Chapter 31

WHO MAY AND WHO MAY NOT MARRY

The Physician Often Consulted as to Advisability of Marriage--_Venereal Disease_ the Most Common Question-- _Tuberculosis_--Sexual Appetite of Tubercular Patients--Effect of Pregnancy Contraceptive Knowledge for Tubercular Wife-- _Heart Disease_--Serious Bar to Marriage--Influence of Sexual Intercourse--_Cancer_--Fear of Hereditary Transmission-- _Exophthalmic Goiter_--Most Frequent in Women--Simple Goiter-- Exceptions to Rule--_Obesity_--Family History--Obesity and Stoutness Not Synonymous--_Arteriosclerosis_--Danger in Sexual Act--_Gout_--Real Causes of Gout--_Mumps_--Parotid Glands and Sex Organs--Mumps and Sterility--Oöphoritis Due to Mumps-- _Hemophilia_--Hemophilic Sons May Marry--Hemophilic Daughters May Not Marry--_Anemia_--_Chlorosis_--_Epilepsy_--Hysteria--Symptoms of Hysteria--Marriage of Hysterical Women--_Alcoholism_--Effect on Offspring--Alcoholics and Impotence--_Feeblemindedness_--Evil Effects on Offspring--Sterilization of Feebleminded Only Preventive--_Insanity_--Functional Insanity--Organic Insanity-- Hereditary Transmissibility of Insanity--Fear Resulting in Insanity--Environment versus Heredity in Insanity--_Neurosis_-- _Neurasthenia_--_Psychasthenia_--_Neuropathy_--_Psychopathy_--Nervous Conditions and Genius--Sexual Impotence and Genius--_Drug Addiction_--External Causes--_Consanguineous Marriages_--When Consanguineous Marriages are Advisable--Offspring of Consanguineous Marriages--Homosexuality--Homosexuals Often Ignorant of Their Condition--Sexual Repression and Homosexuality--Sadism and Divorce--Masochism--Sexual Impotence and Marriage--Effect Upon the Wife--Frigidity--Marital Relations and Frigid Woman--Excessive Libido and Marriage--Excessive Demands Upon Wife--Satyriasis-- The Excessively Libidinous Wife--Nymphomania--Treatment--Harelip-- Myopia--Astigmatism--Premature Baldness--Criminality--Crime as Result of Environment--Legal and Moral Crime--Ancestral Criminality and Marriage--Rules of Heredity--Pauperism--Difference Between Pauperism and Poverty.

In former years, nobody thought of asking a physician for permission to get married. He was not consulted in the matter at all. The parents would investigate the young man's social standing, his ability to make a living, his habits perhaps, whether he was a drinking man or not, but to ask the physician's expert advice--why, as said, nobody thought of it. And how much sorrow and unhappiness, how many tragedies the doctor could have averted, if he had been asked in time! Fortunately, in the last few years, a great change has taken place in this respect. It is now a very common occurrence for the intelligent layman and laywoman, imbued with a sense of responsibility for the welfare of their presumptive future offspring and actuated, perhaps, also by some fear of infection, to consult a physician as to the advisability of the marriage, leaving it to him to make the decision and they abiding by that decision.

As a matter of fact, as often is the case, the pendulum now is in danger of swinging to the other extreme; for, a little knowledge is a dangerous thing, and the tendency of the layman is to exaggerate matters and to take things in an absolute instead of in a relative manner. As a result, many laymen and laywomen nowadays insist upon a thorough examination of their own person and the person of their future partner, when there is nothing the matter with either. Still, this is a minor evil, and it is better to be too careful than not careful enough.

I am frequently consulted as to the advisability or nonadvisability of a certain marriage taking place. I, therefore, thought it desirable to discuss in a separate chapter the various factors, physical and mental, personal and ancestral, likely to exert an influence upon the marital partner and on the expected offspring, and to state as briefly as possible and so far as our present state of knowledge permits which factors may be considered eugenic, or favorable to the offspring, and dysgenic, or unfavorable to the offspring.

The questions concerning the advisability of marriage which the layman as well as the physician have most often to deal with are questions concerning venereal disease. On account of the importance of the subject, these have been discussed rather in detail under the headings "Gonorrhea and Marriage" and "Syphilis and Marriage." Other factors affecting marriage, either in the eugenic or dysgenic sense, will be discussed more briefly in the present chapter, and more or less in the order of their importance.

=Tuberculosis=

Tuberculosis, which carries off such a large part of humanity every year, is caused by the well-known bacillus tuberculosis, discovered by Koch. The germ is generally inhaled through the respiratory tract, and most frequently settles in the lungs, giving rise to what is known as pulmonary consumption. However, many other organs and tissues may be affected by tuberculosis.

Tuberculosis used to be considered the hereditary disease _par excellence_. Entire families were carried off by it, and, seeing a tuberculous father or mother and then tuberculous children, it was assumed that the infection had been transmitted to the children by heredity. As a matter of fact, the disease was spread by infection. In former years, little care was exercised about destroying the sputum; the patients would spit indiscriminately on the floor, and the sputum, drying up, would be mixed with the dust and inhaled. Often the children crawling on the floor would introduce the infective material directly, by putting their little fingers in their mouths.

It is now known that tuberculosis is not a hereditary disease, that is, that the germs are not transmitted by heredity. _The weak constitution_, however, which favors the development of tuberculosis, is inherited. And children of tuberculous parents, therefore, must not only be guarded against infection, but must be brought up with special care, so as to strengthen their resistance and overcome the weakened constitution which they inherited.

That a person with an active tuberculous lesion should not get married goes without saying. But, it is a good rule to follow for a tuberculous person not to marry for two or three years, until all tuberculous lesions have been declared healed by a competent physician. As a rule, a tuberculous patient is a poor provider, and that also counts in the advice against marriage. Then sexual intercourse has, as a rule, a strong influence on the development of the disease. Unfortunately the sexual appetite of tuberculous patients is not diminished, but, rather, very frequently heightened; and frequent sexual relations weaken them and hasten the progress of the disease.

As to pregnancy, that has an extremely pernicious effect on the course of tuberculosis, and no tuberculous woman should ever marry. If such a one does marry or if the disease develops after her getting married, means should be given her to prevent her from having children. During the pregnancy, the disease may not seem to be making any progress--occasionally the patient may even seem to improve--but after childbirth the disease makes very rapid strides and the patient may quickly succumb. In the early days of my practice I saw a number of such cases. If precautions are taken against pregnancy, then permission to indulge in sexual relations may be given, provided it is done rarely and moderately.

If a patient who has tuberculosis conceals the fact from the future partner, a fraud is committed, and the marriage is morally annullable. It has been declared legally annullable by a recent decision of a New York judge.

=Heart Disease=

Heart disease also is no longer considered hereditary. Nevertheless, heart disease, if at all serious, is a contraindication to marriage. First, because the patient's life may be cut off at any time. Second, sexual intercourse is injurious for people having heart disease; it may aggravate the disease or even cause sudden death. It is more injurious even than it is in tuberculosis. Third--and this concerns the woman only--pregnancy has a _very_ detrimental effect upon a diseased heart. A heart that, with proper care, might be able to do its work for years, often is suddenly snapped by the extra work put upon it by pregnancy and childbirth. Sometimes a woman with a diseased heart will keep up to the last minute of the delivery of the child and then suddenly will gasp and expire. In the first year of my practice I saw such a case, and I never have wanted to see another. Women suffering from heart disease of any serious character should not, under any circumstance, be permitted to become pregnant.

=Cancer=

No man will knowingly marry a woman, and no woman will marry a man, afflicted with cancer. However, this question often comes up in cases where the matrimonial candidates are free from cancer, but where there has been cancer in the family.

Cancer is not a hereditary disease, contrary to the opinions that have prevailed, and, if the matrimonial candidate otherwise is healthy, no hesitation need be felt on the score of heredity. The fear of hereditary transmission of the disease has caused a great deal of mischief and unnecessary anxiety to people. Scientifically conducted investigations and carefully prepared statistics have shown that many diseases formerly considered hereditary are not hereditary in the least degree.

Should it, however, be shown that in one family there were _many_ members who died of cancer, it would indicate that there is some disease or dyscrasia in that family, and the contracting of a marriage with any member of that family would be inadvisable.

=Exophthalmic Goiter= (=Basedow's Disease=)

Exophthalmic goiter is a disease characterised by enlargement of the thyroid gland, protrusion of the eyeballs, and rapid beating of the heart. The disease is confined almost entirely, though not exclusively, to women, and I should not advise any exophthalmic woman to marry; neither should I advise a man to marry an exophthalmic goiter woman. It is a very annoying disease, while sexual intercourse aggravates all the symptoms, particularly the palpitation of the heart. The children, if not affected by exophthalmic goiter, are liable to be very neurotic.

_Simple goiter_, that is, enlargement of the thyroid gland (chiefly occurring in certain high mountainous localities, such as Switzerland), is not so strongly dysgenic as is exophthalmic goiter. Still, goiter patients are not good matrimonial risks.

Of course, there are always exceptions. I know an exophthalmic goiter woman who brought up four children, and very good, healthy children they are. But in writing we can only speak of the average and not of exceptions.

=Obesity=

Obesity, or excessive stoutness, is an undue development of fat throughout the body. That it is hereditary, that it runs in families, there is no question whatsoever. And, while with great care as to the diet and by proper exercise, obesity may, as a rule, be avoided in those predisposed, it none the less often will develop in spite of all measures taken against it. Some very obese people eat only one-half or less of what many thin people do; but in the former, everything seems to run to fat.

Obesity must be considered a dysgenic factor. The obese are subject to heart disease, asthma, apoplexy, gallstones, gout, diabetes, constipation; they withstand pneumonia and acute infectious diseases poorly, and they are bad risks when they have to undergo major surgical operations. They also, as a rule, are readily fatigued by physical and mental work. (As to the latter, there are remarkable exceptions. Some very obese people can turn out a great amount of work, and are almost indefatigable in their constant activity.) Each case should be considered individually, and with reference to the respective family history. If the obese person comes from a healthy, long lived family and shows no circulatory disturbances, no strong objections can be raised to him or to her. But, as a general proposition, it must be laid down that obesity is a dysgenic factor.

But bear in mind that obesity and stoutness are not synonymous terms.

=Arteriosclerosis=

Arteriosclerosis means hardening of the arteries. All men over fifty are beginning to develop some degree of arteriosclerosis; but, if the process is very gradual, it may be considered normal and is not a danger to life; when, however, it develops rapidly and the blood pressure is of a high degree, there is danger of apoplexy. Consequently, arteriosclerosis and high blood pressure must be considered decided bars to marriage.

It must be borne in mind that the sexual act is, in itself, a danger to arteriosclerotics and people with high blood pressure, because it may bring about rupture of a blood-vessel. There are many cases of sudden death from this cause of which the public naturally never learns. Married persons who find that they have arteriosclerosis or high blood pressure should abstain from sexual relations altogether or indulge only at rare intervals and moderately.

=Gout=

A consideration of gout in connection with the question of heredity will show how near-sighted people can be, how they can go on believing a certain thing for centuries without analyzing, until somebody suddenly shows them the absurdity of the thing. Gout was always considered a typical hereditary disease; for it was seen in the grandfathers, fathers, children, grandchildren, and so on. So, certainly, it must be hereditary! It did not come to our doctors' minds to think that perhaps, after all, it was not heredity that was to blame, but simply that _the same conditions_ that produced gout in the ancestors likewise produced it in their descendants.

We know now that gout is caused by excessive eating, excessive drinking, lack of exercise, and faulty elimination. And, since, as a general thing, children lead the same lives that their fathers did, they are likely to develop the same diseases as their fathers did. A poor man who leads an abstemious life doesn't develop gout, and if his children lead the same abstemious lives they do not develop gout. (There are some cases of gout among the poor, but they are very rare.) But if they should begin to gorge and live an improper life they would be prone to develop the disease.

The disease, therefore, cannot in any way be considered hereditary. In matrimony, gout in either of the couple is not a desirable quality, but it is not a bar to marriage; and, if the candidate individually is healthy and free from gout, the fact that there was gout in the ancestry should play no rôle.

=Mumps=

Mumps is the common name for what is technically called parotitis (or parotiditis). Parotitis is an inflammation of the parotid glands. The parotid glands are situated, one on each side, immediately in front and below the external ear, and they are between one-half and one ounce in weight. They belong to the salivary glands; that is, they manufacture saliva, and each parotid gland has a duct through which it pours the saliva into the mouth. These ducts open opposite the second upper molar teeth.

We might be surprised to be told that these parotid glands can have anything to do with the sex organs, but there is no other remote organ that has such a close and rather mysterious relationship with the sex-glands as have the parotids. When the parotid glands, either one or both, are inflamed, the testicles or ovaries are also liable to be attacked by inflammation. The inflammation of the testicles may be so severe as to cause them to shrivel and dry up; or, even when no shrivelling, no atrophy of the testicles occurs, they may be so affected as to become incapable of producing spermatozoa. Moreover, in cases where the testicles of a mumps patient seemingly were not attacked--that is, where the patient was not aware of any inflammation, having no pain and no other symptoms--the testicles may have become incapable of generating spermatozoa.

Besides the testicles, the prostate gland, the secretion of which is necessary to the fertility of the spermatozoa, may also become affected and _atrophied_.

It is, therefore, a very common thing for men who had the mumps in their childhood to be found sterile.

As to the sexual power of mumps patients, that differs. Some patients lose their virility entirely; others remain potent, but become sterile.

The same thing happens to girls attacked by mumps. They may have a severe inflammation of the ovaries (ovaritis or oöphoritis) or the inflammation may be so mild as to escape notice. In either case, the girl when grown to womanhood may find herself sterile.

A man who never had any venereal disease, but who has had mumps, should have himself examined for sterility before he gets married. As explained in the chapter "Marriage and Gonorrhea," we can, in the case of a man, easily find out whether he is fertile or sterile. But, in the case of a woman, we can not. Time, necessarily, has to answer that question. In all cases, mumps reduces the chances of fertility, and no man or woman who once had mumps should get married without informing the respective partner of the fact. There should be no concealment before marriage. When the partners to the marriage contract know of the facts, they can then decide as to whether or not the marriage is desirable to them.

=Hemophilia, or Bleeders' Disease=

Hemophilia is a peculiar disease, consisting in frequent and often uncontrollable hemorrhages. The least cut or the pulling of a tooth may cause a severe or even dangerous hemorrhage. The slightest blow, squeeze or hurt will cause _ecchymoses_, or discolorations of the skin. The peculiarity of this hereditary disease is, that it attacks almost exclusively the males, but is transmitted almost exclusively through the female members. For instance, Miss A., herself _not_ a bleeder, comes from a bleeder-family. She marries and has three boys and three girls; the three boys will be bleeders, the three girls will not; the three boys marry and have children; their children will _not_ be bleeders; the three girls marry, and _their male_ children will be bleeders.

What is the lesson? The lesson is, that boys who are bleeders may marry, because they will most likely _not_ transmit the disease; but girls who come from a hemophilic family, irrespective of whether they themselves are hemophilics or not, must not marry, because most likely they _will_ transmit the disease.

=Anemia=

Anemia is a poor condition of the blood. The blood may contain an insufficient number of red blood cells or an insufficient percentage of the coloring matter of the blood, that is, hemoglobin. A special kind of anemia affecting young girls is called chlorosis.

Anemia and chlorosis cannot be considered contra-indications to marriage, because they are usually amenable to treatment. In fact, some cases of anemia and chlorosis are due to the lack of normal sexual relations, and the subjects get well very soon after marriage. But it is best and safest to subject anemic patients to a course of treatment and to improve their condition before they marry.

=Epilepsy=

While epilepsy--known commonly as fits or falling sickness--is not as hereditary as it was one time thought to be, its hereditary character being ascertainable in only about 5 per cent. of cases, nevertheless, it is a decidedly dysgenic agent, and marriage with an epileptic is distinctly advised against. Where both parents are epileptics, the children are almost sure to be epileptic, and such a marriage should be prohibited by law. Under no circumstances should parents who are both epileptic bring children into the world. It should be the duty of the State to instruct them in methods of preventing conception.

=Hysteria=

Hysteria is a disease the chief characteristics of which are a _lack of control_ over one's emotions and acts, the _imitation_ of the symptoms of various diseases, and an _exaggerated_ self-consciousness. The patient may have extreme pain in the region of the head, ovaries, spine; in some parts of the skin there is extreme hypersensitiveness (hyperesthesia), so that the least touch causes great pain; in others, there is complete anesthesia--that is, absence of sensation--so that when you stick the patient with a needle she will not feel it. A very frequent symptom is a choking sensation, as if a ball came up the throat and stuck there (globus hystericus). Then there may be spasms, convulsions, retention of urine, paralysis, aphonia (loss of voice), blindness, and a lot more. There is hardly a functional or organic nervous disorder that hysteria may not simulate.

Of late years our ideas about hysteria have undergone a radical change, and we now know that most, if not all, cases of hysteria are due to a repression or non-satisfaction of the sexual instinct or to some shock of a sexual character in childhood. Only too often a girl who was very hysterical before marriage loses her hysteria as if by magic upon contracting a _satisfactory_ marriage. On the other hand, a healthy girl can become quickly hysterical if she marries a man who is sexually impotent or who is disagreeable to her and incapable of satisfying her sexually.

While hysteria, in itself, is not hereditary, it, nevertheless, is a question whether a strongly hysterical woman would make a satisfactory mother. The entire family history should be investigated. If the hysteria is found to be an isolated instance in the given girl, it may be disregarded, if not extreme; but if the entire family or several members of it are neuropathic, the condition is a dysgenic one. Marriage may be contracted, provided no children are brought into the world until several years have elapsed and the mother's organization seems to have become more stable. In some cases, a child acts as a good medicine against hysteria. In short, every case must be examined individually on its merits, and the counsel of a good psychologist or psychoanalyst may prove very valuable.

=Alcoholism=

A good deal depends upon what we understand by alcoholism. The fanatics consider a person an alcoholic who drinks a glass of beer or wine with his meals. This is nonsense. This is not alcoholism, and cannot be considered a dysgenic factor. But, where there is a distinct habit, so that the individual _must_ have his alcohol daily, or if he goes on an occasional drunken "spree," marriage must be advised against. And where the man (or woman) is what we call a real drunkard, marriage not only should be advised against, but most decidedly should be prohibited by law.

Alcoholism, as a habit, is one of the worst dysgenic factors to reckon with. First, the offspring is liable to be affected, which is sufficient in itself to condemn marriage with an alcoholic. Second, the earning powers of an alcoholic are generally diminished, and are likely gradually to diminish more and more. Third, an alcoholic is irritable, quarrelsome, and is liable to do bodily injury to his wife. Fourth an alcoholic often develops sexual weakness or complete sexual impotence. Fifth, alcoholics are likely to develop extreme jealousy, which may become pathological, even to the extent of a psychosis.

If both the husband and wife are alcoholics, then marriage between them which results in children is not merely a sin, but a crime.

We do not now come across cases so often as we used to of women marrying drunkards in the hope or with the hope of reforming them. But such cases still happen. This is a very foolish procedure. Let the man reform first, let him stay reformed for two or three years, and then the woman may take the chance, if she wants to.

=Feeblemindedness=

Feeblemindedness, in all its gradations--including idiocy, imbecility, moronism, and so on--is strongly hereditary and is one of the most dysgenic factors we have to deal with. It is the most dysgenic of all factors. It is more dysgenic than insanity. Marriage with a feebleminded person not only should be advised against, but should be prohibited by law. A feebleminded man has much fewer chances for marriage than has a feebleminded woman. Feebleminded girls, even to the extent of being morons, if pretty (as they often are) have very good chances of getting married, not infrequently getting for husbands young men of good families who themselves of course are not very strong mentally, but still are far from being considered feebleminded.

There are many cases of brilliant men--more than the public has any idea of--who married pretty, shy, demure, but withal feebleminded, girls, and the result has been in the largest percentage of cases very disastrous. In many cases all the children are feebleminded, or if not feebleminded, so weak mentally that it is impossible to make them go through any college or school. All the private tutoring is often in vain. And the brilliant father's heart breaks. It must be borne in mind that feeblemindedness or weak mentality is much more difficult to detect in a woman than it is in a man. Weakmindedness in a woman often passes for "cuteness," and as among the conservatives a woman is not expected to be able to discuss current topics, her intellectual caliber is often not discovered by the blinded husband until some weeks after the marriage ceremony.

As any instruction in the use of contraceptives would be wasted on the feebleminded, the only way to guard the race against pollution with feebleminded stock is either to segregate or to sterilize them. Society could have no objection against the feebleminded marrying or indulging in sexual relations, provided it could be assured that they will not bring any feebleminded stock into the world. After the man and the woman have been sterilized there is no objection to their getting married.

Where a normal, able or brilliant husband finds out too late that his wife's mentality is of rather a low order he is certainly justified in using contraceptives; and if he is determined to have children he will be obliged to divorce his wife. Of course this applies also to the wife of a weak minded husband.

=Insanity=

Insanity may be briefly defined as a disease of the mind. We will not here go into a discussion as to what constitutes real insanity, as to what is understood by insanity in the legal sense of the term, and so on, except to note that we have two divisions.

One is functional insanity. This may be temporary, or periodical, and is due to some external cause, is curable, and is not hereditary. For instance, a person may get insane from a severe shock, from trouble, from anxiety, from a severe accident (such as a shipwreck), from a sudden and total loss of his fortune, of his wife and children (by fire, earthquake, shipwreck or railroad accident). Such insanities are curable and are not transmissible. Another example is what is known as puerperal insanity. Some women during childbirth, due probably to some toxic infection, become insane. This insanity may be extreme and maniacal in character. Still, it often passes away in a few days _without leaving any trace_ and may never return again, or, if it does return, it may return only during another childbirth. This kind of insanity is not transmissible.

The second division is what we call organic insanity. This expresses itself in mania and melancholy, so-called manic-depressive insanity. This is due to a degeneration of the brain-and nerve-tissue and is hereditary.

But, our entire conception as to the hereditary transmissibility of insanity has undergone a radical change. There is hardly another disease the fear of whose hereditary character is responsible for so much anguish and torture. In former years, when there was an insane uncle or aunt or grandparent that fact weighed like a veritable incubus on the entire family. Every member of the family was tortured by the secret anguish that maybe he or she would be next to be affected by this most horrible of all diseases--disease of the mind. If an ancestral member of the family became insane at a certain age, every member of that family was living in fear and trembling until several years had passed _after_ that critical age, and only then would they begin to breathe freely. Indeed, many people became insane from the very fear of becoming insane. It cannot be subject to any doubt that many people do become mentally unbalanced from the fear that they will become unbalanced. Fear has a tremendous influence on the purely bodily functions, but its influence on the mental functions is incomparably greater, and a person will often get that which he fears he is going to get.

Now the hereditary character of insanity is not taken in the same absolute sense in which it was formerly. While we still consider it a dysgenic factor, yet we recognize the paramount importance of environment; and we know that by proper bringing-up, using the expression bringing-up in its broadest sense--including a proper mental and physical discipline--any hereditary taint can be counteracted. In connection with this subject, the following very recent statistics will prove of interest.

The families of 558 insane persons cared for in the London county asylums were investigated, and, according to reports received from the educational authorities, only 15 of these (less than 3 per cent) had mentally defective children. As to the time of the birth of the children, whether before or after the attack of the insanity, we find the following figures: 56 out of 573 parents had children after their first attack of insanity, and 106 children were born after the onset of insanity in the parent; while the remaining 1259 children were born before the parent became insane.

Altogether, as will be seen from a discussion of the various factors rendering marriage permissible or nonpermissible, I am inclined to consider environment a more important factor than heredity. The purely physical characteristics bear the indelible impress of heredity. But the moral and cultural characteristics, which in the modern civilized man are much more important than the physical, are almost exclusively the results of environment.

=Neuroses--Neurasthenia--Psychasthenia--Neuropathy--Psychopathy=

I will not attempt either exhaustive or concise definitions of the terms named in the caption, for the simple reason that it is impossible to give satisfactory definitions of them. The conditions which these terms designate do not constitute definite disease-entities, and many different things are understood by different people when these terms are mentioned. Only brief indications of the meaning will be given.

Neurosis is a functional disease of the nervous system.

Neurasthenia is a condition of nervous exhaustion, brought about by various causes, such as overwork, worry, fright, sexual excesses, sexual abstinence, and so on. The basis of neurasthenia, however, is often or even generally a hereditary taint, a nervous weakness inherited from the parents.

Psychasthenia is a neurosis or psychoneurosis similar to neurasthenia, characterized by an exhaustion of the nervous system, also by weakness of the will, overscrupulousness, fear, and a feeling of the _unreality_ of things.

Neuropathy is a disease or disorder of the nervous system. Psychopathy is a disease or disorder of the mind.

Of late years we often hear people referred to as neurotics, neurasthenics, psychasthenics, neuropaths or psychopaths. These are undoubtedly abnormal conditions, and, taken as a general thing, they are dysgenic factors.

But a dysgenic factor in an animal _is_ a dysgenic factor, and that is all there is to it. There are no two sides to the question. But if anything goes to show the difference between animals and human beings, and to demonstrate why principles of eugenics, as derived from a study of animals, can never be _fully_ applicable to human beings, it is these considerations which we now have under discussion. To repeat, neuroses, neurasthenia, psychasthenia, and the various forms of neuropathy and psychopathy are dysgenic factors. But people suffering from these conditions often are among _the world's greatest geniuses_, have done some of the world's greatest work, and, if we prevented or discouraged marriage among people who are somewhat "abnormal" or "queer," we should deprive the world of some of its greatest men and women. For insanity is allied to genius, and if we were to exterminate all mentally or nervously abnormal people we should at the same time exterminate some of the men and women that have made life worth living.

And what is true of mentally abnormal is also true of physically inferior people. An inferior horse or dog _is_ inferior. There is no compensation for the inferiority. But a man may be physically inferior, he may be, for instance, a consumptive, but still he may have given to the world some of the sweetest and most wonderful poems. A man may be lame, or deaf, or strabismic, he may be a hunchback or a cripple and altogether physically repulsive, and yet he may be one of the world's greatest philosophers or mathematicians. A man may be sexually impotent and absolutely useless for race purposes, yet may be one of the world's greatest singers or greatest discoverers.

In short, the eugenic problem in the human is not, and never will be, as simple as it is in the animal and vegetable kingdoms. If we want to strive after healthy, normal mediocrity, then the principles of animal eugenics become applicable to the human race. If, on the other hand, we want talent, if we want genius, if we want benefactors of the human race, then we must go very slow with our eugenic applications.

=Drug Addiction or Narcotism=

Addiction to drugs, whether it be opium, morphine, heroin or cocaine, is a strongly dysgenic factor. The addiction to the drug is of itself not transmissible, but the weakened constitution or degeneracy which is generally responsible for the development of the drug addiction is inheritable.

A few cases of drug addiction are external; that is, the patient may have a good healthy constitution, no hereditary taint, and still because during some sickness he was given morphine a number of times he may have developed an addiction to the drug. But those cases are rare. And such cases, if they are cured and if the addiction is completely overcome, may marry.

But in most cases it isn't the drug addiction that causes the degeneracy; it is the degeneracy or the neuropathic or psychopathic constitution that causes the drug addiction. And such cases are bad matrimonial risks.

And it is a very risky thing for a woman to marry an addict with the idea of reforming him. As I said about the alcoholic: Let him reform first, let him stay reformed for a few years, and then the rest is not so great.

=Consanguineous Marriages=

Consanguinity means blood relationship, and consanguineous marriages are marriages between near blood relatives. The physician is frequently consulted as to the permissibility or danger of marriages between near relations. The question generally concerns first cousins, second cousins, uncle and niece, and nephew and aunt.

The popular idea is that consanguineous marriages are bad _per se_. The children of near relatives, such as first cousins, are apt to be defective, deaf and dumb, blind, or feebleminded, and what not. This popular idea, as so many popular ideas are, is wrong. And still there is of course, as there always is, some foundation for it. The matter, however, is quite simple.

We know that many traits, good and bad, are transmitted by heredity. And naturally when traits are possessed by both father and mother they stand a much greater chance of being transmitted to the offspring than if possessed by one of the parents alone. Now then, if a certain bad trait, such as epilepsy or insanity, is present in a family that trait is present in both cousins, and the likelihood of children from such a marriage inheriting that trait is much greater than when the parents are strangers, the taint being present in the family of only one of the parents. But if there be no hereditary taint in the cousins' family, and, still more, if the family is an intelligent one, if there are geniuses in the family, then there cannot be the slightest objection to marriage between cousins, and the children of such marriages are apt to inherit in a strong degree the talents or genius of their ancestors. In short, if the family is a bad one, one below par, then marriage between cousins or between uncle and niece should be forbidden. If the family is a good one, above par, then marriage between relatives of that family should be encouraged.

The idea that the children from consanguineous marriages are apt to be deaf and dumb has no foundation in fact. Recent statistics from various asylums in Germany, for instance, have shown that only about five per cent. of the deaf and dumb children were the offspring of consanguineous marriages. If 95 per cent, of the deaf and dumb had _non_-consanguineous parents, how could one say that even in the other five per cent, the consanguinity was the cause? If it were the other way around, then of course we could blame consanguinity. As it is, we can assume even in this five per cent, a mere coincidence, and we have no right to say that consanguinity and deaf and dumbness stand in the relation to each other of cause and effect.

It is interesting to know that among the Egyptians, Persians, and Incas of Peru close consanguineous marriages were very common. The Egyptian kings generally married their sisters. This was common custom and if the children born of such unions were defectives or monstrosities the fact would have become quickly apparent and the custom would have been abolished. Evidently the offspring of very close consanguinity was normal, or even above normal, or the practice would not have been continued such a long time.

It is perhaps worth while noting that one of the world's greatest scientists, Charles Darwin, was the child of parents who were first cousins.

=Homosexuality=

Homosexuality (homos--the same) is a perversion in which a person is attracted not to persons of the opposite but to persons of the same sex. Thus a homosexual man does not care for women, but is attracted to men. A homosexual woman is not attracted to men; she only cares for women and may even loathe men. A homosexual, man or woman, has no right to marry. The wrong committed by a homosexual marrying is a double one: it is wrong to the partner, wrong to the children. The normal partner is bound to discover the abnormality, and if he (or she) does, then the married life is a very unhappy one. Even if the abnormal partner uses the utmost efforts to conceal the abnormality, he cannot afford any pleasure to the normal partner, because the sexual act committed under loathing cannot be satisfactory. The other wrong is committed on the offspring. Homosexuality is hereditary, and nobody has a right to bring homosexuals into the world, for there is no unhappier being than a homosexual. I know a homosexual woman, who, knowing her abnormality, married for the sake of a comfortable home. She has been successful in hiding from her husband her abnormality, he simply considering her frigid. But each sexual act costs her tortures. So far she has succeeded in avoiding pregnancy. I also know a highly refined and educated homosexual gentleman, who married before understanding his condition. Many homosexuals, not knowing that such a thing as homosexuality even exists, do not understand their own condition; they feel a little strange, a little puzzled, but they don't know that they ought not to marry. Soon after marrying his condition became clear to him, but in the meantime his wife conceived, and he is now the father of a healthy, good-looking boy. It is possible that with proper bringing up the development of any homosexual traits will be prevented. It should be borne in mind that long sexual repression is favorable to the development of homosexuality.

But to emphasize: homosexuality is a dysgenic factor, and no homosexual should marry.

=Sadism=

Sadism is a sexual perversion in which the person derives pleasure only when beating, biting, striking, or otherwise inflicting pain on the person of the opposite sex. The degree of cruelty varies, but all sadists should be shunned. Unfortunately the fact that a man is a sadist is often not found out until after marriage, but as soon as the wife has found it out she should leave the man and demand a divorce. Sadism is a sufficient ground for a separation or divorce. No person with any moral feeling in him or her should be responsible for bringing children into the world with a possible sadistic heredity.

Sadistic cruelty is often of the gross, brutal, repulsive kind, but sometimes the sadist inflicts on his "beloved" object refined tortures of which only a cunning "demon" is capable. The sufferings which the wives of some sadists have to undergo are known only to themselves and to a few--very few--physicians.

=Masochism=

Masochism is a sexual perversion in which the person, man or woman, _likes_ to suffer pain, beatings, insults and other cruelties at the hands of the beloved object. It is a dysgenic factor but much less important than sadism.

=Sexual Impotence=

Sexual impotence is not hereditary, but impotence in the male either so complete that he cannot perform the act or consisting only in premature ejaculations (relative impotence or sexual insufficiency) should constitute a bar to marriage. This impotence may not interfere with impregnation; the wife may have children and the children will not be in any way defective, but the wife herself, unless she is completely frigid, will suffer the tortures of hell, and may quickly become a sexual neurasthenic, a nervous wreck, or she may even develop a psychosis. Any man suffering with impotence should have himself treated before marriage until he is cured; if his impotence is incurable, then for his own sake and for the sake of the girl or woman he is supposed to love he should give up the idea of marriage. The only permissible exception is in cases in which the prospective wife knows the nature of her prospective husband's trouble, and claims that she does not care for gross sexual relations and therefore does not mind the impotence. In case the wife is absolutely _frigid_, the marriage may turn out satisfactory. But I would always have my misgivings, and should the wife's apparently absent but in reality only dormant libido suddenly awaken there would be trouble for both husband and wife. It is therefore necessary to emphasize: in all cases of impotence--caution!

=Frigidity=

Frigidity, as we have explained in a previous chapter, is a term applied to lack of sexual desire or sexual enjoyment in women. Of course many women before marriage are themselves ignorant of their sexual condition. Having learned to restrain their impulses, to repress any sexual stir, they themselves are often unable to say whether they have a strong or weak libido, or any at all. And whether or no a given woman would derive any pleasure from the sexual act can only be found out after marriage. Many girls, however, know very well whether they are "passionate" or not, but they wouldn't tell. They are afraid to confess to a complete lack of passion--they fear they might lose a husband.

Frigidity as an agent in marriage may be considered from two points of view: the offspring and the husband. The offspring is not affected by the mother's frigidity. A very frigid woman, if the frigidity is not due to serious organic causes, may have very healthy children and make an excellent mother. As far as the husband is concerned, it will depend a good deal on the degree of frigidity. If the woman is merely cold, and, while herself not enjoying the act, raises no objection to it, then it cannot be considered a bar to marriage. In fact many men, themselves not overstrong sexually, are praying for somewhat frigid wives. (It must be stated, however, that to some husbands relations with frigid and non-participating wives are extremely distasteful.) But when the frigidity is of such a degree that it amounts to a strong physical aversion to the act, it should be considered a bar to marriage. Such frigidity is often the cause of a disrupted home, often leads to divorce and is legally considered a sufficient cause for divorce or for the annulment of marriage, the same as impotence in the man is.

=Excessive Libido in Men=

We have seen that sexual impotence is a dysgenic factor and if complete and incurable should constitute a barrier to marriage. The opposite condition is that of excessive libido. Libido is the desire for the opposite sex. A proper amount of libido is normal and desirable. A lack of libido is abnormal. And an excess of libido is also abnormal. But a good many men are possessed of an excess of libido; it is either congenital or _acquired_. Some men torture their wives "to death," not literally but figuratively. Harboring the prevailing idea that a wife has no rights in this respect, that her body is not her own, that she must always hold herself ready to satisfy his abnormal desires, such a husband exercises his marital rights without consideration for the physical condition or the mental feelings of his partner. Some husbands demand that their wives satisfy them _daily_ from one to five or more times a day. Some wives who happen to be possessed of an equally strong libido do not mind these excessive demands (though in time they are almost sure to feel the evil effects), but if the wife possesses only a moderate amount of sexuality and if she is too weak in body and in will-power to resist her lord and master's demands, her health is often ruined and she becomes a wreck. (Complete abstinence and excessive indulgence often have the same evil end-results.) Some men "kill" four or five women before the fury of their libido is at last moderated. Of course, it is hard to find out a man's libido beforehand. But if a delicate girl or a woman of moderate sexuality has reasons to suspect that a man is possessed of an abnormally excessive libido, she would do well to think twice before taking the often irretrievable step.

I have spoken so far of excessive libido in normal men, that is, in men who are otherwise normal, sane and can _whenever necessary_ control their desires. There is a form of excessive libido in men called satyriasis, which reaches such a degree that the men are often not able to control their desires, and they will satisfy their passion even if they know that the result is sure to be a venereal infection or several years in prison. Of course, satyriasis is a dysgenic factor; those suffering with that disorder are not normal; they are on the borderland of insanity, and not only should they not be permitted to marry, but they should be confined to institutions where they can be subjected to the proper treatment.

=Excessive Libido in Women=

Just as we have impotent and excessively libidinous men, so we have frigid and excessively libidinous women. A wife possessed of excessive libido is a terrible calamity for a husband of a normal or moderate sexuality. Many a libidinous wife has driven her husband, especially if she is young and he is old, to a premature grave. And "grave" is used in the literal, not figurative, sense of the word. It would be a good thing if a man could find out the character of his future wife's libido before marriage. Unfortunately, it is impossible. At best, it can only be guessed at. But a really excessive libido on the part of either husband or wife should constitute a valid ground for divorce. When the libido in woman is so excessive that she _cannot_ control her passion, and forgetting religion, morality, modesty, custom and possible social consequences, she offers herself to every man she meets, we use the term nymphomania. It is a disease which corresponds to satyriasis in men, and what I said of satyriasis applies with equal force to nymphomania. Nymphomaniac women should not be permitted to marry or to run around loose, but should be confined to institutions in which they can be subjected to proper treatment.

=Harelip=

This is a congenital defect consisting in a notch or split in the upper lip. It is due to defective development of the embryo and is as a rule found in association with cleft palate. Probably hereditary, but is not common and is not of much importance.

=Myopia=

Myopia means nearsightedness. This defect is undoubtedly hereditary to a certain degree, but it is doubtful if, other conditions being favorable, any man would give up a girl because she is myopic or vice versa. Still, if the condition is extreme, as it sometimes is, it should be taken into consideration. And where both the man and the woman are strongly myopic some hesitation should be felt in contracting a marriage. If the husband alone is myopic, then the defect may be transmitted to the sons but not to the daughters, and these daughters may in their turn transmit the defect to their sons but not to their daughters. In other words, the defect is more or less _sex-limited_.

=Astigmatism=

This is a defect of the eye, depending upon some irregularity of the cornea or the lens, in which light rays in different meridians are not brought to the same focus. It is to a certain extent hereditary, but plays an insignificant rôle. It is an undesirable trait, but cannot be considered a dysgenic factor.

=Baldness=

Premature baldness is a decidedly inheritable trait. And so is premature grayness of the hair. But it is doubtful if any woman would permit these factors to play any rôle in her choice of a husband.

=Criminality=

Almost a complete change has taken place in our ideas of criminality, and there are but very few criminologists now who believe in the Lombrosian nonsense of most criminality being inherited and being accompanied by physical stigmata of degeneration. The idea that the criminal is born and not made is now held only by an insignificant number of thinkers. We know now that by far the greatest percentage of crime is the result of environment, of poverty, with all that that word implies, of bad bringing up, of bad companions. We know that the child of the criminal, properly brought up, will develop into a model citizen, and vice versa, the child of the saint, brought into the slums, might develop into a criminal.

Then we must remember that there are many crimes which are not crimes, per se, but which are merely infractions of man-made laws, or representing rebellious acts against an unjust and cruel social order. Thus, for instance, a man or a woman who defying the law, would give information about birth control, and be convicted for the offence, would be legally a criminal. Morally he or she would be a high-minded humanitarian. A man who would throw a bomb at the Russian Czar or at a murderous pogrom-inciting Russian Governor would be considered an assassin, and if caught would be hanged; and in making up the pedigree of such a family, a narrow-minded eugenist would be apt to say that there was criminality in that family. But as a matter of fact, that "assassin" may have belonged to the noblest-minded heroes in history.

The eugenists will therefore pay little attention to criminality in the ancestry as a dysgenic factor. As long as the matrimonial candidate himself is not a criminal, the ancestral criminality should constitute no bar to the marriage. It is not likely to show itself atavistically in the children. Altogether a good deal of nonsense has been written about atavism. And people forget that the same rules of heredity that are applied to physical conditions cannot be applied to spiritual and moral qualities, the latter being much more dependent upon environment than the former. Of course the various circumstances must be taken into consideration, and each case must be decided upon its merits. No generalizations can be permitted. The _kind_ of crime must always be considered.

And, furthermore, it should be borne in mind that not only is a criminal ancestry _per se_ no bar to marriage, the marriage candidate himself may be an ex-criminal, may have served time in prison, and still be a very desirable father or mother from the eugenic viewpoint. A man who in a fit of passion or during a quarrel, perhaps under the slight influence of liquor, struck or killed a man is not, therefore, a real criminal. After serving his time in prison he may never again commit the slightest antisocial act, may make a moral citizen and an ideal husband and father.

This is not a plea for the under dog. For in this case, where the future of the race is at stake, all other considerations must be put into the background. I simply plead for an intelligent consideration of the subject. Many honored citizens are worse criminals and worse fathers than many people who have served prison sentences.

=Pauperism=

It may seem strange to discuss pauperism in relation to marriage and to speak of it as a hereditary factor, but it is necessary to discuss it, because considerable ignorance prevails on the subject, it being generally confused with poverty. There is a radical difference between pauperism and poverty. People may be poor for generations and generations, even very poor, and still not be considered or classed with paupers. Pauperism generally implies a lack of physical and mental stamina, loss of _self-respect_ and unconquerable laziness. Of course we know now that laziness often rests upon a physical basis, being due to imperfect working of the internal glands. But whatever the cause of the laziness may be, the fact is that it is one of the characteristics of the pauper. And while we cannot speak of pauperism being hereditary, the qualities that go to make up the pauper are transmissible. No normal woman would marry a pauper, and the woman who would marry a pauper is not amenable to any advice or to any book knowledge. But men are sometimes tempted to marry daughters of paupers if they happen to be pretty. They should consider the matter very carefully, for some of the ancestral traits may become manifest in the children.