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CRIMINAL ABORTION;

ITS EXTENT AND PREVENTION.

BY ANDREW NEBINGER, M.D.

TO TAE MEDICAL SOCIETY OF PENNSYLVANIA:

The Committee appointed by you to report upon Criminal Abortion; its Extent and Prevention, respectfully submit

That Criminal Abortion, to be considered and presented in all its vastness of moral infamy-its wilful destruction of ante-natal human life, the amount of maternal lives destroyed, the extent of uterine and other diseases entailed by its practice, and the inefliciency of the laws to limitedly meet, and even partially control, the onward march of this rapidly growing “ fashionable crime," would require not only an essay of ordinary size to be prepared, but would require the compass of a volume. The Committee, therefore, determined to present the subject in such form only, or, rather, such phases of it, as will tend still further to excite and awaken than is already the case, the spirit of inquiry and reform, not only among the members of the medical profession, but especially among the members of the clerical profession and legislators. To especially arouse the attention of these two classes, and to invoke their cooperation in the good work of crushing out the crime--the one, by imparting the proper instruction in relation to the moral turpitude of the crime, the other to the creation of such laws as shall fully meet the necessities which now exist in regard to the punishment of those who engage in its practice. When these two classes shall be fully aroused to the importance of the labor, and zealously co-operate in the work of preventing and punishing the commission of the crime, then the prevention and cure of this terrible moral evil, with all its entailment of physical suffering, will be more than half accomplished.

To say that criminal abortion is now and bas been for a long series of years on the increase, and that the percentage of increase is marked by an excess in every succeeding year, or decade, is only

to express that which is familiar to every one who has paid thoughtful attention to the subject. So vast, indeed, is now the practice of the crime, and so universal is it, that it finds its patrons and devo. tees, not only in large cities, towns, and hamlets, but in rural districts, and glories in embracing alike within its vast, corrupting, and murderous influence, the ignorant and the educated, the vicious and

the refined, the professors and non-professors of religion. So broad . and vastly extended is the practice of criminal abortion, and so constant and persistent is its influence over nearly all classes of people, that it may be said to be now, and for a great number of years past, prevailing as a great immoral, body and soul-defiling, epidemic.

To demonstrate this fact, it is only necessary to consult the statistics bearing upon this subject, which have been carefully collected in such portions of our country, and abroad, where the laws regulating the registry of births and deaths are such as fully cover the important matters of the natural increase and the mortuary decrease of population.

The statistics, in this respect, of the city of New York, Massachusetts, Connecticut, Rhode Island, and other New England States, present facts and figures which are suggestive of a degree and vastness of a peculiar immorality, which, when fully comprehended, will fix the conviction, that criminal abortion, the murder of the innocent," is now in our day of such magnitude as to “out-Herod Herod,” and to demand the most active labors of all those whose efficiency in the correction and prevention of this crime is mainly to be relied upon, in freeing the land from this worse than an abomination.

Criminal abortion is now and has been steadily, for a long series of years, on the increase in this country. In proof of this declaration is here presented to you a few figures of unquestioned and unquestionable correctness: "In New York, from 1854 to 1857, there were 48,323 births, and 5931 still-births at the full time and prematurely, or one to every 8.1 were born dead" (Storer). These fig. ures indicate a mortality-as every accoucheur knows—too great to be attributed to the ordinary accidental or unavoidable causes which are generally operative in the production of still-births, and, therefore, it is fair to attribute the great excess to avoidable causes; or, in other words, the result of criminal intentions and acts on the part of the mother and her abettors.

At the present time the art of obstetrics is more perfect, and its practitioners more skilful and expert than at any anterior period This improved condition of the obstetric art, and the advance in

the skill and expertness of obstetricians, is not the growth or outcropping of any recent period, nor has it been of sudden develop. ment, but is the result of a steady and gradual progress made year by year. The number of still-births should have steadily and relatively decreased as advances were made in the art, the intent and best purpose of which is to give the mother a safe delivery of living offspring.

Statistics, however, exhibit the reverse of what we should expect, and what certainly would be the case, if still-births were the result of unavoidable causes only. To present this feature of the subject, in part of its hideousness, your patient attention is invited to some figures compiled from statistics collected by Dr. E. Harris, Registrar of Vital Statistics in New York, viz. :

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From 1804 to 1809, total mortality, 13,428; still-births, 349-1 to 37.6 1899 · 1815,

14,011;

533-1 · 26.3 1815 “ 1825,

34,798 ;

1818-1 " 19.1 1825 “ 1835,

59,317 ;

3744--1 " 15.9 1835 “ 1855,

289,786 ;

21,702-1 “ 13.3 1856

21,658;

1943-1 " 11.1 1868

1 " 10.5

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Thus is the exhibit made, that the percentage of still-births to the total sum of deaths has been rapidly increasing from 1809, when they were in the ratio of one still-born to every 37.6 of the total mortality, until, in 1868, we find the ratio of still-births has increased to one in 10.5, or that in the roll of 59 years they had nearly quad. rupled. What is true of New York is true of all the other old cities of the United States, as may be seen by a close inspection and study of statistics and facts which have been published in reference to this phase of the subject.

For this startling increase in the ratio of still-births to the entire sum of deaths, there is but one rational cause to which it can in justice and candor be assigned, and that, no matter how much we may regret the necessity for the admission, is criminal abortion. We must, in contemplating these figures and facts, not fail to recol. lect that the number of still-births referred to by these statistics embodies only the sum, at most, of those foetal beings which had passed the so-called, but improperly called, period of "quickening.” The number of those fætuses which have not reached this condition, for which there is not any numerical qualification, but which may in truth be said to be immense, a knowledge of which never reaches the Registrar, although to a great degree it does the physician, if added to the sum total of still-births, would run the figures up so high that, to name even a proximate number, would not only startle

you, but tend largely to fix in your minds a conviction that the great crime of the women of the present era, yea of the last half century, is criminal abortion; from which, God deliver them!

In Harper's Monthly Magazine of February, 1869, page 386, may be found an article entitled "Changes in Population," abounding with a large amount of facts of much importance to those who feel an interest in our subject. From that article is here presented a few matters of very decided interest.

"In a report upon the comparative view of the population of Boston in 1849 and 1850, made to the city government November, 1851, Dr. Jesse Chickering, after a most careful analysis of the births and deaths, states that the most important result derived from this view is the fact that the whole increase of population arising from the excess of births over the deaths for these two years has been among the foreign population. No higher authority can be cited on this subject than that of Dr. Chickering, who devoted more time and attention to the changes of population in Massachusetts than any other person.

" An examination of the Registration Reports for a series of years as to the relative number of births and deaths in the several counties, cities, and towns of the State will show this general fact that, wherever the births most exceed the deaths, there the foreign element most abounds; but where the population is made up mostly or entirely of the original native stock, the births and deatlis approximate near together, and not unfrequently alternate in excess, first one, then the other. From an examination into the history of several towns of this class, it was found that, for a long series of years the deaths had actually exceeded the birthis. A similar result was arrived at from an examination of the births and deaths for several years, confined exclusively to the Americans, in two of the principal cities of the State.

“But one of the most striking evidences of change in this respect is in the number and character of the pupils attending the public schools. In many school districts of country towns, where the population is made up wholly or principally of American stock, you can hardly find now children enough to make in numbers a respectable school, where once those same neighborhoods thronged with children. On the other hand, in large towns and villages, where the foreign population abounds, we find an abundance of children; the regular schools are crowded, and new schools every now and then have to be opened. To such an extent has this foreign element increased that, in some of the large towns and cities of the State it actually comprises full one-half of all the school

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children in those places. If a majority of all the youth and children under fifteen years of age, in a place, is made up from those of a foreign parentage, and is relatively increasing in number every year, how long will it be before such a power will be felt in the management, if not in the control, of the municipal government of those towns and cities?

" In Connecticut, where the proportion of the foreign class is much less than in Massachusetts, the School Report for 1866 states that the relative number of children had been steadily decreasing for the last forty years,' and the Report for 1867 states that the number was less even than in the previous year.

The State of Vermont, in which there is still less of the foreign element, reports relatively a less proportion of children than either of the New Eng. land States. In the Registration Report of Vermont for 1858 is found this remarkable comparison. It states that, while the producing part of the population, say from fifteen to fifty, was almost in precisely the same proportion to the whole population as that in England, the birth-rate in Vermont was 1 in 49, and in England (the same year) it was I in 31;' and should the foreign element, as small as it is, be separated, the birth-rate would be still lower-in fact, only about one-half as large as that of England. Considering that this comparison is made between a people engaged in agricultoral pursuits, and somewhat scattered in settlement, with a population situated as that of England is, living mostly in cities and thickly settled places, and composed largely of the extremes in society, the result is surprising."

It will not be contended that this non-production of offspring on the part of the Americans is entirely the result of the practice of criminal abortion, or the effect of the recourse to other censurable means for the purpose of preventing the increase of families, but We are ready to urge and prove that it is the result maily of the practice of criminal abortion.

Early in 1867, a committee was appointed by the Philadelphia County Medical Society to inquire into the extent of the practice of criminal abortion in Philadelphia, and to suggest a plan by which that crime might be abated; if possible, prevented.

The committee had several meetings, and had made considerable advance in the collection of the material necessary to the completion of a report, when, from the pressing public duties and commanding private engagements of its chairman-the late and lamented Dr. Wilson Jewell—the further prosecution of the duties of the committee was prevented.

Being a member of the committee, and learning from Dr. Jewell

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