PHYSICAL FACTORS IN RACE SURVIVAL 285 



For example the maternal mortality in New York City, as tabulated in 

 the accurate statistics of the Health Department, for the period of the 

 33 years from 1898 to 1930 inclusive, shows some very impressive figures. 

 As these statistics cover almost four million cases of child-birth, they may 

 be taken as indicative. The total maternal death-rate of child-birth grad- 

 ually rose from 4.77 per thousand in 1898 to 5.43 in 1930, an increase of 24 

 per cent. But this gross death-rate by no means betrays the full signifi- 

 cance of these figures. When we segregate the causes of death in these 

 statistics, we find that the death-rate from puerperal septicemia fell from 

 1.93 per thousand in 1898 to .92 in 1930, whereas the death-rate from other 

 causes gradually rose from 2.34 per thousand in 1898 to 4.51 in 1930. 

 Puerperal septicemia is an intercurrent infection of child-birth which is 

 capable of being diminished in its incidence by medical precaution, and of 

 amelioration by medical treatment. But the causes of death in child-birth, 

 other than puerperal septicemia, are mainly due to some abnormal occur- 

 rence in labour or to some constitutional weakness. The fall in the death- 

 rate from puerperal septicemia in this period may be fairly taken as the 

 result of an increase in medical skill and care. But increased medical skill 

 and care were unable to prevent the deaths from these other causes from 

 rising from 2.84 to 4.51 per thousand, an increase in maternal mortality in 

 thirty-one years of over 58 per cent. These are startling figures, but they 

 can not be gainsaid. Even making every possible allowance for fortuity, 

 they can only indicate a marked decrease in the physical ability of this 

 large urban group of women to bear offspring successfully. 



These facts are all the more arresting when we consider that medical 

 science has been able to bring about a marked diminution in infant mor- 

 tality, and most diseases, leading to the general prolongation of the average 

 life. We are compelled to draw the inference that our civilization has pro- 

 duced living conditions of women which tend to make human reproduction 

 more perilous, conditions over which not only eugenists but all humanists 

 need feel deeply concerned, and which call for thorough investigation. 



A somewhat less alarming, but equally significant fact is to be discovered 

 in the increased percentage of mothers in the United States who are unable 

 to suckle their infants. This increase seems to be general, but rises with 

 the cultural scale. Allowing for the modern tendency toward the artificial 

 feeding of infants, there is still an undoubted actual increase in this physical 

 disability of women. In some reports this inability to suckle their infants 

 runs as high as 75 per cent of mothers. Some observers have found this 

 lacteal deficiency to recur in the daughters of mothers who were so deficient. 

 If such a hereditary transmission should apply to any considerable proportion 



