Sunlit Exercise and Motherhood
HERE is Baby Week again ; and a delightful discovery which bears directly and happily upon the prevention of maternal mortality, one of the most tragic facts of modern civilization, and notably so in our own country.
In Mfin, Dr. T. A. Palm, a returned medical missionary, showed by geographical comparison that rickets is what, a decade ago, J called a " disease of darkness." But it was not until an American bibliographer in 1920, directed my rrltcntion to the work of Dr. Palm, during a visit to the laboratories where the action of sunlight was being studied in Columbia University by Dr. A. F. Hess, that we learnt how signal a discovery had been made, a generation earlier--to be ignored by everyone concerned. A whole generation had been lost, and meanwhile rickets abounded. A recent enquiry by the Ministry of Health has shown that more than 50 per cent. of our children, at three years of age, suffer from well-defined rickets. Well and ill may (his be known on the Continent as " the English disease."
Despite Dr. Palm's discovery—and he was the true pioneer, Great Britain bears the Palm, and not Dr. Iluldschinsky of Berlin in 1920—we have neglected the disease, both in its cause and its consequences. We recognize it only when we see gross knock knees or bow legs or pigeon chests ; and we neglect those early months and years when the disease begins and could so easily be arrested. Above all, we have neglected what, in view of recent remarkable work by Dr. Kathleen Vaughan, may he indeed by far the most important consequence of rickets.
Even in the brief and notoriously inadequate teaching of obstetrics to medical students, time has long been found to point to the deformity known as a flat or rickety pelvis ; and if the " examinee " can identify such a pelvis in his tied rocc and note that it is misshapen, being flattened from before backwards, and correspondingly widened from side to side, he is likely to get his pass.
But Dr. Vaughan has, at long last, raised this perfunc- torily taught and quickly forgotten matter to its proper level as a national and racial question of life and death. This is not the place in which to discuss at length her paper, recently read to the Royal Society of Medicine. The reader will find a simple and cogent statement, from her own pens, with a tragic and unforgettable illus- tration of a high-class Indian mother in purdah, in Sunlight for July 1928.* The simplest way of teaching what is really a very simple fact is to do as she did at the recent Annual Meeting of the Sunlight League at the Duke of Sutherland's house, where, having visited a toyshop on her way, she showed an india-rubber ring and an india-rubber ball which just nicely went through it—until the ring Was ffattcitom by pressure, and then the ball could be got through only with much pressure, and some temporary deformation. (How many feeble-minded are now in costly and hopeless institutions because their heads were thus deformed at birth ?)
• A few copies still obtainable from the Sunlight League, 29 Gordon Square, 1V.C., nrieo
For the healthy development of our bodies, and notably of our bones—and teeth, but that is another and a very poignant story—we need Vitamin D, the magic chisel, as I have called it here, of the sculptor sun ; and exercise of the growing bones (including jaw bones and teeth). Hence the appalling rickets and maternal and infant mortality, far worse than anything we see here, in high-caste Indian homes, whither the light of life may never penetrate. The little girls suffer, and when they become mothers their boy babies suffer most, having somewhat bigger heads than girls. Surely the time must be at hand when leading Indians, in the interest of their finest stocks, take up this matter.
But our concern here is our own race. After com- paring the pelves of stay-at-home urban women and country women, of idle women and active out-of-door women, as found in the world-famous Museum of the Royal College of Surgeons, Dr. Vaughan concludes that a leading cause of the deaths of mothers and new-born babies in our country is slight rickety deformity of the pelvis, not observed as we all observe that extremely common, slight, rickety curvature of the shin bone, which not the costliest silk stockings can conceal, on the courts at Wimbledon and elsewhere—but a deformity of awful importance—a matter of life or death, sanity or imbecility, for this generation and the next.
The right exercise in true sunlight is the remedy : no, not the remedy, but the course for creative hygiene and practical eugenics. I asked my friend Sir Arthur Keith, F.R.S., the great student of mankind, by whose permission and with whose help Dr. Vaughan made her observations in the Museum of which he is the Curator, what would be the best exercise for the young girlhood of our land, in view of her conclusions, and his answer was " Skipping in the sunshine." It were to gild refined gold to add comment on this latest, jolliest, wisest word of true obstetrics and eugenics and Humanism. The Dark Ages have lasted long enough ; now is the Dawn
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