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Margaret Sanger
Mar 1923
The Physician and Birth Control
msp320596
The Medical Times, Mar. 1923, pp. 73-74, 77
Unknown
International Neo-Malthusian and Birth Control Conference, 5th
(1922)
British Medical Journal
Yawger, Nathanial Shurtz
Drysdale, George
This article was co-authored by Thomas Webster
Edgar. For a reprint of this article see, Margaret Sanger
Microfilm, Collected Documents Series, C16:0189.
abortion, frequency of
abortion, health risks
birth control, history of
birth control, definitions of
birth control, international
birth control, health benefits and risks
birth control, neo-Malthusian arguments for
conferences, International Neo-Malthusian and Birth Control Conference, 1922 (5th)
conferences, Lambeth Conference, 1920
England, birth control in
heredity, and disease
heredity, MS on
infanticide
Japan, birth control in
Japan, birth control clinics and leagues
mentally diseased or disabled, as social burdens
Netherlands, the, birth control clinics
physically diseased or disabled, as social burdens
physicians, and birth control
physicians, MS on
United States, birth control in
World War I, MS on
The Physician and Birth Control
Thomas Webster Edgar, M.D., and Margaret Sanger
320 West 82nd Street.
Foreword.
Due to my great interest in birth control, legitimately sponsored and
properly advocated, I have collaborated with Margaret Sanger in presenting this
article. My interest in the subject is purely humanitarian.--Thomas W.
Edgar.
Although it is only in the last few years that the doctrine of Birth Control has
assumed the proportions of a definitely crystallized world movement, its history is
ancient. This history began with the first crude efforts to control and direct the
human reproduction. This custom of infanticide, a custom practiced in certain
portions of the globe even today, was the first crude and barbarous expression of a
dim realization that instinct must in some way be made to subserve intelligent
adaptation. The next step toward conscious control of population was the practice of
abortion. It is unnecessary here to go into the history of this cruel and barbarous
practice. Physicians even today are brought sufficiently into contact with the
dangers and the frightful cost of this emergency measure, which still remains, among
large sections of the world's population, the only method of control over the great
overwhelming power of the procreative instincts. Birth Control, as it is understood
by all intelligent students today, means the substitution of scientific
contraception of a sanitary and harmless nature for the costly, cruel and often
fatal customs of infanticide and abortion.
The World War has concentrated interest in and thrown new light on the complex
problems of population, of racial conflicts, as well as upon the qualitative
analysis of human intelligence. A large and distinguished body of social and
economic thinkers are coming to realize that the complex economic and political
problems which confront human society today are organically bound up with the
question of Birth Control. But in thus emphasizing the larger aspects of this
program, we should never forget that actual progress is impossible without the
cooperation and the guidance of, the scientist and the physician.
The program for Birth Control parallels recent developments in the sphere of
medicine. In the war against disease and epidemic, prevention and sanitation are now
recognized as the only adequate weapons. Undoubtedly for many years to come the
majority of physicians and surgeons must direct their energies to individual cases
of disease. But because this is their task, a task requiring a vast fund of
fortitude and patience, it would be an error to suppose that the role of the
physician in society should be limited to the care and cure of the diseased and
ailing. His is a vastly more important role. His sphere is by no means limited to
the mere amelioration of human suffering; it embraces the whole of life, health as
well as disease. Individual and racial health, as every day we are coming more
intensely to realize, has its own laws and structure--laws as complex, as deeply
rooted, and as worthy of investigation as those of disease. In our more
superficially humanitarian efforts we have perhaps not realized until very recently,
that the prevention of disease is dependent upon broadly based programs of social
hygiene and racial prophylaxis. When laymen, as well as physicians, awaken to the
fact that disease is not a matter of chance occurrence, but is closely related to
every manifestation of life, the pivotal importance of the physician to every human
being, in health as in illness, will be recognized. The day is not far distant let
us hope, when the doctor, armed with the intimate knowledge of every phase of the
human constitution, and standing with the calm authority of far-seeing vision, may
be acclaimed, rather than the priest, the politician or the warrior, as the only
true leader competent to show suffering humanity the path out of its vale of tears.
For today only to the physician is afforded a view of man as a biological organism.
If the physician be possessed of the "divine curiosity" of Science, he comes to the
realization that the greatest menace to the health of humanity is found not in those
dire epidemic of infectious or contagious diseases that may cut down whole
communities, calamitous as these seem. The direct menaces is to be found in the
heritable maladies and defects which are handed down to generation after generation,
and manifest themselves in myriad forms. Thus syphilis allies itself with
feeble-mindedness. And mental defect, wearing the mask of delinquency, pauperism,
prostitution and crime, renders almost impossible the Herculean task of attaining
racial health. Our poorhouses, our prisons, our asylums for the feeble-minded, all
have a common biological root. Crime is not merely a
matter of law. It has a physiological history. A faulty heredity, a defective germ
plasm, a biological or physiological imperfection of the nervous and endocrine
system--these lie at the root of most of our social and racial problems.
It has been the realization of these truths that has enlisted most of the physicians
and scientists of other countries who have challenged conservative opinion by
bravely championing the cause of Birth Control. This movement is by means of
propaganda of extremists who are seeking to tell physicians and doctors their duty.
On the contrary, from the earliest days of the Neo-Malthusian agitation it has been
inspired and directed by physicians who had the clear vision that enabled them to
look beyond the special individual case to the underlying significance. In
England those valiant pioneer Doctors George and Charles R. Drysdale fought for years against the momentum of Victorian
opinion. In Holland, where the First Birth
Control Clinic in the world was opened in Amsterdam in 1881, it has been mainly due to the efforts of two
physicians, Dr. Aletta Jacobs and Dr. J. Rutgers that we have that splendid example
of what the practice of Birth Control and the establishment of clinics under the
direction of trained specialists may accomplish for a nation.
We present hereith authentic tables indicating the results in Holland, where fifty-two clinics are in operation
among a population of some 6,000,000 people:
Amsterdam (Malthusian [Birth Control] League started 1881; Dr. Aletta
Jacobs gave advice to poor women, 1885.)
1881-1889
1906-10
1912
37.1
24.1
23.3
25.1
13.1
11.2
203
90
64
The Hague (now headquarters of the Neo-Malthusian [Birth Control]
League)
1881-1889
1906-10
1912
38.7
27.5
23.6
23.3
13.2
10.9
214
99
66
Rotterdam
1881-1889
1906-10
1912
37.4
32.0
29.0
24.2
13.4
11.3
209
105
79
Fertility and Illegitimacy Rates
1880-2
1890-2
1900-02
306.4
296.5
252.7
16.1
16.3
11.3
The Hague
1880-2
1890-2
1900-02
346.5
303.9
255.0
13.4>
13.6
7.7
Rotterdam
1880-2
1890-2
1900-02
331.4
312.0
299.0
17.4
16.5
13.1
At the present moment, England offers a brilliant illustration of the
interest of physicians in the problem of Birth Control. The sensational address on
"Married Love" of Lord Dawson, the King's
physician, at the Lambeth
Conference of the Bishop of the Church of England, in which he defended
the practice of Birth Control, is one outstanding instance. At the Fifth
International Congress on Birth Control held in London last summer, the Contraceptive Section, held for doctors and
medical students only, under the presidency of Dr. Norman Haire, illustrated the growing adherence of British physicians
to the movement. It was attended by no less than 164 medical men and women,
including Lord Dawson and Sir Arbuthnot
Lane, who, with the exception of only three dissenters, passed this
resolution:
"That this meeting of the medical members of the
Fifth International Neo-Malthusian and Birth Control Conference
wishes to point out that Birth Control by hygienic contraceptive devices is
absolutely distinct from abortion in its physiological, legal and moral aspects.
It further records its opinion that there is no evidence that the best
contraceptive methods are injurious to health or conducive to
sterility."
Similarly, the Medical Section, held under the presidency of Dr. C. Killick Millard, unanimously passed
the following resolution:
"That this meeting of the Fifth International
Neo-Malthusian and Birth Control Conference, consisting chiefly of members of
the British medial profession, considers that it is of the greatest importance
that the provisions of hygienic Birth Control instruction should become part of
the recognized duty of the medical profession, and that such instruction should
especially be given at all hospitals and public health centers to which the
poorest classes and those suffering from hereditary disease or defectiveness
apply for help."
Previous to the Conference, Dr. Millard had sent a questionnaire to the leading
members of the British medical profession. From their replies, Dr. Millard reported,
it could no longer be claimed that the medical profession in Great
Britain condemned contraceptive methods; but he made a strong plea that
the profession should concentrate its attention upon this important subject,
because, if it continued to be silent, it committed to laymen the solution of
problems which are legitimately within the sphere of its activity. Two of the
leading medical journals of Great Britain, the Lancet
and the British Medical Journal, devoted much space to
the conference, especially the contraceptive and medical aspects. The British Medical Journal notes: ". . .It was
interesting to observe the way in which people who were sharply divided on other
subjects found a common meeting place in Birth Control. The matter was pressed
to the same conclusion from the point of view of the Socialist and the
individualist, the nationalist and the internationalist. . . ." The Lancet reported the speeches of Lord Dawson, Sir
Arbuthnot Lane, and other men eminent in the medical profession.
But it has not been in the Western world alone that physicians have pioneered the way
for hygienic Birth Control. In Japan, Dr. Kezutami Ukita, a decade or so ago, courageously
advocated Birth Control, in the face of the most powerful militarists of the island
empire. Dr. Tokijiro Kaji, returning from
Germany and Holland where he had undertaken a technical study of
contraception, devised appropriate methods for the Japanese. He established a free
clinic in Tokyo and finally opened the
People's Hospital, for the benefit of women of the poorer classes.
Only last year the Japanese Birth Control Association was
organized, with Dr. Kaji as one of the four founders.
It would be unfair not to record here the strong support given to the Birth Control
Movement in the United States by individual physicians. The scientific and medical
magazines often contain papers of the greatest importance upon this question, and
papers are read in the various societies that bear pertinently upon Birth Control.
Unfortunately the physician too often confines his remarks to his colleagues, and
the significant truths of his experiences are seldom conveyed to the general public.
Thus, Dr. N. S. Yawger read a
compelling paper before the Philadelphia Neurological Society (Footnote:
January 27, 1922,
N. Y. Med. Jour., Vol. CXVI, No. 6, p.
334), dealing with an epileptic and her sixteen children, a study "of
a family that was rendered distressingly poor through the circumstances of a
blind father, and of an epileptic mother who scouted race suicide by living up
to sixteen pregnancies, who clung to all these maternal burdens save one--the
tenth conception miscarried--but who still ran true to a total of sixteen, by
reason of her first effort having brought forth twins. Despite the fact that
there was no evidence of syphilis that the diseases and defects of the unfortunate
children do not appear especially to have developed upon a leutic basis--only three
of the children appeared to have escaped the hereditary blight. Dr. Yawger concludes
that " a small volume could be written upon the disorders which will
develop among the early descendants of this ill-fated family." Such studies
are of the greatest value not merely to the medical profession, but to all who have
the health of the nation and of the race at heart--and where else, we may ask, is
true patriotism to be found? In the matter of breeding out disease and breeding in
health, prophylaxis, as a distinguished authority asserts, is ninety per cent. of
the cure. Until the medical profession, not merely at home but in all countries in
the world, and the laity under the leadership of medical science, realize these
fundamental and unchanging truths, we cannot hope to make any progress toward the
eradication of those monstrous biological diseases, the full terror of whose blight
we can only realize when we study them through a succession of generations, when we
study them genetically instead of in the individual patient.
The profession of medicine stands upon the threshold of a new era in the social
organism. The physician today is in possession of truths of the most vital
importance to the community; and it is his duty, as a member of one of the noblest,
if not the noblest of all professions, to co-operate to the full extent of his
ability with Science in enlightening the public concerning those necessary biological laws which we must observe or perish.
In the past, medicine has too often been looked down upon as a plodding prosaic and
uninteresting profession, secondary in importance to that of the Church, the law, or
politics. " How can the voice of the physician be heard,"
exclaimed George Drysdale, "if he can urge only the feeble motives of
expediency, while the moralist and the clergyman have at their command the
armory of duty and religion, with the array of eternal rewards and punishments,
to enforce reverence for their precepts?"
It is because the Birth Control Movement is the only organized current of thought in
the world today that emphasizes the basic and fundamental place of the physician in
the community that we urge upon all members of the profession the immediate study of
this problem in all its aspects. Mere agreement with or assent to the doctrine is
not enough. The immediate need of the country is technical study and
experimentation, and the presentation of the results to all parents and
parents-to-be. The destiny of the United States cannot be founded.
Subject Terms:
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