RETROSPECT AND PROSPECT 367 
children. Dr. A. Bluhm states that in the Grand Duchy of 
Baden “since 1871 to 1879 artificial premature births have 
increased eight-fold, perforation three-fold, and embryotomy 
has doubled; moreover the number of Cesarian sections, which 
are generally intended to avoid perforation and embryotomy, 
have increased nine-fold.” This is not due, according to Dr. 
Bluhm, to an increased tendency to perform operations. “ Arti- 
ficial premature birth, on the one hand and perforation and embry- 
otomy on the other are two species of operations, one precluding 
the other. If the number of premature births increases, the 
numbers of perforation and embryotomy should fall. If both 
rise this points of necessity to an increase in the inability to bear.” 
The ease with which the women of primitive races bear children 
has often been remarked upon. It is not improbable that the 
matter has usually been exaggerated.1 The after effects of this 
facile child bearing have not often been followed up to determine 
how it affects the future health of the mother. Child-bearing is 
easier among women who are used to a moderate amount of 
physical labor. Undoubtedly the life of modern women, espe- 
cially those of the more well-to-do classes, is not favorable to easy 
child bearing. The form of the pelvis is unfavorably influenced 
by a sedentary life. The employment of large numbers of young 
women in sedentary occupations such as stenography, office work, 
etc., cannot fail to multiply the troubles of childbirth. It is 
difficult to estimate, however, the extent to which environment is 
responsible for the present difficulties of parturition. The form 
of the pelvis is a transmissible characteristic. The frequency of 
narrow pelvis has been found by Rése to vary considerably in 
different parts of Germany; those regions in which this defect is 
common are found to have the largest number of children who 
were artificially fed. This investigator also found that breast- 
fed children were superior in later life to those artificially fed, in 
weight, character of teeth, intelligence and general physical 
development. 
If difficulty of bearing children depends upon a hereditary 
1 See Ploss-Bartels, Das Weib, 8th ed. 1905. 
