39°Section IV.A. Bluhm.
In mixed births, in which the father is very big in comparison to the
mother, troubles in labour are of common occurrence, even among primitive
peoples (for example: father, Aleutian; mother, Kamschadale).
But such mixed births are much less frequent among them than among
civilized races, who through their constant intercourse with each other
become closely connected. In these, again, we cannot properly speak of
degeneration. Nevertheless, there remain among civilized races a very considerable
number of cases in which a pathological course of delivery, in the true
meaning of the phrase, comes into the question.
The question now is : how far this lessened ability to bear can be
individually acquired, and how far it depends upon inherited predisposition.
How far, consequently, medical assistance in confinements assists in its
further transmission.
For when through the skill of the obstetrician a mother with a much
contracted pelvis brings a living child into the world, while without this skill
she would have been delivered of a dead child, then, presuming that deformi
ties of the pelvis are transmissible, the obstetrician contributes towards the
spread of the contracted pelvis.
We can to the foregoing question, as to all similar questions, at present
give no answer borne out by figures; we feel justified in saying, however,
that the defective power of bringing forth children is at least as often in
herited as acquired. The power of bearing depends essentially upon two
forces, namely, the power of expulsion and the resistance opposed to it—or
expressed anatomically on the condition of the muscles of the uterus and
abdomen on the one hand and that of the bony pelvis and of the perineum
on the other. Both factors can be influenced unfavourably through an
unsuitable mode of life, above all, through insufficient exercise and through
too much sitting or standing.
The uterus belongs, it is true, to the so-called “ involuntary muscles,”
which cannot be knowingly used like the “ voluntary muscles ” (arm, leg,
back muscles, etc.). The exercise of the latter is, however, not without influ
ence on the former, and the condition of the voluntary muscles depends to a
great degree upon the circulation of the blood, which, for its part, depends
again upon the movement of the body.
It is in accordance with this that the aristocratic Chinese women, who,
in consequence of their “ foot-crippling, ” are doomed to almost constant
sitting, as well as those women of Malay and Java, who lead sedentary lives
by preference, mostly have difficult confinements. Kottnitz, who studied
the conditions of health of the industrial women-workers of Saxony, saw the
so-called “ flat pelvis ” most frequently among women who had had no
rickets as children, but had entered weaving mills at fourteen years of age,
where they had been obliged to stand continuously.
