Chapter IX: The Duty of the Profession

I have stated that the prevalence of criminal abortion is in great measure owing to a seeming neglect of fœtal life on the part of medical practitioners, and that in other degree it is attributable to ignorance by the community of the actual character of the offence, an ignorance of physiological facts and laws; and on both these points abundant proof has been afforded of the truth of my assertions.

I have also stated that medical men, in all obstetric matters, are the physical guardians of women and their offspring; a proposition that none can deny.

We have seen that unjustifiable abortion, alike as concerns the infant and society, is a crime second to none; that it abounds, and is frightfully on the increase; and that on medical grounds alone, mistaken and exploded, a misconception of the time at which man becomes a living being, the law fails to afford to infants and to society that protection which they have an absolute right to receive at its hands, and for the absence of which every individual who has, or can exert, any influence in the matter, is rendered so far responsible.

Under these circumstances, therefore, it becomes the medical profession to look to it, lest the _whole_ guilt of this crime rest upon themselves.

And, in the first place, it might be asserted with some truth, that such is indeed the case. For, on the one hand, it was from physicians, as is proved by early medical literature, that the mistaken notions, both of the law and of the people, regarding intra-uterine vitality, were derived; and on the other, the apathy and silence still existing on this subject among medical men, though thousands and hundreds of thousands of human lives are thus directly at stake, and are annually sacrificed, can only be explained on one of two suppositions,—either that we do not yet really believe in the existence of fœtal life, though professing to do so, or that we are too timid or slothful to affirm and defend it. By the one alternative a gross lie seems proved; by the other a degrading and strange inconsistency.

But, I believe, this apparent negligence proceeds only from ignorance of the real duty of the profession. It is my aim, while setting forth a deliberate and carefully prepared opinion upon this point, to inspire, if possible, in my fellow-practitioners throughout the land, somewhat of the holy enthusiasm sure in a good cause to succeed despite every obstacle, and an earnest, uncompromising hostility to this result of combined error and injustice, the permitted increase of criminal abortion.

Enough has already been said to show that there is need of increased vigilance on the part of medical men, lest they themselves become innocent and unintentional abettors of the crime.[256] If, on the other hand, the community were made to understand and to feel that marriage, where the parties shrink from its highest responsibilities, is nothing less than legalized prostitution, many would shrink from their present public confession of cowardly, selfish and sinful lust. If they were taught by the speech and daily practice of their medical attendants, that a value attaches to the unborn child, hardly increased by the accident of its birth, they also would be persuaded or compelled to a similar belief in its sanctity, and to a commensurate respect.

But it is asked, is our silence wrong? Is there not danger otherwise of increasing the crime? These are the questions not of wisdom, or prudence, or philanthropy, but of an arrant pusillanimity. Vice and crime, if kept concealed, but grow apace. They should be stripped of such protection, and their apologists, thereby their accomplices, condemned. Answers, however, are ready at hand to the questions proposed.

“It is one of the great desiderata of registration, that more
particularity should be observed in collecting facts relating
to the subject of the still-born.”[257]

“Has it been sought,” society demands of the profession, “to
account for the peculiarities relating to the still-born, and
to combat the causes which in certain circumstances swell their
number in so deplorable a manner?”[258]

“An honest and fearless expression of these causes and
circumstances, on the part of medical men, would bring to light
an amount of knowledge that might be useful in checking this
horrible and increasing waste of life.”[259]

“Such an exercise of his knowledge, experience, and true moral
courage, is not only the province, but the conscientious duty
of the physician.”[260]

“It should be constantly borne in mind, that there is here a
high and stern morality, that should stimulate the medical
profession in the exercise of their utmost effort and
ingenuity, with the view to master and disclose the secrets of
these villainous practices; the more villainous, because they
are very generally conceived in fraud, practiced in deception,
upon innocent and unsuspecting victims, and result the most
commonly in the destruction of two lives at once.”[261]

“For ourselves, we have no fear that the truth in reference to
the crime of procuring abortion, would do aught but good. It
would appear that sheer ignorance in many honest people, is the
spring of the horrible intra-uterine murder which exists among
us; why not then enlighten this ignorance? It would be far more
effectually done by some bold and manly appeal, than by the
scattered influence of honorable practitioners alone. Will not
the mischief, by-and-by, be all the more deadly, for delaying
exposure and attempting relief?

“Whatever estimate may attach to our opinion, we believe that
not only ought these things not so to be, but that the public
should know it from good authority.”[262]

“This is a topic which ought to be regarded of the highest
interest to the profession and the public.”[263]

“It is by far the most important subject before the profession,
and in its medical as well as moral bearings, appeals alike to
our patriotism and humanity.”[264]

“We think the public have very erroneous ideas of the turpitude
of this crime, and we deem it our duty, as conservators both
of the public health and morals, to set it in a correct light
before them.”[265]

“The question of criminal abortion is doubtless one of extreme
difficulty; it is not, however, beyond the reach of the
enlightened prudence and the firm will of the authorities. It
is a subject of such vital import to society in general, that
we feel convinced it cannot but awaken the anxious thought of
the persons who, from their position, are entrusted with the
application of the laws and the control of public morals.”[266]

Whoever shall succeed in fixing upon it the attention it
deserves, “has taken a stand in this matter alike creditable to
his head and his heart, and we feel that he will receive the
hearty thanks of every true physician.”[267]

“The increasing prevalence of infanticide,” which is but
rare compared with criminal abortion, “its dangerous moral
influence, the apathy with which so many regard its spread,
and the very considerable difficulty in obtaining conviction,
call loudly for reform. The question is one of national
importance.”[268]

“With this view of the case before us, I suggest it as our
imperative duty to direct the attention of legislators to the
importance of enacting a statute in conformity thereto.”[269]

Such are the confessions, independently given, of high-minded and honorable medical men. No more can be added, no less would have been true.

It must be granted, then, that a bold and manly utterance of the truth, combining as this must, contradiction of the error and denouncement of the crime, should be made by the members of the profession on every occasion. By this course it is plain that a healthier moral tone would be made to prevail in the community, the crime would become of rarer occurrence, and the laws, such as they are, would be more faithfully attempted to be enforced.

But it has been shown that the laws on the subject of criminal abortion are radically imperfect and defective, and that this is attributable, wholly, to a medical cause. We assert, therefore, that not only is it the duty of the profession as individual components of society, but more especially as medical men, to see them amended, and to leave no means untried, no effort unmade, for the attainment of this end.

“Physicians alone,” says Hodge in his Introductory Address, “can rectify public opinion, they alone can present the subject in such a manner that legislators can exercise their powers aright in the preparation of suitable laws; that moralists and theologians can be furnished with facts to enforce the truth upon the moral sense of the community, so that not only may the crime of infanticide be abolished, but criminal abortion properly reprehended, and that women in every rank and condition of life may be made sensible of the value of the fœtus, and of the high responsibility which rests upon its parents.”[270]

It has been stated, indeed publicly avowed by a medical body,[271] that when a physician “shall become cognizant of any attempt unlawfully to procure abortion, either by persons in the profession or out of it, it shall be his duty immediately to lodge information with some proper legal officer, to the end that such information may lead to the exposure and conviction of the offender.”

This doctrine is doubtless true to a great extent, but it cannot be applied to the confidential disclosures of patients themselves, which no man has a right to reveal, unless constrained by the direct command of the court, at which, it has been ruled, even professional secrets must be divulged.[272]

* * * * *

It follows, from the evidence we have now adduced, that if it be the duty of the profession to urge upon individuals the truth regarding this crime, it is equally their duty to urge it upon the law, by whose doctrines the people are bound; and upon that people, the community, by whose action the laws are made.

And this should be done by us, if we would succeed in suppressing the crime, not by separate action alone, but conjointly, as the profession, grandly representing its highest claim,—the saving of human life.

Every step toward this end should be hailed with enthusiasm. The late action of the State Society of Massachusetts, directly resulting from professional agitation of the subject, deserves praise and imitation; the body referred to having passed a series of resolutions to the following effect: “That the Fellows of the Massachusetts Medical Society regard with disapprobation and abhorrence all attempts to procure or promote abortion, except in cases where it may be necessary for the preservation of the mother’s life; and that no person convicted of such attempt, can, consistently with its by-laws, any longer remain a fellow of the society.”[273]

But the mere passage of resolutions in disapproval of this horrible and so rapidly increasing crime is not sufficient to effect its abatement. Something more is wanted than the testimony of record books, the pointless vote of a board of councillors. There must come a hearty, earnest, and unanimous voice from the mass of the profession; an assertion that criminal abortion, or at least its permitted commission, shall no longer exist.

Too much zeal cannot be shown by physicians in relieving themselves from the weight of responsibility they may have incurred by innocently causing the increased destruction of human life. Let it not be supposed by the public that there is among us, either in theory or practice, any disregard of the unborn child. If such impression have already obtained, from our own negligence, the falsehoods of irregular practitioners, or otherwise, it should at once be removed. Fœtal life ever is, and ever has been, held sacred by all respectable physicians, and whenever criminal abortion has been known to have been advised, perpetrated or abetted by one claiming our honorable name, he has invariably and at once lost all professional standing.

We have seen that it is no trifling matter, this awful waste of human life. It is a subject that demands the best efforts of the whole profession as a body and as men. The crime, no longer practiced in secret, must be met boldly; and met with unanimity, it will be met successfully.

But whether these efforts are to be at once decisive or not, whether they are to be received with the gratitude of the community or its disfavor, is no concern of ours. Our duty is very plain; it is to stand, irrespective of personal consequences, in the breach fast making in the public morality, decency, and conscience, and, to the best of our strength, to defend them.

It might be, it very likely would be, for our immediate pecuniary interest, as a profession, to preserve silence; for we have shown that abortions, of all causes, tend to break down and ruin the health of the community at large. But to harbor this thought, even for a moment, were dishonorable. “I will never set politics against ethics,” said Bacon, “for true ethics are but as a handmaid to divinity and religion.”

We must take this decided stand, there is no choice; else we are recreant to the high trust we have assumed, and to ourselves. Whether the suppression of abortion be effected or no, one thing is certain, our own hands will have been cleansed of this sea of blood. We shall have declared our abhorrence and our innocence of the crime.

Longer silence and waiting by the profession would be criminal. If these wretched women, these married, lawful mothers, aye, and these Christian husbands, are thus murdering their children by thousands, through ignorance, they must be taught the truth; but if, as there is reason to believe is too often the case, they have been influenced to do so by fashion, extravagance of living, or lust, no language of condemnation can be too strong.

Let us, then, meet the issue earnestly and boldly. Silence and patient expectance have been fairly tried; the disease is not self-limited; the evil, instead of working its own cure, has assumed a gigantic, an awful growth.

Abstract discussions of this matter, by ourselves, and within the closed doors of our several societies, no longer avail. We are all agreed upon the guilt of abortion; we ever have been. Our prayers for its suppression have not been answered, for they have hitherto been offered with inactive hand.

We should, as a profession, openly and with one accord appeal to the community in words of earnest warning; setting forth the deplorable consequences of criminal abortion, the actual and independent existence, from the moment of conception, of fœtal life. And that the effort should not be one of words merely, we should, as a profession, recommend to the legislative bodies of the land, the revision and subsequent enforcement of all laws, statutory or otherwise, pertaining to this crime,—that the present slaughter of the innocents may to some extent, at least, be made to cease. For it is “a thing deserving all hate and detestation, that a man in his very originall, whiles he is framed, whiles he is enlived, should be put to death under the very hands and in the shop of nature.”[274]

In conclusion; a committee, consisting of Drs. Blatchford, of New York, Hodge, of Pennsylvania, Pope, of Missouri, Barton, of South Carolina, Lopez, of Alabama, Semmes, of the District of Columbia, Brisbane, of Wisconsin, and the writer, was appointed by the National Medical Association, at its meeting at Nashville, in 1857, to report upon criminal abortion, with a view to its general suppression. The report of this committee, brief, but in strict accordance with the series of papers now ended, has lately been made to the Association, at its session held at Louisville, in May of the present year. The report was accepted, and the resolutions appended to it[275] were _unanimously_ adopted.

In behalf of the committee, of whom he had the honor to be chairman, the writer cannot close this portion of his labors without thanking the physicians of the land, represented as they are by the Association, for their hearty and noble response to the appeal that has been made them. He would express, were it possible, the gratitude not of individuals, but society; for by this act the profession has again been true to “its mighty and responsible office of shutting the great gates of human death.”

FOOTNOTES

[1] So far as the writer is aware, there exists, in this or any other language, no paper upon the subject at all commensurate with its importance. The chapters devoted to it in medical text-books, though some of them admirable so far as they go, especially that of Beck, are defective and often erroneous; while but little information of any value can be found elsewhere. In the French periodicals have appeared articles on special points hereafter referred to; in Great Britain able arguments regarding the commencement of fœtal life have been made by Radford, (1848;) and in this country, with remarks on the frequency of the crime, by Hodge, of Philadelphia, (1839 and 1854,) and by the present Professor of Obstetrics in Harvard University, (1855.) To the latter, his father, and to the journalists (Drs. Morland and Minot, of Boston,) by whom the effort then made was so warmly and eloquently seconded, the writer acknowledges his indebtedness for the thought of the present undertaking.

[2] As quoted by Hodge. Introductory Lecture, p. 15.

[3] Hippocrates states that this is a fact, and that he had found the difference of a whole month, which he attributes to the “greater strength” of the male.—(_On the Nature of the Child_, Sect. 11.) I am unaware that this point has been investigated by any modern writer.

[4] “These sounds may sometimes be distinguished several weeks before the mother becomes conscious of the motions of the child.”—NÆGELE; _Treatise on Obstetric Auscultation_, p. 50.

[5] Memoire sur la cause des Présentations de la Tête, &c.—_Mém. de l’Acad. Roy. de Méd._ tome ii.

[6] A. PARÉ; English Trans., p. 899. HUGH CHAMBERLEN’S Trans. of Mauriceau on _Diseases of Women with Child_, p. 147, Note. ENNEMOSER; Historisch-physiologische Untersuchungen über den Ursprung und das Wesen der menschlichen Seele; Bonn, 1824. CABANIS; Rapports du Physique et du moral de l’Homme, tome ii. p. 431.

[7] Ed. _Med. and Surg. Journ._, Jan. 1855, p. 50.

[8] SIMPSON, _Obstetric Works_, vol. ii. p. 88.

[9] Many of the statistics now presented we have also embodied in a paper upon the decrease of the rate of increase of population now obtaining in Europe and America, read before the American Academy of Arts and Sciences, December 14th, 1858, as a contribution to the Science of Political Economy.

[10] MOREAU DE JONNÉS, Eléments de Statistique, 1856, p. 202.

[11] Journal des Economistes, March and May, 1847.

[12] Edinburgh Review, Jan. 1857, p. 342. Med. Times and Gazette, May, 1857, p. 462.

[13] Lehrbuch der Politischen Oekonomie.

[14] Sur l’Homme et la Developpement de ses Facultés, tome i. ch. 7.

[15] Journal des Economistes, May, 1847.

[16] MILL, Principles of Political Economy, i. p. 343.

[17] HUSSON, Les Consummations de Paris, 1856.

[18] Compiled from DE JONNÉS.

[19] 10,925 births; 646 still-births.

[20] Births, 52,538; still-births, 2624.

[21] Compiled from QUETELET, Theory of Probabilities, p. 152; 406,073 living births; 16,767 still-births.

[22] Births, 7,593,017; still-births, 257,068. 1839-41, 1 to 26; ELLIOTT, Hunt’s Merchants’ Magazine, July, 1856.

[23] 2080 still-births.

[24] 2349 still-births.

[25] DE JONNÉS, loc. cit., p. 239.

[26] QUETELET, loc. cit., p. 152.

[27] Register of the Morgue.

[28] DE JONNÉS, loc. cit., p. 193.

[29] Report of City Inspector of New York for 1849.

[30] City Inspector’s Report for 1856.

[31] Ibid.

[32] Compiled from QUETELET, loc. cit., p. 152.

[33] Compiled from City Inspector’s Report for 1855.

[34] Ibid. for 1856.

[35] CLAY, Obstetric Cyclopedia, p. 21.

[36] Separate records of the premature births in New York were not made before this period. They were not rendered in 1842; I have therefore omitted in the calculation the still-births of the same year. For a series of the official reports, I am indebted to the present City Inspector, Mr. Geo. W. Morton.

[37] Report of 1849.

[38] Loc. cit., p. 195.

[39] Loc. cit., i. p. 344.

[40] Ibid., p. 343.

[41] Med. Times and Gazette, June 1856, p. 611.

[42] Les Consummations de Paris.

[43] Loc. cit.

[44] DE JONNÉS, loc. cit., p. 194.

[45] Ibid., p. 195.

[46] Journal des Economistes, 1847.

[47] MILL, loc. cit., i. p. 336. The italics are my own. I shall hereafter refer back to this passage.

[48] Ibid., i. p. 417.

[49] Essay on Population.

[50] MILL, loc. cit., i. p. 417.

[51] Travels of Anacharsis, v. p. 270.

[52] Ibid., iv. p. 342.

[53] Satires, vi., v. 592.

[54] Amor., lib. 2.; Heroïdes, epist. 2.

[55] REEVE’s Apologies.

[56] BLAQUIERE, Letters from the Med., pp. 90, 184; SLADE, Records of Travels, ii. p. 162.

[57] BARROW, Travels in China, p. 113; DE PAUW, Philosoph. Dissert; MEDHURST, China, &c., p. 45; SMITH, Exploratory Visit, &c., i. p. 53.

[58] GOLOWNIN, Memoirs of a Captivity, iii. p. 222.

[59] MOOR, Hindoo Infanticide, p. 63; BUCHANAN, Christian Researches in Asia, p. 49; WARD, View of the History, &c., of the Hindoos, p. 393.

[60] For a long list of authorities on these points, see BECK, ii. p. 389, et seq.

[61] Belgium.

[62] Local exceptions to this general rule will of course be found to exist, as is always the case with laws based on mere statistics, especially, as here, where reports to the registry are liable, for evident reasons, to be withheld. Thus it appears from Dr. Jewell’s collections (this Journal, March, 1857, p. 277,) that the proportion of still-births in Philadelphia was, in 1856, only 1 in 913 to the total population, and 1 in 20.1 to the general mortality, against which evidence must be placed that which we subsequently furnish from Prof. Hodge.

[63] MSS. Letter from City Registrar, March 26, 1857.

[64] CHICKERING, Comparative View of the Population of Boston, 1850. City Document, No. 60, p. 44.

[65] Twelfth Registration Report to the Legislature of Massachusetts, 1853, p. 116. The truth of this statement has been corroborated by Dr. Curtis, in his Report on the Census of Boston in 1855. City Document, 1856, p. 22. Also, Fifteenth State Registration Report, 1856, p. 179.

[66] “Had the rate of the annual increase of the numbers living under the age of five (3.13 per cent.) resulted entirely from the increase of births in a permanent population, the number of births of 1855 (in the districts where the ratio of the registered deaths to the population was greater than one to sixty-three, 166 of the 331 towns) would have been 24,457, instead of 23,481, the number registered. On the other hand, had the increase resulted wholly from migration, (the annual number of births in the permanent population being constant,) the number of births would have been only 22,956. The number of births registered is somewhat nearer the latter than the former of these two values.

“Assuming the correctness of the births, deaths, and population, in the selected districts, it appears that 35 per cent. of the increase of the population under the age of five was due to births in the permanent portion of the population, and 65 per cent. due to the movement of the migratory portion; also, that 38 per cent. of the increase of population at all ages was due to excess of births over deaths, leaving 62 per cent. to be accounted for by excess of immigration over emigration.”—ELLIOTT, The Laws of Human Mortality in Massachusetts; Proceedings of Am. Assoc. for Adv. of Science, Montreal, 1857, p. 57.

[67] CHICKERING, loc. cit., p. 49.

[68] The tables now presented, we have compiled from the fifteen published Registration Reports of the State of Massachusetts. Advance sheets of the Sixteenth Report have kindly been furnished me while this article is passing through the press, by the compiler, Dr. Josiah Curtis, of Boston. The premature births for 1856 and 1857 are not given in the reports for those years, so that I cannot extend my calculations beyond 1855. Deductions from the still-births at the full time, which are alone given in the years referred to, are of course useless for the present inquiry.

[69] Births, 27,664; population, 994,665.

[70] Births, 32,845; population, 1,132,369.

[71] Total births at full time, 32,845; living births at full time, 32,120. Fœtal deaths, 2064; still, at full time, 725; premature, 1339.

[72] Total deaths, including 1462 fœtal, 19,461.

[73] Total deaths, including 2064 fœtal, 21,523.

[74] Births at full time, 154,245; premature, 5899.

[75] Fourteenth Registration Report, 1855.

[76] Fourteenth Registration Report, 1855.

[77] In the above remarks we must not be misunderstood. We believe Massachusetts no worse with regard to abortion than many other portions of the country, but that its registration is conducted with greater care. From the statistics given it may easily be surmised what the amount of this crime _must be elsewhere_. It is necessarily of infinitely more common occurrence than infanticide, the murder of children after birth, for proof of the frequency of which, at the present moment, in Great Britain, we refer to Dr. Burke Ryan’s Fothergillian Essay on the subject in the London Sanitary Review for last July, and to the London Lancet of corresponding date.

[78] As, for instance, in the regularly progressive series of deaths and births, as compared with the population; constant, also as compared with each other:—Population of Massachusetts: by census of 1850, 994,665; 1855, 1,132,369. Deaths: 1851, 18,934; 1852, 18,482; 1853, 20,301; 1854, 21,414; 1855, 20,798. Births: 1851, 28,681; 1852, 29,802; 1853, 30,920; 1854, 31,997; 1855, 32,845.

[79] Reports of Attorney-General of Massachusetts, from 1849 to 1858. State Documents.

[80] Comptes Rendus Annuels de la Justice Criminelle.

[81] Introductory Lecture, 1854, p. 17.

[82] Report to Suffolk Dist. Med. Society, May, 1857; New York Med. Gazette, July, 1857, p. 390; N. H. Journal of Medicine, July, 1857, p. 211.

[83] Loc. cit., p. 313.

[84] The Law of Population, 1830.

[85] HUME, Essays, vol. i. No. xi., p. 431.

[86] Études sur l’Économie Politique; Nouveaux Principes d’Économie Politique.

[87] Loc. cit., ii. p. 253.

[88] Ibid., i. p. 451. An opinion to the same effect, italicized, has already been quoted.

[89] Ibid., ii. pp. 316, 317.

[90] Ibid., i. p. 452, foot-note.

[91] Ibid., i. p. 447.

[92] Nouveaux Principes, &c., liv. vii. ch. 5.

[93] Medical Ethics, p. 79.

[94] Since our last article, the report of the Committee appointed in 1858 to investigate the Health Department of the City of New York has appeared, and we find that our statements regarding the frequency of the crime in the metropolis are fully corroborated. Not merely are additional official statistics on this point given (pp. 182, 183), but valuable testimony from Drs. Griscom (pp. 25, 30), McNulty (p. 55), Francis (p. 64), and Bulkley (p. 133). Dr. Reese’s paper on Infant Mortality, republished by the Committee (pp. 90-100), from the Transactions of the American Medical Association for 1857, also contains incidental reference to the frequency of abortion, and for its direct and earnest dealing with the subject deserves unqualified commendation.

In this connection we would call attention to the evidence of the extent of the crime in Boston, afforded since our own remarks upon that point were in type, by Dr. Walter Channing. (Boston Med. and Surg. Journal, March 17, 1859.)

[95] Annales d’Hygiène Publique, 1856, p. 122.

[96] Les Consummations, etc.

[97] Comptes Rendus Annuels, etc.

[98] MAYER, Des Rapports Conjugaux, considérés sous le triple point de vue de la population, de la santé et de la morale publique. Paris, 1857.

[99] CANGIAMILA, Embryologia Sacra, p. 15.

[100] In verification of this statement I am enabled to quote from the last authorized edition of the Canon Laws of the Church of Rome. “Omnes, qui abortûs seu fœtûs immaturi, tam animati quam inanimati, formati vel informis, ejectionem procuraverint, pœnas propositas et inflictas tam divino quam humano jure, ac tam per canonicas sanctiones et apostolicas constitutiones quam civilia jura adversus veros homicidas incurrere, hâc nostrâ perpetuo valiturâ constitutione statuimus et ordinamus.” REIFFENSTUELL, Jus Canonicum Universum, tome iii. Paris, 1854.

[101] Decreta Synodi plenariæ Episcoporum Hiberniæ, apud Thurles habitæ anno 1850. Art. de Baptismo, p. 20.

[102] Dublin Review, April, 1858, p. 100.

[103] DEVENTER, 1734, p. 366; STERNE, Tristram Shandy, p. 54; Med. Times and Gazette, Aug., 1858, p. 196. Though the fact of this decision has been doubted, it is nevertheless strictly true. Through the kindness of Bishop Fitzpatrick I have been favored with a copy of BARRY’s Medico-Christian Embryology, as presenting upon this point the authorized and generally received doctrine of the Catholic Church. I quote the following from the chapter “On Baptism in Impracticable and Difficult Labors:”

“In case of impacted head and at all times that one is obliged to apply the forceps, whether at one of the straits or in the pelvic excavation, it becomes necessary to baptize the child on the part which presents at the uterine orifice after the rupture of the bag containing the waters.

“In order to baptize the child, a syringe charged with natural water may be used. If this be not at hand, a person may use a sponge, or a linen or cotton rag, wetted with water, which is to be carried to the child by the fingers, a pair of forceps, or any other suitable contrivance, and then squeezed or pressed on the surface of the part presenting.” (Loc. cit., p. 45.)

“Any person, whether man, woman or child, may baptize an infant when in danger of death.” (Ibid., p. 76.)

If the facts now stated should be generally known and acted upon by the profession, hundreds of lives, infant and maternal, would annually be saved.

[104] MS. Letter, dated Nov. 14th, 1858.

[105] It is not of course intended to imply that Protestantism, as such, in any way encourages, or indeed permits, the practice of inducing abortion; its tenets are uncompromisingly hostile to all crime. So great, however, is the popular ignorance regarding this offence, that an abstract morality is here comparatively powerless; and there can be no doubt that the Romish ordinance, flanked on the one hand by the confessional, and by denouncement and excommunication on the other, has saved to the world thousands of infant lives.

[106] PASSOT, Des dangers de l’avortement provoqué dans un but criminel; Gazette Méd. de Lyon, 1853.

[107] Ann. d’Hygiène, 1856, p. 147.

[108] DUBOIS and DEVERGIE, ibid., tome xix. p. 425; tome xxxix. p. 157.

[109] Ibid.

[110] Review of MONTGOMERY’s Signs of Pregnancy; The North American Medico-Chirurgical Review, March, 1857, p. 249.

[111] Principles of Midwifery, p. 547.

[112] BAUDELOCQUE, tome i. p. 115; FODERE, ii. p. 17; MARC, Dict. de Méd., i. p. 228; MONTGOMERY, Signs of Pregnancy, p. 578; DEVERGIE, Méd. Légale, i. p. 244.

[113] RYAN, p. 267; TARDIEU, loc. cit.

[114] CLARKE, Trans. of Soc. for Impr. of Med.-Chir. Knowledge, iii. p. 290; BAUDELOCQUE, i. p. 123, note; LEROUX, Traité des Pertes, Obs. xiii. p. 25; MONTGOMERY, loc. cit., p. 618.

[115] GARDNER, of New York, note to TYLER SMITH’s Lectures on Obstetrics, p. 203.

[116] Am. Journ. of the Med. Sciences, April, 1859. In the instance referred to, the cervix had been deeply and extensively lacerated, forceps having been used in four previous labors; while depressions existing between the old cicatrices and half filled and ragged with clots, were decidedly suggestive of punctured wounds. The true nature of the case was rendered evident by its past history, and corroborated by the fact that the patient was a Catholic; the latter being a point to which I am inclined to attach much importance, for reasons already given.

[117] Practical Treatise, p. 275.

[118] RYAN, Med. Jurisprudence, p. 282.

[119] ROSCOE, Law of Evidence, 242.

[120] ARCHBOLD, Crim. Pleading, 491; 1 HALE, 455.

[121] DAVIS, Crim. Justice, 482.

[122] DAVIS, Crim. Justice, 483.

[123] Reg. _v._ Haynes; Reg. _v._ Goodall; Rex _v._ Phillips.

[124] Med. Times and Gazette, Jan., 1856, p. 611.

[125] “This operation must not on any account be undertaken without the sanction, and in the presence, of another practitioner.”—CLAY, Hand-book of Obstetric Surgery, p. 13.

[126] 1 GABBETT, Cr. Law, 523.

[127] Loc. cit.

[128] CHEVALIER and DEVERGIE, Ann. d’Hyg., 1856, p. 157.

[129] Med. Jurisp.; Griffith’s ed., p. 472, Hartshorne’s ed., p. 378.

[130] TARDIEU, loc. cit., 1856, p. 124.

[131] A Woman’s Thoughts about Women. By the author of “John Halifax, Gentleman.” 1858, p. 14.

[132] Loc. cit.

[133] Ibid.

[134] Mass. Laws of 1847, chap. 83.

[135] “By imprisonment in the State prison, house of correction, or common jail, not more than three years, or by fine not exceeding one thousand dollars.”

[136] Opera omnia. Ed. 1655, i., p. 643.

[137] JÖRG of Leipsic, who speaks of the human fœtus as “only a higher species of intestinal worm, not endowed with a human soul, nor entitled to human attributes.”

[138] SIMPSON, Obst. Works, i. pp. 352, 404.

[139] Boston Med. and Surg. Journal, January, 1857, p. 462.

[140] The immorality of craniotomy, where delivery can be effected by any other method, is gradually becoming acknowledged in Great Britain. A late discussion on this subject, at the Obstetric Society of London, is reported in the Medical Times and Gazette for February, 1859.

[141] CLAY, Obstetric Surgery, p. 68.

[142] SINCLAIR and JOHNSTON, Practical Midwifery, 1858. 130 cases of craniotomy in 13,748 labors.

[143] CLAY, Loc. cit., p. 69.

[144] The subject of justifiable craniotomy has of late been ably though controversially discussed by an anonymous writer (Dublin Review, April and October, 1858,) and Dr. Churchill (Dublin Quarterly Journal of Medical Science, August and November, of the same year). Care must be taken, lest in assenting to the decided and imperative necessity of the operation in certain cases, and by a natural professional sympathy, too great frequency is not allowed to this most horrible and appalling of all the operations to which as physicians we can ever be called.

[145] Review of CLAY’s Obstetric Surgery; Boston Med. and Surg. Journal, November, 1856, p. 283.

[146] Theory and Practice of Midwifery, p. 348.

[147] De jure vitæ et necis quod competit medico in partu. Heidelberg, 1826.

[148] “Where one only can by any possibility be preserved, the female herself may use her right of self-preservation and choose whether her own life or that of her child shall fall a sacrifice.” GUY, Principles of Forensic Medicine, p. 145.

[149] Guy’s Hospital Reports, 1856, p. 12.

[150] Dublin Quarterly Journ. of Med. Science, August, 1858, p. 10.

[151] RADFORD, British Record of Obst. Medicine, 1848, p. 84.

[152] The rules of the Catholic Church upon this point have been already referred to. Suffice it to say, further, that while they enjoin the Cæsarean and vaginal sections, in preference to craniotomy and in cases of extra-uterine fœtation, yet turning, the use of forceps, and the induction of premature labor, where such are indicated, are distinctly allowed by them. BARRY, Medico-Christian Embryology, pp. 41, 44, 45, 60.

[153] Guy’s Hosp. Reports, 1856, p. 4.

[154] For a full discussion of the respective merits of the several methods instanced above, see SIMPSON, loc. cit., i. p. 738.

I have lately contrived an instrument very similar to one not long since proposed by Spencer Wells for dilatation of the female urethra, which by a simple combination of the three principles involved, will probably prove of material service in the induction of premature labor. It may be called the uterine dilator, as it possesses many advantages over expansible tents for all cases of uterine disease where dilatation is necessary, either for diagnosis or treatment. A description of the instrument, and of its first application to obstetric practice, is published in the current number of the American Journal of the Medical Sciences.

[155] Bulletin de l’Académie, xvii. p. 364.

[156] British Record, etc., p. 82.

[157] I have elsewhere discussed this subject; American Journal of the Medical Sciences, January, 1859.

[158] Enchiridion Medicum, p. 510.

[159] Question d’Embryologie Médicale, etc.; Revue de l’Amérique et de l’Ouest, 1846.

[160] JOAN. RIOLAN., Anthropographia, lib. vi. cap. vii. p. 589.

[161] CHURCHILL, Dublin Quarterly Journ. of Med. Science, August, 1858, p. 22.

[162] A case in point has been reported by the writer; Amer. Journ. of the Med. Sciences, April, 1859.

[163] Reports to the Suffolk Dist. Med. Society of Massachusetts, 1857, and to the American Medical Association, 1859.

[164] “It would in my opinion,” says Ramsbotham, referring to the nature of fœtal existence, “be much better not to endeavor to explain the secrets of nature, so deeply hidden.”—(Obst. Medicine and Surgery, p. 309.) This belief seems still, in practice, very widely entertained.

[165] CLAY, Obstetric Retrospect, March, 1848, p. 44.

[166] Medical Communications of the Mass. Med. Soc., 1858, p. 77.

The writer having been a member of this committee, here enters, as he has already done by letter to the councillors of the Society, his earnest protest against the plainly erroneous opinion avowed in that report, which was presented and accepted during his absence from the State.

By the laws of Massachusetts, the offence is considered as mainly against the person of the mother. In case of her death, already sufficiently provided for at common law, convictions can be effected, with great difficulty, under the statute,—as has twice occurred the present year, in the cases of Jackson and Brown; but hardly otherwise.

[167] In this connection honorable mention is due Drs. TATUM and JOYNES, of Virginia, for their papers on “The Attributes of the Impregnated Germ,” and “Some of the Legal Relations of the Fœtus in Utero” (Virginia Medical Journal, 1856.) Through the agency of the latter of these gentlemen, an important modification has been made in the law of the State; as has also been effected in Wisconsin, by Dr. BRISBANE.

[168] For valuable information in this connection, I am indebted to many friends, more particularly to Drs. THAYER, of New Hampshire, PHELPS, of Vermont, CHAS. HOOKER, of Connecticut, BLATCHFORD, of New York, WOOD, of Pennsylvania, THOMPSON, of Delaware, WROTH, of Maryland, BRAINARD, of Illinois, CAMERON, of Indiana, LELAND, of Michigan, LE BOUTILLIER, of Minnesota, BRISBANE, of Wisconsin, POPE, of Missouri, HOYT, of Tennessee, HAXALL and JOYNES, of Virginia, SEMMES, of District of Columbia, DICKSON, of North Carolina, LOPEZ, of Alabama, BARTON, of Louisiana, (now of South Carolina,) and to my relatives, WOODBURY and BELLAMY STORER, Esqrs., of Maine and Ohio, and JAMES M. KEITH, Esq., of Boston, late District-Attorney for Norfolk and Plymouth Counties. In every instance, however, verification of the statutes has been made from copies in the State Library of Massachusetts.

[169] DAVIS, Criminal Justice, p. 482.

[170] 1 Commentaries, 129.

[171] Ibid.

[172] 43 George III., c. 58.

[173] 9 Geo. IV., c. 31; 10 Geo. IV., c. 34.

[174] 7 William IV.; 1 Vict., c. 85.

[175] To this list may also be added the Territory of Washington.

[176] The Territory of Kansas belongs to the above group.

[177] Compiled Statutes of Connecticut, 1854, p. 307.

[178] Revised Code of Mississippi, 1857, chap. 64, p. 601.

[179] Digest of Statutes of Arkansas, 1848, chap. 51, p. 325.

[180] Revised Statutes of Minnesota, 1851, chap. 100, p. 493.

[181] Statutes of Oregon, 1855, chap. 3, p. 310.

[182] Revised Statutes of Maine, 1857, chap. 124, p. 685.

[183] The above should evidently read “the first two sections,” to be possible.

[184] Compiled Statutes of New Hampshire, 1853, chap. 227, p. 544.

[185] Revised Statutes of New York, 1852, ii. pp. 847, 876. The last section of this statute does not require proof of pregnancy.

[186] Revised Statutes of Ohio, 1854, chap. 162, p. 296.

[187] Compiled Laws of Michigan, 1857, vol. ii. chap. 180, p. 1509. The statute of the Territory of WASHINGTON is very similar to those above.

“Every person who shall administer to any woman pregnant with a quick child, any medicine, drug, or substance whatever, or shall use or employ any instrument, or other means, with intent thereby to destroy such child, unless the same shall have been necessary to preserve the life of such mother, shall, in case the death of such child or of such mother be thereby produced, on conviction thereof, be imprisoned in the penitentiary not more than twenty years, nor less than one year.

“Every person who shall administer to any pregnant woman, or to any woman whom he supposes to be pregnant, any medicine, drug, or substance whatever, or shall use or employ any instrument, or other means, thereby to procure the miscarriage of such woman, unless the same is necessary to preserve her life, shall, on conviction thereof, be imprisoned in the penitentiary not more than five years, nor less than one year, or be imprisoned in the county jail not more than twelve months, nor less than one month, and be fined in any sum not exceeding one thousand dollars.” Statutes of the Territory of Washington, 1855, p. 81.

[188] Compiled Statutes of Vermont, 1850, chap. 108, p. 560.

[189] Supplement to the Revised Statutes of Massachusetts, 1849, p. 322.

[190] Statutes of Illinois, 1858, vol. i. p. 381.

[191] Revised Statutes of Wisconsin, 1858, chap. 169, sect. 58. It will be noticed that the second section of the above statute differs from the first, in not requiring the proof of pregnancy.

[192] Code of Virginia, 1849, chap. 191, p. 724.

[193] Revised Statutes of Missouri, 1856, i. chap. 50, p. 567.

[194] Code of Alabama, 1852, sect. 3230, p. 582.

[195] Revised Statutes of Louisiana, 1856, p. 138. By its wording, this statute might be forced into the next division.

[196] I insert this clause not merely for its relation to the points we are now considering, but for its important bearing on the broad question of infanticide during labor; concerning which it stands in bold and direct antagonism to all the rulings of the common law in this country and abroad. In other respects also, though not faultless, the Texas statute is rationally and admirably drawn.

[197] Penal Code of Texas, 1857, p. 103.

[198] Digest of Laws of California, 1857, art. 1905, p. 334. The statute of the Territory of KANSAS, similar to the above, is as follows:—

“Every physician or other person who shall willfully administer to any pregnant woman, any medicine, drug, or substance whatever, or shall use or employ any instrument or means whatsoever, with intent thereby to procure abortion, or the miscarriage of any such woman, unless the same shall have been necessary to preserve the life of such woman, or shall have been advised by a physician to be necessary for that purpose, shall, upon conviction, be adjudged guilty of a misdemeanor, and punished by imprisonment in a county jail not exceeding one year, or by fine not exceeding five hundred dollars, or by both such fine and imprisonment.” Statutes of Kansas, 1855, chap. 48, p. 243.

[199] We have already commented upon the phraseology of the Louisiana statute. The latitude of its first clause is shown by the context to have been unintentional, and therefore hardly justifies a change in its classification. The second section of the Statute of Washington Territory, however, is closely analogous to that now given; while the final sections of the statutes both of New York and Wisconsin, which make it penal for a woman voluntarily to effect or submit to the unjustifiable induction of abortion, are equally silent regarding proof of the existence of pregnancy.

[200] Revised Statutes of Indiana, 1852, p. 437.

[201] Rex _vs._ Phillips, 3 CAMPBELL, 77; RUSSELL, Crim. Law, 553-4; 1 GABBETT, Crim. Law, 522; 1 BISHOP, Crim. Law, 386.

[202] State _vs._ Cooper, 2 ZABRISKIE, 52, 57; Rex _vs._ Russell, 1 MOODY, 356, 360.

[203] Regina _vs._ Wycherley, 8 CARRINGTON and PAYNE, 265.

[204] The People _vs._ Jackson, 3 HILL, N. Y. Reports, 92; WHARTON, Criminal Law, 98.

[205] DAVIS, Crim. Justice, 484.

[206] WHARTON, Amer. Crim. Law, 424.

[207] WHARTON, Amer. Crim. Law, 75.

[208] The State _vs._ Vawter, 7 BLACKFORD, 592.

[209] 1 GABBETT, Crim. Law, 523; ARCHBOLD, P. A., lxx, 2.

[210] ROSCOE, L. E., 242; Eng. Com. L. Rep., xxv. 453; Rex _vs._ Coe, 6 CAR. & P., 403; Vaughan, 13.

[211] 1 BISHOP, Crim. Law, 527.

[212] In Massachusetts, though the statute is silent on these points, it is asserted that whenever a potion is given, or other means are used, by “a surgeon,” for the purpose of saving the life of the woman, the case is free of malice, and has a lawful justification. DAVIS, Crim. Justice, 282; Report of the Criminal Law Commissioners, 1844, Causing Abortion, I., note _a_.

[213] After a little reflection, it will be seen that this word is not so open to objection as might at first be supposed.

[214] 1 RUSSELL, Crimes, 671; 1 VESEY, 86; 3 COKE, Inst., 50; 1 HAWKINS, C. B., s. 16; 1 HALE, 434; 1 EAST, P. C., 90; 3 CHITTY, Crim. Law, 798; WHARTON, Crim. Law, 537.

[215] DAVIS, Crim. Justice, 486.

[216] ARCHBOLD, Crim. Pleading, 490.

[217] Regina _vs._ Trilloe, 2 MOODY, C. C., 260, 413.

[218] The State _vs._ Cooper, 2 ZABRISKIE, 52; HANES, U. S. Digest, 5.

[219] The Commonwealth _vs._ Parker, 9 METCALF, 263; The Commonwealth _vs._ Bangs, 9 Mass., 387; The State _vs._ Cooper, 2 ZABRISKIE, 57; HANES, U. S. Digest, 5; Smith _vs._ State, 33 MAINE, (3 RED.) 48.

[220] BISHOP, Crim. Law, 386; Mills _vs._ The Commonw., 1 HARRIS, Pa., 631, 633.

[221] WHARTON, Crim. Law of the U. S., 537.

[222] 1 RUSSELL, Crimes, 661; 1 VESEY, 86; 3 COKE, Inst., 50; 1 HAWKINS, c. 13, s. 16; BRACTON, 1. 3, c. 21.

[223] BAC. Ab., tit. Infants.

[224] 2 VERNON, 710.

[225] Doe _vs._ Clark, 2 H. Bl., 399; 2 VESEY, jr., 673; Thellusson _vs._ Woodford, 4 VESEY, 340; Swift _vs._ Duffield, 6 SERG. & RAWLE, 38.

[226] FEARNE, 429.

[227] 2 VERNON, 710; The Commonwealth _vs._ Demain, 6 Penn. Law Journ., 29; BRIGHTLY, 441.

[228] 1 HALE, 90; The Commonw. _vs._ Chauncey, 1 ASHMEAD, 227; Smith _vs._ State, 33 MAINE, (3 RED.) 48.

[229] Ibid.; HANES, U. S. Digest, 5.

[230] WHARTON, Law of Homicide, 44.

[231] The Commonw. _vs._ Parker, 9 METCALF, 263, 265; DAVIS, Crim. Justice, 281.

[232] 1 BLACKSTONE, 129; Rex _vs._ Senior, 1 MOODY, C. C., 346; 3 Inst., 50; WHARTON, C. L., 537; Ibid., Law of Homicide, 93.

[233] Rex _vs._ West, 2 CARR. & KIR., 784; 1 BISHOP, C. L., 255; WHARTON, Law of Homicide, 93.

[234] Rex _vs._ Scudder, 1 MOODY, 216, 3 CAR. & P., 605, overruling Rex _vs._ Phillips, 3 CAMPBELL, 73; RUSSELL, Cr., 763, note.

[235] If made without her consent?

[236] Regina _vs._ Goodchild, 2 CAR. & KIR., 293; Rex _vs._ Goodhall, 1 DEN. C. C., 187; 3 CAMPBELL, 76.

[237] 1 BISHOP, Crim. Law, 518.

[238] 1 BISHOP, Crim. Law, 385.

[239] WHARTON, Crim. Law, 541.

[240] 1 HARRIS, Pa., 631, 633.

[241] LEE, Note to Guy’s Principles of Forensic Medicine, p. 134.

[242] BECCARIA, Crimes and Punishments, 104.

[243] “An efficient, and practical remedy for the prevention of this crime would be a law requiring the causes of death to be certified by the physician in attendance, or where there has been no physician, by one called in for the purpose. In this way the cause of death, both in infants and mothers, could be traced to attempts to procure abortion. In three cases which occurred in Boston, in 1855, the death was reported by friends to be owing to natural causes, and in each it was subsequently ascertained that the patient died in consequence of injuries received in procuring abortion. It is probable that such cases are by no means rare; and if the cause of death were known, an immediate investigation might lead to the detection of the guilty party.” (Boston Med. and Surg. Journal, Dec., 1857, p. 365.)

[244] Register of the Morgue.

[245] From 1846 to 1850, 188 cases of criminal abortion were discovered in Paris, but for want of proof, only 22 of them were sent to trial. (Comptes Rendus Ann. de la Justice Criminelle.)

[246] Report on the Medico-legal duties of Coroner. 1857.

[247] RADFORD, British Record of Obstetric Medicine, vol. i. p. 55.

[248] WHARTON, Criminal Law, 540.

[249] Smith _vs._ The State, 33 MAINE, (3 RED.) 48.

[250] Rex _vs._ Phillips; Regina _vs._ Goodall; Reg. _vs._ Haynes, etc.

[251] TAYLOR, Med. Jurisprudence, p. 386.

[252] PERCIVAL, Medical Ethics, p. 84.

[253] Ibid., p. 85.

[254] Loc. cit., article 317.

[255] Report to Suffolk District Med. Society, May, 1857, p. 12.

[256] In this connection, I cannot too strongly deprecate a practice that has lately been proposed, the detection, namely, of the early existence of pregnancy by the administration of ergot. (Boston Med. and Surg. Journal, April, 1859, p. 197.) The use of ergot for this purpose, in however small a dose, would seem utterly unjustifiable.

[257] Fifteenth Massachusetts Registration Report, 1857, p. 199.

[258] QUETELET, Theory of Probabilities, p. 234.

[259] New York Med. Gazette, Editorial; London Medical Times and Gazette, 1850, p. 487.

[260] Boston Med. and Surg. Journal, Editorial, 1855, p. 411.

[261] DEAN, Medical Jurisprudence, p. 139.

[262] Boston Med. and Surg. Journal, Editorial, Dec. 13, 1855.

[263] American Medical Gazette, Editorial, July, 1857, p. 390.

[264] Ibid., April 1859, p. 289.

[265] Maine Med. and Surg. Reporter, Editorial, June, 1858, p. 39.

[266] DEVILLE, Researches on the proportion of still-born children compared with the mortality of the City of Paris during the thirteen years, 1846-58. Memoirs of the French Academy, 1859.

[267] New Hampshire Journal of Medicine, Editorial, July, 1857, p. 216.

[268] London Lancet, Editorial, July, 1858, p. 66.

[269] TATUM, Virginia Med. Journal, June, 1856, p. 457.

[270] Loc. cit., p. 19.

[271] The Councillors of the Massachusetts Medical Society. Proceedings of the Society, 1858, p. 77.

[272] PHILLIPS, On Evidence, i. p. 135; RYAN, Medical Jurisprudence, p. 193; STORER, Sen., Introductory Address, 1855, p. 10; SIMPSON, Physicians and Physic, p. 31.

[273] Proceedings of the Society, 1858.

[274] Man Transformed. Oxford, 1653.

[275] “_Resolved_, That while physicians have long been united in condemning the procuring of abortion, at every period of gestation, except as necessary for preserving the life of either mother or child, it has become the duty of this Association, in view of the prevalence and increasing frequency of the crime, publicly to enter an earnest and solemn protest against such unwarrantable destruction of human life.

“_Resolved_, That in pursuance of the grand and noble calling we profess,—the saving of human life,—and of the sacred responsibilities thereby devolving upon us, the Association present this subject to the attention of the several legislative assemblies of the Union, with the prayer that the laws by which the crime of abortion is attempted to be controlled may be revised, and that such other action may be taken in the premises as they in their wisdom may deem necessary.

“_Resolved_, That the Association request the zealous co-operation of the various State medical societies in pressing this subject upon the legislatures of their respective States, and that the president and secretaries of the Association are hereby authorized to carry out, by memorial, these resolutions.”—_Transactions of the Am. Med. Association_, 1859, vol. xii. p. 75.