




‘Ss 
Both these views the lecturer regarded as based chiefly on 
insufficient data. The birth-rate was not governed at present 
chiefly by postponement of marriage, neither were there grounds 
for saying that the birth-rate of the better type of workman had 
relatively decreased. Both writers seemed to ignore the fact that 
infantile mortality was commonly twice as high amongst the 
so-called ‘‘inefficients ’’ as amongst those other grades of society 
with fewer children. ‘There was no sufficient ground for thinking 
that in these respects the nation was worse than formerly, though 
there was ample scope for the adoption of practical means to 
secure improvement. Mr. Balfour’s statement justified the 
inference that some kind of inferiority (of what nature he did not 
specify) was necessarily transmitted, but modern scientists 
inclined to the view that innate inferiority was the only form 
permanently transmissible, and so far from any innate inferiority 
being prevalent among the wage-earning classes, the lecturer 
stated that most medical men held that, given equally good 
education and physical conditions, there need be no fear of 
“deterioration ” were the wage-earning to take the place of other 
classes. These two distinguished men, instead of taking a 
conspective view of the classes of whom they were speaking, had 
applied a microscope to relatively small and abnorial groups of 
society, and generalising therefrom. 
The lecturer thought that a sound view of public health 
policy lay in wider considerations than were involved in the 
passages above quoted. It was an economical fact that the 
average fit man contributed more to the aggregate resources of 
the community than he dissipated in his own person. Many men 
of less than average fitness also contributed a surplus, but at what 
degree of unfitness equilibrium occurred was impossible to say, 
_ but it could be taken as certain that the average man of to-day 
was a valuable economical asset, and that probably only a very 
small minority were incapable of becoming so under proper 
conditions. In practice it was impossible to prescribe public 
health measures which should operate only in favour of the fit. 
When the efficient cause of disease arrived, it attacked both 
classes in the same manner, and any circumstance which lowered 
the resistance of a fit man increased the chance of an efficient 
cause of disease catching him in a susceptible condition—each 
successful attack left the victim less capable of resistance to 
further attack. The omission of measures to improve the 
resistance to disease, e.g., general sanitation, abatement of over- 
crowding, &c.,—and of measures to prevent access of infection 
and other causes of disease tended, therefore, not only to eliminate 
the cbronically unfit, but to increase the number of transfers from 
_ the class of fit, or occasionally unfit, to that of chronically unfit, 
and therefore the chance of death of an attacked individual. 
Obviously the very strongest evidence of benefit would be required 
