Full text: Problems in eugenics

A. Bluhm.Medicine and Eugenics.391 
This upholds the idea that the bony pelvis can also be influenced by the 
manner of life. 
On the other hand, it is undoubtedly true that the bones of the pelvis, 
as well as the “ muscular bearing apparatus ” (like the whole muscular 
system), are under the influence of heredity. 
We know whole districts in Germany in which, owing to the want of 
muscular suppleness, forceps must be used. 
Seitz values the annual loss of child life which Germany suffers through 
“ primary difficulties ” of this kind as 16,000—25% of the total number of 
stillbirths. Since Obstetrics can overcome just these difficulties most easily 
these figures show how widespread they are in Germany (and presumably in 
other lands). The frequency of the contracted pelvis in Germany is 
reckoned as 14—20% of all mothers; the contractions of the pelvis which 
are sufficient to bring about important difficulties in delivery are estimated 
by Sonntag as 3—5%. Since the material which supplies these figures 
comes from “ Lying-in Institutions ” and “ Cliniques,” and represents an 
unfavourable selection from the population, they should be somewhat reduced 
for the whole nation. 
Nevertheless, they remain high enough. That the so-called “ generally 
contracted pelvis ” depends upon inheritance is proved beyond doubt. For 
this “ infantile, ” inheritance is doubtless also responsible. 
Both together account, according to Ahlfeld, in the neighbourhood of 
Marburg, in Germany, for more than one-third of the total deformities of 
the pelvis. 
A further 55 to 60% of the latter depend upon rickets. 
Since we, to-day, hold the belief, which is supported by an array of 
facts capable of proof, that the disposition to rickets is transmitted, we 
may say that in at least 90% of the hindrances to birth, brought about 
through the pelvis, heredity plays a part. 
Hence we see to what a great extent short-sighted Obstetrics, which, in 
all cases, considers as its duty the indiscriminate preservation not only of 
the maternal but also of the infant life, may contribute to the increasing 
degeneration of the power to bear children. 
Like every branch of surgery, Obstetrics has gained an enormous impetus 
through antisepsis, discovered by your famous countryman, Lord Lister. 
I have sought to find out from Badensian statistics whether, since this, a 
diminution of the ability to bring forth is noticeable. 
That the number of operations has increased from 4.38% of births in 
the years 1871 to 1879 to 8.12% in the years 1900 to 1907 would be in itself 
no proof of this, for the number of operations depends to a great extent on 
the number of medical men, and this has considerably increased in the period 
concerned. The growth of special operations gives a better proof. When 
there is a great disproportion between the pelvis of the mother and the skull 
of the child, in order to avoid perforation or embryotomy (dismemberment
	        

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