imbecility in infants in whom (neither alcoholism nor syphilis being present) the occupation of one parent as lead worker must have determined the imperfect nervous system of the child.”

In France, in hospitals for nervous cases, it has been found that slowly induced lead poisoning of one or both parents causes convulsions, imbecility and idiocy in children that survive the first year. We are all familiar with the effects of alcohol, but to see the curse in its fullness one should go to London, where the women drink openly and a drunken woman is not an unusual spectacle.

A father whose system is saturated with alcohol cannot beget healthy children, but inebriate mothers are more dangerous to the race. Abortions, degenerate children, elipeptics and criminals are the product. It is true that alcoholism is often a symptom of degeneracy, but the children then inherit a double

curse.

The English are beginning to see a national peril in alcohol and we, too, should realize that drinking among our women is steadily increasing. Whatever special interests or privileged classes uphold the traffic, it is our duty to agitate against this evil, to advance any plan that may prevent parenthood of inebriates and protect our boys and girls, future parents, from the curse. Huntington's chorea is a form leading to dementia and death. Davenport has charted five generations of one family, father affected, mother normal. In the second generation there were four children, all affected. The marriage of one daughter with a normal man resulted in four normal and three defective children. Of this third generation two were suicides. In the fourth generation one affected child again with a normal mate, all children were affected, with seven deaths. In the fifth generation again one affected child with a normal mate, eight deaths from chorea and other nervous diseases have occurred. Some children are still living.

In records of insanity the hereditary taint is easily traced. There are 300,000 insane and feeble-minded in the United States. There is no case on record where two imbecile parents have produced a normal child.

These congenital defects are both mental and physical. Any deviation from the normal, however slight, menaces the descendants of that individual. It is a great misfortune that a man should be born deaf, epileptic or feeble-minded, but it is a greater misfortune if he be allowed to transmit his defects. Immorality plays a great part, both as a cause and a result of

degeneracy. Pauperism, crime, prostitution, with its complement of illegitimate, neglected children, form a picture most distressing and hopeless.

Referring, now, to diseases of inherited predisposition, tuberculosis stands first, and education of the masses upon proper environment as the cure has already produced good results. The wonderful work of the anti-tuberculosis campaign points the way for the attack upon these other, even greater perils, as so many of them threaten our moral and spiritual welfare. The three important factors in the fight against these. evils are investigation, education and legislation.

Davenport, secretary of committee on eugenics, read an interesting report at the American Breeders' Association at Omaha December 8, 1909. Committees were appointed as follows: Upon feeble-mindedness, Dr. F. A. Rogers, superintendent of Minnesota School for Feeble-Mindedness and Colony of Epileptics; upon insanity, Dr. Adolph Meyer of Johns Hopkins. Other committees are contemplated to study the protoplasmic basis of eye defects. and predisposition toward certain diseases.

Every practitioner can aid this work by observing and charting peculiar family traits that come under his observation, and whenever possible he should make a post-mortem of the still-born child. The pathology of the foetus is little known and such investigations, gross and microscopical, will build up a new branch of foetal pathology.

Thus we may help investigation and it rests largely with us to educate the laity.

Tuberculous girls should be warned of the danger to themselves and possible offspring in marriage. In tubercular laryngitis especially pregnancy causes an alarming hastening of the disease and the mother may die of dyspnoea. A great effort. should be made to prevent the marriage of epileptics.

Education can only develop our inherent powers and therefore cannot achieve an ideal race. The child does not begin where the parent left off.

We must first educate our boys and girls that they may use intelligent care in selecting their mates. Then we shall have better inherent material to work upon. By careful selection and proper environment any breed may be improved.

The helpless baby, though he be a potential poet or musician, can never realize his powers unless he has proper aids to development. Here motherhood reigns supreme.

The importance of the functions of motherhood have long been recognized, but the right of selection, of adequate protection and education for motherhood are still to be realized.

Love is the first essential. No child should ever be born without love. The desire for motherhood is inherent in girls, as the doll play well attests, and it is a comparatively easy matter to educate the young girl to consider her body and its functions as holy and to look forward to marriage as a means to maternity. Educate her along eugenic lines and then there will be fewer hasty marriages, fewer divorces and a reduction in criminal abortions. The boy is not so easily reached, but he can be taught the glory of his manhood and awakened to a high conception of fatherhood. The holy rite of marriage will be understood and will result in a real home, the necessary factor for children and for society. Not long ago a group of girls were discussing the approaching marriage of one of their number. The trousseau, the church ceremony, the bridesmaids' hats and gowns had all received due attention, when one of them exclaimed enviously, "Oh, it must be such fun to get married.” Not a single thought of the sacred beginning of a new family. I would not take away any of the sweetness of the young girl's dream, but I would that we might add a saving knowledge of what it all means and protect her from sorrow and possible bitter disappointment when it is too late.

Not until education is well begun can we consider legislation. Public opinion must enforce any laws that may be enacted. When the time is ripe we will segregate and protect the feeble-minded, caring for them, making them happy, but preventing reproduction.

We will prevent the marriage of diseased men and women, cutting off the supply of the feeble-minded. We will put a stop to the reproduction of criminals, both by segregation and sterilization. These things may seem visionary, but only by the most stringent methods shall we save the babies already born, prevent the reproduction of degenerates and lead our race to a higher plane.

DISCUSSION.

Dr. Edmunds, Nebraska City, Neb.

This paper is very thorough and all are glad that it was brought before us, and yet there is another topic that could be brought under this heading. That is the subject of marriage. Within the past two years I have been following up to some extent this subject and I find that in cases where blood relatives have married there is always some defect in the child; they are either Albinoes or the child is suffering from polyuria, incontenance of

urine, etc. As far back as I can go the parents seem perfectly healthy on either side and yet there is a defect of some kind creeping out in children whose parents are so related. I think that we should take some steps in the prevention of the marrying of blood relations.

Dr. Strong, Omaha, Neb.

On this subject I have had considerable experience for nearly thirteen years and I think I know something about it. A law preventing the marrying of degenerates is not enough. I have had one woman patient who is a degenerate and who evidently was born a degenerate and she has had six illegal children and she came from over in Iowa. I think they just passed a pretty good law in Iowa on this very thing, and I think the law ought to be enforced in every such case with every man and woman. It is wicked for such people to be allowed to propagate as they will in the world. Dr. Holmes said that when you want to have a good child you should begin with the great grandfather. This subject of the degenerate is something we have got to consider because this kind of people will breed bastards and degenerates. The people that ought to have children are not the ones that are having children; it is the degenerates, and this country will be full of degenerates unless something is done very soon.

I know about things that I hate to tell. I have had sixteen or seventeen children under 15 years of age under my care, one that was barely 14 years old, and who has had a child, and I think that if it is constitutional a law should be passed that would put a stop to such things by operation on the male offender.

Dr. Munroe, Omaha, Neb.

I want to express my appreciation of this paper by Dr. Mack. The subject is such a broad one that to even attempt to discuss it would be impossible. The idea that the child comes into the world with inherent weakness we know is true. I think the doctor has failed to sufficiently emphasize the importance of the acquired traits and characteristics which the individual obtains after he is born through his environments. We are all born with such hereditary characteristics, but the scientific mind has begun to teach the child and the people to use their minds in the way that will do the most good and to show them wherein their weakness lies. I think the doctor failed to place sufficient emphasis upon the acquired characteristics and the influence of their environment upon such cases. We must take our patient as he is and help him to make the best use of what he has. Dr. A. E. Mack, closing:

I can best answer Dr. Edmund's question by referring to part of my paper. Germ cells are units, both dominant and recessive. No one knows through how many generations a cell may be dominant or recessive. Sooner or later in consanguineous marriages there will be abnormal offspring and especially is this true if there be any abnormality, however slight, in either cousin.

Acquired traits are not transmitted. It is only the inherent characteristics that are transmitted. Eugenics should be taught in the high schools and made a special sudy in the medical schools and when this study of eugenics becomes a more understood subject all people will be more charitable to one another.

Those who believe that the English have no sense of humor will try to prove it by this, from the London Globe: "Bill," said the invalid's friend, "I've come to cheer yer up a bit like. I've brought yer a few flahrs, Bill. I fought if I was too late they'd come in 'andy for a wreaf, yer know. Don't get down 'earted, Bill. Lummy, don't you look gashly! But there, keep up yer spirits, 'ole sport; I've come to see yer and cheer yer up a bit. Nice little room yer 'ave 'ere; but as I sez to meself a-comin' up, wot a orkard staircase to get a coffin dahn."

Subparietal Injuries of the Kidneys.

*By B. B. DAVIS, M. D., Omaha, Neb.

The essential cause of injury to the kidney is a blow over the lower arch of the ribs, over the abdomen or the loin. Rarely the injury is a penetrating wound of the kidney made by a broken rib. In most instances the trauma is produced by the kidney being crushed between the impinging body or arch of the ribs and the fixed spinal column. Kuster has shown that a frequent cause of rupture is the hydraulic pressure acting through the full vessels and pelvis, causing the kidney to burst, just as a cask will burst when it falls from a height.

There are some contributing factors that bring about serious injuries where the same blow under more favorable conditions would have been practically harmless. First among these contributing causes are pathologic kidneys and displaced kidneys. In its normal position the kidney is guarded well by the spinal column, the ribs and the heavy muscles of the loin. When prolapsed it is easy for it to be caught between the impinging body and the spinal column. A soft, friable kidney or one that is cystic or the subject of hydronephrosis would naturally suecumb to a lighter blow than a normal organ.

Weak musculature is also a predisposing factor. A force exerted over a weak, flabby muscle will produce much more displacement than the same blow over a strong muscle with good tone. The same blow is more apt to do damage when the recipient is unprepared than when the muscles are made tense to resist the blow.

The blow may be received in such a manner as to catch the kidney directly between the bony wall and the direction of the force, or it may be received obliquely in such a manner that the kidney is rolled between the body of impact and the spinal column.

Kuster collected a series of 306 cases of kidney trauma; 93.98 per cent were in males and only 6.02 per cent in females. This great disparity between the sexes is not easy to explain. Anatomical differences may be in part the cause and the corsets usually worn by women may act as a protection. But the greater exposure of men and boys to violent accidents is doubtless the chief reason that their kidneys are so much more frequently injured.

The symptom complex of a kidney injury is usually fairly

*Read before the Nebraska State Medical Association, Omaha, May 2, 3 and 4, 1911.