The Improvement of Offspring
Dr. Philip A. Ashkar

A country's wealth is its people, and its worth lies in their numbers, their state of health, and their capacity for mental and practical production. Growth in population is measured by the excess of the annual birth rate over the death rate — provided that deaths fall mostly among the old and least among children; and the rate of deaths among children is the index of a country's advancement, government and people alike.

The child has no say in the matter of his health, nor in the matter of deaths in the first years of his life; that depends on the health of his parents, on what he inherits from it, and on the healthy surroundings which they, and which society, prepare for him so that he may grow up sound, well, and vigorous. Society, through the laws it enacts, is alone responsible for the choice of the child's parents. Before they proceed to marry, they must be sound and free of the diseases that may be a cause of the child's death in his first years, or a cause of some mental or bodily infirmity that would make him a burden upon his surroundings or a danger to them. In the hope of averting this danger, the custom has arisen for the applicant for marriage to present a health certificate to the responsible authorities. But this law, in its present form, is a general one and binds the physician to nothing; so every physician has come to exercise a judgment of his own. Some believe that the presence of vene

real diseases is sufficient ground to prevent marriage; some think that the chronic diseases — diseases of the heart, the lungs, the kidneys, and the circulatory system, which may bear down harder on the sufferer after marriage — are an essential ground for preventing marriage; and so on through the range of opinions. Would that a committee were formed of those whom the matter concerns — from the Ministry of Health, from the spiritual authorities, and from specialists in the science of eugenics — to study the diseases and the mental conditions that have their effect on the health and soundness of offspring, and that the results of their researches and their decisions were placed in the hands of physicians, to guide them whenever an applicant comes to them for a health certificate for the purpose of marriage.

This is the first aspect of the improvement of offspring; it is still a general theory in its earliest days, and years may pass before society profits from scientific progress in the two branches of heredity and sociology.

The second aspect is the care of the pregnant woman throughout the days of her pregnancy, at delivery, and throughout the period of nursing. And though talk on this subject has become commonplace, the matter has not yet reached the level that befits it: it is still confined to one particular class of the people, and some of the health centers set up for the purpose lack a

great deal in the way of modern examinations.

Every institution that takes upon itself the care of the pregnant woman must be equipped with a laboratory for biological examination and for X-ray photography; the work must be carried on by a physician, a nurse, and a clerk to keep the records; and it must have connection with a hospital where the woman will find all she needs should she fall ill during pregnancy or should her delivery prove difficult. The record clerk enters in a special register, for every woman, her health history: what her diet was as a child and in what year of her life she walked; what her family's material condition is; if she has been pregnant before, how that pregnancy ended and how her previous deliveries went; whether she was stricken with puerperal fever; whether she nursed her child, or suffered an inflammation of the breasts. Then comes the physician's turn to perform his professional duty toward her, letting nothing great or small pass without the attention it deserves: he treats when treatment is called for, and supplies the woman with what she must know about her food, her work, her dress, the care of her teeth, and the rest of the elementary directions that everyone knows. Of late, however, calcium preparations and vitamins have multiplied in the hands of physicians, thanks to the publicity carried on by the commercial houses, and the pregnant woman has received a large share of these substances.

A country like Lebanon — with its temperate air, the warmth of its sun, the abundance of its food

stuffs, and the spaciousness of its houses, into the humblest of which air and sun find their way — has no problems of nutrition; natural foods contain all the substances the body needs.

The pregnant woman needs protein and iron, which are found in meat, egg yolk, brown bread, cereals, and vegetables; she needs iodine, which is found in fish; calcium is plentiful in milk, which also contains vitamin D and phosphorus.

If a woman's diet were of milk, eggs, meat, fish, vegetables, and fruit — and all of these are abundant among us — she could do without all the tonics that are given by injection into the vein or under the skin.

In the wake of the first world war, woman went down into the field of labor, and in the course of this war her footing there was made firm; her ability to do the work that men do is a settled matter. But her entry into the field of labor has not kept her from marriage and pregnancy. The question today is: shall the pregnant working woman be permitted to continue at her work? The answer is no, from both the health and the economic standpoints, for the pregnant woman needs rest. True, the pregnant woman works in her house and in her field; but that work is according to her own will — she works as much as she is able, and at the hour she chooses. The hired working woman, however, owes a duty to the employer, and he may show no mercy.

He may consent to keep her on, because the wage he pays her is less than what he pays a man; were wages equal, the competition between the

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