the world through the thin abdominal walls rather than to wait for the more tedious passage per vias naturales. The teachings of the medical profession are, under the more careful physiological studies of the last hundred years, that the old notion of quickening is absurd and false; that there is no time from the moment of conception to the moment of birth when the fœtus is not a human being; and that its life is as sacred at one period as at another. Quickening, which may occur earlier or later as the child is vigorous or not, also depends in a measure upon the sensitiveness of the mother to feeble motions, one noticing them earlier than another. A child that may not be killed the day after it is born, can no more properly be killed the day before it is born-unless it be to save the mother, who is in imminent jeopardy, and when no other course. is practicable. Indeed, it is claimed by some that the living child in utero, whose passage into the world alive is impossible by the natural passages, has the right to have the mother's life imperilled by the Cæsarean section that it may have a chance of escape. But if the child may not be sacrificed the day before its birth can it be at any prior day? in the ninth month of gestation? or in the eighth month? or in the seventh? or when? From conception till the close of a life rounding its three score years and ten, physiology shows that the same individual exists, with no more distinctive periods which allow its life to be lawfully taken before birth than occur during its extra-uterine life. The medical profession also knows that abortion or miscarriage, whether artificially produced or not, always places the mother in great jeopardy; and no one, I presume, ever assumes the medical charge of such a case without dread, and is peculiarly happy when the innocent woman can be told that she is out of danger. Thus, then, the physicians as a body denounce this double crime, fatal if necessary to the child, and often proving to be so to the mother. Thus, then, the lawyers, recognizing the peril to the mother, seem to think she may demand that the operation shall be done by taking upon herself the risk, just as she might decide to have a tumor removed, which by its growth might be inconvenient though not dangerous, if she were willing to risk the peril of the anaesthetic, and the other possibilities of erysipelas or septicæmia, and that the operator in either case would be equally innocent. The destruction, I might say the murder, of the child does not seem to be an item taken into consideration. There is little doubt that the position taken by the lawyers is generally entertained by the community. Married as well as unmarried women apply to medical men to have an abortion produced with as much if not more readiness than they do to have a cancerous breast removed. Mothers will say that they prefer the life of the daughter shall be imperilled rather than have disgrace fall upon her. I have been told when refusing to do the operation on a married woman that I was too squeamish. A professional friend refusing to operate for a fee of five hundred dollars was told that it was a great loss to the community when Madam Restell died. It is, therefore, desirable to make the enormity of the crime more generally known, that physicians, who as a body refuse to do this operation, may be protected from the temptation which the comparatively large sums offered, and paid too, very naturally hold out to them. Our profession is not a wealthy one, and a five hundred dollar fee, and much more twice that sum, for a few minutes' work, requiring no great amount of skill, has very great attractions. I think I may properly quote the experience of a distinguished professor of obstetrics, now dead, but held in kind remembrance by hundreds throughout the country. He told me that, when his first wife was very ill and he was poor enough, a thousand dollars were offered to him to do this operation. Said he, "I thought how many things this would enable me to get for my poor wife, who needed them, but which I could not buy, but thank God-and as he said this his lip trembled-thank God, I said no." Now this same temptation, recognized in the excuses for the convict in Case III., comes to many a young man just commencing to practise medicine, and to many an older man who has perhaps "somehow got down hill," and who have not Gilman's rugged virtue to defend them. Can we wonder that they yield? While the whole tone of the medical profession as a body is against this crime, I see no other safeguards against its commission so likely to be effectual as a determined effort on the part of the courts to enforce the laws-which are, I am told, quite sufficient and a rigid holding of the criminal to the full amount of his sentence. I pity the innocent friends of the criminal, but the possibility of bringing such disgrace upon them ought to have deterred him from committing the crime. Let slackness in prosecution, or a ready throwing out of court for insufficient reasons, or easy access to gubernatorial clemency be characteristic of these cases, and the tempter will be still successful. But let the opposite to these characterize the crime, and they will do much to strengthen weak-kneed virtue. My purpose in bringing the subject before this Association, eminently representative of the medical profession of this country, is to urge upon it, either as a body, or upon its members as individuals, a decided and continued effort to enlighten the community in general, and the legal profession especially, upon the enormity of the crime of fœticide. The peril to the woman, great as it is, is safely escaped by very many-exactly what proportion it is impossible to say-but an abortion is of necessity fatal to the child, and the number of human lives thus destroyed is enormous. I therefore respectfully present the following propositions, urging their adoption by this Section and, if possible, by the whole Association: 1. Abortion should never be brought on by the use of medicinal or instrumental means unless necessary to the safety of the mother in consequence of pathological complications. 2. The destruction of the foetus in utero for any other reason, properly ranks with other forms of murder. 3. Abortion produced artificially always places the mother's life in jeopardy and thus becomes a double crime. 4. The severe punishment of the operator when possible, without any probability of executive clemency, is due in justice to the honorable members of the medical profession, and yet more to the community at large. UNSANITARY ENGINEERING AND ARCHITECTURE. By A. N. BELL, A.M., M.D., NEW YORK. SANITARY Engineering and Architecture should imply the construction of works, facilitating and protecting the purity of air and soil, as the essential conditions of human health, under all circumstances. But it is the misfortune of modern sanitary science that engineers and architects have, for the most part, treated it as an innovation not to be regarded at all, or only in its grosser parts, instead of an effort to incorporate and elaborate it as the most important of all contributions to their art and science. Hence are to be found habitual negligence or practical ignorance of sanitary science in the attempted following of, or improvement upon, more enlightened ancient works, and consequent recurrence or aggravation of diseases, which properly executed sanitary works would wholly prevent. The soil-drains of Rome and other ancient cities have been adopted by modern engineers as typical sewers-diverted to uses for which they were never intended; and soil drainage, the purpose for which the oft-cited cloaca of the ancients were constructed, is well-nigh or wholly neglected. While sanitary science has, for the last forty years, been enlarging its bounds by grasping the natural history of diseases, pointing out the nature of their causes, and the way they operate, exhibiting the vast extent of mortality from causes wholly removable; showing, by reason, experiment, and analogy, how life may be prolonged, health regained, and general happiness increased by the removal and prevention of the impurities of air, water, and soil, skilled engineers and architects-skilled in the arts which please the eye, and, for a time, flatter the pride of their admirers-habitually fail to recognize the presence of anything which they cannot see or feel: the diffusibility of gases, the emanations of organic matter in process of putrefaction, the permeability of material substances to moisture and gases, the VOL. XXXI.-31 |