Putting aside, however, all humanitarian considerations, the serious error of attempting to stem the progress of civilization in the direction of procreative control could never have occurred if the general tendencies of zoological evolution had been understood, even in their elements. All zoological progress is from the more prolific to the less prolific; the higher the species the less fruitful are its individual members. The same tendency is found within the limits of the human species, though not in an invariable straight line; the growth of civilization involves a diminution in fertility. This is by no means a new phenomenon; ancient Rome and later Geneva, "the Protestant Rome," bear witness to it; no doubt it has occurred in every high centre of moral and intellectual culture, although the data for measuring the tendency no longer exist. When we take a sufficiently wide and intelligent survey, we realize that the tendency of a community to slacken its natural rate of increase is an essential phenomenon of all advanced civilization. The more intelligent nations have manifested the tendency first, and in each nation the more educated cla.s.ses have taken the lead, but it is only a matter of time to bring all civilized nations, and all social cla.s.ses in each nation, into line.[429] This movement, we have to remember-in opposition to the ignorant outcry of certain would-be moralists and politicians-is a beneficent movement. It means a greater regard to the quality than to the quant.i.ty of the increase; it involves the possibility of combating successfully the evils of high mortality, disease, overcrowding, and all the manifold misfortunes which inevitably accompany a too exuberant birthrate. For it is only in a community which increases slowly that it is possible to secure the adequate economic adjustment and environmental modifications necessary for a sane and wholesome civic and personal life.[430] If those persons who raise the cry of "race suicide" in face of the decline of the birthrate really had the knowledge and intelligence to realize the manifold evils which they are invoking they would deserve to be treated as criminals.
On the practical side a knowledge of the possibility of preventing conception has, doubtless, never been quite extinct in civilization and even in lower stages of culture, though it has mostly been utilized for ends of personal convenience or practiced in obedience to conventional social rules which demanded chast.i.ty, and has only of recent times been made subservient to the larger interests of society and the elevation of the race. The theoretical basis of the control of procreation, on its social and economic, as distinct from its eugenic, aspects, may be said to date from Malthus"s famous Essay on Population, first published in 1798, an epoch-marking book,-though its central thesis is not susceptible of actual demonstration,-since it not only served as the starting-point of the modern humanitarian movement for the control of procreation, but also furnished to Darwin (and independently to Wallace also) the fruitful idea which was finally developed into the great evolutionary theory of natural selection.
Malthus, however, was very far from suggesting that the control of procreation, which he advocated for the benefit of mankind, should be exercised by the introduction of preventive methods into s.e.xual intercourse. He believed that civilization involved an increased power of self-control, which would make it possible to refrain altogether from s.e.xual intercourse, when such self-restraint was demanded in the interests of humanity. Later thinkers realized, however, that, while it is undoubtedly true that civilization involves greater forethought and greater self-control, we cannot antic.i.p.ate that those qualities should be developed to the extent demanded by Malthus, especially when the impulse to be controlled is of so powerful and explosive a nature.
James Mill was the pioneer in advocating Neo-Malthusian methods, though he spoke cautiously. In 1818, in the article "Colony" in the supplement to the Encyclopaedia Britannica, after remarking that the means of checking the unrestricted increase of the population const.i.tutes "the most important practical problem to which the wisdom of the politician and moralist can be applied," he continued: "If the superst.i.tions of the nursery were discarded, and the principle of utility kept steadily in view, a solution might not be very difficult to be found." Four years later, James Mill"s friend, the Radical reformer, Francis Place, more distinctly expressed the thought that was evidently in Mill"s mind. After enumerating the facts concerning the necessity of self-control in procreation and the evils of early marriage, which he thinks ought to be clearly taught, Place continues: "If a hundredth, perhaps a thousandth part of the pains were taken to teach these truths, that are taken to teach dogmas, a great change for the better might, in no considerable s.p.a.ce of time, be expected to take place in the appearance and the habits of the people. If, above all, it were once clearly understood that it was not disreputable for married persons to avail themselves of such precautionary means as would, without being injurious to health, or destructive of female delicacy, prevent conception, a sufficient check might at once be given to the increase of population beyond the means of subsistence; vice and misery, to a prodigious extent, might be removed from society, and the object of Mr. Malthus, Mr. G.o.dwin, and of every philanthropic person, be promoted, by the increase of comfort, of intelligence, and of moral conduct, in the ma.s.s of the population. The course recommended will, I am fully persuaded, at some period be pursued by the people even if left to themselves."[431]
It was not long before Place"s prophetic words began to be realized, and in another half century the movement was affecting the birthrate of all civilized lands, though it can scarcely yet be said that justice has been done to the pioneers who promoted it in the face of much persecution from the ignorant and superst.i.tious public whom they sought to benefit. In 1831, Robert Dale Owen, the son of Robert Owen, published his Moral Physiology, setting forth the methods of preventing conception. A little later the brothers George and Charles Drysdale (born 1825 and 1829), two ardent and unwearying philanthropists, devoted much of their energy to the propagation of Neo-Malthusian principles. George Drysdale, in 1854, published his Elements of Social Science, which during many years had an enormous circulation all over Europe in eight different languages. It was by no means in every respect a scientific or sound work, but it certainly had great influence, and it came into the hands of many who never saw any other work on s.e.xual topics. Although the Neo-Malthusian propagandists of those days often met with much obloquy, their cause was triumphantly vindicated in 1876, when Charles Bradlaugh and Mrs. Besant, having been prosecuted for disseminating Neo-Malthusian pamphlets, the charge was dismissed, the Lord Chief Justice declaring that so ill-advised and injudicious a charge had probably never before been made in a court of justice. This trial, even by its mere publicity and apart from its issue, gave an enormous impetus to the Neo-Malthusian movement. It is well known that the steady decline in the English birthrate begun in 1877, the year following the trial. There could be no more brilliant ill.u.s.tration of the fact, that what used to be called "the instruments of Providence" are indeed unconscious instruments in bringing about great ends which they themselves were far from either intending or desiring.
In 1877, Dr. C. R. Drysdale founded the Malthusian League, and edited a periodical, The Malthusian, aided throughout by his wife, Dr. Alice Drysdale Vickery. He died in 1907. (The n.o.ble and pioneering work of the Drysdales has not yet been adequately recognized in their own country; an appreciative and well-informed article by Dr. Hermann Rohleder, "Dr. C. R. Drysdale, Der Hauptvortreter der Neumalthusianische Lehre," appeared in the Zeitschrift fur s.e.xualwissenschaft, March, 1908). There are now societies and periodicals in all civilized countries for the propagation of Neo-Malthusian principles, as they are still commonly called, though it would be desirable to avoid the use of Malthus"s name in this connection. In the medical profession, the advocacy of preventive methods of s.e.xual intercourse, not on social, but on medical and hygienic grounds, began same thirty years ago, though in France, at an earlier date, Raciborski advocated the method of avoiding the neighborhood of menstruation. In Germany, Dr. Mensinga, the gynaecologist, is the most prominent advocate, on medical and hygienic grounds, of what he terms "facultative sterility," which he first put forward about 1889. In Russia, about the same time, artificial sterility was first openly advocated by the distinguished gynaecologist, Professor Ott, at the St. Petersburg Obstetric and Gynaecological Society. Such medical recommendations, in particular cases, are now becoming common.
There are certain cases in which a person ought not to marry at all; this is so, for instance, when there has been an attack of insanity; it can never be said with certainty that a person who has had one attack of insanity will not have another, and persons who have had such attacks ought not, as Blandford says (Lumleian Lectures on Insanity, British Medical Journal, April 20, 1895), "to inflict on their partner for life, the anxiety, and even danger, of another attack." There are other and numerous cases in which marriage may be permitted, or may have already taken place, under more favorable circ.u.mstances, but where it is, or has become, highly desirable that there should be no children. This is the case when a first attack of insanity occurs after marriage, the more urgently if the affected party is the wife, and especially if the disease takes the form of puerperal mania. "What can be more lamentable," asks Blandford (loc. cit.), "than to see a woman break down in childbed, recover, break down again with the next child, and so on, for six, seven, or eight children, the recovery between each being less and less, until she is almost a chronic maniac?" It has been found, moreover, by Tredgold (Lancet, May 17, 1902), that among children born to insane mothers, the mortality is twice as great as the ordinary infantile mortality, in even the poorest districts. In cases of unions between persons with tuberculous antecedents, also, it is held by many (e.g., by Ma.s.salongo, in discussing tuberculosis and marriage at the Tuberculosis Congress, at Naples, in 1900) that every precaution should be taken to make the marriage childless. In a third cla.s.s of cases, it is necessary to limit the children to one or two; this happens in some forms of heart disease, in which pregnancy has a progressively deteriorating effect on the heart (Kisch, Therapeutische Monatsheft, Feb., 1898, and s.e.xual Life of Woman; Vinay, Lyon Medical, Jan. 8, 1889); in some cases of heart disease, however, it is possible that, though there is no reason for prohibiting marriage, it is desirable for a woman not to have any children (J. F. Blacker, "Heart Disease in Relation to Pregnancy," British Medical Journal, May 25, 1907).
In all such cases, the recommendation of preventive methods of intercourse is obviously an indispensable aid to the physician in emphasizing the supremacy of hygienic precautions. In the absence of such methods, he can never be sure that his warnings will be heard, and even the observance of his advice would be attended with various undesirable results. It sometimes happens that a married couple agree, even before marriage, to live together without s.e.xual relations, but, for various reasons, it is seldom found possible or convenient to maintain this resolution for a long period.
It is the recognition of these and similar considerations which has led-though only within recent years-on the one hand, as we have seen, to the embodiment of the control of procreation into the practical morality of all civilized nations, and, on the other hand, to the a.s.sertion, now perhaps without exception, by all medical authorities on matters of s.e.x that the use of the methods of preventing conception is under certain circ.u.mstances urgently necessary and quite harmless.[432] It arouses a smile to-day when we find that less than a century ago it was possible for an able and esteemed medical author to declare that the use of "various abominable means" to prevent conception is "based upon a most presumptuous doubt in the conservative power of the Creator."[433]
The adaptation of theory to practice is not yet complete, and we could not expect that it should be so, for, as we have seen, there is always an antagonism between practical morality and traditional morality. From time to time flagrant ill.u.s.trations of this antagonism occur.[434] Even in England, which played a pioneering part in the control of procreation, attempts are still made-sometimes in quarters where we have a right to expect a better knowledge-to cast discredit on a movement which, since it has conquered alike scientific approval and popular practice, it is now idle to call in question.
It would be out of place to discuss here the various methods which are used for the control of procreation, or their respective merits and defects. It is sufficient to say that the condom or protective sheath, which seems to be the most ancient of all methods of preventing conception, after withdrawal, is now regarded by nearly all authorities as, when properly used, the safest, the most convenient, and the most harmless method.[435] This is the opinion of Krafft-Ebing, of Moll, of Schrenck-Notzing, of Lowenfeld, of Forel, of Kisch, of Furbringer, to mention only a few of the most distinguished medical authorities.[436]
There is some interest in attempting to trace the origin and history of the condom, though it seems impossible to do so with any precision. It is probable that, in a rudimentary form, such an appliance is of great antiquity. In China and j.a.pan, it would appear, rounds of oiled silk paper are used to cover the mouth of the womb, at all events, by prost.i.tutes. This seems the simplest and most obvious mechanical method of preventing conception, and may have suggested the application of a sheath to the p.e.n.i.s as a more effectual method. In Europe, it is in the middle of the sixteenth century, in Italy, that we first seem to hear of such appliances, in the shape of linen sheaths, adapted to the shape of the p.e.n.i.s; Fallopius recommended the use of such an appliance. Improvements in the manufacture were gradually devised; the caec.u.m of the lamb was employed, and afterwards, isingla.s.s. It appears that a considerable improvement in the manufacture took place in the seventeenth or eighteenth century, and this improvement was generally a.s.sociated with England. The appliance thus became known as the English cape or mantle, the "capote anglaise," or the "redingote anglaise," and, under the latter name, is referred to by Casanova, in the middle of the eighteenth century (Casanova, Memoires, ed. Garnier, vol. iv, p. 464); Casanova never seems, however, to have used these redingotes himself, not caring, he said, "to shut myself up in a piece of dead skin in order to prove that I am perfectly alive." These capotes-then made of goldbeaters" skin-were, also, it appears, known at an earlier period to Mme. de Sevigne, who did not regard them with favor, for, in one of her letters, she refers to them as "cuira.s.ses contre la volupte et toiles d"arraignee contre le mal." The name, "condom," dates from the eighteenth century, first appearing in France, and is generally considered to be that of an English physician, or surgeon, who invented, or, rather, improved the appliance. Condom is not, however, an English name, but there is an English name, Condon, of which "condom" may well be a corruption. This supposition is strengthened by the fact that the word sometimes actually was written "condon." Thus, in lines quoted by Bachaumont, in his Diary (Dec. 15, 1773), and supposed to be addressed to a former ballet dancer who had become a prost.i.tute, I find:-
"Du condon cependant, vous connaissez l"usage, "Le condon, c"est la loi, ma fille, et les prophetes!"
The difficulty remains, however, of discovering any Englishman of the name of Condon, who can plausibly be a.s.sociated with the condom; doubtless he took no care to put the matter on record, never suspecting the fame that would accrue to his invention, or the immortality that awaited his name. I find no mention of any Condon in the records of the College of Physicians, and at the College of Surgeons, also, where, indeed, the old lists are very imperfect, Mr. Victor Plarr, the librarian, after kindly making a search, has a.s.sured me that there is no record of the name. Other varying explanations of the name have been offered, with more or less a.s.surance, though usually without any proofs. Thus, Hyrtl (Handbuch der Topographischen Anatomic, 7th ed., vol. ii, p. 212) states that the condom was originally called gondom, from the name of the English discoverer, a Cavalier of Charles II"s Court, who first prepared it from the amnion of the sheep; Gondom is, however, no more an English name than Condom. There happens to be a French town, in Gascony, called Condom, and Bloch suggests, without any evidence, that this furnished the name; if so, however, it is improbable that it would have been unknown in France. Finally, Hans Ferdy considers that it is derived from "condus"-that which preserves-and, in accordance with his theory, he terms the condom a condus.
The early history of the condom is briefly discussed by various writers, as by Proksch, Die Vorbauung der Venerischen Krankheiten, p. 48; Bloch, s.e.xual Life of Our Time, Chs. XV and XXVIII; Cabanes, Indiscretions de l"Histoire, p. 121, etc.
The control of procreation by the prevention of conception has, we have seen, become a part of the morality of civilized peoples. There is another method, not indeed for preventing conception, but for limiting offspring, which is of much more ancient appearance in the world, though it has at different times been very differently viewed and still arouses widely opposing opinions. This is the method of abortion.
While the practice of abortion has by no means, like the practice of preventing conception, become accepted in civilization, it scarcely appears to excite profound repulsion in a large proportion of the population of civilized countries. The majority of women, not excluding educated and highly moral women, who become pregnant against their wish contemplate the possibility of procuring abortion without the slightest twinge of conscience, and often are not even aware of the usual professional att.i.tude of the Church, the law, and medicine regarding abortion. Probably all doctors have encountered this fact, and even so distinguished and correct a medico-legist as Brouardel stated[437] that he had been not infrequently solicited to procure abortion, for themselves or their wet-nurses, by ladies who looked on it as a perfectly natural thing, and had not the least suspicion that the law regarded the deed as a crime.
It is not, therefore, surprising that abortion is exceedingly common in all civilized and progressive countries. It cannot, indeed, unfortunately, be said that abortion has been conducted in accordance with eugenic considerations, nor has it often been so much as advocated from the eugenic standpoint. But in numerous cla.s.ses of cases of undesired pregnancy, occurring in women of character and energy, not accustomed to submit tamely to conditions they may not have sought, and in any case consider undesirable, abortion is frequently resorted to. It is usual to regard the United States as a land in which the practice especially flourishes, and certainly a land in which the ideal of chast.i.ty for unmarried women, of freedom for married women, of independence for all, is actively followed cannot fail to be favorable to the practice of abortion. But the way in which the prevalence of abortion is proclaimed in the United States is probably in large part due to the honesty of the Americans in setting forth, and endeavoring to correct, what, rightly or wrongly, they regard as social defects, and may not indicate any real pre-eminence in the practice. Comparative statistics are difficult, and it is certainly true that abortion is extremely common in England, in France, and in Germany. It is probable that any national differences may be accounted for by differences in general social habits and ideals. Thus in Germany, where considerable s.e.xual freedom is permitted to unmarried women and married women are very domesticated, abortion may be less frequent than in France where purity is stringently demanded from the young girl, while the married woman demands freedom for work and for pleasure. But such national differences, if they exist, are tending to be levelled down, and charges of criminal abortion are constantly becoming more common in Germany; though this increase, again, may be merely due to greater zeal in pursuing the offence.
Brouardel (op. cit., p. 39) quotes the opinion that, in New York, only one in every thousand abortions is discovered. Dr. J. F. Scott (The s.e.xual Instinct, Ch. VIII), who is himself strongly opposed to the practice, considers that in America, the custom of procuring abortion has to-day reached "such vast proportions as to be almost beyond belief," while "countless thousands" of cases are never reported. "It has increased so rapidly in our day and generation," Scott states, "that it has created surprise and alarm in the minds of all conscientious persons who are informed of the extent to which it is carried." (The a.s.sumption that those who approve of abortion are necessarily not "conscientious persons" is, as we shall see, mistaken.) The change has taken place since 1840. The Michigan Special Committee on Criminal Abortion reported in 1881 that, from correspondence with nearly one hundred physicians, it appeared that there came to the knowledge of the profession seventeen abortions to every one hundred pregnancies; to these, the committee believe, may be added as many more that never came to the physician"s knowledge. The committee further quoted, though without endors.e.m.e.nt, the opinion of a physician who believed that a change is now coming over public feeling in regard to the abortionist, who is beginning to be regarded in America as a useful member of society, and even a benefactor.
In England, also, there appears to have been a marked increase of abortion during recent years, perhaps specially marked among the poor and hard-working cla.s.ses. A writer in the British Medical Journal (April 9, 1904, p. 865) finds that abortion is "wholesale and systematic," and gives four cases occurring in his practice during four months, in which women either attempted to produce abortion, or requested him to do so; they were married women, usually with large families, and in delicate health, and were willing to endure any suffering, if they might be saved from further child-bearing. Abortion is frequently effected, or attempted, by taking "Female Pills," which contain small portions of lead, and are thus liable to produce very serious symptoms, whether or not they induce abortion. Professor Arthur Hall, of Sheffield, who has especially studied this use of lead ("The Increasing Use of Lead as an Abortifacient," British Medical Journal, March 18, 1905), finds that the practice has lately become very common in the English Midlands, and is gradually, it appears, widening its circle. It occurs chiefly among married women with families, belonging to the working cla.s.s, and it tends to become specially prevalent during periods of trade depression (cf. G. Newman, Infant Mortality, p. 81). Women of better social cla.s.s resort to professional abortionists, and sometimes go over to Paris.
In France, also, and especially in Paris, there has been a great increase during recent years in the practice of abortion. (See e.g., a discussion at the Paris Societe de Medecine Legale, Archives d"Anthropologie Criminelle, May, 1907.) Doleris has shown (Bulletin de la Societe d"Obstetrique, Feb., 1905) that in the Paris Maternites the percentage of abortions in pregnancies doubled between 1898 and 1904, and Doleris estimates that about half of these abortions were artificially induced. In France, abortion is mainly carried on by professional abortionists. One of these, Mme. Thomas, who was condemned to penal servitude, in 1891, acknowledged performing 10,000 abortions during eight years; her charge for the operation was two francs and upwards. She was a peasant"s daughter, brought up in the home of her uncle, a doctor, whose medical and obstetrical books she had devoured (A. Hamon, La France en 1891, pp. 629-631). French public opinion is lenient to abortion, especially to women who perform the operation on themselves; not many cases are brought into court, and of these, forty per cent. are acquitted (Eugene Bausset, L"Avortement Criminel, These de Paris, 1907). The professional abortionist is, however, usually sent to prison.
In Germany, also, abortion appears to have greatly increased during recent years, and the yearly number of cases of criminal abortion brought into the courts was, in 1903, more than double as many as in 1885. (See, also, Elisabeth Zanzinger, Geschlecht und Gesellschaft, Bd. II, Heft 5; and s.e.xual-Probleme, Jan., 1908, p. 23.)
In view of these facts it is not surprising that the induction of abortion has been permitted and even encouraged in many civilizations. Its unqualified condemnation is only found in Christendom, and is due to theoretical notions. In Turkey, under ordinary circ.u.mstances, there is no punishment for abortion. In the cla.s.sic civilization of Greece and Rome, likewise, abortion was permitted though with certain qualifications and conditions. Plato admitted the mother"s right to decide on abortion but said that the question should be settled as early as possible in pregnancy. Aristotle, who approved of abortion, was of the same opinion. Zeno and the Stoics regarded the ftus as the fruit of the womb, the soul being acquired at birth; this was in accordance with Roman law which decreed that the ftus only became a human being at birth.[438] Among the Romans abortion became very common, but, in accordance with the patriarchal basis of early Roman inst.i.tutions, it was the father, not the mother, who had the right to exercise it. Christianity introduced a new circle of ideas based on the importance of the soul, on its immortality, and the necessity of baptism as a method of salvation from the results of inherited sin. We already see this new att.i.tude in St. Augustine who, discussing whether embryos that died in the womb will rise at the resurrection, says "I make bold neither to affirm nor to deny, although I fail to see why, if they are not excluded from the number of the dead, they should not attain to the resurrection of the dead."[439] The criminality of abortion was, however, speedily established, and the early Christian Emperors, in agreement with the Church, edicted many fantastic and extreme penalties against abortion. This tendency continued under ecclesiastical influence, unrestrained, until the humanitarian movement of the eighteenth century, when Beccaria, Voltaire, Rousseau and other great reformers succeeded in turning the tide of public opinion against the barbarity of the laws, and the penalty of death for abortion was finally abolished.[440]
Medical science and practice at the present day-although it can scarcely be said that it speaks with an absolutely unanimous voice-on the whole occupies a position midway between that of the cla.s.sic lawyers and that of the later Christian ecclesiastics. It is, on the whole, in favor of sacrificing the ftus whenever the interests of the mother demand such a sacrifice. General medical opinion is not, however, prepared at present to go further, and is distinctly disinclined to aid the parents in exerting an unqualified control over the ftus in the womb, nor is it yet disposed to practice abortion on eugenic grounds. It is obvious, indeed, that medicine cannot in this matter take the initiative, for it is the primary duty of medicine to save life. Society itself must a.s.sume the responsibility of protecting the race.
Dr. S. Macvie ("Mother versus Child," Transactions Edinburgh Obstetrical Society, vol. xxiv, 1899) elaborately discusses the respective values of the ftus and the adult on the basis of life-expectancy, and concludes that the ftus is merely "a parasite performing no function whatever," and that "unless the life-expectancy of the child covers the years in which its potentiality is converted into actuality, the relative values of the maternal and ftal life will be that of actual as against potential." This statement seems fairly sound. Ballantyne (Manual of Antenatal Pathology: The Ftus, p. 459) endeavors to make the statement more precise by saying that "the mother"s life has a value, because she is what she is, while the ftus only has a possible value, on account of what it may become."
Durlacher, among others, has discussed, in careful and cautious detail, the various conditions in which the physician should, or should not, induce abortion in the interests of the mother ("Der Kunstliche Abort," Wiener Klinik, Aug. and Sept., 1906); so also, Eugen Wilhelm ("Die Abtreibung und das Recht des Arztes zur Vernichtung der Leibesfrucht," s.e.xual-Probleme, May and June, 1909). Wilhelm further discusses whether it is desirable to alter the laws in order to give the physician greater freedom in deciding on abortion. He concludes that this is not necessary, and might even act injuriously, by unduly hampering medical freedom. Any change in the law should merely be, he considers, in the direction of a.s.serting that the destruction of the ftus is not abortion in the legal sense, provided it is indicated by the rules of medical science. With reference to the timidity of some medical men in inducing abortion, Wilhelm remarks that, even in the present state of the law, the physician who conscientiously effects abortion, in accordance with his best knowledge, even if mistakenly, may consider himself safe from all legal penalties, and that he is much more likely to come in conflict with the law if it can be proved that death followed as a result of his neglect to induce abortion.
Pinard, who has discussed the right to control the ftal life (Annales de Gynecologie, vols. lii and liii, 1899 and 1900), inspired by his enthusiastic propaganda for the salvation of infant life, is led to the unwarranted conclusion that no one has the rights of life and death over the ftus; "the infant"s right to his life is an imprescriptible and sacred right, which no power can take from him." There is a mistake here, unless Pinard deliberately desires to place himself, like Tolstoy, in opposition to current civilized morality. So far from the infant having any "imprescriptible right to life," even the adult has, in human societies, no such inalienable right, and very much less the ftus, which is not strictly a human being at all. We a.s.sume the right of terminating the lives of those individuals whose anti-social conduct makes them dangerous, and, in war, we deliberately terminate, amid general applause and enthusiasm, the lives of men who have been specially selected for this purpose on account of their physical and general efficiency. It would be absurdly inconsistent to say that we have no rights over the lives of creatures that have, as yet, no part in human society at all, and are not so much as born. We are here in presence of a vestige of ancient theological dogma, and there can be little doubt that, on the theoretical side at all events, the "imprescriptible right" of the embryo will go the same way as the "imprescriptible right" of the spermatozoon. Both rights are indeed "imprescriptible."
Of recent years a new, and, it must be admitted, somewhat unexpected, aspect of this question of abortion has been revealed. Hitherto it has been a question entirely in the hands of men, first, following the Roman traditions, in the hands of Christian ecclesiastics, and later, in those of the professional castes. Yet the question is in reality very largely, and indeed mainly, a woman"s question, and now, more especially in Germany, it has been actively taken up by women. The Grafin Gisela Streitberg occupies the pioneering place in this movement with her book Das Recht zur Beiseitigung Keimenden Lebens, and was speedily followed, from 1897 onwards, by a number of distinguished women who occupy a prominent place in the German woman"s movement, among others Helene Stocker, Oda Olberg, Elisabeth Zanzinger, Camilla Jellinek. All these writers insist that the ftus is not yet an independent human being, and that every woman, by virtue of the right over her own body, is ent.i.tled to decide whether it shall become an independent human being. At the Woman"s Congress held in the autumn of 1905, a resolution was pa.s.sed demanding that abortion should only be punishable when effected by another person against the wish of the pregnant women herself.[441] The acceptance of this resolution by a representative a.s.sembly is interesting proof of the interest now taken by women in the question, and of the strenuous att.i.tude they are tending to a.s.sume.
Elisabeth Zanzinger ("Verbrechen gegen die Leibesfrucht," Geschlecht und Gesellschaft, Bd. II, Heft 5, 1907) ably and energetically condemns the law which makes abortion a crime. "A woman herself is the only legitimate possessor of her own body and her own health.... Just as it is a woman"s private right, and most intimate concern, to present her virginity as her best gift to the chosen of her heart, so it is certainly a pregnant woman"s own private concern if, for reasons which seem good to her, she decides to destroy the results of her action." A woman who destroys the embryo which might become a burden to the community, or is likely to be an inferior member of society, this writer urges, is doing a service to the community, which ought to reward her, perhaps by granting her special privileges as regards the upbringing of her other children. Oda Olberg, in a thoughtful paper ("Ueber den Juristischen Schutz des Keimenden Lebens," Die Neue Generation, June, 1908), endeavors to make clear all that is involved in the effort to protect the developing embryo against the organism that carries it, to protect a creature, that is, against itself and its own instincts. She considers that most of the women who terminate their pregnancies artificially would only have produced undesirables, for the normal, healthy, robust woman has no desire to effect abortion. "There are women who are psychically sterile, without being physically so, and who possess nothing of motherhood but the ability to bring forth. These, when they abort, are simply correcting a failure of Nature." Some of them, she remarks, by going on to term, become guilty of the far worse offence of infanticide. As for the women who desire abortion merely from motives of vanity, or convenience, Oda Olberg points out that the circles in which these motives rule are quite able to limit their children without having to resort to abortion. She concludes that society must protect the young life in every way, by social hygiene, by laws for the protection of the workers, by spreading a new morality on the basis of the laws of heredity. But we need no law to protect the young creature against its own mother, for a thousand natural forces are urging the mother to protect her own child, and we may be sure that she will not disobey these forces without very good reasons. Camilla Jellinek, again (Die Strafrechtsreform, etc., Heidelberg, 1909), in a powerful and well-informed address before the a.s.sociated German Frauenvereine, at Breslau, argues in the same sense.
The lawyers very speedily came to the a.s.sistance of the women in this matter, the more readily, no doubt, since the traditions of the greatest and most influential body of law already pointed, on one side at all events, in the same direction. It may, indeed, be claimed that it was from the side of law-and in Italy, the cla.s.sic land of legal reform-that this new movement first begun. In 1888, Balestrini published, at Turin, his Aborto, Infanticidio ed Esposizione d"Infante, in which he argued that the penalty should be removed from abortion. It was a very able and learned book, inspired by large ideas and a humanitarian spirit, but though its importance is now recognized, it cannot be said that it attracted much attention on publication.
It is especially in Germany that, during recent years, lawyers have followed women reformers, by advocating, more or less completely, the abolition of the punishment for abortion. So distinguished an authority as Von Liszt, in a private letter to Camilla Jellinek (op. cit.), states that he regards the punishment of abortion as "very doubtful," though he considers its complete abolition impracticable; he thinks abortion might be permitted during the early months of pregnancy, thus bringing about a return of the old view. Hans Gross states his opinion (Archiv fur Kriminal-Anthropologie, Bd. XII, p. 345) that the time is not far distant when abortion will no longer be punished. Radbruch and Von Lilienthal speak in the same sense. Weinberg has advocated a change in the law (Mutterschutz, 1905, Heft 8), and Kurt Hiller (Die Neue Generation, April, 1909), also from the legal side, argues that abortion should only be punishable when effected by a married woman, without the knowledge and consent of her husband.
The medical profession, which took the first step in modern times in the authorization of abortion, has not at present taken any further step. It has been content to lay down the principle that when the interests of the mother are opposed to those of the ftus, it is the latter which must be sacrificed. It has hesitated to take the further step of placing abortion on the eugenic basis, and of claiming the right to insist on abortion whenever the medical and hygienic interests of society demand such a step. This att.i.tude is perfectly intelligible. Medicine has in the past been chiefly identified with the saving of lives, even of worthless and worse than worthless lives; "Keep everything alive! Keep everything alive!" nervously cried Sir James Paget. Medicine has confined itself to the humble task of attempting to cure evils, and is only to-day beginning to undertake the larger and n.o.bler task of preventing them.
"The step from killing the child in the womb to murdering a person when out of the womb, is a dangerously narrow one," sagely remarks a recent medical author, probably speaking for many others, who somehow succeed in blinding themselves to the fact that this "dangerously narrow step" has been taken by mankind, only too freely, for thousands of years past, long before abortion was known in the world.
Here and there, however, medical authors of repute have advocated the further extension of abortion, with precautions, and under proper supervision, as an aid to eugenic progress. Thus, Professor Max Flesch (Die Neue Generation, April, 1909) is in favor of a change in the law permitting abortion (provided it is carried out by the physician) in special cases, as when the mother"s pregnancy has been due to force, when she has been abandoned, or when, in the interests of the community, it is desirable to prevent the propagation of insane, criminal, alcoholic, or tuberculous persons.
In France, a medical man, Dr. Jean Darricarrere, has written a remarkable novel, Le Droit d"Avortement (1906), which advocates the thesis that a woman always possesses a complete right to abortion, and is the supreme judge as to whether she will or not undergo the pain and risks of childbirth. The question is, here, however, obviously placed not on medical, but on humanitarian and feminist grounds.
We have seen that, alike on the side of practice and of theory, a great change has taken place during recent years in the att.i.tude towards abortion. It must, however, clearly be recognized that, unlike the control of procreation by methods for preventing conception, facultative abortion has not yet been embodied in our current social morality. If it is permissible to interpolate a personal opinion, I may say that to me it seems that our morality is here fairly reasonable.[442] I am decidedly of opinion that an unrestricted permission for women to practice abortion in their own interests, or even for communities to practice it in the interests of the race, would be to reach beyond the stage of civilization we have at present attained. As Ellen Key very forcibly argues, a civilization which permits, without protest, the barbarous slaughter of its carefully selected adults in war has not yet won the right to destroy deliberately even its most inferior vital products in the womb. A civilization guilty of so reckless a waste of life cannot safely be entrusted with this judicial function. The blind and aimless anxiety to cherish the most hopeless and degraded forms of life, even of unborn life, may well be a weakness, and since it often leads to incalculable suffering, even a crime. But as yet there is an impenetrable barrier against progress in this direction. Before we are ent.i.tled to take life deliberately for the sake of purifying life, we must learn how to preserve it by abolishing such destructive influences-war, disease, bad industrial conditions-as are easily within our social power as civilized nations.[443]
There is, further, another consideration which seems to me to carry weight. The progress of civilization is in the direction of greater foresight, of greater prevention, of a diminished need for struggling with the reckless lack of prevision. The necessity for abortion is precisely one of those results of reckless action which civilization tends to diminish. While we may admit that in a sounder state of civilization a few cases might still occur when the induction of abortion would be desirable, it seems probable that the number of such cases will decrease rather than increase. In order to do away with the need for abortion, and to counteract the propaganda in its favor, our main reliance must be placed, on the one hand, on increased foresight in the determination of conception and increased knowledge of the means for preventing conception,[444] and on the other hand, on a better provision by the State for the care of pregnant women, married and unmarried alike, and a practical recognition of the qualified mother"s claim on society.[445] There can be little doubt that, in many a charge of criminal abortion, the real offence lies at the door of those who have failed to exercise their social and professional duty of making known the more natural and harmless methods for preventing conception, or else by their social att.i.tude have made the pregnant woman"s position intolerable. By active social reform in these two directions, the new movement in favor of abortion may be kept in check, and it may even be found that by stimulating such reform that movement has been beneficial.
We have seen that the deliberate restraint of conception has become a part of our civilized morality, and that the practice and theory of facultative abortion has gained a footing among us. There remains a third and yet more radical method of controlling procreation, the method of preventing the possibility of procreation altogether by the performance of castration or other slighter operation having a like inhibitory effect on reproduction. The other two methods only effect a single act of union or its results, but castration affects all subsequent acts of s.e.xual union and usually destroys the procreative power permanently.
Castration for various social and other purposes is an ancient and widespread practice, carried out on men and on animals. There has, however, been on the whole a certain prejudice against it when applied to men. Many peoples have attached a very sacred value to the integrity of the s.e.xual organs. Among some primitive peoples the removal of these organs has been regarded as a peculiarly ferocious insult, only to be carried out in moments of great excitement, as after a battle. Medicine has been opposed to any interference with the s.e.xual organs. The oath taken by the Greek physicians appears to prohibit castration: "I will not cut."[446] In modern times a great change has taken place, the castration of both men and women is commonly performed in diseased conditions; the same operation is sometimes advocated and occasionally performed in the hope that it may remove strong and abnormal s.e.xual impulses. And during recent years castration has been invoked in the cause of negative eugenics, to a greater extent, indeed, on account of its more radical character, than either the prevention of conception or abortion.
The movement in favor of castration appears to have begun in the United States, where various experiments have been made in embodying it in law. It was first advocated merely as a punishment for criminals, and especially s.e.xual offenders, by Hammond, Everts, Lydston and others. From this point of view, however, it seems to be unsatisfactory and perhaps illegitimate. In many cases castration is no punishment at all, and indeed a positive benefit. In other cases, when inflicted against the subject"s will, it may produce very disturbing mental effects, leading in already degenerate or unbalanced persons to insanity, criminality, and anti-social tendencies generally, much more dangerous than the original state. Eugenic considerations, which were later brought forward, const.i.tute a much sounder argument for castration; in this case the castration is carried out, by no means in order to inflict a barbarous and degrading punishment, but, with the subject"s consent, in order to protect the community from the risk of useless or mischievous members.
The fact that castration can no longer be properly considered a punishment, is shown by the possibility of deliberately seeking the operation simply for the sake of convenience, as a preferable and most effective subst.i.tute for the adoption of preventive methods in s.e.xual intercourse. I am only at present acquainted with one case in which this course has been adopted. This subject is a medical man (of Puritan New England ancestry) with whose s.e.xual history, which is quite normal, I have been acquainted for a long time past. His present age is thirty-nine. A few years since, having a sufficiently large family, he adopted preventive methods of intercourse. The subsequent events I narrate in his own words: "The trouble, forethought, etc., rendered necessary by preventive measures, grew more and more irksome to me as the years pa.s.sed by, and finally, I laid the matter before another physician, and on his a.s.surances, and after mature deliberation with my wife, was operated on some time since, and rendered sterile by having the vas deferens on each side exposed through a slit in the s.c.r.o.t.u.m, then tied in two places with silk and severed between the ligatures. This was done under cocaine infiltrative anaesthesia, and was not so extremely painful, though what pain there was (dragging the cord out through the slit, etc.) seemed very hard to endure. I was not out of my office a single day, nor seriously disturbed in any way. In six days all st.i.tches in the s.c.r.o.t.u.m were removed, and in three weeks I abandoned the suspensory bandage that had been rendered necessary by the extreme sensitiveness of the t.e.s.t.i.c.l.es and cord.
"The operation has proved a most complete success in every way. s.e.xual functions are absolutely unaffected in any way whatsoever. There is no sense of discomfort or uneasiness in the s.e.xual tract, and what seems strangest of all to me, is the fact that the s.e.m.e.n, so far as one can judge by ordinary means of observation, is undiminished in quant.i.ty and unchanged in character. (Of course, the microscope would reveal its fatal lack.)
"My wife is delighted at having fear banished from our love, and, taken all in all, it certainly seems as if life would mean more to us both. Incidentally, the health of both of us seems better than usual, particularly so in my wife"s case, and this she attributes to a soothing influence that is attained by allowing the seminal fluid to be deposited in a perfectly normal manner, and remain in contact with the v.a.g.i.n.al secretions until it naturally pa.s.ses off.
"This operation being comparatively new, and, as yet, not often done on others than the insane, criminal, etc., I thought it might be of interest to you. If I shed even the faintest ray of light on this greatest of all human problems ... I shall be glad indeed."
Such a case, with its so far satisfactory issue, certainly deserves to be placed on record, though it may well be that at present it will not be widely imitated.
The earliest advocacy of castration, which I have met with as a part of negative eugenics, for the specific "purpose of prophylaxis as applied to race improvement and the protection of society," is by Dr. F. E. Daniel, of Texas, and dates from 1893.[447] Daniel mixed up, however, somewhat inextricably, castration as a method of purifying the race, a method which can be carried out with the concurrence of the individual operated on, with castration as a punishment, to be inflicted for rape, sodomy, b.e.s.t.i.a.lity, pederasty and even habitual masturbation, the method of its performance, moreover, to be the extremely barbarous and primitive method of total ablation of the s.e.xual organs. In more recent years somewhat more equitable, practical, and scientific methods of castration have been advocated, not involving the removal of the s.e.xual glands or organs, and not as a punishment, but simply for the sake of protecting the community and the race from the burden of probably unproductive and possibly dangerous members. Nacke has, from 1899 onwards, repeatedly urged the social advantages of this measure.[448] The propagation of the inferior elements of society, Nacke insists, brings unhappiness into the family and is a source of great expense to the State. He regards castration as the only effective method of prevention, and concludes that it is, therefore, our duty to adopt it, just as we have adopted vaccination, taking care to secure the consent of the subject himself or his guardian, of the civil authorities, and, if necessary, of a committee of experts. Professor Angelo Zuccarelli of Naples has also, from 1899 onwards, emphasized the importance of castration in the sterilization of the epileptic, the insane of various cla.s.ses, the alcoholic, the tuberculous, and instinctive criminals, the choice of cases for operation to be made by a commission of experts who would examine school-children, candidates for public employments, or persons about to marry.[449] This movement rapidly gained ground, and in 1905 at the annual meeting of Swiss alienists it was unanimously agreed that the sterilization of the insane is desirable, and that it is necessary that the question should be legally regulated. It is in Switzerland, indeed, that the first steps have been taken in Europe to carry out castration as a measure of social prophylaxis. The sixteenth yearly report (1907) of the Cantonal asylum at Wil describes four cases of castration, two in men and two in women, performed-with the permission of the patients and the civil authorities-for social reasons; both women had previously had illegitimate children who were a burden on the community, and all four patients were s.e.xually abnormal; the operation enabled the patients to be liberated and to work, and the results were considered in every respect satisfactory to all concerned.[450]
The introduction of castration as a method of negative eugenics has been facilitated by the use of new methods of performing it without risk, and without actual removal of the testes or ovaries. For men, there is the simple method of vasectomy, as recommended by Nacke and many others. For women, there is the corresponding, and almost equally simple and harmless method of Kehrer, by section and ligation of the Fallopian tubes through the v.a.g.i.n.a, as recommended by Kisch, or Rose"s very similar procedure, easily carried out in a few minutes by an experienced hand, as recommended by Zuccarelli.
It has been found that repeated exposure to the X-rays produces sterility in both s.e.xes, alike in animals and men, and X-ray workers have to adopt various precautions to avoid suffering from this effect. It has been suggested that the application of the X-rays would be a good subst.i.tute for castration; it appears that the effects of the application are only likely to last a few years, which, in some doubtful cases, might be an advantage. (See British Medical Journal, Aug. 13, 1904; ib., March 11, 1905; ib., July 6, 1907.)
It is scarcely possible, it seems to me, to view castration as a method of negative eugenics with great enthusiasm. The recklessness, moreover, with which it is sometimes proposed to apply it by law-owing no doubt to the fact that it is not so obviously repulsive as the less radical procedure of abortion-ought to render us very cautious. We must, too, dismiss the idea of castration as a punishment; as such it is not merely barbarous but degrading and is unlikely to have a beneficial effect. As a method of negative eugenics it should never be carried out except with the subject"s consent. The fact that in some cases it might be necessary to enforce seclusion in the absence of castration would doubtless be a fact exerting influence in favor of such consent; but the consent is essential if the subject of the operation is to be safeguarded from degradation. A man who has been degraded and embittered by an enforced castration might not be dangerous to posterity, but might very easily become a dangerous member of the society in which he actually lived. With due precautions and safeguards, castration may doubtless play a certain part in the elevation and improvement of the race.[451]
The methods we have been considering, in so far as they limit the procreative powers of the less healthy and efficient stocks in a community, are methods of eugenics. It must not, however, be supposed that they are the whole of eugenics, or indeed that they are in any way essential to a eugenic scheme. Eugenics is concerned with the whole of the agencies which elevate and improve the human breed; abortion and castration are methods which may be used to this end, but they are not methods of which everyone approves, nor is it always clear that the ends they effect would not better be attained by other methods; in any case they are methods of negative eugenics. There remains the field of positive eugenics, which is concerned, not with the elimination of the inferior stocks but with ascertaining which are the superior stocks and with furthering their procreative power.
While the necessity of refraining from procreation is no longer a bar to marriage, the question of whether two persons ought to marry each other still remains in the majority of cases a serious question from the standpoint of positive as well as of negative eugenics, for the normal marriage cannot fail to involve children, as, indeed, its chief and most desirable end. We have to consider not merely what are the stocks or the individuals that are unfit to breed, but also what are these stocks or individuals that are most fit to breed, and under what conditions procreation may best be effected. The present imperfection of our knowledge on these questions emphasizes the need for care and caution in approaching their consideration.