Progressive Medicine and Social Hygiene
Progressive reformers and social critics identified a myriad of ills surrounding the dramatic alterations in American life during the late nineteenth and early twentieth century. Few problems evoked more fear than the perceived "crisis of the family." During the Victorian years the middle-class family had become, preeminently, an institution devoted to child-rearing and the maintenance of the home. No longer fulfilling the basic economic functions of earlier periods, the home had become a private place, given over to motherhood, childhood, and domesticity. 1 Acute observers at the turn of the century saw trends within the family itself that threatened this ideal. Medical doctors in particular came to share these concerns when it became accepted that venereal disease constituted a special danger to the family.
The growing tendency toward later marriages and smaller families and the precipitous rise in the number of divorces foretold the demise of the middle- class family, the bulwark of American society, in the minds of Progressive social critics. The depressed economic conditions of the late nineteenth century led members of the middle class to postpone marriage in order to support their families in their accustomed manner. Family size was often limited to maintain this standard of living; by 1900 the average American family had only 3.56 children, down from 6.14 in 1840. 2In addition, the heightened emotional demands placed upon the family caused more marriages to end in the courts. In the years between 1870 and 1920 the divorce rate increased by a factor of fifteen. 3 Moreover, a growing number of women, particularly the best educated, passed up domestic life altogether to pursue careers.
Critics charged that the American family, in a flight of selfishness, was failing in its primary responsibility, the "reproduction of the race." When social scientists reported that couples of Anglo-Saxon descent were falling behind their immigrant counterparts in producing children, Theodore Roosevelt raised the pitch of concern by proclaiming that the great white middle class was committing "race suicide," borrowing the phrase from the noted sociologist E.A. Ross. Roosevelt argued that men and women were "shirking" their most important