Part 13

A medical friend of my own, when once in the dentist's chair under the influence of nitrous oxide anaesthesia (a condition, as William James showed, which frequently leads us to believe we are solving the problems of the universe), imagined himself facing the Almighty and insistently demanding the real object of the existence of the world. And the Almighty's answer came in one word: "Reproduction." My friend is a man of philosophic mind, and the solution of the mystery of the world's purpose thus presented to him in vision may perhaps serve as a simple and ultimate statement of the object of life. From the very outset the great object of Nature to our human eyes seems to be primarily reproduction, in the long run, indeed, an effort after economy of method in the attainment of an ever greater perfection, but primarily reproduction. This tendency to reproduction is indeed so fundamental, it is impressed on vital organisation with so great a violence of emphasis, that we may regard the course of evolution as much more an effort to slow down reproduction than to furnish it with any new facilities.

We must remember that reproduction appears in the history of life before sex appears. The lower forms of animal and plant life often reproduce themselves without the aid of sex, and it has even been argued that reproduction and sex are directly antagonistic, that active propagation is always checked when sexual differentiation is established. "The impression one gains of sexuality," remarks Professor Coulter, foremost of American botanists, "is that it represents reproduction under peculiar difficulties." Bacteria among primitive plants and protozoa among primitive animals are patterns of rapid and prolific reproduction, though sex begins to appear in a rudimentary form in very lowly forms of life, even among the protozoa, and is at first compatible with a high degree of reproduction. A single infusorian becomes in a week the ancestor of millions, that is to say, of far more individuals than could proceed under the most favourable conditions from a pair of elephants in five centuries, while Huxley calculated that the progeny of a single parthenogenetic aphis, under favouring circumstances, would in a few months outweigh the whole population of China. That proviso--"under favouring conditions"--is of great importance, for it reveals the weak point in this early method of Nature's for conducting evolution by enormously rapid multiplication. Creatures so easily produced could be, and were, easily destroyed; no time had been spent on imparting to them the qualities that would enable them to lead, what we should call in our own case, long and useful lives.

Yet the method of rapid multiplication was not readily or speedily abandoned by Nature. Still speaking in our human way, we may say that she tried to give it every chance. Among insects that have advanced so far as the white ants, we find that the queen lays eggs at an enormous rate during the whole of her active life, according to some estimates at the rate of 80,000 a day. Even in the more primitive members of the great vertebrate group, to which we ourselves belong, reproduction is sometimes still on almost as vast a scale as among lower organisms. Thus, among herrings, nearly 70,000 eggs have been found in a single female; but the herring, nevertheless, does not tend to increase in the seas, for it is everywhere preyed upon by whales and seals and sharks and birds, and, not least, by man. Thus early we see the connection between a high death-rate and a high birth-rate.

The evidence against reckless reproduction at last, however, proved overwhelming. With whatever hesitation, Nature finally decided, once and for all, that it was better, from every point of view, to produce a few superior beings than a vast number of inferior beings. For while the primary end of Nature may be said to be reproduction, there is a secondary end of scarcely less equal urgency, and that is evolution. In other words, while Nature seems to our human eyes to be seeking after quantity, she is also seeking, and with ever greater eagerness, after quality. Now the method of rapid and easy reproduction, it had become clear, not only failed of its own end, for the inferior creatures thus produced were unable to maintain their position in life, but it was distinctly unfavourable to any advance in quality. The method of sexual reproduction, which had existed in a germinal form more or less from the beginning, asserted itself ever more emphatically, and a method like that of parthenogenesis, or reproduction by the female unaided by the male (illustrated by the aphis), which had lingered on even beside sexual reproduction, absolutely died out in higher evolution. Now the fertilisation involved by the existence of two sexes is, as Weismann insisted, simply an arrangement which renders possible the intermingling of two different hereditary tendencies. The object of sex, that is to say, is by no means to aid reproduction, but rather to subordinate and check reproduction in order to evolve higher and more complex beings. Here we come to the great principle, which Herbert Spencer developed at length in his Principles of Biology, that, as he put it, Individuation and Genesis vary inversely, whence it followed that advancing evolution must be accompanied by declining fertility. Individuation, which means complexity of structure, has advanced, as Genesis, the unrestricted tendency to mere multiplication, has receded. This involves a diminished number of offspring, but an increased amount of time and care in the creation and breeding of each; it involves also that the reproductive life of the organism is shortened and more or less confined to special periods; it begins much later, it usually ends earlier, and even in its period of activity it tends to fall into cycles. Nature, we see, who, at the outset, had endowed her children so lavishly with the aptitude for multiplication, grown wiser now, expends her fertile imagination in devising preventive checks on reproduction for her children's use.

The result is that, though reproduction is greatly slackened, evolution is greatly accelerated. The significance of sex, as Coulter puts it, "lies in the fact that it makes organic evolution more rapid and far more varied." It is scarcely necessary to emphasise that a highly important, and, indeed, essential aspect of this greater individuation is a higher survival value. The more complex and better equipped creature can meet and subdue difficulties and dangers to which the more lowly organised creature that came before--produced wholesale in a way which Nature seems now to look back on as cheap and nasty--succumbed helplessly without an effort. The idea of economy begins to assert itself in the world. It became clear in the course of evolution that it is better to produce really good and highly efficient organisms, at whatever cost, than to be content with cheap production on a wholesale scale. They allowed greater developmental progress to be made, and they lasted better. Even before man began it was proved in the animal world that the death-rate falls as the birth-rate falls.

If we wish to realise the vast progress in method which has been made, even within the limits of the vertebrates to which we ourselves belong, we have but to compare with the lowly herring, already cited, the highly evolved elephant. The herring multiplies with enormous rapidity and on a vast scale, and it possesses a very small brain, and is almost totally unequipped to grapple with the special difficulties of its life, to which it succumbs on a wholesale scale. A single elephant is carried for about two years in his mother's womb, and is carefully guarded by her for many years after birth; he possesses a large brain; his muscular system is as remarkable for its delicacy as for its power and is guided by the most sensitive perceptions. He is fully equipped for all the dangers of his life, save for those which have been introduced by the subtle devilry of modern man, and though a single pair of elephants produces so few offspring, yet their high cost is justified, for each of them has a reasonable chance of surviving to old age. The contrast from the point of view of reproduction of the herring and the elephant, the low vertebrate and the high vertebrate, well illustrates the tendency of evolution. It clearly brings before us the difference between Nature's earlier and later methods, the ever growing preference for quality of offspring over quantity.

It has been necessary to touch on the wider aspects of reproduction in Nature, even when our main concern is with particular aspects of reproduction in man, for unless we understand the progressive tendency of reproduction in Nature, we shall probably fail to understand it in man. With these preliminary observations, we may now take up the question as it affects man.

It is not easy to ascertain the exact tendencies of reproduction in our own historical past or among the lower races of to-day. On the whole, it seems fairly clear that, under ordinary savage and barbarous conditions, rather more children are produced and rather more children die than among ourselves; there is, in other words, a higher birth-rate and a higher infantile death-rate. A high birth-rate with a low death-rate seems to have been even more exceptional than among ourselves, for under inelastic social conditions the community cannot adjust itself to the rapid expansion that would thus be rendered necessary. The community contracts, as it were, on this expanding portion and largely crushes it out of life by the forces of neglect, poverty, and disease. The only part of Europe in which we can to-day see how this works out on a large scale is Russia, for here we find in an exaggerated form conditions, which once tended to rule all over Europe, side by side with the beginnings of better things, with scientific progress and statistical observation. Yet in Russia, up till recently, if not even still, there has only been about one doctor to every twelve thousand inhabitants, and the witch-doctor has flourished. Small-pox, scarlet fever, diphtheria, typhoid, and syphilis also flourish, and not only flourish, but show an enormously higher mortality than in other European countries. More significant still, famine and typhus, the special disease of filth and overcrowding and misery--both of them banished, save in the most abnormal times, from the rest of Europe--have in modern times ravaged Russia on a vast scale. Ignorance, superstition, insanitation, filth, bad food, impure water, lead to a vast mortality among children which has sometimes destroyed more than half of them before they reach the age of five; so that, enormously high as the Russian birth-rate is, the death-rate has sometimes exceeded it. Nor is it found, as some would-be sagacious persons confidently assert, that the high birth-rate is justified by the better quality of the survivors. On the contrary, there is a very large proportion of chronic and incurable diseases among the survivors; blindness and other defects abound; and though there are many very large and fine people in Russia, the average stature of the Russians is lower than that of most European peoples.

Russia is in the era of expanding industrialism--a fateful period for any people, as we shall see directly--and the results resemble those which followed, and to some extent exist still, further west. The workers, whose hours often extended to twelve or fourteen, frequently had no homes but slept in the factory itself, in the midst of the machinery, or in a sort of dormitory above it, with a minimum of space and fresh air, men and women promiscuously, on wooden shelves, one above the other, under the eye of Government inspectors whose protests were powerless to effect any change. This is, always and everywhere, even among so humane a people as the Russians, the natural and inevitable result of a high birth-rate in an era of expanding industrialism. Here is the goal of unrestricted reproduction, the same among men as among herrings. This is the ideal of those persons, whether they know it or not, who in their criminal rashness would dare to arrest that fall in the birth-rate which is now beginning to spread its beneficent influence in every civilised land.

We have no means of ascertaining precisely the birth-rate in Western Europe before the nineteenth century, but the estimates of the population which have been made by the help of various data indicate that the increase during a century was very moderate. In England, for instance, families scarcely seem to have been very large, and, even apart from wars, many plagues and pestilences, during the eighteenth century more especially small-pox, constantly devastated the population, so that, with these checks on the results of reproduction, the population was able to adjust itself to its very gradual expansion. The mortality fell heavily on young children, as we observe in old family records, where we frequently find two or even three children of the same Christian name, the first child having died and its name been given to a successor.

During the last quarter of the eighteenth century, a new phase of social life, profoundly affecting the reproductive habits of the community, made its appearance in Western Europe, at first in England. This was the new industrial era, due to the introduction of machinery. All the social methods of gradual though awkward adaptation to a slow expansion were dislocated. Easy expansion of population became a possibility, for factories were constantly springing up, and "hands" were always in demand. Moreover, these "hands" could be children for it was possible to tend machinery at a very early age. The richest family was the family with most children. The population began to expand rapidly.

It was an era of prosperity. But when it began to be realised what this meant it was seen that such "prosperity" was far from an enviable condition. A community cannot suddenly adjust itself to a sudden expansion, still less can it adjust itself to a continuous rapid expansion. Disease, misery, and poverty flourished in this prosperous new industrial era. Filth and insanitation, immorality and crime, were fostered by overcrowding in ill-built urban areas. Ignorance and stupidity abounded, for the child, placed in the monotonous routine of the factory when little more than an infant, was deprived alike of the education of the school and of the world. Higher wages brought no higher refinement and were squandered on food and drink, on the lowest vulgar tastes. Such "prosperity" was merely a brutalising influence; it meant nothing for the growth of civilisation and humanity.

Then a wholesome movement of reaction set in. The betterment of the environment--that was the great task that social pioneers and reformers saw before them. They courageously set about the herculean task of cleansing this Augean stable of "Prosperity." The era of sanitation began. The endless and highly beneficent course of factory legislature was inaugurated.

That is the era which, in every progressive country of the world, we are living in still. The final tendency of it, however, was not foreseen by its great pioneers, or even its humble day-labourers of the present time. For they were not attacking reproduction; they were fighting against bad conditions, and may even have thought that they were enabling reproduction to expand more freely. They had not realised that to improve the environment is to check reproduction, being indeed the one and only way in which undue reproduction can be checked. That may be said to be an aspect of the opposition between Genesis and Individuation, on which Herbert Spencer insisted, for by improving the environment we necessarily improve the individual who is rooted in that environment. It is not, we must remember, a matter of conscious and voluntary action. That is clearly manifest by the fact that it occurs even among the most primitive micro-organisms; when placed under unfavourable conditions as to food and environment they tend to pass into a reproductive phase and by sporulation or otherwise begin to produce new individuals rapidly. It is the same in Man. Improve the environment and reproduction is checked. That is, as Professor Benjamin Moore has said, "the simple biological reply to good economic conditions." It is only among the poor, the ignorant, and the wretched that reproduction flourishes. "The tendency of civilisation," as Leroy-Beaulieu concludes, "is to reduce the birth-rate." Those who desire a high birth-rate are desiring, whether they know it or not, the increase of poverty, ignorance, and wretchedness.

So far we have been dealing with fundamental laws and tendencies, which were established long before Man appeared on the earth, although Man has often illustrated, and still illustrates, their inevitable character. We have not been brought in contact with the influence of conscious design and deliberate intention. At this point we reach a totally new aspect of reproduction.

II.

THE ORIGIN AND RESULTS OF BIRTH CONTROL

In tracing the course of reproduction we have so far been concerned with what are commonly considered the blind operations of Nature in the absence of conscious and deliberate volition. We have seen that while at the outset Nature seems to have impressed an immense reproductive impetus on her creatures, all her energy since has been directed to the imposition of preventive checks on that reproductive impetus. The end attained by these checks has been an extreme diminution in the number of offspring, a prolongation of the time devoted to the breeding and care of each new member of the family, in harmony with its greatly prolonged life, a spacing out of the intervals between the offspring, and, as a result, a vastly greater development of each individual and an ever better equipment for the task of living. All this was slowly attained automatically, without any conscious volition on the part of the individuals, even when they were human beings, who were the agents. Now occurred a change which we may regard as, in some respects, the most momentous sudden advance in the whole history of reproduction: the process of reproductive progress became conscious and deliberately volitional.

We often fancy that when natural progress becomes manifested in the mind and will of man it is somehow unnatural. It is one of the wisest of Shakespeare's utterances in one of the most mature of his plays that

"Nature is made better by no mean But Nature makes that mean ... This is an art Which does mend Nature, change it rather, but The art itself is Nature."

Birth control, when it ceases to be automatic and becomes conscious, is an art. But it is an art directed precisely to the attainment of ends which Nature has been struggling after for millions of years, and, being consciously and deliberately an art, it is enabled to avoid many of the pitfalls which the unconscious method falls into. It is an art, but

"The art itself is Nature."

It is always possible for the narrow-eyed fanatic to object to the employment of birth control, precisely as he might object to the use of clothes, as "unnatural." But, if we look more deeply into the matter, we see that even clothes are not truly unnatural. A vast number of creatures may be said to be born in clothes, clothes so naturally such that, when stripped from the animals they belong to, we are proud to wear them ourselves. Even our own ancestors were born in clothes, which they lost by the combined or separate action of natural selection, sexual selection, and the environment, which action, however, has not sufficed to abolish the desirability of clothes. So that the impulse by which we make for ourselves clothes is merely a conscious and volitional form of an impulse which, in the absence of consciousness and will, had acted automatically. It is just the same with the control and limitation of reproductive activity. It is an attempt by open-eyed intelligence and foresight to attain those ends which Nature through untold generations has been painfully yet tirelessly struggling for. The deliberate co-operation of Man in the natural task of birth-control represents an identification of the human will with what we may, if we choose, regard as the divinely appointed law of the world. We can well believe that the great pioneers who, a century ago, acted in the spirit of this faith may have echoed the thought of Kepler when, on discovering his great planetary law, he exclaimed in rapture: "O God! I think Thy thoughts after Thee."

As a matter of fact, however, it was in no such spirit of ecstasy that the pioneers of the movement for birth control acted. The Divine command is less likely to be heard in the whirlwind than in the still small voice. These great pioneers were thoughtful, cautious, hard-headed men, who spoke scarcely above a whisper, and were far too modest to realise that a great forward movement in natural evolution had in them begun to be manifested. Early man could not have taken this step because it is even doubtful whether he knew that the conjunction of the sexes had anything to do with the production of offspring, which he was inclined to attribute to magical causes. Later, although intelligence grew, the uncontrolled rule of the sexual impulse obtained so firm a grip on men that they laughed at the idea that it was possible to exercise forethought and prudence in this sphere; at the same time religion and superstition came into action to preserve the established tradition and to persuade people that it would be wicked to do anything different from what they had always done. But a saner feeling was awakening here and there, in various parts of the world. At last, under the stress of the devastation and misery caused by the reproductive relapse of the industrial era, this feeling, voiced by a few distinguished men, began to take shape in action.

The pioneers were English. Among them Malthus occupies the first place. That distinguished man, in his great and influential work, The Principle of Population, in 1798, emphasised the immense importance of foresight and self-control in procreation, and the profound significance of birth limitation for human welfare. Malthus relied, however, on ascetic self-restraint, a method which could only appeal to the few; he had nothing to say for the prevention of conception in intercourse. That was suggested, twenty years later, very cautiously by James Mill, the father of John Stuart Mill, in the Encyclopedia Britannica. Four years afterwards, Mill's friend, the Radical reformer, Francis Place, advocated this method more clearly. Finally, in 1831, Robert Dale Owen, the son of the great Robert Owen, published his Moral Physiology, in which he set forth the ways of preventing conception; while a little later the Drysdale brothers, ardent and unwearying philanthropists, devoted their energies to a propaganda which has been spreading ever since and has now conquered the whole civilised world.

It was not, however, in England but in France, so often at the head of an advance in civilisation, that birth control first became firmly established, and that the extravagantly high birth-rate of earlier times began to fall; this happened in the first half of the nineteenth century, whether or not it was mainly due to voluntary control. In England the movement came later, and the steady decline in the English birth-rate, which is still proceeding, began in 1877. In the previous year there had been a famous prosecution of Bradlaugh and Mrs. Besant for disseminating pamphlets describing the methods of preventing conception; the charge was described by the Lord Chief Justice, who tried the case, as one of the most ill-advised and injudicious ever made in a court of justice. But it served an undesigned end by giving enormous publicity to the subject and advertising the methods it sought to suppress. There can be no doubt, however, that even apart from this trial the movement would have proceeded on the same lines. The times were ripe, the great industrial expansion had passed its first feverish phase, social conditions were improving, education was spreading. The inevitable character of the movement is indicated by the fact that at the very same time it began to be manifested all over Europe, indeed in every civilised country of the world. At the present time the birth-rate (as well as usually the death-rate) is falling in every country of the world sufficiently civilised to possess statistics of its own vital movement. The fall varies in rapidity. It has been considerable in the more progressive countries; it has lingered in the more backward countries. If we examine the latest statistics for Europe (usually those for 1913) we find that every country, without exception, with a progressive and educated population, and a fairly high state of social well-being, presents a birth-rate below 30 per 1,000. We also find that every country in Europe in which the mass of the people are primitive, ignorant, or in a socially unsatisfactory condition (even although the governing classes may be progressive or ambitious) shows a birth-rate above 30 per 1,000. France, Great Britain, Belgium, Holland, the Scandinavian countries and Switzerland are in the first group. Russia, Austro-Hungary, Italy, Spain and the Balkan countries are in the second group. The German Empire was formerly in this second group but now comes within the first group, and has carried on the movement so energetically that the birth-rate of Berlin is already below that of London, and that at the present rate of decline the birth-rate of the German Empire will before long sink to that of France. Outside Europe, in the United States just as much as in Australia and New Zealand, the same great progressive movement is proceeding with equal activity.

The wide survey of the question of birth limitation here taken may seem to some readers unnecessary. Why not get at once to matters of practical detail? But, if we think of it, our wide survey has been of the greatest practical help to us. It has, for instance, settled the question of the desirability of the adoption of methods of preventing conception and finally silenced those who would waste our time with their fears lest it is not right to control conception. We know now on whose side are the laws of God and Nature. We realise that in exercising control over the entrance gate of life we are not only performing, consciously and deliberately, a great human duty, but carrying on rationally a beneficial process which has, more blindly and wastefully, been carried on since the beginning of the world. There are still a few persons ignorant enough or foolish enough to fight against the advance of civilisation in this matter; we can well afford to leave them severely alone, knowing that in a few years all of them will have passed away. It is not our business to defend the control of birth, but simply to discuss how we may most wisely exercise that control.

Many ways of preventing conception have been devised since the method which is still the commonest was first introduced, so far as our certainly imperfect knowledge extends, by a clever Jew, Onan (Genesis, Chap. XXXVIII), whose name has since been wrongly attached to another practice with which the Mosaic record in no way associates him. There are now many contraceptive methods, some dependent on precautions adopted by the man, others dependent on the woman, others again which take the form of an operation permanently preventing conception, and, therefore, not to be adopted save by couples who already have as many children as they desire, or else who ought never to have children at all and thus wisely adopt a method of sterilisation. It is unnecessary here, even if it were otherwise desirable, to discuss these various methods in detail. It is even useless to do so, for we must bear in mind that no method can be absolutely approved or absolutely condemned. Each may be suitable under certain conditions and for certain couples, and it is not easy to recommend any method indiscriminately. We need to know the intimate circumstances of individual cases. For the most part, experience is the final test. Forel compared the use of contraceptive devices to the use of eyeglasses, and it is obvious that, without expert advice, the results in either case may sometimes be mischievous or at all events ineffective. Personal advice and instruction are always desirable. In Holland nurses are medically trained in a practical knowledge of contraceptive methods, and are thus enabled to enlighten the women of the community. This is an admirable plan. Considering that the use of contraceptive measures is now almost universal, it is astonishing that there are yet so many so-called "civilised" countries in which this method of enlightenment is not everywhere adopted. Until it is adopted, and a necessary knowledge of the most fundamental facts of the sexual life brought into every home, the physician must be regarded as the proper adviser. It is true that until recently he was generally in these matters a blind leader of the blind. Nowadays it is beginning to be recognised that the physician has no more serious and responsible duty than that of giving help in the difficult path of the sexual life. Very frequently, indeed, even yet, he has not risen to a sense of his responsibilities in this matter. It is as well to remember, however, that a physician who is unable or unwilling to give frank and sound advice in this most important department of life, is unlikely to be reliable in any other department. If he is not up to date here he is probably not up to date anywhere.