. If there is a red flag put 
out, people are alarmed, and yet there isn 't any very great danger, as 
smallpox is not very readily communicated. If the nurse who has 
care of the smallpox patient will simply keep his whole skin covered 
with a little carbolated vaseline, nobody wall get the disease from him. 




Syphilitic S.-lfrosis of Ton^iu 



I>:xamples of Heredit;iry .Syi)hilis. 





..^^-^vf 





Syphilitic Caries of Cranial Boii 



Syphilis of the Fetus 



SEX QUESTIONS 301 

Not very long ago, in a hospital, smallpox patients, measles patients and 
scarlet fever patients were all kept together in the same ward in the 
same room, and the disease was not communicated from one to another. 
It is now known that these diseases are not nearly so communicable as 
we used to think they were. Reasonable care will prevent their ex- 
tension. But suppose there is a house in town where the loathsome dis- 
eases produced by vice prevail, to serve as an incubator. In unthought 
of ways this disease may be communicated every day. For example, 
here comes the milkman and sends in a bottle of milk, receives his pay 
at the door — a dollar bill, or a silver dollar, or a quarter, or a half dollar 
or a dime. That money may be smeared with the virus of vice. It goes 
into his pocket, mingling with the rest of his cash, and in the next house 
he passes out the same vile quarter to a little girl who, having both 
hands occupied, puts the quarter in her mouth. She has an easy chance 
of getting an impure disease. This is only one of many ways by which 
it is scattered about the town. 

Public sentiment has got to be changed with reference to the 
brothel. Clergjnnen and doctors must be willing to speak out 
and arouse the whole community to rise up in arms, to protest^ 
and say: "We will not tolerate one of these unlawful houses in 
our midst." If the women of this tovim w^ould say to themselves. "We 
Mali not have a brothel in this town," — there would be none. 

The brothel is a rendezvous of criminals. The laws of the 
state of Michigan, as of every state in this Union, make licentiousness 
a crime. No man can visit such a house without committing a crime. 
Every person in that house is guilty of crime, and the laws upon the 
statute book of the state of Michigan expressly forbid the conduct of 
such places, and the only reason why they exist is because the officers 
of the law do not carry out and administer the laws upon our statute 
books. We must protest against these horrible incubators of crime and 
disease. 

But the stereopticon is ready. First I will show you some 
beautiful flowers. Here are two or three things you may think are not 
so very beautiful. They illustrate the slavery of woman to fashion. 
Men are the makers of fashion. To increase their gain they are con- 
tinually changing them, thereby making a demand for new clothes. 
You know that. The fashion plates have debauched the taste of 
American women. They have put false ideals into their minds, until 
they actually believe that physical deformities are artistic and beau- 
tiful, and so they are committing crimes against their bodies which, in 
the end perhaps, are responsible for as much race degeneracy as these 
vice diseases we are talking about. Now, my women friends— I like 
the word women better than ladies ; it is a stronger word — my wo- 



302 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

iiuMi friends — I beseech you to think of that. How can you expect thivt 
men are going to respect the laws of God which relate to their bodies 
unless you respect the laws of God which relate to your bodies? This 
debasing, abusing and danuigiug the body, degrading the body in obey- 
ing the mandates of fashion, is perhaps, on the whole, as harmful antl 
as damaging as the evils that can be traced to vice. I just want you to 
look at these splendid figures, strong as God made them. They are two 
daughters of a king from the Congo region. They have splendid 
bodies, strong, vigorous and well, capable of performing all the func- 
tions of womanhood. Here are two more good, strong, well-made 
bodies, ignorant and debased by savagery, but splendid bodies. 
Now, isn't civilized woman entitled to just as good a body as a savage 
woman ? We are all born savages and have to be tamed. The taming 
sometimes goes so far as to spoil us. Now look at this Venus of Milo. 
Here the liver, colon and stomach and kidneys are right where tln^y 
belong. Every organ is where it belongs, all above the lower border 
of the ribs. Here is the figure of a woman who had worn a conven- 
tional dress. She could not be convicted of tight lacing. No woman 
ever did admit that she laced herself tightly but this woman wore 
what she called a health corset and you see the liver is way down out 
of place. The stomach is entirely out of place, as is also the colon. 
Both kidneys are displaced and the organs which lie naturally above 
the lower border of the ribs were in this case nearly all below the 
lower border of the ribs and of course there was an ugly prominence 
of the lower abdomen that had to be held in by some sort of corset 
to give it shape. 

Some diseases and weaknesses are hereditary. A boy is a chip oft' 
the family block, not oi¥ the father block alone. It is fortunate that 
this law exists because by means of this law it is possible to breed out 
evil qualities and to breed in good ones. When one parent is defective, 
feeble-minded, the children of the first generation may not show this, 
but in the third generation the children may show it, but if both par- 
ents are feeble-minded, then all the children are feeble-minded. This 
is well shown in this genealogy here, the Kallikak family. A man in 
a state of intoxication had a child by a feeble-minded girl. He after- 
vizards married. All of his lawful descendants were strong-minded, 
splendid people. From the descendants of that feeble-minded girl, 
you see a whole line of feeble-minded and criminals. After awhile, you 
see, a feeble-minded grandson married a feeble-minded girl. Then the 
children were all feeble-minded. 

Now the diseases of vice are particularly hereditary in char- 
acter. They are also communicated in more ways than one, not 
simply by immoral acts but in other ways. Let me tell you of a 



Died 1735 



Q 



O 



Q 



■O 



O- 



Died 1770 



LAWFUL WIFE Q- 

O- 
Q 



O 



NAMELESS FEEBLEMINDED 

Q— T — •girl 



O 



a 






BLACK SYMBOLS 
INDICATE FEEBLEMINDEDNESS 
□=MALE O" FEMALE 






O 



1913 ^ 

Feeble-mmdi-dness tends to be. transmissible, but 

so dce«'. normality'. Tliv:^ gr^xi and the bad branch 

of the KallJkak famiiv 



SEX QUESTIONS 303 

little tragedy that happened not long ago. A man, a public servant 
of a city, married a young wife. Presumably he had been 
wandering around in haunts of vice and had become infected with 
a nameless disease. With a kiss upon the lips of his wife he in- 
oculated her with that same disease. In a few^ months a child was 
born to them. It had an eruption when it was bom, a primary 
eruption of this awful disease, and it wasn't very long before other 
symptoms appeared, the so-called secondary symptoms. That is 
what that man had in his mouth, a mucous patch, and when he 
kissed his wife that is what infected her. He had no sores upon his lips 
but the disease had become systemic and little white patches were found 
in his mouth, virus of syphilis, the protozoa, the animal parasite that 
communicates this disease, which looks for all the world like a vinegar 
eel when it is magnified. It bores its way all through the body and 
produces a deadly poison and infects and contaminates the entire body. 
This man's mouth was swarming with these horrible, wiggling para- 
sites, his saliva was alive with them and some of them were deposited 
upon his wife's lips and made that awful sore. Thus the disease was 
communicated to her body and to her unborn son. By and by these 
secondary eruptions appeared. 

I was called once to the hospital to see a case in consultation and 
found a young woman covered all over with an eruption such as you 
have just looked at. She was a girl of good character, a stenographer 
employed in an office, but she had been keeping company and had 
become engaged to a young man who had unsuspectingly inoculated 
her vnth this vile disease and her life was ruined. 

Here is the more advanced stage of the disease. This shows 
the disease on the top of the skull eating its way into the very 
brain. Those spots here, when they disappear, leave a copper- 
colored stain upon the skin. That is one of the characteristics 
of this disease. The eruption at certain stages leaves behind a copper- 
colored spot and the doctors learn to recognize these very readily. 

Here is another form of the disease, rather an unusual form. I have 
seen similar cases more than once. Some of you have seen persons just 
like that upon the street, men going about with horrible evidences of 
vice right upon their countenances. In the third stages of the disease 
you see the bones and the harder parts of the body are undergoing de- 
struction. That poor boy I was telling you about a little while ago that 
Avas born with this awful eruption, his whole body infected, that poor 
little boy has gone through all the stages of that disease and at the 
present time his nose is almost destroyed. The roof of his mouth is al- 
most entirely gone and that awful disease is slowly eating him up and 



30-1 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

iu two or tluve years more he will be dead. He was rol)l)('d of the life 
he was entitled to. 

Here is tlie skull and you see the disease eating down through the 
bones into the very brain. Here is a syphilitic sore upon the tongue, 
one of the later forms, a sclerotic form of the disease. Here is another 
of the hereditary forms of the disease also, in the hand here, and this 
is the characteristic appearance of syphilitic teeth — ^the hereditary ef- 
fect of syphilis upon the teeth. This is not the ordinary notched 
appearance of the teeth that is natural. It is a different kind of 
notch, first described by a great English surgeon, Doctor Hutchinson. 
Here is a syphilitic baby. More than one baby I have seen bom into 
the world with the characteristics you see here. I want you to look 
at that but a moment. Look instead at this baby and carry its 
picture of sweet innocence in your mind (the Minnesota Baby). 
My friends, we must fight this evil and every other evil that is attack- 
ing the vitality of the race so that these beautiful, innocent human 
flowers that God gives to us may be preserved intact. 



VENEREAL DISEASE 

(A Special Address to Men.) 

Mr. F. 0. Clements, Representative of the National Cash Register Com- 
pany, Dayton, Ohio. 

Unquestionably a great many in this audience will wonder why an 
industrial concern should deal with this subject, venereal disease. The 
President of The National Cash Register Company, from its earliest 
inception, has devoted a great deal of time and attention to health sub- 
jects. 

We find after careful analysis that the elements requisite for suc- 
cess are : health, honesty, ability, industry and a thorough knowledge 
of the business. Health first. So you will find in our very earliest 
publications frequent excerpts and short sayings dealing with the 
underlying principles of good physical well-being. Later on these 
publications were supplemented by graphic methods of presentation, 
including lantern slides, and still later the moving picture film. 

Quite a number of years ago, the need of some sane instruction with 
reference to sex hygiene became apparent. Two very unfortunate 
occurrences were brought vividly to the attention of the officers 
of our company. One of our very much honored and respected em- 
ployees, who had served the company faithfully and well for many 
years, the father of a clean family, contracted gonorrhea of the eye 
and lost his sight. This was definitely proved to be the fault of a 
fellow-workman affected with gonorrhea, who endeavored to remove 




'lip Mi;inesota Biiby — ;i splt-iulid ty]).- of linaltl 



SEX QUESTIONS 305 

a small particle of metal from his friend's eye. Still later one of our 
trained nurses contracted syphilis in a dental chair, due to the tools 
not being properly sterilized. At least the dentist recognized his re- 
sponsibility in the case and paid all the bills incident to the medical 
attendance required. 

These two \erj unfortunate occurrences answer the question as to 
why an industrial concern should spend the money necessary to collect 
and arrange this particular talk of the evening. 

Still again, many of the officers of the company keenly felt the 
need of instruction along this particular line, for fathers of this and 
the preceding generation failed to tell their children the things that 
they should know. 

Improved machinery moved the world during the century. We 
believe that the improved human machine will give evidence of the 
greatest progress in the century to come. 

Much of the welfare work of The National Cash Register Com- 
pany has to do with the boys and girls of the coming generation, and 
this type of lecture should, without question, be presented to the par- 
ents so that they can bring this most difficult subject to their children 
in the proper manner. 

It is indeed gratifying, in view of the long-continued and mis- 
taken policy of silence with reference to the functions and relations 
of sex, that a Christian church would receive a talk of this kind, and 
permit the same to be made a .regular part of the church program. 
This has been partly due to certain medical discoveries which have 
contributed, to a very large degree, in changing public opinion. 

The material to be presented hereafter and the arrangement 
thereof was done under the personal supervision of Dr. F. M. Loomis. 
of the University of Michigan. 

After the talk was completed, and in shape for presentation, we 
were actually afraid to utilize the results. This was due to the fact 
that we were so ignorant on the subject, and had no conception of the 
severe penalties coming from violation of Nature's laws. Neither 
could we understand how sadly society was affected by venereal dis- 
ease, nor even the danger to the innocent person. We felt that the 
statements made could not be true, and we arranged for a representa- 
tive audience of Dayton citizens, particularly selected because of their 
association with the boy and girl problem. We had several leading 
physicians of our city, the superintendent of schools, the judge of 
the Juvenile Court, several church men, social workers, and a little 
gathering that totaled some twenty persons. Our entire idea at the 
beginning was to secure suggestions and criticisms so that none of the 
facts included in the talk would be subject to exaggeration or inae- 



306 FJUST NATIONAL CONFERENCE ON RACE BETTERMENT 

curacy of stutenieiit. For the same reason, later on, the talk was yivon 
before two of the Ohio State Medical Societies, meeting in annual con- 
vention in Dayton. Still later, the presentation was made before the 
Ohio State Board of Health, and before The American Medical Society 
in annual convention at Atlantic City. 

The entire idea was to put up a scientific, well-founded talk, in 
simple language, divested of all medical terms, so that a boy fifteen or 
sixteen years of age could readily understand every single word or 
reference, and this, you will readily admit, is a difficult problem. To 
have big ideas and express them in simple terms is one of the elements 
of real greatness in men. 

After this subject had been presented a number of times to 
technical societies and technical men, largely from a desire for con- 
structive criticism, we decided that we would present same to our high- 
grade salesmen, fearing somewhat the outcome of the venture. Much 
to our surprise, the subject has provoked very little criticism, during 
its entire history ; and the talk has been given to all of our appren- 
tices, to the younger men of the organization, to the girls (number- 
ing about 700), in modified form, to all of our salesmen, and the vari- 
ous training schools for salesmen, and to the members of our Officers' 
School. Some of the letters, expressing appreciation for the knowledge 
afforded, have been particularly gratifying, and have repaid, many 
times, for the money and efforts spent in preparing the talk. ]Most 
of the men were glad for this type of • instruction mainly because of 
their children. If the community is to be protected, the policy of 
silence, and the concealment of vital facte must cease, and what better 
way of teaching is there than teaching through the eye. The larger 
proportion of our knowledge comes to us in this manner. The im- 
pressions made are lasting, particularly with the young. jNIincing of 
words is unknown in this talk, and so we say gonorrhea is clap, and 
clap is gonorrhea. 

The germ which causes gonorrhea is as easily recognized as any 
criminal in the Rogues' Gallery. "We know that this germ and no 
other causes this disease, because it is always present in the body of 
a person suffering from gonorrhea. It can be grown outside like a 
plant, and, if placed artificially in a healthy man. will immediately 
cause the disease. 

Quite a number of diagrams are shown, illustrating the simple 
physiology of both male and female reproductive organs. We partic- 
ularly consider these diagrams necessary so that the growing boy can 
be told that the sexual organs do not suffer by non-use, and to illus- 
trate the fact that the medical faker scares the boy by undue refer- 
ence to emissions which might be occasioned by an impacted bowel 



SEX QUESTIONS ' 307 

producing pressure on the seminal vesicles, making said emissions a 
perfectly natural process. 

The man who says that clap is no worse than a common cold is an 
ignorant and a dangerous liar. Thousands of sightless babies, sterile 
women and rheumatic men owe their condition to the-clap-no-worse- 
than-a-cold lie. Unquestionably, the time for hinting at unpleasant 
truths is past. 

There would be but little need for the discussion of gonorrhea if it 
were not for the fact that innocent women and children suffer so 
keenly the wrongs of society. A man may think himself cured of 
gonorrhea, and still be capable of giving it to his wife. "Whatsoever 
a man soweth, that shall he also reap," but in this ease the innocent 
wife and babies are often the reapers. Blindness from gonorrhea costs 
America $16,000 a day. Not long ago doctors thought gonorrhea a 
mild local disease. Now all good doctors know better. Beware of the 
one who laughs at it : he does not know his business. 

Comparative slides are shown, illustrating the normal female re- 
productive organs, and the same organs infected with gonorrhea. An 
innocent bride may be infected by her husband. The germ makes its 
way up through the womb, and out through the Fallopian tubes, where 
it is impossible to reach it by injection or medication, and where it 
rapidly increases in number. The result is that the pain constantly 
becomes more severe until finally an operation is necessary. It is 
said that 60 per cent of all pus operations on women's abdomens are 
caused by common clap, and so the surgeon finds the tubes and ovaries 
bursting with gonorrheal pus. They must be removed and her hopes 
for children are blasted forever. 

Syphilis, the second form of venereal disease, occurs in three 
stages — primary, secondary and tertiary. 

Primary syphilis. The germs shown on the screen enter through a 
break in the skin, even though that break be microscopic in size. 
Several weeks later the first real symptom is noticed. There is no gen- 
eral disturbance in the health or appearance of the infected one. We 
would ask you to particularly study the moving picture film, giving all 
of the characteristic life movements of this spiral-shaped germ which 
causes so much of disease and suffering in the world. The film was 
made in Paris, and wonderful patience and perseverance were required 
to secure the results depicted here. The film is taken through an ultra- 
microscope, an instrument particularly adapted for such difficult work. 
Also consider the possibility of education by means of moving picture 
films. It has only been a comparatively short time that the scientific 
world has known the exact cause of syphilis, and in a few short years 
such progress has been made that we are permitted to pry into the in- 



308 F1K8T NATIONAIj CDNFERENCIO ON RACE BETTliiRMENT 

lU'i-most siH'ivts of Xiituiv. As in the case of gonorrhea, syphilis never 
develops until its seed (the germ) is first planted. Wheat never 
grows unless wheat is planted. 

This subject is of the utmost importance to every living being, due 
to the fact that it is possible to accidentally infect the innocent. Treat- 
ment for other contagious diseases is adequately provided for, but 
thus far little attempt has been made to regularly isolate or control 
these most destructive diseases. We propose showing you a few cases 
of accidental infection. One, a roller towel case. The roller towel is 
ruled out. by law, in a number of the states. On the other screen, an 
innocent infection from a telephone transmitter. Here, a boy of 
twelve years of age, an employee of a shoe factory, the innocent victim 
of the common drinking cup. These cases readily explain the legisla- 
tion, which has spread all over America, calling for the abolition of 
the common drinking cup. Two men infected by a careless barber; 
every man w^ho patronizes a cheap barber shop, where no precautions 
are taken with reference to sterilization of tools and towels, runs a 
chance of acquiring this or some other disease. Even the doctors are 
subject to accidental infection. This, of course, is not to be wondered 
at. Here are two doctors, one infected while examining a woman 
whose body showed no exterior signs of the disease, the other infected 
while delivering a child given in birth by a syphilitic mother. 

Secondary syphilis. Poison distributed throughout the entire body. 
Enters the blood stream. Glands enlarge, skin erupts, general con- 
dition of health fair ; usually little or no pain. 

All of these various illustrations are taken from actual subjects, 
colored to perfection by an expert artist. 

Public opinion has been moved strongly by this subject, largely due 
to former ignorance, and by the further fact that refusal to consider 
the cjuestion spells the physical deterioration of the civilized nations 
of the world. Syphilis is poisoning and slowly but surely undermining 
the very fountain of life, sowing the seed of death among our people, 
and gradually deteriorating the national health. It is estimated that 
5,000,000 people in the United States are or have been tainted with 
syphilis, and yet up to a few years ago a question of this kind could 
not be discussed in polite society. 

Tertiary syphilis. There is no definite line between the secondary 
and tertiary periods. This stage is characterized by the formation of 
soft tumors, which may attack any portion of the human body. Is it 
right that diseases that are causing more suffering, more expense and 
more deaths than any other disease should ])e allowed a free course, and 
that there should be no efforts to control them ? 



SEX QUESTIONS 309 

Syphilis and gonorrhea make more sokliers in the United States 
Army unfit for service than any other disease. A marked change has 
taken place in the United States Army and Navy since instruction in 
sex hygiene has been instituted. The Navy Department reported 
publicly that the crews of the sixteen battleships that went around 
the world returned with a better record in respect to veneral disease 
than was ever noted before. This M^as due to the instruction of our 
sailor boys in this very vital subject. The Prussian Army and the 
Bavarian Army have presented sane instruction along this line for 
many years, and their total average of venereal cases is about eighteen 
per one thousand, about one-tenth as many as w^e had according to the 
statistics of the American Army prior to the introduction of similar 
education. 

One of the most important questions before tHe Race Betterment 
Conference is what force can be put into effect to deal with these 
formidable evils which greatly threaten family ties, human happiness 
and the very life of the race. Until recently it was impossible to dis- 
cuss fearlessly and openly the question of prostitution. The original 
source of most of these infections is in that of irregular commerce be- 
tween the sexes, known as prostitution. There are no other diseases 
whose absolute prevention lies so wholly in human power as these. We 
believe that the fellow who steals, cheats, robs and even murders is not 
so injurious a character to the community at large as the person wlio 
distributes syphilis. 

"Prostitution is a commercialized business of large proportions, 
with tremendous profits, controlled largely by men and not women. ' ' 
This is the statement made by the Chicago Vice Commission, an epoch- 
making report of utmost value to the entire nation. These conditions 
are with us. To pretend that they do not exist is hypocrisy, far-reach- 
ing in its harmful effects, and yet it is hardly fair to let the boy find 
out for himself. Many have to their sorrow. 

Prostitution leaves in its wake sterility, insanity, paralysis, the 
blinded eyes of little babies, the twisted limbs of deformed children, 
degradation, physical rot and mental decay. ,We can show the dis- 
figurements and sores, but we can't show the suffering, mental agony, 
divorces and ruined homes caused by syphilis and gonorrhea. 

Can prostitution be abolished? Not entirely. The history of the 
world demonstrates the existence of this vice in all ages and among all 
nations, since the day the first pages were written, and yet we can- 
not admit that prostitution, as a commercialized business, or anything 
akin to it, is necessary. The old way of handling the question was to 
exterminate with statutory enactment, with the result that vice is 
usually driven into seclusion, thereby aggravating the evil. The new 



310 I'lKST NATIONAL CONFERENCE ON RACE BETTERMENT 

way must l»c a caiuijaiiiii of ediu-atiou. dealing' w illi the parents ol' the 
next yeueration. Cliristianity and Denioeraey have failed, signally, 
thus far to cope with these evils, which are sappiug the vitality of 
civilized society. It is clear that no one force or agency can be relied 
upon to bring to pass the remedy. We do believe, however, that there 
is a public conscience, which, when aroused to the truth, will instantly 
rebel against the social evil in all its phases; and so it is incumbent 
upon all right-thinking men and women to raise social life to the high- 
est standard of righteousness, and to teach the youth of our land 
loyalty and honor to womanhood. 

Since this is an audience of men, I would say that the one thing 
that we can all do is to live cleanly. Some poet of the past has aptly 
said, "Your actions speak so loud that I cannot hear your voice." 
"We all have greaf influence over the younger life of the nation by our 
example. The man who tells dirty sex stories should be suppressed. 
Let him tell them to his own son and daughter. 

The finest crop that this nation raises is its crop of American boys. 
Ever)'' year nearly one million reach manhood. Many of these, at the 
present rate, will acquire gonorrhea and syphilis, a very large number 
ignorantly. These young chaps are the flower of American manhood, 
our owTi younger brothers, the boys who will grow up and marry our 
sisters and daughters. We believe that they have a right to this 
type of Imow^ledge, and that they should be forewarned as to the be- 
setting dangers of life. You remember that to be forewarned is to be 
forearmed. Such instruction should be given preferably in the home 
and by the parents. Unquestionably, this type of lecture is particu- 
larly suitable for the enlightenment of parents. It would be folly to 
introduce sex hygiene in the schools until the teachers are suitably 
trained to impart this knowledge in the proper way. Intelligence re- 
garding sexual matters, if discreetly imparted, is a safeguard to the 
youth of the country, yet the indiscriminate circulation of sex infor- 
mation among children by means of books and pamphlets is dangerous. 

We realize also that the reformer, so-called, can do a great deal of 
damage in handling this subject. For that reason a sane presentation 
of the subject is much to be desired, and I think you will agree with me 
that it has been sane. 

The greatest menace to the girl is the man without a spark of either 
bravery or honor. Fathers and mothers should be companions and 
comrades with their children, far more than is customary, and there 
would be very little prostitution. Today, mothers teach their daugh- 
ters nearly everything except the things they most need to know. 
Why not place sexual matters on the same basis as any other natural 
function of life ? It can be readily accomplished, utilizing some of the 



SEX QUESTIONS 311 

beauties of Nature, for instance beautiful tiower slides and films. 
These, especially in natural colors, permit opportunity to mention the 
botanical and zoological side of reproduction, and also call attention to 
the beauty of Nature methods of reproduction of kind. 

No father or elder brother has a right to look his little boy or 
brother in the face if he is letting him grow up in ignorance of this 
most vital question. As we learn, let us teach, preferably through the 
eye, and little by little the results will surely come. Venereal dis- 
eases are not theories but facts. The only way that we can save our- 
selves is to tell the coming generation what we know, and practice 
Avhat we tell. An ounce of prevention of these diseases is worth a 
hundred pounds of cure. 



A MAN'S PROBLEM 

(A Special Addres^s to "Women.) 

J. N. HuRTY, M.D., Commissioner of Health, State of Indiana. Indianapolis, 
Indiana. 

p]arly in my work as Secretary of the State Board of Health of 
Indiana I took up this problem that we have before us tonight. 
Two members of the Board were specialists in the cure of social dis- 
eases. Early in my experience in medicine. I had served as an assis- 
tant to a specialist in that line. As a young man. I was astounded to 
discover some of the truths that came out of those offices. I will not 
attempt to tell you of the things that I saw there, for they would make 
your blood run cold. That is all I have now to say of this matter. 
But it started me to thinking early in life. Can the human race 
possibly be saved from the terrible social diseases ? Is it possible ? I 
believe it is possible. Oh, but what a long, hard road the human race 
must travel before it is rid of the social diseases. 

But where lies the battle ? What is the cause that these terrible 
sexual plagues should so continually and so horribly plague the human 
race ? What is at the bottom of it ? I think the principal reason lies 
in the very strong, exceedingly strong, sexual appetite of men. AVe 
know full well that that appetite was given for a purpose by the 
Creator, and, at the same time, He gave us freedom of will and gave 
us power of free will to exercise and to control it. The social evil is 
largely a man's problem. 

Let me tell you what we have been trying to do to check this evil in 
Indiana through the Health Department. We have given a great 
deal of time and a great deal of work to the prevention and cure of 
tuberculosis, but I believe this is more important. Now that we have 
the laity going upon the subject of tuberculosis, the state health 



:W2 I'lUST NATIOXAl, CON Kl'iUKNCl', ON' IJACK lil'VI'Tliini lONT 

autlun'itics arc \vitlulra\viii,u' from that (ii^lit llial is. I'r-oin the foiv- 
fi'oiit of the liiiht, to take a place in the ivai-, to |)usli fi-oiii l)ehmd. 
Now we are trying" to start a ])iibli(". oi)eii light against these horrible 
plagues, which, to me, seem more horrible and of more importance 
than the conquest of consumption. 

How to attack them, how to get at them, that is the question. It is 
obvious and plain that if men were but virtuous, we would have none 
of them ; that in proportion as we can make men virtuous, in that 
proportion will we get rid of them. I think that is reasonable. 
How shall we do it? Shall we commence with adults? Shall we com- 
mence with grown men that have not restrained themselves, have not 
acquired that control over themselves which they should have acquired 
in youth? Shall we begin there? Will it do any good? I think not. 
We must begin with the child. I want to read to you some of the little 
documents and writings that we send over the state in order to pre- 
pare the public mind to receive the bare truth. We send out a circu- 
lar that is now in its third edition of 115,000. It treats of this 
subject plainly, squarely, straight out. It was at first denied by the 
rule of postal authorities the privilege of the mails because it 
spoke so plainly. When we presented this circular to the United 
States postal authorities and got a reply it would not be admitted 
to the mail, we appealed to a man whom we all know, Theodore 
Roosevelt, and he put it into the mails. I want you to Imow of that 
one service, for I do think it w^as a great service. Now that 
circular may be sent in the mail. We are glad to send it to anyone 
who will write for it. It tells the story from the scientific standpoint. 
It appeals to manhood and to w^omanhood. It is intended more for the 
young than for the developed, but nevertheless, we find it is read with 
interest by all. That circular has gone around the earth. That is one 
thing that we have done. Now I beg your indulgence to listen to one 
or two or perhaps three of the little sketches we send out, hoping 
thereby to prepare the public mind, for we get letters condemning us 
for taking hold of this subject at all. In tracing back and finding the 
names of some authors of these letters, w^e found that in three instances 
they were officers in churches, protesting against any rational effort, 
any kind of effort to check the social plagues. So we have had to 
try to prepare the public mind, and of course, it is not yet prepared. 
The first sketch is entitled the Diseased Child or rather Diseased Chil- 
dren : 

"A weak, sickly child is indeed a sad sight. The putty complexion, 
the lack-luster eyes, the thin hands, arms and legs, and the weary look 
make our hearts bleed. But why is the child diseased? How came 



SEX QUESTIONS 313 

it to be diseased? Have the sins of the father descended? If they 
have, why is he not arrested and punished? If he were to slowly 
poison the child with a poison bought at the drug store, he would be 
promptly arrested and punished. What is the difference? Ask the 
child which poisoning he prefers. He will certainly tell you when he 
has suffered and salved his sores for a few years that arsenic poisoning 
is preferable to blood poisoning. Why does not society class as dis- 
graced him who bears syphilitic poison in his blood, having wickedly 
put it there? And what a strange, inconsistent thing is society, any- 
how. It has one standard of morals for women and another for men. 
And, so long as this condition prevails, so long will the blood sins of 
husbands descend upon their wives and children. In the Orphans' 
Home at Indianapolis are seventeen innocent children all suffering 
from the hereditary malady which is worse than leprosy. They can- 
not develop into strong, useful members of society. The disease pre- 
vents. They will be a burden to themselves and to the state all their 
lives, and possibly produce more like themselves. Why does society 
permit such conditions? We strive to prevent fire, for it destroys 
property. Why not strive to prevent that awful disease that bums up 
human beings? Is it our high intelligence which keeps us silent and 
inactive in this matter? 

"The law should require the prompt reporting of cases of the 
social plagues. They are. excepting in certain instances, ac- 
quired in sin and self-disgrace. Why should we speak of the matter 
in a whisper? Is our silence strength, or weakness?" 

This was sent to three hundred papers in the state of Indiana six 
years ago. Only six of them would print it. Do you think there is 
anything horrible about it? Anything terrible? But since then, 
numbers — I don't know how many — have printed it and since then 
much editorial comment has been heard. Let me give you another one, 
simply entitled, ' ' Her Baby Died. ' ' 

"The hour for the funeral had arrived and neighbors were com- 
ing in to the services. The dead baby lay in a little white coffin lined 
with white satin, was dressed in white, and flowers in profusion 
decorated the room and testified to the sympathy of the neighbors. 

"The preacher made a short prayer, uttered a few comforting 
words, a song was sung, the little baby was borne to the white hearse 
by four young girls in white, and the procession moved toward the 
cemetery. 

"The baby had died from intestinal disorder induced by wrong 
feeding, yet the preacher had said — 'The Lord giveth and the Lord 
has taken away. ' The doctor told how it all happened. ' That baby, ' 
said he, 'was born strong and healthy. The mother nursed it for 



;n4 FJK8T NATIONAL CONFERENCE ON RACE BETTERMENT 

weeks, but finding that nursing interfered with bridge i)arties and 
other social affairs, she provided a bottle, and when she was absent, 
her aunt, who lived with her, fed cow's milk to the baby. This irregu- 
larity of breast-feeding soon lessened the amount of the mother's 
milk, and she concluded she would cease nursing altogether. The child 
seemed to do well on the bottle for a while, but it soon became 
evident that something was wrong. One time I saw the mother give a 
piece of rich pie crust to her baby, and I warned her against doing 
so. She told me she found the infant liked coffee, and a little was 
frequently given to it. And so, despite my medicines and my warnings 
in regard to feeding, the child's digestive apparatus gradually broke 
down. An old grandmother told the mother it was natural for babies 
to throw up. Another one prescribed soothing syrup which contained 
morphine. Another one recommended anise seed cordial — and so it 
went, the young mother being willing to depend upon drugs and 
remedies, but not to practice 'prevention' by feeding rationally. 
When the digestive machinery was put to the bad, the baby finally took 
dysentery and died.' Continuing, the doctor said: 'I had three in- 
fants die of pneumonia last winter, simply because their mothers 
would not give them air enough. In spite of my instructions that 
plenty of air made babies strong and protected them against colds and 
coughs, still they would cover their babies' faces with veils and nap- 
kins, keeping the life-giving air away. The foolish idea,' said the 
doctor, 'which seems to exist everywhere, that fresh, cold air is in- 
jurious, must somehow be extracted from the minds which hold the 
same, or else pneumonia and dead babies will always be wdth us.' " 
There is another entitled, "The Ladies and the Alley Children:" 
"A very rich lady who owned a beautiful garden concluded to 
spend the summer at the seashore. While contemplating the pleasure 
she would have, the thought suddenly rose in her mind, 'What shall 
I do about my flowers ? The gardener will look after the garden, ' she 
said to herself, 'but the flowers which must be picked to keep the 
bushes healthy and productive, what of them? They must not be 
wasted. Oh ! I know, ' she said, after a minute 's thought, ' I will tell 
Mrs. Scottmann and Mrs. Wharfington to help themselves, and, graci- 
ous knows, they will pick them close enough.' She told these ladies 
(who also had gardens) to help themselves to her flowers while she 
was away. 

' ' One day, the ladies went in Mrs, Scottmann 's electric cab to the 
beautiful garden and entered by the wrought-iron gate opening on the 
side street. They carefully clased the gate, and almost immediately the 
wan faces of two ragged alley-children appeared between the bars. 
In silence, their longing, lack-luster eyes looked upon the scene. Both 



SEX QUESTIONS 315 

ladies were richly dressed, and the alley-children thought the ladies 
were quite as beautiful as the ilowers. Finally their curiously wrought 
ornamental baskets were filled with beautiful flowers, and Mrs. Scott- 
mann and Mrs. Wharfington started for their handsome homes, think- 
ing how lovely their flowers would look upon their mantels and tables. 
They saw the wan faces between the gate bars, but upon their ap- 
proach the faces disappeared. 

* ' The ladies placed their baskets in the cab, and were about to drive 
away, when they remembered they had left their silver scissors used for 
cutting the flowers, on the seat near the fountain under the pergola. 
Neither was pushed for time, and both re-entered the garden to get the 
scissors, leaving the cab door open. The alley-children returned and 
glanced into the cab. They viewed the handsome, rich, blue interior 
for a moment, then each snatched a rose and fled down the alley. A 
policeman witnessed the theft, but he simply looked away. The rich 
women returned, but did not notice that two of their roses were gone. 
They could not possibly miss them where there Avere so many. 

' ' The alley-children ran directly home to the bare room where their 
mother lay upon a bed of rags, dying of consumption. 'See what we 
have brought you. Mamma, ' said the girls. ' How beautiful ! ' said the 
mother in a whisper; 'but where did you get them?' 'Two lovely 
ladies, who had each a basketful, gave them to us for you.' 'How 
kind, ' whispered the mother ; ' did you thank them ? ' The girls placed 
the roses in a small, cracked pitcher at their mother's bedside, and 
she greatly enjoyed their beauty and their fragrance. And just as 
she fell into her final sleep, the ladies who sent the roses appeared to 
her as two angels in her vision." 

This method of approach we think is doing good. We are getting 
the thought into people that something must be done in regard to 
dealing with these certain problems. That is the first idea that it 
seems to me should be executed. That was the whole object of this 
series of papers. 

We have more of them, but I shall not burden you, but shall ask you 
to think of this point : That diet has a good deal to do with the per- 
petuation and the transference of the sexual plagues. I know it from 
experience, such as no one except those can know as have either been 
specialists in this question or been assistants to one, as I have. A young 
man, a bank cashier, of good birth and with pure blood in his veins 
at one time, came to our office with a sexual disease. My principal 
said, ' ' How did this happen ? " " Oh, " said he, ' ' don 't ask me. " " But 
I want to know, ' ' he said, ' ' that I may have better information in re- 
gard to it. He said, "I was down town. We had a great feast, wine, 
cocktails, champagne, thick beefsteak, a whole list of stimulating foods, 



316 FIKST NATIONAL OONPERKNCE ON RACK HKTTKKMENT 

and tluMi tliore eanie up some stories of a sexual nature. Had I stayed 
at home and read and had I taken a frugal meal at night, I would not 
have found myself sexually stinnilated. It was the stimulation and 
that association that put into my mind the sexual act, and I went off 
Avhere I should not have gone." And he said, "I was a fool." He 
Avas a fool and he knew it, but you see how he was influenced. 

So it is true that if we could hut change the diet of mankind, 
abolish stimulants of all kinds, keep them out of the human body, 
it would be best for the brain and for our brawn, best for our success — 
to keej) stimulating foods away, and keep drugs out of the human 
body. Surely this appeals to everyone. But the idea is abroad that 
we must have meat. We know what resistance against meat will do 
when we look at the numerous patients who come here. We ask them 
to try it,- but the cry is, ' ' Oh, you are a crank. ' ' But experience shows 
that diet has something to do with it. We must reform our diet. The 
great work that is being done by this great institution, in teaching peo- 
ple how to keep themselves healthy, is working against the sexual 
plagues, which have so terribly cursed us. 

I doubt very much if the discovery of salvarsan, or 606, for 
the cure of syphilis will be beneficial to the race. I doubt it ex- 
ceedingly. Several men were at a club. They asked a doctor who 
was present, "Doctor, is this a sure cure?" Said he, "I believe 
it is." Then they said, I'Why take care of one's self?" But, 
they don't get a cure. The syphilitic poison has its effect finally 
upon the race, degenerating it slowly, ever so slowly, degenerating the 
germ plasm that is carried by every human being. Wliat effect will 
this other poison called ' ' 606 ' ' have upon the human race ? It, too, is a 
poison. It kills the spirocheta, the animal, for it is an animal, a pro- 
tozoon that causes syphilis. It kills it, but how and with what? The 
poison of the spirocheta is not neutralized. The organism itself is 
destroyed and it makes no more syphilitic poison ; we have introduced 
another poison, so I doubt very much whether this discovery will be 
beneficial to the race. That it will be beneficial to individuals is 
certainly very plain to us all. 

My whole refrain is that of prevention. At the risk of your having 
read it, I want to read an Indiana poem, and then close. It is pre- 
vention, not cure, to which we must give attention. We must finally 
let all mankind know that to be sick is a sin. Of course it is. I have 
been sick, and I know how I became so. When we get typhoid fever, 
we know why. An individual can protect himself absolutely against 
typhoid fever ; an individual cannot protect himself absolutely against 
consumption, but he can do a great deal, and the state must do the 
rest. Let me read this poem to close. As I said, it is an Indiana 



SEX QUESTIONS 317 

product, and I do not want you to forget that, for I am proud of it. 
It is entitled "The Fence or the Ambulance," and has been printed 
abroad. 

FENCE OR AMBULANCE 

'Twas a dangerous cliff, as they freely confessed. 

Though to walk near its crest was so pleasant; 
But over its terrible edge there had slipped 

A duke, and full many a peasant; 
So the people said something would have to be done 

But their projects did not at all tally. 
Some said, "Put a fence 'round the edge of the cliff," 

Some, "An ambulance down in the valley." 

But the cry for the ambulance carried the day 

For it spread through the neighboring city ; 
A fence may be useful or not, it is time, 

But each heart became brimful of pity 
For those who slipped over that dangerous cliff, 

And the dwellers in highway and alley 
Gave pounds or gave pence, not to put up a fence 

But an ambulance down in the valley. 

"For the cliff is all right if you're careful," they said, 

"And if folks ever slip and are dropping, 
It isn't the slipping that hurts them so much 

As the shock down below when they'i-e stopping;" 
So day after day as those mishaps occurred, 

Quick forth would these rescuers sally. 
To pick up the victims who fell off the cliff 

With the ambulance down in the valley. 

Then an old sage remarked, "It's a mai-^^el to me 

That people give far more attention 
To repairing results than to stopping the cause. 

When they'd much better aim at prevention. 
"Let us stop at its source all this mischief," cried he, 

"Come, neighbors and friends, let us rally; 
If the cliff we will fence we might almost dispense 

With the ambulance down in the valley." 

"Oh, he's a fanatic." the other rejoined, 

"Dispense with the ambulance? Never! 
He'd dispense with all charities, too, if he could. 

No, no! We'll support them forever! 
Aren't we picking up folk just as fast as they fall? 

And shall this man dictate to us? Shall he? 
Why should people of sense stop to put up a fence 

While their ambulance works in the valley?" 

But a sensible few, who are practical too. 

Will not bear with such nonsense much longer; 

They believe that prevention is better than cure. 
And their party will soon be the stronger. 



318 FIRST NATIONAl. CONFERENCE ON RACE BETTERMENT 

Kii('(iui;il;(' IIumii. tlicii, with your luirsc, Noicc jiiid \)vn, 

Ami (while uther piiilanllirupists dally) 
Tlu-y will scorn all pretense and put a stout fence 

On the cliff that liani^s over the valley. 

Better yuide well the younji' than reclaim them when old. 

For the voice of true wisdom is callini>'; 
To rescue the fallen is good, but 'tis best 

To prevent other people from falling; 
Better close up the source of temptation and crime 

Tlian deliver from dungeon or galley ; 
Better put a strong fence 'round the top of the cliff. 

Than an ambulance down in the valley. 

Prevention is the thing, not cure. "We are obsessed with the idea 
of cure. Let us get away from it. Ijet us tell those who are sick, A 
law has been violated. We are all obsessed with the idea of keep- 
ing men out of hell. Let us reverse this, and by prevention, keep hell 
out of men. 



A WOMAN'S PROBLEM 

(A Special Address to Women.) 
Dr. Carolyn Geisel, Shorter College, Rome, Georgia. 

Wha.t I have to say is just this, to remind you, my sister, that he 
who spoke before me said it is a man's problem. Well then, if the 
problem be a man 's — hear me with patience when I say it in my own 
way — if the problem be a man's, why then it is all ours, for the man 
is ours. He is yours, because you bore him ; he is yours because you 
loved him ; he is your son first, lover afterwards, your husband by and 
by ; he is yours. This problem is woman 's, because the man, your son, 
was yours by the gift of Almighty Grod. 

What are you going to do about it, then ? Have you a part in the 
solution of the problem ? I said the problem was yours. Wait a minute 
then. First, as individual woman, can you help solve the problem"? 
If you can, how? By standing straight, but that does not sound like 
much. Let me emphasize this. Are there some things always right — 
are there? Oh, of course. Are there some things always wrong? Of 
course. Then hear me. As an individual woman, you can help solve 
the problem by standing straight every single time, no matter what 
the occasion, for the thing that is always right. Oh, you waver so! 
I, you, we waver so ! We believe deep down in our souls that something 
is wrong — this thing that someone is talking about ; it is wrong. 
In some little corner, when a group of some kind of people are talking 
about it and condoning it as though perhaps it wasn 't so wrong after 
all, we keep still. Ah, you have lost your influence, and your influence 



SEX QUESTIONS 319 

as an individual from that time is naught on that point. Stand square, 
and say a thing- is right when it is right, and say it is wrong 
when it is wrong. 

I am saying to you, then, be strong ! And I have backing from a 
Holy Book when I bid you be strong. Read it yourself, the command- 
ments of the living God, Hear me read it to you, ''Be strong, quit 
you like men. " To whom did He say that? Oh, to the men, of course, 
and to us who are mothers of men. Be strong, and quit you like men — 
if you would be the mother of a man and not the mother of a degen- 
erate. You can stand squarely for a thing that is always right and 
squarely against the thing that is always wrong, by your actions more 
than your words. 

Now, come on ! Is your door ever opened to admit a man whose 
character you know is sullied? Were you ever guilty of inviting into 
your home the man of reputation because of money, the man of so- 
called family standing, the man of position or influence, or because of 
money the inan who had trailed his soul to shame in the red light dis- 
trict ? Were you ever guilty of that ? Then you did not stand square. 
If you ever admitted to your parlor by invitation or consent, whether 
invitation or no, the man whose reputation was to your knowledge 
sullied or unclean, then you have not stood true to the things that you 
have applauded at this Conference. If you ever intend to solve this 
problem, which is the greatest, almost the greatest, of the race better- 
ment problems, be true to the thing that is always right, and stand 
always against the thing that is always wrong. That means, shut your 
door in the face of the unclean man, no matter how much money 
he has. Will you do it? That's another thing. The Race Better- 
ment Conference is of no purpose whatever if it bringeth not forth 
results, and if you go back to your homes today to do what you have al- 
ways done — some of you have always done right, God bless you, but 
some of you have been uncertain in your standing for the things that 
are rights — if you go back to your homes then and continue to be un- 
certain, I say the world will get no benefit from your delegateship to 
this particular Conference, 

Hear me then I He who comes into your presence accompanied by 
the enameled-faced w^oman of imcertain reputation ; he who comes into 
your presence and comes under your roof accompanied by such a one, 
what will you do with him ? What will you do with him ? 

' Will you say, as I heard a woman say a few days ago, " Oh ! a man 
must drink a little for the sake of company." Now are you as un- 
certain as that, believing as I think you do, that alcohol is the tap root 
of this fearful problem of the social evil? 

What about the places to which you go ? Young girls, I want your 



320 FIKST NATIONAL CONFKHENCK ON RACE BETTERMENT 

attention. Young women, I am talking to you. now. What about tlie 
places to whieli you go ? What about the company you keep ? What 
about tlic man whose invitation you accept? 

Oh: closer yet, what about the color of your hair? I'croxidc? 
Stand squarely there, if the thing is not right, if it be not right, against 
putting on the label of sin. If you put it on, you are inviting dis- 
aster. What about the color of your cheek? Unnatural, or is it the 
badge of the underworld? What about the arrangement of your 
gown ? What about it ? He said, he whose quiet voice you listened to 
with such rapt attention, standing here but a little while ago — he said, 
the indecent gown of the twentieth century woman drives many a man 
to the place that is questionable. Plear me. my sisters, hear! You 
know, you do know% that the fashions of today are not of your seeking. 
You did not make them, but I call upon you in the strength of your 
united M;omanliood, that we arise in our power and demand that decent 
clothes be put upon the market for us to wear, or else that we remain 
in our homes until we can get gowTis that will be seemly. A little 
matter, is it? Not a little matter, if by the mighty power of sugges- 
tion, that hardly a man can resist, he is driven by it — that power of 
suggestion — to the place that is ciuestionable, the results of which are 
not questionable. 

Next, then, let me ask you to think of yourself as a business wo- 
man. Oh no, I didn't mean in the shop, I am not going to take time 
for that. I am not thinking of you as women in commercialism, but 
as just plain women, that 's all. I want you to think of yourselves just 
for a minute as being business women. Oh. I fancy you would like to 
fling back to me that you said you were not going to talk business. 
Ah ! I mean the business which we call the majestic, holy, blessed, 
sacred business of motherhood itself. Oh, my sister! Nothing, nothing 
in all God's world should appeal to you as the helpless babe that lies 
against your breast ! Oh, how I love it ! I was wdth a woman a few days 
ago who had her baby lying across her Imee. I said, ' ' Do you love it, 
honey ? ' ' And looking into my face, her own radiant with a light inde- 
scribable, she said, "Love it, love my baby?" — Then, taking a very deep 
breath, she said, ' ' I love it so that if Christ had not gone to Calvary to 
give my l)oy life eternal, if by so doing I could secure life eternal for 
him, I would go to hell that he might go to heaven." "Oh," I said, 
' ' daughter, that would hardly be love. The real kind of love for your 
baby, ' ' I said to her, ' ' would be to take his little hand in yours and go 
with him to heaven. That is mother love. " I want to ask you to con- 
sider yourself now, I am asking you to see how you can solve the 
problem. Consider yourself now as a business woman in the business 
of raising a man-child. Can you raise this man-child so he will live 



SEX QUESTIONS 321 

with God through all eternity? Have him give you the first seven 
straight, uninterrupted years of his little life, hold him to your breast, 
keep him close to your knee for seven years, then hear me ! I believe I 
am speaking the truth, if you are true to God Almighty and to Jesus 
Christ, His Son, your boy will be safe through all eternity. 
I honestly believe it, I don't believe that my Lord died in vain; I 
don't believe that salvation is of no avail. I believe with all my soul 
that the knowledge of Jesus Christ saves from sin. It is written in 
Matthew. Read it yourself. "And thou shalt call his name Jesus: 
for He shall save His people from their sins. ' ' 

Now women, close attention for just a minute. How is a boy to 
be saved for all eternity or kept from falling in the world if he knows 
not Christ? I cannot tell you how the blood of Jesus Christ saves, 
cleanses from sin ; I cannot tell you how the knowledge of Jesus 
Christ keeps from sin. Lots of things I don't know. I don't Jmow 
how breathing air into your lungs keeps you alive. I know it does, but 
I don 't know how. Explanation does not explain it alL I know that, 
by some mysterious alchemy of a power that is divine, the knowledge of 
Jesus Christ does keep from sin. But how is the boy to be kept who 
is not introduced to his Saviour ? Then I am asking you to be business 
women. If the blood of Jesus Christ will save your son from the 
stain of sin, then give him Christ. Talk about 606 for your boy ? But 
his body is stained with sin ! Send him to Vienna that he may be 
treated by 606 ? I don 't believe that there is no remedy for syphilis. 
There is a remedy, the remedy that God sent. He came. I am not 
even talking religion, I am talking plain business with you. It is not so 
much health certificates ; it is not so much a remedy for syphilis that 
we need, it is God and His Son, Jesus Christ. I am not trying to 
preach, I am only trying to talk business. The Catholics know that for 
truth. They say, ' ' Give me the boy till he is seven years. ' ' Then let 
me say, "You keep your boy for seven years and let him get acquainted 
with the Holy Book and his mother's God; let him see his mother on 
her knees, and you have got your boy and Satan cannot get him." 
Let me say it now from someone wdser than I by far, ' ' If virtue be in 
the blood — and that is the way to get it in the blood — if virtue be in 
the blood, vice is not so much alien as it is impossible." What you 
want, oh, my sister, you who are a mother, what you want for your 
boy is to make vice impossible to your baby when he becomes a man. 
The impossibility of vice is the thing you want. 

Now come away from that, from the child on your knees, nursing 
from your breast, from the salvation and knowledge of salvation as it is 
in Christ Jesus — come away from that now to your business, again, 
your business of home-maker. Let me repeat w^hat Doctor Hurty 

(12) 



322 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

said. "I am speaking to you now wholly as a physician." Ji'or seven- 
teen long years I have had the great honor, blessed privilege indeed, 
to be associated with this wonderful institution. The most of you 
know that I spent some years of my life in rescue work away down 
there in the slums. The harlot women who presided over what might 
well be called the ''little hells," wherein were girls exploited, as Dean 
Sumner said, "for the mad passions of indecent men" — those women 
said to me over and over through the years that I did rescue work, 
"Oh, we couldn't keep our girls here if we didn't feed for it. We 
always serve plenty of meat three times a day, always, and we always 
use coffee and we always use pepper. " I am not saying that because 
you are at the Sanitarium. I am talking to you as individuals, out of 
my experience as a rescue worker and a medical woman. I want to tell 
you that is true. They could not keep them down there if they did 
not feed for it. The harlot who presides over a house of sin knows her 
business, the business of sin, and feeds her victims to keep them in the 
business. No, that is not a fairy tale. Not one, but dozens of these 
women told me that: Then let me say to you, You are not in that 
business, but you are presiding over a home, not a house. Why 
not study your business. You are feeding to keep men safe in 
the world and to get them into the Kingdom of God, and why 
not study how to feed them so that their feet may take their hold 
of the straight and narrow way and lead them up to His King- 
dom? If it be true, and there is absolutely no longer question 
about it, if it be true that some sorts of food waken the very 
demon of passion in human life, and I say it is true, it is your business 
to find out what those foods are and never to serve them on your 
table. Study your business. Then, you know — and it is quite well 
proved — that vigorous, physical exercise out in the open air quiets the 
hot blood of the individual. Oh, my sister, when by and by, the roll is 
called up yonder, and the hard task of rearing a family and keeping 
them from sin is all over, and you are up there close by the great white 
throne of the living God, and your children are with you, won't it be 
worth all the price you paid, if the price meant effort? Won 'tit? Ah, 
and what of the other ? If some day she comes back to you with her 
baby in her arms, all despoiled and broken, because of the shame of 
her life, the awful mistake of her marriage, the heartbreak is yours 
and, in a way, you will almost deserve it, if you have neglected your 
business. 

Something more. And this is my final word — it is about our posi- 
tion as citizens in the United States of America. You say, ' ' Why, we 
are not citizens." But it says so in the constitution, anyhow, and I 
am just waiting until somebody has courage enough to test the eon- 



SEX QUESTIONS 323 

stitution of the United States. All persons born -or naturalized in the 
United States are citizens ; it is so in the constitution. Well, aren 't 
you a person, my lovely ? Then you are a citizen. Are you ready to 
do your duty as a citizen ? Are you ? I believe in peace, but what of 
him who says peace, peace, when there is no peace ? Is there peace in 
your woman's eyes tonight, you who have listened to the tragedies that 
have been detailed from this platform concerning the white slave 
traffic ? Is there peace in your soul ? I sat there just last night and 
groaned aloud while they were talking of the white slave traffic. I sat 
there this very afternoon and could hardly keep my place while they 
talked again of the white slave traffic and little women, our sisters, 
imprisoned through a nameless torture of shame. I am talking to 
the citizens of the United States of America. Back in the yesterday, 
not so very long ago, not much more than fifty years, our daddies 
took off their coats and went to war, went to war to strike the shackles 
of slavery from the wrists and ankles of the black men. What sort 
of slavery ? A slavery to honest toil, a slavery to clean manual labor. 
And no one lifts a hand to strike the shackles from the souls of help- 
less little white women. I don't know, I don't know, but sometimes 
there comes into my soul such a cry of rebellion against this fearful 
outrage to our womanhood, as well as to our liberty and peace, that 
I would God would call me to take a sword in hand and to lead you, 
a literal, veritable army, to make war, literal, actual war, until this 
thing be stamped out. Vicious, am I ? Were they vicious who would 
free a black man from labor ? Sensational, am I ? Was he sensational, 
who declared that all men are born free and equal, with the right to 
life, liberty and the pursuit of happiness ? Was he sensational ? Then 
let me say it again — all women under God were born free and equal, 
and because of the precious blood of Jesus Christ, we are called to 
liberate our sisters. "But," you say, "Doctor Geisel, you really don't 
mean it. You wouldn't have us go to war?" Hear me, then. There 
may be a peaceable way out. There will be thrust into your hands 
before very long, you cannot escape it, that little piece of paper 
called the ballot. It is as surely coming as tomorrow is coming, 
wanted or not. It doesn't matter — it is coming. Will you use it for 
the liberty of your sisters ? Or will you say, ' ' Leave politics to men. ' ' 
If you must go into politics to liberate helpless little girls who are 
enslaved now, then do it. Do it as quickly as ever you can. Done 
noAv, am I, when I have asked you to bow your heads where you are, 
and let your hearts say with Kipling : 

"Lord, God of Hosts, be with iis yet, 
Lest we forget, lest we forget !" 



324 l-MKST .NATIONAL CONFERKNCK OX HACK HKTTKKM KNT 

THE RELATION OF -EDUCATION IN SEX TO RACE BETTERMENT 

AViNFiKi.i) Scott Hall, Pii.D., M.D., Profossof oT IMiysiolo^y, Northwcstcni 
rnivei'sity Medical School, Chicaiio, Illinois. 

By race betterment we mean the increase not only of the physical 
health and eflficiency of the race, but also of the psychical solidity and 
nobility of the race. The first question which one naturally asks in 
this connection is, ' ' Hoav may this race betterment be accomplished ? ' ' 
In seeking- an answer to this question, we turn naturally to the lower- 
animals and ask how they are modified in race development. 

Those species of the lower animals that have been most closely 
associated with man — for example, the horse, the ox, the sheep, the 
hog- and the dog — have been very greatly modified and very greatly 
improved in modern times through the influence of factors which are 
very largely under the control of man. As we classify these factors 
of race betterment among the lower animals, we find that they natur- 
ally fall into two groups : first, environment ; second, heredity. 
These two factors are the universally recognized biological factors of 
race change. It is through them that all changes in living things 
have been accomplished as the millenniums of the past have rolled by. 

In comparatively recent times man has consciously and designedly 
modified and controlled both the environment and the heredity of 
these domestic animals with which he is so closely associated. He has 
secured for them the finest possible heredity through careful choice of 
the animals who were to breed the young. He has insured for them 
the most hygienic possible conditions from the day of the birth of 
each animal until its complete maturity. It has been kept in clean, 
comfortable surroundings and provided with wholesome and nourish- 
ing food. The result of this care in the domestic animals has been 
to produce horses, cattle, sheep, and hogs so far superior to those that 
existed in the days of our grandfathers that they could be classified 
almost as different species. 

Thoughtful men are now everywhere asking if it is possible to ac- 
complish for the human race changes anything like as profound as 
those already accomplished for the lower animals. If such a change 
is possible, it is generally agreed that it is possible only through the 
combined influence of the two universally recognized biological factors, 
— e7wiro7mient and heredity. 

The various conditions of environment are largely comprised in 
the more familiar popular term, hygiene, while the essential elements 
in heredity are practically covered by the popular term, eugenics. We 
must therefore look toward hygiene and eugenics as affording our 
sole hope for race betterment. 



SEX QUESTIONS 325 

Now, hygiene accomplishes two things. These are in two direc- 
tions. They may be classified as toward the positive, on the one hand, 
and toward the negative, on the other-^or, perhaps better, toward the 
positive, on the one hand, and away from the negative, on the other. 
In other words, hygiene seeks to accomplish certain things that are 
agreed to be good, and- to avoid certain things that are agreed to 
be bad. It seeks to promote, in the individual, habits of life whose 
influence is to steady, to stimulate and to strengthen both physical and 
mental powers. On the other hand, hygiene seeks to avoid, in the in- 
dividual, habits of life whose influence is to derange, to deplete, and to 
destroy. 

In a similar way eugenics presents a double phase : namely, a 
positive and a negative. First, it seeks not only to promote the 
propagation of the fit, but furthermore to advance the efficiency of the 
fit. Second, it seeks to avoid the propagation of the unfit. Among 
the domesticated animals, eugenics is accomplished easily by the arbi- 
trary will, guided by judgment and experience, of the owners of these 
lower animals, so that the mating of these animals is more or less 
absolutely controlled by the will of the owners. In the human species, 
no such arbitrary control is possible even if it were admitted to be 
advantageous. What is true of the control of eugenics is also, in a 
measure, true of the control of hygiene. The state and the munici- 
pality may arbitrarily quarantine such contagious diseases as scarlet 
fever, smallpox, etc., as it may arbitrarily refuse marriage license to 
the seriously diseased and palpably unfit. To such an extent the in- 
terference of the state will be generally welcomed, but we must recog- 
nize at the start that the influence of that interference at the very best 
can accomplish but little, important though that little may be, to- 
ward general race betterment. It will decrease the percentage of 
imbeciles, insane, criminals and degenerates, but important as this is, 
it can hardly be looked upon as accomplishing race betterment; at 
best it can only stay race degeneration. Race betterment or actual 
improvement of the rank and file of the race in physical and mental 
quality can only he accomplished through positive hygiene and posi- 
tive eugenics. 

But positive hygiene and positive eugenics can be brought about 
in the human race only through education. Education should lead 
the youth to adopt a regime of hygiene that would develop in him the 
highest possible degree of physical and mental efficiency. Education 
should also lead him to choose as his mate a life partner who possesses 
similar physical and mental qualities, besides possessing a blemishless 
heredity, as good as we will assume his own to be. 

The study of social conditions reveals the fact that a large ma- 



326 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

jority of those conditions which are inimical to race welfare are the 
result of ignorance and of distorted mental attitude regarding the sex 
life. These distorted mental attitudes can only be rectified and this 
deplorable and dense ignorance can only be dispelled by education. 
Those who have given attention to this problem of education agree 
with one accord that the distorted mental viewpoint possessed by so 
large a proportion of the population dates back to early childhood and 
is to be attributed solely to the fact that parents do not implant in 
the minds of their children the wholesome and inspiring viewpoint 
of the great fundamental truths of life. 

The first lesson regarding life should be taught by the mother 
to her questioning child. It is practically a universal custom of 
childhood to ask the mother how the baby came, or where they got the 
baby. The thoughtful twentieth-century mother accepts the question 
as indicating the psychological moment to teach her child the first 
great lesson and to give it a wholesome viewpoint regarding life. So 
she answers the question of her child truthfully and not as the 
mothers of a generation ago did, through evasions and fantastic fic- 
tions. 

The twentieth-century mother recognizes the fact that when her 
child comes asking this perfectly natural and perfectly fair question, 
she has one of the great opportunities of motherhood— namely, an 
opportunity to implant in the mind of the child the feeling that 
motherhood is a sacred relationship and the mother a sacred object. 
One twentieth-century mother answered her child's question in these 
words, "Baby sister came out of mamma's body. She was formed 
Mdthin mamma's body. She was formed from materials that were 
drawn out of mamma's blood; and that is the reason why mamma's 
cheeks are so pale and mannna's hands so thin and white." The 
little boy's eyes opened wide with wonder. This story, told in such 
a matchlessly simple way, \^'as incomparably more wonderful to the 
child's mind than the stork story would have been and he looked in 
his wide-eyed wonder from mamma's pale face down to little baby 
sister — back and forth — trying to comprehend it all. Then he asked 
this question: ''Mamma, was I formed within your body, too?*' 
And the mother answered, "Yes, my boy, you were and that is the 
reason why mamma loves her boy so — because she gave her own life's 
blood for him." The little boy's wide-open eyes now took on a far- 
away look and he seemed to be trying to comprehend the great truth 
of mother sacrifice. Presently, he seemed to catch a glimmer of the 
truth and his eyes welled full of tears as he turned toward his mother 
and threw his arms about her neck, saying, "0, mamma, mamma, 
I never loved you so much before. ' ' 



SEX QUESTIONS 327 

When the mother in whose experience the above episode had oc- 
curred, related it to the writer, he asked her what her boy's attitude 
had been toward motherhood and she replied, "Since the day I told 
him how baby sister came and how he had come, he has seemed to look 
upon motherhood as a sacred relationship." It is the uniform and 
universal testimony of parents who have been telling the storj'- of life 
in this frank, sympathetic, earnest and serious way to their children 
in answer to the instinctive questions of childhood, that the children 
accept these truths as sacred, that they are drawn into a much closer 
and confidential relationship to the parents, that they are protected 
against contamination of the mind by associates of low ideals, and 
that they are also protected against being misled by older, low-minded 
associates into deleterious and depleting personal habits. 

While, as intimated above, the primary responsibility for this 
teaching in early childhood must naturally rest upon the mother, a 
responsibility no less real and serious, though less urgent and imme- 
diate, rests also upon the paternal ancestor and the teacher of the 
young child. The father should reinforce the mother's teaching and, 
in the same spirit in which the mother tells the story of life, the 
father should confirm it whenever the child comes to him seeking con- 
firmation. In no way can the father more positively teach the sacred- 
ness of motherhood to his children than by uniformly showing toward 
the mother the spirit of affection and tender solicitude for her well- 
being and happiness. Such an attitude speaks much more loudly and 
impressively than any words which the father could utter, his personal 
feeling of the sacredness of motherhood. The children instinctively 
catch the spirit of the father and it confirms and fixes indelibly the 
attitude which the mother herself implanted by her story of life. 

The teacher of the child, before that child reaches the thirteenth 
to the fifteenth year, should not be called upon and should not feel a re- 
sponsibility for imparting to the child these great fundamental truths 
of life which it is the inherent right of the child to hear from the lips 
of his parents and which it is the natural privilege of the parents 
to impart direct to their own offspring. However, the teacher does 
carry a very definite responsibility and one which may not be evaded. 
This responsibility comes very naturally with the teacher's relation 
to the home. When we consider that the school is an extension of 
the home and the teacher, so to speak, an extension of the parents, or, 
we might say, ^'vicarious parent," it is easy to understand how 
natural and essential this responsibility is. The teacher is respon- 
sible for two very definite things in the education of the young child 
between his fifth and his fifteenth year. First, the teacher should 
show the same vigilant watchfulness that a mother shows to protect 



328 FJKST NATIONAL CONFERENCE ON RACE BETTERME^^T 

the child against the dek^tcrious iiitluenee' of the occasional pupil that 
is found from time to time in every school, namely, the pupil whose 
home influence has been weak or bad and whose associations have per- 
haps been vicious. Such a child is quite likely to be physically pre- 
cocious and mentally backward and thus be thrown into association 
with children from one to three years younger than himself. The 
influence of such a pupil in a school may be most unfortunate and it 
requires the greatest vigilance and tact on the part of the teacher to 
protect the children against such an influence. First, then, the teacher 
must show all vigilance and tact in protecting the children of her 
school against bad influences. As a rule, this can perhaps be best 
accomplished through such an administration of school sports and 
recreations as fully and completely to occupy the minds of the pupils 
during the hours when they are on the school grounds but not in the 
school room. Thus, again, turning the mind toward the positive and 
away from the negative. 

Second, the teacher should accept every opportunity which pre- 
sents itself to implant in the mind of the child, or we may perhaps 
better say, to confirm in the mind of the child, the same wholesome 
attitude regarding the sacredness of life and the sanctity of home re- 
lationships which she herself holds in her own mind and which she 
may assume has been implanted by the parents in the minds of the 
children. Many an opportunity will be offered the teacher for drop- 
ping a word in harmony with this mental attitude in the course of 
the nature study work. Even in the kindergarten, it is a very common 
thing for the teacher to have a little family of baby kittens, of baby 
rabbits, or baby birds, for the children to take care of and to love. 
While the thoroughly ecjuipped and tactful teacher, who under- 
stands the psychology' of youth, will not make opportunities repeatedly 
to impress "morals" about maternal and filial relationships, the 
teacher may. not infrequently, drop some remark that leaves an in- 
delible impression upon the child regarding these relationships. The 
social ethics of the robin's family, housed in a nest that may be 
watched from the schoolroom window, may set forth in compelling con- 
viction the whole law and gospel of social ethics of human society. 
While, in this teaching, we must take care not to attribute to the 
robins a degree of consciousness and discernment commensurate Avith 
that of the human species, the most conservative biologist must admit 
that the same kind of sentiment which prompts parental care on the 
part of the human mother prompts it on the part of the robin mother 
— that maternal altruism in the human species, while possessing a 
greater element of emotion and a smaller element of the automatic, 
is, from a psychological standpoint, the natural and necessary out- 



SEX QUESTIONS 329 

growth in man of the same thing which prompts the sacrifice and love 
of the robin mother. 

The Nature Teaching, therefore, in the public school affords the 
teacher an opportunity to make an atmosphere about life that im- 
presses the child with the sacredness of all life and with the special 
sacredness of human life and of human parenthood. 

We have now set forth in sufficient detail the character, if not the 
whole content, of the teaching regarding the sex life that the child 
should have up to the threshold of adolescence, which may be taken as 
about thirteen years for the girl and about fifteen for the boy. Just 
before the crossing of the threshold from girlhood into womanhood, 
or from boyhood into manhood, the first lesson regarding the in- 
dividual sex life should be taught to the girl by her mother and to the 
boy by his father. This first lesson is the lesson of womanhood or of 
manhood respectively. 

I. Womanhood or Manhood 

The parent should seek a favorable opportunity for a heart-to-heart 
talk with the youth who is approaching the threshold of adulthood and 
should explain what it means to grow into womanhood or manhood 
as the case may be. The mother, for example, explains to her daughter 
the phenomena of physical and mental development of the girl into 
the woman and pictures womanhood in such vivid and glowing terms 
that it fills the whole soul of the girl with a consuming desire to grow 
into the highest type of womanhood. Then the mother explains that 
this wonderful development of the physical, mental and spiritual 
qualities of womanhood is dominated and controlled by a wonderful 
and magical substance that is prepared in the ovaries of the girl, 
absorbed into her blood and distributed throughout the body from the 
threshold of womanhood, throughout midlife and until the beginning 
of old age. The natural influence and result of this story of woman- 
hood, told to the girl by the mother in the same spirit in which she, 
years before, told her the story of motherhood, is to impress upon 
the mind of the girl, so strongly that it is never effaced, the feeling 
which amounts to a dominant conviction that: HER PERSON IS 
SACRED TO HER WOMANHOOD. 

'This teaching fortifies the girl absolutely against the malevolent 
influences of low-minded, older girls with whom she might, by some 
ill chance, be thrown into association in the school. 

In a similar way, the father should tell his twelve-year-old boy the 
story of manhood and arouse in the youth a consuming desire to grow 
into the highest type of manhood. As a part of this lesson, he should 
reveal to his boy the new-found truth that the development of manly 



330 FIRST NATIONAL CUNFEKENCE OX RACE BETTERMENT 

qualities is caused and ooutrolled in body and mind through the in- 
fluence of an Internal Secretion prepared by the testicles, absorbed 
into the blood and distributed throughout the body. This substance, 
carried into the muscles with the blood, causes these muscles to grow 
big and hard, carried into the brain and spinal cord, lights the fires of 
manhood in the young man's brain and these fires shine through his 
eyes and illuminate his face. When the boy realizes that a substance 
made in his testicles holds the secret of manhood, he is fortified 
against any evil influences to which he may be subjected by his asso- 
ciates. A boy thus instructed is absolutely protected against being 
misled by low-minded associates into destructive, and depleting habits. 
He learns that great lesson of life: HIS PERSON IS SxlCRED TO 
HIS MANHOOD. 

II, Periodicity 

At the time that the youth crosses the threshold from youth into 
womanhood or manhood, respectively, the parents should impart the 
second lesson concerning the sex life. This second lesson consists of 
an explanation of the periodicity of the sex life upon which the youth 
is entering. It is little short of a tragedy in the case of many a girl to 
enter upon womanhood with no explanation of the experiences to 
which she is introduced incident to this new phase of life. Many ques- 
tions crowd into her mind, demanding answer. When no answers are 
forthcoming, we cannot wonder that her heart is filled with rebellion 
at life and its unexplained mysteries. Society, therefore, demands 
that mothers answer frankly the questions that come into the minds of 
their daughters at this period of life. The mother Avill therefore ex- 
plain to her daughter adequately the periodicity of the sex life and 
will further explain that this experience to which the girl is intro- 
duced is her Creator's preparation of her for future motherhood. 
This explanation will control the girl's mental attitude toward woman- 
hood. Instead of rebelling against the experiences of womanhood, 
she exults in its wonders and its possibilities. 

In a similar way, the father explains frankly to his boy the 
periodicity in his life and, in thus explaining, forestalls the worry 
and dispels the fear that would surely come but for the explanation, 

III. ■ Social Relationships 

Early in the adolescent period, say the fifteenth or sixteenth year 
for the girl and the sixteenth or seventeenth year for the young man, 
there should be some very definite instruction on the part of parents 
regarding social relationships. This lesson might very properly be 
given when fifteen-year-old Margaret and seventeen-year-old John are 



SEX QUESTIONS 331 

seated with mother and father about the family hearthstone. It 
will be a very wholesome experience for John to hear his mother in- 
structing Margaret regarding the social relationships, because he is 
just beginning to enter with zest into society. 

The mother will explain to Margaret that in all her social relation- 
ships with her young gentlemen friends, she should have a jolly good 
time, but should permit no familiarities. The mother may well ex- 
plain to the daughter somewhat in detail the reasons why the parents, 
from their broader experiences in life, make these rules for their chil- 
dren, and explain that it is not to debar the children from the enjoy- 
ment of any legitimate pleasure ; that these rules are given rather 
to insure the greatest ultimate joy in life. 

As John hears this instruction from his mother to his sister, he 
very naturally thinks to himself, "My girl friend, Jennie, must have 
received just such instruction from her mother, so it's up to me, if I 
am to be the chivalrous young man that I shall not be ashamed of, to 
treat my girl friend, Jennie, in the way that I would have the other 
fellow treat my sister." 

The parents explain to their children that such common familiar- 
ities as putting the arm about a girl's waist or kissing her — familiari- 
ties which many young people look upon in a frivolous way and carry 
off with a jest — are unfortunate and dangerous familiarities because, 
harmless and innocent though they may be in themselves, they break 
down the delicate self-respecting reserve of the girl and in many 
cases, by insidious advances, lead the way to other familiarities which 
eventually compromise the dignity of the girl's womanhood, perhaps 
even compromise her character. The young people should have it 
very clearly set forth that the only absolute safety for the girl is not 
to permit the beginning of familiarity. 

Let the young people be taught that the embrace is Society's 
Sacred Symbol of Protection and that the kiss is Society's Sacred 
Symbol of Affection. Once that lesson is clearly impressed, we may 
trust the young people to guard even the threshold of familiarity. 

Young people of this age are living over again the impulses and 
the instincts of Chivalry. Instinctively, they acquire a code of honor 
inherited from days of Chivalry : The honor of wommi and a square 
deal among men. Every knight stood ready to drop in his tracks, 
shedding his blood or laying down his life to enforce this code of 
honor. So, the youth of today can be very easily inspired to adopt 
this code of honor and to be ready to fight for it. Most of his in- 
struction in this lesson No. Ill should be positive in its char- 
acter and should seek to inspire in the youth the spirit of chivalry 
and of altruism. 



,>.>L' KIKST XATIONAI- CONFEHENCE l)N RACE BETTERMENT 

The neyjitive side oi" Social Kclatioiisliips should call Ihc attention 
of the young people to certain utiroitunate things in human society 
that must be avoided. Departure i'rom the high ethical standards set 
forth above is uniformly punished. This natural retribution may. 
take various forms, but as the laws of Nature are immutable, so the 
punishment that Mother Nature metes out for the one who breaks her 
law follows absolutely. One of the forms is found in those con- 
tagious diseases which are disseminated largely through illicit social 
relationships. Enough should be told every young person by mother 
and father so that the daughter and the son will realize that the 
breaking of Nature 's laws is sure to bring a punishment in some form. 
This method of instruction puts the matter in its proper perspective 
and links it up not only with the physical and intellectual life, but also 
with the moral life, thus being an important element not only in the 
formation of character, but in the solidification and fortification of 
character. 

IV. Eugenics 

The relation of education in sex to eugenics is a most important 
one. As alreaciy intimated above, , in the introductory paragraphs, 
state laws guarding the licensure to marriage may help some in 
eugenics, but at most, little can be accomplished through state inter- 
vention. Most that may be hoped for in race betterment through 
eugenics must be accomplished through education. This education 
should begin in the later teens, in the case of both the young woman 
and the young man, and, like the other lessons in life, should em- 
phasize, first of all and most strongly, the positive side, though not 
omitting the negative side. 

A — Positive Eugenics 

That young woman who has come to the estate of ripe young 
womanhood at twenty-one to twenty-three years of age, having 
learned all the lessons set forth above from the lips of a loving, sympa- 
thetic, clear-visioned mother, having in many a heart-to-heart talk 
wdth mother received full and adequate answers to the hundred and 
one questions that crowd into the girl's mind, is in a mental attitude 
toward mother easily to be led and guided as to her choice of a 
future life partner. "We may also assume that such a young woman 
sees in her father and her brothers men who help her to accpire a 
high ideal of manhood. Mother and daughter will discuss manhood 
and the elements of ideal, perfect manhood — perfect physically, 
mentally and morally. A girl who has acquired such a high ideal of 
manhood can be trusted not to fall in love with and marrv a man who 



SEX QUESTIONS 333 

falls far short of this ideal. Of course, we must recognize that 
"love is blind." which is simply another way of saying that a young 
woman may be led to ignore many a shortcoming in the man who 
showers attentions upon her and protests undying love and volubly 
promises to reform. The days, however, of the ill-advised mating of 
a perfect woman with a grossly imperfect man, with the hope of over- 
coming his imperfections, are rapidly passing. Her instruction in the 
elements of manhood enables her to analyze, and she instinctively 
stops to analyze before she permits her heart to go out to a man. 

In a similar way, the young man should be taught to recognize 
ideal womanhood and, having made himself worthy of a perfect wo- 
man, to look for one for a wife. 

B — Negative Eugenics 

The preparation of young people for a wise choice of a life partner 
is not complete until they know some of the things assiduously to be 
avoided in this choice of a life partner. Every young person should 
know that there are certain serious impairments, physical or mental, 
that may be transmitted from parent to child, and that there are 
other such impairments that positively will be thus transmitted. 
Among such impairments must be noted INSANITY, FEEBLE- 
MINDEDNESS, DEGENERACY, CRIMINALITY, especially when 
such serious impairments are noted to occur in successive generations, 
— several individuals in each generation. Even though the individual 
in question may seem to be ciuite normal, if he has tAvo or three im- 
paired brothers and if one of his parents and perhaps one or two of 
their brothers and sisters and grandparents, wdth great uncles and 
aunts, have the same impairment sent down two or three generations 
and perhaps more, then the individual in question would make a dan- 
gerous life partner, because without any reasonable doubt the germ- 
plasm of the individual has been impaired, and his children would be 
very likely, and some of them certainly, to show the impairment in 
some degree. If, now, there is a taint on the side of the mother, as 
well as on the side of the father, it is hardly likely that one of their 
children would escape being marked in some way with one or the other 
or both of these family taints. 

Another serious impairment that must not be omitted is venereal 
infection or hereditary venereal taint. Every person choosing a 
life partner should know about the possibility of these above-men- 
tioned taints and should avoid them as they would avoid poison. 

Some have asked how this information will influence a young 
person in the choice of a life partner and will it not destroy senti- 
mentality and old-time love. It is to be hoped that instruction in 



334 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

eugenics will destroy that sentimontalisiu which leads a woman de- 
liberately to mai-ry a man who is absolutely unworthy of her and can 
only bring disease, degeneration and death, and that maudlin, so- 
called love which is blind to imperfections that are so glaring that 
they might be seen through opaque lenses. What instruction in 
eugenics will accomplish is to establish psychic inhibition at the thresh- 
old of love, so that on meeting a young person of the opposite sex, 
however attractive and agreeable that person may be, the one in ques- 
tion does not at once go out in unquestioning, blind love-at-first-sight 
that was so common in the days of our fathers, but will experience a 
"psychic inhibition;" in other words, there will be an instinctive hold- 
ing back or hesitation on the threshold of love to ask if all within and 
beyond is favorable. Is the admired one in good health and does he 
(or she) possess the qualities of ideal manhood (or womanhood), and 
has he (or she) a parentage free from hereditary taints. These 
questions answered affirmatively, the questioner steps boldly across 
the threshold and enters into an unreserved love. 

Summary 

Race Betterment depends upon the two biological factors: 
Heredity and Environment. One of these is as important as the 
other; and each is all-important. Both of these factors may be 
guided, assisted and controlled by two forces: State Lav^s and Edu- 
cation. 

Important as is legal control of marriage licensure, that control 
can hardly accomplish more than to forbid marriage to the grossly 
unfit; but stopping the breeding of the unfit can never uplift the 
race; it can, at best, mily arrest race decadence. 

Race Betterment can be accomplished through Education only. 
While this education culminates in a course of instruction in Eugenics 
during the mid-adolescent period, the foundation of this education 
must be laid in Childhood and Early Youth. 

The object of this teaching is: (I) To give a ivholesome viewpoint 
of the great, sacred truths of life; and (II) To give high ideals to- 
ward which to strive. This teaching is Home work and for the parents 
to do. 

But, as the school is an extension of the home, and the teacher an 
extension of the parent, so the teacher must cooperate tvith and 
supplement the honne instruction and in the school must foster the 
wholesome viewpoint and must establish HIGH ideals. 

Education should cover the following lessons: Motherhood and 
Fatherhood; Wotnanhood or Manhood; Periodicity; Social Rela- 
tionships and EUGENICS. 



SCHOOL AND INDUSTRIAL HYGIENE 

SOME CHANGING CONCEPTIONS OF SCHOOL HYGIENE 

Ernest Bryant Hoag, M.D., Ijecturer in Leland Stanford University and 
General Director of Child Hygiene in the Long Beach City Schools, Cali- 
fornia. 

School hygiene, as an organized scientific study of the school child 
and his environment, has engaged the serious attention of school ad- 
ministrators for a period of less than fifteen years/**" 

We are accustomed to say that health work in schools began when 
the schools of Boston, New York and Chicago organized so-called 
''Medical Inspection" between the years 1894 and 1897; but this Is 
not strictly true, for sporadic attempts to improve school health con- 
ditions had been made in various places at periods much earlier than 
this. For example, in Minnesota, where the secretary of the State 
Board of Health encouraged a study of the eyes, ears, periods of sleep 
and general physical appearance of university students, normal school 
students and pupils in certain public schools, as early as 1878; in 
Boston, where studies in anthropometric measurements were long ago 
instituted by Doctor Bowditch; in Elmira, N. Y., where the health of 
children in the schools is said to have received some specific attention 
as long ago as 1876 ; and in Minneapolis, where Dr. Frank Allport 
organized systematic examinations of eyes and ears of school children 
in 1888. Doctor Allport 's work was unquestionably the most impor- 
tant and far-reaching in its influence of any of the early attempts in 
school health supervision, and it is a matter of considerable interest 
that to this day he is in the vanguard of school hygienists. 

Most of the early efforts to improve the health of pupils in the 
schools were directed toward the recognition and control of the trans- 
missible diseases of childhood, with the notable exceptions of those, 
of Doctor Allport and one or two other pioneers in the field. 

After 1898, however, a broader conception of Medical Inspection 
developed and it was soon recognized that important as is the control 
of contagious disease among pupils, as a matter of plain fact this is the 
least of the many problems of school health. Children who under the 
old method of inspection were passed as satisfactory were found 
in many instances, under the new health conception, suffering from 
serious defects of sight and hearing; from defects of the nose and 
throat; from nervous disorders and nutritional disturbances; from 
defects of the mouth and teeth; from functional and organic heart 



330 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

disturbaiu'es; and last, but far fi'oni least, from tlic various dcji'rees 
of actual mental deficiency. 

At first the medical officer in schools was an appointee of the 
local Board of Health and his function was naturally regarded largely 
as that of a public health official or inspecior. Today the health 
ofificer in schools is, in the most enlightened communities, looked upon 
as a Specialist in Child Hygiene and School Sanitation, and his func- 
tion is therefore regarded as that of a school official interested in im- 
proving the personal health and health environment of the school 
child. To this end his interests are related to those of Boards of 
Education rather than to those of Boards of Health, although there 
must be, of course, a close relation and effective cooperation betM^een 
these two important bodies. 

Formerly, and to a considerable extent at present, school health 
officers were chosen without any particular regard to special fitness. 
In many instances they were, and are still, men who have passed the 
age of active usefulness in practice or men who w^ere beginning their 
practice and therefore had abundant time to devote to the work; in 
both instances the schools usually received ineffective service for 
reasons which require no special elucidation. 

THE MEDIC.VL OFFICER IN SCHOOLS 

There is no general agreement in respect to the qualities necessary 
for school medical officers. Many communities appoint almost any 
physician who has a fair standing, without reference to his special 
training or aptitude. In some places men or women have been ap- 
pointed as school health officers who have had no medical training of 
any description. 

As a matter of fact the position of school health officer in the 
United States has never been standardized. As conditions now exist, 
we find the following types of health officers in schools: (1) well- 
trained, full-time medical officers; (2) well-trained, part-time medi- 
cal officers; (3) well-trained, emergency medical officers; (4) in- 
adequately trained medical officers in divisions 1, 2 and 3; (5) hy- 
gienists without medical training on part or full time; (6) physical 
directors who include health examinations as part of their duties, 
and who may or may not possess medical training; (7) full-time 
nurses who make examinations; (8) part-time nurses who make 
examinations; (9) principals or teachers who make partial tests of 
physical conditions. 

Whether a community employs a medical officer for part or full 
time is a matter of secondary importance compared with competency. 
In England school health officers must show preparation for their 



SCHOOL AND INDUSTRIAL HYGIENE 337 

work; but very few physicians in this country have had any special 
training in school hygiene. Well-trained physicians may, however, 
easily acquire the special training necessary. A physician whose 
preparation has included the usual academic branches and thorough 
work in biology, general hygiene, physiology, chemistry, physics, 
pathology, and bacteriology, need find no special difficulty in rapidly 
acquiring the details of child and school hygiene; nor will he in 
every instance need for this purpose attendance upon special courses 
of instruction, desirable as the latter undoubtedly are. 

Such a physician must, first of all, possess aptitude in handling 
school children ; second, he must understand and be in sympathy wit'i 
modem pedagogical problems ; third, he must possess diplomacy in 
handling all sorts and conditions of people. 

The special knowledge of school hygiene and of pedagogy he may, 
if need be, acquire through an acquaintance with the now abundant 
literature on these subjects; the other qualities he must naturally 
possess, for he can never acquire them through study alone. 

A community, then, in selecting a school medical officer, should 
seek a cultured physician whose training in the fundamentals of 
medical science has been adequate and who, in addition, possesses 
aptitude and enthusiasm for the work and a willingness to suppl>' 
any deficiency he may have along special lines. Having standardized 
these general qualifications, most other matters will be found to con- 
sist of small details of administration. 

Large communities, requiring full-time men at adequate salaries, 
have a right to demand special and somewhat prolonged training, for 
child and school hygiene is truly a specialty. Ordinarily such training 
will not be acquired in less than one year in addition to the usual 
four-year medical course, or six-year "combined courses." The 
possession of a Doctor of Public Health degree, such as has long been 
given in England and is now given at Harvard, the University of 
Michigan, and the University of Wisconsin, \^'ill furnish evidence of 
the highest specialized training and is certainly most desirable when it 
can be obtained, for school hygiene is after all only one phase of 
public hygiene. 

Having agreed on the main principles which should underlie the 
appointment of a school health officer, certain details of administration 
should be considered. 

1. The school health officer should in the larger places be con- 
trolled by the board of education. 

2. A cooperative plan whereby the board of education and board 
of health jointly control school hygiene may be desirable for special 
local reasons. • 



338 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

3. School health officers may be provided by conibiniiii^' the posi- 
tion of town or small city health officer with that of school health 
officer, in Avhieh case the expense may be shared by the board of 
health and board of education ; the appointment may be made by the 
former board with the approval of the latter. This is an excellent ar- 
rangement for large towTis and small cities. It has worked out 
admirably in the city of Rochester, Minn. 

4. County health officers, if properly qualified, may be appointed 
as school officers as well, and in this joint capacity supervise the school 
health of a village or a whole county, according to the population and 
distance involved. This will often solve the problem of hygiene in 
rural schools. 

5. The compensation for a school health officer maj^ be based upon 
the time required of him and upon the amount of his responsibility. 
A full-time officer should receive from $2,500 to $5,000, according 
to the size of the community.* A part-time officer may be paid for 
one-half of every school day from $900 to $2,000. In some instances 
where, for example, one man is responsible for the entire health super- 
vision of a rather large community, as in Pasadena and San Diego, 
Cal., the salaiy should be from $1,600 to $2,000.t Where less than 
half of everv' day is required, it is advisable to base the remuneration 
upon the number of pupils examined, and not less than 50 to 75 cents 
should be paid for each examination. At this rate a town with a school 
population of 600 pupils should pay from $300 to $450. Any com- 
munity^ with less than 1,800 pupils would do well to adopt the per 
capita plan of payment as a basis for salary. Voluntary or cheaply 
paid ser\ace is never advisable. It invariably fails after a com- 
paratively short trial. 

6. Large cities should employ a director of school hygiene and 
several assistant directors on full time. A few half-time men may 
be required, but in general the work of half-time men in large cities 
will be better done by full-time school nurses. 

7. School health officers should familiarize themselves with the 
following divisions of school and child hygiene: (a) Transmissible 
diseases; (b) school sanitation; (c) physical defects; (d) mental 
defects; (e) dental hygiene; (f) the teaching of hygiene; (g) ju- 
venile delinquency; (h) retardation; (i) school hygiene literature; 
(j) the elements of school architecture. 



* Oakland, Cal., pays $3,600 ; St. Louis, Mo., pays $3,500 ; Milwaukee, 
Wis., pays $3,800; Minneapolis, Minn., pays $3,500. All of these salaries 
are too low for the service given. 

t Pasadena pays $1,700; San Diego pays $1,800. Each of these cities 
should pay $2,000." 



SCHOOL AND INDUSTRIAL HYGIENE 339 

The position of the health officer in schools must uo longer be re- 
garded as a cheap job for a cheap man. Schools which are satisfied 
with inferior officers and teachers will no doubt be satisfied with in- 
competent medical officers. Progressive schools will appoint only 
well4rained medical officers who are worthy of the respect of the 
communities in which they live. American school communities may 
well study the subject of school health supervision as carried out in 
England, Germany, Denmark, and some other European countries 
where the matter has long ago passed the experimental stage. There 
a school health officer is treated with at least as much deference as the 
school superintendent or head master. 

The new conception of the school health officer, then, is that he 
shall be a specialist carefully trained in the problems of child hygiene 
and particularly as this applies to the school child; one who can 
command the full respect of the community in general and of the 
medical profession in particular. 

The child hygienist occupies a new field and his work makes neces- 
sary the recognition of a new profession. Until this idea is fully 
grasped by those in authority in schools we shall continue to have, as 
in the past, a very large number of more or less incompetent medical 
and other health workers in our schools; we need not experience sur- 
prise if under these conditions school health work often fails to secure 
the support of local communities and the medical profession in them. 
The modem school health officer must be in a position to demand the 
same degree of professional respect which is accorded to other special- 
ists in either the medical or educational professions, and only those 
who have properly prepared themselves may justly make such de- 
mands. 

SOME OP THE FUNCTIONS OP THE SCHOOL HEALTH DEPARTMENT 

The division of school hygiene should include in its functions not 
only the health supervision of school children and the maintenance 
of a healthful school environment, but also such subdivisions as the 
following : 

1. Supervision of the teaching of hygiene. 

2. Supervision of the health of teachers. 

3. Supervision of physical education. 

4. Maintenance of a central office for special examinations and 
consultations with parents. 

5. Maintenance of a central laboratory for the study of excep- 
tional children, especially those who are retarded and mentally sub- 
normal.* 



3-10 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

6. Supervision of a i)iiblie lecture ilepurtiiient for i)arents, wlierc 
topics ou the home and school hygiene of the child may be presented. 

7. Instruction of teachers on the subject of the physical and 
mental observation of children. 

A school department of hygiene organized on a basis such as this 
will be recognized as one of unquestionable general utility instead 
of one of restricted and often questionable usefulness. In such a 
department all factions in a school community may discover work 
with which they can sympathize and cooperate, while in the narrower 
work of mere medical inspection there will always be many who are 
either apathetic or positively antagonistic. It will be recognized by 
all that work organized on such a basis is primarily educational in 
character and designed to directly promote the educational oppor- 
tunities of the entire school system. In such a plan no one function 
is emphasized at the expense of another, but to each is accorded only 
its legitimate field of usefulness. 

The latest and perhaps the most important development in school 
hygiene is that which relates to the study of the "Exceptional Child." 
Children who belong in this somewhat vague classification may for 
purposes of convenience be grouped as follows : 

1. Retarded children of all classes (including defectives). 

2. Unusually nervous children. 

3. Dull children (not necessarily retarded). 
•4. Precocious children. 

5. Delinquent children. 

6. Peculiar children who cannot always be specifically classified 
(border-line cases). 

The proper study of children included in the above list requires 
some special training in psychological procedures, which cannot at 
present be required of every school iiealth official. Every large, 
well-organized school health department will, how^ever, include this 
division and provide a well-trained person to carry out the work, as 
is now done in Los Angeles, Philadelphia, Milwaukee, Minneapolis, 
Grand Rapids, and a few other cities. Smaller places nnist usually 
content themselves wdth a less comprehensive plan. 

In every community, however, which essays serious health work, 
some provision should be made for a study of exceptional children. 
This may often be accomplished by placing the work in charge of a 
teacher who has had previous opportunity to follow courses in child 
study and applied psychology under competent and experienced 
teachers. 



SCHOOL AND INDUSTRIAL HYGIENE 341 

The Vineland School under Doctor Goddard has for some time 
offered limited courses along these lines for teachers, and many have 
already availed themselves of the special privileges it holds for them. 

That there are many defective children in our schools, most of 
whom are unrecognized as such, has become apparent since the Binet 
intelligence tests have come into common use. Not less than one per 
cent and probably nearly three per cent of the children in the average 
school system are beloAV normal in intelligence as evidenced by the 
use of the Binet Scale, and this to a degree which unfits them to profit 
by the usual school methods. It is of the greatest possible importance 
to clearly distinguish between the merely dull and the defective child ; 
between the morally delinquent and mentally defective ; between the 
mis-fit or specialized defective and the intellectually subnormal; yet 
this is rarely done in our schools today. About forty per cent of our 
twenty million school children are retarded one or more grades, and 
fifty per cent of our children never pass beyond the sixth grade ; yet 
comparatively little is being done to discover the real underlying 
causes. That to a considerable extent this situation is due to mental or 
physical peculiarities, or both, no one of much experience in school 
hygiene has any serious doubts. 

The new conception of child hygiene involves the adaptation of 
the school to the child instead of vain attempts to force the child to 
fit the school, as has been the usual custom in the past. When this 
new field in child hygiene becomes well established in our public 
schools, they will not only be relieved of a tremendous drain upon 
their daily efforts, but a large sum of money will be saved every year 
in avoiding the expense of carrying over hopeless repeaters. This 
sum might well be expended for the special education of certain sub- 
normal pupils who at present receive no profit in school and go out 
into life to become the wards of society. 

School health work needs standardization and standards ought 
to be furnished by the state. Minnesota, and to a limited extent, 
Virginia, are the only states which up to the present have attempted 
to furnish such standards. This state work in school hygiene ought to 
be carried on either by the State Department of Public Instruction or 
State Board of Health, or by the cooperation of these two bodies. 
The latter plan is probably the most desirable and was found to work 
out admirably in Minnesota under the able management of Dr. H. M. 
Bracken and Superintendent Schulz. ]\Iichigan has (1914) under- 
taken a limited amount of work along similar lines by the employment 
of a specialist to make a tour of some of the most important parts of 
the state, in connection with the Department of Public Instruction. 



342 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

This is iu fact the ''Century of the Chikl," and the phrase— 
"the child is our greatest natural asset" is fast becoming recognized 
as one of fundamental truth instead of one of rhetorical effect. The 
public schools are in some respects, as has been recently said, guilty of 
more wastefulness and less effective results than any other public in- 
stitution. Yet there is no real cause for alarm, for the evils of our 
public school system have come to light and no class of people appre- 
ciate them fuller than the school people themselves. Our public 
schools will indeed become the real as well as the rhetorical ' ' bulwark 
of the nation" just as soon as the public will grant the officials and 
• o;?.che!.^ the power, privilege, and financial support which they so 
n'hlv ...eserve. 



THE RACE BETTERMENT MOVEMENT IN WOMEN'S COLLEGES 

Dr. Carolyn Geisel, Shorter College, Rome, Georgia. 

If Race Betterment is to mean anything at all to the great, wide 
world, it must begin with education for her who has to do with the 
race in its infancy. Allow me to put to you a conundrum. Let me 
put it in approved twentieth century phrasing. Why is a college? 
Now let me answer my own conundrum. - A college is for the same 
reason as is a grindstone, if you please, just to sharpen the instrument 
that touches it. The college should make fit for use, make fit for its 
place in the world, that which comes in touch with it. Do the colleges 
do this? All the colleges in the world? Please understand I am not 
making a sweeping statement. I do not mean that colleges as a whole 
are inefficient, but I want to ask this audience, if, generally 
speaking, the colleges do what the colleges are expected to do? Let 
me illustrate. Do you know Mr. Tilden ? I knew him when he was a 
boy and I a short-skirted girl. He said, ' ' I am going to do something 
before I die, ' ' and I answered, ' ' If you are, get about it. ' ' Later when 
as college woman I met him, the college man, I asked, ''What has be- 
come of that you intended to do?" He answered, "I am doing it. I 
am getting ready, just wait."- And she is in this audience who was 
with me at the Streator Illinois Chautauqua when there was put in 
my hands a long newspaper excerpt, detailing the work this man 
Tilden had done. In eleven years of time in one of the largest uni- 
versities of this great world, a university backed by millions of money, 
he had pursued an idea. Curious to know what he did ? Then let me 
ask you, Are you fastidious? Would you like just one stripe on the 
backs of your potato bugs ? Well, Tilden can tell you how. And you 



SCHOOL AND INDUSTRIAL HYGIENE 343 

don 't care ? You are willing to leave ten stripes on yours ? All right, 
Tilden can tell you how. In other words it took him eleven years of 
time with the backing of one of the world 's greatest universities, which 
in turn was backed by millions of money, to find out how to vary the 
stripes on the backs of potato bugs. I read it all, and this leaden 
thing in here you call a heart went away down in my shoes with a 
thud, and my woman's soul cried out to the God of things as they are, 
for eleven years of time and for the backing of some great university, 
with millions of money, to teach us women folk, wh© are mothers of 
men, how to vary the stripes on the backs of the two hundred and 
forty thousand criminals in these United States of ours. They are our 
sons, born of women — ours. A woman goes almost to the door of 
death to bring back a man child and then the world takes him, and at 
the end of twenty-one years, when a mother's part of the work is over, 
he is already marked for the penitentiary mayhap and a man 's place in 
life is vacant and a mother 's heart is broken. Could she have changed 
his stripes, and saved her own soul from sorrow, if she had had eleven 
years of college training? Is there some possible wrong when a 
college no better prepares for real life or teaches that Avhicli concerns 
real life than the problem I have just presented to you? Was the 
world ever robbed of a man, and a criminal made from an innocent 
babe, because some mother woman lacked that education which made 
wise Tilden able to change stripes? 

Of the colleges for women here in America it is but a few years 
since these were of two sorts, two only, and neither one paid any par- 
ticular attention to preparing the real woman for a woman's real 
life. Again I am not making sweeping statements. Bear with me. 
I do not wish to be understood as saying that all women in all col- 
leges receive no education that is adequate, nor yet am I saying that 
all colleges for women are inadequate. Speaking generally there are 
two sorts of colleges for women in these United States of America 
(away back in the years women had some difficulty getting into any 
at all). The first of these colleges is the co-educational institution 
which gives to women folk the same kind of education our brothers 
receive. What shall we do with this education when it is finished and 
we have our degrees ? Do with it what i did, of course. You know 
what they used to call us at Ann Arbor? Some of you are here from 
Ann Arbor. You know perfectly well that my Alma Mater used to 
speak of us as "female medical men." We cut our hair short and 
strode up and dow^n the great big world, burned our books upon home 
and motherhood and let the problems of race betterment be handled by 
someone else than the mothers of men. We would have none of it. 
Why not ? — Because we were educated for commercial life ; the kind 



344 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

of (Hluciitioii our brothers received, sent us wlici'e our brothers went, 
into tlie connuereial tield and nowhere else. 

The second kind of school for women was familiarly known as the 
"finishing school," the "female seminarv^" Now don't you mis- 
understand me, again, I am literally quaking in my shoes lest you do ; 
all the colleges for women are not of the "finishing school" sort, but 
there does exist in this great United States of America, as in other 
countries, a so-called finishing school, of a rather superficial sort, to 
which we send our girls, some of us, sometimes. They learn to dance, 
oh, yes. of course! Learn to jibber French and German, of course! 
Learn to read Greek and Latin limitedly, to sing in Italian, to paint 
on china, on canvas, and on flesh; and decorate their bodies after 
the approved fashion, and when you get your daughter back from 
that school, my brother, she is finished, indeed. xVt medical banquets, 
which you sometimes attend, you repeatedly hear this one toast of- 
fered to women, "Woman, God's greatest gift to man and the chief 
support of the doctors. ' ' Is she so prepared for her holy place in life, 
the place of motherhood, which is the very tap-root of all race better- 
ment? Prepared! Of course not. She may give her life with the 
first attempt at motherhood, and if she gives not her life, she some- 
times brings back from the grave, which she so nearly entered, a 
weakling child which for one transcendent, rapturous minute she holds 
close to her woman's heart. Holds it there with feeble hands that 
tremble with ecstatic joy, then lets it slip away into its little grave. 
We buried in the United States of America last year so many little 
wee new babies that their graves, if brought together, would carpet 
this beautiful state of Michigan. One out of every two of all the 
children born of woman, die before they are fully mature. Tell me, 
if one out of every two of the hogs that come to be — let me say that 
again so you will hear me — if one out of every two of all the hogs 
that are bom were to die before they matured, would not every man in 
the stock-raising business go squarely out of the hog business? 
Of course he would. He would be simple and nothing short of it to 
remain in a business which promised him such limited returns. Are 
we, then, of less mental capacity than our brothers that we are simple 
enough to continue in the business of race nurture when the whole 
world taunts us because of limited returns ? Woman did not get her 
life-work by her own choosing. She was appointed by the Great I 
Am to this business of raising men. It is a stupendous task! An 
awful job ! It takes twenty-one years of a mother 's life ; then when 
the mother's part of it is over, she surrenders the unfinished piece 
into the hands of a wife. It takes at least two women to raise one 
good man, his mother and his wife. Sometimes it takes more than 



SCHOOL AND INDUSTRIAL HYGIENE 345 

one of the latter. What has all this to do with the race betterment 
movement? What has it all to do with colleges for women? I shall 
have to talk rapidly now. 

It is well-lmown to all of you that many schools and colleges where 
women go to get learning have for some years been teaching Domestic 
Science, Physical Culture, Sanitation, Hj^giene, and here and there 
one is teaching Eugenics, and in the fall of 1913, Bryn Mawr is said 
to have declared for health as of first importance. But this, good as it 
is, is not enough. As the agricultural college prepares the farmer for 
a farmer's life, the business college prepares the business man for 
business, so should the woman's college first of all prepare a woman 
for a woman's life. All or any education added thereto can in no way 
be injured by such firm foundations. 

Ninety per cent of all the women in the world marry. 

Marriage should mean home-making. Marriage and home-making 
should mean motherhood. Countless and pitiful are the tragedies of 
the unprepared. 

For more than ten years I have gone up and down this land of 
ours, in schools, colleges, Chautauquas and wherenot, crying out for 
a college that would definitely teach a woman her own business. Why 
not? 

Two years ago this month I went to Shorter College, in Rome, 
Georgia, to fill an engagement which Doctor Kellogg had made. I 
was to talk Health and Eace Betterment to the women students as I 
had talked it to hundreds of others. The president, faculty and 
trustees listened, then the president said, "Come with us" and the 
trustees said, "You belong to this college and the college belongs to 
you." So was established in Shorter College, at Rome, Georgia, the 
first endowed Chair of Health in an American college for women. 
Then the title ' ' Chair of Health ' ' seemed not comprehensive enough. 
We decided to make it a Chair of Health and Home Economics with 
the avowed purpose that I have stated. Mr. Chairman, I do not in- 
tend to die until this movement for definite education which means 
Race Betterment is put into every college in the United States of 
America. 

The plans for procedure, the purposes and aims of the department, 
are two: First, to build a strong body for the student herself, to 
definitely establish her in health so firm that when she leaves college 
she will not be the "chief support of the doctor" but instead, a 
balanced, strong unit in the support of this liberty-loving government 
of ours, of which, we trust, she will by that time be a full-fledged 
citizen. 



346 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

The second plan of procedure in llie work of the department is 
to give the student such complete knowledge of Health and Home- 
making as will secure strong bodies to her family. 

The first — the establishment of the student in healtli — is to be ac- 
complished by systenuitic living of health principles during the four 
years of her college life. The second by scientific study of Health and 
Home-making, which study is definitely recjuired as part of the curricu- 
lum. She will be expected to follow six practical lines which lead to 
health. 

1. Scientifically ordered diet — arranged by a graduate dietitian. 

2. Systematic exercise and a due amount of rest — directed by a 
physical trainer. 

3. The out-of-door life. 

4. Healthful dress. 

5. Avoidance of self-drugging; the use of rational remedies for 
diseased conditions under supervision of a resident physician and 
trained nurse. 

6. Freedom from worry which comes from a living faith in a 
loving God as taught and encouraged by the daily life of the college. 

Does the diet of a young woman of college age need the attention 
of educators? Look you! I can speak feelingly on that subject. I 
went through college on chocolate creams and coffee, and when college 
days were over it took Doctor Kellogg and this institution months and 
months to bring me back from the grave. There are so-called colleges 
in existence right now which daily serve a~bill-of-fare that is just as 
bad as can be. No attempt made at balance and little intelligent 
attention given to nutritive value of the day's rations, while much 
thought appears to be put upon so-called economy. More than one 
girl away from home in school tonight is subsisting on dill-pickles, 
saratoga-chips, chocolate creams and what-not that she buys from the 
little store around the corner. That little-store-around-the-corner takes 
no small part of her money and as a result some doctor among us 
makes a vacant-looking place in her Daddy's bank account later. 
Correct the diet then. 

This department will encourage the out-of-door life. Put the 
student out-of-doors for physical exercise. This does not mean delsarte 
and calisthenics; it does not mean the fancy work of physical exer- 
cise. It means downright hard work — riding, driving, ninning, living 
out-of-doors, studying lessons out-of-doors, deep breathing exercises 
out-of-doors, staying out-of-doors nights as well as days, encouraging 
the out-of-door life. 

Did you notice that I mentioned, as a third maneuver for establish- 
ing this young woman in health, the matter of dress? Awfully sensi- 



SCHOOI. AND INDUSTRIAL HYGIENE 347 

tive point just now. The next-to-notliing with which the twentieth 
centur^^ American girl gow^ns herself is not a poem. We propose by 
the work done in this department to correct a girl's ideals of dress. 
There will then be displayed upon the screen no more such pictures 
as you saw last night with the visceral organs displaced because of 
mischievous constrictions around the middle of the body. There will 
be no more coughs, colds, or pneumonia contracted because of the 
uncoveredness of her — neck. 

When she enters college the student will be examined; examined 
from the cro^Ti of her head to the tips of her beautiful little toes. In- 
cipient disease can sometimes be discovered and corrected by the resi- 
dent physician. Flat-chest, spinal curvatures and other deformities 
of habit will be sent to the gymnasium and trained out. Dyspepsia, 
anemia, and other mischiefs consequent upon indigestion, malassimi- 
lation or malnutrition will be sent to the dietetic department and my 
lady be fed away from disease. 

All that in this four years of college life she is asked to practise 
for health sake, she is also required to study ; and in addition she 
must study sanitation, civics, household management, everything in 
short that is covered by that word Euthenics. The last year in college 
she will spend much time in the model cottage in actual management 
of a household, for a bit of practise helps to make perfect. 

You with much gray in your hair, and you with no hair on top of 
your head — plain proof of life that is passed in part — have talked 
much and wisely of Eugenics, but why not talk all this to her? To 
her who is yet to be wife and mother ? Why tell her when her head 
is bowed in shame over a sacred defective child. All this cannot avail 
to save her after the fatal mistake has been made. In this new depart- 
ment the seniors will study Eugenics. 

And now let me tell you something which she won 't tell. This is the 
girl who will marry, of course she will. You are all acquainted with 
my club? I have the great honor to be president of the A. M. K.'s. 
You know what the club is by the letters ' ' Antique Maidens ' Club. ' ' 
The major number of college women who recruit mj^ club come from 
the co-educational colleges, from the colleges which have educated the 
woman in the same direction or along the same lines of thought as 
the man. Of course this woman is able to live her bachelor life quite 
independently and "she does not care." But the girl educated in the 
college for women alone will marry, if she be educated for the home 
and marrying ; she will be a helpmeet indeed, a mother indeed. All' 
because she has a strong body ? No, not entirely, but because she was 
trained in every single little bit of a thing that can help to make her 
an efficient wife and mother. This is her husiness. Oh, vou are wast- 



348 FIKST NATIONAL CONFKRKNCE ON RACK HKTTKRMENT 

iiig- time! [Applanso] AVon 't you plrasc krrp slill now aiid Id iiic talk? 
I have only a minute more. Hear me! A woman's business to keep a 
home and rear eliildren, that sounds badly coming from an old 
maid who campaij?ned the State of IMiehigan for suffrage last year; 
but in spite of suffrage, let me say it to you again, it is a woman's 
business to attend to that that the Master of Tiife called her to do, 
and God called her to motherhood. Why is she not a mother? Is it 
because, lacking training, she fears her inefficiency? Why is it that 
of one hundred women visited a few weeks ago by my friend, Miss 
Gearing, of Texas, there was found one and one-seventh of a baby for 
each little wife? In New York City I met with a club of fourteen 
women, wives they were, and one baby for the whole fourteen. This 
is the answer given to me when I asked a little woman in that club 
why she was not a mother. She said, lifting her shoulders with a 
shrug. "Why should I tie myself to the drudgery of rearing chil- 
dren ? ' ' Let me answer that. Drudgery goes out when science comes 
in. They called the farm drudgery when it, the farm, could not pro- 
duce corn enough to support the family, but when science with the 
help of this government said to the boys, ' ' Back to the farm, back to 
the farm," and the boys came from the agricultural college back to 
the farm, drudgery disappeared, was swallowed np by science in the 
full joy of returns. So also will science in home-making turn drud- 
gery into delight. WTien she has learned the science of child-culture 
she will return to her own wdth eager joy. 

But the government pays ninety millions of dollars — hard-earned 
tax money, yours and mine — to call the boys back to the farm. When 
has it paid ninety cents to call the woman back to the home? You 
can make a fuss about that if you want to. But unless we call the 
woman back to the home the very foundations of government will 
dissolve away. How^ shall we better the race without home? And 
how shall there be a home without a "female person around." 
The home is dependent upon a w^oman, the children are dependent 
npon her. why the very master of the house himself is dependent 
upon her. 

There died last year fifty-six thousand more middle-aged men than 
ever before, so saith the man of statistics. I don't want all the 
middle-aged men to die. I shall be lonesome. Whose business is it to 
take care of a man? Why the business of her who vowed she loved 
him, the business of her who spends his money. Oh women, listen ! If 
he is nothing in the big world but a money-making machine, it still 
will stand you in good stead to take care of him. You cannot get 
good, efficient work out of a money-making machine unless you have 
first learned what feeds him best, and he has a right when he gives you 



SCHOOL AND INDUSTRIAL HYGIENE 349 

his money to spend, to ask, "Do you know how to spend it wisely?" 
This Race Betterment movement in woman's colleges will teach a 
Avoman the value of a dollar as well as the value of a man, the value 
of things as well as the value of babies, and we dare hope to so reduce 
the high cost of living. 

And now I am done when I have said to you this one thing more. 
Man is not all mind and a college is inefficient so long as it tries to 
train either man or woman in his mental capacity only ; and man is not 
all animal and a college still is inefficient though it train both mind and 
body, for you were created. Oh, friends of mine, in the image of a 
Triune God, God the Father, God the Son, and God the Holy Ghost, 
and you the mental man, the physical man, and the spiritual should 
be nourished by another who loiows Him, whom to know aright is 
light eternal. Hold, then, the babe to the breast of a Christian mother. 
The world may need penitentiaries, but praying mothers keep men 
from penitentiaries and so diminish the need for them. The world 
may need law, but the Law of the Lord converteth the Soul, and 
needs not to be enforced by the police. Let a Christian mother hpld 
her child close to her, as the Catholic church would keep him close to 
itself through the first, malleable, impressionable seven years of his 
life, then let him go from his praying mother's knee out into the 
school, out into the world, and by and by to his place as man among 
men. He will have nursed from her breast that which will bind him to 
God and thereby shall the Soul of him be kept. Give us then colleges 
for women that shall teach a woman all that pertains to her oaat:i busi- 
ness and you have solved the Race Betterment problem. 

Oh, I thank you. You have behaved beautifully. I thank you. 

College Courses in Euthenics 

Mrs. Melvil Dewey. 
Discussion. 

We are told that the educational forces pull up from the top ; the,y 
don't push up from the bottom. Mrs. Richards' idea for Euthenics, 
this right living, should be in the course of study in the colleges and 
universities under this name. Then we will have these college-trained 
people, and they will be fitted for teaching in the normal schools. 
What has been done today in the normal schools to prepare teachers 
for this kind of instruction ? That is the place that we are going to 
get it, if at all — ^j^our colleges, universities and normal schools, and it 
will come down and pull them right up. 



350 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

FACTORY degeneration- 
Rev. Newell Dwight Hillis 

Pastor Plymouth Church, Brooklyn, N. Y. 

I hnve been asked to speak on the causes of tlie deterioration of our 
factory classes. ]\Iore than one hundred years have now passed by 
since tools and machinery began to influence the physique of the in- 
dustrial Avorkers. During this century the handful of operatives has 
become an anny. With the increase of tools has come the congested 
populations, crowded about the great centers of Manchester and 
Birmingham, of Lawrence and Lowell, Fall River and New Bedford, 
and of the tenement region of New York. Now that long time has 
passed, the experts and physicians have had time to assemble the facts, 
and to find out what is the influence of the factory life upon the 
American physique. From time to time scientists have lifted up the 
voice of warning and alarm. The most striking portrayal of the 
perils of the English and American physique was that made by 
Prof. Alfred Eussell Wallace, who has just celebrated his ninetieth 
birthday. Sharing with Charles Darwin the honor of discovering 
evolution. Professor Wallace has lately received many and signal 
honors from scientific societies. At the dinner given him in London 
his address Avas largely made up of reminiscences. He reviewed the 
progress of civilization during the last century and made a series of 
brilliant and startling contrasts between the England of 1813 and the 
world of 1913. He affirmed that our progress is only seeming and not 
real. Professor Wallace insists that the painters, the sculptors, the 
architects of Athens and Rome were so superior to the modern men 
that the very fragments of their marbles and temples are the despair 
of the present-day artists. He tells us that man has improved his 
telescope and spectacles, but that he is losing his eyesight ; that man 
is improving his looms, but stiffening his fingers ; improving his 
automobile and his locomotive, but losing his legs; improving his 
foods, but losing his digestion. He adds that the modern white slave 
traffic, orphan asylums, and tenement house life in factory towns make 
a black page in the history of the twentieth century. 

THE ENGLISH REPORT 

Professor Wallace's views are reinforced by the report of the 
commission of Parliament on the causes of the deterioration of the 
factory class people. In our own country Professor Jordan warns us 
against war, intemperance, overworking, underfeeding of poor chil- 
dren, and disturbs our contentment with his ''Harvest of Blood." 
Professor Jenks is more pessimistic. He thinks that the pace, the 
climate and the stress of city life has broken down the Puritan stock, 



SCHOOL AND INDUSTRIAL HYGIENE 351 

that in another century our old families will be extinct, and that the 
flood of inuhigration means a Niagara of muddy waters fouling the 
pure springs of American life. In his address in New Haven Professor 
Kellogg calls the roll of the signs of race degeneracy and tells us that 
this deterioration even indicates a trend toward race extinction. 
From every side come warnings to the American people. Books 
and magazines, fresh from the press, tell us plainly that our people are 
fronting a social crisis. Scarcely a single city in our land that is not 
conducting an investigation of the police and exposing the social evil. 
A wave of immorality has swept over the country. It is the subject 
of conversation in the street cars, in the office and store, and at the 
family board. Such authorities as Doctor Kelley, of Baltimore, and 
Dr. W. W. Keen, the great surgeon, of Philadelphia, find the ex- 
planation of this singular breakdown in and decay of morals, first, in 
the incoming of the Huns and Vandals, with the low ideals of the Old 
"World, and second, in the breakdown of character among our wealthy 
classes, with their debauchery, their divorces and their unending 
scandals, that lie like a black stain across the page of each morning, 
paper. To all other causes we must add the influence of a group of 
degenerate authors and, worst of all, of authoresses. Sinclair says: 
"What we call prostitutes are not the worst, but generally the best 
of the poorer classes ; people of fine physique, who cannot get their 
true match in the sphere where they were born, and must, by the 
holiest of all instincts, that of truth, seek upward by any means." 
A popular American actor has had so many wives that he now speaks 
of them by number, and recently defended American women against 
an attack of a Frenchman by saying that ''in his experience nearly 
all American women made good wives." He calls this loose and in- 
discriminate epoch ' ' a new experiment in living. ' ' Stanley found in 
Africa a brilliant spider that spread itself out like a flower, and 
beauty-seeking insects, lighting upon it, found, not honey, but fetters, 
pain and death. In every American city there is a black quarter and 
above those streets should be written Dante's words, "Abandon hope 
all ye who enter here. " The time has fully come for the public school- 
teacher, the editor, the lecturer, the physician, the parent and teacher 
to end this guilty silence and to lift the wreath from that diseased hag 
named Lust, that has so long masqueraded as an angel of light. For the 
individual and the nation it is true that "he who soweth the wind 
shall reap the whirlwind." 

SIGNS OF RACE DEGENERATION 

The wise man always studies the signs of his time. Our experts 
are our ph^^sieians and scientists who have had an opportunity for 



352 FIUST NATIONAL CONFEUENCE ON RACE BETTERMENT 

observation. 'Phe Knylisli author, Prof. Watt Smith, tells us that 
in ]8i;5 the English standard for admission to the army was si.\ feet; 
in 1845, the standard was dropped to five feet six inches; in ^SS'^, 
it was lowered to five feet three inches, and in 1901, to five feet. The 
connni.ssion of the English government, appointed to study this sub- 
ject, says on page 177 of its report: "In England degeneration is 
especially manifest in Manchester and other manufacturing districts. 
The police force is largely recruited from country districts, it not 
being possible to find men who are large enough in Manchester and 
Salford." Now comes the report from the recruiting department of 
England that "sixty per cent of the young men who offered them- 
selves as volunteers for military duty were rejected because of physical 
unfitness." In our own country, the condition is no better. The 
New York Bureau of Municipal Research has published its examina- 
tion of 1,500 school children in the Bowery district, and only seven 
per cent of these children had perfect sight, hearing, teeth and heart 
action. One of the first signs of the breakdown of a race is the in- 
crease of digestive disorders and the birth of children with, poor 
teeth. When the mother has all the life and blood she needs for her- 
self, the excess goes to build a perfect babe. In Cambridge, England, 
only one per cent of the children of eleven years of age had perfect 
teeth, yet the teeth taken from a plague pit into which the bodies 
were cast after the black death of two centuries ago show^ed that the 
deterioration is not only marked, but appalling. Another sign of the 
breakdown of our people is the alarming decrease in the birth-rate, 
and even of the women that bear children Doctor Holt says "three 
out of four born in the homes of the well-to-do classes must be fed at 
some other fount than the maternal breast." 

THE INCREASE OF INSANITY 

More alarming still is the increase of nervous diseases. Modern city 
life is very taxing. The fast pressure breaks down the heart and the 
arteries. Unable to keep up, young men stimulate, and this excited 
condition of the young father reappears in the nerves of his babe. 
Dr. Forbes Winslow, one of the great authorities on the brain and 
nerves, tells us in an article in the London Times, that, in his opinion, 
' ' the entire English race is destined to become insane. ' ' Doctor Kellogg 
quotes from the report from the superintendent of the insane asylum 
in Austin, Texas, and shows that both in New York State, at the one 
extreme of the country, and Texas, at the other, "every time the 
population doubles, the insane and defective people quadruple," so 
that it is oi^ly a question of a little time when the crazy people will 
"break out of the asylums and put us in." Constant excitement and 



SCHOOL AND INDUSTRIAL HYGIENE 353 

oyerwork are breaking down that wonderful engine named the human 
heart. Three times as many people die from diseases of the blood- 
vessels as died ten years ago. Life insurance men have made a 
singular discovery. It has been found that during the last century 
the average life has increased from thirty-three years to forty-two 
years, that singularly enough the gain has been through the saving of 
the lives of children, while the expectancy of life after forty years, 
instead of increasing notably, decreased. But Doctor Kellogg tells us 
"that the real measure and the physical vigor of a race is not the 
age at which the average man dies, but the proportion of individuals 
who attain great age." The time has gone by when Ave can any 
longer say that race degeneracy is simply a bugaboo created by pessi- 
mists and alarmists. The simple fact is, a tide of degeneracy is rolling 
in upon us, and the time has come to recognize the fact that unless 
drastic measures are taken, the whole standard of civilization will 
have to change in order to avert race extinction. 

THE NEMESIS OF NATIONS 

History is God's judgment day. Our earth is the graveyard of the 
races. In terms of the eternity of God, great nations fade like a 
leaf, to be blown up and down the long aisles of time. Witness 
Germany and England ! More than 1.200 years ago alcoholic liquors 
were discovered by the forest children. These early people did not 
know how to drive out the fusel oil with other poisons. Nitric acid 
bums the hand and fusel-oil whiskey the stomach. The law of the 
survival of the fittest began to work. Historians believe that nine 
families out of ten went to the wall. Our forefathers had nerve so 
sound, digestion so firm, that they could not be killed off— no, not 
even by filth diseases and fusel-oil. The result was a generation im- 
mune. But the Indian had never had the test until the last three 
centuries. Under the influence of whiskey, nicotine, passions, only 
125,000 remain of several millions. All of these Indians have now 
been charted and an overwhelming portion have one of four diseases 
— they are a vanishing people. The condition in Mexico is even more 
dreadful. Witness the Mexican colony in San Antonio, Texas, dev- 
astated by tuberculosis, Bright 's disease, and the two unmentionable 
diseases. Of the 41,000,000 living in South America, 21,000,000 are 
native Indians, and under the stress of these terrific tests they are 
dissolving like red snow flakes in a river. The colored people are 
fronting the same problem. So long as they live on the Southern 
plantations, leave stimulants alone, they reproduce, but bring them 
into the great city, put them into competition with the white race, 
and they suffer beyond all words. The white man has had centuries 

(13) 



354 FIRST NATIONAL CONFERENCE ON RACE IJETTERMENT 

of oivilization in wiiieli to liartlon his nerves and to hceonic inuunnizcd. 
The colored man is now having his tost throiigli alcohol, nicotine and 
morphine and deadly drugs. When a horse is tired the spur in the 
bloody tiank is fatal. "When a colored man is tired the stinudant is 
as deadly as a dagger. In the city the colored race is not only not 
increasing in population, but is steadily losing. One-tenth of the 
white race survived, and if one-tenth of the colored prove immune to 
these modern stimulants, they will do well. IMother Nature is kind 
and tender to the obedient, but she is a stern mother to the disobedient, 
and she gets rid of the mifit as a form of social pity and mercy. Not 
that she immediately bows out of existence the youth that has one of 
the two diseases that make up the Red Plague. More often she 
shortens the life of the child of the diseased man and in the next gen- 
eration gets rid of the stock altogether. The physicians of New York 
have published a report of the number of men ; 225,000 cases of the 
worst of these two diseases, and three times as many more have tw^o 
other diseases. In terms of three generations this large group will be 
wiped out. Only those who have sound nerve, rich blood and the 
strong heart engine can keep up the pace, and their descendants will 
people the earth. 

THE CAUSES OF RACE DETERIORATION 

One-half of our physicians and scientific experts tell us that the 
race is growing taller and stronger and healthier; the other half of 
the scientists, headed by men like Dr. Forbes Winslow, of London, tell 
us that the race is degenerating, steadily losing in stature, beauty and 
health ; that it will wane to the point of extinction, begin once more 
on the edge of the forest, and perhaps, by obedience to the laws of 
nature, once more spread over the earth. Both statements are true. 
One-half of our people are God-fearing, law-loving, pure-living, and 
their children and descendants are growing taller, handsomer, health- 
ier, happier. The other half is living for pleasure, the body and 
animalism, and their descendants are deteriorating in health, and will 
finally drop out of the world. Our climate is exciting, being dry, full 
of ozone that stimulates the nerve and heart. The undeveloped re- 
sources of our country make a powerful appeal to ambition and lead 
to overwork. Modern life is very complex, its details infinite, and 
men break down because of the pace. The new chemistry has dis- 
covered' new stimulants. There are drugs for the heart and brain, 
and drugs for the nerves, until whiskey, wine, beer, absinthe, nicotine, 
opium, morphine, are among the gentler drugs. In a damp atmos- 
phere stimulants are more easily expelled from the human body. In a 
dry atmosphere like ours, stimulants that would be harmless in Scot- 



SCHOOL AND INDUSTRIAL HYGIENE 355 

land or Holland are deadly in America. In such a climate and under 
such conditions, the young father rearing children and who stimulates 
during the twenties and thirties reproduces the stimulated and ex- 
citable nerv'ous sj^stem in his babe, with the result that defective chil- 
dren are one of the most alarming facts of our era. But above all 
other causes is the influence of the Red Plague. 

THE GREAT RED PLAGUE 

A wave of terror has swept over this country. These infectious 
diseases have spread with such rapidity in the last ten years that 
whole states have become alarmed, and are passing the most drastic 
laAvs. So many diseased men are now on trains that the Pullman 
palace car is not allowed to furnish a glass drinking cup for ice water. 
In many states the law forbids the hotel permitting a public towel, and 
in some states only paper towels are permitted in hotels. One even 
finds warnings in depots to safeguard little children from infection. 
In a through train from California the other day, the passengers 
signed a roundrobin, asking the conductor to confine in a stateroom one 
man whose condition Avas obvious, and to prevent two others from 
entering the dining car. The physicians of New York, Chicago, 
Philadelphia and Baltimore have sent out warnings covering the fol- 
lowing points. Of the great plagues afflicting humanity, the Great 
Red Plague is the most serious. 

No man doubts for one minute but that a man of iron nerve and 
will could end this era of lawlessness and anarchy. Either he must 
end the anarchy or the lawlessness Mali end our great cities and our 
republics. On the slopes of Vesuvius there are cracks through which 
the sulphur issues, and the stench of hell mingles with the perfume 
of orange blossoms, and therefore the recent burial of a village under 
ashes and lurid lava. Just now our city is pouring forth passion in 
fiery waves, and our physicians and scientists are alarmed. But better 
days are coming. The people are waking up. There is to be an elect 
group, an aristocracy of health. Instead of the race breaking down, 
there is to be a new stock, taller, stronger, healthier, handsomer. But 
meanwhile it is for the people of this nation to remember that he who 
sows to the flesh shall of the flesh reap corruption. But the individual 
and the city that sow through the school, the home, the library, the 
factory, the sound business, shall of obedience to law reap health, hap- 
piness, peace and social prosperity. 



356 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

INDUSTRIAL WELFARE 

F. 0. Clemkn-ts, K'epresfiitativo of The Nalioiial Cash K('<>ister Co., Day- 
ton. Ohio. 

A great many industrial concerns practice welfare work, and it 
requires no extended argument for justification. It is right and fair. 
For that reason, the subject is of interest to every one in this audi- 
ence. It means the addition to business of convenience, comfort, 
healthful surroundings, in fact, anything that will assist in securing 
the prosperity and happiness of the worker. Incidentally, it tends, of 
course, to produce harmonious relations between men in the organi- 
zation. 

Several large industrial concerns located in England have been 
pioneers in the application of welfare work abroad. One of them, the 
Cadbury Company, chocolate manufacturers, has made a very enviable 
reputation for itself by introducing a great deal of educational work 
into its general scheme of operation. 

The efforts of Port Sunlight, an English concern active in welfare 
work, have been particularly noticeable along the line of proper hous- 
ing for their people — at least, this is one of the noteworthy fea- 
tures of their work. Many industrial concerns in the United States 
might be cited, like the United Shoe Machinery Company, Interna- 
tional Harvester Company, United States Steel Corporation, and many 
others have instituted welfare work. 

In 1892 we found that our people had no heart in what they were 
doing. They did not seem to care whether the business succeeded or 
not. As fast as employees were trained to the point where they would 
be of real service, they would leave and go to positions elsewhere. 
There was no special inducement or encouragement offered to keep 
them with us, because our factory was no better than the average 
American factory of that time. Five women left. They realized 
that they could secure equally as pleasant and remunerative employ- 
ment elsewhere, and consequently they had no interest in our business. 

Our President, Mr. Patterson, in going through the factory one 
day, noticed a woman heating coft'ee on a radiator. Later he saw a 
group of girls eating cold lunches at their workbenches, and so a 
kitchen was installed and they are now sensed a warm lunch at a 
nominal fee. The lunch furnished consists of a bowl of soup, one 
vegetable, bread and butter, milk and fruit- — all at the cost of five 
cents. 

In the early days of the business, the men and women came to 
work at the same time, while now the women arrive later than the men. 
In the evening they are well on their way home before the men leave 



SCHOOL AND INDUSTRIAL HYGIENE 357 

the factory. In the old days all employees were compelled to climb 
the stairs to the various departments. Today, elevator service is pro- 
vided in advance of working hours for all employees, with separate 
elevator service for the women. The uncomfortable stool has been re- 
placed by the high-back chair and foot rests. These cost very little 
more than the old-style stools, and result in greater comfort, health, 
and efficiency. 

The National Cash Register Company have installed every type of 
convenience, sanitation, and safety wdthin the factory. A great deal of 
time and effort have been devoted to the boys. The particular lo- 
cation of this manufacturing plant in 1892 was regarded as the most 
undesirable part of Dayton. It was called Slidertown, and it lived up 
to everything that its name implied. Much of the vileness and evil of 
the city seemed to center there. The yards were full of rubbish and 
refuse. Rents were low. Employees were ashamed to say that they 
worked at the factory. In addition, Slidertown was infested with what 
were believed to be bad boys. They broke the windows of the factory, 
pulled up the shrubbery and were constantly in mischief. A picket 
fence ten feet high was erected around the factory to keep these 
youngsters out, but even that was unavailing. 

The President of the Company was convinced that if given an 
opportunity, a boy will do what is right and that a boy is bad in pro- 
portion as his mind is unoccupied. This theory was put into effect by 
giving them a meeting-place and by establishing classes in what today 
would be called manual training, and the setting apart of a plot of 
ground for garden work. The boys were supplied with seeds and tools 
and put to work. We were much surprised to find that the ring- 
leaders in" the evil were also the leaders in the good. They were very 
enthusiastic when they found that they were going to do something 
that was really worth while. It was much better than replacing win- 
dow-panes and repairing other damage. It taught the boys industry 
and perseverance. It improved their physical lives and had a lasting 
moral influence upon them. Many of these boys have entered the 
factory and have made the very best kind of apprentices and work- 
men. Others have gone out into the world as journeymen workmen, 
and most of them have been successful. We have followed their ca- 
reers carefully because we early believed that there were great possi- 
bilities of making useful citizens out of mischievous boys. 

To clean up the unsightly surroundings it was found necessary to 
do a great deal of neighborhood work. Due to vileness and unsightli- 
uess and bad surroundings, it was impossible to procure the class of 
help needed to manufacture a finished product of high grade. Skilled 



358 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

labor would not come to Slidertown. To overcome the difficulty, 
neigliborhood houses, or as we would call them today, social centers, 
were provided. Lectures illustrated by crude slides were ni.ulc up to 
illustrate the proper and improper way of beautifying the f^urround- 
ings. 

Good housing and beautiful surroundings have a whole lot to do 
with the Avelfare and health of people. A backyard was improved 
by a boy twelve years of age — just a little seed and a little bit of 
hard work on the part of the boy. Furthermore, it stimulates 
outdoor life. Efficient work unquestionably depends upon the 
physical condition of the employee. From early days we have always 




PLANT OF THE NATIONAL CASH REGISTER COMPANY, DAYTON, OHIO 

believed that the efficiency of the worker is based upon health. As a 
consecpience, for many years much of our type of instruction has had 
to do with the general question of health, and I wish to say in this 
connection that much of our finest inspiration has come from the 
Battle Creek Sanitarium — First, Health. 

You know the other slogan that the industries are using so much — 
Safety First. They are both good. We do not believe it will be 
necessary to produce many arguments as to the value of fresh air. 
You would not think of putting an athlete into the basement of a 
building to train for some athletic event and expect him to excel. 

Fresh air is absolutely essential, of course. In our older type of 



SCHOOL AND INDUSTRIAL HYGIENE 



359 



buildings, air is drawn in through a ventilating duct from the top 
and distributed throughout the building. The aii* is changed evei^y 
fifteen minutes. Some of our more modern buildings wash and 
humidify the air and a very close regulation of temperature is, possibly. 
One man spends his entire time regulating the -heat. of the buildings 
and controlling ventilation. In our Polishing Departinejit ^nd 
metal working rooms there is au exhaust system installed for carrying 
away the metal dust. This dust is discharged into large bins. About 
one week's accumulation is represented by nine barrels of this dust. 




AN EXERCISING CLASS 



This would have injured the eyes and lungs of the men if it had 
not been removed by some such device. 

The Company makes every effort possible to keep every department 
just as clean and healthful as possible. The factory, in a sense, 
is really located in a garden. Doctor Read said yesterday "that 
flowers upon the table really produce a sort of psychic gastric 
juice." Unquestionably, beautiful shrubbery and floAvers have a 
somewhat analogous effect on our product. At least, we believe 
better working conditions are closely related to good business. 



360 



FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 



Shrubbery hides the foundations and walls, makes a hi-eak in the 
line of the wall, adding very much to tlie beauty of the stirrouiidinji^s. 

We are great believers in exercise. At ten o'clock in the morning 
and at three in the afternoon, the windows in the office departments 
are thrown open and the men and women indulge in light exercises. 
"We have a gymnasium and health classes for increasing the 
efficiency of the office force and the women employees. At the 




TENNIS COURTS ADJACENT TO FACTORY 



present time, these classes are under the direction of a Battle Creek 
Sanitarium graduate. 

The office clerks meet three times a week in the gymnasium after 
working hours. The athletic fields surrounding the factorj^ are used 
by employees before and after work and during the noon hour. They 
consist of tennis courts, baseball grounds and gun club grounds. 
About three miles south of the factory is located the country club, 
which was established as a further incentive to outdoor exercise. 
It is located on a portion of Hills and Dales, a 1,100-acre estate 
owned by the President of the Company, which has been thrown 
open as a playground not only to the employees and their families, 
but to the citizens of Dayton as well. The club is nearly self-sup- 



SCHOOL AND INDUSTRIAL HYGIENE 



361 



pointing, and every employee is eligible to membership. The member- 
ship fee is $1.00 per year. 

All kinds of athletic sports are particularly fostered for the sake of 
the exercise and fresh air. Scattered throughout Hills and Dales are a 
number of Adirondack Camps. These are fully equipped with big fire- 
places and water supply, fuel supply, and potatoes are to be found 
in the cupboards for baking. These camps are very popular and can 
be used by any employee on application. 




THE EMERGENCY HOSPITAL 



The Woman's Century Club is composed of the women employees 
nt the factory. Any woman employee is eligible. Its object is to pro- 
mote the intellectual and social welfare of its members. Meetings 
are held twice monthly. Prominent speakers are engaged from time 
to time to address the club members. A vacation house located in 
Hills and Dales is used by the Woman's Century Club for entertain- 
ments, week-end parties, etc. Its main object is to teach the women 
how to manage a home. The house will accommodate thirty girls. We 
have about seven hundred women in the factory, and most of them are 
at this club for at least a few days during the summer time. A Battle 
Creek Sanitarium graduate was in charge last summer. 

The NCR Riding Club is eligible to any employee owning a horse. 



362 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

i 

In fact, the company eneouragcs horseback riding because it l)rings 
the men ont into the open air and gives tliem the exercise they need. 
In order to encourage employees to take part in this exercise, the horses 
are boarded in the Company's stables at cost. 

Few people in the city are acquainted with the many beautiful 
highways and lanes which are to be found in the neighboring country. 
Nature study classes and walking classes make one realize that they 
have neglected one great branch of education ; namely, that which 
Nature teaches. If time would permit, a great deal of attention should 
be paid to the various types of schools connected with all depart- 
ments in our business. The future of any business is based upon 
teaching. 

The National Cash Register Company early brought the school 
idea into the business, in order that merchants and business men 
throughout the world might learn the best way for handling their 
cash accounts. The company maintains training schools in various 
parts of the world for its agents. They also have advertising, account- 
ing, apprenticeship, physical training, salesmanship, and other classes, 
meeting at regular intervals. 

\ The water supply is very satisfactory. The factory secures this 
Water from deep wells, samples of which are taken every two weeks 
and analyzed and submitted to a bacteriological test. The office build- 
ing is supplied with distilled water and individual cup service. 

, Two hundred and twenty shower baths are distributed throughout 
the factory. Every employee is given company time to take two 
baths a week, and can have as many more as desired on his own 
time. 

Treatment rooms have been provided, modeled very much after 
the hydrotherapy methods of the Sanitarium. Tliis is also in charge 
of two Sanitarium graduates. The benefits to be derived are not 
confined simply to the men higher up. Men in the shop needing 
attention can have access to the baiths. We have a good many 
health classes intended to increase the efficiency, particularly of our 
sedentary workers. Much attention has been paid to food. Quite a 
number of men have adopted the low-protein diet. They believe in 
the advantages derived therefrom. 

Our Officers' Club accommodates about six hundred people at 
lunch. We serve a very wholesome; well-cooked dinner, very simple 
and very plain. Food is k;ept hot in chafing dishes and served on 
plates holding hot water. 

Brushes and combs are sterilized dailv and washed in benzine, then 



SCHOOL AND INDUSTRIAL HYGIENE 363 

placed in sterilizers. Roller towels have been done away with, sub- 
stituting individual hand towels. The girls are provided with sleeve- 
lets and clean aprons every week. Umbrellas and overshoes are loaned 
on rainy days. They are issued on checks and are returned the fol- 
lowing day. 

All new employees must undergo a physical examination. This is 
done as a protection to those already employed. After employees are 
accepted, great care is taken to protect them. We believe in periodic 
examinations, but have not done very much along this line to date. 

The employees have a strong voluntary Relief Association which 
pays sick, accident and death benefits. 

We also have an emergency hospital wh6re accidents are cared for. 
Our accidents, however, are reduced to a minimum. This is due to 
the safety devices with which all machines throughout the plant are 
equipped. We have a trained nurse who visits our sick employees, in 
their homes, offering suggestions and advice. It is far more economical 
to keep employees well than to employ new ones in their places. An 
oculist examines the eyes of our employees and decides when glasses 
are needed. Free examination is afforded and the company pays half 
of the price of the glasses. 

A new building, called our Hall of Industrial Education was 
erected recently. It is capable of seating about 1,200 people and 
has. besides a large auditorium, a number of small school rooms. 
We are thorough believers in teaching through the eye. In fact, 
about eighty -five per cent of the knowledge which we acquire comes 
through the eye. Consequently these lecture halls and school- 
rooms are thoroughly equipped with projection apparatus. In the 
large hall the projection is done from the rear through a glass screen. 
Noise is eliminated and there is no danger of fire, both very attractive 
features. This hall is aptly called our Power-House, and really is 
more distinctly a power-house than the one housing our turbines, 
engines, etc. Much of our time has been devoted to educational talks 
on health, and we have many lectures on many different subjects. 
Even a class of salesmen coming in to spend six M^eeks in study is given 
quite a bit of training in hygiene. We believe in health education very 
thoroughly. We endeavor to make these talks very simple. We try 
for short words and big ideas. It is a very difficult matter to put up 
a talk in physiology so simple that everybody can understand it. We 
have talks on bacteria, common cold, constipation, and a great many 
other allied subjects. It was the school idea that saved the day at 
the time of the breakdown in 1892. We had to do something to over- 
come the inertia or lack of interest in the work, so we started the 
school idea and have been at it ever since. 



3G4 FIUST NATIONAL CONFERENCE ON RACE BETTERMENT 

Tlu' slitlos used ill tlu' I'arly (l;iys were extremely eriidc Despite 
their enideness, however, they were of considerable value. Today our 
collection totals somewhere around fifty thousand different slides. Our 
belief in health education is not a recent move on our part, but dates 
back many years. Our early literature had little excerpts and short 
sayings relating to health. Moving picture films, if they have any 
educational value, are utilized for educational purposes. Our weekly 
paper helps to disseminate this type of information. 

A large number of our office employees asked for a vegetarian table 
voluntarily. It is very difficult to get the average man to understand 
what we mean by protein, fat, carbohydrate, balanced diet, etc. We 
spend a great deal of time trying to simplify this particular subject, 
believing it to be one of the most important. 

You will probably agree with us when we say that welfare work is 
right, but you may be just a bit skeptical when we repeat it is an abso- 
lute necessity in our business. AVe feel that we could not build a good 
reliable, accurate cash register without it because no system of in- 
spection has been devised that will give us the accuracy we want. 
When an employee is not feeling well, he does poor work, and when an 
inspector is not feeling well, he passes parts that he would not pass 
ordinarily. Welfare work supplies just that which is lacking in the 
inspection system. It brings the best there is out of each employee and 
results in cooperation and team play. AVelfare work does not take 
the place of wages. It costs us less than six cents per day per em- 
ployee. For that six cents, we provide healthful surroundings, 
personal comfort, recreation, education and training. We receive in 
return much more than six cents' worth of efficiency from each em- 
ployee. So welfare w^ork is not philanthropy. It is nothing more 
than good common sense, and it pays. 



CITY, STATE AND NATIONAL HYGIENE 

FUNCTION OF INDIVIDUAL, CITY, STATE AND NATION IN 
RACE BETTERMENT 

{Letter to the President of the Conference) 

Sir Horace Plunkett, K.C.V.O., F.R.S., Ex-Minister of AgTieulture 
for Ireland, Dublin, Ireland. 

The work for which I suppose I was born, calls me home. I 
had hoped that I might remain and make a modest contribution 
to the deliberations over which those of us who were consulted upon 
the program and arrangements of the National Eace Betterment 
Conference unanimously agreed that you were the ideal presiding 
ofScer. But, as you know, Ireland just now needs all her workers, 
and I must go. 

The program you will have to get through is — to saj'- the least — 
full; and no one need regret that I do not crowd out any of the 
absorbingly interesting subjects which are to be treated, nearly all 
by real experts, and not by laymen like myself. Moreover, I feel 
that, as I cannot be present, the particular question I intended to 
discuss, "The Function of the Individual, City, State and Nation in 
Bringing about Eace Betterment," would better be left over, until, 
as the result of the Conference's deliberations, we know the scope 
of the work which has to be done to attain the end the Conference 
has in view. Then only can the responsibility be divided and the 
tasks assigned to the effective agencies, educational, administrative, 
and propagandist, which must follow up the conclusions at which 
the Conference arrives. 

Will you allow me to make one suggestion (which is within 
the province of the layman), relating to a real issue not directly 
raised in any of the subjects announced for discussion, and yet in 
a sense germane to nearly all of them. (My own life's work relates 
to the rural side of our civilization, which I hold to have been badly 
neglected.) The people of my own country are predominantly rural, 
and my experience in studying and dealing practically with its 
problems has brought me into embarrassingly intimate relations 
with a numerous body of social workers in the rural sections of 
the United States. These workers aim at a complete reconstruction 
of rural life — an improvement of its technical and business methods 
and of its domestic and social conditions. For reasons of national 
importance and urgency^ — reasons economic, social, and political — 
the settlement of a much greater proportion of the people upon the 

365 



366 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

farm lands of the country, in healthy, happy, and progressire com- 
munities, is becoming every year increasingly the aim and object 
of philanthropic endeavor. These workers believe that the country 
offers a far better hope of race betterment than the city. But in 
the neglect of rural problems, in the urbanization of all thought 
which characterizes this age, there is very little statistical or other 
material on which the rural reformer can base this part of his case. 
Speaking as one of these workers, may I ask the Conference to 
bear in mind the countryside, and to give us any help they can, 
by way of counsel and advice, as to how we may re-enforce our 
plea that country life is better for the race than city life, and how 
we may, by applying the wisdom of the Conference, demonstrate 
that truth. I won't promise to preach eugenics, because the prophets 
of that science tell me that I had no business to be born. But in 
any other direction I will be guided by you and the other scientists 
over whom you will preside. 

May I say in conclusion how glad I am that the Conference is, 
by the choice of its meeting-place, doing honor to and enlarging the 
influence of an institution and a body of workers for humanity 
whose services have not, I think, been fully appreciated. You will 
doubtless express far more clearly and with tenfold weight my own 
estimate of Doctor Kellogg 's and his staff's efforts in teaching the 
ignorant among us how to live that we may do well the work we 
are here for. In anticipation, may I associate myself with all you 
will say upon this. 

I regret more than I can say that I cannot stand behind the 
venerable physician and public servant whose life is the best in- 
spiration my imagination can conceive for those who wish, as I do, 
that the Conference may mark a memorable departure in philan- 
thropic endeavor. 



Miss M. E. Bingeman, Board of Education, Rochester, New York. 

The city of Rochester, N. Y., has just adopted a new point of 
view in this matter of municipal responsibility. It is beginning to 
see that as it suffers economically from premature death, from un- 
necessary inefficiency and unnecessary sickness, and that because 
these three things are due in a general way to ignorance, it is the 
function of the city to place within the reach of every person in 
Rochester the necessary Icnowledge. Up to this time, people have 
obtained their knowledge about these things in a haphazard way. They 
obtained it from hearsay; they obtained it from the newspapers and. 



CITY, STATE AND NATIONAL HYGIENE 367 

from magazines. At the same time, from these same sources they 
obtained very mistaken ideas. In sorting it for themselves, they are 
not in a position to do it intelligently. In Rochester, the Women's 
Educational and Industrial Union sent a petition, signed by three 
thousand pastors, to the Board of Education, asking them to furnish 
instruction in physiology, hygiene, nursing, first aid, dietetics, and 
things of that description. The Board of Education has agreed to 
do this. Beginning next Monday, such a course is to be offered in 
the high school of the city. There will be a course of twelve weeks, 
two lessons a week, one by the doctor and one by the nurse, of an hour 
each, and in this course there is to be taught physiology and the care 
of the child from birth to two years, from two years to twelve years, 
hygiene, psychology of adolescence, first aid, emergencies, causes of 
disease, prevention and recognition of disease, rational principles for 
the cure of disease, household and civic hygiene, motherhood, and 
things of that description. 

If the women of Rochester appreciate this course by attending, 
this work is to be enlarged, and every school in the city in turn is 
to have this instruction offered, so that by and by this instruction 
will be placed within walking distance of the women of the city. 
There are to be classes whenever the women can come in— forenoon 
classes, and^ if there is a demand for it, afternoon classes from four to 
five, and evening classes in the evening schools. We believe that in 
this way, with two teachers, one a doctor and one a nurse, we can 
reach six hundred women a year if the women are ready to do it. 

There is no reason why that six hundred should not be sixty 
thousand if every other city does likewise. 



COMMUNITY HYGIENE — WITH SPECIAL REFERENCE TO 
MEAT INSPECTION 

Rev. Caroline Bartlett Crane, A.M., Kalamazoo, Michigan. 

If we may speak of the ''birth of cities," it must be admitted 
that thus far eugenics has played but an unimportant part in their 
production. Cities are born of unions founded on love and propin- 
quity — love of money and propinquity to the main chance. Cities, 
by their forebears affianced from birth to "Business," grow up 
to bring forth a brood of good and evil offspring. They are proud 
(sometimes not till years after) of their good offspring, while the 



368 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

responsibility for the evil offsprin"- they lay onto the mother, sayinj;- 
"Business is Business." When the evils become too numerous and 
fierce, so as even to interfere with beloved "Business," this tyran- 
nical dame consents, perforce, to the espousal of Hygeia, as a sort 
of supplementary wnfe, to clean things up a bit. 

And here is where and how Community Hygiene begins — outside 
of a few modern and "model" industrial-and-army-camps, which 
are the only eugenically-&or/i communities we have. 

The genesis of certain important items of Community Hygiene 
is strikingly illustrated in a far Western state, where recently I 
made a sanitary survey of twelve cities. At this moment, in a com- 
munity of some seven thousand persons, a typhoid epidemic is rag- 
ing which has laid low more than two hundred persons in the first 
fortnight, out of which number nine are now dead. Fresh cases are 
developing daily. This epidemic is the natural and to-be-expected 
outcome of a domestic water supply taken from a stream polluted 
by the sewage of another community. For years the State Board 
of Health has endeavored to persuade the city to purify the water. 
At the same time it has been endeavoring in vain to persuade the 
State Legislature to pass a Water and Sewage Bill (similar to that 
now in effect in Pennsylvania), which would make such an epidemic 
from such a source practically impossible. Now, after the event, 
the State Board has had to come in and take charge of affairs, be- 
cause there is no city or county health organization worth mention- 
ing. The State Board has installed an emergency hypochlorite plant, 
a supervision over milk and food, an emergency hospital and home 
nursing service ; a systematic case-reporting scheme, a compre- 
hensive clean-up campaign for the whole town, and free vaccination 
of all the well against the disease. 

In another city in that state, where public health work in general 
is of an exceptionally high order, some twenty persons, mostly chil- 
dren, are daily receiving Pasteur treatment. More than forty human 
beings have been bitten recently by rabid dogs. The chief concern 
of the city council seems to be to prevent this damaging fact from 
getting abroad. To pass an ordinance for suppression of the cause 
of hydrophobia would be to advertise the damaging fact of its ex- 
istence. The first mad dog ever seen in the state was brought from 
another state about a year ago. Rabies is now well entrenched in 
a dozen cities and in the rural districts all up and down the coast- 
side of that second state. In the metropolis of this same state some 
twenty-five plague-infested rats have been discovered within the 
last few weeks. The original plague-infested rats came by ship 
from Asiatic ports. The city has already burned dow^i some 1,100 



CITY, STATE AND NATIONAL HYGIENE 369 

old buildings in a but partially successful struggle to be rid of rats. 

These illustrations serve abundantly to point out the fact that 
no community lives unto itself alone ; that community hygiene may 
depend in no small part upon the behavior of neighboring (but un- 
neighborly) communities; upon state laws and their administration; 
upon national control of the movements of persons, animals, and 
things transported from one state into or through another, to the 
possible injury of public health; and upon such international regu- 
lation as may prfevent the introduction into any portion of our coun- 
try of disease or disease-producing factors from regions of the 
world beyond our direct hygienic control. 

Therefore, a proper division of function, and proper functioning 
in each division of public health work is of vital concern to every 
community. The "leading citizen" in the fever-stricken little city 
above referred to, who was not afraid of the water because he had 
been drinking it for seventeen years, is now in the emergency hospi- 
tal. But he was a leading citizen, and he led his fellow-citizens in a 
successful opposition to a Water and Sewage Bill which would have 
given the State Board of Health some warrant to interfere with 
their heaven-born right to drink whatever water they chose. Be- 
sides, to have sanctioned the requirement that the city higher up 
on the stream should treat its sewage before discharging it into the 
river, would be a pointed suggestion to the city below to require as 
much of them. And a sewage-disposal plant would mean a munici- 
pal bond issue ; hence, not to be thought of. 

But to the wise and discriminating person, it is evident that 
each community must not only do its own part, but it must main- 
tain a partnership in public hygiene with other communities, under 
supervision of the state, which grants to municipal corporations all 
the rights and privileges they possess, and which may naturally 
be looked to to maintain substantial justice between these corpora- 
tions; also, that states, and communities within states, may justly 
expect the national government to exercise strongly, in behalf of 
the general welfare, any power it may possess ; as, for example, the 
power assumed to itself by what is known as the "Interstate and 
Foreign Commerce clause" of the Federal Constitution. 

I have been asked by your Committee to speak this evening on 
"Community Hygiene, with Special Reference to Meat Inspection." 

In such a scheme as I have described for division of health ad- 
ministration between city, state, and nation, where would one natu- 
rally expect meat inspection to fall? Meat shipped abroad would 
need to be inspected and certified by our Federal Government. 
Meat shipped from one state to another, becoming an article of in- 



370 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

terstate eommorce, wonld also fall naturally to inspection by the 
federal government. Meat slaughtered for consumption within 
the state might be inspected and certified either by the state or by 
the municipality in which it is to be offered for sale. 

In an agricultural region such as surrounds thousands of cities 
and villages in the United States, one would naturally expect that 
the meat supply, like the milk supply, would be shipped in from 
the surrounding country, and that each city might protect itself 
against diseased or unwholesome meat by a propel ordinance and 
a proper system of inspection. I believe that the general police 
power conferred upon municipalities by most states includes the 
power to bar from entrance into the city any meat whose sanitary 
character or condition fails to comply with reasonable standards 
set by the city in question. Just as a city, before it grants a milk 
dealer's license, may send its inspectors across state lines to inspect 
animals and stables and milk houses and may even require the 
tuberculin test to be administered to cows, so a city may (and a 
few cities in this country already do) require that all meats sold 
therein shall either be slaughtered under municipal inspection, or 
the carcasses elsewhere slaughtered shall be subject to inspection 
before they are admitted to sale in the city. 

As a matter of fact, local meat inspection has lagged very far 
behind local milk inspection, and federal meat inspection is gener- 
ally looked to in this country as a protection against diseased and 
otherwise unwholesome meat and meat food products. Federal in- 
spection, however, was not instituted for the sake of protecting the 
American consumer. Nearly thirty years ago foreign countries 
which purchased enormous quantities of American meats, began to 
put restrictions upon our meats, especially pork, because of evi- 
dence of disease. These countries, which carried on a systematic 
inspection of their own meats, demanded that American meats 
should be inspected ai;id certified before they could be admitted to 
their markets. Thus, federal meat inspection was inaugurated 
twenty-three years ago, not as a protection to American consumers, 
but to restore to American packers an enormous but rapidly van- 
ishing foreign trade. 

Federal inspection assumed to cover all -meat shipped in either 
foreign or interstate trade, since inspection was instituted under 
sanction of the "interstate and foreign commerce clause" of the 
federal constitution. But we find by admissions of later years that 
only a small percentage of interstate shipments was inspected. JHow- 
ever. the government guarantee, "U. S. Inspected and Passed." was 
found to be a valuable asset, giving the great packer yet one more 



CITY, STATE AND NATION^U. HYGIENE 371 

advantage over the local independent butcher, and from year to 
year more and more of the meat shipped interstate has borne the 
federal stamp. Both the Department of Agriculture and the pack- 
ers have made strenuous efforts to instil into the American mind 
the belief that the stamp, "U. S. Inspected and Passed," is a safe 
guarantee of the entire wholesomeness of the meat. 

Were this true, we might well prefer the guarantee of our na- 
tional government to that of any city or state. 

But it is not true. 

We all recall the "Jungle"' expose of 1906, followed by a storm 
of popular disgust and indignation, a new law, new regulations and 
a new meat inspection appropriation of three million dollars granted 
by Congress for the express purpose of protecting the American 
consumer. Since that time, the Department of Agriculture and 
the packers have redoubled their efforts to win the confidence of 
the American people. Many official bulletins and popular articles 
have been issued, describing and guaranteeing the inspection, and 
it is argued that if the most particular and suspiciously-inclined 
countries in the world accept our government guarantee, surely the 
people of this country should do the same. 

But the fact is that the ''most particular countries" do not ac- 
cept our meat inspection certificates without reservation or without 
requiring tell-tale organs and glands to be left in their natural 
attachments for reinspection at the point of entry, and that we have 
never regained the degree of European confidence which was lost 
in 1906. 

Furthermore, Americans should know that when a foreign gov- 
ernment or purchaser does accept the meat inspection guarantee 
of our government, it is a different and vastly better guarantee 
than our government gives to the American purchaser. In the 
very law of 1906 is a cunningly hidden clause which requires the 
inspection of the animal while it is alive, as well as the inspection 
of the carcass, of all meat which goes abroad, by virtue of the fact 
that no vessel can get clearance papers if it has on board any meat 
from this country unless there is a certificate from the Department 
of Agriculture saying that this meat, and also the animal from which 
it was taken, has been inspected by federal inspectors and has been 
found sound, wholesome, free from disease, and fit for human food. 

Now, for Americans, this is not required; there is no certificate 
— nothing except the stamp upon the meat, "U. S. Inspected and 
Passed." The meat which goes abroad is really above the Regula- 
tions, because the Regulations themselves permit the passing of car- 
casses of animals which on inspection proved to have tuberculosis 



372 FIRST NATIONAL CONFERENCE ON RACE BETTERMENT 

distributed in several different portions of the body. The same with 
lumpy jaw; the same with animals which are affected with tape- 
worm cysts and with other parasites ; the same with animals which 
are affected by cancer, and many other diseases. The Regulations 
require the cutting out of the visibly diseased portion before the 
carcass is released for food. However, I fancy that I need not 
argue Avith this audience the danger of this proceeding. Take 
cancer, for example : 

Since we do not know the cause of cancer nor its method of 
transmission, we are entirely unable to say that there is any stage 
of the disease in which any of the meat of such an animal could be 
safely eaten. When we reflect upon the eft'ect of even a fourth of 
a grain of morphine upon a human body of two hundred pounds, 
upon the inconceivably minute quantity of tetanus toxin which will 
cause death, think how small a portion of the cancer cells, or 
toxins, or whatever it is, might suffice to cause death; when we 
reflect upon the terrible nature and increasing frequency with, 
which it affects the stomach, intestines, liver and other organs of 
the human abdominal cavity, how is it possible that such a "Regu- 
lation" as this shall be allowed to stand? 

If you will procure the Regulations of the Bureau of Animal 
Industry of the Department of Agriculture (which were issued May 
1st, 1908, and are the latest Regulations), you will find that what I 
say it true, that these very Regulations permit the passing of the 
meat of animals which, from my standpoint, at least, are seriously 
diseased. But the certificate which is required to be sent with meat 
which goes abroad would preclude the export of such meat unless 
it is acknowledged that the export certificate is false. Therefore, 
Americans are discriminated against through the very law which 
was supposedly enacted for their special protection. 

Not only is it true that there exists this discrimination against 
Americans in the law and in the printed Regulations, but, also, 
this fact: Within a few months following the new law of 1906, the 
Chief of the Bureau of Animal Industry began to issue special in- 
structions to inspectors subversive of the Regulations and even of 
the law under which the Regulations were drawn. These special 
instructions were carefully guarded from public knowledge. This 
is made evident, not only from the prefatory notes placed at the 
top of these confidential circulars, cautioning employees against 
giving or showing copies to outsiders, but, also, by the contents 
of these circulars, which are such as discretion Avould naturally lead 
the Bureau to keep from knowledge of the public. An instance 



CITY, STATE AND NATIONAL HYGIENE 373 

or two will best serve to illustrate the character of these circulars 
called "Service Announcements." 

The Regulations prescribe that any organ or part of a carcass 
which is the seat