Aspects of birth control

iCKET SERIES NO. 209
E. Haldeman-Julius

ts of Birth
ontrol

.phus Knopf

HALDEMAN-JULIUS COMPANY
GIRARD, KANSAS

TEN CENT ROCKET SERIES NO. 209
Edited by E. Haldeman-Julius

Aspects of Birth
Control

Adolphus Knopf

HALDEiMAN-JULIUS COMPANY
GIRARD, KANSAS

^t(^^^!>0

SRLF

MORAL ASPECTS OF BIRTH
CONTROL.

When at this very moment across the sea
in Europe the best blood of the nations which
were heretofore considered the most enlight-
ened, cultured, and civilized, is daily being
shed and hundreds of thousands of young men
in the prime of life sacrificed to the Moloch
of war, it must seem a hazardous undertak-
ing to talk of birth control, which means ar-
tificial birth limitation and by some super-
ficial observers is designated as race suicide.
I trust, however, that before I arrive at the
end of my paper, I will have convinced you
that the object of my appeal is not a plea for
reducing the population but for increasing its
vigor by reducing the number of the physi-
cally, mentally and morally unfit and adding
to the number of physically strong, mentally
sound, and higher morally developed men and
women.

In accordance with the program outlined,
I will deal first with the medical and san-
itary aspects of the subject. No one will deny
that we occasionally come across a family,
well- co-do and intelligent, where the parents
by reason of unusual vigor, and particularly
by reason of the physical strength of the
mother, have been able to rear a large num-

4 ASPECTS OF BIRTH CONTROL

ber of children. In some instances all have
survived and have grown up to be healthy
and vigorous, but these instances are rare and
are becoming more and more so every day.
On the other hand, large families, that is to
say, numerous children as the issue of one
couple, among the ignorant, the poor, the un-
derfed and badly housed, the tuberculous, the
degenerate, the alcoholic, the vicious, and even
the mentally defective, is an everyday spec-
tacle. It is well known to every general prac-
titioner whose field of activity lies among the
poor and the above mentioned classes, that the
infant mortality among these is very great.
The same holds true of the mortality of school
children coming from large families among
these classes of the population.

Concerning tuberculosis, with which, by
reason of many years' experience, I am per-
haps more familiar than with other medical
and social diseases, let me relate the interest-
ing fact that a carefully taken history of
many, many cases has revealed to me that
with surprising regularity the tuberculous in-
dividual, when he or she comes from a large
family, is one of the later born children — the
fifth, sixth, seventh, eighth, ninth, etc. The
explanation for this phenomenon is obvious
When parents are older, and particularly
when the mother is worn out by frequent
pregnancies and often weakened because
•bliged to work in mill, factory, or workshop
«p to the very day of confinement, the child
win eome into the world with lessened vital-

ASPECTS OF BIRTH CONTROL 8

ity, its main inheritance being a physological
poverty. This systemic poverty will leave it
less resistant, not only to tuberculosis but to
all other diseases of infancy and childhood as
well.

The morbidity and mortality among these
children is greatest when the children are
most numerous in one family. Miss Emma
Duke, in the third of the Infant Mortality
Series, gives the result of a field study in
Johnstown, Pa., based on the births of one
calendar year (1911.) The inspection was
made in 1913, of the 1911 babies, so that even
the last born baby included had reached its
first birthday — or rather had had a chance to
reach its first birthday; many of them were
dead long before that day. The following is
Miss Duke's table showing the infant mor-
tality rate for all children born by married
mothers in Johnstown during that year;

Deaths per 1,000 births in —

Families of 1 and 2 children 108.6

Families of 3 and 4 children 126.0

Families of 5 and « children 162.8

Families of 7 and 8 children 176.4

Families of 9 and more children 191.9

Dr. Alice Hamilton of the Memorial Insti-
tute for Infectious Diseases, Hull House,
Chicago, made a study of 1,600 families in
the neighborhood of the settlement. The fol-
lowing is the table of the child mortality rate
of the 1,600 families as published by Doctor

6 ASPECTS OF BIRTH CONTROL

Hamilton :

Deaths per 1,000 births in —

Families of 4 children and less 118

Families of 6 children 287

Families of 7 children 280

Families of 8 children 291

Families of 9 children and more 808

Many families were found of thirteen,
fourteen, and even sixteen members. The
largest of all was that of an Italian woman
who had born twenty-two and raised two
The small family of every nationality had a
lower mortality rate than the large families
of the same nationality. The Jewish families
of four and less had the astonishingly low
mortality rate of 81 per 1,000, while in families
of eight and less, the rate rose to 260 pei
1,000.

The larger the family, the more congested
will be the quarters they live in and the more
unsanitary will be the environment. Last,
but not least, with the increase of the family
there is by no means a corresponding increase
of the earning capacity of the father or
mother, and as a result malnutrition and in-
sufficient clothing enter as factors to predis-
pose to tuberculosis or cause an already ex-
isting latent tuberculosis to become active.

What is the result of this condition in re-
lation to tuberculosis — one single disease?
Out of the 200,000 individuals who die an-
nually of tuberculosis in the United States.
50,000 are children. Of the economic loss re-
sulting from these early deaths I will speak

ASPECTS OF BIRTH CONTROL 1

later on, but in continuing along the medical
and sanitary lines of my subjejct, I must call
your attention to the fact that according to
some authors 65 per cent of women afflicted
with tuberculosis, even when afflicted only in
the relatively early and curable stages, die as
a result of pregnancy which could have been
avoided and their lives been saved had they
but known the means of prevention. Some
times we succeed in saving such a mother by
a timely and careful emptying of the uterus.
But an abortion even scientifically carried
out and only resorted to with a view of saving
the life of the mother, is never desirable,
either for the consultant to advise, nor for
the gynecologist or obstetrician to perform;
and who will dare to say that even under the
best conditions this operation is devoid of
danger.

What is the explanation and what are the
consequences from the point of view of sanita-
tion, of the death of 50,000 tuberculous chil-
dren? They have mostly become infected
from tuberculous parents or tuberculous board-
ers who had to be taken into the family to
help pay the rent. In the crowded homes of
the poor there was neither sunlight, air, nor
food enough to cure the sufferers and before
they died they became disseminators of the
disease. Nearly all of the infectious and
communicable diseases are more prevalent in
the congested, overcrowded homes of the poor
and particularly in those of large families.
The propagation of syphilis and gonorrhoea by

8 ASPECTS OF BIRTH CONTROL

contact infection, other than sexual, can
sometimes be avoided in the homes of the well-
to-do, by enlightenment and the conscientious-
ness of the afflicted. They are almost in-
variably communicated to the innocent in the
homes of the ignorant and poor. Gonorrhoe-
al infection from parent to child or from one
infected member of the family to the other,
is responsible more than anything else for
the 57,272 blind persons in the United States.*

The great syphilographer Foumier left U8
the following irrefutable statistical evidences
of the seriousness of syphilitic transmission.
As a result of parental transmission there is
a morbidity of 37.0 per cent, and a mortality
of 28.0 per cent; maternal transmission re-
sults in 84.0 per cent morbidity and 60.0 per
cent mortality; and the combined transmis-
sions are no less than 90.0 per cent of mor-
bidity and 68.5 per cent of mortality.!

I venture to say right here that would or
could a syphilitic or gonorrhoeic parent be
taught how to prevent conception during the
acute and infectious stages of his or her dis-
ease, there would certainly be less inherited
syphilis, less blindness from gonorrhoeal in-
fection; in other words, less unfortunate chil-
dren in this world handicapped for life and a
burden to the community.

That insanity, idiocy, epilepsy, and alco

•United States Census, 1910.

IBerkowitE! "Late Congenital Syphilis." N. Y. Medi
eal Journal, June 17, 1916.

ASPECTS OF BIRTH CONTROL «

holic predisposition are often transmitted
from parent to child is now universally ad-
mitted, and corroborated by every day ex-
perience and by an abundance of statistics.
Countless are the millions of dollars expended
for the maintenance of these mentally unfit.
The state of New York alone spends ^2,000,-
000 annually for the care of its insane.
Whether sterilization of these individuals
would be the best remedy is a question still
open for discussion. The constitutionality of
the procedure is doubted by some of our legal
authorities. Segregation is resorted to in the
meantime with more or less rigor, according
to the state laws. Every year, however, many
of the individuals who had been committed to
institutions for the treatment of mental dis-
orders are discharged as cured. They are al-
lowed to procreate their kind. Would it not
be an economic saving if at least the individ-
uals whose intelligence has been restored were
instructed in the prevention of bringing into
the world children who are most likely to be
mentally tainted and to become a burden to
the community?

The economic loss to our commonwealth
from bringing into this world thousands of
children mentally and psysically crippled for
life is beyond calculation. But considering
tuberculosis we have been able to calculate
at least approximately what it costs. I
stated above that 50,000 children die an-
nually from tuberculosis in the United States.
Figuring the average length of life of these

10 ASPECTS OF BIRTH CONTROL

children to be seven and one half years and
their cost to the community as only $200 per
annum, represents a loss of $75,000,000. Such
children have died without having been able
to give any return to their parents or to the
community. Who will dare to calculate in
dollars and cents the loss which has accrued
to the community because so many mothers
died of tuberculosis when an avoidable preg-
aancy was added to a slight tuberculous ail-
ment in a curable stage? Who will dare to
estimate the cost of the loss of an equally
large or perhaps larger number of mothers
afflicted with serious cardiac or renal diseases,
or frail or ill from other causes, whose lives
could have been prolonged had an additional
pregnancy not aggravated their condition?

Of the many mothers married and unmar-
ried, who have become chronic invalids and
even lost their lives as a result of having re-
sorted to abortive measures in order to rid
themselves of an unwelcome child, no statis-
tics are available. If there were, they would
be an appalling evidence of the great danger
of such criminal procedures and would cer-
tainly show the advantage of a more enlight-
ened attitude regarding the means of contra-
ception, at least for the married women who
are enfeebled or diseased.

The many diseases I have mentioned
whereby children in large families and moth-
ers because of too frequent pregnancies are
carried off to an early grave, are not limited
to the poor. In regard to economics, the

ASPECTS OF BIRTH CONTROL 11

middle class suffers also. Thus, if even a
relatively well-to-do family begins to increase
out of all proportion to the earnings of the
father, the family will soon be in want and
approaching poverty. Less and less food, less
sanitary housing, less care of the children,
and more sickness will almost inevitably re-
sult. Every sickness or death of child ot
adult has increased the expenses of the fam-
ily. There is the doctor's bill, the druggist's
bill, and last but not least, that of the under-
taker. A grave had to be purchased. If
there have been savings, they are gradually
swallowed up and debts are often contracted
for the sake of a decent funeral.

Next to the medical and sanitary come?
the physiological aspect of birth control which
can be summarized in a very few sentences.
The average mother with two, three or four
children, not having arrived in too rapid suc-
cession, say with two or three years interven-
ing, is physiologically, that is to say, physi-
cally and mentally, stronger and better equip-
ped to cope with life's problems than the
worn out and w^eakened mother whose life is
shortened by frequent and numerous preg-
nancies.

What is the physiological effect of volun-
tary artificial restriction of the birth-rate ?
In Holland, where the medical and legal pro-
fessions have openly approved and helped to
extend artificial restriction of the birth-rate,
the health of the people at large, as shown by
its general death-rate, has improved faster

12 ASPECTS OF BIRTH CONTROL

than in any other country in the world. At
the recent Eugenics Congress it was stated
that the stature of the Dutch people was in-
creasing more rapidly than that of any other
country — the increase being no less than four
inches within the last fifty years. According
to the Official Statistical Year Book of the
Netherlands, the proportion of young men
drawn for the army over 5 feet 7 inches in
height has increased from 24 1-2 to 47 1-2 per
cent since 1865, while the proportion below 5
feet 2 1-2 inches in height has fallen from 25
per cent to under 8 per cent.*

In that enlightened country, the teaching
by the medical profession of the most hygienic
methods of birth control limitation has en-
abled the poor to have small families which
they could raise to be physically and morally
better equipped than formerly. What is most
interesting to observe, however, is that, wheth-
er as a result of this or for some other reason,
the families among the well-to-do are not
nearly as small as in other countries.

In Australia and New Zealand, the means
of artificial restriction are in free circulation
and the restriction of families is almost uni-
versal. Yet these two English colonies have
furnished to their mother country in these
hours of struggle the most efficient, and phys-
ically and mentally best equipped regiments.

•"The Small Family System ; Is It Injurious or Im-
moral T' By Dr. C. V. Drysdale ; Published by B. W.
finebech, New York.

ASPECTS OF BIRTH CONTROL It

The soldiers of Australia and New Zealand
have shown themselves brave and fearless
fighters and certainly equal, if not superior
as far as physical endurance is concerned, to
their English brethren. In the latter country
it is well known that birth control is frowned
upon by the legal and nearly all the ecclesias-
tical authorities.

And what of France? Before the present
war Drysdale, in his "Small Family System,"
very aptly says: "It has become the fashion
to speak of the depravity of France, of hei
alcoholism, of her disregard for law and order,
and of her terrible 'crimes passionels,' and to
ascribe to them the falling birth rate. If this
were the case it is obvious that these evils
would be most intense where the process had
gone furthest, i. e., in the cantons of the low-
er birth- rate (The French islands of Re and
Oleron.)" The passions of the inhabitants
of these islands are very innocent. "They
are reading and dancing. The dancing, al-
ways decent, is the preparation for mar-
riage; illegitimate births are very rare. One
could not imagine manners more pleasant or
more honorable. Nevertheless the birth rate
in these islands is among the lowest. It is
because everyone there is more or less of a
proprietor. Each person has some property
to protect; each is ambitious for his children."
But we have the authority of Doctor Bertil-
lon, the great French statistician, that it is
just in the cantons of these islands in which
the greatest moral improvement has taken

U ASPECTS OF BIRTH CONTROL

place, and that where the French have obeyed
the command to increase and multiply, there
alcoholism and crime abound.

Let me quote briefly from an editorial on
contraception which appeared in the Medical
Times of April, 1916: "France today is pre-
senting her splendid spectacle of utter effic-
iency to the world because only the fittest of
her people have survived, and the chief factor
there has admittedly been contraception.
Surely we have heard the last of the croakers
about decadent France. Holland would give
an equally good account of herself if the need
should arise and for the same reason."

We have already touched in part on the
economic cost growing into the millions which
accrues annually to the nation because of a
high birth-rate concomitant with a high infant
and child mortality rate. Well may we ask
the question whether disease and the deaths
of thousands of women and children can not
be prevented by an enlightened attitude to-
ward the question of birth control. Why is
it not done? If the millions of dollars ex-
pended uselessly reverted to the nation's
wealth, would they not add immeasurably to
the health and economic happiness of the
nation at large?

And now we come to the social or sociolog-
ical aspect of our topic, so closely interwoven
with economics. That the social and moral
life of a smaller family, where the father
earns enough to support wife and children,
where the mother can devote her time to the

ASPECTS OF BIRTH CONTROL IB

care of them, and where neither she nor the
children must go out and help in the support
of the family, is superior to that of a family
with a large number of children where the
mother and often the older children must
slave, does not permit discussion. The larger
the family of the poor the more child labor,
the more there is disruption and irregularity,
and the more frequent one finds a lower stan-
dard of life and morals in general.

The records of our charities and benevo-
lent societies amply prove that as a rule the
larger the families are that apply for relief
the greater is their distress.

In answer to a letter from Doctor Foote.
containing suggestions on this topic, the pres-
ident of the New York Association for Im-
proving the Conditions of the Poor very per-
tinently said:

"The race suicide theory which has been so
much exploited of late, is an immense en-
couragement to the large family idea and the
illiterate are hardly to be blamed if they are
misled upon this question. The subject that
you discuss is one that is worthy of serious
consideration and that has in the past been
treated with an excess of sentiment."

That judicious birth control does not mean
race suicide, but on the contrary race preser-
vation, may best be shown from the reports
from Holland. The average birth-rate in the
three principal cities of Holland was 37.7 per
1,000 in 1881^ when birth control clinics were
started. In 1912 it had fallen to 25.3 per

16 ASPECTS OF BIRTH CONTROL

1,000. The general death-rate, however, had
dropped in the same period from 24.2 to 11.1
per 1,000, or to less than half, while the two-
thirds reduction in the mortality of children
under one year of age — from 209 to 70 per
1,000 living births — is even more significant.
As a final evidence of the social and eco-
nomic value of imparting information con-
cerning family limitation, permit me to quote
from a personal letter to me from the great
pioneer of this humanitarian movement, Dr.
J. Rutgers, the Honorable Secretary of the
Neo-Malthusian League of The Hague. The
league has been in existence since 1888 and
received its legal sanction by a royal decree
January 30, 1895. It has 6,000 contributing
members; all information is given gratuitous-
ly. As a result of this league in Holland one
does not see any children dressed in rags as
in former years prior to the starting of this
movement. To use the venerable secretary's
own words: "All children you now see are
suitably dressed, they look now as neat as
formerly only the children of the village cler-
gyman did. In the families of the laborers
there is now a better personal and general hy-
giene, a finer moral and intellectual develop-
ment. All this has become possible by limita-
tion in the number of children in these fami-
lies. It may be that now and then this preven-
tive teaching has caused illicit intercourse, but
on the whole morality is now on a much higher
level and mercenary prostitution with its de-
moralizing consequences and propagation of

ASPECTS OF BIRTH CONTROL 17

contagious disease is on the decline. The best
test (the only possible mathematical test) of
our moral physiological -and financial progress
is the constant increase in longevity of our
population. In 1890 to 1899 it was 46.20; in
1900 to 1909 it was 51 years. Such rise cannot
be equalled in any other country except in
Scandinavia where birth limitation was preach-
ed long before it was in Holland. None of the
dreadful ,consequences anticipated by the ad-
vocates of clericalism, militarism, and con-
servatism have occurred. In spite of our low
birth-rate the population in our country is
rising faster than ever before, simply because
it is concomitant with a greater economic im-
provement and better child hygiene."

To verify these figures statistically, Doc-
tor Rutgers refers to Drysdale's diagrams.*
The good doctor closes his splendid letter by
saying: "One must have been a family phy-
sician for twenty-five years like myself in a
large city (Rotterdam) to appreciate the
blessings of conscious motherhood resulting
in the better care of children, the higher mor-
al standard. And all these blessings are tak-
en away from you by your government's pe-
culiar laws, made to please the Puritans."

To these latter well-meaning people and
those similarly minded who fear race suicide,

•"Diagrams of International Vital Statistics With De-
scription in Enprlish and Esperanto, together with a
Table of Coirelation Coefficients Between Birth and
Death-rates, etc." Bv C. V. Drysdale. D. Sc. ; London :
Wm. Bell, 162 Drury Lane, W. C. 1912.

18 ASPBCTS OF BIRTH CONTROL

particularly a decline of the American stock,
I strongly recommend the reading of that
splendid address by ^Professor Charles A. S.
Reed, A. M., M. D.,* former president of the
American Medical Association, entitled, "The
American Family." In the chapter on "The
Outlook of the American Family," he very
pertinently says: "We see in a declining
birth-rate only a natural and evolutional ad-
justment of race to environment — an adjust-
ment that insures rather than menaces the
perpetuation of our kind under favoring con-
ditions." And concerning under-population in
general, this distinguished writer says in the
same address: "It seems, indeed, to the care-
ful student that the danger to the American
family today and still more in the future lies
in the direction of over-population rather than
under-population."

According to Mulhall and Reed, the in-
crease in the density of population from
1820 to 1890 was 650 per cent in the United
States (only 25 per cent in the United King-
dom and less than 100 per cent in France and
Belgium.) The rate of increase in this coun-
try has been vastly accelerated in the twenty-
five years that have since elapsed. Our pop-
ulation today of over 100,000,000 has beeni
doubline itself on an average of once in less
than twenty-five years since 1790, and it will
probably continue to do so in the future. May
I say in passing, that in the state of New
York we have observed the alarming phen-
omenon that the proportional increase among

ASPECTS OF BIRTH CONTROL 19

the insane is double that among the sane pop-
ulation ?

And now I approach the last and most
important phase of my subject, namely the
moral, which to me means no less than the
religious phase of this great problem. Let
me say to you, my colleagues, that I approach
it with awe and reverence, for I believe 1
fully understand the import of it.

A quarter of a century of practice among
the tuberculous, the rich and the poor, in pa-
latial homes, humble cottages, dark and dreary
tenements, and in over-crowded hospitals, has
shown me enough to bring to my mind the
utter immorality of thoughtless procreation,
and my experience has been limited to this
one disease of the masses. The tears and suf-
fering I have witnessed when I have had to
decline help because it was too late to prevent
the despair of the poor, frail mother at the
prospect of another inevitable confinement,
and later the sight of a puny babe destined to
disease, poverty, and misery, has made me
take the stand I am taking today. I am do-
ing it after profound reflection, and I am fully
aware of the opposition I am bound to meet.
But in my early career as an anti-tuberculosis
crusader, I became accustomed to the fate of
those who venture on new and heretofore
untrodden paths of progress.

What would the moral outcome of birth
control, or let us rather say, rational family
limitation be, if taught judiciously to those
seeking and needing the advice? Millions of

20 ASPECTS OF BIRTH CONTROL

unborn children would be saved by contracep-
tion from the curse of handicapped existence
as members of a family struggling with pov-
erty or disease.

There are hundreds of young men and
women, physically and morally strong, who
gladly would enter wedlock if they knew that
they could restrict their family to such an ex-
tent to raise few children well. But their
fear of a large family retards, if it does not
prevent, their happiness and ipso facto the
procreation of a better and stronger manhood
and womanhood. The woman withers away
in sorrowful maidenhood and the man whose
sexual instincts are often so strong that he
cannot refrain, seeks relief in association with
the unfortunate and often diseased sisters,
called prostitutes. The result is a propaga-
tion of venereal diseases with all its dire con-
sequences. To an audience composed of phy-
sicians and sanitarians I need not say what
these consequences are. They involve sterility
physical and mental suffering in the man, or
sterility in both man and woman; and accord-
ing to the severity of the infection, pelvic dis-
orders, abortion, premature labor, a dead child
or one lastingly tainted with disease.

At times disease does not enter as a factor
in the tragedy, but the result is a girl mother,
a blasted life, for our double standard of mor-
ality recognizes only the "sin" in our sisters,
not in ourselves. Of her, compassionate ton-
gues only say she loved not wisely but too
well; of him, nothing is said at all. He is

ASPECTS OF BIRTH CONTROL 21

spotless and virtuous in the eyes of the world
and can go through life as if he had never
sinned and been responsible for a blasted life
or two.

Even our moralists must acknowledge that
by an early marriage with a man of her
choice, enabled by understanding to limit the
number of children, many a girl would be sav-
ed from so-called dishonor and in many in-
stances from pr(/stitution. One of the strong-
est arguments of our moralists and purists
is that the knowledge of contraception would
lead the young to enter forbidden sexual re-
lations and degrade them morally. Granted
that this may happen in a number of instances
the benefit derived from a diminution of ven-
ereal diseases, from a greater number of happy
and successful marriages among the younger
people, fewer but better and healthier off-
spring instead of an unrestricted procreation
of the underfed, the tuberculous, the alcohol-
ics, the degenerate, the feeble-minded and in-
sane, would more than outweigh the isolated
Instances of sexual intercourse prior to mar-
riage.

I absolutely agree with our moral teach-
ers when they say that self-control is possible
— I believe it to be the cleanest, purest and
best preventive measure for family limitation
— but while it may be easy for many it is not
easy for all. Sociologically speaking, it is
even more difficult when you deal with a
married couple belonging to the poorer classes
who cannot have separate bedrooms. Salf-

22 ASPECTS OF BIRTH CONTROL

control can be more easily exercised prior to
marriage than afterwards.

The critics of birth control maintain that
with the knowledge of birth limitation many
women, whether poor or rich, who should
and can bear children, will shirk the duties
of motherhood. This I do not believe to be
true. You can no more prevent the desire
for motherhood in the normal, healthy woman
than you can stem the tide of the ocean. It
is inherent in every woman's heart. With
more marriages of young people and a ration-
al birth control, I do believe there will not be
fewer children but the same number of better
ones. There will be, of course, instances — and
there are too many in certain classes of so-
ciety now — where for purely selfish reasons
ihe marriage remains barren, but it is a ques-
tion in my mind whether it would be really
'lesirable for society to have such women be
mothers.

It has been asserted by the same critics
that the enfeebled, diseased, ignorant, and
poverty stricken woman in whose case birth
control might be justified, will never know
about the existence of birth control clinics.
In Holland, however, there must have been
some such ignorant women, yet they seem
to have learned to avail themselves of the
service of such clinics. Besides, these classes
will sooner or later come under the observa-
tion of some physician, either privately or in
a hospital. Some opponents to the birth con-
trol propaganda say that the measure advo-

ASPECTS OF BIRTH CONTROL 2«

cated would not reach the feeble-minded, the
idiotic, half insane, chronic alcoholics and
chronic criminals. This, I will grant, and
sterilization of those totally unfit for parent-
hood will some day have to become a state
measure, unless segregation is resorted to
more universally and more rigorously. Birth
control is only one measure toward a saner
and happier manhood, womanhood, and child-
hood.

Finally, I must mention the almost pa-
thetic criticisms of some of my colleagues who
wrote me in answer to my request for an
expression of opinion, that the matter of
birth control was a question not for the
medical profession, but for the laity. To
such I can only express my regret at their
attitude. The physician of the twentieth cen-
tury who deals only with the purely medical
and curative part of his profession, who is
indifferent to measures to prevent disease,
and cannot feel with the social sufferings of
the masses, is lacking in the highest ideals of
his calling and misses the greatest opportun-
ity of benefitting suffering mankind.

After all is said, I feel impelled to plead
with great earnestness for the abolishment of
the state and federal laws which make the
imparting of knowledge for contraception a
criminal offense. I plead for the re-establish-
ment of gratuitous clinics, directed by regular
physicians of high repute, remunerated by
city or state, who are competent to give in-
formation as to birth limitation in cases where

24 ASPECTS OP BIRTH CONTROL

t^ey deem the giving of such instructions ad-
rUable.

Concerning the urgency and the wisdona
of efforts to change these laws* I am sure
that you will be willing to listen to the worda
of two of our greatest American physicians;
first, to those of our venerable nestor of the
medical profession, Professor A. Jacobi, of
New York, the ex-president of the American
Medical Association; secondly, to Professor
Hermann M. Biggs of New York, my beloved

♦United States Criminal Code, Section 211 (Act ot
March 4, 1909, Chapter 321, Section 211, U. S. Statute*
at Large. Vol, 35, part 1, page 1088 et seq.) New York
Statute Book, (Section 1142 of the Penal Law). The
federal law prescribes a fine of $5,000 or imprisonment
of not more than five years, or both, for any one using
the mails to give advice for producing abortion or pre-
venting conception. The New York State law, above
mentioned, makes the giving of a recipe, drug or medi-
cine for the prevention of conception or for causing un-
lawful abortion a misdemeanor punishable with no less
than ten days nor more than one year imprisonment or
a fine of not less than $50 nor more than $1,000, or both,
fine and imprisonment for each offense. It will be
noticed that both laws make the giving of advice for the
prevention of conception as great an offense as produc-
ing abortion. According to the New York State law, b
"lawful" abortion is permitted and not punishable, but
to prevent such abortion, always more or less dangerous
to life, is not permitted and punishable by law. In all
medical colleges careful instruction is given how to per-
form the "lawful" abortion. All good textbooks on
gynecology describe the operation as carefully as an
amputation of the cervix or a hysterectomy ; but con-
cerning the advice to give, for example, to the poor
tuberculous mother who has had her uterus emptied
once, so that she may not be obliged to submit to such a
"lawful" operation again, our teachers of grynecology and
amr textbooks dare not Bay a word.

ASPECTS OF BIRTH CONTROL 29

teacher, the distinguished sanitarian and pio-
neer in the modern warfare against tuberculo-
sis. In his preface to Dr. William J, Robin-
son's book "The Limitation of Offspring," Dr.
Jacobi says: "Our federal and state laws on
the subject of prevention of conception are
grievously wrong and unjust. It is important
that these laws be repealed at the earliest pos-
sible moment; it is important that useful
teaching be not crippled, that personal free-
dom be not interfered ^vith, that the inde-
pendence of married couples be protected, that
families be safe-guarded in regard to health
and comfort, and that the future children of
the nation be prepared for competent and
comfortable citizenship."

Dr. Hermann M. Briggs, prior to the recent
dismissal of the case by Judge Dayton of the
federal court, against Mrs. Sanger for send-
ing information about birth control through
the mails, gave to the press the following
statement: "I am strongly of the opinion
that the present laws in regard to the giving
out of information in relation to the govern-
ing of infant control are unwise and should
be revised. There can be no question in the
mind of any one. familiar with the facts that
the unrestricted propagation of the mentally
and physically unfit as legally encouraged at
the present time is coming to be a serious
menace to civilization and constitutes a great
drain on our economic resources. This is my
personal view."

To the foregoing expressions of opinions

26 ASPECTS OF BIRTH CONTROL

let me add what one of our most distinguished
jurists, the Hon. Judge William H. Wadhams,
of the Court of General Sessions, wrote me
concerning these laws: "In order to save the
state from the burden of large families, where
there is no possibility of their being support-
ed and where the neglect which follows often
results in their becoming state charges not
only because they are mentally but often phys-
ically unfit to bear the burdens of life, I am
of the opinion that there should be some
proper birth regulation after a certain num-
ber of children have been born, and that there-
fore, there should also be some modification
of the laws with respect to the giving of in-
formation upon this subject. I think the sani-
tary, medical, social, economic, and moral
status of the population would be improved by
proper and more general information upon
this subject."

Besides the letter from this eminent ju-
Icial authority and the strong expressions of
opinion of A. Jacobi, M. D., and Hermann M.
Biggs, M. D., I have been the recipient of
communications from many leading physic-
ians, divines, political economists, and sociol-
ogists, all agreeing with me that judicious
birth control, under the highest ethical and
medical guidance, is a national necessity and
that our present laws on the subject need
urgent revision. For want of space I will
mention only the following: Dr. John N.
Hurty, secretary, Indiana State Board of
Health; Dr. Godfrey R. Pisek, professor of

ASPECTS OF BIRTH CONTROL 27

diseases of children, New York Post-Graduate
Medical School and Hospital; Dr. J. W. Trask,
of Washington, D. C; Dr. Lydia Allen de
Vilbiss, formerly of the New York State De-
partment of Health, now in charge of the
division of Child Hygiene of the State Board
of Kansas; Dr. Ira S. Wile, editor of American
Medicine, New York; Dr. John A. Wyeth, pro-
fessor of surgery and president of the New
York Polyclinic Medical School and Hospital,
ex-president of the American Medical Asso-
ciation and New York Academy of Medicine;
Frank Crane, D. D., formerly pastor of the
Union Congregational Church of Worcester.
Mass., now well known writer of leading edi-
torial articles; Percy S. Grant, D. D., rector.
Protestant Episcopal Church of the Ascension
of New York City; Frank Oliver Hall, D. D..
minister of the Church of the Divine Patern-
ity, New York City; John Haynes Holmes, M.
A., Minister, Unitarian Church of the Mes-
siah, New York City; Stephen S. Wise, D. D..
Rabbi of the Free Synagogue, New York
City; James A. Field, Ph. D., Professor of
Economics, University of Chicago; Irving
Fisher, Ph. D., professor of political economy
of Yale University and chairman of the Hy-
giene Reference Board of the Life Extension
Institute; Franklin H. Giddings, Ph. D., pro-
fessor of political science, Columbia Univers-
ity; William H. Allen, Ph. D., director of the
Institute for Public Service of New York City;
Hon. Homer Folks, former commissioner of
charities of New York, now secretary of the

28 ASPECTS OF BIRTH CONTROL

State Charities Aid Association of New York;
Lillian D. Wald, founder of the Henry Street
Settlement and originator of the work of the
School Nurse in New York; Prof. Melvil Dew-
ey, LL. D., educator and president of the
National Society for Efficiency.

I leave it to this distinguished body of phy-
sicians and sanitarians either to send a mem-
orandum to the federal and state governments
setting forth the reason for a change of these
laws, or, if it is thought wiser, to form a com-
mittee to study the best and most practical
suggestions for federal or state legislatures
to act upon.

Dr. William L. Holt, writing on birth con-
trol as a social necessity and duty, says:
"Conscious and limited procreation is dic-
tated by love and intelligence; it improves the
race. Unconscious, irresponsible procreation
produces domestic misery, and half-starved
children. Conscious procreation of human
lives elevates man to the gods. Unconscious
procreation degrades man to the level of
brutes."

May I be permitted to close with what I
am free to confess is my innermost conviction ?
I believe in birth control, that is to say, birth
limitation, based on medical, sanitary, high-
est ethical, moral, and economic reasons. I
believe in it because with the aid of it man
and woman can decide when to have a child,
work and prepare for its arrival, welcome it
as the fulfillment of their heart's desire, watch
over it, tenderly care for and educate it, and

ASPECTS OF BIRTH CONTROL 29

raise it to be what every child should be des-
tined to be — a being happy, healthy, strong
in mind, body, and soul. If we but use our
God-given sense to regulate the affairs of
government and family wisely and economi-
cally, this great world of ours will be one of
plenty and beauty where the good will pre-
dominate over the evil and the children bom
in it will becojne men and women only a little
lower than the angels — images of their
Creator.

DISCUSSION.

Dr. Ira S. Wile, New York City: In read-
ing the thoughtful paper of Doctor Knopf,
a number of thoughts suggested themselves.
Birth control is recognized today as a factor
in eugenic control. Some states take cogni-
zance of the advantages of limiting the num-
ber of offspring insofar as defectives and
criminals are concerned. The laws of numer-
ous states permitting sterilization or asexual-
ization place the seal of governmental ap-
proval upon the prevention of procreation in
the interests of the public weal. Numerous
regulations providing for the segregation of
defectives represent crystallizations into law
of the principle that the state has a vital in-
terest in controlling the birth of certain tjrpe*
of citizens. States requiring a certificate of
health previous to marriage point out a deep

30 ASPECTS OF BIRTH CONTROL

interest in the character of health of those
who are to become parents. The underlying
principle is the protection of the state from
the development of undesirable children.

The law recognizes the interruption of
pregnancy as legal and justifiable in order to
save the lives of women suffering from tu-
berculosis, nephritis, cardiac diseases, or from
conditions, whose fatal progress would be
hastened through continued pregnancy, but
the law holds it to be illegal to teach these
same women how to avoid conception. It is
manifestly contrary to every principle of mod-
ern preventive medicine that there should be
such interference with the judgment and ac-
tion of physicians where it seems most ration-
al and medically sound to give advice as to
the methods of preventing a condition con-
taining a hazard to life.

Despite the existing laws, contraception is
practiced and undoubtedly taught by mem-
bers of the medical and nursing profession, as
well as by piidwives. What is equally im-
portant is the fact that contraceptives are
sold in drug stores throughout the country
without any interference, providing conscience
is stretched and the instrumentalities are dis-
pensed on the plea that they are agents for
the prevention of disease.

It is known that in 1900 there were only
three-quarters as many living children to each
1,000 potential mothers in the United States
as in 1860. The reason for this decreased
birth-rate is undoubtedly in a large part due

ASPECTS OF BIRTH CONTROL 81

to "the deliberate and voluntary avoidance or
prevention of child bearing on the part of a
steadily increasing number of married people,
who not only prefer to have but few children,
but who know how to obtain their wish" to
quote the words of Dr. John Shaw Billings.
At the present time, the practice of birth con-
trol is more or less limited to the more intel-
ligent part of the population and indeed to
those whose means would most warrant the
• levelopment of large families.

Public health sees in poverty its great en-
emy and realizes that education is its most
capable ally. The education of potential par-
ents, as to the methods of preventing concep-
tion may be regarded distinctly as a public
health measure. From the standpoint of the
welfare of the race, those interested in public
hea'th measures are more vitally interested
in the vigor and quality of children born than
in their absolute numbers. The birth of the
most vigorous children, those least susceptible
to disease, and possessing the greatest chance
of living are the particular types of infancy
in which health officers should be interested.
The reduction of dysgenic types of offspring
and the decrease of infants variously handi-
capped, whose care-needing existence lessens
family vitality represent a considerable part
of the public health problem.

The tremendous wastage of human life re-
sulting from stillbirths, congenital diseases,
malformations, puerperal injuries and infec-
tions, and economic pressures may be partial-

32 ASPECTS OF BIRTH CONTROL

ly offset by a properly controlled systen A
dissemination of information concerning the
limitation of offspring. The old doctrine of
the survival of the fittest has been superseded
by our more artificial and humanitarian pro-
gram which permits the survival of even many
of the weakest of the infantile populaltion.

It is well known that the rate of infant
mortality, as pointed out in the paper of Doc-
tor Knopf, increases with the size of the fam-
ily. To quote from Doctor Hibbs, in his dis-
cussion of Infant Mortality: Its Relations to
Social and Industrial Conditions, "However
dangerous 'race suicide* and the declining
birth-rate may be, there can be little doubt
that excessively large families is no remedy
and however desirable a high rate of births
may be, it is a mere waste to bring children
into the world faster than the laws of nature
decree to be desirable." Race suicide is not
due to limiting the number of births, but is
determined by the ratio between births and
deaths. From the standpoint of public health,
it is a greater degree of race suicide to bring
six children into the world and lose two or
three than to have two bom and reared. The
social consequences of large families with the
accompanying loss in lives and vitality have
been sufficiently described, so that further
comment is unnecessary.

From the standpoint of public health, it is
important that a very sharp line of demarca-
tion should be established between abortions
and the prevention of conception. The interrup-

ASPECTS OF BIRTH CONTROL 38

tion of pregnancy to destroy a developing
ovum entails physical hazards to the woman
which often adds to the mortality rate. At
the same time this is equally the destruction
of life as foeticide and, literally speaking, in-
fanticide. According to DeLee, while abor-
tion occurs oftener among the lower classes,
criminal abortion is more frequent among the
more educated classes.

Howard Kelly (Medical Gynecology, page
449), comments "to what extent the medical
profession is responsible for the murder of
the unborn" is shown by the methods that
women employ to induce abortions upon them-
selves making use of antiseptic technic in
which they obviously had been instructed.

The Report of the Special Committee on
Criminal Abortions quoted in Textbook of
Legal Medicine and Toxicology (Peterson and
Haines, Volume H, page 92) "estimated that
one-third of all pregnancies throughout the
country end in abortions. This is estimated at
not less than 100,000 yearly. A large number
of these are criminal abortions from which
the committee estimated that 6,000 women die
yearly." A fact of this character merits care-
ful consideration by a public health associa-
tion with a view to pointing out to the intelli-
crent laity and legislators the importance of
differentiating between the prevention of con-
ception, which carries practically no morbidity
and certainly no mortality and abortion, which
may cause destruction of two lives.

Howard Kelly in discussing syphilis (Med-

^

34 ASPECTS OF BIRTH CONTROL

ical Gynecology, page 423), states "It is the
recognized duty of all physicians in the pres-
ence of any contagious disease to protect
others from the risk of infection. In the case
of syphilis, where there is a question of its
introduction into marriage, the physicians'
protective duty embraces not only the pro-
spective wife, but the children she may bring
into the world and through them the interests
of society." (Page 424.) After marriage
has occurred "when a married man has syph-
ilis the first indication is to prevent the con-
tamination of the wife, the second is to guard
against pregnancy." The interpretation of
the term "guarding against pregnancy" open?
up the question as to how this is to be ac-
complished without violating existing laws.

It is urged that the frank discussion of
methods of contraception by physicians will
lead to an increase of clandestine relations
among unmarried girls by virtue of the
new knowledge. Clandestine prostitution ex-
ists today and fear of pregnancy is not an im-
passable barrier. The development of a con-
scious morality, which is the greatest pro-
tective force, should not be based upon fear.
Admitting for the sake of argument that the
same degree of immortality .might exist, there
would be at least a decreased destruction of
life for the women now illegitimately preg-
nant and the foetus to be destroyed. Fewer
homes would suffer disgrace, foundlings would
decrease in number, while an accursed bas-
tardy Would be greatly diminished.

ASPECTS OF BIRTH CONTROL 36

I do not advocate, however, that know-
ledge concerning the prevention of conception
should be given to the young, but merely to
adults and only to those who are wedded. It
cannot be denied that a law of this character
would undoubtedly be broken just as is the
present law today. The transmission of some
facts with reference to contraception is con-
stantly going on, but they emanate from pol-
luted sources and reflect folk lore rather than
intelligent medical opinion.

I do not favor the abolition of federal or
state laws which deal with abortions, though
owing to the weight of public opinion convic-
tions for violations of these laws are remark-
ably limited in view of the large number of
violations occurring annually. I believe and
would urge that the federal and state laws be
amended so that in effect the procuring of an
abortion and the preventing of conception
will be dissociated as acts not synonymous in
character and meriting entirely different
treatment. The procuring of an abortion
should still be penalized. The prevention of
conception should be permitted. The New
York state law links prevention of conception
and unlawful abortion, thus indicating the
legality of certain types of abortion.

Because the state already recognizes its
right to limit procreation among certain groups
of the population, because the decrease in the
birth rate will result in improved public health
and the social economic improvement of the
masses of this country, because prevention oi

86 ASPECTS OF BIRTH CONTROL

conception would add to the health and racial
betterment of the nation, I believe that the
American Public Health Association should
take a stand upon the subject •£ limitation of
offspring. To this end, I urge that resolu-
tions be passed favoring the amendment of
federal and state laws, so that the words pre-
venting or prevention of conception be elim-
inated therefrom.

Dr. J. H. Landis, Health officer, Cincinnati,
Ohio: It goes without saying that we are all
in favor of reducing the number of those who
are physically, mentally and morally unfit and
adding to the number of those who are physi-
cally fit, mentally sound and more highly de-
veloped morally.

The paper brings to our attention a num-
ber of facts that have long been recognized
as true. No one will deny that the offspring
of a tuberculous mother has a poorer chance
of living than one from a mother without a
wasting disease or that the healthy mother has
a better chance of surviving pregnancy than
has her diseased sister.

No one doubts that infant mortality is
greatest among the offspring of the ignor-
ant, the poor, the underfed and badly housed,
the tuberculous, the degenerate, the alcoholic,
the vicious and the mentally defective.

Congestion and lack of air and sunshine
have long been recognized as powerful predis-
posing factors in the dissemination of disease
and death among those exposed.

The remedy suggested for all of these con-

ASPECTS OF BIRTH CONTROL 81

ditions is birth control. The remedy is direct-
ed towards the effects produced instead of be-
ing directed at the causes producing them.

I am unable to see how birth control is to
solve the problems created by vice, poverty,
ignorance and alcoholism while these condi-
tions go on unchecked, and am unwilling to be-
lieve that the size of the family has anything
to do with any of them with the possible ex-
ception of poverty.

The pride and glory of the medical profes-
sion is bound up in the word "prevention."
Humanity owes us a far greater debt for sick-
ness prevented than for sickness cured.

A multitude of causes are responsible for
the high tuberculosis rates that prevail. The
disease is one of the most contagious with
which we have to deal. Nature's favorite
method of removing the unfit, from any cause,
is by the tuberculosis route.

The control of tuberculosis involves all of
the factors active in producing individuals who
are rendered susceptible by these factors, the
quarantining of those who are spreading the
disease and the care of those other members
of the family rendered dependent. Birth con-
trol can play only a minor role in the control
of this disease.

Birth control will not enlighten the ignor-
ant, render the poverty-stricken affluent,
transform the alcoholic into a total abstainer,
make the vicious virtuous, or remove the cloud
from the brain of the mentally defective.

Definite causes are combining to produce

38 ASPECTS OF BIRTH CONTROL

these results and the logical point of attack is
the combination of causes.

The ignorant can be educated; the poor
made more thrifty; the vicious forcibly re-
strained; and the mentally defective rendered
incapable of reproducing their kind.

The prevalence of typhoid fever is an in-
dex to the purity of a community's v^^ater and
milk supply. Filtration of water and pas-
teurization of milk have solved the typhoid
fever problem in those communities in which
they have been efficiently carried on.

Vice, crime, tuberculosis, poverty, degen-
eracy, alcoholism, ignorance and feeble-mind-
edness are as distinctly due to particular pre-
ventive causes as typhoid fever is to impure
water and milk, and it appears to me that
birth control would be as impotent to control
the first set of conditions as it would be to
control typhoid fever.

Dissemination of the knowledge of birth
control would, in my humble judgment, de-
crease the number of fit and increase the
number of unfit for the reason that the know-
ledge wouM be applied by those capable of
producing normal children and ignored by
those unfit individuals who are under the
guidance and control of the most powerful
primal instinct.

Dr. J. N. Hurty, Indianapolis, Ind.: We.
the people, are suffering from many delu-
sions. Nearly everyone entertains the de-
lusion, that they can violate the laws of na-
ture, abuse their bodies, bring on disease and

ASPECTS OF BIRTH CONTROL 39

tlegeneracy, and then find repair in a medi-
cine. It is a fool idea, yet it is very general.
There are other delusions. There is only one
way to improve the human race, and that is
the natural way. The first high point of in-
terest in the paper is when Doctor Knopf
>ays — "My appeal is not a plea for reducing
the population but for increasing its vigor by
reducing the number of the physically, men-
tally and morally unfit and adding to the
number of physically strong, mentally sound
and higher morally developed men and wom-
en," Certainly no one on any score can ob-
ject to this. The idea is practical, pure and
lofty. If general birth control will help it
onward, even a little bit, then I am for gener-
al birth control. I suppose no one would ad-
vocate the raising of idiots or physically de-
formed people, yet when it is proposed not to
raise them, through the practical application
of sterilization or segregation, up goes a howl
from the prudes which is of character likely
to provoke emesis. It is important and inter-
esting to learn that when tuberculosis appears
in a large family, it is generally numbers 5.
6, 7, 8 or 9 of the children that are stricken.
This is indeed significant, and I believe it to
be true. When I read this in Doctor Knopf's
paper I made some inquiries of two men who
have done a great deal of tuberculosis work,
and they confirmed it and said they believed
it was true. Again, Miss Duke's Johnstown
figures speak loudly against families of above
four children. For a pair to have more is

40 ASPECTS OF BIRTH CONTROL

generally to invite sickness, invalidism and
death, and if we will stop to think and look
around among the prosperous, great and
strong people as a rule (of course there are
exceptions) they do not have families of more
than four and generally about two. I do not
believe that this condition has been brought
about by continence. Surely pregnancy is
contra-indicated in a tuberculous woman un-
less it is desirable to kill her and add to the
number of pitiful motherless babies. A hus-
band who cannot be continent with a tubercu-
lous wife is a sorry specimen of manhood and
truly such specimens are many. And here 1
think it proper to say that birth control will
not likely ever be a resultant of voluntary
continence. Like education and monogamy, it
must be forced upon most of the animals we
call men. An important point made by Doc-
tor Knopf is, "would or could a syphilitic or
gonorrhoeic parent know how to prevent con-
ception during the acute and infectious stages
of his or her disease, there would certainly be
less of congenital syphilis, less blindness from
gonorrhoeal infection." If these ends can be
gained, even in slight degree, by birth con-
trol, I'm for it strong. I remember the doc-
tor in "Damaged Goods" says — "It is better
to have fifty sound and whole men than to
have a hundred, sixty or seventy of whom are
more or less rotten."

That is an important interrogatory in the
paper which reads — "What is the physiological
effect of voluntary artificial restriction of the

ASPECTS OF BIRTH CONTROL 41

birth-rate of the offspring?" The answer is
satisfactory, for the reports from Holland,
where the medical profession have openly
approved and helped to extend artificial re-
striction, are to the effect that the morbidity
and mortality rates have improved more rap-
idly than in other countries. Holland also
supplies data to prove that rational birth
control does not mean race suicide, but on the
contrary, race preservation and strengthen-
ing. Doctor Holt, as quoted by Doctor Knopf,
talks wisely when he says — ^'Conscious and
limited procreation is dictated by love and
intelligence; it improves the race. Uncon-
scious, irresponsible procreation produces do-
mestic misery and half-starved children. Con-
scious procreation of human lives elevates
man to the gods; unconscious procreation de-
grades man to the level of brutes." It is
plain that Doctor Knopf has contended and
written well. Conscientiousness in his con-
tention is apparent. I am sure good will fol-
low his effort.

Dr. W. L. Holt: I should like to call your
attention to the fact that we as a nation, like
all the ci\ilized nations, are already practic-
ing birth control; but in a very stupid and
mistaken way. Namely, just that part of
the population which is called the "upper
class," which is undoubtedly superior physi-
cally and mentally as well as financially and
accordingly produces the most desirable chil-
dren and ought to produce at least its share
of the future generation, is practicing birth

42 ASPECTS OF BIRTH CONTROL

control to such an extent that the old families
are dying out; whereas the inferior part of
our population, which is also financially least
able to raise four children, is raising four and
more. What could be more stupid?

Dr. Louis I. Dublin, New York City: The
other day I contributed a paper in another
section on the commoner errors in statistical
work. I wish I had had Doctor Knopf's paper
at my disposal for I could have used it very
profitably for my text. I do not recall any
paper that I have read for some time that is
more subject to criticism on the score of
method than the paper we have just heard.
I believe it is fundamentally erroneous be-
cause of the emotional attitude of the writer
which has caused him to draw general con-
clusions from an examination of only a very
limited part of his subject.. His emphasis is
entirely in the wrong place. There is alto-
gether too much birth control now and what
the community needs is emphasis on birth re-
lease by the healthy, capable and self-respect-
mg elements of the community.

There is time only for one word and I want
to limit that to the story of France. In
France, we have today a sorry spectacle of
the results of birth control. The lesson is
obvious. France is today crying for men; for
men who were either not born or died at an
alarming rate in infancy or later of tubercu-
losis. The attitude of mind which is engen-
dered by a nation-wide policy of birth control
ultimately brings about more infant mortality

ASPECTS OF BIRTH CONTROL 48

and more tuberculosis because of the general
weakening of the stock which directly results
therefrom.

A Member: It strikes me that the whole
question resolves itself into who should marry
and who should not marry. Unless we have
some laws regulating marriage, to teach young
men and young women the nature of the social
disease and the conditions necessary for a
good physical body, why, we will have tuber-
culosis, we will have degenerates, we will have
idiots and imbeciles and our penitentiaries
and almshouses and every other penal insti-
tution will be filled. The whole question is
prevention; I believe strictly in the doctrine
of heredity. Heredity, environment and educa-
tion is the triangle that leads to greatness.
If we do not hover around those three points,
we will never succeed. We know that if two
degenerates marry, they beget degenerate
children, beget imbeciles. If an imbecile mar-
ries a normal person, half of the children will
be imbeciles or degenerates, and we have the
records of criminality and all those deficien-
cies and the penalty is the result of improper
marriage. Teach the laws of nature and our
mothers will demand that their daughters
don't marry a man who has in his veins the
virus of a venereal disease circulating through
his body.

Dr. John W. Trask, United States Public
Health Service, Washington, D. C: The sub-
ject may be approached from a number of
different angles. During the discussion a

44 ASPECTS OF BIRTH CONTROL

thought has occurred to me which may be
worth presenting. What is the common rea-
son for wanting the population to grow?
What is at the bottom of the more or less
prevalent idea that it is meritorious to be the
parent of many children? It has occurred
to me while sitting here that chambers of
commerce and boards of trade want the pop-
ulation of their respective cities to increase —
the faster, the better — because it is to their
interest to have more individuals to sell things
to, more individuals to whom they can sell
dry goods, clothing, and groceries, more in-
dividuals to whom to sell houses and land.
The greater the population the more business
will be done and the greater the increase in the
value of real estate. On the other hand, those
interested in affairs of state may want the
population of their counti-y to grow that there
may be a larger group from which to draw
an army for purposes of defense or perhaps
offence. Birth control is opposed in a way to
the interests of business and of the holders
of real estate. Nor will it be the best national
policy where a growing population and large
armies are necessary as a protection against
invasion or oppression by lawless peoples.
However, it would seem at least worthy of
consideration whether the best conditions
would not be attained by families commen-
surate in size with the household incomes and
by nations commensurate in population with
their areas, economic conditions and natural
resources. Better people, living cleaner,

ASPECTS OF BIRTH CONTROL «

healthier and more rational lives, and not
more people, would seem to be the logical
objective.

Dr. Knopf:* My first duty is of course to
thank all of you for the very kind attention
you have given to my paper on a rather un-
usual and, in some circles, rather unpopular
subject. It shows that you have come here
determined to listen and then to judge — to
accept my ideas, to reject them, or to sus-
pend judgment.

Dr. Ira S. Wile agrees with me so thor-
oughly that I see very little reason to take
up time in referring to his paper, except to
thank him for his co-operation and particu-
larly for the strong opinion he has expressed
concerning the urgent need of recommending
an amendment of the federal and state laws
to the effect that the procuring of an abortion
and the prevention of conception will be dis-
associated, and considered as acts meriting
entirely different treatment. We all agree
that producing an abortion for no other rea-
son than to rid a healthy mother of an un-
welcome child is a crime and should continue
to be considered as such.

Doctor Landis' paper is a little surprising
to me. When the doctor says in today's dis-
cussion that birth control will not do away
with our social evils, will not render the pov-
erty stricken affluent, transform the alcoholic

*This discussion has been revised and enlarged Binc«
Its presentation.— EDITOR.

46 ASPECTS OF BIRTH CONTROL

into a total abstainer, nor remove the cloud
from a mentally defective, he is but partially
right. Birth control has enlightened the ig-
norant in Holland and has rendered the pov-
erty stricken not affluent but economically
more comfortable; it has decreased crime,
immorality, and illegitimacy. At the same
time, I do not for a moment think that birth
control alone will do away with the procreation
of the feeble-minded, idiotic, half insane,
chronic aleoholics, or chronic criminals. Birth
control is not a panacea for all the ills of
society, it is only one measure toward a saner
and happier man-, woman-, and childhood. To
minimize the harm to society and to future
generations produced by the just mentioned
class of unfortunates, the state should step in
and demand medical examination of both the
prospective father and mother, prior to grant-
ing them a marriage license. Even with our
present limited but growing knowledge of the
laws of heredity we should be able to prevent
many of the evidently unfit from becoming
parents and save many a child of tomorrow
from a handicapped existence — a burden to
himself and others.

As already indicated in my paper, there
is a certain class so mentally and physically
diseased that sterilization, or at least segre-
eration, must be resorted to. Doctor Landi?
is absolutely right when he says that "A mul-
titude of causes are responsible for the high
tuberculosis rates that prevail." If I did not
think that, would I have devoted twenty-five

ASPECTS OF BIRTH CONTROL 47

of the best years of my life to the combat of
tuberculosis ? Bad housing conditions, bad
factory hygiene, over-crowded and unhygienic
schools, useless studies and not enough out-
door play for the children, child labor, ignor-
ance on the part of the laity, the late diagnosis
of the disease on the part of the profession,
failure of rational treatment and lack of in-
stitutions, are some of the multiple causes
responsible for the high tuberculosis morbid-
ity and mortality rate.

Those of my colleagues who have honored
me by their steadfast friendship and constant
co-operation will bear me out when I say that
I have done my best to help to remove these
causes during years of conscientious labor.

I have approached the subject of birth
control after deep reflection and with the
same earnestness and zeal I am devoting to
my tuberculosis work, and with due reverence
for all that is sacred in man's physical, moral
and religious life. I now believe in it with
all the sincerity and earnestness I am capable
of. I believe in it because by its aid there
will rise a generation of men physically, men-
tally, and morally fit, and children free from
disease and prepared to take up the struggle
for life.

I must revert once more to my friend
Doctor Landis' discussion of the tuberculosis
problem. I said he was absolutely right in
the statement that a multitude of causes were
responsible for the high tuberculosis death
rates that prevail. But J say with equal em-

48 ASPECTS OF BIRTH CONTROL

phasis that he is absolutely wrong when he
says in the following sentence that "the dis-
ease is one of the most contagious with which
we have to deal." It is not the most but the
least contagious and should always be classed
with communicable diseases. It should not be
considered as most contagious like smallpox
for example. On the contrary, strictly speak-
ing, it is not contagious at all. The word con-
tagious comes from the Latin contingere, "to
touch," but the touch of the honest, con-
scientious and clean consumptive is no more
contagious than that of a healthy person. This
can hardly be said of the smallpox patient,
be he ever so clean. It is best for an unvac-
cinated individual never to touch him, and
still better to stay away from him as far as
possible.

I would consider it a most regrettable
thing if it should go out to the public that a
distinguished member of the American Public
Health Association has suddenly declared tu-
berculosis to be the most contagious of dis-
eases. We have already too much phthisio-
phobia which makes the lot of the unfortunate
consumptives hard enough.

For the kindly words said by my good
friend, Doctor Hurty, I am deeply grateful.
He is always progressive, fearless and out-
spoken. He agrees with me so thoroughly
that I feel he will do his share toward a bet-
ter understanding of the problem under con-
sideration and be an enthusiastic supporter
of the all important movement for the better-

ASPECTS OF BIRTH CONTROL 49

ment of mankind, which he loves so much.

To the member whose name I could not
catch and who maintained that the whole ques-
tion resolves itself into who should marry and
who should not marry, I wish to say that it
was merely for lack of time that I did not
touch on this subject in my paper. That I
strongly advocate a medical examination of
the man as well as the woman prior to grant-
ing a marriage license, I have already said in
my reply to Doctor Landis' criticisms. Much
unhappiness and misery could be avoided by
such obligatory examination and if we could
add to our institutions of learning a school of
parenthood with obligatory attendance for
every one desiring to enter the matrimonial
state, we would add still more to the happiness
and prosperity of the individual and the com-
munity at large.

Now a word to our Catholic friends and
those of other faiths who are so strongly op-
posed to contraception and limiting family
increase. Let us have no word of bitterness
or reproach because millions of devout Cath-
olics hold these views. Let us not antagon-
ize either Catholic priest or layman, who have
a right to their convictions as much as we
have to ours. This is a purely scientific
meeting, composed of men who should not
have, and I hope do not have, any hatred in
their heart because of differences of opinion
regarding religious views. Therefore, in re-
ply to the somewhat passionate remarks of
the* distrngpitshed statiaticiati of the M«tropoli-

jO ASPECTS OF BIRTH CONTROL

tan Life Insurance Company who questions
the accuracy of my statistics and my state-
ments, and says that it is all fundamentally
erroneous, I wish to reply with less vehemence.
I would calmly state that if we do not believe
in official statistics of one kind, we cannot
believe in official statistics of another kind.
Mine were prepared by the government in
Holland and by the United States government
and officials of various cities. The gentle-
man makes the statement that because of
my emotional attitude toward the question of
birth control, my conclusions are fundament-
ally erroneous and drawn from an examina-
tion of only a very limited part of my subject
Mr. Dublin is not a physician; he is a Doctor
of Philosophy, and this perhaps is an excuse
for finding fault with my emotional attitude.
My experience as a physician has brought me
into contact not only with the happy and well-
to-do but also with the poverty stricken and
the mentally and morally diseased, and with
the unfortunate girl-mother and our unfor-
tunate sister, the so-called prostitute, and
last, but not least, with the honest but poor
and ignorant mother of a large family who is
a slave by day and by night. It has been my
earnest desire to lessen the misery caused by
thoughtless procreation, and I may perhaps
be forgiven if I have approached the subject
with deep conviction and not without emotion.
We physicians cannot, and God forbid that we
ever shall, deal merely with cold figures and
statistical facts. We k>ve science, y6i, and

ASPECTS OF BIRTH CONTROL 61

accuracy in science and statistics, but this
does not prevent us from feeling with our
patients in their sufferings of mind, body, or
soul.

I do not at all disagree with the gentle-
man when he speaks of birth release by the
healthy and well-to-do. In my paper I have
referred to this and also believe to have dis-
tinctly shown that I do not plead for race
suicide but most emphatically for race pres-
ervation and multiplication of the best and
noblest, physically, mentally and morally.
What I think of France of today, I have al-
ready said, and when the gentleman says that
France is crying for more men, I might first
say that the quality of the French soldiers
has made up for the quantity. Russia has
had and has the most men. It does not cry
for more men, and still its achievements do not
compare, at least up to this day, with the
achievements of France.

Lastly, when Dr. Dublin says: "The at-
titude of mind which is engendered by a na-
tion-wide policy of birth control, brings about
more infant mortality and more tuberculosis
because of the general weakening of the stock
which directly results therefrom," I most
thoroughly disagree with this argument. My
personal statistics regarding the frequency of
tuberculosis among the later children born in
large families have been, as you have heard,
corroborated by Dr. Hurty's investigations;
and all physicians know that women, particu-
larly those of the working class when worn

eS ASPECTS OF BIRTH CONTROL

out by frequent pregnancies, are more subje&t
to tuberculosis than almost any other class
of people. How then can Dr. Dublin believe
that birth limitation would cause more tuber-
culosis? In Russia, where the word birth
control is unknown, tuberculosis and infant
mortality are the highest of all civilized coun-
tries. On the other hand, in Holland, where
we might speak of nation-wide birth control,
as already stated in my paper, after forty
years of this policy there is less infant mor-
tality, an increase in population, a better
physique, and a higher morality. Further-
more, there has not been a general weakening
but a general improvement in the strength
of the stock which is shown by an increase in
stature and increase in the longevity of the
population at large.

My good friend. Assistant Surgeon-General
John W. Trask, has admirably answered the
question as to what, aside of the war and its
demands for more men, is the common reason
for wanting the population to grow. It is a
splendid answer and I could not possibly im-
prove on it but wish to thank him most heart-
ily for what he said. And here I cannot help
saying one word which, however, I hope may
not be misunderstood. I am an American to
the core of my being, but my cradle stood in
Germany whose people I love as warmly as
ever; and yet I cannot help feeling that the
over-population of Germany has been one of
the vital causes of this disastrous war which
has brought so much misery to all humanity.

ASPECTS OF BIRTH CONTROL K

Professor Robert J. Sprague, of the Massa-
chusetts Agricultural College, expressed this
veiw very strongly the other day at the meet-
ing of the Genetic Association when he said:
"The barbaric birth-rate of Germany hemmed
in as she is by the other nations, made the
great war inevitable and will, if it keeps up,
make war forever in the future. Some be-
lieve this will work eugenically for the sur-
vival and predominance of the strongest and
best race, but this is still a mooted question.
The survival of the merely strong may result
in the survival of the strong animal. Pres-
sure of population on subsistence and area
develops brutality, selfishness, and disregard
of human life. It crushes leisure, generosity,
and art and makes impossible some of the
finest virtues of the race."

I have already said how anxious I am that
we may treat this subject as a scientific one
and that we should only have in view the
highest ideal, namely, a normal increase of
population concomitant with our resources
and an improvement of the quality of our
population; in other words, we should strive
to render the lives of man, woman and child
more healthy and more happy, and economic-
ally secure. My personal belief is that we
shall thereby become more highly developed
spiritually and approach more rapidly toward
the millennium. When at last an enlightened
government will permit contraception to
be taught where it is likely to be produc-
tive of the most good, when in years

54 ASPECTS OF BIRTH CONTROL

to come we can show our Catholic
brethren and all those who oppose us now
that because of judicious birth control result-
ing in a rational family limitation, we have
decreased poverty, disease, and crime and
have produced a better generation of men and
women, better equipped for life's mission, in
short, men worthy to be called true citizens
of a great republic, then I am sure our Cath-
olic friends and other opponents will see that
after all we have not been so wrong and they
may then be willing to follow along the same
lines of teaching rational birth control.

I have been asked why I became interested
in birth control so suddenly, which is appar-
ently so foreign to my specialty, but I can
assure you that while I have taken up the
work only recently, my interest was not sud-
den at all. As already stated it began many
years ago in connection with my work in the
tenements and over-crowded hospitals where
I witnessed the suffering of many a tubercu-
lous mother whom I could not help because it
was too late to prevent. The despair of some
poor, frail creature at the prospect of another
inevitable confinement, the likelihood of her
early decease as a result of this newly added
pregnancy, the thought of her other children
who would be deprived of a mother's care at
ages when they need it most, and later the
sight of a puny babe destined to disease, pov-
erty, and misery, opened my eyes to the utter
immorality of thoughtless procreation, not
-jnly of the tuberculous, but of all other phys-

ASPECTS OF BIRTH CONTROL 56

ically and mentally diseased and impoverished.

Nature's forces are blind. She creates
without thought of provision for the offspring.
Think of bacterial life if it had remained un-
checked by the genius of a Pasteur, a Koch, a
Lister; of the insects, such as the yellow fev-
er and malaria-spreading mosquitoes, if un-
checked by a Reed and a Gorgas! I could
continue the theme of man's triumph and con-
trol over nature indefinitely if I were to enter
into the field of agricultural and industrial
science. I could tell you of battles of the
Australian farmer with the rapidly multiply-
ing rabbit. Here nature's blind tendency to
procreate devastated the fields destined to
nourish the population.

The excessive birth-rate of human beings
in India and China is to my mind also largely
responsible for the frequent famines and their
sequellae of pestilence, plagues, etc. The idea
that there is and always will be enough room
and food for all mankind on this earth, no
matter how great the increase in population,
is, to say the least, erroneous. In my address
I have already referred to the work of Doctor
Reed who says, "It seems, indeed, to the care-
ful student that the danger to the American
family today and still more in the future lies
in the direction of over-population rather than
under-population."

Is there no danger at all in this country
of ours of a possible famine due to over-pop-
ulation and under-production of food sub-
stances? In his forthcoming book on Food

56 ASPECTS OF BIRTH CONTROL

Problems (Goodhue & Co., Publ., New York),
of which I had the privilege to see the proof,
my friend, Dr. Henry Smith Williams, the well
known physician and economist, makes the
following statement:

"In the census period of 1900-1910,
the population of the United States in-
creased by 21 per cent, but the production of
cereal grain increased by only 1.7 per cent.
In the meantime there has been such a falling
off in the animal industry that there would
have been required 60,000,000 more meat an-
imals (cattle and sheep) on the hoof in order
that meat should have been as abundant per
capita as it was in 1890."

This authoritative statement should give
serious food for thought to statesmen and
sociologists, as well as to us physicians. The
difference between the increase in production
and population is too great at this time for
family limitation alone to prevent food prob-
lems becoming intensified from year to year.
There must be very soon a wiser distribution
of wealth and population, that is to say, more
social justice for all — man, woman and child —
and a return to the field of some of the masses
through making farming more profitable. Be-
sides taxing unimproved property in and
around cities or utilizing it for the public good
or temporary cultivation, there should be an
intensive cultivation of the vast areas as yet
unused. A steady decrease in the food sup-
ply will not only lead ultimately to famine
but prio- to that will increase tuberculosis

ASPECTS OF BIRTH CONTROL 67

and other diseases of malnutrition to an alarm-
ing degree, as is demonstrated at this time
in the warring countries of Europe. In order
to thrive physically, mentally, and morally,
man must have room. Over-population and
over-crowding is injurious to man, beast and
plant. Professor Sprague, whom I have al-
ready referred to, is right when he says: "Man
has learned that corn and potatoes must be
given proper spacing lest Mother Earth be
crowded and they do not grow well, but he
has often forgotten to place sufficient spacing
between his human children that they might
develop to the highest."

If non-interference with thoughtless na-
ture comprises one of the tenets of the relig-
ion of others, to me man's intellectual control
over nature's blind forces and nature's thought-
less procreation of undesirable bacterial, in-
sect or animal life, and his powers to bring
forth more useful products and make life for
man, woman, and child not only more bearable
but even more beautiful and glorious, are
among the greatest proofs of the existence
of God's power in man. But the greatest of
all achievements, the most divine gift which
God has bestowed upon man, is conscious pro-
creation. To me, judicious birth control under
the guidance of the beat and ablest among our
own profession, among the clergy and sociol-
ogists, based on the highest conception of
sanitary, medical, moral, ethical, and econom-
ic reasons, can well be considered a spiritual
asset which will uplift the race.

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95 Confessions of An

Opium Eater.
213 Lecture on Lincoln.

Ingersoll.

177 Subjection of Women.
.John Stuart Mill.

17 On Walking. Thoreau.
70 Charles Lamb's Essavs.
235 Essays. Gilbert K."
Chesterton.
7 A Liberal Education.
Thomas Ilu.xley.
233 Thoughts on Literature

and Art. Goethe.
225 Condescension in

Foreigners. Lowell.
221 Women, and Other
Essays. Maeterlinck.

10 .Shelley. Francis

Thompson.
2 89 Pepys' Diary.
299 Prose Nature Notes.

Walt Whitman.
315 Pen, Pencil and Poison.

Oscar Wilde.
313 The Decay of Lying.

Oscar Wilde.
36 Soul of Man Under

Socialism. 0. Wilde.
293 Francois Villon:

Student, Poet and

Housebreaker. R. L.

Stevenson.

Maxims and Epigrams

179 Gems from Emerson.
77 What Great Men Have

Said About Women.
304 ^^'hat Great Women

Have Said About Men.
310 The Wisdom of

Thackeray.
193 Wit and Wisdom of

Charles Lamb.
.'.r, Wisdom of IngersoU.
106 Aphorisms. George

Sand.
168 Epigrams. Oscar

Wilde.
.'9 Epigrams of W^it nd

Wisdom.
35 Maxims.

Rochefoucauld.
l.")4 Epigrams of Ibsen.
197 Witticisms and Re-
flections. De Sevigne.
ISO Epigrams of George

Bernard Shaw.
l.'>") Maxims. Napoleon.
1>1 Epigrams. Thoreau.
•2 2 8 .\phoiism>. Huxley.
113 Proverbs of England.
I 114 Proverbs of France.

TKN CKNT I'UCKET SERIES

115 Proverbs of Japan.

116 Proverbs of China.

117 Proverbs of It;\'y.

118 Proverbs of H:issia.

119 Proverb: of |:e!;ind.

120 l'ro\erbs of Rpiin.

121 Proverbs of Arabia.

Philosophy, Religion

15J

Du-

ir)7

A Guide to Plato,
rani.
322 The Buddliist Phi'.os --

phv of Life.
317 A Guid to Stoicism.
124 Theory of Reincarna-
tion Explained.
Plato's Republic.
62 Schopenhauer's Essays.
94 Trial and Death of

Socrates.
65 Meditations of
Marcus Aurelius.

64 Rudolf Eucken: His
Life and Philosophy.

I Age of Reason. Thomas
Paine.

65 Herbert Spencer: His
Life and Works.

4 4 Aesop's Fables.

165 Discovery of the Fu-
ture. H, G. Wells.
96 DinlopTues of P^nto.

3 25 Esseni-c of Buddhism.

103 Pn^kot Theology.
"^'oHnire.

132 Fnimdntions of Re-
ligion,

138 StnrliVf; in Possimism.
S'"hopcn1->i"»^r.

211 Idea of God in V'
t'lrp. .John St'i •'•t

212 Tif" ^nd Ch^rrir+rr
Ooo+>ie

200 Tenorant Philosopher.

VnltnirP

101

Thoughts of Pascal.

210

The Stoic Philosophy,

Piof. G. Murray.

224

God: Known and

Unknown. Butler.

19

Xiet/.sche: Who he

Was and What He

Stood For.

204

Sun Worship and

Later Beliefs.

Tichcnor.

207

O'ympian Gods.

IL M. Tichenor.

1^4

Primitive Beliefs.

l.-,3

Chinese Philosophy of

Life.

30

What Life Means to

Me. Tack London.

Poetry

152

The Kasidah. Burton

317

L'ATegro and Othe:

Poems. Mi'ton.

283

Courtship of Miles

Standish. T,ongfePo\v.

2 82

Rime of An ient Mar-

iner. Co'eridgc.

297

Poems. Robert

"^^oiithev.

329

Dante's Inferno,

^'ol1lme 1 .

330

Dinte's ^-"ferno,

Yo'ume

son

A Shropshire Lad

TToiism'-n.

284

Poems of Robert

Burns.

1

Rubaiynt of Omar

Khnwnm

73

W.qlt' Whitman's

Pr.'^ms.

2

Wiido's B-"-d of

Read'nsr J'^^'^

32

Poo's iPoems

164

M'"rboo1 Angelo'&

VI

TEN CENT POCKET SERIES

VI

71
146

88
•Bl
-73
'22
•^7

321

327

140

275

49

42

238

202

:91

133
92

Poems of Evolution.
Snovv-Bounii. Pied
Piper.

Great English Poeiiis.
Enoch Arden.
Tennyson.

Shakespeare's Son-
nets.

Lays nf Ancient Rome.
Marnuhiy.

Vision of Sir Launfal.
Lowell.

The Vampire and
Other Poems. Kipling.
Prose Poems.
Baudelaire.

Science

A History of Evohtion.
Fenton.

The Ice Age. Finger.
The Puzz e of Person-
ality; a Study in
Psvcho-Analysis.
Fielding.

Psyrh o- A n a ' y ;^ i =;— Th e
Key to Human Be-
havior. Fie'fling.
Biologv and Spiritual
Philosophy.
The Bui'ding of the
Enrth. C. L. Fenton.
Three Lectures on
Evolution. Haec'kel.
Origin of the Human
Race.

Reflections on Mod-
ern Science. Huxlev.
Survival of the Fittest.
FT. M. Tichenor.
Evolution vs. Religion.
B:i'mforth.

E'ectricity M:nle Plain.
Hvpnotism Made
Plain.

1 Insects and Men:
Instinct and Reason,

9 Engl nics. Havelock
Ellis.

Series of Debates

11

130

43

Debate on Religion.
Did .Jesus Ever Live?
Controversy on Chris-
tianity. Ingersoll and
Gladstone.

Marriage and Divorce.
Horace Greeley and
Robert Owen.

208 Debate on Birth Con-
trol. Mrs. Sanger and
"Winter Russell.

129 Rome or Reason.

Ingersoll and Manning.

122 Spiritualism. Conan
Doyle and McCabe.

171 Has Life Any Mean-
ing? Frank Harris
and Percy Ward.

206 Capitalism vs. Social-
ism. Seligman and
Nearing.

Is Free Will a Fact or
a Fallacy?
McNeal-Sinclair De-
bate on Socialism.
Would Practice of
Christ's Teachings
Make for Social
Progress? Nearing
and Ward.

13

!34

141

Miscellaneous

326

19

Hints on Writing

Sliort Stories. Finger.

Book of Synonyms.
2.') Rhyming Dictionary.
7S How to Be an Orator.
82 Common Faults in

Writing English.

8ij33irtM tUi JTHMHaU .ilJAu HU MV

VII

TEN CENT POCKET SERIES

VII

27

What Expectant

98

How to Love.

Mothers Should Know.

172

Evolution of Love.

81

Care of tlu- I3al>v.

Ellen Key.

3G

Child Training.

203

Rights of Women.

•6 7

Home Nursing.

Havelock Ellis.

14

What Every Girl Should

209

Aspects of Birth Con-

Know. Mrs. Sanger.

trol. Medical. Moral,

34

Case for Birth Control.

Sociological.

91

Manhood: Facts of

93

How to Live 100

Life Presented to

Men. 1

Years.

83

Marriage: Past, 1

167

Plutarch's Rules of

Present and Future.

Health.

Besant.

320

The Prince.

74

On Threshold of Sex.

Macbiavelli.

WIV. OF CAUf. UBRARY. LOS ANGELES

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