Being Well Born Part 10

+-------------------- Remarks.

--------------------- ----- ------ ----- ------ -------------------- 1. Mother showing One infant died symptoms of plubism 4 15 13 2 within 24 hours.

2. Mother working in type foundry, all of whose previous pregnancies had Four of these died been normal 5 36 29 7 in first year.

3. Mother who during period of work in After ceasing to type foundry had work had five pregnancies 1 5 5 0 healthy child.

4. Mother working When away from intermittently in work for some type foundry; period of time while working gave birth to there 3 3 3 0 healthy children.

5. Mother in whom blue line on gum the only sign of lead poisoning 6 29 21 8 Of these, eight died 6. Husband alone in first year, exposed to lead ? 32 12 20 four in second, five in third.

FIG. 29

Tabulation of eighty-one cases of lead poisoning recorded by Constantin Paul (from Adami).

[Ill.u.s.tration: Fig. 30

Photograph of young rabbits from the same litter, the smaller one stunted by lead-poisoning of its father (Courtesy of Professor L. J. Cole).]

=The Expectant Mother Should Have Rest.--=The mere matter of rest on the part of the pregnant mother is, judging from the work of Pinard, a Frenchman, and his pupils, an important one. In a number of detailed investigations they have shown that rest on the part of the working mother during the last three months before the child is born results in the production of markedly larger and more robust children than those born of mothers equally healthy but who have not had such rest. Moreover the danger of premature birth is considerably lessened.

=Too Short Intervals Between Children.--=Too short an interval between childbirths would also seem to be an infringement on the rights of the child as well as of the mother. Thus Doctor R. J. Ewart ("The Influence of Parental Age on Offspring," _Eugenic Review_, October, 1911) finds that children born at intervals of less than two years after the birth of the previous child still show at the age of six a notable deficiency in height, weight and intelligence, when compared with the children born after a longer interval, or even with first-born children.

=Our Duty to Safeguard Motherhood.--=Doubtless the unventilated factory and tenement also do their share, even though we can give no exact quant.i.tative measure of it. Obviously, it becomes a civic duty to protect as much as possible all members of our social system from such injurious factors as have just been discussed. It is particularly necessary to safeguard mothers before confinement, especially working mothers.

=Expectant Mothers Neglected.--=According to the claims of life insurance men, expectant mothers are the most neglected members of our population.

Doctor Van Ingen, of New York City, estimates that ninety per cent. of women in this country are wholly without prenatal care. Yet every prospective mother should be taught the probable meaning of such symptoms as headache, hemorrhages, swelling of the feet and disturbed vision. She should realize the importance of submitting a sample of urine for a.n.a.lysis at least once a month before childbirth and twice a month for a while thereafter. She should be specially informed regarding work, exercise, diet and dress. A recent government bulletin written by Mrs. Max West which may be had free by writing to the Children's Bureau, Department of Labor, Washington, D. C., gives much useful information on this subject.

ALCOHOLISM

=Unreliability of Much of the Data.--=One of the most important poisons that plays a prominent part among ante-natal influences is alcohol. But when it comes to a study of the problem of alcoholism from the standpoint of heredity and parental influences we meet with many difficulties, prominent among which are the inaccuracy and unreliability of many of the statistics brought forward in this connection. Many of the results are vitiated by the prejudices of propagandists who propose to make a case either for or against alcohol as a beverage whether or not the facts justify their conclusions. When one tries to view the matter with an open mind he finds that there is a deplorable lack of statistics which are not susceptible to more than one interpretation. However, using as much as possible what seems to be unbiased data, the evidence is almost wholly against alcohol as a beverage, at least to any immoderate extent.

=Alcohol a Germinal or Fetal Poison.--=The bad effects as far as offspring are concerned reveal themselves in the main under the category of "false heredity," i. e., germinal or fetal poisonings rather than of heritable changes induced in the germ-cells. Most investigators feel that there are too many criminal, imbecile, insane and unhealthy persons among the offspring of drunkards to dismiss the matter as a coincidence. In an investigation of Imbault, for example, we find recorded of one hundred tuberculous children that while forty-one were of tuberculous parentage, thirty-six per cent, were the offspring of inebriates. Furthermore Imbault cites the observations of Arrive on 1,506 cases of juvenile meningitis to the effect that this malady is twice as frequent in the children of alcoholic as in those of tuberculous parentage. It has been proved by Nicloux (_L'Obstetrique_, Vol. 99, 1900) that in dogs and guinea-pigs alcohol pa.s.ses through the placenta and may be detected in fetal tissues; hence it is in position to influence the fetus. He found that in a very short time the amount of alcohol in the blood of the fetus about paralleled that in the blood of the mother.

=Progressive Increase in Death-Rate of Offspring of Inebriate Women.--=In an investigation on the effects of parental alcoholism on the offspring, Sullivan (_Journal of Mental Science_, Vol. 45, 1899) gives some important figures. To avoid other complications he chose female drunkards in whom no other degenerative features were evident. He found that among these the percentage of abortions, still-births and deaths of infants before their third year was 55.8 per cent. as against 23.9 per cent. in sober mothers. In answer to the objection that this high percentage may be due merely to neglect, and not to impairment of the fetus by alcoholism, he points out the fact based on the history of the successive births, that there was a progressive increase in the death-rate of offspring in proportion to the length of time the mother had been an inebriate, thus:

------------------------------------------------------------- No. of Per cent. Per cent. dying Total cases born dead before 3 percentage ----------------- ------ --------- --------------- ---------- First births 80 6.2 27.5 33.7 Second births 80 11.2 40.8 50.0 Third births 80 7.6 45.0 52.6 Fourth and fifth 111 10.8 54.9 65.7 Sixth to tenth 93 17.2 54.8 72.0 -------------------------------------------------------------

=Views of a Psychiatrist on Alcohol.--=Forel, who for years was the psychiatrist at the head of a large insane asylum at Zurich, Switzerland, has this to say about the effects of narcotic poisons and alcohol in particular:

"The offspring tainted with alcoholic blastophthoria suffer various bodily and physical anomalies, among which are dwarfism, rickets, a predisposition to tuberculosis and epilepsy, moral idiocy, and idiocy in general, a predisposition to crime and mental diseases, s.e.xual perversions, loss of suckling in women, and many other misfortunes."

In another pa.s.sage he[6] remarks as follows:

"But what is of much greater importance is the fact that acute and chronic alcoholic intoxication deteriorates the germinal protoplasm of the procreators.... The recent researches of Bezzola seem to prove that the old belief in the bad quality of children conceived during drunkenness is not without foundation. Relying on the Swiss census of 1900, in which there figure nine thousand idiots, and after careful examination of the bulletins concerning them, this author has proved that there are two acute annual maximum periods for the conception of idiots (calculated from nine months before birth); the periods of carnival and vintage, when the people drink most. In the wine-growing districts the maximum conception of idiots is enormous, while it is almost nil at other periods. Moreover, these two maximum periods come at the time of year when conception is at a minimum among the rest of the population, the maximum of normal conceptions occurring at the beginning of summer."

Another interpretation of Bezzola's results has been suggested to the effect that the license of these periods enables the defective members of the community, such as the feeble-minded, an opportunity of mating more readily and that consequently the result is direct inheritance of idiocy and allied defects instead of idiocy produced through alcoholic poisoning of the parental germ-cell.

=Other Views.--=There are indeed many competent investigators who believe that alcoholism in parents has little or no part in the direct production of mental defects in children. For instance, Tredgold quotes Doctor Ireland's observations that although at New Year, when the fishermen return, the whole population of certain villages in Scotland gets drunk, there is no noticeable excess of defectives born nine months later, and remarks further that, "I have histories of idiots conceived under such circ.u.mstances, but so I have of normal children, and my opinion is, that while this may be a cause in some cases, the number of instances in this country at any rate is exceedingly small." Again, G.o.ddard, one of our best known American students of feeble-mindedness, who has made careful study of this point under especially favorable conditions, feels that his data do not prove that alcoholism of either the father or the mother causes feeble-mindedness in the child. He concludes, "Everything seems to indicate that alcoholism itself is only a symptom; that it for the most part occurs in families where there is some form of neurotic taint, especially feeble-mindedness." G.o.ddard, however, in common with many other observers, notes that miscarriages and deaths in infancy are far higher among inebriates than among abstainers.

Doctor Mjoen cites an interesting parallel between the increase of feeble-mindedness in Norway and a period from 1816 to 1835, when every one was permitted to distil brandy. In some districts many of the farmers distilled brandy from corn and potatoes, and in such regions during this period feeble-mindedness increased nearly one hundred per cent. Later the home distillation of brandy was stopped. According to Doctor Mjoen, "The enormous increase in idiots came and went with the brandy." He is inclined to believe, however, that the alcohol operated injuriously mainly on stocks already defective.

=The Affinity of Alcohol for Germinal Tissue.--=Nicloux and Renault have shown that alcohol has a decided affinity for the reproductive glands. In individuals who have recently taken alcohol the proportion of alcohol in the gonads is soon almost equal to the amount found in the blood. Thus in experiments on mammals it was found that the proportion of alcohol in the ovary to that in the blood was as three to five, and in the testis as two to three. This would afford abundant opportunity for alcohol to act directly on the spermatozoon or the ovum.

A number of different investigators concur in finding that the germ-glands of the male human inebriate in many cases show more or less atrophy and other degenerative changes. In guinea-pigs which have been repeatedly intoxicated with alcohol, Stockard found that while he could detect no visible abnormality in the gonad, nevertheless their defective and weakened progeny showed that the germ-cells had been affected.

=Innate Degeneracy Versus the Effects of Alcohol.--=Many observations on human beings have been brought forward which at first sight seem to indicate that noticeable defects, particularly mental and nervous, occur with appalling frequency in children resulting from conception during intoxication, although, unfortunately, the evidence is rarely clear as to whether the defects are really due to the effects of the alcohol or to the fact that the parent or parents were degenerate to begin with.

A very interesting human case cited by Forel on the authority of Schweighofer is that of a normal woman who had three sound children when married to a normal man. After the death of this husband she married an inebriate by whom she had three other children. One of these suffered from infantilism, one turned out to be a drunkard, and the third became a social degenerate and drunkard. Moreover the first two contracted tuberculosis, although hitherto the family stock had been free from this malady. Ultimately the woman married again and by this third husband, who was normal, she again had sound children. Similar cases might be cited, as, for example, a record of eighty-three epileptics, of whom sixty had drunken parents, but it can be urged against all of them, of course, that the defective offspring were due to an innate degeneracy of the drunken parent which made him a drunkard rather than to the effects of the alcohol he took. While one is skeptical as to the validity of this objection in all of the many cases which occur with such monotonous frequency in man, there is no way of escaping such an interpretation with the evidence at hand. It must be admitted, moreover, that there are many families with one or both parents alcoholic in which the children are not mentally defective.

=Experimental Alcoholism in Lower Animals.--=Many of the objections that exist in the case of man, however, do not apply in that of lower animals.

If normal animals are experimentally alcoholized and are shown to produce defective offspring under such conditions, then in their cases at least, the disorders in the offspring must be due to the effects of alcohol and not to an innately degenerate condition of the parent. Disorders similar to some of those seen in the children of alcoholics do actually result in alcoholized animals of one kind or another.

Against the earlier experiments on animals it has been urged that too few individuals were used to give conclusive results, but this objection can not be brought against the recent experiments of Stockard. While he has published accounts of his work in various scientific periodicals lately, the reader will find a full statement of his own experiments, together with a review of the whole subject of experimental alcoholism in animals and the effects on progeny in _The American Naturalist_, Vol. XLVII, November, 1913, together with a useful bibliography.

Before taking up Stockard's results we may select a few of the more significant experiments made earlier by other investigators.

Laitinen alcoholized rabbits and guinea-pigs. He found that the treated individuals had more still-born young than the control, and also that growth of the living young was r.e.t.a.r.ded. His alcoholized rabbits and guinea-pigs produced more young than did the normal individuals used as a control. Laitinen's studies on man, together with three other studies of the Eugenics Laboratory in London, show that in man also more children are born to alcoholics than to normal parents. G.o.ddard's investigations in America corroborate this fact.

Ceni found that only 43 per cent. of the eggs from alcoholized fowls developed normally, as against 77 per cent. of normal development in the controls. Moreover the eggs of alcoholic fowls were shown to be less resistant to adverse conditions than normal eggs from the fact that fluctuations of temperature at the beginning of incubation kept all the alcoholic eggs from developing perfectly, while 27 per cent. of the control eggs developed normally under the same adverse circ.u.mstances.

Hodge made a pair of dogs alcoholic. Of 23 pups obtained from the pair, 8 were deformed and 9 were dead; 4 alone were viable. From a control pair of dogs 45 pups were obtained, of which 4 were deformed, none were born dead, and 41 were viable.

=Stockard's Experiments on Guinea-Pigs.--=Stockard's experiments demonstrate that the offspring of mammals may be injured or modified in their development by treating either parent repeatedly with alcohol. The guinea-pigs used in the experiment were all first tested by normal matings and found to yield normal offspring. The alcohol was given to them by inhalation. It was found to be readily taken into the animals' blood and to produce intoxication. While guinea-pigs alcoholized in this way as often as six times a week for two and one-half years would maintain their own bodily vigor and health apparently, the deleterious effects on their progeny were marked. The defects were general rather than specific, although the central nervous system and special sense organs were apparently affected most.

Out of 119 total young produced by the alcoholic animals, only 52, or less than 44 per cent., survived, whereas out of 64 young produced from normal parents used as a control for the experiment, 56, or over 87 per cent., survived. In some cases alcoholic males were mated with normal females, in other, alcoholic females with normal males. In still other instances both parents were alcoholic.

The results are summarized in the accompanying table (Fig. 31), taken from Stockard's paper:

CONDITION OF THE OFFSPRING FROM GUINEA-PIGS TREATED WITH ALCOHOL

----------------------------------------------------------------- Number of Matings +-------------------------------------- Negative Result or Early Abortion +--------------------------------- Stillborn Litters +---------------------------- Number Stillborn Young +--------------------- Living Litters +---------------- Young Dying Soon After Birth +--------- Condition of Surviving the Animals Young -------------------- ----- ---- ---- ------ ---- ------ --------- Alcoholic [male] by normal [female] 59 25 8 15 26 21 33 Normal [male] by alcoholic [female] 15 3 3 9 9 9 10 Alcoholic [male] by alcoholic [female] 29 15 3 6 11 7 9 SUMMARY 103 43 14 30 46 37 52 Normal [male] by normal [female] 35 2 1 4 32 4 56 2d generation by normal 3 0 0 0 3 0 4 2d generation by alcoholic 3 0 2 5 1 0 2 1 def. 2d generation by 2d generation 19 7 0 0 12 6 13 1 def. Female treated during pregnancy 4 0 0 0 4 1 7 -----------------------------------------------------------------

FIG. 31

Table showing condition of the offspring from guinea-pigs treated with alcohol (after Stockard).

Lines four and five give a comparison between the 103 total matings of all treated individuals and 35 normal matings. In the first case almost 42 per cent. of the matings gave negative results or early abortions, whereas in the normal control matings, failure to yield a full-term litter occurred in only two cases. The 103 matings of alcoholic animals gave only 46 living litters, or about 45 per cent. On the other hand the 35 control matings produced 32 living litters, or 91-1/2 per cent. It will be observed also that from such of the 103 matings of alcoholics as produced young there were 30 still-born, 37 which died soon after birth, and only 52 surviving young, whereas from the 35 matings of normal individuals there were only 4 still-born young, 4 which died soon after birth, and 56 surviving young.

The bottom line of the table, although, as Stockard points out, containing too few cases to prove wholly convincing, indicates that alcoholizing erstwhile normal females during pregnancy was not particularly harmful to the embryos _in utero_.

Some of the most interesting results were obtained when offspring termed second generation animals, derived from alcoholic parents though not themselves treated with alcohol, were mated in various ways. When such individuals were mated with normal individuals, although the litters were small, the results were normal, the normal mate having seemingly counteracted any defects which might have lurked in the second generation animal. On the other hand, out of three matings of second generation animals with alcoholic individuals, two produced still-born young, of which one was markedly deformed, while the third yielded two living young.

However, the most striking results were obtained when two second generation individuals, the offspring of alcoholic parents, were bred together. Although themselves untreated, these individuals, of which 19 matings were made, produced as many or more defective young than did their alcoholic parents. Seven of the matings were unfruitful. The remaining 12 matings gave living litters consisting of 19 individuals in all. Six of these showed various nerve disorders (spasms, epileptic-like seizures, etc.) soon after birth; one was eyeless and otherwise deformed.

=Stockard's Interpretation.--=Stockard's interpretation of his experiments is as follows: "Mammals treated with injurious substances, such as alcohol, ether, lead, etc., suffer from the treatments by having the tissues of their bodies injured. When the reproductive glands and germ-cells become injured in this way they give rise to offspring showing weak and degenerative conditions of a general nature, and every cell of these offspring having been derived from the injured egg or sperm-cell are necessarily similarly injured and can only give rise to other injured cells and thus the next generation of offspring are equally weak and injured and so on. The only hope for such a line of individuals is that it can be crossed by normal stock, in which case the vigor of the normal germ-cell in the combination may counteract, or at any rate reduce, the extent of injury in the body cells of the resulting animal."

He also believes that various deformities and developmental arrests such as harelip and cleft-palate may similarly be cases of transmission rather than true inheritance, due to the weakening of the germ-cells in some way, or to some lack of full vigor in the uterine environment.

=Further Remarks on the Situation in Man.--=Returning now to the question of alcoholism in man, it seems in view of the strong circ.u.mstantial evidence in the case of man himself, together with the result of experiments on animals, that little doubt remains that excessive alcoholism might result in the production of defective offspring. On the other hand an antecedent degeneracy or neural instability undoubtedly plays an important part in many cases, in the original production of drunkards, and when such occurs, it, as well as the direct effects of alcoholic poisoning, must be reckoned with in the effects on progeny.