favorable variations since nothing was to be gained by modification of the hands or eyes. Other observers alleged that modern customs were actually promoting degenerative changes which were held to be progressive. The increased use of sugar as food was said to be destroying the teeth, in the race, as well as in the individual. It is true that primitive races seem to have suffered less from caries. The habit of wearing tight hats was claimed to be producing a race of bald men, and it seems true that civilized men are balder than were their ancestors. The wearing of heavy leather shoes was held to be productive not only of corns but of the progressive degeneration of the little toe whose ultimate disappearance was to be expected. Man has less use for his toes than in days gone by. The accuracy of this interpretation of these facts will be considered a bit later.

Industry and Health

Other charges are based on the alleged influences of modern industry. The shift from an active out-of-door life to a more sedentary indoor life not only means less muscular development but involves, as just noted, a new exposure to certain diseases. The development of industry has led to the use of many poisonous materials such as lead and phosphorus whose effect on the workers is very harmful. No one can doubt this. Attention has been called to the dangers involved in the temperature contrasts of house or workshop and the out-of-doors. In many ways the influence of some of these things is ever more serious for woman, especially if she is exposed during the later months of pregnancy. On this point we have expert testimony.

Women are more affected by lead than men. They suffer too from the worst types of it. Their sexual life is readily deranged by the metal. Menstruation becomes excessive and women if pregnant tend to miscarry. A large percentage of pregnant lead workers fail to reach their term. Should they succeed the infants

are either stillborn or they die in convulsions shortly after birth. . . . As already stated females suffer from the worst forms of lead poisoning. They experience severe headaches, and without having colic or wrist-drop they may pass without warning into convulsions in which they die, or if they recover from these their eyesight is temporarily or permanently lost.2

Among women working during pregnancy a recent study showed that of live births 6.2 per cent were premature as compared to 5.7 among unemployed mothers. The mortality rate during the first month of life was 77.3 per thousand where the mothers were employed and 39.9 where they were unemployed. Nearly 40 per cent of the employed mothers had worked until within two months of confinement and 25 per cent until within two weeks of confinement.

3

It is freely admitted that the dust often present in such employments as street-cleaning, stone-working or mining either contains the germs of such diseases as tuberculosis, as does street dust, or by coating the lungs renders the worker less able to resist infection.

Accidents

It is charged, and not disputed, that the use of power machinery has put a new aspect on the problem of accidents. It is impossible to get accurate information as to the relative frequency of serious accidents among hunting and fishing peoples as compared to modern industrial workers but the presence of different types of accidents is evident and the unequal accident rate in different industries is revealed by the statistics of our insurance companies.

Monotonous Work

Much complaint has been made of the evil influence of the monotony involved in the tending of machinery. Modern methods appear to require much greater regularity of labor and more concentration than those of our ancestors. It may

well be that adequate attention has not been given to the psychology of the matter. That fatigue bears a relation to accident needs no proof. Short rest periods have shown a marked increase in production. A weakness of present industry may lie in the inability of the worker to think in terms of the finished product. In a school for the feebleminded a rug-making machine was introduced which the children liked to work. After a time the institution tried to have long strips of carpet made but the children lost their interest. Finally, one boy in reply to a question said: “Oh, you don't never get anything done." The hint was taken. The children were put to work on short strips easily finished by individuals. The machine became popular again. They couldn't distinguish their share of the long pieces. When, however, Jack London ascribes his wandering habits to the monotonous employment of early years a question is raised as to whether this is a reason or an excuse. Men like Jack London and Josiah Flynt are seldom steady workers.

Antisocial Selection

The complaints are by no means limited to industry. It is alleged that medicine and surgery, in the long run, are harmful in their results. They too interfere with the beneficial operation of the law of natural selection. Often they save the weaklings who without them would perish and make it possible for them to become parents. The woman with a narrow pelvis, physically unfit to become a mother, instead of dying in childbirth is saved by an operation. She lives but has no more children. The family is saved at the expense of the race for, otherwise, the widower would have remarried and had other children as the tombstones in old cemeteries indicate. Thus the healing art benefits the individual but harms the race. Furthermore it imposes a financial burden on the survivors who must care for the wrecks unable to maintain themselves.

To some extent all the foregoing charges contain a criticism of social ideals and customs, for the doctor in the long run does what society wants. He cannot be held responsible for what society later allows to happen. There are, however, certain specific complaints of current standards deserving of notice.

POPULATION PROBLEMS

The Declining Birth Rate

It has been noted in all civilizations by careful observers that the birth rate was falling. "In my day all Hellas suffered from childlessness, and from lack of population, to such an extent that the cities were emptied and the earth did not produce its fruits, though neither uninterrupted wars nor pestilences had fallen to our lot. Man had succumbed to vanity, to lust of gold, to laziness; he would not marry, or if he did, he raised no children." So wrote Polybius in the second century B.C. Later Greeks voiced the same complaint. The old Greek population seems to have been replaced by newcomers, only the larger towns preserving even their old Greek names. This appears to have happened many times in history. It is well known that the rate of population growth has fallen recently in civilized lands despite the tremendous expansion of the last century. This is shown in the graph in Figure 35.*

We are not now concerned with the question as to whether a fall in the rate of population growth is in itself a good or a bad thing. From the standpoint of the critics the significance lies, in large part, in the belief that the decline comes chiefly in the groups best fitted to become parents. The charge, then, is that the change is not only one of quantity but also of quality. This merits far more careful inquiry than can be made here and a mere outline must suffice.

Man is distinguished from other animals by the lengthened

period of care for the young. The child of primitive man becomes independent of parental support much earlier than does the child of civilized man. The child destined for professional life cannot become self-supporting until he is much older than one who is to earn his bread by unskilled

FIG. 35. THE DECLINING BIRTH RATE IN EUROPE

Smoothed curves based on decennial census enumerations of population and average number of births reported for groups of five years, of which the census year is the central year. This graph disregards short-time fluctuations due to wars, famine, business cycles, and the like. Post-war figures are for the latest single year available. (From Louis I. Dublin, Population Problems in the United States and Canada, Publication Number Five of the Pollak Foundation for Economic Research, Houghton Mifflin Co.)

labor. The cost of this added training steadily increases and the burden on the family exchequer rises. On these facts all are agreed. Moreover, in agriculture-and to a lesser extent in unskilled trades-the children become workers, that is, family assets, long before they start out for themselves.

The net result of these things is the creation of a differential marriage rate and, consequently, a differential birth