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Yes, our descendants may well be proud. In the end, real progress in this history, in this quest to battle disease and human suffering, will be found in our descendants, Dr. Bell believed. This was why he had to sterilize Carrie, and this was why he was dedicated to the care of epileptics and feebleminded. To those not familiar with the recent discoveries of "genetics"—a new term in science—Carrie might have seemed a normal girl, if sassy and simple and even a little slow. But Dr. Bell knew she carried within her, like the taint of original sin, the defective "germ-plasm" she would pass on to her children. A defect in her genes made her unusually promiscuous, unable to control herself, and prone to bear a child out of wedlock without shame. It kept her—and her mother Emma before her—from being a productive, law-abiding citizen. And he could say with all confidence, too, that Carrie's illegitimate daughter Vivian, not quite three years old, would follow the same wanton path.

Yes, our descendants may well be proud. Science was revealing the subtleties of nature, the mysterious, microscopic forces that somehow passed on human traits, the genes that kept generations of families mired in poverty, ignorance, and the cesspool of immoral behavior. These families were a breed afflicted by this low-grade mental deficiency called "feeble-mindedness," the primary cause, Dr. Bell and other reformers believed, of the social ills weakening the fabric of the nation. These people weren't insane, exactly. They were not "idiots" or "imbeciles"—terms doctors had long used for people with more noticeable mental defects. No, they were simply a population who behaved like perpetual adolescents—mental dullards without developed moral consciences. To the untrained layperson, someone afflicted with feeblemindedness might even appear normal. So scientists had just devised a new term for these unmasked defectives: "morons." These people engaged in the unhealthy and antisocial practice of masturbation, which led to sexual impurity and hosts of illegitimate children. These frequented saloons and whorehouses, filled state almshouses and prisons, and worst of all, passed their feebleminded genes to their children.

Biologically speaking, science was revealing perhaps the greatest menace to the future of the human race: fecund, feebleminded females.

This surreptitious menace arose from a strange irony in evolution, Dr. Bell believed. Mankind, the most intelligent and ingenious of creatures, had reached its lofty status through millions of years of toil and struggle. The law of the survival of the fittest had always weeded out the weak and foolish, allowing the best of the race to keep evolving to a higher state. But as this clever species made life less nasty and brutish, as it began to protect the weak of mind and frail of body, the genetic pool began to be polluted. Christian charity and enlightened altruism—and even advances in medical science—had disrupted the natural laws of progress and allowed the weak to live and breed. For Dr. Bell, this irony was made even more ominous as the strong were choosing lives of ease and leisure, shunning large families and the burdens of rearing children. The fitter families of the human race, especially those of the most intelligent Northern European "Nordic" stocks, were reproducing less, while the degenerate stocks were running amok. If nothing were done, the strong might start to lose this battle of genetic survival.

Excerpted from Better for All the World by Harry Bruinius Copyright © 2006 by Harry Bruinius. Excerpted by permission of Knopf, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.