The inability to suckle acquires great significance if we realize that it is associated, probably in a large measure as a direct cause, with infantile mortality. The mortality of artificially-fed infants during the first year of life is seldom less than double that of the breast-fed, sometimes it is as much as three times that of the breast-fed, or even more; thus at Derby 51.7 per cent. of hand-fed infants die under the age of twelve months, but only 8.6 per cent. of breast-fed infants. Those who survive are by no means free from suffering. At the end of the first year they are found to weigh about 25 per cent. less than the breast-fed, and to be much shorter; they are more liable to tuberculosis and rickets, with all the evil results that flow from these diseases; and there is some reason to believe that the development of their teeth is injuriously affected. The degenerate character of the artificially-fed is well indicated by the fact that of 40,000 children who were brought for treatment to the Children's Hospital in Munich, 86 per cent. had been brought up by hand, and the few who had been suckled had usually only had the breast for a short time. The evil influence persists even up to adult life. In some parts of France where the wet-nurse industry flourishes so greatly that nearly all the children are brought up by hand, it has been found that the percentage of rejected conscripts is nearly double that for France generally. Corresponding results have been found by Friedjung in a large German athletic association. Among 155 members, 65 per cent. were found on inquiry to have been breast-fed as infants (for an average of six months); but among the best athletes the percentage of breast-fed rose to 72 per cent. (for an average period of nine or ten months), while for the group of 56 who stood lowest in athletic power the percentage of breast-fed fell to 57 (for an average of only three months).
The advantages for an infant of being suckled by its mother are greater than can be accounted for by the mere fact of being suckled rather than hand-fed. This has been shown by Vitrey (_De la Mortalité Infantile_, Thèse de Lyon, 1907), who found from the statistics of the Hôtel-Dieu at Lyons, that infants suckled by their mothers have a mortality of only 12 per cent., but if suckled by strangers, the mortality rises to 33 per cent. It may be added that, while suckling is essential to the complete well-being of the child, it is highly desirable for the sake of the mother's health also. (Some important statistics are summarized in a paper on "Infantile Mortality" in _British Medical Journal_, Nov. 2, 1907), while the various aspects of suckling have been thoroughly discussed by Bollinger, "Ueber Säuglings-Sterblichkeit und die Erbliche functionelle Atrophie der menschlichen Milchdrüse" (_Correspondenzblatt Deutschen Gesellschaft Anthropologie_, Oct., 1899).
It appears that in Sweden, in the middle of the eighteenth century, it was a punishable offense for a woman to give her baby the bottle when she was able to suckle it. In recent years Prof. Anton von Menger, of Vienna, has argued (in his _Burgerliche Recht und die Besitzlosen Klassen_) that the future generation has the right to make this claim, and he proposes that every mother shall be legally bound to suckle her child unless her inability to do so has been certified by a physician. E.A. Schroeder (_Das Recht in der Geschlechtlichen Ordnung_, 1893, p. 346) also argued that a mother should be legally bound to suckle her infant for at least nine months, unless solid grounds could be shown to the contrary, and this demand, which seems reasonable and natural, since it is a mother's privilege as well as her duty to suckle her infant when able to do so, has been insistently made by others also. It has been supported from the legal side by Weinberg (_Mutterschutz_, Sept., 1907). In France the Loi Roussel forbids a woman to act as a wet-nurse until her child is seven months old, and this has had an excellent effect in lowering infantile mortality (A. Allée, _Puériculture et la Loi Roussel_, Thèse de Paris, 1908). In some parts of Germany manufacturers are compelled to set up a suckling-room in the factory, where mothers can give the breast to the child in the intervals of work. The control and upkeep of these rooms, with provision of doctors and nurses, is undertaken by the municipality (_Sexual-Probleme_, Sept., 1908, p. 573).
As things are to-day in modern industrial countries the righting of these wrongs cannot be left to Nature, that is, to the ignorant and untrained impulses of persons who live in a whirl of artificial life where the voice of instinct is drowned. The mother, we are accustomed to think, may be trusted to see to the welfare of her child, and it is unnecessary, or even "immoral," to come to her assistance. Yet there are few things, I think, more pathetic than the sight of a young Lancashire mother who works in the mills, when she has to stay at home to nurse her sick child. She is used to rise before day-break to go to the mill; she has scarcely seen her child by the light of the sun, she knows nothing of its necessities, the hands that are so skilful to catch the loom cannot soothe the child. The mother gazes down at it in vague, awkward, speechless misery. It is not a sight one can ever forget.
It is France that is taking the lead in the initiation of the scientific and practical movements for the care of the young child before and after birth, and it is in France that we may find the germs of nearly all the methods now becoming adopted for arresting infantile mortality. The village system of Villiers-le-Duc, near Dijon in the Côte d'Or, has proved a germ of this fruitful kind. Here every pregnant woman not able to secure the right conditions for her own life and that of the child she is bearing, is able to claim the assistance of the village authorities; she is entitled, without payment, to the attendance of a doctor and midwife and to one franc a day during her confinement. The measures adopted in this village have practically abolished both maternal and infantile mortality. A few years ago Dr. Samson Moore, the medical officer of health for Huddersfield, heard of this village, and Mr. Benjamin Broadbent, the Mayor of Huddersfield, visited Villiers-le-Duc. It was resolved to initiate in Huddersfield a movement for combating infant mortality. Henceforth arose what is known as the Huddersfield scheme, a scheme which has been fruitful in splendid results. The points of the Huddersfield scheme are: (1) compulsory notification of births within forty-eight hours; (2) the appointment of lady assistant medical officers of help to visit the home, inquire, advise, and assist; (3) the organized aid of voluntary lady workers in subordination to the municipal part of the scheme; (4) appeal to the medical officer of help when the baby, not being under medical care, fails to thrive. The infantile mortality of Huddersfield has been very greatly reduced by this scheme.[16] The Huddersfield scheme may be said to be the origin of the English Notification of Births Act, which came into operation in 1908. This Act represents, in England, the national inauguration of a scheme for the betterment of the race, the ultimate results of which it is impossible to foresee. When this Act comes into universal action every baby of the land will be entitled--legally and not by individual caprice or philanthropic condescension--to medical attention from the day of birth, and every mother will have at hand the counsel of an educated woman in touch with the municipal authorities. There could be no greater triumph for medical science, for national efficiency, and the cause of humanity generally. Even on the lower financial plane, it is easy to see that an enormous saving of public and private money will thus be effected. The Act is adoptive, and not compulsory. This was a wise precaution, for an Act of this kind cannot be effectual unless it is carried out thoroughly by the community adopting it, and it will not be adopted until a community has clearly realized its advantages and the methods of attaining them.
An important adjunct of this organization is the School for Mothers. Such schools, which are now beginning to spring up everywhere, may be said to have their origins in the _Consultations de Nourrissons_ (with their offshoot the _Goutte de Lait_), established by Professor Budin in 1892, which have spread all over France and been widely influential for good. At the _Consultations_ infants are examined and weighed weekly, and the mothers advised and encouraged to suckle their children. The _Gouttes_ are practically milk dispensaries where infants for whom breast-feeding is impossible are fed with milk under medical supervision. Schools for Mothers represent an enlargement of the same scheme, covering a variety of subjects which it is necessary for a mother to know. Some of the first of these schools were established at Bonn, at the Bavarian town of Weissenberg, and in Ghent. At some of the Schools for Mothers, and notably at Ghent (described by Mrs. Bertrand Russell in the _Nineteenth Century_, 1906), the important step has been taken of giving training to young girls from fourteen to eighteen; they receive instruction in infant anatomy and physiology, in the preparation of sterilized milk, in weighing children, in taking temperatures and making charts, in managing crêches, and after two years are able to earn a salary. In various parts of England, schools for young mothers and girls on these lines are now being established, first in London, under the auspices of Dr. F.J. Sykes, Medical Officer of Health for St. Pancreas (see, e.g., _A School For Mothers_, 1908, describing an establishment of this kind at Somers Town, with a preface by Sir Thomas Barlow; an account of recent attempts to improve the care of infants in London will also be found in the _Lancet_, Sept. 26, 1908). It may be added that some English municipalities have established depôts for supplying mothers cheaply with good milk. Such depôts are, however, likely to be more mischievous than beneficial if they promote the substitution of hand-feeding for suckling. They should never be established except in connection with Schools for Mothers, where an educational influence may be exerted, and no mother should be supplied with milk unless she presents a medical certificate showing that she is unable to nourish her child (Byers, "Medical Women and Public Health Questions," _British Medical Journal_, Oct. 6, 1906). It is noteworthy that in England the local authorities will shortly be empowered by law to establish Schools for Mothers.
The great benefits produced by these institutions in France, both in diminishing the infant mortality and in promoting the education of mothers and their pride and interest in their children, have been set forth in two Paris theses by G. Chaignon (_Organisation des Consultations de Nourrissons à la Campagne_, 1908), and Alcide Alexandre (_Consultation de Nourrissons et Goutte de Lait d'Arques_, 1908).
The movement is now spreading throughout Europe, and an International Union has been formed, including all the institutions specially founded for the protection of child life and the promotion of puericulture. The permanent committee is in Brussels, and a Congress of Infant Protection (_Goutte de Lait_) is held every two years.
It will be seen that all the movements now being set in action for the improvement of the race through the child and the child's mother, recognize the intimacy of the relation between the mother and her child and are designed to aid her, even if necessary by the exercise of some pressure, in performing her natural functions in relation to her child. To the theoretical philanthropist, eager to reform the world on paper, nothing seems simpler than to cure the present evils of child-rearing by setting up State nurseries which are at once to relieve mothers of everything connected with the production of the men of the future beyond the pleasure--if such it happens to be--of conceiving them and the trouble of bearing them, and at the same time to rear them up independently of the home, in a wholesome, economical, and scientific manner.[17] Nothing seems simpler, but from the fundamental psychological standpoint nothing is falser. The idea of a State which is outside the community is but a survival in another form of that antiquated notion which compelled Louis XIV to declare "L'Etat c'est moi!" A State which admits that the individuals composing it are incompetent to perform their own most sacred and intimate functions, and takes upon itself to perform them instead, attempts a task which would be undesirable, even if it were possible of achievement. It must always be remembered that a State which proposes to relieve its constituent members of their natural functions and responsibilities attempts something quite different from the State which seeks to aid its members to fulfil their own biological and social functions more adequately. A State which enables its mothers to rest when they are child-bearing is engaged in a reasonable task; a State which takes over its mothers' children is reducing philanthropy to absurdity. It is easy to realize this if we consider the inevitable course of circumstances under a system of "State-nurseries." The child would be removed from its natural mother at the earliest age, but some one has to perform the mother's duties; the substitute must therefore be properly trained for such duties; and in exercising them under favorable circumstances a maternal relationship is developed between the child and the "mother," who doubtless possesses natural maternal instincts but has no natural maternal bond to the child she is mothering. Such a relationship tends to become on both sides practically and emotionally the real relationship. We very often have opportunity of seeing how unsatisfactory such a relationship becomes. The artificial mother is deprived of a child she had begun to feel her own; the child's emotional relationships are upset, split and distorted; the real mother has the bitterness of feeling that for her child she is not the real mother. Would it not have been much better for all if the State had encouraged the vast army of women it had trained for the position of mothering other women's children, to have, instead, children of their own? The women who are incapable of mothering their own children could then be trained to refrain from bearing them.
Ellen Key (in her _Century of the Child_, and elsewhere) has advocated for all young women a year of compulsory "service," analogous to the compulsory military service imposed in most countries on young men. During this period the girl would be trained in rational housekeeping, in the principles of hygiene, in the care of the sick, and especially in the care of infants and all that concerns the physical and psychic development of children. The principle of this proposal has since been widely accepted. Marie von Schmid (in her _Mutterdienst_, 1907) goes so far as to advocate a general training of young women in such duties, carried on in a kind of enlarged and improved midwifery school. The service would last a year, and the young woman would then be for three years in the reserves, and liable to be called up for duty. There is certainly much to be said for such a proposal, considerably more than is to be said for compulsory military service. For while it is very doubtful whether a man will ever be called on to fight, most women are liable to be called on to exercise household duties or to look after children, whether for themselves or for other people.
FOOTNOTES: FOOTNOTES: [1] It is not, of course, always literally true that each parent supplies exactly half the heredity, for, as we see among animals generally, the offspring may sometimes approach more nearly to one parent, sometimes to the other, while among plants, as De Vries and others have shown, the heredity may be still more unequally divided.
[2] It should scarcely be necessary to say that to assert that motherhood is a woman's supreme function is by no means to assert that her activities should be confined to the home. That is an opinion which may now be regarded as almost extinct even among those who most glorify the function of woman as mother. As Friedrich Naumann and others have very truly pointed out, a woman is not adequately equipped to fulfil her functions as mother and trainer of children unless she has lived in the world and exercised a vocation.
[3] "Were the capacities of the brain and the heart equal in the sexes," Lily Braun (_Die Frauenfrage_, page 207) well says, "the entry of women into public life would be of no value to humanity, and would even lead to a still wilder competition. Only the recognition that the entire nature of woman is different from that of man, that it signifies a new vivifying principle in human life, makes the women's movement, in spite of the misconception of its enemies and its friends, a social revolution" (see also Havelock Ellis, _Man and Woman_, fourth edition, 1904, especially Ch. XVIII).
[4] The word "puericulture" was invented by Dr. Caron in 1866 to signify the culture of children after birth. It was Pinard, the distinguished French obstetrician, who, in 1895, gave it a larger and truer significance by applying it to include the culture of children before birth. It is now defined as "the science which has for its end the search for the knowledge relative to the reproduction, the preservation, and the amelioration of the human race" (Péchin, _La Puériculture avant la Naissance_, Thèse de Paris, 1908).
[5] In _La Grossesse_ (pp. 450 et seq.) Bouchacourt has discussed the problems of puericulture at some length.
[6] The importance of antenatal puericulture was fully recognized in China a thousand years ago. Thus Madame Cheng wrote at that time concerning the education of the child: "Even before birth his education may begin; and, therefore, the prospective mother of old, when lying down, lay straight; when sitting down, sat upright; and when standing, stood erect. She would not taste strange flavors, nor have anything to do with spiritualism; if her food were not cut straight she would not eat it, and if her mat were not set straight, she would not sit upon it. She would not look at any objectionable sight, nor listen to any objectionable sound, nor utter any rude word, nor handle any impure thing. At night she studied some canonical work, by day she occupied herself with ceremonies and music. Therefore, her sons were upright and eminent for their talents and virtues; such was the result of antenatal training" (H.A. Giles, "Woman in Chinese Literature," _Nineteenth Century_, Nov., 1904).
[7] Max Bartels, "Isländischer Brauch," etc., _Zeitschrift für Ethnologie_, 1900, p. 65. A summary of the customs of various peoples in regard to pregnancy is given by Ploss and Bartels, _Das Weib_, Sect. XXIX.
[8] On the influence of alcohol during pregnancy on the embryo, see, e.g., G. Newman, _Infant Mortality_, pp. 72-77. W.C. Sullivan (_Alcoholism_, 1906, Ch. XI), summarizes the evidence showing that alcohol is a factor in human degeneration.
[9] There is even reason to believe that the alcoholism of the mother's father may impair her ability as a mother. Bunge (_Die Zunehmende Unfähigkeit der Frauen ihre Kinder zu Stillen_, fifth edition, 1907), from an investigation extending over 2,000 families, finds that chronic alcoholic poisoning in the father is the chief cause of the daughter's inability to suckle, this inability not usually being recovered in subsequent generations. Bunge has, however, been opposed by Dr. Agnes Bluhm, "Die Stillungsnot," _Zeitschrift für Soziale Medizin_, 1908 (fully summarized by herself in _Sexual-Probleme_, Jan., 1909).
[10] See, e.g., T. Arthur Helme, "The Unborn Child," _British Medical Journal_, Aug. 24, 1907. Nutrition should, of course, be adequate. Noel Paton has shown (_Lancet_, July 4, 1903) that defective nutrition of the pregnant woman diminishes the weight of the offspring.
[11] Debreyne, _Moechialogie_, p. 277. And from the Protestant side see Northcote (_Christianity and Sex Problems_, Ch. IX), who permits sexual intercourse during pregnancy.
[12] See Appendix A to the third volume of these _Studies_; also Ploss and Bartels, loc. cit.
[13] Thus one lady writes: "I have only had one child, but I may say that during pregnancy the desire for union was much stronger, for the whole time, than at any other period." Bouchacourt (_La Grossesse_, pp. 180-183) states that, as a rule, sexual desire is not diminished by pregnancy, and is occasionally increased.
[14] This "inconvenience" remains to-day a stumbling-block with many excellent authorities. "Except when there is a tendency to miscarriage," says Kossmann (Senator and Kaminer, _Health and Disease in Relation to Marriage_, vol. i, p. 257), "we must be very guarded in ordering abstinence from intercourse during pregnancy," and Ballantyne (_The Foetus_, p. 475) cautiously remarks that the question is difficult to decide. Forel also (_Die Sexuelle Frage_, fourth edition, p. 81), who is not prepared to advocate complete sexual abstinence during a normal pregnancy, admits that it is a rather difficult question.
[15] This point is discussed, for instance, by Séropian in a Paris Thesis (_Fréquence comparée des Causes de l'Accouchement Prémature_, 1907); he concludes that coitus during pregnancy is a more frequent cause of premature confinement than is commonly supposed, especially in primiparæ, and markedly so by the ninth month.
[16] "Infantile Mortality: The Huddersfield Scheme," _British Medical Journal_, Dec., 1907; Samson Moore, "Infant Mortality," ib., August 29, 1908.
[17] Ellen Key has admirably dealt with proposals of this kind (as put forth by C.P. Stetson) in her Essays "On Love and Marriage." In opposition to such proposals Ellen Key suggests that such women as have been properly trained for maternal duties and are unable entirely to support themselves while exercising them should be subsidized by the State during the child's first three years of life. It may be added that in Leipzig the plan of subsidizing mothers who (under proper medical and other supervision) suckle their infants has already been introduced.
CHAPTER II.
SEXUAL EDUCATION.
Nurture Necessary as Well as Breed--Precocious Manifestations of the Sexual Impulse--Are They to be Regarded as Normal?--The Sexual Play of Children--The Emotion of Love in Childhood--Are Town Children More Precocious Sexually Than Country Children?--Children's Ideas Concerning the Origin of Babies--Need for Beginning the Sexual Education of Children in Early Years--The Importance of Early Training in Responsibility--Evil of the Old Doctrine of Silence in Matters of Sex--The Evil Magnified When Applied to Girls--The Mother the Natural and Best Teacher--The Morbid Influence of Artificial Mystery in Sex Matters--Books on Sexual Enlightenment of the Young--Nature of the Mother's Task--Sexual Education in the School--The Value of Botany--Zoölogy--Sexual Education After Puberty--The Necessity of Counteracting Quack Literature--Danger of Neglecting to Prepare for the First Onset of Menstruation--The Right Attitude Towards Woman's Sexual Life--The Vital Necessity of the Hygiene of Menstruation During Adolescence--Such Hygiene Compatible with the Educational and Social Equality of the Sexes--The Invalidism of Women Mainly Due to Hygienic Neglect--Good Influence of Physical Training on Women and Bad Influence of Athletics--The Evils of Emotional Suppression--Need of Teaching the Dignity of Sex--Influence of These Factors on a Woman's Fate in Marriage--Lectures and Addresses on Sexual Hygiene--The Doctor's Part in Sexual Education--Pubertal Initiation Into the Ideal World--The Place of the Religious and Ethical Teacher--The Initiation Rites of Savages Into Manhood and Womanhood--The Sexual Influence of Literature--The Sexual Influence of Art.
It may seem to some that in attaching weight to the ancestry, the parentage, the conception, the gestation, even the first infancy, of the child we are wandering away from the sphere of the psychology of sex. That is far from being the case. We are, on the contrary, going to the root of sex. All our growing knowledge tends to show that, equally with his physical nature, the child's psychic nature is based on breed and nurture, on the quality of the stocks he belongs to, and on the care taken at the early moments when care counts for most, to preserve the fine quality of those stocks.
It must, of course, be remembered that the influences of both breed and nurture are alike influential on the fate of the individual. The influence of nurture is so obvious that few are likely to under-rate it. The influence of breed, however, is less obvious, and we may still meet with persons so ill informed, and perhaps so prejudiced, as to deny it altogether. The growth of our knowledge in this matter, by showing how subtle and penetrative is the influence of heredity, cannot fail to dispel this mischievous notion. No sound civilization is possible except in a community which in the mass is not only well-nurtured but well-bred. And in no part of life so much as in the sexual relationships is the influence of good breeding more decisive. An instructive illustration may be gleaned from the minute and precise history of his early life furnished to me by a highly cultured Russian gentleman. He was brought up in childhood with his own brothers and sisters and a little girl of the same age who had been adopted from infancy, the child of a prostitute who had died soon after the infant's birth. The adopted child was treated as one of the family, and all the children supposed that she was a real sister. Yet from early years she developed instincts unlike those of the children with whom she was nurtured; she lied, she was cruel, she loved to make mischief, and she developed precociously vicious sexual impulses; though carefully educated, she adopted the occupation of her mother, and at the age of twenty-two was exiled to Siberia for robbery and attempt to murder. The child of a chance father and a prostitute mother is not fatally devoted to ruin; but such a child is ill-bred, and that fact, in some cases, may neutralize all the influences of good nurture.
When we reach the period of infancy we have already passed beyond the foundations and potentialities of the sexual life; we are in some cases witnessing its actual beginnings. It is a well-established fact that auto-erotic manifestations may sometimes be observed even in infants of less than twelve months. We are not now called upon to discuss the disputable point as to how far such manifestations at this age can be called normal.[18] A slight degree of menstrual and mammary activity sometimes occurs at birth.[19] It seems clear that nervous and psychic sexual activity has its first springs at this early period, and as the years go by an increasing number of individuals join the stream until at puberty practically all are carried along in the great current.
While, therefore, it is possibly, even probably, true that the soundest and healthiest individuals show no definite signs of nervous and psychic sexuality in childhood, such manifestations are still sufficiently frequent to make it impossible to say that sexual hygiene may be completely ignored until puberty is approaching.
Precocious physical development occurs as a somewhat rare variation. W. Roger Williams ("Precocious Sexual Development with Abstracts of over One Hundred Cases," _British Gynæcological Journal_, May, 1902) has furnished an important contribution to the knowledge of this anomaly which is much commoner in girls than in boys. Roger Williams's cases include only twenty boys to eighty girls, and precocity is not only more frequent but more pronounced in girls, who have been known to conceive at eight, while thirteen is stated to be the earliest age at which boys have proved able to beget children. This, it may be remarked, is also the earliest age at which spermatozoa are found in the seminal fluid of boys; before that age the ejaculations contain no spermatozoa, and, as Fürbringer and Moll have found, they may even be absent at sixteen, or later. In female children precocious sexual development is less commonly associated with general increase of bodily development than in boys. (An individual case of early sexual development in a girl of five has been completely described and figured in the _Zeitschrift für Ethnologie_, 1896, Heft 4, p. 262.)
Precocious sexual impulses are generally vague, occasional, and more or less innocent. A case of rare and pronounced character, in which a child, a boy, from the age of two had been sexually attracted to girls and women, and directed all his thoughts and actions to sexual attempts on them, has been described by Herbert Rich, of Detroit (_Alienist and Neurologist_, Nov., 1905). General evidence from the literature of the subject as to sexual precocity, its frequency and significance, has been brought together by L.M. Terman ("A Study in Precocity," _American Journal Psychology_, April, 1905).