VIII. Recapitulation 79 · Part 2

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.

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HERMAN: OR, YOUNG KNIGHTHOOD.

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_Oliver Optic in a New Field._

THE WAY OF THE WORLD.

+A NOVEL.+

+BY+ WILLIAM T. ADAMS, (+OLIVER OPTIC+.)

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* * * * *

[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.]