Alfred Grotjahn, The Hygiene of Human Reproduction: An Attempt at Practical Eugenics (1926)

Foreword

Decades of studying the problem of the social causes of disease and the influence of environmental factors on physical conditions have by no means blinded the author to their polar opposite – namely, the influence of hereditary factors. In fact, his focus on social pathology and social hygiene has taught him from the very beginning that, in all cases where the causes of disease are concerned, alongside the social influences, hereditary traits also appear as deep-seated, difficult to recognize – and even more difficult to influence – causes of disease, and the former can only be isolated when the latter are examined at the same time. Only such an approach can safeguard against the fatal error of expecting success in the fight against mass pathological phenomena by influencing social factors alone. The author therefore has always considered it his duty to include the problems of eugenics in the teaching activities that he has carried out for years at the University and at the Academy for Social Hygiene, insofar as it was possible for him as a non-biologist. Lectures limited to a certain number of hours, however, can only convey the most important facts and concepts, whereas the need to pursue the suggestions raised in the lecture hall and reexamining particulars can only be satisfied through a textbook. For the field of social hygiene, there is already a wealth of material in comprehensive books, and this suffices to cover the most varied requirements in detail. But that is not the case in the field of eugenics, which is so closely intertwined with social hygiene. The books to which one must refer today are much too heavily weighted towards biological specifics and operate almost exclusively within the framework of Darwin’s theory of natural selection. For this reason, they shift so much emphasis on botanical and zoological materials, and the analogical conclusions drawn from them, that the sociological and demographic policy aspects are neglected.

This book results from the desire to remedy this deficiency. It is specifically intended for readers, who, as doctors, welfare administrators, and social policymakers, are interested in eugenic issues and have the opportunity to affect eugenic change. This provision makes it possible to dispense with the treatment of individual inherited biological factors, insofar as they are not absolutely essential to the understanding of human procreation. This is permissible, since that subject is already covered in relevant textbooks and comprehensive expositions. The space thus gained is used for the benefit of eugenics and its connections to social hygiene, which the author has understandably positioned in the foreground. Thus, the practical side of eugenics is given precedence over the theoretical. For until now, there was no account of what we should do to stop or even reverse the looming decline and degeneration of the population. The author had already presented some essential rules for procreation in the first edition of his “Social Pathology,” published in 1912, and expressed his view that within this framework, a determination could be made as to what was possible within contemporary practical reproductive hygiene; here an attempt has been made to fill out this framework with details.

The local and current relevance of the questions considered in the following remarks is undeniable. The scope of our country’s food supply is limited; its population is dense. As statistics clearly demonstrate, for decades now our people have not let natural fertility follow its own course; rather, they have restricted it to such an extent that we need to examine whether this process should be welcomed or regretted, supported or impeded. With good reason, calls for population planning policy have increased. Yet such a policy must not be based primarily on feeling, desires, fears, or the questionable demands of the day, but rather on scientific knowledge. For only this can be the basis for passing laws and managing the great masses, as such, in order to serve the shaping of customs and life habits.

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Rather, the author will endeavor to employ only the social hygienic method, i.e., by gathering building blocks from the most varied natural and social scientific fields and assembling them to try to answer the question: how can we consciously and systematically pursue a population planning policy in order to maintain, quantitatively and qualitatively, a conglomeration of people generatively connected to one another (the relevant example always being that of our own people in their current state) at its present quality, at least, or even improve it?

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Chapter 4. The Improvement of the Characteristics of the Population

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d) Planned Eradication through Custody and Forced Sterilization

The undeniable eugenic effect of psychopaths degenerating into vagrants, criminals, and prostitutes, however, is such an inhuman process with such unbearable attendant phenomena that civilized nations cannot calmly tolerate it on a long-term basis. Welfare and care facilities of all kinds are thus working, with growing success, to limit or even eliminate this effect entirely. From the perspective of reproductive hygiene, there is the danger that in the future some psychopaths will still get married and have offspring, and that, were it not for charitable efforts, such a situation might actually have been prevented through degeneration itself. However, even without such care, many psychopaths escape social control and produce malign progeny. For instance, in some districts, notably less frequently in the soul-destroying big cities than in isolated mountain valleys and remote areas, entire clans have been identified who have produced asocial psychopaths over centuries from generation to generation.[1] Even in the cities, it has been observed that imbeciles still marry and conceive children in great numbers. In fact, Reiter and Osthoff[2] found in 1920 that for 234 mothers there were 1,490 live-born imbecilic children in the Rostock Special Education School, i.e., 6.4 per mother, of whom 4.5 reached marriageable age. We must therefore search for more reliable means of preventing procreation among psychopaths than those provided by natural sterility and degeneration.

The most important among such means is the timely and permanent detention of all of the mentally inferior, who, being insane, habitual offenders, incurable drunkards, and above all untreatable psychopaths, must be separated from the population at any rate. Their permanent confinement in asylums prevents marriage and procreation, or at least interrupts these and thus has a pronounced eugenic effect. Unfortunately, at present, courts, welfare agencies, and asylums are not yet sufficiently oriented towards this goal; rather, they leave countless gaps through which these kinds of individuals can again escape. However, for psychopaths whose behavior does not warrant permanent confinement in an asylum (because they are capable of working and do not cause serious disturbances), the application of eugenic measures may be considered a means of prevention. Since this primarily concerns persons with deficient intelligence and an abnormal sex life, those simple means that are sufficient for asthenics (such as a condom for men or a diaphragm for women) are not recommended, but rather surgical sterilization as already described. Certainly, legal principles must first be established for this course of action. Because only in this way can the correct diagnosis be guaranteed and the execution of fundamentally invasive methods be assigned to the responsible medical officers. However, not all groups of psychopaths are to be subjected to forced sterilization; rather, this is predominately reserved for individuals of imbecilic or epileptic constitution; persons who are possessed of schizoid and bipolar constitutions, but who do not require confinement in an asylum, should be allowed to procreate, because they are also bearers of traits that can result in the production of gifted individuals.

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Chapter 7. Social Reproductive Hygiene

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d) The Health Certificate before Marriage

Whereas no significant understanding of eugenic thought can be spoken of thus far, there is one demand that is increasingly preoccupying the public and is probably destined to become the seed for the development of reproductive hygiene legislation: that is the demand for the introduction of a health certificate before marriage. The implementation of this demand would also be welcome for other reasons, because persons afflicted with sexually transmitted diseases, tuberculosis, and other chronic illnesses would be forced to receive treatment before marriage or refrain from it.

It is to be expected that such a health certificate will become law sooner or later. We may already see a precedent in an informational pamphlet handed by the registry office to all engaged persons in advance of their filing a notice of intent to marry. This followed a proposal by the eugenic scientist E. Schubert (who comes from a legal background) and was enacted as law on June 11, 1920 (Reichsgesetzblatt, p. 1209) […].