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 attitude 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 classes 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 chastity 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 sexual 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 Sexual 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 assumption 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 endorsement, 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 classes. 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 class, and it tends to become specially prevalent during periods of trade depression (cf. G. Newman, Infant Mortality, p. 81). Women of better social class 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 Société de Médecine Légale, Archives d'Anthropologie Criminelle, May, 1907.) Doléris has shown (Bulletin de la Société d'Obstétrique, Feb., 1905) that in the Paris Maternités the percentage of abortions in pregnancies doubled between 1898 and 1904, and Doléris 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 (Eugène Bausset, L'Avortement Criminel, Thèse 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 Sexual-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 circumstances, there is no punishment for abortion. In the classic 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 fœtus as the fruit of the womb, the soul being acquired at birth; this was in accordance with Roman law which decreed that the fœtus 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 institutions, 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 attitude 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 classic lawyers and that of the later Christian ecclesiastics. It is, on the whole, in favor of sacrificing the fœtus 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 fœtus 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 assume 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 fœtus and the adult on the basis of life-expectancy, and concludes that the fœtus 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 fœtal life will be that of actual as against potential." This statement seems fairly sound. Ballantyne (Manual of Antenatal Pathology: The Fœtus, 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 fœtus 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 Künstliche Abort," Wiener Klinik, Aug. and Sept., 1906); so also, Eugen Wilhelm ("Die Abtreibung und das Recht des Arztes zur Vernichtung der Leibesfrucht," Sexual-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 asserting that the destruction of the fœtus 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 fœtal life (Annales de Gynécologie, 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 fœtus; "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 fœtus, which is not strictly a human being at all. We assume 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 spermatozöon. 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 Gräfin 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 Stöcker, Oda Olberg, Elisabeth Zanzinger, Camilla Jellinek. All these writers insist that the fœtus is not yet an independent human being, and that every woman, by virtue of the right over her own body, is entitled to decide whether it shall become an independent human being. At the Woman's Congress held in the autumn of 1905, a resolution was passed 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 assembly is interesting proof of the interest now taken by women in the question, and of the strenuous attitude they are tending to assume.
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 Associated German Frauenvereine, at Breslau, argues in the same sense.
The lawyers very speedily came to the assistance 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 classic 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 für 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 fœtus, 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 attitude 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 nobler 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 Darricarrère, 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 attitude 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 entitled 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 attitude 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 sexual 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 sexual 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 sexual 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 sexual 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 sexual 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, constitute 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 substitute for the adoption of preventive methods in sexual 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 sexual 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 passed by, and finally, I laid the matter before another physician, and on his assurances, 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 scrotum, then tied in two places with silk and severed between the ligatures. This was done under cocaine infiltrative anæsthesia, 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 stitches in the scrotum were removed, and in three weeks I abandoned the suspensory bandage that had been rendered necessary by the extreme sensitiveness of the testicles and cord.
"The operation has proved a most complete success in every way. Sexual functions are absolutely unaffected in any way whatsoever. There is no sense of discomfort or uneasiness in the sexual tract, and what seems strangest of all to me, is the fact that the semen, so far as one can judge by ordinary means of observation, is undiminished in quantity 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 vaginal secretions until it naturally passes 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, bestiality, pederasty and even habitual masturbation, the method of its performance, moreover, to be the extremely barbarous and primitive method of total ablation of the sexual organs. In more recent years somewhat more equitable, practical, and scientific methods of castration have been advocated, not involving the removal of the sexual 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. Näcke has, from 1899 onwards, repeatedly urged the social advantages of this measure.[448] The propagation of the inferior elements of society, Näcke 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 classes, 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 sexually 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 Näcke 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 vagina, 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 sexes, 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 substitute 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.
It may be fitting, at this point, to refer to the experiment of the Oneida Community in establishing a system of scientific propagation, under the guidance of a man whose ability and distinction as a pioneer are only to-day beginning to be adequately recognized. John Humphrey Noyes was too far ahead of his own day to be recognized at his true worth; at the most, he was regarded as the sagacious and successful founder of a sect, and his attempts to apply eugenics to life only aroused ridicule and persecution, so that he was, unfortunately, compelled by outside pressure to bring a most instructive experiment to a premature end. His aim and principle are set forth in an Essay on Scientific Propagation, printed some forty years ago, which discusses problems that are only now beginning to attract the attention of the practical man, as within the range of social politics. When Noyes turned his vigorous and practical mind to the question of eugenics, that question was exclusively in the hands of scientific men, who felt all the natural timidity of the scientific man towards the realization of his proposals, and who were not prepared to depart a hair's breadth from the conventional customs of their time. The experiment of Noyes, at Oneida, marked a new stage in the history of eugenics; whatever might be the value of the experiment—and a first experiment cannot well be final—with Noyes the questions of eugenics passed beyond the purely academic stage in which, from the time of Plato, they had peacefully reposed. "It is becoming clear," Noyes states at the outset, "that the foundations of scientific society are to be laid in the scientific propagation of human beings." In doing this, we must attend to two things: blood (or heredity) and training; and he puts blood first. In that, he was at one with the most recent biometrical eugenists of to-day ("the nation has for years been putting its money on 'Environment,' when 'Heredity' wins in a canter," as Karl Pearson prefers to put it), and at the same time revealed the breadth of his vision in comparison with the ordinary social reformer, who, in that day, was usually a fanatical believer in the influence of training and surroundings. Noyes sets forth the position of Darwin on the principles of breeding, and the step beyond Darwin, which had been taken by Galton. He then remarks that, when Galton comes to the point where it is necessary to advance from theory to the duties the theory suggests, he "subsides into the meekest conservatism." (It must be remembered that this was written at an early stage in Galton's work.) This conclusion was entirely opposed to Noyes' practical and religious temperament. "Duty is plain; we say we ought to do it—we want to do it; but we cannot. The law of God urges us on; but the law of society holds us back. The boldest course is the safest. Let us take an honest and steady look at the law. It is only in the timidity of ignorance that the duty seems impracticable." Noyes anticipated Galton in regarding eugenics as a matter of religion.
Noyes proposed to term the work of modern science in propagation "Stirpiculture," in which he has sometimes been followed by others. He considered that it is the business of the stirpiculturist to keep in view both quantity and quality of stocks, and he held that, without diminishing quantity, it was possible to raise the quality by exercising a very stringent discrimination in selecting males. At this point, Noyes has been supported in recent years by Karl Pearson and others, who have shown that only a relatively small portion of a population is needed to produce the next generation, and that, in fact, twelve per cent. of one generation in man produces fifty per cent. of the next generation. What we need to ensure is that this small reproducing section of the population shall be the best adapted for the purpose. "The quantity of production will be in direct proportion to the number of fertile females," as Noyes saw the question, "and the value produced, so far as it depends on selection, will be nearly in inverse proportion to the number of fertilizing males." In this matter, Noyes anticipated Ehrenfels. The two principles to be held in mind were, "Breed from the best," and "Breed in-and-in," with a cautious and occasional introduction of new strains. (It may be noted that Reibmayr, in his recent Entwicklungsgeschichte des Genics und Talentes, argues that the superior races, and superior individuals, in the human species, have been produced by an unconscious adherence to exactly these principles.) "By segregating superior families, and by breeding these in-and-in, superior varieties of human beings might be produced, which would be comparable to the thoroughbreds in all the domestic races." He illustrates this by the early history of the Jews.
Noyes finally criticises the present method, or lack of method, in matters of propagation. Our marriage system, he states, "leaves mating to be determined by a general scramble." By ignoring, also, the great difference between the sexes in reproductive power, it "restricts each man, whatever may be his potency and his value, to the amount of production of which one woman, chosen blindly, may be capable." Moreover, he continues, "practically it discriminates against the best, and in favor of the worst; for, while the good man will be limited by his conscience to what the law allows, the bad man, free from moral check, will distribute his seed beyond the legal limits, as widely as he dares." "We are safe every way in saying that there is no possibility of carrying the two precepts of scientific propagation into an institution which pretends to no discrimination, allows no suppression, gives no more liberty to the best than to the worst, and which, in fact, must inevitably discriminate the wrong way, so long as the inferior classes are most prolific and least amenable to the admonitions of science and morality." In modifying our sexual institutions, Noyes insists there are two essential points to remember: the preservation of liberty, and the preservation of the home. There must be no compulsion about human scientific propagation; it must be autonomous, directed by self-government, "by the free choice of those who love science well enough to 'make themselves eunuchs for the Kingdom of Heaven's sake.'" The home, also, must be preserved, since "marriage is the best thing for man as he is;" but it is necessary to enlarge the home, for, "if all could learn to love other children than their own, there would be nothing to hinder scientific propagation in the midst of homes far better than any that now exist."
This memorable pamphlet contains no exposition of the precise measures adopted by the Oneida Community to carry out these principles. The two essential points were, as we know, "male continence" (see ante p. 553), and the enlarged family, in which all the men were the actual or potential mates of all the women, but no union for propagation took place, except as the result of reason and deliberate resolve. "The community," says H. J. Seymour, one of the original members (The Oneida Community, 1894, p. 5), "was a family, as distinctly separated from surrounding society as ordinary households. The tie that bound it together was as permanent, and at least as sacred, as that of marriage. Every man's care, and the whole of the common property, was pledged for the maintenance and protection of the women, and the support and education of the children." It is not probable that the Oneida Community presented in detail the model to which human society generally will conform. But even at the lowest estimate, its success showed, as Lord Morely has pointed out (Diderot, vol. ii, p. 19), "how modifiable are some of these facts of existing human character which are vulgarly deemed to be ultimate and ineradicable," and that "the discipline of the appetites and affections of sex," on which the future of civilization largely rests, is very far from an impossibility.
In many respects, the Oneida Community was ahead of its time,—and even of ours,—but it is interesting to note that, in the matter of the control of conception, our marriage system has come into line with the theory and practice of Oneida; it cannot, indeed, be said that we always control conception in accordance with eugenic principles, but the fact that such control has now become a generally accepted habit of civilization, to some extent deprives Noyes' criticism of our marriage system of the force it possessed half a century ago. Another change in our customs—the advocacy, and even the practice, of abortion and castration—would not have met with his approval; he was strongly opposed to both, and with the high moral level that ruled his community, neither was necessary to the maintenance of the stirpiculture that prevailed.
The Oneida Community endured for the space of one generation, and came to an end in 1879, by no means through a recognition of failure, but by a wise deference to external pressure. Its members, many of them highly educated, continued to cherish the memory of the practices and ideals of the Community. Noyes Miller (the author of The Strike of a Sex, and Zugassant's Discovery) to the last, looked with quiet confidence to the time when, as he anticipated, the great discovery of Noyes would be accepted and adopted by the world at large. Another member of the Community (Henry J. Seymour) wrote of the Community long afterwards that "It was an anticipation and imperfect miniature of the Kingdom of Heaven on earth."
Perhaps the commonest type of proposal or attempt to improve the biological level of the race is by the exclusion of certain classes of degenerates from marriage, or by the encouragement of better classes of the community to marry. This seems to be, at present, the most popular form of eugenics, and in so far as it is not effected by compulsion but is the outcome of a voluntary resolve to treat the question of the creation of the race with the jealous care and guardianship which so tremendously serious, so godlike, a task involves, it has much to be said in its favor and nothing against it.
But it is quite another matter when the attempt is made to regulate such an institution as marriage by law. In the first place we do not yet know enough about the principles of heredity and the transmissibility of pathological states to enable us to formulate sound legislative proposals on this basis. Even so comparatively simple a matter as the relationship of tuberculosis to heredity can scarcely be said to be a matter of common agreement, even if it can yet be claimed that we possess adequate material on which to attain a common agreement. Supposing, moreover, that our knowledge on all these questions were far more advanced than it is, we still should not have attained a position in which we could lay down general propositions regarding the desirability or the undesirability of certain classes of persons procreating. The question is necessarily an individual question, and it can only be decided when all the circumstances of the individual case have been fairly passed in review.
The objection to any legislative and compulsory regulation of the right to marry is, however, much more fundamental than the consideration that our knowledge is at present inadequate. It lies in the extraordinary confusion, in the minds of those who advocate such legislation, between legal marriage and procreation. The persons who fall into such confusion have not yet learnt the alphabet of the subject they presume to dictate about, and are no more competent to legislate than a child who cannot tell A from B is competent to read.
Marriage, in so far as it is the partnership for mutual help and consolation of two people who in such partnership are free, if they please, to exercise sexual union, is an elementary right of every person who is able to reason, who is guilty of no fraud or concealment, and who is not likely to injure the partner selected, for in that case society is entitled to interfere by virtue of its duty to protect its members. But the right to marry, thus understood, in no way involves the right to procreate. For while marriage per se only affects the two individuals concerned, and in no way affects the State, procreation, on the other hand, primarily affects the community which is ultimately made up of procreated persons, and only secondarily affects the two individuals who are the instruments of procreation. So that just as the individual couple has the first right in the question of marriage, the State has the first right in the question of procreation. The State is just as incompetent to lay down the law about marriage as the individual is to lay down the law about procreation.
That, however, is only one-half of the folly committed by those who would select the candidates for matrimony by statute. Let us suppose—as is not indeed easy to suppose—that a community will meekly accept the abstract prohibitions of the statute book and quietly go home again when the registrar of marriages informs them that they are shut out from legal matrimony by the new table of prohibited degrees. An explicit prohibition to procreate within marriage is an implicit permission to procreate outside marriage. Thus the undesirable procreation, instead of being carried out under the least dangerous conditions, is carried out under the most dangerous conditions, and the net result to the community is not a gain but a loss.
What seems usually to happen, in the presence of a formal legislative prohibition against the marriage of a particular class, is a combination of various evils. In part the law becomes a dead letter, in part it is evaded by skill and fraud, in part it is obeyed to give rise to worse evils. This happened, for instance, in the Terek district of the Caucasus where, on the demand of a medical committee, priests were prohibited from marrying persons among whose relatives or ancestry any cases of leprosy had occurred. So much and such various mischief was caused by this order that it was speedily withdrawn.[452]
If we remember that the Catholic Church was occupied for more than a thousand years in the attempt to impose the prohibition of marriage on its priesthood,—an educated and trained body of men, who had every spiritual and worldly motive to accept the prohibition, and were, moreover, brought up to regard asceticism as the best ideal in life,[453]—we may realize how absurd it is to attempt to gain the same end by mere casual prohibitions issued to untrained people with no motives to obey such prohibitions, and no ideals of celibacy.
The hopelessness and even absurdity of effecting the eugenic improvement of the race by merely placing on the statute book prohibitions to certain classes of people to enter the legal bonds of matrimony as at present constituted, reveals the weakness of those who undervalue the eugenic importance of environment. Those who affirm that heredity is everything and environment nothing seem strangely to forget that it is precisely the lower classes—those who are most subjected to the influence of bad environment—who procreate most copiously, most recklessly, and most disastrously. The restraint of procreation, and a concomitant regard for heredity, increase pari passu with improvement of the environment and rise in social well-being. If even already it can be said that probably fifty per cent. of sexual intercourse—perhaps the most procreatively productive moiety—takes place outside legal marriage, it becomes obvious that statutory prohibition to the unfit classes to refrain from legal marriage merely involves their joining the procreating classes outside legal matrimony. It is also clear that if we are to neglect the factor of environment, and leave the lower social classes to the ignorance and recklessness which are the result of such environment, the only practical method of eugenics left open is that by castration and abortion. But this method—if applied on a wholesale scale as it would need to be[454] and without reference to the consent of the individual—is entirely opposed to modern democratic feeling. Thus those short-sighted eugenists who overlook the importance of environment are overlooking the only practical channel through which their aims can be realized. Attention to procreation and attention to environment are not, as some have supposed, antagonistic, but they play harmoniously into each other's hands. The care for environment leads to a restraint on reckless procreation, and the restraint of procreation leads to improved environment.
Legislation on marriage, to be effectual, must be enacted in the home, in the school, in the doctor's consulting room. Force is helpless here; it is education that is needed, not merely instruction, but the education of the conscience and will, and the training of the emotions.
Legal action may come in to further this process of education, though it cannot replace it. Thus it is very desirable that when there has been a concealment of serious disease by a party to a marriage such concealment should be a ground for divorce. Epilepsy may be taken as typical of the diseases which should be a bar to procreation, and their concealment equivalent to an annulment of marriage.[455] In the United States the Supreme Court of Errors of Connecticut laid it down in 1906 that the Superior Court has the power to pass a decree of divorce when one of the parties has concealed the existence of epilepsy. This weighty deliverence, it has been well said,[456] marks a forward step in human progress. There are many other seriously pathological conditions in which divorce should be pronounced, or indeed, occur automatically, except when procreation has been renounced, for in that case the State is no longer concerned in the relationship, except to punish any fraud committed by concealment.
The demand that a medical certificate of health should be compulsory on marriage, has been especially made in France. In 1858, Diday, of Lyons, proposed, indeed, that all persons, without exception, should be compelled to possess a certificate of health and disease, a kind of sanitary passport. In 1872, Bertillon (Art. "Demographic," Dictionnaire Encyclopédique des Sciences Médicales) advocated the registration, at marriage, of the chief anthropological and pathological traits of the contracting parties (height, weight, color of hair and eyes, muscular force, size of head, condition of vision, hearing, etc., deformities and defects, etc.), not so much, however, for the end of preventing undesirable marriages, as to facilitate the study and comparison of human groups at particular periods. Subsequent demands, of a more limited and partial character, for legal medical certificates as a condition of marriage, have been made by Fournier (Syphilis et Mariage, 1890), Cazalis (Le Science et le Mariage, 1890), and Jullien (Blenorrhagie et Mariage, 1898). In Austria, Haskovec, of Prague ("Contrat Matrimonial et L'Hygiène Publique," Comptes-rendus Congrès International de Médecine, Lisbon, 1906, Section VII, p. 600), argues that, on marriage, a medical certificate should be presented, showing that the subject is exempt from tuberculosis, alcoholism, syphilis, gonorrhœa, severe mental, or nervous, or other degenerative state, likely to be injurious to the other partner, or to the offspring. In America, Rosenberg and Aronstam argue that every candidate for marriage, male or female, should undergo a strict examination by a competent board of medical examiners, concerning (1) Family and Past History (syphilis, consumption, alcoholism, nervous, and mental diseases), and (2) Status Presens (thorough examination of all the organs); if satisfactory, a certificate of matrimonial eligibility would then be granted. It is pointed out that a measure of this kind would render unnecessary the acts passed by some States for the punishment by fine, or imprisonment, of the concealment of disease. Ellen Key also considers (Liebe und Ehe, p. 436) that each party at marriage should produce a certificate of health. "It seems to me just as necessary," she remarks, elsewhere (Century of the Child, Ch. I), "to demand medical testimony concerning capacity for marriage, as concerning capacity for military service. In the one case, it is a matter of giving life; in the other, of taking it, although certainly the latter occasion has hitherto been considered as much the more serious."
The certificate, as usually advocated, would be a private but necessary legitimation of the marriage in the eyes of the civil and religious authorities. Such a step, being required for the protection alike of the conjugal partner and of posterity, would involve a new legal organization of the matrimonial contract. That such demands are so frequently made, is a significant sign of the growth of moral consciousness in the community, and it is good that the public should be made acquainted with the urgent need for them. But it is highly undesirable that they should, at present, or, perhaps, ever, be embodied in legal codes. What is needed is the cultivation of the feeling of individual responsibility, and the development of social antagonism towards those individuals who fail to recognize their responsibility. It is the reality of marriage, and not its mere legal forms, that it is necessary to act upon.
The voluntary method is the only sound way of approach in this matter. Duclaux considered that the candidate for marriage should possess a certificate of health in much the same way as the candidate for life assurance, the question of professional secrecy, as well as that of compulsion, no more coming into one question than into the other. There is no reason why such certificates, of an entirely voluntary character, should not become customary among those persons who are sufficiently enlightened to realize all the grave personal, family, and social issues involved in marriage. The system of eugenic certification, as originated and developed by Galton, will constitute a valuable instrument for raising the moral consciousness in this matter. Galton's eugenic certificates would deal mainly with the natural virtues of superior hereditary breed—"the public recognition of a natural nobility"—but they would include the question of personal health and personal aptitude.[457]