,,birth ,,control ,,and ,,the ,,state ,,birth ,,control ,,and ,,the ,,state ,a ,,plea ,,and ,a ,,forecast ,,by ,c4 ,p4 ,,blacker ,m4,c41 ,m4,a41 ,m4,r4,c4,s41 ,l4,r4,c4,p4 ,illustration ,,new ,,york ,e4 ,p4 ,,dutton ,,company #fha ,,fifth ,,avenue ,copyright1 #aibf ,by ,e4 ,p4 ,,dutton ,,company ,all ,rights ,reserved ,,printed ,,in ,,the ,,united ,,states ,,of ,,america ,,foreword ,the pioneer battles on behalf of ,birth ,control1 as everybody knows1 have been fought in this country by ,dr ,marie ,stopes1 who has largely borne the brunt of that abuse which is meted out to all popular exponents of ideas that do not harmonize with traditional morality4 ,the fact that ,dr ,stopes has been criticized1 and at times attacked by the medical profession 7which until recently refused to acknowledge that the subject of ,contraception fell within its sphere7 on the grounds that she does not possess a medical degree1 and the fact that she has retaliated with vigourand continues to do so in most of her public utterances1 have led to a breach between her and the more orthodox elements of the profession1 which to a certain extent1 has impeded the realization of her ultimate aim1 namely the undertaking by the ,state of the work she performs on a small scale in her privately-run clinique4 ,in what follows ,i have drawn attention to drawbacks attending the dissemination of knowledge of ,contraception by ,general ,propaganda4 ,i have done so1 however1 fully realizing that this propaganda was1 in the first instance1 necessary to override the barrier of prejudice presented by orthodox morality1 and equally realizing that if it had not been for ,dr ,stopes and her propaganda this book would probably never have been written4 ,in its essential plea that advice on ,contraception1 now obtainable only at private institutions1 be made generally available by the ,ministry of ,health at the centres under its control1 this book is at one with the wider aim expressed by ,dr ,stopes in the words that commemorate the founding of her first private clinique4 ,i know that in the past it has proved nearly impossible in a single book to appeal effectively both to the general public1 and to the medical profession4 ,yet ,i have attempted to do that here4 ,the task has been made perhaps less difficult than usual by the fact that until recently the subject of contraception has been completely ignored by the medical profession1 which as a whole seems to remain as uninformed of its wider implication as does the general public4 ,it will be found that the book ends with a practical suggestion taking the form of an appeal to the medical profession4 ,the substance of the first part of what follows originally appeared as a series of articles in ,the ,saturday ,review1 to which ,i am indebted for permission to publish the book in its present form4 ,c4 ,p4 ,b4 ,,birth ,,control ,,and ,,the ,,state ,a ,,plea ,,and ,a ,,forecast ,since the ,war1 the subject of ,birth ,control has been widely discussed1 and much has been written about it4 ,by some of its advocates it has been extolled to the point where any criticism1 however tentative1 is resentfully repudiated4 ,by its enemies it has been represented as a pernicious and unnatural practice leading to the degeneracy and1 ultimately1 to the extinction of the race4 ,so wholeheartedly felt1 and yet so profoundly opposed are these views1 that it has been difficult for the average person to find his bearings on any other basis than that of his own sentiment4 ,it is clear that the implications of ,birth ,control1 or1 rather1 what is generally1 though not logically understood by the term1 of the practice of contraception1 are far reaching4 ,it profoundly affects the life of the individual2 it reacts upon the internal economy of the community2 and it has a most important bearing upon the international future of the country wherein it is practised4 ,it is therefore incumbent upon all serious students of contemporary world-problems to realize clearly what is to be said on both sides1 and to form thereon1 as far as lies in their power1 an unbiassed opinion4 ,this obligation weighs especially heavily on medical men since1 if the practice is to be tolerated at all1 it is by them that it should be administered and controlled4 ,it is a general survey of this sort that is attempted here4 ,the book will begin with a consideration of the more important arguments that have been advanced on each side4 ,these will then be discussed1 and there will follow a conclusion as to the bearing of the practice upon the future of civilization4 ,it will be convenient first to review the more serious arguments used against ,birth ,control1 the problem being considered throughout both as a world-problem and as one with a special significance for this country4 ,they fall into two distinct categories concerning 7,a7 the ,race and 7,b7 the ,individual4 ,a4 #a4 ,the #8military' argument finds exponents among ,nationalists1 who are convinced that the essential merit of a country lies in its powers of offence and defence1 or who are persuaded that future wars are1 by the constitution of human nature1 inevitable1 and that it is therefore necessary for the country to which they belong to be fully equipped4 ,by such persons1 ,birth ,control is opposed in so far as it would impair their country's man power4 #b4 ,an argument allied to the above1 yet one which must be distinguished carefully from it1 deserves close scrutiny4 ,it is to the effect that quite apart from military considerations the practice of ,birth ,control in a country is capable of acquiring in a short time such universality that the population may decrease1 and eventually dwindle to proportions which would place that country1 whatever its status1 in a position of a second or third-rate power4 ,from history the approximate generalization can be made that prolific races get the better of infertile races in the struggle1 first for existence1 and then at a later stage1 for power4 ,this generalization is likely to hold good in an economic sphere4 ,thus a graphic picture has been drawn of what will happen to ,england1 in the matter of its population1 if it follows in the wake of ,france4 ,it will come to assume the proportions of an insignificant little island in the ,north ,sea1 the possessor1 actually1 of a mighty past1 but in the present counting for nothing beside the densely peopled territories of ,southern and ,eastern ,europe1 ,asia and ,america4 ,birth ,control uncontrolled means race suicide4 #c4 ,there is an #8economic' argument against ,birth ,control1 which itself takes two forms4 ,in the first place it is felt1 in under-populated countries like ,new ,zealand1 ,australia1 and perhaps to a less extent the ,united ,states1 that since it is desirable in the general interests that the population should increase1 it is to be preferred that this increase be effected from native-born stock rather than through the process of accretion by often undesirable aliens4 ,hence in most under-populated countries1 ,birth ,control is opposed4 ,in the second place it is probably felt 7though probably not admitted7 by the ,governments of those capitalistic countries confronted with a labour problem1 which are at the same time desirous of limiting immigration1 that the unrestricted multiplication of their working classes1 by causing a competition for wages1 will create a cheap labour market4 ,it is highly unlikely that this view has much weight here1 though it may easily be otherwise in the ,united ,states1 where the labour problem is acute and where it is universally desired to limit coloured immigration and immigration from ,south-,eastern ,europe4 #d4 ,there is an argument against ,birth ,control1 which has special reference to the position of this country as the original founder of a great ,empire4 ,since most of the ,dominions are still under-populated and wish their numbers to increase1 and since the increase of native stock1 even though fully encouraged1 is unable to supply the demand for labour1 it is contended that ,great ,britain should always be able to turn out a numerical surplus to send to the ,dominions each year1 which in addition to satisfying a need for better-class immigrants would serve to consolidate the racial and cultural bonds that keep the ,empire together4 ,b4 ,the above arguments concern the race4 ,the remainder which follow refer primarily to the individual4 #e4 ,a #8medical' argument has been heard to the effect that the actual practice of ,birth ,control or1 more precisely1 the use of contraceptives1 is inimical to health1 being capable of causing both local disease and more general constitutional disorders4 ,emotional instability and various neuroses have been quoted as such products4 ,no woman making use of a contraceptive for the first time can escape a feeling of revulsion at such a callous interference with a process that above all others should be spontaneous and instinctive4 ,no woman can then fail to experience a sense of aversion from such a deliberate thwarting of ,nature's most fundamental purpose4 #f4 ,very potent also1 is a #8conventional' objection which in practice is often associated with the religious argument next to be considered1 though in reality it is distinguishable from it4 ,on these grounds it is felt that all that pertains to the province of sex is indecent1 disgusting1 and unfit for discussion4 ,the topic of ,birth ,control is thus stigmatized as #8immoral' by many people of no deep religious conviction4 #g4 ,the #8religious' objection nowadays finds its chief exponents among the ,japanese and ,roman ,catholics1 though it is also strongly upheld by many ,anglicans and others4 ,by the ,japanese1 ,birth ,control is condemned on grounds that seem to be1 partly at any rate1 nationalistic4 ,the ,japanese religion1 intimately connected as it is with ,ancestor ,cult1 holds that it is the duty of every man to marry young1 and to produce the largest possible number of children1 especially males1 who may carry on the tradition of the family and at the same time grow up into soldiers capable of fighting for the ,mikado in war4 ,by the ,japanese1 the ,mikado is believed to be a ,deity incarnate1 not in the symbolical sense in which some people have thought of the divine right of kings1 but in a real and vital sense1 as #8the occupant of a sacred throne which was established at the time when the heavens and the earth became separated4' ,to die for him in war is the most supreme1 the most glorious duty4 ,the objection to ,birth ,control here would thus seem closely allied to the #8military' objection first advanced4 ,by ,roman ,catholics it is held to be a mortal sin to employ any chemical or mechanical means to prevent conception1 the only permissible form of control being voluntary abstinence from each other on the part of both parents4 ,the abstinence of one parent against the will of the other is also considered a mortal sin on the part of the refractory parent4 ,an exception to this rule is now made which permits parents not desiring children to make use of a moment in the periodic life of the mother during which conception is less likely to take place than at other timesthe so-called #8safe' period4 ,it is1 however1 generally agreed nowadays that the #8safety' pertaining to this period is in many cases quite illusory and devoid of serious physiological or medical basis4 ,opponents of the ,roman ,catholic ,church have represented its insistence on this prohibition as dictated by a desire to extend her spiritual empire throughout the world1 since obedience to it must bring about a greater relative increase of believing ,roman ,catholics than of adherents to other religious denominations tolerating ,birth ,control4 ,but its attitude would further appear to express a conviction 7manifested elsewhere in the insistence upon celibacy among ,catholic priests and in its systems of penances and abstinences7 that sexual indulgence is somehow incompatible with devotion to a purely spiritual life1 and when excessive produces a demoralizing effect upon human nature1 tending to make it weak1 lazy1 selfish and often vicious4 ,probably the ,catholic ,church feels that the use of devices to prevent conception would abolish the necessity for salutary self-restraint1 and would promote promiscuous and excessive indulgence4 ,the effect of this prohibition is that most ,catholics who are conscientious about not using contraceptives have large families4 ,there are some1 however1 particularly in ,france1 who do not take the prohibition very seriously4 ,at the bottom1 however1 of the religious objection1 would appear to lie the conviction that excessive sexual indulgence1 dissociated from the sequel of procreation and rendered possible by the use of contraceptives1 is morally harmful to the individual4 #h4 ,an objection of a pseudo-political nature is sometimes heard which envisages a bureaucratic extension of ,birth ,control4 ,the phrase is here understood to imply a #8,national ,control of ,births' and not a #8,voluntary ,regulation of ,births'1 its more usual acceptance4 ,such a bureaucratic interference in people's private lives is held to constitute an infringement of the liberty of the individualin this case his liberty to have as many children as he likes1 when he likes4 ,the principle of individual liberty1 the corner-stone of nineteenth century ,liberalism1 still has a certain number of adherents4 #i4 ,the last outstanding argument is to the effect that the popularization of ,birth ,control will lead to a general increase in promiscuity1 both among married and unmarried people4 ,the temptation to illicit indulgence would be made greater1 the process of seducing an innocent girl would be made easier1 the ever-present lure of prostitution to the underpaid girl worker would be made more difficult to resist1 if an assurance could be felt that the subsequent birth of a childhitherto a generally prevalent and effective deterrentcould be prevented by the exercise of a popularly known technique4 ,the restraint imposed by fear may not be one of a high moral order1 yet the end which it serves is here1 by common consent1 socially desirable4 ,in face of the absence of any authoritative source of information on ,birth ,control1 and of the indifference of the medical profession with regard to it1 certain popular works on the subject have acquired an immense vogue and have enjoyed an enormous sale4 ,though not intended for this purpose1 they are purchased and read extensively by young persons in much the same spirit that improper literature in general is read4 ,further1 the sale to adults of these works containing as they do a magnification and eulogy of the sexual act per se 7to be conceived1 expressly1 apart from its normal biological sequel of child-birth as a salutary and health-giving process71 and containing also minute instructions as to the technical use of contraceptives1 has not been confined to married persons4 ,such works have been held to inflame and pervert the imagination of the young1 and on pseudo-medical grounds1 to incite adults to promiscuity4 ,it is to be noted1 however1 that the above is an argument directed not so much against ,birth ,control itself as against the method by which knowledge of it is communicated to the public4 99 99 99 99 99 ,these appear to be the most important arguments currently advanced against ,birth ,control4 ,it will be noted that several have been omitted from consideration4 ,the one based upon biblical condemnation is too futile to merit restatement4 ,the argument that contraception is #8unnatural' is equally undeserving of repetition4 ,the contention that it is anti-biological will be discussed later4 99 99 99 99 99 ,arguments on the other side will now be considered4 ,they divide themselves into three groups1 which may arbitrarily be designated as ,international1 ,social1 and ,individual arguments4 7a7 ,international4,the connexion between over-population and war is nowadays fairly obvious and is particularly manifest in those countries which are both industrially organized and consciously nationalist in spirit4 ,in the absence of these two conditions over-multiplication need not be followed by war4 ,india and ,china1 for instance1 are very densely populated countries where over-multiplication frequently takes place4 ,this process does not1 however1 give rise to much danger of international disturbance1 in that both countries are1 from the nature of their organization1 incapable of conducting war on modern lines1 and neither has a generally-felt1 or a unifying national consciousness4 ,excessive increase is here frequently checked by famines1 which1 though causing incalculable suffering1 do not readily generate wars4 ,within recent years two countries have demonstrated the relation between over-population and war1 or the threat of war1 namely ,germany and ,japan4 ,in ,germany before the war1 where the #8military' objection to ,birth ,control1 first advanced1 was prevalent1 there existed an ethical code by which ,german mothers were persuaded that they were fulfilling the highest spiritual purpose of which their sex was capable by producing male children destined to be soldiers1 prepared to fight for their country in a victorious war4 ,it is now generally recognized here that it was this attitude of mind1 involving an expectation and a glorification of war1 associated with the distinctively ,german powers of efficient organization centred in implicit obedience to the ,kaiser1 which served to produce that exultant pride of power and aggressive national consciousness which precipitated1 if it did not actually cause1 the late war4 ,the increase in the population of ,germany was advocated and extolled without regard to that country's capacity to support her swelling populations4 ,to-day1 though ,birth ,control is largely practised by the upper and middle classes in ,germany as it is in this country1 the old ideal still lingers on1 and to it is attributable that fear of ,germany which1 until recently1 has so conspicuously directed ,french policy since the ,armistice4 ,in ,japan the connexion between numerical increase and a possible war is now coming to be recognized here4 ,australia1 ,new ,zealand and the ,united ,states are already definitely conscious of it4 ,the ,japanese religion1 based upon piety towards ancestors 7to whom every man is bound to perpetuate his family71 and upon loyalty to the ,mikado who1 as ,emperor ,god1 is held to be divine1 imposes upon all faithful subjects the duty of marrying young and of producing many children4 ,this injunction is again promulgated irrespective of the native resources of ,japan1 and in the past has necessitated a considerable annual emigration to other countries4 ,the recent restrictions imposed by ,america upon ,japanese immigration1 themselves prompted by motives common to most ,english-speaking races1 have led directly and inevitably to the existing tension between ,america and ,japan4 ,as things stand at present1 it appears that this tension is likely to increase and may easily eventuate in a war1 in which there would be a greater probability of our being involved than there was1 initially1 of ,america being involved in the late war4 ,both the ,americans and ,japanese are sensitive and proud people4 ,after further tension has accumulated1 a trivial incidentthe possible murder of an ,american official in ,japan by some irresponsible personmight lead to the despatch of a curtly-worded note or to the formulation of an abrupt ultimatum out of which a second world war might1 like the last1 suddenly flare up1 to reduce modern civilization to ruins and ashes4 ,stress is laid on this particular aspect of the population problem partly because it is felt that few nations now hold the desirable ideal of adapting their numbers to their particular economic optimum1 and partly because it would seem that in face of this nationally encouraged increase of population and of certain apparently unalterable race antipathies1 no amount of international pacifism1 or of condemnation of violence1 or of genuine humanitarian goodwill can prevent war4 ,germany and ,japan display the connexion between numerical increase and wars most clearly to-day4 ,it is possible that in the future other nations may become conspicuous in this respect4 ,thus ,america1 where the teaching of contraception is illegal 7in so far as anything is71 may1 in another #ej or #ajj years1 develop an aggressive foreign policy4 ,and now that restrictions have been imposed on the entry of ,italians into ,america1 it is conceivable that ,italy may at some time discover an ,imperialist mission on the shores of the ,mediterranean4 7b7 ,social4,this aspect of ,birth ,control has been much discussed and is concerned with the dimensions and quality of the population of these islands4 ,the argument1 in the form in which it is usually advanced1 distinguishes a quantitative and a qualitative point of view1 the latter further possessing two aspects4 ,quantitatively1 it has been pointed out that in the last hundred years1 the increase in the population of this country has been excessive4 ,because ,england was the pioneer of the ,industrial ,revolution1 she enjoyed initially an unprecedented national prosperity1 unharassed by competitors and with the world as her market4 ,though the conditions of many of the early factory-workers were unquestionably appalling1 the wealth and economic importance of this country increased so rapidly that she was enabled to support immensely greater numbers than at any previous period of her history4 ,thus in #ahba the population of ,england and ,wales was just over #ab millions2 in #aiba it had risen to nearly #ch millions4 ,that is to say that in a hundred years our population had more than trebled4 ,when1 however1 at the beginning of this century other countries began to enter into competition with us1 and to produce manufactured goods on a large scale often underselling ,british goods1 our hitherto unchallenged industrial supremacy gradually commenced to suffer eclipse4 ,but our numbers have not adapted themselves to our diminished power of employing labour thus created4 ,on the contrary1 the population has continued steadily to increase1 with the result that by slow degrees the unemployment problem which1 at present1 looms so large on our political horizon began insidiously to disclose itself4 ,the present formidable figure of nearly a million and a quarter of unemployed1 together with a large number of workers on short hours1 testifies to the fact that at the present time in relation to existing economic conditions1 this country seems to be over-populated4 99 99 99 99 99 ,from the point of view of quality it has been pointed out that there are two factors which now tend to impoverish the race4 ,they might be distinguished and arbitrarily named as #8,dysgenic' and #8,economic' respectively4 ,the dysgenic factor may be propounded as follows3 ,though the ,birth-rate in ,england has fallen from #cf per #ajjj in #ahgg to #bj per #ajjj or less to-day1 this decrease has not been accompanied by a decrease in the population1 since the ,death-rate has dropped correspondingly4 ,this has taken place by reason of the complete suspension1 if not the actual reversal1 in civilized countries to-day of the principle of ,natural ,selection1 operative amongst animals and primitive peoples4 ,there are three outstanding reasons to which this suspension is attributable4 ,they are the advances in sanitation and medical science1 the increase in humanitarianism1 and the method of obtaining votes which prevails in democratic countries4 ,the advances in sanitation and medical science made in the last #fj years have resulted in an enormous reduction of infant mortality in large towns1 and also in an average prolongation of life4 ,epidemics of smallpox1 cholera1 typhus1 diphtheria1 scarlet fever1 etc41 which took such a heavy toll in the past1 are now effectively controlled by the existing system of isolation hospitals1 and of efficient public health supervision4 ,to-day it is possible for the medical student to traverse his six laborious years of training without seeing a single case of typhoid fevera disease which in the times of his elders used to be one of the commonplaces of a hospital4 ,these improvements in sanitation1 the progress made in aseptic surgery1 in prophylactic medicine1 and in the general treatment of disease1 have been largely responsible for the lowering of the death-rate already mentioned4 ,the increase of humanitarianism in civilized countries has resulted in the creation of an enormous number of philanthropic institutions and charity organizations1 through the channels of which much relief is brought to the impoverished classes4 ,this spirit now makes it difficult for those endowed with a superfluity1 or even a sufficiency of wealth1 to contemplate with indifference the misery and degradation of less fortunately placed fellow human beings4 ,and lastly1 since the entry to power of any given political party is conditioned by the acquisition by that party of a sufficient number of votes1 given by a mainly proletarian electorate1 it follows that politics are likely to be framed in such a way as to commend themselves to such an electorate4 ,it would seem unfair to omit this fact from consideration1 though it has been over-emphasized by a school of political cynics who deny the participation of humanitarian feelings in politics 7outside the realm of speech-making71 and who attribute to political expediency an excessive if not an exclusive rle in improving the lot of the very poor4 ,in virtue1 then1 of these factors it would nowadays be very difficult for any individual1 however worthless1 actually to starve1 and many people of defective stock and bad physique who1 in the ordinary course of nature would perish1 are now artificially kept alive to perpetuate their kind4 99 99 99 99 99 ,the #8economic' factor tending to produce deterioration in the race1 presupposes the dysgenic4 ,among uncivilized peoples it is the biologically superior type which is most prolific4 ,in advanced civilized countries1 which are democratic in social organization1 the reverse obtains4 ,thus among most primitive people1 the ,chiefi4e4 the man with most courage1 initiative1 resourcefulness and power of leadershipenjoys the possession of most wives1 and therefore produces most offspring4 ,the analogue of the drunken unemployable of to-day would probably not be permitted to marry4 ,in ,england now1 however1 the drunken unemployable finds his nearest approach to an occupation in endowing his ill-fated wife with a stream of children1 the regular succession of which is only eventually interrupted by the breakdown1 age1 or premature death of the wife1 or by the death of the husband4 ,and the only discouragement extended to such a man is forthcoming from the strictures passed upon him by his slum neighbours4 ,none is forthcoming from the ,government1 and none from the hospital1 which gratuitously delivers the wife of her children4 ,in fact1 information as to how she may arrest this devastating succession of children is deliberately withheld from her by nearly all hospitals1 because it is felt that the condition of public opinion1 upon which the hospitals largely depend for their finances1 is averse from her being enlightened in this respect4 ,the organization for relief in this country is now so comprehensive and far-reaching that every necessity can be obtained gratis by those who cannot afford to pay for it4 ,thus the wife of the poor man is delivered of her children free of charge2 the children are educated for nothing2 if employment is not available for them at the time of leaving school1 they are supplied with doles and relief free of obligation4 ,and when they become senile1 they are given old age pensions gratuitously4 ,the funds necessary for the administration of these works are levied from the middle and upper classes1 in rates and taxes4 ,now the ,englishman possesses a strong sentiment for institutions4 ,a man who has himself received a certain kind of education1 and who has been brought up according to a certain tradition1 likes to provide the same education and the same tradition for his children4 ,and if in the face of the increase in taxation1 the rise in the cost of living1 and the expenses of education1 he cannot afford this1 sooner than have children to whom he must deny what he considers a good start in life1 he prefers to limit his family4 ,this obtains of the man who suffers from a sense of obligation towards his children4 ,the opposite holds good of the unemployed man at the other end of the social scale4 ,he feels that he has sunk as low as is possible for him while still remaining out of prison4 ,insidiously his ambition and his self-respect become sapped by the soul-killing experience of finding himself a useless parasite upon the community4 ,frequently1 as prison reports show1 he takes to crime or drink4 ,and slowly he is overcome by that sense of irresponsibility1 of bitterness1 of carelessness of the future1 of improvident fatalism that takes possession of those living under continuously adverse circumstances4 ,it is a matter of indifference to him how many children are born to him since with each one his dole is increased4 ,none of the restraints which enter into the longer view of the future held by the middle classes is felt by him4 ,and so he goes ahead1 and has as many children as time and the health of his wife 7of which last he does not always show excessive consideration7 will permit4 ,the following figures clearly illustrate this state of things4 ,whereas the number of children produced annually by a thousand teachers is #ie1 by ,church of ,england ministers is #aja1 by doctors is #ajc1 the average number produced by general labourers is #bca4 ,and among these general labourers it is the least desirable individualsthose1 with least self-restraint1 least foresight and with least consideration for their wives or the future of their childrenwho have largest families4 ,and the undesirability may be of another kind4 ,mental defectives generally are very prolific4 ,girls of this condition1 if left unwatched1 are constantly becoming pregnant1 there being apparently no shortage of men prepared to take advantage sexually of such unfortunate victims4 ,it is to be noted that the economic situation following war is especially favourable to this discrepancy of fertility between classes4 ,it would seem that the recent experience of the significance of war1 the existing sense of social instability1 the universal prevalence of unrest1 hatred and international discord1 make the more considerate parents feel that the world is not a very desirable place to bring children into4 ,and this feeling is emphasized if they have to pay in taxation four times what they had to pay before1 after which what money remains is worth about sixty-five per cent4 of its previous value4 ,but these considerations hardly affect the classes whose occupation is manual labour1 or who have accustomed themselves to no occupation at all4 ,thus from a social point of view it is to be observed that quantitatively1 in relation to the present resources of the country1 ,england is at the present day considerably over-populated2 and qualitatively that many persons of all classes possessing inferior physique are now artificially kept alive to perpetuate their stock1 while at the same time those elements of the population who1 by lack of intelligence or thrift or steadiness1 or who by possession of other defects have been reduced to the lowest level of the social structure1 to-day constitute the most fertile strain in the country4 7c7 ,individual4,the argument has frequently been heard that it is desirable to communicate knowledge of ,birth ,control to the poorer classes in the interests of the mother and the children4 ,it is difficult to know what percentage of the unwanted children born in the poorer quarters of our large towns are conceived as the result of a culpable aggression on the part of the husband upon his wifeas when he returns home drunk on ,saturday night and threatens her with physical violence if she refuses to submit to his conjugal rightsor as the result of an ignorance of ,birth ,control methods which are familiar to the more educated classes4 ,certain it is that a large percentage of the children born are unwanted1 and equally certain that among the very poor ignorance of contraception is such as to appear incredible to those who have not had personal experience of it4 ,thus in the ,autumn of #aibd a group of seven externs1 working in the district covered by ,guy's ,hospital1 made inquiries of the mothers whose confinements they attended as to whether the child just born had been wanted or not4 ,the inquiries were made1 when possible1 on the tenth day1 when the patients were last visited1 in such a way that their answers were more likely to be favourably influenced by fondness for the child than unfavourably by recollection of the pains of labour4 ,furthermore1 where any doubt existed1 as for instance when a woman replied that she had not particularly desired the baby before it was born1 but would not part with it for the world now1 she was given the benefit of the doubt and the baby was counted as wanted4 ,in all1 inquiries were made in the case of seventy-eight children born4 ,out of these1 forty-seven were definitely not wanted1 and thirty-one wanted2 and the writer can vouch for the fact that if these figures erred at all1 they did so on the side of moderation4 ,thus1 in at least one poor quarter of ,london1 well over half of the children born were emphatically not wanted4 ,the hardships imposed on the mother by such conditions are sometimes very cruel4 ,numerous cases have been quoted by advocates of ,birth ,control in their propaganda which there is not space to reproduce here4 ,the reader can1 however1 picture to himself the experience of a woman suffering from the sickness1 shortness of breath1 emotional instability1 and deformity of pregnancy1 having to maintain life in some squalid slum1 house-keeping1 cooking1 cleaning and tending the children without change of air or scene and without holidays1 up till the incidence of the final labour pains4 ,and no sooner is a child born than the husband reasserts his 8rights10 and the same dismal cycle repeats itself without prospect or hope of change1 or of relief from a body that has ceased to know the easy freedom and self-forgetfulness of good health4 ,indifference to the children appears4 ,they are looked after out of a stern sense of duty4 ,the native impulse of spontaneous maternal fondness is killed by the deadly routine1 and when1 as frequently happens1 the child dies1 after a few pangs of grief1 an easy reconciliation 7perhaps not without a deep-seated sense of inward gratitude71 is made to what is acknowledged as the 8,will of the ,almighty40 ,sometimes1 the mother makes no secret of her relief4 ,but no man who has come for any length of time in contact with these working-class mothers can fail to admire the patience1 the stoicism and the grim fortitude with which they face their dreary lot4 ,their ignorance of ,birth ,control1 in face of the publicity the subject is now given in the ,press1 is almost incredible4 ,the same quality of fatalism and resignation felt by the soldier in the war before the prospect of wounds or death1 is still evinced by these women in the matter of child-birth4 ,one frequently meets with a sentiment that 8we must take what comes without grumbling10 that 8what is fated must be10 and even that 8we must not fly in the face of the ,almighty40 ,there further exists a superstition that any object requiring internal adjustment1 like a pessary1 runs the risk of being lost in the woman's inside4 ,a further aspect of the problem is the prevalence under the existing system of the practice of abortion4 ,it is difficult1 of course1 to give any trustworthy figures in this connexion1 since in many cases the fact that the mother has attempted to induce an abortion is not revealed to the medical man who attends her1 or to the hospital authorities who take her in4 ,the methods usually resorted to are of an amazing crudity4 ,they vary from the pregnant mother jumping three or four times consecutively off a table on to the floor or throwing herself downstairs1 to her swallowing large quantities of lead1 ergot1 quinine and other substances as well as nocuous doses of emetics1 irritants and purgatives4 ,frequently the woman practises local violence upon herself1 or engages the services of a professional abortionist1 a class more numerous than is generally supposed4 ,such a person1 after practising his art1 is in the habit of instructing the woman as soon as she feels the pain or notices any haemorrhage1 to report herself to a medical man or present herself at a hospital where she is taken in as an ordinary case of threatened abortion4 ,the responsibility for what may subsequently happen to the woman is thus effectively removed from the abortionist's shoulders1 it being in the interest of everyone concerned to preserve silence as to the part he has played4 ,the damage done to the health of many poor women by such practices is enormous1 and might largely be avoided by a judicious instruction in ,birth ,control4 ,when the effects of all this upon the children are considered1 it is at once found that the question of ,birth ,control is intimately connected with the housing problem4 ,the overcrowding in large slum families is notorious4 ,at an early age the day is passed by these children in the street1 where1 filthy and untended1 they receive little by way of notice from their elders except hard words or blows4 ,their nights are spent packed1 in a fetid atmosphere1 several together in the same bed from which they may witness their parents in sexual intercourse1 sometimes their mother in labour1 and where they are free to indulge in what1 later in life1 would be called incestuous practices with one another4 ,the writer has on more than one occasion attended a woman in confinement while several children were watching her from a bed in the same room1 there being1 in the urgency of the situation1 no time to dispose of them and nowhere immediately available to send them4 99 99 99 99 99 ,substantially this is what has been said on each side of this complex question4 ,before proceeding to discuss the arguments heretofore propounded1 it is necessary to emphasize the fact that from the technical point of view a really satisfactory contraceptive does not yet exist4 ,the chief disadvantage attaching to the contraceptive used by the man is that it is quite impossible to induce the type of individual whose procreation we would wish to restrict to use any contraceptive at all4 ,the child is usually begotten by such a parent when he is drunk1 and everyone who has had experience of the conditions prevailing in bad slums will know that it is futile to expect to achieve anything along these lines through the man4 ,the problem must be met through the woman who1 unlike the man1 has to put up with the discomfort and the pain of repeated pregnancies1 and has to shoulder the main burden of large families4 ,were it not for this elementary human fact all attempts to teach ,birth ,control to the very poor and destitute would fail completely4 ,essentially1 contraceptives which the woman can use are of two sorts1 and involve two principlesnamely1 a mechanical or occlusive1 and a chemical or spermicidal principle4 ,the objections to the first are two1 namely that they are far from being fool-proof1 and that unless sanctioned by a doctor their use can be followed by serious harm4 ,it will be clear to any medical man that for a patient suffering from gonorrhal cervicitis1 or indeed from any condition involving a chronic cervical discharge1 the use of an occlusive pessary may lead to disastrous consequences4 ,the broadcasting of promiscuous advice as to the utilization of these objects in the absence of an examination by a competent medical man or woman is therefore to be strongly condemned4 ,the drawback1 to all existing spermicidal suppositories is simply their uncertainty1 though they are as nearly fool-proof as anything of the kind can be4 ,it is possible that by further research a suppository1 physically harmless but of certain action may be discovered1 in which case1 from its practical and sociological aspect1 the problem of birth control will be greatly simplified4 ,it remains1 however1 a little doubtful whether the chemical principle1 however actively spermicidal1 will ever dispense with the necessity of some occlusive device4 ,but this is a sphere in which later research may prove of great value1 and nothing but a tentative statement is now possible4 ,the statement may1 however1 be made that if there is one method of ,birth ,control as to whose harmfulness there is little room for doubt1 it is the method of coitus interruptus4 ,in both sexes it gives rise to a condition of chronic anxiety which1 nowadays1 is far from uncommon4 ,in the absence of local disease any of the above methods of contraception is preferable to this one4 ,the effectiveness of those women's contraceptives now in vogue is difficult to estimate4 ,there is little doubt that an unduly high estimation of their success has been formed in certain quarters1 based on the assumption that in cases of failure1 the working woman will promptly report the event to the centre where the contraceptive was obtained4 ,the writer is persuaded that this is often a mistaken assumption1 and that many cases of failure pass in consequence unnoted4 ,there is also difficulty in knowing whether the instructions in the adjustment of the occlusive pessary have been adequately followed out4 ,this process is not always easy1 and as has been said above1 is far from fool-proof4 ,the arguments above advanced will now be considered in their relation to 7a7 the ,individual and 7b7 the ,race4 7a7 ,the ,individual4,the arguments relating to the individual are divisible into those applicable to 7#a7 married1 and 7#b7 unmarried persons4 7#a7 ,it is to be noted that some of the contentions advanced on each side apply to the different phases of the married life of the woman4 ,thus the revulsion of feeling against the use of contraceptives is experienced chiefly by the woman who has had either no children or few children4 ,on the other hand1 the woman who has the greatest need for a knowledge of ,birth ,control is the one who has had many children and desiring no more would probably feel little or no aversion from taking precautions against conceiving them4 ,it appears to the writer that there is no adequate objection to communicating to such a multiparous mother this much needed information4 ,the difficulty in the case of the newly-married woman is of another type4 ,the discrepancy between the ages at which human beings reach sexual maturity and at which they find themselves capable of maintaining a family1 raises a number of exceedingly difficult problems4 ,seeing that the sexual requirements of man constitute a factor varying very greatly from individual to individual1 and to a large extent depending1 as is now realized1 upon a very complex balance of glandular functions1 it is more difficult than most popular moralists seem to realize to lay down general rules applicable impartially to every body4 ,questions such as the following are raised3 ,can it reasonably be expected of every man to live ten or more years of his sexually adult life in complete continence8 ,if not1 is it better for him to marry young and probably unequipped to support children1 having remained continent till that time1 or to marry later1 probably better equipped financially to become a father1 yet having had promiscuous experience of women before marriage8 ,and if he does marry young1 can he be expected to remain continent in his married life till he and his wife feel that they can satisfactorily maintain a family8 ,if he finds he cannot do this1 should he proceed to have children whom he cannot properly support1 or is it better for the couple to overcome their dislike of contraceptivesa feeling which it is idle for advocates of ,birth ,control to ignoreand thus avoid having children till they are wanted8 ,these are a few of the general questions which are raised in this connexion to which no comprehensive answer can possibly be given4 ,much controversy has revolved round the question of the desirability of self-control as a means of regulating births1 and of its universal practicability4 ,it is here contended that where possible this is immeasurably the best means of regulating births4 ,at the same time1 it is futile to advance a counsel of such perfection and difficulty that a highly probable failure to observe it will be followed by socially disastrous results4 ,everyone would acknowledge that the ,medical ,officer of a military unit who refused to instruct the soldiers under his supervision in the precautions they should take against contracting venereal disease1 on the high moral grounds that they should never expose themselves to such risk1 would be carrying his idealism to socially harmful lengths4 ,yet it is a much more difficult task for two people in love with each other and living together in the intimacies of married life to exercise continuous self-denial over long periods extending to years1 than it is for the soldier to abstain from occasional promiscuity4 ,in both cases it is clear that the correct course is to start by putting the case for restraint as clearly and forcibly as possible1 and then to explain what steps must be taken in the event of that restraint proving too great a task4 ,in the ,army and ,navy such appeals1 when tactfully made1 have met with a response which justifies the view that1 within limits1 more can be done in this way than might be supposed4 ,as a general rule1 then1 it would appear desirable that contraceptives should be used as little as possible1 especially in the early years of married life4 ,it also seems to the writer that in the case of normal married people1 too much has been made of the demoralizing effect of the #8excessiveness' of that indulgence which is supposed to be permitted by the practice of contraception and which forms the basis of the #8moral' objection advanced in this country4 ,this argument frequently emanates from ecclesiastical sources1 where knowledge of the sexual aspect of human nature as well as of the technical side of contraception is apt to be restricted and biassed4 ,in effect1 the man who is sufficiently provident and considerate of his wife to encourage the necessary precautions 7whicha point too often ignored by prejudiced criticsfrom the immediately selfish point of view both parties would far sooner forego71 is not the kind of man to indulge in reprehensible excesses4 ,actually1 demoralization seems rather to be produced in those men who insist on gratifying themselves regardless of their means1 or of the welfare of the children they so abundantly procreate1 or of the feelings and health of their wives4 7#b7 ,the case of unmarried persons clearly falls into a different category4 ,there can be little doubt that the publicity given to the subject of ,birth ,control has kindled the imagination of many young people and led to various transgressions4 ,the requirement here is to discover a method by which at the same time this publicity may be diminished and information made selectively more available4 ,both these results could be achieved if the subject were taken up by the ,ministry of ,health1 and facilities created for the appropriate giving of knowledge thereon by responsible qualified persons4 ,by such means the particular advice suited to each individual case could be privately given1 precisely where it is required1 and steps might be taken to stop the journalistic broadcasting of information and discussion which has brought the subject into such discredit4 ,the effects of this measure would be comparable to the arrest of the literature upon the subject of venereal diseases1 and to the reduction of their incidence that has been brought about by the institution of special departments for the treatment of these diseases in the large towns4 ,it is clear1 however1 that all arguments relating to the individual are limited in their appeal to those in whose minds the conception of morality is somehow related to that of individual harmony and happiness and to the ideal of the general good4 ,to those for whom the word #8morality' has an ulterior meaning1 unconnected with the affairs of this world and relevant1 solely1 to the destiny of the individual soul,i refer1 here to those who enlist the #8,will of ,god' of which they are the self-constituted interpreters1 on their sideno argument can be of any avail4 ,since the subject is thus removed from the sphere of practical controversy1 no further discussion is possible1 and the only thing to hope is that with the passage of time such persons will become less numerous4 99 99 99 99 99 ,consideration of the arguments bearing upon the individual1 it is submitted1 points to the desirability of 7#a7 the ,ministry of ,health giving the subject recognition and sanction1 and 7#b7 limiting the publicity that now attaches to it4 7b7 ,the ,race4 ,turning now from the individual to the race1 we enter on a more difficult part of the subject4 ,adhering to our original conception of the question we find that the solution 7if it is to be accepted as such7 of the quantitative difficulty1 and of the qualitative problem described as #8economic' in nature1 are one and the same4 ,the remedy for that aspect of the qualitative problem distinguished as #8dysgenic' is different and must be considered separately4 ,the quantitative difficulty reduces itself to this4 ,admitting the greater fertility to-day of those whose occupations are manual1 or who have no occupation at all 7in other words1 of the less select type7 and admitting that at the present moment the country is overpopulated1 how are we to be certain that we are not within sight of more prosperous times when unemployment will disappear8 ,and how are we to feel assured that the dissemination of knowledge of ,birth ,control will not1 in the long run1 lead to a disastrous decline in the birth rate1 producing an irretrievable diminution in our numbers8 ,the practical difficulty is here to prophesy what will be the optimum population 7i4e41 that at which average return of labour per individual would be greatest7 for a given country fourteen years aheadat the time1 that is1 when the children born to-day would enter the labour market4 ,and here we are in the realm of almost pure guesswork1 and probably no economist could be found who would venture upon more than a tentative speculation4 ,what the optimum is at the moment remains even a disputed question4 ,there is reason to suppose that unemployment returns are not necessarily a trustworthy guide to the figure4 ,a consensus of opinion however exists 7including that of ,mr4 ,baldwin7 that at the moment our numbers are above their optimum1 though expectations vary almost infinitely as to what the optimum will be in a few years4 ,those who hope for a boom in trade are satisfied with the present condition4 ,others who do not anticipate such an event1 would more willingly see an alteration brought about4 ,in the absence of any definite knowledge1 the best we can do is not to try to look too far ahead but to consider the solution of our problems as we find them to-day4 ,at the moment the indisputable facts of the problem in this country are that we are over-populated1 that contraception is practised too much by the upper and middle classesperhaps even by the skilled working classesand not enough by the improvident unskilled masses at the bottom of the social edifice4 ,the outstanding question is whether1 as a result of a reduction of our numbers to a point somewhere in the neighbourhood of the economic optimum for this countryby which reduction the existing burden of taxation1 an increasing element of which is now devoted to charity and relief1 will be correspondingly diminishedour upper and middle classes would be enabled to produce more children1 and to continue to produce enough to maintain our numbers in the neighbourhood of their optimum4 ,the answer to this question depends on a further question4 ,to what extent is the relative sterility of the professional and skilled working classes attributable to the heavy taxation now imposed on them1 and to the rise in the cost of living due to the war1 and to what extent is it the result of a preference shown by many people for a more or less luxurious life1 with few or no children1 to a simpler life with several children8 ,in other words1 to what extent is it attributable to an economic factor and to what extent to motives of selfishness8 ,to what extent does that quality of self-interest play a part which prompts a woman to refuse to breastfeed her baby because she is afraid of the effects thereof upon her figure1 which causes her to abstain from having children because she dislikes the discomfort and deformity preliminary to1 and the actual pains of1 childbirth1 or which makes her value amusements and expensive forms of pleasure and recreation more highly than the experience of maternity8 ,to what extent is the relative infertility of the upper and middle classes accounted for by the kind of egotism which induces the husband to go in for entertaining1 for a motor1 and a house with several servants1 and generally to live in comparative affluence rather than do without his superfluities and bring up a family of children8 ,this attitude nowadays certainly plays a part4 ,dissatisfaction with the elementary pleasures of life1 the craving after artificial stimuli and new sensations1 have always been1 and probably will always remain1 the surest way to decadence in a race1 and as such should be combated4 ,it is more in the interest of the race that the professional and artisan classes should produce plenty of good children than that the families of the very poor should be restricted4 ,the argument is sometimes advanced by complacent and wealthy individuals that the working classes should be encouraged to reproduce freely in order to keep up the country's numbers4 ,the dirty work is thrown1 so to speak1 on the shoulders of those least qualified to discharge it4 ,it must appeal to the sense of justice of everyone that if the maintenance of numbers of the race is to be conceived as a burden 7which of course it should not71 the burden should be borne equally by all classes4 ,the writer1 who has had occasion to witness the results of over-multiplication among the very poor1 feels that it is only in fairness to them that they should be equipped with every possible means of improving their lot4 ,at present one of the most important of such means is the creation of facilities by the ,ministry of ,health for the giving of information to those mothers who need it about how they may limit their families and space their children4 ,the immediate social results of such a measure would unquestionably be good4 ,the remote results are more open to doubt4 ,and it is this doubt which renders it of the utmost importance to add that every form of pressure and persuasion be brought to bear on the other classes1 to make them realize that it is morally incumbent on them1 in the interests of the country and of the race1 to have as many children as they can possibly afford1 even at the expense of the minor luxuries of life4 ,up till now no such pressure has been exerted1 and most people regard it as a matter of moral indifference1 whether1 when married1 they have children or not4 ,the problem as to whether the general public1 once it has been educated to realize the national importance of the question of having children1 would act upon it and thereby avert the threat of a dwindling population is again one of great difficulty4 ,admittedly1 the example set us by ,france is not encouraging4 ,what is the likelihood of our following in her footsteps8 ,it is a delicate and important question4 ,the writer is of the opinion that our national character differs from that of the ,french in a way that would make us more responsive to such an appeal for children than the ,french have shown themselves to be4 ,but again we are in the realm of conjecture1 and each person is entitled to his opinion4 ,the fact remains1 however1 that as long as the advertisement now given to ,birth ,control is permitted to continue1 its practice will become yearly more prevalent4 ,its spread will certainly not be limited by an attitude of official negativism towards it while the propaganda is allowed to continue unchecked4 99 99 99 99 99 ,there remains the other process above distinguished as #8dysgenic1' the effect of which upon the quality of the race is probably as detrimental as the one just considered1 namely1 the nurture and perpetuation of the morally and physically unfit4 ,this tendency can only possibly be met by some form of ,eugenic legislation4 ,the existing opposition to anything of the sort in this country probably springs from a deep-seated dislike of bureaucratic interference in people's private lives1 and is associated with a failure to realize the harmful consequences of the existing order4 ,it is of interest1 however1 to observe that in ,america1 where1 in practice if not in theory1 individual liberty is valued less highly than in this country1 various enactments have been passed with a definitely ,eugenic object4 ,thus in the ,state of ,nebraska marriage is forbidden to anyone afflicted with venereal disease1 and all applications for marriage licenses have to be accompanied by affidavits of freedom from such disease4 ,nobody acquainted with the nature of the infant mortality produced by congenital syphilis can fail to approve of this measure4 ,in #ahie the ,state of ,connecticut forbade the marriage of epileptics and feeble-minded persons1 under penalty of three years' imprisonment4 ,everyone possessing knowledge of the ,neurological ,out-patients' ,department of any large hospital must realize the existing prevalence of epilepsy and appreciate how this hereditary disease may incapacitate and stultify its victims4 ,montana provides for the sterilizing of idiots1 epileptics1 feeble-minded and insane persons1 which measure must again commend itself to those aware of how prolific such types can be if left unwatched4 ,in males1 sterilization can be effected by a very minor operation1 the use of ,x-rays for this purpose being a procedure with regard to which there is still medical controversy4 ,the principle might even be extended to individuals who1 by a record of crime or misdemeanour1 prove themselves to belong to a type which the nation does not want perpetuated4 ,the sterilization of the male leaves quite undisturbed his sexual function1 though it destroys his power of reproduction4 ,the infringement which it therefore involves of the liberty of the individual is far less than that made by the ,state when it takes it upon itself to hang a man4 ,yet the social benefit arising from the two measures cannot be compared4 ,though it is difficult at this stage to define the details of ,eugenic legislation it seems likely that the physical and moral standard of the race could broadly be raised by such a qualitative ,birth ,control4 ,the number of emigrants which we are in a position to send to the ,dominions each year is limited by difficulties of transport1 and could never amount to more than a fraction of our present unemployment figure4 ,there is further the important consideration that the ,dominions themselves do not relish the idea of our regarding them as dumping grounds for our superfluous undesirables4 ,the type of emigrant they want is a courageous1 hardworking1 physically healthy type1 capable of initiative1 of withstanding hardships without grumbling1 and of making a good citizen4 ,such do not tend to become unemployed here1 though1 under very adverse circumstances1 they often may4 ,a decrease of our population need not therefore be opposed to our ,imperial interests if1 in the process1 we raise the standard of the race and improve our national stock4 99 99 99 99 99 ,what will be the bearings of such enlightened ,birth ,control upon the future8 ,it will affect the ,individual directly in his immediate relation to his family1 and it will influence him indirectly through its effect upon the community as well as through the international relationships of the country to which he belongs4 ,the international implications will be considered first1 since they are the most far-reaching4 ,the most obvious of these is the connexion between unrestricted increase of population and wars4 ,to what extent was the late war due to this cause1 and to what extent has the world learnt from it the necessity of regulating such increase8 ,the causes of the late war were complex and are not yet wholly understood4 ,a fact however stands out clearly now that we contemplate it in retrospect and now that changes in international feelings have forced upon us a consideration of the point of view of our late enemies4 ,it is that the causes now recognized are essentially different from what those causes were represented to be in the war propaganda of the various belligerents4 ,it is to the interests of each belligerent to place the whole blame for a war upon its enemies and completely to exculpate itself4 ,thus in the late war both sides were convinced that they were fighting for ,righteousness1 ,liberty1 ,justice1 ,law and ,order1 ,civilization1 etc41 against enemies inspired by cruelty1 subtlety1 insatiable greed1 jealousy and lust for world-power4 ,when1 however1 we contemplate the war after a lapse of several years through an aftermath of much suffering and disillusionment1 we realize that it was the product of historical causes and racial antipathies and of certain social and economic phenomena rather than of any unequal partition of moral qualities4 ,before the war1 ,great ,britain was the most powerful nation in the world and was naturally jealous of any other nation that coveted1 or aspired to usurp1 her enviable status4 ,russia found herself in a condition of acute social instability1 momentarily threatened by the event which in #aiag cast her beyond the pale of western civilization4 ,to ,russia the war came as a happening which could dissipate the revolutionary ferments1 mobilize her refractory workers into the army1 and1 through the tremendous appeal of a national crusade1 sidetrack the forces of anarchy in precisely the way that those forces were sidetracked in ,ireland in #aiad4 ,had the war been won quicklyas there were grounds for hoping when it beganthe ,czar would probably still be on the throne of an enlarged and yet more powerful ,russia4 ,by the events of the last hundred years ,germany had been elevated from a position of relative unimportance to that of the most highly organized and perfectly industrialized power in the world4 ,in achieving this promotion she had earned the venomous hatred1 born of her humiliation1 of ,france1 and the slowly growing1 disquieting suspicion of ,great ,britain4 ,conscious of her growing industrial strength1 becoming restive within the frontiers which confined her swelling population1 aware of the hostility of her neighbours1 and never allowed to forget that her kingdom had been built upon the sword1 the youthful soul of ,germany found1 in her ,emperor1 a fitting symbol for her aspirations4 ,he was the creation of her mood1 and together with the party of which he was the mouthpiece led her to her downfall4 ,it would not be a fair statement to assert that population pressure in ,germany was the cause of the war4 ,it was unquestionably a part-cause and a predisposing cause1 as it was of migration in prehistoric times and of most wars since4 ,but it was here complicated by other factors both inside and outside ,germany4 ,the universal desire to avert a similar catastrophe in the future has materialized in the ,league of ,nations4 ,it is hoped that through its agency many precipitating causes of war will be eliminated4 ,by it provocation will be made more difficult and commitment more perilous4 ,but the essential predisposing cause1 that of over-multiplication1 remains unassailed4 ,like some dull-witted monster it is left to wax in strength and malignancy within its fetters1 till at last1 no longer to be denied1 it will break all bounds1 turn1 and rend the world4 ,from the late war no lesson as to the importance of population control has been learnt4 ,will another war be necessary to teach us this lesson8 ,earlier in the book reference was made to the possibility of a war between ,japan and either ,america or ourselves4 ,though this contingency is being thought out in detail by the naval authorities of all three countries1 care is taken in diplomatic circles to assert that such practical measures as the equipment of ,singapore imply no unfriendly or suspicious attitude toward ,japan4 ,few people1 however1 are deceived by these utterances4 ,the mutual fear and distrust is growing and will probably continue to grow4 ,there is little doubt1 that1 if this war comes about1 its essential cause1 the increase of ,japanese in excess of the power of maintenance of their country1 will be obscured by that outburst of vilification of the enemy and glorification of self which is now demanded by popular sentiment in the conduct of wars4 ,yet this cause will remain here incomparably the most important of the predisposing causes4 ,after such a war will there remain any vestige of civilization to profit from the hard-won lesson8 ,the principal aim of ,soviet ,russia to-day is the spread of her communistic principles throughout the world4 ,the chief obstacles to this are the firmly entrenched and powerful capitalism of the ,united ,states1 and the more diffused and essentially more vulnerable capitalistic organisations of the ,british ,empire4 ,these last the ,russians are doing their best to undermine now4 ,a second world war would give them a long-coveted opportunity4 ,realizing that prolonged wars and the social unrest that follows them are the soil from which revolutions most readily spring1 ,russia would probably associate herself with ,japan4 ,the secret treaty between the two countries whose aspirations and political ideals have otherwise little in common1 gives a premonition of this4 ,by the time a war comes it is possible that the exploitation of ,china by ,japan will be more complete1 and the effects of anti-foreign propaganda1 carried on by ,russia1 more far-reaching4 ,the increase of anti-,british feeling in ,india1 also stimulated by ,russia1 will co-operate to unify ,asia and ,european ,russia in a solid block1 determined to shake off the yoke of the ,western ,powers and of ,america4 ,such a war could never be conclusive1 however prolonged4 ,the vast length of the fighting front1 the colossal numbers of active belligerents1 and the enhanced destructiveness of war would probably lead1 after initial successes1 to a collapse of the organized fighting forces of the ,west4 ,the seeds of revolution in ,europe1 by then more deeply sown1 would germinate1 and the present social order would come to an end4 ,the continent would then embark upon a new phase of its history1 with the first chapter steeped in the bloodshed of revolution1 and founded upon the ruins of our industrial civilization4 ,the centre of civilization might then shift to the southern hemisphere where to-day there is less to destroy4 ,the fact remains that if the price that humanity will have to pay for learning to regulate its over-multiplication is to be a second world warthe much talked of war1 this time1 between ,east and ,westit is doubtful if there will be left a civilization capable of learning the lesson4 ,it seems worth while1 therefore1 to try to put the principle into effect before we are taught its necessity in such a way4 ,to this there are at present two obstacles1 namely the nature of certain religions and the criterion of national evaluation that is still prevalent4 ,the first obstacle rests in the fact that two powerful religions have not adapted themselves to the changes of human relationships imposed by the unification through science of the human race4 ,these religions remain with their eyes fixed either on the next world or on the exclusive welfare of the tribe4 ,by the ,catholic ,church a mode of behaviour is imposed calculated to achieve salvation in the next world irrespective of its effects on this one4 ,omitting from consideration1 as probably unjust1 the motive of wishing to increase the number of its adherents1 with which the ,roman ,catholic ,church has been charged by reason of its attitude towards ,birth ,control1 there remains a motive arising from a theory of a relation between salvation in the next world and certain modes of behaviour in this4 ,contraception is condemned because it is held to incur damnation4 ,it is not condemned because it leads to social injustice1 to wars1 to human suffering4 ,the point is that it is still condemned in spite of its leading away from these things4 ,it is therefore devoutly to be hoped that in the event of the population of any ,catholic country at any time in the future expanding to proportions that threaten the peace of the world1 the ,pope will see his way to modify the ,church's attitude in the matter before it is too late4 ,failure to do so would result in the depressing spectacle of the leader of the religion of #8,peace and ,goodwill' among men deliberately refusing to take a step to avert war4 ,the second type of religion is represented in ,japan and is tribal in the sense that it is avowedly concerned with the glorification of the ,japanese1 irrespective of the consequences to the world that this may involve4 ,in its object of elevating ,japan to the status of a first class power the cult of revived ,shinto has succeeded admirably and has proved itself1 in several wars1 to be a splendid fighting creed4 ,the present increase of the population of ,japan by #gjj1jjj a year is wholly in accordance with its precepts4 ,again we may devoutly hope that it will not overreach itself and plunge ,japan1 as well as the rest of us1 into a world war after which we would probably cease to exist as civilized countries4 ,it is1 of course1 obvious that a modification of ,japanese policy where ,birth ,control is concerned would be welcomed with inexpressible relief by the rest of the world4 ,the militancy of ,mohammedanism will probably have little effect on the future of the world1 because ,mohammedan countries are at present poorly organized for extensive modern war4 ,the ,church of ,england is more concerned with the social and international implications of religion than any other1 and the above remarks have little relevance to it4 ,if1 therefore1 the cataclysm above contemplated is to be averted the first necessity would seem to be a revision of the standards of existing religions1 in consideration of the unification of the human race1 so as to accord with a formula of something of this sort3 ,that is good and morally right which will promote the general happiness and goodwill of humanity1 and the harmony of the world4 ,it is clear that action leading to the limitation of over-multiplication would in this sense be good and in accordance with religion4 99 99 99 99 99 ,the second obstacle to the realization of a control of population is the standard by which the merit of a nation is now generally appraised1 and to which most nations aspire4 ,this merit is largely estimated in terms of power of offence and defence4 ,this is a bad criterion and should be altered for a better one which will now be considered4 ,earlier in the book reference was made to a biological argument against contraception1 consideration of which was deferred4 ,this argument holds that in so far as reproduction is a primary biological function1 a thwarting of that function is not only unnatural but anti-biological4 ,this view has a certain plausibility but does not stand close scrutiny4 ,the criterion of biological value or fitness is essentially racial1 not individual4 ,that is biologically good which will improve or benefit the race1 that is bad which will harm or weaken it4 ,under stable conditions of racial equilibrium there is a reasonable expectation that instincts and structures which have had survival value in the past will continue to have such value in the future4 ,but during moments of crisis1 at those turning points in the history of living things when new forms appear1 such a presumption is quite unjustified4 ,thus if we picture to ourselves1 allegorically1 an event which probably took many thousands of years to accomplish1 we might imagine the comments of a conservative piscine critic upon the emergence of the first ,dipnoid from some muddy river on to land4 ,the development of fore and hind limbs from fins1 of lung from swim-bladder1 and of instincts appropriate to the new medium1 would strike all conservative fishes as highly immoral deviations from that biological tradition which had given stability to the glorious race of fishes4 ,nothing could seem more a-biological4 ,similarly with the development of fur and feathers and of the parental instinct1 all of which were probably1 in part at any rate1 invested with survival value by the spell of cold which followed the ,secondary period1 and which perhaps conditioned the substitution of birds and mammals for the hitherto ubiquitous reptile as dominant vertebrates on the earth4 ,from the point of view of the conservative reptile such changes would appear highly anti-biological4 ,in moments of racial crisis1 therefore1 it is dangerous to generalize as to what is biologically good from past experience alone4 ,in the past a high degree of fertility has been1 for most species1 a biologically valuable asset4 ,it does not follow that it will continue to be so for the human race4 ,in fact there are good reasons for supposing that it will not4 ,the human race is now passing through a biological crisis unprecedented in the history of life4 ,it has achieved a mastery over nature such that mankind is now economically unified throughout the world by the astounding feats of intercommunication and transport4 ,but as yet the human race has achieved little ethical unification4 ,it is directly in the interests of the race that such unification should take place1 and all things which promote it may therefore be considered biologically good4 ,and of those things a restriction of human fertility is one of the most important4 ,what then is to be our biological criterion of racial fitness and our standard for judging of a nation's merit8 ,it is clear that our biological criterion must be racial rather than individual4 ,division of labour and differentiation of function are carried to such lengths in civilized societies that it does not seem possible to hold up any individual type as an ideal of biological fitness4 ,qualities which1 to the solitary animal1 would irrevocably spell extinction may for the gregarious animal have the highest survival value4 ,thus no attribute would be more irremediably fatal to a non-social animal than sterility4 ,yet the sterility of #iii out of #ajjj female bees in the community of the hive has endowed the species with a vitality and a biological importance such that it has largely conditioned the appearance on the planet of many kinds of entomophilous flowers4 ,our biological criterion must therefore1 with our standard of merit1 be social rather than individual1 and the following general outline is suggested4 ,the population of each country should be proportionate to its resources4 ,the numerical adjustment should be such that there be no unemployment and that individual productivity be highest without idlers at either end of the social scale4 ,the physical average of the race should be good with no congenital diseases of mind or body and with the minimum of other diseases1 and of crime4 ,there should be a high average standard of comfort1 self-respect and happiness1 and a high moral standard of honesty1 tolerance1 and kindliness4 ,one would hope for a wide prevalence of that #8joie de vivre' and contentment which is doubtless largely temperamental in origin and which contributes more to an individual's happiness than any number of worldly possessions can ever do4 ,and the social cleavage between classes1 and the now stupendous discrepancies between the very rich and the very poor should be reduced to a minimum4 ,such conditions all would wish generally distributed4 ,it is a question whether a uniformly high degree of intelligence should be equally ubiquitous4 ,in every community1 primitive or civilized1 an immense amount of crude physical labour has to be done4 ,the soil has to be tilled1 someone has to dig coal and iron out of the ground1 and endless other kinds of manual work have to be performed4 ,it is doubtful whether the possession of a very high degree of intelligence would make such workers happier or more efficient4 ,but whatever we may individually feel about this point1 we would all wish such workers to be healthy1 happy1 well housed1 contented with their lot1 fond of their children1 and both appreciated by1 and on good terms with1 the rest of the community4 ,and obviously it is a condition of this sort which an enlightened ,birth ,control could help to achieve4 ,the above is intended both to be a criterion of biological fitness for the human race1 and a more satisfactory standard of national evaluation than the one that is in vogue to-day4 ,it will be noted that there is nothing in it about capacity for wars4 ,if we could substitute some such standard in place of the armament standard by which to grade countries in an order of merit1 we should be in a better position to avert the catastrophe of another world war than we are at present4 ,according to such a standard the country most deserving of admiration1 respect and imitation to-day would probably be ,switzerland4 ,knowing that she cannot defend herself against her powerful neighbours1 she does not aspire to large armies4 ,when other countries can1 by a simultaneous control of population1 realize a similar security1 it will be open to them to follow in her footsteps4 ,the ideal may not appeal to the romantic1 but much that passes for romance is frequently pernicious nonsense1 like the sentiment by which war is glorified in the eyes of many women and elderly men who have never participated in it4 ,from an international equilibrium based upon a modification of religions as above suggested and upon an alteration in our standards of national evaluation1 social harmony would follow fairly readily4 ,it is unlikely that the antagonism between capital and labour will be much affected by a control of population beyond removing that source of social unrest which is furnished by a large body of unemployed4 ,it remains doubtful1 however1 if the essential political issue will be much modified by a solution of the unemployment problem4 ,the psychological forces which give the ,labour party its driving power are not such as to produce the fullest economic prosperity in this country2 but none the less they demand and must ultimately receive satisfaction4 ,the best that can be hoped is that those forces will gradually be appeased1 and will not lead to bloodshed1 too great a dislocation of trade1 or too drastic a loss of international status4 ,the gain to the individual following the general application of knowledge of ,birth ,control will be twofold4 ,in the first place parents will be able to space their children in accordance with their physical and financial resources2 in the second they will feel more confident of producing healthy well-balanced children1 untainted by disease1 than they can feel at present4 ,their children would further be welcomed by the community1 and their future would be assured4 99 99 99 99 99 ,such are the bearings of an enlightened ,birth ,control upon the future4 ,it is obvious that such advantages could only be gained by slow and laborious degrees4 ,the writer is far from the opinion that the application of his views will immediately transform the world into a ,utopia4 ,he is convinced however that if the existing form of civilization is to have any permanence1 the necessity for controlling population will have to be realized and striven for by all educated people4 ,in practice1 the #8plea1' referred to in the sub-title1 is that the ,ministry of ,health should give the subject of contraception its sanction4 ,in ,may of #aibd a petition supported by twenty-two ,labour members of ,parliament was presented to the ,minister of ,health by a deputation of eighteen persons1 some of them well known1 requesting that official permission be accorded to doctors in charge of ,welfare ,centres to give information on ,birth ,control to such working women as desired it and were considered fit for it4 ,though the existing technique is not wholly satisfactory it is avowedly worth something1 having already proved of great help to many women4 ,this permission was refused in deference1 it seems1 to ecclesiastical opinion1 to certain reactionary political forces which1 in the ,house1 were opposed to it1 and to popular prejudice4 ,it is possible that by the time this book is published the ,ministry of ,health may have changed its attitude4 ,at present1 however1 information on contraception can only be obtained from a few private organizations such as those of the ,malthusian ,league in ,walworth and ,kensington1 of ,dr ,stopes in ,holloway1 and from another centre in the ,edgware ,road4 ,the ,malthusian ,league has worked quietly1 unostentatiously1 and1 so far as its means allow1 with the utmost effectiveness in one of the poorest quarters of ,london4 ,for what it has done there can be nothing but praise4 ,but however valuable the work of these organizations1 they cannot possibly meet the requirements of our large slums1 where such information as exists is handed about by irresponsible midwives and gamps1 often with the worst results4 ,it also seems desirable to the writer to restrict the often vulgar publicity by which this subject is frequently attended1 and to which attention was drawn when the objections to ,birth ,control were reviewed4 ,after the first blast of criticism which it would evoke from the baser organs of the press1 such a sanction from the ,ministry of ,health would render further newspaper advertisement of ,birth ,control superfluous4 ,if it does not cease of its own accord steps should be taken to suppress it4 ,how best can this sanction be obtained8 ,clearly through an appeal from the medical profession4 ,an expression of unanimity1 or relative unanimity1 from doctors in this country as to the desirability of this sanction would constitute an argument which the ,ministry of ,health could not easily ignore4 ,if the sanction were thus obtained it would be open to those medical men who had approved the measure in this country to invite their colleagues in other countries to follow in our footsteps4 ,it would seem best to begin with ,germany and ,america1 where there is reason to suppose that such an appeal would meet with response4 ,if support were forthcoming from these countries1 others might be approachedsuch as ,japan1 ,italy and perhaps ,india1 in which last the suffering caused by an excessive birth rate and a high early death rate is immense and almost wholly avoidable4 ,in this way the medical profession in whose hands the health of each community lies would take the first step in the direction of an international control of population1 and would thereby lay the basis for a genuine and permanent world-peace4 99 99 99 99 99 ,transcriber's ,notes3 ,text in italics is enclosed by underscores 7italics74 ,punctuation and spelling inaccuracies were silently corrected4 ,archaic and variable spelling has been preserved4 ,variations in hyphenation and compound words have been preserved4