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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. Anyone seeking to utilize +this eBook outside of the United States should confirm copyright +status under the laws that apply to them. diff --git a/README.md b/README.md new file mode 100644 index 0000000..c5ffd00 --- /dev/null +++ b/README.md @@ -0,0 +1,2 @@ +Project Gutenberg (https://www.gutenberg.org) public repository for +eBook #65701 (https://www.gutenberg.org/ebooks/65701) diff --git a/old/65701-0.txt b/old/65701-0.txt deleted file mode 100644 index 82a1f33..0000000 --- a/old/65701-0.txt +++ /dev/null @@ -1,2353 +0,0 @@ -The Project Gutenberg eBook of Why Not? A Book for Every Woman, by -Horatio Storer - -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you -will have to check the laws of the country where you are located before -using this eBook. - -Title: Why Not? A Book for Every Woman - -Author: Horatio Storer - -Release Date: June 26, 2021 [eBook #65701] - -Language: English - -Produced by: Brian Wilson, Jwala Kumar Sista and the Online Distributed - Proofreading Team at https://www.pgdp.net (This file was - produced from images generously made available by The - Internet Archive/American Libraries.) - -*** START OF THE PROJECT GUTENBERG EBOOK WHY NOT? A BOOK FOR EVERY -WOMAN *** - - - Transcriber's Notes - - 1. Typographical errors and hyphenation inconsistencies were - corrected. - - 2 The text version is coded for italics and other mark-ups i.e., - (a) Italics are indicated thus _italic_; - (b) Smallcaps thus +CAPS+: - - * * * * * - - WHY NOT? - - A BOOK FOR EVERY WOMAN. - - The Prize Essay - - TO WHICH THE AMERICAN MEDICAL ASSOCIATION - AWARDED THE GOLD MEDAL - FOR MDCCCLXV. - - BY - - HORATIO ROBINSON STORER, M.D., - - OF BOSTON, - -Assistant in Obstetrics and Medical Jurisprudence in Harvard University; - Surgeon to the New England Hospital for Women; and - Professor of Obstetrics and the Diseases of Women - in Berkshire Medical College. - - ISSUED FOR GENERAL CIRCULATION, BY ORDER OF THE - AMERICAN MEDICAL ASSOCIATION. - - _Casta placent superis. Casta cum mente venito, - Et manibus puris sumito fontis aquam._ - - BOSTON: - LEE AND SHEPARD. - 1866. - - - Entered, according to Act of Congress, in the year 1866, by - - LEE AND SHEPARD, - - In the Clerk's Office of the District Court of the - District of Massachusetts. - - -At the Sixteenth Annual Meeting of the American Medical Association, -held at Boston in June, 1865, it was, upon recommendation of the -Section on Practical Medicine and Obstetrics,-- - - _Resolved_, That the Committee on Publication be requested to - adopt such appropriate measures as will insure a speedy and general - circulation of the Prize Essay written for women; provided this can - be done without expense to the Association. - - - - - CONTENTS. - - - +PAGE+ - - +PREFATORY REMARKS+ 5 - - I. Origin and Purpose of the Present Essay 11 - - II. What has been done by Physicians to Foster, - and what to Prevent, the Evil 15 - - III. What is the True Nature of an Intentional - Abortion when not Requisite to Save the - Life of the Mother 27 - - IV. The Inherent Dangers of Abortion to a Woman's - Health and to her Life 36 - - V. The Frequency of Forced Abortions, even among - the Married 62 - - VI. The Excuses and Pretexts that are given for the - Act 70 - - VII. Alternatives, Public and Private, and Measures - of Relief 74 - - VIII. Recapitulation 79 - - +APPENDIX.+--Correspondence 88 - - - - - PREFATORY REMARKS. - - -It will be noticed that in the following Essay, the recipient of the -special prize for 1864–5 of the American Medical Association, its -author makes frequent reference, as to those of another, to his own -previous labors. This circumstance, now that his identity has been -revealed, might at first seem an infringement of the rules of good -taste. In the facts, however, that he felt compelled to take unusual -pains to conceal that identity prior to the decision of the Committee, -with all of whose members he has long enjoyed intimate acquaintance, -and that little other published material as yet exists, from which to -draw upon this subject, save his own, he places his excuse, and throws -himself upon the generous sympathy and forbearance of his readers. - -The Essay, when placed in the hands of the Committee, was accompanied -by the following statement, which it may not be out of place to -reproduce at the present time:-- - -"The writer, knowing nothing of the project to elicit a direct and -effective appeal to women upon the subject of criminal abortion, until -after it had been decided at the New York meeting,[1] has long been -a member of the Association. He is aware, from personal observation, -that induced miscarriage is of very frequent occurrence, and that its -effects are to the last degree disastrous to the country at large. He -has seen the change that has been effected in professional feeling -upon the subject as to the need that this depopulation, or rather -prevention of repopulation of the country, should be arrested, since -the publication of the Report of the Association's Special Committee, -which was appointed at Nashville in 1857. - -"It is, perhaps, presumptuous for him to undertake a task so strongly -appealing to all one's eloquence, sympathy, and zeal, and for the -proper performance of which there exist so many gentlemen in the -profession better qualified than himself. He does it, however, as the -passing traveller in distant lands, by casting his pebble upon the pile -of similar contributions that mark a single wayside grave, helps raise -a monument to warn of danger and to tell of crime, in the hope that -this waif of his may, perchance, effect somewhat toward arousing the -nation to the countless fœtal deaths intentionally produced each day in -its midst, and to prevent them. - -"The Association has empowered the Prize Committee to award the premium -of the present year to the best popular tract upon the subject of -induced abortion. The writer presents the accompanying paper neither -for fame nor for reward. It has been prepared solely for the good of -the community. If it be considered by the Committee worthy its end, -they will please adjudge it no fee, nor measure it by any pecuniary -recompense. Were the finances of the Association such as to warrant -it in more than the most absolutely necessary expenditures, yet would -the approbation of the Committee, and of the profession at large, be -more grateful to the writer than any tangible and therefore trivial -reward. - -"It is a singular and appropriate coincidence that the action of -the Association, originating as it did from Boston, in 1857, and -recognizing in no uncertain language, alike by the resolutions that -were formally adopted by the Louisville Convention, and by the memorial -presented by its President to the different legislative assemblies -and State Medical Societies of the Union, the necessity of a radical -change as to the popular estimate of the crime,--should now culminate -and become effective at a meeting of the Association in Boston, by -an authorized appeal in behalf of the profession to the community, -which alone makes and enforces the laws, till now a dead letter as -regards abortion, and which alone commits, palliates, and suffers from -the crime. It it is an equally striking and appropriate coincidence -that the Chairman of the Committee, at whose hands the selection of -that appeal must be made, though the Committee had been chosen for a -general purpose before it had been decided by the Association to elicit -essays upon this special subject, should be the physician who, in New -England, first appreciated the frequency of criminal abortions, pointed -out their true character, and denounced them. - -"If this Essay prove successful, its author only asks that the seal -which covers his identity may not be broken until the announcement is -made upon the platform of the Convention, pledging himself that this is -but for a whim of his own, and that he is well, and he trusts favorably -known, by many of the best men of the Association throughout the -Union."[2] - -There is one point, in connection with the present Essay, to which I -feel bound, in fairness alike to my professional brethren and to those -for whom I have now written, to direct attention. - -As every author who has decided opinions, and is alive to their -importance, must naturally and very necessarily do, I have incidentally -taken occasion to express myself upon certain collateral topics, but -only in so far as they were directly connected with, and germane to, -the main subject under discussion. Such statements are all of them to -be considered merely as expressions of my own individual opinion, and -not as the views, necessarily, of the mass of the profession. - -An instance of the kind referred to is where I allude to the advantages -of giving anæsthetics in child-bed, even though the labor is what is -termed a natural one; and I adduce correspondence upon this subject in -an appendix to the Essay. - -As upon some of these questions physicians honestly differ among -themselves, I have thought this disclaimer alike due to others and to -myself; they are matters, however, only incidental to the Essay, upon -the general subject of which the profession are wholly unanimous in -opinion. - - +HOTEL PELHAM, BOSTON+, - April, 1866. - - - - - WHY NOT? - - A BOOK FOR EVERY WOMAN. - - -I.--_Origin and Purpose of the Present Essay._ - -At the meeting of the American Medical Association, held at New York, -in 1864, it was, after mature deliberation, decided to issue "a short -and comprehensive tract, for circulation among females, for the purpose -of enlightening them upon the criminality and physical evils of forced -abortions." - -The source of this Essay is, therefore, in itself, well worthy -attention. The Association referred to represents the medical -profession of America, for it is composed of delegates, and only of -delegates, from every regularly organized hospital, medical society, -and medical college throughout the land, its members being, therefore, -almost all of them gentlemen advanced in years, of extended experience, -and of acknowledged reputation. That they should unanimously have -concurred in recommending any measure is, so far, proof that it was -needed. - -There are those, perhaps, who may suppose that in advising that -pregnancies, once begun, should be allowed to go on to their full -period, physicians are actuated by a selfish motive. On the contrary, -it will be shown that miscarriages are often a thousand fold more -dangerous in their immediate consequences, and, therefore, more -decidedly requiring medical treatment, than the average of natural -labors; that they are not only frequently much more hazardous to life -at the time, but to subsequent health, their results in some instances -remaining latent for many years, at times not showing themselves until -the so-called turn of life, and then giving rise to uncontrollable and -fatal hemorrhage, or to the development of cancer, or other incurable -disease. It is in reality the physician's province, indeed, it is his -sacred duty, to prevent disease as well as to cure it, and this, even -though it must plainly lessen the business and the emoluments that -would otherwise fall into his hands. Would women listen to the appeal -now to be made them, an immense deal of ill-health would be prevented, -and thousands of maternal as well as fœtal lives would annually be -saved. - -And, moreover, in the fact that the profession thus transcends, almost -for the first time, upon any matter in this country, the barrier which -for mutual protection, both of science and the community, has always -been allowed to stand, and directly addresses itself to the judgment -and to the hearts of women upon a question vital to themselves and to -the nation, there is afforded most conclusive evidence that the subject -is of the highest importance, that the step now taken is a necessary -one, and the motives that prompt it sincere. - -To women, on the other hand, how interesting the topic! It is one that -affects, and more directly, perhaps, than can anything else, their -health, their lives. It concerns their discretion, their conscience, -their moral character, their peace of mind, even its very possession, -for cases of insanity in women from the physical shock of an induced -abortion, or from subsequent remorse, are not uncommon. It involves -often all the elements of domestic happiness, the extent or existence -of the home circle, the matron's own self-respect, and often the very -gift or return of conjugal love; for, as has forcibly been asserted of -marriage where conception or the birth of children is intentionally -prevented, such is, in reality, but legalized prostitution, a sensual -rather than a spiritual union. - -Who can deny these premises? The experience of every physician confirms -them, as do a glance throughout every circle of society, and the -experience, personal or by observation, of almost every nurse, every -matron, every mother. Let us then, physicians and the community, -meet each other half way--ready to acknowledge, upon due evidence, -the frightful extent of the evil that exists in our homes--an evil, -in part occasioned by ignorance and carelessness, and that we are -both, in a measure, accountable for, and should be ready to assist -each other in its cure. I propose to show that induced abortions -are not only a crime against life, the child being always alive, or -practically supposed to be so; against the mother, for the laws do -not allow suicide, or the commission of acts upon one's own person -involving great risk to life; against nature and all natural instinct, -and against public interests and morality, but that, barring ethical -considerations, and looked at in a selfish light alone, they are so -dangerous to the woman's health, her own physical and domestic best -interests, that their induction, permittal, or solicitation by one -cognizant of their true character, should almost be looked upon as -proof of actual insanity. - - -II.--_What has been done by Physicians to Foster, and what to Prevent, -this Evil._ - -In our appeal we shall endeavor to go straight towards the mark, -nothing concealing, undervaluing, or selfishly excusing. And, first of -all, what part have physicians had in this great tragedy, wherein so -many women have been chief players? For it is to the medical attendant -that the community have a right to look for counsel, for assistance, -and for protection, and the present is an evil more especially and -directly coming within these bounds. - -From time immemorial such have been the deplorable tendencies of -unbridled desire, of selfishness and extravagance, of an absence of -true conjugal affection, there has existed in countless human breasts a -wanton disregard for fœtal life, a practical approval of infanticide. -This has, however, in the main been confined either to savage tribes, -or to nations, like the Chinese, with a redundant population, with each -of whom the slaughter of children after their birth is common, or to -the lowest classes of more civilized communities, impelled either by -shame, or, as in the burial clubs of the London poor, the revelations -of which a year or two since so startled the world, by the stimulus of -comparatively excessive pecuniary gain. - -That infanticide is of occasional occurrence in our own country, the -effect of vice or of insanity, has long been known; instances being -occasionally brought to the surface of society, and to notice by the -police, and through courts of law. - -The closely allied crime of abortion also dates back through all -history, like every other form or fruit of wickedness, originating -in those deeply-lying passions coeval with the existence of mankind. -Till of late, however, even physicians, who from time to time have -accidentally become cognizant of an isolated instance, have supposed or -hoped (and here the wish was father to the thought), that the evil was -of slight and trivial extent, and therefore, and undoubtedly with the -feeling that a thing so frightful and so repugnant to every instinct -should be ignored, the profession have, until within a few years, -preserved an almost unbroken silence upon the subject. - -Some ten years since, this matter was thoroughly taken in hand by -a physician much interested in the diseases of women, the younger -Dr. Storer, of Boston, with the frank acknowledgment that it was to -his father, the Professor of Midwifery in Harvard University, that -the credit of initiating the anti-abortion movement in New England -was justly due. Prof. Hodge, of Philadelphia, like the elder Dr. -Storer, had previously commented, in a public lecture to his class, -afterwards printed, upon the immorality and frequency of induced -miscarriage; and in Europe one or two physicians of eminence, as Dr. -Radford, had endeavored to arouse the profession to the real value -of fœtal life. The subject had also received some slight attention -in works upon medical jurisprudence, but in special treatises upon -abortion and sterility, their causes and treatment, of which the most -celebrated has been that of Dr. Whitehead, of England, the chance of -this occurrence and condition being dependent upon a criminal origin -had been almost entirely lost sight of. In investigating the cases -of disease in the better classes that came under observation, it was -now ascertained that a very large proportion of them were directly -owing to a previous abortion, and that in many of them this occurrence -had been intentional; the physician's consultation room proving in -reality a confessional, wherein, under the implied pledge of secrecy -and inviolate confidence, the most weighty and at times astounding -revelations are daily made. In such instances as those to which we are -now referring, the disclosures are in answer to no idle curiosity, but -to the necessity which always exists of knowing and understanding -every point relating to the causation, the treatment, the cure of -obscure disease. - -The profession were soon aroused to an appreciation of facts, whose -existence it was shown could so easily be proved by every physician, -and in 1857 a Committee, consisting of some of the more prominent and -most reliable practitioners in various parts of the country, with the -younger Storer as Chairman, was appointed by the American Medical -Association, at its meeting in Nashville, to investigate the crime with -a view to its possible suppression.[3] The report of this Committee was -rendered at Louisville, in 1859, and, supported as it was by a mass of -evidence of almost boundless scope, the measures proposed, chiefly of -a legislative character, were unanimously indorsed by the Association. -The evidence upon which the report was based was subsequently -published at Philadelphia, as a separate volume, "the first of a series -of contributions to Obstetric Jurisprudence" by its writer, under the -title of "Criminal Abortion in America," and was feelingly dedicated -"to those whom it may concern--Physician, Attorney, Juror, Judge, and -Parent." - -This detail, otherwise out of place in an appeal to the community, -is rendered perhaps necessary, that an exact and true impression may -be given of the steps that have been taken by medical men to redeem -themselves from the imputation of having been sluggish guardians of the -public weal. Since the time of the Louisville report, the profession -have been fully alive to the claims of the subject, and it is not with -unnatural satisfaction that its author, in a subsequent publication,[4] -has taken occasion to observe that the importance and legitimacy of -the investigation has now been acknowledged in the current files of -every medical journal, in the published transactions of the national -and minor medical associations, in many medical addresses, as that by -Dr. Miller, of Louisville, at the meeting of the Association at New -Haven, in 1860, over which he presided, and in nearly every general -obstetric work of any importance issued in this country since that -date, Bedford's Principles and Practice of Obstetrics, for instance, -and in many works of criminal law and medical jurisprudence, as Elwell, -Wharton and Stillé, and Hartshorne's edition of Taylor, to a much -greater extent than the subject in these works had ever been treated -before. - -I am constrained to acknowledge my indebtedness to the various -publications of the writer from whom I have quoted, for much of the -evidence I shall now present upon the subject of forced abortions. I -trust that thus offered it may lose none of its freshness, point, and -force. My frequent extracts from one who has given more thought to the -subject than probably any other person in the country, will, I am sure, -need no excuse. - -An opinion has obtained credence to a certain extent, and it has -been fostered by the miserable wretches, for pecuniary gain, at once -pandering to the lust and fattening upon the blood of their victims, -that induced abortions are not unfrequently effected by the better -class of physicians. Such representations are grossly untrue, for -wherever and whenever a practitioner of any standing in the profession -has been known, or believed to be guilty of producing abortion, except -absolutely to save a woman's life, he has immediately and universally -been cast from fellowship, in all cases losing the respect of his -associates, and frequently, by formal action, being expelled from all -professional associations he may have held or enjoyed. - -The old Hippocratic oath, to which each of his pupils was sworn by -the father of medicine, pledged the physician never to be guilty of -unnecessarily inducing miscarriage. That the standard, in this respect, -of the profession of the present day has not deteriorated, is proved by -the first of the resolutions adopted by the Convention at Louisville, -in 1859: "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."[5] - -It is true, however, that while physicians are unanimous as to the -sanctity of fœtal life, they have yet to a certain extent innocently -and unintentionally given grounds for the prevalent ignorance upon this -subject, to which I shall soon allude. The fact that in some cases of -difficult labor it becomes imperatively necessary to remove the child -piecemeal, if dead, or, if living, to destroy it for the sake of saving -the mother's life, ought not to imply that the physician has attached -a trifling value to the child itself. Compared with the mother, who -is already mature and playing so important a part in the world, he -justly allows the balance to fall, but he fully recognizes that he is -assuming a tremendous responsibility, that his action is only justified -by the excuse of dire necessity, and he suffers, if he is a man of any -sensibility and feeling, an amount of mental anguish not easily to be -described, and that none of us, who have been compelled to so terrible -a duty, need feel ashamed to confess. - -There are cases again, where, during pregnancy, the patient may be -reduced by the shock of severe and long-continued pain or excessive -vomiting, and its consequent inanition, to the verge of the grave. In -such instances, it has been supposed that abortion was necessary to -preserve the woman's life. The advance of science, however, has now -shown that this procedure is not only often unnecessary, but in reality -unscientific; the disturbances referred to occurring, as they generally -do, in the earlier months of gestation, being owing not to the direct -pressure of the womb upon the stomach or other organs, but to a -so-called reflex and sympathetic disturbance of those organs, through -the agency of the nervous system; and that a cure can in general be -readily effected without in any way endangering the vitality of the -child. - -There are other instances that might be cited, cases of dangerous -organic disease, as cancer of the womb, in which, however improbable -it might seem, pregnancy does occasionally occur; cases of insanity, -of epilepsy, or of other mental lesion, where there is fear of -transmitting the malady to a line of offspring; cases of general -ill-health, where there is perhaps a chance of the patient becoming an -invalid for life; but for all these, and similar emergencies, there -is a single answer, and but this one--that abortion, however it may -seem indicated, should never be induced by a physician upon his own -uncorroborated opinion, and, in a matter so grave, affecting, with -his own reputation, the life of at least one, if not of a second -human being, every man worthy of so weighty and responsible a trust -will seek in consultation a second opinion. This is a matter of such -importance to the welfare of the community, that long ago the law -should have provided for its various dangers, and should wisely have -left it to no man's discretion or purity of character to withstand the -tremendous temptations which must be allowed to here exist. The law now -provides, in one or more at least of our States, that the certificate -of a single physician, no matter what his skill or standing, cannot -commit a patient to the often necessary and beneficial seclusion of -a lunatic asylum; two are required. How much more requisite is it -that in the question we are now considering, to one mode of deciding -which the physician may be prompted by pity, by personal sympathy, the -entreaties of a favorite patient, and not seldom by the direct offer of -comparatively enormous pecuniary compensation, the law should offer him -its protecting shield, saving him even from himself, and helping him -to see that the fee for an unnecessarily induced or allowed abortion -is in reality the price of blood. As a class, it cannot be gainsaid -that physicians of standing will spurn with indignation the direct -bribe; let them look to it that they never carelessly permit what they -condemn, by endeavoring to bring on the woman's periodical discharge -when it is possible that she may have conceived, or by carelessly -passing an instrument into her womb without ascertaining whether or no -it contain the fruit of impregnation, or by allowing the completion -of a miscarriage that may threaten or even have commenced, without -resorting to every measure, of whatever character, that can possibly -result in its arrest, and the consequent completion of the full period. - - -III.--_What is the True Nature of an Intentional Abortion when not -Requisite to Save the Life of the Mother._ - -There are those who will be influenced by evidence presented from -abstract morality and religion. To such I shall first address myself. -There are others who care nothing for ethical considerations, and -who arrogate to themselves a right to decide as to the morality of -taking or destroying the life of an unborn child. For these, also, I -have an unanswerable argument--their own self-interest--an appeal to -which will usually arrest the most hardened adept in other crime, much -more these intelligent and otherwise innocent women, who have mostly -erred through ignorance and a misapprehension of their own physical -condition, and their own physical dangers, their own physical welfare. - -Physicians have now arrived at the unanimous opinion, that the fœtus in -utero is _alive_ from the very moment of conception. - -"To extinguish the first spark of life is a crime of the same nature, -both against our Maker and society, as to destroy an infant, a child, -or a man."[6] - -More than two hundred years ago the same idea was as vigorously as -quaintly expressed: "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."[7] - -The law, whose judgments are arrived at so deliberately, and usually -so safely, has come to the same conclusion, and though in some of its -decisions it has lost sight of this fundamental truth, it has averred, -in most pithy and emphatic language, that "quick with child, is having -conceived."[8] - -By that higher than human law, which, though scoffed at by many a -tongue, is yet acknowledged by every conscience, "the wilful killing of -a human being, at any stage of its existence, is murder."[9] - -Abortion or miscarriage is known by every woman to consist of the -premature expulsion of the product of conception. It is not as well -known, however, if the statements of patients are to be relied upon, -that this product of conception is in reality endowed with vitality -from the moment of conception itself. It is important, therefore, to -decide in what the moment of conception consists. It has now been -ascertained that every variety of animal life originates from an egg, -even primarily those lowest forms in which occur the phenomena of -so-called alternate generation; in each and every one of them, mammals -or invertebrates, the origin is from as distinct an egg as is laid -by bird, tortoise, or fish; the human species being no exception to -this general rule. Before this egg has left the woman's ovary, before -impregnation has been effected, it may perhaps be considered as a -part and parcel of herself, but not afterwards. When it has reached -the womb, that nest provided for the little one by kindly nature, -it has assumed a separate and independent existence, though still -dependent upon the mother for subsistence. For this end the embryo is -again attached to its parent's person, temporarily only, although so -intimately that it may become nourished from her blood, just as months -afterwards it is from the milk her breasts afford. This is no fanciful -analogy; its truth is proved by countless facts. In the kangaroo, -for instance, the offspring is born into the world at an extremely -early stage of development, "resembling an earthworm in its color and -semi-transparent integument,"[10] and then is placed by the mother -in an external, abdominal, or marsupial pouch, to portions of which -corresponding, so far as function goes, at once to teats and to the -uterine sinuses, these embryos cling by an almost vascular connection, -until they are sufficiently advanced to bear detachment, or in reality -to be born. The first impregnation of the egg, whether in man or in -kangaroo, is the birth of the offspring to life; its emergence into -the outside world for wholly separate existence is, for one as for the -other, but an accident in time. It has been asserted by some authors, -as by Meigs, that conception is only coincident with the attachment -of the impregnated egg to the uterine cavity for its temporary abode -therein, or, in exceptional cases, as in extra-uterine pregnancy -so called, with its attachment to some other tissue of the mother; -thereby attempting to establish a difference between impregnation and -conception; a difference that is at once philosophically unfounded, -and plainly disproved by all analogical evidence, as the fact, for -instance, that in most fishes impregnation occurs entirely external to -the body of the mother, from which the ova had previously, or during -the process of copulation, permanently been discharged. - -Many women suppose that the child is not alive till quickening has -occurred, others that it is practically dead till it has breathed. As -well one of these suppositions as the other; they are both of them -erroneous. - -Many women never quicken at all, though their children are born living; -others quicken earlier or later than the usual standard of time; or, -others again may, in their own persons, have noticed either or all of -these peculiarities in different pregnancies. Quickening is in fact -but a sensation, the perception of the first throes of life--but of a -twofold occurrence, and this not merely the motion of the child, but -often the sudden emergence of the womb upwards from its confinement in -the low regions of the pelvis into the freer space of the abdomen. The -motions of the child, which have been proved by Simpson, of Edinburgh, -to be its involuntary efforts, through the reflex action of its nervous -system, to retain itself in certain attitudes and positions essential -to its security, its sustenance, and its proper development, are -usually present for a period long prior to the possibility of their -being perceived by the parent. They may very constantly be recognized -by the physician in cases where no sensation is felt by the mother, and -the fœtus has been seen to move when born, during miscarriage, at a -very early period. - -During the early months of pregnancy, while the fœtus is very small -in proportion to the size of the cavity which contains it, sounds, -produced by its movements, may be distinguished by the attentive ear -applied to the abdomen of the mother, as gentle taps repeated at -intervals, and continued uninterruptedly for a considerable time. These -sounds may sometimes be heard several weeks before the usual period -of the mother's becoming conscious of the motion of the child, and -also earlier than the pulsations of the fœtal heart or the uterine -souffle,[11] as the murmur of the circulation in the walls of that -organ, or in the tissue of the after-birth, is technically termed. -These motions must be allowed to prove life, and independent life. -In what does this life really differ from that of the child five -minutes in the world? Is not, then, forced abortion a crime? Moreover, -instances have occurred where, the membranes having been accidentally -ruptured, the child has breathed, and even cried, though yet unborn, -as proved alike by the sounds within the mother, well authenticated by -bystanders, and by auscultation of her abdomen, and by the fact that -sometimes, when not born living, the lungs of the fœtus have been found -fully expanded, a process which can be effected only by respiration, -and of which the proofs are such as can be occasioned in no other way -whatever. - -In the majority of instances of forced abortion, the act is committed -prior to the usual period of quickening. There are other women, who -have confessed to me that they have destroyed their children long -after they have felt them leap within their womb. There are others -still, whom I have known to wilfully suffocate them during birth, or to -prevent the air from reaching them under the bedclothes; and there are -others, who have wilfully killed their wholly separated and breathing -offspring, by strangling them or drowning them, or throwing them into a -noisome vault. Wherein among all these criminals does there in reality -exist any difference in guilt? - -I would gladly arrive at, and avow any other conviction than that -I have now presented, were it possible in the light of fact and -of science, for I know it must carry grief and remorse to many an -otherwise innocent bosom. The truth is, that our silence has rendered -all of us accessory to the crime, and now that the time has come to -strip down the veil, and apply the searching caustic or knife to this -foul sore in the body politic, the physician needs courage as well as -his patient, and may well overflow with regretful sympathy. - -That there has existed a wide and sincere ignorance of the true -character of the act, I have already allowed; it is a point to which -I shall again refer. At present let us turn from the crime against -the child, to the crime as against the mother's own life and health. -I here refer more particularly to her own agency therein. Of the -guilt of abortion when committed by another person than herself, and -with reference both to the mother's life and that of the child, there -can be no doubt, but it is to the woman's own agency in the act, as -principal, or accessory by its solicitation or permission, that we have -now to deal; not as to its abstract wrong alone, but as to its physical -dangers, and therefore its utter folly. - - -IV.--_The Inherent Dangers of Abortion to a Woman's Health and to her -Life._ - -It is generally supposed, not merely that a woman can wilfully throw -off the product of conception without guilt or moral harm, but that -she can do it with positive or comparative impunity as regards her own -health. This is a very grievous and most fatal error, and I do not -hesitate to assert, from extended observation, that, despite apparent -and isolated instances to the contrary-- - -1. A larger proportion of women die during or in consequence of an -abortion, than during or in consequence of childbed at the full term -of pregnancy; - -2. A very much larger proportion of women become confirmed invalids, -perhaps for life; and, - -3. The tendency to serious and often fatal organic disease, as cancer, -is rendered much greater at the so-called turn of life, which has very -generally, and not without good reason, been considered as especially -the critical period of a woman's existence. - -These, as I have said, are conclusions that cannot be gainsaid, as they -are based on facts; and that these facts are merely what ought, in the -very nature of things, to occur, can readily enough be shown. - -1. Nature does all her work, of whatever character it may be, in -accordance with certain simple and general laws, any infringement of -which must necessarily cause derangement, disaster, or ruin. - -In the present instance, it has been ascertained, by careful -dissections and microscopic study, that the woman's general system, -both as a whole and as regards each individual organ and its tissues, -is slowly and gradually prepared for the great change which naturally -occurs at the end of nine months' gestation; and that if this change -is by any means prematurely induced, whether by accident or design, -it finds the system unprepared. Not even do I except from this law -the earlier months of pregnancy, when it is thought by so many that -abortion can be brought on without any physical shock. - -During pregnancy all the vital energies of the mother are devoted to -a single end: the protection and nourishment of the child. Such wise -provision is made for its security, such intimate vascular connection -is established between the fœtal circulation and the blood-vessels of -the mother, that its premature rupture is usually attended by profuse -hemorrhage, often fatal, often persistent to a greater or less degree -for many months after the act has been completed, and always attended -with more or less shock to the maternal system, even though the full -effect of this is not noticed for years. - -In birth at the full period, it is found that what is called by -pathologists fatty degeneration of the tissues, occurs both in the -walls of the mother's womb, and in the placenta or after-birth, by -which attachment is kept up with the child. This change, in all other -instances a diseased process, is here an essential and healthy one. By -it the occurrence of labor at its normal period is to a certain extent -determined; by it is provision made against an inordinate discharge of -blood during the separation and escape of the after-birth, and by it is -the return of the uterus to the comparatively insignificant size, that -is natural to it when unimpregnated, insured. Any deviation from this -process at the full term, which prevents the whole chain of events now -enumerated from being completed, lays the foundation of, and causes a -wide range of uterine accidents and disease, displacements of various -kinds, falling of the womb downwards or forwards or backwards, with the -long list of neuralgic pains in the back, groins, thighs, and elsewhere -that they occasion; constant and inordinate leucorrhœa; sympathetic -attacks of ovarian irritation, running even into dropsy, &c., &c. These -are only a portion of the results that might be enumerated. - -Now, while all this is true of any interference with the natural -process at the full time, it is just as true, and if anything more -certain, when pregnancy has been prematurely terminated; and out of -many hundred invalid women, whose cases I have critically examined, in -a very large proportion I have traced these symptoms, to the mental -conviction of the patient, as well as to my own, directly back to an -induced abortion. - -Again--not merely does nature prepare the appendages of the child and -the womb of its mother for the separation that in due time is to ensue -between them, it also provides an additional means of insuring its -successful accomplishment through the action that takes place in the -woman's breasts, namely, the secretion of the milk. Though the escape -of this fluid does not ordinarily occur in any quantity until some -little time after birth has been effected, yet the changes that ensue -have gradually been progressing for days, or weeks, or even months; -for, as is well known, in some women the lacteal secretion is present -before birth, at times even during a large part of pregnancy, and in -all women there is doubtless a decided tendency of the circulation -towards the breasts, prior to the birth of the child, just as there -has been so extreme a tendency of the circulation for so long a time -towards the womb. It is indeed to take the place of the latter that -the former is established, and to prevent the evil consequences that -might otherwise ensue. The sympathy between the mammary glands and -the uterus is now well established; it is shown in many different -ways: in some women the application of the child to the breasts is -immediately followed by after-pains, and in others these pains, which -are usually but contractions of the womb to expel any clots that may -have accumulated, are attended by a freer secretion or discharge of -the milk. It is not uncommon, when the monthly discharge is scanty -or suddenly checked, for the breasts to become enlarged and painful, -as is so often the case soon after impregnation, while, on the other -hand, one of the most efficient means we have of establishing the -periodical flow, when suppressed, is by the application of sinapisms -to the surface of the breasts. In view of these facts it will -readily be understood why it is that women who make good nurses are -so much less likely than others to suffer from the various disorders -of the womb, and why they are also less likely to rapidly conceive, -and why, moreover, too long lactation should not be indulged in for -either of these so desirable ends. The demands of fashion shorten or -prevent nursing, the demands of fashion often forbid a woman from -bearing children; but whether this is attained by the prevention -of impregnation, or by the induction of miscarriage, it is almost -inevitably attended, as is to a certain extent the sudden cessation of -suckling, by a grievous shock to the mother's system, that sooner or -later undermines her health, if even it does not directly induce her -death. - -I have asserted that dangers attend the occurrence of abortion which -directly threaten a mother's life. This is true of all miscarriages, -whether accidental or otherwise; but these dangers are enhanced when -the act is intentional. When caused by an accident, the disturbance -is often of a secondary character, the vitality of the ovum being -destroyed, or the activity of the maternal circulation checked, before -the separation of the two beings from each other finally takes place. -But in a forced abortion there is no such preservative action; the -separation is immediate if produced by instruments, which often besides -do grievous damage to the tissues of the mother with which they are -brought into contact, lacerating them, and often inducing subsequent -sloughing or mortification; or, if the act is effected by medicines, -it is usually in consequence of violent purgation or vomiting, which -of themselves often occasion local inflammation of the stomach or -intestines, and death. Add to this that even though the occurrence of -any such feeling may be denied, there is probably always a certain -measure of compunction for the deed in the woman's heart--a touch of -pity for the little being about to be sacrificed--a trace of regret for -the child that, if born, would have proved so dear--a trace of shame -at casting from her the pledge of a husband's or lover's affection--a -trace of remorse for what she knows to be a wrong, no matter to what -small extent, or how justifiable, it may seem to herself, and we -have an explanation of the additional element in these intentional -abortions, which increases the evil effect upon the mother, not as -regards her bodily health alone, but in some sad cases to the extent -even of utterly overthrowing her reason. - -The causes of an immediately or secondarily fatal result of labor -at the full period are few; in abortion nearly every one of these -is present, with the addition of others peculiar to the sudden and -untimely interruption of a natural process, and the death of the -product of conception. There is the same or greater physical shock, -the same or greater liability to hemorrhage, the same and much greater -liability to subsequent uterine or ovarian disease. To these elements -we must add another, and by no means an unimportant one; a degree of -mental disturbance, often profound, from disappointment or fear, that -to the same extent may be said rarely to exist in labors at the full -period.[12] - -Viewing this subject in a medical light, we find that death, however -frequent, is by no means the most common or the worst result of the -attempts at criminal abortion. This statement applies not to the mother -alone, but, in a degree, to the child. - -We shall perceive that many of the measures resorted to are by no means -certain of success, often indeed decidedly inefficacious in causing the -immediate expulsion of the fœtus from the womb; though almost always -producing more or less severe local or general injury to the mother, -and often, directly or by sympathy, to the child. - -The membranes or placenta may be but partially detached, and the ovum -may be retained. This does not necessarily occasion degeneration, as -into a mole, or hydatids, or entire arrest of development. The latter -may be partial, as under many forms, from some cause or another, does -constantly occur; if from an unsuccessful attempt at abortion, would -this be confessed, or indeed always suggest itself to the mother's own -mind? Fractures of the fœtal limbs, prior to birth, are often reported, -unattributable in any way to the funis, which may amputate, indeed, -but seldom break a limb. A fall or a blow is recollected; perhaps it -was accidental, perhaps not, for resort to these for criminal purposes -is very common. In precisely the same manner may injury be occasioned -to the nervous system of the fœtus, as in a hydrocephalic case long -under the writer's own observation, where the cause and effect were -plainly evident. Intrauterine convulsions have been reported; as -induced by external violence they are probably not uncommon, and the -disease thus begun may eventuate in epilepsy, paralysis, or idiocy. - -To the mother there may happen correspondingly frequent and serious -results. Not alone death, immediate or subsequent, may occur from -metritis, hemorrhage, peritonitic, or phlebitic inflammation, from -almost every cause possibly attending not merely labor at the full -period, comparatively safe, but miscarriage increased and multiplied by -ignorance, by wounds, and violence; but if life still remain, it is too -often rendered worse than death. - -The results of abortion from natural causes, as obstetric disease, -separate or in common, of mother, fœtus, or membranes, or from a morbid -habit consequent on its repetition, are much worse than those following -the average of labors at the full period. If the abortion be from -accident, from external violence, mental shock, great constitutional -disturbance from disease or poison, or even necessarily induced by the -skilful physician in early pregnancy, the risks are worse. But if, -taking into account the patient's constitution, her previous health, -and the period of gestation, the abortion has been criminal, these -risks are infinitely increased. Those who escape them are few. - -In thirty-four cases of criminal abortion reported by Tardieu, where -the history was known, twenty-two were followed, as a consequence, by -death, and only twelve were not. In fifteen cases necessarily induced -by physicians, not one was fatal. - -It is a mistake to suppose, with Devergie, that death must be -immediate, and owing only to the causes just mentioned. The rapidity -of death, even where directly the consequence, greatly varies; though -generally taking place almost at once if there be hemorrhage, it may -be delayed even for hours where there has been great laceration of -the uterus, its surrounding tissues, and even of the intestines; if -metro-peritonitis ensue, the patient may survive for from one to four -days, even, indeed, to seven and ten. But there are other fatal cases, -where on autopsy there is revealed no appreciable lesion, death, the -penalty of unwarrantably interfering with nature, being occasioned by -syncope, by excess of pain, or by moral shock from the thought of the -crime. - -That abortions, even when criminally induced, may sometimes be safely -borne by the system, is of little avail to disprove the evidence of -numberless cases to the contrary. We have instanced death. Pelvic -cellulitis, on the other hand, fistulæ, vesical, uterine, or between -the organs alluded to; adhesions of the os or vagina, rendering -liable subsequent rupture of the womb, during labor or from retained -menses, or, in the latter case, discharge of the secretion through a -Fallopian tube, and consequent peritonitis; diseases and degenerations, -inflammatory or malignant, of both uterus and ovary; of this long -and fearful list, each, too frequently incurable, may be the direct and -evident consequence, to one patient or another, of an intentional and -unjustifiable abortion. - -We have seen that, in some instances, the thought of the crime, -coming upon the mind at a time when the physical system is weak and -prostrated, is sufficient to occasion death. The same tremendous -idea, so laden with the consciousness of guilt against God, humanity, -and even mere natural instinct, is undoubtedly able, where not -affecting life, to produce insanity. This it may do either by its -first and sudden occurrence to the mind, or, subsequently, by those -long and unavailing regrets, that remorse, if conscience exist, is -sure to bring. Were we wrong in considering death the preferable -alternative?[13] - -To the above remarks it might truthfully be added, that not only is -the fœtus endangered by the attempt at abortion, and the mother's -health, but that the stamp of disease thus impressed is very apt to -be perceived upon any children she may subsequently bear. Not only -do women become sterile in consequence of a miscarriage, and then, -longing for offspring, find themselves permanently incapacitated for -conception, but, in other cases, impregnation, or rather the attachment -of the ovum to the uterus, being but imperfectly effected, or the -mother's system being so insidiously undermined, the children that are -subsequently brought forth are unhealthy, deformed, or diseased. This -matter of conception and gestation, after a miscarriage, has of late -been made the subject of special study, and there is little doubt that -from this, as the primal origin, arises much of the nervous, mental, -and organic derangement and deficiency that, occurring in children, -cuts short or embitters their lives. - -It may be alleged by those who, sceptical or not sceptical as to these -conclusions, have reason, nevertheless, to desire to throw discredit -upon them, that the weekly or annual bills of mortality, the mortuary -statistics, do not show such direct influence from the crime of -abortion as I have claimed exists. - -On the other hand, it must not be forgotten that in these cases there -is always present every reason for concealment. In the earlier months -of pregnancy it is very difficult to prove, in the living subject, that -pregnancy has occurred. Such a conclusion being arrived at, before -the sound of the fœtal heart can be heard, for this is the only sign -that is positively certain, by merely circumstantial and probable -evidence, which becomes of weight only as it is accumulated and found -corroborative. In the dead subject, the victim of an abortion in -the earlier months, the case is often equally obscure, or at least -doubtful, unless the product of conception has not yet escaped, or, -having been thrown off, has been detected or preserved. When found, -it of course proves pregnancy, whether the parent be living or dead; -that is, in the former instance, if its discharge can be traced -directly to the woman in question, and to no other, and correlative -circumstances may show that an abortion has occurred; but this may -have been accidental and guiltless. Where the act has been committed -by an accomplice, the proofs of such commission and of the intent, -though this is generally implied by the act itself, are by no means -always forthcoming. Where the abortion has been induced by the woman -herself, as is now so frequently the case, certainty upon the point -becomes far more difficult. The only positive evidence by which to -judge of the real frequency of the crime is _confession_, and it is -from the confessions of many hundreds of women, in all classes of -society, married and unmarried, rich and poor, otherwise good, bad, or -indifferent, that physicians have obtained their knowledge of the true -frequency of the crime. - -The confidential relations in which the physician stands to his -patient; the understanding that nothing can wring from him her -disclosures, save the direct commands of the law, so unlikely in -any given case to become cognizant of its existence, elicits from a -woman in almost every instance, especially if she believes herself in -peril of death, a frank statement of the means by which she has been -brought low; for it is evident that upon such knowledge must depend -the measures of relief to which the physician may resort. Could the -test of confession be always applied, as is, however, manifestly -impossible, so many women die during or in consequence of an abortion, -without the attendance of a physician and without making any sign, it -would be found that many of the cases now reported upon our bills of -mortality as deaths from hemorrhage, from menorrhagia, from dysentery, -from peritonitis, from inflammation of the bowels or of the womb, from -obscure tumor, or from uterine cancer, would be found in reality to -be deaths from intentional abortion. At first sight, it would seem -impossible that such grossly erroneous opinions as the above could -be rendered; but their likelihood is readily perceived when it is -recollected how often, when the best medical skill has been secured, -attending circumstances are such as to excite little or no suspicion of -the true state of the case, and a physical examination of the patient -is therefore neglected. Women are still allowed to die of ovarian or -of other tumors that might be easily and successfully removed, and, in -default of a proper examination, are sometimes mistakenly pronounced -instances of disease of the liver or of ordinary abdominal dropsy, and -as such are buried. If such and similar errors can occur in chronic -cases, where time and opportunity have permitted the most thorough -examination and study, still more likely are they to take place during -the hurry and anxieties of an acute and alarming attack, where the -conscience and shame of the patient are alike interested in causing or -keeping up a deception. - -It will have been seen, then, not merely that an induced abortion may -be attended with great immediate danger to the mother, but that in -reality it is very often fatal, either from the so-called shock to her -system, or from hemorrhage, or from immediately ensuing peritonitis. - - * * * * * - -2. Should the woman survive these immediate consequences, no matter how -excellently she may have seemed to rally, she is by no means safe as to -her subsequent health. There are a host of diseases, some of them very -dangerous, to which she is directly liable. - -The product of conception is not always entirely gotten rid of. If a -fragment remains, no matter how trifling in size, it may serve as the -channel of the most severe and constant hemorrhagic discharge. Of this, -examples are by no means infrequent; the flux lasting at times for very -many months, and, if the cause is not finally detected and removed, -hurrying the patient to her grave. - -The product of conception is sometimes retained entire, after its -detachment from the uterine walls has been supposed wholly effected. -It may be carried for many years, always acting as a foreign body; at -times occasioning extreme irritation, shown perhaps only by distant -and otherwise inexplicable symptoms, or it may lie dormant for a time -without apparent trouble--finally making itself known by some sudden -explosion of disease, whether by purulent absorption and general -pyæmia; by ulceration and discharge of fœtal debris, through the -intestines, bladder, or even abdominal integuments; or, by metritic -inflammation, followed by sympathetic or consequent fatal peritonitis. - -The patient, after an abortion, is very liable to one or another of -the forms of uterine displacement, which are now known to lie at the -foundation of so very large a proportion of the lame backs, formerly -supposed consequent on spinal irritation; of the painfully neuralgic -breasts, so often suggestive of incipient cancer; of the disabled -limbs, pronounced affected with sciatica, cramps, or even paralysis; -of the impatient bladders, from whose irritability or incontinence -the kidneys are supposed diseased; of the obscure abdominal aches and -pains, which unjustly condemn so many a liver and so many an ovary; -of the constipation from mere mechanical pressure, which is so often -thought to argue stoppage from stricture or other organic disease; of -the severe and intractable headaches that, resisting all and every -form of direct or constitutional treatment, are supposed to indicate -an incurable affection of the brain; of the easily deranged stomachs, -that are so suggestive of ulceration or of malignant degeneration; of -the general hypochondria and despondency, that of the most gentle, -even almost angelic, dispositions make the shrew and virago, and of -the purest and most innocent produce, in her own conceit, the worst of -sinners, even at times effecting suicide. Who that has suffered will -think this picture overdrawn? Who that has practised will not recognize -in displacements, the key by which these riddles may be solved? - -Their mode of causation is plain. After an abortion, just as after -labor at the full term, the womb is more weighty than natural--its -walls thicker and heavier than usual, alike by the excess of blood -they contain, and by the increased deposition of muscular fibre. After -childbed, it has been shown that this increase is normally lessened -by certain physiological processes attending the natural completion -of that function. After an abortion, these processes are absent or -are but imperfectly performed. It is notorious that during the slight -increase of weight from simple congestion that occurs at the regular -monthly periods, women are very liable to displacement on any effort, -extreme or slight, whether riding on horseback, gently lifting, or -even straining at stool; during or after an abortion, the risk is very -greatly increased. - -With equal justice could I refer to the chances of trouble that -otherwise accompany the premature ending of pregnancy. In many -instances, I have now been summoned to attend, and frequently to -operate upon, the consequences of local uterine or vaginal inflammation -or of laceration, for both of these results may ensue where the womb -has not been prepared to evacuate itself by the normal closure of -pregnancy--and this, whether or not instruments may have been employed. -Adhesions of varying situation and extent are not uncommon as the -result of an abortion. They may be slight, and merely tilt or draw -the womb to one side, giving rise only to severe local or distant -neuralgias, and rendering the occurrence of a subsequent pregnancy -somewhat dangerous; they may be more decided, and as bridles or septa -partially close the canal of the vagina, rendering menstruation and -conjugal intercourse alike difficult and painful; they may be so -complete as entirely to obliterate the mouth of the womb or of the -external passage, in these instances preventing the escape of the -menses, and rendering an operation necessary to avoid a rupture that -might perhaps be fatal. Should it be the outer entrance that is -occluded, the woman is of course entirely shut off from her husband's -embrace; an effect that, however grateful to many an invalid, her shame -would hardly be willing to accept as the consequence of disease. - -These that I have mentioned are but a tithe of the pathological effects -daily revealed to physicians, as in consequence of an intentional -abortion. They are, however, sufficient for our purpose. - - * * * * * - -3. But not only is a woman in peril both as to life and health, alike -at the time of an abortion and for months or years subsequently. She -may seem to herself and to others successfully to have escaped these -dangers, and yet when she has reached the critical turn of life, -succumb. - -At this eventful period, when the fountains of youth dry up, and the -scanty circulation is turned from its accustomed channel, the woman -ceases from the periodical discharges, which in health and with care -are the secret of her beauty, her attractions, her charms. At its -occurrence not merely is a change produced in the system generally, -but the womb, no longer required, becomes atrophied and dwindles into -insignificance. It may have had impressed upon it, years and years -back, the stamp of derangement, till now not rendered effective; for, -as in other portions of the body, a part once weakened may retain -itself in tolerably good condition until some accident or other change -develops or awakens the seed of disease. Thus it is that an ancient -hypertrophy, or a chronic irritation, may become scirrhous and -degenerate into undoubted carcinoma, or chronic menorrhagia or uterine -leucorrhœa become intractable hemorrhage, or a latent fibroid deposit -develop into an irrepressible, and, perhaps, irremediable tumor. - -Little the comfort for a woman to have had her own way against the -dictates of her conscience, the advice, perhaps, of her physician, -if to the dangers she must directly incur, she must add the looking -forward through all the rest of her life to possible disease, -invalidism or death as the direct consequence of her folly; no wonder -if she should consider prevention better than such cure as this, -and yet the prevention of pregnancy, by whatever means it may be -sought, by cold vaginal injections, or by incomplete or impeded sexual -intercourse, is alike destructive to sensual enjoyment and to the -woman's health; her only safeguard is either to restrict approach to a -portion of the menstrual interval, or to refrain from it altogether. - -Not merely are certain of the measures to which I have alluded -detrimental to the health of the woman, they are so to both parties -engaged, and it is to their frequent employment, freely confessed -as this is to the physician, that much of the ill health of the -community, both of men and women is to be attributed. Though they may -seem sanctioned by the rites of marriage, they are in some respects -worse for the physical health, I might almost say for the moral health -likewise, than illicit intercourse or even prostitution, for they bring -both parties down to all the evils and dangers, mental and physical, of -self-abuse. - - -V.--_The Frequency of Forced Abortions, even among the Married._ - -All are familiar with the fact, to be perceived everywhere upon the -most casual scrutiny, that the standard size of families is not on -the average what used to be seen; in other words, that instances of -an excess over three or four children are not nearly as common as we -know was the case a generation or two back. No one supposes that men or -women have, as a whole, so deteriorated in procreative ability as this -might otherwise seem to imply. - -There can be but one solution to the problem, either that pregnancies -are very generally prevented, or that, occurring, they are prematurely -cut short. We have seen that countless confessions prove that this -surmise is true. - -In the treatise to which we have already alluded, its author has shown -by a series of unanswerable deductions, based on material gathered -from many sources both at home and abroad, that forced abortions in -America are of very frequent occurrence, and that this frequency -is rapidly increasing, not in the cities alone, but in the country -districts, where there is less excuse on the ground of excessive -expenditures, the claims of fashionable life, or an overcrowding of -the population. It was proved, for instance, that in one State that -was named, one of the wealthiest in the Union, the natural increase -of the population, or the excess of the births over the deaths, has -of late years been wholly by those of recent foreign origin. This was -the state of things existing in 1850; three years later it was evident -that the births in that commonwealth, with the usual increase, had -resulted in favor of foreign parents in an increased ratio. In other -words, it is found that, in so far as depends upon the American and -native element, and in the absence of the existing immigration from -abroad, the population of our older States, even allowing for the loss -by emigration, is stationary or decreasing. - -The strange and otherwise unaccountable phenomenon to which we are now -referring, appears to have been first elucidated in a memoir, upon the -decrease of the rate of increase of population now obtaining in Europe -and America, read by the same author in 1858 to the American Academy -of Arts and Sciences, as a contribution to the science of political -economy. That paper, with all its mass of evidence, that as yet there -seems to have been no attempt to controvert, we find embodied in the -treatise to which I have referred, and which will prove of absorbing -interest to even the casual reader. - -Thus it is seen that abortion is a crime not merely against the life of -the child and the health of its mother, and against good morals, but -that it strikes a blow at the very foundation of society itself. - -One of the strange and unexpected results at which the author we have -so often referred to has arrived, but which he has both proved to a -demonstration and satisfactorily explained, is that abortions are -infinitely more frequent among Protestant women than among Catholic; -a fact, however, that becomes less unaccountable in view of the known -size, comparatively so great, of the families of the latter--in the -Irish, for instance--the point being that the different frequency of -the abortions depends not upon a difference in social position or in -fecundity, but in the religion. We should suppose _à priori_ that the -Protestant, especially if of New England and Puritan stock, would be -much the safer against all such assaults of the world, the flesh, and -the devil. The following is the concise and convincing solution of the -paradox that has been given:-- - -"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."[14] - -There is another surprising result that must strike every candid -observer whose position gives him extended and frequent observation -of women, and of late years the study and treatment of their special -diseases has become so recognized that there are many physicians thus -rendered competent to judge; it is this, but a second one of the many -very frightful characteristics of induced abortion, that the act is -proportionately much more common in the married than in the unmarried -basing the calculation upon an equal number of pregnancies in each case. - -This fact also may be easily accounted for. Abortion is undoubtedly -more common in the earlier than in the later months of pregnancy, -because the sensible signs of fœtal vitality are then less permanently -present, and the conscience is then better able to persuade itself that -the child may possibly be without life, or the alarm wholly a false -one. It is less common with first than with subsequent children, though -instances of its occurrence with the former are certainly not rare. A -woman who has never been pregnant does not, as a general rule, conceive -as readily as one who has already been impregnated before, perhaps -partly from the fact that intercourse, under certain circumstances, is -more likely to be excessive in such cases, at times producing acute or -subacute inflammation of the cervix uteri, and consequent sterility, -as is so constantly observed in prostitutes, very many of whom, upon -ceasing their trade, after accumulating a little property, as in -France, or upon being sent to out-lying colonies, as in England, and -becoming married, at once fall pregnant. - -The unmarried woman, if _enceinte_, has not the opportunity of lying by -for a few days' sickness, without exciting suspicion, that the married -can easily seize for themselves. She is often not so conversant with -the early symptoms of gestation, and is more prone to wait until its -existence has been rendered certain by the sensation of quickening, in -the hope, doubtless, not unfrequently, that this certainty may persuade -her paramour to marriage, instead of deciding him against it, as is -so often the case. It may be allowed, I think, that infanticide, the -murder of a child after its birth, or its exposure to the vicissitudes -and perils of chance, is more common among the unmarried, but that -destruction of the fœtus in utero, the rather prevails where the rites -of law and religion would seem to have extended to that fœtus every -possible safeguard. - -In the latest of the papers upon the subject of abortion, to which we -have already alluded, there is furnished additional evidence as to the -frequency of induced miscarriage. - -"The infrequency of abortions," it is said, "as compared with labors -at the full period, is disproved by the experience of every physician -in special or large general practice, who will faithfully investigate -the subject. The truth of this statement has been fully verified, in -the instance of abortion criminally induced, by many of my professional -friends who were at first inclined to doubt the accuracy of my -inferences on that point; with reference to abortions more naturally -occurring, the evidence is of course more easily arrived at, and is in -consequence proportionately more striking. In many cases of sterility -it will be found that the number of abortions in a single patient have -been almost innumerable; and, it may be added, in a large proportion -of the cases of uterine disease occurring in the married, inquiry as -to their past history will reveal abortions, unsuspected perhaps even -by the family physician, as the cause. It is not so much the general -practitioner, the hospital attendant, or the accoucheur, as such, who -can testify as to the true frequency of abortion; for many cases, -even of the most deplorably fatal results, do not seek for medical -assistance at the time of the accident. The real balance sheet of these -cases is to be made out by the hands which are more especially called -to the treatment of chronic uterine disease."[15] - -But not only is abortion of excessively frequent occurrence; the -nefarious practice is yearly extending, as does every vice that custom -and habit have rendered familiar. It is foolish to trust that a change -for the better may be spontaneously effected. "Longer silence and -waiting by the profession would be criminal. If these wretched women, -these married, lawful mothers, ay, 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."[16] - - -VI.--_The Excuses and Pretexts that are given for the Act._ - -I have already stated that in many instances it is alleged by the -mother that she is ignorant of the true character of the act of wilful -abortion, and in some cases I am satisfied that the excuse is sincerely -given, although, in these days of the general diffusion of a certain -amount of physiological knowledge, such ignorance would seem incredible. - -The above is, however, the only excuse that can be given with any show -of plausibility, and even this holds for nought should the case by any -chance come under the cognizance of the law, just as would a plea of -ignorance of the law itself; it being always taken for granted that -any intentional act implies a knowledge of its own nature and its -consequences, be these trivial or grave. - -I have stated that in no case should abortion be permitted, or allowed -to be permitted, by the advice or approval of a single physician; -that in all cases where such counsel is taken, it should be from -a consultation of at least two competent men. Submitted to such a -tribunal, seldom indeed would the sanction be given. - -Ill health would be no excuse, for there is hardly a conceivable case -where the invalidism could either not be relieved in some other mode, -or where by an abortion it would not be made worse. - -The fear of childbed would be no excuse, for we have seen that its -risks are in reality less than those of an abortion, and its pains -and anguish can now be materially mitigated or entirely subdued -by anæsthesia, which the skill of medical science can induce, and -should induce, in every case of labor. My remarks apply not to first -pregnancies alone, when one might expect that women would naturally be -anxious and timid, but even to those cases of pregnancy that have been -preceded by difficult and dangerous labors. - -It has been urged, and not so absurdly as would at first sight appear, -that the present possibilities of painless and so much safer delivery, -by changing thus completely the primal curse, from anguish to a state -frequently of positive pleasure, remove a drawback of actual advantage, -and, by offering too many inducements for pregnancy, tend to keep women -in that state the greater part of their menstrual lives.[17] - -Much of the low morale of the community, as regards the guilt of -abortion, depends upon the very erroneous doctrines extensively -inculcated by popular authors and lecturers for their own sinister -purposes. - -One of these is the doctrine that it is detrimental to a woman's -health to bear children beyond a certain number, or oftener than at -certain stated periods, and that any number of abortions are not merely -excusable, as preventives, but advisable; it being entirely forgotten -that the frequency of connection may be kept within bounds, and the -times of its occurrence regulated, by those who are not willing to -hazard its consequences; that if women will, to escape trouble, or -for fashion's sake, forego the duty and privilege of nursing,--a law -entailed upon them by nature, and seldom neglected without disastrous -results to their own constitutions,--they must expect more frequent -impregnation; that the habit of aborting is generally attended with the -habit of more readily conceiving; and that abortions, accidental, and -still more if induced, are generally attended by the loss of subsequent -health, if not of life. - -This error is one which would justify abortion as necessary for the -mother's own good; a selfish plea. The other is based on a more -generous motive. It is, that the fewer one's children the more healthy -they are likely to be, and the more worth to society. It is, however, -equally fallacious with the first, and is without foundation in fact. -The Spartans and Romans, so confidently appealed to, gave birth -probably to as many weakly children as do our own women; that they -destroyed many for this reason, in infancy, is notorious. The brawny -Highlanders are not the only offspring of their parents; the others -cannot endure the national processes of hardening by exposure and diet, -and so die young from natural causes. But were this theory true even -so far as it goes, the world, our own country, could ill spare its -frailer children, who oftenest, perhaps, represent its intellect and -its genius.[18] - - -VII.--_Alternatives, Public and Private, and Measures of Relief._ - -It may be asked if there is no latitude to be allowed for extreme cases -of the character already described. We are compelled to answer, None. -If each woman were allowed to judge for herself in this matter, her -decision upon the abstract question would be too sure to be warped -by personal considerations, and those of the moment. Woman's mind is -prone to depression, and, indeed, to temporary actual derangement, -under the stimulus of uterine excitation, and this alike at the time of -puberty and the final cessation of the menses, at the monthly period -and at conception, during pregnancy, at labor, and during lactation; -a matter that also seems to have been more thoroughly investigated by -the authority I have so freely drawn from in reference to the question -of abortion, than by any other writer in this country.[19] During -the state of gestation the woman is therefore liable to thoughts, -convictions even, that at other times she would turn from in disgust or -dismay; and in this fact, that must be as familiar to herself as it is -to the physician, we find her most valid excuse for the crime. - -Is there then no alternative but for women, when married and prone to -conception, to occasionally bear children? This, as we have seen, is -the end for which they are physiologically constituted and for which -they are destined by nature. In it lies their most efficient safeguard -for length of days and immunity from disease. Intentionally to prevent -the occurrence of pregnancy, otherwise than by total abstinence -from coition, intentionally to bring it, when begun, to a premature -close, are alike disastrous to a woman's mental, moral, and physical -well-being. - -There are various alternatives to these so degrading habits of the -community. To some of them equal objections apply. But, in reality, -there is little difference between the immorality by which a man -forsakes his home for an occasional visit to a house of prostitution, -that he may preserve his wife from the chance of pregnancy, and the -immorality by which that wife brings herself wilfully to destroy the -living fruit of her womb. Allowing for the weakness and frailty of -human nature, the first were surely the preferable of the twain. But -we need not compare these odious customs, each so common and each so -wrong. With greater frugality of living, and greater self-denial, and -self-control in more trivial matters, there need be no interference, -at least no intentional interference, on the part of either husband -or wife with the first great law of human weal and human happiness, in -accordance with which, by the divine institution of home and its mutual -joys, the due propagation and natural increase of the species was -intended to be insured. - -Were well-arranged foundling hospitals provided in all our large -cities, they would prove a most efficient means of preventing -the sacrifice of hundreds of the children of shame, and, so far -from encouraging immorality, they would afford one of its surest -preventives, for by keeping a woman from the crime of infanticide or -the equally guilty intentional miscarriage, they would save her from -one element of the self-condemnation and hatred which so often hurry -the victim of seduction downward to the life of the brothel. A certain -amount of illicit intercourse between the sexes will always take place, -no matter how condemned by law, until the public standard of morals -shall be so elevated as to render the practice unknown. This is a fact -that is self-evident, and cannot be frowned out of existence. How -much better to provide for its innocent victims, its irresponsible -offspring, than, as now, to permit the so frequent destruction of both. -It is foolish to assert that by such provision we but pander to sin. -In many of these instances the woman is innocent of intentional wrong, -being led astray by her perfect confidence in the constancy and good -faith of a lover, and in others she is, doubtless, ignorant of the true -character of the act she is committing. Should she be driven by what is -comparatively a venial, and not so unnatural an offence, to one of the -deadliest crimes? - -But for the married, who have not this strong stimulus of necessity, -and the excuse of having been led astray or deceived, there need be no -public channel provided, through which to purchase safety for their -children. Is it not, indeed, inconceivable that the very women, who, -when their darlings of a month old, or a year, are snatched from them -by disease, find the parting attended with so acute a pang, can so -deliberately provide for, and congratulate themselves and each other, -upon a wilful abortion! Here, words fail us. - -"Of the mother, by consent or by her own hand, imbrued with her -infant's blood; of the equally guilty father, who counsels or allows -the crime; of the wretches, who by their wholesale murders, far -out-Herod Burke and Hare; of the public sentiment which palliates, -pardons, and would even praise this, so common, violation of all law, -human and divine, of all instinct, all reason, all pity, all mercy, all -love, we leave those to speak who can."[20] - - -VIII.--_Recapitulation._ - -We have now seen that the induction of a forced abortion is, in -reality, a crime against the infant, its mother, the family circle, and -society; that it is attended with extreme danger, whether immediate -or remote, to the mother's happiness, to her health, mental and -physical, and to her life; that there is, in reality, no valid excuse -for it that can be urged, save when it has been decided to be an -absolute necessity by two competent medical men, and that there are -alternatives, such as greater temperance and frugality of living, -which, if practised, would be equally for the public and for private -good. - -We have also seen that not only is abortion wrong, no matter from -what quarter we contemplate the act, but so also is the deliberate -prevention of pregnancy in the married alike detrimental to the -health and to the moral sense. Moderation and temperance here, as -elsewhere, afford the golden rule. Under the circumstances to which I -allude, total abstinence may, as far as the health is concerned, be as -injurious as is the other extreme of excessive indulgence. To the woman -in good bodily condition, occasional child-bearing is an important -means of healthful self-preservation; to the invalid, an intentional -miscarriage is no means of cure; if she be in poor health, let her seek -aid and relief in the proper quarter, but not, by thus tampering with -natural and physiological laws, alike imperilling both body and soul. - -Were woman intended as a mere plaything, or for the gratification of -her own or her husband's desires, there would have been need for her -of neither uterus nor ovaries, nor would the prevention of their being -used for their clearly legitimate purpose have been attended by such -tremendous penalties as is in reality the case. - -We have seen that in a perverted and mistaken public opinion lies the -secret of the whole matter. "Ladies boast to each other of the impunity -with which they have aborted, as they do of their expenditures, of -their dress, of their success in society. There is a fashion in this, -as in all other female customs, good and bad. The wretch whose account -with the Almighty is heaviest with guilt, too often becomes a heroine. -So truly is this the case, that the woman who dares at the present day, -publicly or privately, to acknowledge it the holiest duty of her sex to -bring forth living children, 'that first, highest, and in earlier times -almost universal lot,'[21] is worthy, and should receive, the highest -admiration and praise."[22] - -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 -medical profession, both as a body and as men, whose every relation -its members are alike best able to appreciate, to understand, and to -advise concerning. "Physicians alone," says Prof. Hodge, "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."[23] - -"If 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."[24] - -We have seen that the above is the deliberate decision of those who, -from their observation and knowledge of the subject, are best able to -judge. "Whatever estimate may attach to our opinion," says an eminent -medical journalist, "we believe that not only ought these things not -so to be, but that the public should know it from good authority. 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?"[25] - -We have also seen that "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."[26] - - * * * * * - -This subject, at all times so important for the consideration of the -people at large, is invested with unusual interest at a period like -the present, when, at the close of a long and closely contested war, -greater fields for human development and success are opened than ever -before. All the fruitfulness of the present generation, tasked to its -utmost, can hardly fill the gaps in our population that have of late -been made by disease and the sword, while the great territories of the -far West, just opening to civilization, and the fertile savannas of the -South, now disinthralled and first made habitable by freemen, offer -homes for countless millions yet unborn. Shall they be filled by our -own children or by those of aliens? This is a question that our own -women must answer; upon their loins depends the future destiny of the -nation. - -In the hope that the present appeal may do somewhat to stem the tide -of fashion and depraved public opinion; that it may tend to persuade -our women that forced abortions are alike unchristian, immoral, and -physically detrimental; that it may dissipate the ignorance concerning -the existence of fœtal life that so extensively prevails, and be the -means of promoting the ratio of increase of our national population, so -unnaturally kept down, the National Medical Association addresses -itself to all American mothers; for thus, in the closing words of -the Essay from which I have so frequently and so freely drawn, would -"the profession again be true to its mighty and responsible office of -shutting the great gates of human death." - - - APPENDIX. - -In the prefatory remarks attention was called to the fact that the -writer may have incidentally expressed personal opinions of his -own, in the course of his Essay, that are not fully coincided in by -every member of the medical profession, and reference was made to -correspondence that had already occurred in connection with this -subject. This correspondence is now presented, and will explain itself. - -It will be noticed that I withhold the name of the gentleman who -addressed me, this being done at his own particular request, though -I would willingly have given him opportunity publicly to assume -the position against anæsthetics in childbed, so long held by his -illustrious townsman, Prof. Meigs. Discretion, however, has thus far -been found, by the opponents of anæsthesia, to be the better part of -valor. In a subsequent letter, under date of February 19, my friend -writes me as follows: "When the pamphlet appears, I will aid you to my -utmost ability in its circulation, and believe it will be productive of -eminent good." - -The criticism referred to is as follows: - - - "+PHILADELPHIA+, Feb. 10, 1866. - - "+MY DEAR DOCTOR+: - - "Your Essay gives much satisfaction to all who have read it, of - course, a very select few (the book being still in the printer's - hands), but several have most strenuously objected to one or two - points, inasmuch as the profession are to take hold of the matter and - endeavor to place it in the hands of their female patients. The only - one concerning which I have deemed it necessary to write you, is your - remark relative to the use of anæsthesia in all cases of labor. Now, - Doctor, though many are fully with you, yet many would object most - decidedly; in fact, it is by special request that I now ask you to - omit, if possible, those few lines. Some of our profession--I believe - many more would if they had read the Essay--object to placing it in - the hands of their patients, and thus condemning their own action and - advice. Many in this city, to my positive knowledge, object to the - use of anæsthesia in labor, _in toto_. Many others only use it in - special cases. While the number of those who use or advise it in all - cases is _very, very_ small. I am satisfied the omission of these few - lines would give great satisfaction, and remove almost entirely all - objections to the paper. - - "I had not the pleasure of reading it prior to seeing the proof, and - must express to you my congratulations for your success. Nothing - pleased me so much as the gratification so pleasantly expressed - by your good father, as he so unexpectedly found his son to be the - essayist. For that reason, I am much pleased that you requested, 'for - a whim,' to have the seals broken upon the platform. - - "Very sincerely, - "Your friend, - "---- ----." - -To the above letter I thus replied: - - - "+HOTEL PELHAM, BOSTON+, 12 Feb., 1866. - - "+MY DEAR DOCTOR+: - - "I have received your kind letter of the 10th inst., and am glad you - have spoken so frankly. I should be delighted to grant the request - thus courteously made, were it possible for me consistently or - conscientiously to do so. - - "This subject of anæsthesia in labor is one to which, for now thirteen - years, I have given earnest attention, and is one of the most - important that has ever presented itself to medical men. - - "It is my sincere conviction that the use of anæsthetics in childbed - is not only indicated by every consideration of humanity, but that - it serves materially to lessen the average rate of mortality to both - mother and child. - - "Previously to the present date my voice has given no uncertain sound - upon this question. I send you, by to-day's mail, a copy of my little - book, "Eutokia," which, two or three years since, excited some - attention from the profession, both at home and abroad, and has made, - I am happy to know, many converts to the true faith. - - "If you will turn to the preface of the American edition of my - Simpson's Obstetrics, published in 1855, you will find upon page xvi. - the following language, none of which, in the added experience and - reflection of all these years, can I honestly retract. 'But yesterday, - and the man who dared give ether or chloroform in labor was considered - as breaking alike the laws of nature and of God; the time is probably - close at hand when such will be said of all who withhold them, even in - natural labor.' - - "In the present instance, the Essay has been carefully scrutinized by - a Committee of the Association,--that on Prize Essays,--and has been - unqualifiedly approved. It has been accepted by the Association, has - been ordered to be printed, and, by special vote, to be pushed to the - most extended circulation possible, in the belief that its influence - would be only for the highest good of the community. I am always - responsible at the bar of professional opinion for any sentiment that - I may utter, and avow none that I am not prepared to defend. If any - gentleman differs from me in opinion, let him carefully prepare an - essay upon the subject, present it to the Association, and, if they so - decide, I will cheerfully vote that it also be presented to the people - as a rejoinder to myself. - - "With all respect for those who think otherwise, I cannot omit or - change one word of the Essay, and have no right to do so if I would. - - "As the present, however, is a point that, though only incidentally - mentioned, yet involves some conflict of professional opinion, while - the Association are of a single mind as to the matter of Criminal - Abortion, I shall cheerfully append your letter to the published - edition, and thus save your associates from any implied credit or - discredit of indorsing my own opinion. This course will be unnecessary - with regard to the Transactions, as the Association is known to be - irresponsible for any views advanced by its members, save when adopted - by special resolution, and its volume does not reach the parties in - reality most interested, namely, the parturient women, whose anguish, - so far as such may be unnecessary, it should be our highest duty to - relieve. - - "Thanking you for the generally favorable opinion you convey to me for - yourself and those for whom you write, for I always value the approval - of my friends next to my own self-respect, - - "I am yours, sincerely, - "+HORATIO R. STORER+. - - "+DR.+ ---- ----." - - * * * * * - - - _A Companion to "John Halifax."_ - - JUST ISSUED, - - IN TRUST: - - OR, - - DR. BERTRAND'S HOUSEHOLD. - - +BY MISS AMANDA M. DOUGLASS.+ - - 1 vol. 12mo. Price $1.75. - -We can give no better idea of the scope and ability of this volume, -than by quoting the opinion of the Northampton Free Press, which is -noted for its free and impartial criticisms. - -"It is a work of which we can hardly speak too warmly in commendation. -It is deeply interesting, even fascinating, but it is also ennobling, -free from any false sentimentality, but beautiful in its narrative of -the high and pure life of Richard Bertrand. As a family history we -have never met with its equal; the portraiture is vivid, yet not too -highly colored, and the reader feels that he is looking upon a scene in -actual life rather than the marvels of a fiction. Richard Bertrand is -not one of those natures actuated by violent passions, not such a one -as Victor Hugo would make the hero of a novel, but a young man always -ready to respond to the call of duty--patient and earnest, loving and -true, unselfish and enduring, in his position as elder brother in a -family, who could look to him alone for earthly support, displaying -all the characteristics of a healthful and well-proportioned Christian -life. It is a book which every young man should read; he will be the -better for its perusal, a correct sense of manliness and of -the nobility of suffering will be enhanced by it. It is a good book to -read in the family, although a better one to read and reflect upon in -solitude. It is one which every parent will gladly place in the hands -of his children, confident that there is nothing in its pages that can -injure, but much that can benefit the reader." - ---> Sent by mail, post paid, on receipt of price, and sold by all -booksellers. - - - +LEE & SHEPARD+, Publishers and Booksellers, - _149 Washington Street, Boston_. - - * * * * * - - - _A Domestic Story of Great Beauty._ - - A THOUSAND A YEAR. - - BY - - +MRS.+ E. M. BRUCE. - - _1 vol. 16mo. Price $1.25._ - -The story of a clergyman who left his country home to seek fortune with -a city parish and One Thousand a Year. - - * * * * * - - _A Valuable Home Book._ - - TALKS ON WOMEN'S TOPICS. - - +BY+ JENNIE JUNE. - - _1 vol. 12mo. Price $1.75._ - -Those who keep up with the current newspaper literature are somewhat -acquainted with the wit and wisdom of Jennie June. This handsome volume -is a collection of her writings, and consists of familiar "Talks" on -a great variety of subjects, all more or less connected with women -and the household, and includes chapters on "Matrimony," "Babies," -"Courtship," "Girls," and various other subjects. The style of -treatment is especially to be commended: it is witty, without vulgarity -or coarseness; sensible, without being in the least prosy. It is -penetrated, moreover, by a vein of womanly tenderness and earnestness, -which shows deep feeling and strong conviction beneath the veil of -good-natured satire. "Talks on Women's Topics" is a capital gift-book, -just the one that a man would like to take to his wife in the country, -or present to his daughter;--there is not a word that is objectionable, -while there is much that will help to make better wives, daughters, and -mothers. - ---> Sent by mail, post paid, on receipt -of price. - - - +LEE & SHEPARD+, Publishers, - _149 Washington Street, Boston_. - - * * * * * - - - _A Remarkable Book._ - - HERMAN: - OR, - YOUNG KNIGHTHOOD. - -We publish below the deliberate and carefully expressed opinions of -critics, whose judgments are matured by years of research. - - "We know of no work of fiction so full as this of beauty and wisdom, - so free from folly, so resplendent with intellectual life and moral - purity."--_Atlantic Monthly for Feb._ - - "There is still a balm in Gilead, and some hope for novel writing - in America." "The evidence of a genius of no common order." 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Y._ - - "Herman is a book on which a mind of exceedingly rich and varied - ambitions has lavished itself without stint."--_Portland Press._ - - "This book is worthy of the encomiums that have been lavished upon - it."--_Springfield Union._ - - "It is a gushing, outspoken narrative of individual - experience."--_Commonwealth, Boston._ - - "This is one of the most notable books of the season."--_Boston Post._ - - "A book not likely to be laid aside among the crowd of ephemeral - issues of the press."--_Presbyterian, Phila._ - -The above are samples of a large number of equally strong -communications. - - 2 vols. 12mo. Price $3.50. - -.*. Sent by mail on receipt of price. - - +LEE & SHEPARD+, Publishers and Booksellers, - _149 Washington Street, Boston_. - - * * * * * - - - _A New Fruit Book._ - - PRACTICAL AND SCIENTIFIC FRUIT CULTURE. - - BY - - _CHARLES R. BAKER_, Of the Dorchester Nurseries. - - _1 vol. 8vo. Profusely Illustrated. 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ADAMS, (+OLIVER OPTIC+.) - -Under his _nom de plume_ of "Oliver Optic," Mr. Adams has acquired an -enviable fame as writer of juvenile books. Always teaching a wholesome -lesson under cover of an attractive story, his books are welcome guests -in every household. - -His "Army and Navy Stories," six in number, viz., "The Soldier Boy," -"The Sailor Boy," "The Young Lieutenant," "The Yankee Middy," "Fighting -Joe," and "Brave Old Salt," have already reached a sale of fifty -thousand copies, while the total sale of his books during the last year -alone reaches one hundred thousand copies. - -That so prolific and pleasing a writer will be equally successful in -his new field of enterprise none can doubt who have witnessed the -eagerness with which his juvenile books have been seized and read by -the "old people" as well as the "young folks." - - - +LEE & SHEPARD+, Publishers, - _149 Washington Street, Boston_. - - * * * * * - -[Footnote 1: "The preamble and resolution were signed by Philo Tillson, -President, and S. L. Andrews, Secretary, of the Northeastern District -Medical Association of Michigan, as having been adopted by that -Association, at its annual meeting, held on the 19th day of May, 1864, -and which its delegate, Dr. Stockwell, was instructed to present to the -Association."--_Trans. Am. Med. Association_, 1864, p. 60.] - -[Footnote 2: Now that the decision of the Prize Committee has been -made, the purpose of the above stipulation becomes evident. The -Committee consisted of Drs. D. Humphreys Storer, Henry I. Bowditch, J. -Mason Warren, and John H. Dix, of Boston; the Chairman of the Committee -being the writer's father.] - -[Footnote 3: The Committee consisted of Drs. H. R. Storer, of Boston; -T. W. Blatchford, of Troy, N. Y.; H. L. Hodge, of Philadelphia; C. A. -Pope, of St. Louis; Barton, of South Carolina; A. Lopez, of Mobile; and -W. H. Brisbane, of Arena, Wis.] - -[Footnote 4: Studies of Abortion; Boston Medical and Surgical Journal, -February 5, 1863.] - -[Footnote 5: Transactions of the American Medical Association, 1859, -vol. xii. p. 75.] - -[Footnote 6: Percival: Medical Ethics, p. 79.] - -[Footnote 7: Man Transformed, Oxford, 1653.] - -[Footnote 8: Regina _v._ Wycherly, 8 Carrington and Payne, 265.] - -[Footnote 9: Criminal Abortion in America, p. 5.] - -[Footnote 10: Owen: Cyclopædia of Anatomy and Physiology, vol. iii. p. -322.] - -[Footnote 11: Naegele: Treatise on Obstetric Auscultation, p. 50.] - -[Footnote 12: Studies of Abortion: Boston Medical and Surgical Journal, -February 5, 1863.] - -[Footnote 13: Criminal Abortion in America, p. 42.] - -[Footnote 14: Essay on Criminal Abortion, p. 42.] - -[Footnote 15: Studies of Abortion, &c.] - -[Footnote 16: Essay on Criminal Abortion, p. 106.] - -[Footnote 17: Essay on Criminal Abortion, p. 34.] - -[Footnote 18: Essay on Criminal Abortion, p. 32.] - -[Footnote 19: H. R. Storer: The Causation, Course, and Treatment of -Insanity in Women; a gynæcist's idea thereof. Transactions of the -American Medical Association, vol. xvi., 1865.] - -[Footnote 20: Essay on Criminal Abortion, p. 13.] - -[Footnote 21: A Woman's Thoughts about Women. By the author of "John -Halifax, Gentleman," p. 14.] - -[Footnote 22: Essay on Criminal Abortion, p. 55.] - -[Footnote 23: Introductory Lecture at University of Pennsylvania, 1854, -p. 19.] - -[Footnote 24: Essay, &c., p. 101.] - -[Footnote 25: Boston Medical and Surgical Journal, editorial, December -13, 1855.] - -[Footnote 26: Essay, &c., p. 106.] - -*** END OF THE PROJECT GUTENBERG EBOOK WHY NOT? 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A Book for Every Woman, by Horatio Storer</p> -<div style='display:block; margin:1em 0'> -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online -at <a href="https://www.gutenberg.org">www.gutenberg.org</a>. If you -are not located in the United States, you will have to check the laws of the -country where you are located before using this eBook. -</div> - -<p style='display:block; margin-top:1em; margin-bottom:1em; margin-left:2em; text-indent:-2em'>Title: Why Not? A Book for Every Woman</p> - <p style='display:block; margin-top:1em; margin-bottom:0; margin-left:2em; text-indent:-2em'>Author: Horatio Storer</p> -<p style='display:block; text-indent:0; margin:1em 0'>Release Date: June 26, 2021 [eBook #65701]</p> -<p style='display:block; text-indent:0; margin:1em 0'>Language: English</p> - <p style='display:block; margin-top:1em; margin-bottom:0; margin-left:2em; text-indent:-2em; text-align:left'>Produced by: Brian Wilson, Jwala Kumar Sista and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive/American Libraries.)</p> -<div style='margin-top:2em; margin-bottom:4em'>*** START OF THE PROJECT GUTENBERG EBOOK WHY NOT? A BOOK FOR EVERY WOMAN ***</div> - -<p><span class="pagenum"><a name="Page_1" id="Page_1">[Pg 1]</a></span></p> - -<div class="tnotes"> -<p class="center xlarge"><a name="Transcriber-Note" id="Transcriber-Note"></a><span class="u">Transcriber's Notes</span></p> -<p>1. Typographical errors and hyphenation inconsistencies were corrected.</p> -<p>2. Topic-wise navigation hyper-links added.</p> -</div> - -<div class="chapter"> -<h1><span class="xxlarge">WHY NOT?</span></h1> -<p class="p0 center xlarge"> -<b>A BOOK FOR EVERY WOMAN.</b></p><br /> -<p class="p0 center xlarge"><span class="font1">The Prize Essay</span></p><br /> -<p class="p0 center large">TO WHICH THE AMERICAN MEDICAL ASSOCIATION<br /> -AWARDED THE GOLD MEDAL<br /> -FOR MDCCCLXV.</p><br /> -<p class="p0 center small"><b>BY</b></p> -<p class="p0 center xlarge"><b>HORATIO ROBINSON STORER, M.D.,</b></p> -<p class="p0 center medium"><b>OF BOSTON,</b></p><br /> -<p class="p0 center medium"><b> -Assistant in Obstetrics and Medical Jurisprudence in Harvard University; Surgeon<br /> -to the New England Hospital for Women; and Professor of Obstetrics<br /> -and the Diseases of Women in Berkshire Medical College.<br /> -</b></p> -<p class="p0 center large mt3"><b>ISSUED FOR GENERAL CIRCULATION, BY ORDER OF THE</b></p> -<p class="p0 center large"><b>AMERICAN MEDICAL ASSOCIATION.</b></p> -<p class="p1 center large mt3"><i>Casta placent superis. Casta cum mente venito,<br /> -Et manibus puris sumito fontis aquam.</i></p><br /> -<p class="p0 center xxlarge"><b> -BOSTON:<br /> -LEE AND SHEPARD.<br /> -1866.</b></p> -</div> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_2" id="Page_2">[Pg 2]</a></span></p> - -<p class="p0 center bold space-above4">Entered, according to Act of Congress, in the year 1866, by<br /> -<br /> -LEE AND SHEPARD,<br /> -<br /> -In the Clerk's Office of the District Court of the District of Massachusetts.<br /> -</p> -<p class="space-above4"></p> -<p><span class="pagenum"><a name="Page_3" id="Page_3">[Pg 3]</a></span></p> - -<p>At the Sixteenth Annual Meeting of the American Medical Association, -held at Boston in June, 1865, it was, upon recommendation of the -Section on Practical Medicine and Obstetrics,—</p> - -<blockquote> - -<p><i>Resolved</i>, That the Committee on Publication be requested to adopt -such appropriate measures as will insure a speedy and general -circulation of the Prize Essay written for women; provided this can be -done without expense to the Association.</p></blockquote> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_4" id="Page_4">[Pg 4]</a></span></p> - -<div class="chapter"> -<h2>CONTENTS.</h2> -</div> - -<table border="0" cellpadding="4" cellspacing="0" summary="table summary"> - -<tr> -<td class="tdl"> </td> -<td> </td> -<td class="tdr"><span class="small smcap">Page</span></td> -</tr> - -<tr> -<td class="tdl"> </td> -<td><span class="smcap">Prefatory Remarks</span></td> -<td class="tdr">5</td> -</tr> - -<tr> -<td class="tdl"><a href="#I.">I.</a></td> -<td>Origin and Purpose of the Present Essay</td> -<td class="tdr">11</td> -</tr> - -<tr> -<td class="tdl"><a href="#II.">II.</a></td> -<td>What has been done by Physicians to Foster, and what to Prevent, the Evil</td> -<td class="tdr">15</td> -</tr> - -<tr> -<td class="tdl"><a href="#III.">III.</a></td> -<td>What is the True Nature of an Intentional Abortion when not Requisite to Save the Life of the Mother</td> -<td class="tdr">27</td> -</tr> - -<tr> -<td class="tdl"><a href="#IV.">IV.</a></td> -<td>The Inherent Dangers of Abortion to a Woman's Health and to her Life</td> -<td class="tdr">36</td> -</tr> - -<tr> -<td class="tdl"><a href="#V.">V.</a></td> -<td>The Frequency of Forced Abortions, even among the Married</td> -<td class="tdr">62</td> -</tr> - -<tr> -<td class="tdl"><a href="#VI.">VI.</a></td> -<td>The Excuses and Pretexts that are given for the Act</td> -<td class="tdr">70</td> -</tr> - -<tr> -<td class="tdl"><a href="#VII.">VII.</a></td> -<td>Alternatives, Public and Private, and Measures of Relief</td> -<td class="tdr">74</td> -</tr> - -<tr> -<td class="tdl"><a href="#VIII.">VIII.</a></td> -<td>Recapitulation</td> -<td class="tdr">79</td> -</tr> - -<tr> -<td class="tdl"> </td> -<td><span class="smcap"><a href="#APPENDIX">APPPENDIX.</a></span>—Correspondence</td> -<td class="tdr">88</td> -</tr> - -</table> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_5" id="Page_5">[Pg 5]</a></span></p> - -<div class="chapter"> -<h2>PREFATORY REMARKS.</h2> -</div> - -<p>It will be noticed that in the following Essay, the recipient of the -special prize for 1864-5 of the American Medical Association, its -author makes frequent reference, as to those of another, to his own -previous labors. This circumstance, now that his identity has been -revealed, might at first seem an infringement of the rules of good -taste. In the facts, however, that he felt compelled to take unusual -pains to conceal that identity prior to the decision of the Committee, -with all of whose members he has long enjoyed intimate acquaintance, -and that little other published material as yet exists, from which to -draw upon this subject, save his own, he places his excuse, and throws -himself upon the generous sympathy and forbearance of his readers.</p> - -<p>The Essay, when placed in the hands of the Committee, was accompanied -by the following statement, which it may not be out of place to -reproduce at the present time:—</p> - -<p><span class="pagenum"><a name="Page_6" id="Page_6">[Pg 6]</a></span></p> - -<p>"The writer, knowing nothing of the project to elicit a direct and -effective appeal to women upon the subject of criminal abortion, until -after it had been decided at the New York meeting, -<a name="FNanchor_1_1" id="FNanchor_1_1"></a><a href="#Footnote_1_1" class="fnanchor">[1]</a> -has long been a member of the Association. He is aware, from personal observation, -that induced miscarriage is of very frequent occurrence, and that its -effects are to the last degree disastrous to the country at large. He -has seen the change that has been effected in professional feeling -upon the subject as to the need that this depopulation, or rather -prevention of repopulation of the country, should be arrested, since -the publication of the Report of the Association's Special Committee, -which was appointed at Nashville in 1857.</p> - -<p><span class="pagenum"><a name="Page_7" id="Page_7">[Pg 7]</a></span></p> - -<p>"It is, perhaps, presumptuous for him to undertake a task so strongly -appealing to all one's eloquence, sympathy, and zeal, and for the proper performance of which there exist -so many gentlemen in the profession better qualified than himself. He -does it, however, as the passing traveller in distant lands, by casting -his pebble upon the pile of similar contributions that mark a single -wayside grave, helps raise a monument to warn of danger and to tell -of crime, in the hope that this waif of his may, perchance, effect -somewhat toward arousing the nation to the countless fœtal deaths -intentionally produced each day in its midst, and to prevent them.</p> - -<p>"The Association has empowered the Prize Committee to award the premium -of the present year to the best popular tract upon the subject of -induced abortion. The writer presents the accompanying paper neither -for fame nor for reward. It has been prepared solely for the good of -the community. If it be considered by the Committee worthy its end, -they will please adjudge it no fee, nor measure it by any pecuniary -recompense. Were the finances of the Association such as to warrant -it in more than the most absolutely necessary expenditures, yet would -the approbation of the Committee, and of the profession at large, be -more grateful to the writer than any tangible and therefore trivial -reward.</p> - -<p><span class="pagenum"><a name="Page_8" id="Page_8">[Pg 8]</a></span></p> - -<p>"It is a singular and appropriate coincidence that the action of -the Association, originating as it did from Boston, in 1857, and -recognizing in no uncertain language, alike by the resolutions that -were formally adopted by the Louisville Convention, and by the memorial -presented by its President to the different legislative assemblies -and State Medical Societies of the Union, the necessity of a radical -change as to the popular estimate of the crime,—should now culminate -and become effective at a meeting of the Association in Boston, by -an authorized appeal in behalf of the profession to the community, -which alone makes and enforces the laws, till now a dead letter as -regards abortion, and which alone commits, palliates, and suffers from -the crime. It it is an equally striking and appropriate coincidence -that the Chairman of the Committee, at whose hands the selection of -that appeal must be made, though the Committee had been chosen for a -general purpose before it had been decided by the Association to elicit -essays upon this special subject, should be the physician who, in New -England, first appreciated the frequency of criminal abortions, pointed -out their true character, and denounced them.</p> - -<p><span class="pagenum"><a name="Page_9" id="Page_9">[Pg 9]</a></span></p> - -<p>"If this Essay prove successful, its author only asks that the seal -which covers his identity may not be broken until the announcement is -made upon the platform of the Convention, pledging himself that this is -but for a whim of his own, and that he is well, and he trusts favorably -known, by many of the best men of the Association throughout the -Union."<a name="FNanchor_2_2" id="FNanchor_2_2"></a><a href="#Footnote_2_2" class="fnanchor">[2]</a></p> - -<p>There is one point, in connection with the present Essay, to which I -feel bound, in fairness alike to my professional brethren and to those -for whom I have now written, to direct attention.</p> - -<p><span class="pagenum"><a name="Page_10" id="Page_10">[Pg 10]</a></span></p> - -<p>As every author who has decided opinions, and is alive to their -importance, must naturally and very necessarily do, I have incidentally -taken occasion to express myself upon certain collateral topics, but -only in so far as they were directly connected with, and germane to, -the main subject under discussion. Such statements are all of them to -be considered merely as expressions of my own individual opinion, and -not as the views, necessarily, of the mass of the profession.</p> - -<p>An instance of the kind referred to is where I allude to the advantages -of giving anæsthetics in child-bed, even though the labor is what is -termed a natural one; and I adduce correspondence upon this subject in -an appendix to the Essay.</p> - -<p>As upon some of these questions physicians honestly differ among -themselves, I have thought this disclaimer alike due to others and to -myself; they are matters, however, only incidental to the Essay, upon -the general subject of which the profession are wholly unanimous in -opinion.</p> - -<p> -<span class="smcap">Hotel Pelham, Boston</span>,<br /> -<span style="margin-left: 4em;">April, 1866.</span><br /> -</p> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_11" id="Page_11">[Pg 11]</a></span></p> - -<div class="chapter"> -<h2><span class="center xlarge">WHY NOT?</span></h2> -</div> -<p class="center xxlarge">A BOOK FOR EVERY WOMAN.</p> - -<hr class="chap" /> -<p class="xlarge bold"><a name="I." id="I."></a> -I.—<i>Origin and Purpose of the Present Essay.</i></p> - -<p><span class="smcap">At</span> the meeting of the American Medical Association, held at New York, -in 1864, it was, after mature deliberation, decided to issue "a short -and comprehensive tract, for circulation among females, for the purpose -of enlightening them upon the criminality and physical evils of forced -abortions."</p> - -<p>The source of this Essay is, therefore, in itself, well worthy -attention. The Association referred to represents the medical -profession of America, for it is composed of delegates, and only of -delegates, from every regularly organized hospital, medical society, -and medical college throughout the land, its members being, therefore, -almost all of them gentlemen advanced in years, of extended experience, -and of acknowledged reputation. That they should unanimously have -concurred in recommending any measure is, so far, proof that it was -needed.</p> - -<p><span class="pagenum"><a name="Page_12" id="Page_12">[Pg 12]</a></span></p> - -<p>There are those, perhaps, who may suppose that in advising that -pregnancies, once begun, should be allowed to go on to their full -period, physicians are actuated by a selfish motive. On the contrary, -it will be shown that miscarriages are often a thousand fold more -dangerous in their immediate consequences, and, therefore, more -decidedly requiring medical treatment, than the average of natural -labors; that they are not only frequently much more hazardous to life -at the time, but to subsequent health, their results in some instances -remaining latent for many years, at times not showing themselves until -the so-called turn of life, and then giving rise to uncontrollable and -fatal hemorrhage, or to the development of cancer, or other incurable -disease. It is in reality the physician's province, indeed, it is his -sacred duty, to prevent disease as well as to cure it, and this, even -though it must plainly lessen the business and the emoluments that -would otherwise fall into his hands. Would women listen to the appeal -now to be made them, an immense deal of ill-health would be prevented, -and thousands of maternal as well as fœtal lives would annually be -saved.</p> - -<p><span class="pagenum"><a name="Page_13" id="Page_13">[Pg 13]</a></span></p> - -<p>And, moreover, in the fact that the profession thus transcends, almost -for the first time, upon any matter in this country, the barrier which -for mutual protection, both of science and the community, has always -been allowed to stand, and directly addresses itself to the judgment -and to the hearts of women upon a question vital to themselves and to -the nation, there is afforded most conclusive evidence that the subject -is of the highest importance, that the step now taken is a necessary -one, and the motives that prompt it sincere.</p> - -<p><span class="pagenum"><a name="Page_14" id="Page_14">[Pg 14]</a></span></p> - -<p>To women, on the other hand, how interesting the topic! It is one that -affects, and more directly, perhaps, than can anything else, their -health, their lives. It concerns their discretion, their conscience, -their moral character, their peace of mind, even its very possession, -for cases of insanity in women from the physical shock of an induced -abortion, or from subsequent remorse, are not uncommon. It involves -often all the elements of domestic happiness, the extent or existence -of the home circle, the matron's own self-respect, and often the very -gift or return of conjugal love; for, as has forcibly been asserted of -marriage where conception or the birth of children is intentionally -prevented, such is, in reality, but legalized prostitution, a sensual -rather than a spiritual union.</p> - -<p>Who can deny these premises? The experience of every physician confirms -them, as do a glance throughout every circle of society, and the -experience, personal or by observation, of almost every nurse, every -matron, every mother. Let us then, physicians and the community, -meet each other half way—ready to acknowledge, upon due evidence, -the frightful extent of the evil that exists in our homes—an evil, -in part occasioned by ignorance and carelessness, and that we are -both, in a measure, accountable for, and should be ready to assist -each other in its cure. I propose to show that induced abortions -are not only a crime against life, the child being always alive, or -practically supposed to be so; against the mother, for the laws do -not allow suicide, or the commission of acts upon one's own person -involving great risk to life; against nature and all natural instinct, -and against public interests and morality, but that, barring ethical -considerations, and looked at in a selfish light alone, they are so -dangerous to the woman's health, her own physical and domestic best -interests, that their induction, permittal, or solicitation by one -cognizant of their true character, should almost be looked upon as -proof of actual insanity.</p> - -<p><span class="pagenum"><a name="Page_15" id="Page_15">[Pg 15]</a></span></p> - -<div class="chapter"> -<p class="xlarge bold"><a name="II." id="II."></a> -II.—<i>What has been done by Physicians to Foster, and what to Prevent, this Evil. -</i></p> -</div> - -<p>In our appeal we shall endeavor to go straight towards the mark, -nothing concealing, undervaluing, or selfishly excusing. And, first of -all, what part have physicians had in this great tragedy, wherein so -many women have been chief players? For it is to the medical attendant -that the community have a right to look for counsel, for assistance, -and for protection, and the present is an evil more especially and -directly coming within these bounds.</p> - -<p><span class="pagenum"><a name="Page_16" id="Page_16">[Pg 16]</a></span></p> - -<p>From time immemorial such have been the deplorable tendencies of -unbridled desire, of selfishness and extravagance, of an absence of -true conjugal affection, there has existed in countless human breasts a -wanton disregard for fœtal life, a practical approval of infanticide. -This has, however, in the main been confined either to savage tribes, -or to nations, like the Chinese, with a redundant population, with each -of whom the slaughter of children after their birth is common, or to -the lowest classes of more civilized communities, impelled either by -shame, or, as in the burial clubs of the London poor, the revelations -of which a year or two since so startled the world, by the stimulus of -comparatively excessive pecuniary gain.</p> - -<p>That infanticide is of occasional occurrence in our own country, the -effect of vice or of insanity, has long been known; instances being -occasionally brought to the surface of society, and to notice by the -police, and through courts of law.</p> - -<p><span class="pagenum"><a name="Page_17" id="Page_17">[Pg 17]</a></span></p> - -<p>The closely allied crime of abortion also dates back through all -history, like every other form or fruit of wickedness, originating -in those deeply-lying passions coeval with the existence of mankind. -Till of late, however, even physicians, who from time to time have -accidentally become cognizant of an isolated instance, have supposed or -hoped (and here the wish was father to the thought), that the evil was -of slight and trivial extent, and therefore, and undoubtedly with the -feeling that a thing so frightful and so repugnant to every instinct -should be ignored, the profession have, until within a few years, -preserved an almost unbroken silence upon the subject.</p> - -<p><span class="pagenum"><a name="Page_18" id="Page_18">[Pg 18]</a></span></p> - -<p>Some ten years since, this matter was thoroughly taken in hand by -a physician much interested in the diseases of women, the younger -Dr. Storer, of Boston, with the frank acknowledgment that it was to -his father, the Professor of Midwifery in Harvard University, that -the credit of initiating the anti-abortion movement in New England -was justly due. Prof. Hodge, of Philadelphia, like the elder Dr. -Storer, had previously commented, in a public lecture to his class, -afterwards printed, upon the immorality and frequency of induced -miscarriage; and in Europe one or two physicians of eminence, as Dr. -Radford, had endeavored to arouse the profession to the real value -of fœtal life. The subject had also received some slight attention -in works upon medical jurisprudence, but in special treatises upon -abortion and sterility, their causes and treatment, of which the most -celebrated has been that of Dr. Whitehead, of England, the chance of -this occurrence and condition being dependent upon a criminal origin -had been almost entirely lost sight of. In investigating the cases -of disease in the better classes that came under observation, it was -now ascertained that a very large proportion of them were directly -owing to a previous abortion, and that in many of them this occurrence -had been intentional; the physician's consultation room proving in -reality a confessional, wherein, under the implied pledge of secrecy -and inviolate confidence, the most weighty and at times astounding -revelations are daily made. In such instances as those to which we are -now referring, the disclosures are in answer to no idle curiosity, but -to the necessity which always exists of knowing and understanding -every point relating to the causation, the treatment, the cure of -obscure disease.</p> - -<p><span class="pagenum"><a name="Page_19" id="Page_19">[Pg 19]</a></span></p> - -<p>The profession were soon aroused to an appreciation of facts, whose -existence it was shown could so easily be proved by every physician, -and in 1857 a Committee, consisting of some of the more prominent and -most reliable practitioners in various parts of the country, with the -younger Storer as Chairman, was appointed by the American Medical -Association, at its meeting in Nashville, to investigate the crime with -a view to its possible suppression.<a name="FNanchor_3_3" id="FNanchor_3_3"></a><a href="#Footnote_3_3" class="fnanchor">[3]</a> -The report of this Committee was rendered at Louisville, in 1859, and, supported as it was by a mass of -evidence of almost boundless scope, the measures proposed, chiefly of -a legislative character, were unanimously indorsed by the Association. -The evidence upon which the report was based was subsequently -published at Philadelphia, as a separate volume, "the first of a series -of contributions to Obstetric Jurisprudence" by its writer, under the -title of "Criminal Abortion in America," and was feelingly dedicated -"to those whom it may concern—Physician, Attorney, Juror, Judge, and -Parent."</p> - -<p><span class="pagenum"><a name="Page_20" id="Page_20">[Pg 20]</a></span></p> - -<p>This detail, otherwise out of place in an appeal to the community, -is rendered perhaps necessary, that an exact and true impression may -be given of the steps that have been taken by medical men to redeem -themselves from the imputation of having been sluggish guardians of the -public weal. Since the time of the Louisville report, the profession -have been fully alive to the claims of the subject, and it is not with -unnatural satisfaction that its author, in a subsequent publication,<a name="FNanchor_4_4" id="FNanchor_4_4"></a><a href="#Footnote_4_4" class="fnanchor">[4]</a> -has taken occasion to observe that the importance and legitimacy of -the investigation has now been acknowledged in the current files of -every medical journal, in the published transactions of the national -and minor medical associations, in many medical addresses, as that by -Dr. Miller, of Louisville, at the meeting of the Association at New -Haven, in 1860, over which he presided, and in nearly every general -obstetric work of any importance issued in this country since that -date, Bedford's Principles and Practice of Obstetrics, for instance, -and in many works of criminal law and medical jurisprudence, as Elwell, -Wharton and Stillé, and Hartshorne's edition of Taylor, to a much -greater extent than the subject in these works had ever been treated -before.</p> - -<p><span class="pagenum"><a name="Page_21" id="Page_21">[Pg 21]</a></span></p> - -<p>I am constrained to acknowledge my indebtedness to the various -publications of the writer from whom I have quoted, for much of the -evidence I shall now present upon the subject of forced abortions. I -trust that thus offered it may lose none of its freshness, point, and -force. My frequent extracts from one who has given more thought to the -subject than probably any other person in the country, will, I am sure, -need no excuse.</p> - -<p><span class="pagenum"><a name="Page_22" id="Page_22">[Pg 22]</a></span></p> - -<p>An opinion has obtained credence to a certain extent, and it has -been fostered by the miserable wretches, for pecuniary gain, at once -pandering to the lust and fattening upon the blood of their victims, -that induced abortions are not unfrequently effected by the better -class of physicians. Such representations are grossly untrue, for -wherever and whenever a practitioner of any standing in the profession -has been known, or believed to be guilty of producing abortion, except -absolutely to save a woman's life, he has immediately and universally -been cast from fellowship, in all cases losing the respect of his -associates, and frequently, by formal action, being expelled from all -professional associations he may have held or enjoyed.</p> - -<p><span class="pagenum"><a name="Page_23" id="Page_23">[Pg 23]</a></span></p> - -<p>The old Hippocratic oath, to which each of his pupils was sworn by -the father of medicine, pledged the physician never to be guilty of -unnecessarily inducing miscarriage. That the standard, in this respect, -of the profession of the present day has not deteriorated, is proved by -the first of the resolutions adopted by the Convention at Louisville, -in 1859: "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. -"<a name="FNanchor_5_5" id="FNanchor_5_5"></a><a href="#Footnote_5_5" class="fnanchor">[5]</a></p> - -<p>It is true, however, that while physicians are unanimous as to the -sanctity of fœtal life, they have yet to a certain extent innocently -and unintentionally given grounds for the prevalent ignorance upon this -subject, to which I shall soon allude. The fact that in some cases of -difficult labor it becomes imperatively necessary to remove the child -piecemeal, if dead, or, if living, to destroy it for the sake of saving -the mother's life, ought not to imply that the physician has attached -a trifling value to the child itself. Compared with the mother, who -is already mature and playing so important a part in the world, he -justly allows the balance to fall, but he fully recognizes that he is -assuming a tremendous responsibility, that his action is only justified -by the excuse of dire necessity, and he suffers, if he is a man of any -sensibility and feeling, an amount of mental anguish not easily to be -described, and that none of us, who have been compelled to so terrible -a duty, need feel ashamed to confess.</p> - -<p><span class="pagenum"><a name="Page_24" id="Page_24">[Pg 24]</a></span></p> - -<p>There are cases again, where, during pregnancy, the patient may be -reduced by the shock of severe and long-continued pain or excessive -vomiting, and its consequent inanition, to the verge of the grave. In -such instances, it has been supposed that abortion was necessary to -preserve the woman's life. The advance of science, however, has now -shown that this procedure is not only often unnecessary, but in reality -unscientific; the disturbances referred to occurring, as they generally -do, in the earlier months of gestation, being owing not to the direct -pressure of the womb upon the stomach or other organs, but to a -so-called reflex and sympathetic disturbance of those organs, through -the agency of the nervous system; and that a cure can in general be -readily effected without in any way endangering the vitality of the -child.</p> - -<p><span class="pagenum"><a name="Page_25" id="Page_25">[Pg 25]</a></span></p> - -<p>There are other instances that might be cited, cases of dangerous -organic disease, as cancer of the womb, in which, however improbable -it might seem, pregnancy does occasionally occur; cases of insanity, -of epilepsy, or of other mental lesion, where there is fear of -transmitting the malady to a line of offspring; cases of general -ill-health, where there is perhaps a chance of the patient becoming an -invalid for life; but for all these, and similar emergencies, there -is a single answer, and but this one—that abortion, however it may -seem indicated, should never be induced by a physician upon his own -uncorroborated opinion, and, in a matter so grave, affecting, with -his own reputation, the life of at least one, if not of a second -human being, every man worthy of so weighty and responsible a trust -will seek in consultation a second opinion. This is a matter of such -importance to the welfare of the community, that long ago the law -should have provided for its various dangers, and should wisely have -left it to no man's discretion or purity of character to withstand the -tremendous temptations which must be allowed to here exist. The law now -provides, in one or more at least of our States, that the certificate -of a single physician, no matter what his skill or standing, cannot -commit a patient to the often necessary and beneficial seclusion of -a lunatic asylum; two are required. How much more requisite is it -that in the question we are now considering, to one mode of deciding -which the physician may be prompted by pity, by personal sympathy, the -entreaties of a favorite patient, and not seldom by the direct offer of -comparatively enormous pecuniary compensation, the law should offer him -its protecting shield, saving him even from himself, and helping him -to see that the fee for an unnecessarily induced or allowed abortion -is in reality the price of blood. As a class, it cannot be gainsaid -that physicians of standing will spurn with indignation the direct -bribe; let them look to it that they never carelessly permit what they -condemn, by endeavoring to bring on the woman's periodical discharge -when it is possible that she may have conceived, or by carelessly -passing an instrument into her womb without ascertaining whether or no -it contain the fruit of impregnation, or by allowing the completion -of a miscarriage that may threaten or even have commenced, without -resorting to every measure, of whatever character, that can possibly -result in its arrest, and the consequent completion of the full period.</p> - -<p><span class="pagenum"><a name="Page_26" id="Page_26">[Pg 26]</a></span></p> - -<div class="chapter"> -<p class="xlarge bold"> -<a name="III." id="III."></a> -III.—<i>What is the True Nature of an Intentional Abortion when not -Requisite to Save the Life of the Mother.</i></p> -</div> - -<p><span class="pagenum"><a name="Page_27" id="Page_27">[Pg 27]</a></span></p> - -<p>There are those who will be influenced by evidence presented from -abstract morality and religion. To such I shall first address myself. -There are others who care nothing for ethical considerations, and -who arrogate to themselves a right to decide as to the morality of -taking or destroying the life of an unborn child. For these, also, I -have an unanswerable argument—their own self-interest—an appeal to -which will usually arrest the most hardened adept in other crime, much -more these intelligent and otherwise innocent women, who have mostly -erred through ignorance and a misapprehension of their own physical -condition, and their own physical dangers, their own physical welfare.</p> - -<p><span class="pagenum"><a name="Page_28" id="Page_28">[Pg 28]</a></span></p> - -<p>Physicians have now arrived at the unanimous opinion, that the fœtus in -utero is <i>alive</i> from the very moment of conception.</p> - -<p>"To extinguish the first spark of life is a crime of the same nature, -both against our Maker and society, as to destroy an infant, a child, -or a man."<a name="FNanchor_6_6" id="FNanchor_6_6"></a><a href="#Footnote_6_6" class="fnanchor">[6]</a></p> - -<p>More than two hundred years ago the same idea was as vigorously as -quaintly expressed: "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."<a name="FNanchor_7_7" id="FNanchor_7_7"></a><a href="#Footnote_7_7" class="fnanchor">[7]</a></p> - -<p>The law, whose judgments are arrived at so deliberately, and usually -so safely, has come to the same conclusion, and though in some of its -decisions it has lost sight of this fundamental truth, it has averred, -in most pithy and emphatic language, that "quick with child, is having -conceived."<a name="FNanchor_8_8" id="FNanchor_8_8"></a><a href="#Footnote_8_8" class="fnanchor">[8]</a></p> - -<p><span class="pagenum"><a name="Page_29" id="Page_29">[Pg 29]</a></span></p> - -<p>By that higher than human law, which, though scoffed at by many a -tongue, is yet acknowledged by every conscience, "the wilful killing of -a human being, at any stage of its existence, is murder."<a name="FNanchor_9_9" id="FNanchor_9_9"></a><a href="#Footnote_9_9" class="fnanchor">[9]</a></p> - -<p><span class="pagenum"><a name="Page_30" id="Page_30">[Pg 30]</a></span></p> - -<p>Abortion or miscarriage is known by every woman to consist of the -premature expulsion of the product of conception. It is not as well -known, however, if the statements of patients are to be relied upon, -that this product of conception is in reality endowed with vitality -from the moment of conception itself. It is important, therefore, to -decide in what the moment of conception consists. It has now been -ascertained that every variety of animal life originates from an egg, -even primarily those lowest forms in which occur the phenomena of -so-called alternate generation; in each and every one of them, mammals -or invertebrates, the origin is from as distinct an egg as is laid -by bird, tortoise, or fish; the human species being no exception to -this general rule. Before this egg has left the woman's ovary, before -impregnation has been effected, it may perhaps be considered as a -part and parcel of herself, but not afterwards. When it has reached -the womb, that nest provided for the little one by kindly nature, -it has assumed a separate and independent existence, though still -dependent upon the mother for subsistence. For this end the embryo is -again attached to its parent's person, temporarily only, although so -intimately that it may become nourished from her blood, just as months -afterwards it is from the milk her breasts afford. This is no fanciful -analogy; its truth is proved by countless facts. In the kangaroo, -for instance, the offspring is born into the world at an extremely -early stage of development, "resembling an earthworm in its color and -semi-transparent integument,"<a name="FNanchor_10_10" id="FNanchor_10_10"></a><a href="#Footnote_10_10" class="fnanchor">[10]</a> -and then is placed by the mother -in an external, abdominal, or marsupial pouch, to portions of which -corresponding, so far as function goes, at once to teats and to the -uterine sinuses, these embryos cling by an almost vascular connection, -until they are sufficiently advanced to bear detachment, or in reality -to be born. The first impregnation of the egg, whether in man or in -kangaroo, is the birth of the offspring to life; its emergence into -the outside world for wholly separate existence is, for one as for the -other, but an accident in time. It has been asserted by some authors, -as by Meigs, that conception is only coincident with the attachment -of the impregnated egg to the uterine cavity for its temporary abode -therein, or, in exceptional cases, as in extra-uterine pregnancy -so called, with its attachment to some other tissue of the mother; -thereby attempting to establish a difference between impregnation and -conception; a difference that is at once philosophically unfounded, -and plainly disproved by all analogical evidence, as the fact, for -instance, that in most fishes impregnation occurs entirely external to -the body of the mother, from which the ova had previously, or during -the process of copulation, permanently been discharged.</p> - -<p><span class="pagenum"><a name="Page_31" id="Page_31">[Pg 31]</a></span></p> - -<p>Many women suppose that the child is not alive till quickening has -occurred, others that it is practically dead till it has breathed. As -well one of these suppositions as the other; they are both of them -erroneous.</p> - -<p><span class="pagenum"><a name="Page_32" id="Page_32">[Pg 32]</a></span></p> - -<p>Many women never quicken at all, though their children are born living; -others quicken earlier or later than the usual standard of time; or, -others again may, in their own persons, have noticed either or all of -these peculiarities in different pregnancies. Quickening is in fact -but a sensation, the perception of the first throes of life—but of a -twofold occurrence, and this not merely the motion of the child, but -often the sudden emergence of the womb upwards from its confinement in -the low regions of the pelvis into the freer space of the abdomen. The -motions of the child, which have been proved by Simpson, of Edinburgh, -to be its involuntary efforts, through the reflex action of its nervous -system, to retain itself in certain attitudes and positions essential -to its security, its sustenance, and its proper development, are -usually present for a period long prior to the possibility of their -being perceived by the parent. They may very constantly be recognized -by the physician in cases where no sensation is felt by the mother, and -the fœtus has been seen to move when born, during miscarriage, at a -very early period.</p> - -<p><span class="pagenum"><a name="Page_33" id="Page_33">[Pg 33]</a></span></p> - -<p>During the early months of pregnancy, while the fœtus is very small -in proportion to the size of the cavity which contains it, sounds, -produced by its movements, may be distinguished by the attentive ear -applied to the abdomen of the mother, as gentle taps repeated at -intervals, and continued uninterruptedly for a considerable time. These -sounds may sometimes be heard several weeks before the usual period -of the mother's becoming conscious of the motion of the child, and -also earlier than the pulsations of the fœtal heart or the uterine -souffle,<a name="FNanchor_11_11" id="FNanchor_11_11"></a><a href="#Footnote_11_11" class="fnanchor">[11]</a> as the murmur of the circulation in the walls of that -organ, or in the tissue of the after-birth, is technically termed. -These motions must be allowed to prove life, and independent life. -In what does this life really differ from that of the child five -minutes in the world? Is not, then, forced abortion a crime? Moreover, -instances have occurred where, the membranes having been accidentally -ruptured, the child has breathed, and even cried, though yet unborn, -as proved alike by the sounds within the mother, well authenticated by -bystanders, and by auscultation of her abdomen, and by the fact that -sometimes, when not born living, the lungs of the fœtus have been found -fully expanded, a process which can be effected only by respiration, -and of which the proofs are such as can be occasioned in no other way -whatever.</p> - -<p><span class="pagenum"><a name="Page_34" id="Page_34">[Pg 34]</a></span></p> - -<p>In the majority of instances of forced abortion, the act is committed -prior to the usual period of quickening. There are other women, who -have confessed to me that they have destroyed their children long -after they have felt them leap within their womb. There are others -still, whom I have known to wilfully suffocate them during birth, or to -prevent the air from reaching them under the bedclothes; and there are -others, who have wilfully killed their wholly separated and breathing -offspring, by strangling them or drowning them, or throwing them into a -noisome vault. Wherein among all these criminals does there in reality -exist any difference in guilt?</p> - -<p><span class="pagenum"><a name="Page_35" id="Page_35">[Pg 35]</a></span></p> - -<p>I would gladly arrive at, and avow any other conviction than that -I have now presented, were it possible in the light of fact and of -science, for I know it must carry grief and remorse to -many an otherwise innocent bosom. The truth is, that our silence has -rendered all of us accessory to the crime, and now that the time has -come to strip down the veil, and apply the searching caustic or knife -to this foul sore in the body politic, the physician needs courage as -well as his patient, and may well overflow with regretful sympathy.</p> - -<p>That there has existed a wide and sincere ignorance of the true -character of the act, I have already allowed; it is a point to which -I shall again refer. At present let us turn from the crime against -the child, to the crime as against the mother's own life and health. -I here refer more particularly to her own agency therein. Of the -guilt of abortion when committed by another person than herself, and -with reference both to the mother's life and that of the child, there -can be no doubt, but it is to the woman's own agency in the act, as -principal, or accessory by its solicitation or permission, that we have -now to deal; not as to its abstract wrong alone, but as to its physical -dangers, and therefore its utter folly.</p> - -<p><span class="pagenum"><a name="Page_36" id="Page_36">[Pg 36]</a></span></p> - -<div class="chapter"> -<p class="xlarge bold"> -<a name="IV." id="IV."></a> -IV.—<i>The Inherent Dangers of Abortion to a Woman's Health and to her -Life.</i></p> -</div> - -<p>It is generally supposed, not merely that a woman can wilfully throw -off the product of conception without guilt or moral harm, but that -she can do it with positive or comparative impunity as regards her own -health. This is a very grievous and most fatal error, and I do not -hesitate to assert, from extended observation, that, despite apparent -and isolated instances to the contrary—</p> - -<p>1. A larger proportion of women die during or in consequence of an -abortion, than during or in consequence of childbed at the full term -of pregnancy;</p> - -<p><span class="pagenum"><a name="Page_37" id="Page_37">[Pg 37]</a></span></p> - -<p>2. A very much larger proportion of women become confirmed invalids, -perhaps for life; and,</p> - -<p>3. The tendency to serious and often fatal organic disease, as cancer, -is rendered much greater at the so-called turn of life, which has very -generally, and not without good reason, been considered as especially -the critical period of a woman's existence.</p> - -<p>These, as I have said, are conclusions that cannot be gainsaid, as they -are based on facts; and that these facts are merely what ought, in the -very nature of things, to occur, can readily enough be shown.</p> - -<p>1. Nature does all her work, of whatever character it may be, in -accordance with certain simple and general laws, any infringement of -which must necessarily cause derangement, disaster, or ruin.</p> - -<p>In the present instance, it has been ascertained, by careful -dissections and microscopic study, that the woman's general system, -both as a whole and as regards each individual organ and its tissues, -is slowly and gradually prepared for the great change which -naturally occurs at the end of nine months' gestation; and that if this -change is by any means prematurely induced, whether by accident or -design, it finds the system unprepared. Not even do I except from this -law the earlier months of pregnancy, when it is thought by so many that -abortion can be brought on without any physical shock.</p> - -<p><span class="pagenum"><a name="Page_38" id="Page_38">[Pg 38]</a></span></p> - -<p>During pregnancy all the vital energies of the mother are devoted to -a single end: the protection and nourishment of the child. Such wise -provision is made for its security, such intimate vascular connection -is established between the fœtal circulation and the blood-vessels of -the mother, that its premature rupture is usually attended by profuse -hemorrhage, often fatal, often persistent to a greater or less degree -for many months after the act has been completed, and always attended -with more or less shock to the maternal system, even though the full -effect of this is not noticed for years.</p> - -<p><span class="pagenum"><a name="Page_39" id="Page_39">[Pg 39]</a></span></p> - -<p>In birth at the full period, it is found that what is called by -pathologists fatty degeneration of the tissues, occurs both in the -walls of the mother's womb, and in the placenta or after-birth, by -which attachment is kept up with the child. This change, in all other -instances a diseased process, is here an essential and healthy one. By -it the occurrence of labor at its normal period is to a certain extent -determined; by it is provision made against an inordinate discharge of -blood during the separation and escape of the after-birth, and by it is -the return of the uterus to the comparatively insignificant size, that -is natural to it when unimpregnated, insured. Any deviation from this -process at the full term, which prevents the whole chain of events now -enumerated from being completed, lays the foundation of, and causes a -wide range of uterine accidents and disease, displacements of various -kinds, falling of the womb downwards or forwards or backwards, with the -long list of neuralgic pains in the back, groins, thighs, and elsewhere -that they occasion; constant and inordinate leucorrhœa; sympathetic -attacks of ovarian irritation, running even into dropsy, &c., &c. These -are only a portion of the results that might be enumerated.</p> - -<p><span class="pagenum"><a name="Page_40" id="Page_40">[Pg 40]</a></span></p> - -<p>Now, while all this is true of any interference with the natural -process at the full time, it is just as true, and if anything more -certain, when pregnancy has been prematurely terminated; and out of -many hundred invalid women, whose cases I have critically examined, in -a very large proportion I have traced these symptoms, to the mental -conviction of the patient, as well as to my own, directly back to an -induced abortion.</p> - -<p><span class="pagenum"><a name="Page_41" id="Page_41">[Pg 41]</a></span></p> - -<p>Again—not merely does nature prepare the appendages of the child and -the womb of its mother for the separation that in due time is to ensue -between them, it also provides an additional means of insuring its -successful accomplishment through the action that takes place in the -woman's breasts, namely, the secretion of the milk. Though the escape -of this fluid does not ordinarily occur in any quantity until some -little time after birth has been effected, yet the changes that ensue -have gradually been progressing for days, or weeks, or even months; -for, as is well known, in some women the lacteal secretion is present -before birth, at times even during a large part of pregnancy, and in -all women there is doubtless a decided tendency of the circulation -towards the breasts, prior to the birth of the child, just as there -has been so extreme a tendency of the circulation for so long a time -towards the womb. It is indeed to take the place of the latter that -the former is established, and to prevent the evil consequences that -might otherwise ensue. The sympathy between the mammary glands and -the uterus is now well established; it is shown in many different -ways: in some women the application of the child to the breasts is -immediately followed by after-pains, and in others these pains, which -are usually but contractions of the womb to expel any clots that may -have accumulated, are attended by a freer secretion or discharge of -the milk. It is not uncommon, when the monthly discharge is scanty -or suddenly checked, for the breasts to become enlarged and painful, -as is so often the case soon after impregnation, while, on the other -hand, one of the most efficient means we have of establishing the -periodical flow, when suppressed, is by the application of sinapisms -to the surface of the breasts. In view of these facts it will -readily be understood why it is that women who make good nurses are -so much less likely than others to suffer from the various disorders -of the womb, and why they are also less likely to rapidly conceive, -and why, moreover, too long lactation should not be indulged in for -either of these so desirable ends. The demands of fashion shorten or -prevent nursing, the demands of fashion often forbid a woman from -bearing children; but whether this is attained by the prevention -of impregnation, or by the induction of miscarriage, it is almost -inevitably attended, as is to a certain extent the sudden cessation of -suckling, by a grievous shock to the mother's system, that sooner or -later undermines her health, if even it does not directly induce her -death.</p> - -<p><span class="pagenum"><a name="Page_42" id="Page_42">[Pg 42]</a></span></p> - -<p>I have asserted that dangers attend the occurrence of abortion which -directly threaten a mother's life. This is true of all miscarriages, -whether accidental or otherwise; but these dangers are enhanced when -the act is intentional. When caused by an accident, the disturbance -is often of a secondary character, the vitality of the ovum being -destroyed, or the activity of the maternal circulation checked, before -the separation of the two beings from each other finally takes place. -But in a forced abortion there is no such preservative action; the -separation is immediate if produced by instruments, which often besides -do grievous damage to the tissues of the mother with which they are -brought into contact, lacerating them, and often inducing subsequent -sloughing or mortification; or, if the act is effected by medicines, -it is usually in consequence of violent purgation or vomiting, which -of themselves often occasion local inflammation of the stomach or -intestines, and death. Add to this that even though the occurrence of -any such feeling may be denied, there is probably always a certain -measure of compunction for the deed in the woman's heart—a touch of -pity for the little being about to be sacrificed—a trace of regret for -the child that, if born, would have proved so dear—a trace of shame -at casting from her the pledge of a husband's or lover's affection—a -trace of remorse for what she knows to be a wrong, no matter to what -small extent, or how justifiable, it may seem to herself, and we -have an explanation of the additional element in these intentional -abortions, which increases the evil effect upon the mother, not as -regards her bodily health alone, but in some sad cases to the extent -even of utterly overthrowing her reason.</p> - -<p><span class="pagenum"><a name="Page_43" id="Page_43">[Pg 43]</a></span></p> - -<p>The causes of an immediately or secondarily fatal result of labor -at the full period are few; in abortion nearly every one of these -is present, with the addition of others peculiar to the sudden and -untimely interruption of a natural process, and the death of the -product of conception. There is the same or greater physical shock, -the same or greater liability to hemorrhage, the same and much greater -liability to subsequent uterine or ovarian disease. To these elements -we must add another, and by no means an unimportant one; a degree of -mental disturbance, often profound, from disappointment or fear, that -to the same extent may be said rarely to exist in labors at the full -period.<a name="FNanchor_12_12" id="FNanchor_12_12"></a><a href="#Footnote_12_12" class="fnanchor">[12]</a></p> - -<p><span class="pagenum"><a name="Page_44" id="Page_44">[Pg 44]</a></span></p> - -<p>Viewing this subject in a medical light, we find that death, however -frequent, is by no means the most common or the worst result of the -attempts at criminal abortion. This statement applies not to the mother -alone, but, in a degree, to the child.</p> - -<p><span class="pagenum"><a name="Page_45" id="Page_45">[Pg 45]</a></span></p> - -<p>We shall perceive that many of the measures resorted to are by no means -certain of success, often indeed decidedly inefficacious in causing the -immediate expulsion of the fœtus from the womb; though almost always -producing more or less severe local or general injury to the mother, -and often, directly or by sympathy, to the child.</p> - -<p>The membranes or placenta may be but partially detached, and the ovum -may be retained. This does not necessarily occasion degeneration, as -into a mole, or hydatids, or entire arrest of development. The latter -may be partial, as under many forms, from some cause or another, does -constantly occur; if from an unsuccessful attempt at abortion, would -this be confessed, or indeed always suggest itself to the mother's own -mind? Fractures of the fœtal limbs, prior to birth, are often reported, -unattributable in any way to the funis, which may amputate, indeed, -but seldom break a limb. A fall or a blow is recollected; perhaps it -was accidental, perhaps not, for resort to these for criminal purposes -is very common. In precisely the same manner may injury be occasioned -to the nervous system of the fœtus, as in a hydrocephalic case long -under the writer's own observation, where the cause and effect were -plainly evident. Intrauterine convulsions have been reported; as -induced by external violence they are probably not uncommon, and the -disease thus begun may eventuate in epilepsy, paralysis, or idiocy.</p> - -<p><span class="pagenum"><a name="Page_46" id="Page_46">[Pg 46]</a></span></p> - -<p>To the mother there may happen correspondingly frequent and serious -results. Not alone death, immediate or subsequent, may occur from -metritis, hemorrhage, peritonitic, or phlebitic inflammation, from -almost every cause possibly attending not merely labor at the full -period, comparatively safe, but miscarriage increased and multiplied by -ignorance, by wounds, and violence; but if life still remain, it is too -often rendered worse than death.</p> - -<p><span class="pagenum"><a name="Page_47" id="Page_47">[Pg 47]</a></span></p> - -<p>The results of abortion from natural causes, as obstetric disease, -separate or in common, of mother, fœtus, or membranes, or from a morbid -habit consequent on its repetition, are much worse than those following -the average of labors at the full period. If the abortion be from -accident, from external violence, mental shock, great constitutional -disturbance from disease or poison, or even necessarily induced by the -skilful physician in early pregnancy, the risks are worse. But if, -taking into account the patient's constitution, her previous health, -and the period of gestation, the abortion has been criminal, these -risks are infinitely increased. Those who escape them are few.</p> - -<p>In thirty-four cases of criminal abortion reported by Tardieu, where -the history was known, twenty-two were followed, as a consequence, by -death, and only twelve were not. In fifteen cases necessarily induced -by physicians, not one was fatal.</p> - -<p><span class="pagenum"><a name="Page_48" id="Page_48">[Pg 48]</a></span></p> - -<p>It is a mistake to suppose, with Devergie, that death must be -immediate, and owing only to the causes just mentioned. The rapidity -of death, even where directly the consequence, greatly varies; though -generally taking place almost at once if there be hemorrhage, it may -be delayed even for hours where there has been great laceration of -the uterus, its surrounding tissues, and even of the intestines; if -metro-peritonitis ensue, the patient may survive for from one to four -days, even, indeed, to seven and ten. But there are other fatal cases, -where on autopsy there is revealed no appreciable lesion, death, the -penalty of unwarrantably interfering with nature, being occasioned by -syncope, by excess of pain, or by moral shock from the thought of the -crime.</p> - -<p>That abortions, even when criminally induced, may sometimes be safely -borne by the system, is of little avail to disprove the evidence of -numberless cases to the contrary. We have instanced death. Pelvic -cellulitis, on the other hand, fistulæ, vesical, uterine, or between -the organs alluded to; adhesions of the os or vagina, rendering -liable subsequent rupture of the womb, during labor or from retained -menses, or, in the latter case, discharge of the secretion through a -Fallopian tube, and consequent peritonitis; diseases and degenerations, -inflammatory or malignant, of both uterus and ovary; of this long -and fearful list, each, too frequently incurable, may be the direct and -evident consequence, to one patient or another, of an intentional and -unjustifiable abortion.</p> - -<p><span class="pagenum"><a name="Page_49" id="Page_49">[Pg 49]</a></span></p> - -<p>We have seen that, in some instances, the thought of the crime, -coming upon the mind at a time when the physical system is weak and -prostrated, is sufficient to occasion death. The same tremendous -idea, so laden with the consciousness of guilt against God, humanity, -and even mere natural instinct, is undoubtedly able, where not -affecting life, to produce insanity. This it may do either by its -first and sudden occurrence to the mind, or, subsequently, by those -long and unavailing regrets, that remorse, if conscience exist, is -sure to bring. Were we wrong in considering death the preferable -alternative?<a name="FNanchor_13_13" id="FNanchor_13_13"></a><a href="#Footnote_13_13" class="fnanchor">[13]</a></p> - -<p><span class="pagenum"><a name="Page_50" id="Page_50">[Pg 50]</a></span></p> - -<p>To the above remarks it might truthfully be added, that not only is -the fœtus endangered by the attempt at abortion, and the mother's -health, but that the stamp of disease thus impressed is very apt to -be perceived upon any children she may subsequently bear. Not only -do women become sterile in consequence of a miscarriage, and then, -longing for offspring, find themselves permanently incapacitated for -conception, but, in other cases, impregnation, or rather the attachment -of the ovum to the uterus, being but imperfectly effected, or the -mother's system being so insidiously undermined, the children that are -subsequently brought forth are unhealthy, deformed, or diseased. This -matter of conception and gestation, after a miscarriage, has of late -been made the subject of special study, and there is little doubt that -from this, as the primal origin, arises much of the nervous, mental, -and organic derangement and deficiency that, occurring in children, -cuts short or embitters their lives.</p> - -<p>It may be alleged by those who, sceptical or not sceptical as to these -conclusions, have reason, nevertheless, to desire to throw discredit -upon them, that the weekly or annual bills of mortality, the mortuary -statistics, do not show such direct influence from the crime of -abortion as I have claimed exists.</p> - -<p><span class="pagenum"><a name="Page_51" id="Page_51">[Pg 51]</a></span></p> - -<p>On the other hand, it must not be forgotten that in these cases there -is always present every reason for concealment. In the earlier months -of pregnancy it is very difficult to prove, in the living subject, that -pregnancy has occurred. Such a conclusion being arrived at, before -the sound of the fœtal heart can be heard, for this is the only sign -that is positively certain, by merely circumstantial and probable -evidence, which becomes of weight only as it is accumulated and found -corroborative. In the dead subject, the victim of an abortion in -the earlier months, the case is often equally obscure, or at least -doubtful, unless the product of conception has not yet escaped, or, -having been thrown off, has been detected or preserved. When found, -it of course proves pregnancy, whether the parent be living or dead; -that is, in the former instance, if its discharge can be traced -directly to the woman in question, and to no other, and correlative -circumstances may show that an abortion has occurred; but this may -have been accidental and guiltless. Where the act has been committed -by an accomplice, the proofs of such commission and of the intent, -though this is generally implied by the act itself, are by no means -always forthcoming. Where the abortion has been induced by the woman -herself, as is now so frequently the case, certainty upon the point -becomes far more difficult. The only positive evidence by which to -judge of the real frequency of the crime is <i>confession</i>, and it is -from the confessions of many hundreds of women, in all classes of -society, married and unmarried, rich and poor, otherwise good, bad, or -indifferent, that physicians have obtained their knowledge of the true -frequency of the crime.</p> - -<p><span class="pagenum"><a name="Page_52" id="Page_52">[Pg 52]</a></span></p> - -<p>The confidential relations in which the physician stands to his -patient; the understanding that nothing can wring from him her -disclosures, save the direct commands of the law, so unlikely in -any given case to become cognizant of its existence, elicits from a -woman in almost every instance, especially if she believes herself in -peril of death, a frank statement of the means by which she has been -brought low; for it is evident that upon such knowledge must depend -the measures of relief to which the physician may resort. Could the -test of confession be always applied, as is, however, manifestly -impossible, so many women die during or in consequence of an abortion, -without the attendance of a physician and without making any sign, it -would be found that many of the cases now reported upon our bills of -mortality as deaths from hemorrhage, from menorrhagia, from dysentery, -from peritonitis, from inflammation of the bowels or of the womb, from -obscure tumor, or from uterine cancer, would be found in reality to -be deaths from intentional abortion. At first sight, it would seem -impossible that such grossly erroneous opinions as the above could -be rendered; but their likelihood is readily perceived when it is -recollected how often, when the best medical skill has been secured, -attending circumstances are such as to excite little or no suspicion of -the true state of the case, and a physical examination of the patient -is therefore neglected. Women are still allowed to die of ovarian or -of other tumors that might be easily and successfully removed, and, in -default of a proper examination, are sometimes mistakenly pronounced -instances of disease of the liver or of ordinary abdominal dropsy, and -as such are buried. If such and similar errors can occur in chronic -cases, where time and opportunity have permitted the most thorough -examination and study, still more likely are they to take place during -the hurry and anxieties of an acute and alarming attack, where the -conscience and shame of the patient are alike interested in causing or -keeping up a deception.</p> - -<p><span class="pagenum"><a name="Page_53" id="Page_53">[Pg 53]</a></span></p> - -<p>It will have been seen, then, not merely that an induced abortion may -be attended with great immediate danger to the mother, but that in -reality it is very often fatal, either from the so-called shock to her -system, or from hemorrhage, or from immediately ensuing peritonitis.</p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_54" id="Page_54">[Pg 54]</a></span></p> - -<p>2. Should the woman survive these immediate consequences, no matter how -excellently she may have seemed to rally, she is by no means safe as to -her subsequent health. There are a host of diseases, some of them very -dangerous, to which she is directly liable.</p> - -<p>The product of conception is not always entirely gotten rid of. If a -fragment remains, no matter how trifling in size, it may serve as the -channel of the most severe and constant hemorrhagic discharge. Of this, -examples are by no means infrequent; the flux lasting at times for very -many months, and, if the cause is not finally detected and removed, -hurrying the patient to her grave.</p> - -<p><span class="pagenum"><a name="Page_55" id="Page_55">[Pg 55]</a></span></p> - -<p>The product of conception is sometimes retained entire, after its -detachment from the uterine walls has been supposed wholly effected. -It may be carried for many years, always acting as a foreign body; at -times occasioning extreme irritation, shown perhaps only by distant -and otherwise inexplicable symptoms, or it may lie dormant for a time -without apparent trouble—finally making itself known by some sudden -explosion of disease, whether by purulent absorption and general -pyæmia; by ulceration and discharge of fœtal debris, through the -intestines, bladder, or even abdominal integuments; or, by metritic -inflammation, followed by sympathetic or consequent fatal peritonitis.</p> - -<p><span class="pagenum"><a name="Page_56" id="Page_56">[Pg 56]</a></span></p> - -<p>The patient, after an abortion, is very liable to one or another of the -forms of uterine displacement, which are now known to lie at the -foundation of so very large a proportion of the lame backs, formerly -supposed consequent on spinal irritation; of the painfully neuralgic -breasts, so often suggestive of incipient cancer; of the disabled -limbs, pronounced affected with sciatica, cramps, or even paralysis; -of the impatient bladders, from whose irritability or incontinence -the kidneys are supposed diseased; of the obscure abdominal aches and -pains, which unjustly condemn so many a liver and so many an ovary; -of the constipation from mere mechanical pressure, which is so often -thought to argue stoppage from stricture or other organic disease; of -the severe and intractable headaches that, resisting all and every -form of direct or constitutional treatment, are supposed to indicate -an incurable affection of the brain; of the easily deranged stomachs, -that are so suggestive of ulceration or of malignant degeneration; of -the general hypochondria and despondency, that of the most gentle, -even almost angelic, dispositions make the shrew and virago, and of -the purest and most innocent produce, in her own conceit, the worst of -sinners, even at times effecting suicide. Who that has suffered will -think this picture overdrawn? Who that has practised will not recognize -in displacements, the key by which these riddles may be solved?</p> - -<p><span class="pagenum"><a name="Page_57" id="Page_57">[Pg 57]</a></span></p> - -<p>Their mode of causation is plain. After an abortion, just as after -labor at the full term, the womb is more weighty than natural—its -walls thicker and heavier than usual, alike by the excess of blood -they contain, and by the increased deposition of muscular fibre. After -childbed, it has been shown that this increase is normally lessened -by certain physiological processes attending the natural completion -of that function. After an abortion, these processes are absent or -are but imperfectly performed. It is notorious that during the slight -increase of weight from simple congestion that occurs at the regular -monthly periods, women are very liable to displacement on any effort, -extreme or slight, whether riding on horseback, gently lifting, or -even straining at stool; during or after an abortion, the risk is very -greatly increased.</p> - -<p><span class="pagenum"><a name="Page_58" id="Page_58">[Pg 58]</a></span></p> - -<p>With equal justice could I refer to the chances of trouble that -otherwise accompany the premature ending of pregnancy. In many -instances, I have now been summoned to attend, and frequently to -operate upon, the consequences of local uterine or vaginal inflammation -or of laceration, for both of these results may ensue where the womb -has not been prepared to evacuate itself by the normal closure of -pregnancy—and this, whether or not instruments may have been employed. -Adhesions of varying situation and extent are not uncommon as the -result of an abortion. They may be slight, and merely tilt or draw -the womb to one side, giving rise only to severe local or distant -neuralgias, and rendering the occurrence of a subsequent pregnancy -somewhat dangerous; they may be more decided, and as bridles or septa -partially close the canal of the vagina, rendering menstruation and -conjugal intercourse alike difficult and painful; they may be so -complete as entirely to obliterate the mouth of the womb or of the -external passage, in these instances preventing the escape of the -menses, and rendering an operation necessary to avoid a rupture that -might perhaps be fatal. Should it be the outer entrance that is -occluded, the woman is of course entirely shut off from her husband's -embrace; an effect that, however grateful to many an invalid, her shame -would hardly be willing to accept as the consequence of disease.</p> - -<p><span class="pagenum"><a name="Page_59" id="Page_59">[Pg 59]</a></span></p> - -<p>These that I have mentioned are but a tithe of the pathological effects -daily revealed to physicians, as in consequence of an intentional -abortion. They are, however, sufficient for our purpose.</p> - -<hr class="tb" /> - -<p>3. But not only is a woman in peril both as to life and health, alike -at the time of an abortion and for months or years subsequently. She -may seem to herself and to others successfully to have escaped these -dangers, and yet when she has reached the critical turn of life, -succumb.</p> - -<p><span class="pagenum"><a name="Page_60" id="Page_60">[Pg 60]</a></span></p> - -<p>At this eventful period, when the fountains of youth dry up, and the -scanty circulation is turned from its accustomed channel, the woman -ceases from the periodical discharges, which in health and with care -are the secret of her beauty, her attractions, her charms. At its -occurrence not merely is a change produced in the system generally, -but the womb, no longer required, becomes atrophied and dwindles into -insignificance. It may have had impressed upon it, years and years -back, the stamp of derangement, till now not rendered effective; for, -as in other portions of the body, a part once weakened may retain -itself in tolerably good condition until some accident or other change -develops or awakens the seed of disease. Thus it is that an ancient -hypertrophy, or a chronic irritation, may become scirrhous and -degenerate into undoubted carcinoma, or chronic menorrhagia or uterine -leucorrhœa become intractable hemorrhage, or a latent fibroid deposit -develop into an irrepressible, and, perhaps, irremediable tumor.</p> - -<p>Little the comfort for a woman to have had her own way against the -dictates of her conscience, the advice, perhaps, of her physician, -if to the dangers she must directly incur, she must add the looking -forward through all the rest of her life to possible disease, -invalidism or death as the direct consequence of her folly; no wonder -if she should consider prevention better than such cure as this, -and yet the prevention of pregnancy, by whatever means it may be -sought, by cold vaginal injections, or by incomplete or impeded sexual -intercourse, is alike destructive to sensual enjoyment and to the -woman's health; her only safeguard is either to restrict approach to a -portion of the menstrual interval, or to refrain from it altogether.</p> - -<p><span class="pagenum"><a name="Page_61" id="Page_61">[Pg 61]</a></span></p> - -<p>Not merely are certain of the measures to which I have alluded -detrimental to the health of the woman, they are so to both parties -engaged, and it is to their frequent employment, freely confessed -as this is to the physician, that much of the ill health of the -community, both of men and women is to be attributed. Though they may -seem sanctioned by the rites of marriage, they are in some respects -worse for the physical health, I might almost say for the moral health -likewise, than illicit intercourse or even prostitution, for they bring -both parties down to all the evils and dangers, mental and physical, of -self-abuse.</p> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_62" id="Page_62">[Pg 62]</a></span></p> - -<div class="chapter"> -<p class="xlarge bold"> -<a name="V." id="V."></a> -V.—<i>The Frequency of Forced Abortions, even among the Married.</i></p> -</div> - -<p>All are familiar with the fact, to be perceived everywhere upon the -most casual scrutiny, that the standard size of families is not on -the average what used to be seen; in other words, that instances of -an excess over three or four children are not nearly as common as we -know was the case a generation or two back. No one supposes that men or -women have, as a whole, so deteriorated in procreative ability as this -might otherwise seem to imply.</p> - -<p>There can be but one solution to the problem, either that pregnancies -are very generally prevented, or that, occurring, they are prematurely -cut short. We have seen that countless confessions prove that this -surmise is true.</p> - -<p><span class="pagenum"><a name="Page_63" id="Page_63">[Pg 63]</a></span></p> - -<p>In the treatise to which we have already alluded, its author has shown -by a series of unanswerable deductions, based on material gathered -from many sources both at home and abroad, that forced abortions in -America are of very frequent occurrence, and that this frequency -is rapidly increasing, not in the cities alone, but in the country -districts, where there is less excuse on the ground of excessive -expenditures, the claims of fashionable life, or an overcrowding of -the population. It was proved, for instance, that in one State that -was named, one of the wealthiest in the Union, the natural increase -of the population, or the excess of the births over the deaths, has -of late years been wholly by those of recent foreign origin. This was -the state of things existing in 1850; three years later it was evident -that the births in that commonwealth, with the usual increase, had -resulted in favor of foreign parents in an increased ratio. In other -words, it is found that, in so far as depends upon the American and -native element, and in the absence of the existing immigration from -abroad, the population of our older States, even allowing for the loss -by emigration, is stationary or decreasing.</p> - -<p><span class="pagenum"><a name="Page_64" id="Page_64">[Pg 64]</a></span></p> - -<p>The strange and otherwise unaccountable phenomenon to which we are now -referring, appears to have been first elucidated in a memoir, upon the -decrease of the rate of increase of population now obtaining in -Europe and America, read by the same author in 1858 to the American -Academy of Arts and Sciences, as a contribution to the science of -political economy. That paper, with all its mass of evidence, that as -yet there seems to have been no attempt to controvert, we find embodied -in the treatise to which I have referred, and which will prove of -absorbing interest to even the casual reader.</p> - -<p>Thus it is seen that abortion is a crime not merely against the life of -the child and the health of its mother, and against good morals, but -that it strikes a blow at the very foundation of society itself.</p> - -<p>One of the strange and unexpected results at which the author we have -so often referred to has arrived, but which he has both proved to a -demonstration and satisfactorily explained, is that abortions are -infinitely more frequent among Protestant women than among Catholic; -a fact, however, that becomes less unaccountable in view of the known -size, comparatively so great, of the families of the latter—in the -Irish, for instance—the point being that the different frequency of -the abortions depends not upon a difference in social position or in -fecundity, but in the religion. We should suppose <i>à priori</i> that the -Protestant, especially if of New England and Puritan stock, would be -much the safer against all such assaults of the world, the flesh, and -the devil. The following is the concise and convincing solution of the -paradox that has been given:—</p> - -<p><span class="pagenum"><a name="Page_65" id="Page_65">[Pg 65]</a></span></p> - -<p>"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."<a name="FNanchor_14_14" id="FNanchor_14_14"></a><a href="#Footnote_14_14" class="fnanchor">[14]</a></p> - -<p><span class="pagenum"><a name="Page_66" id="Page_66">[Pg 66]</a></span></p> - -<p>There is another surprising result that must strike every candid -observer whose position gives him extended and frequent observation -of women, and of late years the study and treatment of their special -diseases has become so recognized that there are many physicians thus -rendered competent to judge; it is this, but a second one of the many -very frightful characteristics of induced abortion, that the act is -proportionately much more common in the married than in the unmarried -basing the calculation upon an equal number of pregnancies in each case.</p> - -<p><span class="pagenum"><a name="Page_67" id="Page_67">[Pg 67]</a></span></p> - -<p>This fact also may be easily accounted for. Abortion is undoubtedly -more common in the earlier than in the later months of pregnancy, -because the sensible signs of fœtal vitality are then less permanently -present, and the conscience is then better able to persuade itself that -the child may possibly be without life, or the alarm wholly a false -one. It is less common with first than with subsequent children, though -instances of its occurrence with the former are certainly not rare. A -woman who has never been pregnant does not, as a general rule, conceive -as readily as one who has already been impregnated before, perhaps -partly from the fact that intercourse, under certain circumstances, is -more likely to be excessive in such cases, at times producing acute or -subacute inflammation of the cervix uteri, and consequent sterility, -as is so constantly observed in prostitutes, very many of whom, upon -ceasing their trade, after accumulating a little property, as in -France, or upon being sent to out-lying colonies, as in England, and -becoming married, at once fall pregnant.</p> - -<p>The unmarried woman, if <i>enceinte</i>, has not the opportunity of lying by -for a few days' sickness, without exciting suspicion, that the married -can easily seize for themselves. She is often not so conversant with -the early symptoms of gestation, and is more prone to wait until its -existence has been rendered certain by the sensation of quickening, in -the hope, doubtless, not unfrequently, that this certainty may persuade -her paramour to marriage, instead of deciding him against it, as is -so often the case. It may be allowed, I think, that infanticide, the -murder of a child after its birth, or its exposure to the vicissitudes -and perils of chance, is more common among the unmarried, but that -destruction of the fœtus in utero, the rather prevails where the rites -of law and religion would seem to have extended to that fœtus every -possible safeguard.</p> - -<p><span class="pagenum"><a name="Page_68" id="Page_68">[Pg 68]</a></span></p> - -<p>In the latest of the papers upon the subject of abortion, to which we -have already alluded, there is furnished additional evidence as to the -frequency of induced miscarriage.</p> - -<p>"The infrequency of abortions," it is said, "as compared with labors -at the full period, is disproved by the experience of every physician -in special or large general practice, who will faithfully investigate -the subject. The truth of this statement has been fully verified, in -the instance of abortion criminally induced, by many of my professional -friends who were at first inclined to doubt the accuracy of my -inferences on that point; with reference to abortions more naturally -occurring, the evidence is of course more easily arrived at, and is in -consequence proportionately more striking. In many cases of sterility -it will be found that the number of abortions in a single patient have -been almost innumerable; and, it may be added, in a large proportion -of the cases of uterine disease occurring in the married, inquiry as -to their past history will reveal abortions, unsuspected perhaps even -by the family physician, as the cause. It is not so much the general -practitioner, the hospital attendant, or the accoucheur, as such, who -can testify as to the true frequency of abortion; for many cases, -even of the most deplorably fatal results, do not seek for medical -assistance at the time of the accident. The real balance sheet of these -cases is to be made out by the hands which are more especially called -to the treatment of chronic uterine disease."<a name="FNanchor_15_15" id="FNanchor_15_15"></a><a href="#Footnote_15_15" class="fnanchor">[15]</a></p> - -<p><span class="pagenum"><a name="Page_69" id="Page_69">[Pg 69]</a></span></p> - -<p>But not only is abortion of excessively frequent -occurrence; the nefarious practice is yearly extending, -as does every vice that custom and habit have rendered familiar. It -is foolish to trust that a change for the better may be spontaneously -effected. "Longer silence and waiting by the profession would be -criminal. If these wretched women, these married, lawful mothers, ay, -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."<a name="FNanchor_16_16" id="FNanchor_16_16"></a><a href="#Footnote_16_16" class="fnanchor">[16]</a></p> - -<p><span class="pagenum"><a name="Page_70" id="Page_70">[Pg 70]</a></span></p> - -<div class="chapter"> -<p class="xlarge bold"><a name="VI." id="VI."></a> -VI.—<i>The Excuses and Pretexts that are given for the Act.</i></p> -</div> - -<p>I have already stated that in many instances it is alleged by the -mother that she is ignorant of the true character of the act of wilful -abortion, and in some cases I am satisfied that the excuse is sincerely -given, although, in these days of the general diffusion of a certain -amount of physiological knowledge, such ignorance would seem incredible.</p> - -<p>The above is, however, the only excuse that can be given with any show -of plausibility, and even this holds for nought should the case by any -chance come under the cognizance of the law, just as would a plea of -ignorance of the law itself; it being always taken for granted that -any intentional act implies a knowledge of its own nature and its -consequences, be these trivial or grave.</p> - -<p><span class="pagenum"><a name="Page_71" id="Page_71">[Pg 71]</a></span></p> - -<p>I have stated that in no case should abortion be permitted, or allowed -to be permitted, by the advice or approval of a single physician; -that in all cases where such counsel is taken, it should be from -a consultation of at least two competent men. Submitted to such a -tribunal, seldom indeed would the sanction be given.</p> - -<p>Ill health would be no excuse, for there is hardly a conceivable case -where the invalidism could either not be relieved in some other mode, -or where by an abortion it would not be made worse.</p> - -<p>The fear of childbed would be no excuse, for we have seen that its -risks are in reality less than those of an abortion, and its pains -and anguish can now be materially mitigated or entirely subdued -by anæsthesia, which the skill of medical science can induce, and -should induce, in every case of labor. My remarks apply not to first -pregnancies alone, when one might expect that women would naturally be -anxious and timid, but even to those cases of pregnancy that have been -preceded by difficult and dangerous labors.</p> - -<p><span class="pagenum"><a name="Page_72" id="Page_72">[Pg 72]</a></span></p> - -<p>It has been urged, and not so absurdly as would at first sight appear, -that the present possibilities of painless and so much safer delivery, -by changing thus completely the primal curse, from anguish to a state -frequently of positive pleasure, remove a drawback of actual advantage, -and, by offering too many inducements for pregnancy, tend to keep women -in that state the greater part of their menstrual lives.<a name="FNanchor_17_17" id="FNanchor_17_17"></a><a href="#Footnote_17_17" class="fnanchor">[17]</a></p> - -<p>Much of the low morale of the community, as regards the guilt of -abortion, depends upon the very erroneous doctrines extensively -inculcated by popular authors and lecturers for their own sinister -purposes.</p> - -<p><span class="pagenum"><a name="Page_73" id="Page_73">[Pg 73]</a></span></p> - -<p>One of these is the doctrine that it is detrimental to a woman's -health to bear children beyond a certain number, or oftener than at -certain stated periods, and that any number of abortions are not merely -excusable, as preventives, but advisable; it being entirely forgotten -that the frequency of connection may be kept within bounds, and the -times of its occurrence regulated, by those who are not willing to -hazard its consequences; that if women will, to escape trouble, or -for fashion's sake, forego the duty and privilege of nursing,—a law -entailed upon them by nature, and seldom neglected without disastrous -results to their own constitutions,—they must expect more frequent -impregnation; that the habit of aborting is generally attended with the -habit of more readily conceiving; and that abortions, accidental, and -still more if induced, are generally attended by the loss of subsequent -health, if not of life.</p> - -<p><span class="pagenum"><a name="Page_74" id="Page_74">[Pg 74]</a></span></p> - -<p>This error is one which would justify abortion as necessary for the -mother's own good; a selfish plea. The other is based on a more -generous motive. It is, that the fewer one's children the more healthy -they are likely to be, and the more worth to society. It is, however, -equally fallacious with the first, and is without foundation in fact. -The Spartans and Romans, so confidently appealed to, gave birth -probably to as many weakly children as do our own women; that they -destroyed many for this reason, in infancy, is notorious. The brawny -Highlanders are not the only offspring of their parents; the others -cannot endure the national processes of hardening by exposure and diet, -and so die young from natural causes. But were this theory true even -so far as it goes, the world, our own country, could ill spare its -frailer children, who oftenest, perhaps, represent its intellect and -its genius.<a name="FNanchor_18_18" id="FNanchor_18_18"></a><a href="#Footnote_18_18" class="fnanchor">[18]</a></p> - -<p><span class="pagenum"><a name="Page_75" id="Page_75">[Pg 75]</a></span></p> - -<div class="chapter"> -<p class="xlarge bold"><a name="VII." id="VII."></a> -VII.—<i>Alternatives, Public and Private, and Measures of Relief.</i></p> -</div> - -<p>It may be asked if there is no latitude to be allowed for extreme cases -of the character already described. We are compelled to answer, None. -If each woman were allowed to judge for herself in this matter, her -decision upon the abstract question would be too sure to be warped -by personal considerations, and those of the moment. Woman's mind is -prone to depression, and, indeed, to temporary actual derangement, -under the stimulus of uterine excitation, and this alike at the time of -puberty and the final cessation of the menses, at the monthly period -and at conception, during pregnancy, at labor, and during lactation; -a matter that also seems to have been more thoroughly investigated by -the authority I have so freely drawn from in reference to the question -of abortion, than by any other writer in this country.<a name="FNanchor_19_19" id="FNanchor_19_19"></a><a href="#Footnote_19_19" class="fnanchor">[19]</a> -During the state of gestation the woman is therefore liable to thoughts, -convictions even, that at other times she would turn from in disgust or -dismay; and in this fact, that must be as familiar to herself as it is -to the physician, we find her most valid excuse for the crime.</p> - -<p><span class="pagenum"><a name="Page_76" id="Page_76">[Pg 76]</a></span></p> - -<p>Is there then no alternative but for women, when married and prone to -conception, to occasionally bear children? This, as we have seen, is -the end for which they are physiologically constituted and for which -they are destined by nature. In it lies their most efficient safeguard -for length of days and immunity from disease. Intentionally to prevent -the occurrence of pregnancy, otherwise than by total abstinence -from coition, intentionally to bring it, when begun, to a premature -close, are alike disastrous to a woman's mental, moral, and physical -well-being.</p> - -<p>There are various alternatives to these so degrading habits of the -community. To some of them equal objections apply. But, in reality, -there is little difference between the immorality by which a man -forsakes his home for an occasional visit to a house of prostitution, -that he may preserve his wife from the chance of pregnancy, and the -immorality by which that wife brings herself wilfully to destroy the -living fruit of her womb. Allowing for the weakness and frailty of -human nature, the first were surely the preferable of the twain. But -we need not compare these odious customs, each so common and each so -wrong. With greater frugality of living, and greater self-denial, and -self-control in more trivial matters, there need be no interference, -at least no intentional interference, on the part of either husband -or wife with the first great law of human weal and human happiness, in -accordance with which, by the divine institution of home and its mutual -joys, the due propagation and natural increase of the species was -intended to be insured.</p> - -<p><span class="pagenum"><a name="Page_77" id="Page_77">[Pg 77]</a></span></p> - -<p>Were well-arranged foundling hospitals provided in all our large -cities, they would prove a most efficient means of preventing -the sacrifice of hundreds of the children of shame, and, so far -from encouraging immorality, they would afford one of its surest -preventives, for by keeping a woman from the crime of infanticide or -the equally guilty intentional miscarriage, they would save her from -one element of the self-condemnation and hatred which so often hurry -the victim of seduction downward to the life of the brothel. A certain -amount of illicit intercourse between the sexes will always take place, -no matter how condemned by law, until the public standard of morals -shall be so elevated as to render the practice unknown. This is a fact -that is self-evident, and cannot be frowned out of existence. How -much better to provide for its innocent victims, its irresponsible -offspring, than, as now, to permit the so frequent destruction of both. -It is foolish to assert that by such provision we but pander to sin. -In many of these instances the woman is innocent of intentional wrong, -being led astray by her perfect confidence in the constancy and good -faith of a lover, and in others she is, doubtless, ignorant of the true -character of the act she is committing. Should she be driven by what is -comparatively a venial, and not so unnatural an offence, to one of the -deadliest crimes?</p> - -<p><span class="pagenum"><a name="Page_78" id="Page_78">[Pg 78]</a></span></p> - -<p>But for the married, who have not this strong stimulus of necessity, -and the excuse of having been led astray or deceived, there need be no -public channel provided, through which to purchase safety for their -children. Is it not, indeed, inconceivable that the very women, who, -when their darlings of a month old, or a year, are snatched from them -by disease, find the parting attended with so acute a pang, can so -deliberately provide for, and congratulate themselves and each other, -upon a wilful abortion! Here, words fail us.</p> - -<p><span class="pagenum"><a name="Page_79" id="Page_79">[Pg 79]</a></span></p> - -<p>"Of the mother, by consent or by her own hand, imbrued with her -infant's blood; of the equally guilty father, who counsels or allows -the crime; of the wretches, who by their wholesale murders, far -out-Herod Burke and Hare; of the public sentiment which palliates, -pardons, and would even praise this, so common, violation of all law, -human and divine, of all instinct, all reason, all pity, all mercy, all -love, we leave those to speak who can."<a name="FNanchor_20_20" id="FNanchor_20_20"></a><a href="#Footnote_20_20" class="fnanchor">[20]</a></p> - -<div class="chapter"> -<p class="xlarge bold"><a name="VIII." id="VIII."></a>VIII.—<i>Recapitulation.</i></p> -</div> - -<p>We have now seen that the induction of a forced abortion is, in -reality, a crime against the infant, its mother, the family circle, and -society; that it is attended with extreme danger, whether immediate -or remote, to the mother's happiness, to her health, mental and -physical, and to her life; that there is, in reality, no valid excuse -for it that can be urged, save when it has been decided to be an -absolute necessity by two competent medical men, and that there are -alternatives, such as greater temperance and frugality of living, -which, if practised, would be equally for the public and for private -good.</p> - -<p><span class="pagenum"><a name="Page_80" id="Page_80">[Pg 80]</a></span></p> - -<p>We have also seen that not only is abortion wrong, no matter from -what quarter we contemplate the act, but so also is the deliberate -prevention of pregnancy in the married alike detrimental to the -health and to the moral sense. Moderation and temperance here, as -elsewhere, afford the golden rule. Under the circumstances to which I -allude, total abstinence may, as far as the health is concerned, be as -injurious as is the other extreme of excessive indulgence. To the woman -in good bodily condition, occasional child-bearing is an important -means of healthful self-preservation; to the invalid, an intentional -miscarriage is no means of cure; if she be in poor health, let her seek -aid and relief in the proper quarter, but not, by thus tampering with -natural and physiological laws, alike imperilling both body and soul.</p> - -<p><span class="pagenum"><a name="Page_81" id="Page_81">[Pg 81]</a></span></p> - -<p>Were woman intended as a mere plaything, or for the gratification of -her own or her husband's desires, there would have been need for her -of neither uterus nor ovaries, nor would the prevention of their being -used for their clearly legitimate purpose have been attended by such -tremendous penalties as is in reality the case.</p> - -<p>We have seen that in a perverted and mistaken public opinion lies the -secret of the whole matter. "Ladies boast to each other of the impunity -with which they have aborted, as they do of their expenditures, of -their dress, of their success in society. There is a fashion in this, -as in all other female customs, good and bad. The wretch whose account -with the Almighty is heaviest with guilt, too often becomes a heroine. -So truly is this the case, that the woman who dares at the present day, -publicly or privately, to acknowledge it the holiest duty of her sex to -bring forth living children, 'that first, highest, and in earlier times -almost universal lot,'<a name="FNanchor_21_21" id="FNanchor_21_21"></a><a href="#Footnote_21_21" class="fnanchor">[21]</a> -is worthy, and should receive, the highest admiration and praise."<a name="FNanchor_22_22" id="FNanchor_22_22"></a><a href="#Footnote_22_22" class="fnanchor">[22]</a></p> - -<p><span class="pagenum"><a name="Page_82" id="Page_82">[Pg 82]</a></span></p> - -<p>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 -medical profession, both as a body and as men, whose every relation -its members are alike best able to appreciate, to understand, and to -advise concerning. "Physicians alone," says Prof. Hodge, "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."<a name="FNanchor_23_23" id="FNanchor_23_23"></a><a href="#Footnote_23_23" class="fnanchor">[23]</a></p> - -<p><span class="pagenum"><a name="Page_83" id="Page_83">[Pg 83]</a></span></p> - -<p>"If 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."<a name="FNanchor_24_24" id="FNanchor_24_24"></a><a href="#Footnote_24_24" class="fnanchor">[24]</a></p> - -<p>We have seen that the above is the deliberate decision of those who, -from their observation and knowledge of the subject, are best able to -judge. "Whatever estimate may attach to our opinion," says an eminent -medical journalist, "we believe that not only ought these things not -so to be, but that the public should know it from good authority. For -ourselves, we have no fear that the truth, in reference to the crime -of procuring abortion, would do aught but good. It would <span class="pagenum"><a name="Page_84" id="Page_84">[Pg 84]</a></span>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?"<a name="FNanchor_25_25" id="FNanchor_25_25"></a><a href="#Footnote_25_25" class="fnanchor">[25]</a></p> - -<p>We have also seen that "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."<a name="FNanchor_26_26" id="FNanchor_26_26"></a><a href="#Footnote_26_26" class="fnanchor">[26]</a></p> - -<hr class="tb" /> - -<p><span class="pagenum"><a name="Page_85" id="Page_85">[Pg 85]</a></span></p> - -<p>This subject, at all times so important for the consideration of the -people at large, is invested with unusual interest at a period like -the present, when, at the close of a long and closely contested war, -greater fields for human development and success are opened than ever -before. All the fruitfulness of the present generation, tasked to its -utmost, can hardly fill the gaps in our population that have of late -been made by disease and the sword, while the great territories of the -far West, just opening to civilization, and the fertile savannas of the -South, now disinthralled and first made habitable by freemen, offer -homes for countless millions yet unborn. Shall they be filled by our -own children or by those of aliens? This is a question that our own -women must answer; upon their loins depends the future destiny of the -nation.</p> - -<p>In the hope that the present appeal may do somewhat to stem the tide -of fashion and depraved public opinion; that it may tend to persuade -our women that forced abortions are alike unchristian, immoral, and -physically detrimental; that it may dissipate the ignorance concerning -the existence of fœtal life that so extensively prevails, and be the -means of promoting the ratio of increase of our national population, so -unnaturally kept down, the National Medical Association addresses -itself to all American mothers; for thus, in the closing words of -the Essay from which I have so frequently and so freely drawn, would -"the profession again be true to its mighty and responsible office of -shutting the great gates of human death."</p> - -<hr class="chap" /> -<p><span class="pagenum"><a name="Page_86" id="Page_86">[Pg 86]</a></span></p> -<p class="space-above4"></p> - -<p><span class="pagenum"><a name="Page_87" id="Page_87">[Pg 87]</a></span></p> - -<div class="chapter"> -<h2><a name="APPENDIX" id="APPENDIX"></a>APPENDIX.</h2> -</div> - -<p>In the prefatory remarks attention was called to the fact that the -writer may have incidentally expressed personal opinions of his -own, in the course of his Essay, that are not fully coincided in by -every member of the medical profession, and reference was made to -correspondence that had already occurred in connection with this -subject. This correspondence is now presented, and will explain itself.</p> - -<p>It will be noticed that I withhold the name of the gentleman who -addressed me, this being done at his own particular request, though -I would willingly have given him opportunity publicly to assume -the position against anæsthetics in childbed, so long held by his -illustrious townsman, Prof. Meigs. Discretion, however, has thus far -been found, by the opponents of anæsthesia, to be the better part of -valor. In a subsequent letter, under date of February 19, my friend -writes me as follows: "When the pamphlet appears, I will aid you to my -utmost ability in its circulation, and believe it will be productive of -eminent good."</p> - -<p><span class="pagenum"><a name="Page_88" id="Page_88">[Pg 88]</a></span></p> - -<p>The criticism referred to is as follows:</p> - -<blockquote> - -<p class="right">"<span class="smcap">Philadelphia</span>, Feb. 10, 1866.</p> -<p class="p0">"<span class="smcap">My Dear Doctor</span>:<br /> -</p> - -<p>"Your Essay gives much satisfaction to all who have read it, of -course, a very select few (the book being still in the printer's -hands), but several have most strenuously objected to one or two -points, inasmuch as the profession are to take hold of the matter and -endeavor to place it in the hands of their female patients. The only -one concerning which I have deemed it necessary to write you, is your -remark relative to the use of anæsthesia in all cases of labor. Now, -Doctor, though many are fully with you, yet many would object most -decidedly; in fact, it is by special request that I now ask you to -omit, if possible, those few lines. Some of our profession—I believe -many more would if they had read the Essay—object to placing it in -the hands of their patients, and thus condemning their own action and -advice. Many in this city, to my positive knowledge, object to the -use of anæsthesia in labor, <i>in toto</i>. Many others only use it in -special cases. While the number of those who use or advise it in all -cases is <i>very, very</i> small. I am satisfied the omission of these few -lines would give great satisfaction, and remove almost entirely all -objections to the paper.</p> - -<p><span class="pagenum"><a name="Page_89" id="Page_89">[Pg 89]</a></span></p> - -<p>"I had not the pleasure of reading it prior to seeing the proof, and -must express to you my congratulations for your success. Nothing -pleased me so much as the gratification so pleasantly expressed -by your good father, as he so unexpectedly found his son to be the -essayist. For that reason, I am much pleased that you requested, 'for -a whim,' to have the seals broken upon the platform.</p> - -<p class="right"> -<span style="margin-right: 8em;">"Very sincerely,</span><br /> -<span style="margin-right: 6em;">"Your friend,</span><br /> -<span style="margin-right: 4em;">"—— ——."</span><br /> -</p> -</blockquote> - -<p>To the above letter I thus replied:</p> - -<blockquote> - -<p class="right"> -"<span class="smcap">Hotel Pelham, Boston</span>, 12 Feb., 1866.</p> -<p class="p0">"<span class="smcap">My Dear Doctor</span>:<br /> -</p> - -<p>"I have received your kind letter of the 10th inst., and am glad you -have spoken so frankly. I should be delighted to grant the request -thus courteously made, were it possible for me consistently or -conscientiously to do so.</p> - -<p>"This subject of anæsthesia in labor is one to which, for now thirteen -years, I have given earnest attention, and is one of the most -important that has ever presented itself to medical men.</p> - -<p>"It is my sincere conviction that the use of anæsthetics in childbed -is not only indicated by every consideration of humanity, but that -it serves materially to lessen the average rate of mortality to both -mother and child.</p> - -<p><span class="pagenum"><a name="Page_90" id="Page_90">[Pg 90]</a></span></p> - -<p>"Previously to the present date my voice has given no uncertain sound -upon this question. I send you, by to-day's mail, a copy of my little -book, "Eutokia," which, two or three years since, excited some -attention from the profession, both at home and abroad, and has made, -I am happy to know, many converts to the true faith.</p> - -<p>"If you will turn to the preface of the American edition of my -Simpson's Obstetrics, published in 1855, you will find upon page xvi. -the following language, none of which, in the added experience and -reflection of all these years, can I honestly retract. 'But yesterday, -and the man who dared give ether or chloroform in labor was considered -as breaking alike the laws of nature and of God; the time is probably -close at hand when such will be said of all who withhold them, even in -natural labor.'</p> - -<p>"In the present instance, the Essay has been carefully scrutinized by -a Committee of the Association,—that on Prize Essays,—and has been -unqualifiedly approved. It has been accepted by the Association, has -been ordered to be printed, and, by special vote, to be pushed to the -most extended circulation possible, in the belief that its influence -would be only for the highest good of the community. I am always -responsible at the bar of professional opinion for any sentiment that -I may utter, and avow none that I am not prepared to defend. If any -gentleman differs from me in opinion, let him carefully prepare an -essay upon the subject, present it to the Association, and, if they so -decide, I will cheerfully vote that it also be presented to the people -as a rejoinder to myself.</p> - -<p><span class="pagenum"><a name="Page_91" id="Page_91">[Pg 91]</a></span></p> - -<p>"With all respect for those who think otherwise, I cannot omit or -change one word of the Essay, and have no right to do so if I would.</p> - -<p>"As the present, however, is a point that, though only incidentally -mentioned, yet involves some conflict of professional opinion, while -the Association are of a single mind as to the matter of Criminal -Abortion, I shall cheerfully append your letter to the published -edition, and thus save your associates from any implied credit or -discredit of indorsing my own opinion. This course will be unnecessary -with regard to the Transactions, as the Association is known to be -irresponsible for any views advanced by its members, save when adopted -by special resolution, and its volume does not reach the parties in -reality most interested, namely, the parturient women, whose anguish, -so far as such may be unnecessary, it should be our highest duty to -relieve.</p> - -<p>"Thanking you for the generally favorable opinion you convey to me for -yourself and those for whom you write, for I always value the approval -of my friends next to my own self-respect,</p> - -<p class="right"> -<span style="margin-right: 6em;">"I am yours, sincerely,</span><br /> -<span style="margin-right: 4em;">"<span class="smcap">Horatio R. Storer</span>.</span><br /> -<span style="margin-right: 26em;">"<span class="smcap">Dr.</span> —— ——."</span><br /> -</p> -</blockquote> - -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_92" id="Page_92">[Pg 92]</a></span></p> - -<div class="chapter bold"> -<p class="center xlarge"><i>A Companion to "John Halifax."</i></p> -<p class="center large">JUST ISSUED,</p> -<p class="center xlarge">IN TRUST:</p> -<p class="center large">OR,</p> -<p class="center xlarge">DR. BERTRAND'S HOUSEHOLD.</p> -<p class="center xlarge"><span class="smcap">By Miss Amanda M. Douglass.</span></p> -<p class="center large">1 vol. 12mo. . . . . . . <span class="large"> Price $1.75.</span></p> - -<p>We can give no better idea of the scope and ability of this volume, -than by quoting the opinion of the Northampton Free Press, which is -noted for its free and impartial criticisms.</p> - -<p>"It is a work of which we can hardly speak too warmly in commendation. -It is deeply interesting, even fascinating, but it is also ennobling, -free from any false sentimentality, but beautiful in its narrative of -the high and pure life of Richard Bertrand. As a family history we -have never met with its equal; the portraiture is vivid, yet not too -highly colored, and the reader feels that he is looking upon a scene in -actual life rather than the marvels of a fiction. Richard Bertrand is -not one of those natures actuated by violent passions, not such a one -as Victor Hugo would make the hero of a novel, but a young man always -ready to respond to the call of duty—patient and earnest, loving and -true, unselfish and enduring, in his position as elder brother in a -family, who could look to him alone for earthly support, displaying -all the characteristics of a healthful and well-proportioned Christian -life. It is a book which every young man should read; he will be the -better for its perusal, a correct sense of manliness and of -the nobility of suffering will be enhanced by it. It is a good book to -read in the family, although a better one to read and reflect upon in -solitude. It is one which every parent will gladly place in the hands -of his children, confident that there is nothing in its pages that can -injure, but much that can benefit the reader."</p> - -<p>👉 Sent by mail, post paid, on receipt of price, and sold by all -booksellers.</p> - -<p class="center xlarge"><span class="smcap">Lee & Shepard</span>, Publishers and Booksellers,</p> -<p class="center xlarge"><i>149 Washington Street, Boston</i>.</p> -</div> -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_93" id="Page_93">[Pg 93]</a></span></p> - -<div class="chapter bold"> -<p class="center xlarge"><i>A Domestic Story of Great Beauty.</i></p> -<p class="center xxlarge">A THOUSAND A YEAR.</p> -<p class="center medium">BY</p> -<p class="center xlarge"><span class="smcap">Mrs.</span> E. M. BRUCE.</p> - -<p class="center large"><i>1 vol. 16mo. . . . .<span class="large"> Price $1.25.</span></i></p> - -<p>The story of a clergyman who left his country home to seek fortune with -a city parish and One Thousand a Year.</p> - -<hr class="tb" /> - -<p class="center xlarge"><i>A Valuable Home Book.</i></p> - -<p class="center xlarge">TALKS ON WOMEN'S TOPICS.</p> - -<p class="center large"><span class="smcap">By</span> JENNIE JUNE.</p> - -<p class="center large"><i>1 vol. 12mo. . . . .<span class="large"> Price $1.75.</span></i></p> - -<p>Those who keep up with the current newspaper literature are somewhat -acquainted with the wit and wisdom of Jennie June. This handsome volume -is a collection of her writings, and consists of familiar "Talks" on -a great variety of subjects, all more or less connected with women -and the household, and includes chapters on "Matrimony," "Babies," -"Courtship," "Girls," and various other subjects. The style of -treatment is especially to be commended: it is witty, without vulgarity -or coarseness; sensible, without being in the least prosy. It is -penetrated, moreover, by a vein of womanly tenderness and earnestness, -which shows deep feeling and strong conviction beneath the veil of -good-natured satire. "Talks on Women's Topics" is a capital gift-book, -just the one that a man would like to take to his wife in the country, -or present to his daughter;—there is not a word that is objectionable, -while there is much that will help to make better wives, daughters, and -mothers.</p> - -<p>👉 Sent by mail, post paid, on receipt of price.</p> - -<p class="center xlarge"><span class="smcap">Lee & Shepard</span>, Publishers,</p> -<p class="center xlarge"><i>149 Washington Street, Boston</i>.</p> -</div> -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_94" id="Page_94">[Pg 94]</a></span></p> - -<div class="chapter bold"> -<p class="center xlarge"><i>A Remarkable Book.</i></p> - -<p class="center xxlarge">HERMAN:</p> -<p class="center xlarge">OR,</p> -<p class="center xxlarge">YOUNG KNIGHTHOOD.</p> - -<p>We publish below the deliberate and carefully expressed opinions of -critics, whose judgments are matured by years of research.</p> - -<p>"We know of no work of fiction so full as this of beauty and wisdom, -so free from folly, so resplendent with intellectual life and moral -purity."—<i>Atlantic Monthly for Feb.</i></p> - -<p>"There is still a balm in Gilead, and some hope for novel writing -in America." "The evidence of a genius of no common order." "In -novel writing quite as much rests on the insight displayed in the -development of character and the clever working up of special passages -as upon the general effect. And here the author shines."—<i>Round -Table.</i></p> - -<p>"The strength of the work is its moral purity and elevation. -The depth and earnestness of nature exhibited in the conception -of Herman's character are worthy of the profoundest respect and -admiration."—<i>Boston Advertiser.</i></p> - -<p>"We recognize in this book one of the ablest of American -novels."—<i>Evening Post, N. Y.</i></p> - -<p>"Herman is a book on which a mind of exceedingly rich and varied -ambitions has lavished itself without stint."—<i>Portland Press.</i></p> - -<p>"This book is worthy of the encomiums that have been lavished upon -it."—<i>Springfield Union.</i></p> - -<p>"It is a gushing, outspoken narrative of individual -experience."—<i>Commonwealth, Boston.</i></p> - -<p>"This is one of the most notable books of the season."—<i>Boston Post.</i></p> - -<p>"A book not likely to be laid aside among the crowd of ephemeral -issues of the press."—<i>Presbyterian, Phila.</i></p> - -<p>The above are samples of a large number of equally strong -communications.</p> - -<p class="center xlarge">2 vols. 12mo. . . . . Price $3.50.</p> - -<p>⁂ Sent by mail on receipt of price.</p> - -<p class="center xlarge"><span class="smcap">Lee & Shepard</span>, Publishers and Booksellers,</p> -<p class="center xlarge"><i>149 Washington Street, Boston</i>.</p> -</div> -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_95" id="Page_95">[Pg 95]</a></span></p> - -<div class="chapter bold"> -<p class="center xlarge"><i>A New Fruit Book.</i></p> - -<p class="center xxlarge">PRACTICAL AND SCIENTIFIC FRUIT CULTURE.</p> - -<p class="center large">BY</p> - -<p class="center xxlarge"><i>CHARLES R. BAKER</i>,</p> -<p class="center xlarge">Of the Dorchester Nurseries.</p> - -<p class="center bold xlarge"><i>1 vol. 8vo. Profusely Illustrated. Price $4.00.</i></p> - -<p>A work of rare excellence, which is destined to take its place beside -the best works on American Pomology. Its author is extensively and -favorably known among fruit-growers, both as a skilful pomologist and -a ripe scholar, and is every way qualified for the preparation of a -book on this his favorite subject. In fruit culture he was educated by -Hon. Marshall P. Wilder, of world-wide fame, with whom he is at present -associated as business partner, and to whose valuable library and ripe -experience he has had the freest access for many years.</p> - -<p>In this volume he gives no delineations or descriptions of Fruits, but -treats with exhaustive fulness the arts of production and cultivation, -together with the scientific principles on which these arts depend; -how persons may supply themselves with the best fruits in variety -and abundance, with the least labor and expense, and in the shortest -possible space of time.</p> - -<p>No family, no cultivator can do without this book, which will save them -many times its cost every year.</p> - -<p>⁂ Sent by mail, post paid, on receipt of price, and for sale -by all booksellers.</p> - -<p class="center xlarge"><span class="smcap">Lee & Shepard</span>, Publishers and Booksellers,</p> -<p class="center xlarge"><i>149 Washington Street, Boston</i>.</p> -</div> -<hr class="chap" /> - -<p><span class="pagenum"><a name="Page_96" id="Page_96">[Pg 96]</a></span></p> - -<div class="chapter bold"> -<p class="center xlarge"><i>Oliver Optic in a New Field.</i></p> - -<p class="center xxlarge">THE WAY OF THE WORLD.</p> - -<p class="center xlarge"><span class="smcap">A Novel.</span></p> - -<p class="center xlarge"><span class="smcap">By</span> WILLIAM T. ADAMS,</p> -<p class="center xlarge">(<span class="smcap">Oliver Optic</span>.)</p> - -<p>Under his <i>nom de plume</i> of "Oliver Optic," Mr. Adams has acquired an -enviable fame as writer of juvenile books. Always teaching a wholesome -lesson under cover of an attractive story, his books are welcome guests -in every household.</p> - -<p>His "Army and Navy Stories," six in number, viz., "The Soldier Boy," -"The Sailor Boy," "The Young Lieutenant," "The Yankee Middy," "Fighting -Joe," and "Brave Old Salt," have already reached a sale of fifty -thousand copies, while the total sale of his books during the last year -alone reaches one hundred thousand copies.</p> - -<p>That so prolific and pleasing a writer will be equally successful in -his new field of enterprise none can doubt who have witnessed the -eagerness with which his juvenile books have been seized and read by -the "old people" as well as the "young folks."</p> - -<p class="xlarge"> -<span style="margin-left: 3em;"><span class="smcap">Lee & Shepard</span>, Publishers,</span><br /> -<span style="margin-left: 8em"><i>149 Washington Street, Boston</i>.</span><br /> -</p> -</div> -<hr class="full" /> - -<p class="center bold xxlarge">FOOTNOTES</p> - -<div class="footnote"> - -<p><a name="Footnote_1_1" id="Footnote_1_1"></a><a href="#FNanchor_1_1"><span class="label">[1]</span></a> "The preamble and resolution were signed by Philo Tillson, -President, and S. L. Andrews, Secretary, of the Northeastern District -Medical Association of Michigan, as having been adopted by that -Association, at its annual meeting, held on the 19th day of May, 1864, -and which its delegate, Dr. Stockwell, was instructed to present to the -Association."—<i>Trans. Am. Med. Association</i>, 1864, p. 60.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_2_2" id="Footnote_2_2"></a><a href="#FNanchor_2_2"><span class="label">[2]</span></a> Now that the decision of the Prize Committee has been -made, the purpose of the above stipulation becomes evident. The -Committee consisted of Drs. D. Humphreys Storer, Henry I. Bowditch, J. -Mason Warren, and John H. Dix, of Boston; the Chairman of the Committee -being the writer's father.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_3_3" id="Footnote_3_3"></a><a href="#FNanchor_3_3"><span class="label">[3]</span></a> The Committee consisted of Drs. H. R. Storer, of Boston; -T. W. Blatchford, of Troy, N. Y.; H. L. Hodge, of Philadelphia; C. A. -Pope, of St. Louis; Barton, of South Carolina; A. Lopez, of Mobile; and -W. H. Brisbane, of Arena, Wis.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_4_4" id="Footnote_4_4"></a><a href="#FNanchor_4_4"><span class="label">[4]</span></a> Studies of Abortion; Boston Medical and Surgical Journal, -February 5, 1863.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_5_5" id="Footnote_5_5"></a><a href="#FNanchor_5_5"><span class="label">[5]</span></a> Transactions of the American Medical Association, 1859, -vol. xii. p. 75.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_6_6" id="Footnote_6_6"></a><a href="#FNanchor_6_6"><span class="label">[6]</span></a> Percival: Medical Ethics, p. 79.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_7_7" id="Footnote_7_7"></a><a href="#FNanchor_7_7"><span class="label">[7]</span></a> Man Transformed, Oxford, 1653.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_8_8" id="Footnote_8_8"></a><a href="#FNanchor_8_8"><span class="label">[8]</span></a> Regina <i>v.</i> Wycherly, 8 Carrington and Payne, 265.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_9_9" id="Footnote_9_9"></a><a href="#FNanchor_9_9"><span class="label">[9]</span></a> Criminal Abortion in America, p. 5.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_10_10" id="Footnote_10_10"></a><a href="#FNanchor_10_10"><span class="label">[10]</span></a> Owen: Cyclopædia of Anatomy and Physiology, vol. iii. p. -322.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_11_11" id="Footnote_11_11"></a><a href="#FNanchor_11_11"><span class="label">[11]</span></a> Naegele: Treatise on Obstetric Auscultation, p. 50.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_12_12" id="Footnote_12_12"></a><a href="#FNanchor_12_12"><span class="label">[12]</span></a> Studies of Abortion: Boston Medical and Surgical Journal, -February 5, 1863.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_13_13" id="Footnote_13_13"></a><a href="#FNanchor_13_13"><span class="label">[13]</span></a> Criminal Abortion in America, p. 42.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_14_14" id="Footnote_14_14"></a><a href="#FNanchor_14_14"><span class="label">[14]</span></a> Essay on Criminal Abortion, p. 42.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_15_15" id="Footnote_15_15"></a><a href="#FNanchor_15_15"><span class="label">[15]</span></a> Studies of Abortion, &c.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_16_16" id="Footnote_16_16"></a><a href="#FNanchor_16_16"><span class="label">[16]</span></a> Essay on Criminal Abortion, p. 106.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_17_17" id="Footnote_17_17"></a><a href="#FNanchor_17_17"><span class="label">[17]</span></a> Essay on Criminal Abortion, p. 34.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_18_18" id="Footnote_18_18"></a><a href="#FNanchor_18_18"><span class="label">[18]</span></a> Essay on Criminal Abortion, p. 32.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_19_19" id="Footnote_19_19"></a><a href="#FNanchor_19_19"><span class="label">[19]</span></a> H. R. Storer: The Causation, Course, and Treatment of -Insanity in Women; a gynæcist's idea thereof. Transactions of the -American Medical Association, vol. xvi., 1865.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_20_20" id="Footnote_20_20"></a><a href="#FNanchor_20_20"><span class="label">[20]</span></a> Essay on Criminal Abortion, p. 13.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_21_21" id="Footnote_21_21"></a><a href="#FNanchor_21_21"><span class="label">[21]</span></a> A Woman's Thoughts about Women. By the author of "John -Halifax, Gentleman," p. 14.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_22_22" id="Footnote_22_22"></a><a href="#FNanchor_22_22"><span class="label">[22]</span></a> Essay on Criminal Abortion, p. 55.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_23_23" id="Footnote_23_23"></a><a href="#FNanchor_23_23"><span class="label">[23]</span></a> Introductory Lecture at University of Pennsylvania, 1854, -p. 19.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_24_24" id="Footnote_24_24"></a><a href="#FNanchor_24_24"><span class="label">[24]</span></a> Essay, &c., p. 101.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_25_25" id="Footnote_25_25"></a><a href="#FNanchor_25_25"><span class="label">[25]</span></a> Boston Medical and Surgical Journal, editorial, December -13, 1855.</p></div> - -<div class="footnote"> - -<p><a name="Footnote_26_26" id="Footnote_26_26"></a><a href="#FNanchor_26_26"><span class="label">[26]</span></a> Essay, &c., p. 106.</p></div> - -<hr class="full" /> -<div style='display:block; margin-top:4em'>*** END OF THE PROJECT GUTENBERG EBOOK WHY NOT? 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