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All such neglect of duty is a coming short of the highest ideal of philanthropy, no less than of religion. While physicians may sometimes be justified in chloroforming a monstrous birth, and while, far off, philosophers think they see the coming of a day when we may have legal suicides, and when we can take human life because we are pitiful, and not because we are selfish, (21) yet for the present it must be held that science justifies and philanthropy corroborates Christianity in holding that each spark of human life must be conserved in all tenderness and with all care. (22)

(22) On the powerful and pervasive influence of the altruism born of Christianity upon social and industrial development, see Kidd, "Social Evolution."

Eventually this policy compels us to search for causes of degeneration and suffering. Could we cheaply rid ourselves of incapables and close our hearts to the appeal of distress, we might never have the compulsion put upon us of seeking out the wiser plans, which may eventually give us a more uniformly healthy race. Extermination might be an easy cure for pauperism, but it would be a costly remedy biologically; and if we allow our instincts to compel us to forego the use of it, we may ultimately be driven to preventive measures. As we shall see in the subsequent chapters, in proportion as the burden of the dependent has increased and the standard of care risen, the search has spread from symptoms to causes, from causes to conditions of poverty, and culminated in a concerted demand for prevention rather than relief.

The influence of charity in diminishing the death-rate has probably had much to do with the increase in the proportion of insane and feeble-minded persons to the total population. The mere lengthening of the lives of lunatics by better care greatly increases their absolute and relative numbers. Badly administered charities, however, may have exactly the opposite result. An unclean hospital may result in the death of an undue number of the sick brought to it. In one maternity hospital the death-rate rose as high as two women for each five confinements. Previous to and during the sixties, European experience in maternity hospitals gave a mortality rate of about one death to twenty-nine confinements; in some large hospitals it was as high as one in seven. It is only recently that hospital service has become better than home service in this branch of medical practice. Undoubtedly the actual result of many foundling hospitals is to kill more infants than would meet death did such hospitals not exist -- the death-rate is fearfully high; sometimes ninety-seven per cent of the children fail to reach the age of three years. Many who support charities designed to save infant life might conclude, if they studied all the facts, that they were contributing to its destruction.

The influence of charity upon the birth-rate is much more obscure. Long before natural selection was discussed under that name, Chalmers called attention to the fact that the relief of the poor from public funds resulted in taking money from the thrifty and giving it to the thriftless. Under the unreformed English poor-law the additional allowance per child was so large as to make it pecuniarily profitable to have large families. As the allowance for illegitimate children was somewhat larger than for those born in wed-lock, a premium was put upon illegitimacy. The demonstration was then complete, that a population might be degraded by the charity-induced propagation of the unfit, and that the influence of charity upon the birth-rate is a factor to be reckoned with. A system of charity which might be admissible, could it be applied to an existing generation alone, is wholly inadmissible if it multiplies the number of dependents in succeeding generations. Both Mr. Dugdale and Mr. McCulloch found that the pauper families they investigated got permission to live from the lavish giving of public outdoor relief, supplemented by indiscriminate giving on the part of individuals.

In the worst-managed almshouses there is sometimes not adequate means of separating the sexes, and the breeding of paupers goes on upon the premises. Formal marriages between almshouse paupers have very frequently received the sanction of both church and state. A much commoner abuse, as we shall find when we come to study these institutions, -- one, in fact, from which few American almshouses are free, -- is the facility with which the dissolute and diseased can go there until sufficiently recuper-ated to be able to have children and then discharge themselves. The doors of the hospitals and almshouses swing freely both ways, and the result is a succession of children, especially from half-witted women. These persons would have been able to have no children or few if left entirely without help, and would have been allowed to have none at all had they been properly taken care of. It is coming to be seen that the feeble-minded (a much larger class than many suppose) must have custodial care through life.